[Research advances on improving the therapeutic efficacy of mesenchymal stem cell-derived exosomes in wound repair]

How to promote high-quality wound healing is a common problem for plastic surgery and burn physicians. In recent years, numerous animal studies have demonstrated that mesenchymal stem cell-derived exosomes promote wound repair through multiple mechanisms and are promising cell-free therapeutic agents with broad prospect of application. How to enhance the therapeutic efficacy of exosomes, optimize their drug delivery strategy, and improve their biological properties are the challenges to be overcome in order to move from basic research to clinical application of exosome therapy for wound repair. This article focuses on methods to improve the wound repair potential of mesenchymal stem cell-derived exosomes, and reviews the recent research advances on improving the therapeutic efficacy of mesenchymal stem cell-derived exosomes in wound repair from three aspects, including pretreatment of parental mesenchymal stem cells, hydrogel bio-scaffold loaded with exosomes, and engineered exosomes, to provide a reference for further clinical studies.

Characterization of sedimentary phosphorus in Lake Erie and on-site quantification of internal phosphorus loading

Lake Erie harmful algal blooms and hypoxia are two major environmental problems, and have severe impacts on human health, aquatic ecosystems, and the economy. However, little is known about internal loading of phosphorus (P) from sediments, which pose a challenge for assessing the efficacy of current conservation measures on the improvement of lake water quality. A modified Hedley's extraction procedure was employed to analyze representative sediment samples collected from the Lake Erie basin for assessing sedimentary P stock, potential availability for release into lake water, and internal P loading. Inorganic and organic P in the sediments were characterized by sequential extractions in H₂O, 0.5 M NaHCO₃, 0.1 M NaOH, and 1.0 M HCl, respectively. In the 0 - 10 cm sediment, total P stock was 172, 191, and 170 metric tons km^-2 in the western, central, and eastern basins, respectively. Sedimentary P seems unlikely to contribute to internal P loading in the western basin, while in the eastern basin it can potentially contribute to an internal loading of 359 metric tons P yr^-1. In the central basin, 41% of organic P, 15% of non-HCl extractable inorganic P, and 9.7% of residual P in the 0 - 10 cm sediment is potentially available for release into lake water; in the 10 - 20 cm sediment, organic P extracted by NaHCO₃ and NaOH is also partially available. The central basin potentially contributes to internal P loading at a total amount of 10,599 metric tons yr^-1. Internal P loading may not contribute to HABs in the western basin, but it can cause and maintain hypoxia in the central basin and delay the recovery of lake water quality for a lengthy time period in response to external P reduction measures.

[The influence of Indian medicine on traditional Chinese medicine from Dunhuang medical literature]

Through the Silk Road, Chinese medicine has different degrees of absorption on different levels of indic medicine. On the whole, Chinese medicine's absorption of indic medicine is "based on me" , "the way of my own, using the instrument." Taking the four levels of "rational, legal, prescription, and medicine" as the entrance, and analyzing the acceptance attitude of traditional Chinese medicine to Indian medicine with the Dunhuang medical literature as the center.Overall the analysis result on Chinese medicine's absorption of Indic medicine is "Based on our principles, utilising their means" , or can be understood as "fitting the foreign ideas into an already mature infrastructure" .

Enhanced Percutaneous Delivery of Methotrexate Using Micelles Prepared with Novel Cationic Amphipathic Material

BACKGROUND

Methotrexate (MTX) is an antiproliferative drug widely used to treat inflammatory diseases and autoimmune diseases. The application of percutaneous administration is hindered due to its poor transdermal penetration. To reduce side effects and enhanced percutaneous delivery of MTX, novel methotrexate (MTX)-loaded micelles prepared with a amphiphilic cationic material, N,N-dimethyl-(N',N'-di-stearoyl-1-ethyl)1,3-diaminopropane (DMSAP), was designed.

MATERIALS AND METHODS

DMSAP was synthesized via three steps using simple chemical agents. H nuclear magnetic resonance and mass spectroscopy were used to confirm the successful synthesis of DMSAP. A safe and non-toxic phosphatidylcholine, soybean phosphatidylcholine (SPC), was added to DMSAP at different ratios to form P/D-micelles. Then, MTX-entrapped micelles (M/P/D-micelles) were prepared by electrostatic adsorption. The physicochemical properties and blood stability of micelles were examined thoroughly. In addition, the transdermal potential of the micelles was evaluated by permeation experiments.

RESULTS

In aqueous environments, DMSAP conjugates could self-assemble spontaneously into micelles with a low critical micelle concentration (CMC) of 0.056 mg/mL. Stable, spherical MTX-entrapped micelles (M/P/D-micelles) with a size of 100-120 nm and high zeta potential of +36.26 mV were prepared. In vitro permeation studies showed that M/P/D-micelles exhibited superior skin permeability and deposition of MTX in the epidermis and dermis compared with that of free MTX.

CONCLUSION

These special novel cationic M/P/D-micelles can enhance the permeability of MTX and are expected to be a promising percutaneous delivery system for therapy skin diseases.

Direct observation of magnetic contrast obtained by photoemission electron microscopy with deep ultra-violet laser excitation

Magnetic circular dichroism (MCD) and magnetic linear dichroism (MLD) have been investigated in a photoemission electron microscopy (PEEM) system excited by a deep ultra-violet (DUV) laser (with λ = 177.3 nm and hυ = 7.0 eV) for the first time. High resolution PEEM magnetic images (down to 43.2 nm) were directly obtained on a (001)-oriented magnetic FePt film surface with a circularly-polarized light under normal incidence. Furthermore, a stepped Cr seeding layer was applied to induce the formation of large-area epitaxial FePt films with (001) and (111) two orientations, where MLD with large asymmetry was observed in the transition area of two phases. It demonstrates that DUV laser can be a powerful source for high resolution magnetic imaging in the laboratory in absence of synchrotron facilities.

[Effect of robot navigation assisted core decompression combined with bone graft treatment of early stage osteonecrosis of the femoral head]

Objective: To evaluate the effects of orthopedic robot navigation system used in core decompression combined with bone graft surgery for osteonecrosis of the femoral head (ONFH). Methods: A retrospective analysis was performed on 9 patients (16 hips) underwent core decompression surgery combined with bone graft treatment for early ONFH in ARCO Ⅱat Department of Osteoarthropathy, Yantaishan Hospital from June 2016 to February 2018.There were 7 males and 2 females, aged 44.6 years (range: 28-60 years). All surgery procedures were completed by the same doctor under the navigation of orthopedic surgery robot using the specific designed tools. The preoperative and postoperative Harris Hip Score and visual analogue score were compared and the time of intraoperative X-ray fluoroscopy was recorded. Results: The mean follow-up period was (12.7±3.5)months (range: 6-18 months). Four cases of treatment failure were observed in 16 hips at the last follow-up and the hip survival rate was 12/16.In stage ARCO Ⅱa, Ⅱb and Ⅱc, the survival rate was 1/1, 2/2, and 9/13.The Harris Hip Score (88.3±1.9 vs.70.0±3.8, t=16.81, P=0.000) and visual analogue score (3.7±0.7 vs. 0.9±0.6, t=13.49, P=0.000) were improved significantly at the last follow-up compared with preoperative value. The total times of intraoperative X-ray fluoroscopy were 15.9±2.5, including 5.8±1.2 before the insertion of the guiding wire and 10.1±1.7 after the insertion of the guiding wire. Conclusions: The domestic orthopedic surgery robot can be applied successfully in the core decompression combined with bone graft surgery for ONFH . It is less invasive with less fluoroscopy time and better bone graft effects.

Efficient delivery of Notch1 siRNA to SKOV3 cells by cationic cholesterol derivative-based liposome

A novel cationic cholesterol derivative-based small interfering RNA (siRNA) interference strategy was suggested to inhibit Notch1 activation in SKOV3 cells for the gene therapy of ovarian cancer. The cationic cholesterol derivative, N-(cholesterylhemisuccinoyl-amino-3-propyl)-N, N-dimethylamine (DMAPA-chems) liposome, was incubated with siRNA at different nitrogen-to-phosphate ratios to form stabilized, near-spherical siRNA/DMAPA-chems nanoparticles with sizes of 100–200 nm and zeta potentials of 40–50 mV. The siRNA/DMAPA-chems nanoparticles protected siRNA from nuclease degradation in 25% fetal bovine serum. The nanoparticles exhibited high cell uptake and Notch1 gene knockdown efficiency in SKOV3 cells at an nitrogen-to-phosphate ratio of 100 and an siRNA concentration of 50 nM. They also inhibited the growth and promoted the apoptosis of SKOV3 cells. These results may provide the potential for using cationic cholesterol derivatives as efficient nonviral siRNA carriers for the suppression of Notch1 activation in ovarian cancer cells.

Treatment of biologically treated leachate by oxidation and coagulation

This work aims to investigate removal efficiency of oxidation and coagulation/flocculation processes, to provide an effective method for the treatment of biologically pre-treated leachate. Leachate containing 985 mg L(-1) COD was treated by using three treatment schemes, i.e. oxidation, coagulation/flocculation and the combined process of coagulation/flocculation followed by oxidation. The application of single oxidation resulted in the effective removal of COD and color up to 80.4 and 83.2%, respectively. However, residual COD values lower than 200 mg L(-1) could only be achieved under intensive experimental conditions (high dosage of Ca(ClO)(2) and prolonged oxidation time). Coagulation/flocculation yielded residual COD values higher than 200 mg L(-1) even at the optimum coagulation conditions. The combined treatment by coagulation/flocculation followed by oxidation yielded final COD lower than 100 mg L(-1) at the following conditions: pre-coagulation with 250 mg L(-1) PFS (poly-ferric sulfate) and over 30-min post-oxidation, or pre-coagulation with 300 mg L(-1) PFS and over 20-min post-oxidation. Hence, pre-coagulation with PFS followed by oxidation with Ca(ClO)(2) was recommended for advanced treatment of biologically treated leachate.

Response time of the Beijing 120 emergency medical service

BACKGROUND

To assess the response time and the details of the operating procedure of the Beijing 120 Emergency Medical Service (EMS).

METHODS

Between June and December 2005, 51 918 EMS cases recorded in the Dispatch Center of the Beijing Emergency Medical Center were analysed.

RESULTS

The median response time of the 51 918 cases was 16.5 min; the cumulative proportions were 2.28%, 9.64% and 18.04% for less than 5 min, 8 min and 10 min of response time respectively, whereas the proportion was 19.20% for more than 30 min of response time.

CONCLUSIONS

On the basis of this analysis, the response time of the Beijing 120 EMS system was found to be longer than that indicated by the national standards.

Simulation of pulmonary pathophysiology during spontaneous breathing

This paper presents a functional model of lung mechanics including a non-linear alveolar pressure volume curve and representation of the work of respiratory muscles during breathing. The model is used to simulate the response to forced inspiration and expiration, and these simulations compared to the standard results of lung function tests routinely performed in departments of lung medicine. The model can simulate the characteristics of inspiratory and expiratory flow profiles seen in normal subjects, and in patients with obstructive or restrictive diseases.

Volatility of heavy metals during incineration of tannery sludge in the presence of chlorides and phosphoric acid

Knowledge of the behaviour of heavy metals in the combustion process is a most important factor in selecting disposal alternatives for waste materials. Accordingly, in this work, the vaporization behaviour of highly concentrated heavy metals (Pb, Zn, Cu and Cr) in tannery sludge were investigated experimentally. The sludge was spiked with various chlorine compounds (i.e. PVC, FeCl3, CaCl2 and NaCl) and pre-treated with phosphoric acid in order to evaluate the capacity of enhancement and weakening of the volatility of the heavy metals contained in tannery sludge. The experimental results show that the vaporization percentages increased with increasing ratio of Cl/sludge and temperature, and the accelerating and increasing effect of the addition of chlorides on the vaporization percentage of heavy metals was dependent on the release capacity of chlorine radicals. The vaporization percentages of lead and zinc increased by 15-20%, whereas those of copper and chromium increased by only about 3 and 10% at 800 degrees C. However, heavy metals were not expected to be completely released in the combustion process in spite of the high ratio of Cl/sludge. Alternately, heavy metals contained in tannery sludge can be immobilized effectively by pre-treatment with phosphoric acid. When the 85% phosphoric acid accounted for 10% of dry basis of tannery sludge, the phosphate-treated sludge showed the lowest vaporization percentage of about 3-15% with formation of Ca18Cu3(PO4)14, Ca9Cr(PO4)7, Ca19Zn2(PO4)14 and PbMgP2O7 in the bottom ash.

Reconstruction of Metacarpophalangeal Joint by Free Vascularized Autogenous Metatarsophalangeal Joint Transplant

Six cases of autotransplantation of free vascularized second metatarsophalangeal joint to reconstruct damaged metacarpophalangeal (MP) joints are reported. Anatomical studies in cadaver and clinical cases involving the origin, course, and importance of preserving the articular branch of the metatarsal artery are described. Follow-up of cases from six months to 21/2 years postoperative reveal recovery of thumb function, stability of the transplanted joint, and no obvious degenerative changes.

Regional patterns of soil organic carbon stocks in China

Soil organic carbon (SOC) is of great importance in the global carbon cycle. Distribution patterns of SOC in various regions of China constitute a nation-wide baseline for studies on soil carbon changes. This paper presents an integrated and multi-level study on SOC stock patterns of China, and presents baseline SOC stock estimates by great administrative regions, river watersheds, soil type regions and ecosystem. The assignment is done by means of a recently completed 1: 1,000,000 scale soil database of China, which is the most detailed and reliable one in China at the present time. SOC densities of 7292 soil profiles collected across China in the middle of the 1980s were calculated and then linked to corresponding polygons in a digital soil map, resulting in a SOC Density Map of China on a 1: 1,000,000 scale, and a 1 km x 1 km grid map. Corresponding maps of administrative regions, river watersheds, soil types (ST), and ecosystems in China were also prepared with an identical resolution and coordinate control points, allowing GIS analyses. Results show that soils in China cover an area of 9.281 x 10(6)km(2) in total, with a total SOC stock of 89.14 Pg (1 Pg=10(15)g) and a mean SOC density of 96.0 t C/ha. Confidence limits of the SOC stock and density in China are estimated as [89.23 Pg, 89.08 Pg] and [96.143 t C/ha, 95.981 t C/ha] at 95% probability, respectively. The largest total SOC stock (23.60 Pg) is found in South-west China while the highest mean SOC density (181.9 t C/ha) is found in north-east China. The total SOC stock and the mean SOC density in the Yangtze river watershed are 21.05 Pg and 120.0 t C/ha, respectively, while the corresponding figures in the Yellow river watershed are 8.46 Pg and 104.3 t C/ha, respectively. The highest total SOC stocks are found in Inceptisols (34.39 Pg) with SOC density of 102.8 t C/ha. The lowest and highest mean SOC densities are found on Entisols (28.1 t C/ha), and on Histosols (994.728.1 t C/ha), respectively. Finally, the total SOC stock in shrub and forest ecosystem classes are 25.55 and 21.50 Pg, respectively; the highest mean SOC density (209.9 t C/ha) was recorded in the wetland ecosystem class and the lowest (29.0 t C/ha) in the desert ecosystem class. Among five forest ecosystem types, Evergreen conifer forest stores the highest SOC stock (6.81 Pg), and Deciduous conifer forest shows the highest SOC density (225.9 t C/ha). Figures of SOC stocks stratified by Administrative regions, river watersheds, soil types and ecosystem types presented in the study may constitute national-wide baseline for studies of SOC stock changes in various regions in the future.

The performance and application of fly ash modified by PDMDAAC

Fly ash modification by polydimethydiallylammonium chloride (PDMDAAC) in laboratory scale was explored in this work and the adsorption performance of modified fly ash and its application in dyeing wastewater treatment were also studied. The key factors (concentration and temperature) for PDMDAAC to affect the adsorption properties of fly ash (FA) were revealed using the orthogonal test with four factors. The results indicated that the adsorption magnitude of fly ash to PDMDAAC increased due to its favorable specific surface causing the change of the surface charge nature. Hence, adsorption performance of modified fly ash on organic molecules and its ion exchange capacity are strengthened. The maximum color removal efficiency was obtained as 88.2% by modified fly ash with 2.0 g/100 mL dosage in dyeing wastewater, which is much higher than 12.5% color removal efficiency by raw fly ash with the same dosage. And, the used modified fly ash could be used for cement production as additive agent. The intensity of cement produced with 15% the modified fly ash in weight reached the Chinese Cement Standard (GB/T17671-1999), blazing a promising novel way in fly ash utilization.

Cancer incidence and risk estimation among medical x-ray workers in China, 1950-1995

Cancer incidence (1950-1995) among 27,011 medical diagnostic x-ray workers was compared by means of O/E system with that of 25,782 other medical specialists employed between 1950 and 1980 to provide evidence of human malignant tumors produced by protracted and fractionated exposure to ionizing radiation and to assess resultant cancer risk. Significant cancer risk was seen among diagnostic x-ray workers (RR = 1.2, 95% CI: 1.1-1.3). Significantly elevated risks were found for leukemia and cancers of skin, female breast, lung, liver, bladder, and esophagus; the RRs were 2.2, 4.1, 1.3, 1.2, 1.2, 1.8, and 2.7, respectively. The patterns of risk associated with years since beginning x-ray work and with age and calendar year of initial employment suggest that the excesses of leukemia, skin cancer, and female breast cancer-and possibly thyroid cancer-were related to occupational exposure to x rays. Because of a lack of individual dosimetry for Chinese medical x-ray workers (CMXW) before 1985, the dose was reconstructed by physical and biological retrospective dosimetry methods. The cancer risk of CMXW was estimated based on the reconstructed dose. The average cumulative dose for the earlier cohort (employed before 1970) was 551 mGy, and for the later cohort (employed from 1970 to 1980) it was 82 mGy. The RRs of leukemia and solid cancer were significantly high for the earlier cohort: 2.4 for leukemia, 1.2 for solid cancer. But no significant increase of RR was evident for the later cohort. The RR of leukemia was 1.7 and 1.1 for solid cancer. This means a significant cancer risk can be induced by long term fractionated exposure to ionizing radiation when the cumulative dose reaches a certain level.

[Cancer risk assessment among medical X-ray workers in China]

Cancer incidence(1950-1995) among 27,011 medical X-ray workers in comparison with 25,782 non X-ray medical specialists between 1950 and 1980 in China was investigated. The average cumulative dose received by the X-ray workers also reconstructed by retrospective dosimetry methods. Significant cancer risk was seen among medical X-ray workers(RR = 1.2). Significantly elevated risks were found in leukemia, cancer of skin, female breast, lung, liver, bladder and esophagus, the RRs were 2.2, 4.1, 1.3, 1.2, 1.2, 1.8 and 2.7 respectively. The patterns of cancer risk were associated with years since beginning of X-ray work, age and calendar year of initial employment and cumulative dose suggest that the risks of leukemia, skin cancer and female breast cancer, possibly thyroid cancer were related to occupational exposure to X-rays. A significant cancer risk could be induced by prolonged exposure to low dose ionizing radiation when the cumulative dose reached a certain level.

[Quantitative determination of chlorogenic acid in eucommia leaf by high performance liquid chromatography]

An HPLC method for the quantitative determination of chlorogenic acid in Eucommia leaf was investigated. The sample was extracted with methanol solution containing 5% fomic acid and then analyzed by HPLC. The operating conditions were Shim-pack CLC-ODS column (6.0 mm i.d. x 150 mm, 5 microns) at 40 degrees C, mobile phase of methanol-0.01 mol/L KH2PO4(25:75, V/V; pH 3.9) at 1 mL/min and UV detection at 328 nm. Mercaptopurine was selected as the internal standard. There was a good linear relationship between the response (area ratio of chlorogenic acid to mercaptopurine) and the concentration of sample in the range of 25-300 mg/L for chlorogenic acid. The corresponding regression equation was Y = 8.0368X + 0.001275, r = 0.9999. The average recovery was 99.89% and RSD was 1.45%(n = 6). The results showed that this method is simple, specific and accurate.

Long-term phenotypic correction of rodent hemiparkinsonism by gene therapy using genetically modified myoblasts

Rat myoblasts were genetically modified to express tyrosine hydroxylase (TH) and produce dopamine in culture. Implanting TH gene-transfected myoblasts into the denervated striatum of 6-OHDA-lesioned rats significantly decreased rotational asymmetry by 50 to approximately 60%. Improvement persisted for up to 13 months. Genetically modified cells could survive and express transgene in the striatum as demonstrated by RT-PCR and immunohistochemical stain-ing. The dopamine content in the striatum tissue of the gene therapy group recovered to 49% of the normal level and was 25-fold higher than that of a control group receiving parental cells. Neither tumor formation nor immunorejection was observed in this study. These results show that myoblasts may be useful as gene carriers for ex vivo gene therapy in the CNS. Gene Therapy (2000) 7, 445-449.

[Expression of foreign tyrosine hydroxylase gene in the rat model of Parkinson's disease]

A total of 75 adult rats were used to produce hemiparkinson's disease (PD) model by unilateral injection of 6-hydroxydopamine (6-OHDA) into the right substantial nigra. Four weeks following the lesions, rats were tested for apomorphine (APO) -induced asymmetric rotation. Only rats that showed more than seven turns per minute were selected as PD models for transplantation. A tyrosine hydroxylase expression plasmid (pSVK3-TH) mixed with lipofectin was transplanted into the right striatum of 15 PD rats. Another 20 PD rats transplanted either with lipofectin or with pSVK3-TH served as controls. Every three days following transplantation, the performance of asymmetric rotation were tested and stained with the TH-immunohistochemistry. Only the animals grafted with pSVK3-TH mixed with lipofectin were found to show the decreased rotational behavior and a few TH-positive cells in the right striatum at the postgraft day 3-12, but not day 18. The results indicate that there exists a correlation between amelioration of asymmetric rotation and the TH gene expression in the denervated striatum. It is suggested that the lipofectin may mediate foreign TH gene expression in the PD rat brain.

[Analysis on current status of drinking water quality in rural areas of China]

An investigation on drinking water quality in rural areas of 180 counties in 26 provinces, municipalities and autonomous regions of China was carried out. The population surveyed was 89.39 million. 69.6% of which was supplied with ground water. Central water supply systems served 47.1% of population. Quality of drinking water was graded according to the "Guidelines for Implementation of the 'Sanitary Standard for Drinking Water' in Rural Areas". The rate of population supplied with unqualified drinking water was 42.7%. The bacteriological indices of drinking water exceeded the standard seriously. Organic pollution occurred extensively. Some regions supplied with water of high concentration of fluoride.

Gene therapy of Parkinson disease model rat by direct injection of plasmid DNA-lipofectin complex

Lipofectin-mediated gene transfer was used to introduce plasmid harboring the tyrosine hydroxylase (TH) gene into the striatum of rats with lesions of the nigrostriatal pathway. The rotational asymmetry of Parkinson disease model rat was reduced quickly and significantly, suggesting that plasmid-DNA-transfected brain cells can generate L-dopa locally in the striatum in quantities sufficient to compensate partially for the loss of intrinsic striatal dopaminergic input. Immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) also confirm that striatal cells can express exogenous TH gene. Such in vivo plasmid DNA transfer strategy may be useful in other neurologic disease therapy, especially acute brain insults.

Preparation of diazotized polystyrene latex and its use in agglutination assays

The preparation of this immunological latex consisted of the following steps: the synthesis of polystyrene, polynitrostyrene, polyaminostyrene and polystyrene diazonium salt latex. The quantities of emulsifier and initiator used in the synthesis of the polystyrene latex were much larger than those used in the conventional method. Reduction of the polynitrostyrene latex involved adding latex dropwise to a large excess of 6% sodium hydrosulphite-2 N potassium hydroxide solution with sodium lauryl benzene sulphonate as an emulsifier. When the mixture was heated at 70 degrees C for 4 h, the emulsion of polyaminostyrene was diazotized. The polystyrene diazonium salt latex obtained was capable of combining with 20-40% by weight of antibody protein. The immunopolystyrene diazonium latex reagents showed a positive agglutination reaction of 78-91% when mixed with serum from patients with leptospirosis and two other infectious diseases. The test, which can be completed within 3 min has been used to assay over 1200 patient samples.

Electron diffraction identification of structure types of martensite in Cu-Zn-Al alloys

Electron diffraction technique for identifying structure types of martensite in beta-Hume-Rothery alloys is described. It includes determination of the stacking sequence of the martensite of the basal planes, differentiation of the long-range ordering in martensite inherited from its parent phase (A2 type disordered; B2 type ordered; and D03, or Heusler, type ordered), and distinguishing between normal-type and modified-type martensite. In addition to the 18R1-type martensite, 12R, 6R, and 2H martensites were found in quenched Cu-Zn-Al alloys using this technique.

Microvascular free flap based on the medial femoral main cutaneous artery

This article introduces a free flap based on the medial femoral main cutaneous artery. Flap transfer was carried out in two cases with complete postoperative success. An anatomical description of the midportion of the medial femoral region, based on magnification and binocular dissection microscope studies is provided, and the operative procedure is described.