Objective To analyze the clinical effects of sinus tarsi approach with minimal-inva-sive percutaneous screw fixation of calcaneal fractures. Methods From February 2014 to July 2015,28 ca-ses of calcaneal fracture patients(Sanders Ⅰ ~ Ⅲ)were treated with minimal-invasive percutaneous screw fixation via sinus tarsi approach in our department. There were 18 males and 10 females with age ranging from 16 to 68 years(mean,32 years). According to the classification of Sanders,six cases were classified as Type I,twelve as Type Ⅱ,and ten as Type Ⅲ. The Bohler angle and Gissane angle were compared be-fore and after operation. Clinical results were evaluated with the Maryland foot scoring system. Results All the patients were followed up for 14 to 20 months(mean,15. 5 months). Anatomic or almost anatomic reduction was achieved in all patients according to the results of postoperative images. All fractures healed,and the healing time ranged from 4 to 7 months(average,5. 3 months). There was no wound infec-tion,necrosis or bone nonunion. According to the Maryland foot scoring system,16 cases were defined as excellent,10 cases as good,and 2 cases as poor. The good and excellent rate was 92. 8% . Conclusion For calcaneal fractures,sinus tarsi approach with minimal-invasive percutaneous screw fixation has the ad-vantages of small trauma,safe operation,limited complication,and stable fixation,which is a satisfactory clinical treatment.

Objective To evaluation the efficacy and safety of endovascular stenting for intracranial artery stenosis.Methods By the checking of DSA,39 patients with intracranial artery stenosis were divided into the anterior circulation group [26 cases,including 11 cases of transient ischemic attack(TIA),15 cases of cerebral infarction(CI)] and posterior circulation group(13 cases,including 3 cases of TIA,10 cases of CI).All the patients were treated with endovascular stents.The rates of the stenting success,improvement rate of stenosis post-stenting and incidence of complications were compared between the two groups.In 6～12 months follow-up,DSA reexamination was performed,and the scores of mRS and BI in patients with CI between pre and post-stenting were compared.Results The rate of stenting success in anterior circulation group was 92.3%,and 100% in posterior circulation group.The improvement rates of stenosis compared pre-stenting in the two groups were all above 70%.The incidence of complications was 19.2% in anterior circulation group and 7.7% in posterior circulation group.There was no statistical difference between the two groups.There were 10 cases in anterior circulation group and 5 cases in posterior circulation group received DSA reexamination,and 50% restenosis was found in the 2 cases(1 case in each group).In the period of the follow-up,the score of mRS and BI at the 6 months and 12 months post-stenting of patients with CI were significant improved than pre-stenting(all P

0.05); 88.6%, 60.0%, and 51.4% for those in group A2, and 59.3%, 48.1%, and 25.9% for those in group B2, respectively (P 8 cm.

Objective To evaluate the effect of transcatheter arterial chemoembolization using ethanol and iodized-oil emulsion(TACE-EIOE) on prognosis of patients with hepatocellular carcinoma(HCC). Methods Eighteen patients with histologically-proven HCC were underwent TACE-EIOE. The extent of apoptosis was analyzed by terminal deoxynucleotidy transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) staining. The expressions of Bcl-2, Bax, p53, Ki-67 and PCNA proteins were detected by immunohistochemical method. Changes of these markers, tumor necrosis, encapsulation, volume, cumulative survival were analyzed. Results Complete tumor necrosis was 33.33%(6/18), severe tumor necrosis was 44.44%(8/18), moderate tumor necrosis was 5.56%(1/18), lesser tumor necrosis was 16.67%(3/18). Apoptosis rate was (22.79?3.34)%. Complete encapsulation was 88.89%(16/18). Evident volume-lessening was 66.67% (12/18), partial volume-lessening was 22.22%(4/18),and stable volume was 11.11%(2/18). Ki-67,PCNA, p53, Bcl-2, and Bax were (30.93?18.10)%, (41.16?11.83)%, (53.41?18.13)%, (6.32?2.10)%, and(58.73?17.32)%, respectively. The cumulative 1-, 2-,and 3-year survival rates were 83.33%,72.22%,and 66.67% for patients, respectively. Conclusions The preoperative TACE-EIOE is safe, it might benefit patients with HCC.

In-stent restenosis after stenting is a major problem to perplex the minimally invasive interventional treatment and development in atherosclerotic cardio-cerebrovascular diseases.Intravascular inflammatory response is one of the important causes for restenosis after stenting in which as represented by interleukins,the cytokines play complex and variable roles.This article reviews the effects of the expression levels of interleukins on vascular endothelial hyperplasia and the incidence of in-stent restenosis.

Objective To investigate the effect of orphan nuclear receptor NR4A1 expression on oxygenglucose deprivation (OGD)-induced apoptosis in cultured rat cerebellar granule neurons and its possible mechanisms.Methods Primary rat cerebellar granule neurons were cultured for 7 to 8 days,and then treated with OGD.The activity of cultured rat cerebellar granule neurons was assessed by methyl thiazolyl tetrazolium (MTT) assay,apoptosis was detected with flow cytometry,the expressions of NR4A1,caspase-3 and cytochrome c were determined by Western blot analysis,NR4A1 mRNA expression was detected with real-time polymerase chain reaction.The rat cerebellar granule neurons were transfected with lentiviral vector-encoding rat NR4A1.The apoptotic rates and expressions of caspase-3 and cytochrome c in rat cerebellar granule neurons transfected with NR4A1 were detected after OGD.Results The activity of rat cerebellar granule neurons decreased significantly,the apoptotic rate increased significantly,the expressions of NR4A1 mRNA and protein as well as caspase-3 and cytochrome c incrased significantly along with the OGD time.NR4A1 was overexpressed,apoptosis rate was significantly reduced in rat cerebellar granule neurons transfected with NR4A1.The expressions of caspase-3 and cytochrome c were significantly reduced in the rat cerebellar granule neurons transfected with NR4A1 after OGD.Conclusions NR4A1 overexpression may reduce OGD-induced apoptosis in rat cerebellar granule neurons by downregulating the expressions of caspase-3 and cytochrome c.

Objective　To evaluate the relationship between the tumor encapsulation,lymphocytic infiltration,fibroplasia and cirrhosis and transcatheter arterial chemoembolization(TACE)methods for hepatocellular carcinoma(HCC).Methods　Histopathological changes were studied in 59 cases of HCCs treated with four kinds of TACE and 58 cases of HCCs treated with surgical resection alone.Results　In TACE group the encapsulation,lymphocytic infiltration,fibroplasia was more severe and extensive than that in group of surgical resection alone(Ρ＜0.01）.The TACE method and treatment time had effect on encapsulation and fibroplasia of tumor,but treatment interval was no effect.The rate of cirrhosis among TACE method had no significantly difference（Ρ＞0.05）,had relation to TACE time（Ρ＜0.05）.Conclusion　The changes in the encapsulation,lymphocytic infiltration,fibroplasia are more easily find by polytimes,multimaterial chemoembolization than that by one time single material chemoembolization and chemotherapy alone.The superselective cathetering can avoid the damage of normal liver.

Objective To discuss the feasibility and long-term effect of free latissimus dorsi muscle flap in repair of severe lower extremity injury in children. Methods From July 1999 to June 2004, nine child patients (at age of 6-13 years) with severe lower extremity injury involving soft tissue defects a-round the calf and the foot associated with complex open fractures, bare dislocation, and injury of the nerve, tendon and artery were repaired with free latissimus donsi flap, with flap area ranging from 30 cm ×12 cm to 10 cm × 5 cm. Results All the latissimus dorsi flaps survived, with success rate of 100%. A follow-up for 4-9 years showed that the flap had sound shape and function and normal blood supply, without significant influence on donor area. Conclusion Latissimus dorsi flap has advantages of constant anatomical site, abundant blood supply, massive area, strong anti-infection ability and less in-fluence on donor area and hence is an ideal method for repairing severe lower extremity injury in children.

In recent years, here are many new understandings in the definition, etiology, diagnosis and treatment of transient ischemic attack (TLA).The latest viewpoint considers that TIA is a transient episode of neurological dysfunction caused by brain, spinal cord or focal retinal ischemia, without the evidence of acute infarction. The duration of TIA is no longer the key factor, whether the existence of infarction or not is the key factor in the differentiation of TIA and ischemic stroke. Therefore ,it should emphasize the importance of neuroimaging in the diagnosis of TIA. As a neurological emergency, the risk level of TIA should be stratified and evaluated, and the active interventions should be performed.

The article introduces the advances in the evaluation of transient ischemic stroke (TLA) and reviews them from four aspects, including identifying whether the symptoms accord with the diagnosis of TLA, which blood supply area the ischemia is located in, evaluating the pathogenesis of TIA, and predicting its prognosis.