Objective To explore the clinical application of sural neurovascular flap with anastomosing small saphenous vein to be transferred distally for repairing soft tissue defect of the leg.Methods Seven patients with soft tissue defects in the distal one third of anterior tibia,the foot dorsum,the heel or the ankle were treated with the distally based sural neurovascular flap with anastomosing small saphenous vein.The size of the flap ranged 8 cm?6 cm ~ 18 cm?10 cm.Results The flaps survived in all the 7 patients,with excellent color and texture.Their appearance and function were satisfactory during 6~40 months of follow-up. Conclusions Use of distally based sural neurovascular flap with anastomosing small saphenous vein is reliable.The performance is simple.This flap has a rich blood supply without the sacrifice of major arteries.Venous blood reflux was unobstructed.It can be used for the reconstruction of soft tissue defects in the distal one third of anterior tibia,the foot dorsum,the heel or the ankle.

Objective To discuss the feasibility of double-low technique applied in aortic MSCTA.Methods Totally 70 patients with BMI not more than 25 kg/m2 were divided into a routine group and an experimental group randomly and equally,and then went through aortic MSCTA.Iohexol (350 mgI/ml) was injected with the velocity of 4 ml/s.The routine group had the parameters as 120 kV,120 mAs and 1.5 ml/kg contrast agent,and the experimental group had the parameters as 90 kV,120 mAs and 1.0 ml/kg contrast agent,while the other scanning parameters were kept the same in the two groups.The radiation doses,contrast agent doses and iodine contents were recorded in the two groups,and the image quality was assessed with double-blind method objectively and subjectively.Results The experimental group had the CT dose index volumes (CTDIvol),dose length product (DLP) and effect dose (ED) significantly lower than those in the routine group (P＜0.05).The two groups had the consistency of subjective scores (Kappa＞0.6) and image quality scores (not lower than 2) meet the desired requirements,and there were no significant differences between the scores (P＞0.05).Objective evaluation showed that the signal values of aortic trunk and major branch vessels as well as image noise SD of the experimental group were obviously higher than those in the routine group (P＜0.05).There were no statistical differences between the signal noise ratios (SNR) and contrast to noises (CNR) in the two groups (P＞0.05),The iodine content in the contrast agent of the experimental group was significantly lower than that in the routine group (P＜0.05).Conclusion Double-low technique applied in aortic MSCTA of the patient with BMI not more than 25 kg/m2 reduces the radiation dose and iodine content in the contrast agent,has the image quality meet the desired requirements,and thus is of great value for clinical application.

Objective To investigate the effect of endovascular cooling on perioperative brain injury in patients undergoing intracranial aneurysm resection.Methods Sixteen Hunt-Hess Ⅱ -Ⅳ patients of both sexes aged 18-64 yr undergoing intracranial aneurysm resection were randomly divided into 2 groups(n = 8 each): mild hypothermia group(group MHT)and nonnothermia group(group NT).A CL-2295AE catheter was placed in the femoral vein after anesthesia induction to perform endovascular cooling.Bladder temperature was reduced to 34 ℃ and maintained for 24 h.The hemodynamic parameters were recorded during and after operation.Coagulantion function and electrolyte levels were determined at 24 h before operation and at 12 and 24 h after operation.The serum neuron-specific enolase(NSE)and S100B concentrations were determined at 1 d before operation and at 1,3and 7 d after operation by ELISA.Neurological function was assessed with GOS grade at 1 and 3 months after operation.Results There was no significant difference in hemodynamic parameters,electrolyte levels(Na+ ,K+ ,Ca2+)and coagulantion function(PT,APTT,Plt)between the two groups(P ＞ 0.05).The GOS grade was significantly higher,while serum NSE and S100B concentrations were significantly lower after operation in group MHT than in group NT(P ＜ 0.05).Conclusion Endovascular cooling(34℃,24 h)can reduce the brain injury safely and effectively during the perioperative period in patients undergoing intracranial aneurysm resection and improve the prognosis.

Objective Genotype data of nine CODIS STR loci were gathered to examine the features of population differentiation and gene flow of seven Xinjiang minorities.Methods Heterozygosity,Nei's coefficient of genetic differentiation,Nei's genetic distance and Wright's F-statistics were calculated. Statistical tests using exact method were performed to measure the level of differentiation.Phylogenetic trees were constructed by Mega;AMOVA was processed by Arlequin.R-matrix model had been applied to describe the patterns of gene flow.Results It shows that average genetic heterogeneity for each population was above 0.7 with genetic differentiation coefficient below 2%.Statistical tests for population differentiation were significant for most of the loci.Phylogenetic analysis and AMOVA showed that all populations were divided into three main groups.The R-matrix analysis reflected that Uygur,Kirgiz and Ozbek had more amounts of gene flow than other populations,while the pattern of Hui was more isolated.Conclusion The seven minorities in Xinjiang are independent populations,while the level of differentiation is at average.The relationship in evolution is not far from each other,with wide gene flow.

BACKGROUND: Type Ⅰ collagen is a specific collagen secreted by in vitro cultured osteoblast, and the formed network is the basis of bone mineralization, which also reflects the ability of osteoblast bone formation. Studies have shown astragalus root increased osteoblast proliferation. However, the effect of astragalus root on improving type Ⅰ collagen expression of osteoblast remains poorly understood.OBJECTIVE: To evaluate the effect of astragalus root injection on the abilities of rat cranium-derived osteoblast proliferation and type Ⅰ collagen expression.METHODS: Rat osteoblast was cultured in vitro and divided into control group (MEM culture solution containing calf serum) and astragalus root groups (different concentrations). The effect on osteoblast proliferation was evaluated on days 1, 3, 5, 7, and 9 by MTT method. Moreover, the expression of type Ⅰ collagen protein was observed after 6 hours of treatment with astragalus root injection using in cell western-blot method. In addition, the gene expression of COLLal was investigated by real-time PCR method.RESULTS AND CONCLUSION: From days 3 to 9, the different concentrations of astragalus root injection improved osteoblast proliferation, respectively compared with control group (P ＜ 0.05), and this ascending trend peaked on day 7. Different concentretions of astragalus root injection improved COLLol mRNA expression, especially 15% astragalus root injection was the most effective. The type Ⅰ collagen protein expression of 15% and 10% astragalus root injection were significantly greater compared with the control group (P ＜ 0.05). Astragalus root injection improved in vitro cultured osteoblast proliferation and type Ⅰ collagen secretion in a certain dose-effect manner.

Objective To strengthen the understanding of the imaging features in congenital aberrant left pulmonary artery (CALPA). Methods All 4 patients underwent chest film and Doppler echocardiography. Thres cases were examined by enhanced spiral CT examination. In addition, MRI and DSA were performed in 2 cases respectively. Thres cases were proven by surgery or autopsy. Results (1) appearances on chest films included cardiomegaly, pulmonary overvascularity, left hilum a little lower than the right one, emphysema, atelectasis, and pneumonia. (2) bronchography showed stenosis of trachea and/or bronchia. (3) Barium esophagram showed an imprint on the left anterior wall of esophagus. (4) Contrast-enhanced spiral CT and MRI showed marked dilatation of main pulmonary artery (MPA) and the root of MPA extended backward to become right pulmonary artery (RPA), the left pulmonary artery (LPA) arose from the RPA directly. (5) echocardiography indicated LPA arose from RPA. (6) DSA showed MPA was marked dilated, and LPA arose from RPA. (7) other abnormalities included 3 PDA, 2 PLSVC, and ~1 ASD. Conclusion CT and MRI are the best methods to diagnose CALPA.

Radiomics is an emerging tumor diagnosis and auxiliary detection technique that has undergone rapid development in the past few decades.The availability of new imaging equipment and reagents, as well as the use of standardized imaging protocol, has made quantitative and standardized imaging analysis possible.Radiomics is a field of study that involves the extraction of a large number of quantitative features from areas of interest in medical images using data-characterization algorithms, and transformation of these data into first-order or high-order data.The accuracy of clinical diagnosis and prognostic value of radiomics can be further improved by analyzing the relationship between data layers.Although radiomics has many advantages and has made great progress, its standardization, reliability, and application in large data and multicenter studies will need to be further optimized.

The classical prescriptions in Typhoid Miscellaneous Disease can be used to alleviate the common hung cancer symptoms and complications like fever, cough, pain and pleural effusion effectively. The preoperative medication can improve lung cancer patients’ surgical tolerance, and postoperative medication can facilitate patients’ postoperative rehabilitation. And if combined with chemotherapy, they cound reduce toxicity and enhance efficiency, enhance the patients’ immunity and improve their life quality. Research shows that classical prescriptions can improve the immunity of lung cancer model mice, facilitate apoptosis of tumor cell and control its migration. This paper sumed up the clinical and experimental research of lung cancer treatment with classical prescriptions in recent 5 years.

Objective To investigate the effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with intensified conditioning regimen followed by rapidly tapering immunosuppressants and sequential minimal residual disease (MRD)-guided donor lymphocyte infusion (DLI) post-transplantation on outcome of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods Two cases of BPDCN from January 2009 to May 2011 in Nanfang hospital were diagnosed according to 2008 WHO classification of tumours of haematopoietic and lymphoid tissues.Case 1 initially presented with typical cutaneous involvement and was promptly diagnosed with CD+4CD+56LCA+TdT+CD+43 BPDCN by skin biopsy.Case 2 was recognized as acute lymphocyte leukemia and acute non-lymphocytic leukemia,which was diagnosed to BPDCN at recurrence through flow cytometry analysis.Total-body-irradiation plus cyclophosphamide based intensified conditioning regimen were followed by allo-HSCT from sibling donor.Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate.Anti-thymocyteglobulin was included additionally for haploid donor allo-HSCT.Multi-color labeling flow cytometry was performed to monitor MRD.Rapidly tapering of prophylactic immunosuppressants and sequential MRD-guided donor lymphocyte infusion (DLI) were performed to control relapse of primary malignancy.Results Two cases of BPDCN received allo-HSCT from sibling donor after intensified conditioning regimen.Both patients achieved complete remission and complete donor engraftment.Case 1 survived refractory acyclovir-resistant Epstein-Barr virus viremia benefiting from preemptive treatment with rituximab and DLI-induced grade Ⅳ acute GVHD,but died of thrombotic microangiopathy mixed with diffuse alveolar hemorrhage and sepsis on +243 days.Case 2 relapsed just 2 months after allo-HSCT despite DLI and rapidly tapering of CsA,died of sepsis followed by diffuse intravascular coagulation on +101 days.Conclusion BPDCN is characterized with typical cutaneous and/or bone marrow involvement with CD4+CD+56CD+123CD+43 blastic plasmacytoid dendritic cell and highly aggressive clinical course.Allo-HSCT seems to be a promising treatment for early phase of aggressive BPDCN aided with MRD monitoring and DLI,but it deserves more intensive researches to promote outcome of advanced staged BPDCN.

Objective To study the clinical features and treatment of 12 cases of lupus vulgaris.Methods A comprehensive study was performed on 12 patients with lupus vulgaris.The clinical and histopathological features,misdiagnosis,treatment and prognosis of this entity were analyzed.Results Of these patients,83.3％ had a history of local trauma before the occurrence of lupus vulgaris.All the patients showed an early onset and long clinical course of lupus vulgaris,absence of obvious symptoms and variety in skin lesions.Lupus vulgaris was misdiagnosed at the first visit in all the patients.The final diagnosis was confirmed by histopathology,purified protein derivative (PPD) test,acid-fast staining,Mycobacterium tuberculosis culture,DNA sequencing,etc.Satisfactory outcomes were achieved in these patients after standard anti-tuberculosis treatment.Conclusions Lupus vulgaris is easy to be misdiagnosed and improperly treated due to its complicated clinical features.Clinicians should expand their knowledge about this entity,which can be diagnosed by histopathology and culture.