Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

Objective To investigate the clinical manifestations and imaging features of dural arterio-venous fistula of super petrosal venous drainage and treatment. Methods From May 2013 to September 2014,9 patients with petrosal vein drained dural arteriovenous fistula at the Department of Neurosurgery, Xuanwu Hospital,Capital Medical University and the Department of Neurosurgery,Beijing Haidian Hospital were enrolled retrospectively. The patients were treated with endovascular embolization or microsurgery,and the MRI and DSA examinations were improved,and the scores of the modified Aminoff&Logue scale (ALS) were performed before and after treatment. Results In the 9 patients,there were 3 females and 6 males. They all had different degrees of limb sensory and motor abnormalities,7 of them also had urination and/or bowel disorders,4 had cranial nerve dysfunction,including hoarseness,bucking,hiccup,and paralysis. Six patients received embolization treatment,3 received microsurgery,and they all achieved anatomic cure. The preoperative ALS score was 6. 0 ± 2. 7,and the score at 3 months after procedure was 2. 8 ± 1. 7. There was significant difference between before and after treatment (t=4. 816,P<0. 05). Conclusions The petrosal vein drained dural arteriovenous fistula is a kind of rare cerebrovascular malformation. The lesion involves a wide range. The clinical manifestations are severe. Both endovascular embolization and microsurgery can achieve a more ideal therapeutic effect. If the vascular condition is permitted,the interventional embolization treatment should be preferred.

Objective To investigate the effect of endovascular treatment of vertebral basilar artery dissecting aneurysms. Methods The clinical data of 40 patients with vertebral basilar artery dissecting aneurysm admitted to Beijing Xuanwu Hospital and Haidian hospital,Capital Medical University from August 2013 to September 2014 were analyzed retrospectively. Their clinical symptoms and imaging were followed up. According to the treatment methods,they were divided into either a stent-assisted coil emboliza-tion group (group A;n = 34)or a parent artery occlusion (group B;n = 6),and according to the clinical symptoms and imaging followed-up,the efficacy was assessed at 1 year after procedure. Results The patients were followed up for 1 year after procedure,29 patients (85. 3%)were improved in group A, 1 (2.9%)was stable,and 4 (11. 8%)deteriorated. All the 4 deteriorated patients died of cerebral infarction complications (at 1 week to 6 months after procedure). The 6 patients in group B were improved compared with before procedure. No intracranial hemorrhage and ischemic events occurred. Conclusion Using the stent-assisted coil embolization technique and the parent artery occlusion technique for the treatment of the vertebral basilar artery dissecting aneurysms are relatively safe and effective.

Objective: To explore the application and effect of superficial temporal fascia flap combined with avulsion auricular tissue in emergency auricular restoration. Methods: From June 2015 to December 2015, 6 patients with auricular large area complete avulsion were underwent treatment in Department of Plastic Surgery of General Hospital of Shenyang Military. After thorough debridement, the auricular cartilage scaffold of the avlusion ear and skin was completely stripped. The auricular cartilage was repositioned on its anatomical site and subsequently covered by superficial temporal fascia flap. The free skin was stripped as full-thickness graft to cover the surface of reconstructed ear. Results: All 6 patients with auricle large area complete avulsion achieved immediate repair under emergency condition. The operations were successfully completed and the ears were healed primarily. The patients were followed-up for one year. Five patients with partial auricular avulsion achieved obvious reconstructed auricle profile. The color of reconstructed ear was close to the surrounding skin and the cranioauricular angle was nearly normal. Patients and their families were very satisfied. One patient of total auricular reconstruction had auricular contracture. The auricle profile was not obvious with small size, morphological changes and external auditory canal stenosis. Conclusions Avulsion auricle and temporal superficial fascia flap can be used to repair partial auricle defects as a first-stage repair with ideal results. It is the best choice for large auricle defects in emergency cases.

Motor imaging therapy is of great significance to the rehabilitation of patients with stroke or motor dysfunction, but there are few studies on lower limb motor imagination. When electrical stimulation is applied to the posterior tibial nerve of the ankle, the steady-state somatosensory evoked potentials (SSSEP) can be induced at the electrical stimulation frequency. In order to better realize the classification of lower extremity motor imagination, improve the classification effect, and enrich the instruction set of lower extremity motor imagination, this paper designs two experimental paradigms: Motor imaging (MI) paradigm and Hybrid paradigm. The Hybrid paradigm contains electrical stimulation assistance. Ten healthy college students were recruited to complete the unilateral movement imagination task of left and right foot in two paradigms. Through time-frequency analysis and classification accuracy analysis, it is found that compared with MI paradigm, Hybrid paradigm could get obvious SSSEP and ERD features. The average classification accuracy of subjects in the Hybrid paradigm was 78.61%, which was obviously higher than the MI paradigm. It proves that electrical stimulation has a positive role in promoting the classification training of lower limb motor imagination.
Brain-Computer Interfaces ; Electric Stimulation ; Electroencephalography ; Humans ; Imagination ; Lower Extremity ; Movement

Aristolochic acids (AAs) have long been considered as a potent carcinogen due to its nephrotoxicity. Aristolochic acid I (AAI) reacts with DNA to form covalent aristolactam (AL)-DNA adducts, leading to subsequent A to T transversion mutation, commonly referred as AA mutational signature. Previous research inferred that AAs were widely implicated in liver cancer throughout Asia. In this study, we explored whether AAs exposure was the main cause of liver cancer in the context of HBV infection in mainland China. Totally 1256 liver cancer samples were randomly retrieved from 3 medical centers and a refined bioanalytical method was used to detect AAI-DNA adducts. 5.10% of these samples could be identified as AAI positive exposure. Whole genome sequencing suggested 8.41% of 107 liver cancer patients exhibited the dominant AA mutational signature, indicating a relatively low overall AAI exposure rate. In animal models, long-term administration of AAI barely increased liver tumorigenesis in adult mice, opposite from its tumor-inducing role when subjected to infant mice. Furthermore, AAI induced dose-dependent accumulation of AA-DNA adduct in target organs in adult mice, with the most detected in kidney instead of liver. Taken together, our data indicate that AA exposure was not the major threat of liver cancer in adulthood.