Objective To explore a new method of functional reconstruction of hand digits and joints with free transfer of foot tissues so as to increase the success rate of the operation.Methods After micro-anatomic study of the plantar and dorsal metatarsal arteries,retrograde and free grafts of foot tissues pedicled with plantar metatarsal arteries were designed and applied in transplantation to treat 76 cases of hand digital or joint defects.The surgeries included 58 cases of transfer of the second toe,four cases of transfer of composite tissues of the second toe, eight cases of transfer of proximal interphalangeal joint,and six cases of nail flap transfer.Results The mi- cro-anatomic study found that the first plantar metatarsal artery was anatomically constant and the diameter of its branch to the second toe was larger than that of the first dorsal metatarsal artery.Flaps survived in 75 of the 76 patients(98.7%),with fine appearance and significantly improved function.One patient who had received free transfer of the second toe to reconstruct the thumb function had to undergo a second repair with infraclavicula skin tube because of refractory arteriospasm of anastomosed vessels.Conclusion Transfer with free retrograde grafts of foot tissues pedicled with plantar metatarsal artery to reconstruct hand functions can effectively improve the success rate of the operation,because it is free of the shortcomings of great anatomic variation of blood vessels and time-consuming and complex procedures in conventional transfer.

Objective To find out the status of drinking-water-borne endemic fluorosis and the effect of preventive measures in Hebei Province,so as to provide a basis to prevent and cure fluorosis.Methods One affected county (city,district) with drinking-water-borne endemic fluorosis was sampled in every city and 10 water improvement projects were investigated in that county.Three villages were taken out in every county.The operating state of the projects,the water fluoride content,and the dental fluorosis of children aged 8-12 and skeletal fluorosis of adults were investigated in these villages.Results A total of 93 projects were investigated,among which 94.6％(88/93) were operating properly and the qualified rate(fluoride content ≤ 1.2 mg/L) of the projects was 54.84％(51/93).Among the 9 large projects,the water fluoride content of 7 projects exceeded 1.2 mg/L.A total of 23 villages with water improvement projects were investigated and only 43.4％ (10/23) of them water fluoride content were lower than 1.2 mg/L.The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.2％ (532/1601),0.74 and 5.7％ (66/1155),respectively.In the 7 villages without water improvement projects,2 of them exceeded 2.0 mg/L,but lower than and equal to 4.0 mg/L of water fluorosis and 5 of them were normal(＜ 1.2 mg/L).The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.4％ (111/332),0.72 and 2.9％ (10/350),respectively.Conclutions The qualified rate of water improvement projects of fluoride content ≤ 1.2 mg/L is low and the endemic fluorosis is still comparatively serious in Hebei Province.The progress of water improvement projects in the areas with endemic fluorosis should be accelerated and the quality of water improvement projects should be increased.

The aim of the study was to look for the chemical constituents of the herb of Lysimachia foenum-graecum. The herb of Lysimachia foenum-graecum was extracted with 70% EtOH. The isolation and purification was performed with a combination of multi-column chromatography and the structure was determined by spectral analysis. The flavonoid compound was obtained and elucidated as kaempferol-7-O(4"-(E)-p-coumaroyl-)-alpha-L-rhmanopyranosyl)-3-O-beta-D-glucopyranosyl (1-->4)-alpha-L-rhmanopyranosyl (1-->2)-beta-D-glucopyranoside. It is a new flavonoid compound.
Flavonoids ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Plant Components, Aerial ; chemistry ; Plants, Medicinal ; chemistry ; Primulaceae ; chemistry

Syncope is a common emergency of children and adolescents,which has serious influence on the quality of life.Neurally-mediated syncope,including postural tachycardia syndrome,vasovagal syncope,orthostatic hypotension and orthostatic hypertension,is the main cause of syncope in children and adolescents.The main manifestations of neurally-mediated syncope are diverse,such as dizziness,headache,chest tightness,chest pain,pale complexion,fatigue,pre-syncope and syncope.Although the clinical manifestations are similar,each subtype of syncope has its hemodynamic feature and optimal treatment option.The diagnosis rate of syncope in children has been greatly improved on account of the development of the diagnostic procedures and methods.In recent years,with the promotion of head-up tilt test and drug-provocated head-up tilt test,the hemodynamic classification of neurally-mediated syncope gets continually refined.In recent years,with the effort of clinicians,an appropriate diagnostic protocol for children with syncope has been established.The initial evaluation consists of history taking,physical examination,standing test and standard electrocardiography.After the initial evaluation,some patients could be diagnosed definitely,such as postural tachycardia syndrome,orthostatic hypotension,and situational syncope.Those with a specific entity causing syncope need selective clinical and laboratory investigations.Patients for whom the cause of syncope remained undetermined should undergo head-up tilt test.The precise pathogenesis of neurally-mediated syncope is not entirely clear.In recent years,studies have shown that neurally-mediated syncope may be related to several factors,including hypovolemia,high catecholamine status,abnormal local vascular tension,decreased skeletal muscle pump activity and abnormal neurohumoral factors.Currently based on the possible pathogenesis,the individualized treatment of neurally-mediated syncope has also been studied in-depth.Generally,the management of neurallymediated syncope includes non-pharmacological and pharmacological interventions.Patient education is the fundamental part above all.In addition to exercise training,the first-line treatments mainly include oral rehydration salts,beta adrenoreceptor blockers,and alpha adrenoreceptor agonists.By analyzing the patient's physiological indexes and biomarkers before treatment,the efficacy of medication could be well predicted.The individualized treatment will become the main direction in the future researches.

Objective To observe the dynamic changes of prevalence of Keshan disease (KD) in Hebei province from 1990 to 2007, to provide scientific basis for its prevention and treatment. Methods The surveillance data of KD was analyzed according to "the National Scheme of KD Surveillance and the Surveillance of KD" (W/T 78-1996) in Hebei province from 1990 to 2007 by the Institute for Prevention of Endemic Disease in Hebei Province Center for Disease Control and Prevention. The data included physical examination, electrocardiogram (ECG), the chest X-ray film of KD patients and the suspected patients, as well as selenium contents of hair collected in 1990, 1992 and 1999. Results No new cases of acute and subacute types of KD patients were found at the surveillance sites from 1990 to 2007. Thirty-five cases of new latent KD and one case of spontaneous chronic KD were identified respectively. Prevalence of chronic and latent KD ranged from 1.12% (8/713) to 8.18% (27/330) and 2.29% (19/831) to 8.20% (45/549) in Hebei province from 1990 to 2007, respectively. The prevalence of KD in children aged 3 - 14 years old and childbearing woman aged 20 - 45 years old decreased year by year, however population over 45 years old were more likely suffering from KD. The major abnormal changes of ECG in KD) patients were complete fight bundle branch block, ST-T change frequent premature ventricular contraction, and left anterior faseicular block. The prevalence of the heart enlargement in KD patients was 47.00% (211/449) averagely, and the prevalence of heart enlargement of medium grade increased remarkably after 2005 [28.57%(8/28) - 48.39%(15/31)]. The average mortality in chronic KD patients was 18.0%(18/100) from 1990 to 2007. Conclusions The prevalence of KD decreased slowly in Hebei province. Hebei province is still the region with higher prevalence of KD around the country, and the tasks of prevention and treatment of KD is still urgent. Enhancing the surveillance of of KD and carrying out management and treatment of KD patients should be emphasized in the future.

OBJECTIVETo develop a method for the determination of Chonglou saponin I and Chonglou saponin II in Yifu ointment.

METHODThe chromatographic separation was performed on Hypersil ODS2 C18 column (4.6 mm x 150 mm, 5 microm) and IBBM-612111 ODS C18 guard column. Acetonitrile-0.02% phosphoric (43:57) as mobile phase. The flow rate was 1 mL min(-1) and column temperature was set at 40 degrees C. The UV detection wavelength was set 203 nm.

RESULTChonglou saponin I showed a good linear relationship at a range of 0.1024-3.2 microg, r =0.9998, the average recovery was 97.4%, and RSD was 1.8% (n = 6); Chonglou saponin II showed a good linear relationship at a range of 0.064-2.0 microg, r = 0.9999, the average recovery was 101.4%, and RSD was 1.0% (n =6).

CONCLUSIONThe method is accurate with the good reproducibility and can be used for the quality control of Yifu Ointment.

Chromatography, High Pressure Liquid ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Liliaceae ; chemistry ; Ointments ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results ; Rosaceae ; chemistry ; Saponins ; analysis

Objective To explore the effect of tirofiban intracoronary in-jection on hemodynamics in patients with acute ST -segment elevation myocardial infarction ( STEMI ) after percutaneous coronary intervention ( PCI) .Methods Five hundred and six cases of patients with acute STEMI in our hospital from November 2011 to November 2012 were se-lected, who were divided into experiment group and control group accor-ding to the random digital table method , with 253 cases in each group. The control group were treated heparin 5000 U by intraoperative arterial sheath injection during PCI operation , after operation who were treated with low molecular weight heparin subcutaneous injection of 5000 U, for 5 d.The experiment group were given injection of tirofiban by the dose in 5 μg? kg -1 ,completing within 3 min before PCI operation , and then the tirofiban for 36 h of continuous infusion , in 0.15 μg? kg -1? min -1 .The changes of blood flow , heart function indexes and reperfusion indexes were observed before and after treatment in two groups .Results There was no significant difference in TIMI blood flow between the two groups before treatment ( P >0.05 ) , which were significantlly improved compared with those before treatment ( P<0.05 ) , and the blood flow of the experiment group after treatment was obviously better than that of the control group (P<0.05).There were no significant differences in left ventricular ejection fraction (LVEF)[(43.1 ±3.25)%vs (42.69 ±3.22)%], left ventricular end diastolic diameter (LVEDD)[(41.05 ±3.22)mm vs (41.09 ±3.31) mm], left ventricular end systolic diameter (LVESD)[(31.66 ±4.65)mm vs (31.05 ±4.59)mm] levels between the two groups before treatment ( P>0.05 ) .The cardiac function indexes of the two groups were significantly improved after treatment than those before treatment .After treatment , the LEVF value of the experiment group was significantly higher than that of the control group [(58.14 ±6.85)%vs (46.12 ±4.15)%], and the LVEDD[(43.11 ±3.12)mm vs (49.79 ±4.52)mm] and LVESD[(34.01 ±5.17)mm vs (39.88 ±5.13)mm] levels were significantly lower than those in the control group (P<0.05).The arterial blood flow classification , 90 minST segment fall more than 50%, CK-MB peak and CK-MB peak time and other indicators in the experiment group were significantly better than those in the control group (P<0.05).Conclusion The application of tirofiban for coronary artery injection can effectively improve hemodynamics , heart function indexes in patients with STEMI in PCI .

Objective To summarize the clinical characteristics of foreign bodies in the upper gastrointestinal tract and analyze its risk factors for complications. Methods We retrospectively analyzed the medical data of the patients who were diagnosed of foreign body impaction in the upper gastrointestinal tract, then analyzed its risk factors of complications. Results The date pits were the most common type of foreign bodies and upper esophagus were the most common locations in upper gastrointestinal tract; In Logistic regression analysis, risk factors for complications were the duration of impaction that longer than 12 hours (OR^ = 9.04, 95%CI: 2.91 ~ 28.04; P = 0.000) and the sharpness of foreign bodies' edge (OR^ = 7.95, 95% CI: 2.09 ~ 30.21; P = 0.002). Conclusion The duration of impaction that longer than 12h and sharpness of foreign bodies' edge are the risk factors for complications.

OBJECTIVETo investigate the use of the electronic tongue in the evaluation of traditional Chinese medicinal materials with sour, bitter, sweet or salty tastes, and assess the possible application of the sensor in the evaluation of different tastes of traditional Chinese medicinal materials.

METHODAqueous extracts of 22 traditional Chinese medicinal materials were measured by the electronic tongue. The data collected with the tongue was evaluated for discrimination of the samples with multivariate statistical methods: principal component analysis (PCA) and discriminant factor analysis (DFA).

RESULTThe electronic tongue was capable of discriminating between samples with different taste modalities and could also distinguish different samples eliciting the same basic taste. Twenty-two traditional Chinese medicinal materials could be classified into five clusters based on PCA. These differences seem to derive from the different tastes. DFA was applied to construct a model to discriminate traditional Chinese medicinal materials with different tastes. And the samples yielded about 88.2% accuracy for cross-validation.

CONCLUSIONWe confirmed that the electronic tongue may provide an analytical procedure for classification of the samples with respect to tastes of the traditional Chinese medicinal materials.

Biosensing Techniques ; instrumentation ; methods ; Cluster Analysis ; Discriminant Analysis ; Drugs, Chinese Herbal ; isolation & purification ; Electrical Equipment and Supplies ; Medicine, Chinese Traditional ; Models, Theoretical ; Multivariate Analysis ; Principal Component Analysis ; Reproducibility of Results ; Taste

Diabetic kidney disease(DKD)is one of the most important complications of diabetes.In recent years,domestic and foreign studies have found that mammalian target protein of rapamycin(mTOR)related signaling pathway is a classic pathway involved in the regulation of autophagy,which can achieve the therapeutic effect of DKD by targeting the autophagy pathway,and plays a crucial role in the prevention and treatment of DKD.In this paper,we reviewed the mechanism of mTOR-related signaling pathway targeted autophagy in the prevention and treatment of DKD,in order to provide a new reference and basis for clinical prevention and treatment of DKD.