Objective To explore the correlation between serum miRNA-216a level and severity of acute pancretitis (AP) .Meth-ods 17 cases of mild acute pancreatitis (MAP group) ,23 cases of severe acute pancreatitis (SAP group) and 30 cases of healthy subjective (control group) were selected in our hospital from June 2015 to June 2016 .Blood amylase activity and serum miRNA-216a were detected ,Ranson value ,APACHEⅡvalue and modified CT severity index (MCTSI) were used to evaluate the severity of AP ,analyze the correlation between miR-216a level and other indexes .Results The serum amylase activity of MAP group and SAP group in acute stage were higher than those in convalescence in these groups and the control group (P<0 .05) ,and the serum amyl-ase activity in the acute phase SAP group was higher than that in the MAP group ,and the difference was statistically significant (P<0 .05) .The relative expressions of serum miR-216a in MAP group and SAP group in acute stage were significantly higher than those in convalescence in these groups and the control group (P<0 .05) ,and the relative expressions of serum miR-216a in SAP group was higher than that in the MAP group ,and the difference was statistically significant (P<0 .05) .The miR-216a expression was positively correlated with Ranson score ,APACHE score and MCTSI score (r=0 .667 ,P<0 .05 ;r=0 .396 ,P<0 .05 ,and r=0 .648 ,P<0 .05) .Conclusion The expression level of serum miR-216a of patients with AP was significantly higher than that of healthy people ,and the expression level of serum miR-216a was positively correlated with the severity of AP ,which was useful for the diagnosis and prognosis of SAP .

Objective: To report the method and effect of in situ suturing technique for severe amputation of facial composite tissues. Methods: We in situ sutured severely amputated composite tissues of facial region in 14 cases in emergency by vessels and nerves anastomosis from May 2004 to December 2017. Results: All replanted composite tissues survived in 13 cases. Edge necrosis of auricle occurred in 1 case because of serious contusion and it was cured after dressing changed. The color and appearance of the replanted composite tissues were close to normal after 3 to 48 months′ follow-up. Conclusions In situ suturing technique in emergency is the ideal treatment for severe amputation of composite tissues of facial region.

Objective:To evaluate the clinical effect of soft tissue defects around wrist joints repaired with forearm distal perforator propeller flap.Methods:The clinical data of 125 patients with defects of popliteal fossa from May 2008 to October 2019 were analyzed retrospectively, in which 71 men and 54 women were included aged from 16 to 87 years old. The sizes of soft tissue defect ranged from 3.5 cm×2.5 cm to 12.0 cm×6.0 cm. Perforator propeller flap was designed and cut to repair the defects according to their location, size and shape. 62 cases of distal radial artery perforator propeller flap, 48 cases of distal ulnar artery perforator propeller flap and 15 cases of distal posterior interosseous artery perforator propeller flap were included, in which the largest was 14.0 cm×6.0 cm and the smallest was 4.0 cm×3.0 cm. The donor sites were covered with free full-thickness skin grafts. Skin swelling rating in early and later stage and the color after 3 to 60 months follow-up were evaluated for the effect.Results:All the flaps survived in 116 patients, though the distal edge of the flaps were necrotic in 9 cases. The incisions in donor and recipient sites were primarily healed. After 3 to 60 months follow-up, we found no deformity of wrist joints and the appearance was good; the color and elasticity were close to normal; the scar was small; two-point discrimination was 6 mm to 9 mm. The outcome was satisfactory in 89 cases, average in 36 cases and without dissatisfactory. Skin swelling rating in early stage was first degree in 80 cases, second degree in 30 cases, third degree in 15 cases; in later stage was first degree in 85 cases, second degree in 35 cases, third degree in 15 cases. Wrist function was assessed in four aspects: palmar flexion, dorsiflexion, radial deviation, and ulnar deviation. Results were excellent in 29 cases, good in 63 cases, average in 33 cases and the good rate was 73.6%. The pain of wrist did not affect the patients’ daily routines and activities.Conclusions:It is reliable to repair soft tissue defects around wrist joints repaired with forearm distal perforator propeller flap which is worthy of clinical use, especially in middle-aged and senile patients.

Objective:To evaluate the clinical effect of transferred direct popliteal cutaneous artery perforator propeller flap for repairing soft tissue defects of the popliteal fossa.Methods:The clinical data of 9 patients with defects of popliteal fossa from June 2013 to June 2019 were analyzed retrospectively, in which including 6 men and 3 women whose ages ranged from 25 to 73 years old. The sizes of soft tissue defects ranged from 6.5 cm×3.5 cm to 17.0 cm×8.5 cm. Perforator propeller flap was designed and cut to repair the defects according to the location, size and shape of defects, in which the largest was 18.0 cm×10.0 cm and the smallest was 7.5 cm×4.5 cm. To evaluate the effect according to survival, infection control, elasticity and color, appearance of the flaps, the scar at the donor site, cutaneous sense, knee joint function, and patients’satisfaction.Results:All the flaps survived. The incisions in donor and recipient site were primary healing. The survival of flaps was good. The appearance, color, and elasticity were close to normal. On the other hand, the scar at the donor site was small after 6 to 60 months follow-up. 2 cases appeared necrosis on edge of distal flaps and were healed after dressing. The efficacy was satisfactory in 8 cases, general in 1 case and without dissatisfactory. The function of knee joint was excellent in 7 cases, good in 1 case, and general in 1 case. Skin swelling rating in early-stage was 1st degree in 6 patients, 2nd degree in 2 patients, 3rd degree in 1 patient; in the later stage was 1st degree in 8 patients, 2nd degree in 1 patient.Conclusions:It is simple, safe and reliable to repair soft tissue defects of popliteal fossa with transferred direct popliteal cutaneous artery perforator propeller flap, which would be an ideal method for repairing soft tissue defects of the popliteal fossa.

Objective:To evaluate the clinical effect of soft tissue defects around wrist joints repaired with forearm distal perforator propeller flap.Methods:The clinical data of 125 patients with defects of popliteal fossa from May 2008 to October 2019 were analyzed retrospectively, in which 71 men and 54 women were included aged from 16 to 87 years old. The sizes of soft tissue defect ranged from 3.5 cm×2.5 cm to 12.0 cm×6.0 cm. Perforator propeller flap was designed and cut to repair the defects according to their location, size and shape. 62 cases of distal radial artery perforator propeller flap, 48 cases of distal ulnar artery perforator propeller flap and 15 cases of distal posterior interosseous artery perforator propeller flap were included, in which the largest was 14.0 cm×6.0 cm and the smallest was 4.0 cm×3.0 cm. The donor sites were covered with free full-thickness skin grafts. Skin swelling rating in early and later stage and the color after 3 to 60 months follow-up were evaluated for the effect.Results:All the flaps survived in 116 patients, though the distal edge of the flaps were necrotic in 9 cases. The incisions in donor and recipient sites were primarily healed. After 3 to 60 months follow-up, we found no deformity of wrist joints and the appearance was good; the color and elasticity were close to normal; the scar was small; two-point discrimination was 6 mm to 9 mm. The outcome was satisfactory in 89 cases, average in 36 cases and without dissatisfactory. Skin swelling rating in early stage was first degree in 80 cases, second degree in 30 cases, third degree in 15 cases; in later stage was first degree in 85 cases, second degree in 35 cases, third degree in 15 cases. Wrist function was assessed in four aspects: palmar flexion, dorsiflexion, radial deviation, and ulnar deviation. Results were excellent in 29 cases, good in 63 cases, average in 33 cases and the good rate was 73.6%. The pain of wrist did not affect the patients’ daily routines and activities.Conclusions:It is reliable to repair soft tissue defects around wrist joints repaired with forearm distal perforator propeller flap which is worthy of clinical use, especially in middle-aged and senile patients.

Objective:To evaluate the clinical effect of transferred direct popliteal cutaneous artery perforator propeller flap for repairing soft tissue defects of the popliteal fossa.Methods:The clinical data of 9 patients with defects of popliteal fossa from June 2013 to June 2019 were analyzed retrospectively, in which including 6 men and 3 women whose ages ranged from 25 to 73 years old. The sizes of soft tissue defects ranged from 6.5 cm×3.5 cm to 17.0 cm×8.5 cm. Perforator propeller flap was designed and cut to repair the defects according to the location, size and shape of defects, in which the largest was 18.0 cm×10.0 cm and the smallest was 7.5 cm×4.5 cm. To evaluate the effect according to survival, infection control, elasticity and color, appearance of the flaps, the scar at the donor site, cutaneous sense, knee joint function, and patients’satisfaction.Results:All the flaps survived. The incisions in donor and recipient site were primary healing. The survival of flaps was good. The appearance, color, and elasticity were close to normal. On the other hand, the scar at the donor site was small after 6 to 60 months follow-up. 2 cases appeared necrosis on edge of distal flaps and were healed after dressing. The efficacy was satisfactory in 8 cases, general in 1 case and without dissatisfactory. The function of knee joint was excellent in 7 cases, good in 1 case, and general in 1 case. Skin swelling rating in early-stage was 1st degree in 6 patients, 2nd degree in 2 patients, 3rd degree in 1 patient; in the later stage was 1st degree in 8 patients, 2nd degree in 1 patient.Conclusions:It is simple, safe and reliable to repair soft tissue defects of popliteal fossa with transferred direct popliteal cutaneous artery perforator propeller flap, which would be an ideal method for repairing soft tissue defects of the popliteal fossa.

Objective:To prepare anti-human IgE nanobody by phage display technology,and to establish a method for hyper-sensitivity detection of cat dander specific IgE antibody.Methods:Allergen bio-information of cat was searched in WHO/IUIS Allergen Database.After synthesizing sequence,recombinant cat dander allergenic protein Fel d 1 was expressed and purified in prokaryotic ex-pression system.Human IgE was used to immunize Bactrian camel and RNA were extracted from lymphocyte to construct phage dis-play library.Library capacity,diversity and insertion rate were analyzed,anti-human IgE nanobody were obtained by screening and identification.A magnetic particle chemical method for cat dander specific IgE antibody detection was established using recombinant allergen-coupled magnetic particles and acridine ester-labeled nanobodies.Results:Capacity of phage display library was 1.88×108 cfu/ml,insertion rate was 93.6%,and purity of nanobody was>95%.Linear range of the method based on nanobody was 0.1～100 U/ml,who was consistent with ImmunoCAP detection system by clinical data.Conclusion:Nanobody-based cat dander specific IgE antibody hypersensitivity assay is successfully prepared,providing a technical basis for auxiliary diagnosis of cat allergic diseases.

Objective:To evaluate the clinical effect of soft tissue defects around knee joints repaired with thigh distal perforator propeller flap.Methods:Clinical data of 72 patients with defects around knee joints from January, 2009 to October, 2019 were analyzed retrospectively, including 43 males and 29 females, aged from 17 to 83 years. The sizes of soft tissue defects ranged from 4.0 cm×3.0 cm to 22.0 cm×13.0 cm. Perforator propeller flaps were designed and harvested to repair the defects according to anatomical features of the origin, course, branches, distribution and anastomosis of vascular network of the perforator vessels and location as well as the size and shape of defects. Nine patients repaired with the lateral distal perforator propeller flaps (LDF), 53 with descending genicular artery perforator propeller flaps (DGF) and 10 with direct popliteal artery perforator propeller flaps (DPF). The size of flap was 4.5 cm×3.5 cm to 24.0 cm×14.0 cm. The donor sites were sutured directly or covered with free full-thickness skin. To evaluate the effect, the skin swelling rating in early and later stage were taken. Three to 72 months of followed-up was conducted through outpatient clinic (78%), telephone (15%) and WeChat (7%).Results:The flaps totally survived in 65 patients and 7 patients underwent partial necrosis at the distal end of the flaps ( 2 cases of LDF, 4 cases of DGF, 1 case of DPF) who were treated with dressing, and the donor sites were completely healed. The appearance and shape of the repaired knee joints was good, and the color and elasticity was close to surrounding normal skin, TPD of the flaps were 7-10 mm, and the scar was small after 3 to 72 months' follow-up. The efficacy was satisfactory in 48 cases ( 4 cases of LDF, 39 cases of DGF, 5 cases of DPF), general in 24 cases ( 5 cases of LDF, 14 cases of DGF, 5 cases of DPF). Degree of flap swelling: in early stage, I° in 40 cases ( 4 cases of LDF, 31 cases of DGF, 5 cases of DPF), II° in 20 cases ( 3 cases of LDF, 14 cases of DGF, 3 cases of DPF), III° in 10 cases ( 2 cases of LDF, 7 cases of DGF, 1 case of DPF), IV° in 2 cases(1 case of DGF, 1 case of DPF); in later stage: I° in 55 cases ( 6 cases of LDF, 41 cases of DGF, 8 cases of DPF), II° in 15 cases ( 2 cases of LDF, 12 cases of DGF, 1 case of DPF), III° in 2 cases ( 1 case of LDF, 1 case of DPF). The evaluation of knee joint function: excellent in 17 cases ( 2 cases of LDF, 12 cases of DGF, 3 cases of DPF), good in 35 cases( 4 cases of LDF, 27 cases of DGF, 4 cases of DPF), general in 20 cases( 3 cases of LDF, 14 cases of DGF, 3 cases of DPF). The good rate was about 73%. The range of motion and stability of the knee joint were basically normal and there was no pain found to affect study and life. All the patients were satisfied with the effect.Conclusion:Repairing soft tissue defect around knee joint with thigh distal perforator propeller flap is reliable and clinical applicable.

Objective:To explore the clinical value of 18F-fluoromisonidazole (FMISO) PET/CT hypoxia imaging in early response to heavy ion radiotherapy in patients with non-small cell lung cancer(NSCLC). Methods:From April 2018 to January 2021, the 18F-FMISO PET/CT images of 23 NSCLC patients (19 males, 4 females; age (64.9±10.3) years) who received heavy ion radiotherapy in Shanghai Proton and Heavy Ion Center were retrospectively analyzed. The evaluation parameters included tumor volume (TV), tumor to background ratio (TBR) before and after radiotherapy. Patients were divided into hypoxia group and non-hypoxia group with the baseline TBR value≥1.4 as hypoxia threshold. Wilcoxon signed rank test was used to compare the differences of TV and TBR before and after radiotherapy in 2 groups. Results:Of 23 NSCLC patients, 17 were hypoxia and 6 were non-hypoxia. Compared with the baseline, TV after the radiotherapy (59.44(22.86, 99.43) and 33.78(8.68, 54.44) cm 3; z=-3.05, P=0.002) and TBR after the radiotherapy (2.25(2.09, 2.82) and 1.42(1.24, 1.67); z=-3.39, P=0.001) of the hypoxia group were significantly lower, while TV (16.19(6.74, 36.52) and 8.59(4.38, 25.47) cm 3; z=-1.57, P=0.120) and TBR (1.19(1.05, 1.27) and 1.10 (0.97, 1.14); z=-1.89, P=0.060) of the non-hypoxia group decreased with no significant differences. Conclusions:Hypoxic NSCLC tumors are sensitive to heavy ion radiation. Compared with non-hypoxic tumors, hypoxic tumors respond more quickly, and a significant reduction in TV can be observed early after radiotherapy. Heavy ion radiation can significantly improve tumor hypoxia.

Objective To explore the predictive value of combined detection of immunoglobulin binding protein 1(IGBP 1)in serum and urine in lupus nephritis(LN).Methods A total of 60 LN patients were selected as LN group,and 60 SLE erythematosus(SLE)patients in the same period were selected as SLE group,the serum IGBP 1 and urinary IGBP 1 levels between the two groups were compared,and the value of serum IGBP 1,urinary IGBP 1 and their combination in predicting LN was analyzed.Results Serum IGBP 1 and urinary IGBP 1 in the LN group were significantly higher than those in the SLE group(P＜0.05).Binary Logistic regression analysis showed that serum IGBP 1 and urinary IGBP 1 were risk factors for LN(P＜0.05).Receiver Operating Characteristic(ROC)curve revealed that the area under the curve(AUC)for serum IGBP1,urinary IGBP1,and their combined detection for LN was 0.856,0.834,and 0.902,respectively.The Youden index was 0.533,0.533,and 0.666,respectively.The sensitivity and specificity of serum IGBP1 were 85.0％and 68.3％,re-spectively.The sensitivity and specificity of urinary IGBP1 were 53.3％and 100.0％,respectively.The sensitivity and specificity of the combined detection were 78.3％and 88.3％,respectively.Con-clusion Serum IGBP 1 and urinary IGBP 1 are highly expressed in LN patients,and their combina-tion has a high predictive value for LN.