Objective To discuss the anatomy,manufacture,merit and demerit of dorsum pedis flap based on anatomic observation and comprehension using free dorsum pedis flap to repair the coloboma of oromaxillo-facial region soft tissue.Methods The courser and disposition of the skin blood vessel and nerve of dorsum of foot of 22 sides of adult cadaver lower limbs were dissected and observed under naked eye and operation microscope. 2 cases got troubled with oromaxillo-facial region malignant tumor,who were prepared 9.5 cm?7.5 cm and 8 cm?6 cm size of free dorsum pedis flap. The site of blood supply and recipient was anastomosed by blood vessel and nerve,and the coloboma of soft tissue was primary repaired after the operation of oromaxillo-facial region malignant tumor. Results Blood circulation of dorsum pedis flap was provided by dorsalis pedis artery,great saphenous vein and small saphenous vein,and fibular nerve was sensory nerve. During two years of follow-up visit,the two cases whose skin flaps were take were satisfactory with the reparation,and tumor recurrence did not take place. Conclusion The blood supply of free dorsum pedis flap is reliable,and it can become ideal skin flap to repair the soft tissue coloboma of oromaxillo-facial region.

[Summary] Regional cerebral oxygen saturation ( rSO2 ) can be used to monitor the changes of cerebral oxygen demand and supply, and postoperative cognitive dysfunction ( POCD ) is a relatively common adverse effect following cardiac surgery. The intraoperative rSO2 decrease may associate with the incidence of POCD. Real-time intraoperative monitoring of rSO2 and necessary interventions performed to correct cerebral rSO2 desaturation may reduce the incidence of POCD of cardiac surgery.

Objective In order to further understand the bioactivity of sphingosine kinase, high efficient replication defective recombinant adenovirus carrying the wild type SPK gene (SPK WT ) and SPK mutant gene (SPK DN ) were constructed respectively. Methods The SPK genes of interest were subcloned into a shuttle vector pshuttle cmv respectively. Pshuttle cmv SPK WT and Pshuttle cmv SPK DN were linearized by PmeI and transformed respectively into the competent cells of E. coli BJ AD 1 cells which contain adenoviral backbone plasmid pAdEasy 1. The linearized recombinant plasmids were transfected into adenovirus 293 packaging cells respectively,and then recombinant adenoviruses were harvested. We performed the PCR, Western blot and enzyme assays to identify the recombinant adenoviruses. Results The recombinant adenoviruses containing the interest gene and being able to infect ECV 304 cells were obtained. Overexpression of wild type SPK gene in ECV 304 cells increased the endogenous SPK activity, whereas overexpression of mutant SPK (SPK DN ) inhibited intracellular SPK activity. Conclusion Recombinant adenoviral vectors can mediate interesting gene expression in cells.

Objective To analyze the pathological significance of CK5 expression in primary cutaneous amyloidosis(PCA).Methods The expression of CK5 in superficial dermis of PCA group and the control group[lichen planus(LP),lupus erythematosus(LE)]were detected by CK5 monoclonal antibody.The infiltration densities of CD3-positive T lymphocytes and CD68-positive macrophages in superficial dermis of PCA and control group were measured respectively by immunohistochemical staining using anti-CD3 antibodies and anti-CD68 antibodies.The skin lesions of PCA and control groups were analyzed by immunofluorescence to detect whether CK5 was phagocytosed by macrophages in superficial dermis.Results Totally,39 cases of PCA all were CK5-positive.Some control cases were positive.The number of CD3-positive T lymphocytes and CD68-positive macrophages in 8 cases of PCA group was lower than that of control group.The result of immunofluorescence colocalization of monoclonal anti-CK5 antibodies and anti-CD68 antibodies in 5 cases of PCA lesions was negative;that in 2 cases of LE lesions were both positive,and that in 2 cases of LP lesions were both negative.Conclusion Amyloid protein may be derived from the basal keratinocytes after interface damage.The amyloid protein deposits may be related to the number decrease or the functional defect of macrophages.

Objective To evaluate the key points of anesthetic management for retroperitoneoscopic nephrectomy combined with inferior vena cava ( IVC ) tumor thrombectomy. Methods Perioperative clinical data of 3 patients undergoing retroperitoneoscopic nephrectomy combined with IVC tumor thrombectomy from December 2010 to June 2014 were retrospectively analyzed.There were 2 cases of level Ⅰthrombus and 1 case of level Ⅱthrombus.All the patients were given general anesthesia with intubation.Brief inferior vena cava occlusion was performed in the patient with level Ⅱ thrombus. Results The operation was completed smoothly in all the cases without conversions to open surgery. The operating time was 244, 333, and 289 min, respectively. The total IVC control time for level Ⅱ thrombus was 10 min.No intraoperative pulmonary embolism and other severe anesthetic complications occurred. One patient with level ⅠIVC thrombus was extubated and sent back to surgical ward after surgery, and the remaining 2 patients underwent intensive care monitoring overnight and were extubated and discharged to surgical ward on the next day. Conclusions Retroperitoneoscopic nephrectomy and IVC thrombectomy is a brand-new, difficult but feasible procedure. Anesthesiologist should have a full recognition of surgical procedures and make perfect anesthetic plan to ensure close collaboration. Furthermore, circulatory swing during IVC clamping and perioperative severe complications such as pulmonary embolization and massive hemorrhage cannot be neglected.

To compare the advantages and the disadvantages of the teaching of problem-based learning(PBL) with lecture based learing(LBL) in Pathophysiology with the questionnaire.

In medical education,to cultivate the medical students with high comprehensive quality,we have carried out the teaching reform in Pathophysiology education.

Ikaros is a regulatory factor playing an important role in control of the development of hema-topoietic cells and immune system;and as a tumor suppressor,its aberration can cause both T and B lineage development arrest and neoplastic transformation,leading to insensitive to therapy and poor prognosis in actue lymphoblastic leukemia. Recently,researches on how Ikaros affects the leukemogenesis and prognosis become the focus of attention.

OBEJECTIVE Gecko has been clinically used in China for many years. It has been proved that the gecko polypeptide mixture(GPM)extracted from gecko could inhibit the growth of multiple types of tumor cells.In order to investigate the possible anti-tumor molecular mechanisms of GPM,we used RNA-seq technology to identify the differentially expressed genes of human hepatocellular carci-noma(HCC)HepG2 cells treated with or without GPM.METHODS The HepG2 cells were treated with different concentration of GPM(0,0.1,0.2,0.3,0.4 mg·mL-1)for 6 h,12 h and 24 h,respectively.MTT assay was used to detect the viability of HepG2 cells. DAPI fluorescence staining was performed to observe nucleus morphological changes of HepG2 cells.Western blot analysis was applied to observe the expres-sion of apoptosis- related proteins and endoplasmic reticulum stress (ERs)-related proteins in HepG2 cells.Flow cytometry was also applied to detect reactive oxygen species(ROS)generation.In this report, we showed that GPM could induce HepG2 cells apoptosis and influence HepG2 cells proliferation in a dose-dependent manner.We applied many analysis methods,including differentially expressed genes analysis,Gene Ontology(GO)enrichment analysis,KEGG pathway enrichment analysis,protein-protein interaction network analysis to screen out possible molecular mechanisms.RESULTS ER-nucleus signaling pathway, cellular response to stress and apoptotic processes were identified the potential anti-cancer molecular biological process of GPM.GPM may also induce apoptosis in HepG2 cells via endoplasmic reticulum stress pathway. The GPM could induce ROS generation and up-regulate ERs-related proteins. CONCLUSION The present study revealed the potential anti-tumor mechanism of GPM.

ObjectiveTo investigate the relationship between carotid intima-media thickness (IMT)and plaque extent of carotid artery with coronary heart disease (CHD).Methods 131 inpatients were divided into 3 groups,in which 54 cases of coronary heart disease group,46 cases of risk group with coronary heart disease,31 cases of control group.The carotid wall IMT,plaque length and thickness was measured by Color Doppler ultrasound.The obtained data using SPSS 17.0 software for statistical processing.ResultsCarotid intimal thickening and the incidence had no significant difference between the group of coronary heart disease and risk group with coronary heart disease risk( all P ＞ 0.05),carotid artery IMT and incidence rate between the above two groups and the control group had statistical differene( t =3.26,3.48,all P ＜ 0.05 ),and the three groups of carotid artery plaque score and plaque classification were statistically significant( F =4.28,P ＜ 0.05 ).ConclusionCarotid IMT and plaque formation was the independent risk factor of CHD,and it could predict the occurrence and development of CHD,especially in carotid artery plaque specificity is higher,in the primary hospital could be used as the auxiliary examination method of CHD.