Objective To provide the biomechanical basis of plantaris tendon for clinical autotransplantation. Methods Fifteen plantaris tendons from 8 fresh adult cadavers were cut into 56 segments with about 6 cm lengths in each. The segments were divided into 3 groups: upper,middle,and lower segments. Fifty segments were taken for the tensile test,while the other six segments were loaded under 30 MPa,40 MPa,and 50 MPa respectively. The histologic structure of the tendons was observed under the microscope after presumptive load. Results The average limit load,tensile strength and elastic modulus of the plantaris tendon were (83.19?42.52) N,(60.32?21.80) MPa,and (714.83?285.44) MPa respectively. The tensile strength of the lower segments was significant higher than the upper and middle segments. Conclusion The biomechanical property of the plantaris tendon is accommodative for autografting.

Objective [WT5”BZ]To evaluate the interventional therapy for Budd Chiari syndrome in which inferior vena cava was segmentally stenotic or occlusive combined with obstruction of hepatic vein and thrombosis.[WT5”HZ] Methods [WT5”BZ] 13 cases with regional stricture or occlusion in inferior vena cava (8 cases with hepatic vein occlusion and 5 cases with thrombosis of inferior vena cava) were reviewed and the length of lesions ranged from 2?cm to 5?cm. For patients with IVC occlusion, atrial septum puncture was used, followed by 1 0～2 0?cm balloon dilation and implantation of metal stent. For patients with hepatic vein occlusion, RUPS 100 liver puncture apparatus was applied and followed by 0 5～1 0?cm balloon dilation. Postoperative anticoagulant therapy was used for 3 months.[WT5”HZ] Results [WT5”BZ]Procedures were successful in all cases. Shrinkage of the spleen and absorption of ascites were observed after operation. There were no relapse of symptoms, nor digestive tract bleeding during 3～26 months of follow up. [WT5”HZ]Conclusions [WT5”BZ] Thrombolytic therapy was very important before the repatency of the IVC for patients with thrombosis formation. The embedded in stent must be away from the orifice of accessory liver vein. Angioplasty of hepatic vein is essential for the interventional treatment of Budd Chiari syndrome. [WT5”HZ]

Objective To measure intrapulmonary tumor motion due to breathing and analyze the impact factors and characteristics of the respiratory movement of large lung tumors.Methods CT sean was conducted in 30 patients with pulmonary cancer,in the calm inspiratory breath-holding and calm breath after breath-holding state.The tumor GTV in the two phases was recorded.The motion range in the left-right and antero-postefior directions in the GTV center level during the respiratory cyele was measured.The motion range of uppermost and lowermost layer of the tumor from top to bottom was also recorded.The clinical variables and anatomical factors assoeiated with the degree of motion were analyzed.Results The position of large lung tumor was relatively fixed,and the motion range was 3-5 mm,but 2 patients movement was found more than 5 mm.The two tumors were located in the lower part and the rear of the chest with low adhesion coefficient and smaller vertical direction of movement.95 ％ of motion range of the intrapulmonary tumors were under 3.8 mm in the vertical direction,under 5.8 mm in the front-rear direction,and under 1.1 mm in the left-right direction.Conclusion The movement of lung tumors caused by respiratory are influenced by tumor location,volume,and other factors such as the degree of adhesion,but the motion ranges are lower.The motion of lower rear tumors mainly occur in the vertical direction with the maximum range.

ObjectiveTo construct expressing vector of microRNA with molecular cloning methods which target CD4 and electroporating the vector to the MT4 cell to determine its effect to CD4 expression.MethodsPredict a microRNA can target CD4.Linking the pre-mir-181a PCR products to T vector,then cloning into the pEGFP-N1 vector after enzyme digestion.To test the integrity through the colony PCR and sequencing analysis.Electroporating the vector to MT4 cell,using FACS to test the CD4 expression.ResultsHsa-mir-181a is able to target CD4.The sequence of the construct was correct.The hsa-mir-181a is stable expressing in MT4 after electroporating with the vector and MT4 cell CD4 was down-regulated.ConclusionThe construct can be stable expressing hsa-mir-181a in MT4 cell and down-regulating the CD4 expressing.This method can be utilized as a novel intervention to the HIV fusion,it shows potential as a gene therapy tool in vitro.

Objective To investigate the long-term results of gastrocnemius fascial turn-down flaps and suture anchors in reconstruction of chronic Achilles tendon rupture.Methods From September 2007 to February 2010,20 patients with chronic Achilles tendon rupture were reconstructed with gastrocnemius fascial turn-down flaps plus suture anchors.There were 13 males and 7 females at mean age of 36 years (range,23-50 years).Unilateral tendon rupture was observed in 19 patients and bilateral in 1 patient.Tendon defect gap was 5-9 cm (mean 6.7 cm).Braces were used to immobilize the lower limber,and early exercise was encouraged.The outcomes were assessed using Arner-Lindhohm scoring system and Leppilahti scoring system.Results Postoperative recovery was uneventful.No patients experienced cut infection or other complications.After a mean 38-month follow-up (range,30-42 months),all patients could stand on the injured toes.Muscular strength of the affected lower limber was restored to 89％ of the unaffected side.According to the Arner-Lindhohm score,10 patients were rated as excellent and ten good.Mean Leppilahti score was 85 points (range,60-100 points),with excellent results in nine patients,good results in 10 and fair result in one.Conclusion For patients with chronic Achilles tendon rupture,the reconstructing using gastrocnemius fascial turn-down flaps combined with suture anchors can attain rigid fixation,early functional exercise,effective prevention of tendon adhesion,and good function recovery.

Neural prosthesis control system is based on brain-computer interface and functional electrical stimulation technology, by an-alyzing the electroencephalograph control commands directly into the muscle system or an external device, which compensated efferent pathway from the brain-spinal cord, and recovered motor function of patients with cervical spinal cord injury. This paper described the basic structure, working principle and key technology of neural prosthetic system, summarized the application, problems and prospects of neural prosthetic technology in the rehabilitation of cervical spinal cord injury.

Background:Conventional gastrointestinal endoscopy is incapable of determining the deriving layers,size and nature of submucosal lesions,however,mini probe ultrasonography(MPS)is effective for mural stratification and determining the deriving layers and nature of lesions within gastrointestinal wall,and is considered to be an optimal examination for suspected submucosal tumors before endoscopic or surgical operation. Aims:To assess the diagnostic value of MPS for gastrointestinal submucosal lesions and the significance of MPS-assisted endoscopic therapy. Methods:A total of 69 patients with presumed gastrointestinal submucosal protruded lesions were retrospectively enrolled. All of them underwent MPS and then endoscopic therapy,such as cyst incision,high frequency electric snare resection,endoscopic mucosal resection and endoscopic submucosal dissection were performed according to the deriving layers,size and nature determined by MPS. The ultimate diagnosis was confirmed by histopathological examination. Results:In the 69 cases of lesions,MPS showed that 15 were derived from muscularis mucosa,40 from submucosa,and 14 from muscularis propria;10 of them were considered as cyst,18 were stromal tumor,8 were leiomyoma,6 were ectopic pancreas,15 were neuroendocrine tumor,and 12 were lipoma. Compared with pathological diagnosis,an overall coincidence rate of 91. 3%(63 / 69)was achieved by MPS. Conclusions:The accuracy rate of MPS is high for determining the deriving layers and nature of gastrointestinal submucosal protruded lesions prior to the attempting of endoscopic removal. It might be helpful for selecting treatment modalities for this kind of lesions.

Objective To investigate the effect of polymorphism of plasminogen activator inhibitor-1(PAI-1) promotor region gene,plasma tissue plasminogen activator(t-PA)and PAI-1 on patients with acute pulmonary thromboembolism(APTE).Method Fifty-two patients with APTE were divided into two groups according to the presence or absence of traditional enviromnent risk facters,and there were26 patients in each gnup,and auother 57 healthy indiriduals as controls were analyzed.The genotypos of subjects were determined for the 4G/5G polymorphism of PAI-1 gene using polymerase chain reaction based restriction fragment length polymorphism analysis.Plasma PAI-1 and tPA were measured by ELISA.Results(1)The ratio of 4G/4G genotype in group without traditional environment risk factors was much higher than that of the other two groups.(2)Plasma t-PA decreased and plasma PAI-1 elevated significantly in group without traditional environment risk factors compared with that of the other two groups.(3)Except the 5G homozygous,plasma PAI-1 level in group without traditional environgment risk factors was significantly higher than the other two groups.There existed correlation between 4G allele and plasma PAI-1.Conclusions 4G/5G polymorphism of PAI-1 gene is associated with AFFE.4G/4G genotype increases the risk of APTE for individuals without traditional risk factors.There are hypercoagulation and hypofibrinolysis in APTE patients without traditional risk factors.

Objective To evaluate the efficacy of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery.Methods A retrospective concurrent comparative study included 60 patients with vaginal recurrence after surgery in early stage cervical cancer.30 cases of the experimental group were treated with intensity-modulated radiotherapy (IMRT),and 30 cases of the control group were treated with conventional radiotherapy.The efficacy and complications between two groups were compared after 3 treatment cycles.Results Of 30 patients in experimental group,22 patients achieved complete remission,7 had partial and 1 progressed.But in the control group,14 had complete remission,5 reached partial remission,7 were stable and 4 progressed.The effective rates were 96.67 ％ (29/30) and 63.33 ％ (19/30),respectively,in the experimental and control group,which showed statistical significance (P =0.009).In the experimental group,there were 1 case with grade 1 radiation cystitis and 1 case with grade 1 radiation proctitis.In the control group,there were 3 cases of vaginal-rectal fistula,1 case of grade 3 radiation proctitis,2 cases of grade 2 radiation cystitis and 2 cases of grade 1 radiation proctitis.Conclusions IMRT for treating vaginal recurrence of early cervical cancer achieves satisfactory short-term effect.In comparison with conventional radiotherapy,IMRT has higher efficacy but less side effects.

Objective: To explore the relationship between family intergenerational contact, depressive symptoms and self-rated health status in the elderly, so as to provide insights into promoting health of the elderly and actively coping with population aging. Methods: Demographic information, intergenerational contact frequency, self-rated health status and depressive symptoms in the elderly at ages of 65 years and older were collected through the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Structural equation model was established to analyze the effects of intergenerational contact on self-rated health and the mediating role of depressive symptoms between family intergenerational contact and self-rated health in the elderly. Results: Totally 15 497 elderly participants were enrolled, with 6 727 males (43.41%) and 8 770 females (56.59%), and there 12 583 individuals lived with family members (81.19%). The median age was 85.00 (interquartile range, 16.00) years. The scores of self-rated health and depressive symptoms were (3.39±0.87) and (2.22±0.56), respectively. The results of structural equation model analysis showed that after adjusting for age, gender and residence, frequent intergenerational contact had a direct positive effect on self-rated health (effect size=0.038, P<0.001), and could improve the depressive symptoms (effect size=0.089, P<0.001) in the elderly. In addition, depressive symptoms had a negative effect on self-rated health in the elderly (effect size=-0.422, P<0.001). Conclusions Frequent intergenerational contact can improve the self-rated health status in the elderly, and indirectly improve the self-rated health level by alleviating depressive symptoms.