A new method to reconstruct a thumb was worked out in the past few years. It was achieved by inverting the skin flap of the amputated thumb stump and suturing it to an island-shaped skin flap with nerves and vessels from the dorsum of the index finger. A piece of artificial bone was inserted between the two skin flaps into the first phalanx. The operative procedure was described in detail and the indications, advantages and disadvantages of this method were discussed. It is suggested that this method be used to reconstruct a thumb since it is simple and effective.

OBJECTIVE: Measure the space direction of semicircular canals to provide the anatomical basis for the diagnosis and treatment of BPPV. METHOD: We calculated angles among semicircular canals of 24 patients using MRI scaning with 3D-CISS sequence. RESULT: The angle between the left and right posterior semicircular canals was 106.61 degress ± 8.58 degrees, so the angle among the posterior semicircular canals and sagittal head plane was 53.31 degrees ± 4.29 degrees. Pairs of contralateral synergistic canal planes were not parallel, forming 171.67 degrees ± 4.36 degrees between the left and right horizontal semicircular canal planes, 154.37 degrees ± 10.87 degrees between the left posterior and right anterior semicircular canal planes and 156.84 degrees ± 9.34 degrees between the right posterior and left anterior semicircular canal planes. CONCLUSION Our measurement of the angles among semicircular canals coincided with those of previous reports. The angles between contralateral synergistic canal planes were close to parallel, but the angle between the posterior semicircular canals and sagittal head plane was great than 45 degrees that traditionally thought to be.
Humans ; Magnetic Resonance Imaging ; Semicircular Canals ; anatomy & histology

Objective To study the effects of miR-200b on proliferation and migration of sw620 colon cancer cells,and its regulation effect on E-cadherin expression.Methods The expressions of miR-200b in sw620 cells at 24 h and 72 h after pEGP-miR-200b transfection were detected by real-time PCR (RT-PCR).The change of the expression level of E-cadherin after miR-200b transfection was detected using the methods of RT-PCR and Western blot.The proliferation and migration abilities were measured by MTT and scratch test after miR-200b transfection.Results The expressions of miR-200b in sw620 cells at 24 h and 72 h after pEGP-miR-200b transfection raised significantly compared to the control group (t =11.579,P ＜ 0.01 ; t =11.579,P ＜0.01).MiR-200b transfection inhibited the proliferation abilities of sw620 cells.It is the most significant of the inhibitory effect on the third day and the inhibition rate was 55.34％.MiR-200b transfection markedly inhibited the migration abilities of sw620 cells.The two groups had significant difference in the migration distance of 24,48,72 h (t =11.579,P ＜0.01 ; t =10.419,P ＜0.01 ; t =6.955,P ＜0.01).The mRNA and protein expressions of E-cadherin gene increased significantly by transfecting miR-200b gene in sw620 cells (t =10.432,P ＜ 0.01 ; t =8.325,P ＜ 0.O1).Conclusion Up-regulated expression of miR-200b could inhibite the proliferation and migration abilities of sw620 colon cancer cells.The involved molecular mechanism is probably related to the change of E-cadherin expression.

Objective To investigate the effect of propofol on ketamine-induced cognitive dysfunction and neuronal apoptosis in hippocampus in aged rats. Methods Thirty-two male SD rats aged 18-24 months weighing 380-470 g were randomly divided into 4 groups ( n = 8 each) :control group (group C);propofol group (group P);ketamine group (group K) and propofol + ketamine group (group PK). Propofol 30 mg·kg-1·h-1 or/and ketamine 40 mg· kg-1·h-1 were infused for 2 h once a day for 7 consecutive days. After the last day of drug administration cognitive function was assessed using Morris water maze (escape latency and the number of animals' swimming across the platform). The animals were sncrificed after water naze test and their hippocampi were removed for determination of neuronal apoptosis (by TUNEL) and caspase-3 expression (by immuno-histochemistry) in hippocampal CA1 region. Results There was no significant difference in escape latency and the number of the animals,swimming across the platform, the neuronal apoptotic rate (the number of apoptotic neurons/the number of total neurons) and caspase-3 expression between group C and P. In group K and PK the escape latency was prolonged,the number of animals' swimming across the platform was decreased, neuronal apoptotic rate increased and the caspase-3 expression up-regulated as compared with group C. The ketamine-induced changes were significantly attenuated by coadministration of propofol in group PK. Conclusion Coadministration of propofol can ameliorate ketamine-induced cognitive dysfunction and hippocampal neuronal apoptosis.

BACKGROUND: As reported in some literatures, articular dysfunction following limb lengthening is one of the commonest complications, but some scholars believe that the articular dysfunction after lower limb lengthening is avoidable providing appropriate technical operation and effective function prevention.OBJECTIVE: To investigate the changes of articular function of knee during limb lengthening in rabbits so as to provide a experimental basis for clinical tasks.DESIGN: A randomized controlled trial SETTING: Department of Orthopeadics, Affiliated Hospital of Some Military Medical University.PARTICIPANTS: Study was conducted in the Experimental Animal Center of the Third Military Medical University of Chinese PLA from February 2001 to June 2002. Totally 30 healthy adult New Zealand rabbits obtained from the Experimental Animal Center of the Third Military Medical University of Chinese PLA were randomly divided into lengthening group and delayed observation group(observed at 3 months after the stop of lengthening).METHODS: Every group was further divided into three sub-groups according to distraction range: 10%, 20% and 40%. Upper-tibia metaphysis distraction was adopted at the rate of 1 mm per day . Distraction and iconography changes of knee joint were observed with X-ray. The motive range of knee was investigated at the end of distraction and three months later.MAIN OUTCOME MEASURES: Articular motive range of the knee before the distraction, at the end of distraction and three months later, X-ray resutls RESULTS: ① There was no obvious radiographic change in knee at every time point in each group. ② Significant flexion disorder in knee was found in 20% distraction subgroup( P ＜ 0. 05), which was only 44. 7% of normal motive range in 40% distraction subgroup( P ＜ 0. 01) . Motive functions of knee in delayed observation group were significantly improved; thereinto,20% distraction subgroup returned to preoperative level, while 40% distraction subgroup also had significant improvement compared with that of 3 months earlier but still lower than normal level, which was only about 88.5% of normal level( P ＜ 0.05).CONCLUSION: Temporary articular dysfunction might occur during limb lengthening process, and mostly during big range of distraction. Although the dysfunction could be gradually recovered after the stop of lengthening, active prevention is still necessary.

OBJECTIVE:To observe therapeutic efficacy and safety of glutamine combined with low molecular weight heparin in the treatment of elderly severe pneumonia (SP).METHODS:In retrospective study,88 SP elderly patients were divided into control group (44 cases) and observation group (44 cases).Based on conventional treatment,control group was given Enteral nutritional suspension via nasal feeding.Observation group was additionally given Alanyl glutamine injection 20 g,dissolved in Amino acid solution with ratio of 1:5 at least and maximum concentration belowing 3.5％,i.v.,once a day+Low molecular weight heparin calcium injection 4 KU/kg subcutaneously,once a day,on the basis of control group.Both groups were treated for 7 d.Clinical efficacies and postoperative recovery (ventilator support time,pulmonary rale disappearance time and ICU hospitalization time) were observed in 2 groups.The levels of IgA,IgG,TNF-a,hs-CRP,APACHE Ⅱ score,coagulation function indexes (APTT,D-D,FIB,PT,PLT),blood gas analysis indexes [pa (CO2),SpO2,Oi,pa (O2)] and receptor for advanced glycation end products (RAGE),the occurrence of ADR before and after treatment were also observed in 2 groups.RESULTS:Total response rate of observation group (90.91％) was significantly higher than that of control group (72.73％),while ventilator support time,pulmonary rale disappearance time and ICU hospitalization time were significantly shorter than control group;the incidence of ADR was significantly lower than control group,with statistical significance (P＜ 0.05).After treatment,the levels of IgA,IgG,Oi,SpO2 and pa (O2) in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group.The levels of TNF-αt,hs-CRP,APACHE Ⅱ score,coagulation function indexes,pa(CO2) and RAGE in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Based on conventional treatment,glutamine combined with low molecular weight heparin show significantly effect on elderly SP,effectively improve cellular immune function,coagulation function and blood gas analysis indexes and reduce RAGE level with good safety.

Objective To explore the significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) for the death risk evaluation in elderly patients with chronic disease in five years.Methods A total of 765 elderly patients with chronic disease[136 patients with coronary heart disease (CHD),76 patients with hypertension disease (HD),86 patients with chronic obstructive pulmonary disease (COPD),75 patients with Type 2 diabetic mellitus (T2DM),76 patients with cerebral infarction (CI),73 patients with coronary heart disease combined with hypertension,71 patients with coronary heart disease combined with chronic obstructive pulmonary disease,61 patients with coronary heart disease combined with diabetic,51 patients with coronary heart disease combined with cerebral infarction,and 60 patients with three comorbidity] were classified into the survival group (312 cases) and the death group (453 cases) according to disease prognosis.The serum NT-proBNP levels of 88 healthy controls and 765 elderly patients with chronic disease were determined by bi-directional lateral flow immunoassay.The death events were followed up and observed for an average of 5 years.The results were analyzed statistically.Results The serum NT-proBNP levels in the death group with various diseases were significantly higher than the survival group (P ＜0.01),the patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels,the patient's age and the Proportion of male in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05).The serum NT-proBNP levels in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05),and were significantly higher than the survival group (P ＜ 0.01).The patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels in the death group in the different periods had statistical significance (P ＜ 0.01),and were significantly higher than the survival group and healthy control group (P ＜ 0.01).The more shorter of the survival time was,the higher the serum NT-proBNP 1eve was.The serum NT-proBNP levels were negatively correlated with the survival time of the patients (r =-0.378,P =0.000).The receiver operator characteristic (ROC) curve indicated that the optimal cut-off values of serum NT-proBNP levels for the death risk evaluation in elder patients with chronic disease were 1 499.50 ng/L.Kaplan-Meier survival curve showed that the survival rates of serum NT-proBNP levels had significant difference (P ＜0.01).The higher the serum NT-proBNP level was,the more shorter of the Survival rates were.Conclusions The levels of serum NT-proBNP have an important prognostic value in the death risk evaluation in elderly patients with various chronic disease.It is an independent risk factor for the death occurred in eiderly patients with chronic disease.The levels of serum NT-proBNP are closely correlated with the survival rates and survival time of elderly patients,It can be used as a monitoring indicator of the elderly patients with chronic disease in risk stratification.

The hybrid pencil beam model (HPBM) is an effective algorithm for calculating electron dose distribution in radiotherapy. The mean energy distribution of incident electron beam in phantom is one of the factors that affect the calculation accuracy of HPBM, especially in field edge areas near the end of the electron range. A new fitted formula based on Monte Carlo (MC) simulation data for electron beams with energy range of 6-20 MeV in the homogeneous water phantom is proposed in this paper. The precision of the fitted formula within the scope of the energy was evaluated by comparing the electron dose distribution of ECWG measured data with that obtained from HPBM which took the mean electron energy that calculated by the fitted formula and the existed empirical formula, respectively. The results showed that the accuracy of dose distribution that obtained by the mean electron energy calculated with the fitted formula increased about 1%.
Algorithms ; Electrons ; Humans ; Monte Carlo Method ; Phantoms, Imaging ; Radiotherapy Planning, Computer-Assisted ; Water

Objective To assess the value of multi-slice spiral CTA in the diagnosis of iliac vein compression syndrome(IVCS)and secondary thrombosis.Methods The CTA data of 80 controls and 31 patients with IVCS conformed by DSA were retrospectively studied.The inner diameters of the compressed iliac vein in two groups were measured and compression ratios were calculated.The data were compared using t test and Wilcoxon test.The findings of CTA were compared with that of DSA and the accuracy of CTA was analyzed.Results For the control group,the inner diameters of left iliac vein in female group(7.0±2.5)mm were significantly less than that in male group(8.1±2.5)mm(t=2.42,P＜0.05).For the control group,the inner diameters of left iliac vein was(7.6±2.0)mm,and the compression ratios were 0 to 65.41%(median 27.65%).The compression ratios were no statistical differences between male group(0 to 61.36%,median 26.82%)and female group(0 to 65.41%,median 28.75%)(Z=-0.59,P＞0.05).For the patients group,the inner diameters of compression iliac vein was(2.7±1.1)mm.The compression ratios were 55.18% to 100%(median 76.12%).Both inner diameters and compression ratios were statistically different between the control and patients group(t=12.78,P＜0.05;Z=-8.18,P＜0.05).Fifteen of 31 cases with IVCS were accompanied with deep vein thrombosis.The left iliac veins were compress in 28 cases,while right iliac veins were compressed in 2 cases.The left and right iliac common veins were compressed by the left and right jliac common arteries in one case.The results of CTA were consistent with that of DSA in all cases.Conclusions CTA can not only measure the inner diameters of iliae vein compression and calculate compression ratios,but also demonstrate secondary thrombosis clearly.CTA is an effective examination in diagnosis of IVCS and secondary thrombosis.

Objective To investigate whether endoscopic nasobiliary drainage (ENBD) after endoscopic stone extraction could reduce post-operative complications.Methods Retrospective analysis of 697 patients with extrahepatic duct stones undergoing ERCP treatment was pedormed.They were assigned to ENBD group (n =538) and control group (n =159).Post-operative complications including pancreatitis,cholangitis and bleeding were observed and compared.Results There were no significant differences in incidence of pancreatitis and bleeding between 2 groups.Incidence of cholangitis in ENBD group was significantly lower than that in control group (1.3％ vs.3.8％,P ＜ 0.05).Conclusion ENBD after endoscopic stone extraction could reduce the incidence of postoperative cholangitis.