4.Clinical application of free super-thin anterolateral femoral perforator lobulated skin flap with nerve for repair of tissue defect of the foot and ankle
Yujin DONG ; Tiehui ZHANG ; Sheng ZHONG ; Yuanfei REN
Chinese Journal of Orthopaedics 2016;36(13):826-832
Objective To explore the clinical outcome of free super?thin anterolateral femoral perforator lobulated skin flap with nerve for repairing the tissue defect of the foot and ankle. Methods Free super?thin anterolateral femoral perforator lob?ulated skin flap with nerve was transferred to repair soft tissue defects of the foot and ankle in 32 cases. There were 20 males and 12 females with an average age of 35.5 years (range, 21-50 years). The wounds located in dorsal and plantar ankle skin with ten?don, bone and/or internal fixation exposed. The defect area was from 12 cm×10 cm to 20 cm×15 cm. At first the site of perforator vessels were determined by Doppler, according to the wound shape and size, the flaps were designed and harvested with the site as center;the femoral lateral cutaneous nerve was carried and most tensor fascia was reserved. During flap harvesting trimming of the flap was carried out, the flap was freed and only connected with its vascular pedicle. A step?wise defatting was done from the pe?riphery of the flap towards the vascular pedicle with 1.0 to 2.0 cm tissue around the perforator preserved. Flap circulation was care?fully observed to prevent damage to the perforators. The vascular pedicle was disconnected and formed a split leaf skin flap, and then the flap was transferred to the foot and ankle to cover the defect. Results All the 32 flaps were survived. No vascular crisis happened and all skin grafts were survived in donor sites. Necrosis of 1.5 cm×1.0 cm of the distal flap occurred in 1 case five days after surgery and it was healed by dress changing. All the 32 cases were followed?up for 6 to 24 months (average, 13 months). The flaps were supple and elastic with near normal color. There was no bulkiness. Sensory function was recovered well and two point discrimination (2?PD) was about 3.0-5.0 mm. The function and appearance of the foot and ankle were good. According to the Chi?nese Medical Association of hand surgery upper limb function evaluation of upper limb, the results were excellent in 22 cases, good in 9, fair in 1, with 97%(31/32) overall excellent and good rate. Conclusion The free super?thin anterolateral femoral perfo?rator lobulated skin flap with nerve is an improvement of the traditional anterolateral thigh flap. The survived flaps are ideal in terms of covering foot and ankle defects and restore function.
5.Analysis on risk factors for deep vein thrombosis in patients with traumatic fractures
Yujin DONG ; Tiehui ZHANG ; Sheng ZHONG ; Yuanfei REN ; Zhiqiang ZHENG
Chinese Journal of Orthopaedics 2015;35(11):1077-1083
Objective To explore the incidence rate and the risk factors of deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT.Methods All of 534 Patients with fresh four extremities or pelvic fracture between January 2010 and December 2013 were involved in this study.The incidence of DVT under 5 risk factors including general state, injury type, fracture condition, operation and laboratory examination were analyzed.Each patient underwent three Doppler ultrasound exams in actions as the epidemiology diagnostic criterion for DVT.Results The total incidence rate of DVT in 534 patients was 11.99%.The univariate analysis showed that male patients with age≥60 years, BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension and coronary artery disease had higher incidence rate of DVT.In different injury types, the fall injury caused the highest incidence rate of DVT (45.71%).There were different DVT rates for different fracture sites, with the highest incidence rate of DVT for femur shaft fracture (20.69%).The incidence rate of DVT was 50.00% for fractures of more than three parts, 15.29% for fractures of two parts and only 3.98% for sole part.The incidence rate of DVT for comminuted fractures was higher than others.The operation duration, massive transfusion during operation and general anesthesia were related with the increase of incidence of DVT.Positive ACA and enhancement of D-dimer, Fib and CRP were related with the increase of incidence of DVT.Conclusion The incidence of DVT in patients with traumatic fractures approaches a considerable level.It has relationships with age≥60 years, BMI≥25 kg/m2, history of smoking, fall injury, fracture of femoral shaft and hip, more than three parts of fractures, comminuted fractures, operation duration≥2 hours, largely blood transfused, massive transfusion during operation, general anesthesia, positive ACA, enhancement of D-dimer, Fib and CRP.The surgeons should recognize the importance to prevent DVT and PE in the traumatic patients.
6.Cancer stem cells:current status
Zhi-Gang SUN ; Sheng-Dong HUANG ; Bao-Ren ZHANG ;
Academic Journal of Second Military Medical University 1981;0(04):-
Recently,study on cencer stem cells has been a focus of study.Cancer stem cell is a small population of cencer cells possessing the properties of stem cells:self-renewal,differentiation and proliferation.To date,the existence of cancer stem cells has been proven in acute and chronic myeloid leukemia,breast cancer,brain tumors,liver cancer and colon cancer,etc..In this article we reviews the current progress on cancer stem cells,including the defination,existing evidence,research methods, and challenges in clinical application.
7.Cloning Chitinase Gene of the Entomopathogene Fungus Metarhizium anisopliae HN1 and High-level Expression in Escherichia coli
Wen-Bin REN ; Shi-Qing ZHANG ; Jun-Sheng HUANG ;
China Biotechnology 2006;0(07):-
Chitinases genes from Metarhizium anisopliae which is an important entomopathogenic fungus were considered one of the key factors to invade their hosts. One Metarhizium anisopliae HN1 strain was isolated and screened. A chitinase gene was amplified by RT-PCR from Metarhizium anisopliae HN1, The whole length of this gene was 1275bp,and the nucleotide sequence of the gene was 96% similarity to that of the M. anisopliae E6 accessed in GenBank ( AF02749). The gene has been registered in GenBank and its accession number is DQ011865. The gene was subcloned into prokaryon expression vector pET-22b( + ), transformed this recombinant expression plasmid into E. coli strain BL 21 and effective expressed. The SDS-PAGE analysis indicated that the recombinant protein was 42kDa which is same to the reported article. The expression level of recombinant protein was about 63. 3% of whole expressed proteins , And when recombinant E. coli were crushed by freeze and supersonic wave , the activity assay indicates that the chitinase expressed in bacteria possesses biological activity.
8.Polylactic-co-glycolic acid complex with different concentrations of Schwann cells for peripheral nerve regeneration
Huanwei SUN ; Tiehui ZHANG ; Xinyan YOU ; Yuanfei REN ; Sheng ZHONG
Chinese Journal of Tissue Engineering Research 2014;(47):7579-7584
BACKGROUND:Studies have shown that nerve grafts with Schwann cels can repair peripheral nerve defect and Schwann cels have an important role in nerve regeneration. OBJECTIVE: To observe the rehabilitation status of neutral function after sciatic nerve injury in rats bridged by nerve grafts with Schwann cels. METHODS: A rat model of sciatic nerve injury was established, and schwann cels were primarily cultured. Then, the rat model was repaired with polylactic-co-glycolic acid copolymer-extracelular matrix gel-Schwann cels complex. According to different concentrations of Schwann cels, there were five cel groups from 105/L to 109 RESULTS AND CONCLUSION: The nerve conduction velocities in the cel groups were al higher than that in the control group at 3, 6, 12 weeks after modeling (P < 0.01), and it was highest in the 10 and a control group. The nerve conduction velocity was detected respectively at 3, 6, 12 weeks after modeling; the e tibialis anterior muscle gravity was detected and histological observation was done at 12 weeks. 8/L (P < 0.05). At 12 weeks, hematoxylin-eosin staining of the tibialis anterior muscle showed that the number of normal muscle fibers was higher in the cel groups than the control group (P < 0.05). In the 108/L and 109 and had similar length, thickness and density. These findings indicate that polylactic-co-glycolic acid complex with 10/L groups, the morphology of tibialis anterior muscle recovered wel; the muscle fibers were in strip-like and wavy shapes, grew in the same direction, 8/L Schwann cels is better to promote sciatic nerve regeneration.
9.Detection of Interleukin-4,-6,-8 in Children with Idiopathic Thronbocytopenic Purpura
shu-ren, ZHANG ; jian-fei, FENG ; guang-yao, SHENG
Journal of Applied Clinical Pediatrics 1986;0(01):-
Objective To study the changes of interleukin-4(IL-4),IL-6,IL-8 in children with idiopathic thrombocytopenic purpura(ITP).Methods The serum of IL-4,IL-6,IL-8 in 35 ITP patients and 20 normal control children were detected by enzyme-linked immunosorbent assay.Results The serum IL-4,IL-6,IL-8 in ITP patients were elevated. There were significant difference between ITP group and control group(P