Objective To retrospect and analysis the long-term follow-up results of different kinds of flaps in repairment of the defects in legs and feet' Methods Seven different kinds of flaps or musculocutaneous flaps were used to repair for 66 cases of the soft tissue defect in legs and feet;of the areas from 30 cm ? 15 cm to 6 cm? 4 cm, 28 flaps were transplanted with vessel anastomosis;36 flaps were pedicle and 2 flaps were crossed legs. Results Two flaps with vessel anastomosis were necrosis,three were necrosis partly' Others were healed by first intention. 5 cases of the flaps in foot weight carrying areas were ulceration at different times after operation, 1 case was intraltable ulcer. conclusion The chronic ulceration and infection cause the leg and foot vessel injury,local tissue adhesion and dissection difficultly. all these causes result in blood vessel crisis after operation. It's better to use pedical flap to repair this kind injury. The result is good to use medial flap of foot to rapair the soft tissue defect of heavy load region of foot. If using flap of anastomotic vessel to trasplant, it's much better to use flap containing sensative nerve to repair the defect so that it can satisfy the demand of foot heavy load

Objective To investigate the protective effect of extracellular ATP on motoneurons of spinal anterior horn from spinal root avulsion induced cell injurey. Methods Thirty-six Wister rats were randomized into 2 groups: single root avulsion and root avulsion with ATP. The left C5-C8 nerve roots were avulsed, the experiment group was gioven extracellular ATP (2 mg/kg) 0.4 ml by intraperitoneal injection and control group physiological saline water was gioven 0.4ml as the same method, all one time daily, contin-ue injection ATP or saline water 2 weeks. At 2,4 and 6 week postoperatively, C5-C8 spinal cord was har-vested after the rats were executed. The change of nitric oxide synthase (NOS) and neurofilament protein (NF-200) were observed after histochemistrical examination. Results At 2、4 and 6 week postoperatively, the survival of motorneurons in the spinal anterior was 80.48%, 73.55% and 53.43% in experiment group, was 68.90%、63.58% and 37.72% in control group;compare experiment group with control group, the le-don-induced motomeurons death in the spinal anterior bern was decreased by 11.58%、9.78% and 15.71% respectively (P < 0.01) ; the activity changes of NOS expression rate was 17.85% ,40.20% and 18.03% in experiment group, was 25.53%,53.88% and 25.58% in control group, compare experiment group with con-trol group, the activity changes of NOS expression rate was decreased by 7.68% (P < 0.01), 13.68% and 7.55% (P < 0.05) respectively. The motoneurons expressed NF-200 in the experiment group was larger than the control group, there was significant difference was found between the control group and the experiment group. Conclusion ATP might play certain protective role in survival of motoneurous after spinal root avulsion.

Objective To retrospect the results and probe into the clinical applied vallue of the pedicled bone flap with deep iliac circumflex artery to the treatment of the femoral neck fracture and femoral neck fracture Methods Eight cases of femoral neck fracture and 21 cases nonunion treated by bone and periost flaps with deep iliac circumflex vessel35 casses treated by closure reduction and fixed with 3 trianglar nails,34 cases by arthroplastyThe results of 3 kinds of methods were contrasted and anslysed Results Twenty-nine cases treated by iliac bone and periost flaps with deep iliac circumflex artery were fellowed from 3 to 7 years,the fracture healed 35 months averagely. One case was avascular necrosis of femoral head after 9 month after operation,others received good results35 cases were treated by 3 nails fixtion healed 74 months averagely and 6 case had complications 37 casese treated by arthroplasty had complications in 8 patients,4 cases need walking-stich for walk. Conclusion Femoral neck fracture were treated by transplantation of the pedicled bone and periost flaps with deep iliac circumflex vessel is keeping with the pathological and anatomical characteristicsThe function of the hip joint is not weaken as the time goes on when the fracture is healedIt is the best methods to treat the femoral neck fracture now,the arthroplasty has many complication,so the indication must be confined

Objective To demonstrate the presentation of the extracellula ATP receptors in peripheral nerve in rats Methods Reverse transcriptase polymerase chain reaction was performed in sciatic nerve of rat Results There were three P2y receptor mRNA expressions in the in the sciatic nerve of the rat,they were P2y2 and P2y4 as well as P2y6 Conclusions Extracellular ATP,as a neurotransmitter,activates the P2y purinoceptors located on the axon regeneration after peripheral nerve injury and decided the direction of the regeneration axon The P2y receptors are related to the regeneration of the peripheral nerve

Objective To evaluate the role of neuropeptide Y2 receptor (NPY2R) in neuropathic pain (NP) in rats.Methods Thirty-six adult male Sprague-Dawley rats,aged 8 weeks,weighing 190-210 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),group NP and NPY2R antisense ohgonucleotide group (group ODN).NP was induced by chronic constrictive injury (CCI).5 μg/μl NPY2R antisense oligonucleotide 30 μl was injected intrathecally 7 days after CCI in group ODN.While normal saline 30 μl was injected intrathecally in group S.The mechanical paw withdrawal threshold and cold allodynia were measured 3 days before CCI (T0,baseline),7 days after CCI (T1) and at 15 min,1.5,3.0,4.5 and 6.0 h after intrathecal injection (T2-6).The animals were then sacrificed after the last measurement and the lumbar segment of spinal cord was removed for determination of the expression of NPY2R and calcitonin gene-related peptide (CGRP) and co-expression of NPY2R with CGRP in spinal dorsal horn neurons (by immuno fluoresceence).Results Compared with group S,the mechanical paw withdrawal threshold was significantly decreased and cold allodynia was increased at T1-6,and the expression of NPY2R and CGRP and co-expression of NPY2R with CGRP in spinal dorsal horn neurons was up-regulated in NP and ODN groups (P ＜ 0.05).Compared with group NP,the mechanical paw with-drawal threshold was significantly increased at T3-5,and the expression of NPY2R and co-expression of NPY2R with CGRP in spinal dorsal horn neurons was down-regulated (P ＜ 0.05),and no significant change was found in cold allodynia and the expression of CGRP in spinal dorsal horn neurons in ODN group (P ＞ 0.05).Conclusion NPY2R in the spinal cord dorsal horn is involved in the maintenance of mechanical hyperalgesia,but not in the maintenance of clod hyperalgesia in rats.

Objective To prove the extracellular ATP attracts the axonal regeneration after peripheral nerve injury via the ATP receptor Methods The sciatic nerve defects had been made in 10 female Sprague Danley rats and repaired by"Y" form silicon tube The single arm of the"Y" form tube were sutured with the proxma the sciatic nerve and the other two end of silicon tube sutured by paralled or cross method so as to differentiate the experimental side and control side, 1mmol/L 10 ?l ATP and 1mmol/L 10 ?m ATP+ 0 2mg/ml Suramin were injected differently into two arms of left side and 10 ?l physiological saling and 10 ?l 0 2mg/ml Suramin injected differently into two arms of right dide The silicon tube were removed after eight weeks and examine the form and number of myelinated tibers as well as the quanlity of the myelinated sheath Results In the left sides regeneration axon were tuned into the silicon tubes containing the ATP and there were not axon regeneration in the silicon tube contained the ATP and there were not axon regeneration in the silicon tube contained ATP+ Suramin In the right sides the regeneration axon were found only three tubes contained suramin and seven tubes contained physiological saline Conclusions The results demonstrated that the suramin inhibited the axon reduction of the extracellular ATP completely

Objective To study the expression of cyclooxypenase-2(COX-2),prognosis of patients and the correlation between COX-2 and CD_(105)in osteosarcoma.Methods The expression of COX-2 and CD_(105)in human osteosarcoma was detected with immunohistochemistry.Then to count the microvessl density (MVD)were marked with CD_(105),The prognosis of the patients with osteosarcoma was analyzed by Cox multi- variate survival analysis.Results The positive rate of COX-2 expression was 77.5 %,The expression of COX-2 was positively correlated with surgical grade and metastasis of osteosarcoma;There were significant difference between surgical grade Ⅰ and Ⅱ b、grade Ⅰ and Ⅲ(P0.05);Metastatic cases had higher MVD than those without metastasis(P

Objective To discuss the selection and clinical efficacy of operative methods for subaxial cervical dislocation without spinal cord injury. Methods A retrospective study was performed on 11 patients with subaxial cervical dislocation without spinal cord injury treated from January 2004 to June 2009. According to Allen' s classification, all patients suffered from retracted flexion injuries, including seven patients with Ⅰ degree dislocation, one with Ⅱ degree dislocation and three with Ⅲ degree dislocation. There were eighth patients with old dislocation and three with fresh dislocation, both of which were simple cervical trauma without other organ injuries. Open reduction, internal fixation and iliac bone graft spinal fusion were performed in seven patients and combined posterior and anterior open reduction,internal fixation and iliac bone graft spinal fusion in four. All the patients were followed up for observation of clinical effect. Results All operations were completed successfully. There were 11 patients at Frankel grade E preoperatively and 11 at grade E postoperatively. X-ray photographs showed that the sequence and curvature of the cervical spine recovered to normal after operation. All patients were followed up for 3-31 months postoperatively, which showed no redislocation or symptoms of spinal cord injury.Conclusion For lower cervical dislocation combined with locked facet, one-stage combined anterior and posterior reduction and internal fixation should be performed. While for those without locked facet, simple anterior reduction and bone graft spinal fusion is needed. Open reduction, internal fixation and bone graft spinal fusion are effective method for treatment of subaxial cervical dislocation without spinal cord injury.

AIM: Tissue engineered periosteum fabricated by porcine small intestinal submucosa (SIS) combined with rabbit bone marrow-derived mesenchymal stem cells (BMSCs), are similar to the natural periosteum in the morphology, structure and function. The study was designed to explore the cell attachment in process of constructing tissue-engineered periosteum by different wetting methods to determine the most effective method of fabricating tissue-engineered periosteum. METHODS: The experiment was carried out in the Institute of Orthopedics, the Second Affiliated Hospital of Lanzhou University from September 2005 to March 2007.①Two New Zealand purebred rabbits, 20 days old, were used in this study.②Bone marrow was obtained from healthy rabbits, and BMSCs were isolated by using density gradient centrifugation for culture in vitro. After induction, BMSCs were seeded to SIS wetted with fetal bovine serum (experimental group) and pretreated with phosphate buffered saline (control group), to construct the tissue-engineered periosteum that was cultured for two weeks in vitro. ③The adhesion rates were calculated, and alkaline phosphatase (ALP) activity was detected after seeding. The growth, dissociation and proliferation of the cells were observed by inverted microscope and scanning electron microscope. RESULTS: ①At 5 hours and 12 hours after seeding, the adhesion rates were higher in the experimental group than in the control group [(57.34?2.23)%, (39.16?5.22)%, P

Wnt/β-catenin signaling pathway participates in cancer cell proliferation,invasion and metastasis and effectively induces drug resistance.It is also the key signal to mediate cancer carcinogenesis.Recent studies in vitro indicate that disturbance of Wnt/β-catenin signaling pathway can increase the sensitivity of the cancer cells to chemotherapeutic drugs.In-depth researches and analysis of tumor drug resistance induced by Wnt/β-catenin will provide potential targets and possible therapeutic means for the treatment of tumors.