Objective To investigate the modified methods and effects of the flaps with nutrient vessels of superficial vein-cutaneous nerve of lower limb which used for repair of the lower extremity soft-tissues defects.Methods Between December 2003 and September 2009, 18 patients were treated with this modified skin flap, in which 11 cases male; 7 cases were female, age from 5 to 73 years.Average age was 45.9 years.Repair parts: 4 cases of dorsal foot, 3 cases of foot, heel in 2 cases, the ankle weeks in 2 cases, calves under 1 / 3 of 7 cases, of which 8 cases of bone exposure wounds, tendons exposed in 3 cases.Surgical repair of soft tissue defect size of about 6 cm×4 cm-22 cm × 10 cm, which retained the donor sural nerve function retrograde sural nerve flap in 4 cases, with a thin layer of muscle retrograde sural nerve flap in 4 cases.Results All the flaps were survived completely without any complications.The appearance and functional results were satisfactory with following up for 3 to 36 months.18 cases of flap were survived completely, primary healing, without any complications such as vein congestion or engorgement.The 4 cases which remains the cutaneous nerve in site had an average recovery time about 13 days of the donor site.The innervated region of the cutaneous nerve had no acroesthesia or dysesthesia.Conclusion This modified operation methods of flap, enhanced the blood support of the flap, impmved the survive rates and also preserved the sensory function of the patients' donor site.This modified flap with nutrient vessels of superficial vein-cutaneous nerve is a convenient and safe method in repairing lower extremity soft-tissues defects.

Objective To observe the effects of secreted protein,acidic and rich in cysteine (SPARC) on the expression of TGF-β1 and collagen type Ⅰ in cultured human keloid fibroblasts by real-time fluorescence quantitative RT-PCR.Methods In vitro keloid fibroblasts were stimulated by different concentrations of recombinant human SPARC,and with the control group for comparison,real-time fluorescence quantitative RT-PCR to detect expression of TGFβ1 and collagen type Ⅰ.Results Compared with the control group,the expression of TGF-β1 and collagen type Ⅰ was significantly increased in the experimental group.Conclusions SPARC could enhance the expression of TGF-β1 and collagen type Ⅰ in keloid fibroblasts significantly.

The influence of exercise at high temperature on adult males' routine blood indexes and biochemical indexes and the expression of HSP72 in peripheral blood lymphocytes (PBLs) was studied in order to provide theoretical ground for health supervision of adults receiving exercise at high temperature. 180 adult males were selected and divided into exercise group and control group, in which the exercise group was subdivided into subgroup 1 and subgroup 2 receiving exercise at high temperature in the afternoon and in the morning, respectively. Peripheral venous blood was phlebotomized before and after the exercise to examine routine blood indexes and blood biochemical indexes. The expression levels of HSP72 in PBLs were detected by flow cytometry. The results showed that the routine blood indexes and biochemical indexes in each group were within the range of normal values of male adults. There was no significant difference between each exercise group and control group in indexes before exercise. After exercise, the expression levels of HSP72 in PBLs in exercise groups were higher than those before exercise, and HSP72 expression levels in subgroup 1 were obviously higher than those in subgroup 2 and control group. The contents of ALT, urea, Na+, Cl-, Ca2+ and K+ in subgroups 1 and 2 were lower than those in control group, but CK level was higher than in control group (P<0.05). The contents of Na+ and Cl- in subgroup 1 were relatively lower than those in subgroup 2 (P<0.05). It was concluded that while receiving exercise at high temperature, adult males' HSP72 levels in PBLs could be increased and the biochemical indexes changed. Attention should be paid to health supervision to avoid obvious body injuries at high temperature.
Blood Chemical Analysis/*methods ; Exercise/*physiology ; HSP72 Heat-Shock Proteins/*blood ; HSP72 Heat-Shock Proteins/metabolism ; Hot Temperature ; Lymphocytes/*metabolism ; Young Adult

Summary: The influence of exercise at high temperature on adult males' routine blood indexes and biochemical indexes and the expression of HSP72 in peripheral blood lymphocytes (PBLs) was studied in order to provide theoretical ground for health supervision of adults receiving exercise at high temperature. 180 adult males were selected and divided into exercise group and control group, in which the exercise group was subdivided into subgroup 1 and subgroup 2 receiving exercise at high temperature in the afternoon and in the morning, respectively. Peripheral venous blood was phlebotomized before and after the exercise to examine routine blood indexes and blood biochemical indexes. The expression levels of HSP72 in PBLs were detected by flow cytometry. The results showed that the routine blood indexes and biochemical indexes in each group were within the range of normal values of male adults. There was no significant difference between each exercise group and control group in indexes before exercise. After exercise, the expression levels of HSP72 in PBLs in exercise groups were higher than those before exercise, and HSP72 expression levels'in subgroup 1 were obviously higher than those in subgroup 2 and control group. The contents of ALT, urea, Na+, Cl-, Ca2+and K+ in subgroups 1 and 2 were lower than those in control group, but CK level was higher than in control group (P<0.05). The contents of Na+ and Cl- in subgroup 1 were relatively lower than those in subgroup 2 (P<0.05). It was concluded that while receiving exercise at high temperature, adult males' HSP72 levels in PBLs could be increased and the biochemical indexes changed. Attention should be paid to health supervision to avoid obvious body injuries at high temperature.

Objective:To investigate the method and clinical effect of horn-shaped perforator flaps with multiple blood supply for reconstructing massive facial defects caused by various reasons.Methods:A retrospective review was performed on patients with massive facial defects in the Department of Plastic Surgery of First Affiliated Hospital of Anhui Medical University from June 2015 to July 2020. The Doppler ultrasound was used to localize the facial source artery and perforators preoperatively. During the operation, the flap was designed according to the defect size, the elasticity of around skin, the length from the distal end of the defect to the location of the selected perforator, and the Langer’s line of the face. The length of the proximal part of the flap was approximately equal to the defect width, and the length of the flap was about 3 to 3.5 times longer than the defect width. An incision was made along the distal part of the flap. The flap dissection proceeded in a proximal to distal fashion superficial to the superficial musculoaponeurotic system, until forming a large perforator flap. A small number of fibrous around the perforator were retained, and the flap was rotated and advanced to reconstruct the defect without any tension. The donor site was closed directly. Wound healing, scar formation, tumor recurrence, and tumor metastasis were followed postoperatively.Results:A total of nine cases were enrolled, with four male patients and five female patients. The mean age of the patients was 58 years, ranging from 35 to 81 years. The size of the flap ranged from 10.0 cm × 6.0 cm to 14.0 cm × 7.0 cm. All flaps survived, and the wound healed primarily. After 3 to 24 months of follow-up, no recurrence of tumor, obvious scar, flap bloated, facial deformity, or other complications were observed. The patients was satisfied with the aesthetic subunit structure and function.Conclusions:The horn-shaped perforator flap with multiple blood supply is simple in design, easy in decision, reliable in blood supply, and consistent in color and texture with the original tissue. The incision scar can be hidden in the Langer’s line with a satisfying appearance, which is suitable for aged patients with sagging facial skin.

Objective:To investigate the method and clinical effect of horn-shaped perforator flaps with multiple blood supply for reconstructing massive facial defects caused by various reasons.Methods:A retrospective review was performed on patients with massive facial defects in the Department of Plastic Surgery of First Affiliated Hospital of Anhui Medical University from June 2015 to July 2020. The Doppler ultrasound was used to localize the facial source artery and perforators preoperatively. During the operation, the flap was designed according to the defect size, the elasticity of around skin, the length from the distal end of the defect to the location of the selected perforator, and the Langer’s line of the face. The length of the proximal part of the flap was approximately equal to the defect width, and the length of the flap was about 3 to 3.5 times longer than the defect width. An incision was made along the distal part of the flap. The flap dissection proceeded in a proximal to distal fashion superficial to the superficial musculoaponeurotic system, until forming a large perforator flap. A small number of fibrous around the perforator were retained, and the flap was rotated and advanced to reconstruct the defect without any tension. The donor site was closed directly. Wound healing, scar formation, tumor recurrence, and tumor metastasis were followed postoperatively.Results:A total of nine cases were enrolled, with four male patients and five female patients. The mean age of the patients was 58 years, ranging from 35 to 81 years. The size of the flap ranged from 10.0 cm × 6.0 cm to 14.0 cm × 7.0 cm. All flaps survived, and the wound healed primarily. After 3 to 24 months of follow-up, no recurrence of tumor, obvious scar, flap bloated, facial deformity, or other complications were observed. The patients was satisfied with the aesthetic subunit structure and function.Conclusions:The horn-shaped perforator flap with multiple blood supply is simple in design, easy in decision, reliable in blood supply, and consistent in color and texture with the original tissue. The incision scar can be hidden in the Langer’s line with a satisfying appearance, which is suitable for aged patients with sagging facial skin.

Objective:To study the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with iodine-125 ( 125Ⅰ) seed strands implantation in patients with hepatocellular carcinoma combined with portal vein tumor thrombosis. Methods:25 cases with diffuse intrahepatic tumor combined with tumor thrombus type Ⅲ/Ⅳ requiring TIPS were simultaneously implanted with 125Ⅰseed strand. Tumor thrombus was controlled with 125I seed implantation brachytherapy to keep the TIPS pathway unobstructed, reduce the portal vein pressure, and observe the changes in the cause of death of the patients. During the same period, 30 cases without TIPS and seed strand implantation were used as controls. Data between groups were compared using t-test, Chi-Squared test or Fisher's exact test. Results:TIPS combined with 125Ⅰ seed strand implantation was safe in patients with diffuse hepatocellular carcinoma combined with type III/IV portal vein tumor thrombus, and 92.0% (23/25) of the patients maintained unobstructed TIPS pathway. Compared with the control group, patients in the treatment group died of fewer lead-related complications, and most died from chronic liver failure (84.0% vs. 56.7%, χ2 = 4.771, P=0.029). The incidence of upper gastrointestinal bleeding was significantly decreased (12.0% vs. 46.7%, χ2 =7.674, P=0.006) and ascites severity was significantly improved (mild 40.0% vs. 16.7%, moderate 52.0% vs. 20.0%, severe 8.0% vs. 46.7%, χ2 =13.246 , P=0.001). Conclusions:TIPS combined with 125Ⅰ seed strand implantation is safe and feasible in patients with diffuse intrahepatic tumor combined with tumor thrombus type Ⅲ/Ⅳ. Moreover, it can effectively keep the shunt patency and reduce portal vein pressure, thereby reducing the incidence of upper gastrointestinal bleeding and improving the degree of ascites. TIPS combined with 125Ⅰ seed strand implantation may be used as a standard treatment modality for patients requiring TIPS therapy combined with tumor thrombus type Ⅲ/Ⅳ.