Objective To report the treatment outcomes and repair methods for soft tissue defects at thumb using miniature flaps. Methods Six different kinds of surgical flaps were used for the repair on different thumb injuries. They were radial lateral thumb reverse island flap, dorsal ulnar thumb revers flap, first metacarpal dorsal reverse flap, first digital dorsal island flap, neurovessel pedicled V-Y advanced island flap, free nail flap first foot digital, and so on. The emergency repair using miniature flaps were studied on 132 different cases, all 137 flaps. Results The flaps survived expect 5 flaps had partial epidermis necorsis in the 137 flaps. But the 5 flaps survived too after disinfecting and changing dressing. The appearances and functions of thumbs were satisfactory for the 1 to 2 years post-operation follow-up. Conclusion It will gain better results if choosing appropriate emergency repair methods using miniature flaps on different cases.

Objective To investigate the influence of age on liver histopathological feature of patients infected with chronic hepatitis B. Methods Liver biopsies were performed on 114 patients with chronic hepatitis B. The biochemical tests were measured by routine automated techniques. Serum hepatitis markers including HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc were assayed by using a microparticle enzyme linked immunosorbent assay. HBV-DNA was measured with quantitative polymerase chain reaction assay. The grades of liver necrosis/inflammation and fibrosis were compared between four groups with different age: younger than 20years, 20 ～ 30, 31 ～40, and older than 40 years. Results All 114 patients had liver histological changes with different degree. 75.4 percent (89/114) of cases had 2/over 2 grades of liver necrosis/inflammation, and 47.4 percent (54/114) of cases had 2/over 2 stages of liver fibrosis.There was no significant relation between the level of ALT and age or between the level of ALT and the grades of liver necrosis/inflammation and fibrosis( P ＞0. 05 ). The significant difference in degrees of liver inflammation and fibrosis was found among three age groups ( x2 = 30. 86, P ＜ 0. 01; x2 = 21.17; P ＜0.05 ). The grades of 1 iver inflammation and fibrosis increased with the increased age of the patients. Conclusion These results suggested that age was an independent factor for the disease progression. It was very important to undertake liver biopsy for patients with CHB more than 30 years to reveal the liver histopathological characteristics and guide the treatment.

Objective To study the expressions of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) in liver injury of acute liver failure (ALF) in rats and the role of PD-1/ PD-L1 in liver inflammatory injury. Methods SD rats were divided into two groups: 6 in normal group and 30 in ALF model group. The ALF models in rats were induced by D-galactosamine (D-Gal). The sera and hepatic tissue samples were collected at 12, 24, 48, 72 and 120 hours after D-Gal injection. Expressions of PD-1 mRNA and PD-L1 mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR). Comparison of measurement data between groups was done by t test. Correlation test was performed using Pearson linear correlation analysis. Results The levels of alanine animotransferase (ALT) and aspartate animotransferase (AST) at 12 h of D-Gal injection were (217. 3±33. 7) U/L and (397. 2± 101.3) U/L, respectively,which were both significantly higher than those in normal group [(30. 5 ±3. 1) U/L and (78. 6±4.2) U/L, respectively; t=-8. 921 and -6. 121, respectively; both P＜0.01] and peaked at 48 h.The expression of PD-1 mRNA in model group at 12 h (0. 385±0. 074) was significantly higher than that in normal group (0. 097±0.009) (t= -7. 725, P＜0.01) , and peaked at 48 h (0. 927±0. 132),then decreased obviously at 72 h. The expression of PD-L1 mRNA in the liver tissue of normal rats was very little, while that in model group was increased gradually over time, then peaked at 48 h (0. 593±0. 105; t =- 10. 076, P＜0. 01). The expressions of PD-1 and PD-L1 were positively correlated with ALT level (r=0. 807 and 0. 792, respectively; both P＜0. 01). Conclusion The expressions of PD-1/PD-L1 may play an important role in liver inflammatory injury in rat model of acute liver failure.

Objective To explore the feasibility of application of the Monte Carlo method to simulate the whole body dose distribution in patients with total body X (γ) ray irradiation by comparing the actual measurement results.Methods A Monte Carlo model of a 6 MV Elekta Synergy Clinical linear accelerator was established by MCNPX.According to the relationship between the CT value and the density of the material,the CT of the ATOM physical phantom was converted into a voxel phantom for MCNPX calculation.The dose distribution of the whole body was simulated in the total body X (γ) ray irradiation.The simulated results were compared with the measurement values of the thermoluminescence dosimetry at different positions in the ATOM physical phantom to analyze the differences.Results The difference between the depth dose curve and the off-axis dose curve and the actual measurement values calculated by the 6 MV accelerator treatment head model in the water tank was less than 2％,with the maximum dose depth of approximately 1.5 cm and field size of 10 cm× 10 cm,which were consistent with the actual measurement values.The maximum difference between the simulated results at different locations in the body and the thermoluminescence dosimeter was approximately 4％,and the simulated results of MCNPX were almost in good agreement with the results of thermoluminescence.Conclusions The whole body dose distribution in patient with total body X (γ) ray irradiation can be accurately simulated by MCNPX.Monte Carlo simulation makes it possible to optimize the uniformity of the total body dose during the total body irradiation process.

The eco-environment in eastern part of Qinghai-Tibet plateau is a rather complicated complex. The plants species there are quite diverse. The plant resource from Polygonaceae family used in traditional Tibetan medicine is very rich according to preliminary investigation. There were 6 genera and 15 species. The flora and the medicine value of them were analyzed. And some suggestions about traditional Tibetan medicine plant resource exploitation and utilization were presented.
China ; Medicine, Tibetan Traditional ; methods ; Polygonaceae

Objective Because of high precision and mild side effects,intensity-modulated proton therapy (IMPT) has become a hot spot in the radiotherapy field.Nevertheless,the precision of IMPT is extremely sensitive to the range uncertainties.In this paper,a novel robust optimization method was proposed to reduce the effect of range uncertainty upon IMPT.Methods Firstly,the robust optimization model was established which contained three types of range including the increased range,the normal range and the shortened range.The objective function was expressed in quadratic function.The organ dose contribution matrix of each range was calculated by proton pencil beam algorithm.The range deviation was discretized and the probability of each range was obtained based on the Gauss distribution function.Finally,the conjugate gradient method was adopted to find the optimal solution to make the actual dose coverage of the target area and the organs at risk distributed within the expected dose as possible.Results The 3 sets of simulation tests provided by the AAPM TG-119 Report were utilized to evaluate the effectiveness of this method:nasopharyngeal carcinoma,prostate and "C"-type cases.Compared with conventional IMPT optimization approach,this novel method was less sensitive to the range uncertainty.When the range deviation occurred,the dose coverage of the target area and organs at risk of the nasopharyngeal carcinoma and prostate cases almost reached the expected dose,and the high dose coverage of the target area and organs at risk protection were improved in the"C"-type cases.Conclusions To compensate for the range uncertainty,this novel method can enhance the dose coverage of the target area and reduce the dose coverage of the organs at risk.

OBJECTIVETo evaluate the feasibility of monitoring clopidogrel resistance with flow cytometric analysis of platelet vasodilator stimulated phosphoprotein (VASP) phosphorylation.

METHODSTwenty patients with coronary heart disease (CHD) and 17 healthy volunteers were examined for platelet aggregation rate and phosphorylation of VASP (calculated as platelet reactivity index, PRI) using traditional optical nephelometry and flow cytometry before and after concurrent therapy of clopidogrel and aspirin.

RESULTSNo significant differences were found in PRI between CHD group and healthy control group [(89.45∓5.22)% vs (86.58∓4.35)%] before treatment. The PRI in CHD group was significantly lowered after treatment to (67.66∓19.77)% (P<0.05). Clopidogrel resistance was found in 6 (30%) cases in CHD group by flow cytometric analysis, which showed a higher sensitivity than optical nephelometry (10%).

CONCLUSIONFlow cytometric analysis of VASP phosphorylation is a more reliable test to specifically evaluate clopidogrel resistance.

Aged ; Aged, 80 and over ; Case-Control Studies ; Cell Adhesion Molecules ; chemistry ; Drug Resistance ; Female ; Flow Cytometry ; Humans ; Male ; Microfilament Proteins ; chemistry ; Middle Aged ; Phosphoproteins ; chemistry ; Phosphorylation ; Platelet Function Tests ; Ticlopidine ; analogs & derivatives ; pharmacology