Objective To discuss the method and treatment outcome of vascular variation in repairing skin defect of the hand by free transplantation of posterior interosseous perforator flap.Methods Eight cases with vascular variation were adjusted flap position,two cases were repaired by single perforator flap,three cases were repaired by cutting perforator and anastomosing perforator after changing the path,three cases were repaired by designing composition leaves flap.Results Seven flaps survived,one flap partly necrosis and healed by skin-grafting,and all of the patients were followed-up 3 to 18 months.The color,texture and thickness of the flaps were satisfactory.The movements of the fingers were satisfactory.According to the hand function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,outcomes were rated excellent in 1 case,good in 5 cases,fair in 2 cases.The excellent and good rate was 75％.Conclusion When finding vascular variation in repairing skin defect of the hand by free transplantation of posterior interosseous perforator flap,adjust flap position,repair by single perforator flap,cutting perforator and anastomosing perforator after changing the path,or designing composition leaves flap is a good treatment option.

Denys-Drash Syndrome ; diagnosis ; Humans ; Infant ; Male

Objective: To observe the clinical efficacy of Zhi Shen Tiao Sui (regulating the mind and marrow) needling in treating depression after ischemic stroke. Methods: A total of 145 patients with depression after ischemic stroke were recruited between January 2016 and January 2018 and divided into two groups using random number table method, with 72 cases in the control group and 73 cases in the observation group. The control group received conventional treatment for ischemic stroke and medication, while the observation group was given additional Zhi Shen Tiao Sui acupuncture. The two groups were treated for 4 successive weeks. Clinical efficacy was analyzed after treatment. The neurological function pertinent scores [Hamilton depression scale (HAMD), clinical neurological deficit score (CNDS), activities of daily living (ADL), Fugl-Meyer assessment scale (FMA) and Barthel index (BI) scores], as well as the levels of cortisol (CORT) and adrenocorticotropic hormone (ACTH) were recorded in the two groups. Adverse reactions that occurred during treatment were also observed. Results: The clinical total effective rate was 82.2％ in the observation group, significantly higher than 66.7％ in the control group (P<0.05). After treatment, the HAMD and CNDS scores were markedly reduced in both groups (all P<0.05), and the ADL, FMA and BI scores were markedly increased (all P<0.05). The HAMD and CNDS scores were significantly lower in the observation group than in the control group after treatment (both P<0.05), and the ADL, FMA and BI scores were significantly higher in the observation group than in the control group (all P<0.05). The levels of CORT and ACTH declined significantly after treatment in the two groups (all P<0.05), and were markedly lower in the observation group than in the control group (both P<0.05). The adverse reaction rate was 2.7％ in the observation group, versus 4.2％ in the control group, and the between-group difference was statistically insignificant (P>0.05). Conclusion: Compared with sole use of Western medication, medication combined with Zhi Shen Tiao Sui acupuncture can promote the recovery of neurological function, down-regulate the levels of CORT and ACTH and enhance the clinical efficacy in treating patients with depression after ischemic stroke, with a relatively high safety rating.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on spinal cord injured rats.Methods Weight-drop spinal cord injury model was made at thoracic 10 segments with NYU impactor device.Stimulated group received daily superthreshold rTMS continued for 4 weeks.BBB locomotor scores were recorded weekly.Growth associated protein 43(GAP43)and 5-hydroxytryptamine(5-HT)were detected with immunofluorescence staining in the area of rostral and caudal to the lesion.Results The BBB scores in stimulation group improved compared with that in the control(P<0.01).GAP43 and 5-HT markers increased in the stimulation group(P<0.01),and they increased in the rostral than in the caudal areas(P<0.01).Conclusion rTMS can improve the locomotor function of incomplete spinal cord injury rats,which may result from the increase of expression of GAP43 and 5-HT.

Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on the spinal segmental excitability after spinal cord injury in adult rats.MethodsT 10 spinal cord injury models were made with weight-drop method.8 weeks later,rTMS were applied to the experimental group at 0.5 Hz suprathreshold stimulation,500 pulses daily for 4 weeks.Spinal cord injury rats without stimulation and normal rats were used as controls.At different time points,electronic evoked F-wave were measured.The ratio of F-wave amplitude to M-wave amplitude(F/M)were compared among these groups.Immunohistochemistry was used to detect the expression of 5-hydroxytryptamine(5-HT)in the rostral and caudal lesion segments.ResultsThe ratio of F/M increased significantly(P<0.01)8 weeks after spinal cord injury compared with baseline ratio and regressed significantly(P<0.01)after 4 weeks of rTMS.Expression of 5-HT in grey matter around lesion was decreased after spinal cord injury and increased significantly(P<0.01)both in the rostral and caudal lesion segments in rTMS treatment group.ConclusionThe increased spinal segmental excitability after spinal cord injury can be regressed by rTMS,which may be resulted in increased expression of 5-HT.

Objective To explore the methods and curative effect of metallic self-expanding stent in inoperable malignant gas-troduodenal obstruction. Methods The data of 15 cases with gastroduodenal obstruction including 9 cases of carcinoma of head of pancreas and 6 cases of carcinoma of stomach were analyzed retrospectively. The operative procedures of the stent implanted and the tors accepted more radiation dose because the manipulation was under the fluoroscopy in a short distance and with a full field of view. sions, the postoperative eating habit and the development turnover of disease. The main death reasons were tumor transfer and sys-tem exhaustion. Conclusion To pay close attention to the details and main points of operative procedure is the key point to implant stent successfully for malignant gastroduodenal obstruction. The determinative factor to influence the curative effect is the develop-ment turnover of tumor.

OBJECTIVETo investigate the expression and significance of CD151 in pituitary adenomas.

METHODSThirty-six pituitary adenomas were collected immediately after surgery together with five normal pituitary tissue. Real time-PCR, Western blot and immunohistochemistry analysis were performed to detect the expression of CD151 mRNA and protein in thirty-six pituitary adenomases and five normal pituitary tissues.

RESULTSThe expression of CD151 in all pituitary adenomases was observed to be significantly higher than that in normal pituitary tissues by Western blot, real time PCR, and immunohistochemistry analysis (P < 0.01). The expression levels of protein and mRNA in invasive pituitary adenomas were much higher than those in non-invasive pituitary adenomas (P < 0.01).

CONCLUSIONThe results suggested that the expression of CD151 was closely correlated with malignant degree of pituitary adenomas, which indicated the expression of CD151 was intimately correlated with occurrence and development of pituitary adenomas. Detecting CD151 might be a vital index to predict prognosis of pituitary adenomas.

Adenoma ; metabolism ; Blotting, Western ; Humans ; Immunohistochemistry ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; metabolism ; Prognosis ; RNA, Messenger ; Real-Time Polymerase Chain Reaction ; Tetraspanin 24 ; metabolism

OBJECTIVETo explore activity laws of mitochondrial complex II in patients of deficiency-cold syndrome (DCS) and deficiency-heat syndrome (DHS) under various ambient temperatures.

METHODSSubjects were recruited by questionnaire and expert diagnosis from grade 1 - 3 undergraduates at Henan College of Traditional Chinese Medicine in November 2012, and assigned to a normal control group, the DCS group, and the DHS group, 20 in each group. Their venous blood samples were collected at two different temperature conditions. Activities of mitochondrial complex II were measured by spectrophotometry.

RESULTS(1) Comparison of mitochondrial complex It under various ambient temperatures: Compared with room temperature in the same group, activity values were all increased in the normal control group at cold temperature with significant difference (P <0.05), but there was no significant difference in the DCS group and the DHS group (P >0. 05). Compared with the normal control group, activity values of complex H were reduced in the DCS group at cold and room temperatures with significant difference (P <0.05). Compared with the DCS group, activity values of complex It were increased in the DHS group with significant difference (P <0. 05). (2) Changes of adjustment rates: Compared with room temperature, the adjustment rate all rose at cold temperature in the normal control group and the DHS group with significant difference (P <0.05), but with no significant difference found in the DCS group (P >0. 05). Compared with the normal control group at the same temperature, the adjustment rate in the DHS group and the DCS group was all reduced at cold and room temperatures with significant difference (P <0. 05). There were no significant difference in the adjustment rate between the DHS group and the DCS group (P > 0. 05).

CONCLUSIONSEnvironment temperature can affect the activity of mitochondrial complex II with different influence degrees on different syndrome types of people, but its change trend are basically identical.

Cold Temperature ; Electron Transport Complex II ; metabolism ; Hot Temperature ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Temperature

Objective To compare the torque resistance effect with different types of reconstruction of the distal radioulnar joint (DRUJ) dislocation,in order to explore biomechanical basis for clinical practice.Methods Six adult cadaver forearm were used,including 4 males and 2 females.The average death age was 64.9 years (range,36-78 years).Three were right side,3 were left side.The DRUJ dislocation model was made after the standardized resection of the palmar and dorsal DRUJ ligament.Clinic reconstruction methods of the DRUJ include trans-bone tunnel renconstruction (intra-articular reconstruction) and Looptie up reconstruction (extra-articular reconstruction).The mechanical properties as follows:torque velocity:5°/min,maximum torque angulation:90°,maximum torsion force:1 N· mm.Each limb was detected for the torque mechanic under four conditions:normal,DRUJ dislocation,intra-articular reconstruction and extra-articular reconstruction.Results Each limb was inspected for intact mechanic baseline and without the visual damage to the bone.The average pronation torque resistance on normal condition was (0.44±0.10) N·mm,(0.37±0.09) N·mm on DRUJ dislocation group,(0.45±0.09) N-mm on intra-articular reconstruction group,and (0.42±0.09) N·nun on extra-articular reconstruction group.Pronation torque resistance of DRUJ dislocation group was apparently lower than the normal group (t=2.043,P=-0.047).The pronation torque resistance reconstruction group had no significant difference with normal group.The average supination torque resistance on normal condition was (0.56±0.16) N·mm,while on DRUJ dislocation group was (0.42±0.11) N-mm,on intra-articular reconstruction group was (0.54±0.16) N·mm,on extra-articular reconstruction group was (0.51±0.13) N·mm.There were no apparent differences among four groups.Conclusion Both internal and external reconstruction could recover the rotation stability and normalize the torque resistance,without statistical difference.

·AIM: To analyze the postoperative anatomical and functional outcomes as well as complications after combined phacoemulsification, pars plana vitrectomy (PPV), removal of the intraocular foreign body (IOFB) and intraocular lens (IOL) implantation in patients with traumatic cataract and intraocular foreign body.·METHODS: Medical records of 13 patients (13 eyes)with traumatic cataract and IOFB who had undergone combined phacoemulsification, PPV, foreign body extraction and IOL implantation were retrospectively analyzed. The postoperative follow-up ranged from 2 to 12 months. The main measurements of outcomes were the extraction success of cataract and intraocular foreign body, intraoperative and postoperative complications and the final best corrected visual acuity (BCVA).·RESULTS: The mean age of 13 patients (10 male, 3 female ) was 36.8 years (range: 17-65 years). All eight lOFBs were removed. Four intraocular lenses were implanted after vitrectomy intraoperatively. In 5 cases, intraocular lenses were implanted during the second operation. Intraocular lenses were not implanted in 4 cases. BCVA at last ranged from 0.8 to hand movement. BCVA was 0. 5 or better in four eyes, 0.1 to 0. 4 in five eyes, less than 0.1 in four eyes. Intraoperative complications were encountered in 3 patients. They had vitreous hemorrhage. Postoperative complications were encountered in 2 patients. They had retinal detachment. The reoperations of the two patients were successful.·CONCLUSION; The combined phacoemulsification,PPV, removal of IOFB and IOL implantation is safe and effective for patients with traumatic cataract and intraocular foreign body. The visual outcome depended primarily on the corneal or scleral wound and underlying posterior segment pathology and sites.