Objective To explore the relationship among the level of blood glucose and lipid, the cerebral infarction(CI) size, neurological deficits, efficacy, complications and mortality in diabetic patients complicated with cerebral infarction. Methods The clinical data of 60 diabetic patients complicated with cerebral infarction were compared with those of 60 cerebral infarction patients with normoglycemia. Results Compared with cerebral infarction of patients with normoglycemia, that of diabetic patients occurred in the main artery branch, who had larger infarct size, more neurological deficits,worse efficacy,more complications and higher mortality. The frequency of complications and mortality were positively related with the level of glycemia and blood lipid in the diabetic patients complicated with cerebral infarction. Conclusion Hyperglycemia and hyperlipemia could aggravate the brain damage in diabetic patients complicated with cerebral infarction. Controlling hyperglycemia and hyperlipemia was beneficial to the prognosis of cerebral infarction.

Objective To explore the relationship among the blood glucose level and cerebral infarction(CI) size, neurological deficits, clinical outcome, complications and mortality in diabetic patients with cerebral infarction. Methods 60 cases of diabetes complicated with cerebral infarction and 60 normoglycemic patients with cerebral infarction were enrolled in this study, and the clinical data were compared between the two groups of patients. Results Compared with normoglycemic patients with cerebral infarction, diabetic patients with cerebral infarction had larger infarct size,more neurological deficits, worse clinical outcome,more complications and higher mortality because cerebral infarction occurred in the main branch. Infarction size was positively related with blood glucose level. Conclusion Hyperglycemia aggravated cerebral infarction and brain damage.Proper insulin administration to control blood glucose level was beneficial to the treatment and prognosis of cerebral infarction.

In addition to the three existing types of skin flaps, supplied by the cutaneous, the myocutaneous and the arterio-reticular vessels, a new type of free skin flap pedicled by the vessels of intermuscular septum was designed. The intermuscular septal arteries are easy to dissect and have relatively longer pedicles. The skin flaps taken from the limbs supplied by these arteries are suitable for grafting in their natural location.The intermuscular septal arteries of the arms and the thighs were studied and measured on 70 adult cadavers and 9 corrosion preparations. The arteries studied were: the superior ulnar collateral arteries, the intermuscular branches of the perforating arteries and the saphenous branches of the highest genicular arteries. The skin flaps supplied by these arteries were studied with regard to their application in surgery and these vessels were believed to be convenient for the microvascular anastomosis during grafting.The practical value of the skin flaps taken from the medial and lateral sides of the arm, the lateral side of the thigh and the medial side of the leg were discussed.

OBJECTIVETo determine the O/W partition coefficient of panax pseudo-ginseng saponin (PNS) and investigate the absortion kinetics of it in whole small intestine and different intestinal segments of rats.

METHODThe shake-flask method was employed to determine the O/W partition co-efficient of geniposide, and an in situ intestinal perfusion model was employed to investigate the absorptive kinetics of geniposide.

RESULTThe partition coefficient (P) of R1, Rg1 and Rb, of PNS were 1.0814, 6.3104 and 0.2743, respectively, and their logP were 0.0340, 0.8001, -0.5618, the absorptive rate constants (Ka) of R1, Rg1 and Rb1 of PNS at the concentration of 0.2, 0.5, 1.0 g x L(-1) were (0.135 +/- 0.006), (0.110 +/- 0.002), (0.095 +/- 0.016), (0.144 +/- 0.015), (0.110 +/- 0.006), (0.099 +/- 0.011), (0.238 +/- 0.013), (0.140 +/- 0.008), (0.137 +/- 0.012)h(-1), respectively. The Kb of R1, Rg1 and Rb1 of PNS were (0.030 +/- 0.006), (0.033 +/- 0.004), (0.033 +/- 0.007), (0.032 +/- 0.006), (0.044 +/- 0.012), (0.044 +/- 0.011), (0.042 +/- 0.007), (0.065 +/- 0.007), (0.044 +/- 0.014)h(-1) at duodenum, jejunum, ileum, respectively. The absorption rate of Rb1 was higher than R1 and Rg1.

CONCLUSIONAccording to the P and the logP, it can be conjectured that the absorption of R1 and Rg1 are better than Rb1. The absorption rate is decreased with the increase of the PNS concentration. Their absorption is the passive diffusion mechanism and other transport may also take part in the transport process. PNS is absorbed at all small-intestinal segments of rats, there are no significant differences between the three sections.

Animals ; Calibration ; Drug Stability ; Intestinal Absorption ; Intestine, Small ; metabolism ; Kinetics ; Male ; Oils ; chemistry ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results ; Saponins ; chemistry ; metabolism ; Water ; chemistry

Objective:To formulate sustainable development strategies for the newly-found clinical science and technology innovation park to improve the clinical research and disease diagnosis and treatment.Methods:PEST-SWOT model was used to analyze the internal and external environmental factors that impact the development of the park.Results:The advantages and disadvantages of the park were analyzed as well as the opportunities and challenges. Effective strategies for the construction and development of the park were put forward from four aspects, such as SO, ST, WO and WT.Conclusions:The development strategy proposed in this study is conducive to establish a well-known clinical science and technology innovation park which is an institute integrating clinical and scientific research.

Objective To clarify the mechanisms that the response of fibroblast-like synovial (FLS) cellsto methotrexate (MTX) in rheumatoid arthritis (RA) and to provide theory basis for the drug treatment of RA.Methods Synovial fibroblasts were isolated from synovial tissue specimens obtained from patients with RA andexposed to MTX.Cell viability was measured using a MTT assay and cell apoptosis was valued by flow cytometry.Western blotting analysis of LC3 and immunocytochemistry were used to analyze the induction of autophagy in RA-FLS after treating with MTX.Transfection of siRNA was used to interfere the expression of Beclin1 to down-regulate the autophagy,cell apoptosis was valued by flow cytometry and western blot analysis was used to test the PARPp85 with or without the presence of MTX.Statistical product and service solutions (SPSS) 18.0 statistical software was used for statistical analysis of all experimental data.Independent sample t test was used according to data distribution status,homogeneity of variance,and normal distribution.GraphPad Prism 5.0 was used to draw statistical graphs.Results MTX induced apoptosis was increased in RA-FLS.MTX stimulated the autophagy response in RA-FLS by inducing autophagosome formation.In RA-FLS,transfection with Beclin1 siRNA inhibited autophagy and increased the susceptibility to MTX,which induced cell death.Conclusion Autophagy of RA-FLS contributes to the resistance to apoptosis induced by methotrexate.

Objective:To explore the potential Hub genes, key miRNAs, biological processes and related signaling pathways in the pathogenesis of osteoarthritis (OA), and provide bioinformatics basis for the pathogenesis and treatment of OA.Methods:The expression profiling chip of OA synovial tissue sample from Gene Expression Omnibus (GEO) were downloaded, differentially expressed genes (DEGs) were identified, and functional enrichment analysis was performed. A protein-protein interaction network (PPI) was constructed. STRING and Cytoscape was used for module analysis, and the Hub gene was further identified, and further miRNAs mining of the Hub gene was carried out.Results:Finally, 9 Hub genes (SOCS3, BTRC, FBXO32, KLHL22, UBE3A, HUWE1, UBR4, ANAPC5, TRIM50) and 2 key miRNAs (hsa-miR-103a-3P, hsa-miR-107) related to the progression of OA were identified .They might be potential biomarkers for the pathogenesis of OA. We also found that signal transduction, the transcriptional positive regulation of RNA polymerase Ⅱ promoter, and protein serine/threoninase activity had a certain correlation with the pathogenesis of OA. In addition, our analysis results showed that cAMP signaling pathway and Rap1 signaling pathway were also involved in the progression of OA.Conclusion:The potential biological molecules, biological processes and related pathways identified in this study may guide us for the further research on the etiology and treatment of OA.

Objective To investigate the diagnostic value of dynamic-extended focused assessment with sonography for trauma (D-EFAST) in patients with multiple trauma in intensive care unit (ICU). Methods A prospective clinical study was conducted. Eighty patients with multiple trauma admitted to ICU of Anhui Provincial Hospital from September 1st, 2014 to December 31st, 2016 were enrolled. Extended focused assessment with sonography for trauma (E-FAST) check was conducted at first, for those who had positive findings diagnosis was confirmed by immediately CT examination or surgical exploration. If it was negative, the patients received E-FAST every morning for 7 days (defined as D-EFAST), for those with positive findings, immediately CT or surgery was performed to clarify the diagnosis. The final clinical diagnosis was used as the "gold standard" to calculate the diagnostic accordance rate of EFAST and D-EFAST examination technique for pneumothorax, pleural effusion, spleen injury, kidney damage, liver damage, gastrointestinal injury, pericardial effusion, bladder rupture, and pancreatic injury, as well as their sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate, and missed diagnosis rate, and the difference between EFAST and D-EFAST was compared. Results There were 4 patients excluded because of death and abandoning treatment, and finally 76 patients were included in the study. The total sensitivity of E-FAST examination technique for pneumothorax, pleural effusion, spleen injury, liver damage, gastrointestinal injury, pericardial effusion, and bladder rupture was 75.9% (66/87), and the specificity was 98.3% (587/597), the positive predictive value was 86.8% (66/76), and the negative predictive value was 96.5% (587/608), the accuracy rate was 95.5% (653/684), and the rate of missed diagnosis was 24.1% (21/87). The most of the delayed injury in patients with multiple trauma occurred at 2-7 days after injury with incidence of 4.8% (33/684). The diagnostic sensitivity of D-EFAST for delayed injury was 98.3% (118/120), the specificity was 99.8% (563/564), the positive predictive value was 99.2% (118/119), the negative predictive value was 99.6% (563/565), the diagnostic accuracy rate was 99.6% (681/684), and rate of missed diagnosis was 1.7% (2/120). When the final clinical diagnosis was set as the "gold standard", D-EFAST technology for the detection rate was 98.3% (118/120) for patients with multiple trauma on organ injury while the detection rate of E-FAST was 75.9% (66/87), with statistical significant difference (P < 0.01), indicating that D-EFAST was better than E-FAST in check of multiple trauma patients with organ injury. Conclusion Although the E-FAST technology can quickly diagnose the multiple trauma patients and win the rescue time for critical patients, multiple trauma patients injured after 2-7 days prone to delayed damage and are difficult to detect, and D-EFAST can be used to find delayed damage earlier, and reduce the misdiagnosis rate of multiple trauma patients.

Objective:To investigate the curative effect of transfer of free anteriolateral thigh flap (ALTF) with partial iliotibial tract on reconstruction of composite tissue defects in dorsal wrist/hand.Methods:Ten patients who were admitted in the Department of Hand Surgery of Yongkang Orthopaedic Hospital from March 2018 to August 2022 were entered in the study due to extensive composite tissue defects in dorsal wrists and hands. The patients were 24-48 (37 in average) years old. All patients had tendon defects in 3 or more digits with 35 digits in total. The length of the tendon defects were 5.0-11.0 cm in various digits. The soft tissue defects ranged from 6.0 cm×8.0 cm to 11.0 cm×21.0 cm in size. Six patients had defects accompanied with metacarpal and phalangeal bone fracture and joint capsule. In emergency surgery, all patients received thorough debridement and VSD coverage after internal fixation for combined fractures. At 3-5 days after the primary surgery, free ALTF transfer with partial iliotibial tract was employed to reconstruct the defects on dorsal wrists and hands and the digit extension function. The size of flap was 6.0 cm×9.0 cm-9.0 cm×17.0 cm, and the rest of defect wound was covered by skin graft. All the donor sites were sutured directly, except 1 that received abdominal skin graft. Patients had the follow-ups in outpatient clinics, or via telephone or Wechat, to observe the sensation and appearance of the flap, and the healing of the donor site. The recovery of the extension function of the hand was evaluated according to the totle active motion (TAM) system.Results:All flaps survived except one that had vascular compromise after the surgery and it survived after two explorations and a vascular transfer. Postoperative follow-ups lasted for 6 to 24 months, with 13 months in average. At the last follow-up, a all the flaps were found soft in texture and slightly swollen in appearance. There was no obvious pigmentation or rupture of skin and extensor tendon. Sensory recovery achieved to S 2 in 7 patients and S 3 in 3 patients. The hand function was evaluated according to TAM system and rated as excellent for 3 digits, good for 18 digits, fair for 9 digits and poor for 5 digits. There were linear scars in the donor sites. Conclusion:Free ALTF transfer with partial iliotibial tract in the reconstruction of composite tissue defect of dorsal wrists and hands can not only reconstruct the wound surface, but also the extension of digits, which cuts short the course of treatment.

Objective:To explore the immune infiltration cells in rheumatoid arthritis (RA) synovial lesions, and to provide new research directions and therapeutic targets for the pathogenesis and treatment of RA.Methods:The three gene expression data sets GSE77298, GSE55457 and GSE1919 were downloaded from gene expression omnibus (GEO) (http://www.ncbi.nlm.nih.gov/geo), and the data were merged with Perl. The "limma" package was used to adjust batch differences. In R, "CIBERSORT" software was used to obtain the expression matrix of 22 kinds of immune cells corresponding to RA synovial tissue samples and normal synovial tissue samples were analyzed with the three packages of "e1071", "parallel" and "preprocessCore". Perl was used to screen samples with P<0.05 in the immune cell matrix. R's "barplot" function was analyzed by the percentage of 22 immune cells in samples with P<0.05. The "pheatmap" package of R was used to visualize heatmaps, and "corrplot" package was used to draw correlation heatmaps. The "vioplot" package of R was used to draw violin plots of differences via the wilcox test. Results:The results of immune cell infiltration analysis showed that in RA synovial tissue samples and normal synovial tissue samples at P<0.05, B cells naive and natural killer cells resting were under-expressed in RA synovial tissue, and plasma cells, mast cells resting, macrophages M1, B cells memory and T cells regulatory were highly expressed in RA synovial tissue. This study also found that in the same sample, the correlation coefficient between natural killer cells resting and neutrophils ( r=0.91) was the highest, indicating synergistic effect between the two. In the same sample, the correlation coefficient between macrophages M0 and plasma cells ( r=-0.88) was the lowest, indicating antagonistic effect between the two. Conclusion:The immune infiltrating cells in RA synovial lesions discovered in this study provide a certain theoretical basis and research direction for the research on the disease mechanism and treatment of RA.