Objective:To further discussion the results of the free transplantation of dorsal flap of the foot repair hand trauma.Methods:From Feb,1990 to Nov,1995,single or combined and com- plex dorsal flaps of the foot were used to repair 32 trauma of hand.a.Results:The follow-up visit was 1 year to 5 years,all flaps survived.Skin graft on donor sites grew healing.The wounded hand can move well and has a good recovery of sensation and looks.There is not influence on the function of the foot.Conclusions:The limit of repairing hand trauma in a large area can be solved by using combined dorsal flaps of the foot.The problem that skin graft on donor sites can't grow union ideally can be solved as long as aponeurosis and periosteum are kept completely and binding up the wound with double pressure.Dorsal flap of the foot is the ideal flap nowadays to repair hand trauma.

Objective To observe the effect ofJiuwei-Sanjie capsuls combined with levothyroxine sodium on IL-17 and IL-23 expression in the patients with Hashimoto’s thyroiditis (HT). Methods A total of 76 HT patients were randomly divided into the control group (n=38) and observation group (n=38). The control group was treated with Levothyroxine Sodium, and the observation group was treated with Levothyroxine Sodium andJiuwei-Sanjie capsuls. The expression of FT3, FT4, TSH, TGAb, and TPOAb were detected by chemiluminescent immunoassay. The expression of IL-17 and IL-23 were detected by ELISA analysis. The clinical effect were compared.ResultsThe clinical effect was 94.7% (36/38) in observation group, which was better than that of 81.6% (31/38) in control group (χ2=2.316,P=0.042) . After treatment, the expression of IL-17 (22.32 ± 4.25 ng/mlvs. 31.55 ± 6.84 ng/ml,t=2.416) and IL-23 (14.72 ± 3.42 ng/mlvs. 23.27 ± 5.26 ng/ml, t=2.512) in observation group was lower than that in control group (P<0.05). The expression of TSH (3.04 ± 0.82 IU/mlvs. 4.83 ± 1.22 IU/ml,t=2.355), TGAb (152.71 ± 38.02 IU/mlvs. 238.48 ± 54.18 IU/ml,t=2.406), and TPOAb (121.31 ± 26.23 IU/mlvs. 184.19 ± 42.53 IU/ml,t=2.423) in observation group was lower than that in control group after treatment (P<0.05).ConclusionsJiuwei-Sanjie capsuls can decrease IL-17 and IL-23
expression in patients with Hashimoto's thyroiditis, and improve thyroid function.

Background Refractive regression is a common complication of high myopia after laser in situ keratomileusis (LASIK),and it affects the stability of surgery.Objective This study was to observe the preventive effect of timolol on refractive regression in high myopia after LASIK.Methods A perspective randomized controlled trial was performed under the approval of Affiliated Hospital of Zunyi Medical College and the informed consent of the patients.Sixty eyes of 60 patients with high myopia (-7.16±0.95) D for LASIK were randomized into experimental group and control group.Regular eye drops were topically administered in the patients after LASIK in both groups,and timolol 0.5 ％ was added topically from 1 day after LASIK.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),spherical equivalent (SE),corneal anterior surface curvature,intraocular pressure (IOP),central corneal thickness (CCT) were measured before LASIK,1 week,1 month,3 months and 6 months after LASIK,respectively.Residual stromal bed thickness was calculated before LASIK.The differences of above-mentioned indexes were analyzed and compared between the two groups and among the various time points using repetitive measurements analysis of variance,independent simple t test and Bonferroni test.Results No significant differences were found in the demography between the experimental group and the control group,including age,UCVA,BCVA,SE,IOP,corneal anterior surface curvature,CCT and residual stromal bed thickness (all at P＞0.05).UCVA was significantly different between the two groups among various time points (Fgroup =3.91,P＜0.05 ; Ftime =3.80,P＜0.05),and the UCVA was significantly higher in the experimental group than the control group 6 months after LASIK (t=2.97,P＜0.05),and UCVA was gradually increased as the lapse of postoperative time with the significant difference between 7 days and 6 months after LASIK in the experimental group (P＜0.05).No significant difference was seen in the BCVA between the two groups at various postoperative time points (Fgroup =2.44,P＞0.05;Ftime =2.31,P＞0.05).SE refraction in both groups were significantly reduced from 7 days through 6 months after LASIK,showing significant difference between the groups at various time points after LASIK(Fgroup =11.52,P＜0.05;Ftime =22.06,P＜0.05).The SE refraction was higher in the experimental group than that in the control group 6 months after LASIK (t =2.47,P＜0.05).Corrected IOP in the experimental group was lower than that of the control group at 7 days,1 month and 3 months after LASIK,respectively (Fgroup =14.83,P＜0.05).The change of CCT was not statistically different between the control group and the experimental group (Fgroup =0.04,P＞0.05).The anterior corneal surface curvature was steady in the experimental group during the following-up duration after LASIK,while the control group was growing gradually (Ftime =18.73,P＜0.05).Conclusions The study data show that topical administration of 0.5％ timolol early in high myopia following LASIK is effective for the reduction of the refractive regression.It is suggested that 0.5％ timolol can prevent cornea ectasia by lowering IOP.Reduction of the IOP may contribute to improving the regression after keratorefractive surgery in high myopic eyes.

Objective To discuss the way and effect of washing intestine and pelvic cavity to prevent the fistula of lo place close entrance's in carcinoma of rectum. Methods Cut the rectum and lymph node,used the tip large intestine to connect with washing machine tube. cut vermiform appendix and put urine tube enter ileocecal them use 500ml N.S to wash large intestine for sustained.After se the recturn and large intestine.Use two tube(0.8～1cm) pelvic cavity about 1～6 days. Results The improvement group(38 cases) had not occur leak of lo place cclose entrance, classical group (18 cases) had occur 2 cases (11.1%)leak of lo place close entrance, usestatistics to deal with, P

Objective　To search for a simple and rapid skin expansion. Methods　 CCPSEPA-A kind of mutual feedback type continuous normal saline perfusion system was assembled with the use of conventional transfusi on apparatus, sphygmomanometer, three-way stopcocks, plasma bag etc.14 cases ( 17 expanders) were carried out with such a device, controlled by patients themselves. Results 　The volume of expanders was 50～300 ml and the duration of expansion was 7～14 days. All the cases proved a wonderful effect that the expansion was finished by only one or two times of water filling of storage water bag, and without any complications.Conclusion　CCPSEPA is a new skin expansion apparatus of new type and practical ,simple and low price .The general goal of safe,simple, rapid and useful was realized basically by the device,and worth popularizing.

Objective To explore the clinical effects of treating chronic pharyngitis with point application of Chinese medicinal bread.. Methods Retrospective analysis was adopted in the study. All patients were divided into a point application group (212 cases)and a dissolved medicine group (174 cases). The point application group was treated with point application of Chinese medicinal bread on Tiantu point for successive 4 therapeutic courses (one therapeutic course constitutes 10 days), while the dissolved medicine group was taken pharyngitis dissolved medicines orally for successive 6 therapeutic courses (one course constitutes 6 days). Results The total therapeutic effect of the point application group and the dissolved medicine group was 99.06% and 93.68% respectively. The difference between the two groups has statistical significance. Conclusion Point application of Chinese medicinal bread on Tiantu point is effective in treating chronic pharyngitis.

Objective To investigate the level of plasma GDF-15 in patients with COPD and its clinical value in the diagnosis of COPD in the stable stage and in acute exacerbation stage. Methods From 2015 to 2016, 58 cases of patients with COPD were enrolled ,including COPD patients in the stable stage and in acute exacerba-tion stage. 29 cases of COPD patients diagnosed in our hospital were enrolled in the experimental group ,and 29 cases of age-,gender and body mass index-matched healthy people were enrolled in the control group. Compared and analyzed the blood cell count ,determination of plasma GDF-15 and C-reactive protein were performed and ana-lyzed. Spearman correlation analysis was conducted to compare levels of GDF-15 and C-reactive protein between pa-tients with the stable stage of COPD and those with acute exacerbation stage of COPD. The diagnostic efficacy was compared between GDF-15 and C-reactive protein in differentiatingthe COPD in acute exacerbation period and in the stable period. Results Level of GDF-15 in the stable COPD patients was significantly increased compared with that in the control group. The plasma GDF-15 level was significantly increased in acute exacerbation COPD patients compared to patient with the stable COPD(P<0.001). For the stable COPD patients,GDF-15 level and C-reactive protein level was positively correlated(r = 0.776,P < 0.001). In acute exacerbation COPD patients, GDF-15 level and C-reactive protein level was positively correlated (r = 0.877,P < 0.001). The ROC curves showed that the GDF-15 level on the diagnosis of acute exacerbation COPD patients with an AUC was 0.783(95%CI,0.666~0.900,P<0.001)and with the diagnostic accuracy was 69%. C-reactive protein in the acute exacer-bation of AUC diagnosis of COPD was 0.686(95%CI:0.549~0.823,P<0.01)and the diagnostic accuracy rate was 59%. Conclusion The plasma level of GDF-15 was significantly increased in COPD patients compared with people in the healthy control group. Plasma GDF-15 and C- reactive protein were highly correlated in the stable stage of COPD patients and in acute exacerbation stage of COPD patients. The diagnostic accuracy of GDF in patients with the stable stage of COPD and with acute exacerbation stage of COPD was higher than C-reactive pro tein.

Objective:To investigate the effects of probiotics on the stabilization of blood glucose and its mechanism in children with severe infectious pneumonia.Methods:Eighty children with severe infectious pneumonia admitted to PICU were enrolled in the clinical trial prospectively.They were divided into two groups by random.Forty patients given probiotics were regarded as treatment group,the others not given probiotics were considered to be controlled group,in addition to the regular therapy.Blood glucose,plasma H2 S,D-lactate and acetic acid,propionic acid and butyric acid concentrations in stools were measured respectively at the beginning of the treatment and on day 8 after the treatment.At the same time the changes of blood glucose,fluctuation of them and prognosis were examined.Results:There was no significance in all the parameters of the two groups at the beginning of the treatment (P ＞ 0.05).The levels of plasma H2S and acetic acid,butyric acid in the stools of the probiotics group was (24.6 ± 7.4) μmol/L,(32.8 ± 8.6) μmol/g,(15.2 ± 5.2) μmoL/g on the day 8 respectively;but the concentration of these parameters in the control group was (20.9 ± 7.4) μ mol/L,(28.6 ± 7.9) μmol/g,(12.9 ± 5.0) μmoL/g.Meanwhile the level of D-lactate in patients given probiotics (1.25 ± 0.39) μg/ ml was significantly lower than that the control group (1.45 ± 0.4) μg/ml.The blood glucose (6.1 ± 2.7) mmol/L was lower than than in the other group (7.4 ± 2.7) mmol/L on day 8.And a higher recov ery rate was found in probiotic group.Furthermore,blood glucose and H2S,acetic acid levels expressed negative correlation at 8 day;but positive correlations were found between blood glucose and D-lactate (P ＜ 0.05).Conclusion:Application of probiotics to children with severe infectious pneumonia can moderate the structure of enterobacteria,reinforce the intestinal barrier and elevate the levels of plasma H2S and had positive effects on the stabilization of blood glucose and prognosis.

Objective To explore the effects of early active mobilization on hand function after zone 5 flexor tendon and ulnar nerve repair.Methods Fifty-five patients who had received primary repair in zone 5 of a flexor tendon and the ulnar nerve were randomly divided into an observation group (26 cases, 88 digits) and a control group (27 cases, 91 digits).Both groups were given routine treatment after the operation, and started to do active and passive exercise 4 weeks later.The observation group was additionally forced to do active range of motion exercise training starting 8 days after the operation.Twelve weeks after the operation, the hand function of both groups was assessed using the total active motion (TAM) scoring system of the American Society for Surgery of the Hand, peripheral nerve function evaluation and the disabilities of arm-shoulder-hand (DASH) scale.Results At the end of the treatment, the average TAM score of the observation group was significantly better than that of the control group.The average active movement range of the wrist in palm flexion, dorsal extension, ulnar deviation and in radial deviation were all significantly better than in the control group.Grip strength, overall hand function and DASH score were also significantly better on average.Conclusion Early active mobilization following flexor tendon and ulnar nerve repair can effectively promote the recovery of hand function.

ObjectiveTo investigate the changes of hepatitis B sarfaceantigen (HBsAg) titer in hepatitis B e antigen (HBeAg) positive chronic hepatitis B (CHB) patients treated with nucleos(t)ide analogs and pegylated interferon alfa-2a (PEG IFNα-2a) sequential therapy.Methods Among 6 HBeAg positive CHB patients,3 patients were treated with nucleos(t)ide analogs followed by PEG IFNα-2a for 48 weeks,3 patients were treated with nucleos(t)ide analog monotherapy.The serum HBsAg,anti-HBs,HBeAg,anti-HBe andanti-HBcweredetectedusingthetime-resolved immunofluorometric assay and serum hepatitis B virus (HBV) DNA levels were determined by Taqman polymerase chain reaction (PCR) every 12 weeks.Results HBsAg loss were achieved in three patients after 48-week nucleos(t)ide analogs and PEG IFNα-2a sequential therapy.However,the HBsAg titers of another 3 patients varied from 100 IU/mL to 320 IU/mL.ConclusionIn HBeAg positive CHB patients who obtain virologic response accompanied with HBsAg titer decreasing dramatically by nucleos(t) ide analog treatment,PEG IFNα-2a sequential treatment can increase HBsAg clearance rate.