Objective To propose the cause and management of necrosis in reversed island flap or distally-pedicled flap. Methods From June 2000 to June 2009, 120 cases with skin and soft tissue defect were repaired using reversed island flap or distally-pedicled flap. In 12 cases the flaps partial necrosis, to analysis the cause of necrosis. Results One hundred and eight cases survived completely in 120 patients,flap necrosis in 12 cases. 3 cases fully necrosis, in which venous disorders cause flap necrosis in 2 cases, arterial blood disorder caused necrosis of flap in 1 case. Partial necrosis in 9 cases, in which dorsal metacarpal artery reversed island flap in 1 case, digital artery reversed island flap in 1 case, posterior tibial artery reversed island flap ankle epithelial branch in 4 cases, medial leg perforating branches of reversed island flap in 1 case, superficial peroneal nerve vascular reversed island flap island flap in 1 case, distally-pedicled based sural neurocutaneous flap in 1 case, after debridement and dressing change subeschar healed in 7 cases, by the other flaps were cut close to rerepair necrotic wounds in 2 cases. Conclusion Blood circulation barrier is the main reason to flap necrosis, improper handling of pedicle is another important reason of flap necrosis,which cannot be ignored.

BACKGROUND:The microenvironment of injured peripheral nerve was one of the most important factors that influence peripheral nerve regeneration. A favorable microenvironment for nerve regeneration would protect damaged neurons and promote axonal regeneration. OBJECTIVE:To simulate the microenvironment of peripheral neural regeneration with an amnion tube filled with polyglycolic polylactic acid(PLGA) filaments and autologous nerve tissue pulps and wrapped with a pedicled epimysium flap,and to study the feasibility to repair sciatic nerve defect. DESIGN,TIME AND SETTING:A randomized controlled study was performed in Experiment Animal Center of Guangdong Medical College from June 2006 to October 2007. MATERIALS:Thirty SD rats of clean grade and aged 2 months old were randomly divided into experimental group,control group,and standard group,with 10 rats in each group. The right side was operated,and the left side was control. Amnion was obtained from healthy,full-term,and spontaneous delivery fetus whose mothers provided the informed consent to establish amnion matrix membrane. Vicryl thread and amnion matrix membrane were used to make PLGA microfilament bridging graft. METHODS:The 6.0-mm sciatic nerve defect was bridged with different grafts,respectively:the amnion tube filled with Vicryl filaments and autologous nerve tissue pulps,and wrapped with a pedicled epimysium flap(experimental group) ;the amnion tube filled with autologous nerve tissue pulps(control group) ;autologous nerve(standard group) . MAIN OUTCOME MEASURES:Gross observation,histological examination,wet weight of the anterior tibial muscle,pass-through rate of myelinated nerve fibres and neural electrophysiology were assessed 8 and 12 weeks after the operation. RESULTS:At 12 weeks after operation,amyotrophy was lightly recovered in the experimental and standard groups except control group. Anterior tibial muscle at injured side was ruddy,well-stacked,and flexible in the experimental and standard groups,but the muscle was dark and poor elasticity. At 8 and 12 weeks after operation,there were significant differences in recovery rate of anterior tibial muscle between the three groups;in addition,at 12 weeks after operation,there were also significant differences in numbers of myelinated nerve fibers,cross-section area,vascular numbers of neural graft,vascular cross-section area,and compound muscle action potential amplitude of triceps surae between the three groups(P

Objective To propose prevention and management of vascular crisis according to cause analysis, and improve the survival rate of digital replantation. Methods The vascular crisis of 132 digits of 98 cases were observed during intraoperative. The replantation was performed under different time and different conditions. The causes of vascular crisis, and propose effective prevention and management of vascular crisis were restrospective analysis. Results From March 2006 to June 2007, 35 amputated digits occurred vascular crisis during intraoperative, 19 amputated digits occurred during postoperative. After using warm physiological saline and injecting the papaverine partly, we proceed operations research with regard to the non-catabatic amputated digits. As result 58 digits survived, the achievement ratio was 89.2%. From July 2007 to March 2009, 10 amputated digits occurred vascular crisis during intraoperative,5 amputated digits occurred during postoperative. After non-surgical treatment, we performed operations research regard to the non-catabatic amputated digits. After blood supply recover, we imbed PCA pump into flex tendinous sheath to avoid the occurrence of vascular crisis postoperative. As result 66 digits survived, the achievement ratio was 98.5%. postoperative 9 cases out of fullow-up, 89 cases follow up ranged from 6 to 8 months. Recovery of the hand function was good. Conclusion Good and adequate anesthetic and an appropriate ambient temperature during operation are important factors to prevent occurrence of vascular crisis in digital replantation. Paying enough attention to these factors can effectively improve the survival rate of replantatian.

Objective To explore the feasibility and clinical resuhs of the tension skin flap of the pedicle of distally based skin flap or reverse-flow island flap. Methods Nine cases were repaired using reversed island flap pedicled with cutaneous branches of medial supramalleolar of posterior tibial artery in clinic,2 cases using distally based skin flap pedicled with the medial perforator of the posterior tibial artery,8 cases using reversalisland flap of peroneal artery lateral mulleolus skin perfarator 4 cases using reversed island flap pedicled with superficial peroneal nerve and its nutrient vessels. 3 cases using distally based sural neurocutaneous flap,and 2 cases using reversed island flap pedicled with dorsal fascia of hand.The area of the tension flap was 1.0 cm×1.0 cm to 5.0 am×3.5 cm. Results All the flaps completely survived.On the postoperative years follow-up,the texture of the flap was excellent,and primary healing was obtained at the donor site. Conclusion It's effective to design at the pedicle of the distally based flap or reversed island flap a tension skin flap,which can prevent the vessels from compressing or destroying.

This article analyzes the forward and backward feedback pathways between cones and horizontal cells in the Cascade model and sets up a Hopfield Network to simulate the interaction mechanism.Additionally,it appears that the phase character of horizontal cell is connected with spectrum and a CMAC Network is established to simulate the mapping process.This article aims to indicate that the mapping of horizontal cell and spectrum might be the underlying way for retina to code the signal from spectral input.

Objective To investigate the cytotoxicity and radiosensitization of 5-nitroindazole-3-formyliminodiacetic acid on HeLa cells.Methods HeLa cells in exponential growth phase were incubated in culture media with different doses and the survival rate was determined by MTT assay.The survival rate of cells receiving radiation combined with different doses of medicine was compared with that of the control.Results The cytotoxicity of S-nitroindazole-3-formyliminodiacetic acid on HeLa cells was very low.The drug had hypoxia radiosensitizing effect on HeLa cells.At doses of 0,6,12,24,48 and 96 μg/ml under hypoxia ,the survival rate were 0.91 ,0.87,0.84,0.81 ,0.76 and 0.60,respectively.At the dosage of 48 and 96 μg/ml,the survival rate were 0.85 and 0.73 under oxygenous).Conclusions 5-Nitroindazole-3-formyliminodiacetic acid has low cytotoxicity and rediosensitizing effect on HeLa cells.

Objective:To explore the clinical significance of interleukin 6(IL 6) in pathogenesis of diabetic nephropathy by comparing the plasma and urinary level of IL 6 in patients with type 2 diabetes mellitus(DM).Methods:The plasma and urinary level of IL 6 were measured with radioimmunoassay in 20 normal controls(NC group) and 45 cases of type 2 DM,including 23 cases without albuminuria(DSM group) and 22 cases with trace albuminuria(EDN group).Results:(1)The plasms and urinary level of IL 6 markly elevated in SDM group(P

Objective To investigate the effects of changing the arteriovenous pressure difference on the survival area of reverse island flap in New Zealand white rabbits models.Methods The saphenous artery and saphenous vein of New Zealand rabbits were selected to design experimental models of reverse island flap.Experi mental rabbits were randomly divided into 4 groups:group A:control group (reserved pedicle integrity of superficial veins);group B:part anastomosis of saphenous artery group (the distal saphenous artery of the flap was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group C:part anastomosis of vein group (distal superficial veins was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group D:ligated superficial veins group (pedicle superficial veins was ligated).After surgery,the flaps were measured by general observation.Blood distribution at different times of the flaps was detected by radionuclide scans.Survival area of the flap was measured to compare the survival rate of flap.Distribution of blood vessels and the state of blood cells were observed by Histological examination.Results The flap survival rate was (82.27-± 11.71)％ in group B,showing significant differences when compared with that group A (47.70-± 11.18)％,group C (47.70 ± 11.18)％ and group D (47.70 ± 11.18)％ (P ＜ 0.05).Radionuclide scans showed that the radioactive material in group B could be seen clearly,the radioactive material in groups A,C and D were a transient existence.Ten days postoperatively,histological observation showed that group B had more capillary regeneration and blood cells remain compared with other groups.Conclusion Increase the blood supply can increase the survival area of the reverse island flap,and simply promote the venous drainage can not effectively improve the survival rate of the flap.

Objective To explore the effects of low-dose X-ray irradiation effects on ischemic flap survival and its possible mechanism.Methods From June, 2014 to December, 2014, 80 SD rats were include in the study, the rats were randomly divided into 2 groups: the experimental group A and control group B.There were 40 rats in each group.The ischemic flaps with the size of 9 cm × 3 cm were designed on the back of the rats.The pedicle of the flaps was near to the tail.A sterile biological isolating membrane was placed under the flap to block the blood supply between muscular layer and flaps.The flaps were intermittently sutured into their original position.The group A was immediately received single and local irradiation of 0.2 Gy after surgery, The group B was not treated.On days 1 to 14 after operation,general observation,HE staining and the western blot of the flaps were performed to calculate the survival vate of the flaps, observe neovascularization and determin the content of VEGF and MMP-9, respectively.Results On the third, seventh and fourteenth days, survival rates of the flaps in the experimental group [(66.46 ± 4.37)％, (44.30 ± 3.86)％, (32.20 ± 4.22)％, respectively] were higher than the control group [(43.15 ± 5.03)％, (27.71 ± 3.20)％, (16.40 ± 5.34)％, respectively] after inspection, there were statistically significant differences between these indices (P ＜ 0.01), HE staining of the flaps in the experimental group were seen in the fibroblast infiltration and neovascularization were higher than that of control group, and experimental group within the lumen of blood vessels were arranged in order, the groups were visible tissue edema obviously control, neovascularization in small numbers, the lumen was irregular.On the third and seventh days, MVD rates of the flaps in the experimental group (85.54 ± 6.12, 44.32 ± 3.56, respectively) were higher than the control group (49.35 ± 4.75,18.75 ± 2.89,respectively) after inspection, there were statistically significant differences between these indices (P ＜ 0.01).VEGF and MMP-9 protein content in the flap for the seventh day in the experimental group were significantly higher than that of the control group.Conclusion Low-dose X-ray irradiation can promote the survival rate of ischemic flap, the mechanism may be related to the expression of VEGF and MMP-9 increased and promoted angiogenesis of the flaps after low-dose X-ray irradiation.

The changes of serum malondialdehyde, myeloperoxidase, total antioxidant capacity, superoxide dismutase activity, and glutathione peroxidase were observed in patients with Graves′ disease. The myeloperoxidase level increased in patients with Graves′ disease. The balance between oxidation and antioxidative defense was disrupted in patients with newly-onset Graves′ disease. Oxidative stress seems to be related to hyperthyroidism.