Detection of virulence genes and analysis of antimicrobial resistance of E. coli from calves with diarrhea in Tongliao City, Inner Mongolia Autonomous Region, China / 中国生物制品学杂志

@#Objective To detect the virulence gene of E. coli from calves with diarrhea in Tongliao City，Inner Mongolia Autonomous Region，China and analyze its antimicrobial resistance as well as the distribution of antimicrobial resistant genes. Methods The sensitivities of 82 E. coli isolates from the fecal samples of calves with diarrhea to thirteen kinds of antibiotics were determined by disk diffusion test. The carrying statuses of thirteen virulence genes and twelve antimicrobial resistant genes of the E. coli isolates were determined by PCR，based on which the phylogenetic background was investigated. Results Of the 82 pathogenic E. coli isolates，48. 78%（40／82）、31. 71%（26／82）、14. 63%（12／82）and 4. 88%（4／82）belonged to phylogenic groups A，B1，B2 and D respectively，indicating that the prominent one was group A. A total of 11 virulence genes were detected in 82 isolates. The detection rates of irp2，fyuA，eaeA and STb genes were 79. 27%（65／82），63. 41%（52／82），53. 66%（44／82）and 50%（41／82）respectively，while those of other virulence genes were less than 50%，and no tsh or LT1 was detected. The 82 isolates were significantly resistant to 13 kinds of antibiotics，in which the resistant rates to tetracycline，doxycycline and amoxicillin were 100%（82／82），97. 56%（80／82）and 90. 24%（74／82）respectively. All the isolates were mutidrug resistant，most of which were resistant to eight kinds of antibiotics（16／82，19. 51%）. A total of twelve antimicrobial resistant genes were detected in the 82 isolates，in which the positive rates of genes resistant to β ‑ lactams（blaTEM），sulfonamide（sul1 and sul2），tetracycline（tetB and tetD）and aminoglycosides（aadB）were more than 70%. Conclusion The 82 pathogenic E. coli isolates mainly belonged to group A，with high detection rates of virulence gene and antimicrobial resistant gene as well as high and multiple drug resistance. The study provided a reference for the prevention and treatment of and clinical medication of E. coli‑associated diseases in calves in Tongliao Region.

Clinical application of Flow-through bridge anterolateral thigh flap in repair of complex calf soft tissue defects / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of Flow-through bridge anterolateral thigh flap transplantation in the treatment of complex calf soft tissue defects.@*METHODS@#The clinical data of the patients with complicated calf soft tissue defects, who were treated with Flow-through bridge anterolateral thigh flap (study group, 23 cases) or bridge anterolateral thigh flap (control group, 23 cases) between January 2008 and January 2022, were retrospectively analyzed. All complex calf soft tissue defects in the two groups were caused by trauma or osteomyelitis, and there was only one major blood vessel in the calf or no blood vessel anastomosed with the grafted skin flap. There was no significant difference between the two groups in general data such as gender, age, etiology, size of leg soft tissue defect, and time from injury to operation ( P>0.05). The lower extremity functional scale (LEFS) was used to evaluate the sufferred lower extremity function of the both groups after operation, and the peripheral blood circulation score of the healthy side was evaluated according to the Chinese Medical Association Hand Surgery Society's functional evaluation standard for replantation of amputated limbs. Weber's quantitative method was used to detect static 2-point discrimination (S2PD) to evaluate peripheral sensation of the healthy side, and the popliteal artery flow velocity, toenail capillary filling time, foot temperature, toe blood oxygen saturation of the healthy side, and the incidence of complications were compared between the two groups.@*RESULTS@#No vascular or nerve injury occurred during operation. All flaps survived, and 1 case of partial flap necrosis occurred in both groups, which healed after free skin grafting. All patients were followed up 6 months to 8 years, with a median time of 26 months. The function of the sufferred limb of the two groups recovered satisfactorily, the blood supply of the flap was good, the texture was soft, and the appearance was fair. The incision in the donor site healed well with a linear scar, and the color of the skin graft area was similar. Only a rectangular scar could be seen in the skin donor area where have a satisfactory appearance. The blood supply of the distal limb of the healthy limb was good, and there was no obvious abnormality in color and skin temperature, and the blood supply of the limb was normal during activity. The popliteal artery flow velocity in the study group was significantly faster than that in the control group at 1 month after the pedicle was cut, and the foot temperature, toe blood oxygen saturation, S2PD, toenail capillary filling time, and peripheral blood circulation score were significantly better than those in the control group ( P<0.05). There were 8 cases of cold feet and 2 cases of numbness on the healthy side in the control group, while only 3 cases of cold feet occurred in the study group. The incidence of complications in the study group (13.04%) was significantly lower than that in the control group (43.47%) ( χ 2=3.860, P=0.049). There was no significant difference in LEFS score between the two groups at 6 months after operation ( P>0.05).@*CONCLUSION@#Flow-through bridge anterolateral thigh flap can reduce postoperative complications of healthy feet and reduce the impact of surgery on blood supply and sensation of healthy feet. It is an effective method for repairing complex calf soft tissue defects.

Calf tissue flap combined with artificial bone of antibiotics loaded calcium sulphate in treatment of tibia osteomyelitis / 中华显微外科杂志

Objective:To observe the surgical method and clinical efficacy of applying calf tissue flap combined with artificial bone of antibiotics loaded calcium sulphate in treatment of tibia osteomyelitis.Methods:From July 2018 to January 2021, calf tissue flaps combined with artificial bone of antibiotics loaded calcium sulphate (or mixed with iliac bone) were applied to treat 16 cases with tibia osteomyelitis in the Department of Hand and Microsurgery of Baoji Third Hospital. There were 10 males and 6 females, aged 15 to 64 years old, with a mean age of 41 years old. For the 5 cases with acute osteomyelitis caused by wound infection, local dressing changes and drainage or VSD wound management were applied after debridement, together with primary systemic anti-infection treatment. After the acute infection period had been under control and stabilised, the wounds were then thoroughly exposed and cavities were filled and covered with the surgical reconstruction procedure with antibiotics-loaded artificial bone of calcium sulphate in combination with calf tissue flaps. For the 11 cases with chronic and hypotoxicity osteomyelitis, calf tissue flaps combined with antibiotics-blended artificial bone of calcium sulphate were applied to fill the cavity and cover the wound in phase I surgical reconstruction after thorough debridement. For the 7 cases with large bone defects or larger cavities after debridement, a mixed bone grafts of antibiotics-loaded artificial bone of calcium sulphate and autologous iliac bone were employed, with muscle flaps or myocutaneous flaps for an embedding repair. Sizes of the tissue flaps were 2.0 cm×3.5 cm to 12.0 cm×23.0 cm. Clinical outcomes were evaluated through follow-ups at outpatient clinic. The therapeutic effect was evaluated by the method described by McKee et al.Results:Except for 1 case of distal necrosis of tissue flap and survived after dressing change, the other tissue flap survived successfully. Postoperative follow-ups lasted for 12 to 40(mean 18) months. All the osteomyelitis were successfully cured, except 1 that had recurrence of osteomyelitis 1 year later, and treated with antibiotics-loaded artificial bone of calcium sulphate combined with autologous iliac bone implants after thorough debridement, and then healed well. The shape and texture of flaps were good. Protective sensations were restored to vary levels after 6 months. The calf regained weight-bearing and walking functions at 1 year after surgery. According to McKee et al., the therapeutic effect was evaluated: 11 cases were cured, 4 cases were improved, and 1 case relapsed, with an effective rate of 93.8%.Conclusion:Application of calf tissue flap combined with antibiotics-loaded artificial bone of calcium sulphate in the treatment of tibia osteomyelitis has a high cure rate and remarkable efficacy. It can significantly reduce the number of surgeries and shorten the course of disease.

Application of "ABC" three line perforator locating method for free anterolateral perforator flap of calf / 中华显微外科杂志

Objective:To explore the feasibility of an "ABC" three line perforator locating method in design and harvest of free anterolateral perforator flap of calf.Methods:Between March 2021 and November 2021, 42 patients with 62 wounds on hand and foot were treated in the Department of Hand Surgery, Suzhou Ruihua Orthopaedic Hospital. The "ABC" three line perforator locating method was applied to determine the location and source of perforating branch before operation and to guide the design and harvest of flap during operation in wound reconstruction. Among the 42 patients, 24 had the injury of single digit, 7 had the injuries with 2 digits, 4 with 3 digits, 1 with 4 digits, 1 of the first web, 1 in the wrist, 2 of the great toe, 1 of second toe and 1 in dorsal foot. The sizes of soft tissue defect were 1.5 cm×2.0 cm-3.0 cm×14.0 cm. The sizes of the flaps were 2.0 cm×2.5 cm-3.5 cm×15.0 cm. All donor sites were sutured directly. In the follow-up, sensations of flaps were evaluated following the sensory function evaluation standard of British Medical Research Council(BMRC), and the recovery of the donor and recipient sites was evaluated by the flap comprehensive evaluation scale. Regular follow-up were scheduled at outpatient clinic.Results:A total of 162 perforators were located before operation. There were 95 perforating branches being explored in the operation, of which 5 patients had 1 extra perforating branch than that located before surgery. Seventy-six perforating branches were found consistent with preoperative localisation, with a coincidence rate of 84.4%(76/90). Sixty-four perforating branches were found consistent with the preoperative source with an accuracy rate of 84.2%(64/76). All the 62 flaps survived without a vascular compromise. Follow-up lasted for 6-10(mean 7.1) months. The colour and texture of the flaps were excellent. The flaps were thin and wear-resistant. The sensory function of the flaps was evaluated at S 1-S 3 by BMRC. Comprehensive evaluation scale of flap was excellent in 38 patients and good in 4 patients. Conclusion:"ABC" three line perforator locating method in design of free anterolateral calf flap is a feasible and an ideal auxiliary method in surgical practice. It combines anatomical knowledge, clinical experience and Doppler ultrasound localisation as well as accurately guides the location and source prediction of perforator before surgery.

Curative effect of wide pedicled double-vessel flap of posterolateral calf in repair of soft tissue defect in hind foot / 中华显微外科杂志

Objective:To explore the curative effect of wide pedicled with double-vessel flap of posterior lateral calf in repair of soft tissue defect in hind foot.Methods:From January 2018 to June 2021, 12 patients with soft tissue defects on hind foot were reconstructed with double-vessel flaps pedicled perforator of peroneal artery and sural nerve nutrient vessels in the Department of Trauma Orthopaedics, No.940 Hospital of Chinese People's Liberation Army Joint Service Support Force. The patients were 8 males and 4 females, aged 9-45(27.17±12.14) years old. Time after injury to admission was 6-24(10.17±4.80) hours. Six patients were with simple soft tissue defects, 2 with tendon defects, 3 with bone defects and 1 with postoperative infection due to an open fracture. The sizes of soft tissue defect ranged from 4 cm×5 cm-8 cm×12 cm. Soft tissue defects were reconstructed by transfer of posterolateral calf flaps, and the bone defects were repaired by phase I or phase II bone grafts or antibiotic cement and membrane induction according to the wound surface. For larger bone defects, stage-II bone transport was carried out to restore the length of the hind foot. Defects of Achilles tendon were reconstructed by direct suture or tendon transposition. Foot functions were evaluated by American Orthopaedic Foot and Ankle Surgery(AOFAS) ankle-posterior sufficient scale, visual analogue scale(VSA) score and flap healing. All patients were included in postoperative follow-up regularly through outpatient clinic or via WeChat.Results:All 12 patients had postoperative follow-up that lasted for 6-24(12.92±6.22) months. One flap developed dark purple colour with swelling at the distal end of the flap 3 days after surgery. It eventually healed after removed some sutures from the pedicle together with blood-letting on the flap surface. Three flaps developed local infection, and they were cured after debridement, dressing change and the use of sensitive antibiotics. The remaining 8 patients had achieved good appearance of flaps and normal ankle function. According to AOFAS, scores of ankle-posterior sufficiency scale increased from 14-45(25.25±5.42) before surgery up to 65-96(75.92±7.73) at the final follow-up. Of the 12 patients, 8 were in excellent, 2 in good and 2 in fair. The VAS scores decreased from 5-8(6.55±1.13) before surgery down to 0-4(1.55±1.37) at the final follow-up. The difference had statistics significance( P<0.01). All patients had satisfactory recovery of ankle function, with the extension at 15-20 degrees and plantar flexion of 30-40 degrees. The donor site healed well and all skin grafts survived. Conclusion:The double-vessel flap pedicled with perforating branch of peroneal artery and nutrient vessels of sural nerve can be used for reconstruction of soft tissue defect of hind foot. It achieved good surgical effects with reliable blood supply, smooth venous return, strong anti-infection ability, satisfactory appearance at donor site and flap itself, as well as a good recovery of foot function.

Combined effects of low calf circumference and vitamin D deficiency on all-cause mortality among community-dwelling older adults / 中华老年医学杂志

Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.

Hydrocephalus, Ankylosis and Brachygnathism in an Non-descript Indigenous Calf: A Case Report

The present finding of a case reports revealed successful management of per-vaginal delivery of an indigenous male calf with multiple congenital anomalies like hydrocephalus, ankylosis and brachygnathism.

EFFECT OF PNF STRETCHING VERSUS SELF STRAP STRETCHING ON ANKLE DORSIFLEXION RANGE OF MOTION AMONG COLLEGIATE ATHLETES WITH CALF MUSCLE TIGHTNESS.

BACKGROUND: Calf muscle tightness is a very common occurring condition in athlete. Stretching is form of physical exercise in which a specific muscle or tendon (muscle group) is deliberately flexed or stretched in order to improve the muscle's elasticity and achieve comfortable muscle tone. Flexibility helps with injury prevention, reduction of soreness following a workout, and a general sense of well-being. There are different stretching technique and protocol for improvement in calf extensibility and flexibility. The purpose of this study was to investigate the effectiveness of two techniques PNF and SELF STRAP STRETCHING for improving calf flexibility among collegiate athletes. MATERIALS AND METHOD: The selected 30 college athletes were randomly allocated to 2 groups equally. Group1 (n= 15) were given PNF and Group2 (n=15) were given self-strap stretching technique. Calf flexibility for each group was measured using goniometer and knee to wall test.Treatment was given for four days a week for 4 weeks. RESULT: The collected values were analyzed using paired 't' test and independent 't' test. The result showed an increase in the values of goniometric measurement and knee to wall test of the PNF technique (group A) compared to baseline value of self-strap stretching (group B) 16.4 and 10.88 at the end of 4 weeks. CONCLUSION: This study concluded that PNF technique is found to bemore effective in improving the calf muscle among collegiate athletes.

Thoracoumbilical flap combined with random abdominal flap in repair of large-area soft tissue defects of calf in children / 中华显微外科杂志

Objective:To investigate the clinical effect of thoracoumbilical flap combined with random abdominal flap in repair of large-area soft tissue defects of calf in children.Methods:The clinical data of 16 children with large-area soft tissue defects of calf treated with thoracoumbilical flap combined with abdominal random flap from January 2004 to December 2007 in PLA Trauma Orthopaedic Research Institute, 80th Group Military Hospital of the PLA were retrospectively analysed. There were 7 boys and 9 girls aged 8 to 14(11.3 in average) years old. Six cases were crushed by heavy objects, 6 crushed by wheels, 3 by thermal press and 1 by machine strangulation. After thorough debridement, the wound area ranged from 16.0 cm×9.0 cm to 38.0 cm×15.0 cm. Four cases were treated after 3-10 hours of injury by emergency surgery. Twelve cases received surgeries 0-11 days after hospital admission and wound being stabilised. Doppler ultrasound was used to locate the perforating vessels according to the location, size and shape of the wound. Thoracoumbilical flap combined with abdominal random flap were designed and harvested to repair the wound. The sizes of flaps were 18.0 cm×11.0 cm-40.0 cm×16.0 cm. All patients entered follow-up at the outpatient clinic or through WeChat interviews. The appearance, texture of the flap and limb recovery were checked and recorded.Results:After surgery, all of 16 flaps survived, of which 12 flaps had phase-one healing, 3 flaps had small area of necrosis at the edge, which healed after repeated dressing changes and 1 flap developed vascular comproise, and survived after surgical exploration. The donor sites healed in phase-one. All 16 children had 6 months to16 years of follow-up, with an average of 20.7 months. The colour of the flaps was normal with soft texture. The motor function of calf was satisfactory. According to Punor functional evaluation criteria, 12 cases were in excellent and 4 in good.Conclusion:The thoracoumbilical flap combined with abdominal random flap features a reasonable design, strong blood supply and repair of a large area. It is a reliable method for repairing large area soft tissue defects in the calf of children.

Repair of soft tissue defect of mid-and forefoot with anterolateral wide pedicled double dynamic flap of calf / 中华显微外科杂志

Objective:To investigate the effects of anterolateral wide pedicled double dynamic flap of the calf in repair of soft tissue defects of mid-and forefoot.Methods:From September 2015 to Septemler 2020, 15 cases with severe soft tissue defects of mid-and forefoot were repaired with the anterolateral wide pedicled double dynamic flap of the calf. There were 11 males and 4 females with an average age of 37(range, 22-53)years old. Of the 15 cases, the defects were caused by traffic accident in 6 cases and objects smash in 9 cases. Three cases were simple soft tissue defect, and 12 cases combined with fracture or dislocation and bone defect. The size of soft tissue defects ranged from 4 cm×5 cm to 7 cm×12 cm. All wounds of donor sites were repaired by skin grafting. All patients entered follow-ups at the outpatient clinic or through WeChat. The appearance of flaps and limb recovery were recorded after surgery.Results:All cases followed-up for 6-24 (mean, 16) months. Two days after surgery, 1 case had flap swelling and cyanosis, which was improved after pedicle suture removal and surface bloodletting. The pedicle of the flap was slightly bloated in 4 cases, and the texture and appearance were good in 11 cases. The ankle function of all cases recovered satisfactorily. The ranges of ankle motion were 15°-20° for dorsiflexion and 30°-40° for plantar flexion. The donor site healed well and all the skin grafts survived.Conclusion:The anterolateral wide pedicled double dynamic flap of the calf is one of the ideal flaps for repairing the soft tissue defects of the mid-and forefoot with reliable blood supply, sufficient venous return, simple operation and no require a vascular anastomosis.

Factors related to sarcopenia in hospitalized elderly patients / 中华老年医学杂志

Objective:To investigate the prevalence of sarcopenia and associated factors in hospitalized elderly patients.Methods:This was a cross-sectional study.A total of 578 patients admitted to the Geriatrics Department of our hospital were consecutively recruited according to the admission criteria.Patients were divided into the sarcopenia group(n=202, 34.95%)and non-sarcopenia group(n=376, 65.05%)based on the diagnostic criteria(2014)of the Asian Working Group for Sarcopenia.Their clinical data and laboratory parameters were collected.All patients underwent comprehensive geriatric assessment.Results:(1)The detection rate of sarcopenia in these hospitalized patients was 34.95%.(2)Age, free thyroxine(FT4), and the prevalences of diabetes and osteoporosis and the incidence of falls in the past year were higher while body mass index(BMI), calf circumference, hemoglobin(Hb), albumin(ALB), triglycerides(TG), low-density cholesterol(LDL), glycosylated hemoglobin(HbA1c)and free triiodothyronine(FT3)were lower in sarcopenia patients than in non-sarcopenia patients, with statistical significance.Scores on the mini-mental state examination(MMSE)and activities of daily living(ADL)were lower in sarcopenia patients than in non-sarcopenia patients while scores on nutritional risk screening 2002(NRS2002)and the FRAIL scale were higher, all with statistical significance.(3)Binary logistic regression analysis revealed that osteoporosis and FRAIL score were risk factors for sarcopenia( OR=9.083 and 2.505, P<0.001)and BMI, calf circumference and ADL score were protective factors for sarcopenia( OR=0.735, 0.774 and 0.967, P<0.05). (4)ROC analysis showed that the areas under the curve for FRAIL score, BMI, calf circumference and ADL score were 0.832, 0.805, 0.841 and 0.812, respectively, with threshold values at 2.5 points, 23.52 kg/m 2, 32.5 cm and 92.5 points.(5)The chi-square test for sarcopenia screening using various related factors found osteoporosis, calf circumference <32.5 cm and ADL <90 points had higher sensitivity(0.787, 0.807, 0.817)while FRAIL ≥ 3 points and BMI <23.5 had slightly lower sensitivity(0.683, 0.708), with each related factor having a high negative detection rate(0.833-0.888). Conclusions:The prevalence of sarcopenia in hospitalized elderly is more than 1/3.Osteoporosis and FRAIL score are risk factors for sarcopenia.BMI, calf circumference and ADL score are protective factors for sarcopenia.All relevant factors have practical clinical value and can be used for preliminary screening of sarcopenia.

Descriptive study of congenital anomalies encountered in ruminants in Elazig region of Turkey / Estudio descriptivo de anomalías congénitas encontradas en rumiantes en la región de Elazig en Turquía

Abstract Congenital malformations are abnormalities of structure, formation or function observable at birth that causes great economic losses in livestock industry. In this study, we describe the incidence of the main congenital anomalies encountered in the last year (June 2020-June 2021) in ruminants from Elazig region according to species, breed, age and sex, number of pregnancies, rectal examination, and method of conception employed. A total of 79 congenital anomalies encountered in 73 animals during this study were evaluated. Of 73 animals most of congenital anomalies were calves (84.93%) and males (68.49%). It was determined that the most common type of congenital anomaly in calves was hernia umbilicalis (21.51%) while in lambs and goat kids was atresia ani. Most of these anomalies were formed in the abdominal wall and organs of gastrointestinal system (46.84%). Congenital anomalies in calves and lambs were more frequently when they came from the first pregnancy of their dams, while in goat kids when their dam had the second pregnancy. Most of small ruminant that had congenital anomalies came from dams with multiple gestation. Rectal examinations performed in cattle during the early stages of gestation was probably one of a predisposing factor for the formation of congenital malformations in this specie. More studies that include the participation of diagnostic laboratories are needed to improve the characterization of congenital anomalies that contribute to the implementation of preventive and control measures in the herds of these species in our region.

Resumen Las malformaciones congénitas son anomalías de estructura, formación o función observables al nacer que provocan grandes pérdidas económicas en la industria ganadera.. En este estudio, se investigó la incidencia de las principales anomalías congénitas encontradas en el último año (junio de 2020-junio de 2021) en rumiantes en la región de Elazig. según especie, raza, edad, sexo, número de preñeces, examen rectal y método de concepción empleado . Se evaluaron un total de 79 anomalías congénitas encontradas en 73 animales . De 73 animales con anomalías congénitas, la mayoría eran terneros (84, 93%) y machos (68,49%). Se determinó que el tipo de anomalía más común en los terneros fue la hernia umbilical (21,51%) mientras que en corderos y cabritos fue la atresia anal. La mayoría de estas anomalías se formaban principalmente en los órganos de la pared abdominal y órganos del sistema gastrointestinal (46,84%). . Las anomalías congénitas en terneros y corderos eran más frecuentes cuando provenían de las madres de primera preñez , mientras que en los cabritos cuando las madres tenían su segunda preñez La mayoría de los rumiantes menores con anormalidades congénitas provenían de madres con gestaciones múltiples. El examen rectal realizado en las vacas durante los primeros estadios de la gestación, fue probablemente uno de los factores predisponentes para la formación de malformaciones congénitas en esta especie. Se requieren más estudios que incluyan la participación de laboratorios de diagnóstico para mejorar la caracterización de las anormalidades congénitas y contribuir a la implementación de medidas de prevención y control en los rodeos de estas especies en nuestra región.

Repair of complex soft tissue defect in calf by ALTF with a cross-limb bridged "Y" shape vascular anastomosis: a report of 33 cases / 中华显微外科杂志

Objective:To explore the clinical effect of ALTF transfer with cross-limb bridged "Y" shape vascular anastomosis in repair of complex soft tissue defects in calf.Methods:From August 2010 to September 2020, 33 patients(23 males and 10 females) with complex traumatic soft tissue defects in calf were treated. Preoperative angiography and intraoperative exploration confirmed that there was only 1 main vessel remained in the affected calf or the wound surface and the vessel could not be anastomosed with the vascular pedicle of the ALTF. The size of flap were 16 cm × 8 cm to 25 cm × 18 cm. Two patients received bilobed ALTFs. A "Y" shape anastomosis between the artery of ALTF vascular pedicle and the posterior tibial artery of the contralateral lower limbs was made in all 33 patients to establish the blood supply to the transferred free ALTF. The "Y" shape cross-limb bridged blood vessels at the proximal end of the vascular pedicle artery of the flap were embedded at both ends of the cut-off superior ankle posterior tibial artery of the contralateral lower limb. The vein of the flap was anastomosed with the saphenous vein that associates with the posterior tibial artery. The surface of the suspended blood vessel "bridge" was wrapped with a free skin craft, and the lower limbs were fixed in a straight and parallel position with an external fixation frame. The perfused area of the flap was directly sutured or covered with a free skin craft. The vascular bridge was kept for 3 to 6 weeks before being separated. Outpatient follow-up after discharge.Results:All the patients were entered the postoperative follow-up was 13 months to 7 years, in an average of 25 months. Among the 33 flaps, 31 survived completely, except 1 had necrosis and the other 1 had partial necrosis at the distal end of the flap. The flaps received good blood supply, hence with soft texture and satisfactory appearance. Doppler or DSA was performed after the surgery on the posterior tibial artery of the healthy limb, and the vascular pulsation and patency were found normal. Donor sites for the free skin graft healed well.Conclusion:The ALTF transfer with cross-limb bridged "Y" vascular anastomosis is one of the effective techniques and it was employed in the repair of complex defects of calf soft tissue. It solved the tissue that there was only 1 main vessel or even without a suitable vessel could be anastomosed with the pedicle of the flap.

Morbidity and mortality in Holstein calves from birth to 145 days of age on a large dairy farm in Brazil / Morbidade e mortalidade em bezerras da raça Holandesa do nascimento aos 145 dias de vida, em uma grande fazenda produtora de leite no Brasil

The present study aimed to investigate the morbidity and mortality associated with the most common diseases during the rearing period of Holstein calves in a high-production dairy farm. The calves (n = 600) were allocated to three groups based on age: G1 (1-7 days, n = 216), G2 (30-40 days, n = 188), and G3 (69-85 days, n = 196). They were evaluated over 60 days at eight different times. The morbidity rates were 47.67% (286/600) for diarrhea, 73.00% (438/600) for bovine respiratory disease (BRD), and 3.83% (23/600) for umbilical inflammation (UI). The mortality rate was 2.33% (14/600) for all the animals studied. The morbidity differed in the groups, with higher rates of diarrhea (78.85%, 166/216) and UI (6.94%, 15/216) in G1, and the highest rate of BRD in G3 (79.59%, 156/196). Diarrhea was associated with the occurrence of BRD in G1 and G2. Even in farms with good management practices, there is high morbidity associated with diarrhea and BRD, with the morbidity rate for diarrhea decreasing and that for BRD increasing as the animals get older. In addition, diarrhea is an important risk factor for BRD, especially in younger animals.(AU)

O presente estudo objetivou investigar a morbidade e a mortalidade associadas às doenças mais comuns no período de criação de bezerras da raça Holandesa, em uma fazenda leiteira de alta produção. As bezerras (n = 600) foram alocadas em três grupos de acordo com a idade: G1 (1-7 dias, n = 216); G2 (30-40 dias, n = 188); G3 (69-85 dias, n = 196). Os animais foram avaliados durante 60 dias, em oito momentos diferentes. A morbidade foi de 47,67% (286/600) para diarreia, 73,00% (438/600) para doença respiratória bovina (DRB) e 3,83% (23/600) para inflamação umbilical (IU). A taxa de mortalidade foi de 2,33% (14/600), para o total de animais avaliados. A morbidade foi diferente entre os grupos, com maior frequência de diarreia (78,85%, 166/216) e IU (6,94%, 15/216) no G1, sendo a maior ocorrência de DRB no G3 (79,59%, 156/196). A diarreia foi associada à DRB no G1 e no G2. Mesmo em fazendas com boas práticas de manejo, há alta morbidade por diarreia e DRB, com a taxa de morbidade por diarreia diminuindo e a de DRB aumentando à medida que os animais envelhecem. Além disso, a diarreia é um importante fator de risco para DRB, especialmente em animais mais jovens.(AU)

Comportamiento diurno de cetáceos en el Área de Conservación Guanacaste, Costa Rica

Introducción: Tres especies de cetáceos, el delfín manchado pantropical (Stenella attenuata attenuata), el delfín nariz de botella (Tursiops truncatus) y la ballena jorobada (Megaptera novaeangliae) son un componente importante de la fauna marina del Área de Conservación Guanacaste. Sin embargo, la información biológica básica sobre el comportamiento y la presencia de estas especies sigue siendo escasa. Objetivo: El objetivo de este estudio es determinar el comportamiento diurno de los cetáceos en el sector marino de la ACG y en sus áreas adyacentes. Métodos: Se muestreó el Pacífico norte de Costa Rica desde Bahía Salinas hasta las Islas Murciélago, incluyendo el Golfo de Santa Elena, entre mayo de 2005 y mayo de 2006. Se utilizó el método de escaneo de comportamiento para identificar el comportamiento general de los grupos. Resultados: Se registraron encuentros para tres especies en un total de 36 avistamientos, pero solo con un tiempo considerable para dos especies, S. attenuata y M. novaeangliae. Los delfines manchados exhibieron una amplia variedad de comportamientos en la temporada de lluvias. La búsqueda de alimento (X2 = 29.42; g.l. = 1; P < 0.001) y los viajes (X2 = 38.33; g.l. = 1; P < 0.001) aumentaron significativamente en la época de lluvias. Los comportamientos predominantes para la ballena jorobada fueron la asociación madre-cría, social y de viaje; este último fue mayor en la época de lluvias (X2 = 78.16; g.l. = 1; P < 0.001). Conclusiones: En la zona, los cetáceos presentaron comportamientos como forrajeo y madre-cría, lo que significa que el área puede clasificarse como un hábitat crítico para estas especies de cetáceos, de mayor importancia para especies altamente migratorias como las ballenas jorobadas.

Introduction: Three species of cetaceans, the pantropical spotted dolphin (Stenella attenuata attenuata), the bottlenose dolphin (Tursiops truncatus) and the humpback whale (Megaptera novaeangliae), are important components of the marine fauna of the Guanacaste Conservation Area (ACG). However, basic biological information on the behavior and occurrence of these species remains scarce. Objective: The objective of this study is to determine the diurnal behavior of the three-mentioned species in the ACG. Methods: The north Pacific of Costa Rica, from Bahía Salinas to the Marine Sector of ACG was sampled between May 2005 and May 2006. The behavior scanning method was used to identify the general behavior of the cetacean groups. Results: Encounters were recorded for the three species, in a total of 36 sightings, but only for S. attenuata and M. novaeangliae for considerable periods of time. Stenella attenuata exhibited a wide variety of behaviors, being foraging (X2 = 29.42; d.f. = 1; P < 0.001) and travelling (X2 = 38.33; d.f. = 1; P < 0.001) significantly higher during the rainy season. Predominant behaviors for the humpback whale were mother-calf association, social and travelling; being the latter higher during the rainy season (X2 = 78.16; d.f. = 1; P < 0.001). Conclusions: Behaviors such as foraging and mother-calf were the most representative among species and the most frequent. This suggests that the area can be considered as a critical habitat for these species of cetaceans, with particular importance for highly migratory species such as humpback whales.

Longitudinal Evaluation of Calf MRI in a Patient with Charcot-Marie-Tooth Disease 2E：A Case Study / The Japanese Journal of Rehabilitation Medicine

We present a case report that a longitudinal calf MR evaluation was performed for a patient with Charcot-Marie-Tooth disease who underwent bilateral reconstructive foot surgeries. A 39 years-old female was referred to our department because of severe bilateral cavus foot deformities and difficulty to walk. On radiological findings, severe bilateral cavus foot deformities were confirmed. On MR findings, fatty infiltrations were detected in the wide range of bilateral lower leg compartments. Difficulty to walk aggravated despite of the conservative treatment, so bilateral reconstructive foot surgeries were performed. She acquired plantigrade and better walking function postoperatively. Two years after surgery, no recurrence of cavus foot deformity was observed, but claw toe deformities and fatty infiltrations were mildly progressing. Since CMT is slowly progressive, we need to conduct a careful follow-up.

Progress in Anticoagulation of Calf Muscle Venous Thrombosis / 中国医学科学院学报

With the wide application of vascular Doppler ultrasound as well as the improvement of instrument precision and personnel operation practice,calf muscular venous thrombosis(CMVT)has been more and more frequently diagnosed among patients,becoming a common clinical disease.However,it is controversial about the anticoagulant therapy for CMVT patients.In this article,we summarize the current research progress of anticoagulation therapy,aiming to provide reference for the treatment of CMVT.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults / 生物医学与环境科学（英文）

Objective@#To evaluate the associations of sarcopenia, handgrip strength and calf circumference with cognitive impairment among Chinese older adults.@*Methods@#Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study. Cognitive impairment was assessed by the Chinese Mini-Mental State Examination. Handgrip strength was calculated from the means of the right and left hand values. Calf circumference was measured at the site of maximum circumference of the non-dominant leg. The formula developed by Ishii was used to define sarcopenia. Multiple logistic regression was performed to evaluate the associations of sarcopenia, handgrip strength, and calf circumference with cognitive impairment.@*Results@#The prevalence of cognitive impairment was 34.36%. The adjusted odds ratio ( @*Conclusion@#Sarcopenia, identified by low handgrip strength and low calf circumference, was positively associated with cognitive impairment.

Application of Upper Arm Circumference and Calf Circumference in Screening and Diagnosis of Sarcopenia for Old Adults in Community / 中国康复理论与实践

Objective:To explore the correlation of upper arm circumference and calf circumference with muscle mass, and the screening effect and the cut-off values for low muscle mass and sarcopenia. Methods:From March to August, 2020, a total of 831 community-dwelling old people (≥ 60 years old) were recruited by using convenience sampling. Muscle mass and other body composition indicators were tested by body composition tester. The upper arm circumference, calf circumference, grip strength and gait speed were measured at the same day. Pearson cofficient was used to analyze the correlation of upper arm circumference and calf circumference with muscle mass, and receiver operation characteristic (ROC) curve was used to analyze the diagnostic effect of upper arm circumference and calf circumference on low muscle mass and sarcopenia, and the Youden index (YI) was used to determine the cut-off values. Results:Upper arm circumference and calf circumference were positively correlated with appendicular skeletal muscle mass (ASM) and skeletal mass index (SMI) (r = 0.6 to 0.8, P < 0.001). For diagnosing low muscle mass, the areas under the ROC curve (AUC) of upper arm circumference were 0.888 for male, 0.787 for female; and that of calf circumference were 0.933 for male, 0.854 for female, respectively. The cut-off values of upper arm circumference for low muscle mass were 26 cm for both male and female; and that of calf circumference were 34 cm for male and 33 cm for female, respectively. For diagnosing sarcopenia, the AUC of upper arm circumference was 0.902 for male, 0.744 for female; and that of calf circumference was 0.923 for male, 0.832 for female, respectively. The cut-off values of upper arm circumference and calf circumference for sarcopenia were 26 cm and 33 cm for both male and female. The AUC of combined diagnosis with age, upper arm circumference, calf circumference, grip strength and gait speed for low muscle mass and sarcopenia in males and females was all greater than 0.85. Conclusion:In the community old adults, upper arm circumference and calf circumference are positively correlated with muscle mass, and both indices can be used to diagnose low muscle mass and sarcopenia. multi-indices combination can improve the diagnosis effect of upper arm circumference in females.

Longitudinal Evaluation of Calf MRI in a Patient with Charcot-Marie-Tooth Disease 2E：A Case Study / The Japanese Journal of Rehabilitation Medicine

We present a case report that a longitudinal calf MR evaluation was performed for a patient with Charcot-Marie-Tooth disease who underwent bilateral reconstructive foot surgeries. A 39 years-old female was referred to our department because of severe bilateral cavus foot deformities and difficulty to walk. On radiological findings, severe bilateral cavus foot deformities were confirmed. On MR findings, fatty infiltrations were detected in the wide range of bilateral lower leg compartments. Difficulty to walk aggravated despite of the conservative treatment, so bilateral reconstructive foot surgeries were performed. She acquired plantigrade and better walking function postoperatively. Two years after surgery, no recurrence of cavus foot deformity was observed, but claw toe deformities and fatty infiltrations were mildly progressing. Since CMT is slowly progressive, we need to conduct a careful follow-up.