Objective To observe the clinical outcome of repair of the tissue defects of the tendon and skin with thigh anterolateral free flap with iliotibial tract. Methods The data was reviewed from June 2006 to June 2010, which the thigh anterolateral free flap with iliotibial tract were used to repair the defects of the tendon and skin of back of hand in 12 patients. The skin flap was 7 cm´10 cm~8 cm´12 cm in area. The iliotibial tract was 7~13 cm in length and 8~10 cm in width. Institute of Hand Surgery of Chinese Medical Association was to assess the effect. The fellow-up of the 12 patients was 6 months~4 years. Results All the flaps survived after the operation. The result showed excellent in 3 patients, good in 6 and fair in 3. Conclusion It is an effective surgical method to repair the tissue defects of the tendon and skin with thigh anterolateral free flap with iliotibial tract.

BACKGROUND:To in vitro isolate neural stem cel s with high purity and uniform biological properties and to establish a complete set of neural stem cel culture system is the basis for neural stem cel research.
OBJECTIVE:To establish an isolation and culture system for neural stem cel s from newborn mouse hippocampus, olfactory bulb and cortex and to analyze the biological properties of cel s.
METHODS:Neural stem cel s were isolated from the hippocampus, olfactory bulb and cortex tissue of newborn Kunming mice by mechanical separation and trypsin digestion. Serum-free culture technology, mechanical pipetting and trypsin digestion were used for subculture of neural stem cel s. 10%fetal bovine serum was used to induce differentiation of neural stem cel s. Neural stem cel s and their differentiated products were identified by
immunofluorescent staining of Nestin, CD133,β-TubulinIII, glial fibril ary acidic protein.
RESULTS AND CONCLUSION:The neural stem cel obtained from newborn mouse hippocampus, olfactory bulb and cortex had the capacity of self-renewal and differentiation which were positive for Nestin and CD133. After induction with fetal bovine serum, neural stem cel could differentiation toβ-tubulinIII or glial fibril ary acidic protein positive cel s that were neurons and astrocytes. This experiment has successful y established the neural stem cel isolation, culture, identification and induction system, providing experimental basis for subsequent studies of neural stem cel s.

The method of triggering the respirator to perform airfeed by the management of the diaphragmatic electromyography (EMG) signal is introduced in this paper. By using LabVIEW, an analysis software of the diaphragmatic electromyographic (EMG) signals is developed to filter the diaphragmatic EMG signal. The characteristics of the filtered signal is analyzed to catch the inspiratory onset, and then a series of signals are sent out duly to trigger the respirator to perform airfeed, and thus the patient's respiration can be synchronized with the respirator.

Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma (MCL) after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen(93%)cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases (100%)primarily with lymph node involvement,7 cases (47%)with bone marrow involvement,4 cases (27%)with gastrointestinal involvement,and 3 cases (20%)with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases (60%),while 6 cases were with more than 40% (40%).One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months (3 -64),and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.

Objective:To identify the current situation of contract signing for family physician services in Luohu District, Shenzhen, and to explore the associated factors with contract signing and access to services.Methods:Using the WeChat official account of"People′s Hospital of Luohu", an online survey was conducted to investigate the status of family physician′s contract services for residents in Luohu District from May 19th to 25th, 2019. A total of 14 487 valid responses were received. Chi-square test and Logistic regression models were used to analyze the contract signing of family physician services and the related factors.Results:8 560 (59.09%) of the participants had signed with a family physician, and 12 696 of them had learnt about the service before. The awareness rate of family doctor services was 87.64%. The contract signing rate of those unemployed, who living or working in Luohu less than 5 years, who living alone, having no Shenzhen medical insurance, or having not heard of family physicians signing services were less than 50%. The signing rate was positively correlated with the awareness of family physician contract service, as well as the possibility of accepting signed medical examination, traditional Chinese medicine services and health information. Only 9.70% of the contractors received health services information.Conclusions:The contract Signing rates and awareness rate of family physicians among young and middle-aged residents in Luohu District are relatively high. However, access to contract services varies considerably. The signing rate and accepted services are mainly affected by job, length of residence in Shenzhen, type of medical insurance, and understanding of contract.

Objective:To investigate the efficacy of atenolol combined with perindopril in the treatment of chronic heart failure in older adult patients and its effects on ventricular function, serum connective tissue growth factor (CTGF), and nexin.Methods:120 older adult patients with chronic heart failure who received treatment in the Department of Cardiology, the First People's Hospital of Fuyang District from January 2016 to January 2018 were included in this study. They were randomly assigned to receive either basic treatment + atenolol treatment (control group, n = 60) or atenolol combined with perindopril treatment (observation group, n = 60). Clinical efficacy and clinical symptom, serum CTGF, nexin level and ventricular function pre- and post-treatment, as well as adverse reactions were compared between the control and observation groups. Results:After treatment, effective rate in the observation group was significantly higher than that in the control group (91.6% vs. 78.3%, χ2 = 4.183, P = 0.041). After treatment, CTGF and nexin levels in the control and observation groups were decreased compared with before treatment (both P < 0.05). After treatment, CTGF and nexin levels in the observation group were (4.42 ± 0.46) μg/L and (0.82 ± 0.03) μg/L, respectively, which were significantly lower than those in the control group [(4.82 ± 0.51) μg/L, (0.98 ± 0.04) μg/L, t = 18.153, 4.511, 19.335, 24.787, all P < 0.05]. After treatment, left ventricular end diastolic diameter and left ventricular end systolic diameter in the control and observation groups were deceased compared with before treatment (both P < 0.05). After treatment, left ventricular end diastolic diameter and left ventricular end systolic diameter in the observation group were (48.73 ± 4.41) mm and (41.13 ± 4.15) mm, respectively, which were significantly lower than those in the control group [(56.01 ± 4.67) mm, (47.45 ± 4.17) mm, t = 5.700, 8.799, 8.317, 8.351, all P < 0.05]. After treatment, left ventricular ejection fraction in the control and observation groups was significantly increased compared with before treatment. After treatment, left ventricular ejection fraction in the observation group was significantly higher than that in the control group [(44.86 ± 4.59) % vs. (39.05 ± 4.69) %, P < 0.05]. Conclusion:Atenolol combined with perindopril in the treatment of older adult patients with chronic heart failure can reduce clinical symptoms, improve ventricular function, decrease serum CTGF and nexin levels and is highly safe. Therefore, this method is worthy of clinical application.

Aim To investigate the effect of curcumin against high-fat-diet induced C57BL/6J mice bone changes and the correlation between the expression of cathepsin K and curcumin.Methods Curcumin treated C57BL/6J mice had been on high fat diet for 12 weeks.The HE, Alizarin red S staining and Safranin O/fast green staining of femur were employed to evaluate bone microstructure, bone metabolism and bone development.The expressions of cathepsin K were assessed by Western blot and immunohistochemical staining.Results Histopathological results showed that curcumin could improve the destruction of trabecular bone structure, cartilage development and bone calcification.Biomechanical results proved that curcumin could improve the bone strength of the type 2 diabetic mice induced by high fat.The results of immunohistochemistry and Western blot assay indicated that curcumin could significantly inhibit the expression of cathepsin K in bone tissues of mice.Conclusion Curcumin can increase bone strength, improve bone microstructure, and enhance the degree of bone calcification, which may be achieved by inhibiting the expression of cathepsin K.

Objective:To compare the clinical results of modified posterolateral approach combined medial approach versus traditional posterolateral approach combined with medial approach in open reduction and internal fixation of trimalleolar ankle fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 46 patients with trimalleolar ankle fracture admitted to the First Affiliated Hospital of Naval Military Medical University from June 2013 to June 2019, including 14 males and 32 females, at age of 19-71 years [(49.2±14.9)years]. There were 33 patients with supination-external rotation type IV ankle fracture and 13 with pronation-external rotation type IV ankle fracture according to Lauge-Hansen classification. Open reduction and internal fixation was performed through the modified posterolateral approach combined with medial approach in 25 patients (modified approach group), and through the traditional posterolateral approach combined with medial approach in 21 patients (traditional approach group). The visual analogue score (VAS) at 3 days and 1 week after surgery, fracture healing time, range of ankle flexion and extension and Baird-Jackson score at the final follow-up and postoperative complications (numbness of the affect limb, wound necrosis, etc.) were compared between the two groups.Results:All patients were followed up for 11-21 months [(14.8±2.2)months]. There was no statistical difference in VAS or fracture healing time at 3 days after surgery between the two groups (all P>0.05). The VAS was 3.0 (3.0, 4.0)points in modified approach group at 1 week after surgery, significantly lower than 4.0 (3.0, 5.0)points in traditional approach group ( P<0.05). At the final follow-up, there was no statistical difference in range of ankle plantarflexion between the two groups ( P>0.05), but range of ankle dorsiflexion was significantly greater in modified approach group [(11.8±2.8)°] than that in traditional approach group [(8.1±3.5)°] ( P<0.01). At the final follow-up, Baird-Jackson score was not statistically different between the two groups ( P>0.05). There were 4 patients with numbness and 2 with wound necrosis in traditional approach group, but no numbness or wound necrosis occurred in modified approach group ( P<0.01). Conclusion:Both the modified posterolateral approach combined with medial approach and traditional posterolateral approach combined with medial approach can achieve good clinical results in open reduction and internal fixation of trimalleolar ankle fractures, but the former has advantages of better pain relief, better recovery of ankle dorsiflexion and less complications.

Objective To analyze the effect of different retained dosage of lauromacrogol within the thyroid cyst in the sclerotherapy of thyroid cysts.Methods A total of 200 patients with thyroid cysts,who were admitted to the Longyan Municipal First Hospital of China between August 2020 and August 2021,were enrolled in this study.The patients were randomly and equally divided into group zero(suctioning out all the amount of the injected lauromacrogol),and,according to the percentage of the retained lauromacrogol dosage to the total cystic fluid,group 10%,group 20%,group 30%and group 50%,with 40 patients in each group.Thyroid color ultrasound was reviewed at 1,3,6,and 12 months after treatment.The changes of capsule volume,curative efficacy,influencing factors,and adverse reactions after the cyst became sclerosis were analyzed.Logistic regression analysis was used to analyze the factors affecting the postoperative efficacy.Results In all the 5 groups,the suctioned fluid was dark red in colour,and the patients had cystic nodules.The preoperative mean cyst volume was(20.43±5.86)cm3.In all the 5 groups,the postoperative changes in cyst volume indicated that the postoperative one-month cyst volume significantly shrank when compared with the preoperative volume,the postoperative 3-month cyst volume remarkably shrank when compared with the postoperative one-month volume,and the postoperative 6-month cyst volume strikingly shrank when compared with the postoperative 3-month volume(all P＜0.05),while no statistically significant difference in the cyst volume existed between the postoperative 12-month value and the postoperative 6-month value(P＞0.05).The postoperative 6-month total effective rate of all the five groups was 87%(174/200),and no statistically significant differences in the postoperative 6-month curative effect existed between each other among the 5 groups(P＞0.05).Taking the postoperative 6-month curative effect as the dependent variable,and the age,sex,thick cystic wall,cystic septum,and preoperative cyst volume as independent variables,the binary logistic regression analysis was conducted,which revealed that the thick cystic wall(OR=0.24,95%CI=0.08-0.72,P=0.01)and the cystic septum(OR=0.21,95%CI=0.07-0.67,P=0.01)were the factors affecting the postoperative 6-month curative effect.The main side reaction was pain,which was tolerable by patients.There was no significant difference in the incidence of adverse reactions between each other among the five groups(all P＞0.05).Conclusion In treating thyroid cysts by using ultrasound-guided lauromacrogol sclerotherapy,there is no relationship between the curative effect and the percentage of the retained lauromacrogol dosage to the total cystic fluid.The best curative effect can be achieved at 6 months after injection of lauromacrogol,which can be used as the optimal time for follow-up check.The thick cystic wall and the cystic septum are the main factors that affect the curative effect of lauromacrogol sclerotherapy.For the treatment of thyroid cyst,lauromacrogol sclerotherapy carries reliable curative effect with few adverse reactions,therefore,this therapy is worthy of clinical application.(J Intervent Radiol,2024,32:69-73)

Under the background of performance evaluation in nationwide tertiary public hospitals and the DRGs reform, how to improve the efficiency of daytime surgery management is becoming a hotspot for hospital managers. Since July 2020, a tertiary general hospital applied the theory of incentive compatibility to guide the medical workers to consciously strive to achieve such management goals as improving the quantity and quality of daytime surgeries by constructing an organizational management system, increasing performance rewards for daytime surgical teams, rewarding advanced collectives and individuals, convening work coordination and promotion meetings, formulating penalty terms, and strengthening supervision of surgical quality and safety indicators. The implementation rate of daytime surgery in hospitals, the number of departments conducting daytime surgery, the number of covered diseases, and the satisfaction rate of inpatients had increased from 6.94%, 6 departments, 64 diseases, and 90.5% in 2019 to 24.08%, 21 departments, 125 diseases, and 95.0% in 2022, respectively. The incidence of daytime surgical bleeding, and readmissions within 15 days decreased from 0.6% and 0.5% in 2019 to 0.5% and 0.2% in 2022, respectively. The theory of incentive compatibility was in line with the development goals of daytime surgery in China, providing an optimal strategy for improving the management efficiency of daytime surgery according to local conditions.