Objective To study the method and effect of deep inferior epigastric perforator flap(DIEP)in repairing the large defects of lower limbs.Methods Eight cases,from July 2009 to November 2011,including 3 cases of plantar skin defects with bone exposure after foot injuries,three cases of plate exposure after tibia fracture surgery and 2 cases of heel repeated ulceration after skin graft,were repaired by deep inferior epigastric perforator flap.Results All deep inferior epigastric perforator flaps survived with good functions,except 1 case whose distal with poor blood supply and the flap survived after treatmenting,three cases of flap bloated with good appearances after second operation.Conclusion DIEP is a proper option for repair of large defects of lower limbs.It has the advantages of abundant blood supply,large flap area,abdomen can suturing without abdominal complications.

Background Light-induced retinal damage models vary as many influence factors,herein the modeling method is difficult to copy.It is necessary to establish the grading standardization of retinal damage after retinal light exposure.Objective This study was to improve the modeling method and establish a grading standardization for light-induced retinal damage in rat.Methods Twenty-four SPF 8-10 week-old male SD rats were randomly divided into 4 groups and 6 eyes for each group.The rats were exposed to light intense of 5000 lx for 1,2,3 hours respectively in 3 groups,and other 6 rats served as the normal group.Full-field light exposure experiment was performed for each individual rat separately,and an annular illumination box was used tO ensure the experimental rat moving in a single direction and exposing the right eye in 5000 lx light surrounding during experimental duration.Ganzfeid electroretinogram(ERG)was recorded from the experimental rats at the fifth day after light exposure,and the animals were then sacrificed for histopathology observation to evaluate the retinal thickness change.All procedures which involved animals adhered to the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research.Results After exposing to intensity light for 1,2,3 hours,the b-wave amplitudes of rod response,maximal mixed response,oscillatory potential in scotopic ERG as well as cone response,20 Hz flicker response of photopic ERG were significant declined as lapse of light exposure time(F=71.690,P=0.000；F=56.250,P=0.000；F=23.610,P=0.000：F=27.130,P=0.000；F=27.030,P=0.000)and lowed by 26.2％,52.5％,70.7％,24.4％,39.3％,58.1％respectively at the end of experiment.Meanwhile,the b-wave latencies of rod response,maximal mixed response in scotopic ERG as well as cone response of photopic ERG were evidently different among different groups (F=1.370,P=0.282；F：0.800,P=0.508；F=11.840,P=0.000；F=2.080,P=0.136).Light induced retinal damage located mainly at the temporal retina area.After intensity light exposure for 1,2,3 hours,the thickness of outer nuclear layer at the superior temporal retina attenuated by 11.3％,25.6％and 72.5％,respectively(P<0.05).A significant difference was seen in mean thickness of outer nuclear layer at superior temporal retina among different groups(F=410.27,P=0.000). Conclusion A standardized grading method for light-induced retinal damage is recommended.The continuous illumination in a intensity of 5000 Ix for 1,2,3 hours can induce the mild,moderate or severe retinal damage respectively at temporal retina.

OBJECTIVETo study the antitumor effect of the stings of Gleditsia sinensis on mice bearing uterine cervical carcinoma (U14) and the expression of PCNA (proliferating cell nuclear antigen) and p53.

METHODThe effect of the ethanolic extract of G. sinensis stings on the inhibition rate of solid tumor and the life span of ascites tumor were calculated by the animal tumor model experiment in vivo. The positive cell numbers of PCNA and mutant p53 protein were measured by immunohistochemical SP method.

RESULTAs compared with the control group, the ethanolic extract of G. sinensis stings (250, 500 and 1 000 mg x kg(-1) body weight, p.o.) and CTX (25 mg kg(-1) body weight, i.p.) administration significantly reduced the tumor weight of solid tumor and increased the life span of ascites tumor harboring mice (P < 0.01). The inhibition rate of solid tumor and the rate in life span were up to 47.44%, 59.49%, 63.92%, 73.42% and 52.21%, 67.26%, 78.76%, 95.58% respectively. Meanwhile,the expression of PCNA and mutant p53 protein also suppressed by ethanolic extract (P < 0.05, P < 0.01).

CONCLUSIONThe stings of G. sinensis showed antitumor activity and its possible mechanism might be related with the expression inhibition of PCNA and mutant p53 protein.

Animals ; Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Cell Line, Tumor ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Gleditsia ; chemistry ; Mice ; Mutation ; Neoplasm Transplantation ; Plants, Medicinal ; chemistry ; Proliferating Cell Nuclear Antigen ; metabolism ; Random Allocation ; Tumor Suppressor Protein p53 ; genetics ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology

Objective To determine the important functional units of medical endoscopes and provide a theoretical basis for improving the maintenance and repair of hospital medical equipment.Methods The units of medical endoscopes were analyzed by the failure mode effects and criticality analysis (FMECA) method to determine the important functional unit.The maintenance methods of the important functional units were proposed and compared with those obtained by a medical equipment repair company.Results According to the risk priority number (RPN) score＞ 36,the important functional units of the medical endoscope were determined as electrical interface,water bottle interface,suction interface,housing,chain,pliers pipeline,water gas pipeline,jacket,charge coupled device (CCD) glass,guided beam glass and nozzles.These units require clinical operators to focus on and perform regular maintenances.Compared with the results obtained by the company,human factors were considered as a greater impact on the reliability of medical endoscopes.Conclusions For clinical operators,the operation training of medical endoscopes should be strengthened to avoid human-induced failures.

Objective To detect retinoid X receptor α (RXRα) mRNA expression in blood of subjects exposed to different concentrations of arsenic via drinking water, to analyze the relationship between RXRα mRNA expression and skin lesion caused by arsenic,and further to explore the skin lesion mechanism of arsenic. Methods Study sites were selected by molecular epidemiology method from high arsenic drinking water area of Bayannur City. Two hundred and thirty-five subjects who had been lived in high arsenic area for more than 10 years were selected;blood samples and water samples were collected from the subjects; according to arsenic concentration in drinking water,they were divided into four groups,<10 μg/L(control group),10-<100 μg/L(low dose group),100- <200 μg/L (middle dose group), and ≥200 μg/L (high dose group). Skin hyperkeratosis and pigment abnormity examination were conducted. The RXRα mRNA expression level in blood samples was detected by real-time quantitative PCR, and then the relationship between expression of RXRα mRNA and different levels of arsenic exposure,and skin lesion induced by arsenic were analyzed. Results ①The results showed that there was a dose-effect relationship between the prevalence of hyperkeratosis, pigment abnormity and arsenic exposure (χ2= 14.597, 12.825, P < 0.05); ②With increasing of arsenic exposure, RXRα mRNA expression in blood decreased firstly and then increased (F = 8.312, P < 0.05), which were significantly different statistically from those of control [(1.20 ±0.53)×10-3]and low dose groups[(0.92 ± 0.49)×10-3,P<0.05];RXRα expression was significantly higher in high dose group[(1.40 ± 0.45)×10-3]than those of middle and low dose groups [(1.12 ± 0.58,0.92 ± 0.49)×10-3,P<0.05]; ③The RXRα mRNA expression in people with different level of skin damage (hyper keratosis and pigment abnormity)were statistically significant(F=4.206,4.389, P< 0.05); degree Ⅲ[(1.98 ± 0.38) × 10-3] hyperkeratosis patients compared with degree Ⅰ [(1.11 ± 0.52) × 10-3] and degree Ⅱ [(1.13 ± 0.42) × 10-3], RXRα mRNA expression was significantly different (P < 0.05), degree Ⅱ and higher degrees [(1.61 ± 0.54) × 10 -3] pigment abnormity patients compared with control [(1.15 ± 0.52)×10-3],RXRα mRNA expression was significantly different (P < 0.05). Conclusions Chronic arsenic exposure has an effect on RXRα mRNA expression in blood. There is a relationship between abnormal expression of RXRα mRNA and skin lesion induced by arsenic.

AIMTo study the effect of different intervals between occlusions of vertebral arteries and bilateral common carotid arteries on the Pulsinelli 4-vessel occlusion global cerebral ischemic model, and the features of ischemia of the brainstem and hippocampus induced by occulusion of bilateral common carotid arteries under the condition of occlusion of unilateral vertebral artery.

METHODSEighty four adult male Wistar rats were divided into 4 groups randomly: control group, bilateral vertebral artery occluding group, global brain ischemic insult group, and unilateral vertebral artery occluding plus bilateral common carotid arteries occluding group. In the global brain ischemic insult group, rats were further divided into 24 h, 48 h, and 72 h interval subgroups according to the interval between the occlusion of the vertebral arteries and bilateral common carotid arteries. The responses including enlarging of pupils and the light reflex during the brain ischemia were observed. The duration of right reflex disappearing, the general state, and the delayed neuronal death (DND) of pyramidal neurons in the CA1 hippocampus of the rats after the brain ischemia were also observed.

RESULTSAmong the global brain ischemic insult group, both the responses and DND were more severe in 72 h interval subgroup than those in 24 h and 48 h interval subgroups. There was no significant difference between 24 h and 48 h interval subgroups. When the bilateral common carotid arteries were occluded under the condition of occlusion of unilateral vertebral artery, severe DND was observed in the CA1 hippocampus ipsilateral to the occluding vertebral artery, but no significant DND was observed in the contralateral CA1 hippocampus.

CONCLUSIONThe results suggested that the prior occlusion of the bilateral vertebral arteries during producing Pulsinelli 4-vessel occlusion global cerebral ischemic model might be a cerebral ischemic preconditioning that could protect to some extent pyramidal neurons of the hippocampus against severe ischemic insult induced by occlusion of bilateral common carotid arteries within 48 h. Moreover, There is ipsilateral predominance of blood perfusion from one side of vertebral artery to the brainstem and hippocampus, although there was Willis artery circle in rats.

Animals ; Brain Ischemia ; prevention & control ; Hippocampus ; blood supply ; Ischemic Preconditioning ; methods ; Male ; Rats ; Rats, Wistar ; Vertebral Artery ; pathology

OBJECTIVETo investigate the safety and feasibility of laparoscopy-assisted total proctocolectomy using medial-to-lateral approach.

METHODSBetween October 2005 and January 2012, 21 consecutive patients underwent laparoscopic-assisted total proctocolectomy by medial-to-lateral approach in Department of General Surgery in Nanfang Hospital. The clinical data and follow-up results were reviewed.

RESULTSTwenty cases underwent laparoscopic resection successfully, and 1 case (4.8%) was converted to open surgery because of serious peritoneal cavity adhesion. The mean operative time was (237.1±64.2) min and intraoperative blood loss was (90.0±77.7) ml. The mean time to first flatus was (2.7±0.8) days. The mean postoperative hospital stay was (11.8±5.7) days. Three patients (14.3%) experienced postoperative complications, including anastomotic leakage (n=1), lymphatic leakage (n=1), and anastomotic stricture (n=1). The median follow-up was 22 months (4-60 months). There were two deaths including one patient died of progressive disease 5 months after surgery and the other died of multiple organ failure.

CONCLUSIONSThe advantages of laparoscopy-assisted total proctocolectomy using medial-to-lateral approach include simplified surgical procedure, clearly revealed surgical plane, and shortened operative time. This procedure is safe and feasible in the experienced department of laparoscopic colorectal surgery.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Proctocolectomy, Restorative ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To understand the changes of skin lesions in population exposed to arsenic through drinking-water in Inner Mongolia after changing water source for 12 years,and to evaluate the long-term harmful effects and the delayed injury to human body due to arsenic exposure and the effect of changing water.Methods The stratified random cluster sampling investigation objects (data derived from the Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention) of the arsenic exposure area before water reform (2004) as the foundation,in 2017,we selected three administrative villages (changed water in 2005) in Bayan Nur City of Inner Mongolia as survey sites.The objects of this study were residents who had been living in the survey site and were eligible for previous survey (n =80,35 males and 45 females).To compare the skin damage of the residents exposed to arsenic before and after the water changed,the water samples of the survey objects were measured arsenic content.According to the content of water arsenic,the respondents were divided into low,medium and high exposure groups (10-,150-,≥300 μg/L),to analyze clinical classification in skin damage before and after changing water.Results The water arsenic content after changing [1.42 (0.18-33.45) μg/L] was lower than those before the changes [238.20 (14.56-824.70) μg/L,Z =-8.34,P ＜ 0.05].A total of 63 persons with skin keratinization,7 persons with hyperpigmentation and 19 persons with depigmentation were identified after the changes of drinking water source,while 38,3 and 18 persons were respectively found before the changes.The detection rate of skin keratinization after water changes was significantly higher than that before water changes [78.8％ (63/80) vs 47.5％ (38/80),x2 =16.78,P ＜0.05].According to the clinical classification of skin damage,23 patients were normal,44 patients were suspicious,10 patients were mild,and 3 patients were moderate or severe after the water changes,compared with those before the water changes (38,18,6 and 18 persons were respectively found),the clinical fractional suspicious detection rate of skin damage in the arsenic exposed population increased,and the medium-severe detection rate decreased,and the differences were statistically significant (x2 =17.80,12.33,P ＜ 0.05).The detection rate of the clinical score of moderate-severe skin damage in men was significantly decreased,and the difference was statistically significant (x2 =7.65,P ＜ 0.05).The normal detection rate of female skin lesions was reduced,and the rate of suspected detection was increased (x2 =5.48,7.65,P ＜ 0.05).In the high-and medium-dose groups,41.9％ (13/31) and 42.9％(12/28) of the arsenic exposure population had a reduced clinical classification of skin damage.The ratios of clinical classification severity of skin damage in the high-,medium-and low-dose groups were 25.8％ (8/31),25.0％ (7/28),and 42.9％ (9/21).The differences were statistical significantly by linear trend chi-square test (x2 =12.96,P ＜ 0.05).Conclusions The skin lesions exposed to arsenic could be effectively improved after changing water.But the skin lesions still appear in some cases due to long-term chronic arsenic exposure.The long-term effects caused by arsenic should be explored persistently.

BACKGROUNDvon Willebrand factor (vWF) mediates the initial capture of platelets to vascular subendothelium and is essential for platelet aggregation under high fluid shear stress as in arterial stenosis. On release from endothelial cells, vWF is rapidly cleaved by ADAMTS13/vWF-cleaving protease (vWF-CP). We investigated the clinical significance of changes in plasma vWF and vWF-CP activities in chronic renal disease.

METHODSPlasma vWF and vWF-CP activities were measured using enzyme-linked immunosorbent assay (ELISA) and residual collagen binding assay respectively in patients with lupus nephritis (n = 31), primary nephritic syndrome (n = 25), diabetic nephropathy (n = 45), chronic glomerulonephritis (n = 38) and 40 normal controls. The relation of their levels with pathological and renal status was analyzed.

RESULTSIn all diseased patients the levels of vWF were significantly higher and vWF-CP activity significantly lower than the controls (both P < 0.01). vWF in the four subgroups did not correlate with the stage of disease but correlated negatively with vWF-CP activity. vWF-CP activity was not changed two weeks after renal transplantation. Renal biopsy demonstrated that the vWF level in stage IV was higher than in stages II and III while vWF-CP activity was lower in patients with lupus nephritis. After eight-week treatment, the vWF level significantly decreased and the vWF-CP activity significantly increased in systemic lupus erythema, disease activity index < 9, but not with index = 9. Even though the vWF-CP activity was significantly lower in membranous nephropathy than in minimal change disease, mesangial proliferative glomerulonephritis or IgA glomerulonephritis, the vWF level was not significantly different.

CONCLUSIONSThe alterations of plasma vWF and vWF-CP activities were associated with different renal pathologies. Injury to endothelial cells and autoantibodies against vWF-CP activity may result in higher vWF level and lower vWF-CP activity in chronic renal disease and thus a mechanism for worsening of chronic renal disease and thrombosis.

ADAM Proteins ; blood ; ADAMTS13 Protein ; Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Humans ; Kidney Diseases ; blood ; Kidney Transplantation ; Lupus Nephritis ; blood ; Male ; Middle Aged ; von Willebrand Factor ; analysis

Adult ; Antiviral Agents ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Male ; Nucleotides ; administration & dosage ; therapeutic use ; Polyethylene Glycols ; administration & dosage ; therapeutic use ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Treatment Outcome ; Young Adult