[Objective]To research the method to repair dorsal skin defect of fingers by using retrograde neurocutaneous flap.[Method]Adopting nutrient vessels of 4 nerve branches in hands of radial-ulnar nerve as pedicle,the flaps were designed and applied to repair dorsal skin defect of fingers.[Result]All 10 flaps in 5 cases survived and wound area were covered.[Conclusion]Retrograde neurocutaneous flaps have sufficient blood supply,with no injury to nominous vesels,and with long distance to repair.Therefore,it is an advantageous method to repair dorsal skin defect,futhermore,two flaps could be used to repair skin defect of two fingers at the same time.

Objective The TiO2 nanotube arrays,fabricated on the surface of orthopedics,was characterized,to provide carrier for orthopedics plant surface modification or coating,and seek a new way for the prevention and treatment of orthopedics plant infection.Methods By adjusting certain parameters,TiO2 nanotube arrays were fabricated on orthopedic titanium plate surface using the method of anodic oxidation,with glycerol system as electrolyte,orthopedics titanium plate as anode,and platinum electrode as cathode.TiO2 nanotube arrays were characterized.The element composition of TiO2 nanotube arrays was analyzed by X-ray photoelectron spectroscopy (XPS),and the morphological changes of TiO2 nanotube arrays was observed at high temperature (300 ℃) by X-ray diffractomer (XRD).Results With glycerol system as electrolyte,TiO2 nanotube array with diameter of about 100 to 200 nm and the length less than 3μm can be fabricated on orthopedic titanium plate surface using anodic oxidation of 24 h.The surface of orthopedic titanium plate was changed from silver white to deep blue in the macroscopic view.The TiO2 nanotube array on orthopedics titanium plate surface was mainly composed of Ti element (75.88％),O element (20.16％),and F element (3.96％) by XPS analysis.TiO2 nanotube arrays morphology was stable when it was heated to 300 ℃ by muffle furnace.Conclusions The method of anodic oxidation can be applied to manufacture TiO2 nanotubes array on titanium plate surface.The array with stable morphology,the inner hollow shape,the bottom sealing,and a large specific surface area,can withstand high temperature,which can provide carrier for orthopedics plant surface modification or coating.

BACKGROUND: Scaffolds are an important part in bone tissue engineering. However, no perfect scaffolds have been developed for bone tissue engineering yet.OBJECTIVE: To evaluate the repair of rabbit radial defects by poly (L-lactic acid)/tricalcium phosphate(PLLA/TCP) scaffolds prepared by rapid prototyping(RP) technology so as to find a new carrier for growth factors.DESIGN: A completely randomized controlled study was conducted. SETTING: Orthopaedic institute of a military medical university.MATERIALS: The study was conducted in the General Orthopedic Institute,Fourth Military Medical University of Chinese PLA, from May 2001 to February 2002. Twenty clean New Zealand rabbits with body mass of(2.5 ±0. 5) kg for this study were obtained from the Experiment Animal Center of Fourth Military Medical University of Chinese PLA. The animals were divided into experiment group and control group with 10 rabbits in each group.INTERVETIONS: PLLA/TCP scaffolds prepared by RP technology and loaded with or without bovine bone morphogenetic protein (BMP) were used to repair the rabbit radial defects of 15 mm.MAIN OUTCOME MEASURES: Main outcomes: ① microscopic observation results of transplanted materials of the two groups; ② degradation rate of scaffolds. Secondary outcomes: ① gross observation; ② radiographic results; ③ bone density.RESULTS: At week 12, bone defect healing in experiment group was good. X-ray examination showed continuous bone callus and partial molding of different degrees. Degradation rate of scaffolds was 39.6%, and bone density in the defected part reached 70% of the normal level. All the indexes of experiment group were superior to those of control group, and no healing was found in the defected area in control group.CONCLUSION: PLLA/TCP scaffolds prepared by RP technology and loaded with bovine BMP can repair radial defects of 15mm in rabbits.

AIM:To establish a method for determining saikosaponin A,paeoniflorin,hesperidin and ferulic acid in Chaihu Shugan Powder(Pericarpium Citri Reticulatae,Radix Bupleuri,Rhizoma Chuanxiong,Fructus Aurantii,Radix Paeoniae alba,etc.).METHODS:The chromatographic saparation was performed on a Hypersil C_(18) column(250 mm×4.6 mm,5 μm).The mobile phase was acetonitril-water(43:57)for saikosaponin A,and the mobile phase for rest components was acetonitrile-0.5% acetic acid(40:60).All of flow rates were 0.8 mL/min and column temperature maintained at 30℃.The detection wavelength was set at 200-400 nm.RESULTS:The four constituents were separated within 15 min.The linear ranges of saikosaponin A,paeoniflorin,hesperidin and ferulic acid were 38.5-166.7 μg/mL(r = 0.999 6),15.9～254.5 μg/mL(r = 0.999 9),22.1-353 μg/mL(r =0.999 3),6.30-201.5 μg/mL(r =0.999 9),respectively.The average recoveries were 97.57%,97.40%,98.86%,96.37%,respectively.The RSD were 2.1%,1.1%,0.70%,1.3%,respectively.CONCLUSION:The method is rapid,simple and accurate,and can be used for quality control of Chaihu Shugan Powder.

Objective To study the curative effect of internal thoracic arterial chemoembolization in the treatment of advanced lung cancer.Methods Internal thoracic artery was confirmed to be the main supplied artery by digital substraction angiography(DSA) in 8 cases with lung cancer. The internal thoracic artery was embolized by stainless steel coil below the supplied segment in order to avoid the normal vascular territory occlusion.Then iodized oil combined with Cis-Diaminedichloroplatinum(DDP) and mitomycin(MMC) were injected into the supplied segment slowly until blood flow stopped,at last,the gelfoam sponge sheet was inserted into this supplied segment to decrease the wash of iodized oil by blood flow.Results Clinical symptoms were improved obviously in all cases after therapy.CT scans showed that iodized oil accumulated in the tumor better four weeks after the chemoembolization. Conclusion For these cases with advanced lung cancer which the blood supply mainly by internal thoracic artery,it is necessary to perform chemoembolization.

AIM:To establish a method for determining saikosaponin A,paeoniflorin,hesperidin and ferulic acid in Chaihu Shugan Powder(Pericarpium Citri Reticulatae,Radix Bupleuri,Rhizoma Chuanxiong,Fructus Aurantii,Radix Paeoniae alba,etc.).METHODS:The chromatographic saparation was performed on a Hypersil C18 column(250 mm?4.6 mm,5 ?m).The mobile phase was acetonitril-water(43:57) for saikosaponin A,and the mobile phase for rest components was acetonitrile -0.5% acetic acid(40:60).All of flow rates were 0.8 mL/min and column temperature maintained at 30 ℃.The detection wavelength was set at 200-400 nm.RESULTS:The four constituents were separated within 15 min.The linear ranges of saikosaponin A,paeoniflorin,hesperidin and ferulic acid were 38.5-166.7 ?g/mL(r=0.999 6),15.9～254.5 ?g/mL(r=0.999 9),22.1-353 ?g/mL(r =0.999 3),6.30-201.5 ?g/mL(r=0.999 9),respectively.The average recoveries were 97.57%,97.40%,98.86%,96.37%,respectively.The RSD were 2.1%,1.1%,0.70%,1.3%,respectively.CONCLUSION:The method is rapid,simple and accurate,and can be used for quality control of Chaihu Shugan Powder.

Objective To establish a rabbit model of lumbar laminectomy and bone grains replantation and provide experimental evidence for the clinical application.Methods Eighteen healthy male New Zealand rabbits were selected and randomly divided into two groups:the control group (n=6) and experimental group (n=12).The rabbits of control group were given general anesthesia, and taking the L5 spinous process as the center to perfom left L5 laminectomy, using a micro lancet forceps to slowly bite the lamina and ligamentum flavum for fenestration and exposed to an approximately 0.8 cm x 0.3 cm sized bone window and then sutured the skin.The rabbits of experimental group were exposed to an approximately 0.8 x 0.3 cm sized bone window as well, and bone fragments were cut into small grains.Then the small bone grains were embedded in medical collagen sponge, to form an arch shape, and replanted them to the site of epidural fenestration.CT scan and histological changes were observed at 4, 8 and 12 weeks after operation.Results At 8 weeks after operation, CT examination showed that in the experimental group, a thin bone plate was formed by the bone grains.At 12 weeks after operation, the bone plate became thicker and was connected with the vertebral bone, and with continuous bone trabeculae.The spinal canal and volume were not obviously changed, and no spinal cord compression was observed. The rabbits of control group showed segment lamina defects, a small scar protruding into the spinal canal, and the vertebral canal was not completely reconstructed. Conclusions The bone grains replantation can effectively promote bone reconstruction in the laminectomized rabbits, and the formed bone plate can prevent epidural scar from intruding into the spinal canal, and can reduce the postlaminectomy adhesion.

Objective To sum up the experience of nursing patients with spinal tuberculosis combined with open pulmonary tuberculosis? Methods Preoperative nursing was done to 16 patients with spinal tuberculosis combined with open pulmonary tuberculosis to enhance their medical appliance? The careful postoperative observations of conditions and incisions were done to prevent pulmonary infections? Results Of the 16 patients,15 were well cured and 1 was discharged with antituberculotics for home treatment due to refusing to transfer to other hospitals for financial reason? Conclusion The enhanced perioperative health education and nursing is significant for the success of the operations and rehabilitation of the disease?

Objective To investigate the classification and treatment of displaced intra articular fractures of the calcaneus. Methods Twelve displaced intra articular fractures of the calcaneus in 8 patients were included in this study. Classification of calcaneus fractures was done according to Sanders' computed tomographic classification system. There were 2 cases of type Ⅱfractures, 4 type Ⅲfractures and 6 type Ⅳfractures. The open reduction and internal fixation (ORIF) and bone grafting were performed using a standard extended lateral approach, and the fractures were fixed with small fragment AO bridge plates with autogenous bone grafting. Average follow up was 28.6 months (range 24 to 33 months). The Creighton Nebraska Health Foundation Assessment Score System for fractures of the calcaneus was used for evaluation. Results The average score was 89.7 for type Ⅱ, 86.5 for type Ⅲ, and 73.5 for type Ⅳfractures. There was statistically significant superiority in treatment by ORIF compared with nonoperative methods (P0.05); whereas in type Ⅳfractures, the differences were significant between with and without bone grafting (P

Objective To discuss diagnostic classification and emergency treatment protocols for complex pelvic fractures. Methods The first aid management of 23 cases of major pelvic fractures were analyzed retrospectively. Results 22 of the patients survived, but one died of hemorrhagic shock.Conclusions Correct classification of severe pelvic fractures is of guidance value to the first aid management. Cooperation among multiple departments, comprehensive application of various surgical methods, early stabilization of hemodynamics, rapid repair of injured organs, stabilization of pelvic ring with external fixator are effective techniques to enhance the survival rate of patients with severe pelvic fractures.