Objective To introduce ramified anterolateral femoral flaps pedicled with different musculocutaneous branches used for primary repair of soft-tissue defects at different regions of extremities. Methods From January 2008 to April 2009, 15 patients, 10 males and 5 females, were treated with an-terolateral thigh flaps for their soft-tissue defects at limbs which involved 4 hands, 6 feet and 5 legs and an-kles. Different shapes of anterolateral thigh flap were designed according to clinical anatomy and particular conditions of blood vessels and musculocutaneous branches in different cases. The flaps were ramified into 2 independent free flaps to repair 2 independent defects. The maximum distance between 2 defects was 8 cm. The area of defect ranged from 3.0 cm×3.5 cm to 8.0 cm×11.5 cm, and the flap area from 5.0 cm×5.0 cm to 9.0 cm×15.0 cm. Results According to clinical anatomy, the presence of sarco-cutaneous branches was 100%. The source blood vessel of the flaps was quadriceps artery of femur. The 15 patients were followed up from 3 to 8 months. The tissue grafts all survived and the flaps primarily healed at the recipient site. Revisions were done 3 weeks to 3 months after the primary operation to thin down the clumsy skin flaps in 6 cases, The shape and texture of the flaps were satisfactory. Conclusion Ramified anterolateral femoral flaps pedicled with different musculocutaneous branches provide an ideal way of repairing severe and complex soft-tissue defects at extremities.

Adolescent ; Astragalus membranaceus ; Case-Control Studies ; Cells, Cultured ; Child ; Child, Preschool ; Dendritic Cells ; drug effects ; metabolism ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-12 ; blood ; Interleukin-18 ; blood ; Male ; Purpura, Schoenlein-Henoch ; blood

Objective To investigate effect of the mild CYP3A4 inhibitor aprepitant on the pharmacokinetics of orally administered controlled-release ( CR) oxycodone.Methods This study designed was an single-sequence with two phases in cancer patients with pain who continued to be administered orally with multiple doses of CR oxycodone every 8 or 12 hours.Plasma concentration of oxycodone and its metabolites were measured up to 8 hours after administration as follows: on day 1, CR oxycodone was administered alone; on day 2, CR oxycodone was administered with aprepitant (125 mg, at the same time of oxycodone dosing in the morning).The steady-state trough concentrations ( Css) were measured from day 1 to day 3.Results Aprepitant increased the area under the plasma concentration-time curve (AUC0-8) of oxycodone by 25%(P<0.001) and of oxymorphone by 34% (P<0.001), as well as decreased the AUC0-8 of noroxycodone by 14% (P<0.001).Moreover, aprepitant increased Css of oxycodone by 57%(P=0.001) and of oxymorphone by 36% (P <0.001) and decreased Css of noroxycodone by 24% (P =0.02) at day 3 compared to day 1.Conclusion The clinical use of aprepitant in patients receiving multiple doses of CR oxycodone for cancer pain significantly altered plasma concentration levels, but would not appear to need modification of the CR oxycodone dose.

BACKGROUND: There has been increasing attention in the study of adolescent idiopathic scoliosis (ALS)and bone metabolism, which is accompanied by osteopenia and osteoporosis. Interleukin(IL) -6, a cytokine that strongly promotes bone resorption, participates in the regulation of bone metablism.OBJECTIVE: To explore the relationship between changes of bone mineral density(BMD) and serum IL-6 content in AIS.DESIGN: A controlled non-randomized concurrent study involving patients with AIS and and healthy volunteers.SETTING: The clinic and wards of the department of spinal surgery of a university-affiliated hospital.PARTICIPANTS: Thirty-six patients with AIS(6 males and 30 females aged 12 to 18 years) were treated in the Department of Spinal Surgery, Drum Tower Hospital, Medical College of Nanjing University from July to October 2003, who had a Cobb angle ranging from 34° - 109° and curvature of the thoracic spine. Thirty-six healthy adolescent volunteers(7 males and 29 females within the range of 13 - 18 years old) served as the control group.METHODS: The BMD was measured at L2- L4 and the proximal femur;(including the femoral neck, greater trochanter and Ward' s triangle) by dual-energy X-ray absorptiometry and serum IL-6 determined by enzyme-linked immunosorbent assay(ELISA).MAIN OUTCOME MEASURES: ① BMD of the lumbar spine and femur ② Comparison of serum IL-6 content of all the subjects.RESULTS: The BMD of AIS patients at L2- L4, femoral neck, greater trochanter and Ward' s triangle was 0.79±0. 12, 0.78±0. 12, 0.65± 0. 10, and 0. 69 ± 0. 13 g/cm2, respectively, all significantly lower than the corresponding measurements of the control group(1.09 ± 0. 11, 0.95 ± 0. 11,0. 78 ± 0. 10, and 0. 88 ± 0. 11 g/cm2, respectively, P ＜ 0. 001), whereas the serum IL-6 content in the patients was significantly higher than that in the control subjects ( P ＜ 0. 005). The changes of BMD at the lumbar spine and the three sites of femur were negatively correlated with serum IL-6 in AIS patients( P ＜ 0. 001 ), but not so in the control group( P ＞ 0.05).CONCLUSION: The BMD is decreased and serum IL-6 elevated in patients with AIS, and excessive secretion of IL-6 might be one of the important factors of osteopenia in AIS.

Antineoplastic Agents ; administration & dosage ; therapeutic use ; Cladribine ; administration & dosage ; therapeutic use ; Humans ; Leukemia, Hairy Cell ; drug therapy ; Male ; Middle Aged

Objective To investigate the variations of multi-segments of the Willis' circle in cases with ACA-A1 variation.Methods Retrospective comparative analysis was applied to images of 2 246 healthy cases which were excluded from abnomalities of physical and biochemistry examination and angiostenosis caused by angiosclerosis.We divided variant group and contrast group according to variation of ACA-A1 segment.Several aspects were carried to comparison:the variation between bilateral ACA-A1 segment within the variant group was studied by x2 test; the proportion of FTP and developing of PCA-P1 were put into test.Finally we use trend x2 test to compare the variation degree of ACA-A1,ipsilateral FTP formation and PCA-P1 variation.Results Variants of ACA-A1 contains 634 cases whereas normal cases were 1 612.A prominence in variation revealed in right side of ACA-A1 (x2=26.19,P＜0.01) which revealed by 429 cases in right side versus 205 cases in lefi side respectively.Parallelled with contrast group,the variant group showed immensely advantages in high proportion of FTP (x2=14.165,P＜0.01) which indicated by variant group 22.56％ (143/634)and contrast group 18.30％ (295/1 612); but crippled in PCA-P1 formation (x2=4.32,P＜0.05)which illustrated by proportions of by dysplasia and deficiency compared by variant group and contrast group was 17.35 ％ (110/634),14.21％ (229/1 612).AC A-A 1 normal,slight variation,dysplasia and deficiency together with FTP dyformation was 9.15％ (58/634),15.62％ (52/333),16.50％ (34/206),23.16％ (22/95) respectively.Within the variation group,a pattern between ACA-A1 and FTP which fluctuated simultaneously with significant statistical discrepancies (x2=51.117,P＜0.01; linear by linear x2=13.340,P＜0.01)which demonstrated by ACA-A1 normal,slight variation,dysplasia,deficiency together with FTP formation was 4.57％ (29/634),12.91％ (43/333),16.02％ (33/206),20.00％ (19/95) respectively,as far as ACA-A1 variation was concerned,The variant group were more prone to develop PCA-P1 dysplasia or deficiency (x2=45.87,P＜0.01; linear-by-linear x2=43.474,P＜0.01).Conclusions There were more multi-variation of Willis' circle in the cases with ACA-A1 variation,MRA can value the anatomy and variation of the Willis' circle.MRA can also guide the clinic diagnosis,treatment and prognosis of the cerebrovascular diseases.

Objective To investigate the association between single nucleotide polymorphisms (SNPs) of ATP-binding cassette B1 (ABCB1),ATP-binding cassette C2 (ABCC2) and solute carrier organic anion transporter 1B1 (SLCO1 B1) genes with high dose methotrexate (HDMTX)-induced toxicity in children with acute lymphoblastic leukemia (ALL).Methods This study was designed as a casecontrol.From September of 2005 to December of 2011,the blood samples were randomly collected from 142ALL patients from Nanjing Children's Hospital,Enzyme-multiplied immunoassay technique (EMIT) was used to measure the plasma concentration of MTX,Seven SNPs in ABCB1 (rs1045642,rs2032582,rs1128503),ABCC2 (rs717620,rs2273697) and SLCO1 B1 (rs4149081,rs11045879) genes were detected by polymerase chain reaction-ligase detection reaction (PCR-LDR).Results A significantly increased risk of MTX-induced toxicity was observed in patients with MTX elimination delay (OR ＝ 2.828,95％ CI:1.217-6.571,P ＜ 0.05).Two SNPs in SLCO1B1,rs4149081 and rs11045879 were linkage disequilibrium (LD) with each other (R2 =0.979,P ＜ 0.05).Multivariate analysis revealed that individuals with SLCO1B1 rs4149081 AA genotype or SLCO1B1 rs11045879 CC genotype showed increased incidence of MTX elimination delay (OR =4.41,95％ CI:1.537-12.654,P =0.042),and the two genotypes were also associated with significantly increased risk of MTX-induced toxicity (OR =4.118,95％ CI:1.135-14.944,P =0.022).No association of MTX elimination delay or MTX-induced toxicity with the other SNPs analyzed was found.Conclusions SLCO1B1 rs4149081 AA or SLCO1B1 rs11045879 CC genotypes might be a risk factor for the susceptibility to MTX-induced toxicity in children with ALL.

Objective To probe the new mechanism of simvastatin on high-fat diet-induced kidney dam-age. Methods Female SD rats were subjected to a standard control diet(SCD)or high-fat diet(HFD)for 20 weeks,then the HFD group was randomly divided into HFD group and HFD group with simvastatin treatment (HFD+ST,10mg·kg-1·d-1 )for another 8 weeks. The expression of adiponectin,adiponectin receptors R1 and R2, Adenosine 5′-monophosphate(AMP)-activated protein kinase(AMPK),peroxisome proliferator-activated receptorα(PPARα),glucose regulated protein 78(GRP78)and GADD153(CHOP)in kidney were assessed respective-ly. Results Body weight and serum lipid levels in HFD group significantly increased ,expression of adiponectin and its receptors significantly down-regulated. Phosphorylation of AMPKα and PPARα expression decreased,and expression of GRP78 and CHOP up-regulated significantly. Above indexes in simvastatin treatment groups improved significantly. Conclusion Simvastatin can improve high-fat induced kidney damages ,probably by increasing expression of adiponectin and its receptors ,decreasing endoplasmic reticulum stress.

Objective To construct two DNA vaccines encoding Gag-Env fusion protein and Tat-Rev-Integrase(C-half)-Vif-Nef fusion protein derived from the first HIV-1 CRF01_AE isolate(AE2f) in Chi-na and to evaluate the immunogenicity in mice. Methods Two DNA vaccines were constructed by inserting the codon optimized and synthesized gag-env fusion gene and tat-rev-integrase(c-half)-vif-nef fusion gene de-rived from AE2f into mammalian expression vector pDRVISV1. 0, the generated DNA vaccines were desig-nated as pSVAE/GE and pSVAE/TRIVN, respectively, and their in vitro expression were determined by Western blot with transfected 293T cells. Mice were i. m. immunized with either pDRVI1.0 as mock control, pSVAE/GE or pSYAE/TRIVN for 4 times at two-week interval. Two weeks following the final im-munization, cellular responses to pool of HIV-1 Env, Gag, Tat, Rev, Intergrase, Vif and Nef peptides were evaluated by ELISPOT assay. Results The construction of DNA vaccine pSVAE/GE and pSVAE/TRIVN was validated by restriction enzyme digestion and bidirectional sequencing. Western blot showed a specific band at molecular mass 220×10~3 in lane of pSVAE/GE transfeeted 293T cell and a specific band at 95×10~3 in the lane of pSVAE/TRIVN. Both DNA vaccines mounted significant specific T cell responses with (3010 ± 566) SFC/10~6 splenocytes for DNA vaccine pSV AE/GE and (948 ± 737) SFC/10~6 spleno-cytes for DNA vaccine pSVAE/TRIVN, whereas the mock control of pDRVISV1.0 only raised marginal T cell responses. Conclusion Both pSVAE/GE and pSVAE/TRIVN were capable of expressing the inserted fusion immunogen genes and able to elicit vigorous cellular immune responses, therefore, these DNA vac-cines are highly immunogenic.

Objective The goal of this study is to understand the function of FKBP51 in resistant to high fat diet-induced obesity using FKBP51 knockout ( KO) mice and in vitro adipocyte differentiation.Methods Four-week old male FKBP51 KO and wild type ( WT) mice were fed separately with regular or high fat diet for 6 weeks.The body weight and food consumption were recorded weekly, the energy expenditure differences ( O2 consumption, CO2 production, respiratory exchange ratio, and heat production) of each group were monitored using the MM-100 metabolism cages system for 24 hours, then the liver from the above animals were stained with the Oil red-O to detect the lipid accumulation and the expression of metabolic genes.In addition, induction of adipocyte differentiation of immortalized MEF cells from WT and FKBP51 KO mice were used to observe the effect of FKBP51 gene on lipogenesis.Results Compared to WT mice, FKBP51 KO mice has less weight increment, and less lipid accumulation in the liver, but with no difference on food consumption during high-fat diet fed.Moreover, FKBP51 KO mice exhibited more O2 consumption, CO2 production and heated production under both RD and HF diet conditions.The PEPCK, G6Pase and UCP-1 genes up-regulation.In addition, lipid content was reduced in FKBP51 gene deficient MEF cells after adipocyte differentiation.Conclusions The FKBP51 gene plays an important role in high fat diet-induced obesity through the energy metabolism enhancement and lipogenesis inhibition.