The three-dimensional organization and anastomoses of lymphatics in the rabbit stomach were demonstrated by scanning electron microscopy of lymphatic corrosion casts. Casting medium is the diluted low viscosity Mercox used for intraparenchymatous injection into the mucosal, submucosal, muscular and serous layers of the stomach. The lymphatic capillaries with blind ends were found in the deep mucosa and the lymphatic capillary networks and lymphatic plexus were observed in all the submucosal, muscular and serous layers. The distinct imprints which correspond to the bicuspid valves of lymphatics and the oval or fusiform impressions of the endothelial nuclei were seen on the casts.

Objective To evaluate the feasibility and therapeutic effect of kyphoplasty in treating severe osteoporotic vertebral compressive fractures. Methods Thirty-five patients (48 vertebral bodies) with severe osteoporotic compressive fractures were included. There were 33 females and 2 males with the mean age of 74.2 years. The average compressive rate of the affected vertebral bodies was 77.0%. The thoracolumbar vertebrae were treated with kyphoplasties. Percutaneous puncture direction was adjusted according to compressive rate and shape of the vertebral bodies. The inflatable bone tamp was inserted into the fractured vertebral body. The balloon was inflated with low pressure and dilate-relieve-dilate method was applied. The balloon was deflated and withdrawn, leaving a cavity within the vertebral body, which then fulfilled with visualized bone cement. Preoperative and postoperative symptom level, complications and radiographic findings were recorded. Results All 35 patients tolerated procedure well. The mean heights of the anterior, mid and posterior vertebral body had improved from (0.8±0.1) cm, (0.8±0.2) cm, (2.1 ±0.8) cm preoperatively to (1.2±0.3) cm, (1.3±0.2) cm, (2.3±1.0) cm respectively after operation (P ＜0.05). There was significance difference between preoperative and postoperative heights of the anterior and mid vertebral body. The mean kyphosis was improved from 28.2°±5.2° before operation to 19.1°±4.9° after operation. Conclusion Kyphoplasty is feasible and effective for severe osteoporotic vertebral compressive fractures.

Objective To analyze the effect of prevention and treatment with lamivudine in HBsAg positive renal allograft recipients with HBV recurrence.Methods In 28 patients with chronic renal failure whose HBsAg was positive,8 cases were positive for HBV-DNA positive.All these 28 cases had normal liver function without hepatic cirrhosis before renal transplantation.All donors were negative for HBsAg.Twenty patients received lamivudine prophylactic treatment:14 cases positive for HBsAg but negative for HBV-DNA before transplantation received lamivudine treatment immedia- tely after transplantation and 6 cases positive for both HBsAg and HBV-DNA received lamidudine treatment before transplantation.Eight patients were treated with lamivudine when their hepatic dys- function with recurrent HBV antigenemia were developed after transplantation.Lamivudine was orally taken and its initial dosage was 100 rag/day.Results The follow-up period of the 28 patients were 13- 54 months with the average of 23.6 months,and 2 died during this period.Mild hepatic dysfunction with recurrent HBV antigenemia developed in 3 of 20 hepatitis antigenemia patients received lamivu- dine prophylactic treatment with a mean duration of 9.3 months after transplantation.The highest average level of serum ALT was 87.5 U/L.The liver function returned to the normal with HBV-DNA negative after lamivudine treatment in 3 patients.The other 17 patients maintained normal liver func- tion with HBV-DNA negative during the follow-up period.Hepatic dysfunction with recurrent HBV antigenemia(or HBV-DNA titer increased significantly)developed with a mean duration of 4.6 months in all 8 patients without receiving lamivudine prophylactic treatment.The highest average level of serum ALT was 174.5 U/L.The liver function returned to the normal with HBV-DNA negative after larnivudine treatment in the 8 cases.HBV-DNA,however,reappeared in 5 eases without any dis- continuation of lamivudine.The creatinine level remained normal without any severe drug side effects in 28 patients during lamivudine treatment.Conclusion Lamivudine treatment before hepatic dysfunc- tion might be a safe and effective strategy for prevention of recurrence of hepatitis B viremia in HBsAg positive renal allograft recipients.

Objective To investigate the clinical features of and GJB2 gene mutations in a Chinese Han patient with keratitis-ichthyosis-deafness syndrome (KID syndrome),in hope to offer evidence for the clinical and genetic diagnosis of KID syndrome.Methods Clinical data were collected from a patient with KID syndrome.DNA was extracted from peripheral blood of the patient and his two family members (mother and brother).PCR was performed to amplify the exon 2 and its flanking splicing sites of GJB2 gene followed by bidirectional direct DNA sequencing. Results The patient presented with the typical triad of vascularizing keratitis,ichthyosis and congenital deafness.A G148A mutation in the exon 2 of GJB2 gene,resulting in the substitution of aspartic acid by asparagine at position 50 of the junction protein connexin 26 (Cx26),was identified in the patient,but not in either of his family members.Conclusion The G148A mutation in GJB2 gene may be responsible for the clinical phenotype of KID syndrome in this Chinese patient.

Objective To summarize the clinical efficacy of free KISS lateral femoral circumflex artery perforator flap in repairing defects of limbs.Methods Twelve cases were suffered wound surface defects on hands and feet.And the defects were repaired by flap construction from October,2010 to May,2013,based on the characteristics of the defects combined with anatomical features of the free lateral femoral circumflex artery perforator flap.Length of flap was adopted as the width for direct suture in the flap donor.Results Postoperative flap and donor area preliminarily healed.There was no vascular crisis.Twelve cases received 6-18 months followed-up (averaged of 12 months).The skin flap was good in color and texture.The dorsal flap was a bit bloated.Linear scar was remained in distal flap donor area.The quadriceps muscle power level 5,knee flexion,extension 10°-180°.Quadriceps strength,knee flexion and stretch activities were all normal.The flaps recovered protective sense.Four cases had tendon adhesion after hand tendon transplantation.The finger function was well recovered after release.At the last followup,the functions of the upper limbs were evaluated according to the trial evaluation standard of the Hand Surgery Association of Chinese Medical Association:6 cases were excellent,1 case was good,and 1 case was qualified.Conclusion The design of the lobulated tissue flap of the lateral femoral circumflex artery descending branch is flexible.Large area of the surface defect can be repaired.The flap donor area is directly sutured.It is an ideal method to repair the wound tissue defect.

Objective To investigate the changes of vital signs and the damage of important organs in dog progressive circulatory failures induced by soman.Method Seven male dogs,weighing(12～15)kg,were injected intramuscularly 1/3 LD sornan(1 LD=10μg/kg)per ten minutes.The moan blood pressure decreased to (40～45)mmHg was defined as circulatory failure.The changes of heart rate,blood pressure.and hemodynamic parameters were evaluated by an eight-channel direct-witing oscillograph,blood gas,pH value,electrolyte,and the damage of important organs were observed before and after sornan injection.Statistical analysis of the data was performed using the self control t test with the SAS 6.12 Software Program.Results In anesthetized dogs intoxicated with sornan,the circulatory failure was characterized by the significant decreases in blood pressure,heart rate and hemodymrnic parameters(P<0.05).Partial pressure of oxygen was less than 60 mmHg,saturation of oxygen Was less than 90% and partial pressure of carbon dioxide was greater than 50 mmHg in arterial blood of the dog model.These results showed mix respiratory failure occurred during intermittent positive pressure.Significant metabolic acidosis was induced by soman[pH(7.345±0.064)vs.(6.956±0.022),P<0.01].The concentralion of sodium ion and chloride ion in blood were changed gently.The concentrations of GTP,GOT,Cr,BUN,CK-MB and LDH were increased significantly(P<0.05),which showed multiple important organs including liver,kidney and heart were damaged by sornan.Conclusions The severe progressive circulatory failure induced by cholinesterase inhibitor sornan leads to the darnage of vital signs and important organs significantly.

In order to investigate the potential anti-leukemic effect of cyclosporin A(CsA), MTT method and cell viability assay in vitro were carried out in this study to observe the effect of CsA on the proliferation and cell viability of various leukemic cell lines, such as T-cell Jurkat, Molt-4, CCRF-CEM, Nalm-6, K562 and multi-drug-resistant leukemic cell line K562/AO2. The results fully showed that CsA did possess the same cytotoxic action on all the leukemic cell lines, particularly including multi-drug-resistant leukemic cell line,and could then inhibit the proliferation and cell viability of these leukemic cells, thereby indicating that CsA might be applied as one of the new, safe and effective anti-leukemic agents when used with clinically adoptable dosage in leukemias.

OBJECTIVETo explore the clinical effects of relaying reversed perforator flaps in repairing skin and soft tissue defects at distal end of finger and donor site.

METHODSSeventeen patients (17 fingers) with skin and soft tissue defects at distal end of finger were hospitalized from June 2011 to June 2013. The reversed digital artery perforator flap with branch of digital nerve was used to repair the defect. The first donor site was repaired by dorsal metacarpal artery perforator flap; the second donor site was closed by suturing. The area of skin defect at distal end of finger ranged from 2.0 cm x 1.5 cm to 3.0 cm x 2.0 cm, and the area of digital artery perforator flap and dorsal metacarpal artery perforator flap ranged from 2.2 cm x 1.5 cm to 3.6 cm x 2.5 cm and 2.5 cm x 2.0 cm to 4.2 cm x 3.0 cm, respectively.

RESULTSAll the 34 flaps survived completely. Cyanosis and partial necrosis of the epidermis appeared in 1 flap, which was healed after dressing change. All the patients were followed up for 1 to 18 months, with mean time of 8 months. The color, texture and appearance of flaps were satisfactory. There was no depression or breakdown in the first donor sites. Some linear scars appeared in the second donor sites, but they did not affect the general appearance. The donor sites at joint or tendon did not affect the joint activity after healing. The results of function evaluation of range of active movement of the fingers were excellent in 15 cases and good in 2 cases. The results of sensation of the flaps were S3 in 1 finger, S4 in 2 fingers, and S5 in 14 fingers. The distance of two-point discrimination of flaps ranged from 5 to 7 mm, with mean distance of 6 mm.

CONCLUSIONSRelaying reversed perforator flap, with reliable blood supply and both donor sites in the hand, can improve the appearance and function of the first donor site as well as repair skin and soft tissue defects at distal end of finger.

Cicatrix ; Depression ; Epidermis ; Extremities ; Finger Injuries ; surgery ; Humans ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Sutures ; Tendons ; Treatment Outcome ; Wound Healing

As the main part of the teaching activities,students play an important role in the teaching reform.The students were trained through 3 pathways,“Extending teaching activities from the classroom to the outside”,“Development from basic to clinical knoledge” and “Culturing students' innovative consciousness”,so as to allow them to give full play in teaching reform,to enhance their ability of practice and learning by themselves,to culture their innovative consciousness and to develop students' leading functions in the anatomy teaching reform.

Objective To study the immune responses of Th1 and Th2 subsets of T cells in 26 children with mycoplasma pneumo-niae pneumonia(MPP).Methods ELISA was used to detect the levels of interferon- ?( IFN- ?) and interleukin-4(IL-4) in the serum in 12 healthy children as normal controls and 26 patients of acute stage as acute stage MPP group, 9 of whom in recovery stage were as recovery stage MPP group. Results IFN - ? level in acute stage MPP group was significant higher than that in normal controls (P 0.05); and IFN - 7/IL - 4 ratio was significant higher than that in normal controls( P0.05).Conclusion Thl responses increase and Th2 responses decrease in children with MPP,and this kind of response persists during the recovery stage.