BACKGROUND: Scholars disagree with each other about the small saphenous vein effects on skin flap and how to dispose vascular proximal pedicles.OBJECTIVE: To analyze effects of different methods of the small saphenous vein disposal on flap survival using sural neurocutaneous island flap retrograde metastasis for repairing defects of soft tissue of instep, heelstick and ankle.DESIGN, TIME AND SETTING: The case control observation experiment was performed at the General Hospital of Guangzhou Military Area Command of Chinese PLA from March 1998 to April 2007.PARTICIPANTS: A total of 56 patients with defects of soft tissue of instep, heelstick and ankle were divided into 2 groups,small sapbenous vein deligation in proximal pedicle flap group (group A) (n=38), and proximal small saphenous vein and great saphenous vein or tributaries at recipient site anastomosis flap group (group B) (n=18).METHODS: During sural neurocutaneous island flap retrograde metastasis for repair,(3.5×4.0)cm-(4.0×4.5) cm flap was obtained in 35 cases, and (4.0×4.5) cm -(10.0×12.0) cm in 21 cases.MAIN OUTCOME MEASURES: Outcome of flap survival at different incision area and implanted methods.RESULTS: No vein articulo occurred in 21 cases, which flap areas were (4.0×4.5) cm -(10.0×12.0) cm. Five of 35 cases which flap areas were (3.5×4.0) cm -(4.0×4.5) cm developed vein articulo.The necrotic rate of flaps in group B was significantly lower compared to the group A (P=0.017 67).CONCLUSION: When the area of skin flap is smaller than (4.0×4.5) cm, the proximal end of the small saphenous vein should be anastomosed with the great saphenous vein or tributaries connecting with the great saphenous vein at recipient site.The small saphenous vein is not a superficial vein, which only cross the skin flap, but it has trophic action on the skin flap.

Objective To compare clinical outcome and adverse reactions between the regimens SOX and XELOX for chemotherapy of advanced gastric carcinoma in Chinese population.Methods The original articles on randomized controlled trials ( RCTs) comparing the chemotherapy of SOX and XELOX in Chinese patients with advanced gastric carcinoma were recruited from the PUBMED, WANFANG, VIP and CNKI databases.The quality of the selected trials were assessed by JADAD method.Meta-analysis about the efficacy and safety of the two chemotherapy methods was performed by Rev Man 5.2.0 software ( Cochrane-information Management System) .Results Eight RCT studies were recruited in our work, including 293 patients in the SOX treatment group and 310 in the XELOX treatment group.The analysis results showed that there was no significant difference in the effect of the two chemotherapy methods (OR=1.19, 95%CI:0.86-1.64,P=0.29), and referred to the safety evaluation, the stomatitis (OR=2.29, 95%CI:1.74-4.89, P<0.0001) incidence in SOX treatment group was higher than XELOX treatment group, and in total, there was no significant difference in adverse reaction incidence of the two chemotherapy methods(OR =0.88, 95%CI: 0.66-1.19, P =0.41).Conclusion In the chemotherapy of advanced gastric carcinoma in Chinese population, there is no significant difference in clinical response rate between SOX and XELOX, and the stomatitis incidence of SOX is significantly higher than that of XELOX.

AIM: To investigate the effect of IL-10 on IL-1?-induced prostaglandin E 2(PGE 2) release and cyclooxygenase-2(COX-2) expression in human mesangial cells and to examine whether IL-10 has effect on the biological function of IL-1?.METHODS: The PGE 2 concentration in supernatants of HMC was measured by radioimmunoassay. The COX-2 mRNA and protein were measured by RT-PCR and Western blot, respectively. RESULTS: PGE 2 and COX-2 were significantly increased after treatment with IL-1?( P0.05 , respectively), while it inhibited IL-1?-elicited PGE 2 production, as well as COX-2 mRNA and protein expression in a concentration-dependent fashion. CONCLUSIONS: These results indicated that IL-10 depressed the IL-1?-induced release of PGE 2 and expression of COX-2. These data suggested that IL-10 could exert anti-inflammatory actions at several levels, not only by inhibiting the production of pro-inflammatory cytokines but also by suppressing their biological function.

Objective To identify the important regulatory elements in the promoter of human CD2 associated protein(CD2AP) by conserved sequence analysis among different species and luciferase functional detection. Methods The promoter sequences of CD2AP from different species were analyzed by BLAST. Plasmids containing different length of deletion mutations of human CD2AP promoter were constructed. Pro-moter activities were tested in 3 kinds of cells from different species by luciferase analysis and were tested in HEK-293 cells treated with all-trans-retinoic acid. Results Homologous sequence comparison in CD2AP promoter area among human, cattle and pig showed that putative specific protein 1 (Sp1) sites and down-stream promoter element (DPE) were highly evolutional]y conserved. Progressive deletion luciferase analysis of DNA fragments revealed similar promoter activity style among 3 different cell lines from 3 different spe-cies, HEK-293, BHK-21 and Vero cells. One basic promoter activity located within 500 bp upstream of ATG. Fragments of further upstream 100 bp or more had drastically 10 times increased promoter activity. Two putative Sp1 sites were in this 100 bp region. All-trans-retinoic acid decreased the luciferase activity of CD2AP promoter. Conclusion Putative Spl sites and DPE have important functions in the promoter activity of CD2AP.

BACKGROUND:The therapeutic effects of donkey-hide glue reinforcing bone oral solution on osteoporosis have been determined, but the exact effective mechanism is to be approached. OBJECTIVE: To investigate the effects of donkey-hide glue reinforcing bone oral solution (DGRBOS) medicated serum on osteoprotegerin (OPG)and its ligand(OPGL)mRNAexpression of osteoblast in fetal rats and explore the molecular mechanism of treating osteoporosis with DGRBOS. DESIGN: A randomized controlled trial. MATERIALS: The experiment was carried out from June 2003 to October 2004 in Bone Metabolic Laboratory of Department of Integrative Chinese and Western Medicine, Affiliated Hospital of Tongji Medical College,Huazhong University of Technology and Science. Totally 30 3-month-oldWistar rats (15 males and 15 females) were randomly divided into 3 groups, I.e. DGRBOS group, estrogen group and control group, with 10 rats in every group. 12 clean newborn SD rats were selected to isolate and cul ture osteoblast. METHODS: ①After intragastric administration for 7 days, medicated serum was prepared respectively from the three groups. ②Skull osteoblast isolated from newborn SD rats was made into single cell suspension, then after digestion and passage, the subcultured osteoblast cell was made into cell suspension. The cultured osteoblasts were divided into 5 groups and given equal volumes of drug liquor. The DGRBOS group was given DGRBOS-medicated serum at the concentration of 100, 500 and 1 000 g/L which was diluted by nutrient solution; the estrogen group was given tibolone-medicated serum of 100 and 1 000 g/L; the control group was givenonly culture fluid. Meanwhile every group was given calf serum (100 g/L) for further culture. ③The osteoblast proliferation was measured by antigenic MTT colorimetric analysis and 3H-TdR penetration method. The in tra-cellular BGP contents were evaluated by radioimmunity .The mRNA expression of OPG and RANKL in osteoblast was analyzed by Rt-PCR. ④ One-way analysis of variance was applied to compare data among groups. MAIN OUTCOME MEASURES: mRNA expression of OPG and PAN KL in osteoblasts from fetal rats after intervention by medicated serum ofDGRBOS or Livial. RESULTS: ①The osteoblast proliferation measured by antigenic MTT colorimetric analysis and 3H-TdR penetration method showed that the proliferation in the DGRBOS group and tibolone group was enhanced moresignificantly than that in the control group (P ＜ 0.05-0.01), and reached maximal effect at the concentration of 500 g/L (P ＜ 0.01), but when the concentration was over 500 g/L, the effect tended to saturate. The medicated serum with all concentrations from DGRBOS and estrogen groups could increase the contents of BGP in osteoblasts (P ＜ 0.05). ②The mRNA expression of OPG reached the peak when the DGRBOS medicated serum was 1 000 g/L, and was obviously higher than that at the concentration of 100 and 500 g/L (P ＜ 0.05). The expression in DGRBOS group at the concentration of 1 000 g/L and in the estrogen group at the concentration of 100 and 1 000 g/L was apparently higher than that of the control group (P ＜ 0.01). ③The mRNAexpression of RANKL was the highest in DGR BOS group with 1 000 g/L concentration, and was markedly lower than that of the concentration of 100 and 500 g/L (P ＜ 0.05). The expression in DGRBOS group at the concentration of 1 000 g/L and in the estrogen group at the concentration of 100 and 1 000 g/L was noticeably lower than that in the control group (P ＜ 0.01).CONCLUSION: ①The DGRBOS could remarkably enhance osteoblast proliferation in dose-dependent and a dose-saturable manner, and the effect was close to that of tibolone. ②Partial mechanism of DGRBOS in treating osteoporosis might be promoting osteoblast proliferation and regulating OPG/RANKL expression.

AIM: To investigate the role of NF-?B/I?B signal pathway in the regulation of (cyclooxygenase-2) (COX-2) expression in human mesangial cells (HMC). METHODS: The PGE_2 concentration in supernatants of HMC was measured by radioimmunoassay. COX-2 mRNA and protein expression were determined by RT-PCR and Western blot. Electrophoretic mobility shift assay (EMSA) and Western blot were used to detect the activity of NF-?B and degradation of I?B. RESULTS: IL-1? significantly upregulated COX-2 expression and PGE_2 production in HMC. Significant up-regulation of NF-?B activation, nuclear translocation of p65 subunit, and degradation of I?B ? and I?B ? were observed in IL-1?-induced HMC. CONCLUSION: Expression of COX-2 in IL-1?-induced HMC is mediated by NF-?B/I?B signal pathway. [

Objective To localize the tibial attachment of the posterior cruciate ligament (PCL) on the magnetic resonance imaging (MRI) and provide parameters for clinical PCL reconstruction.Methods We retrospectively analyzed 524 patients with intact tibial PCL attachment who had undergone knee MRI from January 2010 to January 2016.They were 286 men and 238 women with an average age of 35 years (from 20 to 50 years).The size and positions of the tibial PCL attachment were measured on the sagittal and coronal MRI slices.The differences were analyzed between different genders.Results On the sagittal slices,the mean distance from the central tibial PCL attachment to the posterior edge of the tibial plateau was 17.9 ± 3.0 mm and the mean anteroposterior diameter of the tibial PCL attachment was 9.7 ± 2.4 mm,with those for males significantly larger than for females (P ＜ 0.05).The above mean values when expressed as a percentage of the posterior tibial slop were 79.9％ ±4.5％ and 43.7％ ± 9.6％,respectively,showing no significant differences between males and females (P ＞ 0.05).On the coronal slices,the distances from the central tibial PCL attachment to the medial and lateral edges of the tibial plateau were 33.5 ± 3.1 mm and 37.4 ±4.1 mm,respectively,and the mediolateral diameter of the tibial PCL attachment was 12.0 ± 1.6 mm,with those for males significantly larger than for females (P ＜ 0.05).The above mean values when expressed as a percentage of the mediolateral diameter of the tibial PCL attachment were 47.4％ ± 3.2％,52.7％ ±3.1％ and 16.9％ ± 1.7％,respectively,showing no significant differences between males and females (P ＞ 0.05).Conclusions On knee MRI images,the distance from the central tibial PCL attachment to the posterior edge of the tibial plateau is about 17.9 mm,the anteroposterior diameter of the tibial PCL attachment around 9.7 mm,and the mediolateral diameter of the tibial PCL attachment roughly 12.0 mm.These measurements for males are larger than for females.

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when fetal platelets are sensitized and then phagocytized by macrophages in the reticuloendothelial system after antibodies specific for allogeneic platelets in the pregnant women cross the placenta and enter the fetus. In severe cases, intracranial hemorrhage and even fetal death may occur. This article reviews the recent progress in the following aspects: the mechanisms of pregnancy-related platelet alloimmunity, platelet destruction mechanisms in FNAIT, correlation of anti-angiogenic effects and intracranial hemorrhage, correlation between anti-GPIbα antibodies and miscarriage, and the diagnosis, treatment and prevention of FNAIT.

OBJECTIVE: To explore the genetic mechanism underlying a case with para-Bombay phenotype. METHODS: The ABO and Lewis phenotype were identified with serological methods. The coding regions of exons 6 and 7 of the ABO and FUT1 genes were amplified with PCR and directly sequenced. Haploid sequence analysis was carried out on the variant sites of the FUT1 gene. RESULTS: Serological analysis confirmed that the proband has a rare para-Bombay phenotype. Direct sequencing revealed that he was a B.01/O.01.02 heterozygote for the ABO gene, and had heterozygous deletion for the 768 and 881-882 sites of the FUT1 gene. Further haploid analysis showed that the c.881_882delTT deletion has occurred in one haploid while c.768delC was present in the other haploid. The proband was therefore determined as a FUT1*01N.13/01N.20 heterozygote, which have resulted in frameshift in polypeptide chain p.Phe294Cysfs*40 and p.Val257Phefs*23, respectively. CONCLUSION A rare bi-allelic heterozygous deletion of para-Bombay phenotype has been identified in a blood donor. The c.881_882delTT and c.768delC deletions may decrease the activity of α-1,2-fucosyltransferase.
Animals ; Male ; ABO Blood-Group System/genetics* ; Alleles ; Fucosyltransferases/genetics* ; Genotype ; Heterozygote ; Mutation ; Phenotype ; Humans

Objective:To explore the effects of the second dorsal metacarpal artery perforator flap relaying the dorsal island flap of index finger in repairing thumb wounds.Methods:The study was a retrospective observational study. From May 2021 to January 2023, 14 patients with thumb wounds who met the inclusion criteria were admitted to Gansu Provincial People's Hospital, including 8 males and 6 females, aged 24 to 63 years. After debridement, the wound area was 2.1 cm×1.2 cm to 5.5 cm×3.5 cm. The dorsal island flap of index finger with incision area of 2.4 cm×1.5 cm to 5.5 cm×3.5 cm was used to repair the thumb wound, and then the second dorsal metacarpal artery perforator flap with incision area of 2.7 cm×1.6 cm to 5.7 cm×3.6 cm was cut through the same incision to repair the donor wound in the index finger, and the donor wound in the dorsal of hand was directly sutured. The survival of flap was observed, and the healing of the donor wound in the dorsal of hand was observed after operation. The condition of donor wound in the dorsal of hand, the color, appearance, and texture of flap, postoperative complications, return to work, and satisfaction with the treatment effect of patients were followed up. At the last follow-up, the function of the thumb and the index finger was evaluated with the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association.Results:After operation, all flaps survived, and the donor wounds on the back of the hands healed. During follow-up of 6-12 months, only linear scars remained on the donor wounds in the dorsal of hands, and the color of flaps was similar to that of the surrounding normal skin, with a full appearance and soft texture. There were no complications such as scar tenderness or scar contracture in any patient. All patients had normal sensation in the thumb and index finger, resumed normal work, and were satisfied with the treatment effects. At the last follow-up, the function of thumb and index finger was evaluated as excellent in 9 cases and good in 5 cases.Conclusions:The second dorsal metacarpal artery perforator flap can repair the thumb wound by relaying the dorsal island flap of index finger, without damaging the major blood vessels, with only linear scars remained on the donor wounds in the dorsal of hands after operation, with good appearance of flap and function of thumb and index finger. The operation is relatively simple with good clinical effects.