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 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.

Humans ; Lipid Peroxidation ; Male ; Pneumoconiosis ; metabolism ; Superoxide Dismutase ; blood

Objective To investigate the stimulate angiogenesis effect of bone marrow stem cell mobilization on coronary collateral development in the hearts of experimental myocardial infarction rats.Methods Left anterior descending coronary arteries were ligated to produce acute myocardial infarction(AMI)model in Wistar rats.Bone marrow stem cells were mobilized and home to the site of myocardial infarction by ginsenoside Rgl and Simvastatin.Hearts were harvested in the 24th hour,1st and 4th week after AMI modeling for histopathological examination.Immu nohistochemisty were used to detect infiltration of CD+34 cells and the expression of VⅢ factor in the part of ischemia.And infarct area were measured.Results Infarct area in mobilized group was obviously less than in AMI group.There were a great number of monocytes infiltrating with CD34 expression by immunohistochemisty in myocardial infracted zone in mobilized rats.Capillary density in mobilized group was greater than those of AMI and sham-operated groups.Conclusion In the AMI model of rat,bone marrow stem cells can be mobilized by ginsenoside Rgl and Simvastatin.The capillary density can be increased by mobilizing bone marrow stem cells.Ginsenoside Rgl and Simvastatin can improve the acute ischemic cardiac function by enhancing angiogenesis.

Objective To investigate the effect of emergency case video segmentally introduction combining with simulation in cultivation of undergraduate nursing students′skills of trauma management. Methods A group of 55 undergraduate nursing students, recruited in the control group from September 2013 to April 2014, were instructed by traditional teaching method, the trauma management skill was delivered by lecture, video and group based practice. Another 50 undergraduate nursing students, recruited in the observation group from September 2014 to April 2015, were located in the simulation group, while the key point of trauma management was segmentally introduced by emergency case video, the skill of trauma management was delivered by lecture and video, a multiple injury case scenario was used for group practice. The score of the practice test and the evaluation of the teaching were compared among the two groups. Results The students in observation group demonstrated more skilled trauma management compared with that in the control group (90.42±8.50 vs. 84.68±8.77, t=3.56, P<0.05). The students in observation group presented significantly higher satisfaction with the teaching, improving study interesting 93.33%(56/60), promoting the theory knowledge deepen 91.67%(55/60), improving the ability of thinking and observation 95.00% (57/60/) , improving the ability of analyzing and solving problems 100.00% (60/60), enhancing the ability of independent learning 96.67%(58/60), while in the control group, they were 76.36%(42/55), 69.09%(38/55), 65.45%(36/55), 69.09%(38/55) and 80.00%(44/55), the differences between the two groups were significant (χ2 =2.30-4.40, P < 0.05). Conclusions Application of emergency case video segmentally introduction combining with simulation provided more opportunity to the undergraduate nursing students to apply relevant knowledge in analyzing and dealing with trauma cases, which contributes to the improvement of undergraduate nursing students′ skills of trauma management.

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.

Objective To investigate the serum levels of Th1 and Th2 cytokines and explore its roles in development and clinical features in the elderly patients with eczema. Methods The serum levels of interleukin-2(IL-2),interleukin 4(IL-4),interleukin-10(IL-10),interleukin-12(IL-12) and tumor necrosis factor alpha (TNF-α) were derected in 50 elderly patients with eczema and 34 healthy elderly as control by enzyme-linked immunosorbent assay (ELISA). The above cytokines were compared between acute and chronic,generalized and localized eczema. Results The serum levels of IL-2 [(16.03±0.47)vs.(15.72±0.33) μg/L],IL-4[(14.04±0.56) vs.(13.56±0.16) μg/L],IL-10 [(33.01±5.40) vs.(29.49± 1.07) μg/L],IL-12 [(39.32± 3.54) vs.(37.93± 1.17) μg/L]and TNF-α [(27.33±0.72) vs.(26.38±0.48) μg/L] were higher in elderly eczema than in control (t/t'=3.55,5.74,4.49,2.58,6.69,all P＜0.05).The serum levels of all cytokines tested in acute eczema(t/t'=3.59,4.68,3.35,2.00,6.44,all P＜0.05),the levels of IL2,IL-4,IL-10 and TNF-α t'=2.46,5.50,3.83,3.10,P＜0.05,but not IL-12 (t'=1.77,P＜0.05) inchronic elderly eczema were increased as compared with control ( P ＜0.05).No significant difference was found in cytokines levels between acute and chronic eczema (P＞0.05)as well as between generalized and localized eczema(t=0.18,5.74,4.49,0.91,0.25,1.11,P＞0.05). Conclusions Changes of Th1 and Th2 cytokines may play some role in the pathogenesis of elderly eczema,but not characterized by clinical types of eczema.