SUMMARY Peripheral nerve defects are still a major challenge in clinical practice,and the most com-monly used method of treatment for peripheral nerve defects is nerve transplantation,which has certain limitations and shortcomings,so new repair methods and techniques are needed.The peripheral nerve is elongated in limb lengthening surgery without injury,from which we got inspirations and proposed a new method to repair peripheral nerve defects:peripheral nerve elongation.The peripheral nerve could be elongated by a certain percent,but the physiological change and the maximum elongation range were still unknown.This study discussed the endurance,the physiological and pathological change of peripheral nerve elongation in detail,and got a lot of useful data.First,we developed peripheral nerve extender which could match the slow and even extension of peripheral nerve.Then,our animal experiment result confirmed that the peripheral nerve had better endurance for chronic elongation than that of acute elonga-tion and cleared the extensibility of peripheral nerve and the range of repair for peripheral nerve defects. Our result also revealed the histological basis and changed the rule for pathological physiology of peri-pheral nerve elongation:the most important structure foundation of peripheral nerve elongation was Fon-tana band,which was the coiling of nerve fibers under the epineurium,so peripheral nerve could be stretched for 8.5% -10.0% without injury because of the Fontana band.We confirmed that peripheral nerve extending technology could have the same repair effect as traditional nerve transplantation through animal experiments.Finally,we compared the clinical outcomes between nerve elongation and perfor-mance of the conventional method in the repair of short-distance transection injuries in human elbows, and the post-operative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group.On the whole,all of these experimental re-sults revealed the physiological phenomenon of peripheral nerve elongation,and described the physiologi-cal change and stretch range in detail.The systematic research results have filled the blank in this field, which is very helpful for clinical limb lengthening surgery,the design of elongation surgery and the evalu-ation of the peripheral nerve stretch injury.Peripheral nerve elongation will become an innovative treat-ment technology in repairing peripheral nerve defects.

SUMMARY Trauma is a global social problem, with the number of deaths up to 5.8 million all over the world annually.Currently, severe trauma has become the first cause of death in young adults in China. Nowadays, there are many problems in the trauma rescue system, including long pre-hospital transfer pe-riod , several secondary transfers, no information exchange between pre-hospital and in-hospital care, and the poor integrated treatment, which results in the situation that the overall treatment level of severe trau -ma in China is relatively low.In order to solve these problems, we carried out the research and promotion of severe trauma rescue standard, involving completing severe trauma information database , providing lo-cal rescue medical workers with standard training , and building up the information system for the linkage and warning of severe trauma.In addition, we developed and promoted the new standard system for se -vere trauma in 15cities with 124 medical centers.Due to our research, the treatment ability of severe trauma in the pilot areas was enhanced, and the mortality and morbidity of severe trauma were reduced significantly.To sum up, we had got the expected results after implementing the project .

Objective To analyze the injury characteristics in 2004-2009 road traffic accidents (RTAS) of 0-25 years old adolescents treated in Beijing 120 Emergency Center so as to provide scientific basis for making effective measures in prevention and control of RTAs. Methods The data of all the adolescents with traffic injuries treated in Beijing 120 Medical Emergency Center were collected for a retrospective analysis on sex,age,traffic injury time,wound regions,injury characteristics and death condition of the injured adolescents. Results( 1 ) There were 17 232 injuries and 259 deaths according to the traffic reports from 2004 to 2009. Among the total injury cases,there were 4 229 cases of 0-25 years old adolescents (24.5％),at (20.13 ± 4.43 ) years of age.The injury number showed a significant rising trend with the increase of age and the injury number of 20 years old group were obvious more than that of other age groups.(2) There were 2 252 males and 1 677 females,with ratio of males to females for 1.5:1 ( P ＜ 0.05 ).( 3 ) Total number of patients was decreased yearly.The high incidence of adolescent RTAs could be seen in September,October and May in one year; Friday,Saturday and Sunday in one week; and between 8:00 am and 11:00 pm in one day.The low incidence of adolescent RTAs could be seen in Tuesday in one week,and 3:00-6:00 am in one day (P ＜0.05).(4) Cases of limb and arthrosis wounds (53.4％) were more than those of head and neck wounds (35％).Most of the cases were pedestrians (49.1％ ).(5) There were 38 deaths,including 28 males and 10 females,at ageof (19.29 ± 5.30) years.The death were mainly resulted from craniocerebral injuries (87％),which mainly concentrated in July ( 13.2％ ) and August ( 15.8％ ). Conclusions The present condition ofadolescent traffic injuries is not good enough.We should strengthen traffic security education,increase executive powers in the traffic rush and promote cooperation and communication in pre-hospital emergency,as may be beneficial for decreasing adolescent RTA.

Objective To investigate the growth inhibition effect of evodiamine (Evo) on renal carcinoma 786-0 cells and to explore its molecular mechanism. Methods After treated with Evo, methyl thiazolyl tetrazolium ( MTT) assay was used to detect the vitality of 786-0 cells, flow cytometry was employed to examine the cell cycle distribution in 786-0 cells, and immunoblotting was utilized to determine the expression levels of target proteins related to cell cycle progression. Results Evo remarkably inhibited 786-0 cells vitality in dose-dependent manner. Cell cycle analysis indicated that 786-0 cells were arrested in G2/M phase followed by Evo treatment. Furthermore, the results of immunoblotting showed that Evo up-regulated the protein expression levels of P53, P21 and its downstream target gene CyclinB1 in 786-0 cells. Conclusion Evo treatment can induce 786-0 cell cycle G2/M arrest, and its underlying mechanism might be dependent on the P53/P21 signal pathway.

AIM: To study the effect of the overexpression of p16 on an anion exchange function of band 3 in HeLa cells. METHODS: The expression of p16 and band 3 in HeLa cells was detected by immunohistochemistry (IHC). The p16 cDNA was subcloned to plasmids pEGFP-C1 by PCR and identified by restriction enzyme digestion and sequencing, and then, the recombinant pEGFP-C1-p16 plasmids were transiently transfected into HeLa cells. The expression of fusion protein in HeLa cells was detected by fluorescence microscope. 6-methoxy-N-(3-sulfopropyl)-quinolinium(SPQ)fluorescent probes were used to detect the anion exchange function of band 3. RESULTS: P16 and band 3 were expressed in HeLa cells. The amplificated p16 cDNA sequence was the same as the report sequence. The transfective efficacy of pEGFP-C1-p16 was above 60%. The anion exchange function increased after the transfection of pEGFP-C1-p16 plasmids. CONCLUSION: p16 facilitates the anion exchange function of band 3 in HeLa cells.

Objective To investigate the potential role of Lycium bararum polysaccharide (LBP) with or without interferon -inducible protein 10 ( CXCL10) in inducing dendritic cells ( DC) functional maturation by monitoring the alteration of cytokines for inducing DC maturation in peripheral blood and by detecting the expression of S-100 protein in tumor tissue, thus to reveal its mechanism of inhibiting experimental liver cancer. Methods H22 bearing mice model was established. The mice were randomized into model group, LBP group (50 mg/kg, ig), CXCL10 (right axillary subcutaneous injection of 15 μg/kg), LBP + CXCL10 group (LBP 50 mg/kg, ig, and right axillary subcutaneous injection of CXCL10 15 μg/kg), 5- fluorouracil (5FU) group ( intraperitoneal injection of 12mg/kg) , 12 mice in each group. The mice were administered the corresponding medicine once a day. After treatment for 2 continuous weeks, blood was sampled from infraorbital vein, and the tumor mass, spleen, thymus were extracted for the calculation of anti-tumor rate, thymus index and spleen index separately . The mRNA expression levels of interleukin 12 (IL-12) and tumor necrosis factor-α (TNF-α) in peripheral blood were detected by fluorescence quantitative PCR, the expression of S-100 protein in tumor tissues was detected by immunohistochemical assay. Results Compared with the model group, tumor growth in LBP group and LBP+CXCL10 group was obviously inhibited, and tumor-inhibitory rate was 55.90%, 50.91%, respectively. Meanwhile, the mRNA expression level of IL-12 was 2.94 folds higher in LBP group and 3.39 folds higher in LBP + CXCL10 group, and TNF-α mRNA expression level was 1.55 folds higher in LBP group and 4.74 folds higher in LBP+CXCL10 group than the model group, the differences being statistical significant ( P<0.05 or P<0.01). Results of immunohistochemical assay showed that S-100+DC number in LBP group and LBP+CXCL10 group was larger than that in the model group (P<0.05 ). Conclusion LBP and LBP+CXCL10 exert significant effect on inhibiting experimental liver cancer. The mechanism may be related with inducing the secretion of IL-12 and TNF-α, which plays a key role in inducing DC maturation, and with the increase of the number of DC in tumor microenvironment.

Objective To describe the rule of the phenotypic changes of schwann cells after peripheral nerve injury.Methods All experiments were performed on 18 male SD rats.Right midsciatic nerves were cut and were repaired by epineurium suture.At selected time points after injury(1 week,2 weeks,3weeks;n=6 rats for each time point),the proximal and distal sciatic nerve stumps(approximately a 2 mm length of nerve to the injured tip)were removed for detecting the expressions of GFAP,Sox2 and Krox20 by immunofluorescence methods. Results After sciatic nerve transection.there was expansion in the population of GFAP-labeled Schwann cells both in the proximal and distal stumps,and those expression reached the peak near to 7 d.Sox2 was neural stem cell markers and there was no Sox2-expressed cells stumps after nerve injury.And Krox20 positive Schwann cells continuously decreased in the first week,then had increased. Conclusion The differentiated stage of Schwann cells during peripheral nerve repair can be detected by using immunolabeling,and the observation above may be beneficial to find methods in improving nerve regeneration.

Objective To investigate the amplifying results of repairing degenerated distal receptor nerves with normal proximal donor nerves.Methods The study was carried out on 12 adult male SD rats that randomly derided into degeneration group and control group.The distal tibial nerve stumps as receptor nerve were denervated for 8 weeks before cross-sutured with partial freshly transected proximal common peroneal nerve stumps in the degeneration group,while in the control group,freshly transected distal tibial nerve stumps were sutured with partial freshly cut proximal common peroneal nerve stumps.The motor nerve conduction (MCV),muscle rigidity contraction force were measured,the histological examinations were carried out and the numbers of myelinated axons were calculated 3 months after the operation.Results The degeneration group showed a poorer regeneration capacity than the control group (P＜0.05).The MCV were (16.992 ± 3.737) m/s,(23.092 ± 2.788) m/s respectively;The ratio of muscle force were (39.642 ±5.865)% and (71.098± 6.778)% respectively.The regenerated myelinated nerve fiber number were 1718.2± 282.0 and 3340.0 ± 506.5 respectively in degeneration group and control group.The amplifying ratio of the degeneration group and control group were 1.581 ± 0.329 and 3.098 ± 0.642.Conclusion The amplifying results of repairing the degenerated nerves are poorer than repairing the freshly injury distal nerves with the freshly transected proximal donor nerves,the results demonstrate a progressive inability of chronically degeneration of the distal nerve to support axonai regeneration.

Seventy-four patients aged 26-63 yr who had suffered cervicogenic headache for 3 months-21 yr were treated with puked radiofrequency applied to C2 dorsal root ganglion, which is located in the middle of the posterior side of lateral atlantoaxial joint. A trochar was introduced percutaneously under the guidance of X-ray aiming at the target point. As it was inserted through the deep fascia, the stylet was withdrawn and a 10 cm long 22 gauge curved blunt electrode was inserted into the trochar and advanced until the patients felt radiating pain from the point of puncture to occiput. Lateral radiograph was obtained to verify the placement of electrode. The tip of the electrode was usually located in front of spinal canal at the atlantoaxial joint level. Sensory stimulation was performed with 50 Hz and 0.1-0.5 V and the patients could feel radiating pain at occiput. Motor stimulation was performed with 2 Hz and 0.4-1.0 V and regular pulsation of the patient's muscle of occiput could occur. Pulsed radiofrequency was applied at 42 ℃7 for 240 s and was performed twice on each side. VAS scores and disturbances of daily activity, mood and sleep were recorded before operation and at 1 week and 1, 3, 6, 12 and 18 months after pulsed radiofrequency treatment. Complications and recurrence within 12 and 18 months were recorded. Follow-up was lost in 22 patients. VAS scores and disturbances of daily activity, mood and sleep significantly decreased after procedure. All of the patients responded without complications like infection, spinal cord and vertebral artery injury. Some patients had transient occipital neuralgia which was usually relieved within 24 h. The recurrence rate in 12 and 18 months after operation was 19% and 31% respectively.

From November 2003 to May 2010, intrathecal drug delivery system (IDDS) was implanted in 18 patients with chronic intractable pain. Analgesia was provided with morphine. Thirteen patients suffered from late stage cancer and 5 from diseases other than cancer. VAS score was used to measure intensity of pain in all 18patients. QLQ-C30 score was used to evaluate quality of life in cancer patients. The patients were followed up for 3-62 months in 5 non-cancer patients. All 13 cancer patients died at 57 days-10 months after operation. VAS scores were significantly decreased and QLQ-C30 scores increased by intrathecal administration of morphine. Side effects developed in all patients to some extent including nausea, vomiting, constipation, urinary retention, pruritus and over-sedation and vanished in a week. Intrathecal catheter was cut while being pulled out of the needle in 1 patient. Two patients developed low intracranial pressure after operation. Cerebrospinal fluid leakage occurred in 1 patient. One patient developed neuropathic pain in the posterolateral side of right leg.