Objective To investigate the methods and therapeutic effects of anterolateral thigh perforator free flaps for reconstruction of soft tissue defects around the ankle.Methods A retrospective case series study was made on 30 patients treated with anterolateral thigh perforator free flaps for traumatic soft tissue defects around the tibia between January 2010 and June 2016.There were 22 males and eight females,with the age range of 16-58 years [(41.5 ± 1.2) years].Dimension of the soft tissue defect ranged from 9 cm ×4 cm to 23 cm × 12 cm.Flap stabilization time,flap survival rate,postoperative complications,second plastic surgery rate,and ankle joint function by Baird-Jackson score were recorded.Results All patients were followed up for (13.0 ± 5.4) months (range,6-24 months).Time for flap stabilization was (6.5 ± 1.1) days.All flaps survived except in one patients with flap loss due to postoperative arterial thrombosis.Postoperatively,one patient had arterial crisis,one had venous thrombosis,and one presented sinus formation due to infection.No second plastic surgery was carried out.According to the Baird-Jackson score,the results were excellent in 25 patients and good in five.Conclusion Anterolateral thigh perforator free flaps for reconstruction of traumatic soft tissue defects around the tibia has advantages of easy harvesting and survival,less postoperative complications,less second surgery,and good function recovery.

Objective To investigate the effects of H_2O_2 on growth and proliferation in CNE-2Z cells.Methods To identify the effects of H_2O_2 on the growth and proliferation in CNE-2Z cells,Cell growth curves,MTT assay and plate colony formation rate were used;Meanwhile,Cell cycle distribution,proliferation index and apoptosis analysis were performed by flow cytometry(FCM) in human NPC cells CNE-2Z in vitro,before and after the action of H_2O_2;the protein expressions of Egr-1,p53,p16,Cyclin D1 were detected by Western-Blotting analysis.Results There were no EGR-1 and P16 proteins expressions in CNE-2Z cells by Western-Blotting analysis before the action of H2O2;the growth and proliferation of CNE-2Z cells were inhibited significantly by H_2O_2 compared with the control cells,and the apoptosis cells were increased.The increased expressions of EGR-1,P53,and Cyclin D1 protein were also shown in CNE-2Z cells by means of Western-Blotting analysis after the action of H_2O_2;but no P16 protein expression;The expression of EGR-1 protein was significant correlation with P53 protein expression,but no significant correlation with Cyclin D1 protein expression.Conclusion There was no EGR-1 protein expression in CNE-2Z cells,and EGR-1 protein can be induced expression rapidly and transiently by H_2O_2,which probably have an important!role in the growth inhibition and apoptosis.The promotor of Egr-1 gene also can be induced activation by radiation(ROS,reactive oxygen species),there is an important application in therapy of NPC and other tumors.

Objective To investigate the feasibility and effects of modified Stoppa approach in treatment of anterior pelvic ring fractures.Methods The therapeutic effects of 21 patients with anterior pelvic ring fractures treated through the modified Stoppa approach from June 2008 to August 2011 were summarized and analyzed.According to Tile classification,there were seven patients with type A2 fractures,six with type B2 fractures,five type B3 fractures and three type C2 fractures.Surgical treatment through the modified Stoppa approach included anterior pelvic ring plates for 14 patients,anterior pelvic ring plates and external fixators for four and anterior pelvic ring plates and sacroiliac joint compressed cannulated screws for three.The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.Results The incision length of the modified Stoppa approach ranged from 10 to 12 cm ( average,11 cm).The operation time ranged from 70 to 120 minutes ( average,95 minutes).The intra-operative blood loss ranged from 400 to 1 000 ml (average,700 ml ).According to the Matta criteria,all 21 patients obtained sound reduction,of whom 15 patients had bony union after 8-20 months follow-up post-operatively.The Majeed score in all patients showed a gradual increase postoperatively.Conclusions The modified Stoppa approach is characterized by convenience and directness in making incisions,clear operation field,easy reduction,few complications and fast recovery and hence is an ideal choice in surgical treatment of anterior pelvic ring fractures.

Objective To investigate the effect and the mechanism of epithelial-mesenchymal transition (EMT) in renal tubular cells induced by uric acid.Methods Normal rat kidney tubular cell line (NRK-52E) were exposed to different concentrations of uric acid (100,200,400,600,800 μmol/L UA) for 48 hours to induce EMT.Morphological changes of the NRK-52E cells were examined under an inverted phase contrast microscope.The protein expression of E-cadherin,α-SMA,p-Akt and Akt were detected by Western blotting.The distribution of E-cadherin and α-SMA were detected by immunofluorescence.NRK-52E cells were pretreated by different concentrations of LY294002(0,2.5,5,10,15 μmol/L),the inhibitor of PI3K/p-Akt signaling pathway,and then processed by uric acid (400 μmol/L) for 48 hours.Western blotting was used to detect the protein expression of p-Akt and Akt.NRK-52E cells were then divided into four groups:normal group (N),uric acid group (UA),LY294002 group (LY),uric acid with LY294002 group (UA + LY).The protein expression of E-cadherin and α-SMA were detected by Western blotting,the distribution of E-cadherin,α-SMA and p-Akt were detected by immunofluorescence.Results There was abundant cellular expression of E-cadherin in unstimulated renal tubular cells whereas its expression was significantly decreased in uric acidstimulated cells (P ＜ 0.05).In addition,uric acid induced de novo expression of α-SMA in contrast to almost negative staining in untreated cells (P ＜ 0.05).p-Akt were obviously increased in high uric acid group (P ＜ 0.05) and Akt changed not significantly (P ＞ 0.05).NRK-52E cells transformed into elongated fibroblast-like cells from cuboidal clustered epithelial cells.These indicated that uric acid has induced EMT and activated PI3K/p-Akt signaling pathway in NRK-52E cells.However,the above effects of uric acid were abolished when p-Akt was blocked by the PI3K inhibitor (10,15 μmol/L LY294002),indicated that LY294002 has reversed the trend of EMT.Conclusions High uric acid induces phenotypic transition of renal tubular cells probably via activating PI3K/Akt signaling pathway.

Objective To assess the impact of physical training on physiological function of adult renal transplant recipients by meta-analysis and to provide theoretical guidance for clinical practice.Methods Randomized controlled trials of physical training for the treatment of renal transplant recipients until October 2017 were searched in the database of Cochrane library,PubMed,Embase,Web of Science,Wanfang Data and CNKI.Data extracted from the literatures were analyzed with RevMan software (version 5.3).Results A total of 10 studies in 10 manuscripts met the inclusion criteria,and 557 cases were included.Meta-analysis results were as follows.Compared with the control group (routine drug therapy),the level of peak exercise oxygen uptake (peak VO2) was significantly increased in physical training group (routine drug therapy and physical training) (MD=2.40,95％ CI 0.15-4.64,P=0.04).However,there was no statistically significant difference in the change of blood lipid,blood pressure,hemoglobin and serum creatinine between the two groups (all P ＞0.05).Conclusions Physical training can improve cardio respiratory fitness of renal transplant recipients in the early stage,but it has no obvious effect on blood pressure,blood lipid,hemoglobin and blood creatinine.

AIM: To evaluate the bioequivalence of cinacalcet hydrochloride tablets in healthy Chinese volunteers. METHODS: A randomized, open, double-period and crossover trial was conducted, 48 healthy volunteers were administered a single dose of cinacalcet test tablets or reference tablets orally under each fasting and fed condition. The concentration of cinacalcet was determined by validated LC-MS/MS method. Pharmacokinetic parameters were calculated by Phoenix WinNonlin 8.0 to study its bioequivalence. RESULTS: The main pharmacokinetic parameters of test tablets and reference tablets under fasting condition were as follows: C