Objective To explore a new method of functional reconstruction of hand digits and joints with free transfer of foot tissues so as to increase the success rate of the operation.Methods After micro-anatomic study of the plantar and dorsal metatarsal arteries,retrograde and free grafts of foot tissues pedicled with plantar metatarsal arteries were designed and applied in transplantation to treat 76 cases of hand digital or joint defects.The surgeries included 58 cases of transfer of the second toe,four cases of transfer of composite tissues of the second toe, eight cases of transfer of proximal interphalangeal joint,and six cases of nail flap transfer.Results The mi- cro-anatomic study found that the first plantar metatarsal artery was anatomically constant and the diameter of its branch to the second toe was larger than that of the first dorsal metatarsal artery.Flaps survived in 75 of the 76 patients(98.7%),with fine appearance and significantly improved function.One patient who had received free transfer of the second toe to reconstruct the thumb function had to undergo a second repair with infraclavicula skin tube because of refractory arteriospasm of anastomosed vessels.Conclusion Transfer with free retrograde grafts of foot tissues pedicled with plantar metatarsal artery to reconstruct hand functions can effectively improve the success rate of the operation,because it is free of the shortcomings of great anatomic variation of blood vessels and time-consuming and complex procedures in conventional transfer.

Aim To evaluate the potency of anti-D. acutus venom IgY neutralizing the main activities of D. acutus venom.Methods After mixing the different a-mounts of IgY with snake venom and incubating togeth-er,the main activities of snake venom were assayed by biochemical methods.Results The in vitro assays in-dicated that anti-D.acutus venom IgY obviously neu-tralized the activities of PLA2 ,5′-nucleotidase,hyalu-ronidase,metalloprotease and serine proteinase (fi-brinogenase)in D.acutus venom.Mouse experiments showed that the ED50 value of IgY for mouse was 1 131.09 μg.Conclusion Anti-D.acutus venom IgY antibodies have good effects in neutralizing D.acutus venom without the toxicities themselves.

Objective To investigate the relationship between fragmented QRS (fQRS) complex and the early left ventricular remodeling or heart function in patients with acute myocardial infarction(AMI).Methods A total of 76 patients with AMI hospitalized in CCU of the Second Hospital of Tianjin Medical University were enrolled in the study.Patients were divided into fQRS group (n=29) and non-fQRS group (n=47). The clinical data including ECG, laboratory indicators, coronary angiography results and real-time three-dimensional (RT-3D) echocardiography parameter were collected in two groups.The relationship between fQRS and baseline data,fQRS and RT-3D echocardiography parameter were analyzed.At the same time,the influencing factors of left ventricular remodeling and heart function were discussed in the study. Results Compared with non-fQRS group, left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV)were significantly higher,and left ventricular ejection fraction(LVEF)was significantly lower in fQRS group(P<0.05).Several three-dimensional parameters including Tmsv16-SD(%)and Tmsv 16-Dif(%)were significantly higher in fQRS group than those in non-fQRS group(P<0.05).There were no significant differences in Tmsv 16-SD(ms),Tmsv 12-SD(ms),Tmsv 12-SD(%),Tmsv 6-SD(ms),Tmsv 6-SD(%),Tmsv 16-Dif(ms),Tmsv 12-Dif(ms),Tmsv 12-Dif(%),Tmsv 6-Dif(ms)and Tmsv 6-Dif(%)between two groups.Logistic regression analysis showed that fQRS and Gensini scores had effects on heart function.At the same time,fQRS was an independent predictor for left ventricular remodeling. Conclusion Left ventricular remodeling is more obvious in patients with acute myocardial infarction complicated with fQRS,and fQRS can predict left ventricular remodeling better.

Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

Human lymphocyte antigen (HLA) is the most complicated human dominant polymorphic genetic system. Accurate HLA genotyping is clinically important for hematopoietic stem cell (HSC) transplantation, also important for research on many human diseases. Polymerase chain reaction-sequence based typing (PCR-SBT) provides the highest resolution level and defines new alleles, so it is widely used for HLA typing. One great disadvantage of PCR-SBT method is the fact that it cannot resolve sequences of heterozygous samples in diploid genomes, leading to ambiguous typing results which make much trouble to the accurate definition of HLA genotype. This article reviewed the occurring reasons and solution method of ambiguous allele combinations in the HLA high resolution genotyping as well as the research prospect in this field.
Genotype ; HLA Antigens ; genetics ; immunology ; Histocompatibility Testing ; Humans

The aim of this study was to investigate the genetic polymorphism of Y-chromosome specific short tandem repeat (Y-STR) loci in Zhuang ethnic group of China. Nine Y-STR loci were amplified by single multiplex and the PCR products were detected by using ABI Prism(TM) 3100 DNA Sequencer. The allele frequencies and haplotype frequencies at 9 Y-STR loci were determined in a total of 85 unrelated male individuals from Zhuang ethnic group of China. The results indicated that in the 85 unrelated male individuals, except for the DYS426 locus with a low GD value, the GD values for other 8 Y-STR loci ranged from 0.4387 to 0.8129. A total of 70 haplotypes at 9 Y-STR loci were found, the haplotype diversity was 0.9926. It is concluded that the haplotype polymorphism of 9 Y-STR loci are highly polymorphic in Zhuang ethnic group and also significantly different from our previous reported data of unrelated male individnals in southern Chinese Han population.
Alleles ; China ; ethnology ; Chromosomes, Human, Y ; genetics ; Genetic Loci ; genetics ; Humans ; Male ; Microsatellite Repeats ; genetics ; Polymorphism, Genetic

Blast injury is the main cause of injury in the battlefield, which also occurs frequently in the civil field and modern society. The damage caused by blast is more complicated than other types of trauma. Primary blast injury is a common type of blast injury, which can cause multiple organ damage with complex mechanism. Tissue and vascular endothelium damage and organ hypoperfusion are the consistent manifestations of most organ damage. However, due to the concealed damage caused by the primary blast injury, it is difficult to recognize it in time. The study of coagulation function and acid-base balance change after primary blast injury can bring benefits to its early diagnosis and intervention, thus improving the prognosis and mortality of blast injury. However, at present, the research on primary blast injury mostly focuses on single organ damage. Lack of research on systemic coagulation and acid-base balance changes calls for further research. Such research has a practical significance for the early diagnosis and optimization of tactical care for primary blast injury. This article reviews the injury characteristics, epidemiology, mechanism and the relationship with trauma-induced coagulopathy (TIC) in primary blast injury to provide reference for related researches.

Objective:To investigate the histone acetylation of interleukin-4(IL-4) gene and its roles in immunological pathogenesis of Kawasaki disease (KD).Methods:Thirty-six children with KD and 28 age-matched healthy children in Shenzhen Children′s Hospital from October 2016 to December 2018 were recruited in this study.Peripheral venous blood samples were collected from healthy controls (28 cases) and patients with KD during acute phase and 4 to 5 days after effective intravenous immunoglobulin (IVIG) treatment.Co-immunoprecipitation followed by real-time PCR was used to assess histone H4 acetylation levels of IL-4 promoter and Va enhancer, and binding abilities of p300 and CREB-binding protein (CBP) with promoter and Va enhancer of IL-4 gene in peripheral blood CD4 + T cells.Flow cytometry was performed to analyze the proportion of CD4 + IL-4 + T cells (Th2) and protein le-vels of phosphorylated signal transducer and activator of transcription 6 (pSTAT6), GATA binding protein 3 (GATA3), nuclear factor 1 of activated T cells(NFAT1), transforming growth factor-β receptor Ⅱ (TGF-βRⅡ), and phosphorylated L-type amino acid transporter 1(pLAT1). Quantitative real-time PCR was used to evaluate the transcription levels of IL-4, IL-5, IL-13, IL-4 receptor α (IL-4Rα), transforming growth factor-β receptor Ⅰ (TGF-βRⅠ) and sex-determining region Y(SRY)-box 4 (SOX4) in CD4 + T cells.Plasma concentrations of IL-4 and transforming growth factor-β(TGF-β) were measured by enzyme-linked immunosorbent assay. Results:(1)Compared with control group, the proportion of Th2 cells, expression levels of Th2-associated cytokines (IL-4, IL-5 and IL-13) and histone H4 acetylation levels associating with IL-4 promoter and Va enhancer, increased remarkably during acute KD(all P<0.05), and restored after IVIG therapy(all P<0.05). Meanwhile, all the former items in KD patients with coronary artery lesions (CAL) were higher than those in patients with non-coronary artery lesions (NCAL) (all P<0.05). (2) Compared with control group, binding abilities of p300 and CBP with IL-4 promoter and Va enhancer in CD4 + T cells were up-regulated significantly during acute KD (all P<0.05), and decreased in varying degrees after IVIG treatment (all P<0.05). Positive correlations between binding abilities of p300 with IL-4 (promoter and Va enhancer) and the expression of IL-4 promoter and Va enhancer were detected in patients with acute KD ( r=0.72, 0.43, all P<0.05). Furthermore, binding abilities of p300 and CBP with IL-4 promoter and Va enhancer in CAL group were higher than those in NCAL group (all P<0.05). (3) Compared with control group, patients with acute KD had remarkably increased plasma concentration of IL-4, and expression levels of IL-4Rα/STAT6/GATA-3 and pLAT1/NFAT1 in CD4 + T cells (all P<0.05), and significantly down-regulated plasma concentration of TGF-β and expression level of TGF-βRⅡ/TGF-βRⅠ/SOX4 (all P<0.05). All the items mentioned above restored in varying degrees after IVIG treatment (all P<0.05). Simultaneously, the 6 items aforementioned in CAL group were found to be higher than those in NCAL group (all P<0.05), while the latter four items were lower than those in NCAL group (all P<0.05). Conclusion:Histone hyperacetylation of IL-4 gene may be related to immune dysfunction in patients with KD.

Objective To investigate the relationship between ultrafiltration rate (UFR) and cardiovascular death in maintenance hemodialysis patients.Methods This retrospective study observed adult hemodialysis patients treated in Kidney Disease Center,the First Affiliated Hospital,College of Medicine,Zhejiang University during January 2010 to December 2015 and the follow-up were finished at April 2017.Patients were averagely divided into 3 groups according to their UFR.Their clinic characteristics were collected,the survival rate and death related factors were analyzed by Kaplan-Meier (Log-rank test) method and Logistic regression.Results Totally 2184 patients (male 1370,62.7％) were enrolled,the age was 53.39±16.47.The UFR was (8.88±3.05) ml·h-1· kg-1.During the 7 years’ follow-up,168 patients died,of whom 58 cases (34.5％) died due to the cardiovascular events.Chi-square test showed that there were significant differences in death causes among the high,middle and low UFR group (x2=12.584,P ＜ 0.01),and the mortality rate of cardiovascular events in high UFR group was significantly higher than that in low (x2=10.861,P=0.010) and middle UFR group (x2=4.671,P=0.031).Kaplan-Meier survival curve showed that the difference of the survival rates in the 3 groups was statistically significant (Log-rank test x2=23.394,P ＜ 0.001).Cox regression analysis showed that high UFR (UFR≥10.95 ml· h-1· kg-1),old age (＞ 60 years old),and low left ventricular ejection fraction (LVEF,≤50％ were independent risk factors of cardiovascular death.Conclusions High UFR level,old age and low LVEF are independent risk factors of cardiovascular death in hemodialysis patients.Maintaining low UFR level is beneficial to reduce cardiovascular mortality in hemodialysis patients.

OBJECTIVES(1) To evaluate the prevalence, phenotypes and suppressive function of CD4+CD25+ regulatory T cells (Tregs) among the in peripheral blood mononuclear cells (PBMCs) and tumor-infiltration lymphocytes (TILs) from hepatocellular carcinoma (HCC) patients and patients with chronic hepatitis B. (2) To investigate the correlation between the frequency of CD4+CD25+ Tregs and clinical characteristics of HCC patients.

METHODSPBMCs and TILs in 18 HCC patients, 10 chronic hepatitis B (CHB) patients and 15 healthy donors were evaluated for the phenotypes of CD4+CD25+ Tregs and the proportion of CD4+CD25+ Tregs as a percentage of the total CD4+ cells, by flow cytometric analysis with three or four color staining. The relationship between the frequency of CD4+CD25+ Tregs and tumor TNM stages was analyzed. The CD4+CD25+ Tregs and CD4+CD25- T cells were isolated from PBMC of HCC patients and donors. The suppressive function of CD4+CD25+ Tregs was analyzed.

RESULTSThe percentages of CD4+CD25+ Tregs of the HCC patients (6.38% +/- 6.30%) and CHB patients (4.29% +/- 1.82%) were significantly higher than those of the healthy donors (1.58% +/- 0.55%, P less than 0.01). Among the TILs, the percentage of CD4+CD25+ Tregs was higher (t = 4.39, P < 0.01). There were significant differences in the prevalence of CD4+CD25+ Tregs in early and advanced stage HCCs (stage II vs. III, P less than 0.05; stage II vs. IV P < 0.01). The proliferative capacity of CD4+CD25- T cells was inhibited by the presence of CD4+CD25+ T cells in a dose-dependent manner where the level of suppression was correlated to the ratio of the two-cell populations.

CONCLUSIONThese results suggest that the increase in frequency of CD4+CD25+ Tregs might play a role in the suppression of the immune response against HCC, which may contribute to the HCC cells that escaped from immunological surveillance.

Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; Female ; Humans ; Interleukin-2 Receptor alpha Subunit ; Liver Neoplasms ; metabolism ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; immunology ; Young Adult