Objective: To sammarize the methodology of the treatment of alveolar cleft by autogenous cancellous bone graft obtained with mini incision(ABGM).Methods: 22 cases of alveolar cleft received ABGM by one operator. The cleft area was restored with autogenous cancellous bone from iliac crest by cylinder osteotomes for extraction of bone transplants(COEBT) with mini incision. All the patients were follow up for at least six months postoperatively. The result of the bone grafting was evaluated on the radiographs. Results: ①The overall survival rate of ABGM was 95.8%,and clinical successful rate was 91.7%;②The successful rate of ABGM in group of patients above 18 year old, or with complete cleft palate or bilateral cleft lip and palate was lower than that in other groups.③The wound for extracting autogenous cancellous bone from iliac crest by COEBT with mini incision was smaller than that by osteotomy. Conclusion: ABGM with COEBT is an effective way in the treatment of alveolar cleft. The successful rate of ABGM is related with the age and cleft style of the patients.

Objective To elucidate the inhibitory effect of 131I-fulvestrant on the growth of human breast cancer cells and the effect on the important organs.Methods MTT assay was used to clarify the difference in killing effects of the 131I-fulvestranton on MCF-7 cells and MDA-MB-231 cells.Breast cancer MCF-7 cell xenografts in nude mice was establishied,and two different administration methods of the 131I-fulvestrant in the MCF-7 cell to nude mice were given respectively.Organs and tumours of nude mice were observed.Results MTT assay demonstrated that 131I-fulvestrant had similar cytotoxicity against MCF-7 cells and MDA-MB-231 cells,and the former was slightly stronger.Transient contact experiments showed that 131I-fulvestrant could play a tumor suppressor effect on MCF-7 cells continually,but MDA-MB-231 cells wasn't.After the injection of 131I-fulvestrant via caudal vein,the radioactivity concentration on tumor site accounted for (4.33 ± 0.28)％ of the total injection,and the volume of the tumor reduced before gradually increasing again.Radioactivity in the blood accounted for (20.76 ± 2.54)％ of the total injection.Qrgans like liver and kidney also showed radioaction distribution.Its distribution was accorded with the distribution of estrogen receptor.Local injection of 131I-fulvestrant got powerful killing effect on the tumor,and the distribution of the radioaction was mainly confined within the tumor.Conclusion 131I-fulvestrant has a good inhibitory effect on MCF-7 breast cancer cells,which is a superposition of radiotherapy and endocrine therapy,and it is controllable on the general condition and important organs of nude mice.

Objective To investigate the clinical characteristics of the tympanic membrane atelectasis and treatment methods ,and to provide a reference value for future clinical diagnosis and treatment .Methods A retro‐spective analysis of 86 patients(104 ears) with tympanic membrane atelectasis treated in our hospital from June 2011 to August 2013 .Disease severity was classified according to the erasmus classification of atelectasis by Sade ,and pre- and post -operative air -bone gaps (ABG) were compared .Results There was no statistical difference of mastoid gasification on CT scan between mild and sever tympanic membrane atelectasis (P>0 .05) .While the sta‐tistical difference was found in two groups of whether there were soft tissues in middle ear and mastoid cavity on CT scan(P<0 .05) .There was an improvement in the average ABG for all stages .Conclusion This study demonstrated that surgical intervention had a favorable effect on hearing level across all stages .The treatment of atelectatic ears should be taken and individualized .

Objective To introduce the clinical application of the extended anterolateral leg flap,which is based on the superficial peroneal artery and lateral supramalleolar artery. Methods Through anatomic study on the blood supplies of the skin over the anterolateral portion of the leg.The combined superficial peroneal artery and lateral supramalleolar artery could extend the size of the traditional anterolateral leg flap.In addition,the point of pivot of the extended anterolateral leg flap could locate at the level of the lateral malleolus,which decreases the distance between the flap and recipient site.Clinically,we have used the extended anterolateral leg flaps in 60 patients to cover skin defect over the feet.The flap ranged from 16 cm×10 cm(pedicle length 8.0 cm)to 26 cm×7 cm(pedicle length 6.0 cm). Results In the series, the flap survived in 53 patients(88.3%)unevently,and partial necrosis occurred in 7 patients(11.7%).Conclusion Based on the combined superficial peroneal artery and lateral supramalleolar artery,the size of the traditional anterolateral leg flap could be inceased,which enlarges its value on the coverage of skin defects over the feet.

Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery.Methods The 16 adult cadaver specimens with 32 feet were dissected and meas-ured by vernier caliper.Then the anatomic data of the first metatarsal dorsal artery were analyzed.Results Through the examinations of 32 feet sample,the first metatarsal dorsal artery were classified into 5 types.Type Ⅰ:the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle (13 sides,40.6%).Type Ⅱ:the first metatarsal dorsal artery runs in the interior of the first dorsal interosse-ous muscle (11sides,34.4%).Type Ⅲ:the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle (6 sides, 18.8%).Type Ⅳ:the first metatarsal dorsal artery is slender (1 side,3.1%).TypeⅤ:the first metatarsal dorsal artery is absent (1 side, 3.1%).Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery:the vertical distance be-tween the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was (2.4 ±0.3)mm,the ver-tical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was (10.1 ±1.0)mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso-phalangeal joint was (7.6 ±2.7)mm.Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet’s trauma and skin flap transplantation such as thumb reconstruction.

Objective To observe the protective effect of acetylcysteine against radiation pneumonia.MethodsTotal of 80 patients who were inoperable were randomly allocated into treatment group and control group.Using conformal radiation technology and the total dose was 65 ～ 75Gy.The patients in treatment group were given acetylcysteine and radiotherapy;the patients in control group were given radiotherapy only.ResultsAll patients were treated radiotherapy.The effective rate( CR and PR) of treatment group was 90％,and that of control group was 85％(P ＞ 0.05);The incidence of acute radiation pneumonia and pulmonary fibrosis in treatment group were 15％ and 20％,respectively;and that of control group were 33％ and 45％ respectively.There was significant difference between the two groups ( P ＜ 0.05 ).ConclusionUsing acetylcysteine during radiotherapy could prevent radiation pneumonia in the non-small cell lung cancer patients.

Objective To explore the effects of the extracellular regulated protein kinase’s (ERK1/2) inhibitor PD98059 and ino-sitol triphosphate kinase (PI3K/PKB) signaling pathway’s inhibitor LY294002 on extracellular matrix (ECM) deposition in pulmonary arterial smooth muscle cells (PASMCs) stimulated by connective tissue growth factor (CTGF). Methods PASMCs of SD rat were cul-tured in vitro. The PASMCs were divided into control group, CTGF group, CP (CTGF+PD98059) group, CL (CTGF+LY294002) group and CPL (CTGF+PD98059+LY294002) group. Real-time lfuorescent quantitative RT-PCR was used to detect the expression of colla-gen III and ifbronectin mRNA of PASMCs, and the expression of collagenШprotein of PASMCs was detected by immunohistochem-istry and western-blot. Results The expressions of collagenШand ifbronectin mRNA of PASMCs stimulated with CTGF (50 ng/ml) for 48 h were signiifcantly higher than those in control group, and the collagen proteinШof PASMCs was decreased signiifcantly after stimulation with CTGF (50 ng/ml) for 72 h (P<0.05). The expressions of collagenШand ifbronectin mRNA in PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 48 h was signiifcantly lower than those in CTGF group (P<0.05). The collagen proteinШin PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 72 h was increased (P<0.05). The expres-sions of collagenШand ifbronectin mRNA of PASMCs stimulated with both PD98059 and LY294002 were more signiifcant. Conclu-sions CTGF may increase the expression of collagenШand ifbronectin mRNA in PASMCs, which may contribute to the deposition of ECM in PASMCs during pulmonary vascular remodeling. PD98059 and LY294002 may repress ERK1/2 and PI3K/PKB signaling pathways and interfere with the biological effect of CTGF.

Objective To explore the effect of hepatocyte growth factor on peripheral nerve regeneration. Methods Sciatic nerve contusion injury was made by a custom-made clamp in Wistar rats,in which human hepatocyte growth factor expressed by adenoviral vector(Ad-HGF)was injected into the muscle around the injured nerve.The results of nerve regeneration were evaluated by sciatic nerve function index(SFI),muscle wet weight,neural electrophysiology and image analysis. Results Four weeks after sciatic nerve injury,the results of sciatic nerve function index(SFI),muscle wet weight,neural electrophysiology and image analysis showed better nerve regeneration in group injected with HGF than control group(P<0.05). Conclusion Hepatocyte growth factor can promote axon regeneration and functional recovery and is an effective neurotrophic factor for peripheral nerve regeneration after injury.

Objective To observe the effects of JAZF1 (Juxtaposed with another zinc finger gene 1 ) overexpression on glucose and lipid metabolism in 3T3-L1 adipocytes. Methods The tissue distribution of JAZF1 in healthy C57BL/6J mice was detected by real-time quantitative PCR( RT-QPCR). Expression vector for JAZF1 gene was constructed and transfected into 3T3-L1 adipocytes. The mRNA levels of JAZF1, GLUT1, GLUT4, FAS, ACC, SREBP1, ATGL, and HSL implicated in glucose and lipid metabolism were determined by RT-QPCR; JAZF1 protein level was measured by Western blot. Intracelluar lipid accumulation were measured by oil red O staining method. Results In JAZF1-transfected adipocytes, JAZF1 mRNA and protein levels were significantly higher than control cells after 48 h. The mRNA level of HSL was increased significantly (P<0. 05) in JAZF1 transfection group compared with negative control and empty vector group, and the expressions of FAS, ACC, SREBP1 mRNA were decreased significantly(all P<0.01). However, the mRNA levels of ATGL, GLUT1, GLUT4 were not changed. Intracelluar lipid accumulation was decreased significantly (P<0.05 ) by oil red O staining and colorimetric in JAZF1 -transfected cells compared with negative control and empty vector group. Conclusions There was an extensive expression of JAZF1 in various tissues of C57BL/6J mice,indicating that JAZF1 might play a role in maintaining normal physiological function. These results show that overexpression of JAZF1 in 3T3-L1 cells can reduce lipid synthesis, increase lipolysis, and improve lipid accumulation. JAZF1 might provide a new potential therapeutic target for obesity and diabetes.

OBJECTIVETo evaluate cost-effectiveness of poking reduction and open reduction for the treatment of Sanders type II calcaneal fractures, in order to provide evidence for standard treatment.

METHODSFrom 2006.10 to 2008.10, 80 patients with Sanders type II calcaneal fractures were selected from Shandong Provincial Hospital of Traditional Chinese Medicine and randomly divided into poking reduction group and open reduction group with 40 cases in each group. There were 26 males and 14 females in poking reduction group and 30 males and 10 females in open reduction group. The average age of patients in poking reduction group was (36.60+/-3.15) years, and (37.10+/-3.45) years in open reduction group. Bohler angle, Gissane angle, the width of central calcaneus, stance phase of gait, HM-HL,arch index and subtalair joint flexibility were measured. The clinical results and expenses of the two treatment schemes were compared and concluded with the method of cost-effetiveness analysis.

RESULTSIn the poking reduction group and open reduction group, the Böhler angle were (30.32+/-1.72) degree and (30.54+/-3.13) degree, Gissane angle were (133.73+/-6.73) degree and (134.86+/-4.90) degree, the width of central calcaneus were (30.18+/-1.59) mm and (30.24+/-1.25) mm, stance phase of gait were (0.679+/-0.070) s and (0.715+/-0.090) s, HM-HL were--(36.49+/-7.56) N and -(34.32+/-6.50) N,arch index were (30.26+/-2.69) and (30.47+/-1.89), and subtalair joint flexibility were (10.53+/-2.30) degree and (10.89+/-1.86) degree respectively. The cost-effectiveness ratio (C/E) were 6.06 and 136.19 respectively.

CONCLUSIONCost-effectiveness ratio of the poking reduction is superior to that of the open reduction in treating Sanders type II calcaneal fractures. Poking reduction is a useful method to treat Sanders type II calcaneal fractures with rapid wound healing and less cost.

Adult ; Calcaneus ; injuries ; surgery ; Cost-Benefit Analysis ; Female ; Fracture Fixation, Internal ; economics ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged