Objective To explore the value of a set of combined vascular anastomosed flap.Methods The 36 cases were injured,the site of injury in knee and leg or ankle and foot,upper limb.Skin defect with bone and joint,tendon exposure.Selection of anastomosis of blood vessel with large flap,wherein the subscapular vascular anastomosis scapular-lateral thoracic flap in 7 cases,the maximum was 70 cm × 10 cm; anastomosis of subscapular artery lateral thoracic-latissimus dorsi muscle flap in 9 cases,the maximum was 42 cm× 24 cm.Anastomosis of subscapular artery of the scapular-back the latissimus dorsi muscle flap in 2 cases; anastomotic lateral circumflex femoral vessels with lateral femoral cutaneous nerve thigh anterior medial-tensor fascia latae flap in 8 cases; anastomosis of anterior tibial artery and the superficial peroneal nerve in the anterior ankle-dorsal foot flap in 5 cases; anastomosis of dorsal vessels and superficial peroneal nerve of the extensor digitorum brevis muscle-dorsal foot joint flap in 5 cases.Results Following up 8 months to 25 years,twenty-three cases were 19 years.All flaps survived and all the wounds were covered,infection were cured,the skin have aesthesia,fracture healing.Five cases were performed muscle tendon and arthrosis solution for creating conditions for the functional recovery of limb.Conclusion Anastomosis of blood vessel anastomosis combined flap can replace multiple vascular flaps combination,saving,convenient,high success rate,widen the indications.

Objective To observe the impacts of Ruangan-Lidan Tang on immune function for liver cancer patients receiving TACE combined with 3D conformal radiotherapy, evaluation of short-term efficacy, survival, to explore the changes of cellular immune function in the treatment. Methods 86 cases of liver cancer patients were randomly divided into treatment group and control group were taken in 3D conformal radiotherapy to 50-60GY/5-6 week for fourth weeks after TACE, the treatment group taking Ruangan-Lidan Tang intervention, control group without the use of traditional Chinese medicine intervention.Before the start, after 1 weeks of TACE, within 3 days before radiotherapy,end of radiotherapy, a total of 4 times for T cell differentiation antigen were measured, and between two groups were compared with t test, 2 months after radiotherapy CT or MRI evaluation of curative effect, survival. Results 5 cases of loss of cases, the total cases were 81 patients, including 40 cases of treatment group, 41 cases in After 1 weeks of TACE, CD3+, CD4+, CD8+of the treatment group were (55.15±4.76)%, (31.88±5.50)%, (22.00±3.18)% of the control group were (53.39±5.00)%, (30.49±5.94)%, (23.39±3.41)%. There was no significant difference between two groups (P>0.05); Before radiotherapy, CD3+, CD4+, CD8+ of the treatment group were (59.05±5.91)%, (40.55±6.17)%, (18.63±3.14)%, of the control group were 55.88±4.65%,33.88±4.41%,22.00±3.78%. There was significant difference between two groups(P<0.01);At the end of radiotherapy, CD3+,CD4+,CD8+ of the treatment group were (61.03±5.54)%, (42.65±4.57)%, (18.10±3.20)%, of the control group were (55.56±5.14)%, (32.95±4.01)%, (23.32±2.69)%. There was significant difference between two groups (P<0.01). Short-term efficacy(CR+PR)of the treatment group was higher compared with the control group(82.50%, 75.61%), but no significant difference (U=1.177, P>0.05). In the treatment group, the median survival time was 22 months,the average survival time was 21.7 months, the half year survival rate was (97.5± 2.5)%(39/40);In the control group, the median survival time was 20 months, the average survival time was 19.3 months, the half year survival rate was (94.9±3.5)% (37/41). Follow-up survival analysis, treatment group than in the control group increased, but there was no statistical difference (P=0.132, P>0.05). Conclusion Ruangan-Lidan Tang can improve the immune function of liver cancer patients receiving TACE combined with radiotherapy, but in the Short-term efficacy and survival did not reflect advantage.

OBJECTIVE： To study the inhibitory effect of modified Maimendong decoction combined with cisplatin on Lewis lung cancer transplantation model mice， and to explore its potential mechanism. METHODS： Lewis lung cancer transplantation mice model was induced via subaxillary inoculation of Lewis lung cancer cells. 60 mice were randomly divided into model group （normal saline， once a day， i.g.）， cisplatin group （6 mg/kg， once a week， i.p.）， modified Maimendong decoction group （20 g/kg. once a day， i.g.） and combination group （cisplatin 6 mg/kg， once a week， i.p.+modified Maimengdong decoction， once a day， i.g.）， with 15 mice in each group. All mice were treated for consecutive 2 weeks. After medication， tumor weight and thymus index were detected； HE staining was used to observe the pathological change of tumor tissue. TUNEL was used to detect apoptotic index of tumor tissue. The protein expressions of Bcl-2 and Bax were detected by Western blot assay. RESULTS： Compared with model group， tumor weight and protein expression of Bcl-2 were decreased significantly in modified Maimengdong decoction， cisplatin group and combination group （P＜0.05）， and thymus index， tumor apoptotic index and the protein expression of Bax were increased significantly （P＜0.05）. Tumor weight and protein expression of Bcl-2 in combination group were significantly lower than modified Maimengdong decoction group and cisplatin group （P＜0.05）； thymus index， tumor apoptotic index and the protein expression of Bax were significantly higher than addition and subtraction of modified Maimengdong decoction group and cisplatin group （P＜0.05）. HE staining showed that the density of tumor cells was decreased to certain degree in modified Maimengdong decoction group， cisplatin group and combination group； the area of necrosis area in the combination group was significantly larger than in modified Maimendong decoction group and cisplatin group. CONCLUSIONS： Modified Maimendong decoction can inhibit the growth of Lewis lung cancer transplanted tumor in mice by down-regulating the protein expression of Bcl-2 and up-regulating the protein expression of Bax.