Objective To study the clinical features of renal angiomyolipomas with tuberous sclerosis and to improve the recognization of this disease. Methods The diagnosis and treatment of 4 cases of tuberous sclerosis with bilateral and multiple renal angiomyolipomas were reviewed.The age range was 17 to 44 years,two of them were men.One patient presented with the classic triad:facial angiofibroma,seizures,and mental retardation.Facial angiofibroma occurred in three and seizures were found in two,three patients showed multiple extrarenal organ involvement including liver,spleen and bone.Brain CT revealed classical calcified cortical tuber and(or) subependymal nodule in three cases. Results The diagnosis of renal angiomyolipomas in three cases was affirmed on CT scan.However,the giant renal angiomyolipomas in one case can not be diagnosed from renal CT scan which did not demonstrate characteristic fatty tissue whereas the diagonsis was confirmed by ultrasound-guided right renal tumor biopsy and subsequent right nephrectomy for the large leisions.Regular monitoring of one patient was adopted for his mild symptomatic small renal leisions,the other two with hemorrhage in renal angiomyolipomas were reluctant to aggressive treatment and underwent conservative therapy.Follow-up ranged 6 to 36 months, none had recurrent symptoms and no significant growth of renal lesions was observed. Conclusions CT may not be pathognomonic for renal angiomyolipomas associated with tuberous sclerosis,needle biopsy may be needed to exclude renal carcinoma.The choice of treatment is based on tumor size distribution pattern,progression,and associated symptoms.

Objective To explore the multiple pelvic fractures projection methods and value. Methods 50 cases of pelvic trauma patients were divided into two groups for control photography, and underwent X-ray examination with different projection angles. Results The display effect of the image of the image by 35? projection was better than that of the control group. Conclusion 35? projection results in the images satisfying clinical requirements.

Objective To investigate the mechanism of Shengji-hongfen Cream(SJHFC)affecting basic fibroblast growth factor(bFGF)in wound and hastening wound healing.Methods Rabbit models of cutaneous deficiency and infection were setup.Self-contrast observation was used for comparing the two wound sides of model rabbit,which were administrated with SJHFC(treatment group)and vaseline(control group)respectively.Microstructure of wound surface and changes of bFGF weTe observed and measured.Results The content of fibroblasts,phlogocyte,collagen and blood vessel in the SJHFC group increased markedly,compared with the control group after one week.The content of bFGF was significantly changed than the control group at the 3rd and 7th day(P<0.05).Conclusion SJHFC Can promote bFGF content of the wound,that maybe the mechanism of its hastening wound healing.

0.05).In groups A and B,the intraoperative blood loss was(94.4?51.6)ml and(155.8?84.3)ml;the 4% mannitol solution used for intraoperative irrigation was(18.4?6.2)L and(25.4?8.8)L;the operative time was(65.0?16.4)min and((86.8?)25.0)min;the time for postoperative bladder infusion was(46.5?9.1)h and(57.8?17.4)h;the infused saline volume was(19.2?4.2)L and(26.7?10.2)L;the degree of satisfaction of the surgeons with the TURP field was 75.0%(36/48) and 41.9%(26/62);the cases who needed to increase the perfusion pressure during TURP accounted for 22.9%(11/48) and 45.2%(28/62);the blood transfusion rates were 6.2%(3/48) and 22.6%(14/62);and the incidence rates of secondary prostatic bleeding were(10.4)%(5/48) and 25.8%(16/62),respectively.The differences in all these parameters were statistically significant between the 2 groups(P

Objective To evaluate the safety of interventional radiotherapy with X-ray angiography. Methods To compare X-ray radiation levels with and without radioprotect with X-ray protective monitor by simulating operators' body's parts. Results The difference is significant. Conclusion Interventional radiotherapy with angiography with effective protect is safe.

BACKGROUND:In recent years,with the improvement of living standards,non-alcoholic fatty liver disease has a gradually increasing trend.miRNA-122 is one of the most abundant microRNAs in the liver,which plays an important role in maintaining the environmental stability and differentiation of the liver.Exercise training is a non-drug treatment for non-alcoholic fatty liver disease,which may improve liver lipid metabolism by regulating the expression of miRNA-122. OBJECTIVE:To review the effects of miRNA-122 on the pathological factors related to non-alcoholic fatty liver disease as well as the effects of exercise on the expression of miRNA-122 and the occurrence and development of nonalcoholic fatty liver disease. METHODS:The first author searched the databases of CNKI,WanFang,VIP,PubMed,Geenmedical,EBSCO,Medline,Web of Science,and Elsevier using"non-alcoholic fatty liver disease,microRNA,microRNA-122,lipid metabolism,inflammatory response,insulin resistance,exercise,physical exercise,exercise training"as the English and Chinese search terms for all relevant literature published before June 5,2022.All included documents were screened,summarized,and analyzed.Finally,68 documents were included for review. RESULTS AND CONCLUSION:Compared with the healthy control group,the expression of circulating miRNA-122 is increased in patients with non-alcoholic fatty liver disease.The level of miRNA-122 may show different expression levels at different stages of non-alcoholic fatty liver disease.miRNA-122 can regulate the expression of downstream-related proteins,influence lipid metabolism,inflammatory response,insulin resistance and other pathogenic factors in non-alcoholic fatty liver disease by targeting base complementary pairing sites on mRNA or directly acting as physiological ligands of some RNA receptors.Different exercise modes can improve non-alcoholic fatty liver disease.Therefore,patients with non-alcoholic fatty liver disease need to complete at least 120 minutes of moderate-intensity exercise every week to have a positive effect.For patients who can tolerate various exercises,priority should be given to the combination of aerobic and resistance exercises 4-5 times a week.The exercise intensity should be 50%-70%of the maximum heart rate and the exercise should last for>3 months.For patients with poor tolerance,resistance exercise may be more feasible than aerobic exercise.In addition,patients with non-alcoholic fatty liver disease can also choose proper exercise modes according to their own disease conditions(such as liver enzymes and lipid levels).Exercise can be used as a feasible strategy to prevent non-alcoholic fatty liver disease,reduce liver steatosis,and alleviate liver inflammatory response and insulin resistance.Exercise training can regulate the expression of miRNA-122,but in patients with non-alcoholic fatty liver disease,the effect of exercise on miRNA-122 and its related signal pathways remains to be studied.

Objective:To explore the clinical effect of ALTF transfer with cross-limb bridged "Y" shape vascular anastomosis in repair of complex soft tissue defects in calf.Methods:From August 2010 to September 2020, 33 patients(23 males and 10 females) with complex traumatic soft tissue defects in calf were treated. Preoperative angiography and intraoperative exploration confirmed that there was only 1 main vessel remained in the affected calf or the wound surface and the vessel could not be anastomosed with the vascular pedicle of the ALTF. The size of flap were 16 cm × 8 cm to 25 cm × 18 cm. Two patients received bilobed ALTFs. A "Y" shape anastomosis between the artery of ALTF vascular pedicle and the posterior tibial artery of the contralateral lower limbs was made in all 33 patients to establish the blood supply to the transferred free ALTF. The "Y" shape cross-limb bridged blood vessels at the proximal end of the vascular pedicle artery of the flap were embedded at both ends of the cut-off superior ankle posterior tibial artery of the contralateral lower limb. The vein of the flap was anastomosed with the saphenous vein that associates with the posterior tibial artery. The surface of the suspended blood vessel "bridge" was wrapped with a free skin craft, and the lower limbs were fixed in a straight and parallel position with an external fixation frame. The perfused area of the flap was directly sutured or covered with a free skin craft. The vascular bridge was kept for 3 to 6 weeks before being separated. Outpatient follow-up after discharge.Results:All the patients were entered the postoperative follow-up was 13 months to 7 years, in an average of 25 months. Among the 33 flaps, 31 survived completely, except 1 had necrosis and the other 1 had partial necrosis at the distal end of the flap. The flaps received good blood supply, hence with soft texture and satisfactory appearance. Doppler or DSA was performed after the surgery on the posterior tibial artery of the healthy limb, and the vascular pulsation and patency were found normal. Donor sites for the free skin graft healed well.Conclusion:The ALTF transfer with cross-limb bridged "Y" vascular anastomosis is one of the effective techniques and it was employed in the repair of complex defects of calf soft tissue. It solved the tissue that there was only 1 main vessel or even without a suitable vessel could be anastomosed with the pedicle of the flap.

OBJECTIVE: To investigate the effectiveness of Flow-through bridge anterolateral thigh flap transplantation in the treatment of complex calf soft tissue defects. METHODS: The clinical data of the patients with complicated calf soft tissue defects, who were treated with Flow-through bridge anterolateral thigh flap (study group, 23 cases) or bridge anterolateral thigh flap (control group, 23 cases) between January 2008 and January 2022, were retrospectively analyzed. All complex calf soft tissue defects in the two groups were caused by trauma or osteomyelitis, and there was only one major blood vessel in the calf or no blood vessel anastomosed with the grafted skin flap. There was no significant difference between the two groups in general data such as gender, age, etiology, size of leg soft tissue defect, and time from injury to operation ( P>0.05). The lower extremity functional scale (LEFS) was used to evaluate the sufferred lower extremity function of the both groups after operation, and the peripheral blood circulation score of the healthy side was evaluated according to the Chinese Medical Association Hand Surgery Society's functional evaluation standard for replantation of amputated limbs. Weber's quantitative method was used to detect static 2-point discrimination (S2PD) to evaluate peripheral sensation of the healthy side, and the popliteal artery flow velocity, toenail capillary filling time, foot temperature, toe blood oxygen saturation of the healthy side, and the incidence of complications were compared between the two groups. RESULTS: No vascular or nerve injury occurred during operation. All flaps survived, and 1 case of partial flap necrosis occurred in both groups, which healed after free skin grafting. All patients were followed up 6 months to 8 years, with a median time of 26 months. The function of the sufferred limb of the two groups recovered satisfactorily, the blood supply of the flap was good, the texture was soft, and the appearance was fair. The incision in the donor site healed well with a linear scar, and the color of the skin graft area was similar. Only a rectangular scar could be seen in the skin donor area where have a satisfactory appearance. The blood supply of the distal limb of the healthy limb was good, and there was no obvious abnormality in color and skin temperature, and the blood supply of the limb was normal during activity. The popliteal artery flow velocity in the study group was significantly faster than that in the control group at 1 month after the pedicle was cut, and the foot temperature, toe blood oxygen saturation, S2PD, toenail capillary filling time, and peripheral blood circulation score were significantly better than those in the control group ( P<0.05). There were 8 cases of cold feet and 2 cases of numbness on the healthy side in the control group, while only 3 cases of cold feet occurred in the study group. The incidence of complications in the study group (13.04%) was significantly lower than that in the control group (43.47%) ( χ ²=3.860, P=0.049). There was no significant difference in LEFS score between the two groups at 6 months after operation ( P>0.05). CONCLUSION Flow-through bridge anterolateral thigh flap can reduce postoperative complications of healthy feet and reduce the impact of surgery on blood supply and sensation of healthy feet. It is an effective method for repairing complex calf soft tissue defects.
Humans ; Thigh/surgery* ; Plastic Surgery Procedures ; Leg/surgery* ; Cicatrix/surgery* ; Retrospective Studies ; Soft Tissue Injuries/surgery* ; Treatment Outcome ; Lower Extremity/surgery* ; Skin Transplantation/methods* ; Perforator Flap