Islet transplantation is an effective method treating insulin-dependent diabetes mellitus, which is apt to supersede pancreas transplantation currently. Although human islet transplantation has already performed successfully, its long-term effect is still unsatisfying. Reasons causing loss of islet function is still not fully understood to date. Thus, deep research of factors influencing transplanted islet survival is of importance to improve long-term effect of islet transplantation. Patient selection and tissue matching, collection, preservation and transport of pancreatic organ, isolation and purification of islet cells, implement of islet transplantation, blood glucose control and immunosuppressive drug application during islet transplantation period, functional assessment after islet transplantation, etc. completion quality of each of these technical links is the factor influencing islet transplantation.

BACKGROUND: The complex prescription of lujiao prescription is made up of antle, malytea scurfpea fruit, korean epimedium herb, dogwood, glossy privet fruit, and Chinese eaglewood wood. It is characterized by its positive myodynamia as well as promoting diuresis and expanding vessels. OBJECTIVE: To observe the effect of lujiao prescription in reversing left ventricular remodeling in rats with pressure overload. DESIGN: A randomized controlled trial. SETTING: Department of Integrated Traditional Chinese Medicine and Western Medicine, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA; Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Postdoctor Institute of Hebei Medical University.MATERIALS: The experiment was conducted at the Laboratory of Shanghai University of Traditional Chinese Medicine from January to December 1998. Totally 153 male Wistar rats were provided by the Experimental Animal Center of Shanghai Medical College. There were five experiments with 36 rats selected for each experiment except 9 rats for the fourth one.METHODS: Totally 36 Wistar male rats selected for each experiment were randomly divided into sham operation group, model group and lujiao prescription group. Sham-operation group: The rats' abdominal aortas were separated, but not narrowed by silver clip. After four weeks, the rats were treated with twice-distilled water (15 mL/mg, ig), once a day for 4 consec utive weeks. Model group: Four weeks after modeling, the rats were treated with twice-distilled water (15 mL/mg, ig) once a day for 4 consecutive weeks. Lujiao prescription group: Four weeks after rat modeling, the ratswere given orally liquid decoction of lujiao prescription (15 mL/mg, ig),once a day for 4 weeks. Observations on left ventricular mass index (LVMI): Collagen type Ⅰ and Ⅲ was measured by immunohistochemistry. mRNA expression of collagen type Ⅰ and Ⅲ was measured by RT-PCR. Ang Ⅱ, ANF and ALD were measured by radioimmunoassay. MAIN OUTCOME MEASURES: LVMI, left ventricular myocardium collagen type Ⅰ and Ⅲ, mRNA expression of collagen type Ⅰ and Ⅲ, and changes of plasm, myocardium Ang Ⅱ, plasm ANF and serum aldosterone.RESULTS: Totally 153 rats entered the final analysis. During the detection of mRNA expression of collagen type Ⅰ , 3 rats in sham-operation group died and 1 in lujiao prescription group died. The other 29 rats en tered the final analysis. During the detection of mRNA expression of collagen type Ⅲ, 3 rats in sham-operation group died, 3 in lujiao prescription group died, and 6 in model group died. The other 26 rats entered the final analysis. All rats were lost because of operation injury. ① LVMI: It was lower in sham-operation group and lujiao prescription group than in model group [(2.24±0.12)/1 000, (2.60±0.44) /1 000, (3.15±0.47)/1 000,t=2.959-6.499, P < 0.05]. ② Changes of absorbency of collagen type Ⅰ :It was lower in sham-operation group and lujiao prescription group than in model group [(0.56±0.23, 0.57±0.19, 2.79±2.00), t=0.661-3.964,P < 0.01]. ③ Changes of absorbency of collagen type Ⅲ: It was lower insham-operation group and lujiao prescription group than in model group [(0.48±0.10,0.55±0.09,0.84±0.27), t=2.898-3.560, P < 0.01]. ④ mRNA expression of collagen type Ⅰ: It was lower in sham-operation group and lujiao prescription group than in model group [58.0±36.0)%, (79.1±18.6)%,(139.0±29.2)%, t=3.027, P < 0.05]. ⑤ Changes of myocardium Aug Ⅱ: It was lower in sham-operation group and lujiao prescription group than in model group [(2.49±0.57, 2.64±0.57,3.96±0.77) pg/mL, t=4.773-5.315,P < 0.001]. ⑥ Changes of serum aldosterone: It was lower in sham-operation group and lujiao prescription group than in model group [(501.6±94.6,476.6±85.7, 647.8±72.2) ng/mL, t=4.256-5.292, P < 0.001].CONCLUSION: Indexes of integrating absorbency of myocardial collagen type Ⅰ and type Ⅲ, mRNA expression of collagen type Ⅰ , myocardial Aug Ⅱ and serum aldosterone are all similar to the changes LVMI. Lujiao prescription can reverse left ventricular remodeling and myocardial fibrosis.

Objective:To investigate the clinical effect of free superficial circumflex iliac artery flap combined with anterolateral thigh flap in repairing large skin defect of the hand.Methods:A retrospective case series study was conducted to analyze the clinical data of 9 patients with large skin defect of the hand admitted to Ningbo No.6 Hospital from January 2016 to December 2019，including 7 males and 2 females，aged 31-63 years［（45.3±5.6）years］. The area of skin defect reanged from 20 cm×15 cm to 25 cm×20 cm. One side of the superficial circumflex iliac artery flap and the contralateral anterolateral thigh flap were used for repair. Both recipient and donor sites were sutured at the first stage. The ilioinguinal region and thigh donor region were sutured directly. The area of superficial circumflex iliac artery flap was from 19 cm×6 cm to 23 cm ×10 cm and that of anterolateral thigh flap was 19 cm×9 cm to 23 cm×8 cm. The flap survival，healing of donor and recipient area and complications were observed. At 1，6 and 12 months after operation，the function of the flap was evaluated by the late functional evaluation criteria of the flap，hand function by the upper limb functional evaluation criteria of the Chinese Medical Association，and scar condition of the donor site by Vancouver Scar Scale（VVS）. At the last follow-up，the color，elasticity，appearance and scar of the donor site were observed.Results:All patients were followed up for 6-18 months［（12.5±2.3）months］. All flaps survived successfully. All patients achieved donor-site healing at the first stage，except that one patient experienced incision dehiscence in the thigh donor site after operation and healed after the second stage suture. The texture and appearance of the flaps were good. The flap in 5 patients was obviously bloated. Therefore，the secondary skin flap repair was selected，and the appearance was significantly improved after operation. Scores for function of the flap and the hand were improved over time（ P<0.05）. At 12 months after operation，the function of the flap was excellent in 3 patients，good in 4 and fair in 2，with the excellent and good rate of 78%；the result of hand function was excellent in 3 patients，good in 3 and fair in 3，with the excellent and good rate of 67%. The VVS score of the donor site decreased from（9.7±1.3）points at postoperative 1 month to（5.7±0.9）points at postoperative 6 months and（3.4±0.8）points at postoperative 12 months（ P<0.05）. At the latest follow-up，the color and elasticity of the flap was similar to that of the surrounding skin tissue，only with slight bloating；the scar of the donor site was small. Conclusions:The free superficial circumflex iliac artery flap combined with anterolateral thigh flap can cover large skin defect of the hand at one time，with good appearance and texture of the flap. The appearance and function of the wounded hand are good after operation，leaving only linear scar in the donor site.