Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

OBJECTIVETo investigate the operative treatment of displaced intra-articular calcaneal fracture by lateral minimally invasive approach reduction and internal fixation.

METHODSDuring January 2006 to September 2009, 30 cases (31 feet) of displaced intra-articular calcaneal fracture were treated by open reduction and hollow screws internal fixation through lateral minimally invasive approach from the fibular tip to the basement of the fourth metatarsal foot (Sanders II in 21 feet, Sanders III in 8 feet, Sanders IV in 2 feet), including 23 males and 7 females with an average age of 36.5 years ranging from 18 to 60 years.

RESULTSThe 31 feet of 30 patients were followed-up for from 3 to 24 months (14 months in average). There was no soft tissue complications such as infected incision, skin necrosis, poor wound healing, and sural nerve injury. X-ray films of 25 feet after the operations showed well reduction of articular surface and satisfactory shape on calcaneal; 6 feet showed roughly normal shape. Based on the Maryland grading system, 6 feet were excellent, 20 feet good and 5 feet fair.

CONCLUSIONThe lateral minimally invasive approach is a good option for calcaneal fracture of Sanders II and III, because of its less damages to soft tissue and fewer complications. It could also provide excellent exposure of articular surface.

Adolescent ; Adult ; Bone Screws ; Bone Transplantation ; Calcaneus ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Time Factors

BACKGROUNDHuman epidermal growth factor 2 (HER2) is one of the most important prediction factors, but only 25% - 30% of breast cancer patients HER2 are positive. It is unknown whether there are other molecular markers that could be used to predict prognosis and recurrence in HER2 negative patients. This study investigated correlations of cyclin A2 and HER2 levels with clinical outcomes in 281 patients with invasive breast cancer in order to identify whether cyclin A2 can serve as a prognostic factor in HER2 negative patients.

METHODSImmunohistochemical staining was used to detect cyclin A2 and HER2 expression in 281 patients. Cyclin A2 and HER2 gene amplifications were analyzed using gene analysis and RT-PCR in 12 patients. Risk and survival estimates were analyzed using Log-rank, Kaplan-Meier, and Cox regression analysis; cyclin A2 and HER2 consistency with survival were analyzed using Kappa analysis.

RESULTSPatients with higher cyclin A2 and HER2 expressions had significantly shorter disease-free survival periods (P = 0.047 and P = 0.05, respectively). Kappa analysis performed that cyclin A2 and HER2 showed a low Kappa index (kappa = 0.37), allowing us to conclude that cyclin A2 and HER2 detect different pathologies. Gene analysis and RT-PCR showed that cyclin A2 was upregulated in patients with early relapse; the average increase was 3.69 - 2.74 fold.

CONCLUSIONSCyclin A2 and HER2 are associated with proliferation and high recurrence, particularly when combined. Cyclin A2 is easily detected by nuclear staining and might be a useful biomarker for recurrence risk in HER2 negative patients.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; genetics ; metabolism ; Cyclin A2 ; genetics ; metabolism ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Multivariate Analysis ; Receptor, ErbB-2 ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUNDThe effect of impaired glucose tolerance (IGT) on cardiac function during the chronic prediabetes state is complicated and plays an important role in clinical outcome. However, the molecular mechanisms are not fully understood. This study was designed to observe cardiac dysfunction in prediabetic rats with IGT and to determine whether glucose metabolic abnormalities, inflammation and apoptosis are linked to it.

METHODSThe IGT rat models were induced by streptozocin, and the heart functions were assessed by echocardiography. Myocardial glucose metabolism was analyzed by glycogen periodic acid-Schiff staining, and the pro-apoptotic effect of IGT was evaluated by TUNEL staining. Additionally, caspase-3 activation, macrophage migration inhibitory factor (MIF) and G-protein coupled receptor kinase 2 (GRK2) were detected by Western blotting in cardiac tissue lysates.

RESULTSArea-under-the-curve of blood glucose in rats injected with streptozotocin was higher than that in controls, increased by 16.28%, 38.60% and 38.61% at 2, 4 and 6 weeks respectively (F = 15.370, P = 0.003). Abnormal cardiac functions and apoptotic cardiomyocytes were observed in the IGT rats, the ejection fraction (EF) being (68.59 ± 6.62)% in IGT rats vs. (81.07 ± 4.59)% in controls (t = 4.020, P = 0.002). There was more glucose which was converted to glycogen in the myocardial tissues of IGT rats, especially in cardiac perivascular tissues. Compared to controls, the cleaved caspase-3, MIF and GRK2 were expressed at higher levels in the myocardial tissues of IGT rats.

CONCLUSIONSIGT in the prediabetes period resulted in cardiac dysfunction linked to abnormal glycogen storage and apoptosis. Additionally, MIF and GRK2 may be involved in the pathogenesis of cardiac dysfunction in prediabetes and their regulation may contribute to the design of novel diagnostic and therapeutic strategies for those who have potential risks for diabetic cardiovascular complications.

Animals ; Apoptosis ; drug effects ; Blotting, Western ; Disease Models, Animal ; Echocardiography ; G-Protein-Coupled Receptor Kinase 2 ; metabolism ; Glucose Intolerance ; chemically induced ; physiopathology ; Glucose Tolerance Test ; In Situ Nick-End Labeling ; Intramolecular Oxidoreductases ; metabolism ; Macrophage Migration-Inhibitory Factors ; metabolism ; Myocardium ; metabolism ; pathology ; Myocytes, Cardiac ; pathology ; Rats ; Streptozocin ; toxicity

Most bacterial cell surface glycans are structurally unique, and have been considered as ideal target molecules for the developments of detection and diagnosis techniques, as well as vaccines. Chemical synthesis has been a promising approach to prepare well-defined oligosaccharides, facilitating the structure-activity relationship exploration and biomedical applications of bacterial glycans. L-Galactosaminuronic acid is a rare sugar that has been only found in cell surface glycans of gram-negative bacteria. Here, an orthogonally protected L-galactosaminuronic acid building block was designed and chemically synthesized. A synthetic strategy based on glycal addition and TEMPO/BAIB-mediated C6 oxidation served well for the transformation of commercial L-galactose to the corresponding L-galactosaminuronic acid. Notably, the C6 oxidation of the allyl glycoside was more efficient than that of the selenoglycoside. In addition, a balance between the formation of allyl glycoside and the recovery of selenoglycoside was essential to improve efficiency of the NIS/TfOH-catalyzed allylation. This synthetically useful L-galactosaminuronic acid building block will provide a basis for the syntheses of complex bacterial glycans.
Carbohydrates ; Glycosides ; Oligosaccharides ; Oxidation-Reduction ; Polysaccharides/chemistry*

Objective:To observe the effect of 3 Hz and 10 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function and activities of daily living in patients with ischemic stroke. Methods:From June, 2016 to September, 2017, 60 inpatients with ischemic stroke were randomly divided into sham rTMS group (n = 19), 3 Hz-rTMS group (n = 21) and 10 Hz-rTMS group (n = 20). All the patients received routine training and their own rTMS for two weeks. Their rest motor threshold (RMT) was measured, and they were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment, and at six weeks follow-up. Results:There were 48 patients completing the trial, while five in 3 Hz-rTMS group, five in 10 Hz-rTMS group and two in the sham rTMS group dropped. The RMT increased in 3 Hz and 10 Hz rTMS groups (t > 2.390, P < 0.05) after treatment, but there was no significantly difference among the three groups (F = 0.164, P > 0.05). The MAS scores of elbow and wrist decreased gradually over time in 3 Hz and 10 Hz rTMS groups (P < 0.05), and the MAS scores of elbow was less in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at follow-up (P < 0.05). The interaction of time and group was significant on the FMA-UE scores (F = 14.243, P < 0.001), and the FMA-UE scores improved more in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at different stages (P < 0.01). The interaction of time and group was not significant in MBI score (F = 1.481, P > 0.05), and there was no significant difference among the three groups at any time (F < 2.925, P > 0.05). Conclusion:Both 3 Hz and 10 Hz rTMS can promote the recovery of upper limb motor function in ischemic stroke patients safely and effectively, and 10 Hz rTMS is recommended as less time is needed.