[The clinical application of the neurovascular island flap of the calf supported by perforating branches of peroneal artery].

OBJECTIVE: To study the clinical application of the neurovascular island flap of the calf supported by perforating branches of peroneal artery for the soft tissue defects of ankle and the foot. METHODS: The flaps were used in 27 cases to repair the soft tissue defects of ankle and the lower leg from February 2004 to December 2007. Among them, 21 cases were male and 6 cases were female, ranging in age from 7 months to 64 years, with an average of 31.5 years. There were 7 cases with external malleolus, 5 cases with medial malleolus, 8 cases with dorsum of foot, 7 cases with achilles tendon. The range of soft tissue defects was from 2.5 cm x 3.5 cm to 10 cm x 24 cm and the range of flap was from 3 cm x 4 cm to 12 cm x 26.5 cm. RESULTS: Seven cases were lightly swelling and distension after operation from 3 to 7 days. After 7 days, the swelling subsidised gradually and all flaps survived. In the follow-up for 3-12 months with an average of 5 months, all flaps showed fine appearance without fat and clumsy. The function of donor site was very well. CONCLUSION: The neurovascular island flap of the calf supported by perforating branches of peroneal artery can provide reliable blood supply, long reversed distance and wide repairing limitation and the proximal end of flap can reach to popliteal fossa. It is a good method to repair the defects of the lower leg and the foot.

[Impact of advanced glycosylation end products-modified human serum albumin on migration of epidermal keratinocytes: an in vitro experiment].

OBJECTIVE: To explore the impact of advanced glycosylation end products (AGE)-modified human serum albumin (AGE-HSA) on keratinocyte migration and the mechanism thereof. METHODS: AGE-HSA was prepared in vitro. Epidermal keratinocytes from Sprague-Dawley rats' back were cultured and treated with AGE-HSA of the terminal concentrations of 0, 30, 60, 90, 120, and 150 microg/ml for 1, 3, 5, and 7 days respectively. MTT method was used to detect the keratinocyte adhesion rate, expressed by absorbance. Keratinocyte migration ability was assessed by scratch wound healing assay and Transwell assay. Expression of integrin alpha3 was determined by flow cytometry. Scanning electron and inverted microscopes were used to observe the pseudopodium and microfilament of the keratinocytes. Immunofluorescence staining was used to detect the form of F-actin in the cells. RESULTS: The adhesion rates of the keratinocyte cultured with AGE-HSA for 12 and 24 hours were (0.112 +/- 0.022) and (0.173 +/- 0.012) respectively, both significantly lower than those of the control group [(0.122 +/- 0.004) and (0.267 +/- 0.024) respectively, both P < 0.05)]. Scratch wound healing assay showed that the amount of migrating cells in the AGE-HSA group was (7 +/- 4)/HP, significantly less than that of the control group [(61 +/- 11)/HP, P < 0.05)], and Transwell assay showed that the amount of migrating cells in the AGE-HSA group was (72 +/- 18)/HP, significantly less than that of the control group [(288 +/- 52)/HP, P < 0.05]. The expression rate of keratinocyte integrin alpha3 in the AGE-HSA group was (3.2 +/- 1.2)%, significantly lower than that in the control group [(36.6 +/- 11.2)%, P < 0.05]. The spreading of cell body, and the formation of pseudopodium and microfilament of the AGE-HSA group were all depressed in comparison with the control group. CONCLUSION: Keratinocyte migration is inhibited by AGE accumulation in high glucose condition. The mechanism may be the abnormality in the integrin inside-out signaling pathway and AGE-RAGE signaling pathway.