Objective To study the clinical pathological characters of malignant melanoma.Methods To analyze the clinical pathological materials of 86 cases of malignant melanoma.Results The original sites of 49 of the whole 86 cases locate at limbs,among those 26 cases at sole or heel.49 cases of them have melanotic nevus history,36 cases have trauma history.30 cases were diagnosed as carcinomatous change of ulcer before the surgical operation while 51 cases were diagnosed as other pathological diseases.Only 5 cases were diagnosed as malignant melanoma.The major histological type of the 86 cases is the epitheliod cell type,which made 50%(43 cases) of all the cases.61 cases(70.9%) of them has lymphnodes metastasis when the diagnosis was made.Conclusion Malignant melanoma most commonly located at limbs,especially at sole or heel.It's inclined to misdiagnose the disease and the disease is likely to metastasize before surgical operation.Final diagnosis should be confirmed by pathology examination.

Objective To explore the therapeutic effect of total hip replacement (T HR) in treating osteonecrosis of the femoral head (ONFH) after failed internal fixation of femoral neck fracture .Methods From January 2003 to June 2012 ,32 cases (19 left hips and 13 right hips) of ONFH after failed internal fixation of femoral neck fracture were treated with THR .There were 18 males and 14 females with an age range from 35 to 62 years (mean ,50 .6 years) .The ONFH was diagnosed at 8-26 months (mean ,17 .1 months) after internal fixation ;the THR were conducted 15-48 months after first surgery (mean ,27 .2 months) .According to Fi‐cat classifi cation ,there were 8 cases at stage Ⅲ and 24 cases at stage IV .The Harris score was (40 .9 ± 9 .8) .The prosthesis of bi‐ology was used .Results All wounds healed by first intention .All cases were followed up for 6-48 months (mean ,28 .3 months) . The Harris score was (90 .8 ± 4 .4) at last follow‐up ,showing significant difference when compared with the preoperative value (P<0 .05) .The hip function were excellent in 25 hips ,good in 5 hips ,fair in 2 hip ,and the excellent and good rate was 93 .8% . There were 1 cases of periprosthetic femoral fracture(type C) ,2 cases of proximal femoral splitting fractures fractures .After corre‐sponding treatment ,fracture was healed in all cases .There were no complications (infection ,loosening dislocation or subsidence , etc) .Conclusion Total hip replacement is an effective method for the treatment of ONFH after failed internal fixation of femoral neck fracture .

BACKGROUND:Mkx (Mohawk, transcription factor) is one of the crucial factors in tendon formation, development and differentiation.
OBJECTIVE:To summarize the molecular structure, distribution and function of Mkx and its research process in the signaling pathways during tendon differentiation.
METHODS:The first author retrieved the databases of CqVip, CNKI and Medline from1990 to 2016 using the keywords of“Mkx, Mohawk, Irxl, tendon, tendon differentiation, tissue engineering, TGFβ, stem cel”in Chinese and English, respectively. The articles related to research process of Mkx in tendon tissue engineering were retrieved, and a total of 55 literatures were enrol ed final y.
RESULTS AND CONCLUSION:Mkx that expresses in various mesoderm-derived tissues plays an important role in the formation and development of tendon and tissue-engineered tendon formation. Although Mkx does not directly act on Scx (Scleraxis), it can regulate the differentiation of tendon progenitor cel s via transforming growth factor-β2 signaling pathway. Cel s from different species and different cel lines as wel as various cytokines for certain make different effects on Mkx involved in tendon tissue engineering.

Magnetic motor evoked potentials (MEP) were measured in 46 patients with Graves′ disease (GD) and 50 normal controls, and its latency、amplitude and central motor conduction time (CMCT) were recorded. Prolonged latency, lowed amplitude and shortened CMCT in MEP suggest the damage of the neurons.

Objective To identify the potential risks in the process of nursing care for children with tracheal foreign body removal and improve the skills and the process, to promote the quality of nursing care and the success rate of tracheal foreign body removal. Methods The failure mode and effect analysis (FMEA) were used to analyze the potential risks in children with tracheal foreign body removal, preoperative, intraoperative and postoperative care, and to find out the possible risks in each medical treatment. For pediatric venous puncture technology was not skilled, surgical position placement inappropriate (especially in the case of foreign body removal surgery posture), surgical instruments and equipment management, intraoperative nursing cooperation and observation of the disease, postoperative transfer and other aspects of the transfer of training and improvement. Results The medical risk value (RPN) in the treatment of pediatric tracheal foreign body removal in the process of nursing in the control group was reduced from 1 284.2 to 213.2 of the experimental group. The average value of doctors' satisfaction was increased from 79.33% in the control group to 93.33%in the experimental group, P<0.05, the difference was statistically significant. Conclusions The use of FMEA in the treatment of pediatric tracheal foreign body removal surgery care and medical risk management improve the quality of surgical care and help improve the success rate of tracheal foreign body removal. It also ensures the safety of the children in the operation process and improves the quality of nursing work.

BACKGROUND: The traditional treatment for skin donor site wound was focus on anti-infection and wound protection, which roof a long time for healing. Studies demonstrated that recombinant human epidermal growth factor (rhEGF) has accelerated effect or epidermal regeneration. OBJECTIVE: To observe the effect of rhEGF on wound healing of skin donor site. METHODS: A total of 32 cases needs wound healing by skin grafting were collected, including 18 males and 14 females. The 32 skin graft donor site wounds were randomly divided into control and treatment groups. In the treatment group, the absorbent gauze was sprinkle soaked with rhEGF (15 mL/ramus, 2 000 IU/mL) and covered the donor site, twice per day. In the control group, donor site was covered by physiological saline gauze and wrapped with dressing, twice per day. After 48 hours, semi-exposed therapy was performed. The healing time of wounds, the systemic and local adverse reactions of patients and blood routine examination and renal function detection prior to and after treatment were observed. RESULTS AND CONCLUSION: The healing time of wound in the rhEGF treatment group was shorter than that in the control group with significant differences (P < 0.01). No Adverse events or side effects were observed in the rhEGF treatment group. rhEGF can shorten wound healing time, reduce scar hyperplasia, and accelerate epithelization at the graft donor.

BACKGROUND:Legacy posterior stabilized prosthesis has advantages in theoretic design,in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes for vaglus knee deformity are better than Legacy constrained condylar knee prosthesis. OBJECTIVE:To explore the midterm folow-up effect of Legacy posterior stabilized prosthesis in total knee arthroplasty in patients with valgus knee deformity. METHODS: From February 2006 to November 2013 in Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical Colege, total knee arthroplasty was used to treat valgus knee deformity in 33 cases (35 knees). Parapatelar medial approach was used. Precise osteotomy was utilized to correct limb alignment. Lateral soft tissue received selective release. Finaly, an equal type of Legacy posterior stabilized prosthesis (Zimmer, USA) was implanted and fixed with antibiotic bone cement. The differences in hospital for special surgery knee score, range of motion of knee, femoral tibial angle, and maximum flexion and extension angle, as wel as X-ray film results were compared and analyzed before and after replacement. The complications including deep vein thrombosis, peri-prosthetic infection, patelar clicking, unstable knee, and common peroneal nerve injury were recorded after surgery. RESULTS AND CONCLUSION: Al patients were folowed up for 24-50 months. The incision was healed in one-stage. No complications such as peri-prosthetic infection appeared. Three patients suffered from common peroneal nerve palsy, which was cured at half a year after surgery by expectant treatment such as trophic nerve. Two cases suffered from knee instability after replacement, which was improved at 1 month after external fixation with a brace. One case experienced deep vein thrombosis in the lower extremity, which was improved after treatment with low molecular weight heparin anticoagulation. During final folow-up, hospital for special surgery knee score increased from (51.85±4.15) preoperatively to (85.77±2.50) postoperatively (P < 0.01). There were excelent in 20 knees, good in 11 knees, with an excelent and good rate of 89%. X-ray films showed that hindlimb alignment was apparently corrected, prosthetic position was good, no loosening occurred. These data indicate that total knee arthroplasty, using parapatelar medial approach, obtained good correction outcomes through the accurate amputation to correct hindlimb alignment and selective release of the soft tissue with Legacy posterior stabilized prosthesis in the treatment of valgus knee deformity.

BACKGROUND:Considering the risk of lack of bone in revision and the bone coverage of component,it is advisable to use bone grafting to increase bone stock in patients with adult Crowe type Ⅲ developmental dysplasia of the hip (DDH) in the first total hip arthroplasty (THA).OBJECTIVE:To investigate the effectiveness of impaction bone grafting with morselized bone and bone paste for acetabular defects of adult Crowe type Ⅲ DDH in THA.METHODS:Forty cases (45 hips) of Crowe type Ⅲ DDH were enrolled,including 8 males and 32 females,aged 31-68 years.All the components were reconstructed at the anatomic acetabulum combined with deepening acetabulum and putting the centre of rotation medially and distally during THA procedures.The patients were all followed up and evaluated with Harris score,limp length,displacement of the centre of rotation,cup coverage,and postoperative complications.RESULTS AND CONCLUSION:The average follow-up was 32.7 months.Acetabular rotation centers of all the cases were recovered (near) to normal.The incisions healed by first intention and there was no complication such as infection,dislocation,prosthesis loosening.The acetabular cup prosthesis did not displace and was covered well by bone at the last follow-up,the grafted bone particles got radiological osseointegration and the bone sclerosis zone disappeared.No radiolucent lines and screw fracture were detected.The Harris scores of affected hips at the last follow-up were significantly higher than those before surgery(P=0).The average leg length was increased (2.31 ±0.18) cm.The mean cup coverage was 78.1％.The postoperative horizontal and vertical distance of the hip center were shorter than those before surgery (P=0).Reconstructing the acetabulum with autogenous morselized bone graft impaction can effectively restore the acetabular coverage,maintain the stability of acetabular cup and provide better relative bone stock in THA for Crowe type Ⅲ DDH in adult,and moreover,the short-term effect is satisfactory.

Objective To analyze the outcome of patients receiving intrauterine insemination with husband sperm,in order to evaluate the effect of relative factors on pregnancy rate after intrauterine insemination. Methods Ninety-eight infertile couples who received intrauterine insemination in the Affiliated Hospital of Nantong University from March 2013 to May 2014 were selected as our subjects and 181 cycles were included. The information including clinical factors including maternal age,infertile time,infertile causes, ovulation induction protocol,time of insemination and postwash total motitle sperm(TMS)and pregnancy rate were recorded. Results (1)Totally 26 patients received clinical pregnancies,and clinical pregnancy rate(CPR) was 14. 36% per cycle. With age increase pregnancy rate decreased( χ2 = 1. 654 9,P = 0. 647).(2)The pregnancy rate of the patients was the same within the infertile time( χ2 = 1. 588 5,P = 0. 662).(3)The pregnancy rate of the patients with secondary infertility was lower than that of the patients with primary infertility,but there was no significant difference(χ2 = 0. 923 3,P = 0. 337).(4)The pregnancy rate of ovulation induction cycles was lower than that of nature cycles,but there was no significant difference(χ2 = 2. 222 0,P= 0. 136).(5)Postwash TMS was showed the same trend(χ2 = 0. 643 4,P = 0. 422). Conclusion In terms of intrauterine insemination with husband sperm,age,infertile time,infertile types,ovulation induction protocol and posrwash TMS can affect pregnancy rate,and the effects of various factors should be considered comprehensively in the process of therapy.

BACKGROUND:The decel ularized porcine smal intestinal submucosa is a kind of bioactive extracel ular matrix, which is mainly composed of col agen, glycoprotein, proteoglycan and rich in col agen, glycosaminoglycan and various growth factors, and these components play an important role in promoting the differentiation and proliferation of tissue cel s. OBJECTIVE:To prepare the injectable smal intestinal submucosa and to investigate its co-culture with rat adipose-derived mesenchymal stem cel s in vitro. METHODS:The injectable smal intestinal submucosa and rat adipose-derived stem cel s were prepared. Cel counting kit-8 test for cel proliferation:Passage 3 adipose-derived stem cel s were seeded onto the injectable smal intestinal submucosa (experimental group) and cel s cultured under normal condition as control group. The cel proliferation was observed at 1, 3, 5 and 7 days of incubation. Live/dead staining test for the survival of cel s:Passage 3 adipose-derived stem cel s were respectively cultured in the injectable smal intestinal submucosa extracts (experimental group) and complete culture medium (control group). Cel survival was determined at 1, 3, 5 and 7 days of culture. RESULTS AND CONCLUSION:Scanning electron microscope oval and strip adipose-derived stem cel s adhered onto the material. The absorbance values in the experimental group were higher than those in the control group at 1 and 5 days of incubation (P<0.05). Cel survival:The number of cel s appeared to be in a rising trend with time in both two groups;after 1-day co-culture, al cel s in the two groups survived. Then dead cel s appeared in both two groups, showing no significant difference. These results show that the injectable smal intestinal submucosa exhibits a good cytocompatibility.