Clinically,peripheral nerve injury is common,treatment is still a clinical problem.Because of the peripheral nerve's particular dissection and the function,repair of its damage is a complex process,meticulous microsurgical technique can be used to restore nerve continuity,but the restoration of nerve function is still not satisfactory.Recently,the domestic and foreign scholars has made effort and achieved some success,particularly,the allograft nerve transplant has applied in clinical.

Objective To investigate the clinical efficacy of S-1 combined with cisplatin in the treatment of old patients with advanced gastric cancer.Methods 85 patients were randomly divided into two groups.Experimental group was treated by S-1 combined with cisplatin,while control group was treated by 5-FU and cisplatin.Short-term efficacy and adverse reactions were evaluated after four cycles.Results All patients had succcssfully accomplished chemotherapy.Compared with the control group ( RR =52.4％,DCR =81.0％ ),RR and DCR in experimental group ( RR =67.4％,DCR =93.0％ ) had statistically significant difference ( P ＜ 0.05 ).The top three of adverse reactions and complications in patients of the two groups were:nausea and vomiting,low WBC,low hemoglobin concentration.Compared with the control group,the toxicity in experimental group had no statistically significant difference ( P ＞0.05).All patients were followed up with a meau of( 15.5 - 2.7 ) months.The 1 year survival rate was 60.5％(26/43) in the experimental group; the 1 year survival rate was 52.4％ (21/42) in the control group.There was no statistically significant difference( P ＞ 0.05 ).Conclusion The S-1 combined with cisplatin had shown better efficacy in the treatment of old patients with advanced gastric carcinoma,and the toxicity was relatively mild and tolerable.

OBJECTIVE: To evaluate the improvement of speech perception in Chinese-native cochlear implant (CI) children using frequency modulated system (FM system). METHOD: The mandarin speech perception (MSP) system was used to evaluate 11 cases with severe and profound hearing loss who were fitted cochlear implants. Listeners were asked to repeat MSP words presented in quiet and several different signal-to-noise ratio (SNR) conditions and percent correct word repetition was determined. Performance was evaluated under FM system and without FM (CI only). In addition, the listeners' subjective performance changes in the experiment were also observed. RESULT: (1) There was significant main effect of the device condition (with FM and no-FM) (F = 72.938, P < 0.01), a significant main effect of signal level (F = 230.715, P < 0.01), a significant interaction effect between the signal level and the device condition (F = 40.893, P < 0.01). (2) Listeners answered the question in a louder voice, showed more confidence, when using with FM system. CONCLUSION FM system could improve the speech reception in a complex environment for Chinese-native CI children.
Child ; Cochlear Implantation ; Cochlear Implants ; Humans ; Noise ; Signal-To-Noise Ratio ; Speech ; Speech Perception ; Speech Therapy

BACKGROUND: Secretion of various neurotrophic factors by Schwann cells plays important roles in neural regeneration. However, the secretion capability is affected by many factors. To seek a feasible method for promoting nerve growth factor secretion by Schwann cells is a key of regeneraion following neurologic defect.OBJECTIVE: To explore the effects of methylprednisolone(solu-medrol) on the secreted function of Schwann cells of cultured rats.METHODS: Schwann cells were isolated and cultured by enzyme digestion method. Cell growth was observed under an inverted phase contrast microscope. Following passage, purity of some Schwann cells was identified using S-100 protein immunity. Other Schwann cells were regulated using cell counting plate into 1×10~9/L, and incubated in a 6-well culture plate (15 wells) for further incubation. Following 4 days of culture, different concentrations of solu-medrol (10~(-3), 10~(-4), 10~(-6), 10~(-8) mol/L) were administrated to the cell, while blank control group (1 well) was given no drug. 24, 48 and 72 hours after administration, reverse trancription-polymerase chain reaction (RT-PCR) was used in the detection of the levels of nerve growth factor mRNA.RESULTS AND CONCLUSION: Number of primarily cultured cells was significantly increased at day 7, and 80% cells were confluent. Subcultured cells were spindle-shaped, with 2 thin long processes, showing positive fluorescence staining. Fibroblasts were round or flat, showing negative reaction of fluorescence staining. Reserve transcription-polymerase chain reaction demonstrated that nerve growth factor number at 72 hours affected by 10~(-8) mol/L radiosone was increased compared with the blank control group and other concentrations and other time points (P < 0.05). Number of nerve growth factor was reduced following treatment of 10~(-3) mol/L radiosone compared with the blank control group and other concentrations (P < 0.05). These results suggested that high concentration of solu-medrol prohibits secreted function of Schwann's cells, but long time and low dosage solu-medrol promotes secreted function of Schwann's cells.

BACKGROUND:The principle of lyophilization is to sublimate the solvent of frozen materials in vacuum and retain the solute, thus making a pore structure. OBJECTIVE: To produce a chitosan tubular scaffold by lyophilization, and to test its physicochemical properties. METHODS: The chitosan tubular material was prepared by lyophilization method, folowed by gross observation and electron microscopic observation. The chitosan tubular material samples were placed into PBS solution and pure water for 50 days, respectively, and then immersed in trypsin liquid for 1 day folowed by embedded into the muscle and dorsal skin of neonatal Sprague-Dawley rats for 30 days. The degradation rate and porosity of the material were observed and calculated. The breaking strength and compressive strength of the material were determined both under drying and soaking conditions using tensile instrument and pressure meter, respectively. RESULTS AND CONCLUSION:The external form of the chitosan tubular material was normaly tubular. Under the electron microscope, it was composited by different size pores, and the pore size was 50-200μm. The degradation rates of the material were (5.33±0.12)% in PBS, (11.26±0.15) in water, 0.012% in the trypsin liquid and (35.2±3.7)in vivo. The porosity rate was (97.5±1.5)%. The breaking strength and compressive strength of the material was higher under the drying state than under the soaking state (P < 0.05). These findings indicate that the lyophilization method can produce the chitosan tubular material with good porosity rate and degradation rate as wel as good tensile ability and compressive capability.

Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.

ObjectiveTo evaluate the efficacy of mini-incisional double-tsuge suture method with 0-0 absorbable polydioxanone-cord (PDS-Ⅱ)in repair of acute achilles tendon rupture.MethodsA total of 34 patients were subjected to acute closed achilles tendon ruptures,including 25 males and 9 females at a mean age of 32 years ( range,20-45 years).Injury causes included sports injuries in 27 patients,falling injuries in six and heavy object impingement injury in one.The time from injury to operation was average 3 days (range,1-6 days).All patients underwent minimally invasive repair with double-tsuge suture method by using PDS-Ⅱ.The ankle joint was fixed with short leg plaster cast at 30° plantar flexion position and the cast was removed six weeks later to take functional exercise.The patients could walk with full weight-bearing 8-10 weeks later and could gradually return to activity 3-4 months later.Results There was one patient with poor incision healing and one patient with reflex sympathetic dystrophy postoperatively.The rest patients had stage Ⅰ incision healing without skin adhesions.No complications such as infection,lower extremity deep venous thrombosis or sural nerve injury occurred postoperatively.All the patients received follow-up of 12-24 months (average 15 months),which showed no complications like tendon rerupture occurred.According to clinical evaluation criterion of Termann,the average score was 92 points (range,76-96 points).The result was excellent in 28 patients,good in five and fair in one,with excellence rate of 97％.ConclusionsSmall incisional double-tsuge suture method achieves low rate of complications and good outcomes for repairing acute achilles tendon rupture and is an ideal tendon surgery approach.

ObjectiveTo evaluate the significance of the detection of serum C-reactive protein (CRP) in elderly patients with diabetes mellitus and cerebral infarction.MethodsSeventy-two patients with diabetes mellitus and cerebral infarction (diabetic cerebral infarction group),66 patients with cerebral infarction and without diabetes mellitus (non-diabetic cerebral infarction group) and 60 healthy persons (control group) from October 2008 to January 2011 were selected.The level of serum CRP was detceted.ResultsThe level of CRP was ( 3.81 ± 2.23 ) mg/L in diabetic cerebral infarction group,( 2.48 ± 2.24 ) mg/L in non-diabetic cerebral infarction group and (0.68±0.16) mg/L in control group.The levels of CRP in diabetic cerebral infarction group and non-diabetic cerebral infarction group were significantly higher than that in control group (P ＜ 0.05).The level of CRP in diabetic cerebral infarction group was obviously higher than that in non-diabetic cerebral infarction group(P ＜0.05).CRP abnormal rate was 70.8％(51/72) in diabetic cerebral infarction group and 43.9％ (29/66) in non-diabetic cerebral infarction group,which had statistical significance (P ＜ 0.05).ConcluslonCRP has important predictive value to the occurrence and development of diabetic cerebral infarction.

Objective To explore the influence of atorvastatin on the carotid atherosclerotic plaque and prognosis of older apoplexy.Methods 124 patients with carotid atherosclerotic plaque were randomly divided into 2groups,64 cases in the observetion group who had given atorvastatin(20mg) and general,and 60 cases in control group who had given genenal treatment.The relapse rate of apoplexy,the level of blood-fat and live viability condition were compared.Results ( 1 ) In the treatment group,the recurrence rate was 4.7％,and 18.3 ％ in the control group,the difference was statistically significant(x2=5.76,P ＜ 0.05 ).The two groups of adverse events had no significant difference ( x2=0.00,P ＞ 0.05 ).(2) In the treatment group,after treatment compared with before treatment,after the treatment group compared with the control group after treatment,TC,TG,LDL-C,HDL-C levels were statistically different ( all P ＜　0.05 ).(3) The life skills of the treatment group after treatment was signiflcantly better than the control group,the difference was statistically significant( x2 =24.18,P ＜ 0.05 ).Conclusion A torvastatin could significantly reduce the level of blood fat,improve prognosis,and reduce the rate of apoplexy,and had good effect.

Objective To explore the risk factors related to refracture after union of congenital pseudarthrosis of the tibia with a combined surgical,and to provide an important reference for clinical treatment.Methods From April 2007 to August 2011,40 cases of congenital pseudarthrosis of the tibia (CPT) confirmed by the use of intramedullary nail combined Ilizarov external fixator treatment of bony union were obtained for retrospective analysis.There were 27 males and 13 females,and the average age was 3.6±2.7 years (ranged from 0.8 to 11.3 years),and the follow-up time are all over 36 months.Survival analysis were applied respectively on gender,whether the merger of neurofibromatosis type 1 (NF-1) and ankle joint,operative age,fibular status and the cross-sectional area ratio of healing site.Multifactorial Cox proportional hazards regression analysis was performed on the single factor with statistical significance.Results No significant inter-group differences existed in gender or whether combined NF-1.In operative age ≥3 years group whose refracture-free survival was significantly better than those ＜ 3 years.Intact fibula or stabilised by tibiofibular synotosis or Kirschner wire group showed significantly better refracture-free survival than those with a pseudarthrotic fibula due to neglect or failed synostosis.There was significant difference between ankle joint fixed group and ankle joint unfixed group in mean refracture-free period.With a cross-sectional area median ratio of healing site of 0.15,refracture-free survival was better than those with a lesser value,and the difference was statistical significant.Cox proportional hazards regression analysis showed a negative correlation between the cross-sectional area and the refracture occurred ~=-1.989,P ＜ 0.05),fibular pseudarthrosis and refracture occurred were positively correlated ~=1.506,P ＜ 0.05),operative age and ankle joint status had no relationship with refracture occurred (P ＞ 0.05).Conclusion The major risk factors for refracture after union of congenital tibia pseudarthrosis with the use of intramedullary nail combined Ilizarov external fixator are the smaller cross-sectional area of pseudarthrosis and with fibula pseudarthrosis.