Objective To explore the survival rate and early-term effects of sensory reconstruction of the modified first dorsal metacarpal artery (FDMCA) flap in treatment of thumb distal soft tissue defect.Methods From March 2004 to October 2007, 65 patients with soft tissue defects of the thumb underwent the FDMCA flap in our department. Forty-nine cases with complete data were included in the study. There were 37 males and 12 females, with an average age of 32 years (ranged, 18-65 years). The conventional surgical methods were used in 18 cases while the improved surgical methods were in 31 cases. The distal necrosis, the vascular crisis rate and the sensory recovery were recorded. Results The mean follow-up period was 2 years (ranged, 20 months to 3 years). Forty-six flaps survived completely. Vascular crisis occurred in five cases harvested by the conventional methods. Eventually, three of them had a partial distal necrosis.Improved FDMCA flap survived well in all 31 patients. Flaps in these patients with nerve anastomosis restored satisfied sense and all sense were located in the thumb. Eighteen cases of nerve transfer group had different levels of mixed feelings (33%) or ectopic sensory (62%). Sense was located in the thumb completely in 1 case. Conclusion The modified FDMCA flap significantly increased the survival rate. Neurorrhaphy could make the sense of the flap locate in the thumb; however it had not been proved that its impact on the recovery of two-point discrimination and stereognosis.

Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.

Objective To study the vascular endothelial growth factor(VEGF) expression and secretion of mesenchymal stem cells(MSCs) of rabbit transfected with pcDNA3-VEGF165 expression plasmid in order to construct a kind of tissue engineering artificial skull with more blood supply.Methods By gene reconstruction method,the VEGF165 gene was cloned into eukaryotic expression plasmid pcDNA3 and recombined eukaryotic expression plasmid pcDNA3-VEGF165 was constructed;By lipofectamine transfection method,pcDNA3-VEGF165 expression plasmid was transfected into MSCs of rabbit;By RT-PCR and Western blotting methods,the VEGF mRNA expression and VEGF protein secretion in the MSCs were detected.Results Recombined eukaryotic expression plasmid pcDNA3-VEGF165 was confirmed to be true by double enzyme digestion,two strips came to appear in 5400 bp and 600 bp of gelose electrophoresis and their sizes accorded with pcDNA3 plasmid and VEGF165 accordingly;Primarily cultured and subcultured MSCs of rabbit were successfully performed and the MSCs storehouse of rabbit was established,primary MSCs presented lymphoid form at first and then the morphology of them became circulara,polygonal or irregular forms,they were more and more like fibroblastic cells after subcultured cultivation.The expressions of VEGF mRNA and VEGF protein in the MSCs were found after transiently transfection by RT-PCR and Western blotting methods.Conclusion Recombined eukaryotic expression plasmid pcDNA3VEGF165 can be transfected into MSCs of rabbit effectively by lipofectamine and the VEGF expression can be detected in the MSCs after transfection.

Aim To study the effect of bioactive compounds from paecilomyces tenuipes(BCPT) on AVP content of hypothalamus,pituitary and expression of AVP mRNA of hypothalamus and behaviour in chronic unpredictable stress model of depression in rats.Methods The depression animal model was induced by chronic unpredictable stress.The behaviour of rats was tested in the open field.The effect of BCPT on AVP content in hypothalamus and pituitary was tested by radioimmunoassay.RT-PCR was used to test the expression of AVP mRNA in hypothalamus.Results BCPT could decrease the expression of AVP mRNA of hypothalamus and decrease AVP content of hypothalamus and pituitary in chronic stressed rats obviously.BCPT could increase ambulation and rearing score of chronic stressed rats in the open-field test.Conclusion BCPT exhibited an antidepressant-like effect may in part be associated with the decreasing AVP content of hypothalamus and pituitary,and the expression of AVPmRNA of hypothalamus in chronic unpredictable stress model of depression in rats

Aim To study the effect of bioactive compounds from paecilomyces tenuipes(BCPT) on antioxidization and lymphocyte proliferation in chronic unpredictable mild stress(CUMS) model of depression in rats.Methods Depression animal model was reproducted in CUMS,UV spectrophotometer analysis technique was used to detect the activity of SOD、GSH-PX and CAT,and content of MDA and NO in rat serum;lymphocyte proliferation was tested with MTT method.Results BCPT could obviously enhance the activities of SOD、GSH-PX and CAT,and also significantly inhibit the increase of MDA and NO content in serum in CUMS rats;BCPT decreased the serum from depressive rat inhibited ConA-induced lymphocyte proliferation.Conclusion BCPT produces an antidespressant-like effect in antioxidation and cellular immunological function in CUMS rats.

OBJECTIVE:To explore the antidepressant effects of bioactive compounds from paecilomyces tenuipes(BCPT)on expression of hippocampus and cortex mineralocorticoid receptor(MR),glucocorticoid receptor(GR)mRNA in CUS(chronic unpredictable stress)rats.METHODS:The depression model rat was produced by CUS,the therapy effect of BCPT was observed in CUS rats.It detected expression of hippocampus and cortex MR,GR mRNA with RT-PCR in CUS rats.RESULTS:BCPT could enhance the expression of hippocampus and cortex MR,GR mRNA or decrease the ratio of MR/GR mRNA in CUS rats.CONCLUSION:BCPT could obviously enhance the expression of hippocampus and cortex MR,GR mRNA or decrease the ratio of MR/GR mRNA in CUS rats,the result of this study suggested that BCPT possess certain antidepressant effect.

AIM: To study the acute toxicity of bioactive compounds from paecilomyces tenuipes (BCPT) and the effect of BCPT on lipid peroxidation of brain in chronic stress model (CMS) of depression in rats. METHODS: The depression animal model was induced by chronic unforeseeable stress (CUS). The maximally tolerated dose (MTD) was used to detect the acute toxicity of BCPT. UV spectrophotometer analysis technique was used to detect the activity of SOD, GSH-PX and CAT, and content of MDA and NO in rat's brain. RESULTS: The MTD of BCPT was 9 g?kg -1 . BCPT could obviously enhance the activities of SOD, GSH-PX and CAT, and also significantly inhibit the increase of MDA and NO content in brain in CMS rats. CONCLUSION: BCPT has little toxicity and produces an antidespressant-like effect in antioxidation in CMS rats.

Aim Exploration of the effects of bioactive compound from paecilomyces tenuipes (BCPT) on the behavior, ultrastructure of hippocampus, and expressions of BDNF and Bax of cerebral cortex in CUS rats. Methods The depression model rat was induced by chronic unpredictable stress(CUS). The Open field test was used to observe the behavior of CUS rats. The expressions of BDNF and Bax of cerebral cortex were studied using immunohistochemical method, and average optical density of cortical neuron was calculated by image analysis. Morphology of hippocampus was observed by transmission electron microscope. Results Compared with model group, BCPT could obviously increase the activity of ambulation and rearing and the number of positive neuron of BDNF, decrease the number of positive neuron of Bax, and effectively prevent pathological damage induced by chronic unpredictable stress. Conclusion BCPT may exhibit the effects of antidepression, up-regulate the expression of BDNF, down-regulate the expression of Bax, and improve of the ultrastructure of hippocampus.

Haemophagocytic lymphohistiocytosis (HLH) is a potentially fatal disorder resulting from uncontrolled hyperinflammatory response. There had been increase in cases of one of the secondary form of HLH, i.e., infectionassociated haemophagocytic syndrome (IAHS) in severe dengue in recent years. However, the condition remains under diagnosed due to lack of awareness compounded by the lack of validated diagnostic criteria. Severe hepatitis with prolonged cytopenias, severe hyperferritinemia, hypofibrinogenemia and persistent fever were evident in all four cases reported. All the subjects survived with supportive care and adjuvant steroid therapy. Prospective controlled studies are needed to develop diagnostic criteria and management protocol for IAHS in severe dengue.
Severe Dengue

Objective To investigate the effect of diabetes on the expression of the glucose transporter (GLUT-1) in blood brain barrier (BBB) endothelial cell at different time points. Methods Forty male SD rats were randomly divided into normal control and diabetic group. Diabetic model of SD rats was established by intravenous streptozotocin(50 mg/kg) injection. Ten rats in each group were sacrificed on the 2nd month and 10th month respectively. The rat' s prefrontal cortex was removed to observe the expression of GLUT-1 in BBB EC with immunohistochemical(IHC) staining. Results By IHC method, the number of GLUT-1 positive microvessels was significantly decreased in diabetic group in the 2nd month (4. 3 ± 0. 9) compared with that of control group (6.4 ± 1.7, t = 7. 586, P < 0. 01 ) ; the number of GLUT-1 positive microvessels was significantly increased in the diabetic group in the 10th month (8.4 ± 1.4) compared with that of control group (5. 8 ± 1.7, t = 15.922,P < 0. 01 ). Conclusions Short-term diabetes GLUT-1 expression in BBB EC is downregulated in early stage, while it is upregulated in advanced stage.