Objective To introduce a new technique of one-stage auricular reconstruction by using the retroauricular fascial flap. Methods The retroauricular fascial flap was designed to cover a cartilage framework for auricular reconstruction. Results Seventeen cases who had injured over two years and received no surgical treatment, underwent auricular construction. In 3-month to 2-year follow-up, all patients obtained satisfactory appearance of the reconstructed ears that possess delicate structure and close color to adjacent skin. Conclusion For retroauricular fascial flap has adequate blood supply, it makes operating procedure simple and the occurrence rate of complication reduced. It is proven that this is a good method of auricular reconstruction.

Objective To seek new skin flap donor sites beyond face to repair deformity of nose. Methods Seven patients underwent reconstruction of nasal tips and columellae with dorsal forefinger sk in flap based on proper palmar digital artery and reverse forearm skin flap base d on tiny cutaneous branches of radial artery. Results Al l flaps survived. Similar external appearance in color and texture compared with adjacent normal skin was achieved for 1～4 years follow-up. Conclus i on Remarkable advantage without second deformity in face is archeive d due to contribution of skin flap. These two methods of correction can be more acceptible by patients than usual ones.

Objective:To investigate the couse of 24 cases AVB during RFCA and 5 cases after RFCA in total 94 AVNRT patients. Methods:94 AVNRT patients received RFCA in which time, the energy and power were gradually discussed. The correlation among AVB and both different anatomical positions (upper, middle and lower zone) and A/V, H-value in intraventricular ablation mapping were studied respectively. Results: With the elevation of ablation zone, the AVB risk was also increased. The intraventricular ablation mapping showed that:①Increase of A/V and H-value means higher AVB risk;② Simultaneous increase of A/V and H-value would lead to the most dangerous result. Conclusion:It is of great importance to perform RFCA under such situation:middle and lower zone as ablation positions multiple-peak A wave, A/V(0.1-0.25) and no H or slightest H(≤0.02?0.03)mV are present in intraventricular ablation mapping, which could significantly lower the risk of RFCA-related AVB.

The arterial source of the flap,the anastomoses of cutaneous arteries in theskin and subcutaneous tissue and nervous distribution in the flap were observed andsurveyed in 42 upper limbs of adult cadavers.1.The arterial source of the flap comes mainly from the cutaneous branches ofprofund brachial artery,radial collateral artery,lateral humeral cutaneous artery andcutaneous branches of the posterior circumflex humeral artery.In most cases theprofund brachial artery and radial collateral artery may be served as the vascularpedicle of the flap of lateral brachium in transplantation.2.The cutaneous arteries in this flap anastomose each other to from a networkin the skin and subcutaneous tissue.Cutaneous arteries arising from the medial brac-hial region and the upper part of forearm also participate in the formation of thisvascular network.3.The veins of the flap contain both superficial and deep groups:The superfi-cial group is the cephalic vein of brachium which goes upward along the lateralsulcus of m.biceps brachii and its outer caliber is somewhat wider;the deep groupfollows the profund brachial artery or radial collateral artery as their venae comit-antes.Both groups may be sutured together or separately with veins of the recipientin skin grafting.4.The lateral brachial cutaneous nerve and posterior antebrachial cutaneousnerve pierce through the lateral intermuscular septum at various levels,and innervateover the skin in lateral brachial and posterior forearm regions.Since the posteriorbrachial cutaneous nerve is accompanied closely by the radial collateral artery,muchattention should be paid to it in cutting skin flap.5.The extent of cutting a skin flap in lateral brachial region can be enlargeddue to free anastomoses with arteries of adjacent regions which was demonstrated byperfusing red ink into profund brachial artery.The flap of lateral brachium maybe subdivided into following three parts:the upper,middle and lower,the vascularpedicle of which are the cutaneous branch of posterior circumflex humeral artery,lateral humeral cutaneous artery and profund brachial artery(or radial collateralartery)respectively.

The cutaneous arteries of the forearm and their anastomoses in skin and subcutaneous tissue were invetigated on 35 upper limbs.1. The average length of the radial artery is 215.3 mm. This artery can be divided into a covered part and a exposed part. Their lengths are 117.7 mm. and 101.4 mm. respectively. The calibers of the upper end, the intermediate point, and the lower end of the radial artery are 2.7mm, 2.3 mm and 2.4 mm respectively.2. The exposed part of the radial artery sends out more cutaneous branches (9.6 branches) than the covered part (4.2 branches), While their muscular branches are nearly equal in number. The calibers of the cutaneous and muscular branches of the radial artery varies from 0.3～0.5 mm.The fine anastomoses of the cutaneous branches exist between the radial and ulnar arteries and between the radial and ulnar arteries and the dorsal interosseus artery and they form an arterial networks in the subcutaneous tissue of the whole forearm. For blood supply a skin flap may be cut from the whole forearm from the standpoint of morphology.4. The calibers of the radial and cephalic veins at the level of middle part of the forearm are 1.3 mm and 2.8 mm respectively. As the vasular pedicle both the veins should be anastomosed during transplant operation in order to increase the volume of the draining blood.5. The skin flap of forearm blongs to a type of blood supply of arterial trunk network, which have been distinguished with that of some other skin and myocutaneous flaps according to the anatomical characteristics of the radial artery.

Cystic echinococcosis (CE) caused by E. granulosus is a serious helminthic zoonosis in humans, livestock and wildlife. Xinjiang is one of high endemic province for CE in China. A total of 55 sheep and cattle livers containing echinococcal cysts were collected from slaughterhouses in Changji and Yining City, northern region of Xinjiang. PCR was employed for cloning 2 gene fragments, 12S rRNA and CO1 for analysis of phylogenetic diversity of E. granulosus. The results showed that all the samples collected were identified as G1 genotype of E. granulosus. Interestingly, YL5 and CJ75 strains were the older branches compared to those strains from France, Argentina, Australia. CO1 gene fragment showed 20 new genotype haploids and 5 new genotype haplogroups (H1-H5) by the analysis of Network 5.0 software, and the YLY17 strain was identified as the most ancestral haplotype. The major haplotypes, such as CJ75 and YL5 strains, showed identical to the isolates from Middle East. The international and domestic trade of livestock might contribute to the dispersal of different haplotypes for E. granulosus evolution.
Abattoirs ; Animals ; Argentina ; Australia ; Cattle ; China ; Clone Cells ; Cloning, Organism ; Echinococcosis ; Echinococcus granulosus ; Echinococcus ; France ; Genetic Variation ; Genotype ; Haploidy ; Haplotypes ; Helminths ; Humans ; Liver ; Livestock ; Middle East ; Polymerase Chain Reaction ; Sheep

Objective To explore the application of limbs and fingers movement combined with moxibustion in patients with PICC catheterization. Methods A total of 346 PICC catheterized patients treated from August 2014 to July 2017 were randomly divided into control group (173 cases) and observation group (173 cases) according to random number table method. The control group was given local hot-wet compression at 3-4 cm of puncture point after 24 h of catheterization, and the observation group was given preventive moxibustion with the direction of the punctured vein at the same site in the control group, and then was given limbs and fingers movement. The levels of serum monocyte chemoattractant protein- 1 (MCP- 1), tumor necrosis factor- α (TNF- α) and interleukin- 8 (IL- 8), hemorheological parameters [rate of high and low shear whole blood viscosity (RBV), rate of plasma specific viscosity (RPV), hematocrit (HCT)] and the incidence rates of mechanical phlebitis and venous thrombosis were compared between the two groups after intervention. Results The levels of MCP-1, TNF-αand IL-8 were (53.03±7.86), (85.93±10.72), (54.65±9.23) ng/L in the observation group, (60.27± 8.45), (94.74±11.36), (63.08±10.07) ng/L in the control group, and there were significant differences (t=8.252, 7.419, 8.117, all P<0.05). The levels of high shear RBV, low shear RBV, RPV and HCT were (3.94 ± 0.85) mPa · s, (6.55 ± 1.22) mPa · s, (1.70 ± 0.54) mPa · s and (43.71 ± 4.82)％ respectively in the observation group, (4.18±0.74) mPa·s, (6.97±1.25) mPa·s, (1.92±0.59) mPa·s and (45.13±4.65)％in the control group, and there were significant differences (t=2.789-3.618, P<0.05). The incidence rates of venous thrombosis and phlebitis were 1.16％(2/173) and 5.78％(10/173) respectively in the observation group, 5.78％(10/173) and 13.29％(23/173) in the control group, there were significant differences (χ2=4.230, 5.661, P<0.05). Conclusions Limbs and fingers movement combined with moxibustion can effectively improve the blood flow status, and reduce the occurrence of mechanical phlebitis and venous thrombosis in patients with PICC catheterization.

Objective:To explore the clinical characteristics and establish a corresponding prognostic scoring model in patients with early-stage clinical features of hepatitis B-induced acute-on-chronic liver failure (HBV-ACLF).Methods:Clinical characteristics of 725 cases with hepatitis B-related acute-on-chronic hepatic dysfunction (HBV-ACHD) were retrospectively analyzed using Chinese group on the study of severe hepatitis B (COSSH). The independent risk factors associated with 90-day prognosis to establish a prognostic scoring model was analyzed by multivariate Cox regression, and was validated by 500 internal and 390 external HBV-ACHD patients.Results:Among 725 cases with HBV-ACHD, 76.8% were male, 96.8% had cirrhosis base,66.5% had complications of ascites, 4.1% had coagulation failure in respect to organ failure, and 9.2% had 90-day mortality rate. Multivariate Cox regression analysis showed that TBil, WBC and ALP were the best predictors of 90-day mortality rate in HBV-ACHD patients. The established scoring model was COSS-HACHADs = 0.75 × ln(WBC) + 0.57 × ln(TBil)-0.94 × ln(ALP) +10. The area under the receiver operating characteristic curve (AUROC) of subjects was significantly higher than MELD, MELD-Na, CTP and CLIF-C ADs( P < 0.05). An analysis of 500 and 390 cases of internal random selection group and external group had similar verified results. Conclusion:HBV-ACHD patients are a group of people with decompensated cirrhosis combined with small number of organ failure, and the 90-day mortality rate is 9.2%. COSSH-ACHDs have a higher predictive effect on HBV-ACHD patients' 90-day prognosis, and thus provide evidence-based medicine for early clinical diagnosis and treatment.