OBJECTIVETo explore clinical effects of digital artery bilobed flap for the treatment of skin degloving injury of thumb.

METHODSFrom January 2007 to December 2012, 45 patients with skin degloving injury of thumb were treated with grafting of digital artery bilobed flap. There were 39 males and 6 females, ranging in age from 19 to 46 years, with an average of 32 years. The disease course ranged from 0.5 to 15 h. Eighteen patients suffered from defect of palmar skin above nail root and nail bed, 19 patients suffered from skin degloving injury of thumb phalangette, and 8 patients had whole skin degloving injury of thumb. The double lobe flaps were designed at the ulnar side of middle finger and the radial side of ring finger according to the defect of thumb skin. The arteria digitalis communis between the middle and ring fingers and its two branches of arteriae digitales propriae supplying the two fingers were used as a vessel pedicle. The flap with digitales proprii nervi was transposed and used to cover the exposed phalanx of thumb. Full thickness graft was used for the donor site. Observation of the appearance, texture, color and wear resistance of flap, appearance, color and depression of grafting area, skin feeling, and finger activities was conducted.

RESULTSAll the flaps and grafts were alive. Forty-three patients were followed up with an average duration of 25 months, and two patients lost follow-up. The color and texture of the flaps were similar to that of the contralateral thumb pulp. The average two point discrimination was 4.2 +/- 0.3 mm. The color of graft skin was slightly deeper than that of the surroundings skin.

CONCLUSIONDigital artery bilobed flap graft is an effective and ideal operation, which is of low risk and high success rates for skin degloving injury of thumb.

Adult ; Arteries ; surgery ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Thumb ; blood supply ; injuries ; surgery ; Young Adult

OBJECTIVE: To describe and analyze the clinical features of nasal respiratory epithelial adenomatoid hamartom and improve the levels of diagnosis and treatment. METHOD: Fourteen cases of nasal respiratory epithelial adenomatoid hamartom confirmed by pathology were collected and analyzed. RESULT: In 14 cases, primary complaint of Hyposmia(or Anosmia)and nasal obstruction were occured in 13 and 11 cases respectively. Four cases had past history of endoscopic sinus surgery because of the diagnosis of nasal polyps. Polypoid neoplasms could be seen in the bilateral olfactory clefts. Sinus CT showed soft tissue shadows in bilateral nasal cavity and mucous membrane thickening in different sinus. Endoscopic sinus surgery were utilized to eliminate focus in all cases. All cases weren t recurred after 2-20 months' following-up visitings. CONCLUSION Nasal respiratory epithelial adenomatoid hamartom is so rare that clinical and pathological doctors have limited knowledge of it. It has its own characteristics from the clinical symptoms, signs to sinus CT although they are nonspecific. So we should improve the understanding about it to avoid misdiagnosis or missed diagnosis.
Diagnosis, Differential ; Endoscopy ; Hamartoma ; diagnosis ; pathology ; surgery ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Paranasal Sinuses

Objective To evaluate endovascular management for isolated iliac artery aneurysm (IIAA). Methods From May 1997 to Jan 2006, 15 IIAA cases underwent endovascular treatment, including 12 true aneurysms and 3 psudoaneurysms. There were 9 common iliac artery aneurysms (CIAA), 3 internal iliac artery aneurysms (IIAA) , and 3 external iliac artery aneurysms (EIAA). The average diameter was (5. 97?1. 49) cm (3. 5-9. 0 cm). IIAA was treated with metallic coils and CIAA/EIAA by stent-grafts. Results Unilateral internal iliac artery was preserved in 14 cases, and bilateral internal arteries were preserved in one case. Postoperative endoleak was found in 2 cases. There was no other major complications nor mortality. One case suffered buttock claudication because of internal iliac artery exclusion. The operation time was 1. 9?1. 1 h, blood loss was 126. 7?70. 1 ml. Patients were up and about after 2. 1?1. 1 d, hospital stay was 5.5?4.7 d. Conclusions Endovascular treatment is safe and effective for isolated iliac artery aneurysm. Internal iliac artery preservation and prevention of endoleak is of great importance.

Objective To establish high-performance liquid chromatography with electrochemical detector(HPLC-ECD) method for the determination for metanephrine and normetanephrine in 24 h urine, and provide a superior test for the diagnostic of pheochromocytomas over plasma/urine catecholamine.Methods MCX solid-phase cartridge was used for extraction of metanephrine and normetanephrine,HPLC-ECD was used for their measurements.The intra-assay CVs,interassay CVs and recoveries of metanephrine and normetanephrine were also calculated.104 hypertensive patients without pheochromocytomas and 5 pheochromocytomas patients were selected in this study.The concentrations of metanephrine and normetanephrine were compared with the plasma and 24h urinary catecholamines concentrations.Results The intra-assay CV,inter-assay CV and recovery of metanephrine were 5.9%, 7.5%,91.1% respectively;the intra-assay CV,inter-assay CV and recovery of normetanephrine were 6.3%,6.6%,88.5%,respectively.The MN,NMN,plasma CA and urine CA of all pheochromocytomas patients were positive.MN and NMN were negative in controls,while plasma CA and urine CA are false positive in 15 patients and 14 patients in controls,respectively.Conclusions The study establish a fast and accurate method for quantification of metanephrine and normetanephrine in 24 h urine by HPLC-ECD.These findings also prove that it is the best biochemical assays for pheochromocytomas at present.

OBJECTIVEIt could give some theory support of confirming the secondary metabolism organ and regulation of echinacoside in Cistanche tubulosa by searching parasitic growth of C. tubulosa ahd echinacoside variation in different organs of host and parasite.

METHODThe echinacoside content was analyzed by HPLC. The relationship between dry matter accumulation and echinacoside accumulation of C. tubulosa as the well as root diameter of host were comparatively analyzed.

RESULTWith the increase of dry matter accumulation of C. tubulosa, echinacoside accumulation increased significantly, and both of them were in significantly positive correlated with the root diameter of host. Echinacoside content in haustorium phloem was 15.53%, higher than that of haustorium xylem, C. tubulosa plant and other organs.

CONCLUSIONHaustorium phloem was probably the secondary metabolism organ of echinacoside in C. tubulosa.

Cistanche ; growth & development ; metabolism ; physiology ; Glycosides ; metabolism ; Host-Parasite Interactions ; Plant Leaves ; metabolism ; Plant Roots ; anatomy & histology ; metabolism ; Plant Stems ; metabolism ; Tamaricaceae ; anatomy & histology ; metabolism ; parasitology

OBJECTIVETo analyze the inoculation ratio and echinacoside content of Cistanche tubulosa and provide theoretical basis for Tamarix introduction, resource protection and screening of C. tubulosa.

METHOD8 Tamarix species were introduced in the North China Plain and inoculation of C. tubulosa was conducted on all species. Phenylethanoid glycosides fingerprinting and echinacoside content of C. tubulosa were analyzed by using HPLC.

RESULTThe adaptability of 8 Tamarix species were significantly different, phenylethanoid glycosides component of C. tubulosa on T. gansuensis and T. austromongolica were basically identical in contrast to T. chinensis, echinacoside content showed no obvious difference in C. tubulosa plant growing 4 months.

CONCLUSIONT. gansuensis and T. Austromongolica are suitable for the host introduction plant of C. tubulosa resource protection and screening in North China Plain.

China ; Cistanche ; chemistry ; growth & development ; Conservation of Natural Resources ; Ecosystem ; Glycosides ; analysis ; Phenols ; analysis ; Plants, Medicinal ; chemistry ; growth & development ; Rain ; Soil ; Tamaricaceae ; classification ; growth & development

OBJECTIVETo understand the process of Cistanche tubulosa.

METHODThe process of seed germination and parasitism was observed using stereomicroscope.

RESULTSeedling of C. tubulosa sprouted after forty day without host root's contact in fields, a tube-like-organ formed and grew auger-type from host root, the tuber apex where touches host root swelled and formed haustorium. Haustorium intruded host root epidermis and vascular bundles, and released brown substances. Then, embryo bud with six or more young leaves formed, finally the swelled tuber-like-organ broken and seed coat shed. Due to the parasitism of C. tubulosa, the host root near stem site swelled, but the other part, shrunk and disappered gradually.

CONCLUSIONSeed of C. tubulosa could germinate indepently in fields. Tuber-like-organ formatin, haustorium formation and bud formation are key steps of C. tubulosa seedling development.

Cistanche ; growth & development ; Germination ; Plants, Medicinal ; growth & development ; Seeds ; growth & development ; Symbiosis ; Tamaricaceae ; growth & development

Objective: To analyze associations of MRI-lesions and clinical features with disability in patients with multiple sclerosis (MS) in Shanghai, China. Methods: We studied patients with MS, identified from a survey in Shanghai, whose sites of lesions in the CNS was based on the MRI examinations. Associations between MRI-lesions, various clinical variables and the severity of disability were analyzed with univariate and multivariate logistic regression analysis. Results: There were 210 patients in this study. The disability of the patients with lesions confined to the spinal cord was significantly more severe than those with lesions in the brain (p < 0.008). Current age (OR: 1.041, 95% CI: 1.007~1.077), MS duration (OR: 1.082, 95% CI: 1.011~1.159) and MRI-lesions in the spinal cord (OR: 2.441, 95% CI: 1.039~5.737) were significantly associated with severity of disability on multivariate logistic regression analysis. Conclusion: MRI-lesions in the spinal cord, older age, a longer MS duration were significantly associated with a more severe disability in this MS study in Shanghai China.

OBJECTIVETo increase inoculation rate of Cistanche tubulosa in the field by studying inoculation technologies.

METHODRoot-tube inoculation methed was used on field experiments. Inoculation rate of C. tubulosa was compared to different size seeds and inoculation mediums and inoculation time.

RESULT AND CONCLUSIONMay is suitable inoculation time. The inoculation rate of C. tubulosa is 92.5% while the seed width is more than 0.7 mm and coarse sand is selected during inoculation period.

Cistanche ; growth & development ; Plants, Medicinal ; growth & development ; Seasons ; Seeds ; growth & development ; Symbiosis ; Tamaricaceae ; growth & development

OBJECTIVETo analyze the oncological and functional outcome of limb salvage in this location.

METHODSFrom November 2003 to January 2010, 20 patients with primary malignant bone tumors of the distal lower extremity were treated. There were 15 male and 5 female, the mean age was 20 years. Among 14 patients with malignant distal tibial sarcoma, 11 patients had ankle arthrodesis reconstructed by using allograft (7 patients) or autografts (4 patients), the other 3 patients underwent below-knee amputation. Three patients with osteosarcoma of distal fibula reconstructed with ipsilateral fibular head, 3 patients with calcaneus osteosarcoma underwent total calcanectomy and reconstructed with fibular segment and iliac crest. The mean follow-up was 36.4 months.

RESULTSFive of 7 (71.4%) patients with allograft reconstruction were associated with delayed wound healing, however, only 1 of 10 patients with autograft had this problem (P = 0.036). One local recurrence was observed, 2 osteosarcoma patients died of disseminated disease. The estimated 2-year and 5-year overall survival for the patients with malignant tibial sarcomas were 92.9% and 79.6% respectively, for the patients with distal tibial high-grade osteosarcoma were 87.5% and 70.0% respectively. The mean functional MSTS score was 82% for limb salvage patients.

CONCLUSIONSThe survival of patients with primary malignant bone tumor of distal lower extremity seems to be better than that of other sites. Limb salvage can provide satisfactory local control and functional results.

Adolescent ; Adult ; Amputation ; Bone Neoplasms ; surgery ; Child ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Limb Salvage ; Lower Extremity ; Male ; Middle Aged ; Treatment Outcome ; Young Adult