[Objective]To study the correction of deformity with major bone defect by lengthening with different external fixators and to evaluate the results.[Method]From August 2000 to March 2004,7 patients suffering from deformity with major bone defect were treated by external fixators including Ilizarov, Orthofix LRS,and Hybrid external fixators combined with Orthofix LRS.Linar or wedged osteostomy was carried out at the deformity site.Wedged osteotomy and callus distraction were used for the cases of deformity with limb shortening,and compression of dock site combined with bone transport was used for those of deformity with bone defect and shortening.[Result]The cases corrected were: 1 femur with anterior angular deformity and 7cm shortening,and 6 tibiae including 2 varus deformities,2 posterior angular deformities,and 2 complex deformities.The average length was 5.3cm(4.5～7 cm),with an average distraction time of 3.5 months and followed by an average time of external fixation of 7 months.There were no obvious complications,such as vascular and nerve injuries.The function of the adjacent knee and ankle was not affected.[Conclusion]External fixators including Ilizarov,Orthofix LRS and Hybrid external fixators may provide one of good alternatives for correction of deformity with major bone defect.Compared with Ilizarov,Orthofix LRS and Hybrid external fixators are more conventional,more advantaged,and preferred,especially for its distinct clamp which can provide multi-plane fixation and correct the deformity simultaneously with limb lengthening.

Objective To explore the clinical result of fixation on the distal femur and/or proximal tibia with LISS(Less Invasive Stabilization System), and to analyze the related factors during the operation. Methods From July 2003 to March 2005, 16 patients(17 fractures) were treated with LISS (Mathys, Swiss). There were 11 males and 5 females, with an average age of 39 years (mean, 19-58 years), including 9 distal femoral fractures and 8 proximal tibial fractures, while 1 patient sustaining distal femoral and proximal tibial fracture on the ipsilateral side. The LISS plates were inserted beneath the periosteum through a small incision after closed reduction(except the intraarticular fractures). The locking screws were inserted through stab incisions, and by monocortical fixation. Only 1 patient underwent the bone graft who accepted the open reduction 21 days after injury. Results All the patients achieved bone union during the follow up from 5 to 25 months ( mean, 15 months ). 3 patients had their implants removed. The function of the knee was evaluated according to Karlstr?觟m score system based on both the subjective feeling and objective PE, and there were 10 excellent and 3 good, and 3 fair, the good-excellent rate was 81%. Secondary reduction loss occurred in one patient, but bone union and the function of the knee were not compromised. There was also neither infection nor implant pull-out and breakage. Conclusion The unique designed LISS has the advantages of protecting the blood supply of bone fragments and the periosteum, optimizing bone union and function recovery. LISS provides an alternative for treatment of distal femoral or proximal tibial fractures. However, as a new designed system, not only conception but the procedure as well should be demanded strictly.

Objective:To survey the relation of different vertical skeletal facial type and the third molar agenesis.Methods:The vertical face type of 207 subjects was divided into high angle(n=45),average angle(n=99)and low angle(n=63)groups by the assessments of MP-SN angle.The assessment of the third molar was made from panoramic radiographs,then the third molar agenesis rate of different vertical skeletal facial types was analysed.Chi-square criterion examination was conducted with SPSS 17.0 software. Results:In the high angle group,whether in the maxillary or mandibular,unilateral or bilateral,the absent percentage of third molar was higher than that in low angle group(P<0.05).In the females the bilateral maxillary third molar absent percentage was higher than in the males(P<0.05).The absent percentage of maxillary third molar was higher than that of the mandibular third molar(P<0.05).Conclusion:The third molar absence depends on vertical skeletal facial type.The absent percentage of third molar in the in-dividuals with high angle type is higher than that in those with low angle type(P<0.05).

Objective: To obtain phage-displayed ScFv library directly against prostate carcinoma cells, and select antibodies binding to prostate carcinoma cells specifically, so as to lay a foundation for developing diagnostic agents and clinical therapies of prostate carcinoma. Methods: Balb/c mice were immunized i. p . with purified membrane protein mixture of prostate carcinoma cells PC3, DU145. mRNA was isolated from the spleens of immunized mice, heavy and light chain genes ( VH and VL) of antibody were amplified separately by RT-PCR and assembled into ScFv gene with a specially constructed linker DNA. , the ScFv gene was ligated into the phagemid vector pCANTAB 5E and the ligated sample was transformed into competent E. coli TG1. The transformed cells were infected with M13K07 helper phage to yield recombinant phage. After five rounds of panning with PC3 cells, the positive clones were selected with the ELISA from the enriched phages. Results: A ScFv library of 3. 5 ? 106 was obtained and one phage-ScFv which can bind specifically PC3 cells was found. Conclusions: A prostate carcinoma specific antibody was identified , which paves a way for study of prostate carcinoma.

Objective:To obtain phage-displayed ScFv library targeting tumor tissues and to screen for antibodies specifically binding to tumor vessels using in vivo phage display,so as to lay a foundation for diagnosis and treatment of cancer.Methods:The membrane proteins were extracted from the specimens of esophageal carcinoma,stomach carcinoma,brain cancer,lung cancer,and spinal cord tumor.The recombinant phage-antibody system was used to construct a single-chain Fv fragment(ScFv)cDNA library from the total RNA of the BALB/c mice immunized with purified membrane protein.The specific primers of VH and VL were used to amplify the cDNA of VH and VL,respectively,which were then assembled into ScFv gene with a specially constructed linker DNA.The ScFv gene was ligated into the phagemid vector pCANTAB 5E and the ligated samples were transformed into competent E.coli TG1.The transformed cells were infected with M13KO7 helper phage to yield recombinant phage.Using the animal model of human cervical carcinoma(HeLa cells),sepecific phage-ScFvs were selected by phage displaying and panning in vivo.After four rounds,24 phage-ScFvs,which were identified by PCR,were analyzed immunohistochemically.The ScFvs expressed in the tumor tissue slices and negative in control kidney tissue slices were sequenced.Results:Tomors-bearing animal models were established with 7 different kinds of carcinoma cell lines in BALB/c nude mice.It was found that inoculation with HeLa cells resulted in most satisfactory tumorigenesis in nude mice.A ScFv library of 1.6?106 was obtained and a tumor vessel specific phage-ScFv named ScFvH1(VH-linker-VL)was selected from the library.Conclusion:A tumor targeting ScFv library has been successfully constructed and a tumor vessel-specifrc antibody has been identified from the library,which provides a new way for the early diagnosis and therapy of cancer.

Objective To study the influence of local administration of Icariin on orthodontically induced inflammatory root resorption (OIIRR ).Methods After rat models of orthodontic root movement were successfully established,rats were injected with 200 mg/kg Icariin (Icariin group)or saline (positive control group), respectively.Left maxillary served as the negative control group.The resorption pit of root surface was measured using scanning electron microscopy (SEM), HE staining, and tartrate resistant acid phosphatase (TRAP ). Results The level of TRAP positive cells and root resorption score in Icariin group were significantly lower than those in the positive control group (P < 0.05 ).Each measured value differed significantly between thenegative control group and the positive control group (P <0.05).The level of TRAP positive cells was significantly different (P <0.05),while root resorption scores did not differ between Icariin group and the negative control group (P >0.05).Conclusion Local administration of Icariin may reduce the degree of orthodontically induced resorption.

Objective To investigate the feasibility of a noval anterior cubital approach for the coronoid via flexor?prona?tor teres interval and assess the clinical result. Methods Five formalin?fixed adult cadaver elbows were used. Through a single universal anteromedial longitudinal skin incision, the coronoid tip was exposed via pronator and flexor carpiradialis interval, and coronoid anteromedial facet and base via palm longus and flexor carpi ulnaris interval. The distances from the entry point to the muscles or branching point of the nerves to the line passing through medial and lateral epicondyles, as well as the length were mea?sured with regard to the motor nerve branches arising from median nerve to pronator teres, flexor carpiradialis, palm longus and flexor digiti superficialis, as well as the most proximal two motor branches to flexor carpi ulnaris arising from ulnar nerve. From September 2013 to August 2014, 4 male patients with ulnar coronoid fracture were treated operatively through the above anterior cubital approach in our hospital. They were all left side involved, with an average age of 32 years (range, 16-42 years). According to O’Driscoll classification, there were two cases of type Ib and two cases IIb respectively. They were all treated by open reduction and internal fixation through flexor?pronator teres interval. Results At cubital fossa, there were 2-3 branches to the pronator teres mostly, 1 branch to flexor carpiradialis and palm longus arising from median nerve. The branch to the flexor digiti superficia?lis usually was long and thick, and divided into 2-5 short twigs near muscle. The branch to palm longus had the same trunk with that to flexor digiti superficialis. The branch to flexor digiti superficialis was the most proximal among those passed through the in?terval of pronator teres and flexor carpiradialis, and its entry point to the muscle had an averaged distance of 37.22 mm to the line passing through medial and lateral humeral epicondyles. It was optimal to expose coronoid tip through the interval of pronator teres and flexor carpiradialis. It was safe to expose coronoid proximal to the branch to flexor digiti superficialis. While, it was better to expose the anteromedial facet and base of corocoid through the interval of palm longus and flexor carpiulnaris via median and ul?nar nerve interface. All of the four patients were followed up for an average period of 9 months. They all achieved bone union from 6 weeks to 3months (mean, 9 weeks). All the patients obtained excellent result according to the modified An&Morrey elbow per?formance index with scores from 94 to 100. Conclusion The novel anteromedial cubital approach via flexor?pronator teres is opti?mal for exposure of coronoid.

Objective To evaluate the clinical results of operative treatments for the complex posterior tibial plateau fractures via posterior approach. Methods Eleven cases with complex posterior tibial plateau fracture from June 2008 through June 2010 were reviewed retrospectively. There were 7 males and 4females, with age from 33 years to 60 years (average, 47.8 years). According to AO classification, there were 41-B2.2.4 type in 2 cases, 41-B3.1.2 type in 3, 41-B3.3.2 type in 3, 41-B3.1.2 type combined 41-B3.3.2 type in 2, 41-C3.3 type in 1. Carlson posterior lateral approach were used in 5 cases, posterior medial approach were used in 3 cases, and posterior medial and/or lateral approach combined with anterior approach were used in 3 cases. All fractures were fixed with plates. Autogenous ilium grafts were used if necessary.Results All cases were followed up. The average follow-up time was 1.6 years (range, 3-24 months). At the final follow-up visit, bone union was obtained in all cases. The mean Rasmussen score was 16.7 (range, 15-18), and the mean HSS was 86.2 (range, 75-96). The postoperative knee range of motion were 0°-135°, 0°-130° and -10°-125° in 5 cases with posterior lateral plateau fractures, 3 cases with posterior medial plateau fractures and 3 cases with anterior and posterior plateau and intercondylar fractures respectively. There was no vascular and nerve injuries. Loosing or breaking of hardware's was not found. Conclusion The Carlson posterior lateral and/or medial approach is preferred for the complex posterior plateau fractures, with the advantages of direct reduction and stabilization.

Objective To discuss the clinical application of percutaneous radiologic gastrostomy (PRG) in treating dysphagia associated with amyotrophic lateral sclerosis (ALS),and to evaluate its safety and improvement effect on patient's nutritional status in ALS patients with pulmonary insufficiency.Methods The clinical data of 51 ALS patients who received PRG were retrospectively analyzed.The success rate of surgery and postoperative complications were recorded.All patients were regularly followed up,and the longterm complications as well as the one-,3-and 6-month mortality rates after the surgery were documented.The improvement of patient's nutritional status was evaluated.Results PRG was successfully accomplished in all 51 patients,the technical success rate was 100％.Mild postoperative complications occurred in 7 patients (13.73％) and severe massive hemorrhage in one patient (2.0％).After PRG,no signs or symptoms of impaired respiratory function were observed.No death occurred in one month and in 3 months after PRG.Six months after PRG,three patients died(6.8 ％,3/44).One month after PRG,31 patients had an increase in body weight of more than 1 kg,and the mean BMI was increased from preoperative t8.60±2.14 to postoperative 19.27±1.81 (one month after PRG),19.17±1.93 (3 month after PRG) and 18.89±2.33 (6 month after PRG).Conclusion For the performance of PRG no gastroscopy or anesthesia is needed,thus,the risk of aspiration asphyxia can be reduced in ALS patients complicated by pulmonary insufficiency and the success rate as well as the safety can be improved.Therefore,this technique is an effective means to ensure that the ALS patients with pulmonary insufficiency can get adequate energy intake to improve their nutritional status.

Objective: To establish a method for determining the molecular weight and molecular weight distribution of Poly(Lactide-co-Glycolide Acid) (PLGA) using Size Exclusion Chromatography-Refractive Index-Multiangle Laser Light Scattering (SEC-RI-MALLS) and Size Exclusion Chromatography-Refractive Index (SEC-RID), and to compare the results obtained from these two methods.
Methods: For SEC-RI-MALLS, tetrahydrofuran was used as the mobile phase, Shodex GPC KF-803L was employed as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, and an injection volume of 100 μL. For SEC-RID, tetrahydrofuran was also used as the mobile phase, Agilent PLgel 5 μm MIXD-D was used as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, differential detector temperature at 35 ℃, and an injection volume of 20 μL. The molecular weight and molecular weight distribution were calculated using Agilent’s GPC software. The newly established methods were validated methodologically, and the molecular weight and molecular weight distribution of 13 batches of samples were determined.
Results: The precision, accuracy, stability, and repeatability tests for SEC-RI-MALLS showed RSD values of 1.35%, 1.58%, 1.53%, and 1.26%, respectively. The SEC-RID method exhibited good linearity (r=0.999 9), with RSD values for precision, accuracy, stability, and repeatability tests (n=6) of 2.05%, 1.62%, 1.30%, and 2.97%, respectively. The results obtained from SEC-RI-MALLS were lower than those from SEC-RID, and the molecular weight distribution coefficient was smaller, but the results from the paired T-test performed with the value measured by SEC-RID method and the value measured by SEC-RI-MALLS method multiplied a conversion coefficient of 1.5 showed no significant difference between the two methods.
Conclusion: Both methods are stable and reliable, and can be used for the determination of PLGA molecular weight and molecular weight distribution based on the specific situations.