Anterior tibial artery injury is not the contraindication of medial plantar flap: digital subtraction angiography evidence and clinical application

The medial plantar artery (MPA) is often sacrificed as the vascular pedicle of the medial plantar flap (MPF). However, for patients with ankle soft tissue defect caused by traffic accident, the anterior tibial artery (ATA) could be damaged and the blood supply of the distal foot would only come from the MPA and the lateral plantar artery (LPA). In this case, sacrificing the MPA for the MPF means that the LPA will become the mainly source of blood supply of the distal foot. Whether the blood supply of the distal foot is adequately guaranteed remains to be discussed. A total of seven patients with ankle soft tissue defect and ATA injury were enrolled in the study. The digital subtraction angiography (DSA) was performed to observe the hemodynamics of the ipsilateral foot. The MPF was harvested only when the foot arterial network consisting of the MPA, the LPA, the deep plantar arch, and the deep plantar artery of DPA, and the blood redistribution existed. DSA results showed the blood from the posterior tibial artery was redistributed to the ipsilateral foot and the MPA is not the dominant artery in the foot. Seven MPFs were harvested, and all flaps survived completely. No complications, such as pain, ulcer, and necrosis, occurred in the ipsilateral toes. The DSA could accurately and intuitively evaluate the hemodynamics of foot in patients with ATA injury. The DSA data and clinical practice proved that the ATA injury is not the contraindication of the MPF.     

Potential role of the gut microbiota in neuromyelitis optica spectrum disorder: Implication for intervention

The gut microbiota plays an important role in the occurrence and development of neuroimmunological diseases. Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by the peripheral production of the disease-specific serum autoantibody aquaporin-4 (AQP4)-IgG. Recently, accumulating evidence has provided insights into the associations of gut microbiota dysbiosis and intestinal mucosal barrier destruction with NMOSD, but the underlying pathogenesis remains unclear. Thus, a microbiota intervention might be a potential therapeutic strategy for NMOSD by regulating the gut microbiota, repairing the intestinal mucosal barrier, and modulating intestinal immunity and peripheral immunity.     

Pre-existing CD19-independent GL7− Breg cells are expanded during inflammation and in mice with lupus-like disease

Interleukin 10 (IL-10)-producing regulatory B-cells (Bregs) suppress inflammatory responses that mediate autoimmune diseases. However, it is unknown whether Bregs derive from a pre-existing dedicated B-cell lineage or if any B-cell can differentiate into Bregs in response to BCR or TLR activation. GL7⁺ B-cells are antigen-experienced differentiated B-cells while GL7^−/lo are at an early stage of B-cell differentiation. While both GL7^−/lo and GL7⁺ B cells can produce IL-10, differentiation of GL7⁻ B-cells into Bregs does not require CD19- or Bcl6-induced signals, suggesting that BCR-induced proliferation or Ig class-switching is not necessary for generation of Breg cells. Of particular importance, we show that GL7⁻ Breg cells are dramatically expanded in lupus-like mice and GL7⁻ Bregs suppressed inflammatory responses in lupus-like mice by inducing expansion of Foxp3⁺Treg cells. Taken together, these results suggest that pre-existing GL7⁻IL-10⁺ cells are expanded during inflammation, differentiate into GL7⁺ Bregs and contribute to immune-regulation in lupus-like mice.     

多模态超声检查对甲状腺弥漫性病变合并结节的诊断分析

目的:探讨分析多模态超声检查对甲状腺弥漫性病变合并结节的诊断价值。方法:选取2017年5月-2019年5月我院收治的甲状腺弥漫性病变合并结节患者400例,所有患者均在我院接受超声检查。并且全部患者均通过穿刺活检或者手术病理检查确诊。观察比较与病理诊断结果相比超声检查的准确性;良性结节与恶性结节在不同超声特征方面的差异。结果:所有400例患者的病理诊断结果提示,共检查出甲状腺结节:418个,其中,良性结节:148个,恶性结节:270个;超声检查共检查出甲状腺结节408个,其中,良性结节:144个,恶性结节:264个,与病理诊断相比,超声检查在甲状腺结节方面的检出率并无显著差异(P>0.05)。恶性结节与良性结节在不同超声特征:形态、纵横比、边界、边缘、声晕、内部回声、钙化灶、后方回声、相对运动、血流分布、阻力指数、硬度等方面均存在显著差异(P<0.05)。结论:甲状腺弥漫性病变合并结节使用多模态超声检查诊断的准确率较高,且通过多模态超声检查也能够有效地区分良性结节与恶性结节,值得应用。     

九节菖蒲的化学成分

目的：研究九节菖蒲的化学成分。方法：对九节菖蒲乙醇提取物的氯仿萃取部分进行色谱分离，根据光谱数据和理化性质确定各化合物的结构。结果：分离并鉴定了7个化合物，分别为；三十烷（1），棕榈酸（2），β-谷甾醇（3），异阿魏酸（4），鸡脚刺醛（5），5-羟基乙酰丙酸（6），胡萝卜苷（7）。结论：化合物4和5为首次从本属植物中分离得到。     

枳实消痞汤颗粒毒性研究

目的:观察枳实消痞汤颗粒对小鼠的急性毒性和对大鼠的长期毒性。方法:急性毒性实验:用枳实消痞汤颗粒(104g/kg)给小鼠灌胃,观察动物的一般活动情况及死亡数;长期毒性实验:用枳实消痞汤颗粒(25、12.5、6.25g/kg)给大鼠连续灌服32天,停药14天,观察大鼠的生长发育、血液学和血液生化学指标、脏器系数并作组织病理学检查。结果:急性毒性实验显示小鼠无一死亡;长期毒性实验显示大鼠的进食量、行为、体重、脏器系数和血清生化指标与空白对照组比较,均无明显差异。结论:枳实消痞汤颗粒的临床拟用量是安全的。     

影响447名医学女生的FDI认知风格差异的因素分析

目的分析医学女生的场依存性一场独立性认知风格（Field dependent—independent，FDI）差异的影响因素。方法采用分层随机抽样方法，抽取中南大学临床医学、护理学2个专业女生466名；让其完成由北京师范大学心理系孟庆茂等人修订的《镶嵌图形测验》。对所收集的数据，进行非条件Logistic回归分析。结果1）影响2个专业女生的场依存性一场独立性认知风格差异的因素有：专业（P=0．000）、父亲职业（P=0．007）、是否排行第一（P=0．077）；2）影响女生形成场独立性认知风格的因素有：专业为临床医学（OR=0．445）、父亲职业为干部（OR=0．858）、职员（OR=0．925）、排行第一（0R=0．655）；3）影响女生形成场依存性认知风格的因素有：父亲职业为工人（OR=1．337）、农民（OR=2．903）、科技人员（OR=1．193）、商业服务类（OR=2．376）。结论影响2个专业女生的FDI认知风格差异的因素有专业、父亲职业、出生次序。其中，影响女生形成场独立性认知风格的因素有临床医学专业、排行第一、父亲职业为干部和职员；而影响女生形成场依存性认知风格的因素有父亲职业为工人、农民、科技人员、商业服务人员。