Objective:To study the anatomic and clinical experience in distally based neuroadipofascial turnover flap incorporating superficial peroneal nerve.Methods:Thirty six (32 preserved and 4 fresh) cadaver lower limbs were used to investigate the blood supply of superficial peroneal nerve and the relationship with the vascularization of its vicinity integument.Distally based neuroadipofascial flap incorporating the nutrifying vessels of superficial peroneal nerve was designed for dorsal foot reconstruction.Results:The proximal part of superficial peroneal nerve was supplied by an accompanying superficial peroneal artery.In the one third part of the lower leg,this artery became an interlacing paraneural vascular plexus and was reinforced by branches from the distal perforators of anterior tibial artery,the supramalleolar perforator of peroneal artery,and the recurrent branches of dorsal pedal artery.Two chain linked longitudinal vascular plexuses (fascial and paraneural) were confirmed in the anterior lower leg integument.In practice,distally based superficial peroneal neuroadipofascial turnover flaps were successfully transferred in 5 cases.The flap measured (10 14) cm?(4 5) cm in size.The pedicle was (3 4) cm in width.The pivot point was located (2 3) cm above the line between medial and lateral malleolus.Conclusion:Distally based superficial peroneal neuroadipofascial turnover flap is a simple and safe procedure with minimal morbidity of the donor site.

Ninety normal subjects were determined by the respofnse of the skin to sunlight, and were classified as sun--reactive skin types of Ⅲ, Ⅳ, Ⅴ,most of them were type Ⅳ (80. 11 % ),to the next were types Ⅴ and Ⅲ. The minimal erythema dose (MED) to UVB and UVA,and the immediate pigment darkening reaction(IPD) to UVA radiation were measured for each type. Bivariate correlation analysis showed a positive correlation between the MED UVB and MED- UVA (r= 0. 47d, P＜O. 001 ). The mean IPDUVA was significantly lower than the mean MED--UVA. Both mean MED--UVB and MED--UVA were significantly higher among the subjects in this study in comparison with the English people with skin types Ⅱ and Ⅲ. The validity of sun--reactive skin type in the study on photosensitive skin diseases and phototherapy is discussed.

Objective To explore the relationships between the expression of PECAM-1 and the degree of ALI in Paraquat induced lung injury model of rabbits. Method Thirty six adult New Zealand rabbits were randomly divided into three groups: 8 mg/kg (Group A), 16 mg/kg (Group B) and 32 mg/kg ( Group C) according to the dose of Paraquat which were infusion into stomach. After poisoned, the animals were monitored for seven days, and then sacrificed. The upper lobe of lung were removed for HE,Masson staining and immunohistochemisty. The ALl score, fibrosis of lung and expression of PECAM-1 were semiquantitative analyzed. Results Each group has 12 animals suffered from poisoning. The survival time of animals in Group C was (6. 47 ± 0. 99 ) days, shorter than (6. 09 + 1.04) days ( P = 0. 031 ) in Group B and (4. 77 + 2. 04) days ( P = 0. 0 07) in Group A. The ALI score were ( 8. 33 ± 1.03) points in Group A, superior to (9. 83 ± 1.17) points ( P = 0. 047 ) in Group B and ( 11.50 + 1.38) points ( P ＜ 0. 01 ) in group C, Group B vs Group C, P=-0.03o The fibrosis degree of lung was (31.09 +2.05)% in Group A,not severe as (34. 37 ±1.62)% (P=0. 002) in Group B and (36. 54 ±0. 44)% (P ＜0. 01 ) in Group C, Group B vs Group C, P = 0. 026. The Pearson correlation analysis showed the expression of PECAM-1 was negative correlated to ALI score (Coe = -0. 732, P =0. 001 ) and fibrosis degree of lung (Coe = -0. 779, P ＜ 0. 001 ) . Conclusions The expressions of PECAM-1 were significantly decreased in New Zealand after Paraquat poisoned, which were dose dependent, correlated to ALI scored and fibrosis degree of lung, so it may play an important role in the development of lung injured induced by Paraquat.

Objective To establish a method of murine local lymph node assay (LLNA) combined with measurement of ear swelling for the identification of photosensitive agents. Methods The female BALB/c mice received test chemicals or vehicle alone on the back skin of both ears and then were exposed to UVA irradiation on three consecutive days. The post-auricular lymph nodes draining the ear tissue were excised 24 h following the last irradiation. Lymph node cell counts and lymphocyte proliferative rates were determined, which indicated lymph node hyperplasia. While ear swelling was also measured, to reveal skin irritating reactions. Some cytokines (IFN-?, IL-2 and IL-4) released by the draining lymph node were also analyzed by ELISA. Results Tetrachlorosalicylanilide, a strong photoallergen, caused lymph node hyperplasia without ear swelling. The mild photoallergen (6-methylcoumarin) showed neither lymph node proliferation nor ear swelling reactions. But 8-methoxypsoralen, a phototoxic substance, induced both lymph node hyperplasia and ear swelling. The level of IL-4 was significantly increased when the mice were previously sensitized with tetrachlorosalicylanilide (P

Objective To investigate the expression of Th1/Th2 cytoki nes in early symptomatic syphilitic lesions and its relationship with the sero-c onversion of RPR test in patients with syphilis. Methods The expression of Th1/Th2 cytokines in lesions from 30 patients with early symptomatic syphilis was i mmunohistochemically detected with ABC method. The serum titers of RPR test in t hese patients were measured in 1, 3, 6, 9 and 12 months after routine benzathine penicillin treatment. Results Among 10 cases of primary syphilis, the express ion of both Th1 and Th2 cytokines in the lesions was found in 9 cases, while onl y Th1 cytokine expression was observed in the remainder case; and the sero-conve rsion of RPR test occurred in all 10 cases during the follow-up period. Among 20 cases of secondary syphilis, Th1/Th2 cytokines expressed in the lesions in 16 c ases, and only Th2 cytokines expressed in 4 cases; and the sero-conversion of RP R test was found in 12 cases during the follow-up period. The expression of Th1 cytokines in early syphilitic lesions was positively correlated with the sero-co nversion of RPR test. The higher the expression of IFN- the more likely the s ero-conversion of RPR test. Conclusion The early activation and persistence of the expression of Th1 cytokines may play an important role in the clearance of pathogens.

Objective To investigate the p53 gene mutations in Chinese patients with epithelial skin cancers. Methods Biopsies of 22 squamous cell carcinoma(SCC)and 18 basal cell carcinoma(BCC)were analyzed by polymerase chain reaction denaturing gradient gel electrophoresis(PCR-DGGE) and DNA sequencing for alterations in the exons 5～8 of p53 tumor suppressor gene. Results p53 gene mutations were found in 32.5%(13/40)of tumor tissues and 92.3%(12/13) of the mutations occurred at sun exposed areas. 36.4%(8/22)of SCC tissues and 27.8%(5/18) of BCC tissues presented p53 gene mutations. Of the 13 mutations within the exons examined, 76.9%(10/13) were missense mutations and 23.1%(3/13) were nonsense mutations. Twelve of the 13 mutations were of single nucleotide substitutions. Six of the 13 mutations involved dipyrimidine sites, where a C was replaced by a T or CC was replaced by TT(five C→T transitions and one CC→TT transition). Conclusion Ultraviolet(UV) radiation might be related to the pathogenesis of skin cancer. Mutations of p53 gene caused by solar UV might play a significant role in UV tumorigenesis, although other carcinogens might also be involved.

Objective To investigate the effects of photochemotherapy on the angiogenic ability of endothelial cells and expression of integrin. Methods In vitro angiogenesis assay ( UVA exposure dose: 0, 2.0, 5.0 J/cm~2) was used to detect the effects of photochemotherapy on the angiogenic ability of endothelial cells. Reverse polymerase chain reaction and flow cytometry were employed to determine the effects of photochemotherapy on the expression of integrin mRNA and protein, respectively. bFGF stimulation group and PMA stimulation group were divided according to the inductors, and subgroups were divided according to the UVA exposure doses of 0, 2. 0 and 5. 0 J/cm~2 in each group. Results Combination of UVA (2.0 and 5.0 J/cm~2) and 8-MOP (100 ng/mL) resulted in a decrease in the angiogenic ability of endothelial cells in vitro and the expression of integrin mRNA and protein. Conclusion Photochemotherapy may inhibit the angiogenic ability of endothelial cells through downregulating the expression of integrin.

Objective To establish a new model of cardiac arrest (CA) in rats by transcutaneous electrical epicardium stimulation. Method Two acupuncture needles connected to the anode and cathode of a stimulator were transcutaneously inserted into the epicardium as electrodes. The stimulating current was steered to the epicardium and the stimulation was maintained for 3 minutes to induce CA. Cardiopulmonary resuscitation (CPR) was performed at 6 minutes after a period of nonintervention. Results The success rate of induction was 12/20 at the current intensity of 1 mA; and reached 20/20 when the current intensity was increased to 2 mA. The average time from the electrical stimulation to CA induction was (5. 10 ± 2. 81) seconds. When the electrical stimulation stopped, 18/20 rats had ventricular fibrillation and 2/20 rats had pulseless electrical activity. CPR was performed for averagely 207.4 ( ± 148.8) seconds. The restoration of spontaneous circulation was 20/20. The death rate within 4 hours after CA was 5/20, and the 72-hour survival rate was 10/20. There were only two cases of complications, a minor muscle contraction and a minor lung lobe injury. Conclusions The model of CA in rats induced by transcutaneous electrical epicardium stimulation is a stable model that requires low-intensity current and has fewer complications.

Objective To investigate the variation of biomarker of coagulation, anti-coagulation, fibrinolysis in elderly critical patients and find out whether they are related to the disease severity. Methods Sixty-seven patients were no less than 60 years old. Eligible criteria: coincidence with the diagnostic criteria of systemic inflammatory response syndrome (SIRS) and APACHE Ⅱ score was no less than 10 scores. Blood sample was drawn from the venous for the test of biomarker (APTT, PT, TT, D-D, Fib, AT-Ⅲ , PC, PAI-1). According to the existent status,all the patients were divided into two groups:survival group (43 cases) and death group(24 cases) ,meanwhile,according to the diagnostic criteria of MODSE,all the patients were divided into MODSE group (30 cases) and non-MODSE group (37 cases). Results There were significant differences in APACHE Ⅱ score between MODSE group and non-MODSE group, survival group and death group [(25.83 ± 1.19) scores vs(18.1±20.73) scores and(18.81±0.72) scores vs(26.50 ± 1.42) scores](P <0.01). The PT and D-D in MODSE group anti death group were higher than those in non-MODSE group and survival group, the differences were significant (P <0.05),while the activity of AT-Ⅲand PC in MODSE group and death group were lower than those in non-MODSE group and survival group, the differences were significant (P <0.05). The PT,D-D and PAI-1 were positively correlated to APACHE Ⅱ score (related coefficients were 0.328, 0.308, 0.335,P <0.05). The AT-Ⅲ and PC were negatively correlated to APACHE Ⅱ score (related coefficients were -0.469, -0.559,P <0.01). Conclusions The abnormality of eoagnlation-fibfinolysis system exists in elderly critical patients. The extended PT, elevated D-D and PAI-1 ,descended PC and AT-Ⅲ are the hints of disease severity and poor prognosis.

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.