[Objective]To observe the effect of treating hallux valgus with modified Mitchell operation.[Method]A total of 18 cases(28 feet) of hallux valgus were treated with modified Mitchell operation from Apr.2000 to Oct.2003.The average preoperative hallux valgus angle(HVA) was 30.5 according to the X-ray images,while the average intermetatarso-phalangeal angle(IMA) was 13.5.The difference between the modified Mitchell operation and normal one was that only one transverse osteotomy need to be carried out in the distal metatarsal without lateral ridge left.The distal position of osteotomy was extended according to the sum of IMA and then moved to the metatarso side by 2~3 mm.Absorbable screws were used for fixation.[Result]All 28 feet were followed up for 10~32 months.It showed excellent result in 24 feet,good in 3,and bad in 1,with the total satisfactory rate of 92.9%.According to the postoperative weight-loading X-ray checking result,the average HVA was 15.5,with an average improving of 15;the average IMA was 8.5,with an average improving of 5.[Conclusion]The modified Mitchell operation can correct the metatarso-varus without destroying the biomechanical status.The loading function of great toe could be resumed by the removing of the first metatarso head.

Objective To investigate relationship between CD133 expression and progression of hepatocellular carcinoma (HCC) by detecting expressions of CD133. Methods 65 cases with HCC were enrolled and their HCC tissues and peripheral blood samples were taken. Expression of CD133 in HCC tissue was detected with immunohistochemical method and the percentages of CD45- CD133+ cells in peripheral blood were assayed by the method of flow cytometry (FCM), and 10 healthy persons were chosen as controls. Results In HCC patients, the positive expression rate of CD133 in HCC tissues was 6.4 % and the percentage of CD45- CD133+ cells in peripheral blood was 2.0 %. The expression rate of CD133 was not found in normal liver tissues and peripheral blood (P <0.01). The amount of CD133+ cells was significantly related to portal vein tumor embolus (P<0.01), tumor amicula integrality (P<0.01), pathology grade (P<0.01) and TNM stage (P <0.01), but not related to tumor diameter(P0.05) and AFP value (P0.05). It showed a positive correlation between HCC tissues and peripheral blood (r=0.36, P <0.01). Conclusion The percentage of CD133+ cell in HCC tissues and peripheral blood from HCC patient is greatly correlated to the progression of HCC. It is useful to exam the CD133 expression in predicting the diagnosis and prognosis evaluation.

Objective To explore the effect of self efficacy combined with mobile health information service applied in pulmonary rehabilitation in residence in elderly patients with chronic obstructive pulmonary disease. Methods Sixty-eight elderly patients in stable situation were divided into the control group and the intervention group with 34 cases in each group accoridng to the random digit table. In the control group, the nursing intervention included health education and telephone follow-up. The intervention group adopted self efficacy theory combined with mobile health information service. The items such as persistence in pulmonary rehabilitation, Exercise Self-Regulatory Efficacy Scale (Ex-SRES) and health condition were assessed. Results After intervention for 12 weeks, the scores of persistence in pulmonary rehabilitation in residence in the intervention group scored 5.35 ±1.42, which was higher than that in the control group (2.03±1.40), the difference was significant (t=160.43, P<0.01). Ex-SRES of the intervention group scored 62.06±13.10,91.21±11.12, which were higher than those of the control group, 50.38±18.03,42.56±18.23, the difference was significant (t=9.32,176.88, P<0.01) . The interaction between treatment effects and time effect was significant in COPD Assessment of Tool (CAT) and Ex-SRES respectively(F=489.95,P=0.00;F=134.80, P=0.00). Comparing value of CAT in baseline (24.97±4.74,24.62±5.39) and at the end of the twelfth week(24.94±4.74,24.65±5.35), the difference was not significant in two groups respectively(P>0.05). The improvement of CAT was significant at the end of the twenty-forth week (21.90±4.67) in the intervention group (t=-12.09, P<0.01). Conclusions Self efficacy theory and the application of mobile health information services can help patients persist in long-term rehabilitation exercise training.

Objective To analyse the levels of estrogen in women patients with Alzheimer's disease(AD),and the relationship of estrogen level,menarche age,age of menopause,pregnancy times with severity of AD.Methods A 1:1 matched case-control study was conducted.The study subjects were given neuropsychological test face to face in questionnaire,including MMSE,ADL,POD,FOM,WISE and HMT depression scale.All the women subjects accepted another questionnaire concerning menarche age,age of menopause and pregnancy times.Radioimmunoassay was used to measure the sex hormone level of all the subjects.Results The level of estrogen in serum was obviously lower in AD group than in the control group(P

0.05). Estrogen was lower in the patients with AD than in the normal controls and there was a significant difference between the two groups (P

Objective To apply short message service (SMS) for pulmonary rehabilitation in residence. Methods A total of 102 old pa-tients with chronic obstructive pulmonary disease (COPD) in stable situation were equally divided into three groups randomly. They all ac-cepted a two-week lesson of exercise project, and then took in the project for 22 weeks. Meanwhile, group A phoned to their experts once a week, group B was phoned by their experts once a week, and group C accepted SMS once a day and sent back to the experts. They were in-vestigated with Exercise Self Regulatory Efficacy Scale (Ex-SERS), modified British Medical Research Council Scale (mMRC) and COPD Assessment Test (CAT) before and after intervention. Results The score of Ex-SERS was the most in group C (F=179.53, P<0.001), with the interaction of time (F=387.09, P<0.001). While the scores of mMRC (F=8.754, P<0.001) and CAT (F=11.32, P<0.001) were the least in group C. Conclusion Application of SMS in the integrated management for pulmonary rehabilitation in residence may improve the self regu-latory efficacy of exercise, release the dyspnea and the influence on living in patients with COPD.

Objective To investigate the expressions of hepatorna stem cell surface marker CD133 CD90 in tissues of hepatocellular carcinoma (HCC) and evaluate their related clinical significances. Method The expressions of CD133 CD90 were detected by immunohistochemical method in HCC tissues of 93 patients, and normal liver tissues of 10 cases. Results Among 93 cases with HCC, the positive expression of CD133 were found in 71 cases (76.3%), and CD90 positive expression in 64 cases (68.8%), and the percentage of positive cells were (6.4±3.3)% and (4.3±3.9)% respectively. No positive expression of CD133 and CD90 was found in normal liver tissues (P<0.01). CD133, CD90 expressions in the HCC tissues of TNM stage Ⅲ-Ⅳ [(8.1±3.7)%,(5.7±4.2)%] were higher than those of TNM stage Ⅰ - Ⅱ [(4.1±2.3)%,(2.3±1.9)%] (P<0.01). Spearman correlation analysis indicated that the expressions of CD133 and CD90 were up-regulated as the pathohistology grades increased (P<0.05). Positive correlation was observed between CD133 and CD90 expression (r=0.402, P<0.01). Conclusions CD133, CD90 positive cells exist in HCC tissues, their expressions positively relate to the TNM stage and the pathohistology grades for HCC patients.

Objectives:Dose-response effect of nicorandil cardioplegia at various concentrations was studied to optimize its myocardial protective effect.Methods:Forty-eight isolated working rat hearts were divided into 6 groups randomly.They were group A:control (depolarized cardiac arrest with St.Thomas solution No.2),group B,C,E,F and G:hyperpolarized cardiac arrest (nicorandil concentration were 25,50,100,125 and 150μmol/L respectively).The hearts underwent a 120-minute hypothermic arrest (15±1)℃ with cardioplegia (40 ml/kg) and reinfused with cardioplegia (40 ml/kg) at interval of 30 minutes.Mechanical arrest time,cardiac functional recoveries,myocardial content of malondialdehyde (MDA) and ultrastructure were measured.Results:The protective effect of nicorandil cardioplegia was dose-related.Conclusions:The optimal concentration of nicorandil in cardiplegia may be 100μmol/L for myocardial protection.

Objective: To study a new method of alveolar cleft bone grafting. Methods: Group A: 62 cases (74 sides) alveolar cleft patients were transplanted with self-ilium spongy bone. Group B: 26 cases (30 sides) alveolar process patients used autologous ilium combined with DDM. Anterior occlusal radiographs and panoramic oral radiogram were taken before and after the operation to observe if there was new bone formation in the bone grafting area. According to Bergland grade criterion, analyzed the X-ray results after 3 months of the operation. Results: Group A: 17cases(17 sides) in class 1 group(23%), 17 cases(20 sides) in class 2 group(27%), 13 cases(14 sides) in class 3 group (19%), 15 case(23 sides) in class 4 group(31%). The overall survival rate of ABGR was 68.9%, and the clinical success rate was 50 %;Group B:16 cases(16 sides) in class 1 group(53.3%), 7 cases(8 sides) in class 2 group(26.7%), 2 cases(4 sides) in class 3 group (13.3%), 1 case(2 sides) in class 4 group(6.7%). The overall survival rate of ABGR was 93.3%, and the clinical success rate was 80%. Conclusion: Ilium spongy bone combined with DDM is good for alveolar process cleft bone grafting. It is better to use decalcified dentinal matrix of human than autologous ilium spongy bone.

BACKGROUND:Acellular dermal matrix possesses good flexibility and simple trimming.The intracutaneous or subcutaneous injection of acellular dermal matrix powder has fibroblast migration and collagen deposition.It has been widely used in plastic and reconstructive surgery.OBJECTIVE:To explore the feasibility of reconstructed acellular dermal matrix as a scaffold for chondrocyte implantation.DESIGN,TIME AND SETTING:Comparative observation.The study was performed at the Peking University Medical Department and Beijing Jishuitan Hospital between August 2003 and February 2007.MATERIALS:Neonatal calf dermis was provided by Beijing Yuanheng Shengma Biology Technology Research Institute.A total of 24 healthy adult SD rats,weighing 250 g,regardless of gender,and 36 New Zealand rabbits,aged 3 months,were selected.METHODS:①Calf full-thickness back skin was incubated with cell free buffer or ABS/AES for decellularization,followed by surface modification using growth factors.②Three rectangle skin flaps at two sides of the spinal cord of rats were made,and implanted with acellular dermal matrix.The implants were harvested at 2,6,and 12 weeks postoperatively.③The rabbits were divided into experimental and control groups.The cartilage was obtained from the left articular facet to isolate chondrocytes.The chondrocytes were seeded on the acellular dermal matrix.The cartilage defect was made on the right hind limb of experimentalrabbits,and implanted with acellular dermal matrix containing autoiogous chondrocytes.Biogel wass dropped on the surface of carrier.In the control group,the cartilage defect was made on the right hind limb of rabbits and the wound was sutured.Two rabbits from control group and 5 from experimental group were selected respectively at 4,12 and 24 weeks postoperatively.MAIN OUTCOME MEASURES:Cross-linking effect comparison;repair effect of rabbit bone defects.RESULTS:①The acellular dermal matrix cross-linked by glutaraldehyde demonstrated an obvious inflammatory reaction with tissue bleeding and necrosis.Conversely,ADM treated with water-soluble cross-linking agent caused displayed good histocompatibility.②The cartilage defects were repaired completely;the attached cells survived and proliferated and the acellular dermal matrix was degraded after 24 weeks of surgery.CONCLUSION:The acellular dermal matrix decellularized with cell free buffer,digested with digestive buffer,Cross-linked by water-soluble cross-linking agent,and further decorated with growth factor exhibited good histocompatibility,and was suitable forcell attachment and growth.The acellular dermal matrix scaffold almost degrades in the rabbits,with no rejection,and the bone defects were repaired after 24 weeks.