The use of flaps for plastic and reconstructive surgery is very popular today.More and more surgeons have realized that the blood supply plays an important role in the design and survival of flaps.After Ian McGregor and Ian Jackson first introduced the axial flaps into clinics,Mathes divided the flaps into two types in 1981,the fasciocutaneous perforator flaps and musculocutaneous perforator flaps.In 1989,the concept of perforator flap was first brought into clinical practice.With the development of microsurgery and anatomy,the epidermis of human skin is divided into areas based on the vascular anatomy.A new century of musculocutaneous perforator flaps has been established.The terminology,classification,characteristics and application of musculocutaneous perforator flaps are described in this paper.

Objective To investigate the neurodevelopmental outcomes and its risk factors of very low birth weight infant (VLBWI) and extremely low birth weight infants (ELBWI).Methods Data of 85 VLBWI and ELBWI hospitalized in Children's Hospital of Fudan University from October 2005 to November 2009 who had finished infant development test of Baley Scales of Infant Development Ⅱ (Bayley Ⅱ) for neurological development at corrected gestational age between 18 to 42 months were retrospectively reviewed.Twelve infants who accepted treatment in other hospital over 10 days were excluded; the rest 73 infants were divided into normal (neurodevelopment) group or abnormal group according to the definition of neurodevelopmental impairment reported by National Institute of Child Health and Human Development (NICHD) Neonatal Network.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression.Results The mean gestational age of 73 infants was (30.4±2.3) weeks; among which 13 were smaller than 28 weeks,42 between 28 and 32 weeks,and 18 older than 32 weeks.The mean birth weight was (1208.0±208.5) g; among which 15 (20.6％) ＜1000 g,and 58 (79.4％) were between 1000 g and 1500 g.Four babies (5.5％) were diagnosed as movement retardation,and neurodevelopmental impairment occurred in 16 cases (21.9 ％),psychomotor developmental index ＜70 occurred in 6 cases (8.2％,one case complicating with cerebral palsy); mental developmental index ＜70 occurred in 2 cases (2.7％); both psychomotor developmental index and mental developmental index ＜70 occurred in 7 cases (9.6 ％,two cases complicating with cerebral palsy),and one case (1.4 ％) was cerebral palsy only.Blind in either eyes and hearing impairment requiring deaf-aid were not found in any of the 73 babies.Logistic stepwise regression showed that use of mechanical ventilation was related to neurodevelopmental impairment (OR =6.183,95％ CI:1.664-22.983,P =0.003).Psychomotor developmental index of infants who needed mechanical ventilation (77.5±15.1) was lower than that of infants did not need (87.3±15.1)(t=2.646,P=0.010).Conclusions VLBWI and ELBWI are in high risk of neurodevelopmental impairment,especially those who need mechanical ventilation.

Total aerobic plate counts for bacterial colonies in the Bullacta exarata ranged from 7. 3?10 5 to 2. 8?10 6 cells per gram. 217 strains of bacteria were isolated from the Bullacta exarata and 88. 5% of them were Gram-negative rod . The predominant genera were composed of Enterobacteriaceae (61 strains), Aeromonas (58), Vibrio (27), Pseudomonas (21). The results indicate that total bacteria numbers exceeds state standard by 1～2 quantity level in every samples. The coliform bacteria numbers exceeds health standard in sample of seven and nine month. It should be brought to attention. The microflora were composed of ten genus , predominant Bacillus of rearing shoal were few in the Bullacta exarata that may play a special role for regulating and controlling the microbial community .

Objective To evaluate the role of early cleavage embryo in combination with embryo growth rate and morphology scoring in embryo selection in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Methods Six hundred and ten IVF/ICSI cycles were randomly assigned to group A(269 cycles) and group B(341 cycles). In group A, transferred embryos were chosen according to embryo growth rate and morphology scoring by 72 h(D3) after fertilization, while early cleavage embryo was added to the selecting system in group B. The pregnancy rate and implantation rate were compared between two groups, and the clinic outcomes were compared between transfers with early cleavage embryos and without early cleavage embryos in group B. Results The pregnancy rate and implantation rate in group B were significantly higher than those in group A (P < 0.05). Transfers with early cleavage embryos also achieved much higher pregnancy rate and implantation rate in group B (P < 0.01). Conclusion Compared with embryo growth rate and morphology scoring, early cleavage embryo in combination with embryo growth rate and morphology scoring can improve the clinical outcomes in IVF/ICSI cycles.

To improve the quality standard of Angelica sinensis, solve the problem of lacking relevant reference substance, a new method-based on the standard reference extract (SRE) was applied to achieve the quality control of Angelica sinensis. SRE of Angelica sinensis was obtained by chromatographic separation technology. After calibration of three makers of the SRE, an UPLC analytical method was developed to determinate the contents of the makers. T-test was used for comparison of the determination results of two methods (reference substances and SRE as reference, respectively), and the results demonstrated that there is no significant difference between the two methods. The presented method is very convenient and practical, which can be used for the quality control of Angelica sinensis.
Angelica sinensis ; chemistry ; Calibration ; Chromatography, High Pressure Liquid ; standards ; Drugs, Chinese Herbal ; chemistry ; standards ; Quality Control ; Reference Standards

This study aimed to analyze the etiology of the encephalitis outbreak in Longyan, Fujian Province, China in 2010, in order to provide valuable information for this prevention and control of this disease. Pathogens were confirmed from cerebrospinal fluid samples with fluorescent RT-PCR, virus isolation (RD cells), and neutralization tests. Then, the VP1 fragments or whole genome nucleotide sequences were determined for four virus strains using PCR. Homology was assessed using the MegAlign software, and a phylogenetic evolutionary tree was drawn using Mega 4.0 software. The results confirmed that the etiology of the outbreak was the ECHO6 intestinal virus, and the nucleotide sequence of the VP1 segment indicated that the C2 subtype was responsible. The genome sequence consisted of 7407 nucleotides, and resembled the genome of other ECHO and CoxB viruses with homology levels of 78.5%-87.3%. The encephalitis outbreak in Longyan in 2010 was caused by the ECHO6 C2 subtype intestinal virus, and its complete genome sequence length is similar to the standard strain (U16283) with a sequence homology of 80.4%.
Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Echovirus 6, Human ; classification ; genetics ; isolation & purification ; Echovirus Infections ; epidemiology ; virology ; Encephalitis ; epidemiology ; virology ; Female ; Humans ; Infant ; Male ; Molecular Sequence Data ; Phylogeny

Objective To explore the change of microRNA let-7b in heat acclimatization/heat stroke rat models and its relation with HSP70,IL-6,TNF-α,TGF-3 and IL-12,and analyze its clinical significance.Methods 60 male rats with almost the same anal temperature,weight,and weeks' age were selected from Laboratory Animal Center in the Second Military Medical University.They were randomly divided into control,heat acclimatization,heat stroke groups averagely.Heat acclimatization/heat stroke rat models were built in hot climate simulated animal tank,blood was collected from cordis apex and serum was separated.Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to test microRNA let-7b in serum,enzyme-linked immunosorbent reaction (ELISA) was to measure the protein level of HSP70,IL-6,TNF-α,TGF-β and IL-12 in serum.Kruskal-Wallis H test was used to analyze quantitative data in the three groups,Spearman rank correlation coefficient was used to reveal relation between two variables in heat stroke group.Results M values of miRNA let-7b in control,heat acclimatization,heat stroke groups were 0.99,1.04 and 1.93 separately,Q values were 0.30,0.25 and 0.44 (x2 =38.95,P＜0.001),separately,with statistical significance.The results of pairwise comparison showed no statistical difference in control and heat acclimatization (P＞0.05),but there were differences in control and heat stroke,heat acclimatization and heat stroke groups statistically (P＜0.05).Spearman correlation analysis showed that in heat stroke group,let-7b was positively related with HSP70,TNF-α and IL-6 (rs =0.579,0.498 and 0.609,P＜0.05) with statistical significance.Conclusion miR let-7b might involve in the pathology of heat stroke,it provided a potential biomarker for monitoring patients in high temperature and humidity clinically.

Acetaminophen (APAP, also known as paracetamol)-induced liver injury is the leading cause of drug-induced liver injury in the world. Wuzhi Tablet (WZ, an ethanol extract of Schisandra sphenanthera) is widely used in clinical practice to protect liver function. Our previous studies have shown that pretreatment with WZ for 3 days can significantly protect against APAP-induced liver injury; however, the effect of different intervals between APAP and WZ treatment on APAP-induced liver injury remains unclear. In this study, the change in liver injury indexes, APAP metabolites, and the activity of cytochrome P450 (CYP450) enzymes after treatment with WZ and APAP at different intervals were determined. The animal experiment was reviewed and approved by the Animal Ethics Committee of Sun Yat-sen University. The results show that 0 h, 0.5 h, and 2 h pretreatment with WZ significantly protected against APAP-induced liver injury in mice, as evidenced by a significant decrease in biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malonaldehyde (MDA). WZ inhibited the metabolic activation of APAP mediated by CYP450 enzymes and reduced the formation of APAP metabolites. This study further demonstrates that pretreatment with WZ at different intervals (0 h, 0.5 h, and 2 h before APAP dosing) exerts a significant hepatoprotective effect against APAP-induced liver injury, and a single-dose of WZ inhibits the activity of CYP450 enzymes related to APAP metabolic activation, thereby protecting against APAP-induced hepatotoxicity.

Objective At present, modern medicine cannot yet clarifythe mechanism of radiation-induceddamage (RID) to salivary glands and its treatment and protective measures remain in the exploration stage .This study was to explore the mechanism of RIDto the submandibular gland and observe the effect of Dark Plum Spray ( DPS) on the submandibular gland after RID in order to provide some evidence for its further application . Methods Using the random number table , 84 healthy Wistar male rats were divid-ed into a normal, an RID model, and an experimental group ,all fed normally.The rats of the RID model groupwere left untreated , while those of the experimental group were intervened with DPS , tid, after RID.On the 1st, 7th, 14th, and 28th day after irradiation, 7 rats were taken from each group for measurement of the body weight, collection of the saliva , and calculation of the salivary flow rate.The submandibular glands were harvested for determination of the mRNA and protein expressions of autophagy-related Atg5 by RT-PCR and Western blot . Results In the 7th day after irradiation , the average body weight in NG[(239.87±16.50)g] was significantly higher (P<0.05) than UG[(213.84±14.42)g] and EG[(222.71±11.14)g].In the 14th ,28th day after irradiation, the average body weight in UG and EG were significantly lower ( P<0.05) than NG;the average body weight in EG was significantly higher ( P<0.05) than UG.In the 1st , 14th day after irradiation , the salivary flow rate in UG and EG were lower than NG but there were no significantly difference(P>0.05).In the 7th day after irradiation, the salivary flow rate in NG[(49.29±16.90)μL/min] and EG[(50.99±6.79)μL/min] were significantly higher (P<0.05) than UG[(30.13±13.19)μL/min].In the 28th day after irradiation, the salivary flow rate in NG[(69.29±11.32)μL/min] were significantly higher (P<0.05) than UG[(49.26±14.13)μL/min] and EG[(46.56±13.60)μL/min] .In the 1st , 7th and 14th day after irradiation , RT-PCR showed that the expressions of Atg 5 in UG and EG were significantly higher(P<0.05) than NG.In the 1st , 7th and 14th day after irradiation, Western blot showed that the expressions of Atg 5 in UG and EG is on the upper trend than NG;In the 1st , 7th day after irradiation , there were no significantly difference between UG and EG .In the 28th day after irradiation , Western blot showed that the expressions of Atg 5 in UG is on the declining trend than NG . Conclusion The autophagic activity of submandibular gland cells may associated with early radiation -induced injury , and Dark Plum Spray may en-hance the action of theanti-apoptosis cytokine in repairingradiation-induceddamageto the submandibular gland .

OBJECTIVETo assess the expression of HER-2 and leptin in gastric cancer and evaluate their relationship with VEGF expression and clinicopathological features, and their prognostic value for gastric cancer patients.

METHODSOne hundred and ten gastric cancer specimens and the corresponding metastatic lymph nodes were detected for HER-2 by immunohistochemistry (IHC). All primary cancer tissues were detected for leptin, OB-Rb and VEGF. Ninty-six specimens of normal gastric mucosa served as the control.

RESULTSThe expression level of HER-2, leptin and OB-Rb in gastric cancer tissues were significantly higher than those in normal tissues (19.1% vs. 8.0%, 49.1% vs. 34.0%, and 60.9% vs. 46.0%, P < 0.05). HER-2 overexpression was moderately homogenous in primary gastric cancer and matastatic lymph nodes (P = 0.607, Kappa = 0.581). There was a correlation between the expression of HER-2 and leptin, both of which were significantly correlated with tumor invasion depth, metastatic lymph nodes ratio (NR), distal metastasis, TNM stage and VEGF expression. However, there was no significant correlation between OB-Rb expression and the clinicopathological features evaluated. Cox regression multivariate analysis showed that tumor size, histological grade, NR, stage, chemotherapy and HER-2 expression were independent prognostic factors.

CONCLUSIONSHER-2 is stably expressed in primary gastric cancer and metastatic lymph nodes. HER-2 and leptin play an important role in the progression and angiogenesis of gastric cancer. High expression of HER-2 is a prognostic factor for poor outcome.

Adenocarcinoma ; drug therapy ; metabolism ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Leptin ; metabolism ; Lymph Nodes ; metabolism ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Receptor, ErbB-2 ; metabolism ; Receptors, Leptin ; metabolism ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Survival Rate ; Tumor Burden ; Vascular Endothelial Growth Factor A ; metabolism