Objective To expore the method of clinical application and the final result of pedicled flap supplied by radial osteo cutaneous branch of anterior interosseous artery Methods Basing on the anatomic basis that the osteo cutaneous and myocutaneous branches of the anterior interosseous artery have constant collateral anastomoses which can give forth a large size dorso radial flap on dorsum of the forearm Four cases of skin defect of first web had been reconstructed by this flap Results All 4 cases were successful with good functional and cosmetic results Conclusion Reconstruction with dorso radial flap of forearm is simple,reliable procedure which bring minimum trauma to the patient and is an ideal alternative operation

Objective To describe the method and review the outcome of reconstruction ofⅠandⅡdegree defect of thumb and finger by p artial transplantation of distal to e tissue from the great and /or second toe.Methods A series of 65cases with 71ⅠandⅡdegree thumb and finger defect were r econstructed.Of those,49were thumb defect,12index finger,5middle finger and 5ring fin ger.In 6cases,two digits were reconstructed simultaneously at th e same setting.For thumb reconstruction,the donor transplants were har-vested from great toe in 14cases,fro m 2nd toe in 35cases.All finger recon struction cases were taken from2nd toe.Results Postoperative arterial crisis occu rred in 10digits and venous crisis in4.All digits survived after operative and medication trea tment.Twenty digits underwent seco ndary plastic operation for better c os-metic effect.Forty-two digits in 38cases followed-up from 6months to 13years revealed good pulp pinch function.Sensation recovery to S3 + and above in 30cases(34digits)and two-point discrimination from 6-8mm in 30digits.The patients were satisfied with the appearance of the reconstructed thumb and fingers.There were no major complication in the don or toes.Conclusion The defect of distal segment and finger tip of thumb and /or finger can be reconstru cted by transplantation of partial t issues from the great,2nd or /and 3rd toe.The operation will not be influenced by anomaly of the blood vessels.Both ultimate function and cosmetic effect can meet the patientsdesire.[

AIM: To investigate the effect of c-Myc inhibitor 10058-F4 on human chronic myeloid leukemia ( CML) K562 cells and imatinib-resistant K562/G cells.METHODS: The protein expression of c-Myc was detected by Western blotting .Cell proliferation was evaluated by MTT assay and colony formation assay .PI staining was used to deter-mine the cell cycle distribution .Annexin V-PI staining was applied for apoptosis detection .RESULTS:Imatinib-resistant K562/G cells displayed lower sensitivity to imatinib than K 562 cells with high expression of c-Myc.Treatment with specific c-Myc inhibitor 10058-F4 inhibited the cell proliferation in a dose-and time-dependent manner , and K562/G displayed more sensitivity to 10058-F4 than K562 cells.10058-F4 also induced cell cycle arrest in G 0/G1 phase and induced apoptot-ic cell death in the 2 cells.Importantly, 10058-F4 suppressed the colony formation ability in K 562 and K562/G cells. CONCLUSION:c-Myc is a novel target to overcome imatinib-induced drug resistance , and c-Myc inhibitor provides a new approach in CML therapy .

Objective:To explore the risk factors of delayed traumatic intracranial hematoma (DTICH)followed by unilateral large decompressive craniectomy (LDC)and its influence in the prognosis of the severe traumatic brain injury (sTBI)patients,and to improve the successful rate of the rescue.Methods:The clinical data of 130 sTBI patients underwent unilateral LDC were retrospectively analyzed.The patients were divided into DTICH group (n=42)and non-DTICH group (n=88)according to whether the DTICH occurred after operation.The risk factors of DTICH and its influence were contrastively analyzed.Results:The analysis results of the clinical data of patients in two groups showed that preoperative GCS,time from trauma to operation,skull fracture,midline shift > 1 cm, basal cistern disappear,activated partial prothrombin time (APTT),fibrinogen (FIB),and thrombin time (TT) were significantly correlated with the appearance of DTICH (P<0.05).Multivariable Logistic regression analysis showed that the time from trauma to operation, skull fracture, basal cistern disappearing and FIB were the independent risk factors of DTICH (P<0.05).The analysis results of GOS 3 months after operation of the patients in two groups showed that the prognosis of the patients in DTICH group was significantly worse than that in non-DTICH group (P<0.01 ).Conclusion:For those patients who accompanied with shorter time from trauma to operation,skull fracture,basal cistern disappearing and FIB decrease,the appearance of DTICH should be paid attention.DTICH can affect the prognosis of patients;prevention and early diagnosis are crucial to improve the prognosis of patients.

Objective To investigate the effects of Panax notoginseng saponins (PNS) on the cerebral water content and thrombin in the rats with intracerebral hemorrhage (ICH), and explore its mechnism for treating ICH. Methods SD male rats were randomly divided into blank group, sham operation group, model group and treatment group, and time points of 6, 24, 48, 72 h and 7 d were observed. ICH rat model was induced by collagenase and heparin in saline solution injected into caudate nucleus. The treatment group was injected PNS intraperitoneally once a day, and the cerebral water content was assessed by dry-wet weight method. Both content of fibrinogen (FIB) and thrombin clotting time (TT) in 48 h were measured. Results The cerebral water content of model group increased at every time point compared with blank group and sham operation group (P<0.05). The cerebral water content of treatment group was significantly decreased at every time point except for 6 h compared with model group (P<0.05). FIB of treatment group decreased compared with model group (P<0.05), while TT of treatment group was not significantly decreased (P>0.05). Conclusion PNS may play a role in treating ICH by decreasing cerebral water content, FIB and TT of ICH rats.

Objective To investigate the clinical effects of different dosages of Shenfu injection for treatment of elderly patients with refractory chronic congestive heart failure (CHF).Methods A prospective study was conducted, 360 patients with CHF from Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled, and they were randomly divided into low dose, middle dose and high dose Shenfu injection groups. In the three groups, the patients received the same conventional medicine therapy, and additionally they were treated by low, medium and high dose Shenfu injection (60, 80, 100 mL/d, respectively), once a day. The therapeutic course was 10 days in the three groups. After treatment, the clinic therapeutic effect, left ventricular diastolic end diameter (LVEDD), left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), cardiac index (CI) and plasma B type natriuretic peptide (BNP) were observed in the three groups.Results The total therapeutic effective rate in middle dose Shenfu injection group was significantly higher than that in low dose and high dose Shenfu injection groups [82.5% (99/120) vs. 54.2% (65/120), 60.0% (72/120), bothP < 0.05]. In high dose Shenfu injection group, increase of blood pressure occurred in 15 cases (12.5%), but no such phenomenon appeared in low and middle dose Shenfu injection groups. In the three groups, no cardiac arrhythmia, liver function abnormality, myocardial enzymogram abnormality, etc. adverse reactions occurred. Compared with those before treatment, after treatment in three groups the LVEDD and BNP were significantly decreased, while LVEF, SV, CO and CI were markedly increased. The changes of above index in middle dose Shenfu injection group were more significant [LVEDD (mm): 46.1±6.3 vs. 58.3±4.4; LVEF: 0.561±0.056 vs. 0.324±0.044, SV (mL): 58.1±6.3 vs. 35.7±5.4, CO (L/min): 5.78±0.60 vs. 4.21±0.78, CI (mL·s-1·m-2): 81.85±7.33 vs. 53.01±9.00, BNP (ng/L): 355.4±76.6 vs. 3 263.2±65.7, allP < 0.05]. Conclusion Shenfu injection 80 mL/d is the best effective dosage for treatment of elderly patients with refractory CHF and its incidence of adverse events is low.

Objective To investigate the lung function testing performing in normal smokers,and urge smokers to stop smoking early. Methods Two hundred and one adult men did the pulmonary function testing by MINATO AS-505 portable spirometer, and analyzed the effect d different smoking degree on the pulmonary function. Results There was no relationship between lung volume index and smoking, smoking degree. Compared with nonsmokers, the indicants such as FEV1, MVV, FEV1/FVC had decreased, and the indexes of the small airway function (PEF, FEF25%-75%)had significantly dropped in the smokers. And the smokers especially long-term smokers, most indexes of the pulmonary functions and all indexes of the small airway function correlated with smoking index. Conclusion Although smokers do not show clinical symptoms, their lung functions have been reduced, especially small airway function.

Objective To introduce the improvement of the flap from the dorsal site of the index in the application of treatment in the thumb web contracture. Methods Apply improved first dorsal metacarpal flap for 111 cases of patients of the thumb web contracture releasing. The original island or tongue-shaped flaps was modified to be the local flap transfer to the thumb web. Surgical method simplified. Before thumb web contracture was released, the flap was taken from ulnar aspect to radial aspect on the dorsum of the index. The flap was transferred to cover the soft tissue defect on the first web space following the contracture releasing. Flap donor area was closed by split-thickness skin graft. Results One hundred and eleven cases of flaps survived. After the 3-18 months (mean follow-up of 8.5 months), the local appearance, thumb function recovered well for 94.6 percent. Conclusion Improved first dorsal metacarpal flap is effective methods in thumb web contracture releasing.

OBJECTIVE To summarize the clinical features, diagnosis, treatment and prognosis of laryngeal rhabdomyosarcoma.METHODS The clinical data of 5 cases of adult laryngeal rhabdomyosarcoma treated in Beijing Tongren Hospital between 2003 and 2015 were analyzed retrospectively.RESULTS All the 5 cases firstly presented with hoarseness. 1 case was treated by combined therapy (surgery followed by radiotherapy and chemotherapy). 2 patients received surgical treatment combined with chemotherapy. 1 patient received surgical treatment only. Another patient received chemotherapy only. Pathological type: 4 patients were embryonal rhabdomyosarcoma, 1 patient was pleomorphic rhabdomyosarcoma. In the follow-up of a period from 11 months to 8 years, 2 cases were alive without tumor, 3 patients were dead.CONCLUSION Adult laryngeal rhabdomyosarcoma is rare. Surgical resection combined with chemotherapy is the main treatment method, and the prognosis is related to the pathological type and tumor stage.

Objective To discuss evolution regularity of Chinese Medicine Syndromes and neurological impairment of acute stroke patients with and without hypertension,and to contrast differences between the two groups.Methods Case observation table of ＂Clinical diagnosis and treatment of stroke patients dialectical law mining and verification of the program of treatment was adopted to record clinical diagnostic messages of 63 cases of non-hypertension and hypertension acute stroke patients.Results ①Contrasting syndrome dements between the two groups it showed that on the tenth day,scores of yin deficiencyin non-hypertension group score (12.83 ±9.97) increased significantly than hypertension group score (8.64±5.90) with statistical significance (P＜0.05) ; on the fourteenth day,scores ofblood deficiency in hypertension group score (12.21±7.71)increased significantly than non-hypertension group score (8.07±8.61),with statistical significance (P＜0.05).② In hypertension group,from the first day to the fourteenth day of admission,scores of wind,hot and phlegm gradually reduced,but scores of blood deficiency gradually score (9.85 ±7.23) increased,with statistical significance.In non-hypertension group,from the first day to the fourteenth day of admission,scores of wind,hot and phlegm gradually reduced,but scores of yin deficiency gradually score (12.21±7.71)increased,with statistical significance (P＜0.05).Conclusion Hypertension turns blood defiency more prominent in evolution of Chinese medicine syndromes of stroke.