[Objective] To observe the clinical efficacy of ZICAOYOUSHA in treating diabetic foot ulcers.[Method] A multi-center ,randomized,double-blind,placebo-control ed study was conducted. A total of 232 patients with diabetic foot ulcers were randomly assigned the treatment group and control group,in foundation treatment at the same time,the therapy group which was treated by External Application ZICAOYOUSHA had 174 patients,the contrast group which was treated by External Application Gentamicin Emery cloth had 58 patients. Observe the aspect improvement situation in two groups separately in accordance with Wagner grading,carry out statistics processing.[Results] Two groups of curative effect indices had significant differ-ence. [Conclusion] ZICAOYOUSHA is an effective drug for external use in treating diabetic foot ulcers.

Objective To identify differentially expressed proteins in keloid tissue and to explore the proteomic characteristics of keloid by utilizing capillary high-performance liquid chromatography (LC) and tandem mass spectrometry (MS).Methods Tissue specimens were obtained from the lesions of 5 patients with non-familial keloid and normal skin of 5 human controls.After extraction and in-solution digestion of proteins,the resultant peptides were separated and identified by LC-MS/MS.Label-free detection and quantitation of peptides were carried out by using the DeCyder MSTM software.Results A total of 570differentially expressed peptides were identified between non-familial keloid and normal tissue (all P ＜ 0.05),which correspond to 1221 proteins.A difference greater than 1.5 folds was observed in the expressions of 293 proteins,including 124 up-regulated and 169 down-regulated proteins in non-familial keloid tissue.Conclusion Differences exist in the expression of proteins between non-familial keloid and normal skin tissue.

Objective To retrospectively analyze the therapeutic effect of wide surgical excision combined with low-dose adjuvant interferon-alpha 2b on cutaneous malignant melanoma.Methods A total of 32 patients with cutaneous malignant melanoma received wide surgical excision after preoperative examination and staging.The excisions were performed with a margin measuring 1-2 cm from the visible lesions or biopsy scars.Surgical modalities included direct suture after excision(4 patients),dactylolysis or toe amputation(6 patients),free skin grafting(15 patients),random skin flap transfer(3 patients)and pedicle skin flap transfer(4 patients).Lymph nodes were selectively dissected in 9 patients with regional transfer of lymph nodes,and inguinal lymph nodes were cleared away in 2 patients.One week after the operation,patients received adjuvant therapy with subcutaneous injection of interferon-alpha 2b(3 million IU,thrice per week)for one to three years.Results Preoperative tumor staging revealed 21 cases of cutaneous malignant melanoma at stage Ⅱ,and 11 cases at stage Ⅲ.The excisions healed by the first stage in all the patients.Up to June 2011,2 patients had been lost to follow up,5 patients with stage Ⅲ melanoma had died.Survival was observed in all of the 4 patients receiving 1-year follow up,12 of 13 patients receiving 1-3 year follow up,5 of 7 patients receiving 3-5 year follow up,and 4 of 6 receiving 5-year follow up.Of the 25 surviving patients,regional lymph node metastasis was observed in 8 patients,which developed within 2 years after the operation in 2 patients.The adjuvant therapy with interferon-alpha 2b lasted 3 years in 8 patients,and more than 1 year in 11 patients.Side effects were mild.Conclusion Wide surgical excision plus low-dose interferon-alpha 2b is effective for the treatment of stage Ⅱ and Ⅲ cutaneous malignant melanoma with lower local recurrence and higher survival rate.

Objective To compare the efficacy of intralesional glucocorticoid injection with a needle-free injector versus an ordinary injector for the treatment of keloid. Methods A total of 60 patients with keloid were enrolled and randomly divided into two groups by using a random number table to receive intralesional injection of compound betamethasone with a needle-free injector(n=31)or an ordinary injector(n=29). The injection was given at a dose of 0.2 ml/cm3 once every 3 weeks for 3 sessions. Parameters for therapeutic efficacy were assessed, adverse reactions were recorded, and clinical pictures were taken before and after each treatment. Statistical analysis was carried out by the Mann-Whitney U test and chi-square test with the SPSS 19.0 software. Results Compared with the ordinary injector group, the needle-free injector group showed significantly different injection time during the first and second treatment (U=299.000, 773.500, respectively, both P=0.000), as well as duration of pain after the first injection(U=730.000, P=0.003). After three sessions of treatment, there was a significant difference in the volume, height, hardness of keloid, scores for pain, itching and appearance, and number of injection points between the needle-free injector group and ordinary injector group (U=295.000, 336.500, 264.000, 464.000, 451.500, 308.000, 233.500, P=0.001, 0.007, 0.000, 0.041, 0.043, 0.003, 0.001, respectively). No significant differences were observed in the incidence of adverse reactions between the two groups(all P>0.05). Moreover, the interval for lesion recurrence was significantly shorter in the needle-free injector group(11.8 days, 95%CI:10.96-12.6 days)than in the ordinary injector group(21.2 days, 95%CI:13.96-28.45 days). Conclusion Compared with the ordinary injector, the needle-free injector shows better efficiency for the treatment of keloid with decreased difficulty in injection and improved compliance in patients.

Objective To investigate the expression changes of Toll-like receptors(TLR) and the signaling pathway function on airway epithelial cells infected with human metapneumovirus(hMPV), and to explore the mechanisms of hMPV-induced airway inflammation. Methods A549 cells were infected with hMPV live or co-cultured with UV-inactivated hMPV in vitro. Growth curve of the virus in A549 cells was established and mRNA expression of TLR were detected by RT-PCR assay and real-time PCR assay at 3, 6, 9, 12, 24 h post infection. IFN-α and TNF-α in the culture supernatants were detected by ELISA. Results hMPV was able to replicate in A549 cell, growing to peak titer of 10~(5.2) TCID_(50)/ml at 3 d after infection. Most of TLR mRNA levels were up-regulated by hMPV infection but not UV-inactivated viruses via RT-PCR assay (P<0.05) after 6 h of stimulation. Real-time PCR assay showed that TLR3-4, TLR7-9 mRNA increased after being infected by hMPV in a time-dependent manner. The expression of IFN-α and TNF-α in the cul-ture supernatants were significantly up-regulated after 24 h infected by hMPV. Conclusion hMPV infection up-regulates the expression of TLR in lung epithelial cells. The inflammatory response to hMPV may associ-ate with part of TLR signal transduction pathway.

Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.

Objective To evaluate the efficacy and safety of brachytherapy by percutaneous paracentesis implantation of iodine-125 seeds for elderly non-small cell lung cancer.Methods 18 patients with peripheral lung cancer were undergone brachytherapy by percutaneous paracentesis implantation of iodine-125 seeds.The effect was evaluated by periodically chest CT.The complications were analyzed.Results 18 patients were observed one,two and six months after operation.CR,PR,SD were seen in 27.8％(3/18),66.7％(14/18),5.6％(1/18)respectively of the patients.Pneumothorax,hemoptysis were seen in 16.67％(3/18),95.37％(17/18),no pleural cavity bleeding.Conclusion Brachytherapy by percutaneous paracentesis implantation of iodine-125 seeds for lung cancer was effecitve.The complications were easy to treat.The methods of implantation of iodine-125 seeds could fully play the advantages of CT,and reduce the damage to the body when raising the tumorous control rate.

[Objective]To evaluate the outcome on patients with primary infection of intervertebral space of the thoracolumbar spine following combined one-stage debridement,strut grafting and internal fixation.[Method] From May 1999 to February 2006,18 patients with spontaneous infection of intervertebral space were analyzed retrospectively.These infections occurred at thoracic spine in 3 cases(16.7%),thoracolumbar junction in 2 cases(11.1%),lumbar spine in 10 cases(55.5%),and lumbosacral junction in 3 cases (16.7%).Their clinical data and outcome were studied.None of all had previous spinal surgery or spinal injection,and their diagnosis were confirmed by histopathology after surgery.All patients were treated by one-stage debridement,strut grafting and internal fixation after failure of nonsurgical treatment.Antibiotics was used following debridement in the infection sites,and was continued to be administered after surgery.Patients were evaluated before and after surgery in terms of pain,neurologic level,sagittal spinal balance,and radiologic fusion.[Result]Postoperatively,all patients experienced significant relief of symptoms,and no fever.Six patients showed improved neurological status(at least one grade improvement on Frankel's functional classification).Only 3 of 18 cases had a positive culture result that pathogen identified Staphylococcus aureus.Histological examination of the specimen after surgery revealed that inflammation occurred in all patients,but no evidence of tuberculosis.The period of follow-up ranged 13 to 45 months with a mean of 26 months.No evidence of recurrence or residual infection was observed in any patient.Postoperative radiological evaluation revealed that implants were stable,there was no phenomena of prosthesis subsidence,hook dislodgment and failure restoration of spinal segments height.Solid bony fusion was obtained in all patients.Eight patients were misdiagnosed for spinal tuberculosis.[Conclusion] One-stage eradication of the infection,strut grafting and internal fixation are effective treatments for primary infection of intervertebral space.The presence of the instrumentations at the site of infection has no negative influence on the course of infection healing.

[Objective] A retrospective study was performed to evaluate the outcome of three-dimensional correction for adolescent idiopathic scoliosis(AIS)and discuss biomechanics of posterior three-dimensional correction surgery and measures for the prevention of spinal imbalance.[Methods]Thirty-one patients with AIS were classified and treated with three-dimensional correction surgery from 2005 to 2007.There were 18 male and 13 female with the average age of 15.2 years(range,11 to 18 years).The cases were classified according to the Lenke surgical classification,including type I 8 cases,type Ⅱ 4 cases,type Ⅲ 8 cases,type Ⅳ 2 case,type Ⅴ 5 cases,type Ⅵ 4 cases.The major curve Cobb's angles,the distance of apical vertebra shift and trunk shift,were measured and analyzed in the reoperative,postoperative and final follow-up radiographies.The average preoperative coronal Cobb's angle was 54?,the distance of both apical vertebra shift and trunk shift was 5.8 cm and 2.6 cm respectively.[Results]The mean time of follow-up was 16 months(range 1 to 3 years).The average postoperative coronal Cobb's angle was 21?,as the correction was 61%,the lost angle at the last follow-up was 4.0?.The postoperative distance of apical vertebra shift was 2.5cm,as the correction was 56%,the lost distance at the last follow-up was 0.5 cm.The distance of trunk shift at the last follow-up was 1.0 cm.[Conclusion]Posterior three-dimensional correction surgery is a good corrective method in the treatment of AIS.The spinal mechanical balance should be noticed during the operaion.

0.05).One case developed hemorrhage of venous plexus in the posterior pedicle screw fixation group.And complications occurred in 6 cases(4 of superior nerve injury,1 of intra-incision hematoma and 1 of esophageal injury).There were significant differences between 2 groups(P