[Objective]To report the clinical results of free medical leg flap containing posterior tibial vessels (FMLFPTV) in repairing of serious limb trauma caused by high-energy in children and discuss the flap's unique superiorities.[Method]From Jan.1999 to Mar.2006,FMLFPTV were obtained under tourniquet and applied in ten children suffered from serious limb and extremity injuries complicated by soft tissue defects,meanwhile,vessels and nerves were repaired with the flaps' corresponding tissues,moreover,broken bones and tendons were reconstructed.[Result]Average blood loss was 183ml and mean operative time was 208 min.All flaps were transplanted successfully with excellent results including satisfactory limb appearance.Follow-up ranged 14 to 67 months (averaged 35 months).Sensation has recovered to more than S3 in all cases.In those who were treated with this innervated flap to repair defects of weight-bearing area of sole,no sore or ulcer occurred and normal gait recovered.Bone union took 4～9 months(averaged 6.7 months).Through investigation forms filled by parents and clinical examination,no blood supply problem or morbidity was discovered in donor limbs.[Conclusion]FMLFPTV is easy to dissect under tourniquets with relative short operative time and less blood lost which especially benefits children.The flap is thin and has almost necessary related tissues for all reconstructive needs,for example,to bridge vessel and nerve defects,and offer excellent results.It is an easy and reliable method.

[Objective]To report the clinical results of immediate reconstruction of open grade Ⅲ long bone fractures caused by high-energy.[Method]From Jan.2001 to Jul.2006,vascular flaps were applied in 29 patients suffering from massive limb trauma,complicated by Gustilo grade-Ⅲ open fractures(11 were type B,and 18 type C) and massive soft tissue defects,caused by high-energy,through an emergency procedure.Meanwhile,vessels and nerves were repaired,broken bones and tendons were reconstructed.The mean MESS(Mangled extremity severity score) score was 6.27(6.27?2.43).[Result]All limbs were salvaged and all the flaps survived without protracted course to obtain soft tissue coverage.The mean hospital stay was 23 days(12-67 days) and the follow-up ranged 14 to 58 months(mean 26 months).No severe complication occurred,including wound infection,bone nonunion,necrosis and morbidity.The ultimate functional results of the salvaged limbs were at least better than artificial limbs.[Conclusion]The immediate reconstruction of severely injured limbs complicated by Gustilo type Ⅲ fractures caused by high energy has the advantages over traditional methods.This technique enables controlling bone,soft tissue and other problems together through an emergency procedure with a relatively shortened in-hospital stay and less fibrosis,thereby favoring the functional outcome.Early wound healing favors antibiotic diffusion and local blood supply.It may be an alternative for fast fixation and better bone healing.

Objective To investigate the effect of the gene polymorphism of cholesterol ester transfer protein (CETP) on the serum lipid levels in renal transplant patients.Methods Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL),high density lipoprotein cholesterol (HDLC),apolipoproteins (Apo A1,B,E) and lipoprotein(a) [Lp(a)] were measured. Polymerase chain reaction-restriction fragment length polymophism (PCR-RFLP) was used to detect CETP gene polymorphism in renal transplant recipients.Results Serum levels of TC,TG,HDLC,LDLC,ApoB,ApoE in the renal transplant recipients were increased significantly after transplantation. The allele frequency and the distribution of the TaqⅠ(intron 1) and MSPⅠ(intron 8) genotypes showed no significant difference between the controls and the renal transplant recipients. The serum TG level was significantly higher in renal transplant recipients with the genotype TaqⅠB1/B1 than those in the patients with genotype TaqⅠ B1/B2 and B2/B2. But there was no statistical difference among the serum lipid levels in renal transplant recipients with different MSPⅠgenotypes.Conclusion The serum lipid levels were increased significantly in transplant after transplantation,and the patients with CETP genotype TaqⅠB1/B1 liable to develop hypertrglyceridemia.

Objective To detect the expression and the biological activity of a recombinant adenovirus expression vector carrying human neurotrophin-3 (NT-3) receptor TrkC gene (Adeno-TrkC) in neural stem cells. Methods The expression of TrkC mRNA in 293 cells infected with Adeno-TrkC was detected by RT-PCR, and the expression of TrkC protein in neural stem cells infected by Adeno-TrkC was detected with immunocytochemistry and Western blotting. The effects of human neurotrophin_3 (NT-3) on the neural stem cells infected by Adeno-TrkC differentiating into neuron-like cells and astrocyte-like cells in vitro were observed. Results The transcription of TrkC mRNA and the expression of TrkC protein was detected in 293 cells and neural stem cells infected by Adeno-TrkC. This kind of TrkC was able to make more neural stem cells differenting into neuron-like cells in vitro with its ligand NT-3 and the percentage of neuron-like cell’s differentiation was 55^2% which was higher than that of other control groups.Conclusion TrkC protein is expressed in neural stem cells transfected with Adeno-TrkC and is able to make neural stem cells differenting into neuron-like cells. The present study may provide the basis on gene therapy of central nervous injury using further NT-3 and TrkC.

This study was aimed to investigate Baishile Capsule on behavior, memory and expression of SYN I and SYNA in hippocampal CA3 region of depression model rats. SD rats were randomly divided into six groups, which were the control group, depression model group, fluoxetine hydrochloride group, and the Baishile Capsule group (2.88 g·kg-1, 1.44 g·kg-1, 0.72 g·kg-1). The chronic stress depression model rats were established by chronic and mild unpredictable stressors as described in the literature. In the model group, medicine was intragastricly administered once per day and continued for 21 days. In the control group and model group, same volume of distilled water was intragastricly administered. The open-field test, preference for 1% sucrose solution, Morris water maze, and rate of weight were carried out and observed. Immunohistochemistry and in situ hybridization were used in the observation of the expression of SYN I and SYNA in each group of model rats. The results showed that high-dosage Baishile Capsule can significantly increase the horizontal and vertical activities of score after two-week treatment (P< 0.01). The middle-dosage Baishile Capsule can significantly increase the horizontal activity of score after three-week treatment (P< 0.05). The rat's preference for sucrose solution was obviously increased in the high-dosage group after one-week treatment and in the middle-dosage group after three-week treatment (P< 0.01, or P< 0.05). The rate of weight of rats was obviously increased in the high-dosage group after two-week treatment and in the middle-dosage group after three-week treatment (P< 0.01, or P< 0.05). The high-dosage and middle-dosage Baishile Capsule can shorten EL, and significantly increase the number of target quadrant. The high-dosage Baishile Capsule can obviously shorten the target quadrant latency (P< 0.05). Compared with the model group, the immunohistochemistry and in situ hybridization showed high-dosage Baishile can significantly promote the expression of SYN I and SYNA in hippocampal CA3 region; and the middle-dosage group can enhance the expression of SYNA (P < 0.05, or P <0.01). It was concluded that Baishile Capsule can obviously improve the behavior and the expression of SYN I and SYNA in hippocampal CA3 region of depression model rats.

Objective To examine the synaptic structure and glutamatergic transmitter of the pathway linking the anterior thalamic nucleus(ATN) and the subicular complex. Methods The HRP tracing and post embedding immunogold technique were used. Results In the anterior thalamic nucleus,anterograde HRP labelled terminals contained clear round synaptic vesicles and several mitochondria,and formed asymmetric synaptic contacts with HRP-labelled or non-HRP labelled dendrites.The highest densities of immunogold particles following glutamate immunostaining were found in HRP-labelled terminals and similar axon terminals devoid of HRP reaction product,They formed asymmetric synaptic contacts(Gray type Ⅰ) with dendrites.The average density of those immunogold particles was more than 3 times higher than that of the gold particles in the dendrites of their contacts and over 6 times higher than that of the particles in the terminals that formed symmetric synapses(Gray type Ⅱ).In two serial GABA immunogold reactive sections,Gray tpye Ⅱ terminals were heavily labeled whereas Gray type Ⅰterminals displayed a very slight labelling.In glutamate immunogold reactive sections,Gray type Ⅱ terminals were slightly labeled.A GABA positive terminal which formed symmetric synapses with HRP-labeled dendrites and the terminal which formed asymmetric synapses converged on the same dendrite.Conclusion The terminals of projection neurons in the pathway linking the anterior thalamic nucleus and the subicular complex are glutamatergic.In anterior thalamic nucleus corticothalamic projection neuron terminals form asymmetric synaptic contacts with HRP-labelled thalamocortical projection neurons by axo-dendritic synapses.

Objective To investigate the effect of apolipoprotein E (ApoE) gene polymorphism on lipid metabolism of renal transplant recipients before and after transplantation. Methods ApoE gene polymorphism was detected by Polymerase chain reaction restriction fragment length polymorphism and serum lipid levels were measured by biochemical method. Results Serum lipid levels in the recipients were increased significantly at 3rd month after renal transplantation, and were ulteriorly elevated at 6 th month and the first year. The patients with higher total serum cholesterol (TC) and triglyceride (TG) levels were only accounted for 2.9 % and 7.6 % respectively before renal transplantation, but for 28.6 % and 46.7 % respectively at 3rd month after renal transplantation ( P

Objective To study the effect of psychological intervention on activity of daily living(ADL) in old stroke patients.Methods 120 old stroke patients were divided into treatment group and control group,each including 60 cases.All the cases accepted routine neurological therapy and early rehabilitation training.The patients in the treatment group were additionally treated with psychological intervention.Before and 2,4 and 12 weeks after treatment,they were assessed with modified Bathel Index(MBI) and National Institutes of Health Stroke Scale(NIHSS).Results 4 and 12 weeks after treatment,the scores of MBI and NIHSS improved more in treatment group than in control group(P<0.05).Conclusion Psychological intervention can facilitate the recovery of neural function and ADL after stroke.

Objective To report the clinical results of one stage reconstruction of high-energyinjured limbs. Methods From January 2001 to July 2006,one stage reconstruction was done on 55patients suffered from massive limb trauma,severe open fractures or spoiled limbs caused by high energy.There included 16 patients with Gustilo Type-Ⅲ C fractures,with mangled extremity severity score (MESS)of(6.25 ±2.53)points.All patients were treated with transplantation of free flaps or pedicle skin flaps,fracture fixation,nerve reconstruction or functional reconstruction. Results All limbs were saved and all flaps were transplanted successfully.without protracted course to obtain soft tissue coverage.The hospitalization was mean 24 days(12-63 days)and follow-up ranged from 12 months to 50 months (averaged 23 months).Complications including wound infection,bone nonunion,necrosis and morbidity were significanfly less likely to appear than conventional ways and the ultimate functional results of the saved limbs were at least better than that of artificial ones. Conclusions In comparison with traditional methods,one stage reconstruction of severe high energy-injured limbs has advantages of easier justification of tissue structure,better match of donor and recipient blood vessels,easier operation design,shorter hospitalization and better functional recovery.Definitive wound closure with vascularised tissue transfer can facilitate local blood supply.decrease bone infection and hence promote bone healing.

Objective ToestimatetheprevalenceofPanton-Valentineleukocidin (PVL)genes and antimicrobial resistance in methicillin-sensitive Staphylococcus aureus (MSSA)isolateds from outpatients with skin and soft-tissue infections (SSTIs)in Wuhan city. Methods A total of 182 MSSA isolates were collected from outpatients with SSTIs in 5 different hospitals in Wuhan city between 2011 and 2013. The Kirby-Bauer′s disk diffusion method was used to evaluate antimicrobial susceptibility of the MSSA isolates, and multiplex PCR was performed to detect mecA and PVL genes in these isolates. Results Of the 182 MSSA isolates, 65 (35.71%)carried PVL genes. The positive rate of PVL genes was significantly different among patients with different diseases (χ2 = 49.76, P = 0.00), and relatively higher in patients with furuncles/carbuncles(7/7), folliculitis(3/3), abscesses(55.53%, 30/57)or impetigo(2/4). The age of patients with PVL-positive MSSA infection was significantly younger than that with PVL-negative MSSA infection (35.40 ± 19.31 years vs. 43.21 ± 20.75 years,t = 2.50, P = 0.01). Among 65 PVL-positive MSSA isolates, the rate of resistance to clindamycin was highest (87.69%), followed by that to penicillin(53.85%)and erythromycin(41.54%). The frequency of resistance to clindamycin was highest in 117 PVL-negative MSSA isolates, followed by that to penicillin (20.51%)and ampicillin (12.82%). Furthermore, there was a significant increase in the rate of resistance to penicillin(χ2 = 21.19), ampicillin(χ2 = 97.97), doxycycline(χ2 =11.61), ciprofloxacin(χ 2 = 8.07), erythromycin(χ 2 = 25.04)and gentamicin(χ 2 = 10.86)in PVL-positive MSSA isolates compared with PVL-negative MSSA isolates (all P < 0.05). Conclusions MSSA isolates from outpatients with SSTIs in Wuhan city are resistant to most β-lactam antibiotics. Flucloxacillin, compound sulfamethoxazole tablets or doxycycline is recommended for empirical treatment of PVL-positive MSSA infections.