Objective:For further exploring the feasibility,we have treated the middle and infe- rior femoral bone fracture nonunion by the transplantation of bone flap with ascending and transvers branch of the lateral femoral circumflex vessels.Method:The technique,on the basis of anatomical study have been designed to treat the femoral bone fracture nonunion by the transplantation of bone flap with ascending and transvers branch which pedicle was descendant branch of the lateral femoral circumflex vessel.Results:8 cases of middle and inferior femoral fracture nonunion had been treated by this method.At follow-up of 1 year 5 months to 4 years 6 months,the results have been satisfacto- ry.Conclusions:The method of the transplantation of the bone flap with ascending and transvers branch of the lateral femoral circumflex vessel for the treatment of middle and inferior femoral fracture nonunion has the adventages of simplicity,easiness,reliability.

Objective To provide an effective and convenient microsurgical method for ischemic necrosis of femoral head in children (Perthes disease) Method Basing on anatomic study, two periosteal flap pedicled with anterior superior iliac and anterior inferior iliac branches of lateral femoral circumflex vessel transposition was designed for the treatement of Perthes disease Result Eleven patients were performed with this method, and the average period of follow up was 2 1 years (range 1～3 5 years) The good and excellent rate was 82 percent Conclusion The operative method can not only provide with plenty of blood supply,but also increase osteogenic ability of the femoral head So, it is an effective method for the treatment of Perthes disease

Objective To explore the effect of expressive writing intervention on social support,resilience and school maladjustment in university freshman.Methods Selecting the freshmen volunteer of 600 university freshmen of Shandong,through the scale before the test recovery and comprehensive scoring chosen the part of low grade college students as the intervention object and were divided into writing expression(n=60) person and control group(n=60).The intervention group received a positive subject writing expression and the control group in the normal writing.Before and after the intervention tested the social support rating scale,the resilience scale for Chinese adolescents and the the student adaptation to college questionnaire were tested to evaluate the effect of active writing expression intervention.Results (1)After intervention,the intervention group and the control group had significant differences among the scales,objective support (t =-2.36,P＜0.05),learning adaptation(t=-1.98,P＜0.05) and subjective support (t=-2.56,P＜0.05),target focus(t=-2.66,P＜0.01),emotional control(t=-2.81,P＜0.01),family support (t=-3.46,P＜0.01),adaptation (t=-2.73,P＜0.01),support utilization (t=-5.91,P＜0.01) and social support score (t =-4.04,P＜ 0.01),positive cognition (t=-2.73,P＜0.01),interpersonal assistance (t=-3.13,P＜0.01),resilience score (t=-7.40,P＜0.01),life adaptation (t=-3.83,P＜ 0.01),emotional state (t =-3.39,P＜ 0.01),and school adaptation score (t=-3.46,P＜0.01).(2)There was no significant difference in objective support between the control group before intervention and after intervention.In addition,the remaining dimensions such as subjective support (20.72±2.46,22.96±2.81,t=4.54,P＜0.01),support utilization (7.49± 1.40,9.86± 1.90,t =7.56,P＜0.01) and social support score (36.79±4.24,41.89±5.18,t=5.76,P＜0.01) were significantly increased.The intervention group had significant difference among target focus (15.98±2.86,17.89±3.35,t=3.28,P＜0.01),emotional control (14.98±2.77,15.70±2.71,t=3.35,P＜0.01),positive cognition (14.61 ± 2.04,16.26±3.09,t=3.36,P＜0.01),interpersonal assistance (15.30±2.44,17.49±2.73,t=4.52,P＜0.01),resilience score(77.65±6.01,88.25±5.74,t=9.63,P＜0.01) and family support(16.77±2.28,19.58± 2.44,t =6.35,P＜ 0.01).In the intervention group of school adaptation scale,life adaptation (40.44± 6.36,45.12± 7.21,t=3.68,P＜0.01),emotional state (34.04±6.99,38.84±5.95,t=3.95,P＜0.01) and school adaptation score (145.21 ±22.86,160.51±21.78,t=3.66,P＜0.01),interpersonal assistance (32.30±5.34,35.23±5.18,t=2.98,P＜0.01),learning adaptation (38.44±7.06,41.32± 5.92,t=2.36,P＜0.05) were significantly increased.Conclusion Written expression intervention has a positive effect on improving the low level of social support,the poor resilience and freshman's adaptation to college.

Objective To analyze the clinical characteristics and enhancement pattern on contrast-enhanced ultrasound (CEUS) of combined hepatocellular-cholangiocarcinoma (cHCC-CC).Methods A total of 49 patients who were pathologically confirmed as cHCC-CC by surgery and underwent CEUS examination in Southwest Hospital Affiliated to Third Military Medical University from January 2005 to February 2015 were retrospectively enrolled.There were 3 enhancement patterns on CEUS:hepatocellular carcinoma (HCC) pattern,cholangiocarcinoma (CC) pattern and indeterminate pattern.The proportions of HCC pattern and CC pattern of cHCC-CC were compared by x2 test.And the proportions of tumour maker elevation [(alpha-fetoproteins,AFP) and/or (carbohydrate antigen,CA19-9)] in accordance or discordance with enhancement patterns were compared by x2 test.Results Among the 49 cHCC-CC patients,44 were male and 5 were female.Mean age was (52.3 ± 9.8) years old (range:28-74 years old).Of all cases,41 (83.7％,41/49) patients had single nodule.Mean size of nodule was (5.3 ± 3.5) cm (range:1.5-13.8 cm),and the size of 51.0％ (25/49) lesions were ＜ 5 cm.Totally 34 (69.4％,34/49) patients had pathologically diagnosed cirrhosis.AFP elevation was found in 31 (63.3％,31/49) patients,CA19-9 elevation was found in 12 (24.5％,12/49) patients,simultaneous elevation of both AFP and CA19-9 was found in 9 (18.4％,9/49) patients.The percentages of CC pattern and HCC pattern were 51.0％ (25/49) and 44.9％ (22/49) respectively.And there was no significant difference between the two patterns (x2=0.368,P=0.544).In 9 patients with simultaneous elevation of both AFP and CA19-9,CC pattern was observed in 5 patients and HCC pattern was noted in 4 patients.There were 12 (24.5％,12/49) patients with tumor marker elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS.Among the 12 cases,9 cases with AFP elevation were CC patterns on CEUS and 3 cases with CA19-9 elevation were HCC patterns on CEUS.Simultaneous elevation of tumor makers (AFP and CA19-9) or tumor mark elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS was found in 21 (42.9％,21/49) patients,which was significantly more than simultaneous elevation of AFP and CA19-9 alone (18.4％,9/49) (x2=6.918,P=0.009).Conclusions Clinical characteristics of patients with cHCC-CC were similar to that of patients with HCC.The proportion of HCC pattern and CC pattern was comparable.Combination of test of tumor makers (AFP and CA19-9) and enhancement pattern on CEUS maybe helpful for the diagnosis of cHCC-CC.

Relative deficiency in production of glycoprotein hormone erythropoietin (Epo) is a major cause of renal anemia. This study planned to investigate whether the hypoxia-regulated system of Epo expression, constructed by fusing Epo gene to the chimeric phosphoglycerate kinase (PGK) hypoxia response elements (HRE) in combination with cytomegalovirus immediate-early (CMV IE) basal gene promoter and delivered by plasmid intramuscular injection, might provide a long-term physiologically regulated Epo secretion expression to correct the anemia in adenine-induced uremic rats. Plasmid vectors (pHRE-Epo) were synthesized by fusing human Epo cDNA to the HRE/CMV promoter. Hypoxia-inducible activity of this promoter was evaluated first in vitro and then in vivo in healthy and uremic rats (n = 30 per group). The vectors (pCMV-Epo) in which Epo expression was directed by a constitutive CMV gene promoter served as control. ANOVA and Student's t-test were used to analyze between-group differences. A high-level expression of Epo was induced by hypoxia in vitro and in vivo. Though both pHRE-Epo and pCMV-Epo corrected anemia, the hematocrit of the pCMV-Epo-treated rats exceeded the normal (P < 0.05), but that of the pHRE-Epo-treated rats didn't. Hypoxia-regulated system of Epo gene expression constructed by fusing Epo to the HRE/CMV promoter and delivered by plasmid intramuscular injection may provide a long-term and stable Epo expression and secretion in vivo to correct the anemia in adenine-induced uremic rats.
Anemia/blood/*therapy ; Animals ; Base Sequence ; Blood Urea Nitrogen ; Cell Hypoxia ; Creatinine/blood ; Erythropoietin/biosynthesis/*genetics/secretion ; Gene Expression Regulation ; Genes, Reporter ; Genetic Therapy ; HeLa Cells ; Humans ; Injections, Intramuscular ; Kidney/pathology ; Luciferases, Firefly/biosynthesis/genetics ; Molecular Sequence Data ; Plasmids/*genetics ; Promoter Regions, Genetic ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins/biosynthesis/genetics/secretion ; Response Elements ; Transcriptional Activation ; Uremia/blood/*therapy

Objective: To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test. Results: The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients). Conclusions Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin.

Objective To analyze the differential expressed genes(DEGs)in the lung tissues of rat model of high altitude pulmonary edema(HAPE)by using microarray analysis in order to provide new clues for molecular mechanism of HAPE.Methods Healthy male SD rats(8 weeks old,weighing 200±20 g)were randomized into normoxia control(NC)group,lipopolysaccharide(LPS)group,hypoxia group and hypoxia+low-dose LPS(HL)group.The rats of the LPS group and HL group were injected with 0.1 mL 0.05％LPS per 100 g body weight,and those of the NC group and the hypoxia group were administered with an equivalent volume of normal saline.The rats of the hypoxia group and the HL group were housed in a hypobaric chamber simulating an altitude of 5 000 m,and those of the NC group and the LPS group were raised simultaneously outside of the chamber.The wet/dry mass ratio(WDR)of lung tissue and total protein content in bronchoalveolar lavage fluid(BALF)were measured,and the histopathological changes of lung tissue was observed using HE staining.The total RNA was extracted from the lung tissues,and the mRNA expression profile was obtained with Affymetrix microarray followed by Gene Ontology(GO)analysis and Kyoto encyclopedia of genes and genomes(KEGG)pathway analysis with Metascape(http://metascape.org).Results The rats of the HL group showed significant congestion,edema,and widened alveolar septa.Compared with the NC group,the HL group had significantly increased lung WDR(P＜0.01)and total protein content in BALF(P＜0.05).Gene expression analysis revealed that there were 79 genes up-regulated and 59 genes down-regulated in the hypoxia group,473 genes up-regulated and 695 genes down-regulated in the LPS group,and especially,669 genes up-regulated and 1 253 genes down-regulated in the HL group.GO and KEGG pathway analyses revealed that the upregulated genes in the HL group were mainly enriched in biological processes,such as cytokine mediated signaling pathways,response to IL-1,regulation of inflammatory response,as well as signaling pathways,including cytokine-cytokine receptor interactions,TNF,NF-κB,IL-17,complement and coagulation cascades,etc.The down-regulated genes were mainly enriched in biological processes,such as extracellular matrix organization,regulation of endothelial cell migration,cell substrate adhesion,as well as signaling pathways,such as focal adhesion,Wnt,cGMP-PKG,PI3K-Akt,Rap1,etc.The mRNA expression of NF-κB,TNF-α,IL-1βand IL-6 was significantly up-regulated in the lung tissue of the HL group(P＜0.01).Conclusion Hypoxia+low-dose LPS is an effective procedure to establish a reliable model for HAPE in rats.Hypoxia can significantly aggravate LPS-induced inflammation and immune response,enhance the expression of inflammatory mediators,and thus promote the pathogenesis of HAPE.