BACKGROUND: There are many advantages in treatment of deglovinginjury in hand with compatible grafting of temporoparietal fascial flaps(TFFs), while there are few relevant reports in China.OBJECTIVE: To evaluate function and appearance of hands after restora-tion of soft tissue defects with compatible grafting of TFFs.DESIGN: Case retrospective analysis.SETTING: Department of Maxillofacial Surgery, Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Sciences.PARTICIPANTS: Eleven patients with hand injuries received compatiblegrafting of TFFs in the Department of Maxillofacial Surgery of PlasticSurgery Hospital, Peking Union Medical College, Chinese Academy ofMedical Sciences from January 2001 to May 2005 were selected including8 males and 3 females with a mean age of 30 years. All subjects participat-ed in the observation and analysis voluntarily. All patients presented expo-sures of tendon, bone or joint.METHODS: Preoperative location was done with Doppler or palpation methods and the orientation of temporal vascular nerve tracts were labelled. Re-cutization of surface of fascial flap was achieved through fullthickness skin transplantation. Sizes of fascial flaps were limited between 10 cm×9 cm and 4 cm×6 cm. Follow-up was 8 months (6-11 months),the items of which included postoperative functional inspection and satisfactory degree of appearance. Ratio of total active range of motion (AROM) with joints injured and corresponding uninjured joints were used for functional evaluation, and the meso was zero. Functional rehabilitation was divided into 3 grades according to the ratio: Good as the ratio above 0.75, fair as the ratio between 0.5 and 0.75, poor as the ratio below 0.5. Evaluation on appearances of hands contained satifactions of both patients and doctor including whether there were fat and clumsy or visible scars.MAIN OUTCOME MEASURES: Postoperative functional recovery of hand after compatible grafting of TFFs.RESULTS: Eleven patients with hand injury were included and 4 patients withdrew from the study. ①Fascial flaps of 9 patients completely survived,one patient got partial necrosis due to venous injury during flap harvesting,and wounds spontaneously healed by exchanging dressing. Venous crisis was found in the 3rd day of postoperation in one patient during operation research (OR) and there were thromboses in anastomosed veins due to the folding of overlong vein, which was unobstructed after reanastomosis, while there were sporadical scars in the raw surfaces. ②Functional recovery of hands were good in 4 cases and better in 3 cases, 4 cases withdrew from the study. Both doctors and patients were satisfied with the recovery status of appearance of hands.CONCLUSION: It is better to simultaneously adapt compatible grafting of TFFs and re-cutization in restoration of tissue defects in hands such as exposures of bone and tendon. Better aesthetic results can be achieved with out second flap restoration. Most of all, the supple texture of fascial tissues provides a good gliding environment for functional recovery of tendon and joint, moreover, scars in donor sites are well camouflaged without functional lesions.

Objective To study the influence of electroacupuncture on the expression of Nestin in neural stem cells after focal cerebral ischemia in rats and to explore the mechanism of electroacupuncture in treating ischemic brain injury. Methods The model of middle cerebral artery occlusion was made by using opening cranium hot coagulation in 72 rats, who were divided randomly into a model group and an electroacupuncture group. Electroacupuncture was applied on "Dazhui" and "Baihui" points in rats in electroacupuncture group, and immunohistochemistry method was used to observe the number of Nestin expression positive cells on the 3th, 7th, 14th and 21st days after ischemia. Results There were Nestin positive cells in the cortex, hippocampal dentate gyrus (DG) and striatum at different time points after cerebral ischemia, and the number of Nestin positive cells in various brain regions were increased significantly on the 7th day (P

Objective: To research the method of Establishing model of polymyositis with damp-heat syndrome. Methods: 45 guinea pigs were randomly divided into three groups, group A (normal group), group B (experimental myositis group, control group), Group C (damp-heat group). In the control group, the rabbit skeletal muscle homogenate Garver,s complete adjuvant for subcutaneous immunization was used to injecting into the original guinea pigs. Besides the above-mentioned immune method, the heat-damp model method was used (feigan diet, hot and humid environment and pathogenic micro-organisms and other complex factors) to establish the polymyositis model with damp-heat syndrome. The general situations, such as the serum muscle enzymes, light microscopy, electron microscopy changes in each group were observed. Results: The results showed that the clinical performance, serum creatase, the pathological changes of skeletal muscle, lungs, liver of guinea pigs in damp-heat group were similar to the human polymyositis with damp-heat syndrome. Conclusion: The model can be used to study the human polymyositis with damp-heat syndrome, and provide the pathogenic and theoretical basis for treating polymyositis by TCM.

This paper draws several thoughts on medical English learning.First,although students have the positive learning attitude and definite learning purpose,they are influenced by the conventional learning habit,so when learning,they depend on their teacher.Second,the emphasis of college English reform should be put on the change of the students' learning habit.Third,the teacher should teach the learning strategy to the students.

Objective Toanalyze and evaluate the value ofthe method ofmedical simulation technique combined with PBL pattern in the training before clinical practice. Methods 80 students were divided into two groups:the experimental group and the control group. The PBL method was used in the experimental group,while the control group was taught by traditional method. Results The students in experimental group had a significant higher score than those in control group. Conclu-sion It means that the method of medical simulation combined with PBL teaching is an effective leaning method and should be widely used in the training before clinical practice.

Hoffa's disease is the clinical condition characterized by anterior knee joint pain secondary to inflammation and/or impingement of the infrapatellar fat pad. The substance P positive nerve fibers rich in the infrapatellar fat pad were stimulated by the noxious stimuli,which may associated with the pain of Hoffa's disease. The relationship between Hoffa's disease and substance P positive nerve fibers in the infrapatellar fat pad was reviewed in this paper.

Objective To investigate antibiotic resistance of Klebsiella pneumoniae and Escherichia coli in old patients with lower respiratory tract infections. Methods Kirby Bauer agar diffusion method was used to evaluate the drug sensitivity in 240 strains of Klebsiella pneumoniae and Escherichia coli isolated from patients with lower respiratory tract infection. Phenotypic confirmatory test recommended by NCCLS1999 was used to detect extended spectrum beta lactamases(ESBLs). Results The resistant rates of Klebsiella pneumoniae and Escherichia coli to 14 antibiotics in old patients and in non old patients with lower respiratory tract infections were amoxicillin 93 2% vs 87 3%, piperacillin 57 1% and 42 9%, cefuroxime 51 4% and 33 3%, cefotaxime 40 1% and 17 5%, ceftazidime 13 6% and 3 2%, ceftriaxone 39 0% and 17 5%, cefoperazone 37 3% and 15 9%, cefepime 10 2% and 3 2%, amikacin 47 5% and 34 9%, ciprofloxacin 54 2% and 38 1%, imipenem 0, cefoperazone/sulbactam 0, piperacillin/tazobactam 1 1% vs 0, and cefmetazole 9 6% and 4 8% respectively. Out of 240 clinical strains of Klebsiella pneumoniae and Escherichia coli, 78(32 5%) were considered ESBLs producers by phenotypic confirmatory test. The prevalence of ESBLs in old patients was 38 4%, which was much higher than that in non old patients(15 9%). The resistant rate of ESBLs producing strains to imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole was the lowest, being 0, 0, 2 6% and 12 8%. Conclusions The resistant rates of Klebsiella pneumoniae and Escherichia coli to most antibiotics and the prevalence of ESBLs in old patients with lower respiratory tract infection were higher than that in non old patients. Imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole were the effective antibiotics to infections caused by ESBLs producing strains.

Objective To construct a simultaneous HPLC-UV dual wavelength spectrometry method for detecting three main contents - harpagide, harpagoside and cinnamic acid in Scrophulariae Radix dispensing particles. Methods Ultimate AQ-C18 column (250 mm×4.6 mm, 5μm) was used, with 1%acetic acid solution and acetonitrile as mobile phase of gradient elution. The flow rate was 1.0 mL/min, detection wavelength was 210 nm at former 13 min and 278 nm after 13 min. The column temperature was 30 ℃. Results The linear range of harpagide, harpagoside and cinnamic acid was 0.066 54-0.665 4 μg (r=1.000 0), 0.024 23-0.242 3 μg (r=0.999 9), and 0.100 28-1.002 8 μg (r=0.999 9), respectively. The average recovery (n=6) was 99.80%±1.22%, 100.31%±1.30% and 100.22%±1.24%, respectively. Conclusion The method is simple, repeatable, stable, and can be used for quality control and standardization of Scrophulariae Radix dispensing particles.

Objective To investigate the effect of baicalin on inflammatory factors and oxygen free radical metabolism in patients with traumatic shock.Methods 38 patients with traumatic shock were treated with baicalin 200mg intravenous injection when admitted to hospital.Before and 1 h after treatment,TNF-α,IL-6,IL-8,MDA and SOD were measured in blood.Results Compared with before treatment,TNF-,IL-6,IL-8,and MDA levels were decreased after treatment (t =7.32,6.12,20.21,16.10,all P ＜ 0.05),while SOD activity was significantly increased (t =1.69,P ＜ 0.01).Conclusion Baicalin could inhibit the production and release of inflammatory factors TNF-α,IL-6,IL-8 in patients with traumatic shock,reduce the damage of oxygen free radicals to the cells.Early treatment with baicalin had protective effect on patients with traumatic shock.

ObjectiveTo compare the effect of salt bag compression and arterial compressor haemostat for patients after cerebral angiography.Methods Four hundred and ninety-five patients undergoing cerebral angiography were divided into two groups according to the methods of arterial compression:salt bag compression group (243 cases) and arterial compressor haemostat group (252 cases) in which 131 patients used the YM-GU-1229 arterial compressor haemostat and 121 patients used the NZ-1 arterial compressor haemostat.The associated complications within 3 days were recorded.ResultsThe incidence of complications in salt bag compression group was 3.70％(9/243),in arterial compressor haemostat group was 9.92％ (25/252),and there was significant difference between the two groups(P ＜ 0.01 ).The incidence of complications in YM-GU-1229 arterial compressor haemostat was 12.21％ ( 16/131 ),in NZ-1 arterial compressor haemostat was 7.44％(9/121 ),and there was no significant difference between the two arterial compressor haemostats (P ＞ 0.05).ConclusionThe incidence of complications of arterial compressor haemostat is higher than that of salt bag compression.