Objective To evaluated the association between the NAGL and the chronic kidney disease (CKD) patients with iron status,which was occurred iron scarcity for CKD patient in clinical.Methods 154 CKD patients were included in this study.Serum neutrophil gelatinase-related lipid transport protein(NGAL) were detected in anemia group and non-anemia group of chronic kidney disease.The NGAL,univariate correlation and multivariate regression analysis,as well as ROC curve analysis,were used to assess and compared the diagnostic potential of NGAL,ferritin,EPO and Tfr (transferrin receptor) in CKD patients after analyzing the patient's iron status.Results NGAL levels were markedly higher in CKD patients with anemia than CKD patients without anemia.In the analysis,NGAL was inverse correlated with hemoglobin,hematocrit,MCV,MCH,serum iron and TSAT(correlation relation was-0.36,-0.32,-0.26,-0.31,-0.38,-0.3,respectively).ROC analysis was employed to assess and compare the diagnostic potentials of the NGAL,ferritin,EPO,and Tfr (transferritin receptor) in identifying this condition among CKD patients.The NGAL showed that the area under the curve of iron deficiency in CKD patients (AUC) was 0.713,with good sensitivity and specificity (58.6％ vs 74.7 ％).Conclusion NGAL might be proposed as a new tool in the assessment of iron deficiency and in the management of iron therapy for CKD patients.

Objective To explore the application and formulas of the tumescent technique in the ultrosonic liposuction for better and more predictable reseults. Methods The tumescent technique formulas were present and analysed through 318 cases of ultrosonic liposuction. Results The following regimen was recommended as a result of the above studies: Lactated Ringer's solution or nosmal sodium was the fluid of choice; Lidocaine (500 mg/l) was a reference anesthetic. The maximal safe dose recommended for liposuction was 35 mg/kg body weight and total dose of epinephrine was 2～3 mg/l. But its concentation should be lower than 1:1 000 000. Concentration of sodium bicarbonate was 500 mg/l, and higer doses were of no value but harmless. Conclusions Safer formulas are provided for the tumescent technique administration in the ultrosonic liposuction. The tumescent technique may reduce potential complications related to ultrosonic liposuction

Objective To introduce a method of comprehension correction for secondary lip-nasal deformities after operation of the completely unilateral cleft lip. Methods The correction consisted of the following procedures: reposition of the columella and nasal alar crus by one tractional suture with nostril base narrowing; modification of flat nostril by a MT-plasty at the edge of naris; arising of the nasal alar and nasal dorsor by ePTFE implantation; reconstruction of the Cupid's bow by M type incision and vermilion advancement; repair of the vermilion deficit with the hinge mucosal flap and bipedicle mucosal flaps of the lower lip. Results Twenty-one cases with secondary lip-nasal deformities were successfully corrected by these comprehensive methods. Ten of them were followed-up for three months to 1 year with satisfactory effects. Conclusion The comprehensive methods can be used to correct satisfactorily the secondary lip-nasal deformities after operation of the completely unilateral cleft lip.

Objective To discuss the CT value measurement of the soft tissue such as sludged blood,gel foam and residual nucleus in vertebral canal at the early stage after lumbar discectomy.Methods 40 patients of lumbar disc herniation were divided into gel foam group and sludged blood group randomly.There were 22 males,18 females,with the mean age 50.6 years(ranged from 25 to 75 years).All patients underwent lumbar CT scan before operation and CT values of herniated nucleus were measured(simulating residual nucleus after operation).Same surgeon group performed posterior approach discectomy through open window in the vertebral plate.A long column roll of gel foam was placed epidurally at the site where nucleus were take out to stop bleeding in gel foam group.While in sludged blood group just douched with saline.All patients underwent lumbar CT scan one week after operation and CT values of the soft tissue in vertebral canal measured.The CT values before and after operation and between groups were compared and analyzed.Results CT values of the herniated disc of 40 patients were 43.70-66.70 HU.CT values of the soft tissue in vertebral canal of 20 patients gel foam group were(23.00?3.36)HU.Paired-samples t test of the values of herniated nucleus before operation and the gel foam showed t=12.32,P=0.00,with statistic significance.CT values of the soft tissue in vertebral canal of sludged blood group were(25.60?6.75)HU.Paired-samples t test of the values of nucleus before operation and sludged blood showed t=13.84,P=0.00,with statistic significance.Independent-samples t test of values of gel foam group and sludged blood group showed t=-0.78,P=0.46.No significant differences existed.Conclusion CT value measurement is valuable to distinguish the nature of the soft tissue in vertebral canal in clinical use.

A spore is another life cycle form of Bacillus anthracis for resisting starvation.When conditions are favorable for growth, the dormant spore will germinate,go through outgrowth, and are ultimately converted back into a growing cell. As the first step back to vegetative growth, germination could be induced by nutrients and a variety of non-nutrient agents. Nutrient germinants trigger cation release and water absorption by binding to receptors in the spore′s inner membrane.Then the spore′s peptidoglycan cortex is hydrolyzed and the spore core rehydrates, which allows the resumption of spore metabo-lism and macromolecular synthesis.This paper reviews the nutrient germinant receptor and cortex lytic enzymes in the spore germination process of B.anthracis.

Objective To observe the distribution of circum-patella nerve fibers in the soft tissue to provide experimental evidence,which is significant in denervation for Total Knee Arthroplasty (TKA).Methods Patella specimens were collected from 4 cadavers (2 cases of diabetic foot,lcase of lower extremity arterial occlusive,and 1case of car accident),all 4 of which were resected soft tissue with a dimension of 0.5cm × 0.5cm and full depth thickness around patella more than 0.5cm for histology and morphology observation.The nerve fibers histology and morphology were observed in all resected specimens with HE staining and silver-gilt glycine staining in the same field of microscopic vision.Results Anatomy found that the vascular network form skins directly involved in the patella nourish hole area and in the 10,2,4,7 clock point have found that blood vessels into the patella.There have a large number of nerve fibers near to the patella under the microscope,but there were no significant difference in the nerve fibers region distribution of all specimens.There were some into patella nerve fiber paths in side of patella soft tissue,which lied in 7,11 and 13 clock point,but outside no this phenomenon.The distribution of circum-patellar nerve fibers were described as distribution of regional concentration,which lied in much more 5,6,7 clock points and 10,11,12,1,2,clock points,in which the quadriceps tendon and patellar tendon have more than the others.In the 13 clock point,the fascia and periosteum of nourish hole area were also found in a large number of nerve fibers,and there were laminar distribution in different soft tissue layers,which were collected much more in synovial layer,fat pad,tendon near to patella.Conclusion There are much more nerve fibers near to the patella and some into patella nerve fiber paths in the medial side and nourish hole area.Nerve fibers distribution of circum-patella can be described as laminar distribution and regional concentration ,which is more in the centre,bottom more than top,outside more than inside,the bipolar more than the others.The patella denervation operation by reducing the number of peripheral nociceptors to achieve desensitization is feasible in TKA.

Objective To evaluate the therapeutic efficacy of congenital muscular torticollis (CMT) by two different methods. Methods A total of 86 patients with congenital muscular torticollis in recent 7 years were involved in this study, including 69 cases under 12 years old and 17 cases over 12. Two different operation methods, incision of inferior extremity of sternocleidomastoid muscle and incision of amphi-sternocleidomastoid muscle with post-operative traction, were alternatively chosen according to the ages and deformed degrees of the patients. Results 72 patients were followed-up for 1 to 7 years (averaged 4.5 years). Based on the effect of function and cosmetology in the group of 57 cases under 12 years old, there were 52 cases (91.2 %) excellent, 5 cases (8.8 %) good and no case with side-effects. Meanwhile, in the group of 15 cases over 12 years old, there were 11 cases (73.3 %) excellent, 4 cases (26.7 %) good and no case with side-effects. The effect was satisfactory. Conclusion Different patients with congenital muscular torticollis should be treated with different therapeutic methods.

Objective To explore and solve the repairing and reconstruction in leg serious damage.Methods Using microsurgical technique to reconstruct 9 cases leg serious defection,especially free combining flap with two area flap were applied in 4 cases,two set of vessel were anastomosised to repair the tremendous defection with deep tissue including in tendon, vessel, nerve injury and exposure. Another 5 cases were repaired with paraumbilical flap with opposite lateral vessel anastomosis. Results All 9 cases were applied successfully with 100%survived and were followed-up for one month to four vears. all flaps were good and appearance was excellent,and there were satisfied function recovery. Conclusion It is better choice for repairing complex tissue defection in leg by combining giant free flap transplantation and it is also reliable method for flap circulation by opposite lateral vessel anastomosis.

Objective To investigate technical points,risks and advantages of primary total knee arthroplasty (TKA) through subvastus approach.Methods The study involved 68 patients of similar basic conditions who were treated by TKA between September 2008 and August 2010,including 34 patients treated through subvastus approach (Group A) and 34 patients treated through traditional medial parapatella approach (Group B).Clinical parameters between groups were comparatively studied after operation.Results All patients were followed up for 6-25 months (mean 8.7 months).Alignment of lower extremities in both groups was restored.Group A showed significant differences from Group B in aspects of postoperative drainage volume [(124 ± 32.4) ml vs (182 ± 41.3) ml,P ＜ 0.05],requirement of lateral retinacular release (7％ vs 23％,P ＜0.01),time before patients being capable of having active straight-leg-raising movement [(1.3 ± 0.7) d vs (3.2 ± 0.6) d,P ＜ 0.05],and time away from patients being able to bend their leg up to 90° [(3.1 ± 0.6) d vs (5.3 ± 0.5) d,P ＜ 0.05].Conclusion Primary total knee arthroplasty through subvastus approach can hardly intervene in extension knee apparatus and in blood circulation around patellas,promote rapid recovery of knee function and achieve satisfactory early outcomes.

Objective To investigate the action mechanism of glutamate-mediated signaling pathway in malignant melanoma. Methods WM451LU melanoma cells in log phase were classified into 6 groups, negative control group treated with PBS (100 μl), MK801 group treated with the non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist MK-801 (100 μmol/L), CPCCOEt group treated with non-competitive metabotropic glutamate receptor 1 (mGluR1) antagonist CPCCOEt, MAP2 group transfected with adenovirus vector containing microtubule associated protein 2a (Ad-MAP2a), MK801 + MAP2 group treated with MK801 of 100 μmol/L and transfected with Ad-MAP2a, CPCCOEt + MAP2 group treated with CPCCOEt of 10 μmol/L and transfected with Ad-MAP2a. Western blot was performed to detect the expression of an ionotropic glutamate receptor, i.e., N-methyl-D-aspartate receptor type 2A (NMDAR2A) in WM451LU cells transfected with Ad-MAP2a. Scratch motility assay and cell invasion assay were conducted in vitro to detect the changes in migration and invasion ability of WM451LU cells after treated with Ad-MAP2a, MK-801, CPCCOEt alone or in combination. In vivo study was carried out to compare the inhibitory effect of the above treatments on melanoma. Results Western blot revealed a decrease in the expression of NMDAR2A in WM451LU cells after transfected with Ad-MAP2a. The scratch motility assay showed that the number of migrating cells per high power field was 117.04 ± 2.76 in MAP2 group,107.64 ± 6.50 in MK801 group,97.36 ± 4.79 in CPCCOEt group, 43.28 ± 3.02 in MK801 + MAP2 group,30.76 ± 3.97 in CPCCOEt + MAP2 group,significantly different from that in the negative control group (152.3 ± 5.75,all P ＜ 0.01 ). Cell invasion assay demonstrated that the average number of invading cells per high power field in the negative control was significantly higher than that in MAP2 group, MK801 group, CPCCOEt group, MK801+MAP2 group and CPCCOEt + MAP2 group (170.43 ±8.72 vs. 98.26 ± 3.84, 97.22 ± 5.54, 112.23 ± 7.21, 42.89 ± 5.06, 58.25 ± 6.68, P ＜ 0.05, 0.05, 0.05, 0.01and 0.01, respectively).A significant decrease was observed in the average volume of experimental melanoma in mice of MAP2 group, MK801 group, MK801 + MAP2 group, CPCCOEt group and CPCCOEt + MAP2 group compared with the negative control group (224.02 ± 46.19 mm3, 160.33 ± 33.91 mm3, 91.49 ± 21.48 mm3,202.30 ± 52.37 mm3, 111.13 ± 69.81 mm3 vs. 342.70 ± 60.92 mm3, all P ＜ 0.01 ). Conclusions To block the glutamate signaling pathway in vitro can inhibit the invasion and migration of melanoma cells, and to block the pathway in vivo can inhibit the growth of malignant melanoma and alter the morphology of melanoma cells.