Objective To introduce the procedure and the clinical experience of two lengthened vascular pedicled flaps in hands to repair soft tissue defect distal to the middle segment of finger. Methods From June 2002 to April 2004, 6 cases with skin and soft tissue defect distal to the middle segment of index and middle finger were treated by the dorsal hand U-I shaped vascular pedicled island flaps, the large area of the repair flap was 5.0 cm?2.8 cm, and the small area was 3.8 cm?2.5 cm, an average of the pedicle length was 8.0 cm. 10 cases with skin and soft tissue defect beyond the middle segment of 2 to 4 finger were treated by the digital artery reversed island flaps of adjacent digit, the large area of the repair flap was 4.6 cm?2.5 cm, and the small area was 2.5 cm?2.4 cm, an average of the pedicle length was 4.0 cm. There were 11 males and 5 females, aged from 18 to 42 years (average, 26 years). Results All flaps survived in 16 cases. After 8 to 24 months postoperative follow-up, with an average of 15 months, the blood supply and texture of the flaps were excellent, their outer aspect and function were satisfactory. Among 4 cases of the dorsal hand U-I shaped vascular pedicled island flaps with connecting nerves, the two-point discrimination was 9 to 11 mm, while in 9 cases of the digital artery reversed island flaps with connecting nerves, the two-point discrimination was 6 to 8 mm. Of the 3 cases that the nerves were disconnected, the sensation of the healed flaps only recovered to S2 or S3. Conclusion The dorsal hand U-I shaped vascular pedicled island flaps and the digital artery reversed island flaps of adjacent digit can form a longer vascular pedicle, to repair the skin and soft tissue defect distal to the middle segment of finger. They are the reliable flaps with good blood supply, and can recover the sensation through connecting nerves.

OBJECTIVE: To investigate the effects of Shenshuning Recipe (SSNR) on gene expression of hepatocyte growth factor (HGF) in renal tissues in rats with glomerulosclerosis. METHODS: Glomerulosclerosis was induced in 42 rats by unilateral nephrectomy and intravenous injection of doxorubicin. Then these 42 rats were randomly divided into three groups: untreated group, SSNR-treated group and benazepril-treated group. Another eight rats were included into sham-operation group. The rats in the SSNR-treated group and the benazepril-treated group were fed SSNR or benazepril respectively for 8 weeks. The levels of 24 h urine protein (Upr), serum creatinine (Cr) and blood urea nitrogen (BUN) of rats in each group were examined. The renal morphological changes were observed under microscope, and the diameter of glomerular capillary, mesangial matrix and glomerulosclerosis index were analyzed by image analysis software. Reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the gene expression of HGF in the renal tissues. RESULTS: The levels of 24 h Upr, serum Cr and BUN in the untreated group were remarkably increased than those in the sham-operation group (P<0.01). The pathological morphological changes in the untreated group showed that the glomerulosclerosis was diffused around the renal tissue and the capillaries were shrunk. The expression level of mesangial matrix was up-regulated and the glomerulosclerosis index was 3.32+/-0.35. The expression level of HGF mRNA in the untreated group was obviously lower than that in the sham-operation group (P<0.05). The levels of 24 h Upr, serum Cr and BUN in the SSNR-treated group and the benazepril-treated group were remarkably decreased as compared with those in the untreated group, while the expression levels of HGF mRNA were both obviously higher than that in the untreated group (P<0.01). The pathological morphological changes in the SSNR-treated group and the benazepril-treated group were both alleviated. There was no significant difference in therapeutic effect between the SSNR-treated group and the benazepril-treated group. CONCLUSION: Shenshuning Recipe can up-regulate the expression of HGF mRNA, decrease the mesangial matrix, and improve the renal function, so that it may retard the development of glomerulosclerosis.

Objective To investigate the effect of autophagy in radiosensitivity of nasopharyngeal carcinoma CNE-2 cells.Methods The expression of ATG5 in CNE-2 cells was inhibited by lentiviral mediated RNA interference.The cells were divided into three groups:control group,NC group and ATG5 group.Cell proliferation,apoptosis and radiosensitivity were detected by CCK-8 method,flow cytometry and colony-forming assay,respectively.Results Compared with the NC group and control group,the survival of ATG5-interfected cells was reduced (F =3.755,46.086,8.609,44.160,P ＜ 0.05).After 6 Gy X-ray irradiation,the apoptosis index of the ATG5 group significantly higher than that of NC group and control group (F =394.876,P ＜ 0.05).In addition,the radiosensitivity of ATG5 group was also higher than that of control cells.Conclusions Suppression of autophagy activity enhances the radiosensitivity of human nasopharyngeal carcinoma cells.

BACKGROUND: In post-menopausal women, the reduction of estrogen level is followed by gradual increase of bone absorption, accompanied by increased cytokine synthesis and bone metabolism disorder. Observation of serum interleukin-6(IL-6), osteocalcin(OC), estradiol(E2)and urinary pyridinoline (PYD) in women with osteoporosis may help understand role of these factors in the onset and development of osteoporosis.OBJECTIVE: To investigate the relationship of serum IL-6, OC, E2, and urinary PYD levels with bone metabolism in women with osteoporosis, so as to identify the factors responsible for the occurrence and development of osteoporosis.DESIGN: A case-controlled clinical observation.SETTING: Central Laboratory of Orthopedics, Nanshan People's Hospital of Shenzhen City.PARTICIPANTS: Between January 1999 and December 2001, 25 post-menopausal women with osteoporosis aged 42 -69 years were selected from the Department of Orthopedics, Nanshan People' s Hospital of Shenzhen to constitute the experimental group, with 10 healthy women from the same hospital serving as control group.METHODS: Two milliliters of fasting venous blood and 2 mL urine samples were collected from women in both groups in the morning to determine the contents of IL-6, OC, PYD and E2, respectively.MAIN OUTCOME MEASURES: Serum IL-6, OC, E2 and urinary PYD levels in the subjects.RESULTS: In the experimental group, the IL-6 level was(201.0±79. 9) ng/L, OC(25.5 ± 16.2) μg/L, and PYD(41.3 ±9.7) nmol/mmol (creatinine), all significantly higher than those in control group( t = 2. 159 -2. 953, P < 0.05-0.01) . Serum E2 level in the experimental group (79. 8 ± 73.2) ng/L, however, was significantly lower than that in control group ( t = 2.071, P < 0.05).CONCLUSION: IL-6, OC, PYD and E2 may play important roles in the occurrence and development of osteoporosis, and adjustment of the levels of these factors can be necessary in the treatment of women with osteoporosis.

Objective To investigate the changes in high voltage-activated (HVA) calcium current in dorsal root ganglion (DRG) neurons isolated from rats with neuropathic pain. Methods Pathogen-free male SD rats aged 4-6 weeks weighing 180-220 g were used in this study. The animals were anesthetized with intraperitoneal pentobarbital sodium 50 mg/kg. Neuropathic pain was induced by ligation of L5 spinal nerve between DRG and sciatic nerve. The nerve was transected distal to the ligature. The animals which showed positive signs of neuropathic pain were decapitated on the 14th postoperative day. L5 and L4 DRGs were isolated and the neurons in the ganglia were enzymatically dissociated (group L5 and L4). The control group received no surgery (group C). The HVA Ca2+ current was recorded using whole-cell patch clamp technique. Results Peak calcium current density was significantly lower in group L5 and L4 than in group C, and was significantly lower in group L5 than in group L4 . Halfactivation value (Va 1/2) was also significantly lower in group L5 than in group C and L4 (P ＜ 0.05). The relative contribution of N-type to the total HVA Ca2+ current was significantly greater in group L5 than in group C and L4(P ＜ 0.05). There was no significant difference in the steady-state inactivation curves among the 3 groups. Conclusion In rats with neuropathic pain, the HVA Ca2+ current in the injured DRG neurons may play a key role in the induction of neuropathic pain.

Objective To investigate the effect of Amp activated protein kinase(AMPK)activity in radiosensitivity of human na-sopharyngeal carcinoma cells .Methods Human nasopharyngeal carcinoma cells ,CNE-2 ,were treated with AMPK inhibitor ,Com-pound C(CC) ,for 1 h .Then cells were explored in X-ray .The expression of total AMPK (t-AMPK) ,phosphorylation AMPK (p-AMPK) ,and MAPlLC3 were detected by Western blot .The number of autophagosomes were observed and calculated by transmis-sion electron microscope(TEM) .Cells processed with CC were explored in X-ray .MTT assay was used to detect the difference of two groups in cell proliferation .Cell apoptosis were assayed by flow cytometry .Results The expression of p-AMPK in CC group cells were significantly downregulated compared to the negative control group cells (P< 0 .01) ,while no significant change of t-AMPK expression were found(P>0 .05) .The expression of MAPlLC3 and the number of autophagosomes in CC group cells were significantly decreased compared to the control group cells (P<0 .05) .Correspondingly ,the cell proliferation rate in CC group was lower than in control group ,and the percent of apoptosis cells was higher in CC group than in control group (P<0 .05) .Conclusion Suppression of AM PK activity could inhibited autophagy induced by decreasing the degree of p-AM PK ,then enhanced the effect of proliferation inhibition and apoptosis promotion in CNE-2 cells .The AMPK inhibitor ,CC ,can serve as an effective assistant treatment of radiotherapy for nasopharyngeal carcinoma .

Objective:To summarize experience of nursing in radiofrequency ablation (RFA) for adrenocortical adenoma with Cushing′s syndrome combined steroid-induced diabetes mellitus.Methods:The key of preoperative nursing was precise glucose control by using insulin pump. Focus on patients psychological intervention. It was important for closely monitor the change of blood pressure, cortisol levels and biochemical index to prevent acute complications such as adrenal crisis during RFA. Pay attention to postoperative nutrition management for reduce blood glucose fluctuation and adverse reactions of hydrocortisone at postoperative.Results:No severe complications occurred during this procedure. After twenty-day nursing and treatment, the patient′s blood glucose control was stable, and the symptoms related to Cushing′s syndrome gradually disappeared.Conclusion:The ultrasound guided radiofrequency ablation in adrenocortical adenoma with Cushing′s syndrome combined with steroid-induced diabetes mellitus was a feasible, safe, and minimally invasive treatment. The key to effectively reduce postoperative complications and ensure the success of the operation. Are adequate preoperative preparation and strict monitor.

Multiple sclerosis (MS) is an idiopathic inflammatory demyelinating diseases of the central nervous system, the underlying cause of which has not been cleared. Previous studies have shown that the pathogenesis of MS is related to the destruction of blood brain barrier, furthermore the drugs used to treat MS have a certain protective effect on the function of blood brain barrier. Therefore, this review combines the research progress at home and abroad to clarify the relationship between the blood brain barrier and MS in pathogenesis and treatment, proposing possible orientation of development.

Objective To analyze the clinical features of patients with acute stage brucellosis in Shenzhen,and provide a scientific basis for prevention and control of brucellosis in immigrant city.Methods A retrospective analysis was conducted to collect clinical data of patients with brucellosis admitted to the Department of Infectious Diseases,Shenzhen People's Hospital from May 2013 to May 2018.The patient's epidemiology manifestations,pathogen and laboratory examination results,diagnosis and treatment outcomes and prognosis were analyzed.Results Among the 39 patients with brucellosis,males were predominant,with a male to female ratio of 1.4 ∶ 1.0 (23 ∶ 16),an age of (44.91 ± 17.18) years and 24 cases were non-Guangdong natives.There were 23 cases with epidemiological history,including 14 cases with mutton,sheep viscera and goat milk history;the disease occurred throughout the year,mainly from February to July,a total of 26 cases.The clinical manifestations of the patients were mainly fever,sweating,fatigue,joint and muscle pain,weight loss,and liver or spleen or lymph nodes swelling.The blood culture was identified as 38 cases of Brucella melitensis and 1 case of Brucella suis.All strains were sensitive to common antibiotics in vitro.All cases were diagnosed as acute stage of brucellosis,2 cases with orchitis,1 case with brucellosis meningoencephalitis,3 cases with spondylitis,and 3 cases with misdiagnosis.Thirty-nine patients were cured according to the "Brucellosis Diagnosis and Treatment Guidelines (Trial)" and were followed up for 1 year.Conclusions Patients with brucellosis in Shenzhen are mainly infected with Brucella melitensis;fever,sweating,joint and muscle pain are the main clinical symptoms;the patient's efficacy and prognosis are better after treatment;for the occurrence of occasional misdiagnosis,it is recommended that in immigrant cities,medical staff should strengthen their understanding of brucellosis.

Objective:To analyze the clinical characteristics of monkeypox patients.Methods:The clinical data and laboratory findings of 4 patients with monkeypox patients diagnosed at Yiwu Central Hospital in July 2023 were analyzed. Herpes fluid and skin tissue samples were collected, the viruses were isolation and cultured in African green monkey kidney cells (Vero) and identified with whole gene sequencing.Results:All four patients were male, aged 24-35 years. All patients had male-to-male behavior within 21 days before onset of the disease. Among them, one patient has AIDS and one patient has syphilis. Four patients presented with perineal skin lesions with itching, and 3 patients were found to have enlarged lymph nodes upon admission. Laboratory testing: lymphocyte abnormality (4.57×10 9/L) in 1 case; increased procalcitonin (0.25 ng/mL) in 1 case; elevated IL-10 levels ( 7.11 ng/L and 9.42 ng/L) in 2 cases; increased IL-6 (66 ng/L) and IL-4 (3.24 ng/L) in 1 case, respectively. One case had abnormal myocardial zymogram with a elevated lactate dehydrogenase level of 313 U/L. The monkeypox virus was isolated from lesion tissue and herpes fluid, and the whole gene sequencing identified it as the B. 1.3 subtype of the IIb evolutionary branch, exhibiting typical pathological effects on Vero cells. Conclusion:The clinical manifestations of the 4 monkeypox patients confirmed in Zhejiang province are mild, patients had a definitive history of male-to-male sexual behavior and the virus strains belong to the B. 1.3 lineage of the IIb evolutionary branch.