Objective To retrospectively analyze management of chronic lateral ankle instability and evaluate its clinical results. Methods There were 74 patients including 43 males and 31 females at age range of 15-63 years (mean 39 years). All patients had at least half year of disease history, more than twice repeated strains and over six weeks of conservative management. Of all, 41 patients were trea-ted with surgical operations including modified Brostrom in 12 patients, Myerson in eight and Chrisman-Snook in 21. The aasoeiated pathological problems should be treated at the same time, ie, tenedesis for the peroneal tendon subluxations in six patients, Achilles tendon lengthening in nine, lateral shift of cal-caneal osteotomies in eight and clearance and holes-making for the osteochondral lesions in 13. Results Of all, functional instability was alleviated in 21 patients through conservative treatment before surgery. Of 53 patients with either functional or mechanical instability, 10 patients showed symptomatic relief, two refused surgical operation and the remained 41 patients were treated surgically. Thirty-nine patients trea-ted surgically and 28 treated conservatively were followed up for 6-91 months. The Roos Functional Out-come Score was used for validating the results. The average value of the ankle functional outcome was 86.24 and 97.34 respectively following operation and conservative management. Conclusions The full examination is needed to remove any possible pathological factors for the patients with chronic lateral ankle instability. The surgical operation can obtain satisfactory functional recovery of the ankle if the conserva-tive management is failed.

Objective To compare the diagnostic value of 3.0T and 1.5T magnetic resonance diffusion weighted imaging (DWI) in lymph node metastasis of gastric cancer. Methods Preoperative magnetic resonance examination was performed on 50 patients with gastric cancer by using Siemens 1.5T and 3.0T superconducting magnetic resonance imaging system, and the outcomes were compared with postoperative pathological results. The sensitivity, specificity and accuracy of the diagnosis in lymph node metastasis of gastric cancer were analyzed statistically. The apparent diffusion coefficient (ADC) values of lymph nodes were also evaluated for 1.5T and 3.0T magnetic resonance DWI. Results The sensitivity, specificity and accuracy of the diagnosis on lymph node metastasis of gastric cancer by 1.5T magnetic resonance DWI were 79.4 %, 81.4%and 80.0%, respectively, and the corresponding percentages of 3.0T magnetic resonance DWI were 84.6%, 79.7%and 83.1%. The accuracy rate of 3.0T magnetic resonance DWI was slightly higher than that of 1.5T in the diagnosis of lymph node metastasis of gastric cancer (χ2=5.451, P=0.020), but there were no significant differences in the sensitivity and specificity between the two groups (both P> 0.05). The accuracy rate of 1.5T magnetic resonance DWI in the diagnosis of lymph node metastasis of gastric cancer was less effective than that of the pathological diagnosis (χ2=7.410, P=0.007), but there was no significant difference between 3.0T magnetic resonance DWI and pathological diagnosis (χ2=2.450, P=0.120). The mean ADC values of metastatic and non-metastatic lymph nodes detected by 1.5T magnetic resonance DWI were (1.036 ±0.203) × 10-3 mm2/s and (1.476 ± 0.215) × 10-3 mm2/s (t= 6.813, P< 0.001), meanwhile, the corresponding values detected by 3.0T magnetic resonance DWI were (1.154 ± 0.183) × 10-3 mm2/s and (1.502 ± 0.264) × 10-3 mm2/s (t= 5.991, P< 0.001). The coincidence of the two methods for ADC value was favorable. Conclusions The diagnostic effect of 3.0T magnetic resonance DWI on lymph node metastasis of gastric cancer is better than that of 1.5T. ADC value provides a reliable imaging quantitative indicator for the determination of metastatic lymph nodes in gastric cancer, which plays a significant role in the clinical treatment options and prognosis of patients.

Objective Embryonic neuroepithelial cells (NEC) were transplanted into the brains of Parkinson disease rats, the survival and differentiation of NEC were investigated. Methods Embryonic rats (E11) were obtained from the pregnant Wistar rats. Neuroepithelial cells were dissociated from embryonic neural tube and treated with 0^25% trypsin, then transplanted them into the striatum of Parkinson disease (PD) rats stereotaxicly. Coronal sections of the brain were made in cryostat. The survival of transplant neuroepithelial cells and tyrosine hydroxylase (TH) expression of some NEP were examined by immunocytochemical technique, also the rotation behavior was tested following different time of transplantation. Results Some grafts were found survived well and some TH-positive cells could be detected in the core of graft region. NEP transplantation could also partly improve the symptoms of PD rats.Conclusion The results demonstrate that embryonic stem cells dissociated from neural tube can survive and differentiate into dopaminergic neurons. NECs contribute to the behavioral recovery.

Objective To observe cell proliferation and neurogenesis in the pregnant mouse dentate gyrus (DG) and the subventricular zone(SVZ). Methods Injection of the thymidine analog 5 bromo 2 deoxyuridine (BrdU)to determine the extent of cell proliferation combined with single or double immunohistochemistry staining with antibodies BrdU,TuJ1(class Ⅲ ? tubulin,neuron specific early differentiation marker)and GFAP. Results The number of BrdU positive cells in the pregnant mouse dentate gyrus was significantly more than that of unpregnant mouse dendate gyrus but not in the subventricular zone.In dentate gyrus,approximately 80% of these cells were neuronal characteristics (TuJ1 immunoreactive)and 3%～5% of these cells were astrocytic characteristics(GFAP immunoreactive).Conclusion\ These findings suggest that pregnancy significantly increases cell proliferation and neurogenesis in the adult mouse dentate gyrus and present the possibility that these new cells exert an important influence on hippocampal function

Objective To isolate neuroepithelial stem cells from the spinal cord neural tube of the embryonic rat and induce them to differentiate into dopaminergic neurons. Methods Serum free cells suspension culture and single cell cloning technique were used to isolate neuroepithelial stem cells. 5 bromo 2 deoxyuridine(BrdU) to label new cells combined with single or double immunocytochemistry staining to detect nestin antigen before differentiation and neural cell specific antigens after differentiation, such as neurofilament (NFM 160?kD), glial fibrillary acidic protein(GFAP), galactocerebroside(GalC) and tyrosine hydroxylase(TH). Striatal extracts were used to induce neuroepithelial stem cells to differentiate into dopaminergic neurons. Results The cells isolated from the spinal cord neural tube of the embryonic rat expressed nestin antigen. They had the potential to serially passage and differentiate into neurons, astrocytes and oligodendrocytes. Striatal extracts could induce 12% of them to differentiate into dopaminergic neurons compared with 3% in controls.Conclusion The cells, which express nestin antigen, isolated from neural tube are multipotent and have the ability to self renew, therefore, they are neural stem cells. These stem cells can be induced to differentiate into specific neurons in vitro. Which can provide materials for neural transplantation.

Objective To evaluate the influence of simple subtalar arthrodesis to the motion and degeneration of midfoot.Methods Data of 37 patients (27 males,10 females) with an average age of 42.6 years who had undergone subtalar joint fusion from January 1996 to August 2011 were retrospectively analyzed.The MOS item short form health survey (SF-36),American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score were used.Midfoot sagittal and coronal motion were measured on ankle radiographs of maximum plantar flexion and dorsiflexion.On sagittal plane,the Meary angle was measured and the bilateral tarsometatarsal joints mobility was compared.On coronal plane,tibio-plantar angles (TPA) on 30 degrees varus slope and 30 degrees valgus slope were respectively measured on the anterio-posterior ankle X-ray films to observe the changes of midfoot activities.Besides,single photon emission computed tomography/computed tomography (SPECT/CT) of bilateral foot and ankle was taken to estimate the degeneration of midfoot joint.Results All the 37 patients were followed-up,with mean follow-up period of 9.2 years.The average SF-36 scores was increased from 34.26± 11.02 points preoperatively to 77.59± 12.57 points postoperatively.The average AOFAS midfoot scores were 86.14± 16.79 points preoperatively and 86.43± 16.70 points postoperatively without any statistical significant difference.On sagittal plane,medial tarsometatarsal joints mobility was limited by 20％.According to coronal plane of varus slope,the average TPA of healthy side and operated side were 61.32° and 64.91°,respectively,so the varus mobility of operated side was limited by 12.5％.While standing on the valgus slope,the average TPA of both sides were 76.54° and 82.28°,which indicated that valgus mobility of operated side was reduced by 42.6％.35.1％ patients of talonavicular joint,56.8％ patients of calcaneocuboid joint,and 27.0％ patients of metatarsal cuboid joint were found mild joint degeneration on SPECT/CT images without any clinical symptoms.Conclusion Subtalar arthrodesis can affect midfoot with less limit of sagittal mobility and more limit of coronal movement.And the lateral joints degeneration is more likely to happen for their compensatory activity.

Objective To evaluate the curative effect and related factors of the treatment for the osteochondral lesion of talus (OLT) by the osteochondral autografts harvested from medial femoral condyle of the ipsilateral knee.Methods The data of 15 OLT patients was retrospectively analyzed who received the operation during July 2009 to November 2012.There were 8 males,and 7 females,with an average age of 49.6±17.2 years (range,19-73 years).International Knee Documentation Committee (IKDC) and Lysholm score were used to evaluate the knee function preoperatively and postoperatively respectively.The ankle functions and pain were assessed according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind-foot score and visual analogue scale (VAS) preoperatively and postoperatively respectively.Correlations between age or follow-up duration and all the score increments were further analyzed by Spearman rank correlation test.Results Twelve patients complete the follow up,with an average duration of 21.8±10.4 months.The average IKDC,Lysholm,AOFAS,and VAS were 90.91±6.44,95.33±8.00,63.58±18.50,and 7.25±1.54 respectively before operation,and 85.63±11.89,90.75±11.83,90.33±4.98,2.17±1.19 respectively after operation.Correlation coefficients of age between AOFAS,Lysholm,and IKDC score increments were -0.74,-0.63,and-0.76,respectively.There were 4 cases which received excellent effect (33％),5 cases (42％) good and 3 (25％) fair.Conclusion The ankle joint function of patients with OLT recovered well by treated with osteochondral autografts harvested from medial femoral condyle of the ipsilateral knee operation.A correlation was found between patients' age and postoperative functional recovery of ankle and knee joint.

Objective To investigate the expression of miR-133b in the brain of methamphetamine(MA) dependent rats and its regulatory effects on neuronal toxic injury.MethodsThrough continuous intraperitoneal injection to rats with MA(10 mg/kg),the conditioned place preference(CPP) rats model was established,and the expression of miR-133b in the cerebral cortex of model rats was detected by real-time fluorescence quantitative PCR(RT-PCR).PC12 cells were cultured in vitro and treated with MA(800 μmol/L),and then miR-133b expression in cultured neurons was detected.miR-133b mimics and inhibitor were transfected to PC12 cells respectively to observe the effect of miR-133b on the mitochondrial membrane potential(MMP) of cultured neurons.ResultsAfter continuous intraperitoneal injection with MA for 14 days,the residence time of rats in the box with medicine((620.20±44.80)s) was significantly longer compared with the control group((341.80±25.12)s,P<0.01),which showed that MA dependent rats model was successfully established.The RT-PCR detection results showed that the expression of miR-133b in the cerebral cortex of model rats(0.36±0.05) significantly decreased compared with the control group(0.99±0.08,P<0.01).In the in vitro model,most of the neuronal cell bodies became round and the neuorites were withdrawn after MA treatment.Compared with the control group(1.00±0.02),the RT-PCR detection results showed that the expression of miR-133b in MA group(0.74±0.05) decreased(P<0.05).The JC-1 detection results showed that the MMP of the MA group(109.85±7.03) decreased significantly contrast to the control group(36.49±3.89,P<0.01),the MMP of the miR-133b mimics group(58.97±6.56) increased significantly contrast to the mimics control group(135.46±15.04,P<0.01) and the MMP of the miR-133b inhibitor group(162.84±14.15) decreased contrast to the inhibitor control group(139.81±12.26,P<0.05).ConclusionsThe expression of miR-133b in the cerebral cortex of MA dependent rats and in vitro neuron model treated with MA are significantly downregulated.By regulating the expression of miR-133b,the MMP damage of cultured neurons treated with MA is changed,indicating that miR-133b is not only involved in the nerve injury induced by MA,but also possiblely as a molecular target for intervention.

Objective To evaluate transurethral fulguration with intravesical instillation of heparin and alkalinized lidocaine for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS).Methods Data from the chnical records of 31 patients (30 female and 1 male) with IC/BPS were analyzed retrospectively.Transurethral fulguration and biopsy were performed.Intravesical instillation of heparin and alkalinized lidocaine (25 000 units of hepmin,10 mL of 2％ lidocaine,and 5 mL of 5％ sodium bicarbonate) was administered weekly for 8 weeks.Thereafter,intmvesical instillation treatment was administered twice a month.The interstitial cystitis symptom index and problem index (O'Leary-Sant index),visual analog scale score for pain,quality-of-life index,voiding frequency,bladder capacity,and side effects of intravesical instillation were recorded preoperatively and at the first and sixth month follow-ups postoperatively.Results The follow-up period was 6 to 24 months.The interstitial cystitis symptom index and problem index,visual analog scale score for pain,quality-of-life index,daily voiding time,and maximal bladder volume improved significantly in 28 cases (90.32％;P ＜ 0.01),and no significant adverse effects were observed.Two patients underwent cystectomy,and the symptoms disappeared after the operation.Carcinoma in situ was detected on histopathological examination in one patient.Conclusion Transurethral fulguration with intravesical instillation of heparin and alkalinized lidocaine is a safe and effective therapy for IC/BPS.

[Objective]To investigate the expression change of miR-134 in methamphetamine(MA)-induced neuronal injury in PC12 cells and its effect on neuronal excitability and understand the pathogenesis of methamphetamine-induced neuronal injury.[Methods]PC12 cells in the logarithmic phase were divided into control group and MA group. The MA group was treated with 800μmol/L MA to establish the model of neuronal injury. The cellular injury was observed under microscope. The neuronal apoptosis was detected by Hoechst3342/PI double staining,and miR-134 expression was measured by using real-time quantitative PCR (Real time-PCR). Furthermore,we constructed miR-134 interference vector and observed its effect on evoked action potential.[Results]The cultured PC12 cells were damaged under the 800 μmol/LMA treatment ,and neurites became shorter ,the apoptotic cells were evidence. Real time-PCR showed that miR-134 expression was increased after MA treatment. Electrophysiological data showed that the evoked action potential increased after miR-134 interference.[Conclusions]High concentration of MA can induce neuronal damage and apoptosis and also increase miR-134 expression. While silence miR-134 expression can increase neuronal excitability.Our study provides an experimental basis for elucidating the possible mechanism of MA-induced neuronal injury and the role of miR-134 in neurotoxicity and neuronal excitability.