Objective To study how design and harvest perforating artery free flaps in posterior region of thigh based on research of the anatomical features and distribution regularities of those perforating artery.Methods Using 8 fresh bodies specimen with latex leaded perfusion of inferior gluteal area to study perforator artery anatomy structure and distribution of rear thigh.Screen the fitting perforator arteries for perforator free flap both in caliber and length.Total 7 cases were performed with perforator free flap in posterior thigh,the flap size:from 3 cm × 8 cm-8 cm × 16 cm,and the first perforating artery flap carried out in 4 cases,the second perforating artery flap in 2 cases,the third perforating artery flap in Ⅰ case.Results Anatomic study showed that perforating artery suitable for free flap in this area were in teams of 4 to 5,the average diameter were in range of 0.4 to 2.8 mm,the average length was 2.2-9.0 cm.Seven cases had been applied with perforator flap and all survived.Followed-up from 5 to 11 months,the wounds repaired by the perforator flap of posterior thigh presented fine elasticity,thin flap,beautiful appearance.Conclusion The distribution,length and diameter of perforating artery in posterior region of thigh are suitable for perforator free flap.Being hidden,direct close the posterior region of thigh expected to acchive satisfactory clinical effects.

Objective Evaluate data of 1270 cases with free flap transplant,to find the problems in the process of operation,and then to analyse its causes and how to prevent and solve it,as well as providing reference for clinical colleagues. Methods To study 1270 cases of free flaps,musculocutaneous flap and perforator flap who was treated in our hospital from October 2000 to October 2010 retrospectively. A total of 722 cases of the group were followed-up 6 months to 5 years. To detective and search the problems and imperfection from designing,harvesting,tranfer,to the management and function of donor site after free flap transplantion.And also to analysis the couse of problems and operation failure,discuss the conclude of and to provide advisable measure. Results Total 1270 free flaps were transplanted successfully except 64 can-celled or failured for some reason, the success rate was 95.0％, the postopertive necrosis rate was 3.8％.Seventy-six cases were encountered vascular complications venous crisis in 42,arterial crisis in 38.Fifty-five cases were saved successfully without surgery,and 15 cases survived completely by vessel explorative operation. Five cases were partial necrosis and 7 cases necrosis. The rate of postoperative infection of emergency cases and chronic one were 4.7％ (682 cases)and 8.8％(588 cases) which show the infective incidence of latter was higher than former. In addition, there were many other problems were found such as distal flaps necrosis,contracture,deformation,impairment function of doner site,etc. Conclusion Preventing and management timely to vessle crisis is the key to flap suvive. The principle of dissecting flap should be followed strictly,and control the indications of modified processing during flap harvest,keep the proper flap tension were technical requirements in flap transplantion. Right way of donor site closed and management of insufficient timely were equally important to prevent and solve to complications and dysfunction.

Objective To explore and solve the problem of insufficiency and malformation due to cripple hand and defect of digital bone resulted of innate and injured. Evaluation to the methods of bone autografting combinated with flaps to reconstruct the deficient hand and digits. Methods Vascularized iliac bone or metatarsophalangeal joints (MPJ) or toes transplantation incorporated with flaps were used to reconstruct the defected bone in palm or fingers. Combined with tendon absence in such cases should be repaired or restituted by tendon autografting in one stage or by stages. Results Total 16 cases were treated by the methods metioned above. Except 1 of 16 was failure resulted in severe infection, the others were reconstructed successfully. 13 of 16 were followed up 8 months to 2 years, the evalution of the group from motion,sensation and appearance shew that the fine rate of motion was 53.8 percent, the rate of appearance and sensation were both 69 percent. Conclusion Vascularized iliac bone or metatarsophalangeal joints (MPJ) or toes transplantation incorporated with flaps are available to reconstruct the defected bone in palm or fingers, and can reduce disability effectively while obtain a satisfactory outlook and proper functions by those methods.

Objective To study the method of solving the complications of large allograft including resorption, nonunion and refracture by means of vascularization and the way of improving bone healing. Methods The bone defect longer than 10 cm of limbs were found in 21 cases, plate or external fixator were used to fix allograft bone, and then vascularied autologous bone or periosteum were transplanted or inserted to the massive allograft In order to vascularizate allograft, improve bone healing and prevent complications of bone resorption and osteolysis. 4 cases were implanted by local vascular bondle in one end. 4 cases were transplanted vascular iliac bone into middle part the allograft bone, 2 cases were into one end. 2 cases were transplanted by vascular fibular bone. 6 cases were used vascular periosteum. 3 cases were used combined methods. Results Twenty-one cases with 10 cm or more bone defect in this group were treated by the method above. 14 cases were achieved primary healing, 6 were healing by farther operation, 1 failure. Complications were found in 7 cases, 4 occur infection in all. All were achieved satisfactory function and outlook by follow-up. Conclusion The method of vascularied autologous bone or periosteum combined with massive allograft are effective to improve bone union, reduce the complication of bone resorption and osteolysis,which proved usefull to treat large bone defect.

ObjectiveTo compare the efficacy of sodium morrhuate versus lauromacrogol in the treatment of hepatic cyst. MethodsSeventy-four patients with hepatic cyst who were admitted to our hospital from January 2009 to May 2013 were enrolled as subjects and divided into two groups. After the cystic fluid was drained by percutaneous liver biopsy, sodium morrhuate solution was injected into the cystic cavity for adhesion and sclerosis in 46 patients in group A, and lauromacrogol solution was injected in 28 patients in group B. The incidence rates of pain in patients during and after surgery were compared between the two groups. The follow-up comparison of hepatic cyst recurrence rates within one year after surgery was performed between the two groups. Between-group comparison was performed by χ2 test. ResultsFive patients (10.87%) in group A and two patients (7.14%) in group B had recurrence within one year after treatment. There was no significant difference in recurrence rate between the two groups (χ2=0.283, P＞0.05). The incidence of pain in group A was significantly higher than that in group B (χ2=5.258, P＜0.05). ConclusionWith the same efficacy as sodium morrhuate in the treatment of hepatic cyst, lauromacrogol can be routinely used as a sclerosing agent due to its mild side effects.

Objective To evaluate the efficacy and safety of Qianggu capsule and calcium drugs for osteoporosis and to provide reference to choose drug for patients with osteoporosis in clinic. Methods Databases including PubMed, Embase, The Cochrane Library, CNKI, WanFang Data, VIP and SinoMed were searched to collect randomized controlled trials (RCTs) of Qianggu capsule and calcium supplements for osteoporosis from inception to the 31th of January 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was performed using RevMan 5.2 software. Results A total of 8 RCTs were included, which involved 594 patients. The results of meta-analysis showed that the effective rate of the Qianggu capsule group was significantly superior to that of the calcium group [RR (95％ CI) was 1.14 (1.06-1.24)]. The bone mineral density (BMD) at lumbar vertebra and femoral intertrochanter of the Qianggu capsule group were statistically higher than those of the calcium group after three months'treatment [MD (95％ CI):0.10 (0.08-0.12), 0.09 (0.06-0.12)]. The bone mineral density (BMD) at lumbar vertebra, femoral neck, ward triangle and femoral intertrochanter of the Qianggu capsule group were statistically higher than those of the calcium group after six months' treatment [SMD (95％ CI): 0.26 (0.03-0.49), 0.56 (0.32-0.80), 0.64 (0.38-0.91); MD (95％ CI): 0.03 (0.02-0.04)]. The incidence of adverse events of the Qianggu capsule group was statistically higher than that of the calcium group [OR (95％ CI) was 2.03 (1.08-3.82)]. Conclusions Comparing to the calcium related drugs, the Qianggu capsule showed a better effect, and could effectively increase the bone mineral density, but the adverse events should be surveillanced.

BACKGROUNDTo study the deletion and mutation in carboxy terminal region of LMP1 gene derived from nasopharyngeal carcinoma (NPC) in Guangdong and Guangxi, the high risk areas of nasopharyngeal carcinoma in China.

METHODSLMP1 gene carboxy terminal region was amplified from nasopharyngeal carcinoma tissues by PCR, and then cloned and sequenced.

RESULTSOf the 20 cases, 17 were LMP1 positive. In all positive cases, only 1 case did not show deletion. Four positive cases were chosen for DNA sequencing, The rusult showed that all the four cases had mutation and the 30bp deletion.

CONCLUSIONSHigh frequency of deletion and mutation in LMP1 gene of nasopharyngeal carcinoma tissues was found in Guangdong and Guangxi. Whether it related to the high incidence of NPC should be further studied.

Amino Acid Sequence ; Base Sequence ; Gene Deletion ; Herpesvirus 4, Human ; genetics ; Humans ; Molecular Sequence Data ; Nasopharyngeal Neoplasms ; virology ; Point Mutation ; Sequence Analysis, DNA ; Viral Matrix Proteins ; genetics

In the folk medicine, it was believed that the raw Sanqi could remove blood stasis, swelling and pain, while the cooked Sanqi could replenish blood. This article began with the first record of Sanqi in ancient herbal medicine literature, and the nature, flavor and efficacy of Sanqi, then listed the processing methods and usage of Sanqi recorded in ancient herbal medicine literature, and compared with the modern processing methods. The results showed that the processing methods of raw Sanqi included making powder, chewing, vinegar grinding and wine grinding, in which the method of making powder was still in use, and there were particle size requirements on the Sanqi powder listed in most modern preparation specifications. The processing methods of cooked Sanqi included baking, frying and steaming, in which the method of steaming was still in use, but had some changes. The new processing method was frying with edible oil. The results clarify the history of the processing of Sanqi, and provide a reference for the research and application of the processing methods of raw and cooked Sanqi.
Drugs, Chinese Herbal ; Panax notoginseng

To build up an identification method on cardiac glycosides in Taxillus chinensis and its Nerium indicum host, and evaluate the influence on medicine quality from host to T. chinensis, ultra-performance liquid chromatography coupled with quadrupole-time-of-flight tandem mass-mass spectrometry(UPLC-Q-TOF-MS/MS)was applied. The samples of T. chinensis(harvested from N. indicum)and its N. indicum host were collected in field. The samples of T. chinensis(harvested from Morus alba)and its M. alba host was taken as control substance. All samples were extracted by ultrasonic extraction in 70% ethanol. Chromatographic separation was performed on an ACQUITY UPLC HSS T3 C_(18)(2.1 mm×100 mm,1.8 μm)column at 40 ℃. Gradient elution was applied, and the mobile phase was consisted of 0.1% formic acid water and acetonitrile. The 0.5 μL of sample solution was injected and the flow rate of the mobile phase was kept at 0.6 mL·min~(-1) in each run. It was done to identify cardiac glycosides and explore the chemical composition correlation in T. chinensis and its N. indicum host by analyzing positive and negative ion mode mass spectrometry data, elemental composition, cardiac glycoside reference substance and searching related literatures. A total of 29 cardiac glycosides were identified, 28 of it belonged to N. indicum host, 5 belonged to T. chinensis(harvested from N. indicum host), none of cardiac glycoside was identified in T. chinensis(harvested from M. alba host). The result could provide a reference in evaluating the influence in T. chinensis medicine quality from host. It was rapid, accurate, and comprehensive to identify cardiac glycosides in T. chinensis and its N. indicum host by UPLC-Q-TOF-MS/MS.
Cardiac Glycosides ; analysis ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Loranthaceae ; chemistry ; Nerium ; chemistry ; Phytochemicals ; analysis ; Tandem Mass Spectrometry

To study the effects of fresh-cut drying methods on the appearance and internal components of Panax notoginseng, and explore the feasibility of fresh-cut drying methods of P. notoginseng, so as to provide more effective processing methods for the production of P. notoginseng slices and Chinese patent medicines. In this study, we have compared the effects of 6 different drying methods on drying time, drying rate, density, appearance and internal components of P. notoginseng roots. It takes about 453 h to dry by whole-root drying in the sun, with a long constant speed period and a slow drying rate, the time of whole-root drying at 50 ℃ was shortened by 61.6% compared with whole-root drying in the sun, which resulted in the decrease of density and poor appearance of the medicinal material with hollow and crack appeared in the xylem, while the drying time of fresh-cut drying method was reduced by 61.82% to 91.58% and the drying rate increased greatly, due to the relatively slow drying process in the sun or in the shade after fresh-cut, salting-out and whitening appeared on the surface, and the internal components were all decreased to some extent. The drying time of fresh-cut drying at 50 ℃ was 91.58% and 68.83% shorter than that of whole-root drying in the sun and at 50 ℃, respectively. When drying at 50 ℃ after fresh-cut, the appearance and content of internal components of the medicinal materials were better, the appearance was yellowish green, the cut sections were clear with uniform pore distribution, and the content of saponin components was increased by 7.24% compared with that of the whole-root drying at 50 ℃, When drying at 40 ℃, the surface of slices has salting-out and whitening spots, and the loss of dencichine and total sugar was large, but at 60 ℃, this high temperature made the rate of dehydration of slices was extremely fast, which led to severe cracking and fragmentation, and the loss of total sugar and alcohol extract was large. By vacuum freeze drying after fresh-cut, the structure of medicinal materials slices was loose, the density was greatly reduced, and the appearance was different from those recorded in traditional books. The contents of total saponin components and dencichine were increased by 16.51% and 22.54%, respectively, compared with traditional whole-root drying. The fresh-cut process method is feasible in the production of P. notoginseng slices. In production, it is recommended that drying at 50 ℃ after fresh-cut can make the medicinal materials better in appearance and content of internal components, which is convenient for the subsequent processing and industrial feeding extraction. For the purpose of internal contents, it is better to adopt freeze-drying after fresh-cut processing method.
Desiccation ; Drugs, Chinese Herbal ; standards ; Freeze Drying ; Panax notoginseng ; Plant Roots ; Quality Control ; Saponins ; analysis