Objective To investigate the clinical effects of reconstruction by using the free iliac flap with nerve anastomosis to repair the composite tissue defects of heel.Methods From March 2009 to August 2012,five cases with the composite tissue defects of heel,including 2 cases with the bottom defects and 3 cases with the tibial defects of heel,were repaired by the free iliac flap,and the feeling of the heel were reconstructed by nerve anastomosis of the flap.The ventral wound were sutured simply.Results All iliac flaps survived and the wound healed in one stage.Patients were followed up from 6 months to 12 months.Appearance and function recovered and the feeling recovered from S2-S3.The foots walked freely.The skin of iliac abdomen were scarred and lead to hyperpigmentation.Conclusion Using the free iliac flap with nerve anastomosis could repair the bone and soft tissue defects of heel and reconstruct the sensation of warmth and sense of pain of the heel.With the characteristics of hidden wound and little damage,the clinical effects was satisfied.

OBJECTIVE: To establish headspace capillary gas chromatography for the content determination of 3 kinds of residual organic solvent (furanidine,methanol and ethanol) in betamethasone sodium phosphate raw material.METHODS: The sample was dissolved in water and n-propanol was used as internal standard.The residual solvent in betamethasone sodium phosphate was separated on HP-INNOWAX (PEG) capillary column with column temperature set at 60 ℃.The injector temperature and FID detector temperature were controlled at 180 ℃ and 250 ℃,respectively.The carried gas was nitrogen at flow rate of 1.0 mL?min-1.The splitting-ratio was 10 ∶ 1.The containers of head-space injector were in equilibrium at 80 ℃ for 30 min.Injection time was 1 min.RESULTS: With this chromatographic condition,those solvents could be separated completely.The linear range were 0.014 4～0.071 8 mg?mL-1 for furanidine,0.060～0.300 mg?mL-1 for methanol and 0.099 3～0.497 mg?mL-1 for ethanol.The average recovery were 103.7% (RSD=0.53%,n=6),95.8% (RSD=0.30%,n=6) and 95.0% (RSD=0.48%,n=6) respectively.The minimum quantitation limit were 0.057 3 ?g?mL-1,0.486 ?g?mL-1,0.145 ?g?mL-1,respectively.3 kinds of residual organic solvents were all in line with the standard stated in Chinese Pharmacopeia.CONCLUSION: The established method is simple,sensitive and accurate for the content determination of residual solvents in betamethasone sodium phosphate raw material.

BACKGROUND:The research and development of scaffold materials is the key to tissue engineering, as the scaffold can provide a stable external environment for cell growth.OBJECTIVE:To summarize the clinical advances in tendon tissue engineering materials.METHODS:We searched CBM, CNKI, CSTJ and PubMed database for relevant articles published from January 2004 to May 2016. The keywords were tissue engineering, tendon injuries, biological scaffold, tendon healing in Chinese and English, respectively.RESULTS AND CONCLUSION:The commonly used tissue engineering tendon materials include natural polymer materials, biological derivatives, synthetic materials and composite materials. Natural polymer materials retain the three-dimensional network structure of the normal tissue, with good biocompatibility but poor mechanical properties and degradation speed. Synthetic polymer materials present with good mechanical properties and biodegradability, but have low hydrophilicity and poor cell adhesion capability. Composite materials as an effective combination of the two above-mentioned materials exhibit a certain potential in clinical practice. Biological derivatives come from organisms, and have a net structure and biomechanical properties most similar to the human body after appropriate treatment. Additionaly, these derivatives also have the normal physiological activity and functions, which are considered as the future development direction of biomedical materials.

Objective To prepare insulin thiolated hyaluronic acid nanoparticles (Ins-HA-Cys-NPs)and study its physicochemical properties. Methods The Ins-HA-Cys-NPs was prepared by ultrasonic emulsifying method,and the properties of nanoparticles including morphology,mean diameter,Zeta potential,entrapment efficiency and drug loading efficiency were studied,as well as the cryoprotectant selection.Results The prepared nanoparticles was round in appearance and the mean diameter was(178.5 ±0.8)nm,the polydispersity index was (0.214 ±0.013)and the Zeta potential was -(38.47 ±0.46 )mV,while the entrapment efficiency was (48.85 ±0.66 )%,drug loading efficiency was (4.79 ±0.13 )%;10%mannitol as cryoprotectant provided uniform and well dispersed suspension of nanoparticles with blue opalescence after redispersion.Conclusion The thiolated hyaluronic acid nanoparticles may be used as the carrier for oral drug delivery system of insulin,and it provides a basis for studies on rats in vivo.

Objective To explore the effect of shifting the little finger abductor muscle and cutting open the metatarsophalangeal joint dorsal articular capsule to improve the appearance and function of reconstructed thumb.Methods From August 2007 to May 2012,twelve cases of Ⅳ°or Ⅴ°defect of thumb were repaired by free transplantation of the second toes with metatarsophalangeal joint.During operation,using the abductor muscle of little finger to reconstruct palmar opposition function,cutting open the joint capsule of metatarsophalangeal joint,adjusting the tension of the joint by the little finger abductor muscle and toe short extensor muscles,which were used to improve the appearance and function of reconstructed thumb.Results Twelve reconstructed thumbs all survived.Followed up from 6 to 24 months,the appearance and function were improved obviously.According to the evaluation trial standards,nine cases were optimal and 3 cases were good.Conclusion The shift of the little finger abductor muscle could reconstruct palmar opposition function,combined with metatarsophalangeal joint dorsal articular capsule incision and adjusting joint tension,could improve the appearance and function of reconstructed thumb.The effect of operation was satisfied.

Objective To observe the effects of estradiol-17? (E 2-17?) on the induction of experimental autoimmune thyroiditis (EAT). Methods Ten-week old female Wistar rats were ovariectomized (OVX). EAT of Wistar rats was induced by immunization with thyroglobulin (Tg) from SD rats in the presence of complete Freund′s adjuvant. Thyroiditis was pathologically evaluated by HE staining. E 2-17? and PRL levels were measured by RIA, anti-Tg antibody (TgAb) was detected by ELISA, and interferon (IFN)-?, interleukin (IL)-10 mRNA in thyroid were assayed by RT-PCR. Results The serum level of E 2-17? (17.60?1.02)pmol/L and PRL (2.45?0.15)?g/L were much lower in OVX rats than intact rats 〔(58.56?6.99)pmol/L and (3.22?0.17)?g/L, respectively〕 (both P

To refine and analyze the characteristics and laws of acupoint selection in treatment of hyperlipidemia with acupuncture and moxibustion. By retrieving the main databases of Chinese and English version, the clinical research literature is included on the definite acupoints for hyperlipidemia treated with acupuncture and moxibustion, and the characteristics and laws are analyzed on the acupoint selection for hyperlipidemia treated with acupuncture and moxibustion. It is found out that the special points have been mainly used in treatment of hyperlipidemia. The first five top acupoints of high frequency use include Fenglong (ST 40), Zusanli (ST 36), Sanyinjiao (SP 6), Neiguan (PC 6) and Tianshu (ST 25). Totally 10 meridians are involved in acupoint prescriptions. The meridians of higher frequency use include the Stomach Meridian, the Spleen Meridian, the Conception Vessel, the Bladder Meridian and the Pericardium Meridian. The specific points are mainly from the Stomach Meridian, the Spleen Meridian, the Conception Vessel, the Bladder Meridian and the Pericardium Meridian in the treatment of hyperlipidemia. The acupoint prescription of acupuncture and moxibustion for hyperlipidemia is characterized as determining the treating principle based on the spleen theory, selecting the acupoints along the running courses of the spleen and stomach meridians, combining the nearby acupoints with the distal ones, selecting the acupoints for adjusting the deficiency and excess of zangfu and syndrome differentiation, collaborating the acupoints located in the front and on the back, as well as supplementing the acupoints based on symptoms.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Hyperlipidemias ; therapy ; Moxibustion

Objective To explore the relationships among organization climate,psychological empowerment and job embeddedness by using path analysis.Methods A total of 514 clinical nurses from 26 departments in 3 hospitals were recruited by convenience cluster sampling method and investigated with demography questionnaire,Nurses Organizational Climate Scale,Psychological Empowerment Scale and Job Embeddedness Scale.Results The mean scores of organization climate,psychological empowerment and job embeddedness was (3.01±0.46),(3.27±0.44),(3.08±0.39).The predictors of job embeddedness of nurses were resources support,work experience,human resources management,marital status,job title,management support,quality management,and self-egicacy,explained 48.9％ of its variance; organization climate,psychological empowerment had direct positive influence on nurses' job embeddedness,explained 33.3％ of its variance.Conclusions Improvement and maintenance of sound organizational climate,increase the sense of psychological empowerment of nurses,are effective ways and means to increase the degree of job embedding of nurses.

Objective To summarize the surgical experience gained from robotic mitral valve replacement (MVR), and demonstrate the long-term clinical follow-up results. Methods From Jan. 2007 to Jan. 2015, more than 700 patients underwent various types of robotic cardiac surgery in the Department the authors served in, and of them 43 patients underwent robotic MVR with da Vinci Surgical System (Intuitive Surgical, USA). Among the 43 patients, the average age was 47±11 years (ranged 19-65 years), and sex ratio (female to male) was 0.8:1. Six patients were with heart function of NYHA class Ⅰ, 30 patients were of NYHA class Ⅱ and 7 patients were of NYHA class Ⅲ. The left ventricular ejection fraction (LVEF) were 54%-78% (64.0%±7.1%), and 20 patients had atrial fibrillation on admission, and 35 patients were with rheumatic mitral stenosis (MS). Atrial septal defect (0.7cm in size) co-existed in 1 case and 1 patient had mild aortic regurgitation. Mechanical or bioprosthetic mitral valve was replaced via left atriotomy by using da Vinci robotic surgical system after cardiopulmonary bypass (CPB) set-up. Radiopaque titan clips was employed by Cor-Knot knot-tying device (LSI Solutions, Inc, Victor, NY) to anchor the prosthetic valve. Trans-esophageal echocardiography (TEE) was performed before and after surgery. The operative data were collected and patients were followed up at outpatient clinic regularly up to 6 years. Results All cases were performed successfully with the same surgery. No conversion to median sternotomy or operative mortality occurred. The average operation time was 292±62 minutes (ranged 140-450 minutes) with CPB time of 124±26 minutes and aortic occlusion time of 88±21 minutes. The postoperative mechanical ventilation support time was continued for 15±6 hours, and the average staying length in critical care unit was 4±1 days. No myocardial infarction, ventricular tachycardia or excessive bleeding was complicated. All patients were successfully followed up for a median of 3.5 years (ranged 1 month to 6 years). In the follow-up period, no incidence of death, stroke, re-operation due to prosthetic endocarditis or prosthetic failure was reported. However, 39.5% (n=17) patients still had atrial fibrillation after surgery. Conclusion Robotic MVR is a safe and effective procedure with excellent long term surgical outcome.

Objective:To observe and compare the clinical effect of single-incision and two-incision posterior chamber phakic intraocularlens implantation in the correction of extreme myopia.Methods:40 cases(80 eyes) of patients with extreme myopia underwent conventional two-incision posterior chamber phakic intraocularlens implantation in our hospital from January 2011 to June 2013 were selected as the control group and 40 cases(80 eyes) underwent single-incision posterior chamber phakic intraocularlens implantation from July 2013 to January 2016 were selected as observation group.The open hole before and after operation,best corrected visual acuity of vision,operation safety,effectiveness index,diopter (column mirror,equivalent ball for eyeglasses),intraocular pressure,ECD,anterior chamber depth and occurrence of complications were compared between two groups.Results:The uncorrected visual acuity (UCVA) of both groups at 6 months after operation were significantly higher than those before operation (P＜0.05),which was significantly higher in the observation group than that of the control group (P＜0.05);The operation safety and effectiveness index of observation group were significantly higher than those of the control group (P＜0.05);The cylinder and spherical equivalent degree of both groups at 6 months after operation were significantly better than those before operation(P＜0.05),which was significantly better in the observation group than that of the control group(P＜0.05).The corneal endothelial cell counts(ECL) of control group after operation was significantly lower than that before operation (P＜0.05),and no significant difference was found in the ECL of observation group before and after operation (P＞0.05).The ECL of observation group after operation was significantly higher than that of the control group (P＜0.05);The incidence rate of complication in observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Compared with two-incision operation,the single-incision posterior chamber phakic intraocularlens implantation had remarkable clinical effect in the correction of extreme myopia with higher security.