Objective To investigate the relationship between ultrasonographic appearance of the endometrium and steroid. Methods A total of 30 women with normal cycle were used for this study. On the day of positive urinary LH, the subjects were classified into group A, group B and group C according to Gonen's criterions of endometrial echogenic patterns. Blood samples were taken for measurement of FSH, LH, PRL, E_2, P, T levels on the third day of the cycle, the pre-ovulatory phase, and the sixth or seventh day after ovulation. Results During the early follicular phase and pre-ovulatory phase, serum E_ 2 concentration was highest in group A, then group B and lowest in group C; there was significant difference between group A and group C (P

OBJECTIVETo investigate the clinical effect of anastomosis of superficial veins for improving the drainage of perforator propeller flaps.

METHODSFrom Sept. 2011 to Dec. 2012, 11 cases with soft tissue defects and chronic ulcer wound at extremities were treated with adjacent perforator propeller flaps, which were pedicled by the peroneal artery(5 cases), or the lateral supramalleolar artery(3 cases), or the ulnar artery (2 cases), or the posterior interrosseous artery (1 case). The wound size ranged from from 3.0 cm x 2. 5 cm to 11. 0 cm x 4. 0 cm, and the falps size ranged from 6 cm x 3 cm to 21 em x 5 cm. One superficial vein in all the flaps was anastomosed with superficial vein in the recipient area. The blood supply of the flaps were recorded after operation 1 - 3 months after operation, the fluency of anastomosed vein was detected by color Doppler ultrasound. Flap swelling evaluations were performed in early 3 months and later 3 - 6 months, and the results were classified into 4 grading degrees. 6 months later, Questionnaire of the flap aesthetic satisfactory was performed for seven patients during follow-up period.

RESULTS9 flaps survived completely, two flaps had partial marginal skin necrosis in the distal end, which were both managed with surgical debridement, and both wounds healed in two months. 9 cases were followed up for more than 12 - 19 months. The early rsults of flap swelling evaluations were: I degree 0 case, II degree 8 cases, III degree 3 cases, IV degree 0 case, and the later results were: I degree 7 cases, II degree 4 cases, III degree 0 case, IV degree 0 case. The flaps had ideal appearance, good contour, and high aesthetic satisfactory (100%). The mean flap survival area rate of veins anastomosed was (98. 6 ± 9. 7) %.

CONCLUSIONSPerforator propeller flaps with anastomosis of superficial veins can improve the flap venous drainage, avoid transient venous venous congestion, so as to increase the flap survival. It is an effective way for improving the vein drainage.

Anastomosis, Surgical ; methods ; Debridement ; Extremities ; blood supply ; Graft Survival ; Humans ; Leg Ulcer ; pathology ; surgery ; Perforator Flap ; transplantation ; Regional Blood Flow ; Tibial Arteries ; Ulnar Artery ; Ultrasonography, Doppler, Color ; Veins ; surgery

Objective To explore the value of shear wave elastography (SWE) in diffuse thyroid disease.Methods The elastic modulus were detected by SWE in 41cases of diffuse thyroid disease [including 16 cases of Graves' disease (GD),16 cases of Hashimoto' s thyroiditis (HT) and 9 cases of subacute thyroiditis(SAT)] and 30 cases of healthy volunteers.The elastic modulus,including Emean,Emin and Emax,were measured and compared.Results Compared with the normal group[Emean(15.7-± 2.5)kPa,Emin(11.6 ± 2.4)kPa and Emax (20.2 ± 3.0)kPa],the Emean[(20.4 ± 4.7)kPa],Emin[(14.4-± 3.8)kPa] and Emax [(27.8 ± 7.3)kPa] of GD,the Emean [(18.4-± 5.0)kPa] and Emax [(25.2 ± 5.8)kPa] of HT,and the Emean[(11.0 ± 2.9)kPa] and Emin [(6.0 ± 2.7)kPa] of the SAT were different significantly(P =0.001,0.007,0.001 ; P =0.045,0.001 ; P =0.000,0.000).There were significant differences between the SAT and the other two groups,namely GD and HT (P ＜0.05).Such differences,however,were not found between GD and HT (P ＞0.05).Conclusions SWE can be used to measure the elastic modulus of the thyroid tissue quantitatively and objectively,serving as a useful technique to predict the diffuse thyroid disease.

Objective To explore the effect of morroniside on blood viscosity in focal cerebral ischemia/reperfusion in rats. Methods The animal model was induced with occlusion of middle cerebral artery (MCAO), and morroniside (30 mg/kg, 90 mg/kg, 270 mg/kg) was then administered intragastrically for 7 d. Whole blood viscosity and plasma viscosity were detected with auto-hemorheological instrument and microplasma testing device. Results Compared with sham-operated group, both whole blood viscosity and plasma viscosity significantly increased in ischemic rats (P<0.001); however, morroniside reduced whole blood and plasma viscosity noticeably (P<0.001). Conclusion Morroniside can inhibit the increase of blood viscosity induced by focal cerebral ischemia/reperfusion in rats.

The pathways of brain injury caused by ischemic stroke are complicated. Due to those largely ineffective current therapeutic strategies, the development of new and efficient therapeutic interventions is clearly needed. This article summarized the progress in the pathogenesis of ischemic stroke, the drugs for treatment and the therapeutic time window.

Objective To investigate the methods and results of lateral leg propeller pedicled flaps based on multi-perforators for coverage of soft-tissue defects on the foot and ankle.Methods From May,2012 to June,2013,8 patients with soft-tissue defects were treated,including 5 cases by trauma,2 cases by chronic unlcers,1 case by infection on the foot and ankle with exposed osseous and tendinous.Lateral leg propeller pedicled flaps based on multi-perforators were elevated and rotated with the angle from 150° to 180° for coverage of soft-tissue de-fects.Flap size ranged from 15.0 cm × 7.0 cm to 23.0 cm × 9.0 cm.Skin graft was applied to cover the donor sites.After the operation,the blood supplies of flaps were observed severely over 10 days.Questionnaire of the flap aesthetic satisfactory and AOFAS evaluation were performed in 7 patients during fellowed-up periods.Results Seven flaps were all survived well,1 flap had partial marginal skin necrosis on the distal,which was managed with surgical debridement,and wound healed in 1 month.Seven patients had a mean of 10.7 months' fellowed-up periods.The flaps had like-like appearance,good contour,and high aesthetic satisfactor (100％).The mean AOFAS score was 90.5.Conclusion Lateral leg propeller pedicled flaps based on multi-perforators can supply the blood of the larger volume of tissue,which can be safely sustained to repair distal and larger defects on the foot and ankle.

Objective To investigate the diagnostic value of the shear-wave elasticity (SWE) imaging technology on the quantitative diagnosis of chronic nephrosis stage.Methods Sixty patients with nephrosis (nephrosis group) were evaluated with SWE and the renal function test.The Young's modulus value and the renal function were measured,and the results were compared with those of twenty healthy subjects (control group).Results Twenty cases of healthy control group were definited as R0.Sixty patients of nephrosis group were divided into four groups according to renal function:R1-R4.The Young's modulus of the nephrosis group was significantly higher than the control group (P ＜0.01).There were also statistically significant differences among each stage of the nephrosis group (except R1 and R2 of nephrosis group)(P ＜ 0.01).According the ROC curve,the cut-off value of the Young's modulus was 5.53 kPa when maximum area under the curve equal to 0.886,the sensitivity and specificity were 81.70％ and 80.40％.The Young's modulus value and renal function were positively correlated with the stage of nephrosis.The areas under the ROC curves for the Young's modulus,urea nitrogen and csytatin C were 0.965,0.950,0.965 for ≥R3,0.978,0.912,0.961 for =R4,respectively.Conclusions SWE imaging technology provided a new quantitative index for the stage of nephrosis through quantizing the elasticity of the tissue.

Objective To investigate the methods and clinical effects of flow-through posterior interrosseous artery flaps for reconstructing digital wounds combined with artery injury.Methods From December 2011 to September 2013,11 patients with traumatic digital defect combined with artery injury were repaired with flow-through posterior interrosseous artery flaps.Flap aesthetic satisfaction was assessed using questionnaires; flaps were tested for pain and touch sensation,temperature perception,and two-point discrimination; finger activity was detect using the total active movement (TAM) ratio of the injured and uninjured side.Results All flaps and injured fingers survived.Wounds healed by the first intension.Nine patients were followed up for 12-24 months.Two-point discrimination of the flaps recovered at postoperative 6 months and averaged (9.7 ± 2.1) mm at postoperative 12 months,with S3 +grade in sensation evaluation.TAM ratio of the injured and uninjured side was 0.85 ±0.17.All patients expressed the satisfaction to flap appearance.Conclusions Flow-through posterior interrosseous artery flaps are safe and effective to cover digital wounds and restore blood circulation.The technique improves the clinical application of perforator flaps.

Abstract: Objective To analyze and compare the effects of different clinical characteristics on the negative conversion time of nucleic acid detection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection, and to provide a scientific basis for the isolation and treatment of coronavirus disease 2019 (COVID-19). Methods　The epidemiological and clinical data of 228 mild SARS-CoV-2 Omicron variant infected patients diagnosed in Shanghai were retrospectively collected from April 27, 2022 to June 8, 2022 in Wujiaochang designated Hospital, Yangpu District, Shanghai. The negative conversion time of nucleic acid detection was used as the outcome variable, and the patients were divided into A (≤18 days) and B (>18 days). Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of the negative conversion time of nucleic acid detection. Results　The mean nucleic acid conversion time of 228 patients was (18.7±12.1) d, with the median time of 18 (2-46) d. Among them, 120 patients in group A had an average nucleic acid conversion time of (13.2±2.0) d, and 108 cases in group B had an average nucleic acid conversion time of (20.8±1.3) d. Univariate analysis showed that there were no statistically significant differences in the effects of hypertension, coronary heart disease, diabetes, hypokalemia, malignant tumors, neuropsychiatric diseases, chronic digestive diseases on the negative nucleic acid conversion time (P>0.05); however, there were significant differences in the effects of combined cerebrovascular disease, leukopenia, chronic respiratory system diseases and vaccination on the negative nucleic acid conversion time (P<0.05). Further multivariate logistic regression analysis revealed that the combination of chronic respiratory diseases and non-vaccination were significant risk factors for prolongation of negative nucleic acid conversion time (P<0.05). Conclusions The results of this study show that gender, age and whether hypertension, coronary heart disease, diabetes mellitus, hypokalemia, malignant tumor, neuropsychiatric disease and chronic digestive disease have no significant effect on the nucleic acid conversion time, whereas chronic respiratory disease and no vaccination are significantly correlated with the prolongation of nucleic acid conversion time in SARS-CoV-2 Omicron-infected patients.

OBJECTIVETo evaluate the efficacy and safety of using Jiangzhi Tongluo Soft Capsule (JTSC) combined with Atorvastatin Calcium Tablet (ACT) or ACT alone in treatment of combined hyperlipidemia.

METHODSA randomized, double blinded, parallel control, and multi-center clinical research design was adopted. Totally 138 combined hyperlipidemia patients were randomly assigned to the combined treatment group (A) and the atorvastatin treatment group (B) by random digit table, 69 in each group. All patients took ACT 20 mg per day. Patients in the A group took JTSC 100 mg each time, 3 times per day. Those in the B group took JTSC simulated agent, 100 mg each time, 3 times per day. The treatment period for all was 8 weeks. Serum levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were observed before treatment, at week 4 and 8 after treatment; and safety was assessed as well.

RESULTSAt week 4 and 8 after treatment serum TG decreased by 26.69% and 33.29% respectively in the A group (both P < 0.01), while it was decreased by 25.7% and 22.98% respectively in the B group (both P < 0.01). At week 8 decreased serum TG was obviously higher in the A group than in the B group (P < 0.05). Compared with before treatment, serum levels of LDL-C and TC levels decreased significantly in the two groups (all P < 0.01). There was no statistical difference in the drop-out value and the drop-out rate of serum LDL-C and TC levels (P > 0.05). At week 8 the serum HDL-C level showed an increasing tendency in the two groups. No obvious increase in peptase or creatase occurred in the two groups after treatment.

CONCLUSIONJTSC combined with ACT could lower the serum TG level of combined hyperlipidemia patients with safety.

Adult ; Atorvastatin Calcium ; Double-Blind Method ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Hyperlipidemias ; drug therapy ; Male ; Middle Aged ; Pyrroles ; therapeutic use ; Treatment Outcome ; Triglycerides ; blood