Objective To study the role of sebaceous gland and its secretion in the progress of abnormal scar and to provide a new idea to prevent pathological scar. Method The sites, pathogenesis and pathological changes were compared between pathological and normal scars.Results Pathological scar often occurred at post-ear, upper lips, maxillofacial skin, and deltoid muscle skin of upper limbs; normal scar often occurred at mid-face, forehead, nose’s tip, and proximal extremity of limbs. Several rows of sebaceous gland and its secretion could be found at the edges of pathological scar, large quantity of sebaceous gland had changes of ductal dilation, and large amount of the secretion accumulated in the cavity in pathological scar; however, on the normal scar base and edges, seldomly showed the expanded sebaceous gland and accumulated secretion. Conclusions Sebaceous gland and its secretion could stimulate the growth of scar. To control the action of sebaceous gland and the formation of secretion could inhibit the formation of pathological scar.

Objective To explore the relationship between the gait behavior changes and cognitive function in APP/PS1 transgenic mice .Methods 16 APP/PS1 transgenic mice were divided into model group and Huperzine A group, C57/BL6J mice with the same age were chosed as control group .After a 150 days consecutive treatment , Morris water maze(MWM) was used to detect the learning and memory ability and Gait analysis system (GAS-2) was used to detect the gait behavior after the treatment when the mice were 8-month-old.Results The escape latency of the model group was significantly higher than that of the control group ( P <0.05 ) , the time spended in the target quadrant , swimming distance in the target quadrant significantly lower than that of the control group ( P <0.05 ) , the first time passing through the platform prolonged significantly than the control group (P <0.05), and the number of passing though the platform reduced significantly than the control group (P <0.05).In the gait behavior experiments , compared with the control group, the average walking speed of the model group reduced significantly (P <0.05), the average walking cycle, the absolute average body angle and lateral movement increased significantly (P <0.05);The percentage of support time in a walking cycle of the left and right foot increased significantly (P <0.05).Accordingly, the percentage of swing time in a walking cycle of the left and right foot reduced significantly (P <0.05).The propulsion index of the left hand , right hand, right foot increased significantly ( P <0.05), and then the braking index of the above three feet decreased significantly ( P <0.05) .Huperzine A can improve the cognitive function , rectify the changes in the gait behavior .The two behavioral relevance shows that cognitive function and the front two feet braking , propulsion index have a high correlation index (correlation coefficients were -0.433, -0.379, P values were 0.039,0.079), the others were not. Conclusion APP/PS1 transgenic mice of 8-months-old have a remarkable impairment of learning and memory ability and disorder of gait behavior , and these two behaviors have a correlation in some extent .

Objective To investigate the protective effect of hypoxia-inducible factor-1α(HIF-1 α) on the neurovascular unit in rats with traumatic brain injury (TBI).Methods The fluid percussion model was applied to induce TBI in rats.A total of 600 rats were divided into sham operation group,TBI group,TBI + HIF-1 α silence group and TBI + control virus group according to the random number table,with 150 rats in each.Virus-mediated HIF-1 α silence gene and control virus were delivered 24 h before the fluid percussion injury.After 3,7 and 14 d,brain injury area and morphological changes in injured region were detected by HE staining,expressions of vascular endothelial cell markers (vWF) and HIF-1 α were detected by Western blot method,and expressions of vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9),tumor necrosis factor-α (TNF-α),interleukin 6 (IL-6) and nuclear factor-κB (NF-κB) in peripheral blood and brain tissue were detected by ELISA method.Rat neural function was dynamically assessed using the modified neurological severity score (mNSS).Results (1) Brain injury area and edema area in TBI + HIF-1 α silence group were higher than those in TBI group at all time points (P ＜ 0.05).(2) Compared with sham operation group and TBI + control virus group,expression of HIF-1α in TBI group gradually increased and remained high at 7 and 14 d postinjury (P ＜ 0.05).Compared with TBI group,expression of vWF in TBI + HIF-1αsilence group decreased at all time points (P ＜ 0.05) and inhibited angiogenesis.(3) TBI + HIF-lα silence group versus TBI group showed remarkably decreased VEGF at all time points,increased expressions of TNF-α,IL-6 and NF-κB at all time point,and increased expression of MMP-9 at 7 and 14 d postinjury (all P ＜0.05).(4) TBI + HIF-1α silence group versus TBI group showed significant difference in mNSS at 7 and 14 d postinjury (all P ＜ 0.05).Conclusions After TBI,high expression of HIF-1αcan facilitate vascular formation and inhibit inflammatory reaction related factor expression,inducing the mitigation of brain edema and brain injury.Therefore,promoting HIF-1α expression may become a new means to improvement of neurovascular function after TBI.

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.

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.

Objective To study the effect of simvastatin (SIM) on the expression of neuron specific enoalse (NSE) in rat brain and serum after traumatic brain injury (TBI), and therapeutic effects of SIM on TBI thereof. Methods A total of 90 Sprague-Dwalye (SD) rats aged 8 weeks were randomly divided into sham TBI group, control group and treatment group (n=30). The TBI model was established in control group and treatment group by using Feeney method. Rats in treatment group were fed SIM 10 mg/kg in the evening pre-injury and in every evening post-injury while those in control group were fed the same dose of starch at the same time. Blood samples (3 mL) were collected from carotid atrery in three groups, then rats were sacrificed and brains were collected at different time points (3 h, 12 h, 24 h, 3 d, 7 d and 14 d post-injury). The serum ex-pressions of NSE were detected by ELISA method. The NSE expressions in hippocampal area CA3 were detected with immu-nohistochemistry. Results (1) In control group, the serum NSE level was significantly increased at 3 h after injury, reached the peak at 3 d, and was still higher than that of sham injury group at 14 d. In treatment group, the serum NSE level was in-creased 3 h after injury, reached the peak at 24 h, decreased after 3 d, and was near the sham injury group at 14 d after inju-ry, but was significantly lower than that of control group. (2) Immunohistochemical detection showed that the NSE optical density values in hippocampal area CA3 area were decreased at 3 h after injury in control group. The optical density values reached the lowest level between 3 d to 7 d and were still significantly lower than those of sham injury group at 14 d. In treat-ment group the optical density value was decreased at 3 h after injury, reached the lowest level between 12 h to 24 h and re-bounded significantly at 7 d, then at 14 d up to the level of sham injury group. Conclusion SIM can promote the decrease of serum NSE level in TBI rats and increase the NSE expression of hippocampal neurons of injured side, showing protective effects on neuronal damage after traumatic brain injury.

Objective To evaluate the repair of perforated fingers using complex tissue transplantation of articulated second toe.Methods From July 2001 to January 2008, complex tissue grafts of articulated second-toe with blood supply were used to repair 14 cases of perforated finger defects, 11 males and 3 females.Their average age wag 25.4 years old.Using the proximal interphalangeal joint of the second toe, total joint transplantation was conducted in 5 cases and half joint transplantation in 3 cases.Using the metatarsophalangeal joint of the second toe, total joint transplantation was performed in 2 cases and half joint transplantation in 4 cases.Results Primary healing of the grafted complex tissues was achieved in 13 cases, though partial necrosis of skin flap was observed in 1 patient with a defect at the metacarpophalangeal joint of the little finger, whose wound healed after change of dressings.In the other cases, followed up for 6 to 15(average, 11)months, the grafts had satisfying appearance and fine healing of joints.No nonunion, bone deformity or degeneration of joints was present.Finger functions were favorably recovered, and finger to finger activity was achieved.According to the criteria for hand functions by Chinese Medical Association, 4 cases were excellent, 6 fine, and 4 fair.Conclusion Repair of perforated fingers using composite tissue grafts of the second toe is a one-off repair of defects of bone, joint, tendon, skin and other tissues, providing fine rehabilitation for each subtle defect and maximizing functional recovery of injured fingers.

Objective To analyze the clinical characteristics of epileptic children at early stage,and to explore the high risk factors for children′s refractory epilepsy(RE)in order to provide evidence for the early and timely treatment of RE.Methods A total of 147 epileptic patients with correct diagnosis and reasonable treatment were enrolled.Forty-nine patients were classified as drug non-responsive epilepsy(DNR-EP group).The remaining 98 patients were classified as drug-responsive epilepsy(DR-EP group).With multiple conditional Logistic regression,the clinical characte-ristics between the 2 groups were compared to identify the early predictors for RE.Results Single factor Logistic regression analysis showed that the initial age of onset <1 year,more than 20 seizures before treatment in a week,focal seizures,more than 2 kinds of epileptic seizures,changes in seizure type in the course of disease,neurological impairment,early intellectual disability,abnormal cranial magnetic resonance imaging(MRI),fixed focal abnormalities on video electroencephalogram(VEEG) after seizure-free interval,diffused anomaly of non-epileptic wave in VEEG before treatment,poor response to initial antiepileptic drugs(AEDs) therapy,compliance with the characteristics of epileptic encephalopathy at early stage significantly increased in DNR-EP group.Then multivariate conditional Logistic regression analysis demonstrated that more than 20 seizures before treatment in a week(OR=2.679,P=0.043),more than 2 kinds of epileptic seizures(OR=4.364,P=0.013),fixed focal abnormalities on VEEG after seizure-free interval(OR=3.898,P=0.008),poor response to initial AEDs therapy(OR=2.611,P=0.036),and compliance with the characteristics of epileptic encephalopathy at early stage(OR=6.022,P=0.002) were the risk factors for developing into RE.Conclusions Children are likely to develop into RE if they have more than 20 seizures before treatment in a week,with more than 2 kinds of epileptic seizures,fixed focal abnormalities on VEEG after seizure-free intervals,poor response to initial AEDs therapy,and compliance with the characteristics of epileptic encephalopathy at early stage.

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.