Objective To explore surgical methods of repairing tibial skin defect using the anterolateral crural island flap.Methods The location,external diameters,anastomosis and distribution of perforators from the anterior tibial artery and the peroneal artery in the anterior septum were observed in 40 cadaveric specimens.Arterial angiography was performed in 4 fresh legs.Clinically,11 cases with tibial skin defect were repaired with the anterolateral crural island flap.There were 7 males and 4 females,with an average of 36 years (20-59 years).The area of the skin defect ranged from 6 cm×4 cm to 12 cm×4 cm.Results An arterial chain was formed by the interconnection of the superficial peroneal artery,the anterior septocutaneous perforator from distal part of the anterior tibial artery and the anterior end-perforator of the peroneal artery.It ran in the anterior septum and went along with the superficial peroneal nerve to supply blood to adjacent fascia and skin.The external diameters of the three perforators were (1.4±0.4) mm,(1.0±0.4) mm and (1.5±0.4) mm respectively,and the external diameter of the arterial chain was (0.6±0.2) mm.Clinically,we designed 4 methods to repair 11 cases of tibial skin defect successfully with the anterolateral cnnal island flap.The anterior septocutaneous perforator from distal part of the anterior tibial artery was used as pedicle in 2 cases;ascending branch of the anterior septocutaneous perforator from distal part of the anterior tibial artery was used as pedicle in 3 cases;descending branch of the anterior septocutaneous perforator from distalpart of the anterior tibial artery was used as pedicle in 3 cases;ascending branch of the anterior end-perforator of the peroneal artery was used as pedicle in 3 cases.The area of the flaps ranged between 7 cm×5 cm and 13 cm×5 cm.All patients were followed up with a mean time of 1.5 years.All flaps survived totally without diabrosis and swelling.Conclusion The anterolateral island flaps pedicled with perforators arising from the anterior septum of the lower leg is a good choice for surgeons to repair tibial skin defect.

OBJECTIVETo explore the method of the treatment for hallux valgus with the proximal crescentic osteotomy of the first metatarsal bone, combining with distal lateral soft tissue release.

METHODSFrom January 2008 to December 2012, 21 cases 21 hallux valgus feet were treated by operative procedure, included 1 male (1 foot) and 20 females (20 feet), with the mean age of 52 years (range, 36-68 years). Among all patients were followed up for 12 to 26 months, with the mean 16 months. The preoperative, post-operative and final follow-up X-ray films of all patients were collected. The hallux valgus angle, intermetatarsal angle and distal metatarsal articular angle were measured and analyzed. The surgical outcome was evaluated combined with the AOFAS score.

RESULTSThe average hallux valgus angle decreased from 42.3° ± 1.8° preoperatively to 14.5° ± 1.8 postoperatively, the average intermetatarsal angle did from 21.9° ± 1.7 to 9.1° ± 1.8°, and the average distal metatarsal articular angle did from 14.9° ± 1.8 to 7.2° ± 1.5, respectively. There were significant differences between the preoperative and postoperative roentgenographic index. AOFAS score was improved from 44.0 ± 1.8 preoperatively to 83.9 ± 2.2 at the final follow-up.

CONCLUSIONSThe proximal crescentic osteotomy of the first metatarsal bone combined distal soft tissue reconstruction obtained satisfactory results in severe hallux valgus patients with big intermetatarsal angle.

Adult ; Aged ; Dermatologic Surgical Procedures ; methods ; Female ; Hallux Valgus ; surgery ; Humans ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Osteotomy ; methods

Objective To investigate the relation between plasma matrix metalloproteinase 9 (MMP 9) levels and transcranial Doppler (TCD) detected microemboli in patients with cerebral infarction and evaluate the clinical significance. Methods The plasma MMP 9 levels were quantified by ELISA and the microemboli were detected with TCD in 50 stroke patients and 20 controls. Results The level of plasma MMP 9 was significantly higher in microembolic signal positive patients than that in negative ones [median (392.87?210.90) ng/ml for those with emboli versus (202.27?153.40) ng/ml for those without, P

Objective To explore a surgical treatment of skin defects on the thumb by reverse-flow island flaps on dorsal thumb web with dorsoulnar artery of thumb as a pedicle.Methods The origin,courses and distribution of dorsoulnar artery of thumb from 70 adult cadaveric hand specimens perfused by red latex were explored.Skin defects on the thumb of 8 cases were repaired with reverse-flow island flaps on dorsal thumb web.The cut areas of flaps vary from 4.5 cm × 3.0 cm to 7.5 cm × 4.0 cm.Results There were 4 types of the dorsoulnar artery of thumb basing on the origin and courses.Type Ⅰ was outside the first dorsal interosseous muscle type,which was the dorsoulnar artery of thumb mainly originated from the first dorsal metacarpal artery and cross through the surface of the first dosal interosseous muscle(42.9％).Type Ⅱ was under the first dorsal interosseous muscle type,which was from the thumb principal artery or deep branch of radial artery and run under the first dorsal interosseous muscle(41.4％).Type Ⅲ was mixed type from the anastomose point of above two arteries at the level of the first metacarpophalangeal joint(11.4％).Type Ⅳ was absence type (4.3％).Eight flaps fully survived.Excellent texture and satisfying appearance of the flaps as well as normal thumb web function were verified after 8 months' follow-up.Conclusion It is significant to determine the type of dorsoulnar artery of thumb to decide different operations due to the artery's considerable variation.The reverse-flow island flap on dorsal thumb is an ideal method to repair soft tissue defect on the thumb for its convenient operating and little effect in the donor area.

Objective To investigate the effects of fluoxetine and pyrrolidine dithidarbamate (PDTC) on the lipopolysaccharide(LPS)-induced interleukine-6(IL-6) release in cultured rat astrocytes.Methods The purified astrocytes were cultured in 48-well tissue culture plate and classified into control group,LPS group,fiuoxetine group and PDTC group.Control group and LPS group were cultured as usual,and fluoxetine group and PDTC group were cultured with fluoxetine or PDTC at different concentrations for 48 hours,and then LPS group,Fluoxetine group and PDTC group were incubated with 1 ug/ml LPS for 24 hours.Finally,the levels of IL-6 in the cell supernatant were detected by enzymatic linked immunosorbent assay (ELISA) method.Results The level of IL-6 in LPS group ((1975.46 ± 171.54) pg/ml) was significantly higher than that in control group((10633 ± 782.15)pg/ml) (P ＜ 0.01).The levels of IL-6 were (6198.6 ± 379.4) pg/ml,(4973.6 ± 132.5) pg/ml and (4747.9 ±473.9) pg/ml respectively when the concentrations of fluoxetine were 10 μM,20 μM and 40 μM,and (4821.6 ±180.8) pg/ml,(4735.7 ±620.0)pg/ml and (3525.9 ± 240.0)pg/ml respectively when the concentrations of PDTC were 100 μM,150 μM and 200 μM.There was significant difference in the levels of IL-6 between LPS group and fluoxetine group (P ＜ 0.05),as well as between LPS group and fluoxetine group (P ＜ 0.05).Conclusion LPS can induce IL-6 release from astrocytes,while fluoxetine or PDTC at some concentrations can suppress LPS-induced IL-6 release.

Objective To investigate the distribution and severity of cerebral artery stenosis and the prognosis in elderly patients with acute cerebral infarction using digital subtraction angiography (DSA). Methods The 432 elderly patients with acute cerebral ischemia infarction underwent DSA,and they were divided into two groups: elderly group (n= 320) and non-elderly group (n= 112). The characteristics of distribution and severity of cerebral artery stenosis, the relationship between artery stenosis and relative risk factors, and the prognosis of acute cerebral infarction were analyzed.Results In elderly group, 270 cases (84.3%) had intra- and extra- cranial artery stenosis, of which 98 patients (30.6%) with pure extracranial arterial stenosis, 132 patients (41.3%) with combined extra- and intra-cranial artery stenosis. They were both significantly higher than the corresponding data in non-elderly group [23 cases (20.5%) and 28 cases (25%), P＜0.05 and 0.01]. The prevalences of moderate and severe cerebral artery stenosises were higher in elderly group than in nonelderly group [224 locations (52.1%) vs. 51 locations (40.8%), P＜0. 05]. The number of patients with previous history of cerebrovascular disease was much more and the prognosis was much worse in elderly group than in non-elderly group (both P＜0.05), Conclusions The elderly patients with cerebral infarction have severer cerebral artery stenosis, increased proportion of multivessel disease and poor prognosis. So it is very important to take aggressive treatment as soon as possible, and to make secondary prevention and effective rehabilitation so as to improve their prognosis.

Objective To study the multi-slice helical CT (MSCT) features of horseshoe lung and to improve its diagnostic ability. Methods The clinical and imaging data were retrospectively reviewed in 5 patients. All of them underwent plain MSCT scan, and 4 patients also had enhanced MSCT scan and threedimensional reconstruction. Results In horseshoe lung, the basal segments of the right and left lungs were fused together by a isthmus of pulmonary parenchyma, across the midline behind the pericardium and before the esophagus, descending aorta and spine. All patients were companied with bronchopulmonary dysplasia,anomalous origin of the central bronchi, anomalous arterial supply. Anomalous pulmonary venous return to inferior vena cava and congenital cardiovascular malformations were also found in 4 cases. Conclusion MSCT and three-dimensional reconstruction are valuable for identification of horseshoe lung.

Objective: To introduce the surgical method of lateral dorsalis pedis chain-linked artery based flap for repairing foot, ankle, and posterior heel wounds, and to evaluate its clinical outcome. Methods: From June 2013 to February 2016, 11 cases with skin defects of foot, ankle, and posterior heel wounds were reviewed. The defects were repaired using the lateral dorsalis pedis chain-linked artery based flap.The wounds in 7 cases were repaired using the island flap based on the descending branch of the anterior lateral malleolar artery. The wounds in 3 cases were repaired using the island flap based on the lateral calcaneal branch of the posterior lateral malleolar artery. The reversed flap based on the forth metatarsal artery was used in one patient. The wound defects ranged from 1.5 cm×2.0 cm to 6.0 cm×13.0 cm.The area of the flap ranged from 2 cm×3 cm to 7 cm×15 cm were used to repair the wound.The donor site was skin grafted with split-thickness skin harvested from the abdomen. Results: Circulations of the all 11 cases were stable, with good wound healing after 2 weeks.10 patients had clinical follow-up. The patients were followed up from 2 months to 18 months, average of 8 months.All flap grafts survived with no bloated menifestion in pedical or "cat′s ear" deformity.Flaps were soft. Color was consistent with normal skin.Skin graft donor sites had no obvious scars.Patients were extremely satisfied with the result of repair. Conclusions The use of the lateral dorsalis pedis chain-linked artery based flap has many advantages, such as no sacrifice of the main vessels, extended coverage area and thin flap. It is a simple and effective method to repair wounds of the foot, ankle, and posterior heel.

To overcome the present limitations of passive biochip, based on the basic principle of antigen-antibody reaction, we develop an antigen-antibody reaction model of solid-phase surface and design a novel active biochip system according to this model, which introduces the negative pressure and controlling devices to control the immunoreactions on the nitrocellulose (NC) membrane. From the computer simulation results, this is a rapid, stable, robust and practicable system, which can be used to increase the efficiency of immunoreactions and improve the reproducibility and accuracy of biochip analysis.
Antigen-Antibody Reactions ; Biosensing Techniques ; instrumentation ; Equipment Design ; Models, Biological

Objective To evaluate the effectiveness of flexor hallucis longus tendon transfer in treatment of chronic Achilles tendinopathy using different technique.Methods Sixty-four embalmed feet of 32 cadavers were analyzed and classified anatomically with respect to the individual cross links in the Henry's knot.These three techniques were then combined to determine the total potential tendon graft length obtainable using single incision,double incision and minimally invasive incision.From January,2012 to June,2015,10 patients (10 feet) with chronic Achilles tendinopathy were treated with double incision technique.The score was 63.04 ±7.75 according to American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system.Results Only two different configurations were found.Type 1,a tendinous slip branched from the FHLT to the FDLT was 96.9％(62 of 64 feet).Type 2,a slip branched from the FHLT to the FDLT and another slip from the FDLT to FHLT was 3.1％(2 of 64).The average length of the FHLT graft available from a single incision measured (5.08±1.09)cm,double incision technique measured (6.72 ± 1.02) cm,and minimally invasive incision measured (17.49 ± 1.80)cm.The difference between the lengths obtained from these three techniques was statistically significant.Ten patients were followed-up 12-36 months (mean,13.7 months).At 12 months after operation,the AOFAS ankle and hindfoot score was 93.28 ± 3.72,showing significant difference when compared with that before operation.The results were excellent in 6 cases,good in 3 cases,and fair in 1 case with an excellent and good rate of 90％.No sural nerve injury,posterior tibial nerve injury,medial plantar nerve injury,and lateral plantar nerve injury occurred.Conclusion In over 96 ％ of the feet,a proximal to distal connection from the FHLT to the FDLT was found,which might contribute to the residual function of the lesser toes after FDLT transfer.The distal stump of the FHLT tendon should be sutured onto the FDLT tendon under tension to en able a co-activation of the great toe,preserved hallux plantar flexion.Chronic Achilles tendinopathy reconstruction with flexor hallucis longus tendon harvested using double incision technique offers a desirable outcome in operative recovery,tendon fixation,preserved hallux plantar flexion and less complications.