Objective To investigate the characteristics and the effect of severed hallux replantation.Methods Eighteen completely severed halluces had been replanted since 1991.Injuried foot were kept in extending at 90?-120? position.The sequence of hallux replantation was opposed to the classical order and was so called"the retrograde replantating means(RRM)".The order of RRM was defined as follows: skin of toe abdomen→subcutaneous vein of toe abdomen→inhered toe nerve→inhered toe artery→flexor toe tendon→toe fixation by a single K-needle→extendor toe tendon→artery in the back of toe→subcutaneous vein of toe back→skin of bilateral and back.Results Sixteen of eighteen halluces survived replantation(89.9%).The total flexion degree in replanted halluces was 25?～70?.The appearance of amputated toes restored well.The two-point discrimination was 10～16 mm.Eleven cases walked as entirely usually in gait, and seven cases had basic normal gait.Conclusions Replantation of severed halluces could alleviate wound and remnant greatly.The recovery of foot function and aspect of replanted toes was satisfactory.The RRM gradation showed a distinctive advantage that there was no requiring for injuried foot be moved during operation.

By one trial passive avoidance respense-step-down task and water maze spatial localizat　ion task, the effect of Ginseng and Angelica Sinensis Decotion (GASD)on pathological mod　els of the anmesia rat with hippocampal lesions induced by quiuolinic acid was studied. Re　sults suggest that GASD can improve learning aud memory deficiency in rats with bilateral hippocampal lesions after administration of quinolinic acid. The major mechanism of GASD may be related to the regulation of the glutamatergic fuuction and prevention of the neuro　toxicity of quinolinic acid

TNF related apoptosis inducing ligand (TRAIL) is a new identified member of TNF family, which selectively kills a broad spectrum of tumor cells, but nontoxic to most normal cells. TRAIL triggers tumor cell apoptosis via death receptor DR4 and DR5 anchored in the cell surface, which is mediated through intracellular induced apoptosis proteins. The major pathway of its action proceeds through the formation of DSIC and activation of caspase8. The apoptotic processes follow two signal pathways, namely the mitochondrial independent activation of caspase3, and mitochondrial dependent apoptosis through the cleavage of BID by caspase8, the release of cytochrome C, the formation of apoptosome, and activation of caspase9 and the downstream apoptosis. In previous researches, it is shown that nontagged TRAIL proved to be noncytotoxic to hepatocytes in monkeys and chimpanzees and to human normal hepatocytes. Thus, the nontagged TRAIL has attracted great attention in recent years as a promising anti cancer reagent.

Objective To construct the prokaryotic expression system of reteplase fusion protein and research the effect of chaperones on its renaturation. Methods Inserted the reteplase gene into the prokaryotie expression vector PET32a and then expressed it by the induction of IPTG in E. coli BL21. Researched the effect of chaperones on the renaturation of fusion protein by adding different chaperones. Results The analysis of SDS-PAGE and Western blot indicated that reteplase fusion protein was expressed correctly. Chaperones DsbA,pKJE7,pTf16 had the conspicu-ous effect on the renaturation of fusion protein. The result of activity assay indicated that the refolded reteplase fu-sion protein had fibrinolytic activity. Conclusion Chaperones can promote renaturation of reteplase fusion protein.

Interferon-alpha is one of the most important drugs against hepatitis virus,and it can inhibit the replication of virus by inducing the expression of 2'-5'-OAS,PKR,MxA through Jak-STAT pathway in hepatocytes.The effects are also concerned with other signal pathways,such as MAPK,IRS-1/PI3K-p70S6 kinase pathways and so on.In order to prolong the half life of interferon-alpha and enhance its effectiveness,many other long-lasting interferons are developed,such as pegylated interferon,recombinant human serum albumin-interferon,and liposome interferon,which maybe take the place of interferon-alpha.The research and development of more long-acting and efficient interferons are becoming a more and more important way to the anti-virus treatment of hepatitis.

Objective To approch the characteristic of diagnosis and treatment of optic nerve injury in double wall optic canal.Methods Six patients,with double wall optic canal found by CT,were treated by drug,operation and visual rehabilitation training.The results of CT,vision-evoked potential and visual recovery were analysed.Results In 6 patients,4 were holo-double wall optic canal and 2 were mero-double wall optic canal,4 were found having bone fracture.All the 6 cases were effective to treatment including 3 patients whose vision was over 0.1.Conclusion In double wall optic canal,the degree of optic nerve injury is slight,visual recovery is better by drug,operation and visual rehabilitation training.

Objective To explore the methods of Y-V vascular pedicle lengthening technique for cover-age of the defect of great toe after wrap-around flap transfer, and decrease the morbidity of donor site in great toes. Methods Fifteen patients received three kinds of flap for immediate resurfacing of donor defect of the great toes during wrap-around flap transfer, all flaps were harvested with Y-V vascular pedicle lengthening technique. Among them, 9 cases received the free lateral tarsal flaps transplantation for coverage of defect in donor great toes, 5 cases was repaired by medial tarsal flaps, and only one was treated by the medial plantar flap. Results All the flaps survived postoperatively. The medial plantar flap encountered the venous crisis in postoperative 3 days, and regained the normal blood supply after continuous bleeding for 2 days. All patients were satisfied with cosmetic and functional outcome in average 10- month follow-up. The appearance and sensory function of donor toe repaired by medial tarsal flaps was best among three ones. Conclusion Depending on the Y-V vascular pedicle lengthening technique, the local pedical flaps of foots are enlarged scope for coverage of great toe after wrap-around flap harvest, which can decrease the complication of donor site at the most.

Objective To compare and evaluate the methods of building model of cervical spondylosis of vertebral artery type (CSA)rats by measuring the learning and memory ability,anxiety and depression,and degree of nervous tension of three kinds of CSA model rats.Methods We randomly divided 120 rats into mixed modeling group,bone graft compression modeling group,mechanical balance disorder modeling group,and blank control group with 30 rats in each.Morris water maze,elevated plus maze test and open field test were used to detect and compare the rats’abilities of learning and memory,anxiety and depression,and degree of nervous tension.We then evaluated the three CSA rat models.Results Compared with those in the blank group,the learning and memory abilities in the mixed modeling, bone graft compression and mechanical balance disorder modeling rats were significantly decreased,the anxiety and depression and degree of nervous tension were significantly increased (P<0.05).Compared with bone graft compression and mechanical balance disorder modeling groups,the mixed modeling group could restore the characteristics of CSA.Conclusion The three kinds of modeling methods can successfully reproduce the CSA animal model;the mixed modeling is superior and thus worthy of promotion.

Object To isolate the active compounds on reversing multidrug resistance (MDR) of tumor cell from the ethanol extract in the seeds of Cnidium monnieri (L ) Cuss Methods The fractionation directed by bioactivity was carried out with silica gel chromatography and RP HPLC Results Three active coumarins were obtained: imperatorin (Ⅰ), edultin (Ⅱ) and 3′ isobutyryloxy O acetyl columbionetin (Ⅲ) Their sturctures were identified by spectroscopic analysis Conclusion These three compounds have a medium reversing MDR of KBV200 in vitro

Objective: To investigate the urban and rural differences in adverse outcomes of pulmonary tuberculosis (PTB) in patients with pulmonary tuberculosis-diabetes mellitus comorbidity (PTB-DM), so as to provide insights into improving the prevention and treatment measures for PTB-DM. Methods: Patients with PTB-DM who were admitted and discharged from 14 designated tuberculosis hospitals in Hangzhou City from 2018 to 2022 were selected. Basic information, and history of diagnosis and treatment were collected through hospital information systems. The adverse outcomes of PTB were defined as endpoints, and the proportions of adverse outcomes of PTB in urban and rural patients with PTB-DM were analyzed. Factors affecting the adverse outcomes of PTB were identified using a multivariable Cox proportional hazards regression model. Results: A total of 823 patients with PTB-DM were enrolled, including 354 (43.01%) urban and 469 (56.99%) rural patients. There were 112 (13.61%) patients with adverse outcomes of PTB. The proportions of adverse outcomes of PTB in urban and rural patients were 14.41% and 13.01%, respectively, with no statistically significant difference (P>0.05). Multivariable Cox proportional hazards regression analysis identified first diagnosed in county-level hospitals or above (HR=2.107, 95%CI: 1.181-3.758) and drug resistance (HR=3.303, 95%CI: 1.653-6.600) as the risk factors for adverse outcomes of PTB in urban patients with PTB-DM, while the treatment/observed management throughout the process (HR=0.470, 95%CI: 0.274-0.803) and fixed-dose combinations throughout the process (HR=0.331, 95%CI: 0.151-0.729) as the protective factors for adverse outcomes in rural patients with PTB-DM. Conclusions There are differences in influencing factors for adverse outcomes of PTB in urban and rural patients with PTB-DM. The adverse outcomes of PTB are associated with first diagnosed hospitals and drug resistance in urban patients, and are associated with the treatment/observed management and fixed-dose combinations throughout the process in rural patients.