Objective:To explore the clinical application of the posterior tibial artery perforator flap with the great saphenous vein (GSV) in the treatment of severe degloving injury of the forearm.Methods:From June 2015 to October 2020, 5 patinets (4 males and 1 female, aged 20-46 years old, mean age 37 years old) were treated in the Department of Hand Surgery of Yantaishan Hospital in Yantai. Aposterior tibial artery perforator flap with GSV was used to repair the partial wound of the injured forearm, together with the establishment of venous circulation of dorsal hand for all 5 patients. All the patients suffered from severe forearm degloving injury. Of which, 3 accompanied with ulna radius fracture, 2 with ulnar and radial artery injury and 2 with blood supply insufficiency in the injured fingers. The sizes of soft-tissue defect were 26 cm×18 cm-32 cm×25 cm. The sizes of the posterior tibial artery perforator flap with GSV ranged from 12 cm×5 cm to 33 cm×6 cm. The anastomoses were performed on the perforating artery and the radial artery. The GSV was anastomosed with cephalic vein with bridging anastomosis to re-establish the venous circulation of dorsal hand. Combined anterolateral thigh flaps (ALTF) were used to repair the rest wound of injured limbs in 4 patients, and the combined pedicled abdominal flap was used in 1 patient. The donor site of calf flap was sutured directly, and the skin of upper limb was thinned into medium thick to cover the thigh flap donor site, which was packed with pressure dressing. Regular follow-up reviews were carried out by outpatient clinic, telephone, WeChat APP or home-visit after the operation to observe the survival of flaps, the swelling of the distal end of injured limb, functional recovery and healing at the donor site. Functional recovery was evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Results:All the grafted flaps in 5 patients survived. Necrosis at epidermal edge occurred in 1 calf flap, and achieved secondary healing after dress changing for 4 weeks. There was neither arterial nor venous crisis in all flaps. The oedema of the hand disappeared within 4-8 weeks, with clear dermatoglyph. There was no obvious enlarged circumference of thumb and fingers. The follow-up was carried out for 8-20 months, with 11 months in average. The flaps were elastic in good colour, and full texture without pigmentation. The donor site of the calf flap showed a linear scar. No swollen was seen in the hands of the injured forearm and the feet of donor lower legs. The range of motion of phalangeal joints was good. Recovery of finger sensation achieved at S 4. The recovery of the sensation of posterior tibial artery perforator flap reached S 3 in 2 patients and S 2 in 3 patients. Assessment of the Upper Limb Function using the Standard Issued by the Hand Surgery Society of Chinese Medical Association rated excellent in 3 patients and good in 2 patients. Conclusion:The posterior tibial artery perforator flap with GSV has a reliable blood supply with a small damage to the donor site. This flap is ideal for repair of severe degloving injury of forearm and meanwhile to achieve the re-establishment of venous circulation in dorsal hand.

Objective:The surgical method and clinical efficacy was studied on the anterior lateral malleolar venous network grafting in repair of the defects of superficial palmar arch.Methods:From February 2015 to July 2021, 8 cases (6 males and 2 females; aged 32-44 years old, mean age at 39 years old) were treated in the Department of Hand Surgery of Yantaishan Hospital. Anterior lateral malleolar venous network was grafted to repair the defects of superficial palmar arch of the patients. The patients had different degrees of tendon damage, and injuries of nerve, deep palmar arch, common palmar digital artery or proper palmar digital artery. The length of the vessel defect was 6.0-10.0 cm. Blood supply insufficiency occurred in 1st-5th digits in 1 case, 2nd-4th fingers in 5 cases, and 2nd-5th fingers in 2 cases. The anterior lateral malleolar venous network was transferred to repair 3 broken ends of vessels in 5 cases, 4 broken ends in 1 case and 5 broken ends in 2 cases. The wound of hand was sutured directly in 2 cases. The emergency surgical repair of the wound of hand by transfer of ALTPF was performed in 2 patients, and elective ALTPF transfer in 3 cases. Forearm dorsi-ulnar flap transfer was performed in 1 case. The follow-up reviews were carried out via the outpatient clinic visit, telephone, WeChat interviews or home visits. The blood supply of the distal digit, skin sensation, TPD, the range of motion of the phalangeal joints were observed.Results:The results showed that all the digits and the grafted flaps survived. The follow-up was carried out for 10-53 months, with an average of 17.9 months. The functions of digit extension and flexion, finger opposition and thumb opposition were restored in 5 cases, and the patients returned back to former jobs. The finger flexion and thumb opposition were limited in 3 cases, and these cases participated in light physical work. The proprioception of the digits were recovered, and the TPD was 5-7 mm. Functional recovery was evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association and rated as excellent in 5 cases and good in 3 cases. The donor sites of the foot showed a linear scar. There was no effect on the function and the shape of the donor site.Conclusion:The anterior lateral malleolar venous network grafting is an ideal method in repair of the defects of superficial palmar arch.

Objective:To identify the differential expression of Peroxiredoxin 4 (PRDX4) in alveolar macrophages (AMs) from patients with silicosis in different phases using Western blot.Methods:From June 2017 to June 2018, Twelve pneumoconiosis patients in the pneumoconiosis Department of Beidaihe Sanitarium were selected by random sampling. A msong them, there were 4 groups, that was lung with dust, silicosis with grade one, silicosis with grade two, silicosis with grade three. There were 3 persons in each group, a total of 12. AMs was obtained by filtration and centrifugation. The intracellular protein was extracted and PRDX4 was detected by using Western blot method.Results:It results showed that PRDX4 was expressed in AMs in 4 groups; with the increase of fibrosis, the average relative expression of PRDX4 in AMs was 0.258±0.026, 0.214±0.012, 0.180±0.004, 0.165±0.008. The highest expression level was in the lung with dust group, and the lowest was in the silicosis with grade three group. The difference of the expression level of PRDX4 protein in AMs between groups was statistically significant ( P<0.05) . Conclusion:This experiment verified that PRDX4 expressed differentially in AMs in patients with silicosis. With the development of silicosis, PRDX4 expression in AMs reduced significantly.

Objective:To identify the differential expression of Peroxiredoxin 4 (PRDX4) in alveolar macrophages (AMs) from patients with silicosis in different phases using Western blot.Methods:From June 2017 to June 2018, Twelve pneumoconiosis patients in the pneumoconiosis Department of Beidaihe Sanitarium were selected by random sampling. A msong them, there were 4 groups, that was lung with dust, silicosis with grade one, silicosis with grade two, silicosis with grade three. There were 3 persons in each group, a total of 12. AMs was obtained by filtration and centrifugation. The intracellular protein was extracted and PRDX4 was detected by using Western blot method.Results:It results showed that PRDX4 was expressed in AMs in 4 groups; with the increase of fibrosis, the average relative expression of PRDX4 in AMs was 0.258±0.026, 0.214±0.012, 0.180±0.004, 0.165±0.008. The highest expression level was in the lung with dust group, and the lowest was in the silicosis with grade three group. The difference of the expression level of PRDX4 protein in AMs between groups was statistically significant ( P<0.05) . Conclusion:This experiment verified that PRDX4 expressed differentially in AMs in patients with silicosis. With the development of silicosis, PRDX4 expression in AMs reduced significantly.

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. Conclusion The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

OBJECTIVE: This paper used plantar pressure analysis equipment to discuss the plantar pressure distribution pattern and balance ability of patients with the knee joint injury under static standing. METHODS: Zebris FDM-S plantar pressure analysis equipment was used to collect plantar pressure data from subjects with the knee joint injury and healthy control subjects. We compared the pressure values in each region of pelma, and then assessing the balance ability of the subjects based on the trajectory of the overall pressure center movement. RESULTS: Compared with the healthy control group, patients with knee joint injury have a significantly lower pressure in the heel areas and a significantly higher pressure in the middle foot area. And the total pressure of the injured limb foot in the patient group is lower than that in the contralateral foot. In addition, there is a significant increase in the parameters of the balance ability index in the patient group. CONCLUSIONS The plantar pressure distribution pattern of patients with knee joint injury is different from that of normal people in static standing, and the balance ability is poor. Therefore, this method has a positive guiding significance in the evaluation and application of knee joint injury.
Biomechanical Phenomena ; Equipment Design ; Foot ; Gait ; Humans ; Knee Joint ; Pressure

Objective To explore the mechanism of Liver-soothing therapy on the Luteotropic hormone receptor (LHR) and Follicle stimulating hormone receptor (FSHR) in Perimenopausal Syndrome (PMS). Methods A total of 30 nature aging rats (13-month-old) were randomly assigned into three groups;PMS Liver-qi stagnation model (n=8), PMS Liver-qi stagnation model (n=8) treated with Chaihu-Shugan powder (4.0 g/kg?d) and PMS Liver-qi stagnation model (n=8) treated with Danzhi-Xiaoyao powder (4.0 g/kg?d). The PMS Liver-qi stagnation syndrome rat model were established by immobilizing the nature aging rats. Twelve-week-old female rats (n=8) were used as normal controls. Water decoctions of Chaihu-Shugan powder or Danzhi-Xiaoyao powder were administered respectively for 3 weeks while the rat models established. The serum E2, FSH, LH level were measured by radioimmunoassay. The LHR, FSHR in ovary were measured by quantitative real-time PCR. Results Compared with Liver-qi stagnation syndrome rat model, FSH in the Chaihu-Shugan powder group (4.32 ± 0.33 mIU/ml vs. 5.24 ± 0.45 mIU/ml) decreased (P<0.01), and LH in the Danzhi-Xiaoyao powder group (6.76 ± 0.52 mIU/ml vs. 8.08 ± 0.59 mIU/ml) decreased (P<0.01). Compared with normal controls, LHR mRNA, FSHR mRNA level increased in PMS Liver-qi stagnation model. Compared with Liver-qi stagnation syndrome rat model, LHR mRNA, FSHR mRNA level decreased (7.42 ± 2.54,4.91 ± 1.76 vs. 3.80 ± 1.36) in the ovary of Danzhi-Xiaoyao powder group (P<0.01), but there was no remarkable FHR, LHR expression changes in Chaihu-Shugan powder group. Conclusions The mechanism of Liver-soothing therapy may be related to the regulation of endocrine and decrease of LHR, FSHR.

At present, the somatic function assessment of the elderly mostly depends on the doctor's observation and the scale evaluation, and there isn't the objective and quantitative assessment criteria. In this paper, we design and construct a digital system for the geriatric somatic function assessment, which is based on digital ground, inertial unit, mobile terminal and PC terminal. The gait and balance parameters of the elderly were obtained by the Time Up and Go test and five postures test. Based on the linear regression model of gait and balance parameters, the system was used to evaluate the somatic function of the elderly. The experimental results show that the system not only can accurately distinguish elderly between fall and non-fall, but also has a high correlation between the score of the system and the score of clinical geriatric physical function scale.

In order to evaluate the ability of Parkinson's patients to walk comprehensively, a system based on MEMS to aid clinical quantification of ability in Parkinson's is established. The inertial units are respectively fixed on the back and the waist of subject to be measured. The Kalman fusion algorithm is used to extract the characteristic parameters of accelerometer and gyroscope data. SVM classifier is designed to train and test the classifier by the feature. The results show that the system possesses a high recognition rate for Parkinson's patients and normal subjects and for the classification of the walking ability of patients with Parkinson's disease. So, this system can aid doctors to give more object diagnostic conclusion.

Objective To explore the effect of liver-soothing therapy on the expression of estrogen receptors mRNA in perimenopausal syndrome (PMS) rats with liver qi stagnation. Methods A total of 30 nature aging rats are assigned into control groups (n=8), model groups (n=8),Chaihu-Shugan San (CHSGS group,n=8) andDanzhi-Xiaoyao San (DZXYS group, n=8), according to the random number table. The PMS liver-Qi stagnation syndrome rat models were established by the methods of isolation raised and chronic bondage in all the groups except the control group. CHSGS group were administered 4.0 g/kg water decoctions ofChaihu ShuganSan, and DZXYS group 4.9 g/kg water decoctions ofDanzhi XiaoyaoSan respectively for 3 weeks after the rat models established. The model group and control group were administered with equal volume of normal saline. The open field test was used for the behavior test. The serum E2, FSH, LH level were measured by radioimmunoassay. The ERα, ERβ in ovary were measured by quantitative real-time PCR. Results Compared with model group on the 21st days, the CHSGS and DZXYS groups showed a significantly increase in crossings (49.6 ± 6.0, 51.6 ± 5.8vs. 40.0 ± 4.6,P<0.05 orP<0.01) and rearings (14.1 ± 0.7, 14.6 ± 2.3vs. 10.9 ± 1.8,P<0.05 orP<0.01). Cmpared with the model group, the FSH (3.96 ± 0.48 mIU/mlvs.5.31 ± 0.41 mIU/ml) significantly decreased in the CHSGS group, and the LH (6.65 ± 0.46 mIU/mlvs. 8.10 ± 0.62 mIU/ml) significantly decreased in the DZXYS group (P<0.05). Compared with the model group, ER alpha mRNA expression (7.42 ± 2.54, 4.91 ± 1.76vs. 3.80 ± 1.36,P<0.01) significantly increased in the CHSGS group, and the ER beta mRNA expression (3.56 ± 0.95vs. 3.10 ± 1.12,P>0.05) increaed in the DZXYS group, but there was no remarkable difference. Conclusion The Liver-soothing therapy can improve the behavior of PMS rats with liver-Qi stagnation, and the mechanism may be related to the regulation of endocrine and ovarian estrogen receptors.