Objective: To investigate the clinical effects of perforating branch flaps of medial vastus muscle in repairing secondary wounds in donor sites of free anterolateral femoral perforator flaps. Methods: From August 2014 to December 2016, 12 patients (8 males and 4 females, aged 35-72 years) with skin and soft tissue defects of extremities associated with tendon and bone exposure were treated in Hanzhong Central Hospital. The sizes of the primary wounds after debridement were 10 cm×8 cm-22 cm×14 cm, and the wounds were repaired with 12 cm×10 cm-24 cm×16 cm free anterolateral femoral perforator flaps. The anterolateral femoral donor sites, which were 8.0 cm×4.0 cm-14.0 cm×7.5 cm in the secondary wounds after skin extensional suture, were repaired with perforating branch flaps of medial vastus muscle in the size of 9.0 cm×5.0 cm-15.0 cm×8.5 cm. The medial femoral donor sites were sutured directly. Results: All the perforating branch flaps of medial vastus muscle and free anterolateral femoral perforator flaps survived in 12 patients. Following up for 6 to 12 months, the medial femoral perforator flaps had good local shape and texture. The flaps of 8 patients without cutaneous nerve transection were sensitive. The sensation of the flaps of the other 4 patients gradually recovered, and the functions of the ipsilateral knee joints were normal. Conclusions The medial femoral perforator flap has a stable anatomy and abundant blood supply, which can be used to repair the secondary wound in the donor site of the free anterolateral femoral perforator flap conveniently. It is safe and easy to be popularized. Moreover, it has a good shape and function after operation.

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.

Objective To investigate the clinical efficacy of lengthened proximal femoral nail antirotation (PFNA) and Gamma nail treatment of proximal femoral fractures (including the intertrochanteric and inferior intertrochanteric area) combined with ipsilateral femoral shaft fractures.Methods A retrospective case control study was made on 68 cases of proximal femoral fractures combined with ipsilateral femoral shaft fractures received from January 2013 to October 2014.According to the operation mode,the patients were assigned to PFNA group (30 cases) and Gamma nail group (38 cases).Between-group differences were compared in aspects of surgical condition,treatment effect,Visual Analogue Scale (VAS),postoperative hip function (Harris score) and living ability (Barthel index).Postoperative complications were recorded as well.Results Duration of follow-up was 12-24 months [(20.8 ± 1.9) months].Incision length in PFNA group was (5.4 ± 1.2) cm versus (7.3 ±1.7) cm in Gamma nail group (P ＜ 0.01).Operative time in PFNA group was (96.8 ± 24.7) min versus (153.5 ±30.4)min in Gamma nail group (P ＜0.01).Blood loss in PFNA group was (151.5 ±16.8) ml versus (184.7 ± 22.7) ml in Gamma nail group (P ＜ 0.01).Healing time of proximal femur fractures and femoral shaft fractures in PFNA group [(16.1 ± 2.5) weeks,(19.5 ± 3.4) weeks] were significantly less than that in Gamma nail group [(18.9 ± 2.6) weeks,(22.6 ± 2.6) weeks] (P ＜0.01).VAS was (3.4 ±0.5) points in PFNA group versus (6.2± 1.3) points in Gamma nail group (P ＜ 0.01).At postoperative 2 weeks,6 months and 12 months,Harris score in PFNA group [(62.4 ±4.9),(73.7 ± 6.3),(86.4 ± 3.7) points] were significantly higher than that in Gamma nail group [(50.1 ± 4.7),(65.5 ± 6.1),(81.0 ± 3.5) points] (P ＜ 0.01).At postoperative 6 months and 12 months,Barthel index in PFNA group (76.4 ± 6.3,88.1 ± 7.0) were significantly higher than that in Gamma group (70.4 ±5.4,81.3 ±6.9) (P ＜0.01).No implant failure,screw cut-out,coxa vara or fracture displacement occurred.One patient (3％) in Gamma nail group had surgical wound infection compared to PFNA group (P ＞ 0.05).Conclusion In treatment of proximal femoral fractures combined with ipsilateral femoral shaft fractures,the lengthened PFNA fixation has advantages over Gamma nail in terms of minor trauma,rapid postoperative recovery and significant effect.

Objective To investigate the preoperative preparation for pheochromocytoma. Methods The data of 286 cases of pheochromocytoma, who were treated in our hospital from 1980 to 2002,were collected and reviewed on the preoperative preparation.Phenoxybenzamine was given to 207 cases and urapidil to 78 during preoperative period, lasting for 2～9 weeks with a mean of 6 weeks.The remaining 1 underwent emergent surgery without use of ?-adrenergic blockers.In 28% of the cases,?-adrenergic blocker was given for control of heart rate. Results In 254 cases,blood pressure remained stable at the level of 120/80 mm Hg (1 mm Hg=0.133 kPa) or so.No paroxysmal hypertension,palpitation and sweating occurred after use of ?-blockade.The heart rate remained 80～85 times/min.No arrhythmia occurred.Peri-microcirculation was obviously improved.The tumor size (range,3～12 cm in diameter;mean,5.2 cm) was not related to the function and length of preoperative use of the medications.Hypertensive crisis occurred in 32 cases 2 weeks before operation. In most cases (96%), blood pressure fluctuated (reaching up to 280/180 mm Hg) when they experienced anesthesia induction and tumor crush during operation.However,it was easy to control.Postoperative blood pressure remained stable. Conclusions The full preoperative preparation for patients with pheochromocytoma is essential for the safety and success of anesthesia and operation.

Objective:In order to investigate the influence of Herba Artiemisiae Capilloais on the UDPGT activity in rat's hepat.Methods: The UDPGT activities induced by Herba Artemisae capillaris were determined by the Black's assay.Results: Herba Artemisiae capillaris increased the activity of UDPGT in rats' hepat and also increased the ratio of liver weight/body weight. Conclusions: Herba Artemisiae capillaris was able to induce the acitvity of UDPGT in rats' hepat.

Objective To analyze the clinical characteristics and changes of serum tumor markers in lung cancer patients with different smoking status in Hanzhong area. Methods A retrospective analysis was performed on 642 hospitalized lung cancer patients in Hanzhong area from March 2017 to March 2019. According to their smoking status, they were divided into observation group (smoking history, n=404) and control group (no smoking history, n=238). Age, sex, place of residence, basic information of the disease including pathological stage, pathological type, short-term efficacy, survival and serum tumor marker level were analyzed retrospectively. Results The proportion of male in observation group (67.08%) was significantly higher(57.56%) (χ²=5.855,P<0.05). Observed a group of 50 or more patients (80.94%) were significantly higher (73.53%) (χ²=4.824 , P<0.05); There was no significant difference between the two groups (χ²=2.110 , P<0.05). The proportion of adenocarcinoma in the control group (49.16%) was the highest, and that of small cell lung cancer in the observation group (41.34%) was the highest (χ²=15.291, P <0.05). Comparison of pathological stages between the two groups showed that stage IIIB (32.77%) was the highest in the control group, followed by stage IV (23.53%), Stage IIIA (20.59%), Stage II (13.03%) and stage I (10.08%). The observation group had the highest proportion in stage IIIA (35.40%), followed by Stage IIIB (25.00%), stage IV (16.09%), Stage IIIA (16.09%), stage II (15.10%) and stage I (8.42%). The difference between the two groups was statistically significant (χ²=10.817,P<0.05). Before treatment, serum CEA, CA125 and CA199 levels in observation group were significantly higher (P<0.05). After treatment, the levels of serum tumor markers in both groups were significantly decreased (P<0.05); The serum CEA, CA125 and CA199 levels in observation group were significantly higher (P<0.05). After treatment, THE ORR of the observation group (48.76%) was lower than that of the control group (53.78%), but the difference was not statistically significant (χ²=2.051, P>0.05). The 1-year survival rate of the observation group (64.85%) was significantly lower than that of the control group (73.95%) (χ²=5.255, P<0.05). Conclusion Middle-aged and elderly male smokers in Hanzhong area have a high incidence of lung cancer, multiple stage Ⅲ squamous cell carcinoma, and the level of tumor markers in serum is higher than that of non-smokers. The prognosis is not good, so we should encourage patients to quit smoking, which can improve the survival rate of patients.

Objective To improve the experience of diagnosis and evaluate the clinical efficacy and safety of the surgical management for ureteral fibroepithelial polyp.Methods The clinical date of 29 patients with ureteral polyps admitted in Peking Union Medical College Hospital during 2001 to 2014 were analysed retrospectively.The patients' age was between 1 1 to 84 years and 19 were male.Twenty patients with frank pain and two patients with hematuria were enrolled.Seven patients were found hydronephrosis.Results Twenty-nine cases were treated surgically.Fifteen cases were treated by ureteroscopic laser ablation,10 cases local resection and reanastomosis,1 case of abnormalities duplex kidney and ureter underwent local resection and ureteroplasty,2 case Partial ureterectomy including the polyps and pyeloplasty,1 cases nephroureterectomy because of giant hydronephrosis and nonfunctional kidney.No recurrences were seen during a mean follow-up of 32 months (range 10-56 mos).No ureteral stricture occurs.Conclusions Ureteral fibroepithelial polyps represent a rare pathology.Local resection is the main treatment.Endoscopic management is recommended to minimize morbidity and complications in treatment of ureteral fibroepithelial polyps.Recurrences seem to be rare in these tumors.

Objective To investigate the effects of Urotensin Ⅱ(UⅡ)on proliferation of rat pheochromocytoma cell line(PC12) and primary cultured human pheochromocytoma cells.Methods We observed the effects of UⅡ on the proliferation of rat PC12 cells and human pheochromocytoma cells in vitro by MTT method.Results 1.UⅡ had no obvious effect on the proliferation of rat PC12 cells.2.UⅡ(at 10-7 and 10-6mol/L) promoted the proliferation of primary cultured human pheochromocytoma cells. Conclusion UⅡ stimulates the proliferation of human pheochromocytoma cells and probably plays a role in the pathogenesis of pheochromocytoma.

OBJECTIVE: To observe the expression changes of metadherin (MTDH) and matrix metalloproteinase-9 (MMP-9) in the laryngeal squamous cell carcinoma tissues and to investigate the significance. METHOD: The expression of MTDH and MMP-9 in 54 cases of laryngeal squamous cell carcinoma tissues(observation group) and 30 cases of para-carcinoma tissues (control group) was examined by immunohistochemical method, the correlation between them and their correlations with the clinicopathological parameters were analyzed. RESULT: The positive expression rates of MTDH in the observation group and control group were 64.8% (35/54) and 6.7% (2/30), respectively; the positive expression rates of MMP-9 in the observation group and control group were 70.4% (38/ 54) and 13.3% (4/30), respectively; and there was a statistically significant difference between two groups (all P < 0.01). In the laryngeal squamous cell carcinoma tissues, the expression of MTDH protein was related with degree of differentiation, lymph-node metastasis and TNM stage (all P < 0.05); and the expression of MMP-9 protein was related lymph-node metastasis and TNM stage (all P < 0.05). The expression of MTDH was positively correlated with MMP-9 in the laryngeal squamous cell carcinoma tissues (r = 0.371, P < 0.01). CONCLUSION The high expression of MTDH and MMP-9 was closely related to the occurrence, development and metastasis of laryngeal squamous cell carcinoma, joint detection of the two proteins was valuable for early diagnosis and prognosis of laryngeal squamous cell carcinoma.
Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Case-Control Studies ; Cell Adhesion Molecules ; metabolism ; Cell Differentiation ; Head and Neck Neoplasms ; diagnosis ; metabolism ; Humans ; Laryngeal Neoplasms ; diagnosis ; metabolism ; Lymphatic Metastasis ; Matrix Metalloproteinase 9 ; metabolism ; Neoplasm Staging ; Prognosis ; Squamous Cell Carcinoma of Head and Neck

OBJECTIVE：To establish a method for the content determination of diosgenin in Dioscorea zingiberensis，and to compare the contents of diosgenin in wild D. zingiberensis from different habitats. METHODS：HPLC method was adopted. The determination was performed on Inertsil ODS-3 column with mobile phase consisted of acetonitrile-water （50 ∶ 50，V/V） at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃. The detection wavelength was set at 203 nm，and sample size was 10 μL. Established method was used to determine the contents of diosgenin in wild D. zingiberensis from different habitats （Shaanxi Shangluo，Shaanxi Ankang，Henan Neixiang，Yunnan Xuanwei，Sichuan Deyang，Hubei Shiyan，Hunan Zhangjiajie，Hunan Changde）. The differences of diosgenin content were compared. RESULTS：The linear range of diosgenin were 4.16-165.6 μg/mL （r＝     0.999 9）. RSDs of precision，reproducible and stability tests were all lower than 2％ （n＝5 or n＝6）. The average recovery of diosgenin was 101.18％ （RSD＝1.27％，n＝6）. The content of diosgenin in wild D. zingiberensis from different habitats were in descending order，i.e. Sichuan Deyang （1 405.36 μg/g）＞Shaanxi Shangluo （1 201.79 μg/g）＞Hunan Zhangjiajie （1 035.18 μg/g）＞Shaanxi Ankang （632.64 μg/g）＞Hunan Changde （598.64 μg/g）＞Yunnan Xuanwei （425.34 μg/g）＞Henan Neixiang （350.13         μg/g）＞Hubei Shiyan （338.39 μg/g）. CONCLUSIONS：Established method is simple，accurate and suitable for the content determination of diosgenin in D. zingiberensis. The contents of diosgenin in wild D. zingiberensis from different habitats are different significantly，and the content of diosgenin in the samples from Sichuan Deyang is the highest.