Objective To explore the clinical application of sural neurovascular flap with anastomosing small saphenous vein to be transferred distally for repairing soft tissue defect of the leg.Methods Seven patients with soft tissue defects in the distal one third of anterior tibia,the foot dorsum,the heel or the ankle were treated with the distally based sural neurovascular flap with anastomosing small saphenous vein.The size of the flap ranged 8 cm?6 cm ~ 18 cm?10 cm.Results The flaps survived in all the 7 patients,with excellent color and texture.Their appearance and function were satisfactory during 6~40 months of follow-up. Conclusions Use of distally based sural neurovascular flap with anastomosing small saphenous vein is reliable.The performance is simple.This flap has a rich blood supply without the sacrifice of major arteries.Venous blood reflux was unobstructed.It can be used for the reconstruction of soft tissue defects in the distal one third of anterior tibia,the foot dorsum,the heel or the ankle.

Objective:To investigate the role of clinical pharmacists in the process of chemotherapy for a patient with intracranial glioma. Methods:Usage and dosage of antitumor drugs, drug interactions, adverse drug reactions and medication education after dis-charged as the breakthrough points, clinical pharmacists and clinicians explored options for the patient treatment and adjusted the medi-cation timely according to the condition. Results:There were no serious adverse drug reactions in the adjusted therapeutic regimen and the treatment results of the patient were satisfactory. Conclusion:Clinical pharmacists provide pharmaceutical care can play an impor-tant role in improving the safety and effectiveness of drug use.

Objective To investigate the influence of illumination changes on the drosophila circadian rhythm and 24 h sleep time.Methods We collect the unmated fruit flies (a total of 128,single-sex) under CO2 anesthesia within 8 hours of eclosion.And put them into the group of normal light group,day and night reversed group,24 h light group and 24 h dark group with the simple random sampling method,male and female with 4 single-sex groups(n=32).Change the illumination conditions of the living environment of the fruit flies and use Drosophila Activity Monitoring System (DAMS) and Data Acquisition System (DAS),to observe and compare the changes of drosophila circadian rhythm and 24 h sleep time between the different illumination conditions.Results Compared with the normal light group,drosophila circadian rhythm of the day and night reversed group was significantly reversed,the number of fruit flies' activities of 24 h light group was increased,and circadian rhythm was decline,drosophila circadian rhythm of the 24 h dark group is still there,but frequent activity appears during the day,and the 19 : 00 activity peak disappears.Conclusion The drosophila circadian rhythm and 24 h sleep time changes with illumination conditions change.

Background Laser assisted in situ keratomileusis (LASIK) for myopia will change corneal asphericity and further affect the quality of vision.However,how operating parameters such as ablation depth and optic zone diameter affect corneal asphericity is still rarely reported.Objective Aim of this study was to investigate the influence of corneal ablation depth and optic zone diameter on corneal asphericity after LASIK for myopia.Methods This prospective study comprised 175 eyes of 89 patients with the spherical equivalent of (-5.93± 1.98)D and the best corrected visual acuity (BCVA) ≥ 1.0.The flap creation with the femtosecond laser combine iris recognize guided LASIK was performed on the patients who were available for the evaluation at postoperative 6 months.Corneal aspherical index (Q value) at the central corneal 6.0 mm were measured with Orbscan IIz-corneal topography before and 6 months after operation.Corneal ablation depth and optic zone diameter were recorded in operation.The changes of visual acuity and spherical equivalent before and after surgery were compared by self-control method,and the correlations between corneal ablation depth or optic zone diameter with alteration of Q value (AQ) after LASIK were assessed using multiple regression analysis.Results The mean spherical power,cylinder diopter and spherical equivalent were (-5.57 ± 1.89) D,(-0.71 ±0.55) D and (-5.93 ± 1.98) D before surgery,and those after surgery were (-0.25 ±0.30),(-0.14±0.22)D and (-0.32±0.37)D,showing significant differences between before and 6 months after LASIK (t=-32.39,-23.91,-35.18,all at P＜0.01).The Q values at the central corneal 6.0 mm were -0.13 ± 0.09 (-0.47-0.08) in preoperation and 1.09 ± 0.54 (0.22-2.51) in postoperation,with a significant increase in postoperation (t=29.37,P＜0.01).Corneal ablation depth was (95±28) μm and optic zone diameter was (6.32±0.26)mm.Ablation depth appeared to be positive correlation with AQ (β =0.803),and optic zone diameter showed a negative correlation with AQ (β =-0.149),with a multiple regression formula AQ =1.517+0.015×ablation depth-0.3 ×optic zone diameter.Conclusions LASIK for myopia increase corneal Q value.The increase of corneal ablation depth and decrease of optic zone diameter contribute to enlargement of corneal Q value.

0.05).But significant enhancement was found after LAD ligation for 4 hours (82.1?15.2) HU.MSCT coronary angiography could show the blockage of LAD in nine dogs.Conclusion MSCT myocardial perfusion combined with coronary angiography could estimate myocardial ischemia and infarction,and show the blockage of the coronary artery.

Objective To study the clinical features and treatment of 12 cases of lupus vulgaris.Methods A comprehensive study was performed on 12 patients with lupus vulgaris.The clinical and histopathological features,misdiagnosis,treatment and prognosis of this entity were analyzed.Results Of these patients,83.3％ had a history of local trauma before the occurrence of lupus vulgaris.All the patients showed an early onset and long clinical course of lupus vulgaris,absence of obvious symptoms and variety in skin lesions.Lupus vulgaris was misdiagnosed at the first visit in all the patients.The final diagnosis was confirmed by histopathology,purified protein derivative (PPD) test,acid-fast staining,Mycobacterium tuberculosis culture,DNA sequencing,etc.Satisfactory outcomes were achieved in these patients after standard anti-tuberculosis treatment.Conclusions Lupus vulgaris is easy to be misdiagnosed and improperly treated due to its complicated clinical features.Clinicians should expand their knowledge about this entity,which can be diagnosed by histopathology and culture.

BACKGROUND:Atorvastatin has been shown to reduce bone loss and fracture, but its effects on implant osseointegration remain unknown.
OBJECTIVE:To investigate the effects of atorvastatin on implant osseointegration in osteoporotic rats and the underlying mechanisms.
METHODS:Forty-eight Sprague-Dawley rats were randomized into sham-surgery, ovariectomy, and atorvastatin (10 and 20 mg/kg per day) treatment groups, respectively. Al rats received ovariectomy and implant surgery except those in the sham-surgery group. Bone mineral density of the lumbar vertebra, osseointegration ratio and pul-out strength of implants were measured after 12-week treatment.Levels of bone formation and resorption markers in osteoblasts treated with atorvastatin were determined by ELISA. Wnt pathway-relatedgene expression was detected by RT-PCR.
RESULTS AND CONCLUSION:Bone mineral density, osseointegration ratio and pul-out strength of implants were significantly increased in 20 mg/kg per day of atorvastatin treatment group compared with ovariectomy group (P< 0.05). Levels of alkaline phosphatase, osteocalcinand osteoprotegerinwere significantly increased in osteoblasts treated with atorvastatinin vitro(P<0 .05), and the level of osteoclast differentiation factor RANKL was significantly inhibited (P< 0.05). Meanwhile, atorvastatin significantly promoted the mRNA expression of low-density lipoprotein associated protein 5and β-catenin, and inhibited the mRNA expression of dickkopfWnt signal pathway inhibitor 1and sclerostin. Our results suggest that atorvastatin promotes implant osseointegration in osteoporotic rats by activating Wnt/β-catenin signal pathway.

Objective To test the drug susceptibility of 16 Mycobactena tuberculosis isolates from patients with cutaneous tuberculosis,and to provide a basis for the treatment of this entity.Methods Sixteen strains of mycobacterium were isolated from patients with cutaneous tuberculosis.and they were consistently identified as M.tuberculosis by biochemistry and molecular biology.Absolute concentration method was used to test the susceptibility of these isolates to isoniazid.streptomycin.rifampicin and ethambutol.For two strains resistant to streptomycin,PCR and sequencing were performed to analyse the mutation of rpsL gene.Results Out ofthe 16 strains of M tuberculosis.2 were resistant to streptomycin but sensitive to isoniazid,rifampicin and ethambutol,and 14 were sensitive to isoniazid,streptomycin,rifampicin and ethambutol.Sequencing of the rpsL gene revealed a mutation of AAG to AGG at codon 43 in one streptomycinresistant strain and a substitution of CGC bv CAC at codon 54 in another resistant strain.Conclusions In past five years,the resistance ratio of M tuberculosis was low in patients with cutaneous tuberculosis,and streptomycin resistance predominated in these strains.

Objective To investigate effects of Danhong on the serum levels of CD137, high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) in patients with non-ST elevation acute myocardial infarction complicating metabolic syndrome. Methods A total of 126 patients with non-ST elevation acute myocardial infarction complicating metabolic syndrome were enrolled and randomly divided into a conventional treatment group and a Danhong treatment group using a random-digit table, with 63 patients in each group. All patients underwent angiography or percutaneous coronary intervention. The patients in the Danhong treatment group treated with intravenous Danhong 20 ml on the basis of conventional treatment for 1 week. The serum levels of CD137, hs-CRP and Hcy were measured at hospital admission and 10 days after treatment. The severity of coronary artery disease was assessed by the Gensini-score. Results The levels of CD137, hs-CRP and Hcy in both groups after treatment were significantly lower than before treatment (conventional treatment group: t 12.393, 17.408 and 9.458; Danhong treatment group: t 16.110, 17.573 and 13.481; all P<0.01), and the Danhong treatment group were significantly decreased than the conventional treatment group (t 2.815, 3.224 and 3.157, all P<0.01). The serum levels of CD137 and hs-CRP before treatment were significantly correlated with Gensini scores in 126 patients (r 0.720 and 0.562,all P<0.01). Conclusions The serum levels of CD137 and hs-CRP are significantly correlated with the severity of coronary artery disease, intravenous Danhong may has protective effect for coronary artery disease via decreasing CD137 and hs-CRP.

Objective To investigate the changes of corneal biomechanics of intrastromal correction (INTRACOR) femtosecond technique to treat presbyopia.Methods A prospective,clinical self-control clinical trial was designed.Twenty-four presbyopic patients with emmetropia or mild hyperopia were enrolled in this study.The INTRACOR procedure was performed using the Technolas femtosecond laser in the nondominant eye.Uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA) and spherical equivalent (SE) were recorded in preoperation and postoperative 12 months,and the quality of life of postoperative patients was evaluated.The corneal deformation parameters including highest concavity deformation amplitude (HC-DA),highest concavity peak distance (HC-PD),highest concavity radius (HC-R),non-contact intraocular pressure and the central corneal thickness (CCT) were measured using the Corvis ST visualization biomechanical analyzer in preoperation and postoperative 1 month,3,6 and 12 months,respectively.This study followed the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering study cohort.This study protocol was approved by Ethic Committee of Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (No.SDZYYDXYKYYLL2011.06).Results Compared with preoperation,UCNVA of all 24 (100％) eyes was improved at 12 months postoperatively with minimal or no change in UCDVA.The mean spherical equivalent was (+0.35± 0.29)D and (-0.37 ± 0.29)D before and 12 months after operation,with a significant difference beteeen them (t=-7.39,P＜0.01).No significant differences were seen in the intraocular pressure,CCT and HC-PD values between preoperation and postoperative 1 month,3,6,12 months (F =1.273,1.347,2.434;all at P ＞ 0.05).Compared with preoperation,the postoperative 1 month,3,6,12 months HC-R values were significantly declined,HC-DA values were significantly increased,with significant differences between them (all at P＜0.05),and no significant differences were found in HC-R and HC-DA between the postoperative adjacent time points (all at P＞0.05).Corneal aspherical index (Q Value) was-0.28±t0.10 at 12 months postoperatively,which was increased compared with the preoperation,and the maximum value added value (diff-K) of the central corneal curvature was (2.55±0.81)D.Conclusions INTRACOR treatment of presbyopia can effectively improve near vision,increase postoperative corneal biomechanical maximum HC-R and HC-DA,negatively increase the corneal central curvature increased aspheric index,which suggests that corneal biomechanics of central cornea is weakened after intrastromal femtosecond presbyopic treatment,and the hyperprolate mutifocal corneal shape is formed under normal intraocular pressure.