Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

OBJECTIVETo observe the clinical significance of postoperative personalized antithrombotic therapy for patients with hemophilic arthritis (HA) patients after arthroplasty.

METHODSFrom September 2005 to October 2013, 11 cases of arthroplasty for hemophilic arthritis in hip and knee total operation 14 times,including 1 case of double knees (calculated as one operation), operation in left knees 6 times, operation in right knees 5 times, 2 in hip. All the patients were male and the age ranged from 23 to 57 years old,with an average of (36.1 ± 11.0) years old; the average weight was (64.1 ± 8.9) kg. All the patients were preoperatively diagnosed and classified as hemophilic arthritis with the radiological images and laboratory tests. According to the function of joints, the risk of postoperative venous thromboembolism (VTE), and dynamic observation of Factor VIII:C (FVIII:C) activity, patients were treated with personalized antithrombus by adjusting the dosage of recombinant human coagulation factor VIII (Kogenate FS). All the patients were orderly divided into postoperatively distal joints moving group and none-moving group to observe the coagulation function.

RESULTSThe enrolled patients had no postoperative complication of VTE and pulmonary embolism (PE). The APTT and D-2 were different between two groups in the postoperative early stage. Length of hospital day was shorter in the moving group than none-moving group.

CONCLUSIONBecause of the self-coagulation disorder, patients with HA tended to bleed. However it doesn't mean that there is no risk of postoperative thrombosis. Therefore,it's important to determine how to control the balance between postoperative antithrombus, hemostasis,and coagulation factor replacement therapy after arthroplasty for HA. Postoperative moving has proved helpful for HA, especially in reducing the risk of hemostasis and shortening the time in hospital.

Adult ; Arthritis ; surgery ; Arthroplasty ; adverse effects ; Factor XIII ; metabolism ; Hemophilia A ; complications ; Hemostasis ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Thrombosis ; prevention & control ; Young Adult

BACKGROUNDOptic nerve injury, caused by retinal and optic nerve diseases, can eventually result in vision loss. To date, few effective treatments have been discovered to restore visual function. Previous studies showed that recombinant human erythropoietin (rhEPO) has a neuroprotective effect on the central nervous system, particularly in nerve injury. In this study, we investigated the effects of rhEPO on axonal regeneration and functional restoration following optic nerve injury. This was done by measuring the expression of growth associated protein 43 (GAP-43), a marker for neuronal regeneration, on the retina and flash-visual evoked potential (F-VEP).

METHODSAdult Wistar rats were randomly assigned to rhEPO and control (saline) groups. Optic nerve crush injury models were established and rhEPO or saline were immediately injected into the vitreous cavity. The expression of GAP-43 was detected by immunohistochemistry and the F-VEP was measured pre-injury, immediately after injury, 1 week and 2 weeks post-injury.

RESULTSNo detectable staining for GAP-43 was observed in normal retina. In the control group, the level of GAP-43 expression was higher at 1 week post-injury, but decreased at 2 weeks. In the rhEPO group, the level of GAP-43 expression was notably higher at both 1 week and 2 weeks. At each time point post-injury, the expression of GAP-43 in rhEPO group was significantly higher than the control group (P < 0.05). Obvious changes in F-VEP examination were detected immediately after optic nerve injury, including significantly prolonged latency and decreased amplitude of the P1 wave. In the control group, the changes were still obvious at 1 week. The latency was decreased and the amplitude had slightly recovered to 28.23% of the normal value at 2 weeks. In rhEPO group, there was significantly more recovery than the control group at 1 week and 2 weeks post-injury (P < 0.05). The latency most close to the normal level and the amplitude had recovered to 65.51% of the normal value at 2 weeks.

CONCLUSIONSrhEPO can prolong the expression of GAP-43 and increase its intensity after optic nerve injury, thereby promoting neural repair and axonal regeneration. Under the protection of rhEPO, the conduction velocity of the optic nerve recovered significantly. Therefore, rhEPO has neuroprotective effects on the optic nerve and promotes functional restoration of the optic nerve.

Animals ; Erythropoietin ; pharmacology ; therapeutic use ; Evoked Potentials, Visual ; drug effects ; GAP-43 Protein ; metabolism ; Humans ; Immunohistochemistry ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Optic Nerve ; drug effects ; Optic Nerve Injuries ; drug therapy ; Random Allocation ; Rats ; Rats, Wistar ; Recombinant Proteins ; Retina ; drug effects ; metabolism

OBJECTIVETo investigate drug resistance, genotype and serotype of hepatitis B virus (HBV) in nucleos(t)ide analogue (NA) naive patients with chronic hepatitis B (CHB).

METHODSFull-length reverse transcriptase region of HBV DNA was amplified by semi-nested polymerase chain reaction from 97 NA-naive CHB patients, and the PCR product was sequenced, and analyzed to screen 11 classical antiviral drug resistance mutation sites and to identify HBV genotypes, subgenotypes and serotypes.

RESULTSWild-type sequences were found at all of the 11 classical antiviral drug resistance mutation sites from all samples. The patients were infected with either genotype B (36.1%, 35/97) or C (63.9%, 62/97) HBV. The former were all belonged to subgenotype B2 strain; while the latter were divided further into subgenotype C2 (91.9%, 57/62), subgenotype C1 (6.5%, 4/62) and unknown subgenotype (1.6%, 1/62). The 71.9% (23/32) of HBV genotype B patients were born in southern China, while 81.6% (40/49) of HBV genotype C patients were from northern China, showing a clear geographic distribution (Chi-square test = 23.19, Probability value less than 0.01). Of 97 CHB patients, 59 (60.8%) were serotype adr associated with genotype C, while 37 (38.1%) were adw related to genotype B (subgenotype B2) (Chi-square test = 87.83, P less than 0.01).

CONCLUSIONThe wild-type HBV strains prevail in NA-naive CHB patients, whose HBV genotypes, subgenotypes and serotypes are associated with their places of birth.

Adult ; Antiviral Agents ; therapeutic use ; Base Sequence ; DNA, Viral ; blood ; genetics ; Drug Resistance, Viral ; genetics ; Female ; Genetic Variation ; Genotype ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; drug therapy ; epidemiology ; virology ; Humans ; Male ; Middle Aged ; Nucleotides ; therapeutic use ; Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA ; Serotyping ; Young Adult

OBJECTIVETo study the effects of aloesin and arbutin on normal cultured human melanocytes in synergetic method.

METHODSBuilding up the system of cultured human melanocytes. The cultured melanocytes in vitro were treated with the mixture of aloesin and arbutin. The cell viability and tyrosinase activity was measured by MTT assay, utilization of L-Dopa as the substrate respectively; melanin content was measured by image analysis system. Furthermore, the effects of the mixture on melanocytes were compared with that of aloesin and arbutin.

RESULTSThe mixture of aloesin and arbutin showed an inhibition on tyrosinase activity of human melanocytes and reduced significantly melanin content. Between the mixture and the single use of aloesin or arbutin, there is significant difference (P < 0.05). On the other hand, the mixture has little influence on melanocytes viability and there is negative significance.

CONCLUSIONThe mixture of aloesin and arbutin can significantly inhibit the tyrosinase activity and melanogenesis of cultured human melanocytes. It showed the effects of aloesin and arbutin in a synergistic manner. It is worth to give farther study later.

Arbutin ; pharmacology ; Cells, Cultured ; Chromones ; pharmacology ; Dose-Response Relationship, Drug ; Drug Synergism ; Glucosides ; pharmacology ; Humans ; Melanocytes ; cytology ; drug effects ; metabolism ; Monophenol Monooxygenase ; drug effects ; metabolism

OBJECTIVEThe aim of this study was to observe the human hair follicle apoptosis status affected by fluorine and the antagonism effect by selenium in vitro.

METHODSThe single hair follicles were separated and cultured, then they were added in different concentrations of sodium fluoride and sodium selenite. Chosen the appropriate concentrations, they were divided into 7 groups. The TUNEL was used to investigate the apoptotic cells of different parts. The morphous of hair follicles was observed consecutively and electron microscope was used.

RESULTSWe found that in 1 mmol/L and 10 mmol/L sodium fluoride groups, when the human hair follicles in vitro were cultured on the 5th day, the apoptotic cells of outer root sheath (ORS), dermal sheath and hair papilla, hair bulb were obviously increased. But 0.01 mmol/L sodium selenite weakened the toxicity of 1 mmol/L sodium fluoride at the outer root sheath and hair bulb (P < 0.05).

CONCLUSIONSDifferent concentrations of sodium fluoride had different effect on the growth of human hair follicle in vitro which were cultured on 5th day. Sodium fluoride of certain concentration could accelerate the apoptosis of human hair follicle in vitro. Sodium selenite of certain concentration could act antagonism to the toxicity of sodium fluoride.

Adolescent ; Adult ; Apoptosis ; drug effects ; Hair Follicle ; drug effects ; Humans ; Middle Aged ; Sodium Fluoride ; pharmacology ; Sodium Selenite ; pharmacology ; Tissue Culture Techniques ; Young Adult

OBJECTIVETo observe the effects of NGF, estrogens and minoxidil on the growth of human hair follicle in vitro.

METHODSIn a model of human hair follicle in vitro, the follicle was separately treated with the NGF, estrogens and minoxidil. The growth of the hair follicle was measured in length with an eyepiece micrometer. The effects of the NGF, estrogens and minoxidil were evaluated by measuring the rates of incorporation of 3H-TdR of DNA synthesis.

RESULTSThe growth of the human hair follicle was showing significantly faster in the 100 ng/ml NGF and 125 micrograms/ml minoxidil groups, compared with the control (P < 0.05), but the growth was significantly inhibited in the 0.5 microgram/ml 17 beta-E2 group (P < 0.05). There was no difference shown for the growth of the hair follicle in the group mixed with 100 ng/ml NGF and 0.5 microgram/ml 17 beta-E2 (P > 0.05). The rates of incorporation of 3H-TdR in the groups were shown that the results just correlated with the results of the above-mentioned method.

CONCLUSIONSThe 100 ng/ml NGF and 125 micrograms/ml minoxidil could increase the growth of human hair follicle while the 0.5 microgram/ml 17 beta-E2 could inhibit it. The 100 ng/ml NGF could neutralized the effect of the 0.5 microgram/ml 17 beta-E2.

Adolescent ; Adult ; Estrogens ; pharmacology ; Hair Follicle ; cytology ; drug effects ; growth & development ; Humans ; In Vitro Techniques ; Middle Aged ; Minoxidil ; pharmacology ; Nerve Growth Factor ; pharmacology ; Vasodilator Agents ; pharmacology

AIM To observe the effects of Placenta Granules (Hominis placenta) on endometrial receptivity and embryo outcome.METHODS Ninety infertile patients meeting the kidney Qi deficiency syndrome were randomly divided into H.placenta group (treatment group) and control group.The endometrial thickness,endometrial morphology,blood flow,ovum pick-up number,fertilization number,developmental embryo number,highquality embryo number,pregnancy rate,implantation rate and abnormal pregnancy rate were observed in the two groups.RESULTS There were significant differences in blood flow,numbers of developmental embryo and high-quality embryo (P ＜ 0.05).Ten cases in the control group and fourteen cases in the treatment group reached standard for fresh embryo transplantation.The number of HCG positive in the control group was four cases,which was lower than six cases in the treatment group.There were three cases in the control group on number of clinical pregnancy,and six cases in the treatment group.There were four cases in the control group on implantation rate,and nine cases in the treatment group.All the differences were not statistically significant (P ＞ 0.05).CONCLUSION Placenta Granules can improve the endometrial receptivity and high-quality embryo number in ovarian-stimulation stage under mild stimulation protocol,showing a rising trend in clinical pregnancy rate.

BACKGROUNDEmergence agitation is a common problem in pediatric anesthesia, especially after sevoflurane induction and maintenance anesthesia. The purpose of this study was to investigate the effect of sufentanil to reduce emergence agitation after sevoflurane anesthesia in children undergoing adenotonsillectomy compared with fentanyl.

METHODSOne hundred and five children, aged 3 - 11 years, were randomly allocated to receive normal saline (control group), sufentanil 0.2 µg/kg (S2) or fentanyl 2 µg/kg (F2) 1 minute after loss of the eyelash reflex. Anesthesia was induced and maintained with sevoflurane. Time to tracheal extubation, recovery time, Paediatric Anesthesia Emergence Delirium (PAED) scale, and emergence behavior were assessed.

RESULTSThe incidence of severe agitation was significantly lower in S2 and F2 groups vs. the control group, 4/32 and 15/34 vs. 24/34 respectively, (P = 0.002, 0.009, respectively). PAED scales were significantly different among three groups (P = 0.007), and lower in the S2 and F2 groups than in the control group (P = 0.007 and P = 0.025, respectively). And the incidence of severe agitation and the PAED scale score was significantly different between the S2 and F2 groups (P = 0.007, P = 0.019, respectively). Time to tracheal extubation and recovery time were similar in all three groups.

CONCLUSIONSAdministration of sufentanil at 0.2 µg/kg after induction of anesthesia reduced emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl. This was without delaying the recovery time or causing significant hypotension.

Adenoidectomy ; methods ; Anesthesia ; methods ; Child ; Child, Preschool ; Female ; Fentanyl ; therapeutic use ; Humans ; Male ; Methyl Ethers ; adverse effects ; therapeutic use ; Prospective Studies ; Psychomotor Agitation ; drug therapy ; etiology ; Sufentanil ; therapeutic use