Objective To explore the treatment methods and clinical result with the flap combining peroneus longus muscle supplying with the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect.Methods After anatomic investigating,Analyzing 6 cases.Excising peroneus lon- gus muscle combining with the foot external flap,supplying with the pediele of the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect,among them,the size of flap was about 6.0 cm?5.5 cm～16.5 cm?11.0 cm,the defect length of achilles tendon 2.0～7.5 cm.Results All ca- ses observed 4 to 16 months,all eases skin and achilles tendon were survived completely,the flap skin appear- ence was good,none ulcer.1 cases part necrosis,1 eases rerupture,Both healed after changed dressings.Ac- cording to Arner-Lindholm criteria to test the efficacy the result were excellent in 3 patients,good in 2,poor in 1.Conclusion It is an ideal way using the flap combining peroneus logus muscle with the nutrient vessels of sural nerve repairing the chronic achilles tendon rupture with skin defect.The advantage is operting conven- iently,transferred adjaeently,repairing the skin and tendon defect simultaneously,healing fastly and anti-bac- teria strongly,biomeehanies property and function is similar to the heel,it can fit the heel and skin for repai- ring.

Objective To explore distally-based the interal ankle perforator saphenou neuro-veno-fasciocutaneous flap has been universally adopted for the repairment of the foot and the ankle soft-tissue defects.Methods Lay a foundation of anatomic studying,using the interal ankle perforator saphenous neuro-venofasciocutaneous flap 10 cases, the flap axis point was 1-3 cm above the pink of the interal ankle, average 2 cm. The scope of the flap were 4.0 cm× 3.0 cm-8.0 cm× 6.0 cm. Results All the perforator saphenous neuro-veno-fasciocutaneous flap were lively. About all, 2 cases had the small distant part necrosis, 1 case accompanying with subcutaneous tissue heels after change dressings, another heels after skin grating. All case can walk as usual, the flap had wear-resisting and keenly feel. Conclusion Distally-based the interal ankle perforator saphenous neuro-veno-fasciocutaneous flap, near ankle, donner area exiting fine, utlizing scope large, skin nice, grating easy, no hurting important blood vessle, alive rate high, it is an good donner area in repairing the foot and the ankle soft-tissue defects.

OBJECTIVETo evaluate a new technique for treatment of the symblepharon caused by physical and chemical burn.

METHODSThirty-eight patients with 40 eyes were undergoing the treatment. It was carried out to reconstruct the conjunctival fornix by pulling the remained conjunctive backward from the corneal limbus in serious stages.

RESULTSThirty-eight patients (40 eyes) were treated with this technique, with the successful results of 13 patients (13 eyes) in 2 times, 19 patients (21 eyes) in 3 and 6 patients (6 eyes) in 1. Only one case was failure.

CONCLUSIONThe above mentioned technique could be a safe and effective way for treatment of symblepharen.

Amnion ; Conjunctival Diseases ; etiology ; therapy ; Eye Burns ; complications ; Eyelid Diseases ; etiology ; therapy ; Humans ; Reconstructive Surgical Procedures ; Tissue Adhesions ; etiology ; therapy

OBJECTIVETo study the dynamic changes in plasma D-dimer and its prognostic value in children with severe hand-foot-mouth disease (HFMD).

METHODSA total of 95 children who suffered from HFMD between May 2010 and September 2012, including 65 cases of severe HFMD (observation group) and 30 cases of non-severe HFMD (control group), were enrolled in the study. Plasma D-dimer levels of the observation group on days 1, 2, 3, 4 and 5 were compared with plasma D-dimer levels of the control group on day 1 after admission. In the observation group, plasma D-dimer levels on days 1, 2, 3, 4 and 5 were compared. The prognostic value of plasma D-dimer was analyzed using the receiver operating characteristic (ROC) curve.

RESULTSOf the 65 cases in the observation group, 15 died, and 50 survived. All the 30 cases in the control group survived. Plasma D-dimer levels in the observation group on days 1, 2, 3, 4 and 5 were significantly higher than in the control group on day 1 after admission (P<0.05). In the observation group, there were significant differences between plasma D-dimer levels on days 1, 2, 3, 4 and 5 (P<0.01), and plasma D-dimer level was the highest on day 1 after admission and second highest on the next day. Of the patients in the observation group, those who died had significantly higher plasma D-dimer levels on day 1 after admission than those who survived (P<0.05). In the observation group, plasma D-dimer levels on day 1 after onset had an area under the ROC curve of 0.877 (95% confidence interval: 0.785-0.969) and an optimal cut-off value of 582.10 μg/L (80% sensitivity and 78% specificity) for predicting mortality.

CONCLUSIONSChildren with severe HFMD have significantly increased plasma D-dimer levels, and the severer the condition, the higher the value. Plasma D-dimer levels can be used as one of the important indices for assessing the severity and prognosis of severe HFMD.

Child ; Child, Preschool ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Hand, Foot and Mouth Disease ; blood ; mortality ; Humans ; Infant ; Male ; Prognosis

AIMTo determine the protective effect of ONO-1078, a leukotriene receptor antagonist, on focal cerebral ischemia induced by endothelin-1 in rats.

METHODSSlow microinjection of endothelin-1 (120 pmol in 6 microL, for > 6 min) into the region near the middle cerebral artery was used to induce focal cerebral ischemia. ONO-1078 (0.1 mg.kg-1) was i.p. injected 1 h before endothelin-1 injection. Neurological symptoms, brain edema, brain infarction size, and the survival neurons in cortex and striatum were observed 24 h after ischemia.

RESULTSIntracerebral microinjection of endothelin-1 induced remarkable neurological symptoms, brain infarction, brain edema, and decrease of survival neurons in the cortex and striatum. In rats pretreated with ONO-1078, endothelin-1-induced brain edema and brain infarction size were decreased. The numbers of survival neurons in striatum and cortex were increased significantly. The neurological symptoms were improved but not significantly.

CONCLUSIONONO-1078 possesses neuroprotective effect against cerebral ischemic injury induced by endothelin-1, therefore, leukotrienes may play a role in the injury of cerebral ischemia.

Animals ; Behavior, Animal ; drug effects ; Brain Edema ; pathology ; Brain Ischemia ; chemically induced ; pathology ; Cerebral Cortex ; pathology ; Cerebral Infarction ; pathology ; Chromones ; pharmacology ; Corpus Striatum ; pathology ; Endothelin-1 ; Leukotriene Antagonists ; pharmacology ; Male ; Neurons ; drug effects ; Neuroprotective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the expression of Livin, an apoptosis inhibitor gene, in prostate cancer, and to investigate its clinical and pathological implications.

METHODSThe expressions of Livin were detected in 62 cases of neoplastic prostate tissues and 10 cases of normal prostate tissues by RT-PCR and immunohistochemistry (SP method).

RESULTSThe Livin gene was highly expressed in neoplastic prostate tissues, but not in normal ones. Positive expression of Livin proteins was observed in 37 of the 62 (59.7%) tumor samples and accounted for 28.6%, 60.0% and 83.3% in the high, middle and low differentiation prostatic carcinoma groups respectively, with significant difference between the high and low groups. Livin positivity was also significantly correlated with tumor stages, increasing with tumor progression.

CONCLUSIONLivin may play an essential role in prostate carcinogenesis and serve as a marker for the prognosis of prostate cancer.

Adaptor Proteins, Signal Transducing ; biosynthesis ; genetics ; Aged ; Disease Progression ; Gene Expression Regulation, Neoplastic ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins ; biosynthesis ; genetics ; Male ; Middle Aged ; Neoplasm Proteins ; biosynthesis ; genetics ; Neoplasm Staging ; Prognosis ; Prostatic Neoplasms ; genetics ; metabolism ; pathology ; Reverse Transcriptase Polymerase Chain Reaction

This study was aimed to investigate the immunological effect of modified dendritic cells (DC) which inducing cytotoxic T cells (CTL) against lymphoma cells. The DC were isolated from the lymph node and peripheral blood of patients with diffuse large B cell lymphoma (DLBCL). DC were transfected with recombinant adenovirus vector carrying human p53 gene (rAd-p53-DC). The expression of p53 gene was detected by flow cytometry. Western-blot was used to detect the expression of P53. ELISA was used to detect IL-12 level in supernatant. The mixed lymphocyte reaction (MLR) was used to detect the proliferative ability of auto-lymphocyte stimulated by DC. The lactate dehydrogenase (LDH) release test was used to determine the cytotoxicity of CTL. The results indicates that the expressions of DC surface molecule (except for CD1a) such as CD83, CD80, CD86 and HLA-DR were significantly higher in experiment group than that in control group and blank control group. The secretion of IL-12 in supernatant was higher in experiment group than that in control group. The autologous T lymphocyte proliferation and cytotoxic activity against the same kind of DLBL-cells increased in experiment group as compared with control group and blank control group (P < 0.05). The ability to stimulate T lymphocyte proliferation increased with the rising of the ratio of DC and T lymphocyte. However, there was statistically significant difference between rAd-p53-DC derived from Lymph node and peripheral blood (P < 0.05). It is concluded that rAd-p53-transfected DC can induce CTL response in vitro against lymphoma cells.
Adenoviridae ; Cell Line, Tumor ; Dendritic Cells ; cytology ; immunology ; Genes, p53 ; Genetic Vectors ; Humans ; Lymphocyte Activation ; Lymphocyte Culture Test, Mixed ; Lymphoma, Large B-Cell, Diffuse ; blood ; immunology ; Transfection

OBJECTIVETo explore the health status of workers exposed to Cd at low concentration.

METHODSOne hundred eighteen workers of zinc powder finishing and 34 staffs were served as the exposure group and control group, respectively. The physical examination, blood cadmium, urinary cadmium, blood lead, urinary 32-microglobin, urine creatine, chest film, pulmonary function , pure tone teat and were detected for all subjects.

RESULTSTwelve air samples from 6 monitoring points in workshop were detected, the air Cd concentrations were 0.002-0.015 mg/m³, which were under the national limit of occupational exposure. In exposure group, the rates of exceeding standards of blood Cd and urinary Cd were 65.25% and 38.16%, respectively, the rate of exceeding standards of urinary Cd for two times was 27.12%, the rate of exceeding standard of urine Cd for two times plus the positive urinary 32-microglobin was 2.54 %. In control group, the rates of exceeding national standard of blood Cd was 26.47 %, but the values of urinary Cd were normal. In exposure group, the rate of exceeding standards of urinary Cd increased with the service length. Smoking could enhance the rates of exceeding standards of blood Cd and urinary Cd.

CONCLUSIONIn zinc powder finishing, the low-concentration cadmium exposure could cause the occupational cadmium poisoning, the comprehensive protection measures can reduce the occupational cadmium poisoning. It is suggested that the limits of occupational exposure to cadmium should be declined.

Adult ; Cadmium ; blood ; urine ; Cadmium Poisoning ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Smoking ; epidemiology ; Workplace ; Young Adult ; Zinc ; analysis

OBJECTIVETo evaluate the prognosis of the total proctocolectomy and ileal-pouch anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP).

METHODSSixty-one patients with ulcer colitis or familial adenomatous polyposis were performed total proctocolectomy and ileal pouches-anal anastomosis during 1985 to 2002. There are S type pouch 25 cases, S-J type pouch 13 cases, J type pouch 17 cases and W type pouch 6 cases. The complication and function after the IPAA were also discussed.

RESULTSNo patient died after operation. The total morbidity is 16% (10/61), the morbidity of group UC (6/25) is higher than FAP's (4/34). The W type pouch's morbidity is higher than other three types', the operation with stapled technique is associated with fewer complication than hand-sewn IPAA (2/20 vs 8/41), however, there is also no significant difference between them. The number of stools per 24 hours is 4.2, the percent of the normal continence of daytime and nighttime is 84% (43/51) and 75% (38/51) respectively. There's only about 6% (3/51) patient with fecal incontinence. The most patients are satisfied with IPAA.

CONCLUSIONThe proctocolectomy ileal pouch-anal anastomosis for FAP and UC has few complication with accepted frequency and preserve a good anal function, it is an ideal alternative approach.

Adenomatous Polyposis Coli ; surgery ; Adolescent ; Adult ; Aged ; Colitis, Ulcerative ; surgery ; Colonic Pouches ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Proctocolectomy, Restorative ; Quality of Life ; Treatment Outcome

OBJECTIVETo evaluate the feasibility and safety of a minilaparotomy approach for curative resection of colorectal cancer in comparison with the conventional laparotomy.

METHODSSeventy-eight patients underwent radical resection for rectal cancer with minilaparotomy during April 2001 to December 2002. The minilaparotomy involved complete resection and a skin incision 2 cm above the link line of left anterior superior iliac spine to pubic symphysis and was about 7-10 cm in length. Another 86 patients who served as control group underwent a similar resection with a conventional laparotomy during the same period.

RESULTThe minilaparotomy approach was successful in all 78 patients. The general status of patients, operative types and histopathological features of tumor were similar in the two groups (P>0.05). Operative blood loss in control group was greater (P<0.001), whereas incision length in minilaparotomy group was significantly shorter than that in conventional laparotomy (9.38 cm compared with 17.32 cm). The operative time, analgesia requirement, first passing flatus,first oral fluids and postoperative hospital stay were significantly shorter in the minilaparotomy group (P<0. 001). In an average 25.4-month follow-up, there were no tumor recurrences in the minilaparotomy group.

CONCLUSIONA minilaparotomy approach for curative resection of rectal cancer may be an ideal alternative approach to conventional laparotomy.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Laparotomy ; methods ; Male ; Middle Aged