To investigate the effect of transfection of adenovirus mediated vascular endothelial growth factor B (VEGF B) gene transfer on the proliferation of endothelial cells. We constructed a replication deficient recombinant adenovirus vector coding for human VEGF B, and detected its gene transcription and expression in Ad. VEGF B infected rat arotic endothelial cells (RAECs) with RT PCR and western blat. The effect of Ad.VEGF B on RAECs prolifeation was examined by MTT assay on days 1, 2, 3, 5, 7 after infection. RAECs were successfully infected with high efficiency and expressed a special protein that is immunoreactive to anti VEGF B monoclonal antibody. This protein could be detected in the culture medium. The proliferation assay of RAECs infected with VEGF B expressing adenovirus revealed a significant increase in cell number over control. These results implied that the use of VEGF B expressing recombinant adenovirus may induce angiogenesis, which might be potential in vivo gene therapy for ischemic heart disease.

Objective To study the technical skill and therapeutic effect of aortic isolation for treating DeBakey Ⅲ dissecting aneurysm.Methods Among 20 cases of DeBakey Ⅲ dissecting aneurysm,7 cases were with DeBakey Ⅲ a and 13 cases were with DeBakey Ⅲb.Imaging examinatin showed that among the 20 cases there were 5 cases with more than two tearings at difreret site.Covered stent was used to close left subclavian artery in 7 cases and distaI aortic isolation of left subclavian artery was conducted in other 13 cases.Restuls All cases were followed up for 3-40 months,finding that 19 cases survived but one case died because of pseudocoele bronchial fistula hemoptysis 18 months later.Conclusions Endovasular covered stent grafts is the simple,safe and effective way to treat dissecting aneurysm.

Obstructive sleep apnea (OSA)is a high incidence of potentially dangerous disease,characterized by intermittent hypoxia or hypercapnia.It is an independent risk factor for ischemic stroke.Currently a number of studies have confirmed OSA closely associated with oxidative stress.In this paper,the complex mechanisms of oxidative stress in the OSA and the occurrence of stroke will be reviewed,such as promoting atherosclerosis,damaging the mitochondria,ischemia -reperfusion injury,ischemic preconditioning.To investigate the relationship between OSA,oxidative stress and stroke from molecular mechanisms.

A case of a 3-year-old child suffered with severe crush injury to the right forearm and right hand on June, 2017. A comprehensive treatment was conducted with limb salvage, free flap repair and the repair of nerve, vessel and tendon for functional reconstructions followed by rehabilitation therapies. The function and appearance of the injured limb and hand recovered well 3 years after surgery.

Objective To evaluate the clinical results of operative treatments for the complex posterior tibial plateau fractures via posterior approach. Methods Eleven cases with complex posterior tibial plateau fracture from June 2008 through June 2010 were reviewed retrospectively. There were 7 males and 4females, with age from 33 years to 60 years (average, 47.8 years). According to AO classification, there were 41-B2.2.4 type in 2 cases, 41-B3.1.2 type in 3, 41-B3.3.2 type in 3, 41-B3.1.2 type combined 41-B3.3.2 type in 2, 41-C3.3 type in 1. Carlson posterior lateral approach were used in 5 cases, posterior medial approach were used in 3 cases, and posterior medial and/or lateral approach combined with anterior approach were used in 3 cases. All fractures were fixed with plates. Autogenous ilium grafts were used if necessary.Results All cases were followed up. The average follow-up time was 1.6 years (range, 3-24 months). At the final follow-up visit, bone union was obtained in all cases. The mean Rasmussen score was 16.7 (range, 15-18), and the mean HSS was 86.2 (range, 75-96). The postoperative knee range of motion were 0°-135°, 0°-130° and -10°-125° in 5 cases with posterior lateral plateau fractures, 3 cases with posterior medial plateau fractures and 3 cases with anterior and posterior plateau and intercondylar fractures respectively. There was no vascular and nerve injuries. Loosing or breaking of hardware's was not found. Conclusion The Carlson posterior lateral and/or medial approach is preferred for the complex posterior plateau fractures, with the advantages of direct reduction and stabilization.

With the development of science and the progress of age,medicinal chemistry is not only limited to the lead discovery and the structure-activity relationship studies,but also finding the target of bioactive small molecule drugs has be-come a tough issue to be solved.The identification and validation of bioactive small molecule targets has become the most criti-cal and difficult task,which plays a decisive role in academic and pharmaceutical research.Herein we summarize the current methods for target identification of small molecules,and mainly discuss about the target identification method by the chemical probes.Recent cases of successful application were also introduced to demonstrate the strategy of probe synthesis and design.

Objective: To explore the clinical effects of expanded forehead flaps in repairing midfacial defects. Methods: From January 2003 to December 2018, 19 patients with midfacial defects were admitted to our unit, including 8 males and 11 females, aged 7 to 52 years. One cylindrical expander with rated capacity ranged from 100 to 170 mL was placed in the forehead of patients in the first stage of expansion, and the total water injection volume was about 2 times of the rated capacity of the expander during 1 to 2 months. The area of midfacial defects was 4 cm×2 cm to 9 cm×5 cm after resection in the second stage surgery. Expanded forehead flaps with vascular pedicle of supratrochlear vessels or frontal branch of superficial temporal vessels were used to repair the midfacial defects, with flap size ranging from 5 cm×2 cm to 16 cm×6 cm. The donor sites were closed by direct suturing. Three weeks later, the pedicle was divided. The complications, blood supply after flap transfer and pedicle division, and the treatment effects during follow-up were observed. Results: Among the patients, flaps of 11 patients had vascular pedicle of supratrochlear vessels; flaps of 8 patients had vascular pedicle of frontal branch of superficial temporal vessels. All the flaps survived with no complications and good blood supply after flap transfer and pedicle division. During the follow-up of 6 to 12 months after the third stage surgery of pedicle division of 12 patients, no lower eyelid ectropion occurred, the appearance of the flaps was similar to the surrounding tissue with no swelling. Conclusions The application of expanded forehead flaps can not only repair the defects but also effectively avoid the complication of lower eyelid ectropion, which is a promising method in repairing midfacial defects.

Objective:To analyze the effective and safety of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA) at one tertiary center, and to improve the outcomes of RAAA under fast-track protocol.Methods:Nineteen cases of RAAA in the 940th Hospital of Joint Logistic Support Force of PLA from January 2014 to December 2020 were reviewed retrospectively. EVAR-fist strategy was employed from the emergency room to the operating room by using fast-track protocol. Preoperative management, anatomic characteristics, choice of anesthesia, operative procedures and postoperative complications were collected and analyzed. Abdominal compartment syndrome (ACS) and hospital mortality were paid special attention.Results:Nineteen cases were undergone EVAR procedures. The age was (73.4 ± 7.4) years old, and the AAA size was (67.8 ± 13.6) mm. Two cases underwent cardiopulmonary resuscitation at emergency department. General anesthesia was used in 13 patients and local anaesthesia in 6 patients. Successful stent graft deployment was achieved in all cases. The duration from emergency room to operating room was (84.8 ± 22.4) min. The hospital stay time was (9.7 ± 5.7) d. The hospital mortality was 5/19. The 5 deaths were reviewed: 3 died for multiple organ failure, 1 for irreversible shock, and 1 for ongoing bleeding.Conclusions:Excellent results were confirmed by using EVAR-first strategy for RAAA. The management of hemodynamically unstable state, standardized endovascular procedure, fast-track program and multidiscipline team collaboration were the very important determining factors for the implementation of EVAR. Focused efforts to reduce RAAA mortality are warranted.

Reports a case admitted in the Ward I of Department of Surgery of Zhengzhou Renji Hospital in June 2017. A young child who suffered destructive injury of left forearm, wrist and palm with severed 3rd-5th fingers. Tendon and neurovascular repairs of forearm, wrist and palm were performed with pedicled abdomina flap and the 3rd-5th fingers ectopic replantation in Phase I surgery. In the Phase II surgery, the abdomina flap division was carried out. The replantation of severed fingers after ectopic replantation and the reconstruction of foot defect with free anterolateral thigh flap(ALTF) were carried out in Phase III surgery. In Phase IV surgery, fingers functional reconstruction and foot flap thinning were performed. Four years after surgery, the thumb oppositions to middle, ring and little fingers could be completed, with slightly limitations. The appearance and texture of transferred foot flap were good, and the child could walk and run almost normally.

Objective:To explore the clinical effect of expanded scalp flaps in repconstructing the wounds after resection of frontal and facial nevus and scar.Methods:From May 2014 to May 2019, 28 patients (5 cases of nevus and 11 cases of scar in the frontal part and 2 cases of nevus, 9 cases of scar and 1 case of verrucous nevus in facial part) were repaired with expanded scalp flaps. According to the size of the lesion, the expander was selected and placed under the galea aponeurotica. After tissue expansion, the wound was reconstructed by random designed or pedicled skin flaps. The pedicled skin flaps took the branch of superficial temporal artery as the pedicle. The pedicle was cut off after 3 weeks. Hair removal by laser was performed 3 to 6 times 2 weeks after removing the suture.Results:In all the 28 cases, expansion in the first stage was sufficient, after skin flap transfer in the second stage, all survived without infection or local necrosis. After the pedicle division, 2 cases had small area of distal blood flow disorder, and the wound was healed after skin grafting The follow-up time ranged from 3 to 31 months. After hair removal by laser, the color and texture matched well with the normal skin in the adjacent area. No contracture and pigmentation occurred, and the effect was satisfactory.Conclusions:The scalp is a good donor site for expansion with sufficient tissue and few secondary deformities. The expanded scalp flap has good blood supply for repairing frontal and facial lesions, after hair removal by laser, the effect is good, and it is worth popularizing and applying.