Objective To summarize the clinical effect and experience of vacuum sealing drainage ( VSD) technology combined with sural neurovascular flap to repair chronic and infection soft tissue defects in the foot and ankle?Methods From 2010 to 2015, the clinical effect of 58 cases patients who were treated negative pressure drainage combined with sural nerve nutrient vessel flap for repairing foot and ankle chronically infected wounds in Zhongnan Hospital of Wuhan University were retrospective analyzed?All cases were treated by debridement,negative pressure suction 1, 2 times, cleaning the wound, Wound secretions were negative after culture,then cut and take the nutrient vessels of the nutrient vessels to repair the wound?Results All flaps survived completely in 58 cases,54 cases inⅠstage healing,postoperative 4 cases were suffered with distal skin flap necrosis,and healed after dressing?The outline and function were satisfactory during 1 to 3 years follow?up?Conclusion The effect of negative pressure drainage combined with sural nerve nutrient vessel flap for repairing chronic wound of foot and ankle is exact, skin flap transposition of the wound should be thoroughly debridement,edge scar tissue should be appropriate resection.

Aim To investigate the effect of total flavonids of Litsea coreana Leve(TFLC)on cytokines production and immunity of peritoneal macrophage(PMΦ)from collagen-induced arthritis(CIA).Methods CIA was induced with Collagen II and Feund's complete adjuvant.The effect of TFLC on CIA was evaluated by body weight, hind paw swelling and histopathological changes.Interleukin-1(IL-1)in PMΦ of CIA rats was measured by mouse thymocyte proliferation method.Interleukin-2(IL-2)in splenocytes of CIA rats was determined by mouse spleen lymphocyte proliferation reaction.Tumor necrosis factor-α(TNF-α)in the supernatant of PMΦ was measured by radioimmunoassay(RIA).And the mRNA expression of TNF-α was detected by RT-PCR.Phagocytosis of PMΦ was measured by neutral red method.Results TFLC(50, 100, 200 mg·kg~(-1))singnificantly inhibited the paw swelling and increased body weight of CIA rats.The pathological damage of knee joint was reversed by TFLC.TFLC(0.05, 0.5, 5 mg·L~(-1))markedly reduced IL-1 and IL-2 in CIA rats.Meanwhile, TFLC singnificantly reduced TNF-α level and inhibited the expression of TNF-α mRNA in PMΦ.Conclusion TFLC has marked therapeutic effect on CIA rats, which is related to reducing the phagocytosis and inhibiting the secretion and expression of cytokines.

Objective To observe the effects of LPS and PMA on proliferation of human len epithelial( HLE )cells and expression of epidermal growth factor receptor(EGFR) in HLE cells.Methods The expressions of EGFR protein of HLE cells from felus,adult lens age-related cataract and cultured HLE cells were detected by immunohistochemical staining.The expression of EGFR mRNA was detected by RT-PCR.The effects of LPS (0.5,1.0,2.0 mg?L-1 ) and PMA(25,50,100 nmol?L-1 )on proliferation of HLE cells were detected by MTT colorimetry method,and the EGFR mRNA expression in HLE cells was determined by RT-PCR. Results The expressions of EGFR protein and mRNA were positive in HLE cells from felus,adult lens age-related cataract and cultured HLE cells.The proliferation rates of HLE cells treated with 0.5,1.0,2.0 mg?L-1 LPS were (3.21?0.42)%,(12.25?1.34)% and (36.67?3.65)%,respectively.The proliferation rate of HLE cells in 2.0 mg?L-1 LPS group was higher than those in 0.5 and 1.0 mg?L-1 LPS groups(F=7.709,P0.05).PMA(25,50,100 nmol?L-1 )could not effect the expression of EGFR mRNA in HLE cells .Conclusion Inflammation stimulant factor such as LPS can promote the proliferation of HLE cells by increasing the expression of EGFR and result in occurrence of posterior capsular opacifition(PCO).

Objective To evaluate the clinical effect of popliteal artery perforator-based sural neurovascular flap for repairing soft tissue defects in middle and distal upper leg.Methods Between December,2011 to September,2015,18 cases with skin soft tissue defects on the middle and distal upper leg were treated with popliteal artery perforator-based sural neurovascular flap,in which 12 cases were males,and 6 cases were females.The age was from 24 to 55 years,with the average age of 35.9 years.The size of tissue defects ranged from 3.0 cm × 3.0 cm to 7.0 cm × 9.0 cm.Results All flaps survived completely in 18 cases,1 case of marginal infection heated after dressing,and the rest cases in Ⅰ healing.The outline and function of survived flap were satisfactory during 3-16 months follow-up,with two-point discrimination of 4.0-10.0 mm.Conclusion The anterograde sural neurovascular flap based on the popliteal artery perforator provides a practical option for covering tissue defects in middle and distal upper leg.This flap is characteristiced by reliable blood supply without sacrificing main vesses,good contour and texture,in addition,the operation is easy of handling.

BACKGROUND:Which an ideal method to treat type Rockwood Ⅲ acromioclavicular joint dislocation is,traditional or surgical therapy,is still controversial.OBJECTIVE:To investigate the clinical effect of clavicular hook plate implantation on type Rockwood Ⅲ acromioclayicular joint dislocation.METHODS:A total of 56 patients with type Rockwood Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopaedics of Yiling Hospital between December 2005 and June 2008.There were 42 males and 14 females,aged 16-65 years and mean age of 32 years.All patients were treated with clavicular hook plate implantation.Indicators including visual analogue scale (VAS),the United States shoulder and elbow surgeon score (ASES),and Constant and Murley scoring system were tested pre-operatively,one year postoperatively,before internal fixation,and 3 months after internal fixation;additionally,functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation.RESULTS AND CONCLUSION:The surgery and following-up were successfully achieved in 56 cases.The following-up lasted for 15-30 months,with the mean time of 20 months.The internal fixation was taken out at about 1 year after implantation.Coracoclavicular ligament was repaired in 32 cases but not in the 24 cases.Two patients with acromioclavicular joint dislocation recurrence were excluded,and coracoclavicular ligament therapy was not performed.Shoulder pain,foreign body sensation,and internal fixation failure occurred in two cases.One year after operation,VAS was decreased compared with that before operation,but ASES and Constant and Murley score were significantly increased (P＜0.01).At three months after internal fixation,VAS was decreased compared with that at 1 year after operation,but ASES and Constant and Murley score were increased (P＜0.05).The results demonstrated that clavicular hook plate implantation for treating type Rockwood Ⅲ acromioclavicular joint dislocation is simple and less invasive,thus it is an ideal internal fixation.

Objective To investigate the influence of gestational vitamin A(VA) deficiency on lipid synthesis in offspring liver tissue by using the rat model of gestational vitamin A deficiency.Methods The rat model of gestational VA deficiency was established and divided into the normal AV,VA deficiency and VA deficiency and supplement (VAD) groups.The offspring blood lipid levels were detected.The mRNA expression changes of lipid synthesis molecule ACC1,FAS and SREBP1 in liver were detected;the lipid droplet deposition situation after HE staining in offspring liver tissue section was observed.Results The HDL-C level of the VAD group was significantly lower than that of the VA normal group(VAN group and VAS group,P＜0.05),and the difference between the VAN group and VAS group had no statistical difference(P＞0.05).The TG level had statistically significant difference among the three groups(P＜0.05).The ACC1,FAS and SREBP1 mRNA expression levels in the VAD group were significantly increased.The liver in the VAD group appeared more lipid droplet deposit with partial lipid droplet vacuoles in cytoplasm;while the liver cells in the VAS and VAN groups showed the regular arrangement without obvious lipid droplet deposit.Conclusion Gestational VA deficiency may induce the abnormal activation of liver lipid synthesis pathway in rat offspring and causes lipid metabolic disturbance.

Objective:To study the association of RAC1 gene polymorphisms with protein expression levels of Rac1-GTP. Methods:A total of 182 healthy Hans population in Hubei were recruited. The 4 tag-SNPs in RAC1 gene were genotyped by Real time TaqMan-MGB genotyping assay. And the Rac1-GTP protein levels in plasma samples from all participants were determined by enzyme linked immunosorbent assays ( ELISA ) . The distribution characteristics of Rac1-GTP expression levels were also analyzed. Furthermore,the expression levels of Rac1-GTP were compared among different genotypes of the 4 tag-SNPs in RAC1 gene. Results:The distribution of Rac1-GTP expression levels was positive skewed in healthy Chinese Hans population. The expression levels were significantly higher in females than in males (P<0. 05),and appeared in decreased trend with age,but without significant differences (P>0. 05). Different expression levels of Rac1-GTP were observed in different genotypes for rs702482 and rs10951982 (P<0. 05). However,no significant difference was found for rs702483 and rs6954996 (P>0. 05). Conclusion:RAC1 genetic polymorphisms can potentially affect the expression levels of Rac1-GTP protein in healthy Chinese Hans population.

Objective To analyze the relationship between the common clinical indicators and diabetic foot ulcer(DFU)in type 2 diabetes mellitus(T2DM)patients by using the cross-sectional study and to provide the reference indicators for clinical DFU monitoring and prognosis evaluation.Methods A total of 115 T2DM patients admitted to the Department of Endocrinology,the Second Affiliated Hospital of Kunming Medical University from June 2021 to June 2023 were selected as the study objects and were divided into group A(with DFU)and group B(without DFU)according to whether they had DFU.Those in group A were then divided into group A1(Wagner0-1),group A2(Wagner2-3)and group A3(Wagner4)according to Wagner classification.The differences of general data,blood pressure,blood glucose,blood lipids and other common clinical indicators among all of the groups were compared,and the correlation between DFU and the above indicators was explored.Results Diabetes duration,D-dimer(DD),systolic blood pressure and other indexes in group A were higher than those in group B and there was a statistically significant difference(P<0.05).DD was the main risk factor for DFU in T2DM patients.Diabetic course in patients with DFU was positively correlated with the age(r>0,P<0.05),and negatively correlated with fasting blood glucose(FPG)level and 2hPG level at 2 hours after meals(r<0,P<0.05).The levels of interleukin-6(IL-6)and C-reactive protein(CRP)in A1 and A2 groups were lower than those in A3 group,the levels of neutrophils and leukocytes in A1 group were lower than those in A3 group,and the high density lipoprotein cholesterol(HDL-C)in A1 group was higher than that in A2 group and there was a statistically significant difference(P<0.05).Conclusion DD and systolic blood pressure are the main risk factors for DFU,and DD is closely related to DFU.The older the patients with T2DM,the later the onset of DFU.The worse the blood glucose control,the earlier the onset of DFU.HDL-C is a protective factor for peripheral vascular disease in T2DM patients.

Diabetic foot(DF)is one of the most severe chronic complications of diabetes mellitus(DM),and it is an important cause of disability and mortality inpatients with DM.Changes in proteins in the tissues,organs and circulation of organisms can serve as microscopic reflections of the disease development process.Proteomics is an important technologyto explore the pathogenesis and treatment mechanism of dis-ease,and to find potential therapeutic targets and prognostic biomarkers of diseases.This article reviews the progress of proteomics research in DF.

Objective:To systematically review the qualitative research on dignity cognition and experience of the elderly in nursing homes.Methods:Qualitative research on the dignity cognition and experience of the elderly in nursing homes was retrieved by computer in PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP and China Biology Medicine disc. The retrieval time limit was from the establishment of the database to May 31, 2021. The quality of the article was assessed using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center.Results:A total of 10 articles were included, and 30 research results were extracted. The research results were grouped into 8 categories, and 4 integrated results were synthesized, namely, the elderly's cognition of dignity, the impact of impaired dignity on the elderly, the factors affecting the maintenance of dignity, and the elderly's dignity maintenance strategies.Conclusions:Nursing homes should attach importance to the dignity of the elderly, provide dignity care, protect the autonomy of the elderly, and strengthen the social support system to promote the realization of the elderly with dignity.