[Objective]To explore the application of computer in dealing with two-dimensional image information of human median nerve series freezing tissue sections,in order to develop nerve three-dimensional visualization system(3D Nerve),and finally to reconstruct 3D internal microstructure of human median nerve and realize 3D visualization.[Method]One fresh cadaver median nerve was taken,located with human hair and embedded in OCT.Series freezing tissue sections were made and stained with ACHE histochemistry method,and 2D image information was obtained through high resolution scanner.Microstructure of median nerve was finally reconstructed with 3D Nerve.[Result]Different cross sections of median nerve had quite different number and positions of fasciculi.In addition,characters of fasciculus' s internal nerve fiber were also quite different.Scross sections observation showed that all fasciculi were mixed fasciculi.With the 3D Nerve,the microstructure of median nerve was able to be observed in magnifying visual field at any cross section,and the tracking of stereo course of fasciculi in median nerve became possible.[Conclusion]Reconstructed 3D visualization can reveal the whole microstructure of median nerve and the three dimensional stereo-structure of fasciculi and fasciculus groups exactly and truly.It can provide exact topographic atlas and facilitate precise clixical repair of median nerve injury.

OBJECTIVETo discuss the replantation of fingertip amputation in lack of availability of intravenous anastomosis.

METHODSFrom November 2009 to November 2010, 86 patients (104 fingers) with fingertip amputation were treated with replantatioin, including 64 males and 22 females, with an average age of 26 years ranging from 2 to 64 years. The time from injury to therapy was from 30 min to 12 h, time of broken finger ischemia was from 2.5 to 12 h. Preoperative examination showed no obvious abnormalities. Four different replantation methods were selectively applied to these 104 amputated fingertips of 86 cases: (1) replantation with anastomosis of single or bilateral proper digital artery in 37 fingers; (2) replantation with arteriovenous bypass in 27 fingers; (3) replantation with exclusive anastomosis of digital artery in 24 fingers; (4) replantation with removing the palmar pocket method in 16 fingers.

RESULTSOne hundred and two of 104 amputated fingertips were survived. Among these survived fingers,75 cases (92 fingers) were followed-up for 6 to 24 months. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 52 cases, good in 19, poor in 4.

CONCLUSIONIt benefits to expand the indications and improve the survival rate of replantation of fingertip amputation with the correct choice of different replantation methods according to the injury situation of the broken fingertip artery after debridement under the microscope.

Adolescent ; Adult ; Amputation ; Child ; Child, Preschool ; Debridement ; Female ; Fingers ; physiology ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Replantation ; methods ; Young Adult

Objective To investigate the clinical effects and postoperative complications of arthrotomy and arthroscopy in repair of 170 menisci in 168 cases.Methods One hundred and sixty-eight patients with meniscus injury were repaired by arthrotomy or arthroscopy.They were 121 males and 47 females.There were 77 left knees and 91 right knees;117 medial menisci and 53 lateral ones.Their average age was 25.5?8.4 years old.Arthro- scopic repair methods included puncture and grinding,bio-absorbable meniscus arrow fixation,Outside-In suturing, Inside-Out suturing,Elite scuff instrument repairing,T-Fix fixation and FasT-Fix fixation techniques.The clinical results were assessed on the basis of symptoms,physical signs,Tegner scores and Lysholm scores of the cases. Postoperative complications were also investigated.Re-arthroscopic exploration was done for patients with obvious symptoms and physical signs.Results The average folluw-up time was 49.3?28.8 months.Their mean pre- operative Tegner score was 3.3?2.3,and their postoperative one 6.8?2.1 (P＜0.05).Their preoperative Lysholm score was 30.1?18.2,and their postoperative one 87.5?22.5 (P＜0.01).There were significant differences in Tegner and Lysholm scores before operation and after operation.Ninety-eight repaired menisci were rated as excellent(57.7%),57 as good (33.5%),10 as fair (5.9%),and five as poor (2.9%).The total ex- cellent and good result was 91.2%.Of the 19 patients with obvious symptoms and physical signs,re-arthroscopic exploration found no healing in five and partial healing in six.Postoperative complications included pain at the Outside-In suture nodes in three cases,referred pain at posterior articular capsule resulted from failed Outside-In meniscus anterior horn suturing in one case,and twinge at the meniscus arrow site in the posterior capsule in five cases.No serious lesion occurred at blood vessels or nerves.The postoperative complication incidence was 5.3%. Conclusion The eight methods of arthrotomy and arthroscopy to repair injured menisci investigated in our study can have a high successful rate and low perioperative and postoperative risk.

Objective To investigate the effect of Clostridium butyricum tablets combined with conventional therapy on the cholinesterase levels and albumin ( ALB) levels in patients with liver cirrhosis.Methods The 236 patients with liver cirrhosis from October 2016 to February 2018 in the Department of Gastroenterology of our hospital were selected as the study subjects.The patients were divided into the treatment group and the control group.The patients in the treatment group were given 2 g Clostridium butyricum tablets orally ,on the basis of general symptomatic treatment,3 times per day for two weeks ;the patients in the control group were stan-dard treatment.The plasma cholinesterase , ALB levels were determined by automatic analyzer.Results The cholinesterase levels in the control group and the treatment group were ( 2.87 ±1.82 ), (7.94 ±2.45) U· L-1, respectively; the ALB levels in the 2 groups were (34.02 ±3.26),(47.63 ±4.05) g· L-1,respectively;comparison between the two groups , the difference was significant ( all P ＜0.05 ) . Conclusion Clostridium butyricum tablets can significantly increase plasma cholinesterase and ALB levels in patients with liver cirrhosis .

OBJECTIVESTo study and analyze the clinical factors contributing to the failure of primary posterior cruciate ligament (PCL) reconstruction and to guide our clinical treatment.

METHODSFrom November 2001 to May 2007, 8 patients underwent PCL reconstruction revision because of pathological instability after primary PCL reconstruction. And the clinical failure factors of the primary reconstruction were analyzed.

RESULTSOne case was reconstructed with bone-patellar tendon-bone (B-T-B) autografts, 7 cases with hamstring tendon autograft. The most probable causes of failure were improper graft placement in 7 cases (both femoral bone tunnels were behind the predicted one and tibial tunnels were in front of the predicted one). The reconstructed PCL in 4 cases ruptured absolutely and had been absorbed. Three cases had obviously loosen but still partly linked reconstructed ligament. These 8 cases all received primary PCL revision reconstruction. Among them, 6 cases were reconstructed with autograft (using a single-bundle quadruple hamstring graft in 3 cases, double-bundle quadruple hamstring graft in 1 case, single-bundle B-T-B autograft in 2 case), and 2 cases were reconstructed with allograft (using a single-bundle and a double-bundle B-T-B allograft reconstruction).

CONCLUSIONSIncorrect bone tunnel placement is the major factor contributing to the surgical failure in many reasons for the failure of PCL reconstruction. So, it might be suggested that there is a great need for a more precise anatomical bone tunnel placement.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reoperation ; statistics & numerical data ; Retrospective Studies ; Treatment Failure ; Young Adult

OBJECTIVETo observe the incidence, causes and deviation angle of axial offset in patients with fracture ununited treated by Ilizarov bone transport technology.

METHODSFrom January 2007 to December 2012, 10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3 ± 10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases, medial tibia in 2 cases, lower tibial in 5 cases, upper femoral in 1 case. For Paley type of bone defect, 6 cases were type B1, 4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley assessment.

RESULTSAll patients were followed up from 19 to 32 months with an average of (22.0 ± 5.6) months. Three cases were natural healed at fracture ends, the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow-up, there were 3 cases occurred coronal angulation of angle 5° to 11° with an average of (8.7 ± 3.2). Sagittal angulation was in 4 cases, angle 6° to 9° with an average of (8.5 ± 2.1)°. There were 4 cases occurred axial offset. In the last follow-up, according to Paley evaluation criteria, osseous results were excellent in 7 cases, good in 3 cases; functional results were excellent in 6 cases, good in 4 cases.

CONCLUSIONAxial deviation after the Ilizarov bone transport treatment is relatively common, which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing, corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.

Adolescent ; Adult ; Female ; Fracture Healing ; Fractures, Ununited ; surgery ; Humans ; Ilizarov Technique ; adverse effects ; Male ; Middle Aged

Angioma serpiginosum is an uncommon, acquired vascular nevoid disorder with capillary dilation and proliferation in the papillary dermis. The eruptions are asymptomatic and characterized by grouped, erythematous to violaceous, serpiginous and punctate macules. The condition usually appears in females during adolescence on unilateral lower extremities and the buttocks. We report a rare case with a late onset and atypical distribution of lesions in a 48-year-old female patient who had groups of punctate lesions on her left foot for four to five years. Histopathological examination showed hyperkeratosis and multiple dilated and proliferated capillaries in the papillary dermis. Inflammation and extravasation of red blood cells were not found. According to the clinical and pathological findings, we established a diagnosis of angioma serpiginosum. She was treated with a pulsed dye laser, and the angiomatous lesions subsequently improved.
Female ; Foot Diseases/diagnosis/surgery ; Humans ; Lasers, Dye/therapeutic use ; Middle Aged ; Skin/blood supply/pathology/surgery ; Skin Diseases, Vascular/*diagnosis/surgery ; Telangiectasis/*diagnosis/surgery ; Treatment Outcome

OBJECTIVETo identify protein markers for the early diagnosis of pancreatic cancer by a comparative proteomic method.

METHODSComparative analysis on the pancreatic peripheral blood protein profiling from 20 pancreatic cancer patients, 10 chronic pancreatitis patients and 20 cancer-free controls from May 2007 to September 2008 was carried out by two-dimensional fluorescence electrophoresis (2D-DIGE). Differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). The significance difference proteins were confirmed by Western-blot.

RESULTSA differentially expressed proteins: complement 3 (C3) was identified. The gray level of C3 in pancreatic cancer tissue, chronic pancreatitis, and normal control group were 1.63 ± 0.28, 0.65 ± 0.13 (t = 11.81, P = 0.00) and 0.88 ± 0.19 (t = 9.93, P = 0.00), respectively. C3 was high expression in pancreatic cancer group compared with normal control group. The expression of C3 was higher in pancreatic cancer group than in chronic pancreatitis group. The high expression of C3 in pancreatic carcinoma was confirmed by Western blot.

CONCLUSIONS2D-DIGE and MALDI-TOF-MS technology is a quick, easy and practical method to screen for specific biomarkers in serum of patients with pancreatic carcinoma. The identified protein C3 in this study may be as specific serum biomarkers of pancreatic carcinoma.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Complement C3 ; analysis ; Early Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; blood ; diagnosis ; Pancreatitis, Chronic ; blood ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Two-Dimensional Difference Gel Electrophoresis

OBJECTIVETo observe the therapeutic effect of CDglyTK gene mediated by radiation-inducible promoters in the treatment of buccal carcinoma in Golden Hamster.

METHODSAnimal models of buccal carcinoma in golden hamster were established by painting 0.5% dimethyl-benzanthracene. The plasmids pcDNA (+) 3.1/E-CDglyTK were transfected into tumors by lipofectamine. 24 h later, the tumors were exposed to 3 Gy irradiation. Animals were monitored at regular intervals for volume of tumors. CDglyTK mRNA was assayed by RT-PCR. Apoptosis and proliferating cell nuclear antigen were detected respectively by in situ end-labeling and immunohistochemical methods.

RESULTSCompared with control groups, the tumor was suppressed obviously by CDglyTK gene therapy combined with 3 Gy induction radiation. The expression of CDglyTK gene could be detected by RT-PCR in the transfected tumor, and up-regulation of CDglyTK expression was found in tumor exposed to radiation (P < 0.05). There was significant difference in apoptosis index or proliferation index between tumor without irradiation and tumor with irradiation (P < 0.05).

CONCLUSIONSThe radiation-inducible promoter can be served as a molecular switch to regulate the expression of CDglyTK gene in buccal carcinoma in golden hamster, and low dose induction radiation can significantly improve the therapeutic effects.

Animals ; Carcinoma, Squamous Cell ; diagnostic imaging ; therapy ; Cheek ; diagnostic imaging ; Cricetinae ; Cytosine Deaminase ; genetics ; Genes, Transgenic, Suicide ; genetics ; Genetic Therapy ; methods ; Mesocricetus ; Mouth Neoplasms ; radiotherapy ; therapy ; Promoter Regions, Genetic ; radiation effects ; Radiography ; Simplexvirus ; enzymology ; Thymidine Kinase ; genetics

Objective To optimize the treatment process of patients in Ophthalmology Outpatient, so as to enhance patient′s satisfaction and quality of care service. Methods The nurse manager of Department of Ophthalmology experienced treatment process in other hospital with team and summarized the feeling of other hospital′s treatment process, and improve the treatment process according to the existed problems including reconstruction of Outpatient work process, the implementation of registration system in Outpatient, building up Office of Returning Visit, doing extended nursing, developing “I am patient” activity, training communication ability and skills for constructing doctor-patient relationship, strengthening health education and other nursing services. Results 2014 and 2015 in Ophthalmology Outpatient of our hospital, the patients′ waiting time for treatment became short after carrying out the experience of nurses′transposition experience ( P<0.05) , and the patients′satisfaction were significantly improved after exchanging ( P<0. 05 ) , as well as the reduction of effective complaint rate (P<0.05).Conclusions To optimize the treatment process of patients in Department of Ophthalmology can shorten the time of treatment waiting time, improve the satisfaction of outpatients, so as to improve the quality of nursing service.