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OBJECTIVE@#To explore the therapeutic mechanism of Liushen Wan (LSW) against colitis-associated colorectal cancer (CAC) by network pharmacology.@*METHODS@#TCMSP, BATMAN-TCM, CNKI, PubMed, Genecards, OMIM, and TTD databases were used to obtain the related targets of LSW and CAC. The common targets of LSW and CAC were obtained using Venny online website. The PPI network was constructed using Cytoscape 3.8.2 to screen the core targets of LSW in the treatment of CAC. GO and KEGG enrichment analysis were conducted using DAVID database. The therapeutic effect of LSW on CAC was evaluated in a C57BL/6J mouse model of AOM/DSS-induced CAC by observing the changes in body weight, disease activity index, colon length, and size and number of the tumor. HE staining and RT-qPCR were used to analyze the effect of LSW on inflammatory mediators. Immunohistochemistry and TUNEL staining were used to evaluate the effect of LSW on the proliferation and apoptosis of AOM/DSS-treated colon tumor cells. Immunohistochemistry and Western blotting were used to detect the effects of LSW on the expression of TLR4 proteins in CAC mice.@*RESULTS@#Network pharmacology analysis identified 69 common targets of LSW and CAC, and 33 hub targets were screened in the PPI network. KEGG pathway enrichment analysis suggested that the effect of LSW on CAC was mediated by the Toll-like receptor signaling pathway. In the mouse model of AOM/DSS-induced CAC, LSW significantly inhibited colitis-associated tumorigenesis, reduced tumor number and tumor load (P < 0.05), obviously improved histopathological changes in the colon, downregulated the mRNA levels of proinflammatory cytokines, and inhibited the proliferation (P < 0.01) and promoted apoptosis of colon tumor cells (P < 0.001). LSW also significantly decreased TLR4 protein expression in the colon tissue (P < 0.05).@*CONCLUSION@#LSW can inhibit CAC in mice possibly by regulating the expression of TLR4 to reduce intestinal inflammation, inhibit colon tumor cell proliferation and promote their apoptosis.
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Ratones , Animales , Receptor Toll-Like 4 , Neoplasias Asociadas a Colitis , Farmacología en Red , Ratones Endogámicos C57BL , Neoplasias del Colon/patologíaRESUMEN
To study the effect and influencing factors of life tree narrative therapy on alleviating stigma in long-term hospitalized patients with chronic stable schizophrenia, and focus on its intervention targets for long-term hospitalization patients with chronic stable schizophrenia. The group therapy plan was set up with life tree narrative therapy, 12 patients were selected to receive the therapy. Semi-structured in-depth interviews were conducted before and after the therapy of life tree narrative therapy, and grounded theory was used to analyze the interview data. There were 5 therapeutic effects of life tree narrative therapy, including improvement of support system, reduction of stigma, improvement of interpersonal relationship, self-confidence, and the enthusiasm for participating in group therapy. And four core categories of influencing factors of life tree group therapy were summarized, which were group process, patients, leaders and other influencing factors. The biggest gain of life tree group therapy for patients is the improvement of the support system, which can promote patients to adjust their inpatient mentality and change their negative emotions. During the process of therapy, patient’s expectations of participating in the group have changed, and serious living and living in the moment have become the main goal at present, which is an additional benefit of group therapy.
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ObjectiveThrough the targeted lipidomics, we explored the intervention mechanism of Kaixuan Bushen method on psoriasis vulgaris (PV) from the perspective of lipid metabolism, providing reference for the diagnosis and treatment of PV. MethodTwenty-six patients with PV admitting the outpatient clinic of the Department of Dermatology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences from September 2019 to November 2020 were selected as the research object (observation group), and 26 sex- and age-matched healthy volunteers in the same period were recruited as control group. Venous blood was collected for lipid index and targeted lipidomics detection in the control and observation groups at inclusion. After 12 weeks of continuous treatment of Kaixuan Bushen method, the psoriasis area and severity index (PASI) was measured and compared before and after treatment to assess the clinical efficacy, while venous blood was collected again in the observation group to compare the blood lipid level and lipid metabolism of patients before and after treatment. Targeted lipidomics analysis was performed by ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) on an ACQUITY UPLC BEH C8 column (2.1 mm×100 mm, 1.7 μm) with mobile phase of 5 mmol∙L-1 ammonium formate in acetonitrile-water (6∶4, A)-5 mmol∙L-1 ammonium formate in acetonitrile-isopropanol (1∶9, B) for gradient elution and flow rate of 0.26 mL∙min-1. Conditions of MS were electrospray ionization (ESI), positive and negative ion modes, and scanning range of m/z 50-1 200. Then principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) models were developed to screen differential metabolites, and the differential metabolites were identified and the pathways were enriched. ResultAfter 12 weeks of treatment with Kaixuan Bushen method, PASI score decreased by more than 50% in a total of 22 out of 26 patients with PV, suggesting the total effective rate was 84.62%. The serum triglyceride level of patients with PV was significantly higher than that of healthy individuals (P<0.05), and the triglyceride level was significantly reduced after treatment (P<0.05). Targeted lipidomics analysis screened a total of 43 potential biomarkers for PV, of which 42 were up-regulated and 1 was down-regulated, involving 7 signaling pathways such as linoleic acid metabolism, glycerophospholipid metabolism and unsaturated fatty acid biosynthesis. Moreover, there were 14 response makers for clinical efficacy of Kaixuan Bushen method on PV, of which 6 were up-regulated and 8 were down-regulated, involving five signaling pathways such as linoleic acid metabolism, glycerophospholipid metabolism and sphingolipids metabolism. In a comparison between healthy individuals and patients with PV and PV before and after treatment, the common differential metabolites were screened as phosphatidylcholine (PC) 38∶0 and ceramide (Cer) 42∶1, and the common pathways were linoleic acid and glycerophospholipid metabolic pathways. ConclusionThe disorder of lipid metabolism in PV are largely due to abnormal sphingolipid, glycerophospholipid and linoleic acid metabolic pathways, of which Kaixuan Bushen method can regulate the glycerophospholipid and linoleic acid metabolism, thereby improving psoriatic lesions.
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Although a variety of SARS-CoV-2 related coronaviruses have been identified, the evolutionary origins of this virus remain elusive. We describe a meta-transcriptomic study of 411 samples collected from 23 bat species in a small (~1100 hectare) region in Yunnan province, China, from May 2019 to November 2020. We identified coronavirus contigs in 40 of 100 sequencing libraries, including seven representing SARS-CoV-2-like contigs. From these data we obtained 24 full-length coronavirus genomes, including four novel SARS-CoV-2 related and three SARS-CoV related genomes. Of these viruses, RpYN06 exhibited 94.5% sequence identity to SARS-CoV-2 across the whole genome and was the closest relative of SARS-CoV-2 in the ORF1ab, ORF7a, ORF8, N, and ORF10 genes. The other three SARS-CoV-2 related coronaviruses were nearly identical in sequence and clustered closely with a virus previously identified in pangolins from Guangxi, China, although with a genetically distinct spike gene sequence. We also identified 17 alphacoronavirus genomes, including those closely related to swine acute diarrhea syndrome virus and porcine epidemic diarrhea virus. Ecological modeling predicted the co-existence of up to 23 Rhinolophus bat species in Southeast Asia and southern China, with the largest contiguous hotspots extending from South Lao and Vietnam to southern China. Our study highlights both the remarkable diversity of bat viruses at the local scale and that relatives of SARS-CoV-2 and SARS-CoV circulate in wildlife species in a broad geographic region of Southeast Asia and southern China. These data will help guide surveillance efforts to determine the origins of SARS-CoV-2 and other pathogenic coronaviruses.
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Objective:By analyzing the patent literature of medical research institutions in Sichuan Province, the current status of patent development in each institution were analyzed to identify existing problems, according to which countermeasures were put forward.Methods:Using IncoPat as the retrieval tool, the patent documents of Sichuan medical scientific research institutions were searched, data about the overall application trend, applicant, patent type, legal events were analyzed, and relevant countermeasures were proposed based on the current patent development situation.Results:At present, the overall development of patents in Sichuan medical scientific research institutions is good, however, there are still some problems and challenges, such as weak awareness of patent protection, low patent quality, insufficient transformation of patent achievements and so on.Conclusions:By analyzing the present situation of patent development of medical scientific research institutions in Sichuan Province, this study put forward some countermeasures, including strengthening publicity on intellectual property protection, improving the driving mechanism, reforming intellectual property management and achievement transformation mechanism, to provide reference for promoting the benign development of patents at medical scientific research institutions, as well as promote the development of medical science and technology innovation.
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Objective To investigate the effect of incremental load training on AMP-activated protein kinase (AMPK) phosphorylation in skeletal muscle satellite cells of aged mice. Methods Experimental mice were divided into 3 groups: young control group (YC group, n=12), old control group (OC group, n=12) and old training group (OT group, n=12). The mice in OT group received incremental load training, and CD45-/CD31-/Sca1-/VCAM (CD106) + cells were isolated by flow cytometry sorting. Desmin, Myod myogenic staining and myogenic differentiation culture were used for identification of muscle satellite cells, and the p-AMPK level of muscle satellite cells was detected by immunohistochemistry combined with Western blotting method. Results The expression levels of AMPK and p-AMPK in skeletal muscle satellite cells in YC group were significantly higher than those in OC group (P0.05), while p-AMPK expression level in OT group was significant higher than that in OC group (P<0.05). Conclusions Incremental load training can promote AMPK phosphorylation of skeletal muscle satellite cells in aged mice, and improve energy metabolism of skeletal muscle in aged mice.
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Detailed knowledge on tissue-specific metabolic reprogramming in diabetic nephropathy (DN) is vital for more accurate understanding the molecular pathological signature and developing novel therapeutic strategies. In the present study, a spatial-resolved metabolomics approach based on air flow-assisted desorption electrospray ionization (AFADESI) and matrix-assisted laser desorption ionization (MALDI) integrated mass spectrometry imaging (MSI) was proposed to investigate tissue-specific metabolic alterations in the kidneys of high-fat diet-fed and streptozotocin (STZ)-treated DN rats and the therapeutic effect of astragaloside IV, a potential anti-diabetic drug, against DN. As a result, a wide range of functional metabolites including sugars, amino acids, nucleotides and their derivatives, fatty acids, phospholipids, sphingolipids, glycerides, carnitine and its derivatives, vitamins, peptides, and metal ions associated with DN were identified and their unique distribution patterns in the rat kidney were visualized with high chemical specificity and high spatial resolution. These region-specific metabolic disturbances were ameliorated by repeated oral administration of astragaloside IV (100 mg/kg) for 12 weeks. This study provided more comprehensive and detailed information about the tissue-specific metabolic reprogramming and molecular pathological signature in the kidney of diabetic rats. These findings highlighted the promising potential of AFADESI and MALDI integrated MSI based metabolomics approach for application in metabolic kidney diseases.
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Objective:To investigate the influencing factors of nursing interns' satisfaction with having internship in third-grade class-A hospitals in Luzhou City.Methods:Using self-compiled satisfaction questionnaire and mentor's behavior scale (MBS), the internship situation of nursing interns in third-grade class-A hospitals in Luzhou City were investigated. The collected data were described by SPSS 22.0 and analyzed by binary logistic regression to understand the influencing factors of nurses' satisfaction.Results:A total of 729 questionnaires were distributed and 567 valid questionnaires were recovered, with an effective recovery rate of 77.78%. The MBS scores of 567 nursing interns were (3.54±0.72) and 81.1% (460/567) were satisfied with the clinical internship. The teaching mode ( OR=3.570) and the behavior of mentors ( OR=1.056) were the influencing factors of students' internship satisfaction. Conclusion:During the internship, one-to-one clinical teaching mode should be adopted in the process of internship, for improving students' internship experience. Meanwhile, teachers' behavior should be standardized to improve students' learning satisfaction and clinical teaching quality.
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Objective:To investigate the clinical application of salvianolate for injection in Tongde Hospital of Zhejiang Province and evaluate its rationality of injection.Methods:From March 2018 to November 2018, 560 patients treated with salvianolate for injection in Tongde Hospital of Zhejiang Province were selected by random sampling method.The indications, usage and dosage, route of administration, choice of vehicle, concentration of vehicle, course of treatment, compatibility, contraindications and adverse reactions of salvianolate for injection were analyzed retrospectively.Results:Totally 560 inpatients received salvianolate for injection were collected, about 26.96%(151/560) was consistent with the indication, 99.82%(559/560) with a correct administration dosage and frequency, 100.00%(560/560) with right administration route, 95.00%(532/560) with a right solvent selection, 67.86%(380/560) with correct solvent concentration, 61.07%(342/560) with a correct treatment course, 100.00%(560/560) with a right medicine combination, about 94.46%(529/560) was consistent with coagulation function contraindication, about 90.18%(505/560) was consistent with liver function contraindication.The incidence of adverse reactions was 1.61%(9/560).Conclusion:In the clinical application of salvianolate for injection, a high rate of unreasonable usage is found in indication, treatment course and solvent selection.Because of the serious problems in the use of salvianolate injection, it should be used strictly to ensure clinical medication safety.
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Objective:To investigate the clinical outcomes of open reduction and cannulated screw fixation directly via the anterior approach for femoral neck fracture of Garden type Ⅳ which is difficultly reducible in young and middle-aged patients.Methods:Forty patients aged younger than 65 years old were treated by open reduction and cannulated screw fixation directly via the anterior approach for femoral neck fractures which were difficulty reducible at Department of Orthopaedics, Mindong Hospital from March 2015 to October 2017. They were 28 males and 12 females, aged from 22 to 62 years (mean, 49.2 years). All the fractures were type Ⅳ by the Garden classification. The time from injury to operation averaged 3.2 d (range, from 1 to 6 d). Their postoperative fracture nonunion and femoral head necrosis were recorded. The reduction quality and hip function were evaluated using Garden reduction index and Harris hip scores.Results:All the 40 patients were followed up for 11 to 44 months (mean, 22.3 months). Nonunion occurred in one patient who had to accept secondary artificial hip replacement. No avascular necrosis of the femoral head occurred in any patients. The anteroposterior Garden reduction indexes at 2 d after surgery and at the last follow-up for the 40 patients were respectively 156.97°±1.40° and 157.07°±1.47°, showing no significant difference( t=-0.302, P=0.765); so were the lateral Garden reduction indexes (171.82°±4.48° and 172.10°±4.27°) ( t=-2.333, P=0.817). The Harris hip scores at the final follow-up for the hip ranged from 77 to 98 (average, 92); 31 cases were rated as excellent, 6 as good, 2 as fair and one as poor, giving an excellent to good rate of 92.5%. Conclusion:In the treatment of femoral neck fracture of Garden type Ⅳ which is difficultly reducible in young and middle-aged patients, if closed reduction has failed, open reduction and cannulated screw fixation directly via the anterior approach can achieve satisfactory short-term outcomes because it facilitates fracture reduction and fixation under direct vision, promotes fracture union and reduces avascular necrosis of the femoral head.
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Objective To observe the influence of a pulsating electromagnetic field (PEMF) on the expression of runt-related transcription factor 2 (Runx2) in ovariectomized rats so as to explore the possibility of using PEMFs to treat osteoporosis.Methods Sixty female Sprague-Dawley rats were randomly divided into four groups of 15-a control group (Sham group),an ovary resection group (OVX group),a resection group treated with alendronate sodium (OVX+ALN group) and a resection group exposed to a PEMF (PEMFs group).Both ovaries were resected to induce osteoporosis,except in the sham group where the adipose tissues around the ovaries were cut bilaterally without resection.After the operation,the ALN group were given 2 mg/kg of alendronate by gavage daily for 30 days,while the PEMFs group was exposed to a 3.8 mT electromagnetic field pulsing at 8 Hz for 40 min twice daily for 30 days.There was no intervention in the other two groups.The animals were sacrificed using intra-peritoneal injection of sodium pentobarbital and the density of their femurs was measured.The expression of Runx2 protein and Runx2 mRNA were detected using western blotting and quantitative PCR.Results The average bone density,Runx2 protein level and Runx2 mRNA level of the PEMFs group were all significantly higher than those of the OVX group,but there was no significant difference between the PEMFs group and ALN group averages.Conclusion PEMF exposure can upregulate the expression of Runx2 protein and Runx2 mRNA in female rats after ovary resection.This may be one of the mechanisms by which PEMFs treat osteoporosis.
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Objective To observe the influence of a pulsating electromagnetic field (PEMF) on the expression of runt-related transcription factor 2 (Runx2) in ovariectomized rats so as to explore the possibility of using PEMFs to treat osteoporosis.Methods Sixty female Sprague-Dawley rats were randomly divided into four groups of 15-a control group (Sham group),an ovary resection group (OVX group),a resection group treated with alendronate sodium (OVX+ALN group) and a resection group exposed to a PEMF (PEMFs group).Both ovaries were resected to induce osteoporosis,except in the sham group where the adipose tissues around the ovaries were cut bilaterally without resection.After the operation,the ALN group were given 2 mg/kg of alendronate by gavage daily for 30 days,while the PEMFs group was exposed to a 3.8 mT electromagnetic field pulsing at 8 Hz for 40 min twice daily for 30 days.There was no intervention in the other two groups.The animals were sacrificed using intra-peritoneal injection of sodium pentobarbital and the density of their femurs was measured.The expression of Runx2 protein and Runx2 mRNA were detected using western blotting and quantitative PCR.Results The average bone density,Runx2 protein level and Runx2 mRNA level of the PEMFs group were all significantly higher than those of the OVX group,but there was no significant difference between the PEMFs group and ALN group averages.Conclusion PEMF exposure can upregulate the expression of Runx2 protein and Runx2 mRNA in female rats after ovary resection.This may be one of the mechanisms by which PEMFs treat osteoporosis.
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Objective To observe the effects of Fuzheng Qingfei Decoction combined with Western medicine basic treatment in pulmonary infection of AIDS patients.Methods A total of 154 cases of AIDS pulmonary infection treated in the Affiliated Hospital of Southwest Medical University from November 2013 to December 2016 were selected.Among them,86 cases in the observation group adopted Fuzheng Qingfei Decoction combined with the Western medicine routine treatment;68 cases in the control group only adopted the Western medicine therapy.The levels of procalcitonin (PCT) and C-reactive protein (CRP),CD4+ T cells count and improvement situation of clinical symptoms in the two groups were observed before and after treatment.Results The CD4+ T cells count,levels of PCT and CRP before treatment had no statistical difference between the two groups (P>0.05),the levels of PCT and CRP after 7 d treatment in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05),and the CD4+T cell count after 3-month treatment in the observation group was higher than that in the control group and the PCT and CRP levels were lower than those in the control group,the differences were statistically significant (P<0.05);the total effective rate in the observation group was 87.21%,which was better than 76.74 % in the control group,the difference was statistically significant (P<0.05).Conclusion Fuzheng Qingfei Decoction combined with routine Western medicine therapy for treating AIDS complicating pulmonary infection can increase the anti-infection effect,reduce the inflammatory response,enhance CD4+ T cells count,relieve the clinical symptoms and improve their living quality.
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<p><b>OBJECTIVE</b>To compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury.</p><p><b>METHODS</b>Eighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups.</p><p><b>RESULTS</b>The total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P < 0.05). After treatment, the results of the VAS and ODI of the two groups were apparently declined (both P < 0.01), and those in the observation group were decreased more obviously (both P < 0.01).</p><p><b>CONCLUSION</b>The effect of oblique inser-tion at anatomical points for sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.</p>
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Puntos de Acupuntura , Terapia por Acupuntura , Artropatías , Terapéutica , Articulación Sacroiliaca , Heridas y LesionesRESUMEN
Objective To investigate the risk factors of postoperative complications in spinal tuberculosis surgery,and try to find a way to improve the results of perioperative management and reduce or avoid the postoperative complications.Methods All of 172 cases of spinal tuberculosis who were treated by surgery from February 2005 to January 2013 in orthopedic department of Zhongshan hospital,Fudan University were retrospectively analyzed.There were 88 males and 84 females,whose average age was 50.9± 18.7y (18-84y).Among them 98 cases got cold abscess,and 56 cases had tuberculosis poisoning symptoms.The lesions located mostly in thoracic spine (112/172,65.1%) and lumbar spine (40/172,23.3%),while rarely in cervical or sacral spine.2 intervertebral spaces were involved in 116 cases (67.4%),more than 2 intervertebral spaces were involved in 32 cases (18.6%),and single intervertebral space were involved in the rest cases (14.0%).38 cases were treated through single anterior approach,54 cases were treated by anterior-posterior surgical approach,and single posterior approach was performed in 80 cases.58 cases were suffered from neurological dysfunction.All the postoperative complications and related clinical parameters during hospitalization period were collected and analyzed with SPSS software.Each clinical parameter was analyzed with univariate analysis to find the factors related to postoperative complications,and then the related factors were analyzed by multivariate regression analysis.Results All of 172 patients were included and 41.9% (72/172) of the patients suffered from postoperative complications.System complications were the most common (33.7%,58/172).The rates of local complications were 10.5% (18/172).Univariate analysis showed that the lesion site,value of hemoglobin,electrolyte disturbances,postoperative ASIA score and blood loss were related with postoperative complications.Posterior approach related with local complications.Multivariate regression analysis showed that preoperative hemoglobin <100 g/L,poor postoperative ASIA scores and long period of preoperative anti-TB treatment (>28 days) were related with the system or local postoperative complications.Conclusion Patients with anemia (hemoglobin < 100g/L),poor postoperative neurological function and long period of preoperative anti-TB treatment could take more risks of the postoperative complications.
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OBJECTIVE:To evaluate the application of prescription comment software in our hospital. METHODS:552 pre-scriptions were evaluated by pharmacist A,B and software,and the Kappa values were calculated to evaluate the reliability of the software. The results of comment by pharmacist B and by software were combined (serial test and parallel test),and then com-pared with the results of comment by pharmacist A. The sensitivity,specificity and Youden's index were calculated to evaluate the reliability of the software. The comment results of 552 prescriptions by pharmacist A for twice were compared to calculate Kappa value,and it was used to evaluate the comment consistency of pharmacist A. RESULTS:The pharmacist A,B comment results and software comment results showed poor consistency,and Kappa value were 0.020 2 and 0.002 0,with significant difference (P<0.001);pharmacist A comment results had strongest consistency with pharmacist B comment results,and Kappa value was 0.843 0,with no significant difference(0.1
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Objective To investigate the methods and results of perforator pedicled flaps by anastomosis of superficial veins for reconstructing the extremity defects.Methods From February, 2012 to September, 2012, a total of 14 patients with traumatic skin and soft tissue and artery defects in extremities were repaired by perforator pedicled flaps anastomosed superficial veins with the recipient vessels.Fourteen flaps were based on five kinds of perforator arteries, the posterior interrosseous artery in 5 cases, the ulnar artery in 3 cases, the metacarpal artery in 2 cases, the peroneal artery in 3 cases, the lateral supramalleolar artery in 2 cases, the ulnar artery in 2 cases,and the posterior interrosseous artery in 1 case.After the operation, the blood supplies of flaps were observed severely,postoperative flap swelling were evaluated by edema level classification.After 1 month the blood flow of vein anastomosis were examed by color Doppler ultrasound.Questionnaire of the flap aesthetic satisfactory were performed during fellow-up periods.Results Twelve flaps were all survived well, 2 flaps had partial marginal skin necrosis in the distal, which was managed with surgical debridement, and wound healed in 1 month.Flap swelling were light, edema level classification were one degree in 4 cases,two degree in 10 cases postoperation 7 days, one degree in 11 cases and two degree in 3 cases, after 6 months.Color Doppler ultrasound examinations showed 9 vein anastomosises were all bypassed well.Eleven cases had 6-12 months' fellow-up periods.The flaps had like-like appearance, good contour, high aesthetic satisfactory.Conclusion Perforator pedicledr flaps by anastomosis of superficial veins can reduce the flap venous pressure obviously, avoid transientvenous venous congestion, improve the survival quality of the flap.It's a safe and effective method for soft tissue coverage of traumatic extremity wounds.
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Objective To explore the effects of early active mobilization on hand function after zone 5 flexor tendon and ulnar nerve repair.Methods Fifty-five patients who had received primary repair in zone 5 of a flexor tendon and the ulnar nerve were randomly divided into an observation group (26 cases, 88 digits) and a control group (27 cases, 91 digits).Both groups were given routine treatment after the operation, and started to do active and passive exercise 4 weeks later.The observation group was additionally forced to do active range of motion exercise training starting 8 days after the operation.Twelve weeks after the operation, the hand function of both groups was assessed using the total active motion (TAM) scoring system of the American Society for Surgery of the Hand, peripheral nerve function evaluation and the disabilities of arm-shoulder-hand (DASH) scale.Results At the end of the treatment, the average TAM score of the observation group was significantly better than that of the control group.The average active movement range of the wrist in palm flexion, dorsal extension, ulnar deviation and in radial deviation were all significantly better than in the control group.Grip strength, overall hand function and DASH score were also significantly better on average.Conclusion Early active mobilization following flexor tendon and ulnar nerve repair can effectively promote the recovery of hand function.
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OBJECTIVE: To investigate the clinical application of flow-through deep inferior epigastric perforator flaps for reconstruction of large defects at the extremities. METHODS: The deep inferior and superior epigastric arteries were designed as the axial vessel and the arterial supply to the flap was the paraumbilical perforator artery. Free deep inferior epigastric perforator flaps were harvested in flow- through manners to reconstruct associated arterial defect in the wound. The sensation assessment,Enneking score,and questionnaire of the flap aesthetic were all performed during follow-up period. RESULTS: From December 2011 to September 2012, 5 patients with large defects at extremities were treated. The deep inferior and superior epigastric arteries were designed as the axial vessel and the arterial supply to the flap was the paraumbilical perforator artery. The wound defects ranged form 11 cm x 5 cm to 30 cm x 11 cm. And the flap size ranged from 13 cm x7 cm to 33 cm x 13 cm. All flaps survived completely. The recipient arteries were all bypassed well documented by color Doppler examinations. All cases had 12-24 months' follow-up period. The flaps had good appearance and high aesthetic satisfactory(100%). 12 months after operations, sensation assessment were all S3+, and the Enneking score ratios were 82%-95% ,with 87.2% in average. CONCLUSIONS: Flow-through deep inferior epigastric perforator flaps are reliable and effective for reconstruction of large defects at the extremities with maintenance of the vascular status of the extremities. The flaps can also be designed in transverse or oblique mode for clinical application.
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Arterias Epigástricas , Extremidades/irrigación sanguínea , Extremidades/cirugía , Traumatismos de la Pierna/cirugía , Colgajo Perforante/irrigación sanguínea , Anciano , Arterias , Estética , Humanos , Procedimientos de Cirugía PlásticaRESUMEN
Objective To establish the condition cultrue cell system and co-culture cell system with SKOV3/PM4,HUVEC and to study the changes of their biological characteristics. Methods The cells of SKOV3/PM4 and HUVEC were labeled with green and red fluorescent respectively. The cell supernatant of SKOV3/PM4 and HUVEC were collected respectively as the condition medium(e.g:the cell supernatant of HUVEC cells was used as SKOV3/PM4 condition medium)and to establish the condition cultrue cell system and the co-culture cell system of the two cell lines. In the condition cultrue cell system, The morphological changes of cells were observed by HE staining to calculate the mitotic index. The ultrastructural changes of the two cells were observed by transmission electron microscopy(TEM). The growth curve of the cells was determined by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry was used to analyzed the cell cycles.In the co-culture cell system, the interaction of the two cells were detected by laser scanning confocal microscope(LSCM). The expression of matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) were detected by gelatin zymography. Results Compared with the single culture SKOV3/PM4, the cells which cultured in HUVEC condition medium showed the increase of pseudopodia and nuclear division,the mitotic index respectively were [(4.8 ± 0.8)%,(11.2 ± 0.3)%;P<0.05]. The growth rate was significantly increased. In cell cycles, it showed the declined cell ratio of G0/G1 phase, respectively[(69.4±3.6)%, (48.4±4.6)%;P<0.05] and the raised cell ratio of G2/M phase, respectively [(5.2±1.6)%, (24.9±2.2)%;P<0.05]. Compared with the single culture HUVEC,the cells which cultured in SKOV3/PM4 condition medium showed the significant morphological change and vacuolization in the cytoplasm, Nuclear division was increased and the mitotic index respectively were [(2.7±0.5)%, (5.7±0.6)%;P<0.05]. The growth rate was slightly declined. In cell cycles, it showed the raised cell ratio in G0/G1 phase, respectively [(51.4 ± 2.2)%,(79.0 ± 4.1)%;P<0.05] and the declined cell ratio in G2/M phase, respectively [(19.1±1.2)%, (3.3±0.5)%;P<0.05]. After co-culture for 48 hours, spontaneous fusion between SKOV3/PM4 and HUVEC cell was observed by the laser confocal microscope. Gelatin zymography assay showed that MMP-2 was not expressed in HUVEC cells, low-expressed in SKOV3/PM4 cells and high-expressed in the co-culture SKOV3/PM4+HUVEC cells. The expression of MMP-2 in co-culture SKOV3/PM4+HUVEC cells and SKOV3/PM4 cells respectively were 1 885 ± 84 and 1 209 ± 114 (P<0.05). But there were no MMP-9 expression in HUVEC cells, SKOV3/PM4 cells, and the co-culture SKOV3/PM4+HUVEC. Conclusion The characteristics of SKOV3/PM4 and HUVEC show significant changes after condition culture and co-culture, it may involve in the microenvironment of the cells and the intercellular crosstalk pathway.