Nature is abundant in protein scaffolds.By selecting suitable protein scaffold,display and screening methods,the rational and constrained random peptide library(RPL)can be constructed.Compared with the non-constrained RPL,it offered more opportunities for obtaining novel protein structures and more higher affinity ligands against the target molecules.At present,the protein scaffold constrained RPLs have been shown great potential in applications such as target selection,basic research,clinical diagnosis,medical therapy and so on.It is systematically introduced the structure bases,classification and construction of constrained RPL based on scaffolds,as well the recent great advances of application in selection against target molecules with S-S constrained scaffolds,antibodies,Zinc finger protein,Z domain,FN3 domain as important examples.

Objective To analyze our clinical results of head and neck reconstruction using microsur- gical free flap transfer techniques.Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed,and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope.The un-buried free flap with a mo- nitoring window were harvest,and do double venous anastomoses in some flaps to ensure adequate venous out- flow.Results From May 1999 to March 2005,1066 consecutive free flap transfers were used to reconstruct head and neck defects.The overall success rate of free flap was 98.3%.The vessel thrombosis rate was 3.1%,and the flap salvage rate was 45.5%.Conclusion Head and neck reconstruetion using microsurgi- cal free flap transfer technique is safe and reliable,and good clinical results can be obtained.

0. 05). Conclu-sion The THT and THC have bioequivalence.

Aim To study relative bioavailablity of cefaclor effervescent tablets in healthy volunteers. Methods According to the crossover design, A volunteers were each orally given a single does of the 0.75 g cefaclor effervescent tablets and cefaclor capsules with an interval of 5 days between the two formulations.The plasma concentrations of the drug were determined by RP-HPLC.Pharmacokinetic parameters were obtained by ATPK programe,and calculated on the basis of open single compartment model.Results After a single oral dose, the peak levels in plasma averaged Cmax(31.27?5.81)?g?ml-1 and(30.56?5.25) ?g?ml-1 at (0.58?0.12)h and(0.73?0.17)h and AUC0～4(35.48?4.65) ?g?h?ml-1 and (35.89?2.90) ?g?h?ml-1 for tablet and capsule,respectively. Conclusion The result shows that two formulations are bioequivalence.

Ear ; surgery ; Humans ; Parotid Neoplasms ; surgery ; Surgical Procedures, Operative ; methods

Objective To evaluate the therapeutic efficacy of combined treatment with surgical decompression and drug for traumatic optic neuropathy (TON) and analyze the influential factors. Methods A retrospective study on 69 patients (70 eyes) with TON treated with optic canal decompression through transnasal endoscopic approach and drug was conducted. The visualacuity was divided into 5 grades:no light perception (NLP), light perception (LP), hand move, count finger, >0.02, marked as Ⅰ-Ⅴ respectively. Of 40 eyes with grade Ⅰ, 18 eyes received emergency operation for severe optic canal fracture confirmed by CT;22 eyes received corticesteroid therapy firstly and then operation. Of 30 eyes above grade Ⅰ, 16 eyes with optic canal fracture confirmed by CT received emergency operation;14 eyes received corticosteroid therapy firstly and 3 days later received operation. Postoperative follow-up lasted 3-12 months to observe the recovery of visual acuity. Results The therapeutic efficacy of patients with the visual acuity of LP and above LP was better than that of NLP (90.0% to 27.5%), the difference had statistical significance (χ2=26.98,P<0.001). In operated group, the therapeutic efficacy in patients whose visual acuity was improved from NLP after glucocorticoid therapy (80.0%) was better than that of the patients with no improvement (5.9%), the difference had statistical significance (χ2=12.09,P<0.001). Conclusion The imaging findings of optic canal fracture can not be used as determinants for operation. The patients with NLP whose visual acuity had no improvement after corticosteroid therapy are poor candidates for surgical decompression. The visual acuity before treatment is the main factor affecting the therapeutic efficacy.

OBJECTIVETo investigate the frequency of micrometastasis in levels lII - IV of clinical negative neck (cN0) in patients with squamous cell carcinoma (SCC) of oral tongue, and to discuss the management of cervical lymph node for cN0 tongue SCC.

METHODSA total of 471 cervical lymph nodes derived from 25 patients with cN0 tongue SCC, including 263 lymph nodes in level III and 208 lymph nodes in level IV, were included in this study. All lymph nodes were re-examined by anti-cytokeratin (CK) immunohistochemical staining combined with semi-serial section per 500 microm.

RESULTSAmong the 25 cases, seven patients were confirmed harboring metastasis in 11 lymph nodes of level III, and no positive lymph node in level IV was detected by routine hematoxylin-eosin (HE) staining. 11 positive lymph nodes in level IIl, which confirmed by HE staining, were also detected by immunohistochemical staining with CK combined with semiserial section. Among the 460 cervical lymph nodes in which HE staining did not show metastasis, only one lymph node in level III harboring a 2.0 mm x 1.5 mm micrometastasis was detected by immunohistochemical staining with CK, and no positive lymph node in level IV was detected by immunohistochemical staining with CK.

CONCLUSIONThe frequency of occult metastasis in level IV was very low, so it seemed unnecessary to dissect level IV for all patients with cN0 tongue SCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; Female ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; Neoplasm Micrometastasis ; Tongue ; Tongue Neoplasms

OBJECTIVETo analyze the value and reliability of combined free flap and pedicled pectoralis major myocutaneous flap in the reconstruction of extensive composite head and neck defects.

METHODSNine consecutive cases of combined free flap and pedicled pectoralis major myocutaneous flap transfers for extensive head and neck defects from March 2002 to April 2005 were reviewed. Data concerning the operation included defect description, type of free flap, recipient vessel and complications.

RESULTSThere were 9 cases in this group, with 7 males and 2 females. Among the 9 free flaps, there were 6 radial forearm flaps, two fibula flaps, and one anterolateral thigh flap. The overall flap survival rate was 100% (all of 18 flaps), without partial or total flap necrosis. One radial forearm flap developed venous thrombosis 24 hours after operation, but salvaged by emergent exploration and reanastomosis of veins. The overall complication rate was 44.4%.

CONCLUSIONIn selected cases, the combined free flap and pedicled pectoralis major myocutaneous flap method provided satisfactory reconstruction for extensive head and neck defect, and simplified the double free flap method.

Female ; Free Tissue Flaps ; Head ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Myocutaneous Flap ; Neck ; Necrosis ; Reconstructive Surgical Procedures ; Reproducibility of Results ; Surgical Flaps

OBJECTIVETo compare the efficacy differences between acupoint catgut-embedding combined western medicine (ACCWM) and simple western medicine (WM) for treatment of epilepsy of generalized seizures type.

METHODSFifty-two patients with epilepsy of generalized seizures type were randomly divided into an ACCWM group (n=30) and a WM group (n=22). Dazhui (GV 14), Yaoshu (GV 2), Jiuwei (CV 15), Qihai (CV 6) were selected in the ACCWM group as the main acupoints combined with routine antiepileptic drugs, Valpromide was taken orally, 2.0 g/d for adult, 50 mg/kg x d for child. The WM group was treated with routine antiepileptic drugs. The epilepsy score and the attack frequency one year before the treatment and one year during treatment were observed and the therapeutic effects in the two groups were compared.

RESULTSThe epilepsy score and the attack frequency were both decreased in the two groups (P<0.01, P<0.05), and the epilepsy score in the ACCWM group decreased significantly (6.57 +/- 3.29 vs 10.73 +/- 2.54, P<0.05). The total effective rate of 90.0% (27/30) in the ACCWM group was superior to that of 68.2% (15/22) in the WM group (P<0.05).

CONCLUSIONThe therapeutic effect of ACCWM is superior to that of simple western medicine in treating epilepsy of generalized seizures type. It can improve significantly the attack symptoms so as to enhance life quality of the patients with epilepsy.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Catgut ; Child ; Child, Preschool ; Combined Modality Therapy ; Epilepsy ; drug therapy ; therapy ; Female ; Humans ; Male ; Middle Aged ; Seizures ; drug therapy ; therapy ; Valproic Acid ; analogs & derivatives ; therapeutic use ; Young Adult

OBJECTIVETo describe a new method of accessory nerve defect reconstruction with sternocleidomastoid muscle-great auricular flap.

METHODSThirty-four cases receiving traditional radical neck dissection were divided into two groups: single neck dissection group (n = 19) and accessory nerve reconstruction group (n = 15). Surgical procedure of the reconstruction was described in detail. Postoperative shoulder functions were compared between the two groups.

RESULTSAccessory nerve reconstruction group experienced much better shoulder function recovery than that in single neck dissection group.

CONCLUSIONSReconstruction of accessory nerve defects with sternocleidomastoid muscle-great auricular nerve flap is simple, effective and complication-free.

Accessory Nerve ; surgery ; Accessory Nerve Injuries ; Adult ; Aged ; Carcinoma, Squamous Cell ; secondary ; surgery ; Ear ; innervation ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; surgery ; Neck ; Neck Dissection ; methods ; Neck Muscles ; surgery ; Nerve Transfer ; methods ; Surgical Flaps ; Treatment Outcome