OBJECTIVE:To study the pharmacological action of Qiweikaixin Granules.METHODS:Brain injured-olfac?tory bulb damage type was adopted,and the rats were divided into normal control group,pseudo-operation group,model group,hydrochloric acid clomipramine group and Qiweikaixin Granules(high,moderate,mild dosage)group,the behaviors of each group was observed,the contents of adrenocorticotrophic hormone corticotrophin(ACTH)and cortisol(COR)in plasma were also observed.RESULTS:In both the open field test and the heliophobic test,the behaviors of the model group had obvious changes;both the Qiweikaixin Granule group and the hydrochloric acid clomipramine group significantly resisted the change of behaviors of rats;the contents of ACTH and COR in the plasma of the model rats group increased significantly(P

Objective To study the therapeutic mechanism of Polygonum cuspidatum extract on the gouty arthritis induced by monosodium urate (MSU). Method Acute gouty arthritis rats model was induced by MSU. Twelve hours after modeling,the positive expression area and integral optical density of intercellular adhesion molecule-1 (ICAM-1) and nuclear factor-?B p65 protein (NF-?Bp65) in synovial membrane were observed by immunohistochemical assay. The effect of Polygonum cuspidatum extract on ICAM-1 and NF-?Bp65 was observed. Results There existed less expression of ICAM-1 and NF-?B p65 protein on synovial membrane in the normal group,and their expression was much increased in the model group. Polygonum cuspidatum extract in the dose of 360 mg/kg significantly reduced the positive expression area and integral optical density of ICAM-1 and NF-?Bp65 protein. Conclusion Polygonum cuspidatum extract can inhibit the abnormal expression and activation of ICAM-1 and NF-?Bp65 in synovial tissue,which may be an important therapeutic and preventive mechanism for gouty arthritis.

ObjectiveTo report the methods and clinical efficacy of bridging severed thumbs and fingers with foot joint compound flaps.Methods Ten patients with completely amputated thumbs and fingers with extensive defects in the proximal phalanx had bridged and repaired by using composite-free flap with joints from foot. Three of 4 cases of thumb amputation were repaired by using composite flaps of the second metatarsophalangeal and proximal interphalangeal joints in foot,and the other was used composite flap of the second metatarsophalangeal joints in foot.Donor sites underwent the second metatarsals distal osteotomy associated with free skin graft. And 6 cases with absent fingers by using composite-free flaps of the proximal interphalangeal joint to repair. The donor site in foot underwent metatarsophalangeal and toe joints osteotomy.ResultsAll flaps and replanted thumbs and fingers survived. Hand wounds recovered by primary repair.Donor site in foot all healed by primary repair except for 1 case,which healed after several dressing changes.All 10 cases were followed-up from 6 to 28 months,averaged of 9 months.The metacarpophalangeal joint of 4 replanted thumbs extension between -10° and 0°,and flexion between 20° and 50°.The function of fullfield digital mammography recovered well in 3 replanted thumbs, as well as the function of thumb-middle in the other. Three of them could completely 2-5 fingers tapping,one case could complete middle finger tapping,four cases could complete radial abduction.The proximal interphalangeal joints of 6 replanted fingers extension between -10° and 0°,and flexion between 30° and 90°,averaged of 50°.Sensory recovery of 1 case reached S4,two cases reached S3+,five cases reached S3,and 2 cases of S2.All replanted bones and joints healed after transplantations(bone healing time was 6 to 16 weeks), with no occurrence of re-fracture nor nonunion. Walking function was not significantly affected. According to the evaluation criteria of replanted severed fingers by Chinese Medical Association,one was excellent,eight were good,and 1 was poor.The excellent and good rate was 90％. Conclusion Repairing amputated thumbs and fingers with foot joint compound flaps could not only maximize the recovery of replanted fingers shape,but also get some function,which to meet everyday needs of patients.

This study was aimed to observe influence of disease/syndrome on the toxicity and effect of aconite roots, in order to reveal relationship among disease/syndrome, toxicity and effect. The mice model of cold syn-drome was establish by wind-cold stimulation. The pain model was established by intraperitioneal injection of glacial acetic acid. Then, LD50 and ED50 of analgesic effect were compared, as well as the therapeutic index (TI) of crude aconite roots. The rat model of cold syndrome was also established by wind-cold stimulation. And the rheumatoid arthritis (RA) model was established by intracutaneous injection of CII and CFA. TD50 of cardiac toxic-ity and arthroncus degree of prepared aconite roots were compared among the normal rats, RA rats, RA with wind-cold stimulation rats according to the recording of lead II ECG. The results showed that after wind-cold stimulation, mice and rats appeared with symptoms which were similar to Chinese medicine cold syndrome. Com-pared with normal mice, LD50 and TI increased, but ED50 decreased in the group of wind-cold stimulation after using powders of crude aconite roots. Compared with normal rats, TD50 of cardiac toxicity and arthroncus degree in-creased in groups of RA and RA with wind-cold stimulation after using prepared aconite roots. It was concluded that in the case of disease/syndrome state, the toxicity of aconite roots decreased, but its effect increased. It sug-gested that there is a significant correlation among disease/syndrome, toxicity and effect.

Objective To explore the operative technique and clinical outcomes of tiled flaps from foot with bone graft for reconstruction of thumb defects.Methods From January, 2008 to December, 2013, 8 cases of thumb defects with varying degrees were treated with tiled flaps from foot and iliac bone graft.Among them, 4 cases caused by emergency trauma, the other 4 cases was old defect after trauma, including 1 case of double thumb defect that caused by electrical burn.The thumb defects was caterorized as type Ⅰ A in 1 case, type Ⅰ B in 2 cases, type Ⅱ A in 1 case, type ⅡB in 2 cases and type ⅢA in 2 cases.Five cases in which were treated with free wrap-around flap from the ipsilateral big toe and tibial lateral-flap from the opposite second toe, 3 cases using free wrap-around flap with series connection of dorsal artery.Results All 8 reconstructed thumbs were survived.The wound healed primarily.In 1 case, the unhealed wound was healing after dressing where skin grafts in the donor sites of the foot were partial necrosis.Postoperative follow-up ranged from 6 to 72 months, the appearance of the thumb was satisfying when was compared with normal thumb.Thumb nail grew well, the blood supply was good, and sensory recovery from S2 to S4.According to the criteria issued by the Hand Surgery Society of Chinese Medical Association for functional assessment of reconstucted thumb and fingers, 5 were excellent and 3 were good.The donor site skin graft had no scar contracture and no ulceration.There was no apparent impairment on the foot function.Conclusion Combined tiled flaps from foot and iliac bone graft for reconstruction of thumb is a good method, which can recover the appearance of thumb without sacrificing toes of the donor foot.

Objective Non-traumatic and posteromedial subchondral osteonecrosis of trochlea tali (NTPSOTT) is a special type of necrosis of the talus , for which early diagnosis and treatment are particularly important .This study investigated the clinical ef-fectiveness of autogeneic cancellous bone transplantation in the treatment of NTPSOTT . Methods We retrospectively analyzed 21 cases of NTPSOTT treated by autogeneic cancellous bone transplantation and evaluated using the Clinical Rating System of the American Orthopedic Foot and Ankle Society ( AOFAS) , Visual Analogue Scale ( VAS) , and X-ray and CT examinations . Results The pa-tients were followed up for 12-26 months and all healed desirably , with the graft well integrated into the surrounding tissue , but no as-similation, collapse of the articular surface , or narrowing of the joint space .The last follow-up visit revealed significantly improved AOFAS score (90.55 ±6.73 vs 50.87 ±11.42, P=0.009) and VAS score (1.32 ±0.81 vs 6.43 ±1.66, P=0.027) as compared with the baseline . Conclusion Autogeneic cancellous bone transplantation is preferable for the treatment of NTPSOTT , which can effectively reduce the pain in the ankle , maintain the joint space , and protect the function of the ankle .

Objective To investigate clinical effects of evaluating the reoeonstructiun of wounds in the thumb-nail donor site using tibial of the second toe in reducing and preventing complications related to this are. Methods Surface of the thumb-nail flap donor site was pestoperatively recovered using tibial flaps of the second toe for 8 patients; conjunct full-thickness dermotaplasthy was performed for the sites which could not be completely covered by flaps. Full-thickness flaps were used to repair the second-toe doner sites. Results All flaps in the thumb-nail donor sites of the 8 patients survived; partial necrosis of base in the second toe was seen in one case, and the wonds healed with change of dreeings. A follow-up study beyon d4 to 14 months revealed favorable texture, normal shape of flaps and complete healing of the graft area without formation of ulcer. Foot-walking functions were not exposed to significant impact. Conclusion It is a safely and reliably effective method to repair the thumb-nail donor sites using tibiai flaps of the second toe such that complications in the donor sites are minimized.

Objective To evaluate a method of the finger reconstruction with second toe in primary operation. Methods Six patients with Ⅲ-Ⅳ° defect of fingers received the reconstructive transplantationusing the second toe. A triangular flap plastic surgery was also performed at the "pulp" and "neck" of the second toe for the reconstruction. Results Finger reconstruction and local triangle skin all survived. Five patients were followed from 8 months to 15 months, the shape of the reconstructed finger got a good looking. Pulp sensory recovery was good, 2-PD reached 8-10 mm. The patients were satisfied. Conclusion local triangle skin flap transfer and finger reconstruction in primary operation is a good method to improve the shape of reconstructed finger, which avoid the shape defect in enlargement pulp and narrow hand palm. The clinical outcomes are satisfying.

Objective To evaluate the clinical effects of free dorsalis pedis flap on the repair of two skin and soft tissue defects in hand. Methods From February 2003 to February 2009, free dorsalis pedis flap was used to repair two skin and soft tissue defects in 11 patients. Six cases were males and 5 females.Two was used the hand skin and soft tissue defects in 4 cases; back of the hand skin and soft tissue defect with the middle finger proximal palmar skin and soft tissue defect in 1 case, the hand ripped through injury to the back of the hand of the hand ripped through skin and soft tissue defects in 3 cases, were cut flap:proximal flap 3 cm× 3 cm-8 cm × 7 cm, distal flap 4 cm × 2 cm-6 cm × 5 cm. Foot for the area will adopt the lower abdominal full-thickness skin grafting. Results Uniform flap survival period of the wound healing class, foot skin graft donor sites were successfully survived. Ten patients were followed up from 6 to 19 months, with an average follow-up of 9 months. Follow-up flap fine texture, appearance of natural, nonbloated, feeling to restore S2-S3, hand function recovered satisfactorily, for the district of foot healed well without ulceration and ulcer formation,had no effect on walking function. Conclusion The dorsalis pedis flap for hand two series of skin and soft tissue defects, with design flexibility, excellent texture flaps, etc., is to repair the hand skin and soft tissue defects of the two better way.

Objective To determine the surgical approaches and evaluate the clinical efficacy of skin defects of the emergency thumb, finger reconstruction.Methods Emergency in 11 cases complicated skin defect of the thumb and the hand, fingers missing injured patients by using the method of combined of toenail flap of biped dorsalis pedis flap or the second toe.The implantation of thumbnail flap of dorsalis pedis flap combined with the second toenail flap was applied on 5 cases.3 cases had received the implantation of thumbnail flap of dorsalis pedis flap combined with the second toe and 3 cases with combined repair of the second toe of biped dorsal flap.Of all the cases, reconstruction of 3 fingers in 1 case, reconstruction of 2 fingers in 10 cases,5 cases with reconstruction by means of implantation of toenail flap of same pediele splitting flap or the second toe, 6 cases with repair of toenail flap of dorsalis pedis flap or second toe.Results Except for 1 necrosis occurred in 1 finger in 1 case of 3 fingers reconstruction, the rest of tissue flaps and fingers all survived.The primary healing was achieved postoperatively.The patients were followed up for 5-24 months.The functions such as grabbing, grasping, nipping were basically restored after the repair.The appearance of hand was also restored to a certain degree.Sensory recovery S2-S4 of reconstruction finger and flap was achieved.Healing was satisfying in the donor area, no obvious cicatricial contracture was seen, while the walk function was not affected.Conclusion The application of combined implantation of toenail flap of biped dorsalis pedis flap or the second toe in the repair of overall hand skin degloving injury could restore the function and appearance of the injured hands to a certain degree.It is proved to be an effective treatment method.