Objective To investigate the clinical effects of reconstruction by using the free iliac flap with nerve anastomosis to repair the composite tissue defects of heel.Methods From March 2009 to August 2012,five cases with the composite tissue defects of heel,including 2 cases with the bottom defects and 3 cases with the tibial defects of heel,were repaired by the free iliac flap,and the feeling of the heel were reconstructed by nerve anastomosis of the flap.The ventral wound were sutured simply.Results All iliac flaps survived and the wound healed in one stage.Patients were followed up from 6 months to 12 months.Appearance and function recovered and the feeling recovered from S2-S3.The foots walked freely.The skin of iliac abdomen were scarred and lead to hyperpigmentation.Conclusion Using the free iliac flap with nerve anastomosis could repair the bone and soft tissue defects of heel and reconstruct the sensation of warmth and sense of pain of the heel.With the characteristics of hidden wound and little damage,the clinical effects was satisfied.

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Three widely used methods of sediment toxicity evaluation were introduced in the present paper, including organism toxicity tests, toxicity identification evaluation(TIE) and sediment quality guidelines(SQGs). Compared with the chemical analysis, toxicity tests have an advantage of taking the bioavailability of POPs into account, however, it fails to identify the causative toxicants. TIE, integrating with physicochemical analysis, implicates the specific pollutants in a tiered approach, and by which effective remediation can be designed accordingly. The sediment toxicity can be identified more quickly and appropriately by SQGs than by the former two methods. The differences among the different SQGs constituted by different standards may affect their values for toxicity evaluation. Extensive and reliable SQGs had been acquired to improve their utility. Finally, the combination of chemical analysis, toxicity tests and in situ bioassays will be the trend of sediment toxicity evaluation in the future.

Objective To study the distribution of pathogenic bacterium and its sensitivity to antibiotic in severe cerebral vascular disease patients with nosocomial pneumonia.Methods Retrospective studies were done in 42 cases of severe cerebral vascular disease patients in neurological intensive care unit (NICU). Secretion from lower respiratory tract was cultivated and done medicine sensitive test at 3 d、4 d、5 d、9 d、16 d after hospitalized,then the etiologic data of nosocomial pneumonia were analyzed.Results Among 42 cases,15 pathogenic microorganisms and 163 strains were cultivated, the fisrt 4 strains were Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella and Enterobacter cloacae. The results of medicine sensitive test indicated that Gram-negative bacteria was sensitive to Imipenem,and Gram-positive bacteria was sensitive to Vancomycin.Conclusions The main pathogen of nosocomial pneumonia in severe cerebral vascular disease patients may be Staphylococcus aureus,Pseudomonas aeruginosa. Staphylococcus aureus was sensitive to Vancomycin,so Vancomycin can be act as the first choice drug to deal Gram-positive bacteria. Pseudomonas aeruginosa is relatively sensitive to Amikacin and Ciprofloxacin,while Imipenem is the second, but drug fast is to cephalosporins. So the first two antibiotics can be as the experience drugs to deal Pseudomonas aeruginosa.

Objective To study the expressions of epithelial symbol factors including E-cadherin,?-catenin,and ?-catenin related to epithelial-mesenchymal transition(EMT) in C57 mice Lewis lung cancer and its mRNA expression affected by Feiyanning Decoction(Decoction for lung cancer).Methods The Real-Time PCR method was adopted to observe the E-cadherin,?-catenin,?-catenin mRNA expression of C57 mice with transplanted tumor in the right armpit and distal metastases and the affection of Feiyanning Decoction on the expression.Results The lung transplanted rate in the Feiyanning group was clearly lower than that in the model group(P

To explore the effects of Quyu Xiaoban Capsule (QXC) on blood lipid level and platelet activity in coronary heart disease (CHD).A randomized single blinded trial was adopted in 62 cases of CHD. Thirty one cases (control group) were treated with routine western medicine and the rest (QXC group) with QXC added. Serum levels of total cholesterols (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL C) and platelet-activating ? granule membrane protein (GMP 140) were detected before and after treatment.After ten weeks of treatment, GMP 140, TC and TG levels were decreased to various degrees in QXC group, the differences being significant as compared with those in control group and those in QXC group before treatment (P0 05).[Conclusion]QXC can decrease the blood lipid level and improve platelet activity and has a certain effect in preventing and treating CHD.

Objective To explore the etiology of headache after aneurismal subarachnoid hemorrhage (SAH) and find clinical features of various kinds of headache.Methods All of the 107 patients with SAH and intracranial aneurysm diagnosed upon CT scan and angiographic demonstration within 24 hours after onset were evaluated by numeric rating scales (NRS) 1,2,3,5,7,10 and 14 days after SAH. Patients suffered from moderate-severe headache were examined by cranial CT scan and transcranial Doppler (TCD) to find the reason, and their diversities were analyzed.Results 86.9% (93/107) patients with SAH suffered from moderate-severe headache. 9.7% (9/93) of them were caused by rebleeding of untreated aneurysm and the pain always occurred abruptly, always followed by conscious disturbance/new neurological signs. CT scan found hydrocephalus in 16.1% (15/93) patients with headache, they could aggravated with time but sometimes released spontaneously; TCD found intracranial vasospasm in 12.9% (12/93) of patients, their clinical features were no more than other 61.3% (57/93) patients with negative results, but patient's condition could exacerbate caused by later brain ischemia or even infarction.Conclusion Majority of SAH patients suffer from headache.

Alcoholic dementia is increasingly becoming both a severe medical issue and a social problem; the unknown overall mechanism is the bottleneck for effective intervention and treatment of alcoholic brain injury. As the primary structure for the release, transmission of neurotransmitter and information integration between neurons, synapse plays a significant role in performing the advanced function of brain, such as learning and memory. Based on the neurobiological principles of synaptic structure and function, the changes in process and efficiency of synaptic transmission and information integration stressed by alcoholic molecular were reviewed in comparison with the normal process. The molecular mechanisms for alcoholic brain damage in learning and memory abilities were systematically discussed from the levels of synaptic morphology, material components, and signal transduction, respectively, and the repairing strategies for the damaged synaptic structure were proposed accordingly. Hopefully, this review could provide a deep insight into understanding the molecular mechanism of alcoholic brain damage, and draw ideas for the memory-enhancing peptides development.

Objective To explore the effect of shifting the little finger abductor muscle and cutting open the metatarsophalangeal joint dorsal articular capsule to improve the appearance and function of reconstructed thumb.Methods From August 2007 to May 2012,twelve cases of Ⅳ°or Ⅴ°defect of thumb were repaired by free transplantation of the second toes with metatarsophalangeal joint.During operation,using the abductor muscle of little finger to reconstruct palmar opposition function,cutting open the joint capsule of metatarsophalangeal joint,adjusting the tension of the joint by the little finger abductor muscle and toe short extensor muscles,which were used to improve the appearance and function of reconstructed thumb.Results Twelve reconstructed thumbs all survived.Followed up from 6 to 24 months,the appearance and function were improved obviously.According to the evaluation trial standards,nine cases were optimal and 3 cases were good.Conclusion The shift of the little finger abductor muscle could reconstruct palmar opposition function,combined with metatarsophalangeal joint dorsal articular capsule incision and adjusting joint tension,could improve the appearance and function of reconstructed thumb.The effect of operation was satisfied.

ObjectiveTo understand the urban preference for outpatient pre-registration in large hospitals,and probe into the influencing factors,for recommendations to improve outpatient preregistration at the hospitals.Methods With Nanjing City as an example,the authors used tailoreddesigned questionnaire and qualitative interviews to investigate the preference of 1200 households of local residents regarding outpatient clinical pre-registration service at the tertiary hospitals.Results Age,education and economic factors are found to be the most important influential ones for urban preference in their outpatient pre-registration at large hospitals.Other factors include traditional approaches to outpatient clinic,inconvenience for outpatient pre-registration,and concerns for appointment breaking.Conclusion in order to increase their preference for outpatient pre-registration at large hospitals,hospitals should work to explore and improve approaches for outpatient pre-registration,and better their service quality,which will involve greater participation of both the hospital staff and residents.