Objective To observe the effects of multidisciplinary therapy on central pain of patients with spinal cord injury.Methods 32 cases of spinal cord injury with central pain were treated with accupuncture, massage and drugs, and the effects were assessed by McGill Pain Questionnaire (MPQ), Visual Analogous Score (VAS) and Barthel Index (BI).Results The scores of pain of all patients significantly decreased and the scores of BI highly increased after treatment (P<0.01).Conclusion Multidisciplinary therapy is effective on central pain in patients with spinal cord injury.

Objective To study the effects of XiaoAiping (XAP) with different concentrations and action time on the proliferation and apoptosis of hepatocellular carcinoma cells Hepa1-6. Methods The hepatocellular carcinoma cell line Hepal-6 was treated with XAP at doses of 30 mg/ml(the high concentration group), 20 mg/ml (the moderate concentration group) and 10 mg/ml (the low concentration group) for 24 h, 48 h and 72 h, respectively. The MTT assay was used to detect the inhibitory effects of XAP on cell growth. The cell morphological alteration was observed after HE staining, and the apoptosis rates were assayed by flow cytometry. Results XAP produced an obvious time-and-dose-dependent inhibitory effect on the Hepa1-6 cells (P<0.01), and the cell differentiation trend was benign on light microscopy. After 48 h Hepa1-6 cells were incubated by XAP, there was an apoptosis peak, and the apoptosis rate was increased statistically in XAP group with the increasing XAP concentration [(7.65±0.40)%, (11.26±1.09)% and (26.71±0.85)% in low, moderate and high concentration group, respectively]compared with that in the controls (2.88 ±0.30)%, P < 0.01). Conclusion XAP produced obvious time-and-dose-dependent inhibitory effects on Hepa1-6 cells. Inhibiting DNA synthesize and inducing apoptosis of tumor cells may involve in the mechanisms of antineoplastic effect.

Objective The High-performance thin-layer(HPTLC) chromatographic fingerprint of Saikosaponin from Chaihu(roots of Bupleurum chinense DC.) was established and fingerprints similarity of different species of Bupleurum spp.were evaluated.Methods High-performance thin-layer chromatography(HPTLC)were carried out.The chromatographic conditions were as follows:pre-coated HPTLC silica-gel plate as stationary phase,dichloromethane-methanol-ethyl acetate-water(30:40:15:3) as mobile phase(solvent system) and 2 %p-DMBA/10 %Sulfuric acid alcoholic solution as derivatization reagent.The common pattern of HPTLC fingerprints were obtained through’Chromafinger’solution software,and authentication and quality assessment were analyzed by similarity and Principle Component Analysis.Results The common pattern of the roots of Bupleurum chinense DC.consists of 19 characteristic peaks,and higher similarities existed between the roots of Bupleurum chinense DC(Bei Chaihu),B.falcatum(San-dao Chaihu) and B.scorzonerifolium Willd.(Nan Chaihu),but Nan Chaihu contains much lower total saponins than that in Bei Chaihu.The other species of Bupleurum demonstrated their different chemical distribution.The toxic species of B.longiradiatum can be easily differentiated from other spp.by comparison with the HPTLC images.Conclusion The survey showed that the main commodities of’Chaihu’in the domestic market can be attributed to’Bei Chaihu fingerprint-pattern’.The toxic species of B.longiradiatum can be easily differentiated from other spp.by comparison with the HPTLC images.

Objective To investigate the effect of core stabilization exercises( CSE) on knee osteoarthritis. Methods Sixty cases patients with knee osteoarthritis were randomly divided into treatment group (n = 30)and control group(n = 30). Patients in control group were accepted conventional therapy including conventional physiotherapy,acupuncture,and massage,while in treatment group were accepted CSE besides conventional therapy. All patients were assessed with Lysholm Knee Scoring Scale(LKSS)and Visual Analogous Scale(VAS)before and after treatment. Results VAS in treatment group before and after treatment were(8. 31 ± 1. 16)and(3. 37 ± 0. 97),and the difference was statistically significant( t = 16. 30,P = 0. 00). VAS in control group before and after treatment VAS were(8. 26 ± 1. 22)and(5. 06 ± 0. 82),and the difference was statistically significant( t = 12. 19,P = 0. 000. VAS in two groups after treatment was statistically significant (t = - 6. 98,P = 0. 00). LKSS in treatment group before and after treatment were(32. 92 ± 4. 21),(60. 19 ± 4. 42),and the difference was statistically significant(t = - 30. 44,P = 0. 00). LKSS in control group before and after treatment was(34. 82 ± 5. 58),(53. 49 ± 3. 66),and the difference was statistically significance (t = - 14. 82,P = 0. 00). After the treatment,LKSS in the two groups was significant difference(t = 7. 16,P= 0. 00). Conclusion The core stability training can improve the patients with knee osteoarthritis of knee joint function,relieve pain.

Objective To discuss the technical feasibility and clinical effectiveness of using complex tissue flap pedicled with inferior gluteal artery perforator for repair giant sacrococcygeal pressure sore.Methods Thirty embalmed lower limbs of adult cadavers perfused with red latex were used for anatomical study,and the followings were observed:①The course,branche and distribution of gluteal artery.②The course and distribution of the posterior femoral cutaneous nerve.③Anastomosis between the posterior cutaneous branch of gluteal artery and nutrient vessels of the posterior femoral cutaneous nerve.8 cases aging from 17 years to 56 years were completed during May 2007 to July 2013,6 cases were males and 2 cases were females.The sizes of pressure sore with the depth to Ⅳ degree were ranged from 16 cm × 9 cm to 22 cm × 10 cm.The sizes of flaps were harvested from 32 cm × 10 cm to 25 cm × 9 cm.Results The gluteal artery crossed the edge of the piriformis,the main stem was (3.1 ± 0.4) mm in diameter and gave out 2-5 muscular branches to supply the gluteus maximus.The posterior femoral cutaneous nerve crossed the edge of gluteus maximus and descended between biceps femoris and semitendinosus.Perforating deep fascia point located was (5.9 ± 0.8) cm above the line between medial and lateral femoral epicondyle.The constant anastomosis were formed by the posterior cutaneous branch of gluteal artery,the obturator artery perforator and the direct popliteal artery perforator around the posterior femoral cutaneous nerve.The complex flap survived successfully in all patients.Sutures were removed at 14 days postoperatively and the wounds healed well.All supplied areas were closed by directly suturing.Recurrent sacrococcygeal pressure sore was not observed in all cases with satisfied appearance and normal color during the outpatient follow-up period from 5 months to 5 years.Conclusion The united flap of gluteal myocutaneous flap and the posterior femoral cutaneous neurovascular flap pedicled with inferior gluteal artery perforator can be used to primary repair giant sacrococcygeal pressure sore.Rich blood supply,simple operation technique and high rate survival rate was considered as advantages of the flap.The lower recurrence of pressure sore was due to nice wear resisting with rich layer of anatomical structure in the flap and strong ability of anti-infection.The clinical effect was satisfied.

Objective To provide anatomical basis for transposition for the periosteal flap pedicled with the lateral anterior malleolus vessel on the anterior external of tibia distally based. Methods The origins, course, branches distribution, and anastomosis of lateral anterior malleous artery and periosteal vessels of the anterior external of tibia distally based were observed on 30 adult cadaveric feet. Results Lateral anterior malleolus arteies had 1～2 branches, whose diameters were(1.6?0.4)mm and the distances the above cusp of extrnal malleolys cusp were(1.1?0.4)cm, the arteries sent off the 1～3 pieces periosteum branches with diameter 0.4 to 0.8 mm, which distribute to the periostalr of anterior external of tibia distally based. To circulate anterior external of lateral malleouls of perforating descending branch of peroneal artery [the distances the above cusp of external malleolys cusp were (5.6?0.5)cm],the arteries sent off the 2～6 pieces periosteum branches with diameter 0.5 to 1.0 mm, which distributed to the periostealr of anterior external of tibia distally based and lateral malleolus. Both anastomosis site in the above cusp of external malleolys cusp were(1.7?0.6)cm, the distances the point of lateral anterior malleolus artery were(2.5?0.6)cm. The artery of anastomosis to undergo posterior of extensor digitorum brevis, along anterior border of tendon of short peroneal muscle, anastomosed with the lateral tarsal artery and the medial taesal atery. Conclusion It is an easy practical for repairing fracture of neck of talus fracture and ischemic necrosis of talus body to achieve the transposition of periosteal flap pedicled with the lateral anterior malleous vessel on the anterior external of tibia distally based.

Objective To provide anatomic basis for transposition of vascularized radial midforearm flap. Methods On 40 adult cadaveric upper limber specimens injected with red dye, the origin, course, branchs, diameters and anastomosis of intermuscular branch of radial artery and its cutaneous branch were observed. Results Originating from radial artery, intermuscular branch of radial artery descended along periosteum closely between pronator teres and supinator, the main stem was (4.8?1.0) cm in length and (1.2?0.2) mm in diameter. After its periosteal branches were sent off to distribute over middle and inferior shaft of radius, its eutaneous branch perforated from intermuscle and deep fascia and anastomosed with some other cutaneous branches in the forearm. Perforating point of the cutaneous branch was located(11.1?1.3) cm beneath laleral epicondyle of humerus, its diameter was about(0.6?0.1)mm. Conclusion Radial midforrarm flap pedicled with intermuscular branch of radial artery can be transferred to repair soft tissue defect of elbow, forearm or hand.

OBJECTIVETo investigate the morphological features of the perforator from the first plantar metatarsal artery, so as to provide anatomic basis for the reconstruction of soft-tissue defects of the forefoot.

METHODSThe first metatarsophalangeal joint was chosen as the landmark on 30 human cadaveric feet prefused with red latex. The following contents were observed under surgical magnifier: (1)The origin, courses,branches,distribution of the perforator of the first plantar metatarsal artery; (2)The anastomoses among the perforator of the first plantar metatarsal artery and other arteries on the medial aspect of the foot. Simulated operation was performed on one fresh specimen.

RESULTSThe perforator of the first plantar metatarsal artery passed through the space between the tendon, the abductor hallucis and the first metatarsal bone, and its entry point into the deep fascia was located (2. 3 ± 0.7 ) cm proximal to the first metatarsophalangeal joint. The perforator anastomosed with either the medial tarsal artery, the medial anterior malleolus artery or the branch of the medial plantar artery on the superior margin of the abductor hallucis, forming a longitudinal arterial chain,through which small branches were given off to the skin of the medial aspect of the foot. The perforator was( 1. 1 ± 0.2) mm in diameter and(3.2 ± 0.2) cm in length.

CONCLUSIONThe flap based on the perforator of the first plantar metatarsal artery can be harvested as an axial flap to repair the defects of soft tissue on the forefoot.

Anatomic Landmarks ; anatomy & histology ; Arteries ; anatomy & histology ; Cadaver ; Foot ; Foot Injuries ; surgery ; Humans ; Metatarsal Bones ; blood supply ; Metatarsophalangeal Joint ; anatomy & histology ; Muscle, Skeletal ; anatomy & histology ; Perforator Flap ; blood supply ; Reconstructive Surgical Procedures

Objective To establish a mouse ’ s cross-territory ear flap that enables chronic , in-vivo observation of the change of vascular morphology .Methods 30 ICR mice, weighing 25~40 g, were used for this study .Commercial depilatory cream was used to first remove the hair of the mice , after which the vascular pattern in the ears was investigated . According to the observation of the vascular pattern in the mouse ’ s ear, the eye scissors were used the sever the outer 2/3 of the base of the ear , in which process a ear ’ s flap based on a vascular pedicle but crossed three vascular territories was created.After the creation of the flap , the mice were placed on an automatic controlled movable machine with the ear ’ s flaps spread over a customized Plexiglas .Then the flaps were photographed under the stereoscope ( ×25) at the following time points:1,2,3,5,7,10,14,21,30 d.the necrosis of the flap, and the morphological change of the vessels within theflap were analyzed .Results The ICR mouse ’ s ear was supplied three angiosomes , which were respectively named as the cephalic , median and caudal angiosomes from inside out .Five days after the flap’s creating, necrotic rate of(15 ±7)%was developed .The choke vessels between the medial and median angiosomes expanded rapidly in diameter , reaching the plateau 10d after flap creation, resulting the dilated choke veins and arteries at their peak being 3.9 ±0.5 and 3.5 ±0.7, respectively, than their initial sizes.The diameter of the choke veins began to shrink at approximately 10d, stabilizing after 21d.The diameter of the choke arteries plateaued and stabilized at around 10d.Conclusion ①after harvest of extended flap, the dilation of veins seemed to passive , whereas the dilation of arteries seemed to active;②the number of the choke vessels between the dynamic and potential territories that are involved in dilation and extent of the dilation are much smaller than that of the choke vessels between the anatomic and dynamic territories;③the mouse ’ s ear flap is an excellent model of further study of mechanism underlining the dilation of choke vessels and for the screening of vasoactive drugs that augment the survival of the large flap .

Purpose To investigate the clinicopathologic characteristics, differential diagnosis, treatment and prognosis of differentia-ted-type vulvar intraepithelial neoplasia ( dVIN) . Methods Clinicopathologic findings and immunophenotypes of 6 cases diagnosed as“dVIN” were retrospectively analyzed, and the relevant literatures were also reviewed. Results 6 patients were all female ranged 53~80 years old with mean age of 62 years old. Clinical aspects included leukoplakia vulvar, pruitis, irritation, pain, ulcer and so on. The histopathological features were hyperplasia of basal and parabasal layer with elongation and anastomosing reteridges. Cells were marked atypia with obvious nucleoli, atypical mitosis, and dyskeratosis. In the middle and surface layer, cells were well differentiated with pronounced intercellular bridges, and eosinophilic cytoplasm, hyperkeratosis and parakeratosis. Oedema and band of infiltration of chronic inflammatory cells of subepidermal could been seen. Immuohistochemistry showed the expression rates of p53 and p16 in totally 6 cases were 83. 3% (5/6), 0 (0/6), respectively. The Ki-67 index was more than 90% in basal and parabasal cells. Four patients were followed up ( mean follow-up 17 months, range 6~36 months) , one patient died at 9 months later after surgery, another patient recurred at 6 months later after surgery, both of the 2 cases were all with invasive lesions after resection, and the rest two cases had no recur in 18 months and 36 months after surgery, respectively. Conclusion dVIN is a high grade squamous intraepithelial lesions of vulvar with low incidence rate, but had more risk of progression. p53, p16 and Ki-67 stain were useful in the diagnosis of dVIN.