Objective To observe and evaluate the clinical effect of submental island myocutaneous flap(SIMF) and free skin graft(FSG) for the reconstruction of buccal defect resulted from the buccal carcinomas .Methods Forty-four aged aging patients di-agnosed with the buccal carcinomas were operated by the total dissection of primary tumor and selective neck dissection and recon-structed simultaneously with SIMF(19 cases) and FSG(25 cases) .The degree of postoperative cheek shape ,limitation of mouth o-pening ,speech sound ,and function of chewing were observed and analyzed .Results Eighteen SIMFs were completely survived .The residual muscle flap had a good blood supply after the debridement of skin island in one case ,the successful rate of flaps was 94 .7%(18/19) while 100% (25/25) .The donor site of SIMF was sutured directly .Follow-up was taken in 12 months for all patients .In SIMF group ,the degree of postoperative cheek shape ,limitation of mouth opening ,speech sound ,and function of chewing were bet-ter than those of FSG group in FSG group(P<0 .05) .There was no significant difference between 2 groups in the field of recur-rence and metastasis although the recurrence adjacent to the primary tumor had happened in FSG group in 5 months after operation (P>0 .05) .Conclusion The submental island flap is an excellent choice for the reconstruction of cheek defects in aging patients af-ter resection of buccal carcinoma .With acceptable cosmetic ,functional results and reasonable oncological saftety ,SIMF has a prom-ising prospect in head and neck surgery .

Objective To study the influence of age on ?-adrenergic responsive cyclic adenosine monophosphate (cAMP) level of human bladder detrusor and its modulation mechanism. Methods The cAMP levels in detrusor muscle of aging group (15 cases) and young group (7 cases) were determined by radioimmunoassay at the presence of isoprenaline (ISO), BRL 37344 and forskolin, in addition, the modulation of cAMP content of aging group by pertussis toxin(PTX), cholera toxin(CTX), vinpocetine(VPT) and KT-5720 were also studied. Results After incubation with ISO, BRL 37344 and forskolin, the cAMP level of aging group was (15.0?1.6),(12.2?1.8)pmol/mg and (4.5?4.0) pmol/mg protein. The cAMP level of aging group was not influenced significantly by CTX; the ?-adrenergic responsive cAMP level was enhanced significantly by PTX and KT-5720, but the increment of cAMP content induced by forskolin was not changed; VPT significantly increased the cAMP levels induced by all the three agents. Conclusions There is age-related decline in the ?-adrenergic responsive cAMP level of detrusor muscle of the aging; reduced activity of adenylyl cyclase and enhanced activity of inhibitory G protein Gi may be the biochemical basis; inhibitors of calcium/calmodulin stimulated phosphodiesterase and protein kinase A improves the ?-adrenergic responsiveness of the senile, therefore might be used to treat the urinary storage dysfunction during aging.

AIM:To investigate the differences among Lenstar 900, A-scan ultrasound and keratometer in measurement of axial length ( AL ) , anterior chamber depth ( ACD ) and corneal curvature ( K1 , K2 , Km ) , and evaluate the consistency of the instruments, with the purpose providing references for the clinical application of Lenstar 900.
METHODS: In this study we picked up 36 patients ( 50 eyes ) underwent cataract surgery, and lens nucleus hardness were under level IV. Before the operation, AL, ACD and K1 , K2 , Km were measured by Lenstar 900, A-scan ultrasound and keratometer respectively. The differences between the results were compared by the paired t-test. The correlation of the results was analyzed by Pearson correlation analysis, and the consistency was measured by Bland-Ahamn method.
RESULTS: The mean AL and ACD values measured by Lenstar 900 and A-scan ultrasound had no significantly statistic differences (P>0. 05). The K1, K2, Km measured by Lenstar 900 and keratometer were not significantly statistical different (P>0. 05). The results measured by these three instruments had close linearity correlation ( r>0.9, P<0. 01). The consistency of the results was well in Bland-Ahamn analysis.
CONCLUSION:The preoperatively biometric result of Lenstar 900, A - scan ultrasound and keratometer in patients with cataract are all reliable, and they can be substituted by each other. However, Lenstar 900 can not only measure AL, ACD and corneal curvature at the same time, but also cornal thickness, lens thickness, white to white, pupil size, optical axis eccentricity, retinal thickness and so on. It has a number of advantages such as non-touching, convenient and efficient, and can be recommended to use widely.

Objective To investigate the effects of hydrogen sulfide on autophagy and the apoptosis after acute spinal cord injury in rats. Methods Thirty-six adult male SD rats (250-300 g) were randomly divided into three groups (n=12 for each group):sham operation group (Sham group), spinal cord injury group (Model group) and hydrogen sulfide pre-treatment group (H2S group). Allen’s method was used to establish the rat model of spinal cord injury. Rats of sham operation group re?ceived only laminectomy. Rats of H2S group received sodium hydrosulphide injection intraperitoneally (50μmol/kg) 1h after spinal cord injury, and Model group was given the same amount of saline solution. Rats in the three groups were sacrificed 24 h after spinal cord injury, then the spinal cord was removed. The expressions of LC3, p70S6K and Cleaved caspase-3 were detected by Western blot assay. The expression of LC3 was also detected by immunofluorescence. The cell apoptosis was as?sessed by TUNEL stain. Results Compared with Sham group, the expression levels of LC3Ⅱ/LC3Ⅰand Cleaved caspase-3 were increased in Model group, but the expression of p70S6K decreased and cell apoptosis increased in Model group (P<0.01). Compared with Model group, the expression levels of LC3Ⅱ/LC3Ⅰand Cleaved caspase-3 were decreased significant?ly, while the expression of p70S6K increased and cell apoptosis decreased significantly in H2S group (P < 0.01). Conclu?sion Hydrogen sulfide can inhibit autophagy and reduce cell apoptosis after acute spinal cord injury in rats.

Objective To investigate the value of lung adenocarcinoma classification developed by International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society ( IASLC/ATS/ERS) in predicting the effect of three-dimensional radiotherapy ( 3DRT) after surgery for locally advanced lung adenocarcinoma.Methods The clinical data of 150 patients with invasive lung adenocarcinoma who underwent radical resection and systematic lymph node dissection in Tianjin Medical University from 2010 to 2013 were analyzed, and according to the IASLC/ATS/ERS classification, they were divided into lepidic predominant group (LEP group), acinar predominant group (ACN group), papillary predominant group (PAP group), micropapillary predominant group (MIP group), and solid predominant group (SOL group), and further divided into LEP group, CAN/PAP group, and MIP/SOL group.The overall survival ( OS) and disease-free survival ( DFS) rates were compared between groups.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for survival difference analysis and univariate prognostic analysis, and the Cox proportional hazards model was used for multivariate prognostic analysis.Results Among all the patients, the median OS and DFS rates were 30.8 and 25.8 months, respectively.For the patients in the LEP group, ACN/PAP group, and MIP/SOL group, the median OS rates were 40.0, 32.2, and 28.4 months, respectively ( P=0.005) , and the median DFS rates were 29.2, 25.8, and 24.2 months, respectively ( P=0.011) .For the ACN/PAP group, the patients who received or did not receive radiotherapy had a median OS rate of 37.4 or 25.3 months ( P=0.000) and a DFS rate of 31.1 or 25.2 months (P=0.000).For the MIP/SOL group, the patients who received or did
not receive radiotherapy had a median OS rate of 28.3 or 27.4 months ( P=0.783) and a DFS rate of 25.3 or 24.0 months ( P=0.732 ) .Conclusions The IASLC/ATS/ERS classification helps to predict the prognosis of patients with locally advanced invasive lung adenocarcinoma who receive postoperative radiotherapy.Postoperative radiotherapy can be performed for ACN and PAP patients, while there is no need to perform radiotherapy for MIP and SOL patients .

AlM:To evaluate the efficacy of combined pranoprofen eye drops and artificial tears on the treatment of mild to moderate dry eye syndrome after trabbeculectomy.METHODS:This prospective case control study included 63 cases (63 eyes) of patients with mild to moderate dry eye syndrome after trabbeculectomy in our hospital from November 2013 to June 2013. All subjects were randomly divided into two groups. Observation group was treated with combined pranoprofen eye drops and artificial tears and control group received simple artificial tears marking the eyes at 1, 2, 4wk. The patient's symptoms, signs, BUT, S▏t, and FL were observed before treatment and 1, 2, 4wk after treatment.RESULTS: After 2wk, the symptoms of observation group were improved, there was statistically significant difference (P<0. 05). FL difference of each group was statistically significant ( P<0. 05 ); After 4wk, symptoms and signs were improved. There was statistically significant difference ( P < 0. 05 ). The BUT of the observation group and corneal FL scores of two groups showed significant differences (P<0. 05). CONCLUSlON: Artificial tears joint pranoprofen eye drops has good curative effect in the treatment of mild to moderate dry eye syndrome after trabbeculectomy.

AlM: To measure ocular biometric values with the degree of axial myopia and determine the relationship between the differences using the Lenstar 900.
METHODS:Totally 413 myopes (826 eyes) were enrolled in this study and were divided into 3 groups: low myopia (myopia <3. 00 diopters, 104 eyes), moderate myopia ( myopia =3. 00-6. 00 diopters, 500 eyes) and high myopia ( myopia > 6. 00 diopters, 222 eyes ). Central corneal thickness ( CCT ) , aqueous depth ( AD ) , lens thickness (LT), axial length (AL) were measured by Lenstar 900. The parameters were tested using analysis of variance and the relations among SE, AL, LT were analyzed.
RESULTS: There were significant difference both in AL (F=206.16, P<0.01) and AD (F=4.764, P<0.05) and no significant difference both in CCT and LT between these myopia groups. With analysis of Person, the Spherical equivalent ( SE) shows a significantly positive correlation with AL (r=0. 662, P<0. 01) and AD (r=0. 095, P<0. 05), no correlation with CCT and LT. AL shows a significantly positive correlation with AD (r=0. 347, P<0. 01) and CCT (r=0.126, P<0.01), negative correlation with LT (r=-0.265, P<0. 01). LT shows a significantly negative correlation with AD (r=-0. 496, P<0. 01).
CONCLUSlON: Along with the diopters increasing in myopia, the axial length and aqueous depth continue to increase. Spherical equivalent ( SE) shows a significantly positive correlation with AD. AL shows positive correlation with SE, AD and CCT and negative correlation with LT. LT shows a significantly negative correlation with AD.

OBJECTIVETo explore the effective method of preventing cubitus varus deformity in nonoperative treatment of humeral supracondylar fracture in children.

METHODSFrom May 1992 to December 2013,319 patients with hemeral supracondylar fracture in children were treated with manual reduction and external plaster fixation in extension position. There were 253 males and 66 females, aged from 15 months to 13 years old with an average of 6.7 years. Among the patients with humeral supracondylar fracture, extension type was in 284 cases and inflexion type was in 35 cases; 167 cases on the left and 152 cases on the right. Injury to treatment time was 1 hour to 7 days with a mean of 1.8 days. No included nerve injury and operative case in the patients.

RESULTSAll patients were followed up from 3 months to 14 years with an average of 37.3 months. All fractures obtained bone healing and healed time was 6 to 8 weeks with an average of 6.9 weeks. No complications of serious cubitus varus deformity,vascular nerve injury or volkmann contracture were found. In 183 cases, the carrying angle was consistent with itself contralateral,ranged from 5° to 15°; in 105 cases, the carrying angle of uninjuryed side was decreased. During the reset, the carrying angle of 26 patients with ulnar deviation angle was for -5° to 0°; and 5 patients with radial deviation angle was for 15° to 18°, basically does not affect the appearance. The activities of all elbow joint were normal.

CONCLUSIONExternal plaster fixation in extension position has some value to preventing cubitus varus deformity in nonoperative treatment of humeral supracondylar fracture in children and hope that more scholars to do further study.

Adolescent ; Casts, Surgical ; Child ; Child, Preschool ; Female ; Fracture Fixation ; methods ; Humans ; Humeral Fractures ; surgery ; Infant ; Male

BACKGROUND: Along with the establishment and development of in vitro culture technique for human keratinocyte, skin would no longer be considered only as the physiological barrier, it's of important significance in immunity and endocrinology and so on.OBJECTIVE: To explore the experimental cultivating technique for human keratinocytes to provide reliable cell resource forthe appliance of keratinocytes in many ways.DESIGN: An opening study with keratinocytes as the subjects of the experiment.SETTING: Department of Immunology and Department of Dermatology,Xijing Hospital, Fourth Military Medical University of Chinese PLA MATERIALS: This experiment was carried out in the clinical laboratory of Department of Immunology of Xijing Hospital of the Fourth Military Medical University of Chinese PLA between March 2003 and March 2005.Prepuce sample was postoperatively obtained from a 6-year-old boy who was admitted to the department of urology surgery of Xijing hospital in April 2003, prepuce was used as the source for keratinocytes.METHODS: ①Two step digestion technique was used for the isolation of epidermal cells: Firstly the skin flap was digested with dispase of mass concentration of 2.5 g/L at 4 ℃ for overnight, followed by separating epidermis the next day; Secondly it was dipped in trypsin and EDTA mixture for subsequent digestion. ② Improved serum-free cultivating technology was applied to the culture of human keratinocytes. The culture medium is composed of human keratinocyte serum free culture medium +2.5 mg/L bovine pituitary lixivium +5 μg/L epidermal growth factor+438 mg/L glutamine, glutamine can promote the growth of the keratinocyte. ③Human keratinocyte in exponential phase were cryopreserved and rewarmed, then made into cell suspension with additional serum free medium, cells were incubated in culture bottle of 75 cm2 by density of 5×105/mL for subculture. Cell morphological changes were observed under microscope and transmission electron microscope.MAIN OUTCOME MEASURES: ① The growth of primary cells and passage cells. ② The cryopreservation and resuscitation of human keratinocyte from different passages. ③ Morphological observation of Keratinocytes RESULTS: ①The growing state of the primary cells and passage cells:cells suspended primarily and gradually adhered to bottom of the culture dish at about 6-24 hours, most of cells were round and gradually stretched to ellipse shape, at about day 3, some keratinocyte clones and clusters can be observed with satellite-like proliferating epidermal cells scattered around, most of them were polygon and cell homogeneity and transparency became strengthened. Cell fusion amount to 70% at around 5 days, reaching to 90% at day 9 and even completely fused into cell diaphragm at day 1 1. Keratinocyte cultured in vitro can survive 2-3 months without obvious changes in cell morphology and growth speed. ② The cryopreservation and resuscitation of human keratinocyte in different passages: Different passage keratinocytes were separately cryopreserved in liquid nitrogen pot and resuscitated 3 months later, the morphology and growth speed of keratinocytes did not change obviously. ③Morphological observation on Keratinocytes: Cells possess typical epidermal cell characteristics under microscope, displaying higher nucleus/plasma ratio, cells arranged closely with clear boundary and good refraction. Transmission electron microscope revealed that cultured epidermal keratinocyte possessed multiple keratinocyte characteristics, such as massive bundles of tonofibrilla in the plasma, clearly observed mitochondria and rough endoplasmic reticule, cytoplasm sticking out short prominence and cells were found connected by desmosome.CONCLUSION: Keratinocyte can keep its normal morphological characeristics during in vitro culture process by using improved cultivating technique, which can be taken as reliable and abundant cell resource for the experimental and clinical study of human keratinocytes.

BACKGROUND:There are several routes for stem cel transplantation;however, it is stil unable to determine which one is the best. As for the different individuals with brain injury, the type of transplanted cel s, transplantation route and time wil affect the therapeutic effects.
OBJECTIVE:To investigate the effect of bone marrow mononuclear cel s transplanted via different approaches on neurological function of rats with traumatic brain injury.
METHODS:Bone marrow mononuclear cel s of rats were administered gradient centrifugation with Ficol lymphocyte separation medium, and were labeled with CFDA-SE in vitro as standby. Rat models of traumatic brain injury were established by the method of freefal . After successful establishment of rat models, bone marrow mononuclear cel s labeled with CFDA-SE were immediately transplanted into rats via injured area, lateral ventricle and internal carotid artery. One control group was designated for each transplantation route (bone marrow mononuclear cel s were replaced with the same volume of DMEM). The degree of neurological deficits was evaluated using mNSS scores at different time points after treatment. The brain tissue was harvested after the last neurobehavioral evaluation. The survival and migration of bone marrow mononuclear cel s in the injured area were observed under an inverted fluorescent microscope.
RESULTS AND CONCLUSION:At 7, 10, and 14 days after treatment, the mNSS scores of rats in al groups were al lower than those at 1 and 3 days (P<0.05). At 7 and 10 days, the mNSS scores of rats in the internal carotid artery transplantation group were significantly lower than those in the control group (P<0.05). At 14 days after treatment, the number of fluorescence-labeled cel s of rats in the internal carotid artery transplantation group was greater than that in the other groups (P<0.05) and these labeled cel s were widely distributed. The results demonstrate that the neurological function of rats can be improved by transplanting bone marrow mononuclear cel s via the internal carotid artery, and a large number of transplanted cel s can survive and migrate in the injured area.