Objective To explore the method of isolation, identification and in vitro differentiation of islet stem cells in neonatal rat. Methods The whole pancreata of neonatal rats were digested with collagenase, then,under the (condition) of pH 7.4～7.6,the digested tissue fragments were cultured with serum and serum-free RPMI 1640 (( bFGF), EGF, N2).The whole formation process of new islet cell-like cell masses was examined.The insulin (release) test was used to detect islet function. The expression of nestin was tested by immunocytochemistry. Results The nestin positive cells can be found within 36 h of culture of the digested pancreatic fragments.After addition of bFGF,ECF,N2,nestin positive cells proliferated fast and formed new islets-like cell masses after 18～24 d, and (insulin)ssion could be confirmed. Conclusions The nestin positive cells of pancreatic cells possess the character of islet stem cells, and can form islet like cell masses through culture in vitro.

Objective To explore the efficacy of peroneus brevis tendon transfer and peroneal tendofascial flap for repairing achilles tendon and overlying skin defect.Methods From April,2004 to May,2015,5 cases of achilles tendon and overlying skin defect were treated with peroneus brevis tendon transfer and peroneal tendofascial flap.In these cases,the length of the achilles tendon defect was from 3.0 cm to 8.0 cm,and the size of skin defect ranged from 2.0 cm × 3.0 cm to 3.0 cm × 5.0 cm.Using peroneus brevis tendon to reconstruct achilles tendon defect,and covered with peroneal tendofascial flap,and then skin graft.One of them combined with the gastrocnemius tendon V-Y advancement to promote the reconstruction of achilles tendon longer defect.The patients were followed-up regularly,and evaluated by the American Society of Ankle Arrhythmia (AOFAS) ankle-hindfoot scoring system.ResultsAll operations were successful and the grafted skin survived.All cases were followed-up from 6 months to 10 years with an average of 5.2 years.At the time of last followed-up,all wounds healed well without re-infection and ulceration.Not foot varus deformity and the strongth was back to the level before the injury.AOFAS ankle-hindfoot score was increased from (50.44 ± 12.05)(preoperative) to (90.02 ± 6.55)(the last follow-up) (P＜0.05).Conclusion There were some advantages in the method of the treatment of achilles tendon and overlying skin defect by using peroneus brevis tendon transfer and peroneal tendofascial flap,such as easy to cut,small damage to the donor area,and no significant deformity to the receptor area,etc.It is a good way to repair achilles tendon and overlying skin defects.

On January 10, 2018, a 35-year-old male patient with a 3 day stingray stinger injury in his left thigh was admitted to Xuzhou Central Hospital. At the time of admission, the patient′s left thigh was red, swollen, and painful. On the day of admission, the patient underwent emergency operation in the outpatient operating room for local debridement to remove the infected and necrotic tissue. After the routine dressing change and the wound got better, surgical debridement and negative-pressure wound therapy were performed, and finally local flap was used to repair the wound. On the 14th day after the flap repair operation, the suture was removed and the patient was discharged. After half a year follow-up, the appearance of the operation area recovered well. This case suggests that the timely and correct pre-hospital treatment, thorough and timely debridement, and systemic antibiotic application are important means to reduce further injury of toxin. The local flap can achieve satisfactory result on wound healing after the wound bed is prepared by negative-pressure wound therapy.