The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Objective:To explore the characteristics of brain dynamic activity in patients with schizophrenia by using functional magnetic resonance imaging(fMRI).Methods:Forty-three patients with schizophrenia and 31 normal controls were recruited and under fMRI scanning.The Positive and Negative Symptom Scale(PANS)was used to assess the severity of clinical symptoms.The DPABI software were used to compute dReHo and dFC.Granger causality analysis was used to calculate the effective connectivity between the significant brain regions of dReHo and the whole brain.Two sample t-test was performed to compare the difference of dReHo and dFC be-tween patients with schizophrenia and normal controls.Results:The dReHo of left postcentral gyrus(LPG)(P＜0.01,cluster-level FWE corrected)in patients with schizophrenia was decreased.The Dfc was increased between left postcentral and left middle frontal gyrus,left superior medial frontal gyrus,right calcarine,left medial cingulum gyrus,right supplementary motor area(P＜0.01,uncorrected).Compared with normal controls,patients with schiz-ophrenia showed decreased effective connectivity from LPG to right putamen.Conclusion:It suggests that the ab-normal functional activity of the postcentral gyrus mightcontribute to the neural physiopathology in patients with schizophrenia.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

OBJECTIVE： To provide reference for constructing ADR damage relief system in China. METHODS： Questionnaire survey was conducted among 217 pharmaceutical manufacturers in Shaanxi province by census method. Fisher’s exact test， Pearson χ2 test and multivariate Logistic regression analysis were used to analyze the factors effecting construction of ADR damage relief systerm unter marketing authorization holder （MAH） system， and the interaction among various factors. RESULTS： A total of 217 drug manufacturers were investigated in this study （217 questionnaires were sent out）. 209 questionnaires were collected and 204 valid questionnaires were screened out with recovery rate of 94.01％. Totally 9 independent influential factors screened by Fisher’s exact test and Pearson χ2 test had a significant impact on the attitude of building ADR damage relief system under MAH system， i.e. the last year’s earnings of enterprises， the proportion of pharmaceutical technicians， whether to set up R&D departments， whether to obtain new drugs/generic drugs in recent 3 years， whether to actively carry out post-marketing safety evaluation of drugs， whether ADR commissioners are familiar with ADR-related policies in MAH system， cognition about whether MAH system promotes the development of pharmaceutical industry， the development direction of enterprises after the full implementation of MAH， cognition about the lack of legal basis for ADR damage relief （P＜0.05）. Multivariate Logistic regression analysis showed that whether the ADR specialist was familiar with the ADR-related policies in MAH system was the main influential factor for constructing ADR damage relief system under the MAH system （P＝0.044）. It was positively correlated with the attitude of approving the construction of ADR damage relief system under MAH system （B＝1.697）. CONCLUSIONS： The pharmaceutical manufacturers， in which ADR specialists who are familiar with the ADR-related policies in the MAH system， are more inclined to agree to constructing ADR damage relief system under  MAH system.

Objective To establish the median equation of second trimester Down′s syndrome (DS) screening maternal serum markers ,alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) ,in Xiangxi area and to investigate the influence of new median values on the local screening results .Methods The electrochemiluminescence immunoassay (ECLIA ) was applied to detect the serum AFP and HCG levels in 2619 second-trimester normal pregnant women ,the medians of AFP and HCG in each gestational week were calculated ,and the regression equation between gestational period and the medians of AFP and HCG were es-tablished by using the statistical software ,then the results were compared with the evaluation results of software built-in medians . Results Serum AFP level was positively correlated with the gestational week (P<0 .01) ,the HCG level was negatively correlated with the gestational week (P< 0 .01);the AFP and HCG levels were negatively correlated with the body weight of pregnant woman (P<0 .01) .Before correcting the body weight ,compared with software built-in human source serum markers ,the average levels of serum AFP and HCG in Xiangxi area increased by 6 .73% and 31 .54% respectively ,the differences were statistically sig-nificant ,after correcting the software ,the screening false positive rate was remarkably decreased .Conclusion The establishment of serum maker medians for second trimester pregnant woman in Xiangxi area can increase the efficiency of the second trimester DS screening ,thus effectively screens out the DS fetus in local area .

Objective To evaluate the implementation of the national essential medicine system in Shaanxi Province.Methods Using a standardized methodology (2008 Edition) developed by the World Health Organization(WHO) and Health Action International(HAD,data on the prices and availability of 38 essential medicines were collected from 120 primary,secondary and tertiary public hospitals in ten cities of Shaanxi Province from March to May 2012.Results The availability of essential medicines is generally low at public hospitals in Shaanxi province,as the average availability of originator brands is but 5.9％,and that of generics of the lowest prices is but 23.9％,while this availability at tertiary hospitals is higher than hospitals of lower levels.The procurement prices of originator drugs within essential medicines are distinctly higher than the international reference prices for the originator brands,and slightly higher for the lowest priced generics.The procurement prices at primary care hospitals are slightly lower than that of other hospitals.Retail prices of essential medicine are not significantly different among regions of different income levels.Affordability of originator brands is poor,while that of their generic equivalents is good.Conclusion The government is recommended to adjust the national essential medicine list,expand the variety of essential medicine moderately,improve the medicine pricing mechanism,and deepen public hospitals reform.

BACKGROUND AND OBJECTIVEExcision repair cross-complementing 1 (Excision-Repair Cross-Complementing 1, ERCC1), an important member of the DNA repair gene family, plays a key role in nucleotide excision repair and apoptosis of tumor cells. Protein kinase C-alpha (Protein kinase C, PKCalpha), an isozyme in protein kinase C family, is an important signaling molecule in signal transduction pathways of tumors, which has been implicated in malignant transformation and proliferation. The aim of this study was to explore the clinical significance of ERCC1 and PKCalpha in non-small cell lung cancer (NSCLC).

METHODSThe expression of ERCC1 and PKCalpha were examined by immunohistochemistry (IHC) in the specimens of 51 cases of NSCLC patients tissue and 21 cases of paracancerous tissue. The relationship between detected data and patients' clinical parameters was analyzed by SPSS 13.0 software.

RESULTSThe positive expression rate of ERCC1 and PKCalpha in NSCLC tissues was significantly higher than paracancerous tissues (P < 0.05). Expression of ERCC1 was closely related to clinical stage and N stage. The positive rate of ERCC1 was higher in III+IV or N1+N2 stage patients compared with I+II or N0 stage (P = 0.011, P = 0.015). We also found that 5-year survival of negative group of ERCC1 was remarkably higher than that of positive group by chi2 test (P < 0.05). Expression of ERCC1 was positively correlative to PKCalpha by Spearman's correlation analysis (r = 0.425, P = 0.002) in NSCLC.

CONCLUSIONThe results suggest ERCC1 and PKCalpha might be correlated with the development of NSCLC. ERCC1 might be related to prognosis of NSCLC. There might be existed a mechanism of coordination or regulation between ERCC1 and PKCalpha.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; DNA-Binding Proteins ; metabolism ; Endonucleases ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Protein Kinase C-alpha ; metabolism

OBJECTIVETo summarize surgical treatments and their corresponding curative effects on sciatic nerve injuries.

METHODSSurgical treatments on sciatic nerve injury were performed in 28 patients from January 1990 to July 2000. The treatments included neurolysis, neurolysis plus partial nerve anastomosis, nerve anastomosis and nerve transplantation. The curative effect was evaluated according to Sunderland criteria.

RESULTSOf 28 cases, 22 patients were followed up with a follow-up period of 13 months to 5 years (average 30 months). Of 22 nerves, 7 were excellent, 5 good, 7 fair and 3 poor, with an excellence rate of 54.5%.

CONCLUSIONSThe fair results of sciatic nerve injury are related to its structural character. Surgical exploration should be performed if nerve function does not recover 3 months after primary operation and if Tinel's sign and electromyogram show no signs of nerve regeneration. Electrophysiological monitoring in the operation is useful in electing surgical methods and predicting the results of nerve anastomosis.

Adolescent ; Adult ; Anastomosis, Surgical ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Nerve Regeneration ; physiology ; Neurosurgical Procedures ; methods ; Recovery of Function ; Retrospective Studies ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; etiology ; surgery ; Treatment Outcome

OBJECTIVETo observe whether bladder controller can restore bladder function in paraplegic dogs.

METHODSFour dogs were studied after their T(10) spinal cord was transected. Electrodes implanted around S(2) bilaterally were connected to subcutaneous recievers. Microsurgical techniques were employed in dorsal rhizotomy at S(1 - 3) intradural segment. After daily stimulation, the results of bladder controller were evaluated by micturition and vesicography.

RESULTSMicturition was given under electrical stimulation with a urine volume of 80 - 140 ml per time. The mode of micturition was post-stimulus voiding. Vesicography showed that the bladder was filled and bladder neck was open in the micturition course of electric stimulation. Residual urine volume was 15 - 20 ml.

CONCLUSIONBladder controller together with a sacral deafferentation procedure can restore bladder function of paraplegic dogs.

Animals ; Disease Models, Animal ; Dogs ; Electric Stimulation ; Male ; Spinal Cord Injuries ; physiopathology ; surgery ; Urinary Bladder ; physiopathology ; surgery ; Urination

To introduce a new modification to simplify the neuroprosthesis of sacral anterior root stimulated micturition for Chinese patients with spinal cord injury (SCI). Spinal cord was transected at T 10 in six dogs and they were randomly divided into 2 groups. In dogs of group I, bilateral L 7 ～S 3 posterior rhizotomy (complete de afferentation, SDAF) was performed. In animals of group II bilateral L 7 , S 2 , S 3 posterior rhizotomy plus bilateral S 1 anterior rhizotomy (partial de afferentation combined with partial de efferentation) were performed. Cystometrogram (CMG) was carried out weekly after the operations. For clinical studies, ten patients with complete SCI above cone were included. Intraoperative electrical stimulation of each individual S 2 ～S 4 roots was carried out and bladder pressure changes were recorded simultaneously. The results showed that the dogs in group II manifested a similar CMG to that of group I, indicating that a flaccid bladder with good compliance and storing function was resulted. For parasympathetic innervation to bladder detrusor in Chinese, it had been found that S 3 root was the most frequent (100%) and the most efficacious (52 2%) contributor, S 4 ranked the second frequent (90%) and a lesser but still significant efficacious (44 9%), and S 2 the least frequent (25%) and the minimal contributor (2 9%). It suggested that using one cable with two electrodes placed on the anterior roots of S 3 and S 4 bilaterally, combined with severance of S 3 and S 4 posterior roots as de afferentation, or plus division of anterior root of S 2 as de efferentation, could restore both voiding and storing function of the bladder in Chinese SCI patients. This new modification has the advantages of reducing the cost of neuroprosthesis and broadening of its indication