Objective To report our results of a study of 21 patients who underwent reconstruction of complicated head and neck defects following cancer ablation using microvascular anastomotic anterolateral thigh flap To discuss the advantages and disadvantages of using this flap Methods Twenty one consecutive free anterolateral thigh flaps in 21 patients were transferred for reconstruction of head and neck defects following cancer ablation between May 1990 and April 2001 The success rate was 95 percent (20 of 21),with one flap lost due to a twisted perforator The anterolateral thigh flaps were classified into four types according to the perforator derivation and the direction in which it traversed the vastus lateralis muscle Type I is the most common,in which a vertical musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery were found in 61 9 percent of cases (13 of 21) Reconstruction of one layer facial skin defect was carried out in 3 cases,through and through defect in 15 cases,the skin defects of the anterior cervical region and the mucosa defects of the hypopharynx in 3 cases Results Nineteen of 21 flaps survived One flap was totally lost and another was partially lost after surgery The mean follow up was 46 months (range:6 to 120 months) A total of 9 patients were disease free survival Two patients are alive with persistent tumor 5 patients died of local recurrence 4 patient died of regional lymph node metastasis,brain metastasis,second primary cancer and cerebral vascular accident respectively,1 patient was lost to follow up Conclusion The anterolateral thigh flap provides more tissue than the radial forearm flap,no important artery sacrificed and the donor scar is more easily hidden The anterolateral thigh flap can be successfully used to repair a variety of complicated defects of the head and neck

Aim To explore the mechanism of insulin in combination with selenium preventing myocardial apoptosis in diabetic cardiomyopathy rats .Methods SD rats ( n =50 ) were randomly divided into five groups: control , diabetic cardiomyopathy ( DCM ) , DCM with insulin treatment , DCM with selenium treat-ment, and DCM with insulin and selenium combination treatment .The cell apoptosis was observed by TUNEL . The levels of Bcl-2, caspase-3, PARP, Cbl-b and p38 MAPK were examined by Western blot .The inter-actions of Cbl-b-p38 MAPK and Ku70-Bax were detec-ted by immunoprecipitation .Results Insulin in com-bination with selenium synergistically inhibited apopto-sis, up-regulated Cbl-b, down-regulated p38MAPK ex-pressions and increased the interactions of Cbl-b-p38MAPK and Ku70-Bax.Conclusion Insulin and selenium synergistically inhibit myocardial apoptosis by regulating Cbl-b-inhibited p38 MAPK and preventing Bax translocation .

AIM:To investigate the effect of insulin and selenium in combination on the apoptosis and the ex-pression of Ku70, acetylated Ku70, Bax and cytochrome C in myocardial cells of the rats with diabetic cardiomyopathy (DCM), and to explore the mechanism of insulin and selenium in their synergistic anti-DCM effect.METHODS:SD rats (n=50) were randomly grouped into control, DCM, DCM with insulin treatment (DCM+In) group, DCM with selenium treatment (DCM+Se) group, and DCM with insulin and selenium combination treatment (DCM+In+Se) group.Mito-chondrial membrane potential ( MMP) was measured by flow cytometry .The cell apoptosis was observed by terminal-deoxy-nucleotidyl transferase mediated nick end labeling (TUNEL).The levels of Ku70, Bax and cytochrome C were examined by Western blot .The acetylation status of Ku 70 was detected by co-immunoprecipitation .RESULTS: The rats in DCM group showed marked cell apoptosis compared with the control rats .The levels of Ku70 and acetylated Ku70 declined sig-nificantly compared with control group .Bax significantly translocated from cytoplasm into mitochondria and cytochrome C translocated from mitochondria into cytoplasm compared with control group .Compared with DCM +In group or DCM +Se group, insulin and selenium in combination significantly inhibited the apoptosis , down-regulated Ku70 and acetylated Ku70 levels, and prevented Bax and cytochrome C translocation .CONCLUSION: Insulin and selenium synergistically inhibits myocardial apoptosis by regulating Ku 70 acetylation and inhibiting Bax translocation .

Objective To investigate the predictive value of serum lactate combined with PIRO (Predisposition,Infection,Response and Organ dysfunction) score in the development of multiple organs dysfunction syndrome (MODS) in septic patients and to study procalcitonin (PCT),in order to provide guidelines for clinical care.Methods From April 2015 to July 2016,a total of 752 sepsis patients were enrolled and divided into MODS group (n =488) and non-MODS group (n =264) according to the criteria of MODS.At 28 d after admission,these patients were divided into survival group (n =477) and death group (n =275).PCT and lactate levels in serum were measured,and PIRO score of these patients was calculated.Then the differences in levels of PCT and lactate in serum were compared among patients at different PIRO score categories.ROC was constructed to observe the clinical values of the biomarkers,PIRO score and lactate combined with PIRO score in predicting prognosis.Result PCT,lactate levels in serum and PIRO score were significantly higher in MODS group and death group,showing significant positive correlation.The areas under ROC curves (AUCs) of serum lactate combined with PIRO score for predicting MODS were 0.906,which was significantly higher than that of serum PCT (0.716),serum lactate (0.851) and PIRO score (0.840) alone (all P ＜ 0.05).Serum PCT,serum lactate and PIRO score were the independent predictors of MODS.Conclusions Serum lactate in combination with PIRO score was a valuable indicator in predicting development of MODS in septic patients.

Objective To investigate the clinical and prognosis characteristics of SLE patients whose initial clinical presentations were Sj(o)gren's syndrome (SS).Methods Medical charts of 41 consecutive SS/SLE inpatients admitted to Peking Union Medical College Hospital (PUMCH) from February 1998 to February 2008 were systematically reviewed,including demographic data,clinical features,laboratory findings,treatment as well as prognosis.Two hundred and fourteen cases were randomly selected as controls from 2331 non SS-onset lupus (NSs/SLE) inpatients weated in PUMCH at the same time period.Results There were significant differences between SS/SLE and NSS/SLE patients in the following aspects (P＜0.05):①gender composition:(F/M) (41/0 vs 184/30),age at the diagnosis of SLE [(43±41) yrs vs (32±31) yrs)],disease duration L(114±84) mollths vs (45±18) months];②clinical features:xerostomia (85.3% vs 6.1%),xerophthalmia (75.6% vs 2.3%),faeial rash (9.8% vs 46.3%),renal tubular acidosis (21.9% vs 0),nephrotic syndrome (7.3% vs 31.3%),central nervous system invoivement (4.9% vs 19.6%),interstitial lung disease (12.2% vs 2.8%);③labratory findings:ESR[(65±75) mm/1 h vs (46±34) mm/1 h)],patients with elevated IgG level (56.4% vs 29.9%) and IgA level (38.5% vs 20.4%),RF,prevalence of anti-SSA and anti-SSB antibodies (70.8% vs 20.3%,82.9% vs 43.4% and 39.0% vs 7.9%);④SLEDAI score (8±8 vs 10±10),glucocorticosteroid treatment (methylprednisolone bolus/1～2 mg·kg-1·d-1 prednisone/1 mg·kg-1·d-1 prednisone)(8/26/7 vs 91/102/21),and rate of death and/or severe irreversible organ failure (2.4% vs 14.9%).SS/SLE patients were followed up for (33±34) months,40 cases remained stable and only one patient died of acute pulmonary embolism.Conclusion Compared to NSS/SLE,SS/SLE patients ale older and have more insidious disease course.They have higher prevalence rate of anti-SSA and anti-SSB antibodies,renal tubular acidosis and interstitial lung disease,but less severe neuropsychiatric and renal involvements and much better prognosis.

Clavicle ; injuries ; Fractures, Bone ; therapy ; Humans

Objective To investigate the serum procalcitonin (PCT) levels in sepsis caused by the bacteria,virus and mycoplasma and explore the role of PCT in etiology diagnosis of sepsis in children.Methods Three hundreds and thirty critically ill children with sepsis caused by bacteria,virus and mycoplasma admitted in PICU of Hunan Children' s Hospital from Feb 1,2011 to Sep 1,2012 were reviewed and analyzed.The PCT levels were measured at admission and day 3.The differences in accidence of sepsis caused by bacteria,viruses and mycoplasma according to different serum PCT levels were analyzed.The differences of PCT levels at admission and day 3 in sepsic children caused by bacteria,viruses and mycoplasma were analyzed.Results The level of serum PCT in sepsis caused by bacterial infection were distinctly increased,caused by virus and mycoplasma infections was not obvious but the increases of serum PCT [0.71 (8.14)ng/ml,0.15 (1.68) ng/ml,0.28 (1.89) ng/ml].According to various PCT levels(0.05 ～ ng/ml,0.5 ～ng/ml,2 ～ ng/ml,10 ～ 300 ng/ml),the differences of accidence of sepsis caused by bacteria,virus and mycoplasma were also statistically significant(x2 =84.50,P ＜ 0.01).The PCT level of septic children caused by bacterial infection in day 3 was significantly decreased compared with that at admission [0.32 (5.68) ng/ml vs 0.71 (8.14) ng/ml] (U =19.34,P ＜0.05).Conclusion PCT plays a certain role in etiology diagnosis of sepsis in children.The increased PCT levels which can be reduced by anti-inflammatory treatment indicate the likelihood of bacterial infection and sepsis.The increase of PCT induced by viral and mycoplasma infections is not obvious,but bacterial infection can not be completely ruled out.

Objective To establish a HPLC method for the determination of psoralen and bergapten in Ficus hirta Vahl.Methods A Merck-lichrospher C18(4 mm?250 mm,5 ?m)column was adopted.The mobile phase was acetonitrile-water(35∶65) with the flow rate of 1.0 mL/min.The column temperature was 35 ℃,and the detection wavelength was set at 222 nm.Results Psoralen's linearity was obtained in the range of 0.12 ?g～1.20 ?g(r=0.999 7),and bergapten's linearity in the range of 0.03 ?g～0.30 ?g(r=0.999 5).Psoralen's average recovery was 100.9 %with RSD 2.9 %,and that of bergapten was 99.6 %with RSD 1.9 %.Conclusion This is the first report of simultaneous determination of psoralen and bergapten in Ficus hirta Vahl.by HPLC,and the results showed the method is accurate,reproducible,and can serve as quality evaluation method for Ficus hirta Vahl.

DAZL, a member of the DAZ family, plays a key role in human spermatogenesis. It regulates the promoter via genetic modification, especially DNA methylation, promoting the transcription of DAZL. Besides, the relation of DAZL SNPs with male infertility has been a hot spot of research for many years. It is deduced that local and ethnic factors may be associated with the failure of spermatogenesis. This article presents an overview on the results of recent studies, changes in the DNA methylation of DAZL in spermatogenesis, and the association of DAZL SNPs with male infertility, aiming to provide a new theoretical basis and clinical strategy for the treatment of male infertility.
DNA Methylation ; Humans ; Infertility, Male ; genetics ; Male ; Polymorphism, Single Nucleotide ; RNA-Binding Proteins ; genetics ; Spermatogenesis

AIM: To construct the mammalian cell expression vector for enhanced green fluorescent protein (EGFP) and HLA-A*0201 fusion protein and analyze its expression and subcellular localization in the transfected K562 cells. METHODS: The HLA-A*0201 cDNA was cloned by RT-PCR and the gene was inserted into pEGFP-N1 to construct a vector for the fusion protein. The expression of the fusion protein in K562 cells transfected with the vector was evaluated by flow cytometry and its subcellular localization was investigated by confocal microscopy. RESULTS: The full-length encoding region of HLA-A*0201 cDNA was cloned from two HLA-A2 positive donors and the expression vector for the HLA-A*0201-EGFP fusion protein was constructed by PCR using a primer pair to introduce a Kozak sequence before ATG and the stop codon was deleted. Five hours after K562 cells was transfected with the vector, the expression percentages of HLA-A*0201 and EGFP were 25.12?2.26 and 27.37?3.59, respectively and no significant increase was observed after 24 h. The fusion protein was predominantly located on the membrane with low level distribution within the cells. In contrast, no HLA-A*0201 but only EGFP was detected in the empty vector transfected K562 cells and the EGFP was dispersed within the cells. CONCLUSIONS: The expression vector for HLA-A*0201-EGFP fusion protein was constructed and the fusion protein expressed in K562 cells was primarily distributed on the membrane. The results suggest that the transfected K562 cells are potential antigen-presenting cells.