Since 1970, 13 cases of reconstruction thumb and finger utilizing the second toe were performed. 13 out of 14 reconstructed digits survied with no complication. All wounds healed by primary intention. Emergency reconstruction has the following merits: it is completed in one stage, hence less suffering and economic loss to the patients;it promises early rehabilitation, early return to work and better functional results, as compared with delayed operation. Traumatic amputation of the thumb at or near the metacarpo-phalangeal joint with the transected part so badly injured that replantation is no longer fet-sible, and severe crushing injury of the thumb or all fingers are indicated for emergency reconstruction. Patient's age, occupation, desire for operation and general health should be considered individually before operation. The method of dissecting the second toe with the preservation of vasculization pattern of dorsalis pedis artery-first plantar metatarsal artery should be adopted in case the anatomic pattern of dorsal metatarsal artery belongs to Gilbert type Ⅲ.

Purpose To analyze clinicopathologic and prognostic features in 9 cases of children endocapillary proliferative glomerulone-phritis with hepatitis B virus antigen deposition ( HBV-ECPGN) . Methods Retrospective analysis of demographic information, clini-cal manifestations, laboratory parameters, pathological and prognostic features was carried out for 9 cases of HBV-ECPGN and 13 cases of acute poststreptococcal infection endocapillary proliferative glomerulonephritis ( APS-ECPGN) for comparison. Renal biopsy tissue were fixed in formalin and embedded in paraffin, stained with HE, PAS and PAM-Masson. Immunohistochemical study with EliVision method was performed. Three cases were submitted for electron microscopy. Results There were 7 males and 2 females ( M ∶ F=7 ∶ 2) of HBV-ECPGN. The median age was 10. 3 years. Serum C4 deposition ratio HBV-ECPGN was significantly greater than APS-ECPGN group (P<0. 05). There was an average of 11. 2 weeks of HBV-ECPGN kidney disease duration, which was significantly lon-ger than an average of 3. 8 weeks of APS-ECPGN group (P<0. 05). There was no disease relapse in all cases during 53. 55 months follow-up. C4d deposit was significantly stronger in all HBV-ECPGN cases compared with control group (APS-ECPGN cases). There were no significant differences in deposit of IgG, IgM, IgA, C3d and C1q between the two groups. HBsAg deposit in juxtaglomerular sites was identified in all cases. Conclusions Serum C4 decrease is more common in HBV-ECPGN than APS-ECPGN. Which may be associated with HBV infection, there is longer disease duration of HBV-ECPGN. C4d deposit is significantly stronger than control group, suggesting pathogenesis of HBV-ECPGN and APS-ECPGN is different. HBsAg deposit may be closely related to the pathogene-sis of HBV-ECPGN. HBsAg deposit in juxtaglomerular sites may be characteristic of HBV-ECPGN.

Objective To compare zinc-finger BED domain-containing 3 ( ZBED3 ) expression in various tissues of C57BL/6J mice and the effects of liraglutide, glucose, and insulin on the levels of ZBED3 protein expression in C57BL/6J mice and db/db mice. Methods The mRNA level of ZBED3 in various tissues of C57BL/6J mice was measured by realtime PCR. The protein level of ZBED3 was measured by using western blot. Results ZBED3 mRNA levels were detected in muscle, spleen, kidney, brain, heart, lung, and liver of C57BL/6J mice, yielding the highest expression in muscle. Additionally, The liver ZBED3 levels were higher in db/db mice compared with C57BL/6J mice (P<0. 01). Furthermore, the protein expression of ZBED3 was significantly increased in liver tissues of db/db mice treated with high concentrations of liraglutide, glucose or insulin(P<0. 05), however, the expression of ZBED3 only responded to high concentration of glucose in liver tissues of C57BL/6J mice. Conclusion ZBED3 may act as a novel factor in regulating glucose metabolism. The expression of ZBED3 can be regulated by liraglutide, glucose, and insulin. Thus, ZBED3 may play an important role in conditioning of hyperglycemia.

ObjectiveTo investigate the effectiveness and toxicity of CyberKnife in the treatment of lung metastases.MethodsTreatment details and outcomes were reviewed for 93 targets of 48 histologically verified patients treated by CyberKnife at the CyberKnife Center of Tianjin between September 2006 and June 2010.The median tumor volume was 6.0(0.2 - 135.2) cm3,the median biological equivalent dose was 140.8(53 - 180) cGy (α/β =10),the median fraction was 3(1-7) times and the median isodose line was 81％ (71％-91％ ).ResultsThe rate of follow-up is 96％.33 cases were followed up for more than 2years.The effective rate was 90.3％.Two targets of 2 patients locally progressed.The 1-and 2-year local control rates,overall survival (OS) rates and progression-free survival (PFS) rates were 98％ and 98％,83％ and 63％,and 64％ and 37％,respectively.Univariate analyses showed that age older than 60 versus ≤60 years tended to be predictor for PFS ( x2 =3.45,P =0.063 ) ;The PFS of patients who had single lesion was better than patients with multiple lesions ( x2 =4.49,P =0.034 ) ; patients with disease-free interval longer than 18 months had better OS ( x2 =6.50,P =0.011 ).Five patients were reported to experience treatment-related grade 1 radiation pulmonary injury,and one each for subcutaneous fibrosis with pigmentation,grade 2 and grade 3 adverse event.ConclusionsFor patients with lung metastatic lesion,CyberKnife is an effective option with high local control rate and little acute reaction.The long-term outcome and toxicity need further study.

Objective To assess the association between polymorphisms in HIF1α gene and prognosis of advanced hepatocelluar carcinoma.Methods We collected prognosis data from a cohort of 448 advanced HCC patients treated by transarterial chemoembo-lisation,and used 5ml peripheral blood from patients for extraction DNA.Three SNPs (rs2301 1 13、rs2057482 and rs1 957757 )in HIF1αgene were selected and genotyped.Multivariate Cox proportional hazards model,Kaplan-Meier curve and log-rank test were used for prognosis analyses.Results The variant-containing genotypes (WV+VV)of SNP rs2301 1 13 exhibited a significant associ-ation with a better overall survival in HCC patients who had tumor size smaller than 5 cm (hazard ratio [HR],0.58,95% confidence interval [CI],0.35-0.96,P =0.036).In the patients taken single tumor subgroup,the variant-containing genotypes (WV+VV) of SNP rs2301 1 13 exhibited a significant association with a better overall survival (log-rank P =0.048),comparing to those carrying wild-type genotype.Conclusion Our results suggest that polymorphisms in HIF1αgene may serve as an independent prognosis bio-marker for advanced HCC patient.

Objective To investigate urine adiponectin changes and related factors in different stage of type-2 diabetic ne-phropathy.Methods A total of 1 1 9 DN patients admitted to the Yongchuan Hospital of Chongqing Medical University in 2013 were selected.The general indices and laboratory examination results were retrospectively analyzed.1 1 9 type-2 diabetic nephropathy patients were divided into normal Proteinuria group,micro-Proteinuria group,macro-Proteinuria group,according to urine albumin excretion rate in 24 hours.45 health subjects from Physical examination center were enrolled as normal group.The UAER of the three groups were compared and the correlation between each index and UAER was analyzed.Results Urine adiponectin levels in normal Proteinuria group was significantly lower than micro-Proteinuria group(P <0.01)and macro-Proteinuria group(P <0.01). Urine adiponectin levels in micro-Proteinuria group was significantly lower than macro-Proteinuria group (P <0.01)and higher than normal group(P < 0.01 ).Urine adiponectin levels in macro-Proteinuria group were significantly higher than normal group (P <0.01 ).Multiple linear regression analysis showed that HDL-C,FPG,HbA1c and UAER had effects on the levels of Urine adiponec-tin.Conclusion Urinary adiponectin levels are associated with type 2 diabetic nephropathy,and which was related with HDL-C, FPG,HbA1c and UAER.

Objective To study the closure time of neonatal ductus venosus and the Z score regression equation, and to explore the variation of closure time of neonatal ductus venosus with gestationalage.Methods Color doppler ultrasound was applied to detect the closure time of neonatal ductus venosus in normal newborns, Z score regression equation ( lnY =a +bX +cX2 ) for the closure time of neonatal ductus venosus ( Y ) was developed by regression analysis which used gestational age ( X) as an independent variable. The Z scores of the closure time of neonatal ductus venosus in different gestational age were calculated by the formula [ Z = ( M - Y )/S x , M for observation value, Y for predictivevalue].Results There were 432 cases in our study.The closure time of neonatal ductus venosus was negatively related to gestational age ( r = -0. 938 , P <0. 001 ) . The nonlinear regression equation was lnY= -5. 228+0. 089X-0. 000228X2, R2 =0. 854, Sx =0. 214(P<0. 001). Based on the predicted mean of the closure time and Sx related to different gestational age, Z scores for specific closure time of neonatal ductus venosus could be calculated by the formula [ Z =( M -Y)/Sx ] . The Z scores were normally distributed,and did not change with gestational age.Conclusions Theclosure & nbsp;time of neonatal ductus venosus is negatively related to gestational age. The Z scores obtained by the predicted nonlinear regression equation are normally distributed.

Plasma nesfatin-1 levels were assayed by ELISA in patients with impaired glucose regulation (IGR),type 2 diabetes mellitus( T2DM ),and healthy subjects with normal glucose tolerance( control group).The results showed that plasma nesfatin-1 levels in IGR and T2DM groups were significantly higher than that in control group [ ( 1.91 ±0.79 and 1.80±0.80 vs 1.41 ±0.58) μg/L,P＜0.01 ].Plasma nesfatin-1 levels were positively correlated with body mass index(BMI),HbA1c,waist hip ratio,fasting plasma glucose,fasting insulin,and homoestasis model assessment insulin resistant index( HOMA-IR,P＜0.05 or P＜0.01 ).Multiple regression analysis showed that BMI and HOMA-IR were independent related factors in influencing plasma nesfatin-1 levels (both P＜0.01 ).These results suggest that nesfatin-1 may partially contribute to the pathogenesis of insulin resistance and T2DM.

Objective To evaluate the safety and efficacy of the human acellular nerve allograft (hANG)for nerve repair in the clinical setting,and report the early outcomes of bridging digital nerve defect with the hANG. Methods Four patients with 5 digital nerve injuries were included in this pilot study.The nerves defect ranged from 10-20 mm and were bridged with the hANG(manufactured by Zhongda Medical Equipment Co.,Ltd,Guangzhou,China).Four digital nerve acute injuries in 3 patients were repaired with hANG primarily,while the nerve in another patient was reconstructed secondarily.The procedure was performed under a 10-manifying operating microscope.The nerve stumps were debrided until the normal fascicles could be seen.hANG was inserted between the proximal and distal stumps and end-to-end neurorrhaphy was performed with 9-0 sutures.Postoperative cares included dressing change and administration of antibiotics.No immunosuppressants had been used.The follow-up time ranged from 1 to 3 months.The wound and blood sample were examined for the safety of hANG.The nerve function Wag evaluated according to the scoring system proposed by the Nerve Injuries Committee of the British Medical Research Council. Results All wounds healed primarily.The adverse effects,such as rejection,allergy,infection,and toxicity to the liver and kidney were absent.The results of blood biochemistry test were within the normal range.The injured nerve achieved good functional recovery.In 2 cages,the 2 point discrimination(2PD)was 8mm(S3~+,excellent). Conclusion Based on the short term follow-up,using hANG to repair digital nerve defect as long as 20mm was safe,and the nerve functional recovery is pretty good.

Objective To prepare monoclonal antibodies (mAb) against mouse Metrnl and identify its specificity . Methods Mouse Metrnl polypeptide fragments and full-length protein were prepared as antigens to immunize mice .Then mice spleen cells were fused with SP2/0 myeloma cells to obtain hybridoma cells which were screened for positive clone in order to subclone for stable cell lines .After ascites were prepared ,ELISA method was used to detect the antibodies titer .Western blot method was applied to identify their specificity .Results No effective antibodies were identified from the ascites derived from 14 polypeptide antigens .Among the 25 antibodies derived from the full-length protein ,12 monoclonal antibodies can be used to identify the recombinant Metrnl protein .Conclusion 12 monoclonal antibodies were successfully prepared to identify mouse Metrnl protein .