OBJECTIVETo analyze the feasibility of reverse island flaps pedicled with cutaneous nerve nutrient vessels in repairing the defect on distal parts of extremities.

METHODSThirty patients with tissue defect in distal extremities, complicated by exposed vessels, nerve, tendons, and/or bones ,were repaired with island flaps pedicled with neurocutaneous nutrient vessel. Among them, five cases were grafted with flaps with external forearm cutaneous nerve vessels, eleven cases were grafted with flap containing sural neural nutrient vessels in its pedicle,and 14 cases with saphenous nerve nutrient vessels in the pedicles.

RESULTSThe flaps of 28 cases survived with perfect appearance and function. In one case partial necrosis occurred because of compression on the pedicle, but the patient healed after dressing, and another case with necrosis of the edge of the flap due to infection, but also healed after skin grafting.

CONCLUSIONThe reverse island flaps pedicled with cutaneous nerve nutrient vessels which are constant in anatomy, with reliable blood supply, can be recommended because its simple operative technique, non-injurious to main blood vessels and muscles, the repair of distal defects of the extremities.

Adolescent ; Adult ; Child ; Extremities ; injuries ; Humans ; Male ; Middle Aged ; Peripheral Nervous System ; Reconstructive Surgical Procedures ; Skin ; innervation ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Wound Healing ; Young Adult

Ischemic stroke is a primary cause of death and long-term disability all over the world. This disease is resulted from ischemia and hypoxia in brain tissues because of insufficient blood supply and causes a series of physiochemical metabolism disorders and physiological dysfunction. Its high disability ratio has bright huge burdens to society, governments and families. However, there is not efficacious medicine to treat it. In this study, a right middle cerebral artery occlusion was established in rats to observe the multi-path and multi-aspect intervention effects of Tibetan patent medicine Ruyi Zhenbao pills in reducing injuries to Nissl bodies, cerebral edema and inflammatory reactions and preventing cellular apoptosis, in order to lay a foundation for defining its therapeutic mechanism in acute ischemic stroke.
Animals ; Brain Ischemia ; drug therapy ; Male ; Medicine, Chinese Traditional ; Medicine, Tibetan Traditional ; NF-kappa B ; physiology ; Patents as Topic ; Rats ; Rats, Sprague-Dawley ; Stroke ; drug therapy

OBJECTIVETo review the mechanisms and current clinical application of pharmacological interventions for phantom limb pain.

DATA SOURCESBoth Chinese and English language literatures were searched using MEDLINE (1982 - 2011), Pubmed (1982 - 2011) and the Index of Chinese Language Literature (1982 - 2011).

STUDY SELECTIONData from published articles about pharmacological management of phantom limb pain in recent domestic and foreign literature were selected. Data extraction Data were mainly extracted from 96 articles which are listed in the reference section of this review.

RESULTSBy reviewing the mechanisms and current clinical application of pharmacological interventions for phantom limb pain, including anticonvulsants, antidepressants, local anaesthetics, N-methyl-D-aspartate receptor antagonists, non-steroidal anti-inflammatory drugs, tramadol, opioids, calcitonin, capsaicin, beta-adrenergic blockers, clonidine, muscle relaxants, and emerging drugs, we examined the efficacy and safety of these medications, outlined the limitations and future directions.

CONCLUSIONSAlthough there is lack of evidence-based consensus guidelines for the pharmacological management of phantom limb pain, we recommend tricyclic antidepressants, gabapentin, tramadol, opioids, local anaesthetics and N-methyl-D-aspartate receptor antagonists as the rational options for the treatment of phantom limb pain.

Analgesics ; therapeutic use ; Analgesics, Opioid ; therapeutic use ; Anticonvulsants ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Humans ; Phantom Limb ; drug therapy ; Tramadol ; therapeutic use

OBJECTIVETo evaluate the clinical effects of Fu Fang Ya Tong Ding on treatment of gingivitis and pericoronitis.

METHODS120 clinical patients with gingivitis or pericoronitis were randomly divided into 3 groups (40 patients in each group). After routine rinse treatment for all patients, patients in the test group were treated with Fu Fang Ya Tong Ding, patients in the positive group were treated with iodine glycerol, while that time patients in the negative group received no treatment anymore. Ten minutes after treatment, visual analogue scale (VAS) was used to record the severity of pain for each patient. 3 days and 7 days later, pain and inflammation degree were also recorded by pain three-degree scoring method and index of gingivitis. The total treatment effects were evaluated under a comprehensive clinical treatment standard.

RESULTS10 minutes after treatment, 40.0% of patients in the test group had almost no pain, while no obvious reduction of pain was found in the control group. 3 days, 7 days after the treatment, 92.5%, 95.0% of patients in the test group had no pain, and 55.0%, 90.0% of patients in the positive group had no pain. In the negative group, there were 47.5% of patients which pain was still remained in 7 days. 7 days after treatment, gingival index in the test group reduced by 25.0% and 42.8% compared with the positive and negative groups (P<0.05). 3 days after treatment, 62.5%, 45.0% and 30.0% patients separately in the test, positive and negative groups manifested good effects under the comprehensive clinical treatment standard; after 7 days, 97.5%, 92.5% and 77.5% patients in the 3 groups manifested good effect. The group using Fu Fang Ya Tong Ding had better effects than groups using iodine glycerol or only applying routine rinsing treatment group (P<0.05).

CONCLUSIONFu Fang Ya Tong Ding can treat gingivitis and pericoronitis through significantly reducing inflammation and pain.

Adult ; Female ; Gingivitis ; Humans ; Male ; Mouthwashes ; Pericoronitis ; Periodontal Index

OBJECTIVETo search for the difference of protein molecules expression of HBV infection.

METHODSSpecimens taken from human normal liver tissues (group A), HBV infected human liver tissues which were HBsAg positive, and HBsAg, anti-HBe, and anti-HBc positive in serum (group B) were analysed through the methods of 2-dimensional electrophoresis (2-DE) and matrix-assisted laser-desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS/MS).

RESULTSTotally 1125 plus/minus 56 (n=3) spots were detected in the sample of group A, 1203 plus/minus 42 (n=3) in group B samples. The percent volume of the protein spots was compared to show the proteome alteration in HBV infected human liver tissues. Forty proteins were found to present variations of two or more than two fold in quantity and 22 differentially expressed protein sports were finally identified by MALDI-TOF-MS/MS, including human mitochondrial aldehyde dehydrogenase, haptoglobin Hp2, peroxiredoxin 2, etc.

CONCLUSIONThe protein profile of human normal liver tissue and HBV infected liver tissues showed obviously difference.

Electrophoresis, Gel, Two-Dimensional ; Hepatitis B ; complications ; metabolism ; Humans ; Liver ; chemistry ; Liver Neoplasms ; etiology ; Proteomics ; methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Biopsy ; Humans ; Liver

BACKGROUNDAs one of the intercellular adhesion molecules, CD58 plays important roles in promotion of the adhesion between T cells and target cells, hyperplasia, activation of T cells and natural killer cells, and balance between Th1 and Th2. We studied the relationship between the levels of CD58 expression in peripheral blood mononuclear cells (PBMCs) and severity of HBV infection.

METHODSThe levels of CD58 mRNA in PBMCs were detected using quantitative reverse transcription PCR. The percentage of CD58 positive cells was detected by flow cytometry in patients and healthy controls.

RESULTSThe levels of CD58 mRNA and the percentage of CD58 positive cells in patients infected with HBV were significantly higher than that in the control. Based on severity of HBV infection, the patients were classified into four groups. The expression of CD58 increased significantly in an order from mild chronic, moderate chronic, severe chronic to severe hepatitis groups. The levels of CD58 mRNA and the percentage of CD58 positive cells in PBMCs from patients with HBV infection were both positively correlated with serum levels of ALT and AST.

CONCLUSIONThe level of CD58 expression is related with the severity of HBV infection and the degree of liver damage.

Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; CD58 Antigens ; genetics ; Hepatitis B ; blood ; physiopathology ; Humans ; Leukocytes, Mononuclear ; metabolism ; RNA, Messenger ; analysis

Objective:To investigate the efficacy and safety of bronchoscopic lavage in children with severe adenoviral pneumonia.Methods:Patients with severe adenovirus pneumonia who were admitted to ICU department of Hunan Children′s Hospital for bronchoscopy were collected from February to June 2019 and divided into lavage group( n=36) and non-lavage group( n=15) in line with whether lavage was performed.Their results, namely, bronchoscopic diagnosis, blood gas analysis before and 2 hours, 24 hours and 48 hours after bronchoscopy, improvement time of clinical symptoms(fever and pulmonary moist rales), the positive rate of pathogen detection and mortality rate, main vital signs such as heart rate, respiratory rate, mean arterial pressure and bronchoscopy-related complications were recorded before and 1 hour, 2 hours and 24 hours after bronchoscopy. Results:A total of 51 children were collected, all of whom suffered from endobronchitis.More secretions were observed in the airways of 36 patients in the lavage group, and only a little or no secretions were observed in 15 patients in the non-lavage group.P/F value and PCO 2 at 2 hours, 24 hours and 48 hours after treatment in the lavage group were improved comparing to those before treatment and were superior to those in the non-lavage group( P<0.05). P/F values at 24 hours and 48 hours after treatment in the non-lavage group increased and PCO 2 decreased at 48 hours after treatment( P<0.05). The thermal duration, time to resolution of moist rales in the lungs in the lavage group were shorter than those in the non-lavage group( P<0.05). The mortality rate in the lavage group was lower than that in the non-lavage group[2.8%(1/36) vs.26.7%(4/15), P<0.05]. The positive rate of pathogen detection in lavage group was higher than that in non-lavage group[55.6%(20/36) vs. 20.0%(3/15), P<0.05]. There was no significant difference in heart rate, respiratory rate, and mean arterial pressure at each time point before and after bronchoscopic treatment( P>0.05). Associated complications were 11 cases of intraoperative transient hypoxemia, four cases of bronchial mucosal bleeding, and one case each of postoperative hypoxemia, intraoperative hypertension and hypotension.There was no significant difference in the incidence of complications between the two groups( P>0.05). Conclusion:Bronchoscopic lavage, in treating children with severe adenovirus pneumonia, may improve clinical symptoms, respiratory function, and rate of pathogen detection, reduce mortality, and is effective and safe.

OBJECTIVE: To compare protein levels of pro-inflammatory factors and bone formation mediators in the fibrous cap and shoulder region of non-calcified and calcified carotid endarterectomy (CEA) plaques. METHODS: Twenty-two CEA plaques were classified as non-calcified and calcified groups (n=11 each) in accordance with the American Heart Association (AHA) consensus in 1995. To make frozen sections and H&E staining using plaque, the mean percent of carotid stenosis and calcification area was determined by quantitative histomorphometry. The protein levels of pro-inflammatory interleukin-8 (IL-8), monocyte chematactic protein-1 (MCP-1), bone formation mediators bone morphogenetic protein-6 (BMP-6), and osteocalcin in the fibrous cap and shoulder region of plaques were determined by western blot and were quantified using ImageJ software. RESULTS: MCP-1 and IL-8 protein were 1.3 (P>0.05) and 1.5 (P<0.05) folds greater in the non-calcified plaques than those in the calcified plaques. BMP-6 and osteocalcin protein were 1.3 (P>0.05) and 2.1 (P<0.01) folds greater in the calcified plaques compared with those of the non-calcified plaques. CONCLUSION Inflammation is more likely to occur in non-calcified carotid plaques, and calcification in the plaques may be associated with bone formation, which indicates that decreased inflammation may be the beginning of calcification in carotid atherosclerotic plaques.
Atherosclerosis ; complications ; metabolism ; pathology ; Bone Morphogenetic Protein 6 ; metabolism ; Calcinosis ; metabolism ; pathology ; Carotid Stenosis ; etiology ; metabolism ; pathology ; Chemokine CCL2 ; metabolism ; Endarterectomy, Carotid ; Humans ; Inflammation ; metabolism ; pathology ; Interleukin-8 ; metabolism

Objective: To investigate the clinical value of independently-designed three-demensional printed navigation templates for hepatectomy in hepatic surgical oncology. Methods: A retrospective study was conducted on 45 patients (including 36 males and 9 females, aged from 40 to 70 years) with hepatocelluar carcinoma treated by hepatoctomy from Department of Hepatobiliary and Intestinal Surgery of Hunan Cancer Hospital from June 2016 to June 2018. These patients were divided into observation group (patients conducted with the 3D navigation-template-aided operation, n=25) and control group (patients conducted with regular operation, n=20) according to operation approach. Virtual liver resection volume and actual liver resection volume were calculated in the observation group, and the correlationship between the volume of virtual liver resection and actual liver resection was analyzed by Pearson correlation analysis. The operative time, intraoperative blood loss, intraoperative intrahepatic duct injury and postoperative hospital stay were compared between the two groups. Results: In the observation group, 3D modeling was successfully completed and intrahepatic and extrahepatic duct reconstruction was successful, surgical simulation. There were no statistically significant difference between the virtual and actual resected liver volume in the observation group (P>0.05). The virtual resected liver volume was positively correlated with the actual resected liver volume (r=0.991, P<0.05). Volume of intraoperative blood loss in the observation group was lower than that in the control group [(245.1±22.3) ml vs. (308.6±19.9) ml], and the length of hospital stay was shorter than that in the control group [(7.4±0.2) d vs. (8.6±0.4) d], the difference was statistically significant (P<0.05). There was no accidental injury of intrahepatic duct in the observation group, 1 case of accidental injury of middle hepatic vein and 1 case of accidental injury of secondary branch of right hepatic vein in the control group. The AST of the observation group was significantly reduced compared with that of the control group on the 4 th and 7th days after the operation, and the difference was statistically significant (P<0.05). Conclusions 3D reconstruction of liver based on high quality MR images, can facilitate restoring the adjoint relationship between hepatic duct system and liver tumor. 3D printed navigation templates effectively guide certain kinds of hepatectomy, ensure that the cutting edge at the same time protect the rest of the liver tissue, reduce bleeding and accidental damage, realize accurate tumor resection.