Objective To provide anatomical basis for reconstruction thumb of free bifoltaed bone flap pedicled with the dorsal carpal branch of ulnar artery. Methods After red latex was infused into the arteries of 35 sides of adult cadaveric upper limbs, the origin, course, branches, diameters, skin branches and periosteal branches of dorsal carpal branch of ulnar artery were observed, to initate operation experiment of reconstruction thumb on 1 sides. Results The dorsal carpal branch begins with ulnar artery (4.0?1.0)cm above the pisiform with diameter of (1.3?0.5)mm, its pedicle ranges(1.2?0.5)cm and branches off into ascending and descending branches. There were outer diameter range(0.8?0.3)mm and (1.1?0.2)mm. Skin branches of dorsal carpal branch of ulnar artery nourinshed the forearm ulnar side, carpal and dorso-ulnar aspect of mid-hand, periosteal branches of dorsal carpal branch of ulnar artery nourished the anterior internus side of the ulnar and the fifth metacarpal bone. Conclusion The free bifoltaed bone flap pedicled with the dorsal carpal branch of ulnar artery is available to reconstruction the thumb.

Objective To explore the size of access channel that may influence the intrarenal pelvic pressure during percutaneous nephrolithotomy.Methods From April 2014 to July 2015,83 patiens with unilateral renal calculus,ranged from 20 to 40mam were divided into 2 group randomly.40 cases underwent F24 channel PCNL and 43 cases underwent F16 channel PCNL.There was no statistically significant difference between the groups in preoperative variables,such as age,gender,preoperative status of infection,status of hydrpnephrosis,size and location of stone (P ＞ 0.05).We used a 6Fr ureteral catheter positioned into the renal pelvic,and the intrarenal pelvic pressure was measured by anesthesia monitor IBP channel during PCNL in different stages (entrance into the collecting system,calculi fragmentation,and termination)for all patients.Removing calculus time,postoperative hemoglobin changing,fever rate,procalcitonin abnormal rate,white blood cell counts and calculi clearance rate were recorded and compared.Results The intrarenal pelvic pressure in different stages on F24 channel and F16 channel were (7.5 ± 1.3)、(22.5± 4.3)、(14.0 ± 2.7) mmHg and (10.3 ± 1.1)、(34.6 ± 4.1)、(23.0 ± 3.6) mmHg,respectively.There was statistically significant difference between 2 groups (P ＜ 0.05).Compared with F16 channel,F24 channel had significant differences in removing calculus time [(12.8 ± 3.7) min vs.(23.3 ± 3.6) min],fever rate [17.5％ (7/40) vs.39.5％ (17/43)],procalcitonin abnormal rate [15.0％ (6/40) vs.34.9％(15/43)] and white blood cell counts abnormal rate [10.0％ (4/40) vs.27.9％ (12/43)] (P ＜ 0.05).However,no significant difference in postoperative hemoglobin changing [(11.8 ± 4.4)g/L vs.(13.7 ±4.7)g/L] and calculi clearance rate [87.5％ (35/40) vs.81.4％ (35/43)] (P ＞0.05).Conclusions Compared with F16 channel,the F24 channel PCNL maintains lower renal pelvic pressure,which is less than reflux limit,during calculi fragmentation,It might be contributed to reduce the postoperative fever rate.It can short time for removing calculi and achieve the better effect.

[Objective]To discuss the common complications and the methods of prevention and treatment in the operation of displaced acetabular fracture.[Method]Sixty-six cases with displaced aceuabular fracture were treated operatively from August 2005 to June 2009.Approach included anterior ilioinguinal approach,posterior Kocher-Langenbeck approach,or combined ilioinguinal and Kocher-Langenbeck approach.The functional results and complications were analyzed.[Result]All cases were followed up for an average of 29 months(12-46 months).According to the Matta evaluation,the anatomical reduction of acetabular fracture were in 34 cases,perfect in 25,and unsatisfactory in 7.According to the modified Merle d' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as being excellent in 23 cases,good in 29,fair in 8,poor in 6.Sciatic nerve injury after operation were noted in 2 hips,osteoarthritis in 14,heterotopic ossification in 10,and avascular necrosis of femoral head in 2.No infection and death were founded in this group.[Conclusion]The important factors to decrease the operative complications of acetabular fracture include correct fracture classification,suitable operative time,good operative approach,proficient technique of reduction and fixation and reasonable perioperative measures.

AIM: To investigate the phenomenon that miR-let-7d regulates the proliferation and invasion abilities of the lung cancer cells through nuclear receptor peroxisome proliferator-activated receptors γ (PPARγ).METHODS: The relation between PPARγ and microRNA was analyzed by bioinformatics.The plasmid reporter assay was used to verify that PPARγ was the target of miR-let-7d.The lung cancer cell line with low expression of PPARγ was selected from different lung cancer cell lines by Western blot.The regulatory role of miR-let-7d in the lung cancer cells was determined by dual luciferase labeling and Western blot.The effect of miR-let-7d on the proliferation ability of lung cancer cells was detected by colony formation assay, the effect of miR-let-7d on the invasive ability of lung cancer cells was detected by Transwell invasion assay.RESULTS: The results of bioinformatic analysis showed that miR-let-7d regulated the expression of PPARγ, and the 3'UTR of PPARγ contained 2 functional miR-let-7d binding sites, indicating that PPARγ is a direct target of miR-let-7d.miR-let-7d was able to directly regulate the expression of PPARγ at mRNA and protein levels.Transfection of miR-let-7d inhibitor promoted the proliferation and invasion abilities of lung cancer cells by increasing the expression of PPARγ.CONCLUSION: miR-let-7d increases the expression of tumor suppressor PPARγ to inhibit the proliferation and invasive abilities of lung cancer cells.

Objective To study the dynamic changes of serum concentration of soluble cell adhesion molecule (sCAM) in patients with aneurysmal subarachnoid hemorrhage.Methods Serum concentrations of sCAM in 30 patients with aneurysmal subarachnoid hemorrhage were detected using ELISA method before surgery and at 1~3 d, 7~9 d and 11~13 d after surgery. Transcranial Doppler sonography was used to measure the velocity of middle cerebral artery (VMCA). The results were compared with 20 healthy controls.Results Serum concentrations of sCAM at 1~3 d and 7~9 d in patient group were significantly higher than that in control group (all P

Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.

Objective To investigate the potential differences in efficacy of anterior and posterior cruciate ligaments(ACL &PCL)reconstruction by using arthroscopy between autologous tendon and tendon allograft.Methods A total of 144 patients with ACL or PCL fracture were assigned into two groups,namely anterior tibial muscle tendons allograft(n =82)and tendons autograft(n =63).The graft was fixed by using the Endobutton and Intrafix systems. The general information,drawer test,Lachman test,IKDC score,Lysholm score and Tegner score were compared between groups before and after surgery.The mean follow -up period was 16 months,ranged from 6 to 24 months. Results Both two groups received significant improvement after surgery and met the requirements of ligament reconstruction.However,those patients received autologous tendon had less complications,better knee stability.There were significant differences in Lachman score,ADT/PDT score,IKDC score[(83.43 ±4.37)points vs.(81.05 ± 4.41)points],Lysholm score [(90.59 ±3.43)points vs.(89.03 ±3.25 )points],and Tegner score [(7.79 ± 0.94)points vs.(7.37 ±0.90)points]between the two groups in 12 -month(χ2 =9.509,9.080,t =3.237,2.770, 2.729,all P <0.05).Conclusion The efficacy of autologous tendon is better than tendon allograft in anterior and posterior cruciate ligaments reconstruction,which should be considered has highest priority in treating patients with anterior or posterior cruciate ligaments fracture.

Objective To prepare HCC-targeted lipid ultrasound microbubble containing 10-hydroxycamptothecin (10-HCPT), and to assess its targeting function in vitro. Methods After the biotinylated monoclonal antibody Hab18 was prepared, the biotinylated degree was determined. Microbubbles containing 10-HCPT were prepared by mechanical vibration. Then the biotinylated antibody was attached to the surface of the microbubbles by avidin-biotin interaction. The physical property, entrapment efficiency and the drug-loading amounts of 10-HCPT lipid microbubbles were determined. The combination of biotinylated Hab18 with microbubbles containing 10-HCPT was proved by immunofluorescent assay, and the targeting function of the targeted microbubbles containing 10-HCPT was observed with light microscope, served non-targeted microbubbles as control group. Results About 13 biotin molecules were coupled to each antibody in average. The disposition of the prepared microbubbles was steady and the mean diameter was 1.52 μm. The drug entrapment efficiency was 76.32% and the drug-loading amounts was 21.81%. Red fluorescence was observed at the edge of the microbubbles in immunofluorescent assay, and the conjugation of the targeted microbubbles containing 10-HCPT with 7721 cells was tight while control group was negative. Conclusion HCC-targeted lipid ultrasound microbubbles containing 10-HPTC can be prepared successfully, with higher entrapment efficiency and drug-loading amounts and strong targeting function in vitro.

Objective:To obtain recombinant Profilin of silkworm,identify its immunogenicity,predict its B cell epitopes and construct the evolutionary trees. Methods: The nucleotide sequence of Profilin was acquired from NCBI,synthesized it and cloned it into pET-28 vector. Then,the recombinant plasimids were transformed to E. coli BL21. After induced by IPTG,recombinant protein was purified by Affinity chromatography. Furtherly,its allergenicity was identified by Western blot,the potential B cell epitopes was analyzed through DNAStar and build the evolutionary trees by MEGA5. 05. Results: The recombinant protein of Profilin was successfully expressed and purified by affinity chromatography. Besides,the protein contains a high IgE-binding activity with IgE existing in serum of patients allergic to silkworm. Conclusion: The recombinant proflilin has IgE-binding activity, and it is meaningful for fundamental research and specific diagnosis studies of allergic diseases caused by silkworm.

Objective To explore the content of peripheral blood T lymphocyte subsets and natural killer (NK) cells in diffuse large B-cell lymphoma (DLBCL) in different clinical stages and analyze their clinical significance.Methods Sixty-two DLBCL patients were divided into 3 groups according to clinical stages:stage Ⅱ group (21 cases),stage Ⅲ group (21 cases ),stage Ⅳ group (20 cases).Thirty healthy examiners were selected as control group.Two ml peripheral blood was taken from every person.Peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+) and NK cell count were detected by flow cytometry(FCM) and CD4+/CD8+ was calculated.Results CD3+ in stage Ⅱ and Ⅲ groups[(854.6 ± 276.9 ) × 106/L,(823.3 ± 211.5)× 106/L] were lower than those in control group[(1268.8 ±684.0) × 106/L] and stage Ⅳ group [(1332.7 ±571.2) × 106/L](P ＜ 0.05).CD4+ in stage Ⅱ,Ⅲ,Ⅳ groups [(433.5 ± 240.7) × 106/L,(423.8 ± 234.8) ×106/L,(423.0 ± 143.8 ) × 106/L] were lower than those in control group [(751.3 ± 367.4) × 106/L] (P ＜0.05).CD8+ and CD4+/CD8+ in stageⅣ group [(861.2 ±634.1) × 106/L,0.5 ±0.3] were significantly higher than those in control group [(455.9 ± 334.6) × 106/L,2.1 ± 1.3],stage Ⅱ group [(390.6 ± 54.1 ) × 106/L,1.0 ±0.8] and stageⅢ group [(377.4 ±493) × 106/L,0.9 + 0.6](P＜0.05).NK cell in stage Ⅳgroup was obviously lower than that in control group[(210.3 ± 122.0) × 106/L vs.(353.3 ± 284.7) × 106/L,P＜ 0.05].And the higher clinical stage was,the lower NK cell was.Conclusions With the clinical stage increasing,the immunity depression and disorder of DLBCL patients become more and more serious,the more tumor burden is,the worse NK cell activity is.