Objective:To investigate the validity and the outcome of a new surgery method that utilizes lateral great toe flap to decoratively reconstruct the thumb pulp loss.Methods:From Jan.2009 to Jan. 2014 , 22 cases with unilateral thumb pulp defect were included, for whom, lateral great toe flap was de-ployed to reconstruct the thumb.Blood circulation was re-established by the anastomosis of the digital vessels of toes and fingers in 18 cases, the other 4 cases were conducted by a dorsal metatarsal artery and vein anastomosed to the deep branch of the radial artery and the dorsal metacarpal vein respectively; as for the nerve repair, toe-to-finger digital nerve anastomosis was performed.The donor sites were covered by full-thickness inguinal skin grafts.Results:All the 22 flaps survived without complications.With 6 to 12 months follow-up, the surviving fingers all presented aesthetically pleasant appearance with vivid loops and whorls.Normal functions like sweating were restored as well, and the two-point-discrimination ranged 3.0 to 6.0 mm (4.2 mm in average).The skin grafts to the donor sites healed uneventfully, the appearance and functions of the feet were unaffected.Conclusion: Lateral toe flap should be the first-line choice for reconstructing thumb defect, as it conveniently restores both functions and outlook.

Objective To explore the extent of agreement between measurements of temporal and spatial gait parameters made with portable gait analysis equipment and in the laboratory.Methods Fifteen healthy young people submitted to laboratory gait analysis using 3D motion analysis apparatus and then on the same day to analysis using the Gait Watch portable apparatus.Cadence,stride length,walking speed and step length were recorded.Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate the agreement between the two gait analyses.Results Test-retest comparisons with the Gait Watch apparatus generated ICCs for the temporal and spatial parameters ranging between 0.80 and 0.98,indicating good test-retest reliability.Bland-Altman plots comparing the two measurement systems also showed good agreement.According to paired simple t tests,the stride length,walking speed,and step length assessments with the two systems showed significant differences.All exceeded the minimum detection threshold (stride length =0.05 m,walking speed =0.12 m/s,left step length =0.03 m,right step length =0.04 m).Conclusions Measurements of cadence,stride length,walking speed and step length with the two systems yield acceptable agreement,and either can be used in clinical walking assessment.

BACKGROUND:Endogenous hydrogen sulfide can be used as a new gaseous signaling molecule, and has important signal transfer function and biological regulation effects. OBJECTIVE:To study the neuroprotective effects of hydrogen sulfide in rats with acute cauda equina syndrome. METHODS: The 72 Sprague-Dawley rats were randomly assigned to three groups. Experimental group, model group: laminectomy was performed at the lumbar 4 (L4) level of the vertebra, and a piece of silicone (10 mm long, 1 mm thick, and 1 mm wide) was placed under the laminae of the L5-6 vertebra to produce the animal model of cauda equina syndrome. Sham surgery group: a simple laminectomy was performed in L4, but silicone was not implanted. In the experimental group, 20 μmol/kg NaHS was injected intraperitonealy at 1 hour before model establishment. Model and sham surgery groups: an equal volume of saline was injected intraperitonealy. At 12, 24, 48 and 72 hours after model establishment, malonaldehyde and glutathione levels in cauda equina nerve tissue were detected. Simultaneously, hematoxylin-eosin staining and TUNEL staining were performed at 48 hours. RESULTS AND CONCLUSION:Hematoxylin-eosin staining demonstrated that cauda equina nerve tissue was dense and regular, with complete myelin sheath, no axon sweling in the sham surgery group. Cauda equina nerve tissue was sparse, with the presence of demyelination, and partial axons and myelin sheath sweling in the model group. Cauda equina nerve tissue was tight, with axonal sweling and demyelination in the experimental group. TUNEL staining demonstrated that the number of positive cels was less in the spinal cord and dorsal root ganglia in the sham surgery group. Abundant positive cels were detected in the spinal cord and dorsal root ganglia in the model group. The number of positive cels was significantly lower in the experimental group than that in the model group. Malonaldehyde levels were lower in the sham surgery and experimental groups than in the model group (P < 0.05, P < 0.01), but glutathione levels were higher than model group (P < 0.05,P < 0.01). These results indicated that hydrogen sulfide could decrease oxidative stress and protect cauda equina nerve in rats with acute cauda equina syndrome.

ObjectiveWe discussed the effect of TMS on the motor conduction pathway and studied the function of TMS in the motor function of patients with stroke. Methods65 patients with acute brain infarction were divided into two groups, treatment group given TMS once a day and contral group. Motor nerve center was stimulated twice or three times each day. 14 days were one period of treatment. MEP, CMCT, force and Fugl-Meyer scores were recorded on the first and the last days. Results Before treatment, there was no difference between two groups on CMCT, force and Fugl-Meyer scores. After treatment, the patients in the treatment group got much better improvement in movement ability than the patients in the control group. But there was no difference between two groups on MEP neither before nor after treatment. Conclusions TMS can help patients with stroke to regain movement ability, and improve the recovery of force and fine movement, and also reduce the CMCT distinguishably. TMS is easy to use and no evidently uncomfortable influence on patients happens.

Objective Mitotic spindle and midbody are both microtubule-based temporary structures during cell growth and play essential roles in mitosis.The purpose of this study was to establish a mature and efficient method to extract mitotic spindle and midbody.Methods Through the cell cycle synchronization method,mitotic spindle or midbody was made appear inside cells.Low permeability swelling and glycerol gradient centrifugation principles were then used to extract spindle and midbody.Results By Western Blot and immunofluorescence staining,the extracts were identified as mitotic spindle and midbody.Conclusions The successful extraction of mitotic spindle and midbody from synchronized Hela cells will provide foundation for identifying the proteins located in cell during mitosis,and be of great significance to the study of molecular regulation mechanisms of mitosis and tumorigenesis.

OBJECTIVETo explore the effects of high altitude on cognitive flexibility.

METHODSSimulated hypoxia at an altitude of 3 600 m was performed in a hypobaric chamber. Twenty-three volunteers without hypoxic experience were selected and the mean age was about 25.1 years. The physiological parameters (heart rate, blood pressure and oxygen saturation) were measured. Task switch paradigm was used to explore the cognitive flexibility in each phase, and the changing anxiety state was evaluated simultaneously.

RESULTSReaction time (RT) switch cost in hypoxia phase showed a significant increase compared with the baseline; anxiety level in hypoxia phase was higher than the adaptation phase; a remarkable negative correlation between anxiety level and RT switch cost was found in adaptation phase, whereas a positive correlation was found in landing phase.

CONCLUSIONHigh altitude (3 600 m) affects cognitive flexibility and anxiety state. Anxiety before the hypoxia exposure improves the cognitive flexibility performance, while anxiety after the hypoxia exposure hampers the performance because of the post-hypoxia effect.

Adult ; Altitude ; Anxiety ; Cognition ; physiology ; Humans ; Hypoxia ; psychology ; Male ; Reaction Time

Objective To evaluate the effects of aerobic exercise of middle intensity on cognitive and motor functions of elderly people with Alzheimer's disease (AD).Methods Forty-eight patients with AD were studied.The subjects were randomly divided into a treatment group and a control group.The subjects in treatment group were treated with cycle ergometer exercise for 3 months.The control group accepted dementia education.All the patients performed the mini-mental state examination (MMSE) and Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog) at the beginning and after 3 months of treatment.Results Forty-one participants completed the whole treatment and observation program.After treatment,the scores of MMSE and ADAS-Cog improved significantly more in treatment group than those in control group (P ＜ 0.05).Conclusion Middle intensity of aerobic exercise can improve cognitive and motor function in patients with AD.

Objective: To investigate the value of positron emission tomography/computerized tomography(PET/CT) with fluorine-18-labeled fluorodeoxyglucose(18FDG) for gastric carcinoma.Methods: Thirty-two patients(25 males,7 females,aged 31-82 years) suspected of gastric carcinoma underwent whole-body PET/CT after taking in 600 ml of water to distend the gastral cavity.The maximal standard uptake value(SUVmax) of the region of interest(ROI) in PET and the maximum width of the gastric wall in CT were analyzed.Pathological specimens were obtained from all the patients during surgery or gastroscopy.Results: 18FDG PET/CT found gastric carcinoma in 24 of the patients.The rates of positive and negative prediction and the accuracy of PET/CT in the diagnosis of the disease were 92.3%,100% and 93.8%.SUVmax was positively correlated with the maximum width of the gastric wall,but they exhibited no statistically significant differences between the patients with involved lymph nodes and those without.Based on the PET/CT findings,the 24 gastric carcinoma patients were clinically classified as follows: 9 in stage Ⅰ,1 in stage Ⅰ-Ⅱ,3 in stage Ⅱ,1 in stage Ⅲ and 10 in stage Ⅳ.Conclusion: 18FDG PET/CT is highly valuable for gastric carcinoma in its diagnosis,the evaluation of its biological behavior and determination of its treatment strategies.

Objective To detect fibrillin-1 gene (FBN1) mutations in patients with Marfan syndrome (MFS) by denaturing high-pedormance liquid chromatography (DHPLC) and DNA sequencing. Methods Genomic DNA was extracted from whole blood sample of 22 MFS patients. All 65 exens of FBN1 were amplified by polymerase chain reaction(PCR) respectively. Mutations were screened by DHPLC followed by DNA sequencing of the PCR products which showed different DHPLC profiles from the normals. Results Ten mutations of the FBN1 were found in 9 MFS patients. The mutations comprised four missense[5015G > C(C1672S),5309G > A(C1770Y),7241G > A(A2414G) and 7769G > A(C2590Y)], four nonsense [3295G > T ( E1099X ), 430"/insTCGT (G1441X), 4621C > T ( R1541X ) and 8080C > T (A2694X)], and two splice site mutations (IVS29 + 4A > T and IVSSO + 1G > A). Conclusion It is suggested that DHPLC coupled with DNA sequencing is an efficient method for the detection of FBN1 gene mutations, and it may be useful in diagnosis of MFS.

[Objective] To propose a criterion for making conclusions on paternity tests based on STR genotyping. [Method] To use binomial distribution formula to calculate minimal numbers of STR loci that must be tested for different scenarios in paternity testing. [ Results ] We proposed a set of criteria for making STR paternity testing conclusions. For triplet tests, concluded "paternity positive" for the following four cases when the cumulative paternity index (PI) was greater than 10 000: 1) no inconsistent STR locus was detected in 15 loci (PE > 0.571 4/locus) or 2) only one inconsistent STR locus was detected in 19 loci or 3) only two inconsistent STR loci were detected in 28 loci or 4) only three inconsistent STR loci were detected in 35 loci; otherwise, concluded "paternity negative" when at least four inconsistent STR loci had been detected. For single parent tests, concluded "paternity non-exclusive" for the following cases when the cumulative PI was greater than 10 000: 1) no inconsistent STR locus was detected in 18 loci (PE>0.411/locus) or 2) only one inconsistent STR locus was detected in 29 loci or 3) two inconsistent STR loci were detected in 41 loci; concluded "paternity negative" when three or more inconsistent loci were detected. [Conclusion] Our experience has proven that these criteria are robust in STR paternity testing.