Isolation of oligostilbenes from Iris lactea Pall. var. chinensis (Fisch.) Koidz and their anti-inflammatory activities.

Iris lactea Pall. var. chinensis (Fisch.) Koidz (Iris lactea) is an herbaceous perennial widely distributed in China, India, and South Korea. Iris lactea has been extensively used in traditional Chinese medicine. The present study isolated a new oligostilbene (compound 1), together with three known oligostilbenes (compounds 2, 3 and 4) from the seeds of Iris lactea. The structures of these compounds were elucidated by HRESIMS, NMR, and chemical analyses. The network-based pharmacologic analysis platform was used to predict the target proteins related to inflammation of isolated compounds. Furthermore, the isolated compounds were tested for their anti-inflammatory effects in LPS-stimulated RAW 264.7 cells. In this network, 138 candidate targets of compounds related to its therapeutic effect on inflammation were identified. In addition, compounds 1, 2, 3 and 4 significantly decreased NO content and the IL-6 levels as well as the expression of COX-2 in LPS-stimulated RAW 264.7 cells.

[Preparation and characterization of fenugreek leaf flavonoids and their protective effects against oxidative damage to hepatocytes].

The present study investigated the main components of fenugreek(Trigonella foenum-graecum L.) leaf flavonoids(FLFs) and their antioxidant activity. FLFs were prepared and enriched by solvent extraction, and the flavonoids were characterized by high-performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry(HPLC-Q-TOF-MS/MS). The protective effect of FLFs against H_2O_2-induced stress damage to L02 hepatocytes was also investigated. Firstly, the cell viability was measured by MTT assay. The oxidative stress injury model was induced by H_2O_2 in L02 cells. The release of lactate dehydrogenase(LDH), the content of reduced glutathione(GSH) and malondialdehyde(MDA), and the activities of superoxide dismutase(SOD) and catalase(CAT) were measured by assay kits. Hoechst fluorescence staining was performed to observe the cell apoptosis. The expression levels of c-Jun N-terminal kinase(JNK), extracellular signal-regulated kinase 1/2(ERK1/2), nuclear factor erythroid-2 related factor 2(Nrf2), heme oxygenase 1(HO-1), and their phosphorylated proteins were detected by Western blot. Based on the MS fragment ion information and data in databases, FLFs contained eight flavonoids with quercetin and kaempferol as the main aglycons. The cell viabi-lity assay revealed that as compared with the conditions in the H_2O_2 treatment group, 3.125-25 µg·mL~(-1) FLFs could increase the viability of L02 cells, reduce LDH release and MDA content in a dose-dependent manner, potentiate the activities of SOD, CAT, and GSH, decrease the phosphorylation of JNK and ERK1/2 proteins, and up-regulate the expression of Nrf2 and HO-1. The results of fluorescence staining showed that the nucleus of the H_2O_2 treatment group showed concentrated and dense strong blue fluorescence, while the blue fluorescence intensity of the FLFs group decreased significantly. FLFs showed a protective effect against H_2O_2-induced oxidative damage in L02 cells, and the underlying mechanism is associated with the enhancement of cell capability in clearing oxygen free radicals and the inhibition of apoptosis by the activation of the MAPKs/Nrf2/HO-1 signaling pathway. The antioxidant effect of fenugreek leaf is related to its rich flavonoids.

Phenotype and genotype features of 11 children with dystonia 28 caused by KMT2B variants / 中华实用儿科临床杂志

Objective:To summarize the clinical characteristics of children with dystonia 28 (DYT28) caused by KMT2B gene variations so as to improve clinicians′ understanding of the disease. Methods:The clinical manifestations, treatment and gene variation data of 11 children with DYT28 caused by KMT2B gene variations were retrospectively collected and analyzed.The subjects were recruited from the Department of Neurology, Beijing Children′s Hospital, Capital Medical University from March 2018 to January 2021.The patients were followed up. Results:There were 8 males and 3 females.The age at onset was ranging from 1 month to 6 years without inducement.Eight cases were gene-ralized dystonia and 3 cases were multifocal dystonia.The initial symptoms of 7 cases were unilateral or bilateral lower limbs tiptoeing.Four cases presented dysarthria, retching or swallowing difficulties at onset.As the disease progressed, all the cases had laryngeal dystonia, 10 cases had lower limbs dystonia, and 8 cases had upper limbs dystonia.Six cases were complicated with other dyskinesia symptoms.Ten cases had varying degrees of short stature, microcephalus, micrognathia, musculoskeletal abnormalities, intellectual disability, endocrinopathies and sleep difficulties.The brain magnetic resonance imaging showed abnormal in only 1 case.Eleven KMT2B gene pathogenic variants were found, including 8 frameshift variants, 1 in-frame variant and 2 missense variants.Four variants were novel.Eleven cases were followed up at the age of 1 year and 7 months to 17 years and 9 months.One case wasn′t given therapy.The dystonia in 3 cases was mildly improved after medication.Dysfunction of urination and defecation was disappeared in 1 case after medication.The symptom of 6 cases had no improvement after drug therapy.Among the above 6 cases, 5 drug refractory cases had deep brain stimulation, and their dystonia symptoms are all obviously improved; 2 cases had normal control of urination and defecation after deep brain stimulation.The motor scores in the Burke-Fahn-Marsden dystonia rating scale were improved by 55.8%-90.7%, and the disability scores were improved by 14.8%-69.6%. Conclusions:DYT28 caused by KMT2B gene variations is one of the most common and early-onset genetic dystonia in children.The dystonia symptom progresses from local parts to the whole body, prominently involving laryngeal muscles and lower limbs.Control of urination and defecation requires attention.Patients with mild dystonia symptoms can be effectively treated by drugs.However, patients with severe dystonia symptoms were drug refractory, and their dystonia symptoms can be effectively improved by deep brain stimulation.

[Role of Dual-layer Detector Energy Spectral CT in Resting Myocardial Perfusion Imaging for Patients with Normal Coronary Artery].

Objective To investigate the role of dual-layer detector energy spectral CT in resting myocardial perfusion imaging for patients with normal coronary artery. Methods One hundred and fifty-six patients with suspected coronary heart disease underwent dual-layer detector energy spectral CT coronary angiography,and resting myocardial perfusion imaging was performed for 28 patients with normal coronary artery.According to American Heart Association's 17-segmentmodel,the iodine density and effective atomic number(Zeff value)of each myocardial segment(except for apical segment)were measured and normalized to those of the aorta.All the data were quantitatively evaluated using ANOVA or Friedman test. Results Iodine density and Zeff value of myocardial segments in middle plane were significantly different(all P<0.001).The iodine density and Zeff value showed no significant difference between segments in basal and apical plane(all P > 0.05). Conclusions Iodine density and Zeff value of myocardial segments can be quantitatively evaluated using dual-layer detector energy spectral CT.Resting myocardial perfusion of segments in middle plane are significantly different in patients with normal coronary artery.

Circular RNA circRNA_101996 promoted cervical cancer development by regulating miR-1236-3p/TRIM37 axis.

Circular RNAs (circRNAs) appear to be significant modulators in various physiological processes. Recently, it is found that circRNA_101996 exerts important roles in various cancers. Our previous studies showed that circRNA_101996 promoted cervical cancer growth and metastasis by regulating miR-8075/TPX2. However, the potential regulatory role of circRNA_101996 in cervical cancer still needs further investigation. Our results in this study suggested that circRNA_101996 was over-expressed in cervical cancer patients. circRNA_101996 up-regulation remarkably assisted cell proliferation, cell cycle progression, and cell migration in cervical cancer, while circRNA_101996 knockdown exerted the inverse effects. The molecular investigations indicated that circRNA_101996 could increase the expression level of miR-1236-3p, tripartite motif-containing 37 (TRIM37), through binding to miR-1236-3p and reducing its expression. Moreover, in vivo results demonstrated that circRNA_101996 shRNA can function as a tumor suppressor through down-regulating TRIM37 in cervical cancer. In conclusion, our data indicated that circRNA_101996/miR-1236-3p/TRIM37 axis accelerated cervical cancer development, providing novel insights into cervical cancer diagnosis and treatment.

Analysis of clinical characteristics of children with slit ventricle syndrome / 中华实用儿科临床杂志

Objective:To identify clinical characteristics of slit ventricle syndrome (SVS) in children, thus improving pediatricians′ understanding of pediatric SVS.Methods:Clinical data of children diagnosed as SVS in the Emergency Department of Beijing Children′s Hospital, Capital Medical University from June 2015 to May 2019 were collected and retrospectively analyzed.Results:A total of 10 children with SVS were included, including 3 cases of arachnoid cyst, 3 cases of congenital hydrocephalus, 2 cases of Dandy-Walker syndrome, 1 case of idiopathic intracranial hypertension syndrome, and 1 case of hydrocephalus secondary to intracranial hemorrhage as the primary disease.The age of first shunting, and that at diagnosis of SVS were 1.3 (0.3-12.8) years, and 9.9 (3.8-13.3) years, respectively.SVS-associated symptoms appeared in 4.4 (0.5-12.0) years after shunting, including intermittent headache (10/10 cases), vomiting (10/10 cases), irritability (4/10 cases), seizures (5/10 cases), diminution of vision (2/10 cases), and intracranial hypertension (10/10 cases) at varying severities.When SVS occurred, the cerebral ventricle presented slit-like morphology.Three cases were relieved with mannitol treatment and 7 cases were treated with emergency lumbar-peritoneal shunt after mannitol failure.During 1-5 years of follow-up, 9 patients did not have SVS-associated symptoms and 1 case with medical therapy had recurrences.Conclusions:SVS is a rare complication after shunt surgery, with the clinical manifestations of intermittent headache and slow valve refilling conforming; imaging showed that the cerebral ventricle was slit-like morphology.When there are signs of intracranial hypertension after shunting and there is no cerebral ventricle dilatation in imaging, SVS should be highly vigilant.Once SVS is confirmed, surgical intervention should be introduced as early as possible after treatment failure of medication, so as to improve the prognosis.

Role of Dual-layer Detector Energy Spectral CT in Resting Myocardial Perfusion Imaging for Patients with Normal Coronary Artery / 中国医学科学院学报

Objective To investigate the role of dual-layer detector energy spectral CT in resting myocardial perfusion imaging for patients with normal coronary artery. Methods One hundred and fifty-six patients with suspected coronary heart disease underwent dual-layer detector energy spectral CT coronary angiography,and resting myocardial perfusion imaging was performed for 28 patients with normal coronary artery.According to American Heart Association's 17-segmentmodel,the iodine density and effective atomic number(Z

Alterations of regional homogeneity in Parkinson's disease with mild cognitive impairment: a preliminary resting-state fMRI study.

PURPOSE: Mild cognitive impairment (MCI) is commonly observed in Parkinson's disease (PD), even in the early stages. However, the neural substrates of cognitive impairment in PD remain unclear. The aim of the current study was to investigate the change of local brain function in PD patients with MCI. METHODS: Fifty patients with PD, including 25 PD patients with MCI (PD-MCI) and 25 PD patients with normal cognition (PD-NC), and 25 age- and sex-matched healthy controls (HC) were enrolled. Conventional magnetic resonance imaging (MRI), 3D structural images, and resting state-functional MRI (rs-fMRI) were performed in all subjects. Regional homogeneity (ReHo) was measured based on the rs-fMRI images to investigate the altered local brain functions. RESULTS: Brain regions with decreased ReHo were located in the left posterior cerebellar lobe in PD sub-groups compared to the HC group, and the brain regions with increased ReHo were located in the limbic lobe (right precuneus/bilateral middle cingulate cortex) in PD-MCI compared with HC group. PD-MCI presented with increased ReHo in the bilateral precuneus/left superior parietal lobe and decreased ReHo in the left insula compared to PD-NC. ReHo values for the left precuneus were negatively related to neuropsychological scores, and ReHo values for the left insula were positively related to neuropsychological scores in PD subjects. CONCLUSION: The present study demonstrated abnormal spontaneous synchrony in the left insula and left precuneus in patients with PD-MCI compared to PD-NC, which might provide a novel insight into the diagnosis and clinical treatment of cognitive impairment in PD.

Expression and effects of JMJD2A histone demethylase in endometrial carcinoma.

Previous studies have demonstrated that JMJD2A is a potential oncogene and is overexpressed in human tumors. However, its role in the endometrial carcinoma remains largely unknown. In this study, we discovered that JMJD2A was overexpressed in endometrial carcinoma, using immunohistochemistry, quantitative real- time polymerase chain reaction, and western blotting. Downregulation of JMJD2A led to reduced endometrial carcinoma RL95-2 and ISK cell proliferation, invasion and metastasis as asessed with cell counting kit-8, cell migration and invasive assays. Collectively, our results support that JMJD2A is a promoter of endometrial carcinoma cell proliferation and survival, and is a potential novel drug target.

Subtemporal transpetrosal apex approach: study on its use in large and giant petroclival meningiomas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study.</p><p><b>METHODS</b>Totally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period.</p><p><b>RESULTS</b>All 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 (68%) patients, subtotal resection in 7 (28%) patients, and partial resection in 1 (4%) patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit (64%). Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference.</p><p><b>CONCLUSIONS</b>Modified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.</p>

[An experimental study of small-caliber tissue engineering vessels with acellular matrix].

OBJECTIVE: To observe the mechanical properties of the prefabricated connective tissue tube as blood vessel substitute and its changes after implantation at the femoral artery. METHODS: The acellular matrix tube of 8-12 cm in length with a silicone rod inside it was implanted into dog peritoneal cavity. 3 weeks later, a new formed tube around the silicone rod was transferred to the femoral artery as blood vessel substitute. The mechanical properties and histological examination of the blood vessel substitute were assessed and compared to those of the carotid artery and vein. 6 months after transfer, the patency of the blood vessels substitute was observed. The histological change was studied by light microscopy, scanning and transmitting electron microscopy. RESULTS: (1) The mechanical properties of blood vessel substitute was not as strong as artery, but better than the vein. (2) There were elastic and collagen fibers with many fibroblasts around the tube wall, but few mesothelial cells around the inner wall. All of the blood vessel substitutes (n = 6) were found to keep patency and the structure of the blood vessels substitutes became similar to femoral artery 6 months after they had been grafted to the femoral artery. CONCLUSIONS: These results suggest that tissue engineering in vivo is a good approach to construct vessels substitute. The tissue tubes made in dog's peritoneal cavity have good condition when it is used as a blood vessel substitutes.

Decellularized aorta of fetal pigs as a potential scaffold for small diameter tissue engineered vascular graft.

BACKGROUND: For cardiovascular tissue engineering, acellularized biomaterials from pig have been widely investigated. Our purpose was to study mechanical properties and biocompatibility of decellularized aorta of fetal pigs (DAFP) to determine its potential as scaffold for small diameter tissue engineered vascular graft. METHODS: Descending aorta of fetal pigs was removed cells using trypsin, ribonuclease and desoxyribonuclease. Mechanical properties of DAFP were evaluated by tensile stress-strain and burst pressure analysis. Assessment of cell adhesion and compatibility was conducted by seeding porcine aortic endothelial cells. To evaluate biocompatibility in vivo, DAFP was implanted subcutaneously into adult male Sprague Dawley rats for 2, 4 and 8 weeks. RESULTS: Histochemistry and scanning electron microscopy examination of DAFP revealed well-preserved extracellular matrix proteins and porous three-dimensional structures. Compared with fresh aorta, DAFP had similar ultimate tensile strength, axial compliance and burst pressure. Cell culture studies in vitro showed that porcine aortic endothelial cells adhered and proliferated on the surfaces of DAFP with excellent cell viability. Subdermal implantation demonstrated that the DAFP did not show almost any immunological reaction and exhibited minimal calcification during the whole follow-up period. CONCLUSION: The DAFP has the potential to serve as scaffolds for small diameter tissue engineered vascular graft.

An experimental study of small-caliber tissue engineering vessels with acellular matrix / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the mechanical properties of the prefabricated connective tissue tube as blood vessel substitute and its changes after implantation at the femoral artery.</p><p><b>METHODS</b>The acellular matrix tube of 8-12 cm in length with a silicone rod inside it was implanted into dog peritoneal cavity. 3 weeks later, a new formed tube around the silicone rod was transferred to the femoral artery as blood vessel substitute. The mechanical properties and histological examination of the blood vessel substitute were assessed and compared to those of the carotid artery and vein. 6 months after transfer, the patency of the blood vessels substitute was observed. The histological change was studied by light microscopy, scanning and transmitting electron microscopy.</p><p><b>RESULTS</b>(1) The mechanical properties of blood vessel substitute was not as strong as artery, but better than the vein. (2) There were elastic and collagen fibers with many fibroblasts around the tube wall, but few mesothelial cells around the inner wall. All of the blood vessel substitutes (n = 6) were found to keep patency and the structure of the blood vessels substitutes became similar to femoral artery 6 months after they had been grafted to the femoral artery.</p><p><b>CONCLUSIONS</b>These results suggest that tissue engineering in vivo is a good approach to construct vessels substitute. The tissue tubes made in dog's peritoneal cavity have good condition when it is used as a blood vessel substitutes.</p>

Decellularized aorta of fetal pigs as a potential scaffold for small diameter tissue engineered vascular graft / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>For cardiovascular tissue engineering, acellularized biomaterials from pig have been widely investigated. Our purpose was to study mechanical properties and biocompatibility of decellularized aorta of fetal pigs (DAFP) to determine its potential as scaffold for small diameter tissue engineered vascular graft.</p><p><b>METHODS</b>Descending aorta of fetal pigs was removed cells using trypsin, ribonuclease and desoxyribonuclease. Mechanical properties of DAFP were evaluated by tensile stress-strain and burst pressure analysis. Assessment of cell adhesion and compatibility was conducted by seeding porcine aortic endothelial cells. To evaluate biocompatibility in vivo, DAFP was implanted subcutaneously into adult male Sprague Dawley rats for 2, 4 and 8 weeks.</p><p><b>RESULTS</b>Histochemistry and scanning electron microscopy examination of DAFP revealed well-preserved extracellular matrix proteins and porous three-dimensional structures. Compared with fresh aorta, DAFP had similar ultimate tensile strength, axial compliance and burst pressure. Cell culture studies in vitro showed that porcine aortic endothelial cells adhered and proliferated on the surfaces of DAFP with excellent cell viability. Subdermal implantation demonstrated that the DAFP did not show almost any immunological reaction and exhibited minimal calcification during the whole follow-up period.</p><p><b>CONCLUSION</b>The DAFP has the potential to serve as scaffolds for small diameter tissue engineered vascular graft.</p>

[Biocompatibility of decellularized canine carotid artery allograft cross-linked by carbodiimide].

UNLABELLED: OBJECTIVE Crosslink decellularized canine carotid artery allograft by EDC [1-3-(dimethylamino)propyl-3-ethylcarbodiimide methiodide] and evaluate the biocompatibility of it. METHODS: Use the multi-step detergent-enzyme method to construct decellularized canine carotid artery allograft and cross-link it by EDC with the weight ratio of decellularized artery to EDC 1:1 and 1:2. Evaluate the biocompatibility of it by the cytotoxical MTT test and the rat subdermal bury test. RESULTS: Decellularized canine carotid artery cross-linked by EDC has a lower degradation rate treated by collagenase type II, the result of MTT test show that the EDC cross-linked decellularized artery has no cytotoxity and the rat subdermal bury test show that crosslinking greatly enhance the ability of decellularize artery to resist the enzyme degradation and lower the immune reaction. The more the artery was cross-linked , the more effects it has. CONCLUSIONS: Decellularized canine carotid artery cross-linked by EDC has fairly good biocompatibility and ability to resist the collagenase degradation.

Biocompatibility of decellularized canine carotid artery allograft cross-linked by carbodiimide / 中华整形外科杂志

<p><b>UNLABELLED</b>OBJECTIVE Crosslink decellularized canine carotid artery allograft by EDC [1-3-(dimethylamino)propyl-3-ethylcarbodiimide methiodide] and evaluate the biocompatibility of it.</p><p><b>METHODS</b>Use the multi-step detergent-enzyme method to construct decellularized canine carotid artery allograft and cross-link it by EDC with the weight ratio of decellularized artery to EDC 1:1 and 1:2. Evaluate the biocompatibility of it by the cytotoxical MTT test and the rat subdermal bury test.</p><p><b>RESULTS</b>Decellularized canine carotid artery cross-linked by EDC has a lower degradation rate treated by collagenase type II, the result of MTT test show that the EDC cross-linked decellularized artery has no cytotoxity and the rat subdermal bury test show that crosslinking greatly enhance the ability of decellularize artery to resist the enzyme degradation and lower the immune reaction. The more the artery was cross-linked , the more effects it has.</p><p><b>CONCLUSIONS</b>Decellularized canine carotid artery cross-linked by EDC has fairly good biocompatibility and ability to resist the collagenase degradation.</p>

[Experimental study of compatibility between chondrocytes and allogenic cartilage microparticle acellular tissue matris in vitro].

OBJECTIVE: To construct tissue engineered cartilage using cartilage microparticle acellular tissue matrix (CMACTM) as scaffold. METHODS: To determine the content of hydroxyproline, glycosaminoglycan and DNA of CMACTM prepared from sheep's articular cartilage with multistep enzymic method, and to analyze CMACTM with gross observation, histology and scanning electron microscopy. Allogenic chondrocytes were mixed with CMACTM and cultured in vitro from 0 to 35 days. Observations through inverted microscope, scanning and transmission electron microscope, quantifications of hydroxyproline, glycosaminoglycan and DNA in the composite, cells adhesion rate were applied to analyze the results. RESULTS: The diameter of CMACTM was 0.100-0.154 mm, which contain extracellular matrix only. Hydroxyproline, glycosaminoglycan and DNA quantifications in CMACTM were 204.374 +/- 3.120 microg/mg, 18.302 +/- 2.037 microg/mg and 0.042 +/- 0.013 microg/mg respectively. Allogenic chondrocytes enclosed CMACTM tightly, hydroxyproline, glycosaminoglycan and DNA quantifications in the composite of the two formers increased with difference on 7th day compared with that on 0 day, reached to the peaks on 14th day (hydroxyproline, DNA) and on 21st day (glycosaminoglycan), and retained at a high level on the following days. Cells adhesion rate was 92%. CONCLUSION: Allogenic CMACTM possessed satisfactory biocompatibility for chondrocytes and provided a new scaffold for cartilage tissue engineering.

[Vascular anatomy and clinical applications of the distally based superficial sural artery island flap].

OBJECTIVE: To document the vascular anatomy of the distally based superficial sural artery flap and to study the vascular anastomoses between the superficial sural artery and the septocutaneous perforators of the peroneal artery. METHODS: Ten fresh human cadavers were injected with lead oxide, gelatin and water. Twenty lags were then dissected and an overall map of the cutaneous vasculature was constructed. Vascular communications between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery was evaluated to determine the cutaneous vascular territory of the superficial sural flap. The distally based superficial sural artery island flap was used in 26 cases. RESULTS: There is constant vascular anastomosis between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery. The 26 flaps survived uneventfully except for two of partial fat necrosis. CONCLUSION: The anatomic information enhances our understanding of flap design.

Vascular anatomy and clinical applications of the distally based superficial sural artery island flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To document the vascular anatomy of the distally based superficial sural artery flap and to study the vascular anastomoses between the superficial sural artery and the septocutaneous perforators of the peroneal artery.</p><p><b>METHODS</b>Ten fresh human cadavers were injected with lead oxide, gelatin and water. Twenty lags were then dissected and an overall map of the cutaneous vasculature was constructed. Vascular communications between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery was evaluated to determine the cutaneous vascular territory of the superficial sural flap. The distally based superficial sural artery island flap was used in 26 cases.</p><p><b>RESULTS</b>There is constant vascular anastomosis between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery. The 26 flaps survived uneventfully except for two of partial fat necrosis.</p><p><b>CONCLUSION</b>The anatomic information enhances our understanding of flap design.</p>

Microvascular free muscle flap reconstruction of soft-tissue defects with bone exposure after the distal tibial fracture / 中华创伤骨科杂志

Objective To present a method to treat soft tissue defects with bone exposure after the distal tihial fracture.Methods Twenty-six patients who had suffered from the distal tibial fracture complications leading to exposure of the bone or fixation material sought medical help in our department.The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases.Five of the 26 cases were treated using a free microvascular muscle flap and the mesh skin graft by one stage.Twenty-one of them were re- paired with the same method by two-stage.Results Follow-ups were 10 to 24 months.The microvascular re- construction was successful in 22 patients.Two of the 26 cases had partial necroses of the skin graft,and the other two cases had delayed wound healing.All the fractures united.Conclusion Microvascular free muscle flap re- construction of the leg is regarded as a reliable method to treat legs with massive soft-tissue defects or defects with bone exposure and chronic infection or fistulation at the distal leg.