Objective To study the efficacy of medial plantar island flap for repairing soft tissue defect of the heel after excision of melanoma.Methods Five patients (including 3 males and 2 females) with malignant melanoma were treated.All lesions were located in the heel and were proved by pathological examination.Local extensive resection was performed in all cases.The surgical margin used for excision of melanoma was 2 cm,and the depth used was deep into periosteum of the calcaneus.Plantar medial artery island skin flaps were applied in the reparation according to the size of heel soft tissue defect and anatomic study.The postoperative follow-up was 8 to 14 months.Results The surgical reparation was successful in all 5 cases.The plantar medial artery was very suitable to cover the surgical wound surface and to recover the function and sense.Before 3 months the sense of flaps remained on the donor area and later went to the heel gradually.All patients remained alive and no tumor recurrence was observed.All the patients were walking normally and had protective sensation in the new heel pad comparable to the opposite normal heel.Two patients with more than 10 years follow-up were reported.Conclusions Plantar medial island flap can be used to repair the wound after malignant melanoma resection in the heel,which is an effective method.

Objective To explore the modification of bionic silk fibroin nerve conduits (SF-NCs) by silk sencin.Methods The innovative SS/SF blended-NCs was fabricated by a vertical sequential cooling thermal induced phase separation (TIPS) processing with SF solution added sericin in proportion,its morphology was observed by Scanning electron microscopy (SEM),X-ray diffraction (XRD) and infrared spectroscopy (FTIR) were used to detect its internal molecular structure.MTT assay was used to quantitatively analyzed the PC12 cells viability co-cultured with the innovative SS/SF-NCs,SEM was used to observe the adhesion and morphology of PC12 cells seeded into the innovative SS/SF,PC12 cells were used to assess the NGF bioactivity released from the SS/SF.Results The SEM results showed that the new fabricated SS/SF-NCs had linearly oriented lamellar-like multiple-channel which distributed evenly,got great changes on the channel microstructure and their mechanical properties had been greatly improved,compared to SF-NCs.The XRD and FTIR results showed that the SS/SF-NCs had the similar internal molecular structure with natural silk.The spaces between parallel lamellar-like channels,porosities and compressive strengths of the SS/SF-NCs decreased with decreasing Sequential freezing temperature.MTT assay results showed that the viability of PC12 cell was better than the control group (P ＜ 0.05).The SEM observation indicated that PC12 cells showed good adhesion and differentiation with neuritis outgrowth during the period of co-culture with the SS/SF-NCs.NGF release from the innovative SS/SF-NCs was prolonged over 4 weeks,and remained bioactive.Conclusion The new fabricated SS/SF-NCs modified though silk sericin,which was highly bionic the structure of peripheral nerve fasciculus,had excellent mechanical properties and could be used as another alternative of artificial nerve conduits.

Objective To investigate the patients' radiation dose received in digital radiography (DR) and provide basic data for developing diagnostic reference levels.Methods The patient' s ESD was estimated using the TLDs and DAP was measured by the dose-area product meter.The E values were then calculated by the DAP using Monte Carlo data and RefDose software.Measurements were made for twelve types of examination:skull PA,skull LAT,chest PA,chest LAT,abdomen AP,pelvis AP,cervix spine PA,cervix spine LAT,thoracic spine PA,thoracic spine LAT,lumber spine PA and lumber spine LAT.Results Both kV and mAs varied in the same type of examination for ESD,DAP and E(F =33.47,24.68,43.19,P ＜ 0.05).The dose each time for lumber spine LAT was the highest,reached 4.62 mGy in ESD and 2.26 Gy·cm2 in DAP,respectively.The E of abdomen AP averaged as 0.59 mSv,higher than that of lumber spine LAT.Even for the same type of examination,the dose from each equipment was different.Conclusions DR has the potential to reduce the patients' radiation doses.The guidance levels suitable for Chinese population should be established as soon as possible.

Objective To investigate the nursing for preventing deep venous thrombosis after mini-incision for total hip arthroplasty in old patients. Methods 53 old patients who accepted total mini-incision hip arthroplasty from July, 2005 to June, 2006 were analyzed retrospectively. Results Affected limb swelling were found in 8 patients 2 d to 2 weeks after operation. They all were cured after anticoagulation treatment, no pulmonary embolism occurred.Conclusion Nursing intervention can prevent deep venous thrombosis after mini-incision for total hip arthroplasty.

AIM: To investigate the effects of lidocain and gentamycin on inflammation reaction and wound infection of explosive wound in limb arthrosis after seawater immersion. METHODS: The explosive wound were made in 48 New Zealand white rabbits. All rabbits were randomly divided into 4 groups: lidocain, gentamycin and glutin sponge bound up and immersed in seawater 1 h group (LGGS group, n=12); bactroban and glutin sponge bound up and immersed in seawater 1 h group (BGS group, n=12); 12 layers common gauze bound up and immersed in seawater 1 h group (GS group, n=12) and 12 layers common gauze bound up 1 h group (G group, n=12). The changes of blood WBC, CRP, IL-1, IL-6, TNF-?, MDA and SOD in each group were tested. The bacterial culture was performed in each group after explosion 1 h, 3 d, 7 d and 1 month. RESULTS: Compared with pre-experiment, the WBC was decreased, the IL-6 and TNF-? values were increased significantly (P0.05), but the other groups did (P

Objective:　To investigate the effects of nimodipine on changes of endothelin after head injury. 　　Methods:　Sixty-five adult rabbits were randomized into an injury group (IG, n=30), a nimodipine-treatment group (NTG, n=30) and a control group (CG, n=5). With their heads unfixed, the animals in IG and NTG were injured in the frontal-parietal zone with BIM-II bioimpact. Blood samples and brain tissue were collected before and after injury. The endothelin level was measured with RIA. 　　Results:　The endothelin level in plasma and brain tissue was significantly increased 24 hours after injury. At the 8th or/and 24th hours postinjury, the endothelin level was significantly lower in NTG than that in IG. 　　Conclusions:　Nimodipine can prevent endothelin from elevation and act as a practical endothelin antagonist after head injury clinically.

Objective To describe an ideal technique to repair full-thickness lower lid marginal defects in a one-stage procedure. Methods The buccal rotation flap and the nasal septal chondromucosal flap were used in one-stage operation to repair full-thickness lower eyelid defect. Results Eleven patients including 6 male patients and 5 female patients underwent lower eyelid reconstruction since January 2000.The age ranged from 29 to 64 years with average 43. Seven patients with full-thickness lower eyelid defect were caused by basal cell carcinoma excision, while four patients were caused by trauma. All the fullthickness lower eyelid defects were reconstructed by using the buccal rotation flap and the nasal septal chondromucosal flap in one-stage operation. All the flaps survived completely after operation. There were no other complications excepting that two patients developed to mild lower eyelid retration after six months. Conclusion The technique consisting of the buccal rotation flap and the nasal septal chondromucosal flap is a simple and useful alternative procedure to close full-thickness defects in the lower eyelid.

Objective To compare the single-shot fields irradiated by three focusing modes of γ-knife and explore the approaches for improving the quality of stereotactic radiosurgery.Methods GAFCHROMIC(R) EBT3 mode flushing-free film was used to measure the single-shot fields irradiated by multi-source static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode of γ-knife.Also the uniformity and penumbra of the single-shot fields were compared.Results The 2D dose distribution of the single-shot fields irradiated by three focusing modes of γ-knife was different.In the axis (x,y,z),the rang of penumbra axial length ratios of multisource static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode were 0.13-0.48,0.17-0.33 and 0.28-0.54,in the diagonal direction of the wings plane (NSD,PSD),were 0.31-0.39,0.38-0.43 and 0.54-0.72,respectively;the penumbra axial length ratio of single-source double-axis rotating focusing mode was bigger than in multi-source static focusing modes and multi-source single-axis rotating focusing mode.On the no-wings plane,the area ratios of 80％ dose curve enveloped and 50％ dose curve enveloped(A80％/A50％)were 0.40,0.47 and 0.19,on the wings plane,were 0.61,0.53 and 0.35,respectively.The field uniformity of multi-source static focusing modes and multi-source single-axis rotating focusing mode were superior to single-source doubleaxis rotating focusing mode.Conclusions Considering dose distribution of the single-shot fields,the multi-source static focusing modes devices and the multi-source single-axis rotating focusing mode devices should be preferred,when important tissues and organs are adjacent to the target areas.Compared with single-source double-axis rotating focusing mode,both multi-source static focusing modes and multi-source single-axis rotating focusing mode could make more target areas to be surrounded by high dose region.

Objective To observe the expression of P21 and CDK6 in cervical squamous cell carcinoma,and to investigate the relationship between their expression and cervical squamous cell carcinoma.Methods The expression of CDK6 and P21 in 100 cases of cervical squamous cell carcinoma,20 cases of cervical CIN lesions and 20 cases of normal cervical tissues were detected by immunohistochemical ABC method,and the relationship between them and tumor differentiation,invasion depth,lymph node metastasis and clinical stage were analyzed.Results The expression rates of P21 and CDK6 in cervical squamous cell carcinoma tissues were significantly higher than those in CIN lesions and normal cervical tissues;The low expression of P21 was associated with the depth of tumor invasion,lymph node metastasis and clinical stage (P＜0.05),and was not associated with the degree of tumor differentiation (P＞0.05);The high expression of CDK6 was associated with tumor differentiation,invasion depth,lymph node metastasis and clinical stage (P＜0.05).Conclusion The abnormal expression of P21 and CDK6 may play an important role in the occurrence and development of cervical squamous cell carcinoma,and the two may have a certain significance in the prognosis of cervical squamous cell carcinoma.

Alzheimer's disease ( AD ) is a complex disease caused by environmental and genetic factors. Therefore, one-drug-multiple-target compounds represent the most promising pharmacological approaches to preventing and treating this dis-ease. We have previously designed and synthesized bis( n)-Cog-nitin, novel anti-Alzheimer's dimers derived from tacrine. Bis ( n)-Cognitin have been proven to act on multiple important AD targets, including acetylcholinesterase, β-secretase, N-methyl-D-aspartic acid receptor and neuronal nitric oxide synthase, con-currently. Moreover, Bis(n)-Cognitin could inhibit β-amyloid-induced neurotoxicity, decrease glutamate-induced excitotoxici-ty, reduce oxidative stress, improve learning and memory, and protect against neuronal apoptosis in various in vitro and in vivo models, suggesting that bis ( n )-Cognitin are potential anti-AD drug candidates.