Objective To investigate the methods and therapeutic effects of anterolateral thigh perforator free flaps for reconstruction of soft tissue defects around the ankle.Methods A retrospective case series study was made on 30 patients treated with anterolateral thigh perforator free flaps for traumatic soft tissue defects around the tibia between January 2010 and June 2016.There were 22 males and eight females,with the age range of 16-58 years [(41.5 ± 1.2) years].Dimension of the soft tissue defect ranged from 9 cm ×4 cm to 23 cm × 12 cm.Flap stabilization time,flap survival rate,postoperative complications,second plastic surgery rate,and ankle joint function by Baird-Jackson score were recorded.Results All patients were followed up for (13.0 ± 5.4) months (range,6-24 months).Time for flap stabilization was (6.5 ± 1.1) days.All flaps survived except in one patients with flap loss due to postoperative arterial thrombosis.Postoperatively,one patient had arterial crisis,one had venous thrombosis,and one presented sinus formation due to infection.No second plastic surgery was carried out.According to the Baird-Jackson score,the results were excellent in 25 patients and good in five.Conclusion Anterolateral thigh perforator free flaps for reconstruction of traumatic soft tissue defects around the tibia has advantages of easy harvesting and survival,less postoperative complications,less second surgery,and good function recovery.

The Wnt pathway plays a crucial role in skeletal development and is indispensable for determination of OS cell lines. In recent years, experimental evidences on Wnt signaling pathway in OS cell lines and OS animal models, and that of Wnt signaling pathway as a diagnosis and prognosis marker of OS suggested that Wnt signaling pathway plays an important role in the progression, invasion and metastasis of OS. In addition, the strategy and safety evaluation to target Wnt to treat OS are underway. Exploring the significant role of Wnt signaling pathway in OS may aid in personalizing therapeutics to increase patient survival.

Objective To review 2006-2007 AIDS response in China by applying the indicators of "Monitoring & Evaluation Plan of AIDS Response". Method Data from the national AIDS routine reporting system and special survey in line with the definitions of the indicators and standardized methods were summarized,classified and analyzed; mid-term targets or indicator value of 2005 were employed as comparison. Results The 2007 result of the national HIV sentinel surveillance showed that the HIV prevalence among female sex workers,injecting drug users,men who have sex with men and pregnant women was 0.0%,1.9%,3.1% and 0.0% respectively;the data from the national HIV comprehensive response information system showed that by the end of 2007,72.8% of the adults and children with advanced HIV infection had received antiretroviral therapy (ART) ,and 83.6% of the ART receivers survived after 12 month treatment. Conclusion Indicators of the "Monitoring & Evaluation Plan" are able to reflect the outcomes and achievements of 2006-2007 HIV/AIDS response in China,which has made good progress and has fulfilled the mid-term targets as defined by the Plan.

Spermatogenesis is a complex process. Current knowledge about human spermatogenesis is mainly based on the mouse model while little is known about the initial stage of this fundamental process in humans. The establishment of the model of spermatogenesis in vitro may contribute to an overall understanding of male germ cell development, an insight into the mechanisms of infertility, and clinical management of male infertility. This review summarizes current knowledge about the generation of germ cell-like cells from induced pluripotent stem cells (iPSCs) in vitro and discusses the potential application of iPSCs in the treatment of male infertility.
Animals ; Cell Differentiation ; Germ Cells ; Humans ; Induced Pluripotent Stem Cells ; Infertility, Male ; therapy ; Male ; Mice ; Spermatogenesis

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

Objective By analysis oflateralepicondylitis patients MRI features to explore the lateralepicondylitis namedrationality and authorized its opinions for the ninth edition surgery textbook. Methods Cochrane's systematic review methods were used to retrieve the literature about lateralepi-condylitis patients MRI features fromCochrane Library, Medline, OVID, EMBASE, Chinese biomedical literature database (CBM), VIP, CNKI, Wan fang digital journals, and totally 31 articles were reviewed. 13 articles met the inclusion criteria for the lateral epicondyle of humerus elbow in patients with MRI findings. In accordance with the case-control data RevMan 5.0 software was used for Meta analysis withodds ratio (OR) as count data statistics. Interval estimation wasmade of 95% confidence interval (CI). When the datacannot be performed Meta analysis, only qualitative analysis was made. Results 13 studies met the inclusion criteria, including 315 ipsilateralelbows (5 patients with bilateral disease, 305 patients with unilateral disease) and 169 asymptomatic side of the elbow (98 cases of patients with the contralateral elbow, 71 cases of healthy volunteers). The results of Meta analysis suggested that pa-tients and healthy volunteers of elbow MRI showed statistically significance [OR=88.55, 95%CI=(29.20, 268.57)]. Between ipsilateral elbow and contra lateral of elbow MRI showed statistically significance [OR=80.17, 95%CI=(21.53, 298.59)]. MRI analysis showed that in addition to signs of extensor tendon injury, the elbow was also widely associated with other changes, such as radial collateral ligament in-jury, bone marrow edema, joint effusion, tendon tear, and elbows muscle edema. Conclusion Through MRI findings,the maln pathological changes of the so-called lateralepicondyliti-saremalnly for total ex-tensor tendon and adjacent tissue of chronic injury, Naming the current external humeral epicondylitis is unreasonable. Therefore, periarthritis of lateral epicondyle of humerus seems to be the best appropri-ate term to be usedwhenthe ninth edition surgery textbooksisauthorized.

Objective To investigate the expression of FZD7 (frizzled homolog protein7,FZD7) and IL-6 (interleukin-6,IL-6) in primary hepatocellular carcinoma(HCC) and the impact on the prognosis.Methods Immunohistochemistry(IHC) was used to detect the expression level of FZD7 and IL-6 in 68 HCC tissues,30 para-carcinoma tissues and 10 healthy controls from patients with hepatic hemangioma.Patients were followed-up for survival analysis.Results The expression ratio of FZD7 in HCC tissue,paracarcinoma tissue and healthy controls were 72％,53％ and 0 (P ＜ 0.001),the ratio of IL-6 expression was respectively 69％,57％ and 0 (P ＜0.001).The expressions of FZD7 were positively correlated with that of AFP level (x2 =7.059,P =0.035),pathology classification (x2 =4.732,P =0.043),and the infection of HBs (x2 =3.508,P =0.032).The overall survival (65 ％ vs.84％,x2 =5.525,P ＜ 0.05) and the disease free survival (33％ vs.75％,x2 =5.991,P ＜0.05) of HCC patients with co-positive was significantly lower than that with co-negative expression of FZD7 and IL-6.Conclusion FZD7 and IL-6 play a critical role in development and progression of HCC.

Objective To review the clinical data of reduction mammoplasty by central pedicle technique,and to summarize all kinds of the complications to modify the technique for improvement of long term aesthetic effects.Methods The postoperative complications were analyzd and then an approach was used to investigate the pattern of the blood supply and the nerve distribution of breast.Based on the anatomical study,a modified double-circle reduction mammoplasty technique was designed to treat patients with hypertrophical breasts. Results With a follow-up for 3 months to 3 years,the patients who underwent this modified central pedicle technique,had an invisible scar,good projection,the better shape of breast and preserved their sensation of nipple-areola complex.Conclusions Modified central pedicle technique is a safe and reliable technique,especially ideal for Chinese women.The blood supply is rich and the sensation of nipple-areola complex is preserved.The fixation of the gland tissue is more important than the dermal-bra.

BACKGROUND: It has reported that nicotinamide is capable of protecting intervertebral disc (IVD) against interleukin-1β (IL-1β) or tumor necrosis factor-alpha (TNF-α) induced degeneration. However, the protective mechanism of nicotinamide on IVD cells apoptosis and proliferation remains unclear.OBJECTIVE: To investigate regulatory effects of nicotinamide on rabbit nucleus pulposus cell apoptosis and proliferation in vitro.DESIGN, TIME AND SETTING: Randomized control grouping design, which was carried out in the Laboratory of Orthopaedics and Stem Cell Center, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from April to October 2007.MATERIALS: Ten Japanese white rabbits (aged 2-3 months weighing 1.5-2.0 kg) were used in this study. Furthermore, nucleus pulposus cells obtained from L1-6 lumbar spine were harvested and cultured for further experiments.METHODS: The NP cells were divided into 6 groups, including control group (without any drug as control), nicotinamide group (0.5 g/L nicotinamide), IL-1β group (10 μg/L IL-1β), IL-1β + caspase group (10 μg/L IL-1β and non-specific caspase inhibitor Z-VAD-FMK), IL-1β + small-dose nicotinamide group (10 μg/L IL-1β and 0.05 g/L nicotinamide), and IL-1β + large-dose nicotinamide group (10 μg/L IL-1β and 0.5 g/L nicotinamide). After 3 days of culture, the cells were examined with Annexin V-PI staining, caspase-3, 8 and 9 activity staining and MTT assay.MAIN OUTCOME MEASURES: The apoptotic rates, the positive rates of caspase-3, 8 and 9 activity staining and the absorbance of MTT assay of each group.RESULTS: ① As compared to IL-1β group, the apoptotic rates were decreased in the IL-1β + caspase group and IL-1β + large-dose nicotinamide group (P < 0.01). ②As compared to IL-1β group, the positive rates of caspase-3, 8 and 9 activity staining were decreased in the IL-1β + caspase group, IL-1β + large-dose and small-dose nicotinamide groups (P < 0.01 or P < 0.01). ③As compared to IL-1β group, the absorbance was increased in the IL-1β + caspase group and IL-1β + large-dose nicotinamide group (P < 0.01).CONCLUSION: Nicotinamide is capable of promoting cell proliferation and inhibiting IL-1β induced apoptosis of nucleus pulposus cells in vitro. The inhibition of apoptosis mainly acts via inhibition of the mitochondrial pathway.

Objective To investigate the effect of erythropoietin on the proliferation,differentiation,and apoptosis of the cultured neonatal porcine islet cells in vitro.Methods Neonatal porcine islet cells were separated and pured from neonatal pigs with collagenase digestion and tissue culture,and their viability and purity were tested. The neonatal porcine islet cells were divided into a control group and an experimental group.The experimental group was treated with erythropoietin but not the control group,and the insulin secretion responsiveness induced by low and high glucose stimulation in the islet was tested after 5 days. Cells were counted and the activation of amplification was determined by MTT chromatometry. The rates of cell apoptosis were observed by ethidium bromide/acridine orange (EB/AO) of fluorescent light staining and flow cytometry,and the cell cycle was analyzed by flow cytometry. The expression of bcl-2,bax,caspase-3,glucose transporter 2 (GlUT-2),and pancreatic duodenal homeobox-1 (PDX-1) mRNA was tested by RT-PCR.Results After erythropoietin was treated in the cell culture,the neonatal porcine islet cells had normal morphology,function,and reaction of insulin secretion to the glucose stimulation. Cell count showed more cells in the experimental group than in the control group (P＜0.05). MTT chromatometry showed the optical absorbance tended to increase with time,and compared with the control group,the optical absorbance was higher in the experimental group (P＜0.05),the expression of PDX-1 mRNA was slightly up-regulated (P＜0.05). The expression of GLUT-2 mRNA had no difference in the 2 groups (P=0.34). In the experimental group,the apoptisis rate was lower than that in the control group by flow cytometry and EB/AO fluoscence staining (P＜0.01),and the expression of bcl-2 mRNA was higher. Howerer bax mRNA and caspase-3 mRNA were obviously lower than those in the control group (P＜0.01).Conclusion Erythropoietin can promote the proliferation but has no effect on the function of neonatal porcine islet cells in vitro. Erythropoietin can protect neonatal porcine islet cells from apoptosis through up-regulating bcl-2 mRNA and downreguling bax and caspase-3 mRNA.