Pleiotrophin, discovered in 1989, was thought as a muhi-funetional growth factor; It plays an important role in tumor occurrence and central neural system. The latest research showed pleiotrophin signal pathway probably takes part in neural repair after peripheral nerve injury, especially in the followed crisis point, such as the protection of spinal cord neuron, the promotion of the speed of neuron axon regeneration, the guidance of neuron axon regeneration, skeleton muscle reirmervation. It potentially makes a key role in the guidance of neural axon regeneration in peripheral neural system and muscle reianervation. Along with the related researches go deep, pleiotrophin gene might become a controllable target for promoting the result of peripheral neural repair and reconstructing the neuromuscular junction.

Objective To investigate the inheritance principle of the expanded GAG repeat allele and the clinical features of spinocerebellar ataxias 3 (SCA3) in a consanguinity family with first cousin marriage.Methods The CAG repeats of SCA3 gene were amplified by means of polymerase chain reaction.Fragment analysis with laser-induced fluorescence in capillary electrophoresis were performed for the positive samples detected by agarose gel electrophoresis.Furthermore,the clinical features were analyzed carefully.Results Fragment analysis revealed that the proband carried 2 alleles with 56 and 72 CAG repeats separately.The proband' s father carried 28 and 66,and the expanded CAG repeat allele inherited from his grandfather.The proband' s mother carried 33 and 56,and the expanded CAG repeat allele inherited from his grandmother.The proband' s son carried 27 and 85 and presented with dystonia besides ataxia.Conclusions The proband' s parents have the common ancestors.Their alleles with expanded CAG repeats probably come from the same allele of their ancestor.The GAG repeat is more unstable in the paternal inheritance than in the maternal inheritance.The 71-year-old asymptomatic family member carry the allele with 56 CAG repeats,which indicates the 56 CAG repeats may be not associated with the disease.The patients within this family have variable clinical features,especially the juvenile-onset case presents with apparent dystonia.

Objective To study the effects of psychological rehabilitation in the treatment of paraplegic patients with spinal cord injury (SCI).Methods A hundred paraplegic spinal fracture survivors were divided into a research group and a control group with 50 cases in each.Systematic rehabilitation was given to the patients in the control group,while this was combined with individualized psychological rehabilitation protocols for the patients in the research group.The daily treatment lasted 10 weeks,6 days a week.All of the patients were assessed with the Barthel index (BI),a functional independence measure (FIM),the Hamilton depression scale (HAMD) and the Hamilton anxiety scale (HAMA) pre-treatment and post-treatment.Results Before the intervention there was no significant difference between the 2 groups in any of the assessments.After ten weeks the average BI,FIM,HAMD and HAMA results in the research group were significantly better than those pre-treatment and also significantly better than those in the control group.Conclusions Psychological rehabilitation can distinctly improve the functioning and psychological state of paraplegic patients after SCI.

Objective To introduce the clinical application of a extensive revense peroneal artery flap in repairing big soft tissue defect in foot, especially in repairing a big defect in distal foot and the exposure of one or more metatarsophalangeal joint. Methods The skin flaps were used in 11 cases to repair the big soft tissue defect in foot, including the distal part of foot. The flap upper boundary may surpass the capitulum fibulae; The lower boundary may reach the back line between external malleolus and internal malleolus; Lat-eral boundary could overrun anterior margin of fibula about 2 cm; Inboard boundary could get to medial mar-gin of gastrocnemius muscle. In attention: the two branch vessels from peroneal vessel in the site of 11-13 cm and of 5-7 cm above the outer anker would be included in the flap. Results Ten of 11 skin flaps survived satisfactory. A small, marginal portion of one flap in one case presented necrosis. Conclusion The reverse peroneal artery flap is easy to elevate and safety, which is an ideal flap for a huge soft tissue defect in foot, especial in the distal part of foot.

Objective To observe the effects of heat-sensitive moxibustion on the expression and activity of super-oxide dismutase (SOD) and the content of malondialdehyde (MDA) in focal cerebral ischemia-reperfusion injury in rats, and the mechanism thereof. Methods Thirty-six male SD rats were randomly divided into four groups, sham-operated group (n=6), ischemia-reperfusion (I/R) injury group (n=10), I/R injury with 15-minute moxibustion group (n=10) and I/R injury with 35-minute moxibustion group (n=10). The focal cerebral ischemia-reperfusion rat model was induced by middle cere-bral artery occlusion (MCAO) for 2 h followed by reperfusion. Values of SOD activity and MDA content were determined by colorimetry, and the cortical expression of SOD2 protein was detected by Western blot technique. Results Values of SOD activities were significantly higher in serum (22.78±1.31)U/mL and cortex (4 909.6±1 345.6) U/g of heat-sensitive moxibus-tion group than those of model group (20.17±1.12)U/mL and (2 602.0±1 515.5)U/g. Values of MDA contents were significant-ly decreased in serum (3.78±2.00)μmol/L and cortex (1 226.5±38.4)nmol/g in heat-sensitive moxibustion group than those of model group (16.82 ± 6.70)μmol/L and (1 905.6 ± 478.6) nmol/g. The cortical expression of SOD2 protein (0.974 ± 0.166) was higher in heat-sensitive moxibustion group than that of model group (0.702±0.040). Conclusion Heat-sensitive moxi-bustion could reduce the damage of cerebral inchemia-reperfusion, which might be through improving SOD activity, increas-ing SOD expression and decreasing MDA content.

Objective to investigate the curative effect of activated vitamin D3 combined with IFN-α on CCl4-induced hepatic fibrosis in BALB/c mouse model. Methods the experimental mice received 100 μL of 10% CCl4 intraperitoneally to induce a model of hepatic fibrosis,and the nor-mal control group were administrated with same volume of 0.9% saline(n = 6). the experimental mice then were randomly divided into four treat-ment groups and treated for six weeks:saline therapy group(0.9% saline,100 μL/mouse,n = 6),IFN-α therapy group(IFN-α 800 U/mouse,n =6),1,25-(OH)2D3 therapy group(50 μg/kg,by gavaged,n = 6)and combined treatment therapy group(combined treatment,n=6). Hepatic inju-ry and hepatic pathology were examined by HE staining and Masson staining. Interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(tNF-α),transforming growth factor-β(tGF-β)and Smad3 were determined by real-time PCR and ELISA. Results Inflammatory cell infiltra-tion and periportal collagen deposition were significantly reduced in all the therapeutic group expect saline therapy group assessed by HE and Masson staining. the IFN-α therapy group,1,25-(OH)2D3 therapy group and combined treatment therapy group displayed significant decrease in Col1α1, IL-6,tNF-α,tGF-β and Smad3 expression and increase in IL-10 expression in liver tissue(P < 0.05). Conclusion the effect of 1,25-(OH)2D3 combined with IFN-α therapy is similar to separated treatment.

Objective To study the effect of different psychological rehabilitation time on patients with spinal cord injury (SCI). Methods 80 patients with SCI caused by spinal fracture were divided into early psychological rehabilitation group (n=40) and late psychological rehabilitation group (n=40). The routine treatment was administered to both groups, and psychological rehabilitative therapy was also administered immediately and 3 weeks after admission respectively. Their function, psychological state and quality of life were evaluated. Results The scores of modified Barthel index (MBI), Functional Independence Measure (FIM), and psychology, independence, social relations and the total score in World Health Organizations Quality of Life (WHOQOL-100) were higher, and the scores of Hamilton Self-rating Scale for Depression (HAMD) and Hamilton Self-rating Scale for Anxiety (HAMA) were lower in the early psychological rehabilitation group than in the late psychological rehabilitation group (P<0.05). Conclusion Early psychological rehabilitation is beneficial for functional and psychological state recovery in patients with SCI.

Objective To research and prepare the individualized knee in vitro guided plate by 3D printing technique and to investigate the feasibility of its application in 8-plate epiphysiodesis.Methods Twelve children patients with knee varus or valgum in our hospital from January 2014 and November 2016,7 boys and 5 girls,average age of 8.2 years old,were performed the lower extremity continuous spiral CT scanning in the knee straight position.The Dicom format stored CT data were imported into software Mimics 15.0 for reconstructing the knee joint 3D model.The knee joint data after reconstruction were guided into software Geomagic1 1.0 with the.stl format.According to the demand that screws without perforating epiphyseal and joint surface,paralle ling to the epiphyseal and locating in the anterior-posterior median line of epiphyseal,the 8-plate placing screw navigation template was designed and printed by using the 3D printing technique;the 8-plate plate and screw internal fixation was conducted by intraoperative template location.The placed screw position was evaluated by postoperative CT.Results The imaging identification showed that 8-plate epiphysiodesis by using 3D printing individualized in vitro guided plate had accurate screw placement.The cases were followed from 6 months to 2 years,the satisfactory orthopedic effect was obtained in all cases.Conclusion Preparing the individualized knee in vitro guided plate by applying 3D printing technique in assisted 8-plate epiphysiodesis for treating child knee varus or valgum has accurate screw position and satisfactory effect.

Adult stem cells from skeletal muscle cells were induced to differentiate into cardiocytes to see if stem cells from another different but histologically-comparable tissues can differentiate to the target cells. Skeletal muscles-derived stem cells (MDSCs) were isolated from adult skeleton muscle tissues by differential adhesion, and immunocytochemically identified by using Sca-1. In order to induce the proliferation but not differentiation of MDSCs, the cells were cultured in Dulbecco's modified Eagle's medium/F12 (DMEM/F12) supplemented with 1:50 B27, 20 ng/mL basic fibroblast growth factor (bFGF), 20 ng/mL epidermal growth factor (EGF) in a suspension for 6 days. Then these stem cells were treated with 5 mumol/L 5-azacytidine for 24 h in an adherence culture. The characteristics of induced cells were examined by immunocytochemistry, quantitative real time RT-PCR and morphological observation of cell phenotype. Our results showed that the appearance of some cells gradually changed from spindle-shape into polygonal or short-column-shape. Some of these post-treated cells could contract spontaneously and rhythmically. The expression of GATA-4 and cTnT was increased 1 and 2 week(s) after the treatment. And about 16.6% of post-treated cells were cTnT-positive. Therefore, we are led to conclude that skeletal muscle-derived stem cells could differentiate into cardiocyte-like cells, which exhibited some characteristics of cardiocytes.

Objective To explore clinical classification and strategies for irreducible femur intertrochateric fractures.Methods A retrospective study was conducted of the 96 patients with irreducible intertrochanteric fracture who had been treated from January 2012 through December 2014 at our department.They were 47 men and 49 women,aged from 48 to 97 years (average,78.5 years).We classified the fractures according to location of fracture line and mechanism of fracture displacement into 5 types:13 cases of type Ⅰ (sagittal irreducible fracture),7 cases of type Ⅱ] (coronal irreducible fracture),72 cases of type Ⅲll (sagittal plus coronal irreducible fracture),zero of type Ⅳ (irreducible fracture involving the lesser trochanter),and 4 cases of type Ⅴ (irreducible fracture involving the greater trochanter).All the patients were managed using different techniques for closed reduction and fixation with proximal femoral nails antirotation Ⅱ.Results Of this series,limited open reduction was eventually conducted in 7.The operation time averaged 40 min;the amount of intraoperative blood loss averaged 200 mL.Fracture reduction was rated as grade Ⅰ in 78 cases and as grade Ⅱ in 18.The follow-up time averaged 16.6 months (from 12 to 24 months).All the fractures got united after an average of 5.8 months (from 3 to 9 months).The function of the affected hip was rated at the final follow-up using Harris scoring system as excellent in 79 cases and as good in 17,with an excellent to good rate of 100％.Refracture happened in one patient due to striking injury,urinary infection occurred in 2 patients and no wound infection was observed.Conclusion According to the classification and reduction strategy proposed by us,satisfactory reduction and fracture fixation can be achieved in management of irreducible intertrochanteric fractures.