Objective To investigate the clinical result of reconstructed thumbs and fingers using frozen allogeneic composite tissues of fingers and autogenous toe Methods Fifty thumbs and fingers were reconstructed in 24 patients (25 hands) by allogeneic composite tissues of finger wrappoed by free neurovascular big toe nail skin flap and combined transplantation with autogenous second toe 15 patients were followed up for 4 years in average with examination in the ambulant clinic, communication and X ray photography to evaluate the clinical effect Results Recovered sensory function of the reconstructed fingers as well as good opposition function were seen There were Charcot's like arthrosis of allogeneic MP and arthroclisisof IP in 2 cases The postoperative gait of the doner's feet was normal The site of grafted skin on big toe was rubbed easily in 4 cases and the valgus hallexo of the doner's foot were seen in 3 cases, the plantaris callus in 2 cases Postoperative immunological rejection didn't elicit The junction between implanted allo phalangen tendon and autophalanges tendon were reliably healed Conclusions This operation gives reconstructed more fingers without sacrificing more toes for patients The walking function of donor foot is good The antigenicity of allogeneic grafts could be abated after preservation under 30℃ or frozen dried

[Objective]To report the surgical managements and their outcomes in high pressure injection injuries of the hand(HPIIH) in 5 cases.[Method]Open wound technique and series debridement in all 5 cases were performed.The residual skin defects following debridement were repaired with cross-finger island flap in 1 case.[Result]From November 2001 to November 2005,5 cases of HPIIH were treated in our department and the wounds were healed satisfactorily.The flap was survived.Amputation of the finger was executed in 1 case.[Conclusion]The time of the first debridement after injury determines the prognosis.Aggressive wound debridement is a key point for good wound healing in HPIIH.

[Objective]To investigate the etiology,pathological characteristic and therapeutic effect of spontaneous rupture of the finger extensors.[Method]Twelve patients were included in this research group.Eight cases were diagnosed as spontaneous rupture of the extensor pollicis long(EPL) and were repaired by transfer of the extensor indicis proprius(EIP).Three cases were spontaneous double rupture of the the ring and small finger extensors.The distal stump of the ring finger extensor was woven into the middle finger extensor and the EIP was transferred to reconstruct the extensor digiti quinti.There was one case of spontaneous triple rupture of the the middle,ring finger and small finger extensors.Transplantation of frozen allogenic extensors was utilized.[Result]The finger extensor rupture occurred after either rheumatic arthritis or distal radius fracture.The former pathological examination showed that the tenosynovitis and chronic inflammation of tendons accompanying with localized necrosis was dominant,while tendon fiber rupture played an important role in the latter.All patients achieved 100% of good results and no recurrent rupture occurred.[Conclusion]The inflammation invasion or attrition in the fracture site was a patological basis to cause spontaneous rupture of finger extensors.The EPI transposition was a reliable option to reconstruct the EPL.It is suggested that allogenic tendon transplantation be applied in the case of multiple ruptures of the extensor tendons.

Objective To investigate the relationship between the marrow edema and general clinical index,quadriceps muscle area,and the meniscus grade of knee osteoarthritis(OA).Methods 72 patients were collected with knee OA in our hospital, underwent X-ray and routine MRI examination of knee, and the same X-ray and MRI were reviewed at 12 months later in different time point.The K-L grading, bone marrow edema score, meniscal grading and VAS score of each knee joint were evaluated.The t-test and Rank-sum test were used to compare the two groups of general data, Spearman was used to perform bivariate correlation analysis.Results The age and VAS score of bone marrow edema group at the initial follow-up were significantly lower than those without edema group(P<0.05),the degree of marrow edema was moderately correlated with age and VAS score, and was not significantly correlated with other indexes.12 months later, BMI and the area of quadriceps femoris in the group with marrow edema were different from those in the group without bone marrow edema(P<0.05), the degree of marrow edema was moderately correlated with age, quadriceps area and VAS.Conclusion The range of marrow edema was related to age, quadriceps area, BMI index and VAS score in MRI.The MRI measurement could reflect the progression of knee OA more than that of X-ray.It also revealed some factors related to the progression of knee OA.

BACKGROUNDTo evaluate and compare the effects and toxicity of the domestic product of nrhTNF combined with chemotherapy in the trial group and chemotherapy alone in the control group in the treatment of patients with non-small cell lung cancer (NSCLC).

METHODSNinety patients with NSCLC in multicenter were randomly devided into trial group and control group. Each group had 45 patients. Chemotherapy with CAP regimen was given for the patients in the trial group. Meanwhile, nrhTNF injection of 4×10⁶U/m ² was also given from the 1st to 7th days, the 11th to 17th days on the chemotherapy course. Twenty-one days were as a cycle, 2 cycles were given each patients. Chemotherapy alone with CAP regimen was given in the control group. The chemothepeutic effects and toxicity were observed and compared between the two groups after the therapy.

RESULTSOf the 90 patients, 3 cases in each group were out of the trial because of economy. The other 84 cases (each group had 42 patients) could be used to analyze and evaluate the clinical effects and toxicity. The response rate of chemotherapy was 47.62% (20/42) in the trial group and 19.05% (8/42) in the control group (P=0.002) respectively. The KPS was 85.02±10.74 in the trial group, and 81.35±9.63 in the control group (P=0.038). No significant difference of degree III+IV toxicity was observed between the trial group and control group (P > 0.05). The side effects related to nrhTNF included slight fever, cold like symptoms, pain, and red and swelling in injection site. All of them were mild and didn't need any treatment and disappeared after the therapy.

CONCLUSIONSThe results demonstrate that the effects of domestic nrhTNF combined with chemotherapy can remarkably higher than that of chemotherapy alone in the treatment of NSCLC. It is able to increase the sensitivity to chemotherapy and improve the quality of life of the patients. The toxicity is also slight and is worth to expand clinical use, so as to further evaluate its effect and toxicity.