Objective To explore the treatment of multifocal lower extremity arteriosclerosis oblitera-tions. Methods From March 2014 to September 2014, combined procedures were performed on 30 lower limbs in 30 patients with multifocal lower extremity arteriosclerosis obliterations for revascularization. All the patients underwent endovascular , 20 of whom received endarterectomy , 10 received artery emboloctomy , and 8 received profundaplasty. The rates of technical success and clinical success were observed. The patients were followed up for 6-12 months to observe the total patency rate and rate of limb reservation. Results The technical success rate was 100%. The perioperative complication rate was 30% (9/30). 29 limbs gained improvement with differ-ent degree and the clinical success rate was 96.67% (29/30). The ankle-brachial index elevated 0.37 ± 0.19 on average (P < 0.001). Primary patency rate was 90% and 73% at 6 and 12 months, and 12-month limb reserva-tion rate was 97.67%. Conclusions The combined procedures for complex lower extremity arteriosclerosis oblit-erations have a higher short- to mid-term patency rate and limb reservation rate.

Objective To investigate the change of dynamic expression of t-PA and PAI-1 during early venous crisis after free perforator flap transplantation.Methods Thirty healthy New Zealand white rabbits weighed 2.5-3.0 kg were chosen and randomly divided into experimental group (n =15) and control group (n =15).Free transplantation of superficial epigastric artery perforator flap (SEAPF) was implemented in all rabbits firstly.Then the model of venous crisis was established by ligating the anastomosis vein in order to interrupt venous blood outflow in experimental group.The blood supply of all flaps was monitored by observing their color,swelling degree and the filling reaction of the capillaries after operation.Peripheral blood was drawn from femoral artery at different time point for measuring the concentration of t-PA and PAI-1 by Elisa.Partial flap tissue was harvested for pathological examination at corresponding time point.Data analysis was performed by using SPSS 17.0 statistical software.P ＜ 0.05 was considered statistically significant.Results One rabbit died of anesthesia,and the venous congestion was observed in 1 rabbit in control group.The models of free transplantation of SEAPF and venous crisis were established successfully in the remaining rabbits.No significant appearance change was observed within 1 h after the outflow vein being ligated,while typical appearance of venous crisis could be observed 2 hours after the outflow vein being ligated.Compared with the control group,the concentration of t-PA was lower,but the concentration of PAI-1 was higher in experimental group at 2 hours,4 hours,6 hours,8 hours after the outflow vein being ligated(P ＜ 0.05).However,there was no obvious differences between two groups at other time points (P ＞ 0.05).The pathological examination showed the red cells gradually got together and adhered to the venous wall,eventually the microcirculation had been blocked completely and theflap became necrosis after venous crisis being occurred.Conclusion t-PA and PAI-1 can't be used to diagnose early venous crisis of perforator flap transplantation.

Objective To investigate the clinical results,indications and precautions of a variety of special forms of the perforator flap for reconstructing limb soft-tissue defect.Methods From January 2008 to December 2013,480 cases suffering from limb soft-tissue defect were treated with special forms of the perforator flap.Types of special forms of the perforator flap included flow-through perforator flaps,micro-dissected perforator flaps,conjointed perforator flaps,polyfoliate perforator flaps and chimeric perforator flaps.Derivative types combined two or three technologies used in basic types.Results Venous crisis of the flap was shown in 10 cases.Through a second surgical exploration,5 cases were diagnosed with anastomotic thrombosis,2 with vascular torsion and 3 with hematoma.After appropriate treatments,flaps survived in 4 cases,but partial necrosis occurred in 6 cases.Twelve cases were found to have infection,which led to arterial crisis followed by total flap necrosis in one of them at postoperative day 5.Other flaps survived and wounds healed by first intention.Donor sites were repaired by skin flap transfer in 8 cases,skin grafting in 3 cases and direct suture in the rest cases.Conclusion Special forms of the perforator flap are optimal for repair of soft-tissue defect of extremities.

Objective To explore the feasibility of building a new model of free superficial epigastric artery perforator flap with New Zealand white rabbits.Methods Twenty-five healthy New Zealand white rabbits were used.Five rabbits were dissected to assess the vascular territory,the source and dimension of the superficial epigastric.According to the anatomic results,the superficial epigastric artery perforator flap were designed and harvested with 6 cm× 3 cm in the abdominal,anastomosis had been done between femoral artery/vein and carotid artery,jugular venous to build an animal model of transplantation of epigastric artery perforator flap.The donor sites were directly closured.Results Superficial epigastric artery originated from the proximal femoral artery,and the diameter of superficial epigastric artery was (0.15 ±0.02) mm,2-3 perforators support the areas of the skin of the lower abdominal wall.A rabbit died in the surgery because of anesthesia,the other animals were alive.The results showed that all flaps were survived in the experiment except a flap lost due to venous crisis.Conclusion The experimental model of free superficial epigastric artery perforator flap can be built in New Zealand white rabbits.It is a simple,practical and reliable model for future physiologic and pharmacologic studies.

Objective To study the efficacy and complications of total hip arthroplasty (THA) with rivet system for reconstruction of joint capsule and external rotator muscles.Methods Data of 170 patients managed with THA of femoral neck fracture between January 2009 and January 2012 were reviewed retrospectively.Hip fracture was the result of a fall and all were subcapital fractures.The fracture patterns were classified as Garden Ⅳ in 139 patients and Garden Ⅱ in 31 patients according to the degree of displacement.In all,85 patients (37 males and 48 females;age between 61 and 84 years,mean 73 years) underwent joint capsule as well as external rotator muscle reconstruction by rivet system (study group).The remaining 85 patients (36 males and 49 females;age between 64-87 years,mean 74 years) were served as control group.The MOS 36-item short form health survey (SF-36),dislocation rate and complications were evaluated at postoperative follow-up.Results Duration of follow-up was 36 to 60 months (mean,46 months).SF-36 questionnaire scale was (45.95 ±4.27)points in study group and (45.38 ± 4.67) points in control group before operation (P ＞ 0.05),while (83.67 ± 3.93) points in study group and (82.16 ± 3.21) points in control group at postoperative follow-up (P ＜ 0.05).Six patients in control group suffered from early prosthetic dislocation,but none in study control.Perioperative incidence of complications was comparable between the two groups (P ＞0.05).Conclusions Application of rivet system for reconstruction of joint capsule and external rotator muscles in THA of patients with femoral neck fracture can reduce incidence of prosthetic dislocation after operation.The operation is simple and will not increase the rate of perioperative complications.

Objective: To explore the nursing countermeasures of children with facial rhabdomyosarcoma treated by radioactive seed implantation. Methods: Retrospective analysis was performed on the diagnosis, treatment and nursing process of a child orbital embryonal rhabdomyosarcoma admitted to the department of tumor radiotherapy, Peking University Third Hospital in February 2018. Results: Mild wound swelling and pain occurred after treatment, and no acute complications such as increased intracranial pressure, particle displacement, wound bleeding and infection, or visual acuity change occurred. Conclusions Disease evaluation and preoperative preparation should be done strictly before the implantation of radioactive particles; changes of the disease should be monitored strictly during the operation to ensure the safety of treatment posture; postoperative complications observation and radiation protection guidance are the basis to ensure the smooth completion of the stage treatment of children.

ObjectiveTo investigate the condition of infants with urolithiasis caused by melaminetainted powdered formula at one-year follow-up. Methods Eighty-one young children with melamine-induced urolithiasis were followed up,which included urinalysis,renal-function tests,urinary tests for biochemical markers of renal glomerular and tubular function,and ultrasonography.Eighty-one age-matched healthy infants without exposure to melamine-contaminated formulas were enrolled as controls. Results Fifty-one of the patients were male and 30 female,with a mean age of 26 months (range 13 -48 months).The 81 children were divided into 2 groups according to treatment protocols.Group 1 received conservative treatment ( n =54 ) and Group 2 received surgical treatment ( n =27 ).In Group 1,3 patients (5.6％) had stone-residual:1 girl had calculus of 0.4 cm in diameter in the left kidney and 2 girls had calculus of 0.3 cm in diameter in the right kidney.In Group 2,2 patients (7.4％) had stone-residual,1 boy had crystallization of 0.2 cm in diameter in the right kidney and 1 boy had calculus of 1.5 cm in diameter in the left kidney,positive stone was confirmed by X-ray and accepted percutaneous nephrolithotomy.Urinary microalbumin levels were significantly increased in the children with melamine-induced urolithiasis compared with the control group (P ＜0.01 ).Blood urea nitrogen and serum creatinine were within the normal range with no significant difference between the 2 groups. ConclusionsAt one-year follow-up most of the children exposed to melamine-tainted infant formula in both treatment groups had returned to a healthy state,suggesting a satisfactory outcome for both treatment options.However,surgery is recommended in patients with stoneresidual ＞ 10 mm.

Objective To construct eukaryotic expression vector of wild type E 4F1 and the mutant deleting amino acid region 32-81, and to detect the interaction between wild type or mutant E 4F1 and p53 and to study the effect of E4F1 on the expression level of p21.Methods Wild type and mutant sequences of E 4F1 were amplified from the mammary library using standard PCR and recombinant PCR .The sequences were cloned into pXJ 40-MYC vector to generate the MYC-E4F1 and MYC-E4F1(Δ32-81) recombinant plasmids that were transfected into 293T cells and identified by Western blotting . FLAG-p53 and MYC-E4F1 or MYC-E4F1(Δ32-81) were co-transfected into 293T cells and immunoprecipitation assay was performed to detect the interaction of wild type or mutant E 4F1 with p53.Wild type and mutant E4F1 expressing vec-tors were co-transfected into osteosarcoma U2OS cells and the expression of p21was detected.Results Recombinant plas-mids of MYC-E4F1 and MYC-E4F1(Δ32-81) were successfully constructed.Both wild type and mutant E4F1 interacted with p53.Deletion of amino acid region 32-81 of E4F1 increased the interaction .The expression level of p21 was in-creased by wild-type E4F1, but not by mutant E4F1.Conclusion The eukaryotic expression vector of wild type E4F1 and its deletion mutant is successfully constructed .Both of them interact with p53.Deletion of amino acid region 32-81 of E4F1 increases the interaction .This study contributes to further studies on the regulation and mechanism of E 4F1 on p53.

IL-18, as a polyphonic cytokine, is important in immune response and physiologic function. We designed one pair of primers, amplified the porcine IL-18 gene fused with a C-terminal 6xHistidine tag, and then subcloned into the pFastBacDual of Baculovirus transfer vector and transformed into DH10Bac containing a shuttle vector of Bacmid. After co-transfecting the recombinant plasmid into insect cells, the 18 kDa expressed protein of porcine IL-18 was detected by SDS-PAGE; the specificity of expressed protein was confirmed by Western blotting. The purified porcine IL-18 protein induced obvious proliferation of porcine T lymphocytes in vitro, which indicated that the expression of IL-18 had high biological activity.
Animals ; Baculoviridae ; genetics ; metabolism ; Cells, Cultured ; Genetic Vectors ; genetics ; Insecta ; genetics ; metabolism ; Interleukin-18 ; biosynthesis ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; Swine ; Transfection

OBJECTIVE:To observe the clinical efficacy and safety of beraprost combined with fibrinogenase in the treatment of lower extremity atherosclerotic occlusive disease(LEAOD).METHODS:A total of 82 LEAOD patients selected from our hospital dur-ing Jan. 2015-Jan. 2016 were divided into control group and observation group according to random number table,with 41 cases in each group.All patients received low salt and low fat diet on the basis of treatment for primary disease.Control group was additionally given Fibrinogenase injection 200 U,ivgtt,qd;observation group was additionally given Beraprost sodium tablets 40 μg,tid,after meal,on the basis of control group.Both groups were treated for 15 d.Clinical efficacies as well as hemorheological indexes,ankle-brachial indexes,pain scores,cold felling scores,intermittent claudication scores and serum oxidation stress indexes before and after treatment were compared between 2 groups. The occurrence of ADR was also recorded. RESULTS:Total response rate of observation group (90.24%)was significantly higher than that of control group(78.05%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in above indexes between 2 groups(P>0.05).Compared to before treatment,whole blood high shear viscosity,plasma viscosity,hematocrit,fibrinogen contents,platelet adhesion rates,pain scores,cold feeling scores,intermit-tent claudication scores and serum MDA levels of 2 groups were decreased significantly after treatment;while ankle-brachial indexes, the serum levels of SOD,T-AOC and GSH-Px were increased;the indexes of observation group were better than those of control group,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:Beraprost combined with fibrinogenase show good therapeutic efficacy for LEAOD,can effectively relieve clinical symptoms,promote local blood circulation and improve oxidant stress level with good safety.