From May 1990 January 1991, 22 patients with recurrent esophageal carcinoma after external radiotherapy were treated by intraluminal brachytherapy of Iridium-192(HDR). Preliminary results showed relief of symptoms and improvment of general condition with gain weight. Barium X-ray films revealed better barium passage and smooth mucosa in 80% patients. 14 cases have survived over 8 months and 2 over 16 months. The average survival was 9.18 months.

Objective To evaluate the efficacy and safety of lamivudine combined with thymosin α1 therapy for patients with chronic hepatitis B.Methods Sixty-eight eligible patients with chronic hepatitis B were enrolled in this multi-center randomized controlled rlinical trial.Patients were randomized into the trial group and the control group(n=34 for each).Patients in trial group received thymosin α1 for 6 months and lamivudine for 12 menths:patients in control group received lamivudine for 12 months only.The rates of serum HBV DNA clearance.HBeAg loss,HBeAg seroconversion,ALT normalization and the safety of thymosin α1 were observed at 3rd.6th,12th and 18th month during and after the treatment.Results At 12th month of the treatment,there were significant differences in the rates of serum HBV DNA clearance,HBeAg loss and ALT normalization between two groups(χ2=31.17,7.17 and 5.92,P＜0.05);at 6th month after the treatment.there were significant differences in the rates of sernm HBV DNA clearance and HBeAg loss between two groups(χ2=4.53 and 7.17,P＜0.05).HBV DNA was not detected in 2 patients during 6-month follow-up study and no sever side effect was observed throughout the study.Conclusion The conlbination of lamivudine and thymosin α1 is safe and has better effect than the monotherapy of lamivudine in patients with chronic hepatitis B.

A series of poly(ethylene terephthalate-Co-ethylene 2,5-furandicarboxylate) (PEFT) copolyesters were synthesized with different terephthalic acid (PTA) /2,5-furandicarboxylic acid (FDCA) molar ratios by direct esterification method. In order to investigate their chain structures, 1 H-NMR and 13 C-NMR spectra of these copolyesters were recorded. The average length ( L) , the degree of randomness ( B) and composition of copolyesters were calculated from the intensities of four kinds of signals, which corresponding to the chemical shifts of hydrogen and carbon atoms in ethylene glycol unit in PEFT copolyesters chains. It was shown that the degree of randomness B of all purified copolyesters reached to 1 by the formula of Yamadera and Murano, which indicated that they were random copolymers. Comparatively, the PEF-block-PET of B value was 0. 577, and the PEF-blend-PET of B value was 0 . It was also consistent with the previous results of differential scanning calorimeter ( DSC) that each of the PEFT copolyesters had only one glass transition temperature and the copolyesters were random copolymers. The randomness B of PEFT-50 was the greatest of all, the value was 1. 012 based on the result of 1 H-NMR, and the value was 1. 028 based on the result of 13 C-NMR. Furthermore, the results above displayed that the activity of 2,5-furandicarboxylic acid and terephthalic acid was similar in this nucleophilic substation reaction with ethylene glycol.

Objective To study the bioactive components from stems of Schisandra propinqua var. intermedia. Methods Compounds were separated with acombination of multi-chromatography. Their che- mical structures were determined on the basis of spectral analysis and chemical evidence. Results Nine compounds were isolated from S. propinqua var. intermedia. The structures were elucidated as vanillic acid- 4- O-?-D-allopyranoside (Ⅰ), salidroside (Ⅱ), 2-hydroxy-5-(2-hydroxyethyl)-phenyl-?-D-glucopyranoside (Ⅲ), 3, 4-dimethoxyphenyl-4-?-D-glucopyranoside (Ⅳ), 3, 5-dihydroxybenzoic acid-4-O-?-D-glucopyranoside (Ⅴ), 3, 5-dimethoxy-4-hydroxy-benzoic acid (Ⅵ), 4-methoxy-benzoic acid (Ⅶ), vanillic acid (Ⅷ) and protocatechuic acid (Ⅸ). Conclusion Compound Ⅰ is a new phenolic alloside and others are isolated from S. propinqua var. intermedia for the first time.

Objective To research the relationship between binocular acuity and monocular acuity,and their effect on the evaluation of visual impairment and disability. Methods 1006 patients, aged between 18 and 60 years, are measured monocular and binocular acuities after the best lens correction. Results Binocular vision is higher than, equal to and less than monocular vision, three accounted for 27.14%, 70.78% and 70.78% respectively. Interocular difference has certain correlation with binocular interactions (χ2=54.939,P<0.05,r=0.228). Thirty-three patients have same binocular acuity but different monocular acuity. Conclusion Binocular acuity associated with the monocular acuity and the better eye vision plays a special role in visual disability evaluation.

Objective To study the effect of 125Iodine seed on the rabbit ischiadic nerve at different time point after implantation. Methods Thirty healthy New-Zealand rabbits were randomly assigned into 3 groups( 2-week group, 2-month group and 4-month group) using envelope method. During operation, 10 radioactive 125I seeds were implanted randomly near one of the ischiadic nerve, while 10 non-radioactive seeds were implanted into the contralateral ischiadie nerve. According to treatment plan system(TPS),90% of the prescription dose (PD)was centered in the specific place, where the nerves were chosen to be studied. After 2 weeks, 2 months and 4 months respectively, nerve electro-physiolngy experiment was used to evaluate the bilateral ischiadic nerves, at the same time the morphology of the ischiadic nerve was examined by general observation, light microscope and electron microscope. The electron microscope photo with the same ×4000 amplification was divided into 100( 10 × 10) cages and non-specific changes in one cage account for 1%. The t test and sum rank test were used for statistics. Results Potential leaking point of experimental ischiadic nerves near heart in 2-week group ,2-month group and 4-month group were (0.52± 0.26), (0.60±0.19), (0.48±0.17)V, while that of the control sides were (0.59±0.19), (0.60± 0.15), (0.53±0.13 ) V, there was no statistical significance in the same group respectively (t=0.91, 0.03,0.67,P>0.05). Potential leak point of experimental ischiadic nerves far from heart in 2-week group, 2-month group and 4-month group were (0.51±0.15), (0.52 s0. 11 ), (0. 53±0.15) V,the control sides were (0.52±0.10), (0.56±0.12), (0.54±0.10)V, there was no statistical significance in the same group respectively (t= 0.25,0.74,0.17, P > 0.05 ). Action potential amplitude of experimental ischiadic nerves near heart in 2-week group,2-menth group and 4-month group were (13.18±4.09), (12.78± 4.42), (12.09±1.20) mV, while that of the control sides were (10.55± 4.21 ), ( 10.31±4.22), (12.88±3.54) mV, there was no statistical significance in the same group respectively (t=1.57,1.36, 0.50,P>0.05). Action potential amplitude of experimental ischiadic nerves far from heart in 2-week group,2-month group and 4-month group were (11.18±3.38), (11.68±3.21), ( 12.52±3.09) mV, while that of the control sides were (11.56±4.80), (10.71±3.40), (11.67±2.48) mV ,there was no statistical significance in the same group respectively(t=0.29,1.01,0.55, P>0.05 ). Nerve conduction velocity of experimental ischiadic nerves in 2-week group,2-month group and 4-month group were (40.56± 9.46), (38.79±5.78), (39.44±8.64) m/V, the control sides were (42.56±6.59), (44.64±7.53), (43.33±6.05)m/V, there was no statistical significance in the same group respectively( t = 0.57,1.94, 0.01,P>0.05). There were some changes in general observation and light microscope, in electron microscope, many non-specificity changes were observed. All of these changes included delamination, collapse, disaggregation of the myelinated nerve, mitochondria swelling and vacuolization of neurilemma cell and axon. The ratio of degenerative alterations in nerves was 60% --70% in 2-week group, 50% in 2-month group and 30% in 4-month group, and there was statistical significance among three groups (P<0.05). Conclusion 125I permanent plantation in our test dose has little effect on ischiadic nerve, all these non-specificity changes were observed in electron microscope, and it has no evident impacts on physiological functions.

OBJECTIVETo explore the clinical effects of relaying reversed perforator flaps in repairing skin and soft tissue defects at distal end of finger and donor site.

METHODSSeventeen patients (17 fingers) with skin and soft tissue defects at distal end of finger were hospitalized from June 2011 to June 2013. The reversed digital artery perforator flap with branch of digital nerve was used to repair the defect. The first donor site was repaired by dorsal metacarpal artery perforator flap; the second donor site was closed by suturing. The area of skin defect at distal end of finger ranged from 2.0 cm x 1.5 cm to 3.0 cm x 2.0 cm, and the area of digital artery perforator flap and dorsal metacarpal artery perforator flap ranged from 2.2 cm x 1.5 cm to 3.6 cm x 2.5 cm and 2.5 cm x 2.0 cm to 4.2 cm x 3.0 cm, respectively.

RESULTSAll the 34 flaps survived completely. Cyanosis and partial necrosis of the epidermis appeared in 1 flap, which was healed after dressing change. All the patients were followed up for 1 to 18 months, with mean time of 8 months. The color, texture and appearance of flaps were satisfactory. There was no depression or breakdown in the first donor sites. Some linear scars appeared in the second donor sites, but they did not affect the general appearance. The donor sites at joint or tendon did not affect the joint activity after healing. The results of function evaluation of range of active movement of the fingers were excellent in 15 cases and good in 2 cases. The results of sensation of the flaps were S3 in 1 finger, S4 in 2 fingers, and S5 in 14 fingers. The distance of two-point discrimination of flaps ranged from 5 to 7 mm, with mean distance of 6 mm.

CONCLUSIONSRelaying reversed perforator flap, with reliable blood supply and both donor sites in the hand, can improve the appearance and function of the first donor site as well as repair skin and soft tissue defects at distal end of finger.

Cicatrix ; Depression ; Epidermis ; Extremities ; Finger Injuries ; surgery ; Humans ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Sutures ; Tendons ; Treatment Outcome ; Wound Healing

BACKGROUND:The therapeutic regimen of intraarticular calcaneal comminuted fractures commonly selects plate and screw fixation. However, for case of posterosuperior calcaneal fracture, the weakness of achil es tendon stretch and plate screw fixation results in difficulty or maintenance of reduction. OBJECTIVE:To investigate the therapeutic effects of open reduction and internal fixation with steel screw and Steinmann pins for comminuted calcaneal intra-articular and posterosuperior fractures. METHODS:From December 2009 to December 2013, forty patients with fractures of comminuted calcaneal posterosuperior fractures were randomly divided into two groups. In the control group, patients were treated by open reduction and internal fixation by plate screw only. In the experimental group, patients were treated by open reduction and internal fixation by combination of plate screw and Steinmann pin. The Gissane and Bohler angles of the calcaneus were measured from lateral radiograph before and 4 weeks after surgery, and the MARYLAND score was assessed at the last fol ow-up. Gissane and Bohler angle and MARYLAND score were compared in each group and among different groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 9-23 months. BOHLER and GISSANE angles were significantly bigger at 4 weeks after surgery compared with pre-treatment in both groups (P<0.05). BOHLER and GISSANE angles were significantly bigger in the experimental group than in the control group at 4 weeks after surgery (P<0.05). During final fol ow-up, the average score by MARYLAND Foot Score was 78 in the experimental group and 67 in control group, with their excellent and good rate of 80%and 73%. The excellent and good rate was significantly higher in the experimental group than in the control group (P<0.05). These data indicated that open reduction and internal fixation with combination of plate screw and Steinmann pin has better efficacy in treatment of the comminuted calcaneal intra-articular and posterosuperior fractures compared with plate and screw fixation alone. Their fixation is firm. Functional exercise can be performed earlier. Postoperative recovery of function of the affected limbs is better than plate and screw fixation alone.

Objective: To investigate the design of free perforator flap, and the efficacy of utilizing perforator flaps for Ⅳ degree Ischia-sacral ulcer treatment. Methods: From January 2010 to October 2016, 18 patients with Ⅳ degree ischia-sacral ulcer were treated. The surface area of the sacral tail ranged from 4 cm×5 cm to 8 cm ×12 cm.Doppler sonography was used to detect potential perforator.All defects were repaired with free perforator flaps, designed based on the size and shape of the wound. The flap size ranged from 6 cm×11 cm to 9 cm×15 cm. Results: One perforator flap went dehiscence after surgery, repaired by V-Y flap. All the rest of perforator flaps survived well, after 3-24 months follow-up. Flap texture and appearance was good, no ulcer reoccurred. Conclusions The free perforator flap is a simple technique.It does not need to tracethe trunk of vessels, and it does not cause major morbidities to the buttocks. Therefore, it is one of the ideal ways to repair Ⅳ degree Ischia-sacral ulcer.

Objective: To investigate the feasibility and efficacy of free lobulated lateral circumflex femoral artery perforator flap for foot and ankle defect at non-weight bearing area. Methods: From January 2008 to June 2016, 28 cases with foot and ankle skin and soft tissue defects at non-weight bearing area were treated, including 16 cases with traffic accident, 8 cases with machine injury, and 4 cases with falling injury. There were 10 cases with Achilles tendon exposure, 16 cases with dorsalis pedis tendons exposure and 12 cases with bone exposure. The defect size ranged from 10 cm×8 cm to 16 cm×13 cm. Doppler ultrasound detector was used to select two perforators of lateral femoral circumflex artery. The lobulated perforator flap was designed and harvested as one flap. After clip test was performed to make sure the blood supply of flap, the flap was segmented and repositioned to cover the wound. The width of lobulated flaps was less than 8cm, in order to close the defect at donor sites directly. Postoperative rountine anti-inflammatory, anticoagulant, anticonvulsive treatment and function exercise were adopted. The patients were followed up for 6-28 months. Results: The flap size ranged from 9.0 cm×4.5 cm to 17.0 cm×7.0 cm. Partial necrosis happened at the end of one flap lobe due to pressure, which healed after dressing. All the other 27 flaps survived completely with satisfactory cosmetic and functional result. The wounds at donor sites all healed primarily. Conclusions Free lobulated lateral circumflex femoral artery perforator flap is one of the ideal flaps with high survival rate and low complication for foot and ankle defect at non-weight bearing area.