OBJECTIVETo introduce the applications of a series of digital island flaps to the repair of finger and/or fingertip defects and explore the indications.

METHODSA total of 79 cases (82 digits) were treated with different flaps, including (1) the digital neurovascular pedicled V-Y advancement flap; (2) the reversed dorsoulnar arterial flap of the thumb; (3) the reversed digital arterial dorsal branch flap; (4) the modified Moberg flap; (5) the reversed digital arterial flap; (6) the Hueston flap; (7) the homodigital adipofascial turnover flap and the twin neurovascular island flaps.

RESULTSSatisfactory results were obtained in digital appearance and function.

CONCLUSIONSThese hoinodigital island flaps were particularly helpful for repair of finger and/or fingertip defects.

Adolescent ; Adult ; Emergency Treatment ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; classification ; Treatment Outcome ; Young Adult

Humans ; Liver Cirrhosis ; classification ; pathology ; Pathology, Clinical ; Terminology as Topic

Recombinant tissue plasminogen activator (rt-PA) is the most effective treatment for acute ischemic stroke and the exclusion criteria of rt-PA has been revised to extend its application. However, in Taiwan, National Health Insurance (NHI) did not follow the latest international consensus due to safety concerns. The present study investigated whether extending the application of rt-PA in Taiwan was safe and effective. The medical records from the Shuang Ho hospital stroke registry between August 2009 and December 2016 were retrospectively reviewed. Post rt-PA intracranial hemorrhage (ICH) and modified Rankin Scale (mRS) score at 3-month after stroke were the primary and secondary outcomes, respectively. Differences were analyzed through Fisher’s exact test and Student’s t test. A p-value of <0.05 was considered statistically significant. Overall, there were 243 patients categorized into two groups: NHI exclusion criteria adherence (n = 160) and non-adherence (n = 83). There was no significant difference in the risk of post rt-PA ICH (12.50% in adherence group, 4.82% in non-adherence group, p=0.07). Among the non-adherence group, 10 patients breached the latest international exclusion criteria and none of them experienced post rt-PA ICH. However, among patients with moderately severe stroke, the odds of mRS < 2 at 3-month were significantly lower in non-adherence group. This study demonstrated that extending administration of rt-PA in Taiwan was safe but the functional outcome after moderate stroke was not as favorable as adherence group. Old age, long onset-to-treatment time and less efficacy of lower dose of rt-PA were the possible factors for the difference in outcome.

The FTIR method was used to investigate the correlation of bacteria in the contaminated drug and the environmental microbes in the clean room for pharmaceutical microbial test. The similarity of bacteria in the contaminated drug and environmental microbes was compared by critical hit value method and cluster analysis method. This constructed the FTIR spectra library of clean room environmental microbe, and determined the criterion to promptly judge if the bacteria isolated from pharmaceuticals were contaminated by environment or not, hence the exactness of "one-off report" of sterile test result can be guaranteed, and can be used for the dynamic monitoring of environmental bacteria of clean room. The method is proven to be simple, accurate and rapid, and can be easily spread to the pharmaceutical microbial control.
Bacteria ; isolation & purification ; Cluster Analysis ; Drug Contamination ; Drug and Narcotic Control ; Environment, Controlled ; Environmental Microbiology ; Spectroscopy, Fourier Transform Infrared ; methods

OBJECTIVETo investigate the relationship between carotid artery intima media thickness (IMT) and apolipoprotein (Apo) E gene polymorphisms in type 2 diabetes mellitus (DM2).

METHODSTwo hundred and fifty-five DM2 patients without angiopathy and 107 healthy individuals were selected. PCR/allele-specific oligonucleotide probe was used to determine their apoE genotypes.

RESULTSThe prevalence distribution of apoE genotypes and alleles in DM2 patients and that in controls were similar. The TC, LDL-C and Lp(a) concentrations in e4/4, e4/3 subgroups were significantly higher than those in e3/2, e2/2 subgroups (P<0.05). The average value of IMT in e4/4 e4/3 carriers (0.89 mm) was significantly greater than that in e3/2 e2/2 carriers (0.62 mm) (P<0.05). After adjustment for TC, LDL-C, TG, Lp(a), FBG, HbA1c, age, BMI, and smoking, ANCOVA showed that the average value of carotid IMT was significantly greater in subjects with e4/4 e4/3, compared with that in subjects with e3/2 e2/2(P=0.033).

CONCLUSIONApo e4 allele increases the risk for carotid artery atherosclerosis in the early stage of diabetic population.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Alleles ; Analysis of Variance ; Apolipoprotein E4 ; Apolipoproteins E ; genetics ; Arteriosclerosis ; pathology ; Body Mass Index ; Carotid Artery Diseases ; pathology ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Diabetes Mellitus, Type 2 ; blood ; genetics ; pathology ; Female ; Gene Frequency ; Genotype ; Glycated Hemoglobin A ; metabolism ; Humans ; Lipoprotein(a) ; blood ; Male ; Middle Aged ; Smoking ; Triglycerides ; blood ; Tunica Intima ; pathology ; Tunica Media ; pathology

OBJECTIVETo present a new neurovascular island flap for fingertip reconstruction.

METHODSBased on the transverse palmar branch of the digital artery, this flap was designed on the volar side of a digit and reversed to repair the fingertip defects.

RESULTS12 fingers in 11 patients were reconstructed using this flap. Of them, 11 flaps survived and one necrosed. The contour of the reconstructed fingers looked well.

CONCLUSIONThis new neurovascular island flap provides excellent padding and sensation for fingertip reconstruction. The technique is simple.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fingers ; blood supply ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; blood supply ; Young Adult

Objective To study the expression levels of IL-37 in serum in chronic HBV(CHB)patients,and investigate their clinical significance in CHB patients.Methods The expression levels of IL-37 in serum from 35 CHB patients and 35 health-y controls were quantified by ELISA.This study also tested ALT,AST,HBsAg,HBeAg,HBV DNA,TNF-αand IL-10 in the serum of CHB patients,and also analyzed the relationship between the levels of IL-37 and ALT,AST,HBsAg,HBeAg, HBV DNA,TNF-α,IL-10 levels.Results The expression levels of IL-37 was increased in CHB patients 437.5±152.7 pg/ml compared to healthy donors(63.0±2.1 pg/ml).The difference between the two groups was statistically significant(t=2.45,P=0.017).The levels of IL-37 was found to correlate with ALT(r=0.406,P=0.019)and IL-10(r=0.433,P=0.035)but not AST,HBsAg,HBeAg,HBV DNA and TNF-α.Conclusion This study reveals the levels of IL-37 in CHB patients was higher than healthy controls,and IL-37 may play an important role in liver damage and HBV chronic infection.

Animals ; Carbon Tetrachloride ; H(+)-K(+)-Exchanging ATPase ; metabolism ; Liver ; metabolism ; pathology ; Liver Cirrhosis, Experimental ; chemically induced ; metabolism ; pathology ; Male ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo estimate the benchmark dose for osteoporosis caused by cadmium exposure in a Chinese general population with an epidemiological study.

METHODSThe inhabitants living in both cadmium polluted and non-polluted areas served as the exposure group and the control group. Urinary cadmium (UCd) and Blood cadmium (BCd) were used as exposure biomarkers while the Z score was used as effect biomarker for the osteoporosis.

RESULTSThe UCd and BCd in the habitants of the polluted areas were significantly higher than those in the habitants of the control area on average (P < 0.05) and the UCd and BCd in the habitants of the highly polluted areas were significantly higher than those in the habitants of the moderately polluted area on average (P < 0.05). The bone mineral density was significantly decreased in the groups of the highest UCd and BCd level compared with the 5 microg/g Cr group with the significant difference (P < 0.05). The morbidity of the osteoporosis would increase significantly with the increase of the cadmium exposure (P < 0.05) with the linear correlation (P < 0.05). BMDs were calculated using BMDS Version l.3.2 software and BMDLs were also determined. The BMDL of UCd for cadmium-induced osteoporosis was higher than those representing cadmium-induced renal dysfunction.

CONCLUSIONHigh level of cadmium exposure can induce osteoporosis, which occurs later than renal damage related to cadmium exposure. The BMD is a practical method.

Aged ; Bone Density ; drug effects ; Cadmium ; adverse effects ; metabolism ; China ; epidemiology ; Dose-Response Relationship, Drug ; Environmental Exposure ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis ; chemically induced ; epidemiology

OBJECTIVETo explore the strategy for the treatment of chronic hepatitis B with YMDD mutation.

METHODSA total of 120 chronic hepatitis B patients with YMDD mutation were randomly assigned into four groups. In group A, patients received adefovir dipivoxil for 48 weeks. In group B, patients received adefovir dipivoxil in combination with lamivudine during the first 12 weeks and adefovir dipivoxil only for the following 36 weeks. In group C, patients received adefovir dipivoxil in combination with lamivudine for 48 weeks. In group D, patients received entecavir for 48 weeks.

RESULTSThe rate of rebound of alanine aminotransferase (ALT) was 30.0% (9/30), 10.0% (3/30), 6.7% (2/30), 10.0% (3/30) (P < 0.05) during the first 12 weeks, and one patient with severe hepatitis was found in group A. The positive rate of YMDD mutation was 17.9%, 0, 0, 0 at week 12. There was no significant difference in the level of ALT and the rate of HBeAg seroconversion after 48-week treatment (P > 0.05). At week 48, there was significant difference in the ALT normalization rate and undetectable HBV DNA rate between group C and group A, and also between group D and group A, and the rate of drug resistant genotype was 6.9%, 6.7%, 0, 0. Two patients had rtN236T mutation in group A, and one patient had rtN236T mutation and another one had rtA181V mutation in group B.

CONCLUSIONAdefovir dipivoxil in combination with lamivudine or entecavir are safe and effective therapies for chronic hepatitis B patients with YMDD mutation.

Adenine ; administration & dosage ; analogs & derivatives ; therapeutic use ; Adult ; Alanine Transaminase ; blood ; Antiviral Agents ; administration & dosage ; therapeutic use ; DNA, Viral ; blood ; Drug Resistance, Viral ; Drug Therapy, Combination ; methods ; Female ; Follow-Up Studies ; Guanine ; administration & dosage ; analogs & derivatives ; therapeutic use ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Mutation ; Organophosphonates ; administration & dosage ; therapeutic use ; Reverse Transcriptase Inhibitors ; administration & dosage ; therapeutic use ; Young Adult