From March 2002 to February 2006, 12 patients with soft tissue defects of lower third of leg, ankle and dorsum of foot, who were repaired with reversed island flap pedicled with nutrient vessels of sural nerve, were enrolled at Department of Plastic and Burn Surgery, Affiliated Hospital of Luzhou Medical College. Of the 12 patients, 6 cases were achilles tendon exposure caused by soft tissue necrosis after trauma, 6 cases chronic ulcer in leg ,ankle and dorsum of foot, respectively. All patients knew and agreed to participate in the experiment. The areas of soft tissue defect from 6 cm?7.5 cm-10 cm?12 cm. The maximal area of flap was 12 cm?14 cm. After debridement, the flap which designed based on the size and shape of defect, the line from fibular head to the middle point of lateral malleolus and achilles as axes was transfered to repair the defect, taking 6 cm on lateral malleolus as swivel. Eleven flaps survived postoperatively, and raw surface was primary healing. Margin necrosis was occurred in 1 patient, and healed after changing drugs. Follow-up was performed from 6-18 months in all cases. The texture and color of skin flap is similar to that normal skin, and the function and shape of recipient and donor site were satisfied. No secondary ulcer or functional disturbance, wear-resisting were found. The patients could walk and load normally. The reversed island flap pedicled with nutrient vessels of sural nerve is ideal donor site for soft tissue defect repairing of lower third of leg, heel, dorsum of foot and ankle.

OBJECTIVE: To analyze HSP70/HSP27 protein expression in the nasopharyngeal carcinoma (NPC) primary tissues and the residual lesion, and to explore its predictive value. METHODS: Immunohistochemical experiment was performed to detect the expression of HSP70 and HSP27 in 58 NPC primary tissues: 28 were in the experimental group with the local residual lesion and 30 in the control group without recurring and metastasis within 5 years by conventional radiotherapy. RESULTS: The positive expression of HSP70 and HSP27 in the experimental group was 92.9%(26/28) and 53.6%(15/28), while that in the control group was 53.3%(16/30) and 53.3%(16/30),respectively. There was significant difference in the 2 groups. The common positive expression of HSP70 and HSP27 between the 2 groups had significant difference, 50.0% (14/28) in the experimental group and 16.7% (5/30) in the control group, respectively. There was no significant difference in the negative ratio of HSP70 and HSP27 common expression between the 2 groups, 3.6% (1/28) in the experimental group and 10.0% (3/30) in the control group, respectively. CONCLUSION HSP70 may have an important role in the radioresistance of NPC, and may predict the residual lesion after radiotherapy.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; radiotherapy ; Female ; HSP27 Heat-Shock Proteins ; metabolism ; HSP70 Heat-Shock Proteins ; metabolism ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; metabolism ; radiotherapy ; Young Adult