腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

以药物相互作用为切入点开展临床药学服务

目前临床上存在的主要问题为临床药师工作尚未有成熟模式,因此临床药师在开展日常临床药学服务工作时需深入临床一线,全程参与用药过程,而选取合理的切入点十分重要。药物间相互作用会对药物的作用效果产生影响,一方面药物作用过度会引起毒性反应增加,另一方面药物作用减弱会引起治疗无效或失败。文章拟从以药物相互作用作为切入点实施临床药学护理服务,现就近几年的相关研究进行综述。     

中医外治膝关节骨关节炎研究进展

骨关节炎（OA）是指由多种因素引起关节软骨纤维化、皲裂、溃疡、脱失而导致的关节疾病。既往文献报道OA的发病率总的趋势是随年龄增高而增高。40岁以下人群的发病率约为5％；而60岁～75岁人群的发病率高达50％；75岁以上人群发病率高达80％。该病的致残率可高达53％。近十年来，随着人们活动频率和强度的增加，世界范围内骨关节炎发病年龄逐渐年轻化。中医中药治疗该病有独特优势，目前已有大量文献报道，特别是中医外治法。因其历史悠久、痛苦少、     

貌似脑梗塞的脊髓病变2例报告

1病例报告例1，女，55岁，以右下肢麻木无力2d为主诉入院，患者于入院前2d在洗脚时突感右下肢麻木无力，无头痛头晕，无不省人事，无肢体抽搐，无发热，无二便障碍，无口角歪斜，无言语含糊，尚可坚持行走，未引起重视，未诊治，今因麻木无力加重入院，门诊头颅CT提示：双基底节多发腔隙性脑梗塞，以脑梗塞收住院。     

不同麻醉状态对针刺调节自主神经的影响及研究新思路

针刺可以通过对自主神经功能的调节来预防和治疗相关疾病,而有关针刺对自主神经调节效应的研究结果并不一致,考虑到在针刺作用机制研究中,不可避免地涉及动物麻醉剂的使用,而麻醉药物在发挥其药理效应的同时,亦可影响自主神经系统活动,因此,在探讨不同针刺效应机制时如何合理使用麻醉剂,尽量减少麻醉剂的影响十分重要。本文通过回顾针刺对自主神经调节作用以及麻醉剂对自主神经活动影响的相关研究,提出对于不同麻醉方式以及不同麻醉深浅状态对针刺调节自主神经效应的影响进行系统研究的新思路,以期为针刺调节自主神经研究中麻醉剂的使用提供参考。     

基于ITS2序列的东北透骨草及其混伪品DNA分子鉴定

目的应用ITS2条形码鉴定东北透骨草及其混伪品,为东北透骨草药材鉴定提供新方法。方法提取35份东北透骨草及其混伪品的基因组DNA,通过PCR扩增ITS2序列并进行双向测序,测序结果提交至GenBank;从GenBank下载13种东北透骨草及其混伪品ITS2序列42条;对提交与下载的77条序列,应用MEGA7.0软件进行序列比对,计算种内和种间遗传距离,构建Neighber-jioning(NJ)系统进化树,并预测ITS2二级结构。结果东北透骨草3种基原的种内最大K2P遗传距离均远远小于其与混伪品的种间最小K2P遗传距离;NJ树结果显示东北透骨草及其混伪品药用植物均可明显区分,表现出良好的单系性;比较ITS2二级结构发现,东北透骨草与其混伪品在4个螺旋区的茎环数目、大小、位置以及螺旋发出时的角度均有明显差异。结论 ITS2序列作为DNA条形码能稳定、准确鉴别东北透骨草,为保障安全用药提供了新的技术手段。     

启东市2000-2014年新发麻风病例分析

目的了解启东市新发麻风病例发病情况及畸残情况。方法对2000-2014年麻风病个案病例及随访资料进行分析。结果启东市2000-2014年新发麻风病5例,无复发病例,均为女性农民,年龄25~48岁,散发,其家属均未感染。4例病例首诊单位为当地乡镇卫生院,1例为启东市人民医院,均有误诊误治情况。5例病例中无畸残1例,Ⅰ级畸残1例,Ⅱ级畸残2例,Ⅲ级畸残1例,畸残发生率为80.00%。结论启东市麻风病呈低流行状态,新发病例畸残发生率较高。早发现、早诊断、早治疗是降低麻风病人发生畸残的关键。     

腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.