Objective To analyze the features of muscle ischemic injury in patients with crush syndrome due to be trapped under the rubble for a super long time in the Wenchuan earthquake.Methods Eight patients were identified with crush syndrome from 1070 hospitalized patients after Wenchuan earth quake in May 12,2008,including 4 males and 4 females,with the mean age of 35.4 years(range,25-45 years).The trapping time ranged from 9 to 152 hours,with an average of 52 hours.Six cages(eight limbs) were amputated due to acute renal failure caused by crush syndrome.Eight patients were treated with continuous renal replacement treatment(CRRT).Two cases died of cerebral hemorrhage and intestinal perforation.One was diagnosed gas gangrene.The mechanisms of the crush syndrome were also analyzed.The musculature necrosis differed after trap condition and time were notified and noted.Results The characteristics of muscla crush injury were described below.1)The ultra long trapping time leading to acute renal failure.2)The patients with crush injury might be easily ignored due to the mild skin damaged.3)Deep muscles revealed more severe injury than the superficial muscles.4)The muscle necrosis took place in multiple compartments and areas.5)It Was ditiicult to identify and resect the muscles of early necrosis mixed with the normal musculature.6)A secondary hemorrhage might occur after necrotic tissues falling from the wounds.Conclusion According to the features of the muscle crush injury in the Wenchuan earthquake,the crushed limbs should be operated for extended decompression and debridment after indicated swellings.The more subterranean necrosis might cause infection even weeks after the injury signaled by that the patient had an unexplainable fever.The decompressed area should be left open.MR examination Was helpful to identify early muscle necrosis.If a crush syndrome is suspected the CRRT application wag beneficial in life save and limb salvage except for the decompression surgery.

20 cases of cavus deformity of foot were corrected by tarsal wedge osteotomy. The procedure was adopted because this type of deformity had its peculiar anatomical features. 18 feet were followed up postoperatively. and the result was found to be satisfactory 7 months to 5 years alter the operation. The following 2 problems were particularly discussed:1.Cavus defomity is characterized by a marked increase in the longitudinal arch and flexion of the forefoot, with the dome of the arch situating just under naviculo-cuneiform joint. It is therefore deemed most reasonable to perform osteotomy at this point. We think that this procedure gives better result than that recommended by McElvenny and Caldwell or v-osteotomy designed by Japas.2.In cavus foot the result of the operation depends a great deal on an accurate measuremnt of the deformity on the x-ray film. It was suggested that the deformity may be classified as mild, moderate and severe types basing on the measurement of the lateral x-ray film of the affected feet.

0.05).There were better effect of removal of myelin(P2

: The management of peripheral nerve injury is a tough problem clinically.Intensive studies in the past were focused on the bridging of nerve defects and the improvement of regeneration rate.But actually the clinical results of functional recovery after peripheral nerve lesion is mainly decided by the accurate regeneration of axons to their original target tissues and structures.Therefore,better clinical results could be obtained by a greater understanding of the cellular and molecular biology of selective nerve regeneration and the application of this theory clinically.This paper summarized recent studies on the cellular and molecular biology mechanisms of peripheral nerve selective regeneration.

Periosteal autograft from different sources have been used to repair 1.5cm bone defects of radius in 10 rabbits.On the left side,sharp-dissected grafts were implanted and the animals were sacrificed 4,8,14,30 and 60 days after operation.Bone formation was studied with X-ray and histologic technique.The results showed that the way of sharp-dissecting can preserve the periosteum completely,and good bone formation was found in this group.It suggested that the sharp-dissecting of the periosteum is the important key for periosteal graft.

Objective To develop a method to prepare human articular cartilage derived microcarrier for both rapid propagating chondrocytes and being used as scaffold to support chondrogenesis. Methods Human articular cartilage was crushed into small pieces by muller after lyophilization, and sorted through two different meshes to collect only those specimens measuring 150-200 microns. Then, in turn, the specimens were subjected to 0.25% trypsin at 37 ℃ for 24 hours and 1% Triton X-100 for 72 hours, respectively. The specimens were observed by inverted phase contrast microscopy, and assessed by staining with haematoxylin-eosin, safranin-O (for GAG), as well as by the immunohistochemistry of aggrecan, collagen type Ⅱ. The microcarriers were seeded with human chondrocytes after being irradiated by 60Co. Results Using inverted phasecontrast microscope, the freezing-dry cartilage particles were observed as yellow, different shapes, and their surfaces were uneven, and with many pits. After treating with trypsin and Triton X-100, the microcarriers showed light yellow, without cartilage morphology. The microcarriers became flocculous or like a hairbrush, and the area of contacting surface significant increased. After culture with cartilage cell for 2 hours, lots of spherical chondrocytes adhered to the microcarriers. HE stain of section confirmed that the celluar constituents of the specimens were removed, the specimens stained weakly positive for GAG, negatively for aggrecan, and positively for collagen type Ⅱ, respectively. Conclusion The detergent and trypsin can remove the cellular constituents and knock out the aggrecan from human articular cartilage while maintaining collagen type Ⅱ and GAG, and made the cartilage pieces flocculous or hairbrush-like. The chondrocytes can be well maintained in human articular cartilage derived microcarriers. Human articular cartilage derived microcarriers were prepared successfullly.

[Objective]To investigate the influence of Nitinol modified on its surfaces by the coating of titanium or titanium-niobium alloy on separat ion of Ni~(2+).[Method]The specimens from 1 to 7 days after the experiments were collected and the concentration of Ni~(2+) were cletermined by physiologic saline immersing test,low temperature ashing furnace,Mg(NO_3)_2 as matrix modifier and graphite furnace atomic absorption spectrometry(GFAAS).[Result]Specimens of Nitinol were devided into 3 groups:alloy coated with Ti(Ti group);alloy with Titanium-Niobium(TiNi group);only Nitanol without coating group.Obvious separation of Ni~(2+) was detected in the groups of Nitinol that were not modified and were put in baking oven(37℃),the separating procedure was mainly within 4 days,the separation rate(10~(-7)??g? cm~(-2)?s~(-1)) from the first to the forth days was 18.2,3.45,1.75 and 0.45 respectively,the Ni~(2+)was no more separated from the fifth day.Whereas,Ni~(2+) was not separated in the groups of Nitinol that were modified by the coating of metallic Ti and TiNb alloy.The recovery rate of the experiments was between 94.6%～108.6%.[Conclusion]The coating of Ti or TiNb on the surfaces of Nitinol stopped Nitinol from separating Ni~(2+).

[Objective]To analyze factors related with surviving rate and to evaluate effectiveness of the adjuvant chemotherapy in the treatment of osteosareoma.[Method]Eighty-four patients aging from 9 to 47 years(averaged,21 years)were analysed respectively:52 of them were male and 32 were female.The tumors were located at the femur in 42,the tibia in 29,the humerus in 13.There were 22 patients classified as stage ⅡA and 62 patients as ⅡB.The pathological study,of subtype of osteosarcoma revealed that 47 were osteoblastic,11 chondroblastic,19 fibroblastic and 7 other subtypes.There were 46 patients who received the chemotherapy;38 patients without chemotherapy,49 of the 84 patients treated surgically had limb salvage procedures,35 had amputations.Multivariate analsis was done by using the proportional hazards model of Cox,categoric data were analyzed by using the chi-square statistic.[Result]All cases were followed up from 6 to 74 months(with an average of 25.5 months).Cox model analysis showed that age,sex,site,and subtype were not significant prognostic variables in this group of patients;the significant affecting prognosis in patients was Enncking staging and chemotherapy.Chi-square showed significant difference in the higher metastasis rates of lung in the group without chemotherapy than in those with chemotherapy group(P

[Objective]The purpose of this paper is to demonstrate whether the nerve length could affect the quality of acellular nerve and investigate the properly repairable distance of nerve defects with acellular nerve allografts.[Method]Fresh sciatic nerves were obtained from adult dogs and divided into 12 cm long segments.The nerve segments were decellularized via an improved chemical decelluarization treatment as following: Nerve segments were rinsed with cold sterile Ringer's solution and submergedin 5% Triton-100 solution 12h,and then soaked the nerve segments into 5% sodium deoxycholate for 12h.The treated nerve segments were washed in distilled water for 3h.This procedures were repeated once again.In vitro,the degrees of decellularization,demyelination and integrity of nerve fiber tubal of chemically extracted acellular nerves were observed with microscope and assessed by a score system.In vivo,the sciatic nerve of dogs on the right was exposed.In 8 cm grafted group(n=6),a 7 cm segment of sciatic nerve was removed from the midthigh level.In 10 cm grafted group(n=6),a 9 cm segment of sciatic nerve was removed at the same level.The gaps were bridged with acellular nerve allografts by 8 cm and 10 cm long segments respectively.The follow-up period was 12 month postoperatively.Motor functional recovery of the right hind following allografting was examined by neurobehavioral,electrophysiological,histological and immunohistochemical assessment.[Result]There was no difference on the degrees of decellularization,demyelination and integrity of nerve fiber tubal among every fraction of the acellular nerve from the two ends to the central portion.In 8 cm grafted group,all survival dogs(n=5) were held upright with the affected hindlimb extended so that the body's weight was supported by the distal metatarsus and toes.In 10 cm grafted group,animals were failed to held upright with the affected hindlimb.Electrophysiological studies showed that elctromyographic activity was observed in both groups.After 12 month the conduction velocity was 32.1+5.1 m/s in 8 cm grafted animals and 18.3+6.0m/s in 10 cm grafted group.In normal animals, the conduction velocity was 106.6+16.4 m/s.The conduction velocity in 10 cm grafted group was lower than 8 cm grafted(P

Objective To investigate the effects of transforming growth factor-?1(TGF-?1), fibroblast growth factor-2 (FGF-2), platelet derived growth factor-bb(PDGF-bb) and hepatocyte growth factor(HGF) on adult human articular chondrocytes(AHAC) proliferation and phenotype maintaining. Methods Isolated AHAC were cultured in DMEM/F-12 supplemented with 10% human AB serum, 50 ?g/ml ascorbic acid-2-phosphate, 0.4 mmol/L proline, 5 ?g/ml insulin and 1 mmol/L non-essential amino acids (NEAA). The cells of 2nd passage were used for proliferation kinetics studying: 2.0?103 cells/well were seeded on 96-well plate, 24 h later, the cells were stimulated with various growth factors or combinations of these growth factors respectively, and the proliferation kinetics were analyzed by MTT colorimetric method. The passaged chondrocytes' phenotype were assessed by safranine O staining and immunostaining for type Ⅰ,Ⅱcollagens and aggrecan. Results All four growth factors: FGF-2, TGF-?1, PDGF-bb and HGF, could promote the proliferation of AHAC, and the optimal concentrations,when used separately, were 50 ng/ml, 1 ng/ml, 1 ng/ml, 20 ng/ml respectively. While 5 ng/ml FGF-2 combined with 1 ng/ml TGF-?1 could achieve the best proliferation effect, additionally adding PDGF-bb, HGF or both could not enhance more. With the combination of FGF-2 and TGF-?1, the AHAC could expand over 2000-fold and passage over 10 times. Chondrocytes of 9th passage still excreted type Ⅱcollagen and glycosaminoglycan(GAG). Conclusion 5 ng/ml FGF-2 combined with 1 ng/ml TGF-?1 is a very appropriated circumstance for in vitro expanding of AHAC.