Objective To determine the effect of resurfacing completely degloved thumbs by free perforator flaps in a spiral fashion.Methods A retrospective case series study was made on 22 patients with completely degloving injury of the thumb treated by different free perforator flaps in a spiral fashion from June 2009 to December 2014,including 19 male and 3 female patients at the age of 18-46 years (mean,27.8 years).A total of 13 patients were reconstructed using the medial arm perforator flaps ranging in size from 8.0 cm × 3.0 cm-14.5 cm × 3.5 cm,and 9 patients were reconstructed using the peroneal artery perforator flaps ranging in size from 6.0 cm × 3.5 cm-21.0 cm × 10.0 cm.Follow-up was made to evaluate the sensation,appearance and function of the thumbs and the recovery of flap donor sites.Results All flaps survived completely,with no occurrence of postoperative vascular crisis and infection.Only one medial arm flap and one soleus perforator flap distal flap showed blood flow disorder in the distal sections and were healed uneventfully after conservative therapy.Function and cosmetic recovery of the reconstructed thumbs were good.Follow-up ranged from 9 to 22 months (mean,14.5 months).Twopoint discrimination test of the flaps was recovered to 6-13 mm.No linear scar contracture was left.Flap donor site wound healed primarily.All patients were satisfied with the overall results.Conclusion The free perforator flap in a spiral fashion can avoid linear scar contracture,maximally decrease donor site morbidity and achieve satisfactory functional recovery and good aesthetic restoration,indicating a good candidate for reconstruction of thumb degloving injury.

AIM: To observe the neuroprotective effect of combined treatment with taurine and diazepam against focal cerebral ischemia-reperfusion in rats. METHODS: Sixty male Sprague-Dawley rats were randomly divided into five groups: sham-operation group, vehicle group, taurine group (200 mg/kg, ip), diazepam group (10 mg/kg, ip) and combined treatment group (taurine 100 mg/kg+diazepam 5 mg/kg). Focal cerebral ischemia was induced by the method of middle cerebral artery occlusion (MCAO) in rats, and reperfusion was emerged by removing the thread 2 h later. The drugs were administered respectively at the time of reperfusion, and subsequently repeated once 12 h later. The animals in vehicle group were intraperitoneally injected with isodose normal saline. The neurological deficit score, the brain water content and cerebral infarction were measured 48 h after MCAO. Other 5 group animals of focal cerebral ischemia-reperfusion (n=16 in each group) were set up as mentioned above and accepted treatments 10 h after reperfusion, likewise repeated once 12 h later. Twelve animals in each group were adopted the same management as the previous 5 groups at 48 h after MCAO. The remained 4 animals in each group were sacrificed until two weeks after MCAO to observe the histopathological changes by nissl staining. RESULTS: Compared to vehicle group, the animals in combined treatment group at 2 h or 12 h after MCAO both decreased the neurological deficit score, reduced the brain water content and infarct volume (P<0.01 or P<0.05). The combined treatment significantly alleviated the neurological necrosis as well. The neuroprotective effect of the combined treatment was superior to that of using taurine or diazepam alone. CONCLUSION: These results suggest that combination of taurine and diazepam treatment has a coordinate neuroprotective effect on both the acute and chronic brain damage of focal cerebral ischemia-reperfusion.

Objective To investigate the implementation and application of rotational DSA dual volume technology in displaying the intracranial artery stent.Methods Firstly,the “stent opacity”single volume technology was used to display 5 types of stent which were released in 7 cases of pure intracranial artery stenting and 12 cases of stent-assisted aneurysm embolization.Then we applied “vessel translucent”and “vessel opacity”single volume technology to display corresponding vessel segments.Finally,by coalescing the single volume imaging of stent and vessel,the “vessel opacity + stent opacity”dual volume image and “vessel translucent+ stent opacity”dual volume image were performed.We compared the effects of two kinds of dual volume imaging and assessed the imaging characteristics and influencing factors of each method.Results (1)On the “stent opacity”single volume display mode,in 7 cases of pure intracranial artery stenting,the display effect of two Pipeline stents and three Apollo stents belongs to level 1,the display effect of two Enterprise stents belongs to level 2;In 12 cases of stent-assisted aneurysm embolization,in the stent segments which weren’t influenced by artifacts,the display effect of two LEVIS stents belongs to level 1,the display effects of 5 Enterprise stents and 2 Solitaire AB stents belongs to level 2;While in the stent segments which were influenced by the artifact of spring coil and bone,the display effect significantly reduced, three pieces of Enterprise stents were even unable to identify.(2)On the “vessel opacity”single volume display mode,1 9 cases of vessel segment at the stent completed opacity display.The surface structure of vessel was very clear,but the structure under the surface was completely being covered.On the “vessel translucent”single volume display mode,the surface structure of 19 cases of vessel segment at the stent displayed clear at the tangential position.The vessel lumen also presented transparent state.(3)On the “stent opacity+vessels opacity”double volume display mode,the start-stop location and the adherence of stents in blood vessels in 1 6 cases were displayed clearly. When using the “stent opacity+ vascular opacity”double volume imaging,except 3 cases which used ball expansion Apollo stents could display comprehensive relationship between the blood vessels,in the other 13 cases,the relationship between stent and vascular could not be fully displayed.Conclusion On the condition that the single volume display technology shows stent well,the “stent opaque+vessels translucent”double volume display technology can well present the stent condition in the vessels.

Objective To study the correlation of 5 polymorphisms of Han Chinese patients in Sichuan Province with age-related macular degeneration (AMD). Methods The blood samples from 384 Han Chinese patients diagnosed with AMD and another 384 matched controls were collected using case-control study method. The chosen gene single nucleotide polymorphisms (SNPs) were genotyped by SnaPShot classify technology in the patients with AMD and 384 controls of Chinese Han population. Results All of the 5 genetype frequencies of the SNPs were in accordance with Hardy-Weinberg Equilibrium (P > 0.05). There were no statistically significantdifferences between the AMD group and the control group in the rs13117504 G allele frequency (P = 0.037, OR=1.24, 95%CI:1.01~1.53), the rs10033900 C allele frequency (P=0.023, OR=1.27, 95%CI: 1.03 ~1.57) and the rs1003390 frequency in the AMD dominant model (P = 0.039, OR = 0.74, 95%CI: 0.55 ~ 0.99). There were no statistically significant differences between the groups in the rs6822976 A allele frequencies (P =0.158), the rs7438961 G allele frequencies (P = 0.798) and, the rs7671905 T allele frequency (P = 0.909). The rs10033900 in the recessive model of AMD had no significant difference as compared to that in the control group (P = 0.107). The two groups showed no significant differences in both the dominant and recessive model of AMD in terms of the frequencies of rs13117504, rs6822976, rs7438961 and rs7671905 (P > 0.05). Conclusion The rs13117504 and rs10033900 of SNPs near CFI gene upstream has significant association with age-related macular degeneration , while the rs6822976 , rs7438961 , rs7671905 of SNPs have no significant correlations with age-related macular degeneration in Han Chinese population.

Objective To explore the influencing factors of ALT abnormality among workers from food industry and related people from public places in Shenzhen and influencing factors.Methods 2,411 workers from food industry and people from public places who had physical examinations in our department from May to October in 2013 were involved in the investigation.ALT abnormality rate and the influencing factors were analyzed.Results The incidence of ALT abnormalities among workers from food industry and related people from public places in Shenzhen was 9.37%.The ALT abnormalities were correlated with censue register,gender,age,marital status,work duration in Shenzhen,education level and monthly income respectively(all P<0.05). Conclusion The ALT abnormality has a higher rate among people from cities,of male gender and old age,with longer work duration in Shenzhen and relatively high level of education and higher monthly income.Therefore,for the population,the health education should be strengthened and the healthy lifestyles should be advocated to effectively reduce the ALT abnormality rate.

Objective To investigate the expression of parathyroid hormone/parathyroid hormone relative protein (PTH/PTHrP) receptor of osteoblast in hemodialysis patients and the effects of calcium channel blocker(CCB) and calcitriol on it. Methods Twenty-one patients on HD were randomly divided into three groups. Six patients were treated with CCB for 8 weeks. Seven patients were given calcitriol for 8 weeks. The rest 8 cases did not take either CCB or calcitriol. Five healthy people were selected as control group. The serum levels of iPTH, BUN, Scr, calcium and phosphorus were measured. The osteoblast was prepared from cultured bone marrow. PTH receptor mRNA expression was detected by semi-quantitive RT-PCR. Results The level of PTH/PTHrP receptor mRNA decreased significantly in patients on HD as compared with control group, and increased in patients with CCB. In calcitriol treated group, and PTH/PTHrP receptor was obviously down-regulated with larger dose of calcitriol(0. 75?g/d), and up-regulated with low dose(0. 25?g/d) . Conclusion Expression of PTH/PTHrP receptor down-regulates in osteoblast of HD patients. CCB can up-regulate the expression of PTH/PTHrP receptor. A large dose of calcitriol may decrease iPTH level and down-regulate PTH/PTHrP receptor expression.

The development of the healthcare industry puts forward higher and higher standards on the medical education, so an effective education management mode is needed urgently for medical schools to promote the cultivation of undergraduate medical students. Tutorial system has a positive effect in building the innovative thinking, critical thinking and clinical thinking of medical students. It also helps students' innovation ability training. This paper first introduces the overview of the implementation of tutorial system in medical colleges, and then expounds the specific implementation measures of the undergraduate tutorial system in the Third Military Medical University. Investigation data shows that, accompanied with these mea-sures, the numbers of article publishes and the achievements in various competitions have been raised whereas the psychological counseling needs decreased, indicating that the tutorial system has a strong posi-tive influence on the development of medical students.

Retinitis pigmentosa (RP) is a group of inherited disorders which involve photoreceptors of the retina and can lead to visual loss. The genetic and clinical phenotypes of RP feature high heterogeneity. RP can be divided into nonsyndromic and syndromic types, both may feature autosomal dominant, autosomal reccesive and X-linked inheritance. So far, many genes have been identified, most of which are expressed in the photoreceptors or retinal pigment epithelium. Sixty-three genes have been identified in nonsyndromic RP. This paper reviews recent progress in the research of the genetics of RP.
Genes, X-Linked ; Humans ; Proteins ; genetics ; Retinitis Pigmentosa ; genetics

Objective To study the characteristics of craniocerebral injury caused by the handgun bullet impacting on the bulletproof helmet.Methods Fourteen healthy landrace pigs were involved and randomly divided into injury group(n =9)and control group(n =5).The landrace pigs of the injury group were shot vertically on the head under the protection of helmet plate with 9 mm handgun bullet at velocity of 360 m/s.While the landrace pigs of the control group were dealt with the same process as the injury group except for use of unarmed handgun bullet of the same ammunition dose.The changes of vital sign in the early period and the retina injury at two hours after injury were observed.Porcine cerebrospinal fluid (CSF)at pre-injury and at three hours post-injury were obtained for investigating the levels of neuron specific enolase(NSE)andαⅡ-spectrin protein.Then,the landrace pigs were sacrificed and dissected to examine the general morphological changes of the brain.The brain cortex was taken,fixed and stained with hematoxylin-eosin for microscopic observation.Results The landrace pigs in the injury group manifested decrease of the blood pressure and increase of the heart rate and respiratory rate in the early stage after injury.General morphological observation found retinal hemorrhage(3/9),skull fracture(3/9)and brain surface damage including local impact lesion(9/9)and contrecoup lesion(9/9),with severe impact lesion than contrecoup lesion.Optical microscopic observation revealed acute injury of the cerebral cortex neuron both on the impact and contrecoup locations.The concentrations of NSE and αⅡ-spectrinwere significantly increased in CSF three hours after injury(P ＜ 0.05).Conclusions The handgun bullet impacts on the pig head protected by the bulletproof helmet may induce blunt craniocerebral injury in the early period,with severe impact lesion than contrecoup lesion.Therefore,traumatic brain injury of the soldiers armed with the helmets should be stressed and managed early.

ObjectiveInvestigate the value and feasibility of image registration with reverse rotation in lateral cerebral DSA.Methods ( 1 ) Experimental study:the target images were subtracted directly,and subtracted again after reverse rotation.Software of registration and subtraction with reverse rotation edited by the author utilizing Visual Basic.The function of the automatic angle detection by the software were evaluated to see whether it detected the angle of line.The subtraction function of DSA by the software was evaluated.(2) Clinical retrospective study:the untreated mask and target inages of 15 patients with motion along vertical axis during lateral cerebral DSA were uploaded to the software.The target images were processed with and without the software to get two sets of images.( 3 ) Evaluation:four experienced radiologists read and compared the two sets of the images,and graded their findings.Results ( 1 ) The automatic detection by the software suggested that the target images should be rotated counterclockwise 1.3°. The subtraction result of the software was satisfactory.(2)In the 15 sets of images,there were only three sets of images deemed optimal after traditional subtraction.After reverse rotation,artifacts were significantly reduced and the image sharper. There were ten cases with significant artifacts after traditional subtraction,and those images were sharper and showed more peripheral vessels after reverse rotation. The traditional subtraction images of two sets could not be interpreted,the reverse rotation registration images reached the diagnostic quality.(3)Subjective evaluation: there were more information and less noise and distortion in the registration images with reverse rotation than in the traditional subtraction. But the image resolution decreased slightly after reverse rotation registration.ConclusionThe registration of digital angiography with reverse rotation can improve the image quality in lateral cerebral DSA.