Sixteen patients underwent fasciocutaneous flap pedicle with the perforating branches of posterior tibial artery to repair the skin defects of the middle and lower leg in Department of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from February 2003 to February 2007.Based on anatomy,the flap axis ray was designed as the connection of internal condyle of tibia and the middle point between inner malleolus and achilles tendon,rotating along the axis ray adjacent to wound with pedicle having perforating branches of posterior tibial artery.Under guidance of Doppler flowmeter,all skin including flap,pedicle,and surface of perforating branches must be fine.The upper leg skin defect was repaired using anterograde flap,and the middle-lower leg skin defect was repaired using retrograde flap,including lower leg defect in 9 cases,middle leg defect in 3 cases and upper leg defect in 4 cases.The skin defects ranged from 2.0 cm?1.5 cm to 12.5 cm?7.5 cm,and the largest size of flap was about 15.0 cm?10 cm,and the smallest size of flap was about 4.0 cm?2.5 cm.The repairing effect was observed.All flaps survived.Two cases developed distal necrosis of skin,but granulation was found in subcutaneous tissue,of which 1 case healed after changing dressings,and the other recovered after skin grating.All subjects were followed up for over 6 months.All cases could walk naturally but felt pain.Fasciocutaneous flap pedicle with the perforating branches of posterior tibial artery can repair the skin defects of leg soft tissue.The donor site is posterior leg.The pedicel is kept well after injury,and the flap is easy to design.In addition,the blood supply is reliable,and survival rate is high.It is a good surgery to repair leg soft tissue defect.

Interferon-γ-inducible protein 10 (IP-10),also known as chemokine (C-X-C motif) ligand 10(CXCL10),belongs to the CXC subfamily.IP-10 exerts its function by binding to chemokine (C-X-C motif) receptor 3 or Toll-like receptor 4.IP-10 plays an important role in the occurrence and development of autoimmune diseases.The expression of IP-10 in blood and body fluid is closely associated with the activity of autoimmune disease.IP-10 is expected to become a potential new marker and possess a significant application value in early screening,condition monitoring and therapeutic evaluation of autoimmune diseases.

Objective To explore the treatment methods and clinical result with the flap combining peroneus longus muscle supplying with the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect.Methods After anatomic investigating,Analyzing 6 cases.Excising peroneus lon- gus muscle combining with the foot external flap,supplying with the pediele of the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect,among them,the size of flap was about 6.0 cm?5.5 cm～16.5 cm?11.0 cm,the defect length of achilles tendon 2.0～7.5 cm.Results All ca- ses observed 4 to 16 months,all eases skin and achilles tendon were survived completely,the flap skin appear- ence was good,none ulcer.1 cases part necrosis,1 eases rerupture,Both healed after changed dressings.Ac- cording to Arner-Lindholm criteria to test the efficacy the result were excellent in 3 patients,good in 2,poor in 1.Conclusion It is an ideal way using the flap combining peroneus logus muscle with the nutrient vessels of sural nerve repairing the chronic achilles tendon rupture with skin defect.The advantage is operting conven- iently,transferred adjaeently,repairing the skin and tendon defect simultaneously,healing fastly and anti-bac- teria strongly,biomeehanies property and function is similar to the heel,it can fit the heel and skin for repai- ring.

Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies, clinical manifestations and treatment of this unique angiographic phenomenon. In our case report, we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries, especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.

Objective To improve the recognition of sarcoidosis in elderly patients.Methods Clinical data of 13 elderly patients with sarcoidosis were retrospectively analyzed.Results There were three cases without symptom and five cases with intra-pulmonary and extra-pulmonary manifestations respectively.Eight cases had atypical radiological appearances and five cases showed inflammatory changes through bronchofibercopy.There were three cases with increased percentage of lymphocytes and high ratio of CD4/CD8 in bronchoalveolar lavage fluid (BALF) respectively.Seven cases were diagnosed through biopsy.And the symptoms of all thirteen patients diminished after treatmeit.Conclusions The clinical symptom and radiologieal manifestation of sarcoidosis in elderly patients are varied and usually atypical.The diagnosis should be based on comprehensive analysis including clinical manifestation and examination.The elderly patients with indication of treatment can be given corticosteroid therapy with close clinical monitoring.

Objective To explore distally-based the interal ankle perforator saphenou neuro-veno-fasciocutaneous flap has been universally adopted for the repairment of the foot and the ankle soft-tissue defects.Methods Lay a foundation of anatomic studying,using the interal ankle perforator saphenous neuro-venofasciocutaneous flap 10 cases, the flap axis point was 1-3 cm above the pink of the interal ankle, average 2 cm. The scope of the flap were 4.0 cm× 3.0 cm-8.0 cm× 6.0 cm. Results All the perforator saphenous neuro-veno-fasciocutaneous flap were lively. About all, 2 cases had the small distant part necrosis, 1 case accompanying with subcutaneous tissue heels after change dressings, another heels after skin grating. All case can walk as usual, the flap had wear-resisting and keenly feel. Conclusion Distally-based the interal ankle perforator saphenous neuro-veno-fasciocutaneous flap, near ankle, donner area exiting fine, utlizing scope large, skin nice, grating easy, no hurting important blood vessle, alive rate high, it is an good donner area in repairing the foot and the ankle soft-tissue defects.

Objective: To explore the expression and gene amplification status of human epidermal growth factor receptor-2 (HER2) in the different stages of invasive urothelial bladder carcinoma. Methods:Tumor tissues from 49 patients with different stages of invasive urothelial bladder carcinoma were tested by immunohistochemical staining for HER2 and HER2 gene fluorescence in situ hybridization. Results:The number of male patients was higher than that of females. The positive rate of HER2 protein expression was higher in the patients with the higher stage of invasive urothelial bladder carcinoma. However, no gene amplification was observed in all patients. Twelve patients had ployploid chromosome 17. More ployploids were observed in the patients with the higher stage of inva-sive urothelial bladder carcinoma. Conclusion:The increase in the protein expression of HER2 in the invasive urothelial bladder carci-noma patients was not caused by gene amplification. Other transcriptional and post-transcriptional mechanisms were probably involved in the regulation of the HER2 protein.

Adult ; Compliance ; Humans ; Male ; Occupational Exposure ; prevention & control ; Population Surveillance ; Quality Control ; Young Adult

Pichia pastoris is a new eukaryotic expression system with great potentials, has unexampled advantages in expressing the heterologous proteins and has gotten more and more wide application. The following aspects were described in detail: the advantages of Pichia pastoris in the expression of heterologous genes, the mechanism of the heterologous gene integrations, the glycosylation of the expressed protein and the modification of the post-translated protein.

Objective To explore the etiological factors of primary pathological duodenogastric reflux (DGR) through investigating the relationship between severity of bile refulx,the changes of surface gastric electric rhythm and gastric emptying movement in primary pathological DGR patients.Methods From January 2007 to April 2008 in Qingdao Municipal Hospital,58 cases of outpatients diagnosed as primary pathological DGR and 21 healthy individuals (control group) were collected and underwent 24-hour gastric bilirubin monitoring,gastric endoscopy,gastric electric rhythm,and gastric emptying test.The relationship between gastric electric parameters and gastric emptying,bilirubin reflux,Hp infection was analyzed.Results 1.The main frequency in fasting and postprandial of primary pathological DGR patients [(1.94±0.04) cpm vs (2.93±0.07) cpm; (2.12±0.03) cpm vs (3.35 ±0.05) cpm],the percentage of normal gastric slow wave in fasting and postprandial (74.46± 0.56 vs 85.55 ± 1.06 ; 63.97 ± 0.64 vs 86.13 ± 1.49),and fasting/postprandial power ratio (PR) (1.68±0.02 vs 2.75±0.09) were all lower than those of control group (P＜0.05).The percentage of bradygastria in fasting and postprandial of DGR patients (18.04±0.36 vs 7.76±0.78;23.73±0.91 vs 8.47±0.55),the percentage of tachygastria in fasting and postprandial (8.93±0.26 vs 5.75±0.66;13.02±0.40 vs 7.66±0.27) were higher than that of control group (P＜0.05).2.The main frequency of severe reflux patients in fasting and postprandial [( 1.68 ± 0.07) cpm vs (2.13 ± 0.07)cpm; (2.18±0.09) cpm vs (2.76±0.06) cpm],the percentage of normal gastric slow wave in fasting and postprandial (69.71±0.43 vs 80.35±0.68; 56.36 ±0.85 vs 72.34±0.80),fasting /postprandial PR (1.47±0.04 vs 2.02±0.04) were lower than those of mild-reflux group (P＜0.05).The percentage of bradygastria in fasting and postprandial of severe reflux patients (22.94 ± 0.68 vs 13.47 ± 0.61; 29.61 ± 1.14 vs 17.55 ± 0.51) and the percentage of tachygastria in fasting and postprandial (9.94 ± 0.54 vs 7.02 ± 0.42 ; 17.04 ± 0.70 vs 10.71 ± 0.20) were higher than that of mild-reflux group (P＜0.05).3.There was no significant difference of gastric electrical parameters in fasting and postprandial between Hp-positive and Hp-negative groups (P＞0.05).4.The ratio of gastric emptying in DGR group was significantly lower than that of control group (37.9％ vs 90.5 ％,P＜0.05).The gastric emptying delay in DGR group significantly increased compared with control group (60.3％ vs 9.5％,P＜0.05).There was no significant difference in gastric emptying delay between severe-reflux group and light-reflux group (69.0％ vs 51.7％,P ＞ 0.05).Conclusions There is dysfuntion of gastric myoelectrical activity and gastric motility in primary pathological DGR patients,which may be an important mechanism in pathological DGR.