OBJECTIVE:To study the bioequivalence of 2 kinds of Losartan potassium tablets in healthy volunteers. METHODS: A single oral dose of test tablet 100 mg and reference tablet 100 mg were given to 20 healthy volunteers in randomized crossover study. The plasma concentrations of losartan and its metabolite EXP3174 were determined by LC-MS. The pharmacokinetic parameters were calculated and bioequivalence of 2 kinds of tablets was evaluated. RESULTS: Main pharmacokinetic parameters of Losartan of test tablets vs. reference tablets were as follows: Cmax(534.230?238.642) ng?mL-1 vs.(520.020?226.800) ng?mL-1; tmax(1.401?0.946)h vs.(1.334?0.750)h; AUC0～36(871.177?232.315) ng?h?mL-1 vs. (773.030?252.209) ng?h?mL-1; pharmacokinetic parameters of metabolite EXP3174 of test tablets vs. reference tablets were as follows: Cmax (1 294.000?387.815) ng?mL-1 vs.(1 140.900?317.615)ng?mL-1;tmax(2.667?1.144)h vs.(2.734?1.162)h;AUC0～36(6 267.905?1 350.300)ng?h?mL-1 vs.(5 719.411?1 127.725) ng?h?mL-1; AUC0～∞(6 316.605?1 343.048)ng?h?mL-1 vs. (5 755.335?1 138.358) ng?h?mL-1. The relative bioavailability of test tablet was (116.6?24.3)%. CONCLUSION: 2 kinds of Losartan potassium tablets are bioequivalent.

OBJECTIVE:To establish a method for the content determination of saccharide in polysaccharides containing galact-uronic acid based on phenol-sulfuric acid method combined with correction factor method. METHODS:The determination condi-tion of phenol-sulfuric acid was optimized. A series of standard curves were drawn with glacturonic aid-glucose mixed control with different mass ratio. The content of saccharide in Codonopsis pilosula polysaccharides CPP1b samples containing galacturonic acid was determined. According to regression equation of galacturonic acid-glucose ratio of 0-100%,the correction factor was calculated by using C. pilosula polysaccharides CPP1b as the reference polysaccharide,and the results of content determination of saccharide were corrected. The rationality of this method was verified by using mixed monosaccharide control with same composition as C. pi-losula polysaccharides CPP1b. RESULTS:The correction factor of C. pilosula polysaccharide CPP1b to glucose was 3.33;in vali-dation test,the content of saccharide in mixed monosaccharide control with same composition as C. pilosula polysaccharides CPP1b was 103.47%. RSDs of precision and stability tests was <1%. The recoveries ranged 93.52%-107.35%(RSD=5.09%,n=6). CONCLUSIONS:The established method can accurately determine the content of saccharide in C. pilosula polysaccharides CPP1b containing galacturonic acid.

Objective To evaluate the clinical outcome of the method of repairing donor site of foot after improved toe-to-thumb reconstruction utilizing superficial circumflex iliac artery perforator (SCIAP) chimeric flap.Methods Fourteen cases of thumb defect were recruited from April,2012 to January,2016.According to Gu Yudong's classification,5 cases met the criterion of type Ⅰ,4 cases met the criterion of type Ⅱ,and 5 cases met the criterion of type Ⅲ.For type Ⅰ,the thumb was reconstructed with the great toe wrap-around flap.For type Ⅱ and Ⅲ,the thumb was reconstructed by the combined tissue with mutual artery (great toe wrap-around flap,and the bonetendon tissue of the second toe).All the donor sites of foot were repaired utilizing SCIAP chimeric flap.Results All the reconstructed thumbs survived.Among 14 free flaps of donor site,1 case suffered venous crisis and survived after exploration and rescue surgery.Dorsal skin necrosis of the second toe was found in 1 case,which was healed by local skin flap transposition.All patients were followed-up ranged from 3 to 30 months (averaged at 16 months).In spite of slightly bloated,the color and texture of all the flaps' was satisfied,and the average healing time of the bone in the donor sites was 2.5 months.All patients did not feel painful and had no adverse effect when walking and running.Three months after the operation,5 slightly bloated flaps in the donor sites under went flap plastic and achieved better appearance.On the part of iliaca,there was only one inconspicuous linear scar without any discomfort.Conclusion Repairing donor site of foot after improved toe-to-thumb reconstruction utilizing SCIAP chimeric flap was an ideal method.Using this method,the reconstructed thumb can achieve good appearance and function,all the toes of donor site were reserved,and the disability of the donor site is minimized.

Objective To explore the anatomic characteristics of the peroneal perforator branches and its clinical application as vascularized flap transfer. Methods Twenty fresh cadaver specimen with 40 sides lower limbs were used in this study.Lead oxide gelatin was injected to the whole body,lower extremity radiaograph, spiral CT scan was then used to construct three demention visual model. The peroneal artery and its perforators were dissected,number of peferators,distance to fibular head,diameter and the length of the vascular pedicles were measured and analyzed. From July 2005 to October 2009, forty-three cases with skin defects were performed vascularized transfer in our study,surviving rate and postoperative function were followed up for 6 months to 2 years.Results Perforators were seen most at (9.80 ± 0.93)cm,(13.40 ±0.90) cm,(17.20 ± 1.13)cm,and (21.30 ± 0.77)cm beneath the fibular head with the artery branch diarneter(1.33 ± 0.39) mm,(1.30 ± 0.46)mm,(1.17 ± 0.30)mm,and (1.22 ± 0.23)mm,respectively,while the pedicle length was (5.87 ± 0.73)cm,(5.83 ± 1.73)cm,(5.44 ± 1.09)cm,and (5.10 ± 1.93) cm respectively.In clinic,42/43 free flaps survived.Postoperative outlook were satisfied except in 7 cases,the flaps looked bulky and needed secondary revision.All the donor calves showed good apperaence and function.Conclusion There are 4 regular perferators in lateral calf, while perforators in the middle 1/3 are bigger with relatively longer vascular pedicles which are appropriate for vascularized transfer.

Summary: The homocysteine (Hcy)-induced tissue factor (TF) expression in human vascular smooth muscle cells (VSMCs) and the effect of Hey on the activity of nuclear factor-kappaB (NF-κB) and the expression of inducible nitric oxide synthase (iNOS) were investigated. Human umbilical artery VSMCs were cultured by tissue explanting method, identified by α-actin immunohistochemistry, and incubated with different concentrations of Hcy/PTDC (NF-κB inhibitor). Semi-quantitative RT-PCR was performed to detect the expression of TF mRNA in VSMCs. Flow cytometry was used to assay the expression of TF protein on the surface of VSMCs and the expression of iNOS in VSMCs. Westem blot was carried out to detect the expression of NF-κB protein in nuclei. The results showed that Hcy could induce VSMCs expressing TF mRNA significantly after the VSMCs were incubated with Hey at concentrations of 10, 100, 500 μmol/L respectively. There was low expression level of TF protein on the surface of the resting VSMCs and Hcy could also induce VSMCs expressing TF protein on the cell surface in different concentrations. Additionally, Hcy could rapidly induce the activation of NF-κB and this effect could be significantly inhibited by PDTC. Hcy alone could not induce the expression of iNOS in VSMCs. It was concluded that Hey could significantly induce the expression of TF in VSMCs and enhance the activation of NF-κB, subsequently mediate TF gene expression and protein synthesis. NF-κB-mediated expression of TF in VSMCs might be the important mechanism of atherosclerosis and thrombosis induced by Hcy.

Objective To investigate the clinical effects of reparing the complicated soft tissue defects of limbs with free thoracodorsal artery perforator (TDAP) flaps.Methods From April,2009 to March,2014,19 limbs (including 8 upper limbs and 11 lower limbs) soft tissue defects with bone and tendon exposure were repaired with free TDAP flaps in the secondary stage.There were 12 thoracodorsal artery perforator flaps,5 polyfoliate perforator flaps,1 chimeric muscle flap,and 1 chimeric muscle polyfoliate flap.The sizes of the flaps ranged from 5.0 cm×6.0cm-20.0 cm×l 1.0 cm.Seventeen wounds of the dornor site were closed directly,and the other 2 were closed with skin grafts.Results Sixteen flaps survived successfully.Two flaps had venous congestion and survived at last after taking the stitches out.One flap had partial necrosis and repaired by skin graft finally.The clinical results were satisfactory after 12-18 months following-up,and the scars of the dornor sites of all but 3 patients were not obvious.All the shoulder function were normal.Conclusion The TDAP flap has dependable blood supply,good texture,less dornor site morbility.The polyfoliate TDAP flap can be used for repairing irregular defect.The chimeric latissimus TDAP flap can be used for the function reconstruction.The free TDAP flap is suited for repairing soft tissue defects of the limbs.

Objective:To introduce the 3-DEEP treatment strategy for Wassel Ⅳ thumb polydactyly and evaluate the clinical efficacy of this treatment strategy.Methods:A retrospective study of Ningbo Sixth Hospital between January 2010 and December 2019 in Wassel Ⅳ thumb polydactyly cases, 153 cases of 155 thumbs, according to the appearance and the X-ray image to be subdivided into type A (balanced type, crab claw shaped), 16 cases; type B (disequilibrium, the thumb joint deviation less than 25 degrees), 97 cases ; and type C (disequilibrium, the thumb joint deviation greater than 25 degrees) , 42 cases. The thumb plastic surgery was divided into three layers: bone and joint, tendon and muscle, and skin-soft-tissue for personalized design (3-DEEP). Postoperative follow-up was conducted to evaluate the efficacy and satisfaction, and complications were observed.Results:153 patients were followed up for 1 to 6 years, and the efficacy evaluation was excellent in 104 cases, good in 46 cases, and poor in 5 cases, with the excellent and good rate of 96.8%. The functional satisfaction and shape satisfaction were 98.1% and 96.8% respectively. Among them, 2 cases showed unsatisfactory postoperatively flexion and extension of the interphalangeal joint and interphalangeal joint deviation deformity, 1 case showed radial hump deformity of the metacarpophalangeal joint 2 years after the operation, and 2 cases showed relatively obvious incision scar.Conclusions:Wassel Ⅳ thumb polydactyly is the most common type of thumb polydactyly, but there are still obvious differences in the same classification group.We further subdivided the classification of cases of Wassel type Ⅳ, and according to the anatomical characteristics of each subtype, we designed 3-DEEP treatment strategies, get better thumb appearance, avoid postoperative joint dysfunction, and less postoperative complications.

The treatment of scar contracture has always been the difficult and key point in clinical research. As a new treatment method, fractional laser has a good effect on the early treatment of scar. After fractional laser thermal stimulation, the texture of scar improved and the traction symptom can be relieved to a certain extent. However, in practical application, the relationship between fractional laser parameters and the improvement degree of scar ductility is not clear, resulting in the blindness and randomness of the treatment. Finite element model analysis is a widely used numerical analysis method with high precision in organization simulation. In this paper, we will review and prospect application of fractional laser in the treatment of scar contracture combining with finite element model analysis method.

Objective:To introduce the 3-DEEP treatment strategy for Wassel Ⅳ thumb polydactyly and evaluate the clinical efficacy of this treatment strategy.Methods:A retrospective study of Ningbo Sixth Hospital between January 2010 and December 2019 in Wassel Ⅳ thumb polydactyly cases, 153 cases of 155 thumbs, according to the appearance and the X-ray image to be subdivided into type A (balanced type, crab claw shaped), 16 cases; type B (disequilibrium, the thumb joint deviation less than 25 degrees), 97 cases ; and type C (disequilibrium, the thumb joint deviation greater than 25 degrees) , 42 cases. The thumb plastic surgery was divided into three layers: bone and joint, tendon and muscle, and skin-soft-tissue for personalized design (3-DEEP). Postoperative follow-up was conducted to evaluate the efficacy and satisfaction, and complications were observed.Results:153 patients were followed up for 1 to 6 years, and the efficacy evaluation was excellent in 104 cases, good in 46 cases, and poor in 5 cases, with the excellent and good rate of 96.8%. The functional satisfaction and shape satisfaction were 98.1% and 96.8% respectively. Among them, 2 cases showed unsatisfactory postoperatively flexion and extension of the interphalangeal joint and interphalangeal joint deviation deformity, 1 case showed radial hump deformity of the metacarpophalangeal joint 2 years after the operation, and 2 cases showed relatively obvious incision scar.Conclusions:Wassel Ⅳ thumb polydactyly is the most common type of thumb polydactyly, but there are still obvious differences in the same classification group.We further subdivided the classification of cases of Wassel type Ⅳ, and according to the anatomical characteristics of each subtype, we designed 3-DEEP treatment strategies, get better thumb appearance, avoid postoperative joint dysfunction, and less postoperative complications.

The treatment of scar contracture has always been the difficult and key point in clinical research. As a new treatment method, fractional laser has a good effect on the early treatment of scar. After fractional laser thermal stimulation, the texture of scar improved and the traction symptom can be relieved to a certain extent. However, in practical application, the relationship between fractional laser parameters and the improvement degree of scar ductility is not clear, resulting in the blindness and randomness of the treatment. Finite element model analysis is a widely used numerical analysis method with high precision in organization simulation. In this paper, we will review and prospect application of fractional laser in the treatment of scar contracture combining with finite element model analysis method.