Objective To investigate the clinical efficiency of kid foot soft tissue defect with reverse flap with cutaneous branch of fibular artery combine with sural nerve nutritional vessel axial. Methods From Feb. 2006 to Feb. 2009, according to the position and size of the soft tissue defects, the sural nerve nutritional vessel flap combine with the cutaneous branch of the peroneal artery were desingned and obtained to repair the 5 cases soft tissue defects of the foot. The flap size ranged from 8 cm × 7 cm to 18 cm × 10 cm. The vessel pedicle of cutaneous branches ranged from 1.7 cm to 3.0 cm. The distribution of the vessel pedicle of cutaneous branches ranged from 4.5 cm to 8.0 cm on the lateral malleolus. Results All flaps survived completely in 6 cases. The outline and function were satisfactory during 6-18 months follow-up. Among of 6 cases, the sural nerve were anastomosed with the acceptor sensory nerve in all cases. The skin sense were sat-isfactory after 1 year of operation and 2-point discrimination was 10-13 mm. Conclusion The blood supply of this flap is reliable without sacrifice of major arteries. Flap elevation is easy. It can reverse to a long dis-tance and can repair large skin defects. Especially this flap could have some sensory nerve. It is very useful in repairing kid foot large soft tissue defect.

Objective To isolate HIV-specific T cell clone and to expand them in vitro through the activation-induced expression of CD137 molecule.Methods The peripheral blood mononuclear cells were isolated from HIV-infected patients and HIV Gag specific CD3+CD8+CD137+T cell subset were sorted to 96-well plate in 1 cell/well by multicolor flowcytometry and single cell sorting.After 14 days in vitro culture with feeder cells and cytokines, the numbers and phenotypes of the cultured HIV-specific T cells were calcu-lated and identified.Results The CD137 expression was low on rested T cells but up regulated by the stim-ulation with Gag peptide pool.The CD8+CD137+T cells could secret IFN-γ.The number of CD8 T cells reached to 106 after 14 days in culture and expanded to 107-108 cells after 28 days of culture in vitro 100%of the cells remained activated upon Gag stimulation.Conclusion In stead of using IFN-γ, CD137 could be utilized as a novel molecule to isolate and expand HIV specific T cells in vitro.The expanded antigen spe-cific T cell clones could maintain good activation status.

BACKGROUND: Traditional Chinese medicine (TCM) has a long history of preventing and treating postmenopausal osteoporosis. With the social development, research in relevant fields is gradually developed. However, there are few analysis and systematic reviews regarding publications, core authors, and research strength in this field. OBJECTIVE: Using visualization method of CiteSpace knowledge map to analyze the relevant literature about prevention and treatment of postmenopausal osteoporosis with TCM, to understand the development, research hot spots and trend of this field, and to offer evidence and advice for the subsequent development. METHODS: The relevant literature about prevention and treatment of postmenopausal osteoporosis with TCM (1993-2019) was retrieved from CNKI and exported in Refworks format. We analyzed the annual number of papers published, scientific research funding, and high-frequency cited literature. CiteSpace V software was used to create knowledge maps of the authors, research institutions and keywords, for visualization analysis. RESULTS AND CONCLUSION: A total of 453 articles were included. The research of this field started from 1993 and was gradually addressed. Journal articles were the main form of research literature in this field. Natural Science Foundation of China was the most financial support. There were 12 core authors in this field. Zheng Hongxin, Liang Wenna, and Ge Jianrong were the main researchers who established their own research team. The most important research institutions included Orthopaedic Hospital Affiliated to Guangzhou University of Chinese Medicine and Liaoning University of TCM. Nine typical clusters of keywords were formed and there was a shift in research direction. To conclude, the research on the prevention and treatment of postmenopausal osteoporosis with TCM have been developed for over 20 years and is still on the rise with the formation of multiple research forces and research themes. It is expected to promote and boom the development of TCM by integrating the research of TCM into national development strategies, by strengthening cooperation between regions and institutions, and by exploiting the characteristics of TCM.

ObjectiveTo investigate imaging features of the liver, portal vein and hepatic vein or transhepatic inferior venacava in patients with severe liver cirrhosisin multidetector row computed tomography ( MDCT), and assess the feasibility, safety and clinical significance of percutaneous transhepatic intrahepatic portosystemic shunt (PTIPS). MethodsFifty patients with severe liver cirrhosis confirmed by clinical data and imaging examination were enrolled in this study. Simulation of intrahepatic portosystemic shunt by percutaneous transhepatic approch is as follows. The right midaxillary line (the eighth or ninth intercostal space) was selected as puncture point A the right branch of portal vein was puncture point B,transhepatic inferior vena cava was puncture point C, and the distal part of right portal vein was D. A-B-C connection is simulated as percutaneous transhepatic puncture tract, C-B-D connection is simulated as portosystemic shunt tract.After tri-phase contrast-enhanced CT scanning, postprocessing images through multiple planner reconstruction ( MPR ) were obtained. The data were indicated statistically by x ± s. And 95％ confidence interval for mean was calculated.Anatomic relationship among the right portal vein,transhepatic inferior vena cava, hepatic artery and bile duct were analyzed for all patients. ResultsThe length of the needle (A-B-C) is ( 145. 7 ± 14. 8 ) mm. The curvature of the needle ( the angle of A-B line and B-C line) is ( 145.0 ±9.9)°. The length of transhepatic shunt tract (B-C) is (42.7 ±7.2) mm. The length of the shunt tract (C-B-D) is ( 117. 7 ±11.6 ) mm; The angle of the shunt tract ( the angle of B-C line and B-D line) is (1O8.5 ± 5.9)°. In 24/50 patients, transhepatic inferior vena cava locate in the dorsal of the right portal vein, in 26/50 patients they are in the same plane.In all patients, the right branches of hepatic artery and bile duct locate in the ventral of the right portal vein.Conclusion The procedure of PTIPS is feasible and safe. To quantify the length and angle of the needle and the length and angle of the shunt tract provides the anatomic basis for clinical application.

Objective To explore the related factors of anxiety and gloomy mentality people aged 60-80 years and investigate the effectiue methods to intervention.Methods A follow-up study was proportional and carried out in Xicheng district of Beijing.Multi-phase,stratified,unequal cluster sampling was adopted to investigate old people in 2011 with WHO-QOL,Memorial University of Newfoundl and Scale of Happiness,Social Support Rating Scale,Self-Rating Anxiety Scale and Self-rating Depression Scale.2342 old people were randomly divided into control group and trial group.The trial group received health education,community social support,lightening the psychological stress in face to face,psychology guiding and group discussion.The control group received general observation only.Results Among 2342 old people,126 (5.3％) obtained anxiety and 201(8.6％) had gloomy mentality.The anxiety in the elderly was significantly related to age,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,keeping pets,character,training,feeling adjusting,life quality,subjective well-being,social support,depression (all P ＜ 0.05).The depression in the elderly was significantly related to gender,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,watching plays,character,feeling adjusting,drinking,training,life quality,subjective well-being,social support,anxiety (all P＜0.05).Scores of two groups had no significant difference before intervention.The change in scores of anxiety and depression in the trial group was obviously lower than in control group (P＜0.05).Conclusions The anxiety and gloomy mentality are common in old people aged 60-80 years in Xicheng District,which independently associated with related factors such as life quality,subjective well-being,social support and so on.After 6 months of treatment,the scores of anxiety and depression in the trial group is obviously lower than in control group.

This study is to develop an HPLC method for the simultaneous determination of (-)-epicatechin, 5-O-caffeoylshikimic acid, neoisoastilbin, astilbin, neoisoastilbin, isoastilbin and engeletin in Smilacis Glabrae Rhizoma. Samples of Smilacis Glabrae Rhizoma, Heterosmilacis Chinensis Rhizoma and Heterosmilacis Yunnanensis Rhizoma were separated on an Agilent Zorbax SB-C18 column with gradient elution of acetonitrile-0.05% phosphoric acid at a flow rate of 1.0 mL · min(-1). The detected wavelength was set at 230 nm and the column temperature was maintained at 35 °C. The contents of (-)-epicatechin, 5-O-caffeoylshikimic acid, neoastilbin, astilbin, neoisoastilbin, isoastilbin and engeletin in 84 Smilacis Glabrae Rhizoma samples were in the range of trace-1.381, trace-9.913, trace-3.673, 0.6706-27.08, trace-1.181, trace-4.833 and trace-2.754 mg · g(-1), respectively. The established method was used for analysis of common adulterants. The results demonstrated that the contents of (-)-epicatechin in Heterosmilacis Yunnanensis Rhizoma and Heterosmilacis Chinensis Rhizoma were 0.01163-0.06007 mg · g(-1) and 0.01583-0.08585 mg · g(-1), respectively, while the other six constituents were not detected. The method is simple and accurate, and can be used for the quality control of Smilacis Glabrae Rhizoma. The constituents of Heterosmilacis Yunnanensis Rhizoma and Heterosmilacis Chinensis Rhizoma are significantly different from Smilacis Glabrae Rhizoma, and they are not suitable for using as Smilacis Glabrae Rhizoma.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Liliaceae ; chemistry ; Rhizome ; chemistry

Objective:To investigate the relationship between body mass index (BMI) and response time of cardioinhibitory type vasovagal syncope (VVS-CI) in children.Methods:The clinical data of 56 children with syncope or pre-syncope were retrospectively analyzed and they visited specialist clinic for syncope and were diagnosed as VVS-CI in the Second Xiangya Hospital, Central South University from December 2012 to September 2019.Based on height and weight, BMI was calculated, and divided into low BMI group (35 cases) and normal BMI group (21 cases). Between the 2 groups, baseline heart rate, head-up tilt test (HUTT) positive response heart rate, baseline head-up tilt test (BHUT) positive response time, and sublingual nitroglycerin-provocated HUTT (SNHUT) positive response time were compared.The correlation between BMI and positive response time was analyzed.SPSS 22.0 software was applied for statistical analysis.Results:There were no significant differences in age, sex, duration of disease and number of syncope between the 2 groups (all P>0.05). No significant differences were found in baseline heart rate and positive response heart rate between the 2 groups [(78.5±15.3) times/min vs.(72.8±8.7) times/min, t=1.223, P=0.230; (44.0±13.9) times/min vs.(47.0±10.0) times/min, t=-0.664, P=0.511]. Compared with normal BMI group, BHUT positive patients/SNHUT positive patients were higher in low BMI group (27/8 cases vs.9/12 cases, χ2=4.839, P=0.027), and the positive response time of BHUT was shorter [(13.1±4.6) min vs.(23.7±9.5) min, t=-2.691, P=0.023]. There were no significant differences in SNHUT positive response time between the 2 groups ( P>0.05). Low BMI was correlated with BHUT positive response time ( r=0.750, P=0.005). Normal BMI was not associated with BHUT positive response time ( r=0.316, P=0.217). There was no correlation between low BMI and normal BMI and SNHUT positive response time ( r=0.177, P=0.431; r=0.021, P=0.940). Conclusions:Low BMI is positively correlated with BHUT positive response time of children with VVS-CI.The time it takes for syncope occurrence was shorter in children with low BMI than that in normal BMI.

Objective:To investigate the difference of heart rate variability in cardioinhibitory type vasovagal syncope(VVS-CI) children with different body mass index(BMI).Methods:Clinical data of thirty-four children with syncope or pre-syncope were retrospectively analyzed, who visited specialist clinic for syncope and diagnosed as VVS-CI at the Second Xiangya Hospital of Central South University from January 2012 to December 2019.BMI was calculated based on height and weight, and divided into lean group(BMI≤18.4 kg/m 2, n=19) and normal group(BMI 18.5-23.9 kg/m 2, n=15). Heart rate variability(HRV) of 24 h dynamic electrocardiogram was analyzed using linear analysis method.Time domain index included SDNN, SDANN, rMSSD and pNN50.Frequency domain index included total power(TP), ultra low frequency power(ULF), very low frequency power(VLF), low frequency power(LF), high frequency power(HF) and LF/HF. Results:There was no significant difference in SDNN, SDANN and rMSSD between lean and normal group( P>0.05), but pNN50 increased in lean group( P<0.05). No significant differences were found in TP, ULF, LF, HF and LF/HF between two groups( P>0.05), while VLF was lower in lean group than that in normal group( P<0.05). There was no statistical difference in time domain index and frequency domain index between different gender between lean and normal group( P>0.05). SDNN, SDANN and LF were higher in<12 years old than those in≥12 years old in lean group( P<0.05). There was no statistical difference in rMSSD, pNN50, TP, ULF, VLF, HF and LF/HF( P>0.05). ULF increased and LF decreased in<12 years old compared to ≥12 years old in normal group( P<0.05). No statistical differences were found in SDNN, SDANN, rMSSD, pNN50, TP, VLF, HF and LF/HF( P>0.05). Conclusion:The autonomic nervous regulation function of VVS-CI children with low BMI and normal BMI is different, resulting in HRV difference.There were also differences in HRV between<12 years old and ≥12 years old with the same BMI.

BACKGROUNDAlthough clinical treatment for heart failure and sudden death has been improved over the last few decades, the morbidity and mortality of dilated cardiomyopathy (DCM) have increased. So a better understanding of the underlying molecular events leading to DCM is urgent. Persistent viral infection (especially coxsackievirus group B3) of the myocardium in viral myocarditis and DCM has never been neglected by experts. Recent data indicate that the up-regulation of coxsackievirus and adenovirus receptor (CAR) in viral cardiomyopathy contributes to viral infection as a key factor in the pathogenesis of this disease. This study aimed to investigate the role and regulatory mechanism of CAR in DCM by the bioinformatic method.

METHODSWe identified the clusters of genes co-expressed with CAR by clustering algorithm based on the public available microarray dataset of DCM (Kittleson, et al. 2005), and mapped these genes into the protein-protein interaction networks to investigate the interaction relationship to each other at the protein level after confirming that the samples are characterized by the cluster of genes in correctly partitioning.

RESULTSThe gene cluster GENESET 11 containing 33 genes including CAR with similar expression pattern was identified by cluster algorithm, of which 19 genes were found to have interaction information of the protein encoded by them in the current human protein interaction database. Especially, 12 genes present as critical nodes (called HUB node) at the protein level are involved in energy metabolism, signal transduction, viral infection, immuno-response, cell apoptosis, cell proliferation, tissue repair, etc.

CONCLUSIONSThe genes in GENESET 11 together with CAR may play a pathogenic role in the development of DCM, mainly involved in the mechanism of energy metabolism, signal transduction, viral infection, immuno-response, cell apoptosis and tissue repair.

Objective To establish a method for content determination of total flavones and polysaccharides in Hedysari Radix in different producing areas in Gansu Province.Methods The contents of total flavones and polysaccharides in Hedysari Radix in different producing areas in Gansu Province were determined by ultraviolet spectroscopy with calycosin-7-glucoside and glucose as reference substance, and the wavelength was set at 260 nm and 484 nm.Results The contents were from 2.82 mg/g to 6.79 mg/g for total flavones and from 106.14 mg/g to 746.40 mg/g for total polysaccharides in Hedysari Radix in different producing areas in Gansu Province. The recoveries of total flavones and total polysaccharides were 97.96％ and 102.90％, respectively.Conclusion There was difference in contents of total flavones and polysaccharides of Hedysari Radix in different producing areas in Gansu Province, and the method of using ultraviolet spectroscopy is simple, reproducible, accurate and reliable, which can be preferably used as the method for content determination of total flavones and polysaccharides in Hedysari Radix.