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Objective To explore the anatomic basis of the thinning of the free posterior tibial artery perforator flaps and the clinical effect of repairing wound on hand or foot due to trauma.Methods From November,2016 to December,2017,10 cases of lower extremity cadaver specimens perfused with red ralex were dissected,which were perfused through the amputated femoral artery.Five of them were left and the rest were right.All cases were males.The number,diameter,branches and distribution of the perforator was observed.From September,2012 to September,2017,there were 13 cases of clinical application,which were 5 cases of hand wound and 8 cases of foot wound.The size of the wound was 3.0 cm × 2.0 cm to 6.0 cm × 4.0 cm,and the flap area was 3.5 cm × 2.2 cm to 6.5 cm × 4.5 cm.The repairing procedure was suitable for the wound associated with tendon,bone,joint capsule exposure.Results The number of posterior tibial artery perforating branches that more than 0.50 mm in diameter was 4 to 6,and the mean diameter was (0.87±0.26) mm.The perforating branch penetrated into the fat layer and was divided into 3 layers of vascular network:deep fat vascular network,superficial fat vascular network and subdermal vascular network.The perforating branch was located according to the positional relationship from deep to shallow,and vessel diameter become smaller step by step.The perforating branch trunk gave off branches to the deep vascular network,and the superficial vascular network had the same origin or shared with the deep blood vessels.The subdermal vascular network issued from the superficial vascular network or directly from the perforating branch trunk.There was no or few communicating branch between the deep vascular network and superficial ones,besides the vessel pedicle.So trimming deep fat layer will not affect the blood supply of superficial vascular network and neither will affect the flap blood supply.Most of the deep fat tissue was trimmed in 13 cases.The superficial and subdermal fat vascular network was preserved,and the same to the trunk and branches of the pedicle.All the flaps survived.Of which,1 appeared arterial crisis on the 2nd day after operation,and relieved by the local injection of papaverine.There was 1 case of venous crisis on the 3rd day,and improved by stitches,local release of congestion.Followed-up time was ranged from 2 to 12 months.All flaps were soft with good blood supply and good appearance,and did not need a second thinning surgery.Flaps restored the protective feeling 6 months later.Conclusion The microdissection of perforator flap of posterior tibial artery provides a theoretical basis for the perforator flap thinning,and the thinning of perforator flap is a good method to repair the appearance and function of the wound after foot and hand injuries.
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Objective To investigate a anatomy research and clinic application of defect of thumb by reverse dorsoradial thumb flap of different rotation point.Methods The origin,course,distribution and vascular chain of the first metacarpal dorsoradial artery of thumb from 11 adult cadaveric hand specimens perfused by red latex were explored from September,2012 to December,2016.There were 3 different rotation points:the proximal of the metacarpophalangeal joint,proximal basal of the first proximal phalanx and distal of the first proximal phalanx.Each could be used as reverse flow flap to repair the defect of thumb.Results The first metacarpal dorsoradial artery of thumb originated from the radial artery and the initial diameter was (0.68±0.26) mm,diagonally across the extensor pollicis brevis tendon and then along the radialis part and terminated in the proximal of the first proximal phalanx of the vascular chain.There was a constant communicating branch among the proximal metacarpophalangeal joint,proximal basal of the first proximal phalanx and digital arterial dorsal branch.All the proximal of the metacarpophalangeal joint 4.3 mm to 10.2 mm and proximal basal of the first proximal phalanx 4.9 mm to 7.2 mm could be used as the rotation point of the flap.The flap of the first promixal phalanx blood supply was based on the vascular chain of neurocutaneous.There was a constant dorsal branch of the pollical artery,which was 8.6 mm to 10.3 mm far from the interphalangeal joint,could be used as the rotation point of the flap.Twenty-four cases with soft tissue defects of thumb were repaired by reverse dorsoradial flap.The flap size ranged from 2.0 cm×1.5 cm to 3.5 cm×2.8 cm.The follow-up period was 3 months to 12 months,protective sensations were restored,and skin flap two-point discrimination were 9.0 mm to 12.0 mm.The appearance of the thumbs was satisfactory.Conclusion Different rotation point of reverse dorsoradial flap can successfully repair the defect of thumb.The operation has advantages of simple,reliable blood supply,high success rate and is an ideal option for reconstruction the defect of thumb.
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Objective To investigate the therapeutic effect of the microdissected thin fibular skin flap of the great toe to repair the finger pulp defect,and to discuss the operation and outcome of the flap for finger pulp defect.Methods From September,2012 to January,2016,12 cases of finger pulp defect were treated with the thin fibular skin flap of great toe removed partially subcutaneous fat under the microscope.One case for index finger,3 cases for middle finger,4 cases for ring finger,and 4 cases for little finger.Among them,5 cases were crush injury,6 cases were stamping injury,1 case was avulsion injury.The flap area was 3.0 cm×1.5 cm-3.2 cm×2.2 cm.The donor site was closed directly or covered with flap.Results All the 12 flaps survived completely without blood supply crisis,and the primary healing was achieved in donor site.Ten cases were followed-up from 6 months to 36 months.The blood-supply,texture and elasticity of transferred flaps and the shape of fingers pulp were excellent.Function recovery of the fingers was good.Pain and temperature sense were regained without hypersensitivity,two-point discrimination of finger pulp was 5-8 mm.Conclusion It is a reliable approrach for the repare of the finger pulp defects using the microdissected thin fibular skin flap of the great toe,especillay in repare finger pulp defect of ring and little finger.
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Objective:To screen the differentially expressed miRNAs in umbilical cord tissue of children with nonsyndromic cleft lip and/or cleft palate( NSCL/P) using miRNA microarray and comprehensive bioinformatics analysis for the prediction of related the bio-logical process and signaling pathways. Methods:Umbilical cord tissues of 4 cases of healthy newborns' and 4 lip or palate tissues of 4 cases with NSCL/P without other disease aged younger than 2 years were collected. The differentially expressed miRNAs were screened by miRNA microarray. Targets of dysrugulated miRNAs were predicted by TARGETSCAN-VERT, MIRDB and RNA22-HSA. All the gene sets were analyzed by gene ontology and pathway enrichment. Results: MiRNA microarray demonstrated that 254 miRNAs were dysregulated(181 miRNAs were up-regulated and 73 downregulated,P <0. 05). The dysregulated miRNAs targets contained 5029 genes. The dysregulated miRNAs targets were enriched in anatomical structure development,cell adhesion,cell proliferation,cell motili-ty and other biological processes. The dysregulated miRNAs targets were enriched in Wnt, mTOR, cGMP-PKG, TGFβ, PI3K-Akt and other signaling pathways. Conclusion:The target genes set of miRNAs are enriched in multiple biological processes and signaling path-ways related to NSCL/P, which indicate that genetic and environmental factors may influence the development process of NSCL/P.
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<p><b>OBJECTIVE</b>To study the molecular mechanism of microcystin (MC) induced liver tumorigenesis in rats.</p><p><b>METHODS</b>The two-stage-medium-term tumorigenesis theory was applied to establish the animal model, and the effect of MC in liver tumor formation was evaluated by the Albert gamma-GT methods, and then, the immunohistochemical technique and image analysis were used to study the expression of the bcl-2 and bax genes during tumorigenesis.</p><p><b>RESULTS</b>(1) MC enhanced the formation of gamma-GT foci in liver (100%), which was significantly higher than the diethylnitrosamine (DEN) control group (22.22%) (P < 0.05). (2) MC decreased the expression of bax gene. The intensity and area of bax gene expression in the pure MC toxin group were 0.028 3 AODV and 0.007 3 ( micro m(2)/ micro m(2)) and in the DEN control group were 0.065 5 AODV and 0.024 4 ( micro m(2)/ micro m(2)), respectively. The intensity and areas of bax gene expression in the pure MC toxin group were significantly lower than those in the DEN control group (P < 0.05). (3) MC increased the expression of bcl-2 gene. The intensity and area of bcl-2 gene expression in the pure MC toxin group wee 0.097 7 AODV and 0.031 5 ( micro m(2)/ micro m(2)), respectively, and in the DEN control group were 0.046 0 AODV and 0.020 5 ( micro m(2)/ micro m(2)) respectively (P < 0.05).</p><p><b>CONCLUSION</b>(1) MC can strongly promote liver tumorigenesis. (2) The changes of bcl-2 and bax gene expression possibly play an important role in the MC induced liver tumor formation.</p>
Subject(s)
Animals , Mice , Rats , Carcinogens , Toxicity , Immunohistochemistry , Liver , Metabolism , Pathology , Liver Neoplasms , Metabolism , Pathology , Microcystins , Peptides, Cyclic , Toxicity , Proto-Oncogene Proteins , Proto-Oncogene Proteins c-bcl-2 , Rats, Wistar , bcl-2-Associated X ProteinABSTRACT
A new orally active non-glycosidic, non-adrenergic cardiotonic agent, 2-[(2-me-thoxy-4-methysulfinyl) phenyl]-1 H-imidazo[4, 5-b]-pyridine, AR-L115BS, has been synthesized.The two key intermediates, 2, 3-diaminopyridine and 2-methoxy-4-methylmercap-tobenzoic acid were prepared according to the routes submitted by Fox and Zipp, respectively. The approaches were improved to adapt large scale laboratory preparation. The structure of the end product was proved by elemental analysis,mass spectra, 1H nuclear magnetic resonance spectra and infrared spectra.