Severe clubfoot has complicated clinical features.Conventional surgical management could hardly get satisfactory results,always with serious trauma,and even smaller foot.This paper summarizes the characteristics of clubfoot in details and its relative assessment standard,principles and advantages of Ilizarov's technique,design of the apparatus and correction procedures.Combination of this and traditional technique and reasonable osteotomy method are also analyzed,complications are discussed for prevention.

Objective To explore the application of the Ilizarov's principle on tension-stress in correction of adult severe talipes equinovarus. Methods From January 1996 to February 2003, 12 patients (13 feet) were corrected with this method, which involved 9 males and 3 females, whose average age was 26 years old (ranged from 20-36 years). The left foot was afflicted in 4 patients, and the right foot in 7, both side in 1. Among these patients, 3 were congenital, 6 were caused by the poliomyelitis, 1 by trauma, 1 by complication from encephalitic paralysis and 1 by radiotherapy for the cavernous hemangioma of the leg. The Ilizarov distraction apparatus of the ankle and foot joint were equipped in terms of the diseases preoperatively. During the operation, the release of the postero-medial soft tissue and the limited osteotomy of triple joints of the clubfoot were performed. According to the principles of Ilizarov, the wires were inserted and the fixator installed, the distraction devices of the ankle and foot joint which had corrective function in three-dimensional directions were applied to the tibia and foot, the telescopic rods on the apparatus were rotated one week after the operation. The deformity of talipes equinovarus, internal rotation and the drooping of the forefoot were gradually corrected, and the patients could bear weight and walked on the deformity foot during the course of distractive correction. Results All the 12 patients were available at follow-up with a mean duration of 15 months (ranged from 7 months to 4 years). There was no recurrence of the deformity and the feet function was good while walking on full weight-bearing. The mean duration of traction was 71 days. 10 patients (11 feet) could gain 0? in full weight-bearing, 2 patients preserved the drooping feet deformity at 15?-20? (because of shortness in the lower extremety). None of the complications occurred postoperatively, such as infection in the incision or pin tract, necrosis of the flap, neurovascular injury and nonunion. Conclusion Utilizing Ilizarov's principle on tension-stress to correct severe adult talipes equinovarus is a safe, minimally invasive and effective method.

[Objective]To study the safety,clinical effect and therapeutic characteristics of distraction apparatus for correcting flexion contracture deformities of the knee joint by evaluating the clinical outcomes and investigating the results of biomechanic test.[Method]Forty-nine patients (included 52 knees) were treated by the standardized distraction apparatus and the comprehensive assessment standard was adopted to evaluate the clinical outcomes.Five patients were examined by three-dimensional CT of the knee joints pre-operatively and post-operatively to observe the changes in the knee structure.To observe the effect of distraction on the popliteal artery and the limb nerves,the popliteal artery diameter and blood flow speed were examined in 15 patients and the regio cruris electromyogram and nerve conduction velocity were examined in 6 patients before and after treatment.Three different means of distraction and measurement were underwent in 3 patients so as to observe the changes in the flexion curve and force of posterior soft tissues of the knee.[Result]All patients (52 knees) regained congruous structure and better function,the final excellent and good result rate was 65%.Three-dimensional CT examination of 5 patients showed that the postoperative knee joint structures were superior to the preoperative ones and there weren't damage of articular surface.The statistic results indicated that the popliteal arteries weren't obviously disturbed by distraction,whereas the limb nerves were probably disturbed temporarily.Three methods of distraction and measurement in 3 patients showed different outcomes,indicating that the effect of distraction on soft tissues was influenced by the distraction method,the ages of patients and the extents of deformities of the limb.[Conclusion]The distraction speed of therapeutic method is safe,reasonable and effective in correcting flexion contracture of the knee joint;The distraction force on posterior soft tissues of the knee is influenced by various elements,thus,the distraction speed should be individualized.Low-load and steady stretch are advantageous to soft tissue regeneration and safer.

[Objective]To explore the methods and effect of using Ilizarov'techniques for correcting severe flexion contracture of the knee joint.[Method]According to Ilizarov's tension-stress principle and its applying technique,the knee joint distraction apparatus was designed and fixed individually.The joint hinges of the apparatus on the two sides were consistent with the rotational center of the knee joint.Joint distraction of 5 to 10 mm was initially performed and followed by gradual correction of the knee joint flexion contracture at an average rate of 1 mm per day at the level of the knee joint by turning the nuts on the distraction rods at 3～4 rounds per day,with the distraction rate modified according to the patient's tolerance.Regular x-ray exams should be carried out to prevent knee joint dislocation and compression of the articular cartilage.The final requirement of correcting the soft tissue flexion deformity of the knee joint was to overcorrect the joint deformity into 5～10 degrees of hyperextension.As for the joint flexion with anterior bowing deformity of the distal femur,the degree of correcting the knee joint flexion contracture should deduce the degree of the bony deformity.The frame was left on for an additional 2 to 4 weeks.When the frame was removed,the knee joint was immediately casted in full extension for 3 to 4 weeks followed by the range of motion exercise on CPM to regain the knee motion and a long-leg brace was provided simultaneously to maintain the correction for 3 months.Secondary osteotomy was performed on anterior bowing deformity of the distal fermur in 8 patients.[Result]More than 30 degrees of severe flexion contracture of knee joint (mean?sd 58.50?21.28?) in 49 patients (52 knees ) were corrected to an average of 4.12?4.61 degrees after treatment.40 joints of 38 cases were followed for an average of 6.8 months,in which 28 joints maintain the postoperative effect.,while 12 joints had partial relapse of 9.30??8.24?.[Conclusion]Ilizarov's technique for correcting severe flexion contracture of the knee joint,can have satisfactory effect with little complications.It is mini-invasive,reliable and safe.

Purpose:To investigate palitaxel (Tax) induct io n of apoptosis in human retinoblastoma Y79 cells and the role of Bcl-2 phosphor ylation in the mechanism. Methods:Antiproliferation effects of Tax on Y79 cells were dete rmined by 3H-thymidine incorporation. Apoptosis of the Tax-treated cells was determined by DNA fragmentation analysis. Bcl-2 phosphorylation was determ ined by Western blot analysis. Cell transfection was used in mutant Bcl-2 trans fecting in Y79 cells. Results:After 24 hours treatment with 1 ?mol/L Tax, 3H- thymidine incorporation decreased in Y79 cells and the effects were time and dos e dependent. DNA ladder appeared in DNA fragmantation analysis after 12-24 hour s treatment with Tax. Bcl-2 Phosphorylation was significantly increased in 12- 24 hours treatment with Tax. Bcl-2, a mutant of Bcl-2, blocked Tax activation process. Conclusions:Tax inhibits cell growth and induces apoptosis in h uman Y79 cells, and phosphorylation of Bcl-2 might be involved in this process.

Objective To investigate the effects of uterine resection and uterine arterial embolization on the function of ovary. Methods The serum concentrations of estrin(E 2), progestogen(P), follicule stimulating hormone(FSH), luteotropic hormone(LH) and prolactin(PRL) were measured in 15 patients with uterine resection and 22 patients with uterine arterial embolization; including 23 patients with uterine leiomyoma and 29 normal women. We compared the results of the five hormones in each group. Results The serum concentrations of E 2 and P in the group of uterine resection were lower than the normal control group, there was a significant difference between them. Compared the serum concentrations of E 2 and P in the group of uterine arterial embolization and normal control group, there was no significant difference. The serum concentration of PRL in the group of uterine leiomyoma was higher than the normal control group with significant difference. When the uterus was resected or uterine artery was embolished, the serum concentration of PRL decreased remarkably. Conclusions Uterine resection has effects on the function of ovary, but uterine arterial embolization would not. PRL may be one of the factors causing the formation of uterine leiomyoma.

Objective To test the clinical effects of the expiration control device with mask in the treat-ment of chronic obstructive pulmonary disease. This device developed by the author. Methods A total of 102 pa-tients were treated by the device. Among them ,50 patients received positive end-expiratory pressure and 52 with expiratory flow retard and blocked function. Differences in carbon dioxide partial pressure(PaCO2),oxygen partial pressure(PaO2)and pH of the arterial blood gas analysis were compared ,as well as differences in forced vital ca-pacity(FVC),forced expiratory volume for1 sec(FEV1),tidal volume(VT)of pulmonary function before and af-ter treatment. Results (1) In the positive end-expiratory pressure group ,there were significant differences of FVC,FEV1 and VT before and after treatment(2.95 ± 0.32)L vs(3.22 ± 0.35)L,(1.88 ± 0.17)L vs(2.00 ± 0.15)L,(335.28 ± 43.59)mL vs(364.64 ± 44.28)mL,(P<0.01)differences of PaCO2,PaO2 and pH before and after treatment had statistical significance(50.42 ± 4.77)mmHg vs(48.42 ± 3.76)mmHg,(65.42 ± 4.60)mmHg vs (68.50 ± 4.69)mmHg,(7.35 ± 0.030)vs(7.37 ± 0.037)(P<0.05).(2)In the expiratory flow retard and blocked group,differences of FVC,FEV1andVT before and after treatment had statistical significance(2.93 ± 0.22)L vs (3.10 ± 0.27)L,(1.83 ± 0.14)L vs(1.91 ± 0.16)L,(335.48 ± 44.16)mL vs(362.46 ± 38.66)mL(P<0.05), differences of PaCO2,PaO2 and pH before and after treatment had statistical significance(52.39 ± 3.37)mmHg vs (50.06 ± 3.92)mmHg,(68.05 ± 3.80)mmHg vs(68.99 ± 4.57)mmHg,(7.34 ± 0.035)vs(7.37 ± 0.036)(P<0.05). Conclusion This device can improve the ventilation function in patients with COPD. It is easy to use ,safe and effective,with high clinical application value.

Objective To establish a CLCN3/MMTV-PyMT double transgenic mouse model of spontaneous breast tumor with simultaneously overexpressing ClC-3.Method CLCN3 transgenic mice were crossed with MMTV-PyMT spon-taneous mammary tumor model mice.The genotype was determined by PCR.The expression of ClC-3 in tissues was detec-ted by immunofluorescence and Western blot.Results CLCN3 and MMTV-PyMT transgenic mice were bred and CLCN3/MMTV-PyMT hybrid mouse model was successfully established.The ClC-3 expression in CLCN3/MMTV-PyMT hybrid mice was higher than that in the MMTV-PyMT mice, assessed by immunofluorescence and Western blot analysis.Conclu-sions Transgenic mouse models of spontaneous breast cancer with simultaneously overexpressing ClC-3 are successfully es-tablished.The double transgenic mice provide a good animal model for further research of ClC-3 in tumor growth and metas-tasis.

Objective To study the effects of Yixinyin on viral myocarditis.Methods The beating myocardial cells were obtained from the ventricular myocardium of newborn Sparaque- Dawley (SD) rats and were incubated with Coxsackie B3 virus for 48 hours to establish the experimental model of viral myocarditis.With Yixinyin- contained serum added, the beating rate and survival rate of myocardial cells,and the activity of lactate dehydrogenase were measured at the 1st, 3rd and 5th day after infection. Results Serum contained Yixinyin can increase the beating rate and survival rate of the infected myocardial cells,and decrease the activity of lactate dehydrogenase significantly. Conclusion Serum contained Yixinyin has significant protective effect on myocardial cells infected with Coxsackie B3 virus in SD rats.