Objective To introduce the method, indications and the usage of abdominal double layer subcutaneous flap for the repair of late complicated hand injury. Methods A new type of flap was designed to repair the complicated hand injury. Sixteen cases were treated with this method since 1998. Results The duration of the follow up ranged from 3 to 24 months with an average of 13 months. All of the flaps survived well. After physiotherapy, the overall excellent and good rate of joint movement was 80%(TAM standard). No further surgery was required in all of the cases. Conclusion The abdominal double layer subcutaneous flap was especially indicated in those cases with bone nonunion, tendon and nerve defect and tendonous adhesions. This kind of flap not only provide a good skin covering, but also offer a soft bed for the tendons, nerves, and bones.

Objective To investigate the changes in cathepsin B (CatB) expression in acutely photodamaged human dermal fibroblasts (HDFs) and their significance.Methods HDFs were isolated from the foreskin of children,and subjected to primary culture and subculture.The fourth-to eighth-passage HDFs were used in the following experiment.HDFs were divided into two groups to receive irradiation with different doses of ultraviolet A (UVA) for different durations (acutely photodamaged group) or remain unirradiated (control group).Cell counting kit-8 (CCK8) assay was conducted to evaluate the proliferative activity of HDFs after irradiation with UVA at 5,10,15,20 and 25 J/cm2 respectively.Western blot and quantitative real-time reverse transcription PCR were performed to measure the protein and mRNA expressions of CatB respectively in HDFs at 24,48 and 72 hours after exposure to UVA at 10 J/cm2,and at 48 hours after exposure to UVA at 10,15,20 and 25 J/cm2.Statistical analysis was carried out by analysis of variance and least significant difference (LSD) test using the SPSS 13.0 software.Results UVA radiation induced a decrease in the proliferative activity of HDFs.When the dose of UVA was ≤ 10 J/cm2,the survival rate of HDFs maintained higher than 85％,and significant differences were observed in cell survival rate between unirradiated and irradiated HDFs at 24,48 and 72 hours (all P ＜ 0.05).Western blot showed that the gray value of CatB protein in the acutely photodamaged group irradiated with 10 J/cm2 UVA was significantly higher than that in the control group at 24 hours (0.76 ± 0.14 vs.0.35 ± 0.01,P ＜ 0.05),48 hours (1.34 ± 0.38 vs.0.45 ± 0.12,P＜ 0.05) and 72 hours (0.82 ± 0.09 vs.0.61 ± 0.06,P＜ 0.05).Increased mRNA expressions of CatB were also observed in the acutely photodamaged group compared with the control group at 24 hours (0.149 ± 0.009 vs.0.089 ± 0.015,P ＜ 0.05),48 hous (0.173 ± 0.009 vs.0.091 ± 0.010,P ＜ 0.05) and 72 hours (0.185 ± 0.158 vs.0.111 ± 0.017,P ＜ 0.05) after UVA radiation at 10 J/cm2.The gray value of CatB protein was 0.99 ± 0.07,1.49 ± 0.14,1.89 ± 0.08,2.07 ± 0.06 in HDFs at 48 hours after exposure to UVA of 10,15,20 and 25 J/cm2,respectively,significantly higher than that in the control group (0.60 ± 0.05,all P ＜ 0.05).Similarly,the mRNA expression of CatB was up-regulated in HDFs at 48 hours after UVA radiation at 10,15,20 and 25 J/cm2 compared with the unirradiated HDFs.Conclusion The protein and mRNA expressions of CatB are up-regulated in acutely photodamaged HDFs induced by UVA radiation.

Objective To evaluate the efficacy and safety of centella triterpenes cream(R) for treating crow's feet.Methods A double-blind,randomized,vehicle-controlled 12-week study was conducted.Centella triterpenes cream(R) was applied to the lateral canthus on one side (treatment side) and vehicle-(c)ontrol cream to the lateral canthus on the other side (control side) 3 times daily.Efficacy was evaluated based on an investigator-blinded assessment,subject self-blinded assessment and a quantitative analysis by Visioscan(R)VC98 at the baseline,4,8,12 weeks after the beginning of treatment.Results Thirty-six volunteers were recruited and 35 subjects completed the 12-week trial.The investigator-blinded assessment showed a significant difference in the changes of wrinkle scores between the treatment side and control side after 4 weeks (P ＜ 0.05),and the improvement of wrinkles was more obvious on the treatment side than on the control side at 8 and 12 weeks with a statistical difference in the wrinkle scores (both P ＜ 0.05).Compared with the control side,a significant increase in SEw value,which suggested an improvement in wrinkles,was observed on the treatment side after the application of centella triterpenes cream(R).Subjects' assessments revealed no significant difference in the occurrence of irritation or the improvement of coarse wrinkles,whereas the treatment side was superior to the control side in the improvement of skin texture (P ＜ 0.05) at the lateral canthus.Conclusion Centella triterpenes cream(R) thrice daily is effective for the improvement of crow's feet with no obvious side effects.

BACKGROUND:The thermosensitive chitosan is a kind of chitosan, its hemostatic effect, tissue compatibility andin vivo absorption need further investigations.
OBJECTIVE:To investigate the hemostasis,in vivo degradation and tissue compatibility of thermosensitive chitosan hemostatic film.
METHODS: A total of 48 Sprague-Dawley rats were randomly divided into four groups, and carried out two
experiments at the same time. (1) The incisions of the liver in three groups were covered with the thermosensitive chitosan hemostatic film, celulose hemostatic cotton and gelatin sponge, respectively. Blank control group
received no treatment. The bleeding time and bleeding amount were recorded. (2) The incisions of the quadriceps femoris muscle of rats in the above three groups were embedded with the same hemostatic materials respectively. Blank control group was not embedded. At 1, 2, 3, 4, 6 weeks, the incision tissues of the liver and the quadriceps femoris muscle were harvested for observation. After 4 weeks, the incisions were observed with hematoxylin-
eosin staining and transmission electron microscopy.
RESULTS AND CONCLUSION: The bleeding time and bleeding amount of thermosensitive chitosan hemostatic film and celulose hemostatic cotton groups were significantly lower than those of gelatin sponge and blank
control groups (P < 0.05). After 6 weeks, the thermosensitive chitosan hemostatic film was absorbed completely. After 3 weeks, the celulose hemostatic cotton was absorbed completely. After 2 weeks, the gelatin sponge was absorbed completely. The liver lobules of thermosensitive chitosan hemostatic film were complete, the liver cellwere normal structure, showing light sweling and little inflammatory cellinfiltration. Under transmission electron
microscopy, the liver cels had integral structure, cellnucleus and organeles remained intact. The muscle fibers showed complete structure and little inflammatory cellinfiltration. Under transmission electron microscopy, the muscle fibers
ranked tidily, with integral cellnucleus and organeles. The thermosensitive chitosan hemostatic film has good hemostasis effect and tissue compatibility.

Objective:To explore the influence of different blood glucose level at hospitalization on no-reflow and prognosis in patients with acute myocardial infarction (AMI),but without diabetes after emergency percutaneous coronary intervention (PCI).Methods:A total of 678 non-diabetic AMI patients undergoing PCI were selected.Ac-cording to blood glucose level at hospitalization,patients were divided into normal group (n=312),blood glucose level higher group (higher group ,n=201)and blood glucose level extremely high group (extremely high group,n=165).Clinical characteristics,no-reflow after PCI and incidence of cardiovascular events within 30d after PCI were compared among three groups.Results:Compared with normal group and higher group,there were significant rise in age,percentages of >1 location of myocardial infarction and Killip's ≥ class II,white blood cell count instant af-ter hospitalization,peak value of creatine kinase (CK)and CK-isoenzyme (CK-MB)in extremely high group,P <0.01 all;Compared with normal group,the age,peak value of CK and CK-MB significantly rose in higher group (P<0.01 all).Along with blood glucose rose,incidence rate of no-reflow significantly increased (17.0% vs.38.8%vs.49.7%),left ventricular ejection fraction (LVEF)on 30d after PCI gradually reduced [(68.6± 5.7)% vs. (62.2±6.4)% vs.(55.6±6.9)%]in above-mentioned 3 groups in turn,there was significant difference between any two groups,P <0.05 or <0.01.Conclusion:Stress hyperglycemia possesses great influence on no-reflow and prognosis in non-diabetic AMI patients after PCI.

To extract praeruptorin A from Radix Peucedani by supercritical fluid extraction (SFE)-CO2.

Objective To explore the influence on the expression of elF4E and heparanase by antisense oligodeoxyribonucleotides (ASODN) transfection in human bladder carcinoma BIU-87 cells.Methods After transfecting the 2.5,5.O,7.5 μg/ml eIF4E ASODN into BIU-87 cells,at 24 h,48 h and 72 h,a cell control group (no transfection),a blank control group (empty liposomes) and a non-sense control group (transfected with non-sense ASODN) were established.The expression of eIF4E,HPA and mRNA were detected by in situ hybridration.The expression of eIF4 and HPA protein were detected by immunocytochemistry.SPSS 13.0 statistical software was used for statistical analysis.Results The expression quantity of eIF4E protein and mRNA were lower in the experimental groups ( protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:3.55 ±0.52,3.52 ±0.51,3.22.±0.44 respectively; 5.0 μg/ml group:3.43 ±0.47,3.41 ± 0.46,3.19 ± 0.41 respectively ; 7.5 μg/ml group:2.36 ± 039,2.33 ± 0.37,2.05 ± 0.30 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:3.19 ±0.41,3.13 ±0.39,2.90 ±0.38 respectively ; 5.0 μg/ml group:3.07 ± 0.39,2.94 ± 038,2.27 ± 0.37 respectively ; 7.5 μg/ml group:2.22 ± 037,2.06 ± 0.30,1.95 ± 0.29 respectively.All data were less than those in the control groups (P ＜0.05).The expression quantity of HPA protein and mRNA were lower in experimental groups (protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:4.44 ±0.55,4.40 ±0.54,3.99 ±0.52 respectively; 5.0 μg/ml group:4.41 ±0.55,4.21 ±0.53,3.77 ±0.50 respectively; 7.5 μg/ml group:4.02 ±0.52,3.98 ±0.52,2.32 ±0.37 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:4.12 ±0.51,3.75 ± 0.50,3.63 ± 0.45 respectively ; 5.0 μg/ml group:4.00 ± 0.51,3.71 ± 0.50,3.54 ± 0.44respectively ; 7.5 μg/ml group:3.87 ± 0.52,3.61 ± 0.49,2.08 ± 0.30 respectively).All data were less than in control groups ( P ＜ 0.05 ).There was a positive correlation on expression of HPA protein and eIF4E protein by inhibitory effect of eIF-4E ASODN (protein r=9.23,mRNA r=9.59,P ＜0.01).Conclusion eIF-4E ASODN might be used to inhibit the expression of eIF-4E gene and HPA gene in bladder cancer BIU-87 cells.

Objective To observe the efficacy and safety of sorafenib in the treatment of the unresectable hepatocellular carcinoma.Methods According to the inclusion criteria,33 patients with the unresectable hepatocellular carcinoma were given sorafenib (400 mg for twice per day).During the course of treatment,dose was adjusted based on the degree of the adverse effects.Tumor response to sorafenib and safety was assessed every 6-8 weeks using the modified RECIST criteria.The survial curve for the time to progression (TTP) and overall survival (OS) were estimated.Results In this series,there was no patients achieved complete response (CR) and partial response (PR),1 1 patients were evaluated as with stable disease(SD),22 patients were with progressive disease (PD).The median TTP was 5.6 months (2.3-8.9 months).The median TTP was longer in patients with BCLC B than BCLC C stage.TTP was longer in good than in poor performance status patients,and shorter in extrahepatic metastasis than in no extrahepatic metastasis patients.The overall incidence of adverse events was 75.8％.The most common adverse events were hand foot skin reaction,diarrhea,hypertension and rash.Three patients had grade 3 adverse events.Conclusions Sorafenib can extend the median time to progression in patients with unresectable hepatocellular carcinoma.Patients with earlier stage of HCC and better performance status are hopeful for more positive response to the treatment of sorafenib.

AIM: To observe the curative effect of titanium wiring in treatment of the fractures of Neer Ⅱ type distal clavicle and dislocation of Tossy Ⅲ type acromioclavicular joint. METHODS: From March 2004 to December 2006, 37 cases with Neer Ⅱ type distal clavicle fractures or Tossy Ⅲ type acromioclavicular joint dislocation were treated with titanium wiring in Changzheng Hospital, Second Military Medical University of Chinese PLA. Titanium wiring (produced by Sofamor-Danek Company in USA) had good histocompatibility, intensity of tension and flexibility. The broken coracoclavicular ligament was repaired directly by titanium wiring in all cases. The outcomes were evaluated according to Herscovici's criteria. RESULTS: All the cases were followed up for 6 to 24 months. All the dislocated acromioclavicular joints returned to normal 2 weeks after operation. Excellent and good rate of shoulder function was 100% according to Herscovici standard. X-ray imaging showed all clavicle fractures united, acromioclavicular joint had no redislocation or titanium wiring breaking. The incisions of all cases had no obvious swelling and exudation. CONCLUSION: When Neer Ⅱ type distal clavicular fracture and Tossy Ⅲ type acromioclavicular joint dislocation are treated with titanium wiring, the acromioclavicular joint can exercise earlier and recover quickly.

Objective To estimate the prevalence and associated factors of facial wrinkling in females.Methods Questionnaires were designed and delivered to collect related data on volunteers. The subjects were divided into outdoor and indoor groups. Wrinkles were classified into 9 grades based on photos taken by SIA0612 image analyzer and quantification analysis via Visioscan VC 98. SPSS 17.0 software was used to assess the associated factors of wrinkling, including sun-protective measures, skin care and cosmetology, onset age and location of wrinkles in these subjects. Results A total of 246 patients aged 19 - 71 years were recruited in this study. Sun-protective measures were applied in 13.5% of the subjects between 12 and 18 years of age,38.5% of those between 19 and 29 years of age, 39.2% of those between 30 and 39 years of age, 44% of those between 40 and 59 years of age, and in none of those between 60 and 75 years of age, 44.1% of all the subjects in the latest 5 years. Wrinkles were absent in 5.7% of the subjects, and pigmentation macules absent in 21.7%. The first development of wrinkles was mainly observed in subjects aged 30 to 35 years, and that of pigmentation macules in those aged 25 to 30 years. The most common locations of facial wrinkles, in order of decreasing frequency, were infraorbital area, lateral angle of eye, nasolabial fold, glabella in the indoor group,lateral angle of eye, infraorbital area, glabella and nasolabial fold in the outdoor group. Fishtail lines seemed to be the commonest wrinkles with an earliest onset among these wrinkles, and showed a prevalence of 100% in subjects aged 45 years or older in the indoor group, and in those aged 30 years or older in the outdoor group.Conclusions Wrinkles and pigmentation macules are dominate manifestations of skin aging in Chinese females. The onset of pigmentation macules is earlier than that of wrinkles. The main manifestations of skin aging in Chinese females, in order of decreasing frequency, are yellow-grey skin, skin dryness, roughness,leather-like appearance, teleangiectasia, and (or) severe pigmentation macules, increase in skin fragility, etc.The order and age of wrinkle appearance are different between indoor and outdoor females.