Objective To explore the available methods in repairing and restoring the composite tissue defects after trauma of the lower extremities Methods One hundred and sixty four cases were studied in this article,each has a large area of skin defect and soft tissue defect,or combined with other tissue defects such as bone,muscle tendon,blood vessel,while blood supply to the foot of the injuried limb in all the cases was deficiency of bloodless which we called"sever trauma of the lower limb" According to the varied tissue defects and its injuried degree,five operating procedures were designed and introduced Result None of the limbs was severed,a 5～10 year follow up found a good result in 96 3% in all the cases Conclusion The five surgical means mentioned above were satisfied in repairing and restoring varied tissue defects following severe trauma of the lower limbs,and the injuried limbs may be saved

From Nov 1980 to Dec 1983, severed distal segments of fingers were successfully replanted by the aid of surgical microscope in 8 children. The age ranged from 31 months to 12 years. 6 fingers were completely amputated and 2 were incompletely amputated. The level of amputation was situated from distal 1/3 of middle phalanx to the distal inlerphalangeal joints. 46 fresh specimens of fingers were dissected under microscope, and regional anatomy of blood vessels and nerves of distal segment of finger were carefully studied and their calibers measured, providing a useful knowledge for replantation. It was emphasized that meticulous and accurate anastomosis of tiny arteries, and veins with diameters ranging from 0.2 to 0.3mm was the key to success o replantation. Indications for digital replantation, careful debridement under operation microscope, and postoperative management were discussed.

From March 1982 through December 1083, free transplantation of the perichondrium was used to repair the cartilagenous surface of interphalangeal joints in 5 cases of traumatic comminuted fracture. Of these 5 cases, the injury involved proximal interphalangeal joint of index fingers in 2 cases, proximal interphalangeal joint of the middle finger in 2, and carpometacarpal joint of the thumb in 1. The perichondrium was harvested from the 8th or 9th costal synchondrosis.X-ray film showed growth of new smooth cartilage surface, and the movement of the joints ranging from 10 to 30 degrees was observed 3 months after operation. Points to be observed in operation are: (1) About 0.5 cm of the recipient site of the phalange should be bitten away to expose the cancellous bone, thus a surface with better blood supply was created to receive the perichondrial transplant; (2) The recipient surface was reshaped into an articular surface so that no dead space was left between the recipient surface and the graft: (3) The transplanted perichondrium should be anchored onto the bone under certain amount of tension to insure close contact with the bony surface; (4) Immobilization should be enforced for 3 weeks post-operatively.

Objective To investigate the imaging features in CT/MR of pancreatic neuroendocrine tumors(PNETs) with multiple lesions and further deepen the understanding of this disease .Methods A retrospective review of 12 PNETs patients′radiological data with pancreatic tumors′numbers≥2 and confirmed by surgery or fine needle aspiration biopsy in Changhai Hospital were conducted .Five cases underwent pancreatic CT plain and enhanced scan , 2 cases underwent MRI plain and enhanced scan , and 5 cases underwent both CT and MRI scan .Results There were totally 46 lesions in 12 patients.There were 29 (63.0%) lesions located in the pancreatic head and neck , and 17(37.0%) lesions located in body and tail of pancreas.The sizes of the lesions ranged from 0.8 to 9.5 cm,and the median size was 2.9 cm.Forty-four (95.7%) of the tumors was round or oval , and 2 ( 4.3%) was lobulated;44 ( 95.7%) mass solid and 2 (4.3%) was cystic.CT plain scan detected punctate , crescent or nodular calcification in 8(17.4%) lesions;enhanced scan found 42 lesions(91.4%) were markedly enhanced in the arterial phase , 2 lesions (4.3%) were markedly enhanced in the pancreatic phase;2 lesions (4.3%) were slightly enhanced and the degree of enhancement was lower than that of the normal pancreas .Four cases (33.3%) had dilatation of pancreatic duct and/or the bile duct, 4 cases (33.3%) had distant organ metastasis, 2 cases (16.7%) had lymph node metastasis, and 3 cases (25.0%) had vascular invasion .Conclusions PNETs can be multiple and vary in the size.Most of the lesions are round or oval solid lesions and the malignant signs for organ metastasis can be found occasionally .In dynamic enhanced scanning , the obvious enhancement of the solid portion in the tumor and the higher enhancement degree than that of normal pancreas is the main characteristic .

Twenty-one rabbits were randomly divided into three groups: experimental group-filling vein with two neural segments being 0.3cm long to bridge 4cm defect of common peroneal nerve, control group-bridging vein directly to the 4cm defect of common peroneal nerve, auto-nerve-grafting group-cutting off a segment (4cm long) from common peroneal nerve and grafting it inversely.After 25 weeks, morphological, electrophysiological and histological examinations were undertaken, which revealed that the experimental group was most similar to the auto-nerve-grafting group in recovery of motion of the limbs, action potential of muscle, nerve conductive velocity, and regenerating density of nerve fibers and axons. It was a failure in control group. Satisfactory results were also achieved in 2 patients with defect of ulnar nerve treated by filling vein with two neural segments. It suggests that our method is feasible.