Bone and Bones ; drug effects ; metabolism ; Humans ; Lead ; adverse effects ; Osteogenesis ; drug effects

Objective: To investigate the anatomic characteristics of the pudendal-thigh flap and provide anatomic basis for clinical design and application. Methods: The perineal regions of 15 male cadavers were anatomized. The flap was designed on the cadavers and the blood vessels/nerves contained in the flap were studied. Based on the above anatomic findings, we designed the flaps in our operation. The axial arteries were isolated according to the designing and the tissue adjacent to the vessel pedicles was preserved. The flaps were transferred to the recipient site. The incision of donor site was directly sutured; skin graft was transplanted when the incision could not be directly sutured. Results: The perineal regions had rich and constant blood supply and had stable nerve innervation. The blood supplies of the perineal region included external pudendal artery, anterior cutaneous branches of obturator artery, lateral branch of posterior labial or scrotum arteries. The location of the above vessels was comparatively constant, especially external pudendal arteries and posterior scrotum arteries. Three groups of blood vessels went through the lower, middle and upper parts, and there were 4 groups of major nerves responsible for the innervation of the pudendal region. We have used 23 cases of pudenal-thigh flaps, with the largest flap being 17 cm × 9 cm and the smallest being 8 cm × 5 cm, and satisfactory outcomes were achieved in all the cases. Conclusion: The pudenal thigh flap has rich blood supply, convenient incision, and covert donor site. It has satisfactory outcome (morphologic and sensory) in repairing and reconstructing male perineal region and is worth popularizing.

Objective: To study the optimum particle size of Cordyceps sinensis for liver fibrosis in combination with in vitro dissolution experiment from serum pharmacology. Methods: To prepare the powder samples with different grinding degrees, Cordyceps sinensis was crushed through 100-, 150-, 200-, and 300-mesh sieves. The in vitro dissolution of adenosine was measured at different time points. Meanwhile, the powder sample was ig administered to rats, and pharmacodynamic approach was adopted to study the inhibition of medicated serum on HSC-T6 proliferation. Results: The accumulative in vitro dissolution of C. sinensis by 200-300 meshes was higher than that of other meshes. Medicated serum could significantly inhibit HSC-T6 cell proliferation. The AUC of HSC-T6 inhibition kinetics of medicated serum crushed to 200-300 meshes was significantly higher than that in other groups. Conclusion: The in vitro dissolution and pharmacodynamic method could be used for the study on different particle sizes of C. sinensis for anti-hepatic fibrosis, and 200-300 meshes are the optimal particle size.

Objective To evaluate the effects of dexmedetomidine used to supplement analgesia with sufentanil on the stress response and inflammatory response after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-four patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into sufentanil analgesia group (group S,n =20) and dexmedetomidine supplementing sufentanil analgesia group (group DS,n=24) using a random number table.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated.Combined intravenous-inhalational anesthesia was used to maintain anesthesia.Dexmedetomidine was infused at 0.3 μg · kg-1 · h-1 from closure of the chest to the end of surgery in group DS,while the equal volume of normal saline was given instead in group S.The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline in group S,or sufentanil 2 μg/kg plus dexmedetomidine 3 μg/kg in 100 ml of normal saline in group DS.The PCIA pump was set up with a 0.5 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 1.5 ml/h.Visual analogue scale score was maintained ≤ 3.When visual analogue scale score ≥ 4,morphine 0.1 mg/kg was injected intravenously.The occurrence of analgesics-related respiratory depression,bradycardia and hypotension was recorded.At the end of surgery (T0),and 12,24,48 and 72 h after surgery (T1-4),blood samples were collected from the central vein for determination of serum cortisol,β-endorphin,C-reactive protein,interleukin-2 (IL-2),and IL-6 concentrations by enzyme-linked immunosorbent assay.Results No analgesics-related adverse events were detected in the two groups.Compared with group S,the requirement for morphine was significantly decreased,the serum cortisol concentration was decreased at T2-4 and the serum β-endorphin,C-reactive protein concentrations were decreased at T1-4,the serum IL-2 concentrations were increased at T1-4,and the serum IL-6 concentrations were increased at T3 in group DS (P＜0.05).Conclusion Dexmedetomidine used to supplement analgesia with sufentanil can alleviate the stress response and inflammatory response after cardiac valve replacement with CPB.

Objective To explore the risk factors of lower extremity deep venous thrombosis (LEDVT) of neurosurgical patients, and to provide references for identifying the most susceptible population and taking preventive measures. Methods A total of 68 cases of neurosurgical patients with LEDVT in three general hospitals from August 2010 to August 2013 were collected. The design method of one to one matching case-control study was used controlling age, sex and neurosurgical disease. Univariate and multivariate analyses were performed to determine the probable risk factors among two groups. Results The univariate analysis showed that coma, paralysis and limb immobilization, infection, trauma and fracture, lower limbs central venous catheterization, trachea cannula or tracheotomy, mechanical ventilation, surgical operation, dehydration and blood transfusion were significantly related to the incidence of LEDVT ( Χ2=4.50-33.23, P<0.05 or 0.01). The Logistic multivariate regression analysis showed that coma (OR=9.410, 95%CI 1.689-52.423), paralysis and limb immobilization (OR=4.950, 95%CI 1.432-17.105), infection (OR=2.927, 95%CI 1.162-7.373) and lower limbs central venous catheterization (OR=6.072, 95%CI 2.187-16.858) were independent risk factors for the development of LEDVT. Conclusions We should pay attention to patients with high risk factors of LEDVT and take preventive measures early to avert the formation of LEDVT.

Objective:To assess the clinical outcome of autologous fat injection in treatment of hemifacial atrophy,so as to search for an ideal treatment of hemifacial atrophy.Methods: Autologous fat granules were obtained by tumescent liposuction.After purification,the fat granules were injected in a multi-strata,multi-tunnel,and multi-spot manner to repair facial introcession abnormality.Patients whose introcession was not improved after the stabilization of the fillings were re-injected with autologous fat granules twice or more until satisfactory outcomes were achieved.Results: All the 7 patients in this study obtained satisfactory outcomes after fat injection and basically reached symmetry.The follow-up result was good after 2 years.Conclusion: Local injection transplantation of autologous fat granules is effective for the treatment of facial depression and hemifacial atrophy,with slight trauma,little complication,and satisfactory outcome.

Objective:To investigate the anatomic characteristics of the pudendal-thigh flap and provide anatomic basis for clinical design and application. Methods: The perineal regions of 15 male cadavers were anatomized. The flap was designed on the cadavers and the blood vessels/nerves contained in the flap were studied. Based on the above anatomic findings, we designed the flaps in our operation. The axial arteries were isolated according to the designing and the tissue adjacent to the vessel pedicles was preserved. The flaps were transferred to the recipient site. The incision of donor site was directly sutured; skin graft was transplanted when the incision could not be directly sutured. Results: The perineal regions had rich and constant blood supply and had stable nerve innervation. The blood supplies of the perineal region included external pudendal artery, anterior cutaneous branches of obturator artery, lateral branch of posterior labial or scrotum arteries. The location of the above vessels was comparatively constant, especially external pudendal arteries and posterior scrotum arteries. Three groups of blood vessels went through the lower, middle and upper parts, and there were 4 groups of major nerves responsible for the innervation of the pudendal region. We have used 23 cases of pudenal-thigh flaps, with the largest flap being 17 cm X 9 cm and the smallest being 8 cm X 5 cm, and satisfactory outcomes were achieved in all the cases. Conclusion: The pudenal thigh flap has rich blood supply, convenient incision, and covert donor site. It has satisfactory outcome (morphologic and sensory) in repairing and reconstructing male perineal region and is worth popularizing.

Aim To observe the effect of the polymerization of HSF1 on the febrile response in fever rabbits,and further to investigate HSF1 action in thermoregulation and the possible central mechanism.Methods 70 rabbits were divided randomly into 4 groups:the control group(N),the quercetin group(Q),the LPS-feverish group(L),the quercetin+LPS-feverish group(Q+L).Changes in body temperature were continually observed;the expression of HSF1 and HSP70 in hypothalamus was detected by Western blot;the content of AVP in hypothalamus and VSA was measured by radioimmunoassay.Results ① The sequence of the maximum change of temperature(△Tmax)from low to high:group Q

Objective To perform PCR site-directed mutagenesis of nine novel PAH gene mutations (Y154H, R157I, Y206C, G247R, D282G, G346R, S349A, A389G, R400K) identified in northern Chinese and construct mutant recombinant plasmids of PAH gene. Methods 1) Every mutant recombinant plasmid was constructed according to the site of the mutation localized in functional domain of PAH gene and the related clinic phenotype of patients with the gene mutation. 2) Using the wild-type PAH expression vector as a templet, the mutant recombinant plasmids were directly amplified by PCR with Platinium Taq DNA polymerase and nine pairs of primers which were designed according to the human PAH cDNA sequence and the requirement for site-directed mutagenesis technology. 3) The positive strains were selected by Amp resistant test, PCR and restriction endonuclease analysis. The Mva Ⅰ, Mva Ⅰ, Hind Ⅲ, Rsa Ⅰ, Rsa Ⅰ sites exist in the sequences near the mutant sites of S349A, D282G, G247R, Y206C, Y154H, respectively, but not in the related sequence of wild-type PAH expression vector. Restriction endonuclease digestion could be directly used in identifying the mutant sites. However, the amplification created restriction site (ACRS) analysis was supplied in the followed identification of R157I, G346R, A389G, R400K. Finally the sequences of mutant recombinant plasmids of PAH gene were confirmed by DNA sequence analysis. Results Every sequence analysis showed that the mutant nucleic acids were introduced at the expected sites of PAH gene, suggesting that the mutant recombinant plasmids of PAH gene were constructed successfully. Conclusion PCR site-directed mutagenesis is accurate and highly efficient. The successfully mutagenized plasmids of PAH gene lay the foundation for the functional analysis of phenylalanine hydroxylase in mammalian cell system.

Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen ( SPF) , vidian canal ( VC ) , and foramen rotundum ( FR ) with regard to an endoscopic endonasal approach to the pterygopalatine fossa(PPF)using three-dimensional reconstruction of high resolution computed tomography (HRCT) scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were(6.26 ±1.59)mm,(2.35 ± 0.77)mm and(2.75 ±0.77)mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was (4.03 ±1.15) mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were(4.94 ±1.35)mm and(9.22 ±3.07)mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%(33/36) of the VC and lateral to the posterior margin of the SPF in 97%(35/36) of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.