Objective To investigate the characteristics of clinical application of skin flap supplied by sural nerve nutrition blood vessel. Methods The flaps were used in 17 cases to repair the soft tissue defect in heel,mallelous,anterior tibial and achilles tendon. Results 14 cases of 17 survived satisfactory. 2 cases presented edema and partially necrosis,they finally survived after open decompression and change of dressing. 1 case presented chronic sinus because of osteomyelitis of calcaneus. 6 months later, when the fracture healed, we performed debridement, removal of internal fixation, curettage and irrigation. It finally healed. Conclusion The sural nerve nutrition blood vessel flap was easy to elevate and safe, which was an ideal flap for repairing the soft tissue defect around the heel, malleolus, achilles tendon and the anterior tibial.

Objective To evaluate the therapeutic effectiveness of treating adrenal gland neoplasms by CT-guided absolute alcohol injection. Methods Eleven patients with adrenal gland neoplasms were examined by CT to identify the lesion′s size, location, and the relationship with its surrounding tissue. The needling direction was first chosen, and the syringe needle was placed at the center of tumor or the destined position. Absolute ethyl alcohol was injected after rescanning to confirm the position of syringe needle was inerrant. The blood sugar and blood pressure were checked before operation. After operation, analysis of the clinical manifestations was performed and the blood sugar and blood pressure were measured at once, 24 h, 48 h, one week, one month, and two months, respectively. To observe the absorption of the lesions, postoperative follow-up CT scans were performed at one month and later on. Results Significant differences in blood pressures and blood sugar were observed between preoperation and 24 hours after the operation (P

[Objective]To study the repair of articular cartilage defects with combined bone morphogenetic protein(BMP)/basic fibroblast growth factor(bFGF)biomaterial in order to supply experimental basis for repairing cartilage defects biologically.[Method]Twenty-four 14-week-old rabbits were randomly divided into four groups,BMP/bFGF biomaterial gel(group A),BMP biomaterial gel(group B),bFGF biomaterial gel(group C)and simple fibrin glue treated group(group D).A couple of knees of each rabbit experienced 5 mm-diameter-full cartilage resection and drilling throuth of bone marrow.Gross appearance,histologicol section and electron microscope were axamined at 8,12,24 weeks after operation.[Result]In group A the cartilage defects were smoothly repaired by white translucent hard tissue at 8 and 12 weeks,and defect boundary was hard to be indentified with normal cartilage at 24 weks.No smooth repairing was observered in B,C and D groups.Group A got a better histological score than B,C and group D(P0.05).[Conclusion]Combined BMP/bFGF biomaterial is good for repair of articular cartilage defects and has better result than using BMP or bFGF alone.These results may provide a therapy for articular cartilage defects.

Objective To compare their antipyretic effect of diclofenac suppository (diclofenac) and injectio amidopyrini compositae (amidopyrin) in the treatment for surgical infection with high fever. Methods One hundred patients suffering from surgical infection with high fever were randomly divided into two groups: 50 cases in diclofenac group (50 mg with rectal administration) and 50 cases in amidopyrin group (2 ml, with intramuscular injection) , and their antipyretic effects were observed. Results The antipyretic effect of diclofenac (with an overall effective rate of 96% ) was better than that of amidopyrin (82% ), with a P-value less than 0.05, and their remarkably effective rates were 82% and 58% for the two groups, respectively, with a P-value less than P

Objective To investigate the clinical value of non-invasive atherosclerosis detection technology for the early diagnosis of young type 2 diabetic patients with lower extremity vascular disease .Methods 78 young patients with type 2 diabetes( T2DM group) and 80 cases in the healthy control group were detected some indicators , including upstroke time(UT)%,mean artery pressure(%MAP),the pulse wave speed(baPWV) and ankle-brachial index(ABI) by Omron arteriosclerosis detector.Those items were comprehensively used to evaluate the diabetes patients of lower extremity vascular disease .Results There were statistically significant differences in UT ,%MAP, baPWV and ABI between the T2DM group and the control group(t=4.218,8.798,-3.392,5.136,all P<0.01). ABI of 6 patients was less than 0.9.Moreover,five of these 6 patients examined by color Doppler ultrasound had arte-rial plaque formation.As to patients of ABI >0.9,2 cases of them were promoted lower extremity arterial stenosis and occlusion,and then they were certified by color Doppler ultrasound .Conclusion Non-invasive atherosclerosis detec-tion technology has better accuracy to the diagnosis of young type 2 diabetes patients with atherosclerosis ,and may find patients with blocked arteries earlier ,provide better value for early clinical intervention .

Objective To develop the quality of life questionnaire applicable to the Chinese patients with dysphagia by the translation and modification,as well as psychometric evaluation of the original swallowing quality of life questionnaire (SWAL-QOL).Methods The English version of the SWAL-QOL was translated into Chinese according to the well-accepted scale translation procedure.Then 103 patients with dysphagia were tested using the translated Chinese SWAL-QOL.The inter-rater reliability,test-retest reliability,internal consistency reliability,the content validity and construct validity were tested.Results The inter-rater reliability correlation coefficient of the SWAL-QOL was between 0.945-0.990 (P＜0.01).Its test-retest coefficients ranged from 0.965 to 0.992 (P＜0.01).The Cronbach coefficients ranged from 0.708 to 0.933 (P＜0.01).There revealed significant correlation between each item of SWAL-QOL and its domain,with correlation coefficients between 0.723 and 0.982 (P＜0.01).Factor analysis of each item of the 10 domains of SWAL-QOL extracted 10 common factors,which were with a cumulative contribution of 79.029％.Factor analysis of the total score of the 10 dimensions extracted 2 common factors including dysphagia-related quality of life and general quality of life,with a cumulative contribution of 54.718％.Conclusions The Chinese version of SWAL-QOL is reliable and valid.It can be used as an effective measuring tool to evaluate the quality of life of dysphagia patients.

Huntington disease (HD) rat model was produced by injection of ibotenic acid (IA) into the head of right caudate putamen (CP). One month post lesion, fetal (El5-17) striatal cell suspension was implanted into the lateral ventricle ipsilateral to the lesion, and the rats were devided into four groups; group I normal control rats (n=8), group II model control rats (n=10), group III simple transplanted with fetal striatal cell suspension, (n=10, ST group), group IV grafted with striatal cell suspension containing laminin (n=6, LST group). Three and six months after grafting, active avoidence test was carried, the results showed that there were significant differences bewteen grafted groups and model control group at three and six months, and no significant differences between LST group and normal group either in three or six months whereas between ST group and normal group no significant difference only can be found at six months. Overnight locomotor activity was measured in each group at six months post grafting, the results indicated that the locomotor behaviour of model control group was hyperactive whereas the overnight hyperactivity was compensated completely in the grafted groups. After the behavioural test, the rat brain was investigated morphologically. The head of the lesioned CP was atrophied and the graft was located at the dorsal part of the atrophied CP and projected into the lateral ventricle. The volume of the graft area of LST group was larger than that of ST group. ChAT, GABA and Leu-ENK positive neurons were found in the graft area of the two grafted groups and their shape and size were similar to those of nomal CP. The processes of AChE positive neurons in the graft of LST group were more and longer than that in the graft of ST group. The results indicated that the fetal striatal neurons implanted into the lateral ventricle of HD model rats not only can survive and grow well but also ameliorate the behavioural deficits of the IA lesioned rats and the laminin may supports the neuronal suvival and growth in vivo.

AIM: To observe the curative efficacy of Shenkang Bolt(SKB) in treating chronic renal failure(CRF) with blood silt and damp pathogen syndrome. METHODS: The randomized,parallel and controlled trial were used.38 cases in treatment group were treated with SKB,and 40 cases in control group were clystered with Chinese herbal medicine.The changes of the cumulative scores of traditional Chinese medicine(TCM) syndrome,the levels of serum creatinine(SCr) and creatinine clearance rate(CCr) before and after treatment in both groups were observed. RESULTS: The total effective rate was 81.5% in the treatment group,but 75% in the control group.The scores of TCM syndrome and the levels of SCr were both significantly decreased(P(0.05)). CONCLUSION: SKB can markedly improve the clinical manifestations of CRF with blood silt and damp pathogen syndrome,decrease the levels of SCr,but increase CCr.There was no difference between Chinese herbal clysis and Shenkang Bolt in curative effect,but it is convenent to take Shenkang Bolt.

Objective To compare the efficacies of da Vinci robotic and traditional laparoscopic resection for colorectal cancer.Methods Databases including Pubmed,Cochrane Library,EMBASE,Medline,Wanfang,CNKI,VIP and FMJS were searched,and literatures published before February 2012 were retrieved.Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) focusing the comparison between da Vinci robotic and laparoscopic resection for colorectal cancer were collected.All the literatures retrieved were screened according to preset standards,and the patients were divided into robotic group and laparoscopic group.A meta analysis on the effectiveness of robotic and laparoscopic surgery for colorectal cancer was carried out using the RevMan 5.1 software.Categorical variables were presented by odds ratio (OR) and 95％ confidence interval (95 ％ CI),continuous variables were presented by weighted mean difference (WMD) and 95 ％ CI.Results One RCT and 10 NRCTs including 974 patients with colorectal cancer were screened out and there were 426 patients in the robotic group and 548 patients in the laparoscopic group.Compared with conventional laparoscopic surgery,longer operation time,lower rate of conversion to laparotomy and shorter anal exsufflation time were observed in the robotic group (WMD =25.61,OR =0.32,WMD =-0.21,P ＜ 0.05).There were no significant differences in the operative blood loss,number of lymph node dissected,distal resection margin,morbidity and duration of hospital stay between the robotic group and the laparoscopic group (WMD =-23.14,-0.31,0.14,OR =1.06,WMD =-0.43,P ＞ 0.05).Conclusion The efficacies of da Vinci robotic and laparoscopic surgery for the treatment of colorectal cancer are comparable,while da Vinci robotic surgery has the features of lower rate of conversion to laparotomy and shorter anal exsufflation time.

BACKGROUND:It remains controversial in term of efficacy for the lightweight mesh and heavyweight mesh in inguinal hernia repair.
OBJECTIVE:To compare the clinical therapeutic effects of lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair with Meta-analysis.
METHODS:Comprehensive electronic search strategies were developed using the fol owing electronic databases:PubMed, Cochrane Library, EMBASE, Medline, Ovid, CNKI, VIP, Wanfang and FMJS. The Literature published before February 2013 was searched. The randomized control ed trials about comparing lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled using RevMan5.1 software through Meta-analysis.
RESULTS AND CONCLUSION:Eighteen trials with a total of 4 450 hernias met the inclusion criteria. The meta-analysis showed that there was a statistical difference between lightweight mesh group and the heavyweight mesh group on short-term pain [odd ratio (OR)=0.57, 95%confidence interval (CI) (0.43, 0.74), P<0.05] and a reduced risk of developing foreign body sensations [OR=0.49, 95%CI (0.35, 0.69), P<0.05]. No significant differences were found between the two groups in recurrence rate, testicular atrophy, seroma, hematoma, wound infection, urine retention (P>0.5). According to limited evidence, there are some findings as fol ows:the lightweight mesh is of feasibility, safety and effectiveness for inguinal hernia repair. Because of the limits of sample and quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use lightweight mesh for inguinal hernia repair.