Objective To investigate clinical effects of cutaneous branch flaps of the low medial leg for the repair of soft tissue defects on the foot and ankle.Methods A flap with pedical of cutaneous branches of the low medial leg was used for the repair of 7 cases of skin and soft tissue defects on the feet and ankle from March 2003 to October 2005.The cutaneous branches of the posterior tibial artery were identified along the medial border of the tibia and between the soleus muscle and the flexor digitorum longus muscle.The flap was mobilized according to the site and length of the cutaneous branches,and was transferred to soft tissue defects for skin grafting. Results The operating time was 3~5 hours(mean,4.2 hours).The flaps survived completely in all the 7 cases.Follow-up checkups were carried out for 5~18 months(mean,10 months).The appearance and functions of the foot were satisfactory and met the requirements for daily activities.Conclusions The procedure can effectively repair soft tissue defects on the foot and ankle and does not sacrifice the major arteries.This flap is easy to be prepared.

Objective To explore the short to long term surgical outcomes and treatment experiences of esophageal atresia（EA）.Methods The clinical data of EA inpatients in our hospital from 2006 to 2009 were reviewed retrospectively.The birth weight,main associated anomalies,details of management,complications and outcomes were discussed.Main risk factors were evaluated with major prognostic classification systems.Results Totally 48 consecutive infants with EA were identified from 2006 to 2009,male 33（69%）,female 15（31%）.Mean birth weight was 2 668 g（range 1 700 g to 3 800 g）.All received primary operation.Complications included pneumonia,anastomotic leakage（16%）,tracheoesophageal fistula,incision sepsis（11%）,delayed tracheoesophageal fistula（7%）,stricture（10%）,and gastroesophageal reflux（GER）（67%）.Mortality was 12.5%,mainly due to severe pneumonia and complex cardiac anomalies.Conclusion Most patients with esophageal atresia could be cured after primary operation with excellent outcomes.The main factors for mortality were complex cardiac anomalies,aspiration and pneumonia.The main mid-term complications were GER and stricture.

Availability of appropriate drugs for children has been a bottleneck both at home and abroad for years.As a result, drugs for adults that are market available emerge a choice of convenience for children's treatment instead.For unique physiological and psychological characteristics of children, these drugs must be dispensed on individual basis before usage to children in question.Such drugs play a key role in children's treatment, and incur many problems on the other hand in their use and practice, such as drug stability, dosage accuracy, potential risks, as well as legitimacy in drug dispensing and use.A safe, reasonable and normalized use of such drugs calls for an orchestrated effort among pharmacists, trade associations and drug regulators as well.

Objective To retrospectively evaluate different methods (laboratory tests,liver / gallbladder ultrasound and magnetic resonance cholangiopancreatography)in differentiating biliary atresia from infant hepatitis syndrome.Methods Seventy infants with cholestatic jaundice,50 cases of biliary atresia and 20 cases of infant hepatitis syndrome were studied prospectively from January 2010 to December 2012.All cases underwent abdominal ultrasound and magnetic resonance cholangiopancreatography.The accuracy,sensitivity,specificity and predictive values of these various methods were compared.Also the laboratory parameters were statistically analyzed and compared between groups.Results Patients with BA had significantly higher GGT values at presentation [(743.5 ± 564) IU/L] compared with infants with IHS [(198.8 ± 197.8) IU/L],showing statistically significant difference (P ＜ 0.05).The sensitivity,specificity,and accuracy of the ultrasound in diagnosis of BA were 84.0％ 、100.0％ 、88.6％ respectively(P ＜ 0.05).The values for magnetic resonance cholangiopancreatography were 82.0％ 、80.0％ 、81.4％ (P ＜ 0.05).Conclusion Currently,the method of ultrasound is more reliable than MRCP for differentiating biliary atresia from infant hepatitis syndrome.

Objective To investigate the probable pathologic basis of amido proton transfer(APT) imaging by analysing APT signal intensity and pathologic features of different grades of glioma.Methods Twenty-eight patients with glioma confirmed by postoperative pathology underwent APT scan.All the patients were divided into two groups,including 11 cases in low grade (WHO Ⅰ and Ⅱ) and 17 cases in high grade (WHO Ⅲ and Ⅳ) group.The APT rate of tumor core was measured.The specimens were processed with routine hematoxylin-eosin (HE) staining and immunohistochemistry of Ki-67 and CD34.Independent-samples t test was used to detect the difference of APT rate,cellularity,microvessel density and Ki-67 labeling indices of tumor core between low grade and high grade group.Pearson correlation analysis and multi-variable linear regression analysis were used to detect the relationship of APT rate with cellularity,microvessel density and Ki-67 labeling indices of the tumor core.Results The APT rate,cellularity and proliferation index were (2.3±0.6) ％,(9.4±2.4) ％ and (14.2±5.4) ％ in low grade group,while (3.6±0.7) ％,(18.4±4.7) ％ and (31.7±4.5) ％ in high grade group,respectively.Microvessel density was (19.0±7.4) per high-power field in low grade group and (38.9±11.3) in high grade group.There were statistical differences of the APT rate,cellularity,microvessel density and proliferation index between the low grade group and the high grade group (t=-4.94,-5.89,-5.13,and-9.28,respectively,P＜0.01).The APT rate was positive correlated with cellularity,microvessel density and proliferation index.The coefficient of correlation were 0.904,0.598,and 0.750,respectively,(P＜0.01).Multiple linear correlative analysis showed that increasing cellularity (X1),microvessel density (X2) and proliferation index (X3) were the main factors for increasing APT rate,and the correlation equation was Y=0.801 + 0.12X1-0.003X2 + 0.026X3 (F=46.437,P＜0.01,R2=0.853).Conclusions The APT signal intensity of the tumor core could reflect the pathologic features of glioma.The APT rate was positive correlated with cellularity,microvessel density and proliferation index,which indicate the higher APT rate the higher grade tumor.

Objective To study the key technology and initial results of laparoscopic liver resection for hepatocellular carcinoma(HCC)with B posthepatitic cirrhosis.Methods From March 2007 to September 2008,37 HCC patients with posthepatitic cirrhosis were treated with laparoscopic liver resection in our hospital.Results Thirty-two patients received successful total laparoscopic liver resection,3 handassisted laparoscopic liver resection,and 2 were converted to open surgery.Anatomic liver resection was performed in 23 patients including 4 left hepatectomy,8 left lateral segmentectomy,1 extended left hepatectomy,2 right hepatectomy,8 segmentectomy.Fourteen patients underwent nonanatomic liver resection.Liver parenchyma was transected under regional hemi-hepatic blood occlusion in 10 patients,under intermittent Pringle's manoeuvre in 15 cases,and without hepatic blood inflow blockage in 12 cases.The mean operative duration was 212 min(76-435 min)and mean blood loss 354 ml(100-1300 ml).Mortality rate was 0%.Six patients developed 9 postoperative complications including intraabdominal hemorrhage in 1 case,ascites and hydrothorax in 3 and encapsulated effusion of liver section in 2.The mean postoperative hospital stay was 8d(4-15d).In a follow-up from 2 to 21 months,3 patients developed intrahepatic tumor recurrence.One of the 3 patients died 6 months after reoperation,and the other 2 received chemoembolization and radiofrequency ablation,respectively.Conclusion Laparoscopic liver resection for HCC with posthepatitic cirrhosis in selected patients is a safe procedure with oncologic efficiency.Its advantages include reduced invasiveness,quick rehabilitation,few postoperative complications and short hospital stay.

BACKGROUND:It is not certain that whether human adipose-derived mesanchymal stem cells express telomerase reverse transcriptase (TERT).OBJECTIVE:To investigate whether human adipose-derived mesenchymal stem cells express telomerase reverse transcriptase or not.DESIGN,TIME AND SETTING:The cytology in vitro experiments were performed at TEDA Life and Technology Research Center,Institute of Hematology and Blood Diseases Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College in August 2009.MATERIALS:Adult adipose tissue was obtained from 5 healthy donors undergoing liposuction at the Tianjin Yili Medical Cosmetology Plastics Outpatient.Hela cells were supplied by the Cell Center of Basic Medical Sciences,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences.METHODS:Human adipose-derived mesenchymal stem cells were isolated from 20 mL human edipose tissue of each healthy donor by collagenase digestion.Cells were digested by trypsin when 80% confluency.Hela cells served as controls,and treated with 1640 medium containing 10% fetal bovine serum,and then digested using trypsin when 80% confluency.MAIN OUTCOME MEASURES:Morphology,phenotype and differentiation of human adipose-derived mesenchymal stem cells.TERT of human adipose-derived mesenchymal stem calls were detected by reverse transcription-polymerase chain reaction (RT-PCR).Telomerase activity was measured by telomeric repeat amplification protocol assay ELISA (TRAP-ELISA).RESULTS:Human adipose-derived mesenchymal stem cells adhered to the flask,presented spindle shape,and whirlpool-shape when cell density was large.Human adipose-derived mesenchymal stem cells were labeled positively for CD73,CD90 and CD105,but negatively for CD19,CD34,CD11b,CD45,and HLA-DR.Following adipogenic induction,oil red O staining showed significant red oil drop.Following ostesgenic induction,Von Kossa staining showed black particles,which indicated calcium deposition.Human adipose-derived mesenchymal stem cells at P1,P4 and P7 did not express telomerase reverse transcriptase gane.Human adipose-derived mesenchymal stem cells from 5 different donors did not expression telomerase reverse transcriptase gane.Hela cells had telomerase activation,but human adipose-derived mesanchymal stem cells did not express telomerase activation.CONCLUSION:Human adipose-derived mesanchymal stem cells do not express mRNA of hTERT,nor the activity of telomerase reverse transcriptase.

Objective To detect the expression of Zbtb7 gene in Phorbol esters(PMA) induced differentiation of leukemia cell lines.Methods 50 nmol/L PMA was used to induce the differentiation of U937 and K562 cell lines.The expression of Zbtb7 was detected by real-time PCR in the cells after induction on day 0,1,3 and 5,respectively. Results The expression of Zbtb7 in leukemia cell lines was markedly enhanced after treated by PMA(P

Objective:To explore the hemodynamic and comfort effect of modified prone-flexed position in complexity renal calculi patients undergoing percutaneous nephrolithotomy.Methods:A total of 82 cases of complexity renal calculi patients who undergoing percutaneous nephrolithotomy were recruited and randomly assigned to experiment group (41 cases) and control group (41 cases). Patients in the control group were placed in conventional prone position, while in the experiment group were placed in modified prone-flexed position. The data include blood pressure, heart rate, respiratory rate, saturation of blood oxygen were recorded at preoprative, lithotomy position, change position 30 minutes after operation and postoperative. The General Comfort Questionnaire (GCQ) score was recorded in patients for postural comfort. The clinical data was also compared between two groups.Results:There was no significant difference in blood pressure, heart rate, respiratory rate, saturation of blood oxygen between experiment group and control group ( P>0.05). Compared to (44.95±4.80) min, 90.2% (37/41) of the control group, the patients in the experiment group was (47.80±6.71) min, 73.2% (30/41), which showed a shorter average operation time and higher total stone clearance rate, the differences were statically significant ( tvalue was 2.216, χ2value was 3.998, P<0.05). At immediately and 30 minutes after operation, the skin pressure were 9 cases and 4 cases in the experiment group, 18 cases and 11 cases in the control group, the differences were statically significant ( Zvalues were 2.132, 2.038, P<0.05). After 48 hours of surgery, the physical subscale and totl GCQ score were (13.32±1.40) and (78.56±4.65) pionts in the experiment group, significantly higher than (12.17±1.41), (75.76±5.16) pionts in the control group, the differences were statically significant ( tvalues were 3.685, 2.584, P<0.01 or 0.05). Conclusion:Modified prone-flexed position can shortern operation time decrease the risk of pressure injury and demonstrate better postural comfort of patients with complexity renal calculi undergoing percutaneous nephrolithotomy.

BACKGROUND:An effective freezing-thawing technique is crucial for the clinical application of human umbilical cord mesenchymal stem cells(UC-MSCs).OBJECTIVE:To investigate biological characteristics of UC-MSCs after cryopreservation.METHODS:UC-MSCs were isolated from human umbilical cord and frozen in liquid nitrogen.The survival rate and the suppressive effect of γ-interferon(IFN-γ)of cryopreserved-thawed and fresh human UC-MSCs were compared.Furthermore,the multiple potentials and phenotype of UC-MSCs were estimated after cryopreservation.RESULTS AND CONCLUSION:There was no significant difference between cryopreserved-thawed and fresh human UC-MSCs on the survival rate and the suppressive effect of IFN-γ of peripheral blood mononuclear cells(PBMCs).After cryopreservation,human UC-MSCs had the potential differentiation and the phenotype of mesenchymal stem cells.