Objective To explore the related factors with skin flap necrosis,we concluded the cases of patients with skin defects after free flap plantation.Methods From 2001 to 2016,188 cases about 20 influencing factors were analyzed (The characteristics of patients:age,sex,smoke,diabetes,high blood pressure;Preoperative factors:injured sections,injured causes,preoperative wound infection,preoperative wound osteomyelitis,the time from injury to operation;Intraoperative factors:operator,operation time,anesthesia time,intraoperative rehydration fluids,the way of vascular anastomosis,the number of venous anastomosis,the area of flap;Postoperative factors:flap hematoma,flap infection,vascular crisis) and multivariate logistic regression analysis was used to analyze the relationship between these risk factors and flap necrosis.Results All 188 cases were treated with free anterolateral thigh flap to repair soft tissue defect and it was revealed that the 174 cases were successful (92.55％) and 23 cases were occured vascular crisis (12.23％),8 cases were arterial crisis,11 cases were vein crisis,4 cases were ateriovenous crisis.After the treatment,the rescue was successful in 5 cases (38.46％).After the analysis we made the conclusion that the number of venous anastomoses,flap hematoma and vascular crisis were related with the skin flap necrosis.Conclusion The number of venous anastomose (≥2) will increase blood return to make the flap easier to survive.Intraoperative stanching and drainage tube placement work will reduce the skin flap hematoma as a result of reducing the skin flap necrosis.Artery and venous crisis handled in time,can enhance the survival rate of flap.

Objective To evaluate the diagnostic evaluation of isotropic scanning and Lung Care soft- ware in solitary pulmonary nodules,and to improve the diagnostic accuracy.Methods 52 patients suffered from SPN were included in our study.Two experts in CT analyzed the films.First,they read the axial images and made diagnosis.Then isotropic scanning and lung care software approaches were used on 16 spiral CT and another analysis were made again.The results were compared with pathological diagnosis respectively. Results Spiculated sign,lobulated sign,vessel convergence were found more on isotropic scanning approach, that had significant difference with axial images analysis(P

At present, most clinical thrombolytic drugs are plasminogen activators, which are highly dependent on the plasminogen level of the patient. Therefore, the efficacy of those drugs is restricted. Unlike the conventional thrombolytic plasminogen activator drugs, fibrinolytic drugs have direct fibrinolytic activity. Thus, fibrinolytic drugs can directly dissolve the thrombus, and its thromlysis efficacy is not restricted by the patients' plasminogen. This is a new type of thrombolytic drug with higher thrombolytic efficiency and safety, and has become one of the research hotspots at present. Although more and more agents that can be used as fibrinolytic drugs have been discovered, only a few of them can successfully be applied in clinical practice. The mainly underlying reason is the risk of bleeding. In this paper, based on the latest research progress of fibrinolytic drugs, the bleeding mechanisms and coping strategies of fibrinolytic drugs were systematically reviewed, five types of bleeding mechanisms of fibrinolytic drugs were summarized, and three types of coping strategies were proposed. We hope our work can provide theoretical basis for the development of safer and more efficient fibrinolytic drugs.

Objective To evaluate the diagnostic value of multi-slice computed tomography (MSCT)for incisional hernia of ab-dominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultra-sound (US)examinations.The value of transverse scan and MPRs & MSCT and US on demonstrating the number,location,con-tents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and com-paired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5% and 56.0%, respectively.MSCT performed better than US on demonstrating the incisional hernias (P =0.000).On MSCT,there was no signif-icant difference in the detection for isolated incisional hernia between the MPRs and axial scans (P = 1.000 ).However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis (P =0.006),and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias (P =0.01 9).Furthermore,MSCT can exactly reveal the complications of incisional hernias (7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of me-tastasis in incisional hernia),which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.

Objective To observe the clinical effect of percutaneous endovascular angioplasty ( PTA) for the treatment of diabetic lower extremity arterial disease( LEAD) , so as to provide a reference for the selection of the best treatment for diabetic lower extremity arterial dis-ease(LEAD). Methods In this parallel study, totally 60 patients were equally divided into the control group and the intervention group. The control group were treated by the conventional method, and the intervention group were treated by percutaneous endovascular angioplasty (PTA). The changes of ankle brachial index (ABI),average blood flow velocity of dorsalis pedis,pulsation index(PI) and the maximum walking distance were observated in 12 weeks and 24 weeks after the treatment. Results Compared with the control group, the ankle brachi-al index ( ABI) , average blood flow velocity of dorsalis pedis, pulsation index ( PI) and the maximum walking distance in the intervention group were significantly improved 12 weeks and 24 weeks after treatment, and the difference between the two groups was statistically signifi-cant (P<0. 05). And compared with thses data before treatment in the intra-group comparison, there were statistically significant difference (P<0. 05). However, the changes in 24 weeks and 12 weeks after treatment in the same group showed no significant difference (P>0. 05). Conclusion Percutaneous endovascular angioplasty ( PTA) is better than traditional drug therapy in the treatment of diabetic lower extremity arterial disease( LEAD) . It is a feasible clinical treatment of lower extremity arterial disease( LEAD) .

Aneurysmal subarachnoid hemorrhage accounted for 70% of subarachnoid hemorrhage. The high fatality and disability rate affected patients′ quality of life. Aneurysmal subarachnoid hemorrhage should be considered as a chronic cerebrovascular disease, and it is very important to take early intervention and strengthen the secondary prevention to the patients with risk factors for disease. This paper reviewed the research status on quality of life of patients with aneurysmal subarachnoid hemorrhage and its influencing factors, in order to provide a reference for neurological physicians.

This study was aimed to observe the protective effect of extract from Rhizoma A nemones Raddeanae (RAR) on hepatic fibrosis induced by porcine serum in rats. A total of 68 SD rats were randomly divided into 5 groups, which were the normal group, model group, RAR group, extraction of RAR (EXRAR) group, Fu-Zheng Hua-Y u(FZHY) group. Each rat was intraperitoneally injected with 0.5~0.6 ml of porcine serum twice a week for 15 suc-cessive weeks to establish liver fibrosis model. Intragastric administration was given after the model was successfully established. The FZHY group was given FZHY capsule (0.525 g·kg-1). The RAR group was given RAR decoction (0.7 g·kg-1). The EXRAR group was given EXRAR (0.071 g·kg-1). The model group and normal group were given e-qual amount of physiological saline. The medication was given once a day. And the treatment course was 8 weeks. At the end of the 23th week, rats were sacrificed. Contents of SOD and MDA in blood serum were assayed. The protein expressions of α-SMA and TGF-β1 in liver tissues were detected by SABC. The results showed that compared with the model group, content of MDA decreased in the EXRAR group, RAR group and FZHY group (P<0.05), and content of SOD increased obviously (P<0.05). In the model group, expression of α-SMA and TGF-β1 increased, with dark brown dyeing and diffusion area. Expression area and strength of the FZHY group, RAR group, and EXRAR group were ob-viously weak with tasteless interval dyeing and no formation of typical pseudolobule in comparison with the model group. The color rendering index showed that compared with the model group, the protein expression of α-SMA and TGF-β1 decreased obviously in liver tissues of the FZHY group, EXRAR group, and RAR group (P< 0.05). It was concluded that RAR and its extract had a good antifibrosis effect. And the EXRAR had basically the same antifibrosis effect as RAR. It was assumed that the possible mechanism was related with the inhibiting of hepatic stellate cell (HSC) activation and the expression of TGF-β1 as well as the resisting of lipid peroxidation.

Human tissue kallikrein-binding protein (Kallistatin, KAL), a secretory protein that participates in the regulation of multiple signaling pathways by binding to the extracellular receptor, however, at present has not been reported about the intracellular activity, and whether it has the similar biological activity with extracellular activity. Here we constructed no signal peptide KAL (NSK) into the adeno-associated virus vector to explore the intracellular activity of KAL. Both the endothelial cell and lung cancer cells could express KAL, but not secreted after rAAV2-NSK transfection. The proliferation and migration of human umbilical vein endothelial cells (HUVECs) were inhibited, but the apoptosis rate was not affected. The proliferation rates, mobility and tubule formation of all the three tested lung cancer cells, such as NCI-H446, NCI-H460 and A549, were inhibited to different extents. This cellular study not only confirmed the intracellular activity, but also suggested it may serve as a kind of "balance factor" in multi-targeted controlling, which may provide a new train of thoughts to explain the regulatory contradiction in PI3K-Akt signaling pathways by KAL.
Apoptosis ; Cell Proliferation ; Dependovirus ; Genetic Vectors ; Human Umbilical Vein Endothelial Cells ; metabolism ; Humans ; Lung Neoplasms ; metabolism ; Serpins ; metabolism ; Signal Transduction ; Transfection

Objective To investigate the changes of lead,zinc,copper,iron and calcium in blood of chronic poisoned infantal mice.(Methods) Forty-eight 21 day-old kunzea mice were randomly divided into 4 groups,each having 12 mice.Distilled water group was as control group and other three lead acetate poisoning groups had a dose of 10,20,40 mg/kg,respectively.The poisoning was carried out by lavage once a day,and consecutively for 46 days.Eyeballs of mice were picked then for blood sampling,and BS trace element analysis grapher was used to determine level of lead,zinc,copper and iron.Level of calcium was measured by Dimentional-RXL auto-biochemistry analysis meter.Results The lead and zinc levels in poisoned mice blood were increased with increasing lead acetate level administration,while zinc level changed inversely with lead acetate level.Significant differences were shown among control group and poisoning groups in terms of lead(P0.05).Conclusion Lead posioning can lead to zinc decreasing and copper(increa)-sing,which suggests that zinc works as a poential antidote of lead poisoning.

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.