[Clinical application of reverse radial hypothenar flap for finger soft tissue defect].

OBJECTIVE: To investigate the therapeutic effect of reverse radial hypothenar flap for finger soft tissue defect. METHODS: From Mar. 2006 to Mar. 2010, 13 cases (14 fingers) with finger soft tissue defects were treated with reverse radial hypothenar flaps pedicled with ulnar palmar digital artery of little finger. The defects were 1.9 cm x 1.5 cm -4.0 cm x 2.0 cm in size. The flap size ranged from 1.5 cm x 2.0 cm to 4.0 cm x 2.0 cm. RESULTS: All the flaps survived completely with primary healing both in donor and recipient area. 12 cases (13 fingers) were followed up for 1-3 years. The flaps color was similar to the unaffected fingers. Cicatricial contracture happened in one case due to contracture of palmar fascia. The two-point discrimination distance on flap was 3.2-5.3mm. The active and passive movement of finger joints was evaluated as excellent in 12 fingers, good in one finger. There was no complaint about the feeling at the donor site. Two months after operation, all patients could go back to work. CONCLUSIONS: The reverse radial hypothenar flap is very suitable for finger soft tissue defect with less morbidity to donor site.

Naringenin enhances the anti-tumor effect of doxorubicin through selectively inhibiting the activity of multidrug resistance-associated proteins but not P-glycoprotein.

PURPOSE: Naringenin has shown paradoxical results to modulate the function of multidrug resistance-associated proteins (MRPs). The aim of this study is to interpret whether naringenin can reverse intrinsic and/or acquired resistance of cancer cells to chemotherapeutic agents. METHODS: The effects of naringenin on the uptake, retention and cytotoxicity of doxorubicin were investigated in A549, MCF-7, HepG2 and MCF-7/DOX cells. Cellular efflux pathways modulated by naringenin were assessed with their specific substrates and inhibitors. The improved antitumor activity of doxorubicin in combination with naringenin was also investigated in vivo. RESULTS: The IC(50) values of doxorubicin in combination with naringenin in A549 and MCF-7 cells were approximately 2-fold lower than that of doxorubicin alone. The increased sensitivity to doxorubicin by naringenin in HepG2 and MCF-7/DOX cells was not observed. Naringenin increased the cellular doxorubicin accumulation through inhibiting doxorubicin efflux in the cells expressing MRPs but not P-gp. In contrast to doxorubicin alone, doxorubicin in combination with naringenin enhanced antitumor activity in vivo with low systemic toxicity. CONCLUSION: Naringenin enhances antitumor effect of doxorubicin by selective modulating drug efflux pathways. Naringenin will be a useful adjunct to improve the effectiveness of chemotherapeutic agents in treatment of human cancers.