Objective To introduce a better operation method to repair the skin and soft tissue defects in the forehead.Methods This kind of frontalis musculocutaneous flap was applied to repair the skin and soft tissue defects in the forehead in 8 cases.The flap was designed carefully according to the shape and the size of the focal lesion before the operation. The maximum area of the flap was 2.9cm?1.6cm, and the minimum area was 1.2cm?1cm. The full flap contained muscle in its proximal area and skin, muscle, and fascia in its distal one. A muscular pedicle with appropriate length was outlined on the paramedian and lateral forehead. The pedicle was composed of frontalis muscle fibers, the terminal part of the frontal branches of the superficial temporal artery, and some small branches from the supraorbital and the supratrocheal arteries. The body of the flap was designed into triangle shape. Full thickness skin was incised around the inverted pattern of the defect. The skin of the paramedian and lateral aspect was then undermined laterally. Superficial dissection was carried out in a subcutaneous layer. The flap was undermined beneath the galea and frontalis muscle just external to the skull. The muscle pedicle was prepared by incising a parallel horizontal incision. Careful attention should be taken so as not to injure the vascular pedicle. At that time, the supraorbital and supratrocheal arteries were carefully ligated to obtain complete hemostasis. Then the flap was advanced and transferred down to cover the wound in the forehead. The donor site could be sutured directedly by undermining the margins of the defect without much difficuties. Results All flaps in 8 cases survived. Venous congestion was observed in early postoperative period in only one case. But the flap survived completely after proper management in final healing. Follow-ups were made from 6 months and 12 months after operations. The color and texture of the flaps were similar to the adjacent skin in the forehead. The shapes were satisfying. Conclusions This kind of flap is a much better method for the repairing of some small or moderate defects in the forehead. It can be easily operated and allow a rapid aesthetic restoration.

Rhodiola capsules show the resistant effects on ischemia, anoxia, radiation, fatigue and virus and so on, and can im-prove the body immune function to relief the plateau symptoms such as fatigue and cerebral hypoxia. The influence mechanism of rhodi-ola capsules in the effect of anti-high altitude pulmonary edema was summarized in the paper.

Objective To compare the efficacy of four different methods to locate tracheal tube in the tracheal:modified transillumination method,21/23 cm rule,marked the intubation at a distance,and fiberoptic bronchoscope.Methods A prospective randomized controlled trial was conducted.120 endotracheally intubated adult patients with American Society of Anesthesiologists (ASA) classification Ⅰ-Ⅱ and admitted to Central Hospital of Fengxian in Shanghai from January to March 2015 were enrolled.The patients were randomly divided into four groups (n =30) and located by 21/23 cm rule,marked the intubation at a distance,fiberoptic bronchoscope and modified transillumination method (using homemade locator guided by a red laser fiber to position the depth of tube) respectively.An endotracheal tube was inserted and measured the distance of the tube tip to the carina (TTC),vocal cords to tracheal tube cuff (VC-TC) in three different neck positions,i.e.neck in flexion,neutral,and extension position.The number of improper position in four groups was recorded.Results There were no significant differences in gender,age,and body mass index among the four groups.Six of the 30 patients using marked tracheal tuba method failed to find vocal cords with laryngoscope,while the other three methods all completed successfully.① From neck flexion to extension,TTC was gradually increased,while VC-TC was gradually decreased.In neck flexion and extension positions,TTC distance in the 21/23 cm rule group was significantly shorter than that in the fiberoptic bronchoscope group (cm:1.44 ± 1.14 vs.2.11 ±0.54,3.01 ±1.18 vs.3.80±0.71,both P ＜ 0.05),and the distance was also shorter than that in modified transillumination method group (cm:1.44 ± 1.14 vs.1.93 ± 0.81,3.01--1.18 vs.3.45 ± 0.91,both P ＞ 0.05).VC-TC distance in the 21/23 cm rule group was significantly longer than that in the modified transillumination,the marked intubation,and the fiberoptic bronchoscope groups in neck neutral and extension positions,respectively (cm:3.07 ± 1.08 vs.2.28±0.76,2.29±0.90,2.49±0.86;2.64±0.94 vs.1.82±0.72,1.81-0.94,2.02±0.91,all P ＜ 0.05).TTC and VC-TC distances in three neck positions in the modified transiflumination group were shorter than those in the fiberoptic bronchoscope group without statistical significance.② If TTC was too short,an accidental bronchus intubation could happen,while if VC-TC was too short,an accidental damage of the vocal cord inducing by the cuff press could happen.In the 21/23 cm rule group,there were 7 cases that the tube wrongly inserted to bronchus in neck flexion,and 1 case in neutral and extension positions respectively.In the marked intubation group,there were 4 cases that the tube wrongly inserted into bronchus in neck flexion,and 1 case in neck neutral position,and there were 4 cases that the vocal cords were pressed by the cuffs in extension position.In the modified transillumintion and the fiberoptic bronchoscope groups,there was only 1 case that the tube wrongly inserted to bronchus in neck flexion respectively.Conclusions When neck position changed during trachea intubation,it was easier that the tube wrongly inserted to bronchus for 21/23 cm rule method to locate the position.Bronchus intubations and cuff press vocal cords could happen using the marked tube method,which was less be found using modified transillumination or fiberoptic bronchoscope methods.Finally,the modified transillumination methods can be used to locate with satisfactory effect.

Objective:To observe the effect of Jianpi Xiaozhang tablets on the bile secretion in rats. Methods: Totally 60 rats were divided into 6 groups randomly. Jianpi Xiaozhang tablet suspension(high, moderate, low dosages), Shudantong suspension, Qinggan Lidan capsule suspension and 0. 5% carboxymethyl cellulose with the same volume was respectively given with intragastric ga-vage once daily for continuous 5 days. The bile was collected to detect total bile acids ( TBA) , total cholesterol and total bilirubin. Re-sults:Jianpi Xiaozhang tablets could notably increase TBA and total bilirubin in the bile (P<0. 01), and decrease the cholesterol content significantly (P<0. 01). Conclusion:Jianpi Xiaozhang tablets can promote the bile secretion.

ObjectiveTo evaluate the effect of auscultation, partial pressure of carbon dioxide in end-expiration (PETCO2), transillumination technique to judge whether the endotracheal tube is misplaced into the esophagus. Methods A blinded randomized controlled trial was conducted. Sixty patients with American Society of Anesthesiology (ASA) gradeⅠ-Ⅱundergoing endotracheal intubation in Fengxian Central Hospital admitted from September 2014 to February 2015 were enrolled. Two endotracheal tubes with the same size were respectively inserted into the trachea and esophagus for the same depth after general anesthesia by the same person. Two blinded anesthetists with different experience checked the tube position using three methods including auscultation, PETCO2, and transillumination technique, respectively. The order of the tubes tested (trachea or esophagus) and the method used were randomized according to randomise numbers table. The experienced anesthetists conducted the test first, followed by an inexperienced anesthetist conducting the same methods. The numbers of right and wrong determinations with different methods by different anesthetists were recorded.Results Sixty patients underwent the procedures for 180 times, with intratracheal intubation for 90 times, and esophageal intubation for 90 times. It was shown that the results were not different in two groups [96.7% (174/180) vs. 92.2% (166/180),χ2 = 3.500,P = 0.057]. By using auscultation, the correct rate of experienced anesthetist was higher than that of inexperienced (95.0% vs. 78.3%,χ2 = 5.786,P = 0.013). Using PETCO2, both anesthetists were correct in all cases, and the accuracy was 100%. Using transillumination, the experienced anesthetist was mistaken in 3 cases (accuracy was 95.0%), while the inexperienced mistook in 1 case (accuracy was 98.3%), and no significant difference was found between two groups (χ2 = 0.500,P = 0.250). The correct rate of using transilluminaion was significantly higher than that of using auscultation (χ2 = 7.563,P = 0.004). The sensitivity and specificity of the auscultation was 70.0% and 80.0%, that of transillumination technique was 96.7% and 93.3%,and PETCO2 was 100%, respectively, for two groups.ConclusionsPETCO2 is the most reliable method for determining tube position, and it is superior to auscultation and transilluminaion. Transillumintaion technique is superior to auscultation, irrespective of anesthetists' experience, while the accuracy of auscultation showed an obvious relationship with the anesthetists' experience.

AIM: To study the effects of chronic metabolic acidosis on glomerulus, mesangial cells and the production of extracellular matrix. METHODS: Chronic metabolic acidosis was induced by addition of 0.28 mol/L NH_4Cl to drinking water for 3, 7, or 14 days in male Wistar rats (n=10). Light microscope combined with computer software (Motic Images Advanced 3.2) was used to determine the effect of chronic acid loading on renal morphologic changes. The expressions of proliferation cell nuclear antigen (PCNA) and p27 in glomeruli were detected by Western blotting or immunohistochemistry. Fibronectin (FN) mRNA was detected by real-time PCR. The proliferation of mesangial cells in vitro was determined by ~3H:-TdR incorporation. The concentration of FN in cultured supernatant was detected by ELISA. RESULTS: On day 1, 3, 7 and 14, the arterial pH and plasma HCO_3~-: in experimental rats were significantly decreased. There was a significantly increased in the kidney weight and the ratio of kidney to body weigh in experimental rats on day 3, 7 and 14. The glomerular area and cell numbers also increased significantly. Immunoblotting demonstrated decreased p27 expression and increased PCNA expression in isolated glomeruli, and the expression of PCNA increased in a time-dependent manner following the time of chronic metabolic acidosis. Immunohistochemistry showed increased positive PCNA expression mainly localized to mesangial cells. The expression of FN mRNA was significantly elevated in experimental rats on day 7 and 14. In vitro, acid loading induced mesangial cell proliferation and synthesis of FN. CONCLUSION: These results suggest that chronic metabolic acidosis induces mesangial cell proliferation, and its mechanism may be associated with the downregulation of cell cycle kinase inhibitor p27.

Objective To observe the growing shape and function of Madin-Darby canine kidney (MDCK) cells implanted on the polysilicon nanopore membrane by micro-electro-mechanical system (MEMS). Methods The polysilicon nanomembrane was made by silicon film processed via whirling photoresist, wet etching, electroplating and so on, and then it was coated by extracellular matrix and implanted with MDCK cells. The cell growth shape and function was observed or examined by scanning electron microscope or MTT test and Trypan Blue staining.Results The nanomembrane with regular slit pores was successfully fabricated. Extracellular matrix-coated nanomembrane, especially for collagen Ⅳ coating, was more suitable for MDCK cells to adhere and proliferate without membrane injury. The polysilicon nanomembrane coated with extracellular matrix did not induce the cell death and also not stimulate cells releasing the cytokines such as interleukin-1β (IL-1β) and tumor necrosis factor α (TNF-α). Under scanning electron microscope, MDCK cells formed a flat single-cell fusion with tight junction on the surface of polysilicon nanomembrane and there was a large number of microvillus on the top of cells.Conclusion The collagen-coated polysilicon nanomembrane made by MEMS techniques, with no cytotoxicity and good biocompatibility, is valuable to frame the artificial glomerular filtration membrane

CD4+CD25+ Regulatory T cells (Treg) have been found to down-regulate immune activation in HIV-1 infection. However, whether the depletion of Treg benefits to the disease status of HIV infection remains undefined. To address this issue, we enumerated the Treg absolute counts and frequency in 75 antiviral-na(i)ve HIV-1-infected individuals in this study. It was found that HIV-infected patients displayed a significant decline in Treg absolute counts but a significant increase in Treg frequency. In addition, with disease progression indicated by CD4 T-cell absolute counts, circulating Treg frequency gradually increased; while Treg absolute counts were gradually decreased, suggesting that the alteration of Treg number closely correlated with disease progression in HIV infection.Functional analysis further showed that Treg efficiently inhibit both CD4 and CD8 T cell proliferation in vitro. Thus, our findings indicates that Treg actively participate in pathogenesis of chronic HIV infection,influencing the disease progression.

OBJECTIVETo summarize the therapeutic experience in removing huge craniofacial hemangioma in 135 cases and reveal the rules of repairing the damaged tissues or organs caused by the extirpation.

METHODSThe procedure was to remove the focal lesion correctly, control hemorrhage, keep the stable blood volume, repair and rebuild the damaged tissues or organs reasonably.

RESULTSThe focal lesion was removed rather completely without accidental injuries or deaths. The damaged tissues or organs were repaired and rebuilt quite satisfactorily.

CONCLUSIONHuge craniofacial hemangioma of any type should be operated on as early as possible with sufficient preoperative preparations.

Objective To study the effect of Xinnaoning tablets on blood stasis rat model which was caused to dexamethasone sodium phosphate injection with symptom score , K-value of blood, modified index, electrophoresis index.Methods 60 rats, were di-vided into 6 groups stochastically , and 1 group for vacuity contrast group , the other 5 groups for blood stasis model , the 5 groups were model group , Naoan tablets group , high dose , medium dose and low dose Xinnaoning tablets groups .Symptom score were evaluated , K-value of blood , Modified index , Electrophoresis index were measured .Results The Model was constructed successfully , model group and administrate groups had significant blood symptoms (P<0.01).The effect of high dose Xinnaoning tablets group to blood stasis rat model which was caused to dexamethasone sodium phosphate injection was best .High dose and medium dose Xinnaoning tab-lets groups could induce K-value significantly (P<0.01).Xinnaoning tablets groups could improve modified index and electrophore-sis index significantly (P<0.01), and the effect of high dose and medium dose Xinnaoning tablets groups to blood stasis rat model which was caused to dexamethasone sodium phosphate injection were better .Conclusion Xinnaoning tablets had good improvement effect on blood stasis .