Objective To explore surgical methods of repairing tibial skin defect using the anterolateral crural island flap.Methods The location,external diameters,anastomosis and distribution of perforators from the anterior tibial artery and the peroneal artery in the anterior septum were observed in 40 cadaveric specimens.Arterial angiography was performed in 4 fresh legs.Clinically,11 cases with tibial skin defect were repaired with the anterolateral crural island flap.There were 7 males and 4 females,with an average of 36 years (20-59 years).The area of the skin defect ranged from 6 cm×4 cm to 12 cm×4 cm.Results An arterial chain was formed by the interconnection of the superficial peroneal artery,the anterior septocutaneous perforator from distal part of the anterior tibial artery and the anterior end-perforator of the peroneal artery.It ran in the anterior septum and went along with the superficial peroneal nerve to supply blood to adjacent fascia and skin.The external diameters of the three perforators were (1.4±0.4) mm,(1.0±0.4) mm and (1.5±0.4) mm respectively,and the external diameter of the arterial chain was (0.6±0.2) mm.Clinically,we designed 4 methods to repair 11 cases of tibial skin defect successfully with the anterolateral cnnal island flap.The anterior septocutaneous perforator from distal part of the anterior tibial artery was used as pedicle in 2 cases;ascending branch of the anterior septocutaneous perforator from distal part of the anterior tibial artery was used as pedicle in 3 cases;descending branch of the anterior septocutaneous perforator from distalpart of the anterior tibial artery was used as pedicle in 3 cases;ascending branch of the anterior end-perforator of the peroneal artery was used as pedicle in 3 cases.The area of the flaps ranged between 7 cm×5 cm and 13 cm×5 cm.All patients were followed up with a mean time of 1.5 years.All flaps survived totally without diabrosis and swelling.Conclusion The anterolateral island flaps pedicled with perforators arising from the anterior septum of the lower leg is a good choice for surgeons to repair tibial skin defect.

Aqueous two phase system(ATPS) provides a gentle, non-denaturing separation environment for proteins, enzymes. While high-speed countercurrent chromatography (HSCCC) is a liquid-liquid partition chromatography which uses centrifugal force to hold the stationary phase and facilities the mobile phase partitioning through the stationary phase, it can produce high separation efficiency with large sample loading capacity. However, the ordinary HSCCC apparatus (Type J ) fails to retention a satisfactory stationary phase of ATPS because of its high viscosity and low interfacial tension. Nevertheless, the later designed cross-axis planetary centrifuge system(X-CPC) can produce a greater lateral force field and enhances significantly the retention of the ATPS stationary phase. A review of the application of these CCC techniques with ATPS in the separation of proteins was given. Meanwhile, new techniques such as pH-peak focusing CCC and dye-ligand affinity CCC and some new CCC column design for improvement of separation efficiency and retention of ATPS stationary phase are introduced.

Objective To explore a surgical treatment of skin defects on the thumb by reverse-flow island flaps on dorsal thumb web with dorsoulnar artery of thumb as a pedicle.Methods The origin,courses and distribution of dorsoulnar artery of thumb from 70 adult cadaveric hand specimens perfused by red latex were explored.Skin defects on the thumb of 8 cases were repaired with reverse-flow island flaps on dorsal thumb web.The cut areas of flaps vary from 4.5 cm × 3.0 cm to 7.5 cm × 4.0 cm.Results There were 4 types of the dorsoulnar artery of thumb basing on the origin and courses.Type Ⅰ was outside the first dorsal interosseous muscle type,which was the dorsoulnar artery of thumb mainly originated from the first dorsal metacarpal artery and cross through the surface of the first dosal interosseous muscle(42.9％).Type Ⅱ was under the first dorsal interosseous muscle type,which was from the thumb principal artery or deep branch of radial artery and run under the first dorsal interosseous muscle(41.4％).Type Ⅲ was mixed type from the anastomose point of above two arteries at the level of the first metacarpophalangeal joint(11.4％).Type Ⅳ was absence type (4.3％).Eight flaps fully survived.Excellent texture and satisfying appearance of the flaps as well as normal thumb web function were verified after 8 months' follow-up.Conclusion It is significant to determine the type of dorsoulnar artery of thumb to decide different operations due to the artery's considerable variation.The reverse-flow island flap on dorsal thumb is an ideal method to repair soft tissue defect on the thumb for its convenient operating and little effect in the donor area.

OBJECTIVE:To establish a method for simultaneous determination of 10 flavonoids in Astragalus membranaceus. METHODS:HPLC method was adopted. The determination was performed on Agilent SB-C18 column with mobile phase consisted of acetonitrile-0.3% formic acid (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelength was set at 254 nm, and the column temperature was 35 ℃. The sample size was 10 μL. RESULTS:The linear ranges of calycosin-7-O-glucoside,iso-quercitrin,genistin,ononin,calycosin,quercetin,genistein,kaempferol,isorhamnetin and formononetion were 0.03029-1.5145μg (r=0.9994),0.01500-0.7500 μg(r=0.9995),0.00739-0.3695 μg(r=0.9991),0.12011-6.0055 μg(r=0.9998),0.03836-1.918 μg (r=0.9999),0.02989-1.4945 μg(r=0.9995),0.00704-0.352 μg(r=0.9994),0.01683-0.8415 μg(r=0.9995),0.00454-0.227μg(r=0.9999),0.01336-0.668 μg(r=0.9999),respectively. RSDs of precision,stability and reproducibility tests were all lower than 2.0% . The recoveries were 99.55% -100.45%(RSD=0.36% ,n=6) ,99.34% -101.00%(RSD=0.59% ,n=6) , 98.05%-100.36%(RSD=1.27%,n=6),99.73%-100.13%(RSD=0.18%,n=6),99.70%-100.30%(RSD=0.22%,n=6), 99.67%-103.27%(RSD=1.37%,n=6),98.13%-104.41%(RSD=2.37%,n=6),96.35%-100.06%(RSD=1.46%,n=6), 99.47%-101.13%(RSD=0.60%,n=6),99.70%-100.06%(RSD=0.15%,n=6),respectively. CONCLUSIONS:This method is convenient,sensitive,stable and reproducible,can be used for simultaneous determination of 10 flavonoids in A. membranaceus.

OBJECTIVE: To compare the influence of traditional Chinese compound recipes (TCCRs) with different efficacy on body weight, tumor weight and immune function in H22 cancer-bearing mice. METHODS: H(22) cancer-bearing mice were chosen to observe the effects of TCCRs with different efficacy on tumor growth inhibition and detect the proliferation function of T lymphocytes, the activity of natural killer (NK) cells, the changes of T lymphocytes and the content of interferon-gamma (IFN-gamma)and interleukin-4 (IL-4). RESULTS: Tumor weight of H(22) cancer-bearing mice in Yidu Gongdu Recipe (YDGDR, a compound traditional Chinese herbal medicine using poison as an antidote for poison)-treated group was obviously lighter than that in the other TCCR-treated groups and the tumor inhibition rate in YDGDR-treated group was 65.76% (P<0.01). The tumor inhibition rates in other TCCR-treated groups were ranged from 10.1% to 17.1% . Body weight of mice in YDGDR-treated group was obviously decreased and depilation was observed at the same time. Pelage of mice in Fuzheng Peiben Recipe (FZPBR, a compound traditional Chinese herbal medicine for supporting the healthy energy)-treated group grew well, and behavior of the mice was active. Stimulation index (SI) of T lymphocyte transformation in YDGDR-treated group was obviously increased (SI=4.34, P<0.01), which showed the proliferation function of T lymphocyte was very strong. The SI of T lymphocyte transformation in the other groups was less than three, which showed the proliferation function of T lymphocytes was not significant. Compared with normal saline (NS)-treated group, percentages of NK cells in Qinre Jiedu Recipe (QRJDR, a compound traditional Chinese herbal medicine for clearing away heat and toxic substances)-treated, Huxue Huayu Recipe (HXHYR, a compound traditional Chinese herbal medicine for activating blood circulation to dissipate blood stasis)-treated and YDGDR-treated groups were obviously increased and 5.05, 4.07 and 5.17 times more than the NS-treated group, respectively (P<0.01). The activity of NK cells wasn't increased in the FZPBR-treated and HXHYR-treated groups. The production of IFN-gamma induced by T cells in YDGDR-treated group was obviously raised (P<0.05), and the production of IL-4 induced by T cells in QRJDR-treated, HXHYR-treated, Huatan Sanjie Recipe (a compound traditional Chinese herbal medicine for eliminating phlegm and resolving masses)-treated and YDGDR-treated groups was also raised obviously (P<0.01). CONCLUSION: YDGDR has a good effect of inhibiting tumor growth and can reinforce cellular and humoral immune function in tumor-bearing mice. FZPBR can strengthen the body.

OBJECTIVE: To investigate the mechanisms of tumor inhibiting and immunoloregulation of Mylabris Mixture on H22 cancer-bearing mice. METHODS: H22 cancer-bearing mice were chosen to observe the effects of tumor inhibiting and detect the proliferation function of T lymphocytes, the toxicity function of NK cells, the changes of T lymphocytes and the contents of interferon-gamma and interleukin-4. RESULTS: Mylabris Mixture could obviously inhibit the growth of H22 cancer in mice, and the tumor inhibition rat was 65.76%. The stimulation index of T lymphocyte transformation and percentage of NK cells in Mylabris Mixture-treated group were obviously higher than those in the normal control group. The subpopulation proportion of T lymphocytes in Mylabris Mixture-treated group was changed more than the normal control group. The production of interferon-gamma and interleukin-4 by T lymphocytes obviously increased in Mylabris Mixture-treated group (P<0.05, P<0.001). CONCLUSION: Mylabris Mixture has the effect of inhibiting the growth of tumor constitution, and regulating immunological function on mice with tumor. Its mechanisms include the reinforcement of T lymphocyte immune function, NK cell killing function and humoral immune function.

OBJECTIVETo investigate the role of nuclear factor erythroid 2-related factor 2 (Nrf2) as a key transcription factor of cytoprotection against inflammation in the spinal cord upregulation of matrix metalloproteinase-9 (MMP-9), tumor necrosis factor-α(TNF-α) after spinal cord injury (SCI).

METHODSWild-type Nrf2(+/+) and Nrf2(-/-)-deficient mice were subjected to a murine SCI model induced by the application of vascular clips (force of 10 g) to the dura after a three-level T8-T10 laminectomy. The wet/dry weight ratio was used to reflect the percentage of water content of impaired spinal cord tissue at 48 h after SCI. The mRNA levels of MMP-9 were determined using reverse-transcriptase polymerase chain reaction (RT-PCR), and the protein levels of TNF-α and MMP-9 were detected by enzyme-linked immunosorbent assay at 24 h after SCI. Furthermore, gelatin zymography analysis was used to show MMP-9 activity of spinal cord tissue at 24 h after SCI. Software SPSS 16.0 was used for the statistical analysis.

RESULTSAfter SCI, spinal cord water content, the expression of TNF-α and MMP-9 all increased in both injured Nrf2(+/+) and Nrf2(-/-) mice compared with their respective sham-operated mice. However, Nrf2(-/-) mice were shown to have more severe spinal cord edema, more TNF-α expression, more production and activity of MMP-9 compared with their wild-type Nrf2(+/+) counterparts after SCI (P < 0.05).

CONCLUSIONSThe results suggest that Nrf2 plays an important protective role in limiting the spinal cord upregulation of TNF-α and MMP-9 after SCI. It may be a new therapeutic target of SCI.

Animals ; Disease Models, Animal ; Female ; Genotype ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Mice ; Mice, Inbred ICR ; Mice, Knockout ; NF-E2-Related Factor 2 ; genetics ; Spinal Cord ; metabolism ; Spinal Cord Injuries ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Postoperative delirium involves attention and cognitive impairment and is a common, serious and often fatal condition in the elderly.This review summarizes the definition, diagnosis, pathogenesis, risk factors, prevention and treatment of postoperative delirium in elderly patients with hip fractures.

OBJECTIVETo investigate the clinical value of artificial insemination by donor (AID).

METHODSWe retrospectively analyzed 480 cycles of AID among 258 infertile couples, who were divided according to the women's age into a < or = 30 yr group and a > or = 31 yr group.

RESULTSA total of 120 pregnancies were achieved in 480 AID cycles, with a cycle pregnancy rate of 25.00% and a cumulative pregnancy rate of 46.51%. In the natural cycles, the cycle pregnancy rate was 29.65% and the cumulative pregnancy rate was 51.00% in the < or = 30 yr group, significantly higher than 13.33% and 25.00% in the > or = 31 yr group (P < 0.05). In the ovulation induction cycles, no significant differences were found in the cycle and cumulative pregnancy rates between the two groups (24.02 and 48.86% versus 23.81 and 43.48% , P > 0.05). The cycle and cumulative pregnancy rates decreased with the increase of infertility duration and the women's age, but had no significant differences. In the first four cycles, the cycle pregnancy rates were 24.03, 24.94, 24.69 and 25.00% (P > 0.05), and the cumulative pregnancy rates were 24.03, 39.53, 45.74 and 46.51%, with significant differences between the first cycle and the other three (P < 0.01).

CONCLUSIONOvulation induction is superior to natural cycle in AID for older women. IVF/ICSI can be resorted to only after AID has failed three or four times.

Adult ; Azoospermia ; therapy ; Female ; Humans ; Insemination, Artificial, Heterologous ; Male ; Ovulation Induction ; Pregnancy ; Pregnancy Rate ; Retrospective Studies

Objective:To investigate the development of hypertension specialty and chronic disease management of county-level hospitals in China, for reference in improving the standardized chronic disease management level of hypertension in the counties.Methods:From September to November 2020, a questionnaire survey on 597 county-level hospitals in 24 provinces was conducted on a voluntary basis. The survey covered such areas as the setup of hypertension specialty, team building of professionals and the management regulations of chronic hypertension of the hospital. The survey data were analyzed by descriptive statistics.Results:Among the 597 county-level hospitals, 54(13.5%) hospitals had independent hypertension departments, 147(24.6%) had hypertension clinics, and 143(24.0%) hospitals had hypertension beds. 431(72.2%) hospitals had hypertension diagnosis and treatment process in outpatient clinics, 454(76.0%) hospitals had hypertension diagnosis and treatment process in wards, and 535(89.6%) hospitals had graded diagnosis and treatment process of hypertension. 473(79.2%) hospitals had established county medical alliance as the lead unit, including 167 compact medical alliances. 97.7% of the hospitals were equipped with basic hypertension risk stratification screening items, and 63.8% could carry out primary screening of secondary hypertension.Conclusions:The pattern of chronic diseases management of hypertension in county-level medical institutions has basically taken shape, but there is still room for improvement. In the future, we should focus on the construction of professional teams of hypertension, the standardized management of diagnosis and treatment of hypertension, and a smoother path of tiered medical service, so as to increase the health management level of hypertension in China.