[Objective]To investigate the clinical application of treating soft tissue defects of the feet、ankle and lower one third of the legs with reverse saphenous neurocutaneous concomitant vessel pedicled island flap.[Method]From March 1999 to June 2003,six cases of soft tissue defects of the feet,ankle and lower one third of the legs were treated with reverse saphenous neurocutaneous concomitant vessel pedicled island flap.The size of flaps were from 12 cm?7 cm to 5 cm?3 cm,aver aging 8 cm?5 cm.[Result]Flaps of 6 cases survived all showing good quality.After 10 months to 3 years follow-up,all of the six cases were thinked very good.[Conclusion]The reversed saphenous neurocutaneous concomitant vessel pedicled island flap treating soft tissue defects of the feet,the ankle and the lower one third of legs is easy to be performed.The flap has liable blood supply and does not sacrifice the major arteries.

Objective To observe the influence of down-regulation of HtrA1 expression by small interfering RNA on light-injured human retinal pigment epithelium (RPE) cells.Methods Cultured human RPE cells(8th-12th generations)were exposed to the blue light at the intensity of (2000 ± 500) Lux for 6 hours to establish the light injured model.Light injured cells were divided into HtrA1 siRNA group,negative control group and blank control group.HtrA1 siRNA group and negative control group were transfected with HtrA1 siRNA and control siRNA respectively.The proliferation of cells was assayed by CCK-8 method.Transwell test was used to detect the invasion ability of these three groups.Flow cytometry was used to detect the cell cycle and apoptosis.The expression of HtrA1 and vascular endothelial growth factor (VEGF)-A was detected by real time-polymerase chain reaction and Western blot respectively.Results The mRNA and protein level of HtrA1 in the light injured cells increased significantly compared to that in normal RPE cells (t=17.62,15.09;P＜0.05).Compared with negative control group and blank control group,the knockdown of HtrA1 in HtrA1 siRNA group was associated with reduced cellular proliferation (t=6.37,4.52),migration (t =9.56,12.13),apoptosis (t =23.37,29.08) and decreased mRNA (t=17.36,11.32,7.29,4.05) and protein levels (t=12.02,15.28,4.98,6.24) of HtrA1 and VEGF-A.Cells of HtrA1 siRNA group mainly remained in G0/G1 phase,the difference was statistically significant (t=6.24,4.93;P ＜0.05).Conclusion Knockdown of HtrA1 gene may reduce the proliferation,migration capability and apoptosis of light-injured RPE cells,and decrease the expression of VEGF-A.

Background Myopic maculopathy leads to visual function damage.Conventional methods for the identification of choroidal neovascularization (CNV) of myopic maculopathy are fundus fluorescine angiography (FFA) and spectral-domain OCT (SD-OCT),but FFA is an invasive process and SD-OCT is incapable to image CNV well.OCT angiography (OCTA),a novel and non-invasive vascular technique,appears to be dominant in enface imaging of CNV,however,its clinical value remains to be evaluated.Objective This study was to evaluate the application of OCTA in imaging CNV of myopic maculopathy.Methods A prospective serial cases-observational study was performed.Forty-two eyes of 40 patients of myopic maculopathy were included in Ophthalmic Center,Renmin Hospital of Wuhan University from January to October 2015,with the diopter (-10.5 ± 3.74) D.Comperehensive optical and imaginal examinations were carried out in all the eyes,including fundus photography,FFA,SD-OCT and OCTA.Ranibizumab (0.5 mg/0.05 ml) was intravitreally injected in 35 eyes of 35 patients under the informed consent and SD-OCT and OCTA were examined 1 day,1 week and subsequent each month after injection.FFA was examined 1 month after injection.The patients were followed-up for 1-6 months to evaluate the clinical values of OCTA in monitoring the CNV of myopic maculopathy.This study followed the Helsinki Declaration and was approved by the Ethics Committee of Renmin Hospital of Wuhan University.Written informed consent was obtained from each patient prior to any medical examination.Results All the affected eyes showed dye leakage in CNV lesions by FFA and high reflection signal of abnormal choroidal vascular network throughout retinal pigment epithelium by SD-OCT.Clusters of high signal CNV image was clearly visible in the lesions by OCTA,and these signals were able to be displayed on both choriocapillary layer and outer layer of retina more clearly than FFA in 31 eyes of 31 patients.In 35 eyes of 35 patients received intravitreal injection of ranibizumab,CNV images on both choriocapillary layer and outer layer of retina from OCTA shrinked 1 week after injection and the lesions were stable 1 month after injection.Conclusions OCTA can display CNV of myopic maculopathy on the retinal outer layer and choriocapillary layer more clearly than FFA.Significant changes in the CNV net can be observed by OCTA 1 week after intravitreal injection of ranibizumab.OCTA plays an important role during the following-up of CNV therapy.

Objective To investigate the influence of sulfated propylene glycol alginate(PSS) and its fractions on the immunoregulation.Methods The immunoregulation activity of PSS and its fractions were investigated by using immunocyte cultivation technique in vitro.The structure activity relationship was analysed on the basis of the structure studies of PSS' fractions.Results The experimental results showed that PSS could improve spleen cell proliferation,enhance macrophage phagocytic function and inhibit T-cell and B-cell proliferation.Conclusion PSS possessed significant immunoregulation effect,whilst the immunocompetence comparison of PSS' fractions proved that the different immunocytes had different requirements for saccharides length.

Objective To observe the characteristics of optical coherence tomography (OCT) angiography (OCTA) in retinal vein occlusion (RVO).Methods Prospective and observational study.Clinical examination of 81 consecutive patients (86 eyes) diagnosed with RVO were included in the study,in which the branch retinal vein occlusion in 47 eyes,central retinal vein occlusion in 39 eyes.Forty-five patients were male and 36 patients were female.Aged from 28 to 76 years old,the mean age was (55.36±10.01) years old.Comprehensive optical and imaging examination were performed,including fundus photography,fundus fluorescein angiography (FFA),spectral domain OCT,en face OCT and OCTA.The retinal blood flow imaging scan mode and the optic disc blood flow imaging scan mode were performed,the scanning region in the macular area were 3 mm × 3 mm,6 mm × 6 mm,8 mm × 8 mm respectively,around the optic disc were 3 mm × 3 mm and 4.5 mm × 4.5 mm.Each region scans 2 times.The characteristics of foveal avascular zone change,macular edema,non-perfusion and optical disc edema in OCTA and their corresponding FFA and en face OCT were observed.Results By OCTA,67 eyes (77.9％) for foveal avascular zone change,23 eyes (26.7％) for macular edema,40 eyes (46.5％) for non-perfusion,and 33 eyes (38.4％) for optical disc edema can be detected.The foveal avascular zone change can be indentified as the tranformation,destruction and even vanish of the arch in superfacial layer of retinal macular area,acompanied with the dilatation and thickening of capillary vessels,the occlusion and expanding of capillary vessels arounded the foveal avascular zone in the deep layer of macular area.Those performances were more clear than FFA.The main expression of macular edema was low signal and was not as clear as en face OCT.The tortuosity and expansion of retinal vessels,density decreasing and even occlusion or abnormal traffic branch of capillary vessels can be observed in non-perfusion.These observations were similar to FFA.However,pieces of highly signal identical with non-perfusion area can b.e detected in chroid capillary.The representation of optical disc edema was the brush-like expanding of capillary vessels aroud optical disc.Conclusions OCTA can help for observing the abnormal changing of capillary vessels in foveal avascular zone and macular edema,non-perfusion and optical disc edema.Foveal avascular zone change showed occlusion and expanding of capillary vessels around the foveal avascular zone in the deep layer of macular area.Macular edema showed the weak signal.Non-perfusion showed tortuosity and expansion of retinal vessels,density decreasing and even occlusion or abnormal traffic branch of capillary vessels.Optical disc edema showed brush-like expanding of capillary vessels around optical disc.

Objective To optimize the manufacture process for Zhibai Anshen oral liquid. Methods The orthogonal designed experiments were conducted to monitor the effects of three factors on the content of mangiferin. The three factors included the amount of water, extraction time and alcohol precipitation concentration. Six month accelerated stability study and twelve month long term stability study were performed. Results Optimum percolation process was boiling the mixture with 10 times of water for 1 hour, followed by deposition with 60% alcohol. Conclusion This optimized process can be used for mass production.

Objective To investigate the positive rate of heparin/platelet factor 4 (H/PF4) antibody in maintenance hemodialysis (MHD) patients, and to explore its clinical significance. Methods Fifty-four MHD patients treated in the Department of Nephrology of Changzheng Hospital of Naval Medical University (Second Military Medical University) were selected. The dialysis duration (unfractionated heparin/low-molecular-weight heparin) of all patients was more than 3 months, with no infections or other active diseases. Serum samples were collected from the MHD patients before dialysis, and IgG H/PF4 antibody was detected by particle immunofiltration assay. The general condition, hemoglobin level, platelet count, anticoagulant method (unfractionated heparin/low-molecular-weight heparin), anticoagulant dosage, and dialysis mode (conventional hemodialysis/nocturnal extended hemodialysis) were compared between the H/PF4 antibody-positive group and H/PF4 antibody-negative group. After 3 years' follow-up, the change of platelets, the incidence of vascular access thrombosis, cardio-cerebral vascular events, hospitalization rates and mortality were compared between the two groups. Results The positive rate of H/PF4 antibody was 63.0% (34/54) in MHD patients. There were no significant differences in gender, age, dialysis age, hemoglobin level or platelet count between the H/PF4 antibody-positive group and H/PF4 antibody-negative group (P0.05). The positive H/PF4 antibody was not correlated with primary kidney disease, anticoagulant method, anticoagulant dosage, or dialysis mode (all P0.05). After 3 years' follow-up, there were no significant differences in the change of platelet, the incidence of vascular access thrombosis (14.7%5/34vs 25.0%5/20), cardiovascular events, cerebrovascular events, hospitalization rates, or mortality between the two groups (all P0.05). Conclusion The positive rate of H/PF4 antibody is high in MHD patients. The production of H/PF4 antibody is not related to the heparin type, heparin dosage, or dialysis mode. The positive H/PF4 antibody has no significant effect on platelet counts or adverse events, including thrombosis and cardiovascular events.

Objective To discuss the value of pulmonary ventilation score in evaluating the extravascular lung water (EVLW) of patients with acute respiratory distress syndrome (ARDS). Methods We retrospectively collected the clinical data of 32 patients with ARDS, who were treated in the Department of Critical Care Medicine of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine from Jun. 2015 to Feb. 2017 and improved within 7 days. The total pulmonary ventilation score, extravascular lung water index (EVLWI), oxygenation index (PaO2/FiO2), and central venous pressure (CVP) of patients at admission and after treatment for 7 d were recorded. The correlations between total pulmonary ventilation score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, EVLWI, oxygenation index and CVP were analyzed. Results The APACHE Ⅱ score, total pulmonary ventilation score and EVLWI of the ARDS patients after treatment for 7 d were significantly decreased compared with those at admission, and the oxygenation index was significantly increased (all P0.01). The pulmonary ventilation score was positively correlated with the APACHE Ⅱ score, EVLWI and CVP (r＝0.95, 0.95, 0.64; all P0.01), and was negatively correlated with the oxygenation index (r＝－0.94, P0.01). Conclusion Pulmonary ventilation score can effectively evaluate the EVLW of patients with ARDS, and can be used as an effective supplement for EVLW monitoring in patients with ARDS in addition to pulse indicator continous cadiac output.

Objective To explore the therapeutic effects of Baizhu Huanglian Decoction on rats with ulcerative colitis (UC) induced by trinitrobenzene sulfonic acid (TNBS). Methods SD rats were used to make rat UC model by TNBS enema. A total of 74 rats were divided into 6 groups with half of each group being male. Model group had 14 rats, and Baizhu Huanglian Decoction low-, middle- and high-dose groups, control group and sulfasalazine group had 12 rats in each group. One rat in the model group and one in the sulfasalazine group were dead on the 2nd day of modeling. After modeling, the rats of Baizhu Huanglian Decoction low-, middle- and high-dose group were intragastrically given (2 times a day, each time with 2 mL) Baizhu Huanglian Decoction of 6.895, 13.790 and 27.580 g/kg, respectively. Sulfasalazine group was given sulfasalazine suspension by gavage 0.2 g/kg (2 times a day, each time with 2 mL) and model group was given the same amount of normal saline after modeling. Normal control group was always given normal saline. After 10 days of continuous administration, the body mass and fecal characteristics of the rats were observed. At the end of the administration, the colonic pathological changes of colon and the length of colorectal were measured. The colon pathology and colon mucosal injury index (CMDI) score were evaluated. The levels of nitric oxide (NO), inducible nitric oxide synthase (iNOS), myeloperoxidase (MPO) and interleukin-6 (IL-6) were measured by ELISA. Results Compared with the model group, the body mass of the rats were significantly increased on the 4th-10th day after administration in the Baizhu Huanliang Decoction low-, middle- and high-dose groups and sulfasalazine group (all P0.05), which had no significant difference versus normal control group. Fecal characteristic scores of the Baizhu Huanglian Decoction high-dose groups and the sulfasalazine group were lower than those of the model group and the Baizhu Huanglian Decoction middle- and low-dose groups, but the differences were not statistically significant. Compared with the model group, the colorectal lengths of the rats were significantly longer in Baizhu Huanglian Decoction middle- and high-dose groups and sulfasalzine group (all P0.05). The colon pathology scores were significantly lower in the Baizhu Huanglian Decoction low-, middle- and high-dose group, and sulfasalazine group versus the model group (all P0.05). CMDI scores of Baizhu Huanglian Decoction high-dose group and sulfasalazine group were significantly lower than those of the model group (both P0.05). The levels of NO, iNOS, MPO and IL-6 of the rat colonic tissues were significantly lower in Baizhu Huanliang Decoction low-, middle- and high-dose groups, and sulfasalazine group than those in the model group (all P0.05). Conclusion Baizhu Huanglian Decoction can improve the general condition and colonic lesions of rats with UC, decreasing the levels of NO, iNOS, MPO and IL-6 and reducing the inflammation.

Cellular senescence is a state of permanent growth arrest characterized by an irreversible exit from the cell cycle and the secretion of senescence-associated secretory phenotype (SASP). The secretory process of SASP can be roughly divided into three steps: DNA damage response (DDR)-rapid paracrine, early and mature stages. The complex molecular regulation mechanisms of SASP involve DDR, p38 mitogen-activated protein kinase (MAPK) signal pathway, activation of nuclear factor κB (NF-κB) and CCAAT/enhancer-binding protein β (C/EBPβ), epigenetic alterations of SASP gene, posttranscriptional regulation of gene and autophagy. SASP regulates a variety of pathological states caused by microenvironment changes and has been a drug target to regulate the aging effect, which providing a new therapeutic method for tumor and agerelated pathological states. In this paper, we classified the different types of SASP, reviewed the role of SASP in biological processes and discussed the related molecular mechanisms.