Objective To discuss the clinical influence and advantages of applying the local flap of finger tip lateral skin to repair the fingertip defective injuries.Methods From August,2013 to December,2015,used the way of local the flap of finger tip lateral skin to repair the first-fourth fingertip defects for 32 cases and 32 fingers,among which there were 20 males and 12 females;finger categories:11 thumbs,9 index fingers,8 middle fingers and 4 ring fingers.The defective area of fingertips was 0.5 cm×0.8 cm-1.0 cm×1.5 cm,all with bone exposure,23 cases had defects at the end part of phalanx,32 cases had different extent of nail bed defects.Reasons for the injuries:13 cases of grind injuries,11 cases of punch pressing injuries,8 cases of sharp tool cutting injuries.The time from injury to the treatment was 0.5-3.0 h,all of them had no associated injuries.Results Thirty-two cases of finger flaps all survived,with the follow-up for 3-24 months and average follow-up of 6 months,the flaps were slightly bloated after 3 months comparing with the normal skin,there was no contracture in the flap area and pedicle scars,two-point discrimination was 4-5mm,the farinterphalangeal joint flexion was normal.Conclusion The local flap of fingertip lateral skin can repair the defects of fingertip with less scar,not bloated flap,satisfying appearance,operation is simple,and good function,so it's the ideal way to repair the defects of fingertip.

The study was o investigate the effectiveness of problem-based learning and scenario simulated teaching in Pathological experiment course.Clinical common,multiple cardiovascular diseases related experiments were selected for reform.The case was in advance handed out to the second year students of clinical medicine,stomatology,imaging medicine and otherspecialty,requiring them to complete the data access,group discussion,PPT production,diagnoses and treatment scenarios simulation video shooting tasks.Every group showed their PPT and video in class.They were asked between groups.Summative evaluation was given before class.Curriculum effectiveness questionnaire was issued and recycled,and according to students' performance teacher gave their scores and reward.The study showed that the comprehensive application of the above teaching methods and means could effectively improve students' learning enthusiasm and initiative,cultivate their medical humanistic spirit,and help to improve the teaching quality of pathology experiment.

Objective To explore the safety of the laparoscopic surgery in radical resection for different stage rectal cancer.Methods Clinical data of 200 cases with rectal cancer underwent laparoscopic radical resection(observation group) were analyzed retrospectively,including 52 cases of stage 0-Ⅰ,148 cases of stage Ⅱ-Ⅲ.Two hundred cases patients with rectal cancer underwent open radical surgery were selected as control group,including 44 cases of stage 0-Ⅰ,156 cases of stage Ⅱ-Ⅲ.The length to distal resection margin,the number of harvested lymph nodes,the incidence of postoperative complications and the prognosis of recent situation were observed,the safety of the laparoscopic surgery was analyzed.Results Whether rectal cancer of stage 0-Ⅰ or Ⅱ-Ⅲ,there were no significant differences in terms of the length of distal resection margin((2.5±0.9) cmvs.(2.4±1.1) cm,t=0.490,P=0.625;(3.1±1.0) cm vs.(3.2±1.3) cm,t=0.749,P=0.454),the number of harvested lymph nodes((12.3±4.2) vs.(12.7±3.9),t=0.480,P=0.632;(13.9±5.4) vs.(15.1±4.9),t=2.369,P=0.118),the incidence of postoperative complications (17.3％ vs.18.2％,x2 =0.012,P=0.911;27.7％ vs.28.8％,x2=0.049,P=0.825),the rate of local recurrence(1.9％vs.2.3％,x2 =0.014,P =1.000;4.1％ vs.3.2％,x2=0.157,P=0.692),the distant metastasis (3.8％ vs.2.3％,x2=0.195,P=1.000;5.4％ vs.4.5％,x2=0.137,P=0.712) and 3-year survival rate (96.2％vs.95.5％,x2=0.010,P=0.808;83.8％ vs.85.3％,x2=0.132,P=0.714) between the observation group and control group (P＞0.05).Conclusion For rectal cancer of stage 0-Ⅰ,laparoscopic surgery has good safety,and worthy of popularization and application.For rectal cancer of stage Ⅱ-Ⅲ,due to its operation for a long time as well as the possible risk in postoperative anastomotic fistula,the implementation of laparoscopic surgery should be more cautious.

Objective To investigate the effect of Rumo Shengji San on promoting tissue regeneration of skin defect after repair with tissue-engineered skin.Methods The dermal scaffolds were reconstructed by collagen sponge in which human skin fibroblasts were transplanted inside and human keratocytes were transplanted on the surface.The tissue-engineered skin was transplanted into the wound surface of defected skin in naked mice.Rumo Shengji San was applied externally once every other day after transplantation for 2 days.The animals were randomly divided into two groups:external application group and control group,4 mice in each group.The differentiation tissue of the tissue-engineered skin was sampled 9 days after transplantation.The epidermis thickness and dermal capillary proliferation in wound of defected skin were observed with HE staining,and double-labeled immunofluorescence method was used to test dermal laminin(Ln) and typeⅠcollagen protein expression.Results Rumo Sheng Jji San promoted the development of epidermis after transplantation for 9 days.The number of capillaries in dermis was increased,and the expression of Ln and typeⅠcollagen protein was promoted in external application group than that in the control group.Conclusion Rumo Shengji San can promote tissue regeneration of skin defect after repair with tissue-engineered skin.

Aim To investigate the changes of plasticity and distribution in the lungs of asthmatic guinea pigs.Methods Guinea pigs were divided into asthma group and control group.Immunohistochemistry was used in this study to observe the changes of ERK1/2 and Elk phosphoryiation in the lungs of guinea pigs.Results There were significant changes in distribution of EPK1/2 and Elk in the lungs of asthma group.The positive cells were detected on the walls of respiratory bronchioles and alveolar ducts,especially on the smooth muscle layer and basement membrane.In addition,the numbers of positive cell were clearly increased in asthma group(P< 0.01). Conclusion There is close relationship between the EPK1/2 and Elk phosphoryiation and attack of asthma.It may be a reason for persistence and progress of asthma.

Objective To investigate three-dimensional localization for sentinel lymph node (SLN) of breast cancer,and by which we can remove the SLNs directly.Methods The ipsilateral axillary lymph nodes of 40 patients were inspected by B-ultrasound and axillary artery and subscapular artery bifurcation point and its trend with Doppler B-ultrasound in the preoperation,then located them in the surface.We found SLNs using methylene blue as the mapping agent with endoscope during the operation,determined which lymphatic group the sentinel lymph node belonged and the spatial location and the surface projection according to the anatomical location.Results We found the three-dimensional location of SLNs in the group of 39 in 40 patients with endoscope,of which 34 cases located in central group,accounting for 87.18％ ;while 4 cases located in the subscapular group,accounting for 10.26％,and their spatial location was as follows:set the root of subscapular artery in this location as a starting point,the subscapular artery as a diameter,and made a diameter of 5cm circle to the bottom,then let the latissimus dorsi as the end,and made a quasi-cylinder through the circle to the axillary central.The height of the quasi-cylinder got up to the surface of the intercostal brachial nerve.Then set the nerve as the diameter of circle of quasi-cylinder,and the centre of circle was crosspoint of subscapnlar artery's surface projection with intercostal brachial nerve.The height of quasi-cylinder varies with somatotypes of the patients,its height was less than or equal to 5cm.What's more,the fiften enlarged lymph nodes located by B-ultrasound in the preoperation were all in the quasi-cylinder,and they were SLNs.Conclusion SLN lies in quasi-cylinder consisting of spatial location of subscapular group and central group lymph nodes.If the enlarged lymph nodes found by B-ultrasound are in above mentioned quasi-cylinder,they can be considered as the SLNs.Make a 5cm-incision parallelling the intercostal brachial nerve and intersecting the surface projection of subscapular artery in the surface of quasi-cylinder,then dissect toward the origin of the subscapular artery,you can find SLNs.

Objective To investigate the effects of estradiol replacement therapy on novel-object recognition and extinction of conditioned fear memory in ovariectomized (OVX) rats.Methods Sixty sexually mature (＞90 days) female SD rats weighing 250g-300g were used as subjects.The rats were randomly divided into 7groups as following:OVX with low dose of estradiol replacement (OVX + LD,0.1 mg · kg-1),medium dose (OVX + MD,0.3mg · kg-1) and high dose (OVX + HD,0.9mg · kg-1),estradiol replacement with medium dose at 2 weeks after OVX (MD + 2W) and 4 weeks after OVX (MD + 4W),OVX group and Sham group (SH).According to the different dose and time schedules,each group was administrated estradiol or vehicle via subcutaneous injection on the dorsal side of the rat.Estradiol maintained for one month after the surgery,and then the novel-object recognition and extinction of conditioned fear memory were tested.Results (1) The rats after OVX (5.83 ±4.5)s showed access-dependent impairments on novel-object recognition ((5.83 ± 4.5)s vs(27.14 ± 6.6)s,P ＜0.01) and the estradiol replacement therapy can reverse this impairment,but not in the HD group.There was an increase of the ability on novel-object recognition in group LD and MD + 2W as compared with group OVX,but the difference was not statistically significant (P ＞ 0.05).Moreover,group MD (27.86 ± 2.6)s had a significant difference compared with group OVX (P ＜ 0.05).(2) The conditioned fear memory of rats after OVX (21.67 ± 2.0) ％showed significantly lower than group SH (56.81 ± 4.6) ％ (P ＜ 0.01).Chronic administration with estradiol enhanced acquisition of context fear,respectively (P ＜ 0.01),but except group HD and group MD + 4W.The group HD(18.43 ± 1.1)％ was negatively enhanced and the group MD +4W(25.25 ±2.5)％ was no difference compared with group OVX.(3) On extinction of conditioned fear memory,the OVX rats produced significantly less freezing by fear context (F =3.337,P ＜ 0.01),and estradiol treatment (except group MD + 4W)also facilitated the extinction of conditioned fear memory,respectively (P ＜ 0.01).Conclusion These results demonstrate that estradiol may have a beneficial effect on the cognition function,and the improving effect is better when estradiol replacement is given at once depriving of sex hormone.

ObjectiveTo summarize the cause of laryngeal stridor in infants in order to make accurate diagnosis and treatment of the disease.MethodsWe reviewed medical records of 297 cases of patients less than 3 year of age with the presenting symptom of stridor who were initially evaluated in the outpatient setting of otorhinolaryngological department from Jan 2005 to Jan 2010.The causes of stridor were clarified by examinations of ultrafine electronic laryngoscope,throat three-dimensional CT,and bronchoscopy in all cases.Patients underwent history-taking,physical examination and flexible laryngoscopy,CT examination or bronchoscopy evaluation in the operating room.ResultsOf all 297 patients,199 cases ( 67.0％ ) were diagnosed as congenital airway abnomalities for cause of stridor,which included congenital laryngeal abnomalities in 169(84.9％,169/199) and congenital tracheal abnormalities in 30 cases( 15.1％,30/199).Another 98 cases (33.0％,98/297) were diagnosed as acquired disease for cause of stridor.The most congenital laryngeal anomaly was laryngomalacia ( 159,94.1％,159/169 ).The most congenital tracheal abnormalities was tracheomalacia ( 14,46.7％,14/30 ).Sixty-four cases ( 65.3％,64/98 ) were diagnosed as foreign body in airway and 26 cases (26.5％,26/98) were respiratory infection,which were the first and second most common causes of acquired disease for stuidor.ConclusionCongenital airway structural abnormalities as a major cause of infant laryngeal stridor,followed by acquired disorders,including airway foreign body and infection.

[Objective] To study the correlation between kidney cell DNA degradation and postmortem interval within the span of 6-48 hour after the subject rats′ death.[Methods] To select 18 healthy mature female SD rats and equally divide them into 6 groups.To execute the rats with cervical spine articulation and put the rats under the incubator temperature of 25.1℃ (the average temperature of the 5 previous Decembers in Guangzhou prefecture).Sample kidney tissue from the rat separately 0 hour,6 hours,12 hours,24 hours,36 hours,48 hours,and 60 hours after the rats′ execution to prepare monoplast suspension,which is committed to comet assay.The comet images were captured by fluorescence CCD.Kinetic Comet 4.0 software was used to analyze images.Relevant data were collected by kinetic Comet 4.0 software and were subjected to Kruskal-Wallis test.[Results] Within the postmortem interval of 6-48 h,the number of SD rat kidney cell DNA fragments increased as the postmortem interval lengthens.So did the comet tail length.The Oliver tail moment and tail DNA of comet also showed sign of increase in positive proportion to the postmortem interval (their values corresponding to 60-hour-postmortem-interval were not obtainable.Kruskal-Wallis test indicated:the discrepancies of TL among the 6 groups were all significant (P ＜ 0.01).The difference of TM between 6 h group and 12 h group was not significant (P ＞ 0.05).The difference of TM between 24 h and 36 h was significant (P ＜ 0.05).The difference of TDNA among 6 h,12 h,and 36 h groups were not significant (P ＞ 0.05).The difference of TDNA between 36 h and 48 h was significant (P ＜ 0.05).[Conclusion] Degradation of nuclear DNA of the rat kidney cells increases as the postmortem interval lengthens and comet assay may provide important empirical evidence for determining the postmortem interval.

Objective To explore the value of preoperative spleen-liver volume ratio (SLVR) for predicting recurrence of primary liver cancer after hepatectomy.Methods Clinical data of 86 cases of hepatocellular carcinoma undergoing hepatectomy were analyzed retrospectively from January 2009 to December 2014.According to the preoperative SLVR,these patients were divided into two groups:SLVR ＜ 0.8 group (low SLVR group) and SLVR≥0.8 group (high SLVR group).Patients were followed-up until June 2015.Cox ratio risk pattern analysis was used for the recurrent correlative factors.Results The 1-,3-,and 5-year survival rates were 95.5％,88.6％,and 81.8％ in the low SLVR group,and 73.8％,47.6％,and 40.5％ in the high SLVR group,respectively.The difference were statistically significant between two groups (P ＜0.05).Cox regression analysis revealed that SLVR≥0.8,AFP-L3％ ≥10％,the maximum diameter of the tumor ＞ 5 cm,and hepatic or portal vein tumor thrombus were independent predictors of poor disease-free survival after hepatectomy for hepatocellular carcinomas (P ＜ 0.05).Conclusions Preoperative SLVR≥0.8 is an independent adverse predictor of poor disease-free survival.