Objective To investigate the methods and therapeutic effects of anterolateral thigh perforator free flaps for reconstruction of soft tissue defects around the ankle.Methods A retrospective case series study was made on 30 patients treated with anterolateral thigh perforator free flaps for traumatic soft tissue defects around the tibia between January 2010 and June 2016.There were 22 males and eight females,with the age range of 16-58 years [(41.5 ± 1.2) years].Dimension of the soft tissue defect ranged from 9 cm ×4 cm to 23 cm × 12 cm.Flap stabilization time,flap survival rate,postoperative complications,second plastic surgery rate,and ankle joint function by Baird-Jackson score were recorded.Results All patients were followed up for (13.0 ± 5.4) months (range,6-24 months).Time for flap stabilization was (6.5 ± 1.1) days.All flaps survived except in one patients with flap loss due to postoperative arterial thrombosis.Postoperatively,one patient had arterial crisis,one had venous thrombosis,and one presented sinus formation due to infection.No second plastic surgery was carried out.According to the Baird-Jackson score,the results were excellent in 25 patients and good in five.Conclusion Anterolateral thigh perforator free flaps for reconstruction of traumatic soft tissue defects around the tibia has advantages of easy harvesting and survival,less postoperative complications,less second surgery,and good function recovery.

Objective To study effect of nasal tolerance with rat-derived 97-116 peptide of AChR α-subunit(Rα97-116(V108A))on the manifestation of muscle weakness and the immunity function of experimental autoimmune myasthenia gravis(EAMG).Methods Twenty-two EAMG model Lewis rats immunized thrice with Rα97-116(V108A)were divided randomly into tolerance group and control group.They were respectively immunized with Rα97-116(V108A)and PBS buffer solution for 10 days via nasal mucous.Then the body weight and Lennon score of two group Lewis rats were measured.Their serum anti-AChR antibodies were tested by ELISA,the expression levels of CD28,CTLA4,B7-1 and B7-2 were determined by flow cytometry.Results Compared with control group at different time points.the body weight of tolerance group rats(tolerance group(228.1±5.8)g,control group(215.0±16.2)g,t=2.395,P＜0.05)increased,the mean clinical score of rats(tolerance group 1.55±0.44.control group 2.10±0.66,t=-2.20,P＜0.05)decreased and the amount of serum anti-AChR antibody(tolerance group 0.97±0.20,control group 1.27±0.26,t=-2.857,P＜0.05)decreased obviously.the amount of CD28,B7-1,B7-2,CTLA4(%)expressed on the surface of peripheral blood cells(tolerance group:27.35±7.05,4.73±0.58,2.71±0.35,1.72±0.44,control group:40.02±8.81,9.52±1.25,5.88±1.09,2.64±0.47)down-regulated markedly(t=3.479,10.861,8.755,4.403,all P＜0.01).Conclusion Nasal mucous tolerance with Rα97-116(V108A)could ameliorate muscular weakness of EAMG rats while activates T cell and inhibits B cellular immunity.

Objective To investigate the feasibility and effects of modified Stoppa approach in treatment of anterior pelvic ring fractures.Methods The therapeutic effects of 21 patients with anterior pelvic ring fractures treated through the modified Stoppa approach from June 2008 to August 2011 were summarized and analyzed.According to Tile classification,there were seven patients with type A2 fractures,six with type B2 fractures,five type B3 fractures and three type C2 fractures.Surgical treatment through the modified Stoppa approach included anterior pelvic ring plates for 14 patients,anterior pelvic ring plates and external fixators for four and anterior pelvic ring plates and sacroiliac joint compressed cannulated screws for three.The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.Results The incision length of the modified Stoppa approach ranged from 10 to 12 cm ( average,11 cm).The operation time ranged from 70 to 120 minutes ( average,95 minutes).The intra-operative blood loss ranged from 400 to 1 000 ml (average,700 ml ).According to the Matta criteria,all 21 patients obtained sound reduction,of whom 15 patients had bony union after 8-20 months follow-up post-operatively.The Majeed score in all patients showed a gradual increase postoperatively.Conclusions The modified Stoppa approach is characterized by convenience and directness in making incisions,clear operation field,easy reduction,few complications and fast recovery and hence is an ideal choice in surgical treatment of anterior pelvic ring fractures.

Objective To establish an animal model of dog severe myocardial contusion (MC) .Methods 12 dogs with the body weight of (11 .36 ± 1 .50)kg were selected .The BIM‐Ⅱ type biological impact machine was adopted to directly impact the bare area of the left chest by the driving pressure of 800 kPa ,the impact area was 16 .61 cm2 and the chest wall was inward compressed within 4-6 cm ,the severe myocardial contusion model was established .The pathological examination was taken at 8 h after injury and grading was performed according to the Abbreviated Injury Scale (AIS ,update in 2005) .Results The scattered large area bleeding spots appeared in the epicardium and endocardium of wound area .No obvious abnormality was found in the non - wound area .The pathological examination was performed based on the coronal plane of the left ventricular cross section .The percentage of the section 8 h necrosis area to the total area was (39 .78 ± 9 .07)% .Conclusion The established dog severe myocardial contusion model is stable and reproducible ,which can accurately simulate the temporary MC mode .

BACKGROUND: The deficiency of perfect animal femoral head necrosis model limited its further investigation. OBJECTIVE: To verify the feasibility of establishing rabbit femoral head necrosis models using liquid nitrogen rsfdgeration method, and to provide a foundation for subsequent research. METHODS: A total of 20 adult, New Zealand, white rabbits were selected in the study. The round ligament of femur was not cut off and femoral head was not dislocated, and the exposed femoral head were quick frozen using cotton bud carrying liquid nitrogen for successive 25 times, with 10 s per time. The specimens were examined by gross anatomy, X-ray film, MRI and histological observation at day 3, 7 and weeks 2, 4, 6, and 8 after operation. RESULTS AND CONCLUSION: The histolOgical section showed that chondrocyte, osteccyts, and myelold tissues presented necrosis in freezing and periphery at 3days after model preparation, and the repair process appeared at 2weeks after operation. The articular surface of femoral heads appeared collapse at 4 weeks after operation, and these changes became obvious at 6 weeks. The femoral head presented ostecarthdtis-like disorder, with seriously collapsed articular surface at8 weeks, and the contour of femoral head changed in 2 animals. The results demonstrated that without hip dislocation, rabbit femoral head necrosis models can be established successfully using liquid nitrogen refrigeration method. This method is simple, feesible, with high succeed rate, which can be used in subsequent research.

Objective To investigate the expression and effect of FOXC2 (forkhead box C2) and Vimentin in gastric carcinoma tissues .Methods To detect the protein expression of FOXC2 and Vimentin in 20 normal gastric tissues and 65 gastric carcinoma tissues with immunochemistry .Results FOXC2 and Vimentin were highly expressed in all gastric carcinoma tissues .In all gastric carcinoma cases ,the FOXC2 expression rate was 41 .53% ,the rate of Vimentin was 35 .38% .The average expression rates of FOXC2 and Vimentin in TNM ( Ⅲ + Ⅳ ) group were significantly higher than those in TNM (Ⅰ + Ⅱ ) group ,respectively (58 .60% vs .27 .78% ,P=0 .012 ;55 .88% vs .29 .03% ,P=0 .018) .The expression rates of FOXC2 and Vimentin in lymph node transfer group were statistically higher than those in no lymph node transfer group (51 .72% vs .22 .22% ,P=0 .013;41 .20% vs . 14 .80% ,P=0 .010) .The correlation between FOXC2 and Vimentin was positive (P= 0 .037) .Conclusion It is possible that FOXC2 and Vimentin are involved in the transformation of epithelial cells into the mesenchymal cells .And they may play an impor-tant role in the metastasis of gastric carcinoma .

A cross-sectional survey of 3589 adolescents was conducted in three cities from different typical geographical zones of Guangdong province. The median urinary iodine concentrations (MUI) of adolescents in Nanxiong, Guangzhou and Maoming were 286.6,204.1 and 166.0μ/L, respectively. The MUI of all these adolescents Was 231.7μg/L, which was slightly higher than the current World Health Organization recommendation.

AIM and METHODS: A study of radioimmunoimaging was carried out on Kcnming mice - uterine cervical cancer (U14) using 99mTc labeled monoclonal Au14-1 with a modified Schwartaz method. RESULTS: The bio - distribution showed that radioactivity accumulated in tumor tissue at 12h after 99mTc - Au14- 1 injection in tail vein. The uptake by tumor was 4. 12 % ID/g at 2h and 8. 79 % ID/g at 24h respectively. The tumor/non - tumor (T/NT) radiocativity ratios for organs except kidneys were ranged from 2.02 to 6.71 at 24h post - injection. The image of tumor showed at 12h and clearer at 24h after injection. CONCLUSION: The quality of tumor image was relevant to the T/NT radioactivity ratios. It was demonstrated that 99mTc- Au14-1 has a good capability of localization for tumor.

Objective To detemine the value of cardiac troponin in early diagnosis of severe myocardial contusion in the dog.Methods Twelve dogs weighing (11.4 ± 1.5) kg were subjected to severe myocardial contusion by impacting the chest area with BIM-Ⅱ biological impact machine.Electrocardiogram,cTnT and cTnI were measured before,immediately,and 2,4,6 and 8 hours after injury.Animals were then killed and the serum was separated for gross examination and triphenyl tetrazolium chloride (TTC) staining.Results Supraventricular tachycardia,ventricular tachycardia,ventricular premature beat,myocardial ischemia,atrial fibrillation,and ventricular fibrillation were seen on the electrocardiogram 2,4,6 and 8 hours after the injury,which suggested a high sensitivity but low specificity.cTnT and cTnI levels revealed no specific changes at postoperative 2 and 4 hours,but cTnT and cTnl were significantly increased to (0.130 ± 0.052) ng/ml and (1.615 ± 0.371) ng/ml at postoperative 8 hours,significantly higher than that immediately after operation (P ＜ 0.01).Sensitivity and specificity of cTnT and cTnI were both 100％,while the specificity of the TTC staining was (39.78 ± 9.07)％.Conclusion Cardiac troponin is of high sensitivity and specificity in early diagnosis of severe myocardial contusion and has good correlation with pathological changes,which exhibits great potential in clinical application.

BACKGROUND AND PURPOSE: External counterpulsation (ECP) is a noninvasive method used to enhance cerebral perfusion by elevating the blood pressure in ischemic stroke. However, the response of the beat-to-beat blood pressure variability (BPV) in ischemic stroke patients during ECP remains unknown. METHODS: We enrolled recent ischemic stroke patients and healthy controls. Changes in the blood flow velocities in bilateral middle cerebral arteries and the continuous beat-to-beat blood pressure before, during, and after ECP were monitored. Power spectral analysis revealed that the BPV included oscillations at very low frequency (VLF; <0.04 Hz), low frequency (LF; 0.04-0.15 Hz), and high frequency (HF; 0.15-0.40 Hz), and the total power spectral density (TP; <0.40 Hz) and LF/HF ratio were calculated. RESULTS: We found that ECP significantly increased the systolic and diastolic blood pressures in both stroke patients and controls. ECP decreased markedly the systolic and diastolic BPVs at VLF and LF and the TP, and the diastolic BPV at HF when compared with baseline. The decreases in diastolic and systolic BPV reached 37.56% and 23.20%, respectively, at VLF, 21.15% and 12.19% at LF, 8.76% and 16.59% at HF, and 31.92% and 23.62% for the total TP in stroke patients, which did not differ from those in healthy controls. The change in flow velocity on the contralateral side was positively correlated with the total TP systolic BPV change induced by ECP (r=0.312, p=0.035). CONCLUSIONS: ECP reduces the beat-to-beat BPV when increasing the blood pressure and cerebral blood flow velocity in ischemic stroke patients. ECP might be able to improve the clinical outcome by decreasing the beat-to-beat BPV in stroke patients, and this should be explored further in future studies.
Blood Flow Velocity ; Blood Pressure* ; Cerebrovascular Circulation* ; Counterpulsation* ; Humans ; Methods ; Middle Cerebral Artery ; Perfusion ; Stroke*