Objective To evaluate clinical application of the gastrocnemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011,twenty adult lower limbs were infused with red glue to observe the origin,streching,branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further.CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.

OBJECTIVE To evaluate the effect of vacuum drainage for deep neck infection.METHODS There were 35 patients with deep neck infection in the First Central Hospital of Tianjin from January 2009 to February 2016. These patients were treated by abscess incision and drained with vacuum.RESULTS After treatment, the symptoms of the general fever and pharyngalgia were significantly turned better. The local inflammatory reaction was controlled within one to 3 days and the wounds were most primary healed in 7 days. CONCLUSION The deep neck inflammatory abscess was mostly able to be cured by incision and vacuum drainage of the abscess. The method can significantly reduce the pain of patients and the workload of the physician, and the effect of the method is better than the traditional treatment method.

Objective To investigate the relationship between vitiligo and thyroid diseases .Methods Chemiluminescence was used to detect serum levels of free triiodothyronine (FT3) ,free thyroxine(FT4) ,thyrotropic stimulating hormone(TSH) ,anti‐thy‐roglobulin antibody(TG‐Ab) and anti‐thyroperoxidase antibody(TPO‐Ab) in 289 vitiligo patients and 128 healthy subjects .All re‐sults were statistically analyzed .Results The abnormal rates of FT3 ,TG‐Ab and TPO‐Ab in vitiligo patients were higher than healthy subjects (P<0 .05) ,which might be correlated with the age and gender of vilitigo patients .Conclusion Levels of thyroid function and autoantibody might be abnormal in vilitigo patients ,which could be more obvious in male and adolescent patients .It could be advantageous to screen thyroid function and antibody levels in patients with vitiligo .

To enforce the application of medical techniques in the primary hospital so as to improve clinical quality and ensure clinical safety, we established the evaluation criteria for admittance of medical techniques class Ⅰ and the incentive system for new technique application. When both systems were applied, favorable results were obtained.

BACKGROUND:Studies have shown that cytokine inhibitor pirfenidone can inhibit biological activity of fibroblasts by regulating a variety of cytokines. It has made good progress in the research and application of anti-fibrosis of internal organs, but the effect and mechanism for hypertrophic scars and skin fibroblasts are unclear. OBJECTIVE:To investigate the effect of pirfenidone on human hypertrophic scar fibroblasts. METHODS:Human hypertrophic scar fibroblasts were cultured using tissue culture method. Passages 3-6 cel s grew wel in the logarithmic growth phase were col ected. Cel s were divided into the control group (0 g/L pirfenidone), 0.15, 0.3 and 1 g/L pirfenidone groups according to different mass concentrations. Cel s were intervened for 12, 36 and 48 hours. RESULTS AND CONCLUSION:MTT, reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay results demonstrated that compared with the control group, cel proliferation, transforming growth factorβ1 mRNA expression, types I and III col agen secretion were decreased in the 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05), and the decrease was most significant in the 1 g/L pirfenidone group (P<0.05). At 24, 48 and 72 hours after intervention, significant differences in inhibitory rate of cel proliferation and the secretion of types I and III col agen were detected among 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05). Results confirmed that pirfenidone apparently inhibited the secretion of col agen of hypertrophic scar fibroblasts cultured in vitro, transforming growth factorβ1 expression and cel proliferation and viability.

Objective To investigate the effect of hypothermia on the expression Toll-like receptor 2 (TLR2),myeloid differentiation factor 88(MyD88),nuclear factor-κBp65(NF-κBp65),plasminogen activator inhibitor-1(PAI-1)in the TLR2/MyD88 pathway in rats with acute lung injury(ALI)induced by lipopolysaccharide (LPS)inhalation. Methods Ninety male Sprague-Dawley(SD)rats were randomly divided into control group (n=18),hypothermia group(n=24),temperature controlled group(n=24),and temperature-uncontrolled group(n=24). The ALI model was reproduced by 0.5 mL/kg LPS intratracheal instillation,while only normal saline was instilled intratracheally for control group. Arterial blood was collected and physical cooling was started 1 hour after instillation. The body temperature was lowered to 32-34 ℃in hypothermia group and 36-37 ℃in temperature controlled group,and no intervention was used for temperature-uncontrolled group and control group. The arterial blood gas was determined in all the groups before and 1 hour after instillation of saline or LPS and 1,6, 12 hours after intervention. Rats were sacrificed respectively at 1,6 and 12 hours after temperature control therapy, the morphological changes in lung tissue were observed under light microscope. The protein expression of PAI-1 in bronchoalveolar lavage fluid(BALF)was determined by enzyme linked immunosorbent assay(ELISA). TLR2 mRNA and MyD88 mRNA transcriptional level were determined by reverse transcription-polymeras chain reaction (RT-PCR). NF-κBp65 protein level was determined by Western Blot. Results After instillation of LPS,the oxygenation index(PaO2/FiO2)of each group was decreased obviously,the damage of lung tissues was aggravating,the lung injury score was increased significantly,PAI-1 protein in BALF and the expressions of TLR2 mRNA,MyD88 mRNA, NF-κBp65 protein in lung tissues were increased obviously. Each index was improved by therapeutic Hypothermia, the effect of which was best in using a cooling period in the 1-6 hours,while might be benefit at 6-12 hours. Compared with temperature controlled group,PaO2/FiO2(mmHg,1 mmHg=0.133 kPa)at 1 hour and 6 hours of hypothermia group was improved(1 hour:402.49±38.61 vs. 324.36±28.93,6 hours:349.72±98.20 vs. 284.35±13.68, both P<0.01),the lung injury score at 1,6 and 12 hours were significantly decreased(1 hour:6.04±0.74 vs. 7.96±0.65,6 hours:9.09±0.80 vs. 13.13±1.02,12 hours:10.79±1.42 vs. 13.42±0.68,all P<0.01),the PAI-1 protein(ng/L)in BALF at 1,6 and 12 hours were significantly decreased(1 hour:121.36±4.62 vs. 197.74±9.42, 6 hours:230.53±10.76 vs. 294.06±16.60,12 hours:270.48±13.20 vs. 319.40±10.24,all P<0.01),TLR2 mRNA and MyD88 mRNA expressions(2-ΔΔCt)in the lung tissues at 1,6 and 12 hours were significantly decreased (TLR2 mRNA 1 hour:2.18±0.26 vs. 3.04±0.39,6 hours:4.09±0.29 vs. 4.90±0.35,12 hours:6.02±0.43 vs. 7.10±0.54;MyD88 mRNA 1 hour:2.25±0.41 vs. 3.04±0.30,6 hours:5.67±0.55 vs. 7.01±0.76,12 hours:7.14±0.60 vs. 8.87±0.54,all P<0.01),NF-κBp65 protein expression(A value)at 6 hours and 12 hours was significantly decreased(6 hours:0.31±0.08 vs. 0.53±0.12,12 hours:1.05±0.17 vs. 1.76±0.35,both P<0.01). There was no difference in each index between temperature controlled group and temperature-uncontrolled group. Conclusion Hypothermia can down-regulate the expression of TLR2 mRNA,MyD88 mRNA,NF-κBp65 protein and PAI-1 in the TLR2/MyD88 pathway to protect lung tissue of rats with ALI induced by LPS inhalation from injury.

Objective: To preliminarily evaluate coronary heart disease (CAD) by dual-source CT vascular functional imaging in relevant patients. Methods: A total of 200 patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS) in our hospital from 2014-09 to 2015-10 were enrolled, 57 of them received dual-source CT angiography (DSCTA) and diagnosed for critical value of left anterior descending (LAD) stenosis; the patients were further examined by selective coronary angiography (SCA) within 1 week to conifrm the degree of stenosis. Meanwhile, fractional lfow reserve (FFR) was measured and taking FFR 0.8 as cut off point, the patients were divided into 2 groups: FFR<0.8 group,n=27 and FFR≥0.8 group,n=30. The values of left ventricular anterior wall, side wall, left ventricular cavity and the segmental thickness in diastolic and systolic stages were measured; relative CT value between ventricular anterior wall and side wall was compared, myocardium thickness at the end-diastolic stage was also compared. Results:①In FFR<0.8 group, compared with the side wall, anterior wall had decreased relative CT value (P=0.000), myocardium thickness at the end-diastolic stage (P=0.000) and myocardial wall thickening rate (P=0.001).②In FFR≥0.8 group, compared with the side wall, anterior wall had decreased relative CT value (P=0.000), myocardium thickness at the end-diastolic stage (P=0.018), while similar myocardial wall thickening rate (P=0.186).③Compared with FFR≥0.8 group, the patients in FFR<0.8group presented reduced relative CT value in anterior wall (P<0.05) and myocardial wall thickening rate (P<0.001), while similar myocardium thickness at the end-diastolic stage (P=0.964). Conclusion: CT information may provide the reference value for treating patients in clinical practice.

Objective To investigate the application value of multi-slice spiral CT on the congenital malformation of coronary sinus. Methods MSCT finding of 98 patients with coronary sinus malformation confirmed by surgery were retrospectively analyzed,and the cases were divided into four categories based on the Mantini theory and comparison was made between the diagnosis from ultrasound and CT.A 2 × 2 table for Chi-square test was also used for statistics analysis.Results Among 98 patients,there were 72 patients with persistent left superior vena cava reflowed to right atria through coronary sinus,with 48 patients diagnosed by ultrasound and 72 patients by MSCT; there were 13 patients with anomalous pulmonary venous connection to coronary sinus,with 12 patients diagnosed by ultrasound and 13 patients by MSCT diagnosis; there were 10 patients with unroofed coronary sinus syndrome,with 6 patients diagnosed by ultrasound and 8 patients by MSCT,there were 2 patients with coronary sinus atresia,all diagnosed by MSCT; there were 1 patient with coronary sinus anomaly reflow to left arita.The significant difference between 2 modalities (x2 =22.7,P＜0.01) shows that CT is superior to ultrasound.Conclusion MSCT is much more better than ultrasound in the diagnosis of malformation of coronary sinus and it can provide reliable diagnosis prior to surgery or interventional therapy.

Objective To investigate the effects ofendothelin-1 (ET-1) and endothelin-3 (ET-3) on the expression of transformation growth factor-beta 1 (TGF-β1) and phosphorylation of Smad 3 in malignant melanoma cell line, A375. Methods Cultured A375 cells were classified into 5 groups, i.e. control group (no stimulation), ET-1 group (stimulated with ET-1), ET-1+BQ123 group (treated with ET-1 and BQ123),ET-1 + BQ788 group (treated with ET-1 and BQ788), ET-3 group (stimulated with ET-3), to receive different stimulation. The working concentrations were 0, 0.1, 1, 10, 100 nmol/L for ET-1 and ET-3, 10 μmol/L for BQ123 and BQ788. After another 12- and 24-hour culture, ELISA, RT-PCR and Western blot were used to detect the expression of TGF-β1 protein and mRNA as well as phosphorylated Smad 3 (P-Smad 3). Results The expression of TGF-β1 in A375 cells was up-regulated by ET-1, but down-regulated by ET-3, and both of the effects were in a concentration-dependent manner. Under the stimulation with ET-1 and ET-3 of 100 nmol/L, the level of TGF-β1 reached 1289.38 ± 89.42 ng/L per 105 cells and 85.09 ± 9.37 ng/L per 105 cells, respectively, significantly different from that in unstimulated cells (both P < 0.05). BQ123 signifi-cantly blocked the up-regnlatory effect of ET-1 on the expression TGF-β1 protein(P < 0.05), but BQ788 had no significant influence on the effect, so was the case with TGF-β1 mRNA. Western blot revealed that ET-1significantly elevated the expression of P-Smad 3 in A375 cells (P <0.05), and the elevation was significantly inhibited by BQ123, but not by BQ788. The expression of P-Smad 3 was statistically decreased by ET-3 in A375 cells (P <0.05). Conclusions The expression of TGF-β1 could be enhanced by ET-1, but suppressed by ET-3. It is likely that endothelin receptor A mediates the phosphorylation of Smad 3 induced by ET-1.

OBJECTIVETo investigate the effect of diclofenac on the expression of Kv1.3 and Kir2.1 channels in human macrophages and the membrane potential and foaming process of the macrophages.

METHODSThe effect of diclofenac on the expression of Kv1.3 and Kir2.1 channels in cultured human monocyte-derived macrophages was investigated using real-time RT-PCR and Western blotting, and its effect on the membrane potential was analyzed with optical mapping of the membrane potential with voltage-sensitive dyes. The ratio of cholesterol ester (CE) in the macrophages following intake of oxidized low-density lipoprotein (OxLDL) was analyzed by an enzymatic fluorometric method.

RESULTSThe expression of Kv1.3 and Kir2.1 channels in the macrophages were down-regulated by diclofenac (1.5 µmol/L and 15 µmol/L). Compared with those in the control group, Kv1.3 mRNA expression was reduced by over 80% and 90% (P<0.05), and Kir2.1 mRNA by over 20% and 30% (P>0.05), respectively; both their protein expression was reduced by over 10% and 60% with a dose- dependent effect (P<0.05). Diclofenac at the two doses dose-dependently reduced the surface fluorescence intensity of the macrophage, and the membrane potential was decreased by 28% and 54%, respectively (P<0.05). Incubation of the macrophages with 30 mg/L OxLDL for 60 h caused an obvious enlargement of the cell volume and deposition of numerous lipid granules in cytoplasm, resulting also in a CE/TC ratio over 50% (P<0.05). Diclofenac at 1.5 and 15 µmol/L both significantly decreased the CE/TC ratio to (23.624∓3.34)% and (13.601∓2.916)% (P<0.05), respectively, but this effect did not show a dose-response relationship (P>0.05).

CONCLUSIONDiclofenac can significant down-regulate the expression of Kv1.3 and Kir2.1 channels in human macrophages, lower their membrane potential and inhibit the process of foam cell formation.

Cells, Cultured ; Diclofenac ; pharmacology ; Foam Cells ; cytology ; drug effects ; Humans ; Kv1.3 Potassium Channel ; metabolism ; Macrophages ; drug effects ; metabolism ; physiology ; Membrane Potentials ; drug effects ; Potassium Channels, Inwardly Rectifying ; metabolism