The use of innervated radial artery superficial palmar branch perforator free flap for complex digital injuries reconstruction

Loco-regional flaps have been widely used for the reconstruction of digital injuries without requiring microvascular anastomosis, however, they result in scarring and compromised functional outcomes. This study demonstrates our experience utilizing the innervated radial artery superficial palmar branch (RASPB) perforator free flap for complex digital injury reconstruction. From May 2007 to March 2014, the innervated RASPB perforator free flap was used to reconstruct 79 distal complex hand and digital soft tissue defects of which 14 were used to re-vascularise the distal digit in a flow-through fashion. All free flaps were innervated by the palmar cutaneous branch of the median nerve. All 79 free flaps survived and all 14 digits re-vascularized successfully. One flow-through free flap developed distal skin necrosis which healed uneventfully without further procedure. The average follow-up was 21.5 months. Measurement of two-point discrimination ranged from 7 to 13?mm. All patients were satisfied with the aesthetic results. The innervated RASPB perforator free flap is a feasible and effective option for the reconstruction of complex digital defects and the flow-through concept, when utilized in cases with compromised vascularity, provides reliable re-vascularization. Level III, therapeutic study.     

急性白血病流式细胞术免疫分型中系相关抗体的敏感性和特异性分析

为了评估急性白血病流式细胞术免疫分型中系相关抗体的敏感性和特异性，参考St Jude研究医院的急性白血病免疫分型方案对184例急性白血病患者进行流式细胞术免疫分型。结果表明：AML系相关抗体CD13和CD33的敏感性较高(95.5％和91．2％)，特异性不足(72．5％和62．2％)；MPO敏感性低(69．1％)，特异性高(100％)；CD117敏感性、特异性都高(88．2％和100％)。CD14、CD15敏感性低(18．4％和27．2％)，CD14对单核细胞特异性高。B细胞系ALL系相关抗体CD19具有高敏感性(100％)，而特异性(83．4％)差；CD79a、CD22(CyCD22)敏感性(96．4％和100％)和特异性(100％和100％)都高；CD10和CD20的敏感性(53．6％和70．4％)、特异性(82．5％和87．5％)均低。T—ALL系列相关抗体CD3(CyCD3)高特异性(97．5％)，而敏感性(80．0％)欠佳；CD7敏感性高(100％)，特异性低(77．9％)；CD5、CD2、CD1a敏感性、特异性均不理想。结论：184例急性白血病系相关抗体的敏感性和特异性分析与St Jude免疫分型方案基本一致，只是在确定AML时CD117似乎优于MPO；确定B细胞系ALL时CD22和CD79a具有相似的敏感性和特异性，所以可以任选一个。     

Menthol in Combination with Iontophoresis Promotes Natamycin Penetration through the Cornea: In Vitro and In Vivo Studies

Bulletin of Experimental Biology and Medicine - We studied whether menthol can promote penetration of natamycin, a representative antifungal macrolide agent, through the cornea. Natamycin...     

出血热肾病综合征患者淋巴细胞亚群动态变化

目的探讨出血热肾病综合征(HFRS)患者淋巴细胞亚群百分比动态变化的意义。方法应用流式细胞仪检测42例HFRS患者的79份外周血标本淋巴细胞亚群百分比。结果在HFRS各病期中,T淋巴细胞(CD3+)、CD3+CD4+淋巴细胞百分比、CD4+/CD8+比值在发热期开始减低,低血压少尿期降至最低(P<0.05);CD3+CD8+淋巴细胞、B淋巴细胞(CD3-CD19+)百分比在发热期开始升高(P<0.01)。结论HFRS患者各病期淋巴细胞亚群比例严重失衡,动态检测淋巴细胞亚群有助于疾病的分期、治疗和预后判断。     

农村留守儿童学校生活满意度、自尊与校园欺凌行为的关系

目的 研究农村留守儿童校园欺凌行为的现状以及学校生活满意度、自尊与校园欺凌行为的关系,为关注留守儿童心理健康提供依据。方法 2017年8月-2018年1月采取整群随机抽样的方法,从湖南、河南、辽宁、广西四省6所农村学校共抽取605名小学5年级学生作为研究对象,其中留守儿童273名,非留守儿童332名,采用学校生活满意度问卷、自尊量表、校园欺凌问卷进行测量。结果 留守儿童比非留守儿童遭受了更多的校园欺凌行为(t=2.90,P＜0.01);校园欺凌行为和受欺凌行为均与学校生活满意度呈显著负相关(r=-0.296,-0.219,P<0.01);自尊与学校生活满意度呈显著正相关(r=0.388,P＜0.01);自尊在学校生活满意度与校园受欺凌行为之间起部分中介作用(β=-0.25,P＜0.05)。结论 留守儿童比非留守儿童遭受更多的校园欺凌行为,学校方面应尽量为儿童创造和谐的校园环境,提高留守儿童的生活满意度,同时通过开展心理活动健康教育,减少校园欺凌行为的发生。     

莫西沙星对早发无多重耐药危险因素医院获得性肺炎的临床疗效

目的 观察莫西沙星对早发且无多重耐药危险因素的医院获得性肺炎临床疗效及预后影响. 方法 选取早发且无多重耐药危险因素的医院获得性肺炎患者60例,随机分为治疗组和对照组各30例. 治疗组给予盐酸莫西沙星0.4 g,加入0.9%氯化钠注射液250 mL静脉滴注,qd;对照组给予头孢曲松钠2.0 g,加入0.9%氯化钠注射液250 mL静脉滴注,qd,两组均治疗7 d,期间不联用其他抗菌药物,观察临床肺部感染评分(CPIS)、C反应蛋白(CRP)、细菌清除率、临床疗效,预后及安全性. 结果治疗组有效率83.3%,对照组为66.7%. 治疗组CPIS由治疗前(6.9±1.1)分降为(3.0±1.9)分,CRP由治疗前(43.0±5.1)降为(17.6±3.9) mg&#8226;L-1;对照组CPIS由(7.1±1.4)分降为(4.6±1.7)分,CRP由(41.5±6.3)降为(30.8±4.4) mg&#8226;L-1. 治疗组细菌清除率为81.0%,对照组为63.2%. 治疗组晚发医院获得性肺炎发生率为6.7%,病死率3.3%,对照组分别为16.7%和10.0%. 结论 莫西沙星治疗早发且无多重耐药危险因素的医院获得性肺炎能及早改善临床症状、缩短疗程和改善预后,疗效确切,安全性好.