Objective To explore and summarize the choices of pedicle skin flaps in repairing cutaneous defect of foot and ankle.Methods Defects of forefoot,pedal dorsum,pedal plantar and ankle were repaired with pedicle skin flaps such as dorsal pedal flap,medial plantar flap,plantar metatarsal flap,fibular hallux flap,tibial flap of 2nd toe,anterior tibial artery flap,posterior tibial artery flap,sural nerve flap,lateral tarsal artery flap,anterior ankle artery flap peroneal artery flap etc.Results Except for necrosis of 2 cases of flap,the other 249 flaps all survived.Blood vessel crisis was induced in 5 patients on 1st postoperative day,and in 2 cases on 2nd postoperative day,by tight package of transplanted skin,which was treated by emergent explorative operation.Finally 135 cases got 3 to 96 months' followed up(average of 16 months).There were 4 cases of medial pedal flap and 3 cases of plantar metatarsal flap received secondary reshaping for treating skin wear out.Nine cases of posterior tibial artery flap,and 6 cases of sural nerve flap were reshaped secondarily to improve bulk shape.Other flaps did not need secondary reshaping.Among them,in medial pedal flap,fibular-side flap of hallux,and tibialside flap of 2nd toe,sensory nerve were all transferred together with the flap,and normal sensory was got,with 4-10 mm two point discrimination.Condusion In covering tissue defects on heel or plantar side of forefoot,medial plantar artery flap is ideal.For defects on plantar side of forefoot,plantar metatarsal flap,fibular hallux flap,tibial flap of 2nd toe have the advantages of wear resistance and nerve innervation.While dorsal pedal flap,anterior tibial artery flap,posterior tibial artery flap,sural nerve flap,lateral tarsal flap,anterior ankle artery flap,and peroneal artery perforator flap have the advantages of large size,thinness,similar color with recipient site,and constant anatomical position,they are feasible for repairing defects on dorsum of foot or near ankle.

Objective To explore the curative effect of the treatment for minor-size tissue defect of forefoot by pedicle fibular side flap of the hallux.Methods The data of 12 patients with minor-size tissue defect of forefoot was retrospectively analyzed who were repaired with fibular side flap of the hallux from September 2003 to June 2012.There were 9 males and 3 females,with an average of 27 years (range,19-55 years).Among them,4 injured on the left,8 on the right side; 3 on the dorsal side and 9 on the plantar.There were 4 cases of traumatic wound,4 of tumor,2 of ulcer,and 2 of scar.Sizes of tissue defect were 1.3 cm×0.5 cm-2.5 cm×2.0 cm,the minimal flap size was 1.5 cm×0.8 cm,and the maximal flap size was 3.0 cm×1.5 cm.All flaps were elevated with fibular side artery and nerve of the hallux,and with width less than 1.5 cm,so wound of donor site could be sutured directly.The postoperative curative effect was assessed from five respects including flap healing,the sensation of the flaps,the flap appearance,the scar and weight-bearing walking.Results This kind of flap all survived successfully in the 12 cases,with satisfying cosmetic effect and sensory,without skin necrosis and blood vessel crisis.Nine patients were followed up for 3-96 months (average,12 months).The flaps were covered with soft and intact normal colored skin,no abrasion or wearing out happened and no subsequent reshaping was needed in the last follow-up.The minor-sized donor site wound could be sutured up directly.Since donor site was selected from non-weight-bearing area,walking and weight-bearing function of the patients were nearly unaffected at all.Sensory of the flaps were normal,with two-point discrimination ranging between 4-10 mm.Conclusion Due to the advantages of thinness,nerve nourishing,constant anatomical position and hidden position of donor site,anterograde fibular side flap of the hallux can be an ideal choice in repairing minor-size tissue defect of forefoot.

OBJECTIVE: To investigate the status quo of pharmacists training in Hong Kong,and to provide reference for pharmaceutical education reform of college in mainland.METHODS: The status quo,role,license examination and culture system of licensed pharmacist in Hong Kong were analyzed.Based on the practice of our university,the difference in culture system of pharmacentical talents and curriculum setting of pharmaceutical education were compared between Hong Kong and mainland.RESULTS & CONCLUSION: On the basis of education reform practice of our university for Hong Kong students,it is suggested to match the pharmacy curriculum setting and training program used in Hong Kong,to improve the clinical practice,to explore "4+2" culture model,and to enhance English training of pharmaceutical education.

OBJECTIVE: To study the mechanisms of Shengqing Capsules, a compound Chinese herbal medicine for dispersing stagnated liver qi and promoting bile flow, in prevention and treatment of pigment gallstone. METHODS: Liver cells from guinea pigs with pigment gallstone were primarily cultured in vitro. The serums containing different concentrations of Shengqing Capsules were prepared by serum pharmacological method. The primary cultured hepatocytes with excessive expression of nuclear factor-kappaB (NF-kappaB) were stimulated with lipopolysaccharides (LPS) and the effects of the drug-containing serums on the NF-kappaB expression were detected by Western-blotting. RESULTS: Shengqing Capsules down-regulated the NF-kappaB expression increased by LPS stimulation. The effect is dose-dependent. CONCLUSION: Shengqing Capsules can down-regulate the NF-kappaB expression increased by LPS stimulation. It may be one of the important mechanisms of this Chinese herbal medicine in prevention and treatment for pigment gallstone formation and the inflammatory reaction in biliary tract.

Objective To study the value of high frequency sonography in diagnosis of peripheral nerve lipofibroma hamartoma.Methods The high frequency sonography images of seventeen patients with diagnosed peripheral nerve lipofibroma hamartoma were retrospective analyzed.The sonography features were compared with clinical surgery.Results The position and internal structure of nerve can be found by high frequency ultrasound,and which nerve fascicle,location and scope of lipofibroma hamartoma can be displayed clearly.The involved peripheral nerve was showed expansive growth.Because the hyperechoic fat tissue and hypoechoic nerve fibers alternated with one and another,the feature of high frequency sonography was lotus-like,there was no blood flow signal in nerve.Conclusions High frequency sonography is the preferred imaging method for diagnosis of lipofibroma hamartoma.

Objective:To investigate the effect of plasma-derived exosomes on the function of human venous endothelial cells in normal and rheumatoid arthritis patients.Methods:The plasma of healthy controls and rheumatoid arthritis patients was collected, and the surface protein markers were identified by transmission electron microscopy (TEM) and NTA. The effects of exosomes on endothelial cell proliferation and migration and invasion were detected by CCK8, cell scratch, Transwell chamber experiments; real time polymerase chain reaction (RT-PCR). The changes of cell secretion hypoxia inducible factor 1α (HIF-1α), vascular endothelial growth factor (VEGF) content were detected. The comparison between the two groups was performed by t test. Results:The double concave disc-like cystic vesicles were observed by transmission electron microscopy, nanoparticle tracking analysis (NTA) showed that the diameter was about 50-150 nm. Western blotting showed that the relative molecular weights of flotillin1 and CD81, on the surface of plasma exosomes were 47 000 and 26 000, respectively. Endothelial cell activity decreased with the increase of exosomes concentration, but the difference between the two groups was not significant( t=1.86, P>0.05). Compared with normal human con-exo, ra-exo significantly inhibited endothelial cell migration [(2.24±0.23) vs (1.46±0.13), t=6.60, P<0.05], reduced invasive capacity [(0.673±0.030) vs (0.827±0.030), t=8.11, P<0.05] in patients with rheumatoid arthritis. In addition, the ability to secrete HIF-1a, VEGF cytokines was decreased significantly, the difference was statistically significant [(0.706±0.020) vs (0.908±0.040), t=10.10, P<0.05; (0.692±0.010) vs (0.841±0.020), t=14.90, P<0.05]. Conclusion:The exosomes from plasma may play an important role in RA and vascular injury.