Effects of six kinds of Chinese herb extracts, including Folium Crataegi extract, Herba Epimedii extract, Folium Acanthopanacis Senticosi extract, Trifolium pratense L. extract, Folium Ginkgo extract and Radix Puerariae extract, on the activities of CYP450 isozymes (CYP1A2, CYP2C, CYP2E1, CYP2D, CYP3A) in rat hepatic microsomals were studied by using a UPLC-MS/MS (MRM) and cocktail probe substrates method. The results showed that effects of six kinds of Chinese herb extracts on each CYP450 isozyme activity were inhibitory. The IC50 of Folium Crataegi extract for the inhibition of rat microsomal CYP2D activity was only for 4.04 microg x mL(-1), which showed the highest inhibition; Trifolium pratense L. extract had strong inhibitory action to CYP2D, the IC50 value was 5.73 microg x mL(-1); Folium Crataegi extract also had strong inhibitory action on CYP2E1, the IC50 value was 10.91 microg x mL(-1). Furthermore, the IC50 of Folium Ginkgo extract for the inhibition of rat microsomal CYP3A, 2D, 2E1 activities were 45.12, 35.45 and 22.41 microg x mL(-1), respectively, and the IC50 of Folium Acanthopanacis Senticosi extract on the inhibition of rat microsomal CYP2E1 activity was 32.89 microg x mL(-1). In addition, mechanism of inhibition experimental results showed that the inhibiting abilities of Folium Crataegi extract and Radix Puerariae extract on each CYP450 isozyme increased with the increasing of the preincubation time, therefore, the inhibitory effects were a mechanism-based inhibition.

Objective To observe the medium-and long-term results of one-stage debridement and total hip arthroplasty (THA) for advanced active tuberculosis of the hip.Methods From January 2002 to December 2008,8 patients (9 hips) with advanced active tuberculosis of the hip underwent one-stage debridement and THA in our hospital.There were 5 males and 3 females,aged from 18 to 59 years (average,39.6 years).According to Babhuulkar and Pande imaging classification,there were 1 case of grade Ⅲ and 7 cases of grade Ⅳ.All patients had hip pain,which got serious during active and passive motion.All patients had dysfunction in stretch,abduction,rotation and flexion of the hip,and the flexion deformity ranged from 30° to 70° (average,46°).Thomas sign were positive in all patients.The erythrocyte sedimentation rate ranged from 45 to 125 mrr/1 h.The results of tuberculin test were all positive.X-rays showed osteoclasia,narrowing or disappearance of the joint space and surrounding abscess in all patients.The diagnosis of hip joint tuberculosis was confirmed by postoperative pathological examination in all patients.All patients were treated with antituberculous medications for 12 to 18 months,including preoperative IRES (≥ 2 weeks) and postoperative IRES (3 months),IRE (6 to 9 months) and IR (3 to 6 months).Results All patients were followed up for 50 to 150 months (average,88.8 months).One-stage healing of incision was obtained in all patients.X-rays showed no signs about loosening of prosthesis and recurrence of tuberculosis.The erythrocyte sedimentation rate returned to normal range within 6 months after operation.The average Harris score improved from preoperative 25.78±16.15 to 94.78±2.91 at final follow-up,and the difference was significant.Conclusion Under the standard antituberculosis chemotherapy,the one-stage debridement and THA are safe and feasible for advanced active tuberculosis of the hip,which can result in satisfactory medium-and long-term resuits.

OBJECTIVETo explore the eyelid's characteristics of outpatients who visited the plastic surgery clinic in 3rd Hospital of Peking University.

METHODSFrom Jan. 2007 to Feb. 2011, we collected facial images and general data of 2,183 outpatients, and divided them into groups according to their genders. The eyelid images were analyzed and epicanthus or foldless eyelid were recorded. Then the incidence rates of epicanthus and foldless eyelid were calculated.

RESULTSIn 2,183 patients (4,366 eyes), the incidence rate of epicanthus is 86.1% (3,760/4,366), and the incidence rate of foldless eyelid is 35.3% (1,541/4,366). In 178 males (356 eyes) and 2,005 females patients (4,010 eyes), the incidence rates of epicanthus are 78.4% (279/356) and 86.8% (3,481/4,010), respectively. The incidence rates of foldless eyelid are 48.0% (171/356) and 34.2% (1,370/4,010), respectively.

CONCLUSIONSThe incidence rates of epicanthus and foldless eyelid are relatively high for the outpatient population in the plastic surgery clinic of Third Hospital of Peking University.

Beijing ; Eyelids ; anatomy & histology ; Female ; Humans ; Male ; Outpatients ; statistics & numerical data ; Sex Factors ; Surgery, Plastic ; statistics & numerical data

Objective To observe the clinical effects of tibial locking multidirectional interlocking intramedullary nail (TLMIIN) for tibial plateau fractures. Methods 38 cases with closed tibial plateau fractures treated by TLMIIN from October 2008 to May 2012 were retrospectively analyzed. There were 22 males and 16 females, with an average age of 48.7 years (range, 28-67 years). There were 24 fractures on the left side while the other 14 factures were on the right side, which were all fresh frac?tures. According to AO/OTA classification of tibial plateau fractures, there were 4 cases of B1, 1 case of B2, 14 cases of B3, 8 cas?es of C1, 5 cases of C2 and 6 cases of C3. Close reduction were performed on 4 cases (10.5%of all cases). Open reduction were performed on the other 34 cases. The limited incision was decided by the distribution of the fragments and fracture line. Hohl?Luck evaluation system was applied for the follow?up. Results The mean follow?up period was 18.1 months (range, 11-23 months). All fractures were healed at an average period of 87.4 days (range, 48-131 days). The average time from operation to full weight?bearing was 108.9 days (range, 80-128 days). Hohl?Luck evaluation system was used in the final follow?up. The excellent and good rate of functional score was 94.7%(36/38), including 28 cases excellent, 8 cases good and 2 cases fair from functional as?pect. The excellent and good rate of radiological score was 84.2%(32/38), including 23 cases excellent, 9 cases good and 6 cases fair from radiological aspect. No complications such as infection, breakage and loosening of the screw, malunion, nonunion oc?curred at the time of the latest follow?up. 6 cases with serious swelling of the knee joint and the soft tissue of crus were cured by an?ticoagulation, dehydration and physiotherapy treatments after operation. The 2 cases with a little exudates and incrustation was bacterial cultured negative and healed after 16 days and 18 days on the incision. 1 case had lost of reduction due to weight?bearing 1 week after operation, who had 25 degree of varus deformity, which was left dispose, and the bone healing and joint function were unaffected. Conclusion The intramedullary support, restrictive and non?restrictive multidirectional tridimensional fixation of TLMIIN technology had satisfactory effects in treating plateau fractures. It can supply a new therapeutic method, with little dam?age of soft tissues when taking out the internal fixation and reduce some postoperative complications.

Objective To explore the operative method and skill for female frontotemporal hairline reconstruction.Methods From October 2010 to October 2016,120 female patients were performed with the hairline reconstruction.The follicular units were arranged irregularly,40-55 FUs/ cm2,with 30°-45° angle from the forehead skin and 15°-20° angle from the temporal skin.The finest hairs were selected and arranged in hairline margin.Results All the patients were followed up for 10-24 months.95 patients were very satisfied,25 patients were satisfied,and no patients were unsatisfied.9 patients complained low density in the middle of the hairline and they had another surgery to improve the density.3 patients's hairline was regular,and another graft was done to correct the unnatural appearance.6 patients's hairs of the hairline margin were thick,hut no further treatment was done.1 patient underwent hair transplantation again,because of the still high hairline.6 patients's transplanted hairs appeared curly,and the curly degree was decreased after 1-2 years.The density of the transplanted hair was (44.7±8.1) FU/cm2.The density of 9 cases who complained low density in the middle of the hairline,was (36.9 ± 3.1) FU/cm2.The hair diameter of the hairline edge was (57.5±13.5) μm.The hair diameter of 6 cases who felt the hair thick was (70.2±5.1) μm.The angle of hair and the frontal skin was (40.2±8.5)°,The angle of hair and the temporal skin was (18.2± 4.7)°.Conclusions In female frontotemporal hairline reconstruction,nature hairline is created by irregular arrangement of hairs,proper density and angle and exact arrangement of different diameter hairs.

Objective: To compare the curative effect between Elastic Locking Intramedullary Nail (ELIN) and Anatomic Locking Plate (ALP) for the treatment of fracture in the mid-shaft of clavicle (Classification AO/OTA:2A/2B). Methods: Data of 47 cases of 2A/2B clavicular fractures who were treated with operation from January 2014 to December 2016 were retrospectively analyzed. The patients were divided into ELIN group and ALP group according to different fixation methods. There were 23 cases in ELIN group, 14 male and 9 female, aged from 19 to 85 years (average, 55.26 years). 14 cases on the left side and 9 cases on the right side. There were 6 cases of type 2A and 17 cases of type 2B. There were 24 cases in the ALP group, 18 male and 6 female, aged from 15 to 71 years (average, 51.25 years). 16 cases on the left side and 8 cases on the right side. There were 9 cases of type 2A and 15 cases of type 2B. The operation time, intraoperative blood loss, length of skin incision, fracture healing time, extraction time of internal fixation, Constant-Murley score of shoulder joint, disabilities of the arm, shoulder, and hand (DASH) score, and complication incidence were compared between the two groups. Results: All the operations were successfully performed. The mean follow-up for the patients in the ELIN group was 19.35 weeks (range, 14-23 weeks). The mean follow-up for the patients in the ALP group was 53.13 weeks (range, 28-76 weeks). In the ELIN group, the operative time was 20.78 ± 7.71 min, the intraoperative blood loss was 13.26±9.72 ml, the length of incision was 1.57±1.24 cm, the fracture healing time was 10.39±2.39 weeks, the extraction time of internal fixation was 13.17±2.37 weeks, the Constant-Murley score of shoulder joint was 99.09±1.86, and the DASH score was 1.20±2.47. In the ALP group, the operative time was 57.79±11.56 min, the intraoperative blood loss was 69.17±46.24 ml, the length of incision was 9.67±2.90 cm, the fracture healing time was 14.21±4.05 weeks, the extraction time of internal fixation was 47.38±10.46 weeks, the Constant-Murley score of shoulder joint was 98.00±2.17, and the DASH score was 0.89±1.65. The operation time (t=12.856, P=0.000), intraoperative blood loss (t=5.791, P=0.000) in the ELIN group were less than that of ALP group. The length of incision was significantly smaller in ELIN group than that of ALP group (t=12.549, P=0.000). The fracture healing time was earlier in ELIN group than that of ALP group (t=3.566, P=0.002). The extraction time of internal fixation was obviously earlier in ELIN group than that of ALP group (t=15.603, P=0.000). Constant-Murley score of shoulder joint and DASH score showed no significant difference. No delayed healing, no infection was found in the ELIN group, however skin irritation and tail bursitis were found in 6 cases, 3-6 weeks after the operation. The dressing was changed, kept clean. Skin irritation and tail bursitis disappeared, after the extraction of the internal fixation. There were 2 cases of delayed healing in the ALP group. After prolonged observation, the 2 cases healed. The healing time was extended to 24 and 27 weeks, respectively. There was 1 case of infection, 1 case of poor skin healing in the ALP group. The infected patient was treated with debridement and sensitive antibiotics, and the patient with poor skin healing was treated with dressing change. All the patients had wound healing about 4 weeks after surgery. 2 cases of skin irritation in the ALP group disappeared, after the extraction of the internal fixation. Conclusion Both ALP and ELIN are effective methods for the treatment of mid-shaft clavicular fracture. ELIN group has the advantages of more minimally invasive, faster union, shorter internal fixation time, better appearance, and lower medical cost. However, the ELIN group also had skin irritation and temporary bursitis.

Objective:Dorsocervical fat pad is common in middle-aged women. Current treatments include surgical excision and liposuction. We evaluated the therapeutic effect of tumescent liposuction on dorsocervical fat pad. Anatomical study was also carried out to explore the anatomical structure and significance of dorsocervical fat pad.Methods:From Jan. 2009 to Dec. 2018, twenty-seven patients with dorsocervical fat pad were treated with tumescent liposuction in Peking University Third Hospital. Small incisions were made in bilateral scapular region and 4 mm suction cannula was applied. A female cadaver fixed with formaldehyde was dissected to investigate the structure of posterior cervical and dorsal region. The specimens were stained with HE and Masson staining.Results:14 patients were followed up for no less than 6 months, with an average follow-up time of 27 months. Patients＇ dorsocervical area were flat and smooth after the surgery. Patient satisfaction rate was 100% and no severe complication was reported except bruise and pain. The symptoms of dorsocervical pain in two patients were significantly improved after operation. Anatomical study showed that the dorsocervical fat pad was composed of superficial and deep layer of adipose tissue, with clear boundary between the two layers and no obvious capsule. The collagen fibers in deep layer were more and denser than those in superficial layer.Conclusions:Tumescent liposuction can effectively treat dorsocervical fat pad. The surgery outcome is ideal with little complication.Through the study of the anatomical structure of the dorsocervical fat pad, the operation method and principle of liposuction can be improved and the operation efficiency can be enhanced.

OBJECTIVE：To investigate the effe cts of Buyang huanwu decoction on hemorheology and platelet related biological indexes of hyperlipidemia model rats. METHODS ：Male Wistar rats were randomly divided into blank control group （10 rats）and model group （40 rats）. Blank control group was given normal diet ，and model group was given high-lipid diet for 6 weeks at least to induce hypelipidemia model. After modeling ，rats were randomly divided into model control group ，positive control group （simvastatin，0.004 g/kg），Buyang huanwu decoction low-dose and medium-dose groups （3.5，14.0 g/kg，by crude drug），with 10 rats in each group. Blank control group and model control group were given normal saline intragastrically ， administration groups were given relevant drug intragastrically ，0.01 mL/g，once a day ，for consecutive 4 weeks. Thirty min after last medication ，hemorheological indexes （whole blood viscosity ，plasma viscosity ），platelet adhesion related indexes [adhesion rate，von Willebrand factor （vWF），fibronectin（FN）]，platelet release related indexes [ β-thromboglobulin（β-TG），platelet factor 4 （PF4）] and platelet fibrinolytic system related indexes [tissue plasminogen activator （t-PA），plasminogen activator inhibitor （PAI-1）]，platelet parameters （PLT，PDW，MPV，PCT，PLCR），4 kinds of coagulation parameters （APTT，TT，PT，FIB）were detected. RESULTS ：Compared with blank control group ，the whole blood viscosity （low，medium and high shear rate ），plasma viscosity，platelet adhesion rate ，the contents or levels of vWF ，FN，β-TG，PAI-1，PLT，MPV，PCT，PLCR and FIB in model control group were increased significantly （P＜0.05 or P＜0.01），and t-PA content was significantly decreased （P＜0.05）. Compared with model control group ，the whole blood viscosity （except for whole blood viscosity of high shear rate in Buyang huanwu decoction high-dose group ），plasma viscosity ，platelet adhesion rate ，the contents or levels of vWF ，FN，β-TG，PAI-1， PLT，PDW（except for Buyang huanwu decoction low-dose and high-dose groups ），MPV，PCT，PLCR（except for Byang huanwu decoction low-dose group ）and FIB were decreased significantly （P＜0.05 or P＜0.01），while t-PA content （except for positive control group ） was increased significantly （P＜0.05）. CONCLUSIONS ：Buyang huanwu decoction can significantly improve the pathological state in hyperlipidemia model rats by reducing blood viscosity and FN content ，improving platelet adhesion，enhancing fibrinolytic activity ，improving platelet aggregation ，inhibiting hypercoagulability and hyperplatelet release.