Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To explore the methods for coverage of the defect of great toe after the wrap-a- round flap transferand decrease the morbidity of donor site in great toes.Methods Twenty-five patients received three kinds of procedure for immediate resurfacing of donor defect of the great toes during wrap-around flap transferAmong them9 cases received the free flaps for coverage of defect in donor great toes12 cases was repaired by local pedieled dorsal or plamarpedis flapsand the other cases were treated by the nail-flap of second toe.Results All the flaps were survivalTwo patients received the flap thinning procedure in 6 months laterall patients were satisfied with cosmetic and functional outcomeThe appearance and sensory function of donor toe repaired by second toe nail-flap was best among three methods.Conclusion Accord- ing the detect situation of great toesthree kinds of flap were selected for immediate coverage of donor site, which can decrease the complication of donor great toe at the most.

Objective - To analyze the effect of using vibration tools on the prevalence of work related musculoskeletal disorders （ ） Methods ， - WMSDs in automobile factory workers. By judgment sampling method front line workers with more than one year of working experience in an automobile factory were selected as the research subjects. Musculoskeletal Disorders Questionnaire was used for investigation. The workers were divided into the control group and the vibration tool group. The propensity score ∶ ， matching method was used to balance the confounding factors of the two groups of workers by 1 1 and 568 people were Results included in each group. The prevalence of WMSDs was compared between the two groups after matching. After ， ， ， ， ， ， matching the prevalence of WMSDs in the shoulder elbow hand/wrist upper back waist hip/buttock and knee of workers in ， （ P ） the vibration tool group was higher than that in the control group and the differences were statistically significant all <0.05 .， The prevalence of WMSDs in different body parts of workers in the vibration tool group ranking from high to low was waist ， ， ， ， ， ， ， ， ， ， neck shoulder hand/wrist upper back knee ankle/foot elbow and hip/buttock with the rate of 74.3% 61.3% 54.2% ， ， ， ， ， （P ） Conclusions 54.0% 50.9% 39.4% 35.2% 31.0% and 27.1% respectively <0.01 . The use of vibration tools can ， ， ， ， ， increase the risk of WMSDs in shoulder elbow hand/wrist upper back waist hip/buttock and knee of automobile factory workers. Corresponding measures should be taken to reduce vibration intensity and reduce contact time to protect workers'

OBJECTIVETo employ reverse first dorsal metatarsal artery island flap to recover the donor site of great toe after free lateral pulp flap transfer, and decrease the morbidity of microsurgical donor site.

METHODSFrom February 2000 to June 2004, 12 cases of soft tissue defect in thumb and finger were treated by free lateral pulp flap of great toe transplantation, and that the secondary defect of great toes were repaired by reverse first dorsal metatarsal artery flap according to the anatomical communicating between first dorsal metatarsal artery and plantar metatarsal artery. The donor exposure of dorsal pedis were straightly sutured.

RESULTSAll the lateral pulp flaps of great toe and the reversed first dorsal metatarsal flaps survived uneventfully with desirable appearance and sensation. In thumb and finger defect reconstructed with lateral pulp flaps of the great toe, there was in mean static two-point discrimination of 6 mm at 10 month follow-up, that was 10 mm in reverse flaps.

CONCLUSIONSIt is an instructive and practical creation to adopt the reverse first dorsal metatarsal artery flap to recover the raw surface in the lateral aspect of the great toe, which minimizes the morbidity at the donor site and gains the twin-win results.

Adolescent ; Adult ; Arteries ; transplantation ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Metatarsus ; blood supply ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; pathology ; Young Adult

Objective To develop the humanized animal model for RA cartilage erosion,and study the mechanisms of its pathogenesis.Methods RA synovium and normal human cartilage under the kidney cap- sule of the SCID mice were engrafted,and were maintained for 4～16 weeks.In addition,mice underwent simi- lar surgery except the engraftment served as controls.After 4,8,12 or 16 weeks,the mice were killed and the grafts were harvested and the cartilage destruction was assessed histologically by haematoxylin/eosin-stained paraffin sections.Results Histological examination revealed the presence of infiltration of RA synovium cells into the cartilage after 4 weeks and the cartilage was destructed evidently.These studies demonstrated that the RA-SCID model maintained many of the phenotypic and functional features of RA.Conclusion This RA-SCID mouse is a useful animal model for study of the pathogenesis and the development of new drugs for RA patients.

OBJECTIVE: To analyze the reasons for the failure of thoracolumbar spine internal fixation after burst fracture, and to discuss the strategy for revision surgery. METHODS: From January 2005 to September 2010, 21 patients with thoracolumbar burst fracture received revision surgery after the failure of internal fixation. The etiology included loose of the fixation after anterior surgery in 4 patients, involving malunion with severe kyphosis in 1 patient, pedicle screw malposition in 3, fracture of adjacent segment vertebra in 2, broken of the fixation as non-union of the fracture vertebra in 10 comprising obvious kyphotic deformity in 5, and 2 had developing kyphosis for over distraction of the vertebra followed by pseudarthrosis after removing the internal fixation. After the first operation, symptoms remained in 6 patients, deteriorated in 7, light to moderate improved in 8. Surgical procedures such as anterior corpectomy and reconstruction, replacement of the internal fixation and canal decompression, vertebroplasty, and posterior pedicle subtraction osteotomy were directed based on individual situation. RESULTS: Patients were followed-up for 6-68 (27.0±13.2) months, and demonstrated solid fusion 6 to 12 months postoperatively. No failure of the internal fixation reccurred. No major complications or deterioration of neurologic status were noted. At the last follow-up, the improvement of Frankel grade was 0-2 (1.3±0.7). The mean visual analog scale (VAS) dropped down from 7.6 to 2.1, and the mean oswestry disability index (ODI) decreased from 48.7 to 10.3. Preoperative angle of 7 kyphotic deformity patients was 10 degree-75 degree (42.5 degree±15.3 degree), and was improved to -3 degree-10 degree (2.3 degree±3.7 degree). At the last follow-up, the loss of correction was 0 degree-1.3 degree (0.7 degree±0.3 degree), with the correction rate of 92.3%. CONCLUSION Solid reconstruction of the anterior and middle column of the spine is the imperative procedure to prevent failure of internal fixation in thoracolumbar burst fractures. Revision surgery with reasonable strategy is beneficial and rewarding with few complications.
Bone Screws ; Decompression, Surgical ; Fracture Fixation, Internal ; Humans ; Kyphosis ; Lumbar Vertebrae ; Prosthesis Failure ; Spinal Fractures ; Spine ; Thoracic Vertebrae ; Treatment Outcome ; Vertebroplasty

To obtain higher potency and specificity, a series of 7-alkoxy analogues of illudalic acid was synthesized on the base of structure-activity relationship (SAR). All of these compounds exhibited submicromolar inhibition of the enzyme when tested against human leukocyte common antigen-related phosphatase (LAR) (for example, for 15e, IC50 = 180 nmol x L(-1)). They represent the most potent small-molecule inhibitors of LAR so far. These analogues also display excellent selectivity for LAR over other protein tyrosine phosphatases (PTPs) except for the highly homologous PTPsigma. The compound 15f is of 120-fold selectivity for LAR versus PTP-1B inhibition. The development of potent enzyme-specific inhibitors is so important that they may serve both as tools to study the role of LAR and as therapeutic agents for treatment of type II diabetes.
Coumarins ; chemical synthesis ; chemistry ; pharmacology ; Enzyme Inhibitors ; chemical synthesis ; chemistry ; pharmacology ; Inhibitory Concentration 50 ; Molecular Structure ; Receptor-Like Protein Tyrosine Phosphatases, Class 2 ; antagonists & inhibitors ; Structure-Activity Relationship

OBJECTIVETo study the effect of thioridazine on the proliferation and apoptosis of human colorectal cancer SW480 cells.

METHODSSW480 cells were treated with different concentrations of thioridazine, and MTT assay was used to evaluate the cell inhibition rate. Hoechst 33342 staining was performed to demonstrate the cell morphology changes. Flow cytometry was used to determine the cell apoptosis and cell cycle changes. RT-qPCR was used to detect PDCD4, c-MYC, BCL2, CCND1, CASPASE3, PARP1, CDK4 and EIF4A mRNA expressions, and Western blotting was employed to assay AKT, p-AKT, and PDCD4 protein expression levels.

RESULTSMTT results showed that thioridazine inhibits the proliferation of SW480 cells. SW480 cells treated with thioridazine presented with such typical features of apoptosis of karyopyknosis, chromatin condensation and nuclear fragmentation. Flow cytometry showed that thioridazine was a cell cycle-specific drug and caused cell cycle arrest at G(1)/G(0) phase and an increased cell apoptosis rate. Thioridazine treatment of the cells resulted in up-regulated PDCD4 mRNA expression and down-regulated mRNA expressions of CCND1, CDK4, c-MYC, BCL2, CASPASE3, PARP1 and EIF4A, increased PDCD4 protein expression and reduced p-AKT protein expression.

CONCLUSIONThioridazine inhibits the proliferation and induces apoptosis of SW480 cells by up-regulating PDCD4 and inhibiting PI3K/Akt pathway.

Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Cell Cycle Checkpoints ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; Colorectal Neoplasms ; pathology ; Down-Regulation ; Humans ; RNA-Binding Proteins ; metabolism ; Signal Transduction ; drug effects ; Thioridazine ; pharmacology

OBJECTIVETo evaluate the application of different variable number tandem repeats (VNTR) locus in genotyping of Mycobacterium tuberculosis (M.tuberculosis) strains isolated from eight provinces in China, and to find the suitable locus-set of VNTR for epidemical strains in China.

METHODSAll 140 M.tuberculosis strains were randomly selected from 2800 M.tuberculosis strains isolated from eight provinces in China, 27 VNTR loci were used for typing all isolates. Discriminatory power (Hunter-Gaston Index, HGI) of every locus and different locus-set were analyzed by BioNumerics software. Meanwhile, Spoligotyping was used to identify Beijing family and non-Beijing family. Then the HGI of different locus-sets in two families was also evaluated.

RESULTSAll 140 isolates were clustered into Beijing kindred (112 strains, 80%) and non-Beijing kindred (28 strains, 20%) by Spoligotyping. The discriminatory power of Spoligotyping in 140 isolates was 0.4589. Every locus showed different polymorphism and HGI were from 0 to 0.809. The number of VNTR loci with HGI higher than 0.5 in all strains, Beijing family and non-Beijing family was 8, 7 and 14 respectively. 27 loci were combined into four groups which included 8, 12, 15 and 24 VNTR loci respectively. Four locus-sets showed different polymorphism, HGI of eight-locus, 12-locus, 15-locus, and 24-locus set in 140 strains was 0.9991, 0.9882, 0.9980 and 0.9986, and their discriminatory power were calculated in Beijing kindred (HGI: 0.9987, 0.9318, 0.9969 and 0.9975) and non-Beijing kindred (HGI: 1, 0.9894, 1 and 1).

CONCLUSIONDifferent VNTR locus and locus-set showed different discriminatory power in the selected M.tuberculosis strains isolated from China. Eight-locus set can be used in molecular epidemiological study of M.tuberculosis in China after standardization.

Bacterial Typing Techniques ; DNA, Bacterial ; genetics ; Mycobacterium tuberculosis ; classification ; genetics ; isolation & purification ; Tandem Repeat Sequences

Objective To investigate the associations between normal serum uric acid (UA) levels and knee symptoms and structural changes in patients with knee osteoarthritis (OA).Methods A total of 205 patients with knee OA were enrolled. According to the inclusion and exclusion criteria, 122 patients with OA were included in the study. The general condition of patients were investingated. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was used to assess severity of the knee joint symptoms. The Kellgren-Lawrence (K-L) grading system was used to assess radiological severity of the knee joint. Osirix software was used to assess changes of knee structure in magnetic resonance imaging (MRI). Peroxidase method was used to measure the serum levels of uric acid. Patients with normal range of uric acid were included in the study.Results The patients with lower levels of UA (split at the median level, 263 μmol/L) had a higher proportion of women, lower height, weight and lower proportions of K-L grade≥2. After adjustment for sex, age and body mass index, serum UA was negatively associated with total WOMAC scores (β=-16.15, P=0.018), WOMAC pain (β=-3.15, P=0.037), and WOMAC stiffness (β=-1.65, P=0.025). However, there were no significant associations between serum UA levels and knee joint structure changes.Conclusions In OA patients with normal serum UA, serum UA is negatively associated with the severity of joint symptoms, suggesting that UA within normal range may play a protective role in OA symptoms.