OBJECTIVETo explore clinical effects of digital artery bilobed flap for the treatment of skin degloving injury of thumb.

METHODSFrom January 2007 to December 2012, 45 patients with skin degloving injury of thumb were treated with grafting of digital artery bilobed flap. There were 39 males and 6 females, ranging in age from 19 to 46 years, with an average of 32 years. The disease course ranged from 0.5 to 15 h. Eighteen patients suffered from defect of palmar skin above nail root and nail bed, 19 patients suffered from skin degloving injury of thumb phalangette, and 8 patients had whole skin degloving injury of thumb. The double lobe flaps were designed at the ulnar side of middle finger and the radial side of ring finger according to the defect of thumb skin. The arteria digitalis communis between the middle and ring fingers and its two branches of arteriae digitales propriae supplying the two fingers were used as a vessel pedicle. The flap with digitales proprii nervi was transposed and used to cover the exposed phalanx of thumb. Full thickness graft was used for the donor site. Observation of the appearance, texture, color and wear resistance of flap, appearance, color and depression of grafting area, skin feeling, and finger activities was conducted.

RESULTSAll the flaps and grafts were alive. Forty-three patients were followed up with an average duration of 25 months, and two patients lost follow-up. The color and texture of the flaps were similar to that of the contralateral thumb pulp. The average two point discrimination was 4.2 +/- 0.3 mm. The color of graft skin was slightly deeper than that of the surroundings skin.

CONCLUSIONDigital artery bilobed flap graft is an effective and ideal operation, which is of low risk and high success rates for skin degloving injury of thumb.

Adult ; Arteries ; surgery ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Thumb ; blood supply ; injuries ; surgery ; Young Adult

Objective To discuss effects of Wugong Baidu Drink on expressions of Bcl-2, NF-κB mRNA genes related to the apoptosis of HaCaT in psoriasis. Methods Wistar rats were randomly divided into 6 groups:blank group, Western medicine control group, TCM control group, and Wugong Baidu Drink high, medium, and low dose groups. They were given normal saline, methotrexate suspension, compound natural indigo capsule suspension, and the different doses of Wugong Baidu Drink for gavage, respectively. Drug-containing serum of each group was prepared, and was put in the HaCaT respectively to subculture. The intervention effect of different Drug-containing serums on expressions of objective genes were detected through PR-PCR method. Results Drug-containing serum of each group could decrease the expressions of Bcl-2 mRNA and NF-κB mRNA. The most obvious effects were shown in the groups of Western medicine control group and Wugong Baidu Drink high dose group. All Wugong Baidu Drink groups showed a dose-response relationship. Conclusion Wugong Baidu Drink probably can promote the apoptosis of HaCaT by reducing the gene expressions of Bcl-2 and NF-κB. It can also decrease immune response by regulating serum factors related to T cells to play the role of anti-psoriasis.

According to the existing Provisions for Drug Registration (SFDA Order No. 28), applications for new drugs of traditional Chinese medicine are divided into two parts: the applications for drug clinical trial and for drug production (including new drug certificate). It will last for about 10 years from the application for drug clinical trial to get approving, and it also remains many problems and the low probability to succeed. From the sight of pharmaceutical review, there are mainly two aspects of regulatory compliance and technical issues, mainly for changes without approval of the competent authorities of the country. For example, sample preparation and approval of clinical trial process are significant changes. Technical problems are reporting incomplete data or information submitted does not comply with the technical requirements for review, such as: production process validation does not provide information, the preparation of samples for clinical trials and field inspection, production information, or the information provided does not meet the technical requirements. This paper summarizes the frequently asked questions and to make recommendations to advise applicants concerned, timely detection of problems, avoid risk, improving the quality and efficiency of the application for registration.
China ; Drug Approval ; legislation & jurisprudence ; Drug Evaluation ; legislation & jurisprudence ; Humans ; Legislation, Drug ; Medicine, Chinese Traditional

Objective To study the relationship between morning blood pressure surge with carotid artery intima-media thickness in good controlled elderly hypertensive patients.Methods A total of 151well controlled elderly hypertensive patients was selected in this study.Through the ABPM examination,the morning blood pressure peak was calculated,and then these patients were divided into two groups according to the morning blood pressure peak.The patients whose morning blood pressure peak ≤30 mmHg were divided into non-morning blood pressure surge group (NMS group),and the patients whose morning blood pressure peak ＞ 30 mmHg were divided into morning blood pressure surge group (MS group).The carotid IMT of these patients was measured with ultrasonic detection.The hypertension-related factors with blood pressure and morning peak phenomenon and the impact of IMT were analyzed,and the relationship between the morning blood pressure peak and IMT was analyzed with linear regression analysis.Results Two groups of 151 cases were well-controlled hypertension,76 patients with morning blood pressure showed peak phenomenon,accounting for 50.3％.Age,gender,body mass index,blood lipids,blood glucose,the maximum systolic blood pressure,average systolic blood pressure,minimum systolic blood pressure,maximum diastolic blood pressure,average diastolic blood pressure and minimum diastolic blood pressure had no difference between the two groups ( P ＞ 0.05 ).However,the morning blood pressure peak in patients with MS group [ (42.34 ± 7.10)mmHg] and IMT [ (0.89 ± 0.13 )mm] was higher than the NMS group [ (21.16 ±5.23) mmHg,(0.84 ±0.14) mm,P ＜0.01 orP ＜0.05],and carotid IMT and peak morning blood pressure was positively correlated ( r =0.56,P ＜0.01 ).Conclusions Good controlled elderly hypertensive patients remained the phenomenon of the morning blood pressure surge,the morning blood pressure peak might lead to carotid atherosclerosis.

Objective To investigate the effeets of ulimstatin on expression of intestinal defemin-5 mRNAin the rat model of sepsis.Method The experiment was performed in pharmaco-laboratory of medical college,Sun Yat-Sen University.sixty Sprague-Dawley rals were randomly divided into control,sepsis,pretreated andtreated groups(n=15).Semis was induced in the mts of latter three groups by cecal lifo.and puncture(CLP).The rats of pretreated group received 25 000 U/kg ulinastatin 2 hours before operation and the rats of uli-nastatin treated groups received 50 000 U/kg ulinastatin 2 hours after operation.Some pieces of ileum mucosa weretaken 12 h after CLP.Tge pathological changes were observed and the expression of RD-5 mRNA was detectedwith RT-PCR.All data were managed by SPSS 13.0 software and arIaIyzed by using One-way ANOVA and LSD-ttest.Results The expression of RD-5 mRNA in the rats of sepsis group significantly decreased compared to col-trol(P<0.05).The expression of RD-5 mRNA of pretreated and treated groups sigificantly inereased comparedto sepsis group(P<0.05);pretreated groups had more increased expression of,RD-5 mRNA compared to treatedgroups(P<0.05).Conclusions The expression of intestinal RD-5 mRNA significantly decreases in sepsis,which could be improved by the treatment of ulinadtatin leading to intestinal mucosal protection of the siqnifleant.The pretreatment may be more effective than the theTapeatic treatment in the rat model of sepsis.

Objective To analyze the effect of different areas of paries medialis defect of femoral trochanter on the stability of fracture ends after percutaneous compression plating for femoral intertrochanteric fracture.Methods Thirteen preserved cadaveric specimens of adult femur were used in this experiment.The age of death ranged from 30 to 50 years.Oblique osteotomy was conducted under the same condition using a wire saw to create experimental models of fracture of Evans-Jensen type Ⅳ.The ratios of the area of paries medialis defect to the projected area of lesser trochanter in the specimens 1 to 13 were set respectively as 0,10.0％,14.5％,20.2％,23.4％,30.6％,45.8％,56.8％,76.8％,88.7％,99.8％,121.3％ and 149.4％.All the fractures were fixated by standard percutaneous compression plating.Cyclic load was applied on each specimen using Instron 2000 universal material tester.A vertical load of 600 N was applied for respectively 1,10,100 and 1,000 times to measure the displacements of proximal and distal fracture ends.Results When the ratio of the area of paries medialis defect to the projected area of lesser trochanter was 30.6％,the average displacements of the proximal and distal ends were 0.14 cm and 0.10 cm.When the ratio was 45.8％,the average displacement of the proximal end was 0.53 cm,278.6％ greater than that for 30.6％;the average displacement of the distal end was 0.41 cm,310.0％ greater than that for 30.6％.When the ratio was 149.4％,the average displacement of the proximal end was 0.93 cm,564.3％ greater than that for 30.6％;the average displacement of the distal end was 0.65 cm,550.0％ greater than that for 30.6％.Conclusions When the ratio of the area of paries medialis defect to the projected area of lesser trochanter reaches ＞ 45.8％,the area of paries medialis defect will have a significant effect on the stability of fracture ends after percutaneous compression plating for femoral intertrochanteric fracture.The displacement will increase linearly under the same compression with the increase in defect area.

Objective To explore the medication rules of Professor Gao Zhongying in treatment of chronic atrophic gastritis on basis of his curative prescriptions.Method Prof.Gao Zhongying clinic medical records were used as data resource.Database was built by using Traditional Chinese Medicine Inheritance Support System (Version 2.5).The core combination and assocical rules among the drugs were confirmed by frequency analysis and assocical rules analysis methods.Results We collected 60 clinical formulas including 83 kinds of Chinese herbs.The bighest frequency used simply drugs were Fritilariae Thunbergh Bulbus,Trichosanthis radix,Galli Gigerii Endothelium Corneum and so on.The most frequency drug combination were Fritilariae Thunbergh Bulbus,Trichosanthis radix,Fritilariae Thunbergh Bulbus,Galli Gigerii Endothelium Corneum,Trichosanthis radix,Galli Gigerii Endothelium Corneum,Fritilariae Thunbergh Bulbus,Curcumae Rhizoma and so on.The drug association rules of drug combination were 447 items.Conclusions The medication rules embodied the thoughts of Professor Gao Zhongying of replenishing qi to invigorate the spleen and regulating the stomach to moisten dryness was the main method in treatment of chronic atrophic gastritis and deficiency of spleen and dryness of stomach,which was the key pathogenesis in occurrence and development of chronic atrophic gastritis.

reliability, content validity, construct validity, and criterion - related validity of the CNS are entirely in accordance with the psychometric demands.

Objective To develop a child neglect scale with Chinese culture background to assess the status of the neglected children in China,and examine the reliability and validity of the child-neglect scale(CNS).Methods Considering the cultural background of China,an item pool was established by revising items in correlative literatures and scales.Then,the first draft of the CNS was improved by reserving the effective items well graded by professional experts.A total of 871 students from 2 junior high schools and a vocational and technical college were involved in the study.Those students were surveyed with Parental Rearing Patterns scale and child neglect scale.Exploratory and confirmatory factor analysis were applied to the development and evaluation of the structure of the scale.Results The findings were as follows:the general Cronbach′s Alpha reliability was 0.85,the split-half reliability was 0.81,the test-retest reliability was 0.90. The CNS was made of the 4 sub-scales which was safe neglect scale,physical neglect scale,communion neglect scale and affection neglect scale.the general Cronbach′s Alpha reliability of the child neglect scale was 0.79-0.85,the split-half reliability was 0.64-0.81,and the test-retest reliability was 0.82-0.90.The item loadings of the neglect scale were over 0.30.The confirmatory factor analysis indicated that the ratio of Chi-square to degrees of freedom were 1.766,the goodness of fit index was 0.917,the Tucker-Lewis index was 0.916,and the root mean square error of approximation was 0.047.Criterion-related validity studies indicated that the scores of the CNS were significantly correlated with the rearing patterns as well(r=0.049,-0.465 P

Objective To evaluate the clinical efficacy and safety of the Huhang Burn Liniment in the treatment of Ⅱ degree burn wounds.Methods 400 cases of Ⅱ[degree burn patients admitted to the 4 research centers were divided into two groups(n=200).The treatment group was treated with external Huhang Burn Liniment and the control group was treated with topical silver sulfadiazine silver paste.The wound healing,safety and effect of treatment were compared between two groups.Results The wound healing time in treatment group was significantly better than that of control group (P＜0.05).Before treatment,there was no significant difference in bacterial infection rate and VAS score between two groups.After treatment,the bacterial infection rate and the degree of pain relief in the treatment group were significantly better than those in control group(P＜0.05).The cure rate and total effective rate in treatment group were 84.0 ％ and 97.5 ％ respectively,while the control group were 72 ％ and 87 ％,the difference were statistically significant (P＜0.05).Conclusion The Huhang Burn Liniment can effectively promote wound healing,inhibit the growth of bacteria,it's safe and reliable.