Objective:To explore the efficacy of the fifth metatarsal perforator flap of the lateral plantar artery in repairing the wounds on the anterolateral side of the foot.Methods:This study was a retrospective observational study. Eight patients with skin and soft tissue defects on the anterolateral side of the foot and conformed to the inclusion criteria were admitted to the Department of Plastic Surgery of Hanzhong Central Hospital from July 2020 to July 2023. There were 6 males and 2 females, aged 22 to 72 years. Among the patients, there were three patients with electrical burns, four patients with trauma, and one patient with plantar wart. Preoperatively, a Doppler blood flow detector was used to clarify the number and location of the fifth metatarsal perforating vessels. The area of the wounds measured during the operation ranged from 4.0 cm×3.0 cm to 7.0 cm×5.0 cm, and the fifth metatarsal perforator flaps of the lateral plantar artery with area of 4.0 cm×4.0 cm to 9.0 cm×6.0 cm were designed and harvested to repair the wounds. The wounds in the flap donor sites were repaired with medium-thickness skin grafts from lower limb on the same side. The duration of surgery and intraoperative blood loss volume were recorded. The survivals of the transplanted flap and skin graft were observed after surgery. At the last follow-up, the appearance of the flap and the occurrence of complication were observed, the two-point discrimination distance of the flap was measured, and the shape of the flap donor site as well as the sensation and other functions of the affected foot were observed.Results:The duration of surgery ranged from 70 to 100 min, with an average of 84.6 min. The intraoperative blood loss volume ranged from 30 to 80 mL, with an average of 53.5 mL. After surgery, all flaps survived completely; only one patient developed partial necrosis of the skin graft in the wound in flap donor site, and the wound healed completely after dressing change and re-grafting medium-thickness skin graft from lower limb on the same side. Postoperative follow-up was conducted for 6 to 24 months, with an average of 13.8 months. At the last follow-up, none of the patients developed bloated and deformed flaps or pressure ulcers, and the two-point discrimination distance of the flap ranged from 5 to 13 mm. No tendon adhesion or scar hyperplasia was observed in the flap donor sites, and the sensation, weight-bearing, and walking functions of the affected feet were normal.Conclusions:The use of the fifth metatarsal perforator flap of the lateral plantar artery for repairing the wounds on the anterolateral side of the foot has the advantages of flexible flap design, minimal damage to the flap donor site, simple and feasible surgical operation, and good postoperative foot appearance and function, which is worthy of clinical application and promotion.

Objective:To explore the efficacy of the fifth metatarsal perforator flap of the lateral plantar artery in repairing the wounds on the anterolateral side of the foot.Methods:This study was a retrospective observational study. Eight patients with skin and soft tissue defects on the anterolateral side of the foot and conformed to the inclusion criteria were admitted to the Department of Plastic Surgery of Hanzhong Central Hospital from July 2020 to July 2023. There were 6 males and 2 females, aged 22 to 72 years. Among the patients, there were three patients with electrical burns, four patients with trauma, and one patient with plantar wart. Preoperatively, a Doppler blood flow detector was used to clarify the number and location of the fifth metatarsal perforating vessels. The area of the wounds measured during the operation ranged from 4.0 cm×3.0 cm to 7.0 cm×5.0 cm, and the fifth metatarsal perforator flaps of the lateral plantar artery with area of 4.0 cm×4.0 cm to 9.0 cm×6.0 cm were designed and harvested to repair the wounds. The wounds in the flap donor sites were repaired with medium-thickness skin grafts from lower limb on the same side. The duration of surgery and intraoperative blood loss volume were recorded. The survivals of the transplanted flap and skin graft were observed after surgery. At the last follow-up, the appearance of the flap and the occurrence of complication were observed, the two-point discrimination distance of the flap was measured, and the shape of the flap donor site as well as the sensation and other functions of the affected foot were observed.Results:The duration of surgery ranged from 70 to 100 min, with an average of 84.6 min. The intraoperative blood loss volume ranged from 30 to 80 mL, with an average of 53.5 mL. After surgery, all flaps survived completely; only one patient developed partial necrosis of the skin graft in the wound in flap donor site, and the wound healed completely after dressing change and re-grafting medium-thickness skin graft from lower limb on the same side. Postoperative follow-up was conducted for 6 to 24 months, with an average of 13.8 months. At the last follow-up, none of the patients developed bloated and deformed flaps or pressure ulcers, and the two-point discrimination distance of the flap ranged from 5 to 13 mm. No tendon adhesion or scar hyperplasia was observed in the flap donor sites, and the sensation, weight-bearing, and walking functions of the affected feet were normal.Conclusions:The use of the fifth metatarsal perforator flap of the lateral plantar artery for repairing the wounds on the anterolateral side of the foot has the advantages of flexible flap design, minimal damage to the flap donor site, simple and feasible surgical operation, and good postoperative foot appearance and function, which is worthy of clinical application and promotion.

SEPT1 2,as a member of the septin gene family,is preferentially expressed in the adult male testis and plays an im-portant role in the spermatogenesis and maturation of sperm.It is also essential for the maintenance of the structural integrity of the sperm tail.SEPT12 is closely related to sperm morphological abnormality,and its mutation leads to decreased fertility or infertility of males.This review presents an overview of the advances in and affords a prospect of the studies on the structure and biological functions of SEPT12 and the impact of its mutation on male fertility.

OBJECTIVE: To investigate the effect of Rictor on the hematopoiesis of fetal liver by specific knock-out of Rictor in hematopoietic cells of Vav-Cre mice. METHODS: E12.5 0.08ee fetal liver cells from the experimental group Vav-Cre; Rictor embryos and control group Rictor or Rictor embryos were transplanted to recipients respectively to observe the effect of Rictor on reconstitution ability of hematopoietic stem cells. In the meantime, E14.5 0, 10, 20, 40, 60, 80 sorted hematopoietic stem cells from the Vav-Cre; Rictor fetal liver of experimental group and Rictor or Rictor fetal liver of control group were transplanted in to recipients to analyze the numbers of functional hematopoietic stem cells after Rictor was knocked-out. Furthermore, the self-renewal capacity was investigated by secondary transplantation of BM cells from primary recipients that had been successfully repopulated with E12.5 fetal liver-derived cells and by cell cycle analysis. RESULTS: All the recipients receiving E12.5 Rictor or Rictor cells were repopulated (8/8, from 2 independent experiments) with an average chimerism of 77.2%±11.1% at 4 months post-transplantation, which resulted in 57 LT-RU per FL. In comparison, 8 out of 8 recipients receiving Vav-Cre; Rictor cells were repopulated with significantly reduced chimerism (37.0%±16.3%) (P＜0.01), which was equivalent to 8 LT-RU per FL. The limiting dilution transplantation experiment showed that there was one functional hematopoietic stem cell out of 17 sorted SLAM cells in the control group, and one functional hematopoietic stem cell out of 39 sorted SLAM cells in the experimental group. The secondary transplantation experiments showed that 2 out of 4 recipients were reconstructed in the control group after 1 month, and 0 was reconstructed in the experimental group by transplanting 4×10 donor cells respectively. What＇s more, the percentage of S/G/M cells in the experimental group increased when compared with controls. CONCLUSION In the process of fetal liver hematopoiesis, the specifically knocking-out the Rictor in hematopoietic system can lead to defect of reconstitution ability, decrease of the functional hematopoietic stem cell numbers and reduction of self-renewal ability of hematopoietic stem cells.
Animals ; Fetus ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Liver ; Mice ; Rapamycin-Insensitive Companion of mTOR Protein

Objective To observe the effect of postconditioning (PostC) on the expression of platelet-leukocyte aggregation (PLA) during the process of myocardial ischemia and reperfusion in rats, and to explore the mechanisms of ischemic postconditioning (PostC) alleviating myocardial ischemia-reperfusion injury (MIRI). Methods Sixty rats were randomly divided into six groups:sham,reperfusion injury(I/R),postconditioning(PostC),SP600125(inhibition of c-Jun N-terminal kinase,I-JNK),anisomycin and postconditioning(Ani+PostC)and anisomycin(Ani)groups.After constructing the model of myocardial ischemia reperfusion in rats,the levels of myocardial injury markers were detected by using the CK-MB kits and TnI kits. The levels of PLA at different time points were detected by using flow cytometry.The myocardial infarction area were measured by using 2.3.5-Triphenyte-trazoliumchloride(TTC)staining,and the level of phosphorylation of JNK(P-JNK) was determined by using Western blot method. Results (1) The levels of CK-MB, TnI and the infarct size were significantly higher in the I/R group than those in the Sham group(P<0.05).The levels of CK-MB,TnI and the infarct size were significantly lower in the PostC group and I-JNK group than those in the I/R group(P<0.05).Compared with the PostC group,the levels of CK-MB,TnI and the infarct size were significantly higher in the Ani+PostC group and Ani group(P<0.05).(2)Compared with the Sham group,the expression levels of PLA significantly increased in the I/R group at different time points after ischemia (P<0.05). At different time points of MIRI, the expressions of PLA increased gradually in I/R group, Ani+PostC group and Ani group (P<0.05). At the time point of reperfusion for 60 minutes and reperfusion for 3 hours,the expressions of PLA were significantly lower in the PostC group and I-JNK group compared with those of I/R group (P<0.05).Compared with the PostC group,the expressions of PLA were significantly higher in the Ani+PostC group and Ani group (P<0.05). (3) Compared with the Sham group, the expression levels of P-JNK were significantly higher in the I/R group(P<0.05).PostC and I-JNK inhibited the production of P-JNK(P<0.05),while Ani promoted the increase of P-JNK (P<0.05).Compared with the PostC group,the expression levels of P-JNK were significantly higher in the Ani+PostC group and Ani group (P<0.05). Conclusion PostC can reduce the expression of PLA during reperfusion by inhibiting the phosphorylation of JNK,thereby reducing myocardial ischemia-reperfusion injury.

Objectives:To explore the possible mechanisms of ischemic postconditioning on alleviating myocardial ischemia-reperfusion injury, focusing on the inflammatory-thrombus related mechanisms. Methods:Rats were randomly divided into six groups (n=10 each):sham group, ischemia-reperfusion injury group, postconditioning group, SB203580 group, anisomycin+postconditioning (Ani+postconditioning) group and anisomycin (Ani) group. After establising the model of myocardial ischemia reperfusion in rats, the levels of myocardial injury markers troponin I (TnI) and creatine kinase isoenzyme (CK-MB), level of leukocyte-platelet aggregation (PLA) were detected by flow cytometry at different time points, myocardial infarction area was measured by using TTC staining and the level of phosphorylation of p38 MAPK (P-p38 MAPK) was determined by Western blot. Results:Compared with the I/R group, the levels of CK-MB, TnI, the infarct size and the expression of PLA at 60 min and 3 h reperfusion were significantly reduced in the postconditioning group and SB203580 group (P＜0.05). Compared with the postconditioning group, the levels of above parameters were significantly higher in the SB203580 group, Ani+postconditioning group and Ani group (P＜0.05). Compared with the I/R group, the expression of P-p38 MAPK in the postconditioning group, SB203580 group, Ani+postconditioning group was significantly reduced (P＜0.05), while it was significantly upregulated in the Ani group (P＜0.05). Furthermore, compared with the postconditioning group, the expression of P-p38 MAPK in the Ani+postconditioning group and Ani group was significantly upregulated (P＜0.05). SB203580 group presented the similar protection effect as the postconditioning group. Cardioprotective effects of postconditioning was partially reduced in the Ani+postconditioning group. Conclusions:Ischemia postconditioning can reduce the expression of PLA during reperfusion by inhibiting the phosphorylation of p38MAPK, thereby attenuating myocardial ischemia-reperfusion injury.

The CatSper channel is known as one of the most important Ca²⁺ channels on the cell membrane of mammalian sperm and plays a key role in the motility, hyperactivation and fertilization function of sperm. The CatSper protein, expressed exclusively in the principal piece of the sperm tail, is composed of CatSper1-4 and 5 auxiliary unitsβ,γ,δ and ε, and has an essential part in the functional and structural domains of Ca²⁺as well as in the spatiotemporal regulation of the P-Tyr protein, sperm hyperactivation, efficient sperm migration in the oviduct, egg penetration, and normal fertility. Recent studies show that functional deficiency of CatSper seriously affects sperm function,and the loss of any one of its 9 subunits may lead to male reproductive dysfunction. This paper outlines recent advances in the studies of the CatSperprotein, focusing on its expression, location, structure, and regulation,as well as itsinfluence on sperm hyperactivation and male reproduction.
Animals ; Calcium Channels ; chemistry ; physiology ; Humans ; Infertility, Male ; etiology ; Male ; Sperm Motility ; physiology ; Sperm Tail ; metabolism ; Sperm-Ovum Interactions ; physiology ; Spermatozoa ; physiology

OBJECTIVETo investigate the role of NF-κB inhibitor in occurence and development of AML.

METHODSAML and normal bone marrow samples were collected from 8 AML patients and 8 normal persons. The expression of NF-κB signaling pathway genes was detected by NF-κB PCR array. Then, AML mouse model was constructed to test the role of NF-κB inhibitor in AML.

RESULTSThe NF-κB signal pathway was activated in AML patients. The up-regulated genes, EDARADD, TNFSF14, could activate the NF-κB signal pathway, IL6 could regulate the inflammatory signal. The down-regulated genes, TNFRSF 10B, TNFRSF1A, could lead to cell apoptosis. the AML mouse model was constructed successfully. Then administration of NF-κB inhibitor reduced the inhibition of leukemia niche to the normal hematopoietic stem cells (HSCs), promoted the HSC to enter into cell cycle.

CONCLUSIONThe NF-κB signal pathway is activated in AML cells. AML mouse model is constructed successfully. NF-κB inhibitor has a potential to treat AML and promotes the HSC to enrter into cell cycle.

OBJECTIVETo investigate the effect of vacuum sealing drainage (VSD) combined with artificial dermis for treatment of the ankle and foot soft tissue defects.

METHODSA total of 15 patients with skin and soft tissue defect of ankle and foot were treated from January 2011 to December 2013, including 10 males and 5 females, with an average age of 32.5 years old ranging from 3 to 55 years old, involving 8 cases by traffic accident, 2 cases by machine accident, 5 cases by crush injury;8 cases with soft tissue exposure, 2 cases with tendor exposure, 5 cases with bone exposure. VSD was used to cover the wounds and continuous negative pressure drainage after debridement, the wounds covered with artificial dermis after the second granulation tissue grew well, again VSD was used to cover the wounds and negative pressure suction was applied, after 7 to 14 days negative pressure closed drainage was removed, free skin graft was transplanted above the artificial dermis, sterile gauze was used to compression bandage.

RESULTSAll cases were followed up for 3 to 14 months with an average of 6.5 months. Skin graft of 15 of patients survived after transplantation, artificial dermis graft interval was 7 to 14 days with an average of 9.5 days. There was no obvious scar hyperplasia and contracture, no obvious pigmentation, appearance and functional recovery.

CONCLUSIONSAfter the implantation of artificial dermis and traditional skin graft method need for 2 to 3 weeks, vacuum sealing drainage technique combined with artificial dermis in treatment of soft tissue defect of foot and ankle skin has advantages of simple operation, significantly shorten the time of the second phase of the skin, without flap to repair, little injury to donor skin area, wound healing quality high, clinical effect of satisfaction.

OBJECTIVETo investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics.

METHODSA total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year (from November 2009 to November 2010) were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed.

RESULTSThe average annual drug cost in hypertension was (621.50 ± 1337.78) yuan per patient; while the cost was (616.13 ± 1248.40) yuan in management group and (626.44 ± 1414.30) yuan in control group respectively. The average annual drug cost of hypertensive patients who took medicine therapy was (702.05 ± 1401.79) yuan per person, while the cost in the management group ((688.50 ± 1300.70) yuan) was much lower than it in control group ((714.64 ± 1489.60) yuan). The annual average drug cost in urban was (731.88 ± 1403.31) yuan per person, which was higher than it in rural as (407.44 ± 1171.44) yuan per person. The average hospitalized rate was 12.2% (1014/8326), and the average annual cost among the hospitalized patients was (9264.47 ± 18 088.49) yuan per person; while the cost was (7583.70 ± 13 267.00) yuan in management group, which was lower than it in control group as (11 028.00 ± 21 919.00) yuan. The average annual hospitalized cost in hypertension was (1064.87 ± 6804.83) yuan per person; while the cost was (936.73 ± 5284.90) yuan in management group, which was lower than it in control group as (1181.50 ± 7937.90) yuan. The average annual direct medical expense in hypertension was (2275.08 ± 8225.66) yuan per person; while the expense was (2165.10 ± 6564.60) yuan in management group and (2375.20 ± 9487.60) yuan in control group. The average annual direct medical expense in urban ((2801.06 ± 9428.54) yuan per person) was higher than it in rural ((1254.70 ± 4990.27) yuan per person).

CONCLUSIONThe community health or standardized management of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.

Aged ; Community Health Services ; economics ; Cost-Benefit Analysis ; Drug Costs ; Female ; Health Care Costs ; statistics & numerical data ; Humans ; Hypertension ; drug therapy ; economics ; Male ; Middle Aged ; Public Health ; economics