Objective To report the outcome of emergency repair traumatized limbs by vascularized free tissue transplantation.Methods From April 1988 to August 2004,86 patients,58 men and 28 women,had undergone emergency vascularized free tissue transplantation to have their injured limbs repaired in 54 cases and the missing thumbs reconstructed in 32.The patients aged from 5 to 55 (mean 27.9) years. The transplants included latissimus dorsi myocutaneons flap,anterolateral femoral skin flap,medial crural skin flaps,dorsal pedal flaps,medial plantar flap,composite tissue mass of the discarded limbs and big toe skin- nail flap.The operations were performed 1 to 5 days after injuries.Results Postoperative vascular crises occurred in 8 cases and were all followed by exploration with successes in 5 cases while failure in 3.The total survival rate of the transplants was 96.5% (83/86).In this series all the patients were followed up for 1 to 16 years with a mean of 7.5 years only to reveal satisfying functional recovery in all the repaired limbs and an ex- cellent and good rate of 87.5% in the reconstructed thumbs.Conclusion Emergency vascularized free tis- sue transplantation is an effective way to repair a traumatized limb and to reconstruct a traumatically missing thumb.

Objective To investigate the prognostic factors of survival time of the Uygur and Han nation-ality elderly patients( over 60 years) with pancreatic cancer in Xinjiang.Methods We carried on a retrospective study of 313 aged patients diagnosed with pancreatic cancer in The First Affiliated Hospital of Xinjiang Medical University from January 1st,2003 to May 30th,2015.We used Kpalan-Meier method for calculation of survival, used Log-rank method for those factors which could affect the prognosis of patients,at last we used Cox propor-tional risk model for those multiple factors which match the role.Results Three hundred and thirteen cases with pancreatic cancer had a median survival of 157 days,and survival rates of half a year,1 and 2 year were 34.8%, 18.5%,7.0%.There was a statistic difference between Uygur patients′and Han patients′survival time(P<0.05).Single factor analysis showed the nationality,tumor size,surgery,ZPS(ECOG),Clinical stage(TNM), chemotherapy and radiotherapy,carcino-embryonic antigen(CEA)level and cancer antigen 199(CA199)level before treatment with outcome(P<0.05).Multiple factor analysis showed that the clinical stage,surgery(P<0.05)can be regarded as independent prognostic decision factors.Conclusion The clinical staging,surgical treatment could be regarded as independent prognostic factors for the elderly prognosis of pancreatic cancer.Both of the Han and Uygur patients,earlier discovered and more appropriate surgery treatment are the key for the elder-ly patients with pancreatic cancer.

Objective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.

Background Stromal-derived factor 1α /chemokine receptor 4(SDF-1α/CXCR4) axis is one of the important signals which mediates several different activities such as chemotaxis,adhesion,proliferation and survival resulting in recruitment to sites of immune and inflammatory reactions.Considerable evidence suggests that CXCR4/SDF-1α axis is involved in tumor angiogenesis and plays a key role in the development of ocular neovascularization.Objective The purpose of this study was to explore the effect of CXCR4 antagonist on the development of cxperimental corneal neovascularization(CNV).Methods CNV model was established in the left eye of 8-weekold clean BALB/c mouse by putting the filter with 1 mol/L NaOH at the central cornea for 40 seconds.The animals were randomizcd into hyaluronate group and CXCR4 antagonist group,and the edydrops was topically administered respectively on the day of modeling 4 times per day for 14 days.CNV was examined under the slit lamp at the fourteenth day,and then the corneal suspension and section were made.Expressions of CXCR4 mRNA and protein in corneas were detected using RT-PCR and Western blot.The CD31 level in cornea was assayed by flowcytometry and immunochemistry.The expression of VEGF in burned corneas and suspension from mouse peritoneal macrophages stimulated with CXCR4 antagonist in vitro was detected by ELISA.The use of the animal followed Ragulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Two weeks after corneal alkali burn,the growth of CNV peaked under the slit lamp.Compared with hyaluronate group,CNV was obviously decreased in the CXCR4 antagonist group.Immunochemistry showed that intensity of positive staining for CD31 in cornea in the CXCR4 antagonist group was weaker than the hyaluronate group.Flowcytometry clarified that CD31 positive cells rate was 9.50％ ±2.34％ in the CXCR4 antagonist group and 17.50％ ±3.16％ in the hyaluronate group,showing a significant difference between them (t=-7.312,P＜0.05).In 2,4,7 days after cornea alkali burn,the expressions of CXCR4 mRNA and protein were significantly enhanced in burn corneas compared with normal corneas(P＜0.01 ;P＜0.05).ELISA showed that the VEGF expression level in corneal tissue and supernatant of mouse peritoneal macrophages in vitro were significantly lower in the CXCR4 antagonist group than that of hyaluronate group(t =10.927,5.151,P＜0.05).The expression level of VEGF in corneal suspension was lower in the GM-CSH+CXCR4 antogonist group than that in the GM-CSH group (P＜0.05).Conclusions CXCR4 antagonist can reduce experimental CNV by down-regulating VEGF expression in cornea.

Objective: To select the telomerase positive cancer cell lines of gastrointestinal tract and to provide a convinced methodology for future telomerase study. Methods: Fifteen cancer cell lines (carcinoma of stomach 4, of liver 6, of pancreas 2, of colon 3) were cultured and telomerase activity were detected by TRAP-ELISA. The normal hepatic cells were taken as control. Results: Thirteen cell lines were telomerase positive in the 15 lines(86.7%). Conclusion: Most of gastrointestinal tract cancer lines express telomerase, indicating the detection of telomerase activity has clinical potential.

Objective: To select the telomerase positive cancer cell lines of gastrointestinal tract and to provide a convinced methodology for future telomerase study. Methods: Fifteen cancer cell lines (carcinoma of stomach 4, of liver 6, of pancreas 2, of colon 3) were cultured and telomerase activity were detected by TRAP-ELISA. The normal hepatic cells were taken as control. Results: Thirteen cell lines were telomerase positive in the 15 lines(86.7%). Conclusion: Most of gastrointestinal tract cancer lines express telomerase, indicating the detection of telomerase activity has clinical potential.

Objective: To study the effect of intracellular-free calcium and the expression of Fas and Fas L on the process of pancreatic carcinoma cell apoptosis. Methods: Apoptosis induced by 2 μmol/L arsenic trioxide in pancreatic cancer cell lines SW-1990 was investigated.Concentration of intracellular-free calcium （［Ca2+］i） was determined by Fura-2a fluorescein load technique. Fas and FasL were determined by flow cytometry. Results: Pancreatic cancer cells treated with 2 μmol/L arsenic trioxide presented apoptotic features: intact cell membrane, chromatin condensation, nucleic fragmentation and apoptotic body formation; agarose electrophoresis showed marked ladder; flow cytometery analysis showed a sub-G1 cell peak. In the process of pancreatic carcinoma cell apoptosis Fas and FasL and the ［Ca2+］i were significantly higher than that in the control. Conclusion: The pancreatic cancer cell apoptosis induced by arsenic trioxide is related to Fas and FasL expression by the cancer cells and the ［Ca2+］i increase in the cancer cells.

Objective： The aim of this study was to observe the effect of As2O3 on malignant ascites of nude mice and investigate its mechanism. Method： One hundred BALB/c-nu/nu nude mice were injected with MKN-45 gastric cancer cell line and were divided into 5 groups at random： Group 1, normal saline; Group 2, Epirubicin; Group 3-5, various concentration of As2O3. The rate of tumor formation, production of ascites and survival period were evaluated. Morphological changes of tumor cell were observed with electromicroscope. Result： Epirubicin and low dose of As2O3 obviously inhibited the production of ascites and prolonged the survival period of tumor-loading nude mice （ P<0.01). Mid to high doses of As2O3 eradicated cancer cells through the way of apoptosis. Conclusion： As2O3 could induce gastric cancer cell apoptosis, inhibit or eradicate production of ascites and prolong the survival period of nude mice that suffered from malignant ascites from metastasis

OBJECTIVETo find an effective operative procedure against reflux after esophagogastric anastomosis with mucosal valve.

METHODSFour hundred and sixty-four patients with esophageal or cardiac cancer were randomly divided into three groups according to anastomosis modes. Group A underwent esophagogastric anastomosis with mucosal valve (175 cases), group B with mechanical stapler (151 cases) and group C one layer anastomosis with handcraft suture (138 cases). The gastroesophageal reflux index (GERI) was examined by isotope,and 24 h esophageal pH was also monitored. The esophageal motor function was compared among three groups.

RESULTSThe reflux rates were 0, 33.3%, and 6.7% in group A, B, C respectively. The esophageal motor function and the 24 h esophageal pH monitoring indicated that the various indexes were approaching to the normal level in group A, but the various indexes in group B and C were significantly different from the normal values (P< 0.05).

CONCLUSIONThe esophagogastric anastomosis with mucosal valve has better antireflux effect and can prevent the reflux esophagitis after esophageal or cardiac cancer eradication.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; therapy ; Esophagus ; surgery ; Female ; Gastroesophageal Reflux ; prevention & control ; Heart Neoplasms ; therapy ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Stomach ; surgery

Objective To investigate the changes in the threshold of auditory brainstem response (ABR),[Ca2+]i and calmodulin(CaM)in cochlear nucleus of the newborn mice infected by murine cytomegalovirus(MCMV)in the brain.Methods Sixty-nine newborn mice were randomized into the model group and the control group.The model group(54 mice)was established by intracranial injection with MCMV viral suspension 20 μl,and the same volume of 0.9％ sodium chloride was injected in the control group(15 mice).After one month,the ABR was tested in a sound-electric screen environment and the threshold was recorded.Then intracellular free calcium [Ca2 +] i and the mRNA level of CaM in the cochlear nucleus were assayed by flow cytometry and RT-PCR.Results Compared to the control group [(64.0 ±1.3)dBSPL],the threshold of ABR in the model group [(84.5 ±2.7)dBSPL] was increased(F =2.789,P =0.000).Moreover,in the model group the intracellular free calcium [Ca2 +] i and the mRNA level of CaM in the cochlear nucleus were increased(F =1.290,P =0.000;F =4.252,P =0.023),the differences were statistically significant.Conclusions The intracranial injection of MCMV can lead to abnormal changes in the threshold of ABR in mice,and the change of [Ca2 +]i/CaM in cochlear nucleus may be the important pathological basis of sensorineural hearing loss induced by MCMV infection.