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.

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.

Aim To investigate the effect of Medi- coscab Tincture could increase the healing rate of burn coscab Tincture on the wound repair of deep partial thickness burn in rats and its possible mechanism. Methods SD100 rats were used to make a rat model of deep partial thickness burn. The rats were randomly divided into five groups; normal, model control, positive control, Medicoscab Tincture high-dose, and Medicoscab Tincture low-dose. The dosing group was changed daily for 14 consecutive days. The healing rate and water content of wound were measured at 3 d, 7 d and 14 d after burn. The activities of superoxide dismutase (SOD) and catalase (CAT) and the content of malondialdehyde ( MDA) were determined by bio-chemical analysis. Serum levels of tumor necrosis fac- tor-a (TNF-a), interleukin-1 (3 (IL-1(3) and interleu- kin-6 (IL-6) in rats were determined. Results Medi- wound and decrease the water content of burn wound tissue in rats ( P < 0. 05 ). The activity of SOD significantly increased, the content of MDA decreased (P < 0. 05), and the contents of TNF-a, IL-1 (3 and IL-6 in serum of burned rats decreased ( P < 0. 05, P < 0.01). Conclusions Medicoscab Tincture can improve the wound healing rate, reduce the wound water content, increase SOD activity, reduce the content of MDA in the wound, and reduce the serum levels of inflammatory factors TNF-a, IL-1 (3 and IL-6. Therefore, Medicoscab Tincture has a protective effect on deep partial thickness burn in rats.

OBJECTIVES: To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients. METHODS: A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed. RESULTS: An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048). CONCLUSIONS Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).
Administration, Inhalation ; Adult ; China ; Coronavirus Infections ; diagnosis ; drug therapy ; mortality ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Integrative Medicine ; Interferon-alpha ; administration & dosage ; Lopinavir ; administration & dosage ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; diagnosis ; drug therapy ; mortality ; Risk Assessment ; Severe Acute Respiratory Syndrome ; diagnosis ; drug therapy ; mortality ; Severity of Illness Index ; Survival Rate

Neurological paroxysmal disease is a large group of clinical syndrome with a characteristic of sudden, recurrent, self-limiting. Clinically, routine biochemical or imaging examinations are usually with no significant abnormalities in the interictal period. However, magnetoencephalography (MEG), as an important electrophysiological tool in studying brain magnetic signals and monitoring brain electric activity, has highly temporal and spatial resolution for its noninvasive measurement of human brain with superconducting quantum interference. Therefore, it has been gradually used in researching for functional activities and mechanisms of the neuropsychiatric disorders and the advanced brain activity. There mainly reviewed the application and studies of MEG in epilepsy, paroxysmal kinesigenic dyskinesias and migraine.

Hereditary spastic paraplegia (HSP) is a group of significantly clinically and genetically heterogeneous neurodegenerative disorders, which are predominantly characterized by progressive lower limbs weakness and spasticity, and spastic paraplegia type 4 (SPG4) is the most common type among them. So far, mutations in 78 distinct loci and 59 mutated genes have been identified in patients with HSP. The protein spastin coded by the SPAST gene plays a critical role in regulating length, number and activity of microtubules, as well as the occurrence and development of various organelles. It is generally believed that the mutated spastin leads to partial or total loss of the function, which is the main pathogenetic mechanism. While recent studies have also suggested that there may exist acquired neurotoxic effects of mutant proteins by the two isoforms (M1, M87) coded by the SPAST gene, which is also one of the critical mechanisms. In this paper, the pathogenesis of SPG4 was reviewed.

Hereditary spastic paraplegia (HSP) is a group of significantly clinically and genetically heterogeneous neurodegenerative disorders, which are predominantly characterized by progressive lower limbs weakness and spasticity inducing gait abnormalities or disorders. In practice, based on the modes of inheritance, it can be divided into autosomal dominant, autosomal recessive, X-linked and mitochondrial maternal inheritance. According to whether the clinical manifestations complicated or not, HSP can be divided into pure and complex form. To date, mutations in 78 distinct loci and 59 mutated gene products have been identified or reported in patients with HSP; among them 20 distinct loci and 13 mutated gene products have been found in autosomal dominant spastic paraplegia. This is a review about the genetic characteristics and research progress of autosomal dominant HSP.

Objective To investigate the effect of Citronella oil on dementia of Alzheimer's type induced by D-galactose and aluminum trichloride (AlCl3) and explore its mechanism.Methods The 60 healthy KM mice with sex in half were enrolled in this study,10 of them were taken randomly as the normal group,the remainder 50 mice were in the model group.The rats received inntraperitoneal injection of D-galactose and oral aluminum trichloride for consecutive 10 weeks to construct the disease models.The model rats were randomly divided into five groups:model group,control group (0.5 g · kg-1 Piracetan) and three doses (0.4,0.6,0.8 mL · kg-1 Citronella oil) experimental groups.The ability of learning and memory was measured by the Morris water maze test.The levels of glutathione peroxidase (GSH-PX) and malondialdehyde (MDA) in serum homogenate and acetylcholine (ACh) in brain tissue homogenate were determined by spectrophotometer.Results At the fifth day in the Morris water maze training period,the escape latency(EL;s) in the normal group,model group,control group and three doses experimental groups were 21.42 ±-3.18,43.33 ± 2.14,26.84 ± 0.71,23.16 ± 3.70,18.48 ± 1.11,21.40 ±0.88.Compared with the normal group,the EL in model group was increased significantly (P ＜ 0.05).Compared with the model group,EL in control group and three doses experimental groups reduced significantly (P ＜ 0.05).The levels of GSH-PX and MDA in serum in the normal group,model group,control group and three doses experimental groups were (299.05 ± 90.62),(246.19 ± 37.90),(532.49 ± 121.52),(587.21 ± 177.37),(497.14 ±82.95),(493.33 ±73.64)U · mL-1;(9.38 ±3.01),(14.89 ±4.41),(6.98 ±2.43),(6.06 ±3.34),(5.26 ± 1.90),(5.01 ± 1.59) mmol · mL-1.Compared with the normal group,the GSH-PX and MDA in model group was decreased or increased significantly (all P ＜ 0.05).Compared with the model group,the GSH-PX and MDA in control group and three doses experimental groups reduced significantly (P ＜ 0.05,P ＜ 0.01).The level of ACh in brain tissue in the normal group,model group,control group and three doses experimental groups were (268.27 ±25.40),(224.95 ±21.52),(392.56 ±50.58),(240.17 ± 17.15),(255.50 ± 15.91),(259.15 ±20.74) μg · mL-1.Compared with the normal group,the ACh in model group was decreased significantly (P ＜ 0.01).Compared with the model group,the ACh in control group and middle and high doses experimental groups increased significantly (P ＜ 0.05,P ＜ 0.01).Conclusion Citronella oil,like Piracetam,enhanced the antioxidant activity of the Alzheimer's type induced by D-galactose and AlCl3,and increased the synthesis of ACh in brain.

OBJECTIVETo explore the effects of integrative medicine (IM) rehabilitation protocolon motor function, activity of daily living, and quality of life (QOL) in hemiplegia patients after stroke.

METHODSTotally 120 patients with post-stroke hemiplegia were allocated to four groups using sealed envalope drawing, i.e., the rehabilitation group, the Chinese medical treatment group, the acupuncture group, and the comprehensive rehabilitation group, 30 cases in each group. Based on routine rehabilitative training, patients in the Chinese medical treatment group, the acupuncture group, and the compre-hensive rehabilitation group received standardized treatment based on syndrome typing, Shi's Consciousness-Restoring Resuscitation acupuncture, Chinese herbs + acupuncture comprehensive rehabilitatino protocol, respectively. The treatmet cycle consisted of 4 weeks with 24-week follow-ups. Fugl-Meyer motor assessment (FMA), Modified Barthel Index (MBI), and Stroke-Specific Quality of Life Scale(SS-QQL), and safety assessment were taken as main effect indices before treatment, at week 4 of treatment, at week 12 and 24 of follow-ups, respectively.

RESULTSThere was no statistical difference in FMA score, MBI score, SS-QOL score among the four groups before treatment (P > 0.05). These scores were significantly improved in the four groups at week 4 of treatment, week 12 and 24 of follow-ups, respectively (P < 0.05). Besides, FMA score and SS-QOL score were significantly improved in the comprehensive rehabilitation group at each corresponding time point, as compared with other treatment groups (P < 0.05).

CONCLUSIONSThe comprehensive protocol could significantly improve motor function, activity of daily living in hemiplegia patients after stroke, and further improve their QOL. Its effect was better than other single treatment.

Activities of Daily Living ; Acupuncture Therapy ; Hemiplegia ; rehabilitation ; Humans ; Integrative Medicine ; methods ; Medicine, Chinese Traditional ; Motor Skills ; Quality of Life ; Stroke Rehabilitation ; Treatment Outcome

This study was purposed to investigate the expression of latent membrane protein 1 (LMP-1) and CD68 in Hodgkin's lymphoma (HL) patients with EB virus infection and to analyze the relation of LMP-1 expression and CD68(+) tumor-associated macrophage count with clinical features and prognosis of HL patients. The expression of LMP1 and count of CD68(+) TAM were detected by immunohistochemical staining in tissue specimens of 72 HL patients; their correlation with clinical features and prognosis of HL patients was analyzed by using statistical method. The results showed that among tissue specimens of 72 HL patients, the positive rate of LMP-1 expression was 18.1% (13/72), the CD68(+) TAM count was more higher in LMP-1 positive expression [250 of CD68(+) TAM/high power field (hpf) is used as demarcation point] (P = 0.003). The statistical analysis showed that the LMP-1 positive expression was more observed in mixed type HL patients (P = 0.000); the positive rate of LMP-1 expression was much high in HL patients with albumin <40 g/L and age ≥ 45 years (P < 0.05). There was no relation of LMP-1 expression and CD68(+) TAM count with the short term therapeutic efficacy of HL patients, but the overall survival time of LMP-1 positive patients among patients followed-up for ≥ 5 years was short (P < 0.05). Moveover, no correlation of CD68(+) TAM count with the overall survival time of HL patients was found. It is concluded that the high count of CD68(+) TAM is more observed in LMP-1 positive expression of HL tissue, the LMP-1 expression states relates both with the pathological types, age and albumin level of patient with HL. The HL patients with LMP-1 positive expression have poor prognosis, suggesting that LMP-1 may be a new prognostic marker for HL patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Biomarkers, Tumor ; metabolism ; Child ; Epstein-Barr Virus Infections ; Female ; Hodgkin Disease ; diagnosis ; virology ; Humans ; Male ; Middle Aged ; Prognosis ; Viral Matrix Proteins ; metabolism ; Young Adult