Objective To evaluate the clinical results of flexor hallucis longus (FHL) tendon transfer in treatment of patients with Achilles tendon defects of more than 6 cm. Methods Between January 2005 to February 2009, 19 patients with Achilles tendon defects, 13 males and 6 females, were treated with FHL tendon transfer. Their ages ranged from 20 to 61 years, with an average of (42. 6 ± 8.2)years. Fifteen defects were found during tendonitis debridement, and 4 were old ruptures. Time from rupture to surgery ranged from 0 to 6 months (average, 2.6 months). Defects were 6 cm to 10 cm long. Procedures were performed in a two-incision manner. The postoperative ROM of ankle joint, American Orthopaedic Foot and Ankle Society(AOFAS) and visual analogue scale(VAS) scores were recorded at 3 months, 12 months,and the last follow-up. The results were statistically analyzed to evaluate the functional recovery. Results Follow-ups lasted from 12 to 48 months (average, 22. 2 months). At the last follow-up, the average ROM of ankle joint was 17.8°± 1.9° at dorsal flexion and 39.1°±2.3° at plantar flexion, and the last average AOFAS score was up to (91.8 ± 1.7), significantly different from those at 3 months after surgery (P＜0.05), but not significantly different from those at 12 months (P＞0.05). The difference were significant between the results of 3 months and 12 months (P＜0.05). The last average VAS score was (1.0±0.7),significantly different from those at 3 months and 12 months(P＜0.05) . There was also significant differences between the VAS scores of 3 months and 12 months (P＜0.05). Patient's satisfaction was 100%.Conclusion FHL tendon transfer is an efficient procedure for long Achilles tendon ruptures associated with tendonitis in relieving pain and maintaining the function of ankle joint.

Objective To evaluate the foot function after Lisfranc injury with local soft tissue in-jury. Methods From November 2000 to April 2006, 43 patients (at mean age of 32 years) with fresh Lisfranc injuries (45 sides) were managed with open reduction and internal fixation with screws, Kir-schner wires and AO plates. All patients had no joint surface damage and received no fusion surgery. Ac-cording to the Quenu-Kuss classification of Lisfranc injury, there were 14 patients with type-A injury, 21 with type-B and 10 with type-C. According to AO classification, there were 29 feet without severe soft tis-sue injury and 16 feet with severe soft tissue injury, of which 10 patients were combined with severe local soft tissue injury (one patient with Foot compartment syndrome). The period from injury to surgery was seven days. All patients received cast immobilization for 8-12 weeks and the foot function was evaluated by anteroposterior and lateral X-rays and American Orthopedic Foot and Ankle Society (AOFAS) score. Results All patients were followed up for 12-69 months (average 37 months), which showed that all pa-tients obtained anatomic reduction and 32 patients were satisfied with operative outcome. The average postoperative AOFAS score was 97 points for patients without severe soft tissue injury and 82 points for pa-tients with severe soft tissue injury (P<0.05). Conclusion After Lisfranc injury, the foot function is related to severity of both joint injury and local soft tissue injury.

Child ; Gene Rearrangement, T-Lymphocyte ; Humans ; Neoplasm, Residual ; diagnosis ; Polymerase Chain Reaction ; methods ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; Receptors, Antigen, T-Cell ; genetics

Adolescent ; Child ; Child, Preschool ; Female ; Homeodomain Proteins ; genetics ; Humans ; Infant ; Male ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics

Emergency Treatment ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; complications ; therapy ; Myocardial Infarction ; complications ; therapy ; Pancreatitis ; complications ; therapy ; Treatment Outcome

Chemokines are major regulators of cell transformation and adhesion.Recent study has demonstrated that CXCR7 can bind to CXCL11 and CXCL12 with high affinity,and the activated CXCR7 may influence tumor invasion and metastasis by regulating extracellular matrix (ECM) and epithelial-mesenchymal transition (EMT) and other signal transduction pathways.Therefore,in-depth study of the molecular mechanisms of CXCR7 in tumor invasion and metastasis may provide a more effective theoretical basis for tumor treatment.

Sepsis is a serious problem among the elderly population as its incidence and mortality rates dramatically increase with advanced age. More importantly, the elderly has increased vulnerability to developing sepsis due to diminished physiologic reserve, presence of comorbidities, immunosenescence and frequent instrumentation. Those who survive severe sepsis are more likely to have irreversible organ damage, cognitive impairments, and diminished overall function. Additionally, elderly patients with sepsis often present with atypical symptoms which further complicates and potentially delays diagnosis. Although sepsis is a serious life-threatening disease, recognition of this problem is very low compared to other age-associated diseases. Therefore, the purpose of this review is to analyze the challenges facing this cohort and how to optimize their management.

Fluid overload is frequently found in patients with intravenous fluid resuscitation,and recent studies showed the potential risks of fluid overload for organ failure and mortality.To avoid volume overload and its associated complications,strategies to identify fluid responsiveness are necessary.Apart from the amount of fluid utilized for resuscitation,the type of fluid used also impacts patient outcome.In recent years,there has also been an increasing focus on comparing various resuscitation fluids with respect to both benefits and risks.In this article,through analyzing the impact of fluid overload on patient outcome,we describe the differences in static and dynamic estimates of fluid responsiveness,and review the current literature regarding choice of intravenous fluids for resuscitation in critically ill patients to help clinicians to make appropriative decision on intravenous fluids prescription and to optimize patient outcome.

The authors first describe the current situation of cooperative medical care in China, pointing out that due to low levels of guarantee, difficulties in fundraising and insufficient government reimbursement, cooperative medical care in rural areas have come across many hardships. It is, therefore, imperative to set up as soon as possible a health security system for people in rural areas. Firstly, it is necessary to break up the dual social security structure of urban and rural areas and set up a model with transitional goals based on the actual situation of the country. Secondly, it is suggested that security taxes begin to be collected, bringing the health security for people in rural areas into line with the social security framework so as to promote the health security for people in rural areas without lowering the level of social security in urban areas.

Objective To prepare huperzine A-carrier protein conjugate and determine its immunogenicity for later production of monoclonal antibody against HupA and establishing an enzyme-linked immunosorbent assay ( ELISA) -based detection method for HupA. Methods HupA was conjugated with bovine serum albumin ( BSA) using glutaraldehyde ( GA) method to obtain the HupA-GA-BSA conjugate,and the hapten number in the conjugate was determined by matrix-assisted laser absorption ionization time-of-flight mass spectrometry ( MALDI-TOF-MS) . BALB /c mice were immunized with HupA-GA-BSA to prepare the antiserum against HupA. The serum titer and specificity of the HupA antibodies were detected by indirect ELISA and competitive ELISA,respectively. Results The conjugation ratio of HupA and the carrier protein BSA was 8∶ 1. The antiserum against HupA with a titer of 1∶ 62 500 was obtained after immunizing the mice with the conjugate,and the antiserum reacted specifically to HupA. Conclusion The synthesized HupA-GA-BSA conjugate possesses good immunogenicity in mice,suggesting the feasibility of preparing the monoclonal antibody against HupA using this conjugate.