Early diagnosis and precision medicine generally show significant differences in the prognosis of patients with carcinoma. Angiogenesis not only plays a key role in tumor pathophysiology but also acts as an important drug target. Peptides with specific se-quences can target specific molecules on the endothelial cellular membrane during tumor angiogenesis. Radionuclide-labeled molecu-lar probes exhibit many advantages in oncotherapy. This article focuses on the progress of radionuclide-labeled RGD and RRL in radio-immunoimaging and radioimmunotherapy targeting tumor angiogenesis.

Objective To study the inhibitory effect of recombinant adenoviruses carrying the mouse endostatin gene on the therapy of endometriosis in nude mice.Methods Animal endometriosis models were established by inoculating human endometrial fragments.Mice were randomly divided into three groups(10 each):PBS control group,Ad-lacZ group and Ad-mEndo therapy group when ectopic lesion diameter reached 5-10mm.The ectopic lesion size was measured every day.The expression of endostatin in ectopic lesion was detected by immunohistochemical stainining.The microvessel density(MVD) of ectopic lesion was traced by CD34 immunohistological labeling.Meanwhile,the contents of steroid hormone and histological changes in mice uterus and ovary were detected.Results The titer of the recombinant adenovirus was about 5.0?109pfu/ml.The endostatin gene was transferred into mice successfully and expressed effectively.The lesion volume was significantly less in Ad-mEndo group(34.3?11.2mm3) than that in Ad-lacZ group(93.3?10.7mm3) and PBS group(90.4?18.7mm3,P

Objective To investigate the effect of di-( 2-ethylhexyl ) phthalate (DEHP) on pregnant rat and the protection of zinc.Methods Fifty rats were randomized equally into 5 groups consisting of blank (given 1 ml 0.9％ sodium chloride),corn oil (given 1 ml corn oil),zinc (given 1 ml zinc gluconate including 1.2 mg zinc),DEHP (given 50 mg · kg-1 · d-1 DEHP)and DEHP + zinc (given 50 mg· kg-1 · d-1 DEHP + zinc gluconate ).At the beginning of the experiment (about 7 d before pregnancy),the female rats were administered with corresponding drugs everyday.The pregnant rats were killed and the fetal rats were removed on 19th day.The following results in each group were recorded:the body weight and the organic weight of the female rats,the number and the weight of fetus rats and the placental weight.Results The weight and the coefficient of female rats' kidney/body,spleen/body,brain/ body,and heart/body in DEHP group compared with other groups were not statistical significance (all P ＞0.05).The coefficient of female rats' liver/body,uterus/body,and ovary/body of blank group were (4.4 ± 0.7 ) ％,( 1.26 ± 0.09 ) ％,( 0.083 ± 0.009 ) ％ respectively,corn oil group were (4.5 ± 0.6 ) ％,( 1.29 ±0.10)％,(0.084 ±0.008)％,zinc group were (4.4 ±0.4)％,( 1.26 ±0.08)％,(0.084 ± 0.009 ) ％,DEHP group were ( 5.4 ± 1.0 ) ％,( 1.11 ± 0.08 ) ％,( 0.074 ± 0.012 ) ％,and DEHP + zinc group were (4.4 ± 1.0)％,( 1.28 ± 0.10)％,(0.082 ± 0.007)％ ; in DEHP group the coefficient of female rats' liver/body,uterus/body,and ovary/body compared with other groups was statistical significance ( P ＜ 0.05 ).The fetal quantity,fetal weight and placental weight of female rats of blank group were 12.8 ± 2.7,(6.03 ±0.16) g,( 1.00 ±0.03) g respectively,corn oil group were 13.6 ±3.1,(6.07 ±0.20) g,(1.00±0.04) g,zinc group were 13.3 ±3.1,(6.16 ±0.18) g,( 1.00 ±0.05) g,DEHP group were 9.2±4.1,(4.03 ±0.09) g,(0.95 ±0.03) g,and zinc +DEHP group were 12.1 ±2.9,(6.09 ± 0.17 ) g,(0.99 ±0.03 ) g.In DEHP group the fetal quantity,fetal weight and placental weight of female rats compared with other groups were statistical significance ( P ＜ 0.05 ).Conclusion DEHP can damage female rats and fetal rats in gestation period.Zinc supplied before pregnancy can relieve the influence by DEHP.

Objective To investigate the clinical effectiveness of the reversed flaps pedicled with lateral vas-cular chain of dorsal branch of digital artery and perforating branch of the dorsal metacarpal artery for relaying repair of soft tissue defects at middle-distal part of the 2nd ～ 5th finger and donor site. Methods From June, 2014 to May, 2016, a total of 18 cases (11 male and 7 female) with soft tissue defects at middle-distal part of 2nd～5th fin-ger were treated with the reversed flap pedicled with lateral vascular chain of dorsal branch of digital artery. The donor site was repaired with the reversed flap pedicled with the perforating branch of the dorsal metacarpal artery. The aver-age age at the time of reconstruction was 41 years. The right hand was involved in 12 cases and the left in 6 cases. The etiologies of injury were avulsion (n=5) , crush (n=6), and saw-cut injury (n=7). There were 15 cases with soft tissue defect at the distal phalanx and 3 cases with loss of distal and middle phalanx. All these cases were exposed with bone or tendon. The defect size ranged from 1.0 cm × 1.8 cm to 2.0 cm × 3.0 cm. And the dimension of the re-versed flaps pedicled with lateral vascular chain of dorsal branch of digital artery and perforating branch of the dorsal metacarpal artery ranged from 1.2 cm × 2.0 cm to 2.3 cm × 3.3 cm, and 1.4 cm × 2.3 cm to 2.6 cm × 3.6 cm, respec-tively. Postoperative follow-up was done termly. Results All flaps survived uneventfully with primary healing at donor site. The mean of followed-up time was 11 months (ranged from 6 to 15 months). The appearance and texture of the flaps were satisfactory and similar to the surrounding tissue. There was only some linear scar left at the dorsum of the palm. On the basis of the MHQ, 16 patients were strongly satisfied (score 5) with the appearance of the flap, and the remaining 2 patients was satisfied (score 4) with the appearance. The static 2-point discrimination of the flaps at the middle-distal part of 2nd～5th finger was 5-9 mm. Based on TAM assessment, the function of the injured finger was graded as excellent in 15 cases, good in 3 cases. Conclusion The relaying reversed flaps pedicled with lat-eral vascular chain of dorsal branch of digital artery and perforating branch of the dorsal metacarpal artery can be applied for repair of soft tissue defects at middle-distal part of 2nd～5th finger and donor site with easy procedure, reliable blood supply, satisfactory results, good appearance as well as less complications at donor sites.

Objective:To investigate the clinical outcomes of homodigital reversed dorsal digital artery island flap innervated by the dorsal digital nerve to repair degloving injury of distal thumb.Methods:From July 2016 to June 2019, a total of 15 cases (15 thumbs) with degloving injury of distal part were admitted to the Department of Hand Surgery, the Second Hospital of Tangshan. Nine males and six females were involved, with an average age of 49 years (range, 41 to 69 years). There were twist injury in eight cases and crush injury in seven cases, with four cases of distal phalanx fracture. The defect dimensions after debridement ranged from 3.5 cm×1.8 cm to 4.6 cm×2.4 cm, and the dimension of the flaps ranged from 3.8 cm×2.1 cm to 5.0 cm×2.7 cm. All defects were repaired using homodigital reversed dorsal digital artery island flap innervated by the dorsal digital nerve. The survival, appearance and sensory recovery of the flaps and function of the injured fingers were observed at the follow-up after operation.Results:All the flaps survived without wound infection and blood supply disorder. The follow-up times ranged from 9 to 22 months (mean, 16 months). There was satisfactory appearance of the flaps with similar color and texture to the surrounding tissue. Fracture healing ranged from 4 to 6 weeks. At final follow-up, the values of static 2-PD test of the flaps ranged from 5 to 10 mm (mean, 7.8 mm). The results of range of motion of injured thumb joints were excellent in nine cases and good in five cases. There was slight linear scar left at the donor area of dorsal thumb.Conclusions:The innervated reversed dorsal digital artery island flap has a simple procedure and minimal donor-site cost, which is especially suitable for elderly patients who refuse to free toe transfers.

OBJECTIVETo evaluate the consistency between the clinical diagnostic criteria and the ascertained diagnostic criteria for diabetic peripheral neuropathy (DPN) in the Preventive and Treatment Guidelines of Diabetes in China (2013) and explore an economic, convenient, and accurate approach to DPN diagnosis.

METHODSThe patients with type 2 diabetes admitted in our department from April to June, 2014 were examined for nerve conduction velocity, 10 g nylon silk, vibration threshold value, sense of temperature and pain, and ankle reflex. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value were calculated to assess the diagnostic power of the two diagnostic criteria.

RESULTSOf the 151 patients enrolled, 106 (70.2%) had a diagnosis of DPN consistent with the ascertained diagnostic criteria, as compared to 86 (56.95%) who were diagnosed according to the clinical diagnostic criteria; the latter patients accounted for 81.13% of former cases. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value of the clinical diagnostic criteria were 80.19%, 97.78%, 98.84%, 67.69%, 77.97%, and 0.69, respectively, which were highly consistent with those of the ascertained diagnostic criteria; the sensitivity to compression showed a poor consistency between the two diagnostic criteria. In the 5 screening tests, the combined test of temperature sensation, vibration perception, and ankle reflex showed the highest AUC value among their different combinations.

CONCLUSIONThe clinical diagnostic criteria for DPN show good consistency with the ascertained diagnostic criteria, and for patients with clinical symptoms or with only one positive sign, combination of the two diagnostic criteria can achieve the maximum diagnostic power.

China ; Diabetes Mellitus, Type 2 ; Diabetic Neuropathies ; diagnosis ; Humans ; Neurologic Examination ; methods ; Predictive Value of Tests ; Sensitivity and Specificity

This article reports a pedigree with two previously deceased neonates. Both neonates did not experience asphyxia but passed away on their 5th and 13th day of life. The chromosomal analysis of the parents' karyotype revealed no abnormalities. Clinical manifestations of the two deceased cases and relevant medical records were recollected. Whole exome sequencing was conducted on the stem blood sample of Neonate 2, revealing a c.729_730insTT homozygous mutation (p.D244Lfs*39) in the methylmalonyl-CoA mutase gene (NM_000255). It was confirmed that Neonate 2 was affected with methylmalonic acidemia. Amniocentesis was performed at 20 +3 weeks in the current pregnancy. Sanger sequencing of amniotic fluid indicated that the fetus carried the same gene mutation as Neonate 2. Consequently, the fetus was expected to be a patient with methylmalonic acidemia and to exhibit the same phenotype as Neonate 2. Termination of pregnancy, therefore, was selected at 24 weeks of gestation.

Objective: To investigate the clinical outcomes of snuffbox perforator flap of radial artery to repair large soft tissue defects of the thenar and dorsal thumb. Methods: From June 2012 to March 2017, a total of 18 cases with large soft tissue defects of the thenar and dorsal thumb were hospitalized in the Second Hospital of Tangshan. There were 13 males and 5 females, with an average age of 39 years (range, 17 to 64 years). The right hand was involved in 14 cases and the left in 4 cases. There were 5 cases of thenar defect, 7 cases of dorsal thumb defect and 6 cases of thenar combined with dorsal thumb defect. The tendon and / or bone were exposed in all 18 cases. The size of the wounds after debridement ranged from 2.5 cm × 3.5 cm to 4.5 cm × 6.0 cm. The snuffbox perforator flap was designed to repair the defect based on the pivot point of snuff box and the axis line from styloid process of radius to capitulum of radius. Four cases with extensor tendon defects of the thumbs were grafted with a section of brachial radial tendon. The dimension of the flaps ranged from 2.8 cm × 3.8 cm to 5.0 cm × 6.8 cm. The observation indexes included blood supply and appearance of the flap, the total activity of flexion and extension (TAM) of the injured thumb, the angle of the first web span and the satisfaction of the patients. Results: All flaps survived uneventfully. The donor area of forearm was directly closed in 16 cases, and the remaining wound in 2 cases was repaired by free skin graft. All the cases were followed up for 8 to 16 months (mean, 12 months). The good appearance of the flaps with soft texture was obtained. The average values of TAM of the injured thumbs and the first webs were 139°and 96°, respectively. They were excellent in 15 cases and good in three cases for TAM, and excellent in all cases for the first webs. 10 patients were very satisfactory with flap appearance and thumb function and the rest was satisfactory. Conclusions The snuffbox perforator flap of radial artery provides a reliable and simple technique with constant blood supply and minimal donor-site cost, which could be an ideal option for repairing large soft tissue defects of the thenar and dorsal thumb with extensor tendon defects of the thumbs.