Objective: To present a modified method for harvesting and shaping fibular flap in reconstruction of mandibular defect. Methods: Fibula flap harvesting was performed under non-blood-evacuation of the donor limb and two gaps were made at the upper and lower ends of the fibular flap during the flap harvesting. Step-like osteotomy was performed to obtain 3 segments(each segment was 3~5 cm in length) of fibular bone. The shaping was achieved by fitting the bone segments together based on the natural contour of the mandible. The modified operation was conducted in 7 patients for mandibular reconstruction. Results:The method was successfully used in all patients with less bleeding during the flap harvesting and after reconstruction.The bone segments were rigidly fixed with good bony consolidation and contour. No complications occurred.Conclusion: The modified fibular flap harvesting method is feasible in mandible reconstruction.

Objective To explore the best formula of the 0 5% liposome podophyllotoxin chitosan film. Methods Chitosan,acetic acid and gelatin were selected as three factors to prepare film, each factor including three levels, and 0 5% liposome podophyllotoxin served as blank factor. The films of different formula were prepared according to orthogonal design. The evaluation was made on the basis of the characteristics of conglutination and dissolution, then the best formula was determined finally. Results The results showed that the conglutination and dissolution of the film which was made of 2% chitosan, 1%acetic acid, 2% gelatin and 0 5% liposome podophyllotoxin chitosan was the most perfect. Conclusion The film designed according to orthogonal experiment was coincidenced with the requirements in aspect of conglutination and dissolution, and its appearance was perfect.

OBJECTIVETo observe the clinical efficacy on constipation predominant irritable bowel syndrome (IBS-C) treated with acupuncture for regulating the mind and strengthening the spleen and the impacts on the quality of life in the patients.

METHODSSixty patients of IBS-C were randomized into two groups. In the acupuncture group (30 cases), acupuncture was applied to Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Taichong (LR 3), Sanyinjiao (SP 6), Yintang (GV 29) and Baihui (GV 20), once a day, 5 treatments a week and 4 weeks treatment as one session. In the western medication group (30 cases), lactulose oral solution was prescribed, 15 mL each time, three times a day, 4 weeks treatment as one session. The symptom grade scale and the quality of life scale (IBS-QOL) were adopted to observe the changes in clinical symptoms and quality of life before treatment, after treatment and 2-month follow-up after treatment in the patients of the two groups separately.

RESULTS(1) Clinical symptom score: the difference in the symptom score at each time point was significant statistically in intra-group comparison (P < 0.01). In 1 week, 4 weeks of treatment and 2 months after treatment, the clinical symptom scores in the acupuncture group were lower than those in the western medication group (P < 0.05, P < 0.01). (2) IBS-QOL score after treatment was improved as compared with that before treatment in the two groups (P < 0.01). The improvement of IBS-QOL at 2 months after treatment in the acupuncture group was apparently superior to the western medication group (P < 0.05). (3) The total effective rate was 90.0% (27/30) in the acupuncture group and was 83.3% (25/30) in the western medication group. The overall efficacy in the acupuncture group was better than that in the western medication group (P < 0.01).

CONCLUSIONAcupuncture for regulating the mind and strengthening the spleen significantly relieves the clinical symptoms of IBS-C and improves QOL of patients. The total efficacy is superior to lactulose oral solution and presents a certain of long-term efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Constipation ; physiopathology ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; physiopathology ; therapy ; Male ; Middle Aged ; Quality of Life ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Objective To investigate the relationship between serum uric acid level and atrial fibrillation in patients with coronary heart disease.Methods Two hundred and forty-seven inpatients with coronary heart disease were selected.All the patients were divided into simple coronary heart disease group (90 cases),coronary heart disease with paroxysmal atrial fibrillation group (85 cases) and coronary heart disease with continuous/permanent atrial fibrillation group (72 cases).The age,history of cardiovascular events,uric acid,echocardiographic characteristics and drug-taking history were carefully recorded.The risk factors of atrial fibrillation in patients with coronary heart disease were analyzed by Logistic regression.Results The level of history of smoking,diastolic blood pressure,body mass index,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,creatinine,fasting plasma glucose,postprandial 2 h plasma glucose,interventricular septal thickness,carotid intima-media thickness and drug-taking history among the 3 groups showed no statistical differences (P ＞ 0.05).The age,systolic blood pressure,uric acid,left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD) in coronary heart disease with paroxysmal atrial fibrillation group and coronary heart disease with continuous/permanent atrial fibrillation group were significantly higher than those in simple coronary heart disease group,the left ventricular ejection fraction (LVEF) was significantly lower than that in simple coronary heart disease group,and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The result of Logistic regression analysis showed high uric acid,high age,expanded LAD and LVEDD were the independent risk factors of atrial fibrillation in patients with coronary heart disease,and uric acid showed the most significant correlation (P =0.001,OR =1.061,95％ CI 1.026-1.096).Conclusion High serum uric acid level maybe a risk factor of atrial fibrillation in patients with coronary heart disease.

Objective: To review the feasibility of transradial percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients elder than 80 years of age. Methods: A total of 661 CAD patients elder than 60 years with PCI in our hospital from 2013-12 to 2015-12 were enrolled and divided into 2 groups: Observation group, the patients with the mean age of (83.2±3.8, 80-92) years,n=76 and Control group, the patients with the mean age of (68.3±5.2, 60-79) years,n=585. Clinical features, coronary lesions, radial puncture failure rate, PCI success rate and intra-, post-operative complications were retrospectively analyzed and compared between 2 groups. Results: In Control group and Observation group, the patients from failed radial artery puncture changing to brachial artery puncture were 1.0% and 2.6%, from failed radial artery puncture changing to femoral artery puncture were 1.5% and 2.6% respectively; PCI success rates were 96.5% and 96.4%, operational times were (45.7±21.2) min and (47.6±18.5) min, the contrast agent used in coronary angiography (CAG) were (28.9±10.2) ml and (30.6±8.8) ml and in CAG+PCI were (150.4±35.7) ml and (155.6±28.2) ml, intra-operative cardiac events were 0.7% and 1.3%, post-operative vascular complications were 0.9% and 2.6%, post-operative hospital stay times were (5.7±1.9) days and (6.3±2.7) days respectively; the above differences had no statistic meaning. Conclusion: Transradial PCI is safe and feasible in elder CAD patients.

Objective To investigate the efficacy of endoscopy for the treatment of benign biliary stricture after biliary surgery.Methods The clinical data of 127 patients with benign biliary stricture after biliary surgery at the First Hospital of Lanzhou University from January 2007 to December 2011 were retrospectively analyzed.According to the Bismuth classification,there were 60 patients with type Ⅰ,35 with type Ⅱ,21 with type Ⅲ and 11 with type Ⅳ.The efficacies of endoscopy for the treatment of biliary stricture with different Bismuth subtypes were analyzed.Results The location and severity of biliary stricture were confirmed by endoscopic retrograde cholangiopancreatography (ERCP) + cholangiography.Sixteen patients ( including 7 with type Ⅲ and 9 with type Ⅳ) were transferred to surgical treatment due to severe biliary stricture.A total of 111 patients underwent endoscopic treatment successfully,with the success rate of 87.4％ (111/127).The success rates of endoscopy for the treatment of patients with Bismuth Ⅰ,Ⅱ,Ⅲ and Ⅳ biliary strictures were 95％ (57/60),86％ (30/35),9/14and 1/2,respectively.Twenty-nine patients were implanted with retrievable metallic biliary stent,and 82 were implantated with plastic biliary stent.Of the 111 patients,only 6 patients were complicated by acute pancreatitis,and they were cured by conservative treatment.The alleviative rates of yellow skin and icteric sclera,tenderness and distending pain of right upper quadrant,fever were 73％ (81/111 ),83％ (74/89),90％ (73/81 ) and 89％(68/76) at 1 week after treatment,and they were 88％ (98/111),91％ (81/89),94％ (76/81) and 92％(70/76) at 8 weeks after treatment.The efficacy of endoscopy was good in 97 patients and poor in 14 patients,and the 14 patients were converted to open surgery.The symptoms including yellow skin and icteric sclera,tenderness and distending pain of right upper quadrant,fever were completely alleviated at postoperative month 6.Conclusion Endoscopic treatment for benign biliary stricture is safe and effective.

Objective To investigate the effect of macrophages on podocytes apoptosis in diabetic nephropathy. Methods Differentiated mouse macrophages (RAW264.7) were exposed to normal glucose, high glucose, then the conditioned media (CM) was collected and considered as NC-CM or HG-CM, respectively. Western blotting and immunofluorescent staining were used to detect the specific markers for M1 macrophages (iNOS) and M2 macrophages (MR). ELISA was used to detect the concentration of TNF-α in the CM. Then normal PRMI 1640 media (control), NC-CM or HG-CM was added to podocytes. In some experiments, ROS inhibitors (Tempo), p38 MAPK inhibitor (SB203580), anti-TNF-α neutralizing antibody, and IgG1 isotype control were respectively added to cells with HG-CM. Besides, recombinant mouse TNF-α alone was applied to incubate podocytes. Podocytes apoptosis was accessed by Annexin V-FITC/PI and Hoechst33342 staining. DCFH-DA staining was used to analyse ROS level. Western blotting was used to detect cleaved casepase-3, p38MAPK, and p-p38MAPK protein. Results Macrophages were activated when exposed to high glucose, displaying pro-inflammatory M1 polarization with higher iNOS and lower MR expression. HG-CM but not NC-CM trigged podocytes apoptosis, up-regulated ROS, cleaved casepase-3 and p-p38MAPK. However, the podocytes apoptosis trigged by HG-CM was abolished by either a ROS inhibitor (Tempo) or a p38 MAPK inhibitor (SB203580). Additionally, TNF-α was increased in the HG-CM. TNF-α protein in macrophage was aslo increased when exposed to high glucose. Anti-TNF-α neutralizing antibody blunted the apoptotic response, excess ROS generation and p-p38 MPAK expression in podocytes induced by HG-CM. Moreover, addition of recombinant TNF-α similarly led to podocytes apoptosis, increased ROS and p38 MPAK expression. Conclusion M1 macrophages activated by high glucose released TNF-α to promote podocytes apoptosis via ROS-p38 MAPK pathway.

Objective · To isolate phages which can fight against extended-spectrum β-lactamase (ESBLs)-producing Escherichia coli (E. coli), and provide basic research for establishment of E. coli phage library and treatment of bacterial infection. Methods · Samples collected from sewage were co-cultured with 93 ESBLs-producing E. coli strains. A phage named JDEC001 was isolated by double agar overlay plaque assay. The biological characteristics, complete genome sequence and comparative genome analyses of JDEC001 were studied respectively. Results · JDEC001 belongs to the lytic phage as a member of the Caudovirales order, Podoviridae family. It has high activity at pH from 5 to 11 and with temperature from 0 to 39 ℃ .Whole-genome sequencing of JDEC001 demonstrated double-stranded DNA genome of 38745 bp with GC content of 49.93%, which encoded 46 open reading frames. The comparative genomics also showed that there was no virulent genes or antibiotic resistant genes in its genome. Conclusion · The phage JDEC001 against ESBLs-producing E. coli was isolated and purified, with good stability in a broad range of pH and temperature.

Objective To investigate whether there is amyloid fibers in the mature neutrophils and to reveal the molecular mechanism of the formation of AD amyloidosis. Method Thirty cases of AD patients and 30 healthy control were enrolled. The white blood cell, the red blood cell,hemoglobin and neutrophil absolute value were determined by Sysmex X5-500i hematology analyzer. The neutrophils and amyloid variable specific probe affinity were measured, The starch like variable fluorescence intensity in plasma was dtected by the sulfur T (Thioflavin T, ThT) method. Results The affinity test results showed that the amyloidosis fluorescent probe (ThT) can be combined with tissue amyloid fibers specifically. The neutrophil amyloid fibers staining also showed a positive reaction. Compared with the AD group, no significant differences were found in white blood cell, red blood cell, hemoglobin and neutrophil absolute value level in the healthy control group The serum amyloid variable fluorescence intensity in the AD group was significantly higher than that in the control group (P < 0.05). Conclusion The amyloid fibers was found in the mature neutrophils, and the level of plasma amyloid fibers was significantly increased in the AD patients.