Objective To explore the response inhibition ability of oppositional defiant disorder symptoms children. Methods Subjects were 27 oppositional defiant disorder symptoms children and 27 normal children. They were asked to complete the stop signal task,go/no go task and the Simon task. Results The delay time of stop reaction (SOA,(260.27 ±69.12)ms) and go reaction time( (554.31 ±55. 81 )ms)of the oppositional defiant disorder symptoms children were shorter than the control group, the difference was significant (P＜0. 05). However,the stop reaction and interference control ability were no significant difference between these two groups. Conclusion Oppositional Defiant Disorder symptoms children's poor prepotent response inhibition ability is cognitive mechanism of their impulsive behaviors.

Objective:To investigate the blood supply pattern and characteristics of bilobate anterolateral thigh flaps, and to summarize the clinical experience.Methods:Date of 102 cases of limb wounds repaired by bilateral anterolateral thigh perforator flaps from March 2014 to July 2019 were retrospectively analyzed. There were 80 males and 22 females with an average age of 40.7 years (range, 9-66 years). All of the patients suffered from limb trauma with complex tissue defects, among which 29 cases had two adjacent and discontinuous wound surfaces on the same limb, and the area ranged from 5 cm×5 cm to 30 cm×18 cm, while the other 73 cases remained a single wound with the area ranged from 12 cm×11 cm to 27 cm×15 cm. Ultrasonic Doppler was used to locate the perforating branches. According to different patterns of blood supply, flaps of different types were designed and applied respectively. For those who with perforating branches of common trunk type or fascial type, the wound surface can be covered by the flap directly; for those who with perforating branches of double trunks type or mixed type, the turbocharging technique was performed after dissection of the pedicles of the flap, while the wound was repaired by reconnection. All the donor sites were sutured directly.Results:Total of 105 bilobed flaps were designed in 102 patients, including 43 flaps of common trunk type, 30 flaps of double trunks type, 24 flaps of fascial type and 8 flaps of mixed type. The single harvested flap area ranged from 6 cm×5 cm to 20 cm×9 cm. One patient's one piece of the bilobed flap repairing two wounds suffered an arterial crisis at 17 h after surgery. The surgery confirmed there was an intractable arterial spasm and the crisis was relieved after a vein trans-plantation. Then about 4 cm×3 cm superficial necrosis appeared in the most distal part of the flap and healed in secondary after dressing changes. Two cases with single wounds suffered from a vein crisis at 48 h after operation. After removing the suture and blood letting, the flaps survived a week later. The average healing time was 19 days (range, 8-83 days). All the thigh donor sites healed by first stage. All the cases were followed-up for an average period of 16 month (range, 6-70 months). The latest follow-up showed that the flaps were of good color and texture, and the sensation of the flaps recovered partially. According to the British Medical Research Council sensory rating scale: 21 cases were grade S2 and 81 cases were grade S3. According to the revascularization assessments of digital replantation standard by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 91 cases, good in 11 cases, with excellent and good rate of 100%. Linear scars were left in most donor sites and the VAS scores were all zero. 5 cases had a large scar area which the width was more than 3 cm, but there was no scar contracture or pain. 9 cases had an abnormal sensation in the donor area in the early stage and recovered gradually 3 months later without any movement disorder.Conclusion:The use of the bilobed anterolateral femoral perforator flap with different blood supply patterns to repair the wounds of extremities could overcome the lack or deficiency of blood supply caused by perforators with different sources. To clarify the blood supply types is conducive to the flap cutting and leaf splitting during the operation, which greatly improves the survival rate of the flap.

Objective The NDRG4 gene methylation in stool is a candidate biomarker for non?invasive diagnosis of colorectal cancer. However, the traditional methods for methylation detection could not be well applied to stool samples due to the low sensitivity and low specificity. The aim of this study was to develop a highly sensitive and specific method for quantifying the methylated NDRG4 gene in stools. Methods Forty one stool samples were collected from 12 colorectal cancer patients, 4 adenoma patients and 25 nor?mal persons. The invasive reaction was combined with real?time PCR and the relative quantification was performed by 2-ΔCT method to develop the highly sensitive and specific methylated DNA detection method, which was used for detecting NDRG4 methylation levels in 41 of stool samples. Results The sensitivity of the method was as low as 10 copies of methylated NDRG4 gene fragments. The specificity was high enough to distinguish 0.01% of methylated fragments from un?methylated fragments and 105 copies of unmethylated NDRG4 fragments gave noamplification signals. The detection results from 41 of stool samples showed that detection rate of the NDRG4 gene in stool from adenoma and colorectal cancer groups had a significant difference comparing to that from the normal group. Conclusion The 2-ΔCT method could accurately quantify the methylation levels of the NDRG4 gene in stool samples, and provide an efficient tool for non?invasive colorectal cancer detection.

Objective To investigate the binding ability of the terminase large subunit of Pseudomonas aeruginosa bacteriophage PaP3 to the cos site. Methods The gene tls was amplified from the genome of bacteriophage PaP3 by PCR and subcloned into pMD18-T vector. Then the gene tls cut down from the vector was inserted into the plasmid pQE31 which could give a 6-His tag at the N-terminal of the expressed protein. The recombinant vector pQE-tls was transformed to E.coli. JM109, after induction with IPTG, the expressed bacteria were resuspended and sonicated, then after centrifugation, the inclusion body was obtained. The inclusion body was dissolved with lysis buffer, then the tagged protein was purified by Ni-NTA affinity chromatography and renatured by dialysis. Finally the DNA-binding ability of the fusion protein rTLS was determined by EMSA. Results The expression plasmid pQE31-tls was successfully constructed, and the target protein yield was up to 30% of the total bacterial proteins. After purification and renaturation, the fusion protein rTLS can partially bind the cos fragment. Conclusion The fusion protein rTLS was successfully expressed, purified and renatured. The rTLS has the specific DNA-binding activity. The present work lays the foundation for the further research of the gene tls.

Objective:To explore the clinical effect of bilobate anterolateral thigh flaps with turbocharging technique in repairing limb wounds.Methods:A retrospective case series study was conducted to analyze the clinical data of 29 patients with complex wounds of limbs admitted to Ruihua Hospital Affiliated to Soochow University from March 2014 to July 2019. There were 26 males and 3 females, aged 22-60 years [(41.9±11.1)years]. A total of 24 patients had single-wounds with the dimension of 12 cm×10 cm to 38 cm×27 cm, and 5 patients had two adjacent and discontinuous wounds with the area from 7 cm×4 cm to 13 cm×9 cm. The bilobate anterolateral thigh flaps with turbocharging technique were used. All the donor sites were directly sutured by primary closure. Routine treatment was given after operation. The origin artery of perforators, time of flap harvesting and operation time were recorded. The survival of the flap, healing of the donor area, long-term shape of the flap and donor area, sensory recovery and complications were observed.Results:All patients were followed up for 6-64 months [(19.0±12.7)months]. A total of 30 bilobed flaps were designed for the 29 patients. The time of flap harvesting ranged from 25 to 60 minutes [(46.6±20.2)minutes]. The operation time was 4-11 hours [(6.4±1.8)hours]. All flaps survived except one piece of a bilobed flap suffered from a vein crisis, which healed well after conservative treatment. These wounds' healing time ranged from 11 to 53 days [(18.5±9.9)days], and all the donor sites healed by first intention. Four patients underwent skin flap thinning operation 4 to 8 months later due to the bloated appearance of flaps. Acceptable cosmetic outcomes, soft and elastic skin, and sensation recovery were achieved at the final follow-up. All patients 'donor area left linear scars. One patient had large scar area, but there was no scar contracture and pain. Two patients had an abnormal sensation in the incision area in the early stage and recovered gradually 3 months later without any other serious complications.Conclusions:Repair of limb wounds with bilobed anterolateral thigh flaps with turbocharged technique can overcome the limitation that the bilobed flap can not be designed if the perforators do not share the same trunk and expand the application scope of the bilobed flaps. The design of bilobate flaps reduces the width of the donor site, which can effectively avoid the complications of the donor site.

OBJECTIVE: To explore the genetic basis for pedigree affected with hereditary nephrogenic diabetes insipidus (HNDI). METHODS: Next generation sequencing (NGS) with an osteology system gene panel was carried out for the proband. Suspected mutation was validated by Sanger sequencing of two relatives with similar symptoms and two unaffected relatives from the pedigree. RESULTS: The proband was found to carry a c.856C>T mutation of the AVPR2 gene. The same mutation was detected in the two relatives with similar symptoms and one unaffected healthy relative. CONCLUSION The HNDI in this pedigree may be attributed to the c.856C>T mutation of the AVPR2 gene.
Diabetes Insipidus, Nephrogenic ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation ; Pedigree ; Receptors, Vasopressin

Objective:To explore the feasibility and clinical effect of repairing the wound of limbs with severe infection by the bilateral chimeric perforator flaps in the anterolateral femoral area.Methods:From December 2015 to October 2018, 12 cases of limb wounds with severe infection were repaired by the lateral femoral bilateral chimeric perforator flaps in the Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, including five cases of traffic accident, four cases of machine strangulation and three cases of other injuries. There were eight males and four females, aged from 25 to 48 years old, with an average age of 40-year-old. All the wounds were complicated with the exposure of bone, tendon, or internal fixation and had different degrees of infection, 10 cases were of soft tissue infection, and two cases were of osteomyelitis. The wounds were outlined by sample cloth. A total of nine cases had single-wounds with the dimension of 12 cm × 11 cm to 26 cm × 11 cm, and these bilobed chimeric flaps were designed by dividing the sample cloth into two parts from the center and changing the width to the length. Three cases had two adjacent and discontinuous wounds in just one limb with an area from 6 cm × 4 cm to 14 cm × 6 cm, and the bilobed flaps were designed according to the size and the shape of these wounds. Six cases were reconstructed with the bilateral chimeric flaps of which the branches originate from one artery, three with flaps of different original arteries, two with fascia skin flaps, and one with a flap of mixed blood supply. The lateral thigh muscle or tensor fascia muscle carried in the flap was used to fill the cavity or sinus, and the donor area was sutured directly. The flap survival, wound healing, and donor area recovery were observed after the operation.Results:All the flaps survived without vascular crisis. The flap size ranged from 24 cm × 6 cm to 32 cm × 7 cm in nine cases of the single wound, and 7 cm × 5 cm to 14 cm× 7 cm in three cases with two wounds. The volume of muscle resection ranged from 4 cm × 3 cm × 2 cm to 11 cm× 6 cm × 4 cm. The average time of wound healing was 27 days (range from 12 to 83 days). All the donor areas of the thigh healed primarily. Follow-up time was 7 to 32 months, showing good color and texture. The sensation of the flaps recovered partially. Linear scars were left in all donor sites, except that one case suffereda large scar with no contracture or pain. One patient had an abnormal sensation in the incision area early but recovered gradually after two months without other serious complications. During the follow-up period, two cases of osteomyelitis showed no sinus, skin nonunion, and wound abscess. One case underwent a bone flap operation due to the bone defect one year later, and the defect healed well.Conclusions:Anterolateral femoral bilateral chimeric perforator flaps could be designed flexibly according to the conditions of the recipient area. By carrying the muscle with an abundant blood supply, the infection can be effectively controlled, and the damage to the donor area can be reduced.

Objective:To explore the clinical effects of bilateral overlength anterolateral femoral perforator flaps connected in series or parallel in repairing large area of wounds in limbs.Methods:From January 2017 to July 2019, 9 patients with large area of skin and soft tissue defects in limbs were admitted to the Departments of Hand Surgery and Foot and Ankle Surgery of Ruihua Affiliated Hospital of Soochow University, including 8 males and 1 female, aged 36 to 63 years. The retrospective cohort study was conducted. The wound areas of patients after debridement were 20 cm×15 cm to 30 cm×25 cm, and the wounds were repaired with bilateral overlength anterolateral femoral perforator flaps. One main artery defect in the receiving area of 4 patients was repaired with bilateral flaps connected in series. Two main artery defects in the receiving area of 5 patients were repaired with bilateral flaps connected in parallel. A total of 18 flaps were excised, and the area of a single flap ranged from 20 cm×8 cm to 46 cm×9 cm. The donor sites of 17 flaps were sutured directly, and the donor site of 1 flap was repaired with free full-thickness skin graft from hypogastrium. Harvesting time of flaps, survival condition of flaps after surgery, and wound healing time, and flap observation, two-point discrimination distance of flaps, functional recovery of joint and appearance of recipient site, and recovery of donor site during follow-up were recorded.Results:In this group of 9 patients, the flap harvesting time was 1.0 to 4.5 hours, and all the 18 flaps survived. The wound healing time of recipient site was 18 to 72 days after flap transplantation. They were followed up for 6 to 34 months. The shape of the recipient site was satisfactory, with no deep tissue infection such as osteomyelitis. Four flaps in 2 patients were bloated and were thinned in 6 months after operation; 4 flaps in 2 patients had skin pigmentation on the edge of the flap; the flap of one patient was scalded but healed by dressing change, with patchy scar being observed during follow-up. The rest of the flaps were soft, elastic, and painless with good blood supply. All the flaps restored with protective sensation, with only one point in two-point discrimination. Only linear scars remained in the donor sites of 17 flaps. All the limbs had good blood supply in the distal end of donor sites, and no restriction occurred in range of motion of knee joint and quadriceps muscle strength.Conclusions:The bilateral overlength anterolateral femoral perforator flaps connected in series or parallel have constant anatomy, reliable blood supply, and flexible combination. It is an ideal surgical method for repairing large area of skin and soft tissue defects in limbs at one time.

Objective To observe the therapeutic effect of scalp and body acupuncture combined with rehabilitation training in the treatment of stroke sequela.Methods 64 stroke pa-tients conforming to the inclusion criteria were equally randomized into control group and acupunc-ture group.The control group was treated with rehabilitation training while acupuncture group was treated with scalp,body acupuncture and rehabilitation training.Therapeutic effects were evaluat-ed after the treatment for 8 weeks.Results All patients had therapeutic effect according to Barthel scale and Brunnstrom scale of upper and lower limbs function after treatment.The differ-ence was statistically significant since the index of Barthel scale remarkably increased in the acupuncture group compared with that in the control group.Conclusion Scalp and body acupunc-ture combined with rehabilitation training in the treatment of stroke sequela have significant thera-peutic effect.

Objective To observe the therapeutic effect of scalp and body acupuncture combined with rehabilitation training in the treatment of stroke sequela.Methods 64 stroke pa-tients conforming to the inclusion criteria were equally randomized into control group and acupunc-ture group.The control group was treated with rehabilitation training while acupuncture group was treated with scalp,body acupuncture and rehabilitation training.Therapeutic effects were evaluat-ed after the treatment for 8 weeks.Results All patients had therapeutic effect according to Barthel scale and Brunnstrom scale of upper and lower limbs function after treatment.The differ-ence was statistically significant since the index of Barthel scale remarkably increased in the acupuncture group compared with that in the control group.Conclusion Scalp and body acupunc-ture combined with rehabilitation training in the treatment of stroke sequela have significant thera-peutic effect.