Objective To investigate effects of pedicle processing methods on the survival and appearance of the pedicle flaps. Methods The study involved 17 patients with soft tissue defects of extremities treated with the “exclamation mark” shaped pedicle flaps from October 2009 to January 2011.The traditional pedicled rotation flaps was designed to be a tennis racket-like shape,then the rotational pedicle was designed to small round tension reduction flap and pedicled rotation flaps,which contributed to formation of the “exclamation mark” shaped pedicle flaps.The soft tissue defects was located at the upper extremity in three patients and at lower extremity in 14,with defect areas of 4.0 cm× 7.2 cm-5.8 cm × 14.0 cm.There used two superficial radial nerve vasotrophic flaps,one ulnar artery supra-carpal cutaneous flap,eight sural neurocutaneous vasotrophic flaps and six saphenous nerve vasotrophic flaps.Results All flaps survived at Ⅰ stage except that one flap had partial distal necrosis postoperatively,which was cured after dress change.The follow-up ranged from six months to one year,which showed unobvious swelling of the survived flaps and good appearance of the rotation point of the pedicle. Conclusion The “ex(c)lamation mark” shaped pedicle flaps can reduce entrapment of the distal pedicle,promote venous drainage,improve survival and modify the appearance of the flaps.

Objective To explore the effects of reconstruction and shaping of thumb or finger defects by free second-toe transfer and one stage appearance remodeling.Methods From October,2007 to August,2013,128 thumb or finger Ⅴ degree defect of 109 cases were reconstruct with free second-toe transfer,and one stage shape remodeling at the same time.Among them,20 fingers by nail bed expand one stage; 23 fingers were nail bed expand added on toe pulp splayed resection on both sides; 29 fingers were added on embedded the philp island flap of great toe to the section of plantar side narrow part in the second digit,19 fingers were added on embedded the abdominal phil chamfered-edge-shape flap to that narrow part in the second digit,and 37 fingers added on toe pulp resection and embedded the philp island flap of great toe to that narrow part.Results All reconstructed thumb or fingers survived and appearance were good.The nail shape of reconstructed thumb or fingers were improved obviously,the shape of narrow part in middle segment was recovered satisfactorily.Seventy-nine cases (72.5％) were followed-up from 3 months to 5 years,and the other 30 cases (27.5％) were lost.The function of the reconstructed thumb or finger and hand feeling was ideal recovered.There were no claudication,no pain and no other sequelaes for donor foot.According to the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of Chinese Medical Association,43 cases excellent,26 cases good,10 cases approve.The rate of excellent and good was 87％.Conclusion Second-toe transfer and shape remodeling is a good method of thumb or finger reconstructing.The appearance of the thumb reconstruction can be improved obviously.Preoperative carefully design and the combination of the above several kinds of operation,for draw up an personalized surgical program is necessary.

BACKGROUND:Atopic individuals predispose to alergic rhinitis after contacting with an alergen, which is mainly released by IgE-mediated histamine. Alergic rhinitis is a kind of non-infectious inflammatory disease that involves a variety of immune cels and cytokines and is related to Th1 and Th2 immune imbalance. Interferon γ is a cytokine secreted by Th1 cels, while interleukin-4 is a cytokine secreted by Th2 cels. OBJECTIVE:To establish a stable 129Sv mouse model of alergic rhinitis, so as to lay the foundation of establishing gene knockout 129Sv mouse models of alergic rhinitis, and to observe the concentration variation of IgE, interleukin-4 and interferon γ. METHODS: Twenty-four mice were randomly divided into 2 groups: model and control groups. Mice in the model group were sensitized by intraperitoneal injection of ovalbumin to establish mouse models of alergic rhinitis. Mice in the control group were subjected to intraperitoneal injection of PBS. After successful modeling, pathological changes of nasal eosinophils and plasmocyte infiltration were evaluated by nasal mucosa staining. Interleukin 4 and interferon γ levels and ovalbumin-specific IgE antibody concentration were detected by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:Enzyme-linked immunosorbent assay showed that compared with the control group, serum ovalbumin-IgE and interleukin-4 concentrations were significantly increased, and Interferon γ concentration was significantly lower in the model group (P < 0.05). Hematoxylin-eosin staining results showed that cilia lodging and submucosal serous gland hyperplasia, eosinophils and plasmocyte infiltration were obvious. These results confirm that a mouse model of allergic rhinitis was successfully constructed in this study and the pathogenesis of allergic rhinitis was related to Th1/Th2 imbalance.

BACKGROUND:HLA-DRB1 is related to the pathogenesis of alergic rhinitis. Construction ofHLA-DRB1 gene knockout animal models not only elucidates the pathogenesis of alergic rhinitis, but also provides a good way for the elucidation of the pathogenesis of alergic rhinitis-related diseases. OBJECTIVE:To establish the HLA-DRB1gene knockout animal models. METHODS:Homozygous, wild-type and heterozygous mice were obtained by inbreeding of the heterozygous mice. Confirmed by gene and protein identification, 24 female wild-type (H2-eb1+/+) mice and 12 H2-eb1-/-mice aged 8 weeks were selected according to the random number table. 12 H2-eb1+/+ mice and 12 H2-eb1-/- mice were sensitized with ovalbumin to establish the mouse models of alergic rhinitis. Another 12 mice were sensitized with PBS as comparison. RESULTS AND CONCLUSION:Compared with the control mice, serum levels of ovalbumin-specific IgE and interleukin-4 were significantly increased, while serum level ofγ-interferon was significantly decreased in the mouse models of alergic rhinitis. Serum levels of IgE and interleukin-4 were lower, while serumγ- interferon level was higher, inH2-eb1-/-gene knockout mice of alergic rhinitis than those in the H2-eb1+/+ gene knockout wild-type mice. These results suggest thatH2-eb1 gene may play an important role in regulating Th1/Th2 imbalance in the pathogenesis of alergic rhinitis.