OBJECTIVETo investigate the therapeutic effect of V-Y advanced flap pedicled with posterior perforator from medial malleolus for small skin defect at achilles tendon region.

METHODSFrom Mar. 2011 to Sep. 2012, 7 cases with small skin defect at achilles tendon region were treated by V-Y advanced flap pedicled with posterior perforator from medial malleolus. The flaps was 6.0 cm x 3.0 cm-9.0 cm x 4.5 cm in size. The defects at the donor sites were closed directly.

RESULTSAll flaps survived completely. 7 cases were followed up for 6-8 months after operation. The flaps had good texture and color match. The function of ankle was normal. All patients were satisfied with postoperative function and shape.

CONCLUSIONIt is an ideal reconstruction method for skin defect at achilles tendon region with V-Y advanced flap pedicled with posterior perforator from medial malleolus. It is easily performed with low risk and short recovery time.

Achilles Tendon ; injuries ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Treatment Outcome ; Young Adult

Objective To investigate the clinical efficiency of repairing ankle and calf wounds by antegrade or retrograde perforating flap of posterior tibial artery. Methods 13 cases with skin defects of ankle and calf wounds were reviewd. The defects were repaired using antegrade or retrograde perforating flap of posterior tibial artery from January 2011 to February 2013, 8 males and 5 females; aged 19 to 65 years old. Wounds were located in the ankle and calf, area which the tibial artery support contu-sioned slightly;defects were associated with exposed bone or tendon, exposed blood vessels. Of the 13 cases, 5 cases have multiple ankle fracture with blood circulation disorders, internal and external fracture fixation were performed emergency with blood ves-sels and nerves exposed, at the same time emergency line wound repair by posterior tibial artery perforating flap. The other 8 cases have no blood vessels and nerves exposure, and accepted vacuum sealing drainage emergency external fixation and flap surgery. Seven cases accepted V-Y antegrade perforating flap of posterior tibial artery, 6 cases using retrograde tibial artery perforator flap. Whose defects were ranged from 1.5 cm×2.0 cm to 9.0 cm×5.0 cm. Antegrade or retrograde perforating flap of posterior tibial ar-tery with 1.5 cm×3.0 cm to 14.0 cm×7.0 cm was used to repair ankle or lower leg medial defect. Antegrade flap donor site sutured directly, but retrograde flap donor site take full thickness skin graft repair from abdomen. Results Circulations of the all 13 cases were stable, with wound healing well after 2 weeks. The patients were followed up for 6 months to 24 months, average of 13 months. All flap graft survived, pedicle no bloated andcat eardeformity. Flaps were soft, no bloated appearance;color was con-sistent with normal skin. Fracture line in the 5 patients was disappeared. Bone healing time was 3.0 to 4.0 months. At the direct su-ture skin donor sites, postoperative scar was small;skin graft donor sites had no obvious scar. Postoperative ankle dorsiflexion 10° to 25°, plantar flexion 15° to 45°. Patients were extremely satisfied with the results of repair. Conclusion Using antegrade or ret-rograde posterior tibial artery perforator flap without sacrificing the main vessel, it is a simple and effective method to repair the medial malleolus and calf wounds.

Objective To research the clinical outcomes of repairing donor site of abdomen flap by V-Y flap pedicled with deep circumflex iliac artery perforator musculocutaneous.Methods Nine cases with skin defects of hand were treated with lower abdomen flap from December, 2011 to March, 2013, abdominal donor sites could not be directly sutured, and pedicled with deep circumflex iliac artery perforator musculocutaneous.The flap was 8 cm × 16 cm-12 cm × 24 cm in size.Results The average healing time of the V-Y flap pedicled with deep circumflex iliac artery perforator musculocutaneous was 17 days.The patients were followed-up for 3 months to 18 months, averaged of 9 months.The appearance and the texture of the flaps were good.Abdominal wound healing was flat, with no significant depression and navel no significant skew.Patients were satisfied with function and appearance.Conclusion This procedure is easy and effective.The treatment result is satisfactory.It is improvement for repairing donor site of tradition abdomen flap.

BACKGROUND:Bone tissue transplantation or osteogenic material fil ing is after used for bone defect repair. To remove autologous bone tissues can lead to additional damage and secondary deformity, therefore, it is extremely urgent to search for a new osteogenic material. OBJECTIVE:To construct the porousβ-tricalcium phosphate (β-TCP)/col agen scaffold modified with human bone morphogenetic protein 2 (hBMP2) gene, and to observe its effects on differentiation of MC3T3-E1 cel lines. METHODS:The porousβ-TCP/col agen scaffold modified with hBMP2 gene was prepared. Then in vitro culture system of MC3T3-E1 cel lines with composite scaffold was established. There were scaffold and plate groups, and each group was divided into two subgroups according to the different concentrations of plasmid. Samples were col ected and observed morphological y by scanning electron microscope and light microscope after complex culture. After 1, 3, 7 and 14 days of induction, calcium nodules were observed through alizarin red staining, the cel cycle was detected by real-time PCR, and expressions ofαI-chain col agen type I gene, Osterix and bone sialoprotein were observed. RESULTS AND CONCLUSION:The number of cel s adhered, differentated and distributed on the composite scaffold was significantly higher than that of the single scaffold (P<0.05). Alizarin red staining and real-time PCR detection showed that the osteogenesis ability of MC3T3-E1 cel lines in the scaffold group was stronger than that in the plate group. To conclude, the porousβ-TCP/col agen scaffold modified with hBMP2 gene is an appropriate candidate for bone defect repair.

Abstract: Objective　In order to understand the radon exposure level of homes in Chongqing, this survey was carried out on the indoor radon concentration in 38 districts and counties of Chongqing. Methods　According to the population ratio of every 100 000 people, one monitoring site was arranged, and the number of parallel samples was 10% of the distribution sites. The monitoring sites covered 38 districts and counties in Chongqing. A total of 1 019 residential monitoring sites in 38 districts and counties in Chongqing were measured with radon accumulation detectors from July 2020 to June 2021. Results　The five districts/counties in Chongqing having the highest average concentration of residential radon in the year were Xiushan County 78.8 Bq/m3, Qianjiang District 78.0 Bq/m3, Yubei District 73.9 Bq/m3, Youyang County 71.4 Bq/m3 and Shapingba District 69.8 Bq/m3. The five districts/counties with the lowest mean concentration of indoor radon were 37.6 Bq/m3 in Zhongxian County, 36.4 Bq/m3 in Changshou District, 33.7 Bq/m3 in Kaizhou District, 33.2 Bq/m3 in Liangping District and 27.3 Bq/m3 in Wushan County. The concentration levels of radon in four seasons were 46.0 Bq/m3, 53.4 Bq/m3, 45.1 Bq/m3 and 59.5 Bq/m3, respectively. The concentration of radon was higher in Summer and Winter, and lower in Spring and Autumn, and the difference of concentration among four seasons was statistically significant (P<0.001). The radon concentration of newly built buildings after 2017 was relatively high, up to 61.8 Bq /m3, but there was no statistical significance in radon concentration in different building ages (P>0.05). The concentration of radon in rooms of buildings with less than 10 floors was higher, up to 63.2 Bq /m3, and there were significant differences in radon concentration among rooms of different floors (P<0.05). The average annual radon concentration in houses in Chongqing was about (51.6±19.5) Bq/m3, and the average annual effective dose of inhaling radon and its progeny by house-related people was about (1.38±0.52) mSv. Conclusion　The average annual radon concentration level of houses in Chongqing is within the standard limit value recommended by China, but the prevention and control of radon should be strengthened.

Background The domestic and international researches discovered that many proteins and enzymes of the extracellular matrix (ECM) participate in the sclera remodeling by affecting the collagen typeⅠand fibronectin.Objective This study was to investigate the effect of matrixmetalloproteinase-2 (TIMP-2) on expression of collagen typeⅠand fibronectin of ECM in the posterior sclera by injecting liposomes containing tissue inhibitor of TIMP-2 gene into suprachoroidal space of the form-deprivation myopia in guinea pig.Methods Form-deprivation myopia was induced by translucent goggles in 36 clean guinea pig for 2 weeks.Then the animals were randomly assigned to TIMP-2 group,empty plasmid group,saline group and 12 for each group.Liposomes of 5μl containing TIMP-2 gene,empty plasmid and saline were suprachoroidally injected in the right eye respectively,and the left eyes without any treatment were used as self-control group.Other 12 matched guinea pigs only covered the right eyes through out the experimental duration as model control group.The guinea pigs were sacrificed and the posterior sclera tissue of the eyeballs were collected at 2,7 and 14 days after injection of drug.The expressions of collagen typeⅠmRNA and fibronectin mRNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).This study followed the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The expression level of collagen type Ⅰ mRNA in the posterior sclera of guinea pig was lower but that of fibronectin mRNA was higher in TIMP-2 group than self-control group,showing significant differences between them (P＜0.05).The expression level of collagen type Ⅰ mRNA in the posterior scleral tissue began to increase from the 2nd day after drug injection and was obviously elevated at the 7th day and then gradually decreased at the 14th day.However,the expression level of fibronectin mRNA in the posterior scleral tissue showed the opposite pattern.The expression levels of collagen typeⅠmRNA and fibronectin mRNA at the 7th after drug injection were significantly lower than that at the 2nd day or 14th day (P＜0.01).Conclusion Suprachoroidal injection of TIMP-2 in form-deprivation myopia could up-regulate the expression of collagen typeⅠmRNA and down-regulate the expression of fibronectin mRNA in the posterior scleral tissue.It may slow down the sclera remodeling of form-deprivation myopia in guinea pig in the early stage.

Alcohol-Related Disorders ; metabolism ; Animals ; Benzofurans ; pharmacology ; Glutamic Acid ; metabolism ; Hippocampus ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism

High-speed counter-current chromatography (HSCCC) was used to high performance separate and prepare lignans from Schisandrae chinensis fructus. The solvent system is composed of n-hexane-ethyl acetate-methanol-water (9 : 1 : 5 : 5) and n-hexane-ethyl acetate-methanol-water (9 : 1 : 9 : 5), speed is at 900 r.min-1, and flow rate is at 2.0 mL.min-1. Five fractions from Schisandrae chinensis fructus extract were separated and prepared with one HSCCC process. They were identified as schisandrin, gomisin J, schisandrol B, schisantherin A and deoxyschizandrin by electrospray ionization-multiple tandem mass spectrometry (ESI-MSn), respectively. Their contents were obtained in 98.74%, 94.32%, 99.53%, 94.23% and 98.68% by ultra high performance liquid chromatography (UPLC), separately. The rapid and simple method can be applied for the preparation of lignans from Schisandrae chinensis fructus.
Countercurrent Distribution ; Cyclooctanes ; chemistry ; isolation & purification ; Dioxoles ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Fruit ; chemistry ; Lignans ; chemistry ; isolation & purification ; Molecular Structure ; Plants, Medicinal ; chemistry ; Polycyclic Compounds ; chemistry ; isolation & purification ; Schisandra ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

Objective To discuss the diagnosis and surgical management of multilocular cystic renal cell carcinoma (MCRCC) and to evaluate the gene function of the mutation of von Hippel-Lindau (VHL) gene in MCRCC. Methods Seventeen MCRCC cases (11 men and 6 women) out of 512 cases of renal cell carcinoma from 2000 to 2010 were retrospectively analyzed. The mean age of the 17 patients was 46 years (37-61 years). Ultrasonography and CT were available in all 17 cases, and 1 case was misdiagnosed as parapelvic renal cyst. The mutation of VHL gene was detected by PCR in the specimens of can-cerous tissue and adjacent normal tissue from 11 cases of MCRCC. Results Three of 17 cases underwent nephron sparing surgery, the others underwent radical nephrectomy. One case underwent unroofing of parapelvic renal cyst, but the rapid frozen pathology of the cyst wall showed renal cell carcinoma of clear type. As a result, radical nephrectomy was eventually performed. All 17 cases were confirmed as MCRCC by eva-luating pathological characteristics, such as the cyst wall lined by single or several layers of clear tumor cells and the nuclei which were small and anachromasis. Clinical stages of all cases were T1N0M0, in which there were 14 cases with pathological T1G1 and 3 cases with pathological T1G2. All patients underwent a follow-up of 9 to 36 months (mean, 12 months) without recurrence or metastasis. Mutation of VHL gene was detected in 7 of 11 cases (64%), but all adjacent normal tissues were negative. Conclusions As a rare subtype of renal cell carcinoma, MCRCC is difficult to diagnose. CT is an essential measure in diagnosis of MCRCC preoperatively. Because of the good prognosis of reported cases, nephron sparing surgery for the treatment of MCRCC is recommended. VHL gene mutations may play an important role in the carcinogenesis of MCRCC.

Objective To explore the safe bone channels for transverse placement of sacroiliac screws via the second sacral vertebra in the fixation of longitudinal fracture of the sacrum by digital analysis and clinical observation.Methods Firstly,abdomen CT scanning was performed in 50 healthy adult volunteers.They were 30 males and 20 females,aged from 18 to 56 years (mean,34.6 years).After their CT images were transformed by software Materialise Mimics Innovation Suite 15.0,three-dimensional (3D) models of the pelvis were generated,stored in stereolithography format,and transferred into software Imageware 12.0.In the standard antero-posterior position,the sacrum was segmented and the points of 2D image coordinate geometric boundary were extracted to generate an optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra.Secondly,we admitted 10 patients with longitudinal fracture of the sacrum.They were 7 men and 3 women,aged from 20 to 51 years (average,38.3 years).By Tile classification,4 cases were type B2 and 6 type C1.All the fractures were Denis region Ⅱ ones.Pubic ramus fracture was complicated in 3 cases.After traction reduction of the tibial tubercle was conducted for patients with obvious displacement,the optimal channel was calculated on the basis of the CT data.On the lateral images of the sacrum acquired before operation by C-arm fluoroscopy,the optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra was located.After the skin was marked,2.5 mm Kirschner wire was drilled and the 6.0 mm hollow screws were fixated along the Kirschner wire.Postoperative CT scanning images and 3D reconstructed models were analyzed to validate the accuracy of screw placement.Results The projection of safety bone channel on the sagittal fluoroscopy of S2 vertebral body displayed an irregular water drop shape;the projection area in males (213.9 ± 52.4 mm2) was significantly larger than that in the females (171.6 ±49.6 mm2) (P ＜ 0.05).The average length of the channel in men (135.2 ± 12.9 mm) was significantly longer than that in women (121.1 ± 10.1 mm);the average diameter of the screw in men (10.2 ± 0.9 mm) was also significantly larger than that in women (9.1 ±0.8 mm) (P ＜ 0.05).The postoperative X-ray and CT scanning images showed satisfactory positions and lengths of the screws.The screw lengths averaged 98.2 mm;the operation time averaged 25.6 min.No nerve or vascular injury,loosening or breakage of the sacroiliac screws occurred in the patients.Follow-ups for 12 to 24 months revealed no other complications.Conclusion The safety channel for transverse placement of sacroiliac screws via the second sacral vertebra can be determined using the lateral 3D reconstruction images of the sacrum in preoperative planning,which facilitates the percutaneous transverse fixation of longitudinal fracture of the sacrum.