Mechanisms of copper transporter 1 gene in regulating radiation induced intestinal injury / 中华放射医学与防护杂志

Objective:To investigate the effects and mechanisms of copper transporter 1 (CTR1) in radiation induced intestinal injury in vitro. Methods:Human small intestinal epithelial cells (HIEC) were irradiated with 2, 4, 6, 8 Gy of X-rays and rat intestinal epithelial cells (IEC-6) were irradiated with 5, 10, 15, 20 Gy of X-rays. At 2, 4, 8, 24, and 48 h after irradiation, the expression of CTR1 was detected by Western blot assay. In some experiments, HIEC and IEC-6 cells were transfected with CTR1 shRNA and then exposed to X-rays. Copper levels were detected by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The radiosensitivity of cells was verified by colonogenic assay, the cellular reactive oxygen species (ROS) level and DNA damage were detected to further explore the related mechanism. In addition, Western blot was applied to detect the expressions of antioxidants and cuproptosis associated proteins in enterocytes after silencing CTR1 or irradiation.Results:The expression of CTR1 was increased by X-ray irradiation in a dose-dependent manner ( t=3.53, 3.45, 6.37, 11.11, 11.13, P<0.05). CTR1 expression was successfully diminished by CTR1 shRNA adenovirus vectors. According to the survival curves, the enhancement ratios of the radiosensitivity of HIEC and IEC-6 cells with CTR1 knocking-down were 1.146 and 1.201, respectively. Radiation-induced copper accumulation was alleviated after CTR1 silencing in IEC-6 cells ( t=3.10, P<0.05). At 0.5 h after irradiation, the ROS production in the CTR1 knockdown group was significantly lower than that in the control group ( t=5.23, 2.96, P<0.05). At 1 h after irradiation, the protein expression of γ-H2AX in the CTR1 knockdown group was obviously lower than that in the control group ( t=7.50, 4.29, P<0.05). The expressions of Nrf2 and HO-1 were increased after irradiation, which could be further increased after CTR1 silencing. In addition, cuproptosis associated protein DLAT, LIAS and FDX1 were reduced post-irradiation, which were recovered after CTR1 silencing. Conclusions:The radioresistance of HIEC and IEC-6 cells was enhanced after CTR1 silencing, possibly through the intracellular ROS and cuproptosis pathway.

Individual Identification in Facial Appearance Biometrics Based on Macroscopical Comparison / 法医学杂志

Individual identification is one of the research hotspots in the practice of forensic science, and the judgment is usually built on the comparison of the unique biological characteristics of the individual, such as fingerprints, iris and DNA. With the dramatic increase in the number of cases related to video image investigations, there is an increasing need for the technology to identify individuals based on the macroscopic comparison of facial appearance biometrics. At present, with the introduction of computer three-dimensional (3D) modeling and 3D superimposition comparison technology, considerable progress has been made in individual identification methods based on macroscopic comparison of facial appearance biometrics. This paper reviews individual facial appearance biometric methods based on macroscopical comparison, comprehensively analyzes the advantages and limitations of different methods, and puts forward recommendations and prospects for subsequent research.

Xiaoyao San, a Chinese herbal formula, ameliorates depression-like behavior in mice through the AdipoR1/AMPK/ACC pathway in hypothalamus / 中西医结合学报

OBJECTIVE@#Depression and metabolic disorders have overlapping psychosocial and pathophysiological causes. Current research is focused on the possible role of adiponectin in regulating common biological mechanisms. Xiaoyao San (XYS), a classic Chinese medicine compound, has been widely used in the treatment of depression and can alleviate metabolic disorders such as lipid or glucose metabolism disorders. However, the ability of XYS to ameliorate depression-like behavior as well as metabolic dysfunction in mice and the underlying mechanisms are unclear.@*METHODS@#An in vivo animal model of depression was established by chronic social defeat stress (CSDS). XYS and fluoxetine were administered by gavage to the drug intervention group. Depression-like behaviors were analyzed by the social interaction test, open field test, forced swim test, and elevated plus maze test. Glucose levels were measured using the oral glucose tolerance test. The involvement of certain molecules was validated by immunofluorescence, histopathology, and Western blotting. In vitro, hypothalamic primary neurons were exposed to high glucose to induce neuronal damage, and the neuroprotective effect of XYS was evaluated by cell counting kit-8 assay. Immunofluorescence and Western blotting were used to evaluate the influences of XYS on adiponectin receptor 1 (AdipoR1), adenosine 5'-monophosphate-activated protein kinase (AMPK), acetyl-coenzyme A carboxylase (ACC) and other related proteins.@*RESULTS@#XYS ameliorated CSDS-induced depression-like behaviors and glucose tolerance impairment in mice and increased the level of serum adiponectin. XYS also restored Nissl bodies in hypothalamic neurons in mice that exhibited depression-like behaviors and decreased the degree of neuronal morphological damage. In vivo and in vitro studies indicated that XYS increased the expression of AdipoR1 in hypothalamic neurons.@*CONCLUSION@#Adiponectin may be a key regulator linking depression and metabolic disorders; regulation of the hypothalamic AdipoR1/AMPK/ACC pathway plays an important role in treatment of depression by XYS.

Policy Framework and Methodological System of Inclusive Development of Health Service System and Physical Activity / 中国康复理论与实践

Objective:To explore the theory and methods of integrating sports into modern health service systems. Methods:Based on the theory of World Health Organization modern health service systems and the policy guideline Rehabilitation in Health Service Systems, we analyzed how to promote the integration of sports into modern health service systems in six areas: leadership and governance capacity, financing, health human resources, service delivery, medical technology and health information systems, systematically analyzed the key elements and requirements for integrating physical education and sports into the health service system in the four segments of the health service continuum: prevention, intervention, rehabilitation and health promotion. Results:The goal of building a human-centered, cross-sectoral and multidisciplinary health service system was proposed, requiring the promotion of the integration of medicine and sports, the use of sports intervention as a method of health intervention, the development of service technologies and standards for the integration of sports and health; the training of professionals who master sports intervention and sports rehabilitation, and the development of information systems to promote the development of the integration of sports and health services. Conclusion:Sports is an important mean of health and an important part of modern health services. Starting from the components of the health service system, we can build a theoretical and methodological system for integrating sports into the modern health service system, so as to promote the realization of a health service system covering the whole population and the whole life cycle, achieve the United Nations 2030 Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages; and realize the goals related to "Healthy China".

Epidemiolgic characteristics and influencing factors of measles among floating children in Shenzhen：a case-control study / 中华疾病控制杂志

Objective To investigate epidemiological characteristics of measles cases and the influencing factors of transmission of measles among floating children in Shenzhen. Methods Descriptive study was conducted in data which were collected from the report system of statutory infectious diseases from 2016 to 2018 in Shenzhen. Case-control study was conducted between 89 cases and relative controls. Results A total of 108 measles cases in floating children were reported from 2016 to 2018, and the incidence trend showed a year-on-year decline( 2trend=68.35, P<0.001). Analysis showed that nosocomial exposure in 7 to 21 days ago(OR=7.80, 95% CI:3.51-17.35, P<0.001), having been to the crowded places(OR=3.37, 95% CI:1.52-7.47, P=0.002), having contact history of fever-rash patients(OR=4.57, 95% CI:1.41-14.84, P=0.007) were influencing factors of transmission of measles among floating children, and immunization at the prescribed time(OR=0.12, 95% CI:0.04-0.32, P<0.001) was a protective factor for measles. Conclusions Vaccination must be strengthened for floating children. Medical institutions should avoid becoming a key place for measles transmission, and need to strengthen health education.

Application of standardized communication mode in interventional ward / 介入放射学杂志

Objective To evaluate the application effect of standardized communication mode, which was based on the situation, background, assessment and recommendation (SBAR communication mode), in interventional ward. Methods SBAR communication mode was implemented in interventional ward. Through the discussion of doctors and nurses, the SBAR communication template of common symptoms of specialized diseases was revised. The training, examination, utilization and evaluation of the SBAR communication template were conducted for all nurses. The medical adverse events caused by poor medical and nursing communication, the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction with nurses were recorded before and after the implement of SBAR communication mode, and the results were compared. Results After the implementation of SBAR communication mode, both the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses were significantly improved, the differences were statistically significant (P<0.05); and the incidence of medical adverse events caused by poor medical and nursing communication was remarkably decreased, the difference was statistically significant (P<0.05) . Conclusion The implementation of SBAR communication mode in the intervention ward can significantly improve the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses, and decrease the incidence of medical adverse events caused by poor medical and nursing communication, thus, the safety of patients can be guaranteed, meanwhile, the establishment of a harmonious medical and nursing team is promoted.

The quality of life of post-discharge patients carrying drainage tube after PTBD: a qualitative study / 介入放射学杂志

Objective To make a further recognition of the real quality of life of post-discharge patients who carry a percutaneous transhepatic biliary drainage (PTBD) tube due to malignant obstructive jaundice in order to formulate the corresponding scheme of health education and continued nursing. Methods By using qualitative research with phenomenological method, the interventional specialized nurse made a indepth interview with the post-discharge patients who carried a PTBD tube due to malignant obstructive jaundice. Colaizzi seven-step analysis method was adopted to collate and analyze the clinical data. Results A total of 10 patients were finally enrolled in this study. The main considerations of patients carrying a PTBD tube in daily life included the changes of self-care ability in daily life, intensification or absence of a patient's role; worrying about prolapse and infection of the tube; disordered self-image and social phobia; different degrees of physical discomfort and negative emotion with psychological pressure; hoping improvement of the drainage bag and fixed materials and way; hoping more convenient way of dressing, etc. Conclusion The post-discharge patients carrying a PTBD tube live in different levels of stress. The medical staff should carry out targeted health education and extension care to help them and make research to improve equipment, so as to improve self-care ability, reduce complications as well as psychological pressure, thus, to improve the quality of life.

High dose volume and low dose volume of the total and ipsilateral lung in prediction of acute radiation pneumonitis / 实用医学杂志

Objective To observe the incidence of acute radiation pneumonitis (ARP) in patients with nonsmall cell lung cancer treated by three-dimensional conformation radiotherapy or intersity-modulated radiation therapy,and investigate the predictive value of high dose volume and low dose volume of the total and ipsilateral lung on ARP.Methods 174 patients with non-small-cell lung cancer verified by pathology who received radical radiotherapy in our hospital from Aug 2013 to Nov 2015 were screened.Radioactive dose was 60 Gy-70 Gy,with 97 patients' dose of 60-64 Gy and 77 patients' dose of 65-70 Gy.Chemotherapy was done by paclitaxel + pentium first line treatment.155 patients were treated with radiotherapy alone and 19 with radiotherapy combined with chemotherapy.The V5～ V30,MLD (mean lung dose),V5ipis ～ V30ipsi,MLDipsi were calculated from the dose volume histogram system.The ARP was evaluated according to Common Toxicity Criteria 4.0 (CTC4.0).Univafiate and nultivariate analysis and receiver operating characteristic (ROC) curves were performed to assess the correlated factors of ARP.Results Of 174 patients,26 patients (14.94％) developed radioactive pneumonia at grade 2,11 patients (6.32％) at grade 3,2 patients (1.15％) at grade 4.The correlative factors included the radiochemotherapy regimen (sequential chemotherapy to radiotherapy or concurrent radiochemotherapy),V5,V10,V20,V30,MLD of the total lung and ipsilateral lung according to univariate analysis.Multivariate analysis of all the factors mentioned above showed the V5,V20ipsi and MLD were the independent predictive factors associated with ARP.ROC analysis indicated that the cut-off point of V5,V20ipsi,MLD were 62.38％,47.14％and 16.85Gy respectively.According to the V5,V20ipsi value,174 patients were divided into three groups:B group V5＜62％+V20ipsi≥47％,C group V5≥62％+V20ipsi＜47％,D group V5≥62％+V20ipsi≥47％.The chisquare test between the C group and D group has statistical significance.Conclusion V5,V20ipsi,and MLD are the independent risk factors of ARP.Compared with V5,limiting V20ipsi threshold is more likely to result in ARP.

Application of continuity nursing model in caring patients receiving percutaneous transhepatic biliary drainage / 介入放射学杂志

Objective To investigate the clinical value of continuity nursing model in caring patients with malignant obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD).Methods A total of 120 patients with malignant obstructive jaundice treated by PTCD were enrolled in this study.The patients were divided into the control group (n=60) and the observation group (n=60).Routine discharge guidance and health education was conducted for the patients of control group,while for the patients of observation group,in addition to conventional discharge education,the continuity nursing was executed by the responsible nurse.Continuity nursing was meant to continue the service,to guide the observation of the wound and dressing change,the observation of the quantity and quality of drainage solution,to teach the knowledge of the management of PTCD catheter as well as its complications,to guide patient's diet and rest,and to establish the continuity nursing records.Results The patients of both groups were followed up for 3 months.The patients' awareness rate of the knowledge related to PTCD tube in the observation group was significantly higher than that in the control group.The wound infection rate,the rate of PTCD tube prolapse or blockage,and the tube-related re-hospitalization rate in the observation group were strikingly lower than those in the control group (P＜0.05).Conclusion The continuity nursing model can significantly improve patients' awareness rate about the knowledge related to PTCD tube,reduce the incidences of biliary tract infection,PTCD tube prolapse or blockage,wound infection,and tube-related re-hospitalization,therefore,the quality of life can be surely improved.

The clinical application of the nursing management model of doctor-nurse same group responsibility system in treating patients receiving TIPS / 介入放射学杂志

Objective To discuss the clinical application of the nursing management mode of doctornurse same group responsibility system in treating patieuts who are receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods A total of 70 TIPS patieots,who were admitted to a certain level Ⅲ hospital during the period from January 2016 to December 2016,were enrolled in this study.Using the table of random number,the patients were equally divided into the control group and the study group with 35 patients in each group.Traditional nursing group management mode was adopted in the control group,while doctor-nurse same group responsibility system was carried out in the study group (including the hospitalization period and the follow-up visit after discharge).Complications during hospitalization,postdischarge incidence of hepatic encephalopathy,readmission rate,and patient's satisfaction with medical staff were calculated,and the results were compared between the two groups.Results After the implementation of doctor-nurse same group responsibility system,the post-TIPS complications,the post-discharge incidence of hepatic encephalopathy and the readmission rate were significantly decreased and the patient's satisfaction with medical staff was remarkably improved,the differences were statistically significant (P＜0.05).Conclusion The implementation of doctor-nurse same group responsibility management mode for TIPS patients in the interventional ward can effectively reduce postoperative complications,post-discharge incidence of hepatic encephalopathy and the readmission rate,meanwhile,the patient's satisfaction with medical staff are obviously improved.Therefore,the implementation of doctor-nurse same group responsibility management mode for TIPS patients is of great value in clinical practice.

Differential Expression of Plasma Protein Profile in Patients with Kidney-yin Deficiency Syndrome / 广州中医药大学学报

Objective To seek for the differentially-expressed proteins in patients with kidney-yin deficiency syndrome and to screen out the specific proteins,so as to provide evidence for the establishment of objective standard of kidney deficiency syndrome of traditional Chinese medicine (TCM).Methods Five patients with typical kidney-yin deficiency syndrome and 6 normal healthy volunteers were enrolled into the study.Plasma proteins in both groups were detected by antibody chip,and then the plasma proteins profile was compared and analyzed.Results A total of 25 differentially-expressed proteins between kidney-yin deficiency group and normal control group were found,of which 2 were up-regulated and 23 were down-regulated.Conclusion The differentially-expressed proteins in patients with kidney-yin deficiency syndrome are mainly related to immune disorder,protein biosynthesis,metabolism,oxidative stress,cell apoptosis,signal transduction,and so on.

Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review / 中国结合医学杂志

<p><b>OBJECTIVE</b>To assess the methodological quality of systematic reviews and meta-analyses regarding acupuncture intervention for stroke and the primary studies within them.</p><p><b>METHODS</b>Two researchers searched PubMed, Cumulative index to Nursing and Allied Health Literature, Embase, ISI Web of Knowledge, Cochrane, Allied and Complementary Medicine, Ovid Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Traditional Chinese Medical Database to identify systematic reviews and meta-analyses about acupuncture for stroke published from the inception to December 2016. Review characteristics and the criteria for assessing the primary studies within reviews were extracted. The methodological quality of the reviews was assessed using adapted Oxman and Guyatt Scale. The methodological quality of primary studies was also assessed.</p><p><b>RESULTS</b>Thirty-two eligible reviews were identified, 15 in English and 17 in Chinese. The English reviews were scored higher than the Chinese reviews (P=0.025), especially in criteria for avoiding bias and the scope of search. All reviews used the quality criteria to evaluate the methodological quality of primary studies, but some criteria were not comprehensive. The primary studies, in particular the Chinese reviews, had problems with randomization, allocation concealment, blinding, dropouts and withdrawals, intent-to-treat analysis and adverse events.</p><p><b>CONCLUSIONS</b>Important methodological flaws were found in Chinese systematic reviews and primary studies. It was necessary to improve the methodological quality and reporting quality of both the systematic reviews published in China and primary studies on acupuncture for stroke.</p>

Thrombolysis of plasmin-ΔK on photochemically induced branch retinal vein occlusion after intravitreal injection in rats / 中华实验眼科杂志

Background Retinal vein occlusion is a common retinal vascular diseases.Thromblysis and anticoagulation therapies are main approaches.However,systemic thrombolysis is relatively inefficient,and it often enhances the risk of hemorrhage.Objective This study was to investigate the therapeutic effects of PLM-ΔK,a kringle deficiency mutant of plasmin,on photochemically induced branch retinal vein occlusion (BRVO) after intravitreal injection.Methods BRVO models were established by the combination of caudal vein injection of Rose Bengal with argon laser radiation of periphery area of retinal veins in SD rats.Forty model rats were randomized into balance salt solution (BSS) group and 0.01 U,0.02 U,0.03 U PLM-ΔK group,and 10 μl corresponding drug was intravtreally injected 12 hours after modeling.Ophthalmoscopy and fundus fluorescein angiography (FFA) were performed to observe the change of retinal veins.The animals were sacrificed 3 days after intravitreal injection,and hematoxylin and eosin staining was used for the histopathological and ultrastructural examination of retinas.The retina of the rats was isolated for the stretched preparation of retina.The expressions of fibronectin (FN) and laminin (LN) in eyeball wall were assayed by immunofluorescence technology.The use and care of the animals complied with Statement of the Association for Research in Vision and Ophthalmology.Results The revascularization of over 2 retinal veins was found in 0,3,6 and 8 rats in the BBS group and 0.01 U,0.02 U,0.03 U PLM-ΔK group 3 days after intravitreal injection,respectively,showing a significant difference among the groups (x2=9.635,P =0.022),and the rat number with revascularization in 0.01 U PLM-ΔK group was not significantly different from that in BSS group (Z=-1.558,P =0.119),but the difference between 0.03 U PLM-ΔK group and 0.01 U PLM-ΔK group was significant (Z=-2.762,P=0.006).In the third day after intravitreal injection,retinal vein thrombus were found in the BSS group under the light microscope,and angiogenesis was seen on the retinal flatmount nuclear.In the 0.03 U PLM-ΔK group,posterior vitreal detachment was exhibited under the light microcope,and no retinal new vessel and cell damage were seen.FN was strongly expressed in the inner limiting membrane (ILM) layer,photocyte layer,outer limiting membrane (OLM) layer,choroid and scleral layer,and LN was expressed mainly in the ILM,OLM and scleral layer in the BSS group.However,the expression intensities of FN and LN were obviously weakened in the 0.03 U PLM-ΔK group.Conclusions Intravitreal injection of PLM-ΔK can enhance the reperfusion of occluded branch retinal vein and serve as a potential therapeutic drug for BRVO.Also it can permeate into choroid after intravitreal injection to degradate FN and LN.

Main biologics for anti-autoimmune disease:research advances / 国际药学研究杂志

Immune system is a security guard to help human body repel or remove bacteria, viruses, parasites and other fore-ign invaders .But when some tissue components or the immune system itself become abnormal, it can not distinguish friend from foe accurately and may attack our own tissue then cause some clinical symptoms, leading to autoimmune diseases. Nearly 5 % of the world's population suffer from various autoimmune diseases. By now in addition to control the formation of autoantigens such as infection,tiredness, the main biologics used in clinic are immunoregulators to block pathological autoimmune response and then to create a new proper immune response. Recently, new biologics to treat autoimmune disease come into being one after another, and this article gives a brief overview about research progress in anti-autoimmune disease biologics.

Thrombolysis of plasmin and its derivatives:research advances / 国际药学研究杂志

All of the thrombolytic agents currently approved for use in humans are plasminogen activators, the application of which is limited by bleeding complications at vascular injury sites and plasminogen content in the thrombus. Plasmin is rapidly neutral-ized in the circulation by α2-antiplasmin and tolerated without bleeding. With the application of catheter-based delivery, the unique bio-chemical properties of plasmin make it a safe and effective direct fibrinolytics. Plasmin derivatives, including miniplasmin,Δ-plasmin and microplsmin, display more thrombolysis efficacy and better hemostatic safety in preclinical study and clinical trials. This review sum-marizes the current information on plasmin and its derivatives, including the advances on biochemical properties, preclinical and clinical trials.

Kinetics analysis on gait termination for children with backpacks / 医用生物力学

Objective To understand kinetics characteristics of gait termination for children with backpacks， and compare the difference between planned gait termination (PGT) and unplanned gait termination (UPGT) as well as effects of backpack carrying by children at the moment of gait termination. Methods Twelve boys (age (9.85±1.34) years old, height (140.89±11.57) cm, weight (34.96±9.62) kg) were recruited in this study. The gait termination scene in real life was simulated in the lab by the subjects who were required to carry different backpacks, while the parameters of ground reaction force and center of pressure (COP) during PGT and UPGT were recorded by two 3D force plates. Results There were significant differences in the peak ground reaction force curve between gait termination and normal walking. Meanwhile the peak ground reaction force and COP shifting during PGT and UPGT were both significantly larger than those during normal walking， and the values were increased with the increase of backpack load. The maximum ground reaction force and COP shifting were found during UPGT while the subject was carrying backpack equal to 15% of the body weight (15% BW). Conclusions The change of ground reaction force was useful for gait termination，but children will suffer much more impact force during both PGT and UPGT, and make the control on postural balance more difficult, which could be dangerous with the increase of backpack load. It is advised that children should lighten their backpack loads, which will be helpful to prevent accidental injuries during suddenly external disturbance.

Analysis of the relationship between mycoplasma pneumoniae infection and children asthma / 中国基层医药

Objective To study the relationship between mycoplasma pneumoniae(MP) infection and children asthma,and to observe the treatment effects of macrolide antibiotics (azithromycin) on mycoplasma pneumoniae infection.Methods 250 children of respiratory disease were investigated with olimpus electron gastroscope,200 children asthma;the serum specific antibodies were determined by Diagnostic Kit for measurement of antibodies to mycoplasma pneumoniae (Passive Particle Agglutination) ;and the eosinophilic grannlocytes were serologically analyzed in children with recent asthma.Random selection 42 MP infection positive to macrolides antibiotics (azithromycin) treatment.Results 44 MP infection positive,200 children asthma cases had MP infection with 21％ (42/200) MP positive,the specific antibody titers to MP showed significant difference in children with recent asthma compared with those in the contol group ( x2 =6.14,P ＜ 0.05 ),and correlated with the count of eosinophilic granulocy positively ( r =0.603,P ＜ 0.05) ;The positive rates of specific antibody,infection with MP were significantly higher than those in the control group( t =4.38,P ＜ 0.05 ).MP infection positive group with azithromycin treatment effect is significantly higher than that of cefuroxime group ( x2 =16.18,P ＜ 0.05 ).Conclusion MP infection is closely associated with the pathogenesis of children asthma;and early routine testing for MP antibodies.Macrolides antibiotics can eliminate MP infection,a new generation of macrolides antibiotics(azithromycin) is more advantageous to the control of acute attack of asthma.

Repairing of the deep burn wounds of the lower extremities with sural nerve nutrition blood vessel island flap / 中国基层医药

ObjectiveTo explore the clinical role of island flap nourished by sural nerve nutrition blood vessel for repairing of the deep burn wounds of the lower extremities.MethodsIsland flap nourished by sural nerve nutrition blood vessel were performed to repair the deep burn wounds of the lower extremities below the knee in 22 cases,aged 10 ～58 years old,average aged 34 years old,including flame burns in 6 cases,electrical burns in 10 cases,chemical burns in 4 cases,scalding hot water in 2 cases.All were deep skin damage,The island flaps,including anterograde and retrograde flaps,was from 5cm ×4cm to 13cm × 10cm in size,The defect at the donor site was sutured primarily or repaired by a skin graft.ResultsAll the flaps survived well,18 patients were follow-up postoperatively for 4 ～24 months.The color,texture,shape of the flaps were satisfactory,but the sensory recovery was unsatisfactory.ConclusionSural neurovascular flap had a constant anatomy and reliable blood supply without the sacrificeof the major blood vessels.The procedure was simple and easy,and an effective method of repairing the skin and soft tissue defects below the knee.

The effects of plasmin Kringle domains deficiency mutant on the interface of vitreous and retina in rabbit eyes / 眼科研究

Background The vitreoretinal traction plays a critical role in the formation of macular hole and cystoid macular edema.Enzymatic vitreolysis has potential in relieving vitreoretinal traction as a simple and less invasive method in comparison with pars plane vitrectomy.ObjectiveThis study is to investigate the effects of plasmin mutant with kringle domains deficiency(Plm△K)on vitreoretinal interface in new Zealand white rabbits.Methods Plm△K was prepared through activating plasminogen mutant with Kringle domains deficiency (Plg△K) by tissue plasminogen activator (tPA).100μL of Plm△K at the dose of 0.5,1.0 and 1.5μmol/min was injected respectively into the vitreous of 48 New Zealand white rabbits and 16 eyes for each dose.B-scan and optical coherence tomography (OCT) were performed to detect the structure variety at the vitreoretinal interface in 1 day and 7 days after injection.The gross anatomy analysis with triamcinolone acetonide fine particle suspension,as well as histopathological examinations by scanning electron microscopy,was performed in the different time points mentioned above.Results Two peptide chains were determined with the relative molecular weight about 26000 and 5000 by the gel imaging analysis of reduced SDS-PAGE.Separation of the posterior vitreous cortex from retina was found after intravitreous injection under the B-scan and OCT.The ultrastructure change of vitreoretinal interface as well as the examination of fine particle suspension by triamcinolone acetonide demonstrated the same outcome.The degree of remnants of vitreous cortex showed the negative correlation with the dosage of Plm△K (r=-0.9516,P=0.048).No significant correlation was found between the degree of remnants of vitreous cortex and the action time(r=-0.720,P=0.470).There was no obvious morphological difference in outer layer of retina between control eyes and Plm△K-treated eyes.No drug-related adverse event was found after intravitreous injection of Plm△K.Conclusion Intravitreous injection of Plm△K alone can induce complete separation of vitreous from retina.This procedure is safe and effective.

Clinical prognostic multivariate analysis of incidental gallbladder cancer: a case controlled retrospective study / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the prognostic risk factors in incidental gallbladder cancer (IGBC) and evaluate the effect of laparoscopic cholecystectomy (LC) applied in treating IGBC.</p><p><b>METHODS</b>The retrospective study enrolled 55 patients with incidental gallbladder adenocarcinoma treated between January 2001 and December 2008. The patients were divided into three groups according to different surgical approaches: laparoscope group (n = 23), conversion group (n = 6) and laparotomy group (n = 26). Survival analysis and Cox regression model were applied to comparing the difference of survival rate between three groups and to analyzing the related prognostic risk factors of IGBC.</p><p><b>RESULTS</b>The overall 1-, 3- and 5-year survival rates were 74.3%, 47.7% and 35.8% respectively. And the median survival time was 36 months. The outcome of survival rate between three groups was not different statistically. Cox regression analysis indicated that pathologic T stage was an independent risk factor influencing IGBC (OR = 2.75, P = 0.00). The prognosis was getting worse according to the rising depth of tumor invasion. However, the other factors, such as surgical approach, tumor incisional implantation, ect.were not related to the prognosis (P > 0.05).</p><p><b>CONCLUSION</b>The factor of pathologic T stage is related to the prognosis of IGBC for which LC, compared with open cholecystectomy, should not be regarded as a negative factor in treatment.</p>