Objective To analyze the effects of vascularized fibular flap combined with vacuum sealing drainage (VSD) in the repair of tibia defect.Methods Clinical data of 24 patients with chronic osteomyelitis of the tibia who accepted the operation of vascularized fibular flap combined with VSD were collected in the study.In the first operation, the lesions were completely debrided and the dead bone was removed, then the vascularized fibular was replaced from the other limb to repair the tibia defect.Later, vacuum-assisted closure was applied to cover the wound.Results All patients enrolled in the study were followed up for 13 to 50 months, with an average of 32.3 months.The sinus of 22 cases healed in 4 weeks and the healing rate was 91.7%.The other two patients received additional debridement for the sinus and they also healed soon after that.All flaps survived and the survival rate was 100%.The X-ray showed that the transplanted fibula was healed in all cases, with a healing rate of 100%.The healing time ranged from 4 to 7 months, with an average of 4.9 months.Based on the Enneking scoring system, the patients achieved an average score of 26 points out of 30 points, and the recovery rate of limb function was evaluated as 86.7%.Conclusion For patients with chronic osteomyelitis of the tibia, vascularized fibular flap combined with VSD can not only effectively repair bone defect, but also restore the continuity of limbs.The application of VSD can effectively control infection, shorten treatment course, and restore limb function.

BACKGROUND:Primary vascular endothelial cels are mostly harvested through aorta endothelial cel cultures and micro-artery endothelial cel cultures using enzyme digestion and tissue adhesion methods, and the quality and purity of harvested cels cannot meet the need for current scientific research.
OBJECTIVE:To investigate an improved extraction of primary vascular endothelial cels and the relevant identification method.
METHODS: A segment of rabbit aorta was cut to culture vascular endothelial cels using the improved extraction method in group A or using adhesion method in group B. In the group A, the vascular intima was striped out with microsurgical instruments, and digested enzymaticaly to acquire single primary cels folowed by culture in endothelial cel culture medium. In the group B, the whole vascular intima was adhered to the culture dish that was incubated in a 5%CO2, 37℃ incubator for 1 hour. Cel pelets in the two groups were culturedin vitro. Cel morphology was observed using a microscope; immunohistochemical staining was used to detect CD31, VIII factor and Vimentin protein for identification of vascular endothelial cels.
RESULTS AND CONCLUSION:The purity and number of vascular endothelial cels extracted by the improved method were higher than those by the adhesion method. Immunohistochemical findings showed positive expression of CD31 and VIII factor, but negative expression of Vimentin. These findings indicate that the improved extraction method can obtain more vascular endothelial cels with higher purity, which is of strong operability and practicality.

Tumor markers can reflect tumor existence,and open an entrance to diagnose tumor at early stage.Recent researches reveal that gastric cancer related tumor markers such as microRNAs,enzymes,cytokines and antibodies-antigens are significant for the diagnosis,treatment,relapse surveillance,prognosis evaluation of gastric cancer.

OBJECTIVETo analyze the risk factors of liver metastasis in patients after radical resection of pancreatic cancer.

METHODSOne hundred and twenty-four patients with non-metastatic, resectable pancreatic cancer treated in our department between 2006 and 2012 were included in this study. All of these patients underwent resection of the primary tumor combined with extensive lymph node dissection. The development of postoperative liver metastases was carefully followed up, and the clinicopathological factors and molecular characteristics were evaluated by univariate analysis and multivariate logistic regression using SPSS 16.0 software.

RESULTSForty-eight cases of liver metastases were found among the 124 cases of pancreatic cancer after radical surgery (38.7%). The rate of liver metastasis of pancreatic cancer after radical surgery in the age groups < 40, 40-60, and > 60 were 68.8%, 33.3% and 35.1%, respectively. The rate of liver metastasis in the body mass index (BMI) group < 20 kg/m2, 20-25 kg/m2, and > 25 kg/m2 were 21.6%, 44.1% and 52.6%, and the rate of liver metastasis in the time between the onset and diagnosis groups ≥ 3 months and < 3 months were 59.4% and 31.5%, respectively. The rate of liver metastasis in patients with preoperative fatty liver was 14.3% and it was 43.7% in patients without preoperative fatty liver. The rate of liver metastasis in patients of histological high, medium and low grade was 10.0%, 35.4% and 49.0%, respectively. The rate of liver metastasis in patients with venous tumor thrombus was 68.8% and it was 34.3% in patients without venous tumor embolus. The rate of liver metastasis in patients with postoperative chemotherapy was 31.2% and it was 51.1% in patients without postoperative chemotherapy. All those differences had statistical significance (P < 0.05). Univariate analysis revealed that age, body mass index (BMI), time between the onset and diagnosis, preoperative fatty liver, histological grading, tumor invasion depth, venous tumor embolus, and postoperative chemotherapy were significantly related to postoperative liver metastasis. Multivariate analysis revealed five statistically independent risk factors for postoperative liver metastasis: BMI, time between onset and diagnosis, preoperative fatty liver, histological grading, and venous tumor embolus.

CONCLUSIONSOur data suggest that patient's BMI, time between onset and diagnosis, histological grade, and venous tumor embolus are significantly correlated with postoperative liver metastases in patients with pancreatic cancer. Pancreatic cancer patients with preoperative fatty liver have less postoperative liver metastasis.

Adult ; Aged ; Body Mass Index ; Humans ; Liver Neoplasms ; secondary ; Lymph Node Excision ; Middle Aged ; Pancreatic Neoplasms ; pathology ; surgery ; Regression Analysis ; Risk Factors

Objective To analyse tratment strategies and to evaluate the relation between different therapies and survival rate of patients of with asynchronous liver metastases after pancreatic cancer surgery (PCLM).Methods From January 2006 to January 2012,48 patients with PCLM were included in this study,and their medical records were retrospectively analyzed.Results Among the 48 patients,27 cases of liver metastases were found within six months after surgery,and the survival rate for 1,3 and 5 years was 22.2％,3.7％ and 0％,respectively,with the median survival of 6 months,and 21 cases of liver metastases were found after six months,and the survival rate for 1,3 and 5 years was 85.7％,30.6％ and 9.2％,with the median survival of 15 months,and the difference between the two groups was statistically significant (P ＜ 0.01).After pancreatic cancer surgery and adjuvant gemcitabine chemotherapy,the probability of liver metastases was 33.3％ (8/24) within six months,the median disease-free survival time was 8 months and the disease-free survival rate for 1,3 and 5 years was 20.8％,4.3％ and 0％.For patients without adjuvant gemcitabine chemotherapy,the probability of liver metastases was 79.2％ (19/24),the median disease-free survival time was 3 months and the disease-free survival rate for 1,3 and 5 years was 4.2％,0％ and 0％,and the difference between the two groups was statistically significant (P ＜ 0.01).The overall survival for patients undergoing resection of liver metastases combined with gemcitabine treatment was better than the other groups (P ＜ 0.01).And the overall survival for patients undergoing transhepatic arterial embolization (TACE) combined with gemcitabine treatment was better than TACE group,gemcitabine group or the observation group (P ＜0.05).There were no difference in overall survival between TACE group,gemcitabine group and observation group.Conclusions Pancreatic cancer patients who develop liver metastasis within six months after surgery have poor prognosis,but postoperative chemotherapy can delay the development of liver metastasis.For patients with resectable lesion,resection of asynchronous liver metastasis is the treatment of choice,and TACE combined with gemcitabine has better efficacy than that of single treatment.

BACKGROUND: Disease pathogenic factors are complicated. There is not an effective method to analyze large sample data mining, and application ability of information technology of clinical doctors needs to be improved. OBJECTIVE: Using BP algorithm of artificial neural network to analyze large sample clinical cases, in order to explore inner relations between disease pathogenic factors and diseases.METHODS: Take hypertension for example, medical data of patients with hypertension in a traditional Chinese medical hospital served as experimental data, and the influence factors of the disease were simulated with Microsoft SQL Server 2005 Analysis Services, the mining data was analyzed, and a single query was used as prediction and decision support.RESULTS AND CONCLUSION: Analysis of effect of disease pathogenic factors on disease itself based on artificial neural network with BP algorithm has good predictive effect in clinical diagnosis, which is of benefit to enhance the diagnostic efficiency of medical personnel using information technology.

Computer science and technology has been used to promote the development of objectification of traditional Chinese medicine (TCM), which is also required for international development of TCM. In this paper, on the basis of current situation of Chinese medicine tongue objective research, the analysis was made on involved computer-related technology, relevant standards, and the future trend was discussed.

Optimization on sustained release preparation formulation is a multi-factor, multi-level complex optimiza-tion problem. Artificial neural network is very suitable for dealing with such complex multivariable nonlinear system. Based on analyzing the characteristics of sustained release preparation and the main influential factors of its quality, this paper focused on building a quality forecast model for sustained release preparation formulation by using BP neural network. The results showed that the BP neural network can effectively forecast the quality of sustained re-lease preparation formulation. It is a powerful optimization tool of sustained release preparation formulation.

Objective To sensitize the T-cell in the peripheral blood of the active tuberculosis pa-tients by rCFP-10/ESAT-6 fusion protein, phytohaemaggiutinin(PHA) and physiologic saline, and to detect the IFN-γ to approach the significance of the tuberculosis infection. Methods One hundred and eleven pa-tients were diagnosed by clinical definite, 292 undergraduate students were chosen by X-ray and PPD-selec-fion as volunteers. 3.0 ml of blood was taken from each volunteer, rCFP-IO/ESAT-6, PHA and physiologic saline were added into each 1.0 ml, respectively. The A valule and antibody of IFN-γ were assayed by ELISA. Results Treated with rCFP-10/ESAT-6 group: the A value average of patients group was 1. 3885±0.6236, students group was 0.2944±0.0917. Intergroup t'=16.4259, P<0.05, set>0.42 as cut-off, the positive rate of patients group was 93.58%, students group was 13.07%. Treated with PHA group: the A value average of patients group was 1.2463±0.5541, of which the other was 0.5613±0.064, t'=19.1797,P<0.05. Treated with physiologic saline group:the A value average of patients group was 0.0772±0.0444,of which the other was 0.0290±0.0235,t'=13.9487,P<0.05. All had significant deviation. The antibody positive rate of the patients group was 66.36%, the students group was 7.19%. Conclusion rCFP-10/ESAT-6 as specific antigen, the sensitivity of IFN-γ release assay by ELISA is above 90%. No matter specific or non-specific disposal, the active tuberculosis patients have higher IFN-γ, release level and antibody than the control group.

Objective To explore the effects of minimally invasive removal of intracranial hematoma on blood-brain barrier (BBB) index, serum myelin basic protein (MBP) and activity of daily living (ADL) in hypertensive patients with cerebral hemorrhage.Methods Through observing 30cases operated within 3.0 hours, 32 case operated between 3. 1-8. 0 hours, 28 cases operated between 8. 1 to 24.0 hours and 22 cases operated over 24 hours, the changes of BBB index, serum MBP and ADL were analyzed. Results The BBB index and serum MBP were significantly lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group:(6.57±0.69)×10-3 and (3. 12±0.40)μg/L;3. 1-8.0 hours group: (7. 37±1.29)×10-3 and (3.25±0.60)μg/L;8. 1-2.0 hours group: ( 12. 02± 1.51 ) × 10 3 and (4. 60±0. 48)μg/L;over 24.0 hours group: ( 14. 68±2.07)×10-3 and (5.88±0.64)μg/L,Q＞13.8,P＜0. 05]. And the ADL was lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group: (2. 60± 1.07)scores; 3.1-8.0 hours group: (3. 06±0. 91 )scores;8. 1-24.0 hours group: (4.00±0.67) scores;over 24.0 hours group:(3.68±1.32)scores,Q＞3. 1,P＜0.05].Conclusions The minimally invasive surgery of intracranial hematoma within 8.0 hours can mitigate the cytotoxicity-damaged BBB so as to lighten brain edema and improve the patients quality of life.