Objective To evaluate the clinical results of an anatomical reconstruction technique for the lateral ligaments with semitendinosus autografts in treatment of chronic lateral ankle instability.Methods From October 2008 to October 2009, 16 patients with lateral instability of the ankle underwent surgery using the proposed methods. They were 8 men and 8 women, with a mean age of 28.2 years (range,19 to 47 years) . Nine patients received only the anterior talofibular ligament reconstruction. Seven patients received both the anterior talofibular ligament and the calcaneofibular ligament reconstruction. Standard stress radiographs under anesthesia were taken to determine which ligament would be reconstructed. The semitendinosus autografts were secured to the fibular insertion site with suture anchors and to the talar or calcaneus insertion site with interference screws. The American Orthopaedic Foot and Ankle Society (AOFAS) scores and standard stress radiographs were used to assess the patients preoperation and at the last follow-up.Results We had a mean follow-up of 12. 1 months (range, 6 to 18 months). In the 16 patients, the average preoperative AOFAS score was 70. 50 ± 3.98, and the final average AOFAS score increased to 93.06 ± 4. 78 ( t = - 24. 010, P = 0. 000). Their average anterior drawer sign improved from 8. 75 ± 3.38 mm to 3.51 ±1.63 mm ( t = 7. 028, P = 0. 000). In the 7 patients who had received both lateral ligaments reconstruction,their average talar tilt improved from 16. 18° ± 7.30° to 5.57° ± 2. 99° ( t = 5. 661, P = 0. 001 ). No significant complications were found in all but one patient who had a 10° limitation of dorsal flexion of the ankle.Conclusions Our short-term results reveal that anatomical reconstruction of the ligaments with chronic lateral ankle instability using the above-mentioned methods may be effective and have the advantages of precise anatomical reconstruction, firm fixation of the grafts, mini-invasive procedure for the fibular skeletal structure and peroneal tendons, and saving the length of grafts.

Objective To determine the prognostic factors after radical resection (RR) for hepatocellular carcinoma (HCC).Methods Altogether 144 patients who had undergone RR for HCC from 1988 through 1995 were included for a univariate and a Cox multivariate analysis.Nineteen factors contributing to overall survival rate (SR) and disease-free SR were analysed.Results The 5-year SR and disease-free SR (N=144) were 47.3% and 23.9%,separately.Multivariate analysis revealed that classification of RR was the signficant factor to overall SR,and presence of vessel invasion was the signficant factor to disease-free SR.The 5-year SR and disease-free SR in the patholngically RR and clinically RR groups were 60.2%,29.0% and 14.0%,0%,respectively.The 5-year disease-free SR in the group without (or with) vessel invasion was 27.8% (or 0%).Conclusions The classification of RR is the determinative prngnostie factor.Pathologically RR is the first option for patients with in- dications.It is essential to improve adjuvant therapy to decrease postoperative recurrence and metastasis rates.

Objective To investigate the relationship between 5 ,10-methylenetetrahydrofolate reductase (MTHFR) gene C677T locus polymorphism and unexplained adverse pregnancy.Methods Three hundreds and twenty pregnant women with unknown ad-verse pregnancy ≥ 2 times in the infertility department ,and obstetrics and gynecology department of our hospital from June 2014 to May 2016 were selected as the case group and 388 healthy non-abortion parous women were taken as the control group.The MTH-FR gene C677T locus polymorphism in the two groups was analyzed by using gene chip method.The differences in genotype and al-lele frequency distribution were compared between the two groups ,and the relationship between unexplained adverse pregnancy and MTHFR C677T locus polymorphism was analyzed.Results The frequency distribution of MTHFR genotype C677T C/C had sta-tistically significant difference between the case group and control group (P<0.05 ,OR=0.284).The frequency distribution of gen-otype C/T had no statistical difference between the case group and control group (P=0.400 ,OR=1.140).The frequency distribu-tion of genotype T/T had statistical difference between the case group and control group (P<0.05 ,OR=7.672).The frequency distribution of allele C and T had statistical difference between the case group and control group ( P< 0.05 ,OR= 0.304 ). Conclusion The high expression of MTHFR C677T genotype T/T may be a risk factor of unknown adverse pregnancy in child-bearing age women.

The DNA microarray study showed that in STZ-induced diabetic rats the elevatedexpression of 42 genes in artery were depressed markedly after atorvastatin treat ment .This suggeststhat atorvastatin may have the protective effects on the diabetic vascular lesion.

Objective:To observe the efficacys and side effects of gefitinib(Iressa)and docetaxel(aisu)as the second-line treatment for advanced non-small cell lung cancer(NSCLC)patients.Methods:A total of 98 patients with advanced non-small cell lung cancer who had failed to previous fimt-line chemotherapy were randomly divided into two groups:gefitinib group and docetaxel group.In the gefitinib group,50 patients took Iressa 250 mg once daily until disease progression or intolerable toxicity occurred.In the docetaxel group,58 patients were treated with aisu 75mg/m~2 i.v.in 60 minutes in day 1.The regimen was repeated every 21 days for at least 2 consecutive cycles.They were assessed on the basis of RECIST evaluation standard of therapeutic effect for solid tumor.Results:In the gefitinib group,the response rate was 22.4%(11/49),the clinical benefit rate was 55.1%(27/49),median survival time was 7.1 months and 1-year survival rate was 35.9%.In the docetaxel group,the response rate,clinical benefit rate,median survival time and 1-year survival rate were 18.8%(9/48),50.0%(24/48),6.9months and 31.5%,respectively(P>0.05).The incidences of Ⅰ～Ⅳ degree and Ⅲ～Ⅳ degree rash were 51.0%and 10.2%in the gefitinib group,significantly lower than those in the docetaxel group (P=0.0000 and P=0.0296).The incidence of Ⅰ～Ⅳ degree diarrhea was significantly higher in the gefitinib group than that in the docetaxel group(P<0.01).The incidence of leukopenia was significantly higher in the docetaxel group than that in the gefitinib group(P=0.0000).The incidences of thrombocytopenia and anemia of Ⅰ～Ⅳ degree were also higher in the docetaxel group (P=0.0000 and P=0.0266).The improvement rate of quality of life was higher in the gefitinib group (P<0.05).Conclusion:Gefitinib has a similar anti-tumor effect as docetaxel on advanced NSCLC patients who have failed to previous fimt-line chemotherapy.Gefitnib can achieve higher improvement rate of quality of life in advanced NSCLC patients,with a lower incidence of toxicity.

AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients,to observe the patients` visual quality,to evaluate the patients` distance visual acuity,near visual acuity,Pseudo-accommodative power,residual astigmatism,the rotational stability of AcrySof IQ Toric Restor intraocular lens (IOLs),contrast the rate of off-distance glass,the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.METHODS:Carried out in 46 patients (48 eyes) with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016.All the cases were randomly divided into 2 groups: experimental group: 23 cases (24 eyes),AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification;control group: 23 cases (24 eyes),AcrySof IQ was implanted.Uncorrected distance visual acuity (UCDVA) and best corrected distance visual acuity (BCDVA),uncorrected near visual acuity (UCNVA) and best-corrected near visual acuity(BCNVA),Pseudo-accommodative power,residual astigmatism,preoperative and postoperative corneal astigmatism,the rate of off-distance glass,the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05).At 1wk,1,3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group (P<0.05).UCNVA were also statistically better than the control group (P<0.05).The mean residual astigmatisms 1wk,1,3 and 6mo postoperatively were statistically differences between the control group and experimental group (P<0.05).At 6mo postoperatively,patients satisfaction of experimental group were significantly better than control group (P<0.05).Spectacles independence for near vision achieved 83% and 17% in experimental group and control group,experimental group were statistically better than control group(P<0.05).Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group,experimental group were statistically better than control group(P<0.05).CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity,which can significantly reduce preexisting corneal astigmatism in cataract surgery,improve spectacles independence for distance vision and spectacles independence for near vision,have a high patient satisfaction.

AIM To establish an HPLC method for the simuhaneous content determination of five flavonoids in Duchesnea indica (Andr.) Focke at five picking time (April,May,June,July and August).METHODS The analysis of D.indica methanol extract was performed on a 25 ℃ thermostatic Agilent ZORBAX SB-C18 column (250 mm×4.6 mm,5 μm),the mobile phase comprising of acetointrile-0.1％ methanoic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 350 nm.RESULTS Rutin,hyperoside,isoquercitrin,celereoin and kaempferol showed good linear relationships within their own ranges (R2 ≥0.998 6),whose average recoveries were 97.1％-101.5％ with the RSDs of 1.37％-2.37％.The contents of five constituents in samples at different picking time exhibited obvious differences,among which lutin and hyperoside contents were the highest in June,isoquercitrin content was the highest in July,and celereoin and kaempferol contents were the highest in August.CONCLUSION The suitable picking time of D.indica is June and July.

Objective To describe a minimal invasional surgical procedure for the treatment of avulsion fracture of tibial intercondylar eminence. Methods From July 1999 to December 2000, 26 cases of avulsion fracture of tibial intercondylar eminence were treated. With the arthroscope, reduction and absorbable suture fixation of anterior cruciate ligament or the avulsion fracture were performed. Taking the advantage of ACL－ aimer, bone tunnels, through which the suture can be pulled out and tied outside the joint, could be accurately produced. Results Twenty-two patients were available for 2－ 17 months(mean 10.5 months) follow-up. Seventeen patients gained normal range of motion, 5 have limited flexion but exceeded 90 degrees. X－ ray demonstrated bone union in all the cases and anatomical reduction obtained in 21 cases. Conclusion Arthroscopically guided operation, gives less trauma, and is a simple and effective method for the avulsion fracture of the tibial intercondylar eminence.

Objective To investigate the effect of ulinastatin on postoperative cardiac troponin I ( cTnI) in patients underwent carotid endarterectomy ( CEA) under general anesthesia. Methods Forty patients with severe symptomatic carotid artery stenosis underwent unilateral CEA under general anesthesia from January 2011 to March 2012 were divided into either a ulinastatin group or a control group according to a random number table ( n=20 in each group) . Patients in the ulinastatin group received 500 000 U of ulinastatin via veins before induction of anesthesia. The patients in the control group were given the same amount of isotonic saline. The serum concentrations of cardiac troponin I ( cTnI ) were detected before surgery and at day 1,2,and 3 after procedure. Myocardial injury was defined as the cTnI peak concentration>0. 04μg/L . Results The levels of serum cTnI before procedure and at day 1,2,and 3 after procedure in the ulinastatin group were median (M) 0. 00 (0. 00-0. 03) μg/L,0. 07 (0. 00-1. 45) μg/L,0. 01 (0. 00-1. 21)μg/L,and 0. 05 (0. 00-0. 89)μg/L,respectively;those in the control group were 0. 00 (0. 00-0. 01)μg/L,0. 00 (0. 00-1. 42)μg/L,0. 00 (0. 00-1. 39)μg/L,and 0. 00 (0. 00-1. 24)μg/L, respectively. At day 1 after procedure,6 patients ( 30%) in the control group and 11 ( 55%) in the ulinastatin group occurred myocardial injury. There was no significant difference between the two groups (P<0. 05). In all the patients with the increased cTnI levels,the peak cTnI occurred at the first day after procedure,however,they did not reach the level ( >1. 5μg/L) of indicating patients occurring myocardial infarction. Conclusion Ulinastatin may not decrease the postoperative serum cTnI levels in CEA patients under general anesthesia. For whether to the CEA patients have myocardial protective effect,more samples are needed to be confirmed.

Objective To study the effects of peroxisome proliferators-activated receptor (PPAR) ? on the growth of human hepatocellular carcinoma cells and explore the roles of phosphatase and tensin homologue deleted on chromosome ten (PTEN) and phospho-Akt in this process. Methods SMMC-7721 cells were treated with 15-d-PGJ2 or pioglitazone, which were two kinds of PPAR? ligands, at different concentrations. The viability of SMMC-7721 cells was evaluated by MTT assay. The cell cycle was analyzed by flow cytometry. PTEN mRNA level was determined by RT-PCR. The protein expressions of PTEN and pAkt were measured by Western blot analysis. Results It was demonstrated through MTT assay that both 15-d-PGJ2 and pioglitazone had an inhibitory effect on the growth of SMMC-7721 cells in a time- and dose- dependent manner. According to flow cytometry detection, more cells were arrested in G0/G1 phase. Increased expression of PTEN mRNA was detected in 15-d-PGJ2 or pioglitazone-treated cells through RT-PCR. Increased expression of PTEN protein and decreased expression of pAkt were confirmed by Western blot analysis. Conclusion The ligands of PPAR? could inhibit SMMC-7721 cells proliferation in a time- and dose- dependent manner. The upregulation of PTEN may be involved in the underlying mechanism.