Objective To investigate the clinical outcomes of arteriovenous anastomosis by microvascular anastomotic coupler device.Methods From January 2013 to November 2013,23 cases of microvascular anastomotic coupler device were applied in 18 patients with vascular injury of upper limb,and anastomosis time and patency rate was observed.Results In 18 patients,the brachial artery injury in 2 cases,the radial artery injury in 11 cases,the ulnar artery injury in 8 cases,the cephalic vein injury in 1 case,and basilic vein injury in 1 case.23 microvascular anastomotic coupler devices were applied in vascular injury.The post procedure vascular patency rate was 100％ and the average time of anastomosis was 3min 59s.Conclusion Microvascular anastomotic coupler device is charactered by higher patency rate and faster operation.It can not only be used in venous anastomosis of tissue graft,and also has a certain value in the repair of arteriovenous injury.

Objective To explore the method and effect of thumb and finger reconstruction and repair by emergent primary toes transplantation. Methods Three hundred and fourteen fingers of 282 cases including finger thumb defect and complex injury with hyperthena palm radid soft tissue of forearm were reconstructed and repaired by the second toes, wrap-around flap and the second third toes wrap-around flap combined with distal flap of leg or other complex tissue flap transplantation. Results Three hundred and eight reconstructed fingers survived, the survival rate was 98%. After a follow up to 6 months to 6 years, the reconstructed thumbs and fingers have accepted nip, grasp, opponent function. The result was graded as excellent in 214 fingers, good in 63, fair in 26, poor in 5. The excellent and good rate was 88%according to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association. Conclusion Different type of toes and combined toes transplantation can obtain preferable clinical effect on emergent primary thumb and finger defect.

Objective:To investigate the effects of human placenta tablets combined with active folic acid and compound nutrient tablets on Th1 cytokines and hormone levels in pregnant patients with threatened miscarriage.Methods:A total of 226 pregnant patients with threatened miscarriage who received treatment in Linyi Traditional Chinese Medicine Hospital from April to September 2021 were included in this study. They were randomly divided into a control group and an observation group, with 113 patients in each group. The control group was treated with human placenta tablets. The observation group was treated with human placenta tablets combined with active folic acid and compound nutrient tablets. All patients were treated for 4 weeks. Before and after treatment, serum levels of Th1 cytokines, β-human chorionic gonadotropin, progesterone, and estradiol as well as the rate of success of protection against miscarriage, adverse reactions, and perinatal complications were compared between the two groups.Results:After 4 weeks of treatment, serum levels of interleukin-2, tumor necrosis factor-α, and interferon-γ in the observation group were significantly lower than those in the control group ( t = 27.53, 20.99, 31.69, all P < 0.001). Serum levels of β-human chorionic gonadotropin, progesterone, and estradiol in the observation group were (143.79 ± 9.56) IU/L, (36.43 ± 4.71) ng/L, (234.72 ± 13.29) pmol/L, which were significantly higher than (122.53 ± 7.47) IU/L, (29.32 ± 4.22) ) ng/L, (167.86 ± 8.93) pmol/L in the control group ( t = 18.63, 11.95, 44.39, all P < 0.001). The rate of success of protection against miscarriage in the observation group was significantly higher than that in the control group (92.9% vs. 76.1%, χ2 = 12.20, P < 0.05). There were no significant differences in the incidences of adverse reactions and perinatal compilations between the two groups (both P > 0.05). Conclusion:Human placenta tablets combined with active folic acid and compound nutrient tablets can improve serum levels of Th1 cytokines and hormones, and increase the rate of success of protection against miscarriage, without increasing the incidences of adverse reactions and perinatal complications.

Objective:To investigate the pathological subtypes and clinicopathological characteristics of the non-squamous immunophenotype nasopharyngeal carcinoma (NSNPC).Methods:The clinicopathological features of the non-squamous immunophenotype nasopharyngeal carcinoma diagnosed between 2011 and 2019 at the First Affiliated Hospital of Zhengzhou University were analyzed using hematoxylin and eosin staining, immunohistochemistry, in situ hybridization, transmission electron microscopy and PCR gene rearrangement. Follow-up data were also collected.Results:There were 14 males and 9 females with a median age of 46 years (ranging from 16 to 76 years) with an average age of 45 years. Microscopically, patterns were similar to the classic nasopharyngeal carcinoma. Immunohistochemistry showed that most NSNPC cases expressed low molecular weight keratin (CK8/18, CK8 and CKL) and expressed pathway proteins in a low level (EGFR, PI3K, p-AKT and p-mTOR), which had significant difference from classic nasopharyngeal carcinoma group ( P<0.05). Other proteins including CK5/6, CKpan, CK7, Syn, CD56, CgA, SOX-10, AKT, mTOR, Notch, STAT3 and p-STAT3 showed no statistical difference between the two groups. Pathogen detection showed that EBER was positive (18/23, 78.3%) and HPV positive(2/23, 8.7%)which were HPV35 and HPV38. The cancer suppressor gene BLU was highly expressed in NSNPC; RASSF1 and Rbms3 were less expressed in NSNPC, in line with classic NPC. As a whole, NSNPC was characterized by ultrastructures of low-differentiated squamous cell carcinoma. Compared with classic nasopharyngeal carcinoma, NSNPC had a lower recurrence rate and earlier clinical stage( P<0.05),but there was no significant correlation with age, sex, distant metastasis and death ( P>0.05). Conclusions:The histological morphology, etiology and gene changes of NSNPC are similar to those of classical nasopharyngeal carcinoma and ultrastructural findings show that NSNPC still belongs to undifferentiated type in non-keratinized squamous cell carcinoma. The malignant degree of NSNPC is low and the prognosis is good.

To investigate the clinical effect of repairing the electrical wound of upper limbs by using the perforator flap pedicled with the descending branch of lateral circumflex femoral artery. Methods From August, 2014 to July, 2018, the perforator flap pedicled with the descending branch of lateral circumflex femoral artery was used to repair the electrical wound of the upper limbs in 10 cases (11 sides), which were 9 cases (10 sides) in males, 1 case (1 side) in female. Three cases in the left side, 6 cases in the right side, and 1 case in both sides. The area of the flap was 12 cm ×6 cm-26 cm×11 cm.The arterial, venous and cutaneous nerves of the perforator flap were anastomosed with those of the recipient area, respectively. The patients were followed-up in outpatient depat-ment, including flap survival, texture, appearance, sensory recovery, donor site healing and scar hyperplasia. Results All the flaps survived without vascular crisis. Infection occurred in 1 case (1 side). The wound was healed 19 d after the operation by using effective antibiotics and dressing change. All cases were followed-up for 4-24 months after the operation. The blood supply of the flaps was good, the texture was similar to that of the recipient area, and the ap-pearance was satisfactory. There was no obvious bloat, and no ulceration of the flap was found. The anterolateral femoral cutaneous nerve was retained in the flap and anastomosed with the cutaneous nerve in the recipient area. The sensory recover to S3 in 3 flaps, S2 in 7 flaps, S1 in 1 flap. The donor site of the flap was sewn up with aesthetic treat-ment.After the operation, the donor sites presented a linear scar with a concealed position and no occurrence of oste-ofascial compartment syndrome. Conclusion The perforator flap pedicled with the descending branch of lateral cir-cumflex femoral artery has a constant anatomical position of perforator vessel, a wide excision range, abundant blood supply, a good appearance and a hidden donor site, which is a good choice for repairing the electrical wound.

Purpose To investigate the clinicopathological features,molecular genetics and prognosis of high grade B cell lymphoma with concurrent MYC rearrangement and 11q aberra-tions(HGBCL-MYC-11q).MethodsThree cases of HGBCL-MYC-11q were reviewed and analyzed using hematoxylin-eosin staining,immunohistochemistry,EBER in situ hybridization and fluorescence in situ hybridization.Clinical data were collected with follow-up.Results All three patients were male,age was 10,61,and 74 years,respectively.All patients had Ann Arbor stage Ⅳ disease.All three cases were biopsies occurring in the nasopharynx,upper pharynx and ileocecus,respectively.Three cases were morphologically similar to diffuse infiltrative growth of tumor cells,moderate or moderately large cells,round to slightly irregular nuclei and easily visible mitotic figures.Focal necrosis was noted in one case.One case exhibited the distinct"starry sky"pattern.All cases expressed CD20,BCL6 and MUM1 and high Ki67 index,two cases expressed CD10 and two cases ex-pressed BCL2.CD3,CD30 and TDT were all negative.EBER in situ hybridization was all negative.FISH analyses using C-MYC break-apart probes were all positive and all cases had 11q aberrations.One case only had the 11q23.3 amplification;and one case only had the 11q24.3 loss.After a follow-up for 1-18 months,one patient died and two patients survived with disease.ConclusionHGBCL-MYC-11q is rare,morphologically similar to BL/HGBCL,with MYC rearrangement and 11q abnormali-ties.We should enhance awareness of the disease and improve more accurate diagnosis and differential diagnosis of the disease.

In this study, voltage was used as a disturbance factor to investigate the relationship between microbial community and methane (CH₄) production flux in a microbial electrolytic cell coupled anaerobic digestion (MEC-AD). Metabolic flux analysis (MFA) was used to explore the relationship between the CH₄ metabolic flux produced and the microbes. The results showed that both methane production flux and hydrogen production flux changed significantly upon voltage disturbance, while the voltage disturbance had little effect on acetic acid production flux. The maximum CH₄ production flux under 0.6 V disturbance was 0.522±0.051, which increased by 77% and 32%, respectively, compared with that of the control group under 1.0 V (0.295±0.013) and under 1.4 V (0.395±0.029). In addition, an average of 15.7%±2.9% of H₂ (flux) was used to reduce CO₂ to produce CH₄ and acetic acid, and an average of 27.7%±6.9% of acetic acid (flux) was converted to CH₄. Moreover, the abundance of Lachnospiraceae significantly affected the flux of acetic acid. The flux of CH₄ production is positively correlated with the abundances of Petrimonas, Syntrophomonas, Blvii28, and Acinetobacter, and negatively correlated with the abundances of Tuzzerella and Sphaerochaeta. The species that affected the flux of H₂ and CH₄ were similar, mostly belonging to Bacteroides, Clostridium, Pseudomonas and Firmicutes. Furthermore, the interspecies interaction is also an important factor affecting the MEC-AD methanogenesis flux.
Acetates ; Anaerobiosis ; Bioreactors ; Electrolysis ; Methane