OBJECTIVETo investigate the clinical application of pedicled superficial circumflex iliac artery (SCIA) flaps in Burns and Plastic Surgery.

METHODS19 cases with skin and soft tissue defects were repaired with the Superficial circumflex iliac artery flaps. The defects located in the hand and forearm, the lower abdomen and perineal area, the radicle area of thigh, etc. Before the SCIA flaps were transfered to the recipient areas, 15 cases with different kinds of wounds were debrided thoroughly, 3 cases with scar were removed directly. The size of the flaps ranged from 3.0 cm x 4.5 cm to 26.0 cm x 22.0 cm, and the pedical was 5 cm to 7 cm in length.

RESULTSThe flaps in the 18 cases survived completely. Skin necrosis in the distal end of the flap appeared in 1 case, and the wound healed after the second repair. The follow-up period rang from 3 to 18 months. The apperance and function of the hand or foot was satisfactory.

CONCLUSIONSBecause the pedicled SCIA flaps can be obtain conveniently and contain sufficient blood-supply, so the flap is easy to survive and the flap can be designed in a large size. We believe it is an ideal method to use this flap to repair skin and soft tissue defects located in hands, forearms, the lower abdomen and perineal areas, the radicle area of thigh and so on.

Burns ; surgery ; Forearm ; Graft Survival ; Hand ; Humans ; Iliac Artery ; Necrosis ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; pathology ; transplantation ; Thigh ; Wound Healing

Microbial is a renewable resource which can produce polysaccharide. Its unique physiological activities and broad applications are attracting increasing attention. In this article, the source and the fermenta- tion conditions of microbial polysaccharide was reviewed, with a view to provide a scientific basis for the production of the microbial polysaccharide.

Abnormalities, Multiple ; genetics ; pathology ; Child, Preschool ; Chromosome Aberrations ; Diagnosis, Differential ; Diarrhea ; diagnosis ; etiology ; therapy ; Exocrine Pancreatic Insufficiency ; complications ; Fever ; diagnosis ; etiology ; Fingers ; abnormalities ; Humans ; Male ; Pancreatic Diseases ; etiology ; Syndrome

OBJECTIVETo explore the difference in the efficacy and effect mechanism of subcortical ischemic vascular disease (SIVD) complicated with depression between acupuncture and medication.

METHODSSixty patients were randomized-into an acupuncture group and a medication group, 30 cases in each one. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Shuigou (GV 26), Fengfu (GV 16), Fengchi (GB 20) and the others, once a day, 6 times a week. The treatment of 4 weeks made one session and totally 2 sessions were required. In the medication group, nimodipine 30 mg, three times a day and fluoxetine 20 mg, once a day were prescribed for oral administration, for 8 weeks totally. Before treatment, at the end of the 4th week and at the end of the 8th week of treatment, cerebral blood flow velocity (CBFV) and solubility CD40 ligand (sCD40L) were determined respectively. The scores in Montreal cognitive assessment (MoCA) and Hamilton' s depression scale (HAMD) were evaluated in the two groups. The efficacies on cognitive function and depression symptoms were compared in the patients between the two groups. Results Compared with the outcome before treatment, mean blood flow velocity (Vm) of middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was increased significantly at the end of the 4th week of treatment in the two groups (all P<0.05). At the end of the 8th week, Vm was increased much significantly (all P<0.01). The differences were not significant in comparison between the two groups (all P>0.05). Compared with the expression before treatment, sCD40L was reduced significantly after treatment in the patients of the two groups (all P<0.01), but the differ- ence was not significant between the two groups (all P>0.05). Compared with that before treatment, MoCA score was increased significantly after treatment in the two groups (all P<0.01), HAMD score was reduced sig- nificantly (all P<0.01), the differences were not significant in comparison between the two groups (all P>0.05). The total effective rate of cognitive improvement was 86.7% (26/30) in the acupuncture group and was 80.0% (24/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05). The total effective rate of the improvement in depression was 93.3% (21/30) in the acupuncture group and was 86.7% (26/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05).

CONCLUSIONAcupuncture could significantly increases CBFV and reduces serum sCD40L expressions in the patients of SIVD complicated with depression, and significantly improves cognitive function and relieves depression symptoms. The efficacy of it is similar to that of western medication. The increase of serum sCD40L expression is possibly involved in the occurrence and development of SIVD. Reducing sCD40L expression contributes to the alleviation of damage induced by cerebral ischemia and reperfusion.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cerebral Infarction ; complications ; drug therapy ; therapy ; Depression ; drug therapy ; etiology ; therapy ; Female ; Fluoxetine ; administration & dosage ; Humans ; Male ; Middle Aged ; Nimodipine ; administration & dosage ; Treatment Outcome

OBJECTIVETo study the impact of IFN-gamma on liver fibrosis and its possible mechanism. Thirty healthy male SD rats were randomly divided into two groups: fibrosis model group, IFN-gamma treatment group. Experimental liver fibrosis was induced by subcutaneous injection of CCl4. After 12-week-treatment, serum hyalurnic acid and TGF-beta1 was examined, histopathological changes and degrees of fibrosis were observed by optical microscopy. Meanwhile, the expression of TGF-beta1, TbetaR- I and Smad2/3 proteins was detected by immunohistochemistry and quantified by using computerized image analysis.

RESULTS(1) Pathological observation of hepatic specimens: histological examination showed that there were significant difference between normal group and fibrosis model group by comparing with the degrees of inflammation and fibrosis (P < 0.05). And the difference between fibrosis model group and IFN-gamma treatment group was significant (P < 0.05). (2) Changes of the hepatic fibrosis index (serum HA and TGF-beta1): the levels of serum HA, TGF-beta1 in fibrosis model group were higher than IFN-gamma treatment groups (P < 0.05). (3) Changes of gene protein levels about TGF-beta1/Smad: the expressions of TGF-beta1, TbetaR- I and Smad2/3 in rat hepatic tissue were detected with immunohistochemistry techniques. The expressions of the three items in model group were higher than normal group (P < 0.01). The difference between model group and IFN-gamma treatment group was significant (P < 0.05);

CONCLUSIONIFN-gamma treatment group had significant results on treating experimental hepatic fibrosis. By the way of inhibiting expressions of TGF-beta1, TbetaR- I, Smad2/3, IFN-gamma treatment group exerted its anti-fibrosis effect.

Animals ; Disease Models, Animal ; Humans ; Interferon-gamma ; therapeutic use ; Liver ; drug effects ; metabolism ; Liver Cirrhosis ; drug therapy ; genetics ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Smad2 Protein ; genetics ; metabolism ; Smad3 Protein ; genetics ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism

Animals ; Animals, Newborn ; Brain ; blood supply ; metabolism ; pathology ; Carrier Proteins ; genetics ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; genetics ; Gene Expression ; Hypoxia-Ischemia, Brain ; genetics ; pathology ; In Situ Hybridization ; Protein Tyrosine Phosphatase, Non-Receptor Type 13 ; Protein Tyrosine Phosphatases ; genetics ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo explore the change of electrocardiographic ischemic J wave in patients with coronary heart disease (CHD) underwent percutaneous coronary intervention (PCI).

METHODSCHD patients (CHD, n = 162) underwent PCI in the hospital were divided into unstable angina pectoris (angina pectoris group, n = 108) and acute myocardial infarction group (AMI group, n = 54), 12-lead electrocardiogram was recorded within 24 hours before and after PCI. Patients were further grouped into left anterior descending artery group and right or circumflex coronary artery stenosis group. The incidence, amplitude and time course of J waves were measured and analyzed.

RESULTS(1) The highest incidence of J wave appeared in II, III, aVF leads pre- and post-PCI in CHD groups (33.95%, 22.84%, 26.54% and 30.86%, 19.75%, 23.46%). Higher incidence of J wave in AMI group was evidenced in V(5), II, aVF, III, V(3) leads before PCI (33.33%, 27.78%, 16.67%, 12.96%, 11.11%) and in V(5), II, aVF, aVL, III leads after PCI (22.22%, 22.22%, 14.81%, 12.96%, 9.26%). (2) Before PCI, higher incidence of J wave was found in V(5), V(6) leads (25.78%) in left anterior descending artery group and in II, III, aVF leads (35.37%) in right or circumflex coronary artery stenosis group. After PCI, the higher incidence of J wave in left anterior descending artery group and right or circumflex coronary artery stenosis group was evidenced in II, III, aVF leads (21.09% and 35.37%, respectively). (3) The ischemic J wave' amplitude and time course in II, III, aVF, V(3), V(4) leads were significantly reduced post PCI in CHD patients.

CONCLUSIONSHigher incidence of J wave was found in II, III, aVF in CHD patients. PCI is associated with reduced amplitude and time course of J wave suggesting PCI could improve ischemic J waves in CHD patients.

Adult ; Aged ; Aged, 80 and over ; Angina, Unstable ; physiopathology ; therapy ; Coronary Disease ; physiopathology ; therapy ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; physiopathology ; therapy ; Percutaneous Coronary Intervention

Anti-Arrhythmia Agents ; therapeutic use ; Cardiomyopathies ; drug therapy ; etiology ; Child, Preschool ; Female ; Humans ; Moricizine ; therapeutic use ; Tachycardia ; complications ; drug therapy ; Treatment Outcome

Adolescent ; Anti-Arrhythmia Agents ; adverse effects ; therapeutic use ; Arrhythmias, Cardiac ; drug therapy ; physiopathology ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Sotalol ; adverse effects ; therapeutic use ; Treatment Outcome

Objective To explore the causes of postoperative recurrence in patients of nodular goiter,the selection of method for reoperation and the postoperative complications. Methods The clinical data of 278 nodular goiter patients admitted in the first affiliated hospital of Harbin Medical University between 2001 and 2008 were analyzed retrospectively,including the methods and complications for first operation and reoperation. Results In the first operation,79 eases received simple eminectomy and 167 cases received partial lobectomy,accounted for 28.4% and 60.1%,respectively. Unilateral subtotal lobectomy plus contralateral eminectomy was performed in 23 cases and subtotal thyroideetomy was conducted in 9 cases,accounted for 8.3% and 3.2%,respectively. Postoperative complications occurred in one hundred and twenty-three cases,the incidence being 8.2% (23/278). Unilateral subtotal Iobectomy plus contralateral partial iobectomy was reperformed in 37 cases and bilateral subtotal thyroidectomy in 241 cases. Postoperative complications occurred in 12 cases,the incidence being 4.2%(12/278). No postoperative recurrence of nodular goiter was found. Conclusions Recurrence of nodular goiter is closely associated with the scope of previous surgical treatment,and correct operative manipulation may reduce the recurrent rate.