Objective To explore the feasibility and effects of one stage vascular free fibular transplantation or combination of bone transport two-stage technique for reconstruction of adversity congenital pseudarthrosis of the tibia. Methods Vascularised free fibular reconstruction operations for adversity congenital pseudarthrosis of tibia were performed in 16 cases, including male in 9 and female in 7,age ranged from 6 to 14 years with the mean in 8.5 years. 2 to 6 operations history were documented in all cases with the mean in 3.2 before went to our hospital, with 3 to 12 cm and mean 5.8 em short of the tibia. Mean9.2 cm (from 6.0 to 16.0 cm) vascular free fibular were harvested and transplanted to reconstruct the bone frame in 16 cases, bone transport operation were performed in 4 cases 1 year later. Results Fourteen cases were followed up for mean 4.5 years, bone union could be found by radiology examination, mean 7.8cm (from 4.0 to 11.5 cm) elongation of the low limb were obtained in 4 cases. Basic walking function was obtained in all cases. Conclusion It is an effective method to treat adversity congenital psuedarthrosis of the tibia by thoroughly resection of the focus and enough length of vascular fibular transplantation, deficiency of low limb can be ameliorated by bone transportation technique in those patients.

Objective To explore the possibility and effectiveness of minimally invasive osteotomy and cable osteosynthesis for the treatment of adolescent eubitus varus. Methods Eleven cases of adolescent cubitus varns(2 cases complicated with internal rotation of 10°)were treated with minimally invasive supracondylar wedged osteotomy to preserve the integrity of the contralateral codex and periosteum.Two screws were inserted above and below the fracture line.They were fixed with cable after the greenstick fracture and internal rotation were adjusted.Plastic bandage was applied for 1 week postoperatively before rehabilitation. Results Bone fractures healed in the 11 cases in 36.3 days averagely,without infection or nerve palsy.Before operation,the mean angles of varus,flexion and extension were 35°±5°,125°±10°and 10°±5°respectively.After a mean follow-up of 33.5 months,the mean valgus angle of the elbow was improved to 8°±2°(t=16.632,P<0.05),flexion to 130°±8°and extension to 8°±3°(P>0.05).Internal rotation deformity was also ameliorated in the 2 cases. Conclusion It is practical and effective to treat adolescent eubitus varus with minimally invasive osteotomy and cable osteosynthesis,for it can lead to stable fixation,short healing time,and does not affect the flexion and extension of the elbow joint.

Objective To evaluate the value of real time three-dimensional ultrasound in differentiating benign and malignant breast tumors. Methods One hundred and fifty-three patients with breast tumors were examined with real time three-dimensional ultrasound. The results were compared with post-operative pathological results. Results A sign of malignancy on the coronal plane was observed by three-dimensional ultrasonography,named “sun-like symptom”,because the sign looked like a shining sun:striated hyperechoic or iso-echoic images scattered radially around cancers,together with the distortion of normal tissue.The accuracy of the sign in differentiating benign and malignant breast tumors was 86.93 %( 133/153 ), the sensitivity was 78.38 %( 58/74 ), and the specificity was 94.94 %( 75/79 ). Conclusions Real time three-dimensional ultrasound is a valuable and new technique in differentiating benign and malignant breast tumors.

BACKGROUND: The articular surface of interphalangeal joint and metacarpophalangeal joint is destroyed or defected, that would remain serious sequela in many patients and affect patient's routine work and living. Therefore, therapeutic efficacy of finger joint damage determines the functional recovery of hands. Tissue engineering provides a novel pathway for finger joint damage. OBJECTIVE: To summarize the research progress on the repair and reconstruction of finger joint damage. RETRIEVAL STRATEGY: The researcher of this article used the computer to retrieve literatures of Pubmed database with docuterms of "Interphalangeal joints fractures, Metacarpophalangeal joints fractures, Finger osteoarticular, Reconstruct", and the language was defined to English. Meanwhile China Academic Journals Full-Text Database from 2000 to 2007 was also retrieved with docuterms of "Interphalangeal joints, Metacarpophalangeal joints, Fractures, Repair and reconstruct", and the language was defined to Chinese. Totally 106 correlated articles were screened out and the data were firstly checked. Inclusion standard: ①closely correlated to the repair and reconstruction of finger joint damage; ②those published in the near future or authorized journal in the same field were preferred. Exclusion standard: repetitive investigation. LITERATURE EVALUATION: The resource of literatures was the clinic empirical studies of the repair and reconstruction of finger joint damage. Among 32 included articles, 3 of them were reviews and the others were clinic or empirical studies. DATA SYNTHESIS: The homogeneity variant bone-joint transplantation has got some successes in clinic, but how to prolong the survival time of transplanting joints would be a new research topic. Autoallergic joint transplantation is a good method to treat the defects of finger joints, but how to make handling conveniently, diminish secondary damage and search new donor site, all deserve to research. The ideal therapeutic efficacy of the finger joint damage is anatomical reset of the joint profile, that can reduce traumatic arthritis and anchylosis at the minimal level. But it is still a tough problem in the fingers joint's repairs, because of the multiple structure of bone-joint in hands and trauma factors. Open reduction and internal fixation, skeletal traction, arthroplasty, fusion of joint, prosthetic replacement of joint, articular transplantation and bone-joint tissue engineering have all obtained success, but none can fully succeed or be generally adopted. CONCLUSION: There are many treatments of the finger joint damage, but their results are not very well. With the research of homogeneity variant bone-joint transplantation, autoallergic joint transplantation and tissue engineering development, bone-joint transplantation will have a wide prospect in treatment of finger joints damage.

Objective To investigate the values of three-dimensional visualization technology in the diagnosis and surgical treatment of hepatic hemangioma. Methods Thirty two patients with hepatic hemangioma who had been hospitalized during the period from July 2010 to January 2014 in our hospital were scanned by 64-slice spiral computerized tomography (CT) before surgical treatment. Three-dimensional (3D) reconstruction based on the CT data was carried out to achieve dignosis and surgical planning. Assisted with the 3D model , we chose the best surgical procedure for liver resection, protecting the major blood vessels near hemangioma and retaining normal liver tissue as far as possible. Results The location, size and shape of hepatic hemangioma, vascular variation, and spatial relationship with intrahepatic vessel were shown factually by three-dimensional reconstruction. All the hemangiomas were preoperatively assessed to be resectable. The compliance rate for preoperative surgical planning to actual surgery was 100%. Under assistance of the 3D model during surgery , 14 patients received laparoscopic hepatectomy and 18 underwent hepatectomy. Pringle′s maneuver was applied in 18 patients , with blocking time of (15.32 ± 7.12) min and blood loss of (188.63 ± 66.37) mL. The postoperative complications included pleural effusion in 5 patients and incision infection in one patients. Conclusions Three-dimensional visualization technology for the individualized diagnosis and treatment of hepatic hemangioma helps reduce surgical trauma and incidence of postoperative complications.

Background Various studies demonstrated that the apoptosis of lens epithelial cells(LECs) is associated with the overexpression of the c-myc gene in LECs induced by galactose.Inhibiting the abnormal expression of the c-myc gene in LECs is an effective approach to mitigate the pathogenesis and development of cataract.Objective The goal of this study is to investigate the inhibitory effects of c-myc antisense oligodeoxynucleotide(c-myc ASODN) on the apoptosis of LECs in the eye with galactose-induced cataract.Methods Galactose-induced cataract models were established by the retrobulbar injection of 0.2 mL of 20% galactose once per day.Lipo-antisense oligodeoxynucleotide(Lipo-ASODN,0.2 mL) was retrobulbarly injected 4 hours after the injection of galactose at one-day intervals.The animals were sacrificed and lenses were obtained to evaluate the apoptosis of LECs and the effect of c-myc ASODN on LECs apoptosis induced by galactose was examined by TUNEL assay after 7,14 and 24 days.The ultrastructural changes of LECs were examined under the transmission electron microscopy(TEM).Results A significant difference in the apoptotic rate of LECs was found among the 7 day,14 day and 24 day groups(F_(7 days)=3 418.495,P＜0.01;F_(14 days)=1137.555,P＜0.01;F_(24 days)=2198.871,P＜0.01).The apoptotic rate of LECs in the galactose group was markedly higher than that in the normal saline solution group 7 days,14 days and 24 days after the experiment(P＜0.01).The apoptotic rate of LECs in the galactose+lipo+ ASODN group significantly declined in comparison to the galactose group after 7 days,14 days and 24 days(P＜0.05).TUNEL assay showed the condensation,breakage and irregularity of the nuclei of apoptotic cells in the galactose group.The destruction of the ultrastructure of the cells and organelles were observed under the transmission electron microscope.Conclusion Galactose induces apoptosis of LECs in cataractogenesis.C-myc ASODN inhibits apoptosis of LECs induced by galactose.

Objective To explore the possibility of treating tibial osteomyelitis with transfer of a compound flap composed of the sural nerve fasciocutaneous flap and the lateral gastroenemius muscle.Methods We observed in cadaver specimens the anatomical structure of the sural nerve fasciocutaneous flap and the lateral gastrocnemius muscle to design a compound flap. Fifteen cases of tibia] osteomyelitis were treated with sinus excision and thorough debridement before the skin defect area was covered with a sural nerve compound flap whose muscle was stuffed into the tibia] channel. Plates were replaced with unilateral fixators in 3 cases of tibial nonunion. Results We observed 5 to 6 perforating branches of blood vessels between the sural nerve fascioeutaneous flap and the lateral gastroenemius muscle, indicating that the two can be harvested simultaneously in one compound flap. The transferred compound flaps survived in 15 cases. Tibial os-teomyelitis was completely cured in 14 cases, 1 case healed after second debridement, and 3 cases of tibial nonunion healed 6 months later after a second stage iliac bone graft. No recurrence was found after a mean follow-up of 18 (10 to 26) months. Conclusion A compound flap composed of the sural nerve fascio-cutaneous flap and the lateral gastrocnemius muscle can be used to treat tibia] osteomyelitis effectively.

0.01). CONCLUSION: The 5th CMC joint of the hamatum can be considered to be a new and well joint donor site, and it can be used to repair and reconstruct the base joints of the proximal phalanx.

Objective To report the outcome of emergency repair traumatized limbs by vascularized free tissue transplantation.Methods From April 1988 to August 2004,86 patients,58 men and 28 women,had undergone emergency vascularized free tissue transplantation to have their injured limbs repaired in 54 cases and the missing thumbs reconstructed in 32.The patients aged from 5 to 55 (mean 27.9) years. The transplants included latissimus dorsi myocutaneons flap,anterolateral femoral skin flap,medial crural skin flaps,dorsal pedal flaps,medial plantar flap,composite tissue mass of the discarded limbs and big toe skin- nail flap.The operations were performed 1 to 5 days after injuries.Results Postoperative vascular crises occurred in 8 cases and were all followed by exploration with successes in 5 cases while failure in 3.The total survival rate of the transplants was 96.5% (83/86).In this series all the patients were followed up for 1 to 16 years with a mean of 7.5 years only to reveal satisfying functional recovery in all the repaired limbs and an ex- cellent and good rate of 87.5% in the reconstructed thumbs.Conclusion Emergency vascularized free tis- sue transplantation is an effective way to repair a traumatized limb and to reconstruct a traumatically missing thumb.

Objective: To understand literacy development of school-aged children of grade 2-5 and its influencing factors in Guangzhou,and to provide a reference for the reform of the teaching of Chinese subject. Methods: By using cluster sampling method, 1 661 school-age children from grade 2 to grade 5 from 5 primary schools in Guangzhou were selected. The self-designed questionnaire was used to obtain demographic data of the participants. The Primary School Literacy Assessment Scale and the Pupil Rating Scale Revised Screening for Learning Disabilities was used to evaluate the literacy and the cognitive characteristics of participants. Results: The average literacy of children of grade 2 to grade 5 in Guangzhou was as follows: grade 2 was (1 159±295), grade 3 was (1 919±394), grade 4 was (2 599±365), grade 5 was (2 947±303), higher than the norm(P<0.01). The average literacy of grade 2 students was lower than the national curriculum requirements while students of grade 3 to grade 5 met the requirements. Univariate analysis found differences in literacy among school-age children based on gender, reading experience before age 6, and parental education background (P<0.01). Multiple linear regression analysis revealed that grade (β=607.04), preschool reading experience (β=109.89), father’s education (β=27.14), language factor (β=27.21), social behavior (β=16.03) was positively correlated with literacy in boys (P<0.05). Grade (β=603.53), auditory comprehension and memory (β=29.39), language factor (β=16.74) was positively correlated with the literacy of girls (P<0.05), while time and orientation judgments were negatively correlated with the literacy of both boys (β=-18.95) and girls (β=-21.93) (P<0.05). Conclusion The literacy level of school-age children in grade 2 to 5 in Guangzhou has reached the national literacy requirements with students in grade 2 being relatively lower. Literacy is related to grade, preschool reading experience, father’s education, and child’s cognitive characteristics. Factors affecting literacy in boys and girls are different. Literacy education should vary according to gender.