Objective To introduce a safe and practical approach for the treatment of severe muscular torticollis. Methods In an axis of the spasmodic sternocleidomastoid muscle, the author designed a five-valve flap with two valvae inside, which ended at the mastoid point and inferior clavicular part of sternocleidomastoid muscle, respectively. The arm length of each valve was approximately half of its axis. Each valve was separated bluntly in naked eyes in order not to detach the platysma myoides from the skin, and to release the webbed neck. Under the flap, the thinned and fibrosed sternocleidomastoid muscle and spasmodic neck sheath and superficial cervical vein were easily found. The sternocleidomastoid muscle was disconnected at the median point, and the two ends were retracted, the superficial cervical vein was cut and ligated, the neck sheath was released to uncover the spasmodic cervical artery and nerve. The head was right positioned, and then the surrounded fascial tissues were released under the protection of the arteries and veins. The flap was sutured to cover the arteries, veins and muscles. Results Reasonably good effect was achieved in one case and intermediate effects in other 4 cases. Surgical results were satisfactory. All the flaps were survival with insignificant scar formation. Conclusions Webbed skin deformity in the neck can be corrected by using five-valve plastic surgery of platysma myoides, which is able to cover the exposed nerves and vessels. This procedure prevents the adhesion of the operated area, ensures the blood supply of the distal portion of the flap, and also avoids the damage of other tissues in the flap area.

Objective:To investigate the effect of sintering temperature on the shrinkage and microstructure of dental fluorosilicic mica glass-ceramic with two different particle size. Methods:Fluorosilicic mica glass powder with average particle diameter of 72.8 ?m was named PO and that with average diameter of 4.5 ?m was named Pm. PO and Pm were molded by cool isostatic pressing technique and then sintered at different temperatures between 600-1 000 ℃. The shrinkage and microstructure of the sintered blocks of PO and Pm were systematically compared with each other. Results:The shrinkage of PO and Pm blocks were all increased as the temperature ascended. However, the shrinkage curves were distinctly different. At the same sintering temperature the shringkage of Pm was larger than that of PO. Moreover, the turning points of temperature (reflecting transition of the sintering mechanisms) of Pm was higher than that of PO. The microstructure observation showed that sintering at 950 ℃ resulted in mica crystal in glass-ceramics and the best compactness of the sintered blocks of both PO and Pm. Conclusion:Sintering glass powder of smaller particle size at 700-850 ℃ may achieve better sintering compactness.

Objective To compare the treatment effectiveness of AO/ASIF proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) in treatment of intertrochanterie fractures. Methods A retrospective study was done on 233 patients with intertroehanteric fractures treated from August 2004 to December 2006. The patients were divided into PFN group (188 patients) and PFNA group (45 patients) for comparing operative procedures and postoperative functional recovery. Results There was statistical difference in aspects of incision length, blood loss and operation time between two groups. The follow-up for 22.8 months showed excellence rate of 89.9% in PFN group and 91.1% in PFNA group, with statistical difference (X2 = 0.06, P > 0.05). There occurred hip varus in one patient and antirotation nail cutting-out in two in PFN group, which was not found in PFNA group. Conclusion PFN and PFNA are both good choices for treatment of intertrochanteric fractures. Compared with PFN, PFNA has more advantages in reducing operation time and blood loss especially for the eider patients with osteoporosis.

Objective To evaluate potential clinical risk factors for the development of early-onset myocardial damage following multiple trauma (MT), and to determine whether early-onset myocardial damage was caused by the combined effects of thoracic and systemic injury factors in MT patients.Methods A total of 231 patients with MT over the last 3 years were retrospectively reviewed. With myocardial damage being a dependent variable and other twenty factors being independent variables, univariate and multivariate logistic regressions were applied to investigate the risk factors for early-onset myocardial damage and to identify the association of thoracic and systemic risk factors with early-onset myocardial damage.Results Multivariable logistic regressions showed that acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score ≥10, injury severity score (ISS) ≥ 25, shock index ≥ 2,coexisting chest trauma, abbreviated injury scale (AIS) of chest≥3, and hypoxia time ≥ 0.5 h were risk factors. The risk of earlyonset myocardial damage following MT obviously increased when thoracic and systemic injury risk factors were coexisting.Conclusion Our results indicated that thoracic injury combined with systemic injury increased the overall risk of early-onset myocardial damage following MT. Prospective validation of these findings in other clinical settings is warranted.

Idiopathic pulmonary fibrosis(IPF), with unknown pathogeny, is an interstitial lung disease.The pathological features are diffuse epithelial-cell lesion, fibroblast proliferation, myofibroblast differentiation and excessive extracellular matrix deposition.CXCR4 is the predominant chemokine receptor on fibrocytes;CXCL12 is the only ligand of CXCR4.A large number of studies have shown that CXCL12/CXCR4 biological axis plays an important role in the pathogenesis of idiopathic pulmonary fibrosis.Under the regulation of hypoxia, HIF-1α and PI3K-Akt-mTOR path, CXCL12/CXCR4 biological axis promotes lung fibroblast proliferation, myofibroblast differentiation and extracellular matrix deposition, resulting in development and progression of IPF.

Objective To investigate the optimal timing of surgical treatment for multi-drug resistance patients,discuss the clinical effect of surgery with chemotherapy treatment for muhi-drug resistant tuberculosis,and obtain more evidence for further optimizing surgical treatment strategy for such patients.Methods 100 cases who were multi-drug resistant and who received treatment in our hospital from July 2003 to June 2010 were included in this retrospective study.Among them,50 (observation group) received pulmonary lobectomy followed by anti-tuberculosis chemotherapy for 12 to 24 months,and the others (control group) only received anti-tuberculosis regimens although they had indications for pulmonary lobectomy.All patients in both groups were followed up for 12 to 24 months.Therapeutic effects and post-operational events were compared statistically in the observation group patients according to their duration of disease.Results Results At the end of follow-up,the cure rate,illness exacerbation rate and mortality were 36.0％ (18/50),16.0％ (8/50) and 26.0％ (13/50) respectively in the control group,whereas those in the observation group were 80.0％ (40/50),2.0％ (1/50) and 4.0％ (2/50) respectively.Resistanee to new anti-tuberculosis drugs appeared in 3 cases (6％) in the control group,while there was no new resistance in the observation group.The cure rate and complication rate were 96.30％ and 3.70％ respectively for patients whose duration of illness was less than 2 years,whereas those were 47.8％ and 43.5％ respectively for cases whose duration of illness was more than 2 years.Bronchopleural fistula,hemorrhage,pyothorax and pulmonary atelectasis were main postoperative complications,from which 11 cases recovered and 2 died,the death caused by choking of big haemoptysisand and multiple organs failure.Conclusion The therapeutic effects of surgical treatment plus anti-tuberculosis chemotherapy were better than chemotherapy alone.Pulmonary lobectomy could result in better response if done at the earlier stages of illness.Complications of operations were acceptable.

Objective To study the value of CT diagnosis of atraumatic acute abdominal disease and how to select CT scan rationally.Methods The CT findings of 319 cases of atraumatic acute abdominal disease were reviewed restrospectively.Results Of 319 cases,226 cases of non-traumatic acute abdomen had positive findings on CT,the positive rate was 70.84%.Of them,the diseases included:urinary tract system in 63 cases,bile system in 62 cases,pancreas in 41 cases,gastro-intestinal system in 37 cases and others in 23 cases.The positive rate of CT findings was higher with aging in non-traumatic acute abdomen.Conclusion CT is of diagnostic value in atraumatic acute abdominal disease.

BACKGROUND: Hundreds of mouse embryonic stem cell lines are established presently. Most of these cell lines are collected from 129, C57BL/6J and BALB/C mice. Success rate of creating embryonic stem cell lines with Kunming mice is very low. OBJECTIVE: To explore the method of isolation and culture of murine embryonic stem cells of kunming species to increase the efficiency of establishment of embryonic stem cell lines from Kunming species mouse. DESIGN, TIME AND SETTING: The cell experiment was performed at the Chongqing Key Laboratory of Neurology from April 2006 to June 2007. MATERIALS: Blastocysts of 3.5 days and 4 days from Kunming species mouse were collected. METHODS: The blastocysts of 3.5 days and 4 days from Kunming species mouse were cultured on the fibroblast cell feeder layers for 4-5 days, and the cells from inner cell mass were isolated and subsequently cultured in vitro in 2.5 g/L trypase-0.4 g/L ethylenediamine tetraacetic acid (EDTA) and 1 g/L trypase-0.2 g/L EDTA at room temperature for 2-4 minutes. Embryonic stem cell colony was mechanically straggled. MAIN OUTCOME MEASURES: Colony growth was observed and determined by alkaline phosphatase staining, OCT-4 staining and karyotype analysis. RESULTS: Adherence rate, inner cell mass frequency and cloning efficiency of 4 day post coitum (dpc) embryo were higher than those of 3.5 dpc embryo (P

Objective By detecting microsatellite instability(MSI) and loss of heterozygosity(LOH) in FHIT gene in sputum specimen,we intended to evaluate the sensitivity of FHIT gene detection to early diagnosis of lung cancer and explore effective method to screen lung cancer.Methods Based on liquid-based cytology,we collected and isolated sputum specimens in high risk group,abstracted DNA,and detected MSI and LOH in FHIT gene.Results The positive rate of MSI or LOH at single locus was between 41.6% and 49.5%;the site D3S1300 was the highest and it was 49.5%.At least 1 site out of 3 sites that had abnormal microsatellite accounted for 72.3% in lung cancer patients,two sites that appeared to change accounted for 45.5%,which was significantly different compared to non-lung cancer patients(P

Objective:To observe the effect of Aalv Capsule on sodium current in guinea pig ventricular myocytes(INa)for exploring the mechanism of its anti-premature beats.Methods:Whole-cell patch-clamp recording technique was used to record the Aalv Capsule for a single cell of sodium currents in guinea pig ventricular myocytes.Results:There was dose-dependent of Aalv Capsule in block of sodium currents and had a certain amount of use-dependent and time-dependent.Conclusion:The role of Aalv Capsule in blocking sodium current block was one of the mechanisms of its in bearing premature.