[Objective]To investigate the clinic application of the reversed sural neurocutaneous island flap in repairing the soft tissue defect of the foot and ankle.[Method]From June 1997 to December 2007,38 cases of the lower leg,around the ankle and the heel soft tissue defects were treated with the reversed sural neurocutaneous island flap.The average of the patients was 38.3 years(range 5 to 65).The longest medical history was 11 years.The lagest area of flap was 17 cm?12 cm and the smallest was 5 cm?4 cm.[Result]Thirty-three flaps were completely survived,there were 5 cases with distal edge of the flaps partially necrosis and healed after short time dressing change.The patients were followed up for half a year to 10 years and the curative effect was satisfactory.[Conclusion]The reversed sural neurocutaneous flap is simple to harvest and its blood supply is reliable without the sacrifice of a major blood vessel.So it is an ideal method for repairing the soft tissue defect of the foot and ankle.

The relationship between blood pressure and various risk factors were investigated in 54 cases of non-insulin-dependent diabetes mellitus (NIDDM) with stepwise regression analysis. After evaluating the influence of age, course, body mass index (BMI), fasting and postprandial blood glucose, serum IRI, C-peptide, HbA1c, plasma lipids (Ch, TG, HDL-C. LDL-C). ApoA1, ApoB2, 24h urine Alb/Cr, NAG/Cr. TRF Cr and RBP/Cr levels on blood pressure, the following results were found: 1) NIDDM patients had a two-fold increased risk of hypertension than normal population. 2) Among the 21 risk factors analysed, 6 variables were strongly correlated with blood pressure, i. e. , age, postprandial blood glucose, serum IRI, blood total cholesterol, 24h urine Alb/Cr and TRF/Cr level. 3) Postprandial hyperglycemia was the most important variable positively correlated with hypertension, followed by 24h urine Alb/Cr and plasma total cholesterol.

0.05],butwaslowerthanthatof STZ group [(9.59?1.08)mmol/L, P

Objective: To investigate the influence of high-fat diet on glucose metabolism and fatty acid composition of serum phospholipid in OLETF rats, a model of spontaneous type 2 diabetes mellitus. Method: Twenty male OLETF rats of 14 w age were divided into 2 groups randomly. The dietary fat in two groups contained identical percentages of saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids. Oral glucose tolerance test and measurement of insulin level were performed after 10 w treatment. The fatty acid composition of serum phospholipid in rats was observed as well. Results:The food intakes were comparable in 2 groups. The body weight gain in high-fat group was higher than standard group during the experiment. The result of oral glucose tolerance test and measurement of insulin level showed that the glucose metabolism in two groups had no significant difference. Only the percentage of total n-6 polyunsaturated fatty acids, 18:3(n-3) of serum phospholipid were comparable, percentages of other fatty acids were significantly different in two groups. Conclusion:With the comparable fatty acid composition, higher dietary fat lead to more body weight gain, but had no significant influence on glucose metabolism in OLETF rats. The amount of dietary fat had significant effect on fatty acids composition of serum phospholipid in OLETF rats.

Objective:To explore the changes of neuron-specific enolase (NSE) and S-100β protein (S-100β) during perioperative period in infants undergoing living liver transplantation and examine the effect of brain injury.Methods:From January 2015 to January 2016 in Department of Anesthesiology First Central Clinical College Tianjin Medical University, study group was composed of forty infants of congenital biliary atresia with an age range of (4-12) months, a body weight of (4-10) kg and American Society of Anesthesiologists (ASA) class Ⅲ/Ⅳ. Another 40 infants undergoing general surgery were selected as control group. In study group, blood samples were harvested from central vein pre-operation (T0), before skin incision (T1), 30 min after anhepatic phase (T2), 1 h of neohepatic phase (T3) and 24h after hepato-reperfusion (T4). In control group, blood samples were collected at pre-operation (T0) and 24 h post-operation (T4). Serum levels of S-100β, NSE, heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and bispectral index (BIS) were monitored at T1-4 and end of surgery. All children were assessed by Bayley Scale of Infant Development (BSID) at Day 1 pre-operation and 2/4 weeks post-operation for observing mental and motor development status. The results were described with mental development index (MDI) and psychomotor development index (PDI). Pediatric anesthesia emergence delirium (PAED) was employed for evaluating the severity of delirium during the recovery stage at 30 min and 2/4h post-extubation.Results:In study group, serum levels of S-100β and NSE changed significantly during non-hepatic and neohepatic reperfusion phases. After inferior vena cava occlusion, serum concentrations of S-100β and NSE spiked ( P<0.05) and gradually recovered during neohepatic reperfusion period ( P<0.05). No significant inter-group difference existed in serum S-100β or NSE at T4 ( P>0.05). In study group, as compared with Day 1 pre-operation, MDI/PDI decreased at Week 2 post-operation ( P<0.05) and increased from Month 1 post-operation ( P<0.05). Both MDI and PDI were lower than control group before and at Week 2 post-operation ( P<0.05). MDI/PDI of study group basically reached the preoperative level at Month 1 post-operation ( P<0.05). In control group, no significant difference existed in MDI/PDI at Day 1 pre-operation and Week 2/4 post-operation ( P>0.05). In study group, the delirium rate was up to 30% post-extubation and decreased at 2/4h post-extubation. In control group, the incidence of delirium was low at 30 min and 2/4h post-extubation ( P<0.05). Conclusions:Perioperative evaluations of serum levels of NSE and S-100β are significant for predicting the postoperative onsets of delirium and cognitive impairment in children with living donor liver transplantation.

BACKGROUND: The conventional X-ray imaging has low absorption contrast for lymphoedema, and the resolution is about mm level, which is not conducive to early diagnosis. Micro-imaging of biological soft tissues can be achieved by phase-contras imaging technique. OBJECTIVE: Using synchrotron radiation in-line phase contrast imaging technique to achieve the lymphoedema model imaging and observe the lesions characteristic of lymphatic vessels. DESIGN, TIME AND SETTING: Observational experiment. The lymphoedema model was prepared at the Capital Medical University from May to June in 2009. And the experiment was completed in Shanghai Synchrotron Radiation Facility (SSRF) BL13W1 in June 2009. MATERIALS: Five New Zealand rabbits were prepared for lower extremity lymphoedema models. METHODS: The lower extremity lymph node eradicates operation was performed on rabbits to result in lower extremity lymphoedema. And the synchrotron radiation in-line phase contrast imaging technology was used to collect the projected image of specimens within the 180°, and to reconstruct three-dimensional image. MAIN OUTCOME MEASURES: Severity of lymphatic vessels and the wall thickness. RESULTS: The lymphatic vessel was swollen, bent and distorted. And the lymphatic vessel generates lateral branches in order to promote lymphatic drainage, which was clearly observed from the image obtained by phase contrast imaging technology.CONCLUSION: The use of synchrotron radiation type coaxial imaging technology can be achieved for lymphedema model for micro-imaging, which has certain significance to the early diagnosis of lymphedema.

Objective To summarize and analyze regularities in clinical use of acupoint application for headache. Method Fifth version Chinese Medical Classics database was searched. Thirty-three library-stored ancient books were searched manually. The ancient literature included for the study was sorted out. Descriptive statistical analysis was made of classification, point selection, used medicine, excipients and dosage forms for acupoint application for headache. Result A total of 51 pieces of literature was included. Statistical analysis showed that there were nine kinds of disease names, three types of classification-based treatment, eight acupoints, fifty kinds of medicines, eight hinds of excipients and five kinds of dosage forms. Conclusion Headache is the most basic nomenclature for pains in the head. Classification-based treatment fully embodies the idea of treatment based on disease differentiation mainly in combination with syndrome differentiation. Point Taiyang is the main point for local selection of point. The most frequently selected medicines are those of going through meridians, opening the orifices, unblocking collaterals and having thick smells. Blistering medicines are used cautiously. Scallion juice is most frequently used as excipients. Medicinal cakes are dosage forms most suitable for acupoint application for headache.

Objective To evaluate the clinical outcomes and correction accuracy of posttraumatic varus and valgus knee deformities using the Taylor Spatial Frame (TSF).Methods From June 2006 to December 2010,26 patients with posttraumatic varus and valgus knee deformities who had been treated with the TSF combined with less invasive high tibial osteotomy (HTO) or supracondylar femur osteotomy (SFO) were retrospectively analyzed,including 19 males and 7 females with an average age of 39 years.There were 20 cases of posttraumatic varus knees and 6 valgus knees.Twenty one patients were treated with HTO and 3 with SFO,2 with HTO and SFO simultaneously.During the operation,the TSF was firstly assembled and then the parameters of the frame were measured followed by less invasive percutaneous osteotomy.Correction was started seven to ten days after the operation following the time schedule provided by the computer program.Correction of the struts were performed 3 times per day,with a total movement of 0-3 mm.Results Through 7-35 days frame adjustments,20 cases of deformities were fully corrected.X-ray showed that the mechanical axis deviations of the tibia and femur all were recovered to normal range,and the deformity of rotation,angulation and crispation were fully corrected.Six cases had residual slight angulation or crispation deformity ( ＜ 4° or ＜ 10 mm).Through the second 4-10 days frame adjustments,these 6 cases of deformities were fully corrected finally.New bone formation and consolidation on the osteotomy site were good.The fixators were removed from 2.5-6.0 months after surgery and the appearance of the limbs and the patients' gait recovered to normal and the keen pain disappeared.All patients were followed up for 12-60 months and without the recurrence of the deformity.Eleven cases occured pin site infection and were controlled by use of the sensitive antibiotics.One case occured refracture of the distal femur osteotomy site 1.5 months after frame removal.Through conservative treatment,the fracture finally healed.Conclusion Posttraumatic varus and valgus knee deformities can be effectively corrected by using TSF and with a high accuracy.

The effect of diet with various fatty acid composition on insulin resistance in male OLETF ratswas observed. The results showed that it was beneficial to insulin sensitivity in rats fed with ? 3 polyunsaturated fatty acid rich food.

To investigate the effect of pancreatic elastase on diabetic nephropathy,104 cases of type Ⅱ diabetic patients were selected as control group and group treated with elastase separately for a course of 6 months.The results showed that pancreatic elastase reduced microproteinuria significantly,especially mi- croalbuminuria and microtransfer rrinuria which reflect the glomerular filtration rate.It was concluded that elastase could improve early diabetic nephropathy and might have some protective effect as well.At the same time,elastase had some good effect on lipid and lipoprotein metabolism.