Objective To investigate the operative procedure and the clinical result of the modified rectangle cross-finger flap based on the dorsal branches in the middle phalange to repair degloved avulsion of fingertip.Methods From January 2006 to March 2010,26 patients with the avulsions of fingertip were treated by the modified rectangle cross-finger flap based on the dorsal branch in the middle phalange of adjacent finger.There were 21 men and 5 women,with an average age of 31.6 years(range,17-56 years).Fourteen cases were crushed by machine,8 cases were pressed and 4 cases were tied.There were 8 index fingers,9 long fingers,4 ring fingers and 5 little fingers.The length of the avulsion was 1.1-2.6 cm.The flap was harvested from the dorsal of contiguous digital of their middle and proximal segment.The both dorsal branches of the both proper palmar digital nerves were cut off and were anatomized with the nerve end of the injured digit.The area of flaps ranged from 3.6 cm×2.3 cm-6.5 cm×3.2 cm.The donors were closed by skin graft.Results The pedicels were cut when 13-23 d after operation.Twenty-five patients were followed up for 6-28 months(mean,16.3 months).All flaps survived with satisfactory appearance,sensation and function.All flaps and donors were primary healing.Two point discrimination was 6-9 mm with an average of 7.8 mm.The postoperative outcomes were evaluated by the total active movement.The results were excellent in 17fingers,good in 7,and fair in 1.The rate of excellent and good was 96%.Conclusion The treatment of degloved avulsion of fingertip with the modified rectangle cross-finger flap based on the dorsal branch in the middle phalange is recommendable.The operative procedure of harvesting the flap is simple.There is enough blood to supply the flap and the surviving rate is high.The postoperative function of the injured hand can be recovered satisfactorily.The figure of flap is well and the sense of flap is sensitive.The technique can be operated in the last 4 fingers without thumb.

Objective:To improve our hospital staff on medical safety awareness. To strengthen the medical device safety management practices. Methods:On the status of hospital, improve the scientific management level of medical equipment. On clinical equipment compulsory verification process, strong check of equipment maintenance is discussed. Results:the clinical departments to further understand the importance of safety in medical equipment using. Conclusion:Enhancement of medical engineering professional cooperation, improve the inspection equipment safety, reliability and validity.

Objective To discuss the treatment and clinical efficacy of repair of soft tissue and nerve defect of thumb with island flap of first dorsal metacarpal artery based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.Methods The skin and nerve defect in 14 thumbs were repaired by dorsal island flap of index fingers based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.The size of skin defect ranged from 52 mm × 32 mm to 10 mm × 8 mm.The length of the nerve defect ranged from 9 mm to 22 mm.Results The average followup was 6-35 months.All 14 flaps survived with satisfactory appearance and function.The injured side of thumb pulp sensation recovered S3 + and the injured two-point discrimination ranged from 4 mm to 7 mm.No scar contracture or sensory dysfunction complication were observed in the donor sites.Conclusions The repair of soft tissue and nerve defect of thumb with dorsal island flap of index finger based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve is recommendable,since it can obtain satisfactory clinical efficacy and be easily and conveniently oerformed.

According to the structure-activity relationships (SARs) of modafinil, a therapeutic drug of hypnolepsy, we designed and synthesized two series of compounds 2-[(diphenylmethane)sulfinyl] acetamides and 2-[(diphenylmethyl)thio] acetamides, and measured their biological activities. The target compounds (6a-6o) were synthesized beginning with diphenyl carbinol by substitution, oxidation, acylation and so on. Their structures were confirmed by ESI-MS, 1H NMR and elemental analysis. The central stimulatory effects of the target compounds were determined by the independent activity assay on mice. Compounds 6c, 6f and 6n have considerable activities, while the central stimulative effect of 6h is slightly better than the positive control modafinil.

Objective To study the first metacarpal dorsal artery anatomy,and explore the flap based on the branch chain of the first metacarpal dorsal artery.To provide anatomical basis for clinical application of the flap.Methods The origin,courses and distribution of the branch chain of the first metacarpal dorsal artery from 8 fresh hand specimens perfused by red latex were explored from January,2015 to December,2016.Results There was a dorsal artery network in the dorsal side of the first metacarpal.The radial and ulnar dorsal artery of the first metacarpal originated from the radial artery and along the first metacarpal lateral margin to go down.The initial diameter of the radial dorsal artery was (0.82±0.06)mm.The initial diameter of the ulnar dorsal artery was (0.74±0.05) mm.And anastomosed with the dorsal branches of the thumb inherent arteries.The both inherent arteries of thumb give off dorsal branches count (2.62±0.34).The initial diameter of proximal dorsal branch was (0.32±0.03) mm.The initial diameter of distal dorsal branch was (0.24±0.08) mm.Conclusion The radial and ulnar dorsal vascular chain of the first metacarpal were constant.The anastomosed branches with the dorsal branches of the thumb inherent arteries were abundant.The free flap or retrograde flap based on the vsscular chain has reliable blood supply.And without destroyed the main artery of thumb.

To discover novel fluoroquinolone lead compounds as possible anti-infective or/and antitumor chemotherapies, combination principle of pharmacophore-based drug design, a series of novel tricyclic fluoroquinolone title compounds, [1,2,4]triazino[3,4-h][1,8]naphthyridine-8-one-7-carboxylic acid derivatives ( 5a-5p), were designed and synthesized with a fused [1,2,4]-triazine ring unit. Their structures were characterized by spectral data and elemental analysis and the in vitro antibacterial and anti-cell proliferation activities were also evaluated. The results showed that the titled compounds exhibited more significant inhibitory activities against drug-resistant bacteria (Methicillin-resistant Staphylococcus aureus and multi drug-resistant Escherichia coli strains) and three tested cancer cell lines (human hepatoma SMMC-7721, murine leukemia L1210 and human murine leukemia HL60 cells). Interestingly, SAR showed that compounds with electron-donating groups attached to benzene ring had stronger antibacterial activity than antitumor activity, but electron-withdrawing compounds displayed more potential antitumor activity than antibacterial activity, especially antitumor activity of nitro compounds was comparable to comparison doxorubicin. Thus, novel triazine-fused tricyclic fluoroquinolones as potent anti-infective or/and antitumor lead compounds are valuable to pay attention and for further development.

To explore an efficient strategy for the conversion of antibacterial fluoroquinolones into antitumor fluoroquinolones, an azole heterocyclic ring of oxadiazole instead of the C-3 carboxylic acid group with a functionalized hydrazone group as a modified side-chain, fifteen novel 2-(fluoroquinolon-3-yl)-oxadiazole-5- sulfanylacetylhydrazone derivatives 7a-7o were designed and synthesized on the basis of the pharmacophore hybridization principle from pefloxacin, separately. The structures for fifteen title compounds were characterized by elemental analysis, 1H NMR and MS, and their in vitro antitumor activity against Hep-3B cell line was evaluated by a MTT assay. The results showed that the title compounds exhibited more significantly inhibitory activity than that of the parent pefloxacin, in which compounds with electron-withdrawing group attached on aryl ring had more potency than that of compounds with electron donating group, especially compounds with a carboxylic substituent were comparable to comparison doxorubicin. It suggests that it is favorable for an improvement of antitumor activity to remain a carboxylic acid unit at the aromatic ring.

Objective: To analyze the association between the concentration of metalloestrogens ( MEs ) in seminal plasma and sperm quality in infertile patients, so as to provide the basis for the study of MEs on human sperm quality. Methods: The spermatozoa concentration, progressive rate ( PR ), normal morphology rate ( NMR ) and DNA fragmentation index ( DFI ) were determined in the infertile male patients from Zhejiang Provincial People's Hospital from March to April, 2020. The contents of As, Cd, Co, Cr, Cu, Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry ( ICP-MS ). The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs ( grouped by quartiles ) were analyzed. Results: Among 105 cases recruited, 28 cases were normal in sperm parameters and 77 cases were abnormal, including 22 cases of oligospermia, 47 cases of asthenospermia, 54 cases of dysspermia and 30 cases of abnormal DFI. As, Cr, Cu, Hg and Ni were detected in all samples, the detection rates of Cd and Co were 78.57%-90.91%. Compared with the normal group, the concentration of As in oligospermia group was higher [( 18.96±12.56 ) µg/L vs. (13.67±4.19) µg/L, P<0.05],the concentration of Cr was higher in asthenospermia, dysspermia and abnormal DFI in Q3 and Q4 groups groups [( 386.62±81.92 ), ( 378.02±81.46 ), ( 393.88±77.03 ) µg/L vs. ( 343.12±55.08 ) µg/L,P<0.05]. The PRs in Q3 and Q4 groups of Cr were lower than that in Q2 group [( 32.95±18.22 )%, ( 27.74±22.77 )% vs. ( 54.18±24.64 )%, P<0.05], the DFI in Q3 and Q4 groups was higher than that in Q2 group [( 26.91±14.77 )%, ( 29.91±16.93 )% vs. ( 9.87±10.93 )%, P<0.05], and the NMR in Q4 group was lower than that in Q2 group [( 1.62±1.72 )% vs. ( 3.36±1.97 )%, P<0.05]. The concentration of sperm in Q3 group of Cu was higher than that in Q2 group [( 115.87±88.22 )×106/mL vs. (61.91±66.16)×106/mL, P<0.05]. Conclusion As and Cu in seminal plasma are associated with abnormal sperm concentration, and Cr is associated with NMR, PR and DFI.

Objective To discuss the clinical outcome of the modified super large dorsal metacarpal artery flap in reconstruction of circumferential fingertip avulsion. Methods Twenty-four patients with circumferential fingertip avulsion were treated by the modified super large dorsal metacarpal artery flap from January 2004 to August 2008. There were six index fingers, 11 middle fingers, five ring fingers and two little fingers with surface defects beyond the distal interphalangeal joint and the distal degloving length ranged from 0.8 cm to 3.1 cm. Emergency operation was performed on 22 fingers and stage Ⅱ surgery was done for distal skin necrosis of two fingers. Results Twenty-one patients with 21 fingers were followed up for 6-28 months, which showed that all flaps survived, with satisfactory appearance and function, and that the point discrimination of flap was for 6-9 mm ( average 7.6 mm). Conclusion Modified super large dorsal metacarpal artery flap is an ideal method for reconstruction of the circumferential fingertip avulsion with advantages of easiness, convenience and short treatment period.

Objective To observe the hemodynamic change and stress reaction of target-con-trolled infusion (TCI)of propofol guided by Narcotrend for anesthetic induction in renal transplanta-tion patients.Methods Forty patients (25 males,1 5 females,aged 21-38 years,ASA grade Ⅲ orⅣ)undergoing related living donor kidney transplantation were randomly divided into two groups:group A and group B (n =20).Group A was induced using TCI system with propofol under the moni-toring of Narcotrend.Group B was induced with propofol manually.HR,MAP,Narcotrend index (NTI),blood glucose (Glu)and plasma cortisol (Cor)were measured before induction (T0 ),before tracheal intubation (T1 ),and 1 (T2 ),3 (T3 ),and 5 (T4 )minutes afterwards.Results HR and MAP at T1 were lower than those at T0 (P < 0.05 )in two groups,they were significantly lower in group B than in group A at corresponding points(P <0.05).HR and MAP in group B increased sig-nificantly (P <0.05)and were significantly higher than those in group A (P <0.05)at T2 and T3 . There was no obvious difference in Glu and Cor between T0 and T2-T4 in group A.Glu and Cor at T2-T4 were obviously higher than those at T0 (P <0.05)in group B and those at corresponding points in group A (P <0.05).Conclusion TCI of propofol guided by Narcotrend in renal transplantation pa-tients can better control the depth of anesthesia,attenuate the stress reaction caused by tracheal intu-bation,and keep hemodynamic smooth during anesthesia induction.