Objective To explore indications for replantation and amputation of complex severed lower legs. Methods Fifteen lower legs in 25 cases with complex severed lower limbs were replanted including four finally amputated again, and other 10 legs were amputated directly after trauma. Those with successful replantation were repaired with microsurgical technology and limb lengthening procedure for complications such as soft tissue defect, bone defect and limb shortening. The amputated cases were fitted with prosthetic limb after wound healing. Results All cases were followed-up for three to 10 years (6.4 years in average), and 11 lower legs were survived in 15 replanted cases and other four were finally amputated and fitted with prosthetic replacement. The limbs of those with successfully replantation shortened to varied extent, and one can be categorized as grade Ⅰ, four as grade Ⅱ, four as grade Ⅲ and two as grade Ⅳ, according to Chen's classification of function evaluation for replanted limbs. Appearance of prosthetic limbs in 14 cases had no significant difference from the normal, and 12 of them could walk with load and two had slight claudication. Those with prosthetic limbs were more satisfactory than those with replantation of the limbs. Conclusion Replantation for complex severed lower legs should be comprehensively considered based on mangled extremity severity score (MESS), their local condition and function prognosis.

Objective To investigate the effects of transforming growth factorβ1(TGFβ1)and β3 (TGFβ3)gene transfer on MMP-2,MMP-9 and TIMP-1 expression in hepatic stellate cells(HSC-T6).Methods TGFβ1 and TGFβ3 expression plagmids were constructed.The recombinant expression plasmid pcDNA3.1(+)-=TGFβ1 and pcDNA3.1(+).TGFβ3 were transfected or cotransfected into HSC-T6.At 24,48 and 72 h after transfection,the expression of MMP-2,MMP-9 and TIMP-1 mRNA were detected by real-time quantitative PCR,and the expression of MMP-2,MMP-9 and TIMP-1 protein were detected by Western blot.The recombinant expression plasmid pcDNA3.1(+).TGFβ1 was transfected into HSC-T6,and positive clones were selected by G418.The positive clones were transfected by the recombinant expression plasmid pcDNA3.1(+).TGFβ1,and the expression of MMP-2,MMP-9 and TIMP-1 were detected at 48 h after transfection.Results After transfection with peDNA3.1-TGFβ1,MMP-2 and TIMP-1 increaged remarkably in HSC-T6 cells(P＜0.05),but MMP-9 remained at the sanle level;After transfection with pcDNA3.1-TGFβ3,expression levels of MMP-2,MMP-9 and TIMP-1 mRNA were not changed,but TIMP-1 protein increased remarkably(P＜0.05);in cotransfection group,the expression of MMP-2 was higher than that in the blank and the control groups(P＜0.05),but MMP-9 level was not changed and TIMP-1was decreased compared with that in the TGF-β1 transfection group(P＜0.05).After TGFβ3was transfected into positive clones,the change of MMP-2 wag not significant(P＞0.05).but MMP-9 increaged and TIMP-1 decreased significantly at 48 h after transfection(P＜0.05).Conclusions TGFB3 may inhibit liver fibrosis by increase the activity of MMP-2 and MMP-9,and decrease the activity of TIMP-1.

Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Emodin ; pharmacology ; Humans ; Neoplasms ; pathology ; Tumor Cells, Cultured

Objective To investigate the efficacy of autologous peripheral hematopoietic stem cell transplantation in the treatment of adult dermatomyositis. Methods A 21-year-old patient with dermatomyositis received autologous peripheral hematopoietic stem cell transplantation and was followed up for 6 years. Autologous peripheral hematopoietic stem cells were mobilized by recombinant human granulocyte colony stimulating factor (rhG-CSF) before the transplantation, and the conditioning regimens consisted of cyclophosphamide,methylprednisolone and cyclosporin. Rabbit anti-human T lymphocyte immunoglobulin began to be applied on day 3 after retransfer of stem cells. The improvement in symptoms, physical signs and biochemical indicators was observed, and hematopoietic restructuration and immunity resurrection were evaluated after the transplantation. Results After the transplantation, skin eruption greatly improved and gradually subsided. The muscle force of extremities restored from level Ⅳ before transplantation to level Ⅴ. The level of creatine kinase declined sharply after transplantation, but gradually returned to previous level. Leucocyte count began to decrease on the day of retransfer, and returned to the normal level on day 8. Immune function remained normal before and after the transplantation. Conclusion Autologous peripheral hematopoietic stem cell transplantation is an alternative treatment for severe and refractory dermatomyositis.

Objective:To study the influence of the serum cytokine levels of patients with Graves′ disease(GD) before and After Treated With ~ 131 I.Methods:Using the method of radioimmunoassay, the serum levels of interleukin-1(IL-1), interleukin-2(IL-2), interleukin-6(IL-6), interleukin-8(IL-8) and tumor necrosis factor(TNF-?) of GD 52 patients were measured before and after ~ 131 I, 30 age-and sex-matched healthy subjects served as controls, and the results were compared with that of the control group.Results:The levels of IL-1, IL-6, IL-8, TNF-? of GD patients were significantly higher than that of the control group(P

Objective·To analyze clinical and pathological characteristics of gastric malignancies from a single center of Ruijin Hospital,and provide references for making healthy policy on gastric tumors.Methods·The data sources were from hospital in-patients database including demographic information,family history,clinicopathological information,and census registering information during 2005 to 2014.The demographic data and clinicopathological data were analyzed.Results·The total number was 3 315 cases with gastric malignancies (2 184 male patients and 1 131 female patients).It was about 2 times as high in males as in females.The patient age was between 18 to 98 years old (mean 59.71 years old).Based on pathologic diagnosis,3 122 cases (94.2％) were gastric adenocarcinoma,others were gastrointestinal stromal tumors (5.5％),neuroendocrine tumor (0.2％) and malignant lymphoma (0.1％).Out of patients with gastric carcinoma,about 4.46％ of cases ran in families.Conclusion·Over 94％ cases of gastric malignancies are gastric carcinomas.Specific risk profiles of gastric carcinomas include age,gender and family factors.

Objective To observe the anatomical and histological features of anterolateral ligament (ALL)in the knee of Chinese adults,so as to identify the existence of ALL and provide an anatomical foundation for clinical reconstruction.Methods Ten adult knee specimens were randomly selected to be dissected,and the femoral,tibial and meniscus attachment points of the ALL were observed.The length,width and thickness were measured using the vernier caliper after the dissection.Three specimens were subjected to histological staining in the end.Results (1)ALL originated from the lateral femoral condyle—the same point of the lateral collateral ligament femoral side or the distal-anterior side,with its body divided into two branches,located in the tibia and the lateral meniscus respectively.The starting point of tibial side ALL was located at the mid-point of Gerdy's tubercle to fibula head,below tibial cartilage edge,with the meniscus point located in the lateral meniscus anterior horn and body junction area.(2) The average length of ALL is 38.89 ± 4.67 mm.The width in the femur,tibial attachment point was fan-shaped spread connected with sclerotin,being the narrowest at the joint line.The width at the femur,tibial attachment point and the joint line was 8.49 ± 1.36 mm,8.15 ± 1.38 mm and 6.49 ± 1.09 mm respectively,with the thickness of 1.33 ± 0.38 mm.The distance from tibia attachment points to the Gerdy's tubercle,fibular head and tibia cartilage margin was 22.59 ± 3.04 mm,21.15 ± 2.78 mm and 5.76 ± 0.57 mm respectively.(3) HE staining showed that ALL was dense connective tissue consisting of parallel arranged collagen fibers,while S-100 staining indicated that ALL contained sensory motor nerve fibers.Conclusion ALL is independent of the joint capsule and originates from the femoral lateral condyle.Its body is divided into two branches,located in the tibia and the lateral meniscus respectively.

?AIM: To study correcting effect and visual quality after laser - assisted in situ keratomileusis ( LASIK ) with femtosecond and posterior chamber intraocular lens ( ICL) implantation in high myopia patients.?METHODS: Fifty-five patients ( 106 eyes ) with high myopia from February 2012 to February 2015 in our hospital were analyzed. According to the different operation, patients were divided into the observation group( using ICL implantation, 27 cases with 53 eyes) and the control group (using LASIK, 28 cases with 53 eyes). Postoperative follow-up was 1a, to observe and analyze the visual quality, higher order aberration and complications of two groups.?RESULTS: Uncorrected visual acuity ( UCVA ) , the best corrected visual acuity ( BCVA ) , effectiveness index and security index at 1a postoperatively of observation group, were 1. 04±0. 86(LogMAR), 0. 97±0. 19(LogMAR), 104. 69± 18. 56, 108. 79 ± 17. 68, significantly higher than those of control group 0. 78 ± 0. 11 ( LogMAR ), 1. 04 ± 0. 09 (LogMAR), 93.78±15. 65, 100. 71±11. 68 (P<0. 05). And observation group in the two kinds of light and shade environment at various spatial frequency contrast sensitivity were higher than the control group. Those under the light environment at 1. 5, 3, 6, 12 c/d and under dark environment at 1. 5, 3, 6, 18 c/d compared were different between the two groups (P<0. 05). Spherical aberration and comatic aberration of observation group at 1a after operation were lower than those of control group (P<0. 05 ). The difference of trefoil between the two groups was not significant ( P > 0. 05 ). No severe complications were observed in both groups.?CONCLUSION: LASIK with femtosecond and ICL lens implantation can effectively improve the patient’s visual quality, but for patients with high myopia, ICL lens implantation effect is more significant, the safety index of ICL implantation, as well as the effectiveness index and the visual quality are better than those of LASIK.

Aged ; Bronchoscopy ; Esophageal Neoplasms ; complications ; Female ; Humans ; Male ; Middle Aged ; Stents ; Thyroid Neoplasms ; complications ; Tracheal Stenosis ; etiology ; therapy

Chemotherapy-induced neuropathy is a serious clinical problem for patients receiving cancer treatment. The aim of this study was to investigate the potential efficacy of pregabalin in chemotherapy-induced neuropathy in rats. A total of 35 male Sprague-Dawley rats were randomly divided into 5 groups: group 1, naive control; group 2, treated with pregabalin (30 mg/kg p.o., for 8 days); group 3, docetaxel was given by single intravenous infusion at 10 mg/kg; groups 4 and 5, pregabalin at 10 mg/kg and 30 mg/kg respectively was orally administered for 8 days after the docetaxel treatment. On day 8, behavioral test was performed, and substance P and CGRP release in dorsal root ganglion (DRG) and sciatic nerve were analyzed by electron microscope. Our results showed that docetaxel induced mechanical allodynia, mechanical hyperalgesia, heat hypoalgesia, cold allodynia, and sciatic nerve impairment and substance P and CGRP release in DRG. However, oral administration of pregabalin (10 mg/kg and 30 mg/kg) for 8 consecutive days significantly attenuated docetaxel-induced neuropathy by ameliorating heat hypoalgesia, cold allodynia, impairment of sciatic nerve and reducing the release of substance P and CGRP. The findings in the present study reveal that pregabalin may be a potential treatment agent against chemotherapy-induced neuropathy.