Objective Comparing the clinical effect between Cinepazide Maleate and low Molecular weight Dextran,to the one which is more effective,safer and less unhealthy to patients after digital replantation.Methods From April 2010 to April 2012 in our hospital during single finger replantation patients,the observation group 120 cases of postoperative to Cinepazide Maleate injection 320mg/d intravenous drip,the control group of 120 cases treated with low Molecular Dextran 500ml/d IVGTT.Results The effective rate of observe group and control group was 96.67％ and 92.50％,respectively.The difference between the two groups was too small to have statistically significant difference (P ＞ 0.05),but the adverse effect of treatment group was only 5.8％,much lower than 14.17％ in control group however with the statistically significant difference (P ＜0.05).Conclusion Cinepazide Maleate Injection and low Molecular weight Dextran both have apparent effect in patients after digital replantation surgery.Both of them significantly improved microcirculation,enhanced the survival rate of replantation.However Cinepazide Maleate injection has fewer adverse effects,which is one of idea auxiliary medicine and deserved more extensive clinic application in currently microsurgery.

Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2％-4％ of alimentary tract duplications.It is a diagnostic dilemma for doctors because its clinical and radiological manifest is usually nonspecific.At the present stage,it can only rely on surgery.We should pay attention to ectopic pancreas resection and ligation of pancreatic duct during operation.There was one case of gastric duplication cyst with ectopic pancreas in adults from the Second Affdiated Hospital of Nanchang University.

OBJECTIVE:To observe the clinical efficacy and safety of vitamin C with large dose combined with diphosphate in the treatment of myocardial injury after neonatal asphyxia and the effects on creatine kinase isoenzyme (CK-MB) level. METH-ODS:Totally 76 children with myocardial injury after neonatal asphyxia were randomly divided into control group and observation group. Control group was given routine treatment,including oxygen inhalation,sedation,cardiotonic,Danshen injection and ener-gy mixture,etc. Based on the treatment of control group,the observation group was added diphosphate 100-150 mg/(kg·d),iv infu-sion,qd;and vitamin C 250 mg/(kg·d)adding into 10%glucose injection 20 ml,iv infusion,qd. 10 d was a course. The clinical ef-ficacy,cardiac troponin T(cTnI),CK-MB level and incidence of adverse reactions before and after treatment were observed. RE-SULTS:The total effective rate in observation group was significantly higher than control group,with significant difference(P<0.05). After treatment,the cTnI and CK-MB level in 2 groups were significantly lower than before,and observation group was low-er than control group,with significant differences (P<0.05). There were no adverse reactions in 2 groups during the treatment. CONCLUSIONS:Based on the routine treatment,Vitamin C with large dose combined with diphosphate has good efficacy in the treatment of myocardial injury after neonatal asphyxia and can effectively reduce the CK-MB level,with good safety.

Objective To investigate the relationship between rapists and related allele genes based on the analysis of 15 short tandem repeats (STRs) loci genetic polymorphism. Methods The method of Genome-wide scan was being used. Buccal swab samples of 129 rapists and 156 random populations were collected and PCR compound amplification was carried out with the aid of AmpFISTR Identifiler system. Then the products were subjected to electrophoresis and gene detection with AB13100 type gene analysis system so as to calculate and compare the alleles of 15 STRs gene frequency in the two groups. Results All the 15 STRs loci allele gene frequency in rapists and random population was found to coincide with Hardy-Weinberg law(P>0. 05). Allele 28 of D21S11 (rapists: 1.55% ,control group:5. 13%) ,allele22 of FGA(rapists:24.03% ,control group:16.99%),allele23 of FGA(rapists: 17.05% ,control group:26.28%) ,allele 10 of TH01(rapists:1.16% ,control group:4.17%) ,allele 8 of TPOX(rapists:55.77% ,control group:63.77%),allele 12 of TPOX(rapists:4.26% ,control group: 1.28%) were different between the two groups (P< 0.05) .while it is no differ significantly in other STRs loci allele gene(P >0.05). Conclusion Allele 28 of D21 S11,allele 22 and 23 of FGA, allele 10 of TH01, allele 8 and 12 of TPOX may be associated with the violent crime of rape. It is suggested that there are existing sensitive or resistance genes about the violent crime of rape in chromosome 2,4,11,21.

BACKGROUND:The effect of advanced glycation end products (AGEs) on bone resorption is controversial. Our previous study has shown that bone resorption is significantly inhibited when AGEs present with pre-osteoclast cells RAW 264.7, while the effect of AGEs on osteoclastic acidification remains unknown. OBJECTIVE:To investigate the effect of AGEs on osteoclastic acidification and the underlying mechanism. METHODS:RAW 264.7 cells were induced by RANKL (15μg/L;normal group) to generate osteoclasts, and AGEs (50-400 mg/L;experimental group) or bovine serum albumin (100 mg/L;control group) were added at the beginning of the induction. The effect of AGEs on bone resorption was evaIuated by anaIyzing the area of bone resorption on the Osteo Assay Surface plates, and the effect of AGEs on osteoclastic acidification was evaluated by acridine orange staining. Furthermore, the expression levels of V-ATPase a3 and CIC-7 were detected to investigate the underlying mechanism. RESULTS AND CONCLUSION:The bone resorption area in the AGEs group was significantly decreased compared with the normal group (P<0.05). Acridine orange staining reveaIed that the red fluorescence (620 nm) intensity in the AGEs group was significantly decreased compared with the normal group (P<0.05), and this inhibitory effect became obvious with the increase of AGEs concentration. Immunocytochemistry, western blot assay and PCR findings showed that the expression levels of V-ATPase a3 and CIC-7 in the AGEs group were decreased significantly compared with the normal group (P<0.05). To conclude, AGEs exert inhibitory effect on osteoclastic acidification, probably by inhibiting the expression of V-ATPase a3 and CIC-7.

Objective To investigate the hallux nail flap with the tibia lateral diamond shaped flap of the second phalange,joints,tendon combined tissue combination reengineering the surgical methods and clinical effects of thumb.Methods From May,2010 to February,2015,thcrc had fifteen cases of the thumb defect on Ⅱ-Ⅳ degree of the patients in our hospital,and we took anastomosis vascular pedicle of the hallux nail flap and thumb reconstruction with a second phalange with the tibia lateral diamond shaped flap,joint,and tendon composite tissue combination to reconstruct the thumb.The provided district of the second metatarsal was amputated to repair the ligaments between metatarsal bones.And we took the second toe bone nail flap covering the hallux toe area wound in anterograde shift.Results 15 cases of thumb reconstruction survived.The patients were followed-up for 6 to 30 months,the shape of the reconstructed thumb was closed to the contralateral thumb.The thumb to the finger and the palm function was good,two-point discrimination of the finger pulp were 0.6-1.0 cm.According to the upper limb function of the Chinese Medical Association Hand Surgery Society,the upper limb partial function of the evaluation trial standard:excellent in 11 cases,good in 4 cases.The district was recovered well,normal walking and running function were not restricted.Long term follow-up showed no blisters formation and skin ulceration.No nail deformity,good growth.Conclusion The hallux nail flap with the tibia lateral diamond shaped flap of the second phalange,joints,tendon combined tissue combination to reconstruct the thumb of the defect on Ⅱ-Ⅳ degree can restore good function and feeling,but also to have beautiful appearance.It is an effective method for reconstruction of thumb defect on Ⅱ-Ⅳ degree.

Objective To investigate the replantation and postoperative rehabilitation methods for simultaneous amputation of 10 fingers and both forearms.Methods A case of replantation for simultaneous amputation of both forearms and 10 fingers was carried out with microsurgery method in September,2014.The replantation involved 3 teams over 11 hours and 55 minutes to consequently conduct alternate anterograde and retrograde replantation and accurate blood vessels,nerve anastomosis and further followed with physical therapy and occupational therapy treatment in 2 weeks of the surgery.Results All the amputated arms and fingers revived after the surgery.After 14 months follow-up,function of wrist flexion and expansion was normal,superficial and deep sensory functions on hands were good,function of thumb and finger grip,pinch and opposition had partially recovered,the two-point discrimination was 8-10 mm,and all of above rated good according to the temporary criteria of the upper limb functionality set forth by Hand Surgery Branch of China Medical Association.Conclusion For the case of simultaneous amputation of both forearms and 10 fingers,it is very likely to carry out successful replantation as well as achieve satisfactory function restoration with excellent teamwork and accurate vessel and nerve anastomosis under microsurgery as well as rehabilitation treatment afterwards.

Objective To investigate the prothetic effect of free grafting of microvascular anastomotic peroneal artery perforator flap when used to repair the donor tissue defects of wrap-around flap of toe.Methods From January 2008 to March 2013,twenty-six cases thumb avulsion at proximal and distal phalanx level with skin and nail bed defect caused by trauma were admitted to our hospital.After incising wrap-around flap of toe to repair the thumb defects,microvascular anastomotic peroneal artery perforator flap was transplanted freely to repair the donor site of it.Results The skin flaps of 26 cases all successfully survived.After a followed-up of 3 months to 4 years,the length of donor toes were the same as before.The appearance of skin flaps were no fat and clumsy and the abradability of their skin were well.Algesia,thalposis and thigmesthesia were partially recovery.Two point discrimination reached to 5-10 mm.There were no obvious uncomfortableness in donor feet when standing and walking except wearing flip-flops.Conclusion Free grafting of peroneal artery perforator flap is a good method to repair the donor defect caused by incising wrap-around flap of toe.

Objective To discuss the clinical effect of thumb and fingers reconstruction with vascular anastomosis transplantation from toes.Methods From April 2009 to April 2013,166 cases of thumb and finger defect were treated,including 46 cases Ⅰ °-Ⅲ° thumb defect and 120 cases Ⅰ °-Ⅴ° finger defects.Sixty-two cases were emergency reconstructed by vascular anastomosis transplantation from toes,the other 104 cases were subemergency reconstructed.Early functional rehabilitation was carried out postoperative.Results All 208 thumb and fingers in 166 cases with these procedures were survived.Patients were followed up from 4 to 24 months,averaged of 1 l months.The reconstructed thumb and fingers were all with abundant blood supply,having similar shape to the normal thumb and fingers,good pain and temperature sensation,with two-point discrimination of 6-10 mm,with normal range of joint activity,flexible function of finger to finger and finger to palm.Most patients were satisfied with the thumb and finger shape,regained life and work ability as before.The donor sites had no obvious discomfort,and walking and weight-bearing function remained normal.Conclusion For patients with thumbs Ⅰ °-Ⅲ° and fingers Ⅰ °-Ⅴ ° degree of traumatic defect,emergency and subemergency reconstruction of fhumb and fingers by vascular anastomosis transplantation from toes have good clinical effect and less damage to the donor site.

Objective:To observe the effect of repeated, bilateral administration of high-frequency transcranial magnetic stimulation (rTMS) in treating post-stroke dysphagia.Methods:Forty-five persons with post-stroke dysphagia were randomly divided into a bilateral group ( n=14 after one dropout), an affected group ( n=15) and a healthy group ( n=15). All received 30 minutes of conventional swallowing rehabilitation training 5 times a week for 2 weeks from a speech therapist. Those in the affected group also received 5Hz rTMS applied to the motor cortex controlling the suprachyoid muscle group. The bilateral group received the same stimulation bilaterally with the same duration and treatment course. Videofluoroscopy was used to assess their swallowing before and after the 2 weeks of treatment. It was rated using the penetration-aspiration scale (PAS) and the functional swallowing disorder scale (FDS). Surface electromyography was employed to evaluate suprachyoid muscle function. Cortical excitability was assessed by measuring the resting motor threshold (RMT) of the unaffected hemisphere. Results:After the treatment, the average PAS, FDS and muscle function values had improved significantly for all three groups, but significant RMT differences were observed only between the bilateral and the unaffected group. Significant differences in the average FDS and PAS scores were observed after the treatment, as well as significant changes in FDS and muscle function between the affected group and the other two groups. The average FDS scores before and after treatment were significantly different between the unaffected and bilateral group, with the former scoring significantly better than the latter. But no significant differences in the average PAS scores were observed after the treatment.Conclusions:5Hz rTMS of either the unaffected or affected cerebral cortex (or bilateral) can effectively improve the swallowing function of persons with post-stroke dysphagia. Bilateral stimulation has the greatest therapeutic effect, followed by stimulation of the unaffected cerebral cortex.