Over the past several decades of innovation and development, Ilizarov technique has been widely recognized and applied in correction of limb deformity and post-traumatic sequelae with outstanding clinical outcomes, which making remarkable contributions to the development of orthopaedics. There is no doubt that tissue regeneration induced by tension-stress is the core of Ilizarov technique, and a series of biological cascades contributing to tissue regeneration could be triggered by mechanical stimulation through signal transduction including bone morphogenetic proteins regulations, inflammatory responses and immune responses, angiogenic activities, stem/progenitor cell homing and other systematic effects. One of main limitations of Ilizarov technique is slow rate of new bone mineralization. To facilitate this technique application better in clinical practices, a multitude of researches of means for promoting bone mineralization have become hot spots in this field in recent years, such as physical measures, chemicals and biological therapies. With better understanding of distraction histogenesis for promoting tissue regeneration, transverse tibial bone transport has been increasingly applied to vascular disease management in lower extremity, such as diabetic foot and thromboangitis obliterans. This review focuses on the recent advances in understanding the basic biological mechanisms of Ilizarov technique and new methods for promoting bone consolidation in distraction areas, providing evidence and ideas for further mechanism investigations and approach innovations.

Objective To investigate the significance of cortactin in primary liver cancer. Methods Fiftythree paraffin embedded primary liver cancer specimens were collected at General Hospital of Air Force of PLA from January 2002 to May 2008. The expression of cortactin was detected by immunohistochemistry, and the relationship between cortactin expression and clinicopathologic parameters was analyzed. All data were analyzed via Wilcoxon rank sum test and Spearman rank correlation analysis. Results There was a significant difference in cortactin expression among tumor capsule integrity, TNM staging, portal vein tumor thrombus and extrahepatic metastasis (u =2. 19, 3. 584, 2. 796, P ＜ 0.05 ). There was a positive correlation between tumor invasion and cortactin expression ( r = 0. 5794, P ＜ 0.05 ). Conclusions Overexpression of cortactin may be one of the factors enhancing the invasion of primary liver cancer. The level of cortactin expression can be used in evaluating the invasive potential of primary liver cancer.

Child ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Radiation Dosage ; Radiosurgery ; Treatment Outcome

Objective To explore the risk factors of esophageal gastric varices in patients with primary biliary cirrhosis (PBC ) .Methods From January 2008 to November 2014 ,112 PBC patients underwent gastroscopy examination and among them 24 received liver biopsy .The correlation between esophageal gastric varices and histological stage ,age ,gender ,anti‐centromere antibodies (ACA) ,platelet (PLT ) , albumin (Alb ) , total bilirubin (TBil ) , alkaline phosphatase (ALP ) , γ‐glutamyl‐transferase (GGT ) ,aspartate‐aminotransferase (AST ) ,alanine‐aminotransferase (ALT ) ,prothrombin time (PT ) and Mayo score was analyzed .Logistic regression analysis was used to identify independent risk factors predicting esophageal gastric varices in PBC patients .Results Among 112 patients with PBC ,varices was found in 62 patients (51 pure esophageal varices ,nine esophageal gastric varices and two pure gastric varices) .Among 24 patients with liver biopsy ,15 had varices (two at early histological stage Ⅰ and Ⅱ , 13 at later histological stage Ⅲ and Ⅳ ) .The ACA positive rate ,PT ,TBil and Mayo score of patients with varices were higher than those of patients without varices ;while Alb ,GGT and PLT were lower than those of patients without varices , and the differences were statistically significant (all P < 0 .01) . Multivariate Logistic regression analysis revealed that positive ACA (odds ratio (OR) = 8 .759 ,95%cofidence interval (CI) :1 .308 to 58 .637) ,Mayo score over 4 .52 (OR = 8 .941 ,95% CI :1 .145 to 69 .809) ,PLT count less than 96 .5 × 109 /L (OR = 10 .410 ,95% CI :2 .344 to 46 .224) ,TBil level over 26 .62 μmol/L(OR = 14 .348 ,95% CI :2 .945 to 69 .913) were independent risk factors predicting varices . Conclusion ACA positive ,PLT count less than 96 .5 × 109 /L ,TBil level over 26 .62 μmol/L and Mayo score over 4 .52 can help to predict esophageal gastric varices in patients with PBC .

Objective To evaluate the safety and efficacy of microwave tissue coagulation assisted laparoscopic hepatectomy for the treatment of hepatic tumors.Methods 29 patients underwent laparoscopic hepatectomy using microwave liver tissue coagulation from December 2011 to June 2014 in the General Air Force Hospital.All patients underwent intraoperative ultrasound guided microwave coagulation assisted laparoscopic local hepatectomy.Intraoperative blood loss,operation time,postoperative hospital stay and complications were observed.Results All the operations were successfully performed without conversion to open surgery.There were 18 cases of hepatocellular carcinoma (HCC),2 cases of intrahepatic cholangiocarcinoma,2 cases of hepatic metastases from the rectal carcinoma,5 cases of hepatic hemangioma,1 case of hepatic focal nodular hyperplasia and 1 case of hepatic cystadenoma.Drainage tubes were placed in 3 patients and removed 5-7 d after the operation.The operation time was 150 (125-210) miu,the median amount of intraoperative bleeding was 120 (30-250) ml,the postoperative hospital stay was 7 (5-10) d.All patients recovered well after the operation and no complications such as intraabdominal bleeding and bile leakage were observed.The cutting edges of liver cancer of these 22 cases were negative.The postoperative follow-up time of these 22 cases were 3-36 months and no tumor recurrence and metastasis were observed.Conclusions Laparoscopic liver resection using intraoperative ultrasound guided microwave hepatic tissue coagulation can effectively control the bleeding,improve the safety of laparoscopic liver resection,which makes it a safe and effective minimally invasive technique.

Objective To discuss the feasibility of preoperative diet by measuring gastric emptying time of carbohydrate and protein nutrient solutions in healthy volunteers.Methods A total of 20 healthy volunteers were collected from August 2013 to May 2014.On the morning of the trial,baseline gastric residual volume of each volunteer was measured with magnetic resonance imaging at 8 a.m.,then each of the 20 healthy volunteers took 12.5％ carbohydrate solution 400 ml (containing 40 g of maltodextrin and 10 g of sucrose) or 12.5％ whey protein solution (containing 50 g whey protein) in 5 minutes.Magnetic resonance imaging was conducted to measure the gastric residual volume every 25 minutes.The volunteers were shifted to the other nutrient solution after a 1-week interval.The gastric emptying time of both nutrient solutions was calculated to generate the curves illustrating the process of gastric emptying.Results The baseline gastric residual volume of the volunteers was (14.90 ± 9.39) ml.The total gastric emptying time of carbohydrate solution was (104.90 ± 27.98) min (95 ％ CI 98.64-111.16 min),while that of whey protein solution was (199.6 ± 34.17) min (95％ CI 184.47-214.73 min).There was a significant difference between these two types of nutrient solution in terms of gastric emptying time (P ＜ 0.000 1).Conclusions The induction of anesthesia could be performed 2 hours after carbohydrate administration,and at least 4 hours after whey protein administration.

Objective To determine the gastric emptying time for liquids in the healthy volunteers by magnetic resonance imaging (MRI) and to provide a reference for reasonable preoperative fasting time.Methods Nineteen healthy volunteers of both sexes,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,were enrolled in the study.The volunteers were fasted from the intake of liquids or solids starting from 22:00 the night before the trial,and 12.5％ carbohydrate solution 400 ml containing 40 g maltodextrin and 10 g sucrose was given orally.MRI was performed to measure the baseline gastric fluid volume at 8:00 on the day of the trial (T0).The gastric fluid volume was measured immediately after administration of the oral solution,and then measured every 25 min until the gastric fluid volume was returned to the baseline before administration of the oral solution or to ＜25 ml,and was recorded as T25,T50,T75,T100,et al.The gastric fluid volume was drawn using a computer to obtain the curve for gastric emptying.The gastric half and total emptying time was calculated using the curves.Results The gastric half emptying time was (32± 12) min,and the gastric total emptying time was (99±22) min in the volunteers.Compared with those at Tb,the gastric fluid volume was significantly increased at T25,T50,T75,T100,and no significant change was found in gastric fluid volume at T125,T150and T175.Conclusion After oral intake of liquids,the gastric emptying time is about 2 h,indicating that the preoperative fasting time for liquids can be shortened to 2 h before anesthesia in the healthy volunteers.

ObjectiveTo investigate the morphologic features of coronary sinus (CS)-left atrium muscle connections,and evaluate the function and anatomical features of coronary sinus on dual-source CT coronary angiography (DSCTCA).MethodsImages of DSCTCA of 144 patients [ control group consisted of 96 patients,and atrial fibrillation (AF) group consisted of 48 patients] were reviewed.The existence of coronary sinus-right atrium muscle connections was indirectly evaluated by measuring the cross-sectional area changes of the CS during atrial systole and atrial diastolic.The number,location,length of the CS-left atrium muscle connections andthe relationship between CS-left atrium muscle connections and CS morphological characteristics were studied.The t test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results( 1 )The anatomic course of the CS in relation to the mitral ring was straight,mild curvature and high riding of 62,16 and 18 cases in control group and 10,8 and 30 cases in AF group,respectively.There was not statistical significance between the 2 group (x2 =0.093,P=0.954). (2)The CS length was (34.1 ±9.1),(33.8 ±8.9)mm in Control group and AF group,respectively.There was no statistical significance between the 2 group ( t =- 0.486,P =0.628 ).(3) Coronary sinus-left atrium muscle connections were seen in 131 of the 144 patients (91.0％).A single connection was seen in 103 of the 144 patients,with a mean length of (22.6 ± 12.7)mm within (6.3 ± 5.8 ) mm of the coronary sinus ostium.28 patients had two connections; distal connections measured ( 13.2 ± 6.2)mm in length within (16.7 ± 6.8 ) mm of the coronary sinus ostium,and proximal connections measured ( 11.1 ± 3.6 ) mm in length within (2.1 ± 1.9) mm of the coronary sinus ostium.And there was no statistical difference the number and length of CS-left atrium connections in between Control group and AF group (P ＞ 0.05 ).(4)The CS narrowed 22.4％ (44.5/198.8 )in cross-sectional area from atrial diastolic to atrial systole in control group( t =- 21.076,P ＜ 0.01 ),while the CS had no obvious contraction in AF group(t =0.374,P ＞ 0.05).The cross-sectional area of the coronary sinus during diastole was obviously larger in the AF group than in the control group[( 230.4 ±77.0) mm2 vs (198.8 ±65.4) mm2,respectively,t =- 2.579,P =0.01 ].In control group ( n =9 ),the coronary sinus-left atrium connection was not seen,however,all showed a CS constriction during atrial systole,indicating that coronary sinus-left atrium muscle continuity is not likely the primary cause for coronary sinus contractions. Conclusions DSCTCA can clearly show the anatomical characteristics of CS,it can help to understand the length,number and location of the CS-left atrium muscle connection.

Objective To evaluate the feaibility and safety of gastrotomy in natural orifice transluminal endoscopic surgery(NOTES)using technique of percutaneous endoscopic gastostomy(PEG).Methods To retrospectively investigate and compare the success rate,complications and procedure time of gastrotomy in NOTES of dogs between PEG-like approach(PEG group,n =20)and needle knife incision(needle knife group,n =18).Results Gastrotomy was successfully performed in all animals.No mass bleeding or organ injury was observed in PEG group,while one dog in needle knife group encountered mass bleeding,and injuries to the adjacent organs were found in 3 others(0％ in PEG group vs.22％ in needle knife group,P ＜ 0.05).The procedure time of gastrotomy in PEG group was longer than that of needle knife group (15.0±3.7 min vs.6.0 ± 1.1 min,P ＜0.05).Conclusion Compared with the techniqued of needle knife incision,gastrotomy using PEG-like approach in NOTES is safe and feasible.