Objective To investigate the expression of ERCC1 in smoking patients with advanced non-small cell lung cancer(NSCLC) and its relationship with clinical features and prognosis.Methods The expression of ERCC1 was detected in 96 patients with advanced NSCLC by PCR assay.The clinicopathologic factors, treatment effect and survival time were observed.Results The expression of ERCC1 was related to smoking index(P=0.029), but it was not related to other clinicopathological factors.The patients with low expression of ERCC1 had better response rate and median survival time when compared to those with high expression patients.The difference was statistically significant(P=0.001,P<0.01).Conclusion ERCC1 expression is associated with smoking index and the patients with low expression of ERCC1 shows higher chemotherapy efficiency and longer median survival than patients with high expression, which indicates that detection of ERCC1 may be a useful parameter in evaluating the therapeutic effect and prognosis of smoking patients with advanced NSCLC.

Objective To observe the effect of the rivaroxaban and low molecular weight heparin calcium to prevent deep vein thrombosis (DVT) after artificial joint replacement. Methods 167 patients included 114 cases for total hip arthroplasty and 53 cases for total knee replacement from Novermber, 2009 to October, 2010 were divided into two groups: observation group (n=84) was treated with rivaroxaban tablets, 6 h after surgery, 10 mg/d, 2 weeks for knee arthroplasty, 5 weeks for total hip arthroplasty; and control group (n=83) was treated with low molecular weight heparin calcium 2500 IU 2 h before and after surgery for 5 d. Ultrasonography was used to detect the deep vein lumen size change and DVT rate of bilateral lower extremities in all patients before and after surgery. Activated partial thromboplastin time (APTT) was tested before surgery, and 2 d, 5 d, 7 d, 14 d, 35 d after surgery. Results ① Incidence of DVT showed that there were 9 cases (10.7%) with DVT in the observation group; there were 15 cases with DVT (18.1%) in the control group. ② Lower limb deep vein lumen size change comparison: there were 23 cases (27.4%) with superficial femoral vein stenosis more than 2 mm in the observation group while 38 cases (45.8%) in the control group, there were 27 cases (32.1%) with popliteal veins stenosis more than 2 mm in the observation group and 47 cases (56.6%) in the control group (P<0.01). ③APTT: APTT prolonged >10 s was 0 in the observation group while 23 cases (27.7%) in the control group (P<0.01). Conclusion Trivaroxaban may prevent DVT after artificial joint replacement and be better than low molecular weight heparins calcium.

Objective To observe the clinical effect of mouse nerve growth factor on protrusion of the lumbar intervertebral disc (LDP) treated with operation. Methods 60 cases with LDP received posterior lamina resection nucleus pulposus decompression excise pedicle screws fixation, in which 30 cases (the treatment group) accepted mouse nerve growth factor for 30 d. Their symptoms and signs, visual analogue score (VAS) for pain, and the electromyogram were recorded before and after treatment. Results The VAS in the treatment group improved more than in control group (P<0.05). the incidence of cure and improvement (76.7%) was higher than in the control group (50.0%)(P<0.05). The nerve conduction velocity and action potential of main muscle group also improved more in the treatment group (P<0.05).Conclusion Mouse nerve growth factor can improve the recovery of pain as well as the neural function in patients after operation for LDP.

Objective To examine the effect of ultrasonic debridement combined with continuous skin stretching to repair refractory infective wound bed.Methods From January 2016 to July 2016,we treated 15 cases of chronic,refractory infective wound beds using ultrasonic debridement combined with skin stretching technique.Results All the 15 (100％) cases were cured without necrosis of the stretched skin edges.Conclusions Ultrasonic debridement combined with continuous skin stretching is an appropriate technique for repairing the refractory wound bed in the patients who are older,in poor general condition,or poor condition of local skin and soft tissue,or have poor postoperative effect,or surgical contraindication or at higher risk of surgery.

Objective To discuss clinical efficacy of patients treated with surgical treatment for posttraumatic elbow stiffness combined with pain.Methods From January 2011 to December 2014,release treatment was performed on 32 cases of posttraumatic contracture of the elbow combined with pain by operation.There were 22 males and 10 females,at average age of 39 years(range from 18 to 65 years).25 cases of these patients with mild-to-moderate pain got a simple elbow release operation.There were 4 cases of severe pain patients complicated with elbow dislocation,after fully release the elbows,reduction was performed under the direct;Both elbow arthrolysis and dermal transplantation interval type elbow arthroplasty were performed in 3 cases of severe pain patients which had severe osteoarthritis.A total of 26 patients were installed hinged external fixator after operation for early functional exercise.Results All patients were followed up for an average time of 14 months(from 12 to 18 months).All patients were significantly improved in the range of elbow and pain symptoms.Postoperative joint function improvement:2 patients with severe stiffness improved to moderate stiffness,19 patients with moderate or severe stiffness improved to mild stiffness,and the remaining of 11 cases without stiffness,The improvement rate was 100％.Postoperative pain:6 cases of moderate or severe pain relieved for mild pain,26 patients pain disappeared,the pain relief rate was 100％.Mayo elbow performance score were evaluated before and after surgery.Preoperative score:the results were good in 6 cases,fair in 14 cases and poorin 12 cases;postoperative score:excellent in 20 cases,good in 8 cases and fair in 4 cases,the good rate is 87.5 ％.The difference between preoperation and postoperation was statistically significant (P＜0.05).Conclusion Elbow arthrolysis combined external fixation is beneficial to early functional rehabilitation and restoring the flexion and extension function of stiff elbow,at the same time,the pain caused by stale dislocation or arthritis of elbow can also get good effect.

Objective: To summarize the effect of propeller flap pedicled with cutaneous branch of digital artery for skin defect at children’s thumb tip. Methods: From December 2012 to October 2015, 12 children with skin defects at thumb tip were treated. The nail matrix was kept in 4 cases, partly injuried in 8 cases. The skin defects size ranged from 1.0 cm×1.0 cm to 1.5 cm×2.0 cm, all more than the size of nail roots. A triangular flap on lateral side of thumb was designed with cutaneous branch of digital artery on thumb ulnar side at wound edge. The defects at donor sites were covered with skin grafts. Results: The flap size ranged from 1.0 cm×1.0 cm to 1.5 cm×2.0 cm. All the flaps and skin grafts survived with primary healing. The children were followed up for 6-12 months(average, 8 months). The flaps had soft texture and good color match and thickness. The cosmeticresult was satisfactory with normal nail growth. According to the standard of the hands of the Chinese Medical Association functional evaluation trial, the hand function was assessed as excellent in 9 cases, good in 3 cases 6 months after operation. Conclusions Propeller flap with cutaneous branch of digital artery is suitable for the skin defect at children’s thumb tip with both satisfactory cosmetic and functionalresult . Themethod is easily performed with reliable venous drainage and less morbidity.