Objective To investigate the clinical application and effect of repair infectious bone defect in femur with free vascularized fibular graft.Methods From April,2008 to April,2013,9 patients that had infectious bone defect in femur underwent repaired with free vascularized fibular graft.The bacterier cultivation of sinus tract excretion in preoperation and focal zone in operation had proved the infection.The length of bone defect were7.5 cm on average.The bone defect was repaired with free vascularized fibular graft on one stage in 6 cases and two stages in 3 cases after the cure of infection.Six patients underwent folded and 3 patients underwent single vascularised fibula graft transfer.The skin island flaps were used as a postoperative predictor of vascularized fibula graft viability in 6 cases.The transfer fibulars were fixed with plate in 6 cases,external fixor in 3 cases.Time to union was recorded through evaluation of plain radiographs.The Enneking score system was applied to evaluate the lower extremity function.Results The vascularized fibular survived and bony fusion was achieved in all patients.All cases were followed up 24.5 months(12-39 months).The average length of the transfer fibula was 14.5 ± 3.2 cm.The average time for bone union at allograft-host junction was 5.5 ± 1.2 months.Of the 9 cases,the mean scores was 24 (their scores ranged from 20 to 27) at final follow-up.The functions of supplied regions were not found malfunctional,no recurrence of infection occurred.There were no stress fracture in inlay fibula.Conclusion Free vascularized fibular graft will benefit to control the infection in femur,have high bone union rate,and is an optimal choice.

Child ; Humans ; Inflammatory Bowel Diseases ; etiology ; pathology

Objective To investigate the value of transcatheter thrombolysis treatment of acute A V internal fistula thrombogenesis in hemodialysis patients. Methods The acute A V fistula thrombogenesis in 32 hemodialysis patients with chronic renal failure were treated with transcatheter pulse spray pharmacomechnical thrombolysis (PSPMT). Results Acute A V fistula thrombogenesis was verified in all 32 patients by angiography and treated with transcatheter PSPMT. The immediate clinical success rate of thrombolysis was achieved in 97% except for one case. The A V fistulas were proved to reopen by post treatment angiography. Recurrent thrombosis was found in 4 cases, reopenning with transcatheter PSPMT was achieved in 2 of them and the rest 2 cases were undergone PTA because of localized vascular stenosis. All the 32 A V fistulae, were reopened after treatment without serious complications such as hemorrhage, pulmonary embolism and others.Conclusions Transcatheter PSPMT is a safe, effective and microinvasive treatment for acute A V fistula thrombolysis with higher immediate reopenning rate. Transcatheter PSPMT combined with PTA and intravascular stent grafting can improve long term patency rate.

Objective To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse.Methods Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations excerted enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image findings were concordant. The herniated nucleus pulposus were resected using rotaing pliers system, MacNab standard was applied for the clinical evaluation. Results The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8 30 HU, 18?5HU in average but no changes in NR patients.Conclusions Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application.

Notch signal pathway can regulate the morphogenesis,apoptosis and cellular proliferation of normal tissues and organs,which plays an important role in regulating hematopoietic cells proliferation and differentiation in bone marrow microenvironment.The occurrence and development of multiple myeloma(MM)are closely related to the bone marrow microenvironment in which many signal pathways are involved.Recent studies show that Notch signal pathway promotes the development and progression of many cancers including MM,which plays key roles in tumor invasion and drug resistance.This review focus on the recent findings on Notch signal pathway in MM,and reveals that Notch signal pathway will be identified as a potential new therapeutic target in MM.

Objective To study the methods of the Chinese New Year (CNY) Factor's Adjustment based on the ARIMA models. Methods First, a common regressor for CNY was created. Then, the re-gressor was included in the seasonal ARIMA regressive model(regARIMA or TRAMO) ,AIC or BIC was used for model selection,and the generalized least squares method or maximum likelihood method was used for the earl-mation of model parameter. The estimated regressive coefficient was used for analyzing the degree of the CNY factor. A case was analyzed with the adjustment methods. Results The analysis on the case showed that the methods of the CNY factor's adjustment could remove the effects of the CNY factor on the time series, and the degree of the effects could be esti-mated in quantity. Conclusion The regressor for CNY is applicable,and the methods of the CNY factor's adjustment based on the ARIMA models can be used in seasonal adjustment on the time series. It's a new approach to analyze the effects of the CNY factor.

Recently numerous studies have demonstrated that Notch signaling pathway plays a critical role in regulating cell proliferation and differentiation in hematopoietic microenvironment,which is associated with MM occurrence and the drug resistance.The latest researches show that there are close relations between hypoxia and Notch signaling pathway in tumor occurrence and progression.Exploring the interactions of microenvironment of hypoxia,HIF-1α and Notch signaling pathway will provide theoretical basis for MM targeted therapy.

Objective To study the effects of severely burned rats serum on migration of BMSCs and mechanism.Methods Severely burned rats model was established,and the preparation of severely burned rats serum.Experimental groups:normal train-ing group(containing 10% fetal bovine serum,group C),burn serum group(containing 10% burns in the rat serum,group B),burn serum+blockers(10% burns in the rat serum+final concentration of 10 μmol/L PI3K signaling pathway inhibitor LY294002 train-ing,group B+LY).Activity of cells was examined with MTT;migration of cells was examined with Transwell chambers testing;protein expression of p-AKT/AKT was determined with Western blot;microtubule structure of cells was examined with immuno-fluorescence.Results Compared with group C,group B burn serum treatment after 24 h,BMSCs activity(P <0.01),p-AKT levels (P <0.05),increased migration quantity(P <0.001);cell microtubule structures appear rupture,after adding inhibitor,compared with group B,group B+LY BMSCs activity(P <0.01),to reduce the number of migration(P <0.001),p-lower AKT(P <0.05), cell microtubule structure similar to the normal group.Conclusion Severely burned rats serum can promote BMSCs migration,may burn serum cytokine activation of PI3K/AKT signal pathway,resulting in cell microtubule structure change,promote the migration of BMSCs.

Transcatheter renal sympathetic denervation with radiofrequency ablation has become a new treatment for refractory hypertension.Recent studies have showed that renal sympathetic denervation can also treat the diseases that are related to increased sympathetic nerve activity, such as metabolic diseases, cardiac disfunction, arrhythmia, obstructive sleep apnea syndrome, polycystic ovary syndrome, renal failure, etc. This paper aims to make a general review on the recent clinical research progress about renal sympathetic denervation with radiofrequency ablation.

To evaluate the effects of tetramethylpyraze (TPZ) on the collapsed lung during one lung ventilation (OLV), 2.4 adult patients with esophageal cancer,ASA grade Ⅰ-Ⅱ,undergoing esopha-goesophagostomy, were randomly allocated to receiving intravenous infusion with TPZ 4mg?kg~(-1) (group T,n=12) or equivalent volume of normal saline (group C,n=12) in 5 mins before onset of OLV respectively. The ultrastracture of collapsed lungat 90th min following OLV showed that in group C mitochondia swelled, the cristae disappeared, and large vecule appeared, but in group T those remained normal. As compared with those in group C,the Ca~(2+) content in erythrocyte decreased significantly 30 and 60 mins following OLV (P