Objective To investigate role of reverse digital artery island flap combined with dig- ital nerve end to side anastomosis.Methods Reverse digital artery island flaps were used for recon- struction of 65 fingertip defects in 57cases,in which the restoration of the flap sense was attained via dig- ital nerve end to side anastomosis.Results After primary repair,all flaps survived,with good appear- ance and wear-resisting as well as satisfactory two-point discriminations.Conclusion Digital artery re- verse island flap combined with digital nerve end to side anastomosis is a simple and effective procedure for repair of finger defect.

Colchicine ; Forensic Medicine

Objective To evaluate the localization of mitral valvular(MV)prolapse by transthoracic echocardiography(TTE),transesophageal echocardiography(TEE)and explore the interrelationship between the different subregions of MV prolapse and mitral regurgitation(MR).Methods Total of thirtythree patients with MV prolapse and more than moderate MR were included.TEE was used to further judge the location of scallop lesions and the result of both TTE and TEE were compared with the surgical findings respectively.The relationship between the different subregions of MV prolapse and MR was analyzed.Results Compared with the surgery findings,the accuracy rate of TTE and TEE in diagnosis of MV prolapse was 100％ qualitatively,80％ for TTE and 94％ for TEE in localizing the diseased region with the anterior and posterior MV,the result of TEE was significantly different from TTE(P＜0.05).MR level was related to the location of MV prolapse.Conclusions Compared with the TTE,TEE had more advantages in localizing the position of the MV prolapse.Mitral regurgitation is related to the location of MV prolapse.

Objective To evaluate the respiratory movement of the both lungs with four-dimensional CT(4DCT), and determine the optimal respiratory phase series CT images for radiation dose calculation. Methods From November 2005 to November 2006,thirty patients with lung cancer who received 4DCT scan were enrolled,including 15 left and 15 right lung cancer cases,25 men and 5 women. The media age was 55 (35-78) years old. After 4DCT scanning, the image was treated with Advantage 4D workstation,and then transmitted into Pinnacle station( Adac 7.4). The both lungs were automatically outlined using Pinnacle station with CT recognition value of-900 to-200 Hu. Then-the same physician examined the unreasonable parts and revised them. After the delineation was completed,the volume of 10 respiratory phases of lung was obtained. Results The average respiratory phase in inspiratory and expiratory phases was 78.87%±2.71% and 26.32%±3.17% in the tumor located lung,77.55%±2.81% and 24.73%±2.55% in the healthy lung. The maximum and minimum mean volume was 106.48%±3.00% and 94.23%±2.78% in the tumor located lung,107.47%±2.43% and 93.65%±2.32% in the healthy lung. The volume at the end of inspiratory and expiratory was 106.43%±3.07% and 94.63%±2.71% in the tumor located lung, 107.37%±4.62% and 93.98%±2.34% in the healthy lung. Conclusions The series CT images scan on 20% ,30% and 80% respiratory phases are reasonable for radiation dose calculation. The maximum and minimum average lung volumes are almost equal to those at the end of inspiratory and expiratory.

BACKGROUND: High mobility group box 1 protein (HMGB1) is a highly conserved, ubiquitous protein in the nuclei and cytoplasm of nearly all cell types. HMGB1 is secreted into the extracellular milieu and acts as a proinflammatory cytokine. In this article we reviewed briefly the cellular immune response mediated by HMGB1 in inflammation and sepsis. METHODS: This systemic review is mainly based on our own work and other related reports. RESULTS: HMGB1 can actively affect the immune functions of many types of cells including T lymphocytes, regulatory T cells (Tregs), dendritic cells (DCs), macrophages, and natural killer cells (NK cells). Various cellular responses can be mediated by HMGB1 which binds to cell-surface receptors [e.g., the receptor for advanced glycation end products (RAGE), Toll-like receptor (TLR)2, and TLR4]. Anti-HMGB1 treatment, such as anti-HMGB1 polyclonal or monoclonal antibodies, inhibitors (e.g., ethyl pyruvate) and antagonists (e.g., A box), can protect against sepsis lethality and give a wider window for the treatment opportunity. CONCLUSION: HMGB1 is an attractive target for the development of new therapeutic strategies in the treatment of patients with septic complications.

The regulation mechanism of arecoline on rat hepatic CYP2E1 was studied in vivo. After oral administration of arecoline hydrobromide (AH; 4, 20 and 100 mg x kg(-1) x d(-1)) to rats for one week, the hepatic CYP2E1 mRNA level remained unchanged, but the hepatic CYP2E1 protein content was dose-dependently increased. Additionally, although the hepatic CYP2E1 activity was induced by AH treatment, the induction was attenuated with the increase in dosage. The results indicate that the effect of arecoline on rat hepaticdoes not involve transcriptional activation of the gene, but largely involves the stabilization of CYP2E1 protein against degradation or increased efficiency of CYP2E1 mRNA translation, and additionally involve the post- ranslational modification of CYP2E1 protein. Furthermore, the CYP2E1 response is fairly equal among the different species, the induction of rat hepatic CYP2E1 by arecoline suggests that there is a risk of metabolic interaction among the substrate drugs of CYP2E1 in betel-quid use human.
Animals ; Arecoline ; pharmacology ; Cytochrome P-450 CYP2E1 ; metabolism ; Cytochrome P-450 CYP2E1 Inducers ; pharmacology ; Humans ; Liver ; drug effects ; metabolism ; RNA, Messenger ; Rats

Objective To evaluate the clinical value of 18-fluoro-deoxyglucose positron emission tomography-CT(~(18)FDG PET-CT) for recurrence and metastasis in treated esophageal carcinoma (EC). Methods A retrospective study is done on 37 previously treated EC patients who underwent PET-CT scans to detect recurrent or metastatic lesions.The diagnostic accuracy of ~(18)FDG PET-CT was assessed with the help of pathological finding as well as clinical or follow-up data.Results Fourty-six sites of recurrence were finally confirmed in 37 patients by cytology,pathology or follow-up data.The sensitivity,specificity and accuracy of PET-CT in detecting recurrence of all sites were 93.5% (43/46),76.9% (20/26) and 87.5% (63/72),respectively.Two false-positive findings were found both at the anastomosis and hilar nodes,which caused the decrease in the overall specificity,especially that locally.The analysis of standard uptake value (SUV) demonstrated that patients with recurrence or who died during follow-up had higher SU- Vs compared with the control group.Condusions ~(18)FDG PET-CT is highly effective in detecting recur- rence in previously treated EC patients despite the low specificity at local sites.The analysis of stardard up- take value(SUV) provides incremental value in prognosis for this patient cohart.

Objective To study the accuracy and the clinical significance of sentinel lymph node biopsy (SLNB)after neoadjuvant chemotherapy for breast cancer.Methods A total of 90 patients with StageⅡorⅢbreast cancer and negative axillary node after neoadjuvant chemotherapy were enrolled in the study.Mapping proce- dure and SLNB were performed using methylene blue injected at the site of the primary breast cancer,followed by the axillary lymph node dissection.Results The sentinel lymph node(SLN)was successfully identified in 82 out of 90 patients(91.1%).The number of sentinel harvested nodes ranged from 1 to 4(average 1.6).The accuracy of SLNB to predict the axillary lymph node status was 93.9 %(77/82),the sensitivity,positive predictive value,nega- tive predictive value and false negative rate were 87.5 %(40/45),100 %,88.1% and 11.1%(5/45),respectively. The SLN identification rate tended to be higher and false negative rate tended to be lower in patients with T2 prima- ry tumor before neoadjuvant chemotherapy.Conclusion Our study indicated that SLNB after neoadjuvant chemotherapy in patients with StageⅡorⅢbreast cancer had a similar effect as SLNB in non-neoadjuvant studies. SLNB was considered to be able to accurately predict the axillary lymph node status in patients with T2 primary tu- mor before neoadjuvant chemotherapy.

Objective To evaluate the blood supply features and effectiveness of arterial chemoembolization for pedunculated hepatocellular carcinoma.Methods Angiography and chemoembolization via supplying blood arteries of tumor were performed in five patients with pedunculated hepatocellular carcinoma.Interventional procedure was carried out with tumor vascular infusion of 350 mg hot elemene emulsion and tumor embolization by cisplantin-lipidol emulsion(cisplantin 60-80 mg+lipidol 8-15 ml)and glutin.Results Ten interventional procedures(TACE)were undertaken in 5 patients.Angiography showed that tumor blood supply mainly coming from collateral circulation adjacent to the tumors,but partially from hepatic artery.Tumor sizes decreased from 30% to 50% in 5 cases,and AFP declined in 4 cases after the treatment. Conclusion Pedunculated hepatocellular carcinoma possessing different blood supply features from intrahepatocellular carcinomas.But transarterial ehemoembolization is still an effective method of choice for this treatment.