BACKGROUND:Obsolete lateral ankle ligament injury is frequently treated by Chrisman-Snook operation.However,this operation destructs some peroneus brevis tendon,and affects the function of peroneus brevis tendon for foot valgus.OBJECTIVE:Based on previous research,to investigate the effect of allogeneic tendon for reconstruction of ankle lateral ligaments.METHODS:A total of 17 cases of ankle lateral ligament injured were selected,with a course of disease from 3 to 6 months.All lateral ligaments were reconstructed by allogeneic tendon & anchors.During the operation,a drill,4.5 rnm diameter,was used to drill a hole on the lateral ankle;one anchor was drilled into the talus at the end of anterior talofibular ligament,another one was threaded on the calcaneus;the allogeneic tendon was permeated through the hole on the lateral ankle,maintaining ankle neutral and moderate valgus position.The allogeneic tendon was sutured with the thread of the anchors.Following operation,the ankle was fixed in neutral position and slightly valgus position;wound healing,AOFAS score and stress radiograph were observed.RESULTS AND CONCLUSION:All 17 patients showed no rejection,and the wound healing well at the primary stage.At 6,12,24 after operation,all patients were followed-up.According to AOFAS criteria,function of ankle in all patients was significantly improved.No patients complained of instability of the ankle,end stress radiograph confirmed this improvement.Reconstruction of lateral ligaments of the ankle with allogeneic tendon and anchors is a practical treatment,which restores stability and function of ankle without long incision or damaging normal tendons.

Objective To study the effect of reducing no-reflow after PCI treatment by early using Tirofiban and suction catheter in AMI patients .Methods 76 cases of patients were divided into group A (38 cases) and group B(38 cases) .The group A began to use Tirofiban with suction catheter to aspiration after coronary guidewire entering ,the suction were used in group B when the thrombus burden became exacerbation after balloon dilation .In addition ,chosen 38 cases of AMI patients treated with Tirofiban af-ter balloon dilation as group C .The influence of different treatment options to no-reflow and slow blood flow ,cardiovascular adverse events and the incidence of bleeding were observed .Results Group A compared with other two groups ,the no-reflow and slow flow rate had statistically significant differences (P< 0 .05) ,but there was no statistically significant differencebetween group B and group C(P>0 .05) .After three different surgical treatments ,the incidence of bleeding complications had no significant difference (P>0 .05 .The occurrence of adverse cardiovascular events had statistically significant between A group and C (P<0 .05) ,but there was no statistically significant difference between group B and group C (P<0 .05) .Conclusion Three kinds of treatment all have certain effect to reduce no-reflow in emergency PCI of AMI ,but early use of tirofiban with suction catheter in treatment of emergen-cy treatment has great clinical significance to reduce no-reflow .This study provides an effective treatment plan to reduce no-reflow in PCI for AMI .

In order to investigate the expression levels of Pin1 mRNA and protein in cervical cancer and its association with Ki67 and their clinical significance, amplification of Pin1 gene was examined by RT-PCR, and the expression of both Pin1 and Ki67 protein was detected by immunohistochemistry in cervical cancer tissues. It was shown that the expression levels of Pin1 were higher in cervical cancer than in normal cervical tissues (P < 0.05). The expression of Pin1 protein was increased progressively along with the disease process from normal cervix to CIN and to cervical cancer (P < 0.05). No significant difference in the Pin1 expression was found between disease stages (FIGO), pathological grades or pelvic lymph node metastasis status (P > 0.05). The expression of Pin1 was significantly higher in adenocarcinoma than in squamous carcinoma of the uterine cervix (P < 0.05). In cervical cancer, the overexpression of Pin1 was positively correlated with that of Ki67 (P < 0.05). These results suggested that the overexpression of Pin1 was closely related with cancer cell proliferation or progression of cervical cancer and contributed to oncogenesis. Pin1 may serve as a potential marker for cervical cancer diagnosis.
Cervical Intraepithelial Neoplasia/metabolism ; Ki-67 Antigen/*biosynthesis ; Ki-67 Antigen/genetics ; Peptidylprolyl Isomerase/*biosynthesis ; Peptidylprolyl Isomerase/genetics ; Tumor Markers, Biological ; Uterine Cervical Neoplasms/*metabolism

ObjectiveTo explore the inductive action of docosapentenoic acid(DPA) on neurite outgrowth in PC12 cells in vitro.MethodsNeurite outgrowth in PC12 cells was examined after the treatment with different concentration of DPA using Motic Zamges Plus software mapping cell image system.Western blot was performed to detect the expression of β Ⅲ-tubulin regulated protein kinase,a neuronal marker as well as ERK and protein kinase B (Akt) phosphorylation.ResultsPC12 cell neurite formation rate was increased in a concentration dependent manner in the induction of DPA,increased by 2.4% (DPA 10 μg/ml,P>0.05),18.6% (DPA 30 μg/ml,P<0.05) and 25.0% (DPA 50 μg/ml,P<0.05) compared with that in the control group.DPA promoted the expression of β Ⅲ-tubulin (P<0.05) and the phosphorylation level of ERK and Akt (P<0.05,P<0.01).ConclusionDPA promotes PC12 cell neurites growth and its mechanism may be related to the activation of ERK and Akt signaling pathways.

The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer, the physical status of HPV-16 in patients with cervical lesions, and the role of HPV-16 integration in cervical carcinogenesis were investigated. HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women. Multiple PCR was done to detect physical status of HPV-16 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection, including 112 specimens with cervical cancer, 151 specimens with CIN I, 246 specimens with CIN and 120 specimens with CINIII. The results showed that there were 112 cervical cancer samples (56.57% of total cervical cancer patients) with HPV-16 infection. The frequency of HPV-16 pure integration was 65.18% (73/112), 56.57% (47/120), 23.58% (58/246) and 7.95% (12/151) in cervical cancer, CINIII, CINII and CINI patients respectively. In situ hybridization was performed on some paraffin-embedded sections of CINII, CINIII and cervical cancer to verify the physical status of HPV-16 infection. Significant difference was observed between cervical cancer and CIN I, CINII, CINIII in the frequency of HPV-16 integration (P<0.01). It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer. In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration. The application of testing HPV genotyping and physical status based on detection of HC-II HPV DNA would be in favor of predicting the prognosis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.

The aim of the present study was to examine the effects of suppression of EphB4 and/or mTOR on the biological behaviors of ovarian cancer cells, and the potential regulatory pathways. Antisense EphB4 vectors and shRNA vectors targeting mammalian target of rapamycin (mTOR) were constructed and transfected into A2780 and SKOV3 cells (two ovarian cancer cell lines). The effects of the antisense EphB4 vectors and the shRNA vectors on the proliferation, apoptosis and invasion of ovarian cancer cells were measured, and the expression of EphB4, mTOR and Akt detected. The results showed that transfection with mTOR shRNA could inhibit growth, induce apoptosis, and reduce invasive ability of ovarian cancer cells, which was accompanied by downregulation of EphB4, mTOR and Akt. The inhibitory effects on cell growth caused by mTOR shRNA alone were weaker than those by antisense pEGFP-C1-EphB4. In the antisense pEGFP-C1-EphB4-transfected cells, it was found that EphB4 knockdown could decrease the mTOR expression and slightly reduce the Akt phosphorylation. Significant suppressive effects on cell growth were observed in cells co-transfected with antisense pEGFP-C1-EphB4 and mTOR shRNA. In co-transfection group, the expression levels of EphB4, mTOR and Akt were distinctly lower than those in other groups. It was concluded that suppression of EphB4 may inhibit the growth of ovarian cancer cells by downregulation of the PI3K/Akt/mTOR pathway, and reverse Akt phosphorylation induced by mTOR shRNA. Inhibition of EphB4 and mTOR combined may cooperatively suppress the biological behaviors of ovarian cancer cells.

Objective To introduce the detailed surgical procedure of parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD),and to study its clinical results.Methods A retrospective study was conducted on 31 patients who underwent parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy between January 2016 and June 2018 in our department.Results Of 31 patients who underwent total laparoscopic pancreaticoduodenectomy,5 patients underwent two-dimensional (2D) LPD and 26 underwent three-dimensional (3D) LPD.Total mesopancreas excision (TMpE) was performed in 12 patients,including 2 patients combined with PV-SMV segmental resection and reconstruction.The mean operative duration,and mean estimated blood loss,post-operative hospital stay were 412.8 ± 102.4 min,462.8 ± 396.7 ml,14.7 ± 8.9 d,respectively.The operating time of parachute-like-suture double-pouch pancreaticojejunostomy was 29.7 ± 6.8 min (20 ～45 min).Post-operative complications occurred in 8 patients (25.8％),3 of whom suffered from more than two types of complications.There were 2 patients (6.5％) with postoperative B/C grade pancreatic fistula,4 patients with postoperative biliary leakage (12.9％),3 patients with delayed gastric emptying (9.7％),1 patient with portal vein thrombosis (3.2％) and 1 patient with peritoneal effusion (3.2％).One patient died during perioperative period due to gastrointestinal hemorrhage.Conclusions Parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy was a simple,convenient,reliable method.It is worthy of clinical promotion and further studied.

Objective To review our experience in laparoscopic pancreaticoduodenectomy combined with major vascular resection and reconstruction.Methods Of 183 patients who underwent laparoscopic pancreaticoduodenectomy in our department from November 2013 to January 2017,major vascular resection and reconstruction using the SMA first approach for total mesopancreas excision was performed in 7 patients.The clinical data of these 7 patients were retrospectively analyzed.Results Total 3D laparoscopic surgery was performed in all these 7 patients.The mean operation time,mean blood loss and blood flow occlusion time were (551.4 ± 83.8) min,(671.3 ± 256.3) ml and (45.8 ± 6.7) min,respectively.Six out of 7 patients were pathologically diagnosed to have pancreatic adenocarcinoma with negative surgical margins.Two patients had lymphatic metastasis (the number of metastatic lymph node was 1 in each patient).The mean number of lymph nodes resected was (12.7 ± 5.8).The portal vein-superior mesenteric vein (PV-SMV) was segmentally resected and reconstructed using an end to end anastomosis following the preoperative plan in 4 patients.These included 2 patients who underwent total pancreatectomy.The portal vein was wedge-resected and reconstructed by venorrhaphy in 2 patients.The remaining 1 patient was histopathologically diagnosed to have a mass-type chronic pancreatitis.Only 1 patient was treated in the ICU for 1 day after surgery.Post-operative complications occurred in 2 patients and they were managed with nonsurgical treatment (PV-SMV thrombosis and gastric emptying disorder in 1 and a pancreatic leakage (level A) in 1).The mean length of post-operative hospital stay was (13.7 ± 3.2) days with no in-hospital mortality.Seven patients were alive by April 2017.The mean follow-up for the 6 patients with pancreatic adenocarcinoma was 4.5 (3.5 ～9) months.Conclusions Based on our experience in skillful and masterly major vascular resection and reconstruction in open surgery and on our experience in standard laparoscopic pancreaticoduodenectomy,laparoscopic pancreatieoduodenectomy combined with major vascular resection and reconstruction was feasible and safe.This surgery requires very mature skills in laparoscopic surgery.

Objective:To explore the changes of levels of coagulation factors at acute phase (within one week) of aneurysmal subarachnoid hemorrhage (aSAH) and their relations with deep venous thrombosis (DVT).Methods:Two hundred and two aSAH patients (aSAH group), admitted to our hospitals from March 2015 to March 2019, were selected in our study, and these patients were divided into a combined DVT subgroup and a uncombined DVT subgroup according to whether they were combined with DVT on the first and third d of onset. One hundred healthy physical examiners whose age and gender matched with those of aSAH group were selected as control group; one, 3, 5, and 7 d after onset, and one d after enrolling of subjects from the control group, thromboelastogram (TEG) was used to detect the R value of TEG (TEG-R) in all subjects. One, two, 3, 4, 5, 6 and 7 d after onset, color Doppler ultrasonography was used to determine whether aSAH patients had DVT.Results:A total of 73 patients (36.14%) were combined with DVT at acute stage of aSAH; 66 were with asymptomatic thrombosis and 7 with symptomatic thrombosis; 59 were with lower extremity intermuscular vein thrombosis and 14 were with intermuscular vein thrombosis. The incidence of DVT (68/73 [93.2%]) peaked on the 1 st-3 rd d of onset. The TEG-R of patients in aSAH group was statistically lower than that of the control group on the 1 st-3 rd d of onset ( P<0.05); the TEG-R of patients in aSAH group on the 1 st-3 rd d of onset was significantly lower than that on 5 th and 7 th d of onset ( P<0.05). The TEG-R of patients in combined DVT subgroup was significantly lower than that of the uncombined DVT subgroup ( P<0.05). Conclusions:Hyperfunction of coagulation factors at acute stage of aSAH is noted within one-3 d of onset; the incidence of DVT is the highest within 3 d of onset, mainly featured as asymptomatic intermuscular venous thrombosis. Whether or not aSAH would combine with DVT is associated with hyperfunction of coagulation factors.

Objective:To survey the training needs for chronic diseases among family health care workers in Beijing.Methods:A questionnaire survey on training needs for chronic disease was conducted from September to November 2018 among 820 family health care workers from 15 community health service centers in Beijing selected by stratified random sampling. The questionnaire consisted of demographic information and training needs related to chronic diseases. The training needs included: the knowledge and skills related to chronic diseases: the types of chronic diseases expected to learn, the basic knowledge of chronic diseases (7 items), preventive health care knowledge (7 items), nursing and rehabilitation skills (9 items); the duration, frequency, method, time and location of training arrangement.Results:The survey showed that chronic disease that family health care workers most wanted to learn was hypertension (90.3%, 717/794); among the basic knowledge of chronic diseases, the highest need was disease risk factor (65.5%, 520/794); among the knowledge of preventive health care, the highest need was home safety protection (87.3%, 693/794); among nursing and rehabilitation skills, the highest need was blood glucose measurement (83.1%, 660/794). The female respondents had higher training need for basic knowledge of chronic diseases than males ( Z=2.51, P=0.012). There were significant differences in the needs for preventive health care knowledge among respondents of different gender ( Z=2.72, P=0.007), occupation ( H=15.02, P=0.001) and educational level ( H=12.01, P=0.002). Respondents with different age ( H=6.49, P=0.039), occupation ( H=52.93, P<0.001) and educational level ( H=9.56, P=0.008)) had different needs for nursing and rehabilitation skills. Among the respondents, 58.2% (462/794) indicated that duration of each course should be 30-59 min, 34.0% (270/794) wanted to participate in the training once a month, 53.1% (422/794) wanted to participate in the training in the form of large class, 39.2% (311/794) were willing to participate in the training on working days and 48.7% (387/794) wanted to be trained in community health service institutions. Conclusions:There are diverse training needs of family health care workers. Attention should be paid to the implementation of need-oriented training. It is crucial to promote the motivation of family health care workers to participate in the training, which can improve the training effect and facilitate their role in family health management.