Talus necrosis is difficult to cure in clinical practice and how to treat it remains con-troversy.Microsurgical methods provide a new path for curing the disease and good curative effects have been achieved according to the literature.This article reviewed microsurgical treatments for talus necrosis in recent years and it may provide references for clinical practice.

Leptomeningeal metastasis (LM),with a high omission rate in diagnosis in approximately 5 ％～8 ％ of all patients, is increasingly recognized as a lethality complication. The diagnosis of LM remains challenges,but commonly can be established by CSF cytology or by definitive neuroimaging. Although a combination of focal radiotherapy,intrathecal chemotherapy,and systemic chemotherapy may be necessary to achieve optimal treatment of patients, but prognosis is unacceptable and therapy remains palliative in most patients.

OBJECTIVE:To find out the regulareity of adverse reactions(ADRs)induced by oral Penicillins(QMSK)and evaluate the safety of QMSK in clinical use.METHODS:Data of ADRs of QMSK,which collected from published articles were retrieved from CHINESE PHARMACEUTICAL ABSTRACT issued between January1995and April2003.According to the given standard,the data were statistically analysed.RESULTS:There were334cases which had24kinds of ADRs of QMSK,of which,121cases were male while213cases were female.There were drug eruption in249cases(74.55%),allergic shock34(10.18%),exfoliative dermatitis9(2.7%)and toxic epidermalnecrolysis7(2.1%),miscellaneous reactions31(8.97%)and5(1.5%)deaths.CONCLUSION:QMSK caused ADRs apparently.QMSK should be used according to penicillins for injections and safe of patients should be ensured in use of QMSK.

The course of functional laboratory science is the bridge between classroom and clinical practice.In functional laboratory science teaching,we should pay attention to features of nursing care,focus on training compassion,clinical awareness,collaboration ability,practical skills for nursing students and combine the reform of functional laboratory science teaching with cultivation of professional quality for nursing students.

Objective:To analyze the osmotic pressure of citicoline sodium injection from different manufacturers to provide experi-mental basis for improving the national standard of the product. Methods:The cryoscopic method was used to detect the osmotic pres-sure of 479 batches of citicoline sodium injection from 45 pharmaceutical factories. Results:The osmotic pressure of citicoline sodium injection was within the range of 359-692 mOsmol · kg-1 , that of citicoline sodium for injection was within the range of 401-1408 mOsmol·kg-1 , and that of citicoline sodium chloride injection was within the range of 278-299 mOsmol·kg-1 . Conclusion:The os-motic pressure of citicoline sodium injection and citicoline sodium for injection from different manufacturers is obviously different. It is necessary to detect osmotic pressure in the quality standard in order to evaluate the quality of preparation process.

Objective:To establish a quantitative method for the determination of lysine hydrochloride in pediatric compound lysine granules. Methods:The quantitative determination was performed on an amino acids analyzer. The cationic resin column(150 mm × 4. 6 mm,7 μm)was used. The mobile phase was citrate buffer solution (pH 3. 45) and citrate buffer solution (pH 10. 85) with gradient elution at a flow rate of 0. 45 ml·min-1 . The detection wavelengths were set at 570 nm and 440 nm. Results:The linear range of lysine hydrochloride was 2. 692-21. 536 μg·ml-1(r=0. 999 5), and the average sample recovery was 98. 85% with RSD of 0. 63% (n=9). Conclusion:The method is sensitive, simple and reproducible. It can be used for the quality control of pediatric compound lysine gran-ules.

BACKGROUND:The severity of tissue injury varies with the causes of the amputated finger. Simple soft tissue, vessels or nerves injury could be easily repaired by adjacent finger flap or abdominal flaps. However, these treatments are short of long repair time, reoperation and unsatisfactory appearance of the finger. OBJECTIVE:To investigate the efficiency of Flow-through flap from the fibular side of great toe to repair skin and soft tissue defects in digital replantation. METHODS:From January 2011 to October 2013, Flow-through flap from the fibular side of great toe was applied to repair soft tissue injury in digital replantation for 11 cases (8 males and 3 females, age ranged from 23 to 42 years. Skin defects ranged from 2.0 cm ×1.5 cm to 4.0 cm×2.2 cm; vascular defect ranged from 1-3 cm, 1.5 cm averagely; and the flap size ranged from 2.2 cm×1.7 cm to 4.5 cm×2.5 cm. RESULTS AND CONCLUSION:The folow-up time of al patients was 6-18 months. Digital replantation was successful in al the 11 cases. Ten cases were healed by first intention, and one case was gradualy rescued after dressing change. Patients were satisfied with the flap and the peripheral sensation. The peripheral discrimination of patients was 4 to 10 mm. The fingers functioned wel in flexion and extension. Of the 11 cases, 9 cases were valued excelent and 2 cases was rated as good, according to the upper extremity function evaluation standard of the Hand Surgey Branch of Chinese Medical Association. Flow-through flap from the fibular side of great toe is an ideal method to repair skin soft tissue and vascular defects in digital replantation.

Objective To investigate the relation and difference of expression phase between classⅡtransactivator (CⅡTA) and HLA-DR antigens after IFN-? incubation, so as to investigate the potential effect of the class Ⅱ trasactivator (CⅡTA) in graft-versus-host disease(GVHD). Methods T lymphocyte from peripheral blood of health was incubated with IFN-? for 1 000 U/ml. RT-PCR was used to detect CⅡTA mRNA and Western blot was used to explore HLA-DR antigen in various time periods. Then Stat1? antisense oligonucleotides (AS) were given to inhibit the expression of CⅡTA, CⅡTA mRNA and HLA-DR antigen were tested again at peak point. Results CⅡTA mRNA was detectable 5 h after IFN-? treatment and peaks at 14 h; HLA-DR protein was detectable 28 h after IFN-? treatment and peaks at 52 h. The expression of CⅡTA mRNA and HLA-DR protein was lower in AS groups than that in control groups. Conclusion CⅡTA expression was positively correlated to HLA-DR expression, and earlier than the HLA-DR expression after IFN-? incubation. CⅡTA might be used as an early predicting marker of GVHD.

Objective To observe the curative effect of the treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.Methods Twenty-nine cases were investigated.In which Garden type Ⅲ were 10 and type IV 19.There were 12 ca$,e8 of fresh fractures and 17 old fractures.According to the X-ray films of old fractures,caput femoris necrosis occurred in 7 patients.Tibial tubercle traction was carried out as preoperative preparation as soon as the patients were sent to hospital.The operation was performed by combining hollow-lag-svcrews fixing with vascularized great trochanter bone flap transposition.Results The foUow-up lasted 39 to 84 months,with an average of 54 months.The patients suffering from fresh femoral neck fractures all recovered and no necrosis WaS found.The healing time was between 4 to 6 months,with an average of 4.5 months or so.And old fractures were all healed up almost within the same time.The recovery time of patients who suffered from fractures and necrosis was with an average of 12.5 months.Of 10 cases of old fractures without caput femoris necrosis prior to operation,necrosis occurred in 3 c88es.The functions of hip joints of 15 cases completely recoveTed,and 12 patients were partially restricted.Another 2 patients could not squat because the flexion function was seriously restricted.The crispation of limbs was well corrected.According to Harris standard.the postoperative mean SCOre is 89.2.Concision It is good for treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.

ObjectiveTo observe the curative effect of Gustilo typeⅢ fracture with soft tissue defect of leg in children.MethodsOf the 15 patients,the area of the soft tissue defect varied from 5 cm × 6 cm to 8 cm × 12 cm.With regard to the location of soft tissue defect,two were situated at the upper third of the leg,eight were middle part of the leg,four were lower portion of the leg and dorsum of foot,one was lower portion of the leg and heel.The fracture was fixed by external fixation device and raw surface was closed by negative pressure drainage in the first stage.The raw surface was eventually covered by the transposition of regional flap or cross leg flap in the second stage.Among them,three patients underwent transposition of saphenous neuro-veno-fasciocutaneous flap, three patients underwent sural neuro-veno-fasciocutaneous flap transposition,one case of medial head of gastrocnemius muscle flap and 7 cases of cross leg flap were performed,while only 1 patient underwent free lateral anterior thigh flap transposition.ResultsOne patient who underwent transposition of saphenous neuro-veno-fasciocutaneous flap present with necrosis of the distal end of the flap 5 days after operation,which was then cured by cross leg saphenous neuro-veno-fasciocutaneous flap.Dark crust in distal end of flap occurred in 1 patient who underwent sural neuro-veno-fasciocutaneous flap,which was cured by changing dressings.Bone fracture of 14 patients were all healed.One patient who was classified as Gustilo Ⅲ c underwent cross leg flap, but bone defect was produced 18 months later.Through 3 months to 2 years follow-up,the texture,colour and shape of flap is good. ConclusionWith regard to Gustilo type Ⅲ fracture combined with soft tissue defect of leg in children,external fixation coupled with flap transposition can cure effectively.