BACKGROUND: Non-invasive vascular ultrasound is used to assess in tima-media thickness (IMT) and atheromatous plaque, of which the result is better correlated to that of pathological examination. OBJECTIVE: Non-invasive vascular ultrasound was used to assess the hemodynamical changes of external and internal carotid in hypertensive elders, so as to investigate the relationship between pulse pressures, left ventricular mass index (LVMI), vascular resistance index (VRI) and shearing ratio. DESIGN: Randomized, controlled, correlative analyzedstudy. SETTING: Ultrasound Department of Affiliated Hospital of Jiangshu University. PARTICIPANTS: Totally 54 hypertensive elders, including 33 males and 21 females, were recruited from the Ultrasound Department of Affiliated Hospital of Jiangshu University, from September 30th 2000 to March 30th 2002. Meanwhile 26 normotensive elders (systolic pressure ＜ 130 mm Hg and/or diastolic pressure ＜ 85 mm Hg), including 16 males and 10 females, were selected as controls, METHODS: Color duplex blood flow imaging technique was used to assess the left ventricular end-diastolic diameter (LVEDD) and the interventricular septum thickness (IVST), so as to calculate the LVMI. The insiddiameter of bilateral common carotid artery (CCA) and internal carotid,IMT, the systolic peak flow velocity and resistance index were measured in order to calculate the vascular shearing ratio and atheromatous plaque index,moreover arterial pressure, LVMI, as well as resistance index and shearing ratio were subjected to linear correlative analysis,of which the results were compared with that of control group. MAIN OUTCOME MEASURES: ① Pulse pressure, LVMI and atheromatous plaque index of CCA. ② The inside diameter of bilateral CCA and internal carotid, IMT and the systolic peak flow velocity and resistance index were measured in order to calculate the atheromatous plaque index and maximum vascular shearing ratio. RESULTS: According to the experimental objective,data of all 80 cases were analyzed without loss. ① The pulse pressure and LVMI, the incidence of atheromatous plaque and plaque index of CCA in hypertensive elder group were obviously higher than that of control group [(64.36±7.44) mm Hg,(45.78±8.72) mm Hg; (131.47±18.73) g/m2, (83.28±12.34) g/m2; 5.62 ±1.78,3.44±1.10; 66.7％, 23.1％, (x2=13.37, t=5.730-13.234, P ＜ 0.01)]. ② The inside diameter of bilateral CCA and internal carotid, IMT and resistance index in hypertensive elders were significantly higher than that of control group [CCA: (8.96±1.20) mm, (8.08±0.96) mm; (1.28±0.88) mm, (0.91±0.17) mm;0.75±0.05, 0.69±0.06; ICA: (6.82±1.12) mm, (5.72±0.92) mm; (1.06±0.17) mm,(0.76±0.15) mm; 0.70±0.07, 0.64±0.06, t=2.872-10.850, P ＜ 0.01], but the systolic peak flow velocity and shearing ratio were markedly lower than that of control group [CCA: (47.44±12.85) cm/s, (60.20±14.32) cm/s;(225.78 ±95.76)/s, (300.26 ±110.42)/s. ICA: (41.22 ±10.18) cm/s,(48.64±11.58) cm/s; (268.54±112.56)/s, (324.52±121.42)/s, t=2.872-10.850, P ＜ 0.01]. ③ The pulse pressure, LVMI, the resistance index of CCA and ICA and shearing ratio were linearly correlated (r=0.30-0.36, P ＜ 0.05). CONCLUSION: Pulse pressure and LVMI were found increased in hypertensive elders, together with carotid vessels dilated, IMT and resistance index increased, as well as shearing ratio decreased, atheromatous plaque formed, vascular stiffness increased, which resulted in consequently decrease of vascular compliance.

Objective To explore the clinical effect of gluteal pressure sore repaired by superior and inferior perforating artery island flap with rotation and joint propulsion.Methods From January 2014 to April 2018,37 patients (27 males,10 females,aged 35～79 years) with hip decubitus were admitted to the First People's Hospital of Yulin City for treatment of hip decubitus.According to the situation of the wound surface,the perforating site of superior and inferior perforator arteries and the local soft tissue,the corresponding perforator arteries were selected as the pedicle to form island skin flap,and the wound surface was transferred by rotation and propulsion.Results All the flaps sur vived well.33 cases healed in the first stage,but 4 cases dehisced and infected in the incision.After dressing change,the wounds healed in the second stage and the wounds were locally smooth.Conclusions The rotational combined push type gluteal superior and inferior perforator island flap is a good method to repair gluteal pressure sore.

Objective:To investigate the clinical effect of using perforator flaps with the microsurgical technique in repairing secondary wounds after resecting superficial malignant tumors.Methods:A retrospective observational study was conducted in patients with superficial malignant tumors admitted to the Yulin NO.1 People’s Hospital from January 2018 to January 2021. After comprehensive examinations and multidisciplinary consultations, tumors were completely or palliatively resected based on results of the preoperative diagnosis and the intraoperative fast pathological test of cutting edge. Perforator flaps were used to repair the secondary wounds with microsurgical technique. The type of perforator flaps, including the lateral femoral circumflex artery perforator flap, the thoracodorsal artery perforator flap, the inferior epigastric artery perforator flap, the superficial iliac circumflex artery perforator flap, were decided by the intraoperative position, the defect size, the caliber and length of the blood vessel, etc. Postoperative conditions of the patients were observed.Results:Twenty-nine cases were included, with 19 males and ten females, aged from 28 to 69 years. Locations of the tumors included head and face (13 cases), upper extremity (four cases), lower extremity (six cases), and chest wall regions (six cases). The pathological type included 12 cases of squamous cell carcinoma, four of basal cell carcinoma, nine of sarcoma, and four of advanced breast cancer. The size of the wound after tumor resection ranged from 9.0 cm×7.5 cm to 22.0 cm×17.0 cm. There were 20 cases repaired with the lateral femoral circumflex artery perforator flap, four with the thoracodorsal artery perforator flap, four with the inferior epigastric artery perforator flap, and one with the superficial iliac circumflex artery perforator flap. The size of the flap ranged from 10.0 cm×9.0 cm to 24.0 cm×18.0 cm. One case had venous reflux obstruction and survived after exploringa bridging vein. One case suffered from the arterial crisis. Since this patient refused the exploration surgery, the skin-grafting was used to repair after flap necrosis. In addition, the other flaps survived successfully. Twenty-five patients achieved R0 resection. No recurrence was observed, and the appearance of the tumor was smooth after half a year to two years of follow-up. Four cases of advanced breast cancer were treated with palliative resection. The wounds were repaired and showed no recurrence. The quality of life was improved in the survival period. The donor site was closed directly in 13 cases, and thick skin grafting was used to cover the remaining 16 cases. No dysfunction was left.Conclusions:Using perforator flaps with microsurgical technique can repair the large and composite wound after extensive resection of malignant tumors. It is an essential guarantee for surgical treatment of body surface malignant tumors.

Objective To study the effects of different concentration of chrysophanol on the activity and glutamate metabolism of primarily cultured astrocytes in vitro. Methods Primarily cultured mice astro-cytes were treated with chrysophanol at concentration of 10 , 20 , 40 , 60 , 80 , 100 , 200 , and 250 mg/L ( chry 1~8 group) for 1 d, 2 d, and 3 d. The cell activities were measured by MTT method, mRNA ex-pressions of glutamate/aspartate transporter (GLAST) and glutamate acid transporter 1(GLT-1) were de-tected by using RT-PCR, and the activities of glutamine synthetase ( GS ) and glutathione peroxidase ( GSH-Px ) were also determined. Results Time-dependence and concentration-dependence of the effects of chrysophanol showed on the following: activity of astrocytes inhibited, mRNA expressions of GLAST and GLT-1 upregulated, and the activities of GSH-Px and GS increased. However, the effect of chrysophanol on extra-cellular concentration of glutamate didn’ t depend on the number or activity of the cells. Conclusion Chrysophanol inhibited the activity of astrocytes in mice, and its effect on glutamate metabolism was concentration-and time-dependent.

Objective:To investigate the clinical effect of using perforator flaps with the microsurgical technique in repairing secondary wounds after resecting superficial malignant tumors.Methods:A retrospective observational study was conducted in patients with superficial malignant tumors admitted to the Yulin NO.1 People’s Hospital from January 2018 to January 2021. After comprehensive examinations and multidisciplinary consultations, tumors were completely or palliatively resected based on results of the preoperative diagnosis and the intraoperative fast pathological test of cutting edge. Perforator flaps were used to repair the secondary wounds with microsurgical technique. The type of perforator flaps, including the lateral femoral circumflex artery perforator flap, the thoracodorsal artery perforator flap, the inferior epigastric artery perforator flap, the superficial iliac circumflex artery perforator flap, were decided by the intraoperative position, the defect size, the caliber and length of the blood vessel, etc. Postoperative conditions of the patients were observed.Results:Twenty-nine cases were included, with 19 males and ten females, aged from 28 to 69 years. Locations of the tumors included head and face (13 cases), upper extremity (four cases), lower extremity (six cases), and chest wall regions (six cases). The pathological type included 12 cases of squamous cell carcinoma, four of basal cell carcinoma, nine of sarcoma, and four of advanced breast cancer. The size of the wound after tumor resection ranged from 9.0 cm×7.5 cm to 22.0 cm×17.0 cm. There were 20 cases repaired with the lateral femoral circumflex artery perforator flap, four with the thoracodorsal artery perforator flap, four with the inferior epigastric artery perforator flap, and one with the superficial iliac circumflex artery perforator flap. The size of the flap ranged from 10.0 cm×9.0 cm to 24.0 cm×18.0 cm. One case had venous reflux obstruction and survived after exploringa bridging vein. One case suffered from the arterial crisis. Since this patient refused the exploration surgery, the skin-grafting was used to repair after flap necrosis. In addition, the other flaps survived successfully. Twenty-five patients achieved R0 resection. No recurrence was observed, and the appearance of the tumor was smooth after half a year to two years of follow-up. Four cases of advanced breast cancer were treated with palliative resection. The wounds were repaired and showed no recurrence. The quality of life was improved in the survival period. The donor site was closed directly in 13 cases, and thick skin grafting was used to cover the remaining 16 cases. No dysfunction was left.Conclusions:Using perforator flaps with microsurgical technique can repair the large and composite wound after extensive resection of malignant tumors. It is an essential guarantee for surgical treatment of body surface malignant tumors.

Objective:To explore the clinical effects of individualized free anterolateral thigh flap in repairing complex refractory wound.Methods:From July 2015 to May 2019, 19 patients with complex refractory wounds were hospitalized in Yulin NO.1 People′s Hospital of Guangxi Zhuang Autonomous Region, including 12 males and 7 female, aged 13-67 years. There were 5 patients with multiple tissue defects, 7 patients with large area of wounds, and 7 patients with wounds in special areas. The sizes of wounds after complete debridement were 8 cm×5 cm-23 cm×7 cm. According to the repair demand, the wounds in 5 patients were repaired with anterolateral thigh flaps and flow-through, the wounds in 7 patients were repaired with anterolateral thigh flaps chimed with lateral thigh muscle flaps, with vascular anastomosis in 2 patients, the wounds in 6 patients were repaired with unilateral anterolateral thigh lobulated flaps, and the wound in 1 patient was repaired with bilateral anterolateral thigh flap in series connection. The sizes of flaps were 10 cm×7 cm-25 cm×9 cm. The donor sites were sutured directly or repaired with thin split-thickness skin graft of head. The survival of the flaps, the appearance of the donor sites, and wounds repair after the operation and during follow-up were observed.Results:The lobulated flap in 1 patient had local necrosis after the operation and finally healed by debridement, dressing change, and transplanting medium split-thickness skin graft in groin. The flaps in 18 patients survived with good blood supply, and the lobulated flap tissue was swollen in 1 of 18 patients. The donor sites which were directly sutured in 18 patients only had linear scar, and the donor site which was repaired with thin split-thickness skin graft of head in 1 patient had flaky scar. Follow-up of 1-12 months showed that all the wounds healed well, the flap thinning operations were performed in 5 patients in 3 months post operation because the flaps were slightly bloated. The CT angiography after the operation showed that the anastomosed blood vessels were unobstructed in 7 patients with reconstructed local blood supply.Conclusions:The special forms of anterolateral thigh flap, such as lobulation, series connection, and chimerism can be designed according to the anatomical characteristics of the descending branch of the lateral femoral artery to meet individualized repair demand for complex refractory wounds, and achieve the double purposes of making full use of the donor site tissue and good repair of the recipient site.

Objective: To explore the clinical effect of free latissimus dorsi myocutaneous flap in the repair of head composite tissue defect. Methods: From July 2015 to April 2018, 7 patients with head composite tissue defect, which included 5 males and 2 females, aged from 10 to 52 years old were admitted in the First People′s Hospital of Yulin. The wounds were caused by various reasons 5 cases of head squamous cell carcinoma, 1 case of electric injury and 1 case of trauma. For tumor patients combined with neurosurgery to remove the lesion tissue, the latissimus dorsi myocutaneous flap were cut and transplanted to cover the wound immediately after the thorough expansion of trauma patients, and the donor area were closed directly or byskin grafts. Results: The latissimus dorsi musculocutaneous flaps were cut with areas from 16 cm×6 cm to 28 cm×20 cm, 6 cases of thoracic and dorsal vessels anastomos is with the superficial temporal vessels, and 1 case of thoracic and dorsal vessels anastomosis with occipital vessels. The blood supply of myocutaneous flaps were good in 6 cases, and venous crisis occurred in 1 case on the second day after the operation. Postoperative follow-up was conducted for 3 months to 1 year. No tumor recurrence was observed in the tumor patients, and the wound surfaces were locally smooth. Conclusions The latissimus dorsi musculocutaneous flap is a good method for repairing the defect of the head composite tissue defect with big size and good blood supply.

ProBiotic-4 is a probiotic preparation composed of , , , and . This study aims to investigate the effects of ProBiotic-4 on the microbiota-gut-brain axis and cognitive deficits, and to explore the underlying molecular mechanism using senescence-accelerated mouse prone 8 (SAMP8) mice. ProBiotic-4 was orally administered to 9-month-old SAMP8 mice for 12 weeks. We observed that ProBiotic-4 significantly improved the memory deficits, cerebral neuronal and synaptic injuries, glial activation, and microbiota composition in the feces and brains of aged SAMP8 mice. ProBiotic-4 substantially attenuated aging-related disruption of the intestinal barrier and blood-brain barrier, decreased interleukin-6 and tumor necrosis factor- at both mRNA and protein levels, reduced plasma and cerebral lipopolysaccharide (LPS) concentration, toll-like receptor 4 (TLR4) expression, and nuclear factor-B (NF-B) nuclear translocation in the brain. In addition, not only did ProBiotic-4 significantly decreased the levels of -H2AX, 8-hydroxydesoxyguanosine, and retinoic-acid-inducible gene-I (RIG-I), it also abrogated RIG-I multimerization in the brain. These findings suggest that targeting gut microbiota with probiotics may have a therapeutic potential for the deficits of the microbiota-gut-brain axis and cognitive function in aging, and that its mechanism is associated with inhibition of both TLR4-and RIG-I-mediated NF-B signaling pathway and inflammatory responses.