BACKGROUND:The severity of tissue injury varies with the causes of the amputated finger. Simple soft tissue, vessels or nerves injury could be easily repaired by adjacent finger flap or abdominal flaps. However, these treatments are short of long repair time, reoperation and unsatisfactory appearance of the finger. OBJECTIVE:To investigate the efficiency of Flow-through flap from the fibular side of great toe to repair skin and soft tissue defects in digital replantation. METHODS:From January 2011 to October 2013, Flow-through flap from the fibular side of great toe was applied to repair soft tissue injury in digital replantation for 11 cases (8 males and 3 females, age ranged from 23 to 42 years. Skin defects ranged from 2.0 cm ×1.5 cm to 4.0 cm×2.2 cm; vascular defect ranged from 1-3 cm, 1.5 cm averagely; and the flap size ranged from 2.2 cm×1.7 cm to 4.5 cm×2.5 cm. RESULTS AND CONCLUSION:The folow-up time of al patients was 6-18 months. Digital replantation was successful in al the 11 cases. Ten cases were healed by first intention, and one case was gradualy rescued after dressing change. Patients were satisfied with the flap and the peripheral sensation. The peripheral discrimination of patients was 4 to 10 mm. The fingers functioned wel in flexion and extension. Of the 11 cases, 9 cases were valued excelent and 2 cases was rated as good, according to the upper extremity function evaluation standard of the Hand Surgey Branch of Chinese Medical Association. Flow-through flap from the fibular side of great toe is an ideal method to repair skin soft tissue and vascular defects in digital replantation.

OBJECTIVE:To study the change of particles of Chinese medicinal injection added to different kinds of infu-sions fluid before and after filtration.METHODS:Particle analysator was adopted to measure the particles of Xueshuantong injection,Yinzhihuang injection,Yuxingcao injection before and after filtration and30minutes after being mixed with0.9%Sodium Chloride injection,5%glucose injection,and10%glucose injection respectively.RESULTS:The number of particles in all kinds of unfiltered mixture increased significantly while those of filtered ones remarkably decreased.CONCLUSION:It is recommended that when intravenous drip of Chinese medicinal injection in the clinic was used,particles addition should be considered.

OBJECTIVE: To investigate the uptake of self-assembled sodium alginate(SA) nanoparticles labeled by FITC(sSAN-FITC) in Caco-2 cells and the influencing factors.METHODS: Fluorescence microscope was utilized to exam the uptake of sSAN-FITC in Caco-2 cells.Multifunction continuous spectrum enzyme-linked immunosorbent assay system was used for the detection of the fluorescence intensity of FITC in the cells and quantitative assay of the effect of sSAN concentration,its action time and pH on the uptake of sSAN-FITC in Caco-2 cells,with blank group as control.RESULTS: Pictures of Caco-2 cells taken by fluorescence microscope showed uptake of sSAN-FITC by Caco-2 cells.As compared with blank control group,among the 3 factors,the fluorescence intensity increased with the increase of the sSAN concentration and the prolonging of the action time(P

BACKGROUND:Clavicular hook plates have been used widely to treat acromioclavicular dislocations in recent years. However, it remains controversial whether coracoclavicular ligament should be repaired during the surgery.
OBJECTIVE:To study the clinical effect and MRI manifestations after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate, and to discuss the necessity of repairing coracoclavicular ligament during the surgery.
METHODS:A total of 44 patients with type III and V acute acromioclavicular Rockwood dislocations were treated with clavicular hook plates without repair of coracoclavicular ligaments, and underwent plate removal operations later. At 24 months after the second surgery, X-rays were taken to measure the width of coracoclavicular joints in both normal and affected limbs, Constant-Murley scores were calculated in both sides, and MR images were used to observe the healing of coracoclavicular ligaments.
RESULTS AND CONCLUSION:39 patients (89%) were fol owed up for 36.9±3.1 months (range, 30 to 45 months). The mean duration for retaining clavicular hook plates was 12.9±3.1 months (range, 6 to 21 months). The mean width of coracoclavicular joints was 6.04±1.21 mm (range, 4.3 to 8.8 mm) in normal limb, while 5.09±1.18 mm (range, 3.4 to 7.8 mm) in affected side without significant difference (P>0.05). The mean Constant-Murley score was 98.9±1.2 (range, 96 to 100) in normal limb, while 96.7±3.4 (range, 90 to 100) in affected side without significant difference (P>0.05). MRI showed healing of the coracoclavicular ligaments and the presence of continuous scar tissue in 38 patients, excluding one patient with recurrence of acromioclavicular joint dislocation. The clinical effects after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate are satisfactory, and it is unnecessary to repair coracoclavicular ligament during the surgery. MR images reveal scar healing of the coracoclavicular ligaments without operative repair.

Objective To investigate the surgical approaches and effects for small hepatocellular carcinoma(HCC) with biliary tumor thrombi.Mothods The clinical data of 14 small HCC patients with biliary tumor thrombi who underwent surgical intervention were analyzed retrospectively.Results The postoperative mean survival time of patient with removal of biliary tumor thrombi(n=4) was 7 months.Three patients underwent limited hepatectomy and removal of biliary tumor thrombi,2 of them survived 4 and 21 months respectively,the other cases underwent second operation 2 months later for recurred tumor in liver.Eight patients underwent left or right hemihepatectomy and removal of biliary tumor thrombi,3 of them combined with extrahepatic bile duct resection and reconstruction.Survival times of these patients were 55 months,53 months,44 months(still alive),31 months(still alive),29 months,18 months,11 months(still alive) and 1 month respectively.Conclusions Regular hemihepatectomy,meanwhile combined with the invaded extrahepatic bile duct resection,might help to prolong the survival time of patients of small HCC with biliary tumor thrombi.

Objective:To investigate the possible association between Thr241Met polymorphism in the DNA repair gene X-ray repair cross-complementing group 3 (XRCC3) with genetic susceptibility to glioma in a Chinese Han population living in Shanghai and the surrounding provinces in east China. Methods: Genotyping by a TaqMan assay was performed in 771 brain glioma patients living in Shanghai and the surrounding provinces (Jiangsu.Zhejiang, Anhui.etc. )and in 752 control participants matched in age and gender. The genotyping results of TaqMan assay and the association between Thr241Met polymorphism in the DNA repair gene XRCC3 with genetic susceptibility to glioma were statistically analyzed. Results: Genotypes of 1 468 subjects (760 with brain glioma and 708 were cancer-free control) were successfully performed by TaqMan assay, with the successful rate being 96.4%. Statistical analysis result showed that gene(C/T) and genotype(C/CT/CT/T) frequencies of XRCC3 were not significantly different between the glioma and cancer-free groups. Compared with the CC genotype, the variant TC(P = 0. 909; adjusted by age and gender OR = 0. 981; 95%CI = 0. 701-1. 371) or TT(P=0. 642; adjusted by age and gender OR = 0. 7; 95%CI = 0. 156-3. 146) genotypes of XRCC3 Thr241Met were associated with a non-statistically significant increase of glioma risk. Conclusion: The variant TC or TT genotypes of XRCC3 Thr241Met may not be risk factors for brain glioma in Chinese Han population living in Shanghai and the surrounding provinces in east China.

Objective:To observe the efficacy and safety of individual dose of intravitreal conbercept (IVC) in the treatment of retinopathy of prematurity (ROP) before type 1 threshold.Methods:A retrospective case study. From January to July, 2019, 23 cases (46 eyes) of children with type 1 pre-threshold ROP were included in the study. Among them, 14 cases (28 eyes) were male and 9 cases (18 eyes) were female. The mean gestational age at birth was 28.06±1.73 weeks. The average birth weight was 1.14±0.19 kg. The mean corrected gestational age was 34.38±1.41 weeks at the time of first intravitreal injection of IVC. The axial length (AL) of children was measured by A-mode ultrasound before IVC for the first time. According to the calculation of AL, the corresponding injection dose range was 14.23-16.19, 16.20-17.57, 17.58-18.63 mm and the injection dose of IVC was 0.015, 0.020, 0.025 ml (including IVC was 0.15, 0.20, 0.25 mg, respectively). The first IVC dose was 0.015 ml. On the first day before IVC and on the first and seventh days after IVC, 2 ml of arterial blood was taken from children, serum vascular endothelial growth factor (VEGF) concentration was detected. The follow-up time after treatment was ≥1 year. After one year of follow-up, the effective rate and recurrence rate of IVC for the first time were tested by χ2 tests. The short-term changes of injection times, injection intervals, retinal vascularization time and serum VEGF concentration in children were tested by t test. Results:Retinal neovascularization subsided and vascular buckling decreased in all eyes. Iris neovascularization subsided, 1-3 weeks after IVC for the first time. Within one year after the first IVC, 16 eyes underwent IVC twice with or without new blood vessels at the junction of the vascular area. The average corrected gestational age was 40.56±3.81 weeks. The injection dose of IVC was 0.015 ml and 0.020 ml for 2 eyes and 14 eyes, respectively.The mean interval from IVC for the first time was 40.89±8.99 days. Of the 16 eyes who underwent IVC twice, 8 eyes showed neovascularization again in the retinal area with or without blood vessels. The average corrected gestational age was 43.00±1.41 weeks. The injection dose of IVC was 0.020 ml and 0.025 ml for 3 eyes and 5 eyes, respectively. The mean interval of the second IVC was 28.60±6.07 days. The mean interval from the first IVC was 69.20±12.40 days. At the end of follow-up, all eyes were treated effectively (100%, 46/46). The mean time of retinal vascularization was 46.31±3.42 weeks. The average number of injections was 1.52±0.76. On the first day before IVC and on the first and seventh days after IVC, the average serum VEGF concentrations were 111.21±148.71, 25.60±27.71 and 42.99±38.01 pg/ml, respectively. Serum VEGF concentration was significantly lower than that before IVC on the 1st and 7th day after IVC ( Z=-4.054, -2.779; P<0.05). Serum VEGF concentration was higher 7 days after IVC than 1 day after IVC, and the difference was statistically significant ( Z=-2.505, P<0.05). All eyes were not treated by laser photocoagulation or vitrectomy. No eye complications such as lens opacification, endophthalmitis and retinal detachment related to drugs or treatment methods were found in all patients. Conclusion:Intravitreal injection of individualized dose of IVC is effective in the treatment of type 1 pre-threshold ROP. Seven days after treatment, serum VEGF concentration of patients’serum decreases.

Objective To explore the relationship between platelet to lymphocyte ratio(PLR) and the severity of renal impairment in elderly patients with type 2 diabetes mellitus (T2DM) Methods Two hundred elderly T2DM patients treated in our department of endocrinology from January 2017 to January 2018 included 100 cases with diabetic nephropathy(DN group)and 100 without nephropathy(control DM group),and 100 individuals undergoing physical healthy examination during the same period(normal control group)were retrospectively enrolled.DN group included 50 early,27 medium and 23 end stage patients.Albumin to globulin ratio (A/G),hemoglobin A1c (HbA1c),urea nitrogen (BUN),serum creatinine (Scr),estimated glomerular filtration rate (eGFR),24-hour urine protein quantification (24h-UTP),neutrophil-lymphocyte ratio (NLR),plateletlymphocyte ratio(PLR),etc.were collected and compared among DN group,control DM group and normal control group.Binary Logistic regression analyses were performed to predict whether elderly patients with T2DM progress to DN.Correlations between PLR and HbA1c were analyzed using Spearman correlation coefficient.Results The BMI,waist circumference,waist-hip ratio,systolic blood pressure,disease duration,A/G,Scr,BUN,eGFR,24 h-UTP,interleukin 6 (IL-6),hypersensitive C-reactive protein(hs-CRP),PLR,and NLR showed statistically significant differences among three groups(all P ＜ 0.05).The differences in A/G,Scr,BUN,eGFR,24h-UTP,hs-CRP,PLR,and NLR between early,medium and end phases of DN were statistically significant (all P ＜ 0.05).The predictors for the progression to diabetic nephropathy were the levels of A/G(OR:1.12,95％CI:0.89-1.65),Scr(OR:200.34,95％CI:65.28-412.36),BUN(OR:10.26,95％CI:8.34-16.94),eGFR (OR:85.37,95 ％ CI:78.31-103.57),24h-UTP (OR:187.32,95 ％ CI:142.92-1523.49),PLR (OR:81.51,95％CI:78.45-132.68),NLR(OR:1.20,95％CI:1.07-3.57),IL-6(OR:4.25,95％CI:3.76-9.31),and hs-CRP (OR:3.41,95％ CI:2.35-10.51) in T2DM patients.There were significant correlations of PLR with A/G,Scr,BUN,eGFR,24 UTP,NLR,IL-6,and hs-CRP (r =-0.338,0.469,0.521,-0.457,0.463,0.642,0.297,0.448,all P＜0.05).Conclusions PLR,which is inexpensive and easy to measure,can predict the risk of progressing to DN in elderly T2DM patients and may evaluate their renal function,and is worth extending in clinical practice.

The purpose of the present work is to establish an ultra-minimal invasive percutaneous puncture inoculation method for a VX2 orthotopic lung cancer rabbit model with fewer technical difficulties, lower mortality of rabbits, a higher success rate and a shorter operation time, to evaluate the growth, metastasis and apoptosis of tumor by CT scans, necropsy, histological examination, flow cytometry and immunohistochemistry. The average inoculation time was 10–15 min per rabbit. The tumor-bearing rate was 100%. More than 90% of the tumor-bearing rabbits showed local solitary tumor with 2–10 mm diameters after two weeks post-inoculation, and the rate of chest seeding was only 8.3% (2/24). The tumors diameters increased to 4–16 mm, and irregularly short thorns were observed 3 weeks after inoculation. Five weeks post-inoculation, the liquefaction necrosis and a cavity developed, and the size of tumor grew further. Before natural death, the CT images showed that the tumors spread to the chest. The flow cytometry and immunohistochemistry indicated that there was less apoptosis in VX2 orthotopic lung cancer rabbit model compared to chemotherapy drug treatment group. Minimal invasive percutaneous puncture inoculation is an easy, fast and accurate method to establish the VX2 orthotopic lung cancer rabbit model, an ideal in situ tumor model similar to human malignant tumor growth.
Apoptosis ; Drug Therapy ; Flow Cytometry ; Humans ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Methods* ; Mortality ; Necrosis ; Neoplasm Metastasis ; Punctures* ; Rabbits ; Thorax ; Tomography, X-Ray Computed

Objective:To analyze the current situation and characteristics of online public sentiments faced by public hospitals since the outbreak of COVID-19, and provide suggestions for coping strategies for such hospitals.Methods:The data of " trending topic" or " Trending hash tag" of " Wuhan Union Hospital" and " anti-epidemic" were captured on three mainstream new media platforms, namely Sina Microblog, Tik Tok and Headline Today with the help of data analysis tools of Sina and online data statistical software from December 2019 to February 2020. Content analysis method was used to analyze the occurrence frequency, time distribution and development trend of public sentiment on Internet.Results:Under the epidemic of COVID-19, public hospitals faced an exponential growth of online public sentiment. The cumulative total number of searches was 72 119 802 tens of thousands of that before the epidemic. The transmission showed fragmentation of content, instantaneous speed and higher attention to negative information, which brought great challenges for public hospitals.Conclusions:The high participation of online discussion of COVID-19 is unprecedented. Thus public hospitals should attach importance to the work related to online public sentiment, and establish corresponding coping mechanism for response.