Objective To find out easily-processed and longly-preservated nerve allograft transplantation which has not only no-obvious antigenicity,but the integral structure of intermal nerve membrane.Mehtods Acquire the nerve allografts under sterile condition,submerge them into 50 ,70 and 85 percent of glycerol for 3 hours respectively at 37 Centigrade degree,then put them into the containers which contain 85 percent of glycerol. After sealed and preservated at 5 Centigrade degree for 6 weeks,the processed nerves can be used for transplantation.Results 14 nerve allografts processed with glycerol were transplanted in 10 patients with nerve defects varying from 2.5 to 18 cm. After follow-up for 5 to 42 months,the effects were proved to be satisfactory.Conclusion It is obviously effective to transplant nerve allograft processed with glycerol and preservated for 6 weeks for bridging the defects of peripherall nerve through a series of clinical observations.

Objective To investigate the clinical efficacy of Asian proximal femur intramedullary nail antirotation (PFNA-Ⅱ) in the treatment of intertrochanteric fractures in elderly people.Methods From July 2009 to December 2011,127 elderly patients with intertrochanteric fracture were treated by PFNA-Ⅱ.They were 49 cases of male and 78 cases of female,with a mean age of (74.3±15) years.127 elderly patients were classified by modified Evans:type Ⅰ (n=37),typeⅡ (n=42),type Ⅲ (n=26),type Ⅳ (n=15),type V (n=7).We made the statistics on the intraoperative bleeding volume,operation time,incision length,X-light exposure times,and made evaluation of the efficacy of postoperative follow-up and complications by the Harris hip score.Results The average operation time was 42.5 min (35-90) min,the average intraoperative bleeding volume was 107.5 ml (65-410)ml,X-light exposure times were (2.5±1.4) times (2-4) times and the average total incision length was (6.5± 1.8) cm (5.5-11.0) cm.No serious complications or original complications were found during perioperative period.All patients received a 6 to 24 month follow-up (mean 12.5 months in average).The X ray examination showed that the average neck shaft angle was (134±13)° (120°-150°).The average fracture healing time was (14.0±2.5) weeks (11 to 19 weeks).The average hip Harris score was (86.5± 19.5) points (65-100 points).Among them,29 cases (22.83％) were excellent,76 cases (59.8％) were good,20 cases (15.7％) were moderate,2 cases (1.6％) were poor.Totally,excellent and good rate was 82.7％.No complications including hip varus deformity,screw cut-out and femoral shaft fractures were found.There were 14 patients (11.0％) with thigh pain and 5 patients (3.9％) with inner thigh pain.The heavier pain in 4 patients were improved by physical therapy.Conclusions Asian PFNA-Ⅱ has advantages including simple operation,fewer complications,and better clinical efficacy for the treatment of intertrochanteric fractures,but its longterm efficacy and complications still need a large sample and multi-center observation.

Objective:To create hospital data fusion centers to solve the problems involving data incompatibility between business system and administration system and incomplete data-sharing service.Methods:The needs for hospital data fusion center were analyzed, and the protocol design for creating hospital data fusion center was put forward according to the needs.Results:The protocol design for creating hospital data fusion center facilitates the specific methods of promoting hospital data fusion.Conclusion: The protocol design for creating hospital data fusion center may promote in-and out-hospital data-sharing service and comprehensive data utilization, so as to improve hospital information utilization.

Objective To investigate the clinical features,safety and clinical efficacy of the posterior decompression and interbody fusion with internal fixation for complete thoracolumbar fracture and dislocation.Methods The clinical data of 23 patients with complete thoracolumbar fracture and dislocation treated by posterior decompression and interbody fusion with pedicle screw fixation from August 2011 to October 2014 were retrospectively analyzed.There were 18 males and 15 females,aging from 20 to 50 years old with an average age of 38.2±0.3 years.There were 8 cases of T10,11 vertebral dislocation,8 of T11,12 vertebral dislocation,3 of T12L1 vertebral dislocation,and 4 of L1.2 vertebral dislocation.All the patients had different degrees of multiple rib fractures and pneumothorax complications.Preoperative spinal cord nerve function was evaluated according to the American Spinal Injury Association of spinal cord function (ASIA).There were 10 cases of ASIA grade A and 13 cases of grade B.Operation time,intraoperative blood loss,clinical outcome,imaging X-ray and CT examination,segmental kyphosis angle and bone graft fusion were recorded.Results All the patients were followed up for 13 to 26 months,average 20.2±4.3 months.The operation time ranged from 150 to 260 min with the average time of 180.3± 14.8 min;intraoperative blood loss was 800-1 500 ml with the average of 950.2±98.1 ml.Preoperative sagittal Cobb angle was-13.5° ±6.3° (range,-20.1° to 2.3°);postoperative sagittal Cobb angle was 1.43°±6.4° (range,-7.6° to 3.5°);at the latest follow-up,sagittal Cobb angle was 1.6°±6.3° (range,-8.1° to 10.3°);the dislocation reduced from preoperative 100％ to postoperative 0-15％ (10％±6％).After operation,the ASIA grade of 2 cases improved from A to B,and 5 cases improved from B to C.All of the patients had bone fusion after operation,no false joint or nonunion occurred,no loosening or breakage of internal fixation occurred.Conclusion There are high risks and difficulty of surgery for those who with thoracolumbar fracture dislocation and severe injuries of spine and spinal cord combined with multiple injuries.Proper treatment of preoperative complications is the premise of good curative effect;reliable fusion and long segment internal fixation is the key of operation.Single posterior decompression and reduction with interbody fusion and internal fixation is less invasive and could achieve satisfactory clinical efficacy.

Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in con-valescent stroke patients. Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and ran-domized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted thera-py was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Func-tional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FMA-UE and FIM were bet-ter in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05);for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890,P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better. Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Objective To investigate the protective mechanism of hyaluronic acid (HA) antagonistic to nitmprusside sodium (SNP) on the tissue engineering cartilage. Methods Alginate culture for two weeks was used to recover phenotype of dedifferentiated chondrocytes. Differentiation state of chondrecytes was analyzed by immunostaining. The growth of alginate-recovered chondrocytes on the chitosan-based scaffold was observed by scanning electron microscope. After cultured for 3 weeks, this tissue engineering cartilage was treated with SNP in the absence or presence of HA combined with specific β1 integrin blocking antibody collagen type Ⅱ and aggreean were detected by RT-PCR and Western blot. Results Collagen type Ⅱ expression in dedifferentiated chondrocytes was significantly enhanced by alginate bead culture. The chitosan-based scaffold supported cell adhesion, proliferation and migration. A dose-dependent inhibitory effect on the expression of collagen type Ⅱ and aggrecan was observed when tissue engineering cartilage was treated with SNP alone. HA significantly promoted collagen type Ⅱ, and aggrecan expression antagonistic to low concentrations of SNP (p<0.05). However, the specific β1,integrin blocking antibody abrogated the effects of HA. Conclusion Alginate culture recovers the phenotype of dedifferentiated chondrocytes. HA abrogats the inhibitory effect of SNP via β1 integrin signal pathway to protect tissue engineering cartilage.

Objective To analyze the long-term survival of patients with middle and distal cholangiocarcinoma,and to explore the influence of nerve invasion on the survival time.Methods We retrospectively analyzed the clinical data of 161 patients with middle or distal cholangiocarcinoma in General Hospital of Fushun Mining Bureau between January 2012 and June 2016.All the patients were divided into nerve group and control group according to the nerve invasion.And then the perioperative and prognosis data of the two groups were analyzed and compared.Results In our research,all patients were successfully completed surgery,the incidence of neural invasion was 47.2％ (76/161),more common of the nerve invasion in distal cholangiocarcinoma and phase Ⅱ cholangiocarcinoma.The perioperative mortality rate was 3.7％ (6/161),and the incidence of complications was 27.3％ (44/161).The 1 years,2 years and 3 years survival rates of middle and distal cholangiocarcinoma were 78.7％,42.1％,20.0％,the average survival time was(23.8 ±1.2) months.The 1 years,2 years and 3 years survival rates of nerve group and control group were 67.1％,29.8％,9.4％ and 89.0％,52.6％,26.8％,the average survival time were (18.6 ± 1.4) months and (27.3 ± 1.6) months.The prognosis of nerve group was significantly poor than the control group (P ＜ 0.05).Conclusions Nerve invasion is a common way of invasion and metastasis of cholangiocarcinoma.And it has a poor prognosis in cholangiocarcinoma patients with nerve invasion.

Objective To observe the influence of intra-articular injection of sodium hyaluronate (HA) on mRNA expression of matrix metalloproteinase (MMP) -1, -3 and tissue inhibitor of metalloproteinase (TIMP)-1 in cartilage and synovium of osteoarthritis (OA) . Methods Sixteen white rabbits underwent unilateral anterior cruciate ligament transection and were divided into 2 groups randomly 5 weeks after transection. Experimental group rabbits received 0.3 ml of intra-articular 1% HA injection once a week. Animals in control group were treated under the same condition using saline. At death, 10 weeks following surgery, histological changes of articular cartilage of medial femoral condyle were evaluated by microscopy. The mRNA expression of MMP-1, MMP-3 and TIMP-1 in cartilage and synovium was analyzed using reverse transcription-polymerase chain reaction (RT-PCR) . Results Cartilage degradation in experimental group was significantly less severe than that in the control group. The expression of MMP-3 mRNA in synovium was significantly suppressed in experimental group compared with the control group (0.40?0.10 vs 0.62?0.13). HA treatment had no effect on MMP-3 expression in cartilage. No significant difference of MMP-1 and TIMP-1 expression in cartilage and synovium was found between experimental group and control group. Conclusion HA can alleviate the degeneration of articular cartilage of OA. One possible mechanism of the therapeutic effect of HA may be inhibition of expression of MMP-3 in synovium during early stage of OA.

Objective To study the influence of carboxymethyl-chitosan (CM-chitosan) on phenotype and proliferation of chondrocytes stimulated by recombinant human interleukin-1? (rhIL-1?), and explore its mechanism. Methods Chondrocytes were isolated and cultured. 10 ng/ml IL-1? with or without CM-chitosan of varied concentrations were added into the culture medium. After 24 h, changes of proliferative ability of chondrocytes were tested by MTT and flow cytometry. Proteoglycan synthesis was measured by incorporation of Na235SO4 into chondrocytes, nitric oxide (NO) production was detected by Greiss reaction, mRNA expression of typeⅠ、Ⅱcollagens, Aggrecan and inducible NO synthase (iNOS) were examined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results CM-chitosan could significantly antagonize IL-1?-induced inhibitory effect on proliferation of chondrocytes, restore proteoglycan synthesis of chondrocytes, decrease NO production of IL-1?-induced chondrocytes, increase the mRNA expression of typeⅡcollagen and Aggrecan, but decrease the expression of typeⅠcollagen and iNOS. The effects of CM-chitosan were in a dose-dependent manner. Conclusion CM-chitosan can maintain the proliferation and phenotype of IL-1?-induced chondrocytes.