Objective To evaluate the clinical outcome of a method of renconstruction of Type Ⅱb defect of thumb both and reserving the length of the donor toe.Methods From March 2012 to Febrary 2014,there were 11 cases of thumb defect treated in our hospital.According to Gu Yudong's classification,all were type Ⅱ b.Three were open defect and others were closed defect.All were treated with combined transfer of big toe wrap-around flap and autogenous iliac graft for thumb reconstruction while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect.The donor site of the belly was sutured directly.Results All of the reconstructed thumb survived.Among 11 flaps,arterial crisis occurrred in 1 case,venous crisis occurred in 2 cases,and all survived after operative treatment.The patients were followed-up from 3 mooths to 15 months,all the thumbs had a good appearance.The thumb opposition function was good and sensation recovery to S3 + and two-point discrimination from 6-8 mm.The donor big-toe was preserved.All the flaps had satisfactory color and texture,but looked a little plump.All the patients had no effect on walking and running.Four flaps had more beautiful appearance after flap plastic.There was only one linear scar on the belly donor without any discomfort.Conclusion It is an effective method of combined transfer of big toe wrap-around flap and autogenous iliac graft while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect used to reconstrucution of Type Ⅱ b defect of thumb is very good.

BACKGROUND:Methods after mechanical stimulation can be combined with various kinds of cells to produce many conversion types so as to start the various physiological functions of the body. OBJECTIVE:To analysis the reason why rol ing massage can improve the intracellular concentration of Ca2+METHODS:A biodynamic experimental device was set up, composed of pressure generating device, pressure forming device, pressure display device and related data recording device. We detected the effects of rol ing massage on Ca . 2+concentration in normal skeletal muscle cells and damaged cells through the different functions of the experimental device and system software. These functions consisted of pressure display, data transmission and recording, signal acquisition and processing, pressure signal acquisition, control and processing of signal acquisition, wireless signal transmission and receiving system, display system, storage system, system implementation function. RESULTS AND CONCLUSION:The experiment results showed that rol ing massage could reduce the Ca 2+concentration in the normal skeletal muscle cells and damaged cells. These findings suggest that rol ing massage can improve the overload of intracellular Ca2+in damaged cells, and it is superior to the sinusoidal mechanical stimulus.

The study of protein-surface interactions represents one of the most important topics in the field of biomaterials.It is believed that blood cells do not actually contact the biomaterial surface directly,but rather interact with the molecular structure of the adsorbed protein layer.Therefore,protein plays a key role in regulation and induction of cells.It provides ideas for biomaterials designing that exploring the molecular mechanism of controlling protein adsorption and regulating cell response.This paper reviews the research progress of the interactions of protein and surfaces,and prospects the future research direction.

Objective To investigate the effect of combined antiplatelet drugs on clinic and aggregation activity of platelet in patient with aucte myocardial infarction(AMI).Methods Consecutive 97 cases with AMI were redomized to receive clopidogrel plus aspirin(treated group,n=48) or aspirin alone(placebo group,n=49) for 30 days.Before and after treatment,the clinical recurrent angina,improvement of heart function,death,ST segment changes of electrocardiogram and the rate of maximun aggregation of paltelet were tested and analysed.Results Recurrent angina occurred in 10.0%(5 cases) in the treated group and 20%(10 cases) in the placebo group.The total frequency of improvement of heart function occurred in 36.7%(18 cases) in the treated group and 22.4%(11 cases) in the placebo group(?~2=3.638,P=0.045).Death occurred in 4%(2 cases) in the treated group and 8%(4 cases) in the placebo group.ST segment of electrocardiogram decreased from (0.36?0.13)mV to (0.13?0.08)mV,compared with placebo from (0.35?0.14)mV to (0.16?0.90)mV(t=3.012,P=0.04).The rate of maximum aggregation of platelet induced by ADP reduced from (74.54?8.99)% to (34.09?9.23)%,the placebo from (72.30?7.78)% to (56.54?6.92)%(t=13.42,P

Diabetic Ketoacidosis ; Humans ; Infant, Newborn ; Male

Against the deficiencies of the current preventive medicine education curriculum,training programs and curriculum were reformed according to the training objectives of the modem preventive medicine, while new ideas of preventive medical personnel training were explored in order to cultivate practical professionals with a certain ability to innovate and to adapt the development of modern public health and preventive medicine preferably.

Objective To investigate the distribution,drug resistance characteristics and genotypes of extended-spectrum-lactamases (ESBLs)-producing strain in pathogenic gram-negative rod in infection of newborn in Guangzhou.Methods The standard was performed by the production for ESBLs by phenotypic screening and confirmatory test provided by the National Committee for Clinical Laboratory Standards in 2001.The method of polymerase chain reaction(PCR) amplification was perbonmed and DNA sequences were analyzed by ESBLs gene sequencing.Results Total of 71 un-repicated and consecutive Gram-negative bacilli were isolated from 13 hospitals in Guangzhou,and the prevalence of ESBLs-producing clinical Gram-negative isolates was 59.2%(42/71).The PCR results showed that most pathogenic bacilli which infected newborn could be separated two or more genes of ESBLs.The type of TEM,SHV,CTX-M1,CTX-M9,OXA was 35.6%, 26.7% ,10.9%,24.8%,2.0%,respectively.The result of drug resistance monitoring showed that pathogenic gram-negative bacillui which infected newborn were Escherichia coli and Klebsiella pneumonia mostly.Most parts of them were drug fast and even multidrug resistant to the commonly used antibiotics.The sensitive drugs were lmipenem(the rate of sensitivty 100%),cefoperazone/sulbactam(87.3%),piperacillin/tazbatam(85.3%),ceftazidime(82%),aztreonam(82%),cefepime(81.8%).Conclusions In Guangzhou,the incidence rate of ESBLs-producing strain are very high inpathogenic bacilli which infected in newborn and is multidrug resistance.The genetypes of produced ESBLs are TEM,SHV,CTX-M1,CTX-M9,OXA.

Objective To determine the random spot albuminuria to creatinine ratio (ACR) of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy (HDCP). Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.

Objective To evaluate and compare the efficacy of holmium laser enucleation of the prostate(HoLEP) and plasmakineticenucleation of the prostate(PKEP) for treating benign prostatic hyperplasia (BPH).Methods A total of 86 cases of BPH were selected from the Shandong Energy Zibo Mining Group Co.Ltd Central Hospital from January 2013 to June 2014.The patients received either HoLEP (40 cases) or PKEP(46 cases) treatment.Clinical data including postvoid residual volume (PVR),international prostate symptom score(IPSS),quality-of-life score(QOL score),maximum urinary flow rate (MFR) were evaluated before and 3 months after operation.Blood loss in operation,operation time,weight of resected prostate tissue,bladder irrigation time,catheterization time and length of hospital stay were also collected from the perioperative period.Results Three months after surgery,PVR,IPSS,QOL and MFR were all significantly improved in both HoLEP and PKEP groups compared with the data before operation (P =0.000),while there was no significant difference between the two groups(P＞0.05).Patients from the HoLEP group showed markedly lower values of bone loss in operation than that of PKEP group((69.5±23.6) ml vs.(87.5±38.0) ml,P=0.011).There were no significant differences in terms of other indexes (P＞ 0.05).Conclusion HoLEP and PKEP have similar efficiency in treating BPH,while HoLEP is suggested superior in regard of bone loss.

Objective To analyze the frequency of NPM1 mutation in de novo acute myeloid leukemia (AML) patients and the relationship between NPM1 mutation and chromosome alterations,as well as FAB subgroups,and to analyze the mutation type.MethodsA total of 99 de novo AML patients from 2004 to 2010 in China-Japan Friendship Hospital were studied.Genomic DNA was amplified by polymerase chain reaction (PCR),denaturing polyacrylamide gel electrophoresis (PAGE) and capillary electrophoresis were used to detect the mutation of NPM1 gene in 99 AML patients,and karyotyping was performed in 72 AML patients by G banding techniques.DNA sequences analysis of NPM1 mutation was performed on 10 patients.Chi-square test was used to compare the frequencies of NPM1 mutation among the different subgroups,and McNemar's test was used to compare the different rates between denaturing PAGE and capillary electrophoresis.ResultsThe frequencies of NPM1 mutations were detected in 15％ (15/99) of AML patients with capillary electrophoresis and 11％ (11/99 ) with denaturing PAGE(x2 =2.25,P ＞0.05 ).The NPM1 was at different rates in M2(27％,8/30),M5(32％,6/19),M6( 13％,1/8),respectively (x2 =1.06,P ＞ 0.05 ),and not detected in the other subgroups.NPM1 mutation in patients with normal karyotype(26％ ) was more prevalent than patients with abnormal karyotype (4％) (x2 =5.61,P ＜ 0.05)All of the 10 patients were of A type ( c.860_863dupTCTG).The C-terminal portion of the NPM protein by replacing the last seven amino acids(WQWRKSL) with 11 residues (CLAVEEVSLRK).Two intronic deletions were novel,one case was IVS10-18_-15delCTTT,the other was IVS10-17_-15delTTT.Conclusions NPM1 mutations represents a common genetic abnormality in AML patients,and NPM1 mutation in patients with normal karyotype is higher than patients with abnormal karyotype.Two new intronic deletion mutations are identified.