Background and purpose:Norcantharidin(NCTD)can inhibit the growth of tumors.In this study,we presented the chorioallantoci membrane(CAM)model to evaluate the effect of NTCD on angiogenesis and to study the anti-angiogenesis of NTCD in the chicken embro implant model of human breast carcinoma MCF-7 cells.Methods:The method was based on the implantation of gelatin sponges on top of growing CAM.The sponges were treated with various amounts of NCTD and 0.9% NaCl.Blood vessels surrounding CAM mesenchyme were counted.Then we established the MCF-7 chicken embryo implant model.The chicken embryo CAMs was treated with 0.9% NaCl,Various amounts of NCTD(72,36,18 ?g per 20 ?l)and the inhibition rates were calculated.Results:NCTD can inhibit the new capillary vessels growing into gelatin sponges placed on the CAM in a dose-dependent manner,and the inhibitory rates were 77.7%,62.9%,50.6% and 33.0% respectively.NCTD at the dosages of 72、36、18 ?g were able to inhibit capillary growth regardless of the angiogenic process induced by xenograft tumor and had a significant inhibition as compared with the control group,and the rates were 66.2%,39.3%,22.8% respectively.Conclusions:NCTD has an anti-angiogenic effect for targeting tumor angiogenesis.NCTD may be a potential therapeutic candidate for clinical application.

Objective The investitgation of vascularized periosteal flap with dorsal branch of anterior interossea vessel was performed to provide anatomical basis for periosteal flap transposition. Methods The courses, branches, distribution and anastomosis of the dorsal branch of anterior interossea vessel were observed on 30 sides of adult cadavers' upper extremities and stimulated operation were perfomed. Results The dorsal branch penetrate out of interosseous membrane of forearm at (6. 6? 1. 4) cm upper the styloid process of the radius. It also sent off branches to the dorsal of ulna and radius that consist the periosteal flap. The dorsal branch send off lateral and medial branch about (2. 6?0. 8) cm upper the styloid process of the radius. The end of the branch anastomoses with dorsal carpal branch of the ulnar and radial vessel' Conclusion The pedicled osteoperiosteal flap can be transferred for repairing the fracture nonunion of ulna and radius and transpose reversely to repair scaphoid and innate bone disease'

Objective To investigate the depressive disorders in patients with respiratory diseases and analyze the countermeasures against it to provide reference for improving clinical treatment compliance. Methods 80 cases was selected according to the screening and exclusion criteria from 262 patients with respiratory diseases from January, 2014 to December, 2015. Then divided them randomly into treatment group and control group. The SDS and SAS show no statistical signiifcance before treatment (P>0.05). The control group with clinical disease symptomatic and supportive treatment, the treatment group combined with anti-anxiety treatment on the basis of clinical symptomatic and supportive group. Then compare the SDS, SAS and dyspnea improvement between the two groups before and after treatment. Results The SDS and SAS scores showed no significant difference before treatment (P>0.05). While after treatment, the SDS and SAS scores in treatment group were signiifcantly lower, and lower than the control group, the difference was statistically signiifcant (P<0.05). The condition of dyspnea of the two groups show no difference before treatment (P>0.05). After treatment, the condition of dyspnea improved greater in treatment group than the control group, the difference was statistically signiifcant (P<0.05). Conclusions Because the respiratory disease of patients suffered leads to psychological burden, negative emotional depression anxiety appears not well with the clinical work, by using Deanxit improve patient confidence and compliance, there is a certain positive to improve the clinical symptoms with good clinical value.

Objective To investigate and evaluate the clinical effect of the direct popliteal artery perforator flap.Methods Thirty embalmed lower limbs of adult cadavers which perfused with red latex were used to dissection,major observations were the origin,perforators and anastomoses regulations of the direct popliteal artery.Based on the anatomical study,direct popliteal artery perforator flaps were designed and used clinically to 7 patients who had soft tissue defects in popliteal fossa.Results The direct popliteal artery perforator was direct started from lateral wall of the superior segment of popliteal artery,and about 7-11 cm above knee joint.Then it goes up along the middle line of posterior region of thigh,and pierced from the carvity between semitendinosus and biceps femoris and gave off several branches in superficial fascia.Finally,these branches anastomoses with many perforating branches which were gave off form deep femoral artery (the 1st to 3rd perforator artery),obturator artery and lateral circumflex femoral artery.Clinically,all flaps were survived eventually,and 6 of them were healed quickly,only 1 case needed to change dressings to healed its partial necrosis for the pedicle had too much soft tissues and too swelling to block its blood supply.After 2-12 months of following-up,the colors and appearances of these flaps were excellent,and the function of knees were nearly normal.Conclusion Direct popliteal artery perforator flap has relatively constant location and sufficient blood supply to use in clinical application,it is safe and easy to use for recovering soft tissue defects in popliteal fossa.

ObjectiveTo discuss the clinical efficacy of distal medial arm perforator flaps.MethodsAccording to the basic anatomy of distal medial arm perforator flaps,the distal medial arm perforator flaps were designed for repairing skin defects around elbow joints and at upper part of forearms in 15 cases.ResultsAll flaps were survived and first intention of wounds was obtained.At 3-36 months of follow-up,flap shape and elbow joint function revealed satisfactory recovery.Conclusions With the constant anatomical position,good blood supply,safe surgical approaches and cryptic donor site,the distal medial arm perforator flap is an alternative to repair the skin defects around elbow joints and in proximal forearms.

Objective Through investigating the anatomical features of the perforator from the ulnar palmar digital artery of the little finger and the dorsal descending branch of the ulnar artery,to establish a new approach for the reconstruction of sofi tissue defect of the ulnar palm and the little finger.Methods The fifth caput metacarpale was taken as the observation points on 30 specimens of adult human upper limb perfused with red latex.Something as follows were observed under surgery magnifier:①The origin,external diameter,branches,distribution and the backbone length of the perforator of the ulnar palmar digital artery of the little finger;the distance from the fifth caput metacarpale to the perforate artery ; ② The route and distribution of the dorsal descending branch of the ulnar artery.Mimic operation was performed on another fresh specimen.Results The origin of the ulnar palmar digital artery of the little finger has two different type:93.3％ spring from the external of the arcus volaris superficialis,6.7％ formed by the combination of the third arteriae metacarpeae palmares and the branch from arcus volaris profundus.Although it has two different origins,the perforator has only one piercing point,which located at (1.3 ±0.3)cm upon the fifth caput metacarpale.The perforator,ultimately,combines with the descending branch of the ulnar artery after it pass through the slot between the muscle tendon of hypothenar superficial layer (the flexor digiti minimi brevis and the abductor digiti minimi) and the fifth metacarpale bone.External diameter of the perforator was (0.8 ± 0.4) mm and the backbone length was(2.0 ±0.6)cm.Conclusion The location of the anastomose point between the perforator,which springs from the ulnar palmar digital artery of the little finger,and the dorsal descending branch of the ulnar artery is constant.The perforator flap based on the perforator of ulnar palmar digital artery of the little finger,with sufficient blood supply,can be transferred flexiblely,and can be designed to repaire the defect of soft tissue on the ulnar palm and the little finger.

BACKGROUND: Distally based flap pedicled with the distal nutritional vessels in forearm is especially suitable for reconstructing the tissue defects in the distal end of hands, while high rotation point cannot satisfy the requirements of reconstructing the distal injuries or defects in hands, and severer lesion may even be caused in the donor site.OBJECTIVE: To study the anatomic proceeding of artery perforators in distal radial margin of forearms, so as to provide anatomic basis for the design of distally based compound flap pedicled with the nutrient vessel of cephalic vein in distal radial margin of forearms.DESIGN: Single sample experiment.SETTING: Center for Clinical Anatomy of the Department of Orthopedics,Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command.MATERIALS: The experiment was conducted in the Laboratory of Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command between August and December 2004. The upper extremities of 30 cadavers injected with a mixture of red gelatin into the artery (provided by the Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command) were adopted.METHODS: The vascular external diameter and distance were measured with sliding caliper and ruler with radial styloid process as the marker.MAIN OUTCOME MEASURES: ① The perforator artery in distal radial margin of forearms. ② The nutrient vessels of cephalic vein. ③ The relationship of blood supply between the nutrient vessels and vicinal bone and skin as well as the lateral antebrachial cutaneous nerve. ④ The superficial and deep communicating branches of cephalic vein.RESULTS: The perforator artery in distal radial margin of forearms derived from: 6-11 cutaneous branches of radial artery with external diameter of (0.7±0.3) mm; 2-6 cutaneous branches of superficial palma with the external diameter of (0.5±0.3) mm; 1-2 recurrent cutaneous branches of the styloid process of radius with the external diameter of (0.5±0.1) mm; 1-2 cutaneous branches of snuff tobacco with the external diameter of (0.6±0.2) mm. At 8.0-15.0 cm above radius styloid process there were 1-3 intermuscular cutaneous branches of radial artery with an initial external diameter of (1.1±0.2) mm, distributing in the exposureregion and corresponding skin of middle and inferior segments in radius. The above-mentioned perforator arteries all developed into cutaneous branch, fascia branch, periosteum branch, cephalic vein and nutrient vessel branch of distal cutaneous nerve,and constituted the vascular chain, the by-pass of cephalic vein, vascular chain of cutaneous nerve stem as well as superficial, deep fascias and periosteal vascular net.CONCLUSION: The perforator artery in distal radial margin of forearms is the source of nutrient vessels in cephalic vein, while the nutrient vessels share an isogeny with the nutrient vessels derived from vicinal bone, skin and lateral antebrachial cutaneous nerve, which provide an anatomic basis for designing the distally based compound flap pedicled with the nutrient vessels of cephalic vein. The rotation point of compound flap pedicled with the recurrent branch of radius styloid process (or branch of snuff tobacco) can reach the surface of rotation joint, which can be adopted in the transposition and reconstruction of distal tissue defects in hands.

AIM:Mesenchymal cells migrating towards fracture site and differentiating into chondrocytes and osteoblasts is the key process during fracture healing. This article is aimed to observe the changes of the expression of bone morphogenetic protein(BMP)-2 in the early stage of tibia fracture in osteoporotic rats so as to evaluate the reason of delayed fracture healing in osteoporotic rats. METHODS:The experiment was conducted at the Key Laboratory for Oral Biomedical Engineering of Ministry of Education from August 2005 to October 2006. ①Sixty-four 6-month-old female SD rats were randomly divided into ovariectomized(OVX) group and control group with 32 in each group. ②The rats in the OVX group underwent ovariectomy to establish type Ⅰ osteoporotic models. A small quantity of fat tissues was removed in the control group. Three months later,standardized tibia fracture was introduced. ③Eight rats were selected at days 7,14,21 and 28 after operation in the two groups. Some soft tissues around tibia and broken ends of fractured bone,bony callus,cortical bone and medullary canal were collected and treated with histological analysis,immunohistochemical staining,semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR),respectively. RESULTS:①Histological analysis showed membrane bone formation and endochondral bone. A mass of chondrocytes appeared in bony callus of the OVX group at days 21 and 28 after operation. ②The results of immunohistochemical staining showed that mean absorbance(A) of BMP-2 was higher in the control group than the OVX group at days 7 and 14,but lower at day 21. ③The findings of RT-PCR revealed that BMP 2 level was higher in the control group than the OVX group at day 7,but lower at day 14. CONCLUSION:BMP-2 plays a key role in the early phase of bone callus formation during fracture healing. The declined and delayed expression of BMP-2 in osteoporotic rats may be an important reason for delayed fracture healing in osteoporotic rats.

Objective To observe the anatomy of the perforator flap of the posterolateral midforearm. Methods Lateral condyle of the humems wag taken as the observation mark on 30 specimens of adult upper limb perfused with red latex.The surgical magnifier Wag used to obse~e the origin,branches and distribution of the perforating branches of the posterolateral midforearm as well as alanagtomosis between perforating branches and peripheral vessels.Mimic operation WaS performed on the two sides of the fresh specimen.Results The perforating branches of the posterolateral midforearm originated from the radial musculoculancous branches of the posterior interosseous artery,the intermuscular branches of the radial artery and the direct periosteal branch of the radial artery had relatively stable location of piercing the deep fascia.Then,the perforating branches of the posterolateral midforearm pagsed through the deep fascia to the subcutaneous part among the spatium intermusculare of extensor digitorum and extensor carpi radialis brevis,supinator and abductor pollicis longus(within 12.5-15.8 cm below the lateral condyle of the humerus).Large number of small blood Vessels were also separated and closely aligned with the musculoculancous branches vascular,perineural and neural stem vascular chain of lateral branches of posterior antebrachial cutaneous nerve.Then,the vascular plexus was formed along the spatium intermusculare and lateral branches of posterior antebrachial cutaneous nerve longitudinal axis between extensor digitorum and extensor carpi radialis brevis. Conclusion The axial pattern flaps or cross-regional blood supply skin flap pedicled with the perforating branches of the posterolateral midforearm Can be formed to repair the soft tissue defect of tlle forearm and wrist.

Objective To explore the clinical application of perforating branch flap of medial vastus muscle. Methods Perforating branch flap (muscle branch) of medial vastus muscle was designed by using the surface projection of the medial vastus muscle artery as flap anxial line and the given point of direct cutaneous artery as flap center to repair skin and soft tissue defects of the knee in seven patients.Results All flaps survived well with primary healing in all patients, with one stage healing. After a follow-up for 1-18 months, all flaps turned out to be with good texture and satisfactory appearance and function of the flaps. Conclusion The surgery of perforating branch flap of medial vastus muscle is simple,safe and easy handling and provides a new feasible surgical procedure to repair skin and soft tissue defects of medial femur and around the knee.