[Objective]To introduce a new technique of ankle arthrodesis with trephine by lateral approach and evaluate its clinical effects.[Method]Ankle arthrodesis with trephine was performed in 20 patients with serious lesions.Lateral incision was adopted and osteotomy of fibula facilitated the exposure of the fusion site.A trephine of appropriate diameter was used for bi-osteotomy,thus inside the trephine gaining two bone blocks were then rotated 90? and replanted in situ.The pruned fibula was fixed with screws as on-lay!grafting.Proper cast was utilized postoperatively to maintain a functional position.[Result]The average follow-up period was 26 months(ranged from 6 months to 4 years).All the wounds healed well at 2 weeks and the callus appeared 4 weeks postoperatively.Sufficient pain relief was obtained in all patients at 12 weeks and appearance improved greatly.A solid union was achieved in all cases through the radiograph.[Conclusion]The use of trephine in ankle fusion by lateral approach is proved to be a simple technique with high union rate.The main advantages of the technique over other methods of arthrodesis include: excellent exposure by regular incision;less disturbance of the original joint,thereby preserving normal height of the joint and length of the extremity;no need for extra graft through in-situ grafting of the bone blocks and rigid on-lay grafting of lateral malleolus for high primary stability.

OBJECTIVE:To know the utilizatior of Shenfu injection(SFI)in our hospital,and provide reference for ratio-nal use of SFI. METHODS:In respective study,patients received SFI from the Hospital Information System(HIS)in surgery department in our hospital from Jan. 2013 to Dec. 2014 were analyzed statistically in aspects of general situation,indications, usage and dosage,course of treatment,drug combination,etc. And the incidence of ADR/ADE was monitored. RESULTS:The 1 247 surgery inpatients used SFI distributed in thyroid and galactophore department(634 cases),comprehensive minimal-ly invasive department (292 cases),gastrointestinal surgery department (250 cases),urology department (64 cases) and car-diothoracic surgery department(7 cases),including 466 male and 781 female,the ratio of male to female was 1∶1.68,aver-age age was 58.50 years;it mainly used in perioperative medication (78.11%) and treated for tumors (11.23%),treatment course concentrated on 2-7 d(71.45%),dosage mainly was 100 ml(70.01%);combination medication were mainly pantopra-zole sodium,Fructus bruceae injection,Xueshuantong for injection(lyophilized),etc. The nonstandard phenomenon was exist-ed in indications,dosage,solvent selection,medication frequency,drug combination,etc. There were no obvious ADR/ADE related to SFI. CONCLUSIONS:More attention must be paid to the irrational use of SFI in surgery clinic of our hospital,the safety of traditional Chinese medicine injection in clinical use should be correctly understood,achieve dialectical therapy and rational drug use.

Agenesis of Corpus Callosum ; Chromosomes, Human, X ; Gene Deletion ; Glycerol Kinase ; genetics ; Humans ; Infant ; Male ; Syndrome

Objective To study the repair of great vessels injured by firearm in extremities. Methods From May 2002 to Sep. 2005, 15 cryopreserved homologous arteries were transplanted to repair the defects of great vessels of extremities in 14 patients, including 5 cases of defect of brachial arteries, 1 case of defect of axillary artery, 1 case of popliteal artery damage and 7 cases of defect of femoral arteries. The average length of homologous arterial transplants was 9.5 cm. After operation, all the 14 patients were monitored and treated according to principles of microsurgery. Result No early reject reaction was found in all the 14 cases, and all the wounds healed after Ⅱ stage treatment. With Doppler ultrasonic examination 2-3 weeks after healing, it was proved that 100% of the vessels were patent. In 4 to 8 month follow up, the function of the extremities recovered well, and no delayed reject reaction was observed. Conclusion The vessels after cryopreservation is a suitable biomaterial in homologous transplantation for repairing the defect of great vessels of the extremities as a result of firearm injury.

BACKGROUND: There are a lot of immunologic studies about limb allotransplantation in animal experiment. But, it is only early investigation in clinic; its clinical immunologic study needs further accumulation.OBJECTIVE: To dynamically analyze the early immunologic state change in patients following hand allotransplantation.DESIGN: Controlled trial.SETTING: Department of Orthopaedics, Guangzhou General Hospital,Guangzhou Military Area Command of Chinese PLA; Department of Traumatic Orthopaedics and Department of Laboratory Medicine, Nanfang Hospital, First Military Medical University of Chinese PLA.PARTICIPANTS: Two patients who underwent unilateral hand allotransplantation in the Department of Orthopaedics, Guangzhou General Hospital,Guangzhou Military Area Command of Chinese PLA were enrolled, serving as experimental group. The observation was between September 1999 and March 2000. Twenty persons, including 12 male and 8 female, who homochronously received health examination, aged 20 to 45 years, were enrolled, serving as healthy control group. They all had no reactive immune and infectious diseases, and voluntarily participated in the trial.METHODS: Peripheral blood was collected from 2 patients who underwent hand allotransplantation once respectively at pre-operative 1 day and 3 days. Blood collecting was performed once per day at post-operative 1 week, three times per week at post-operative 2 to 4 weeks, twice per week at 5 to 8 weeks post-operation, once per week at 9 to 16 weeks post-operation, twice per month at 5 to 6 months post-operation. ① Peripheral blood T cell subgroups (CD3+,CD4+,CD8+T cells)were detected by flow cytometer,serum panel reactive antibody (PRA) by ELISA method, serum C-reactive protein by turbidimetric immanoassay (TIA), serum creatine kinase (CK) by enzyme dynamics method. ②Mixed lymphocyte reaction(MLR): mitomycin C-treated donor peripheral blood lymphocytes were used as stimulator, and proliferative reaction of peripheral blood lymphocyte of patients to donor transplanted antigen was detected with the incorporation of 3H-TDR method (Negative: There was no significant difference between the mean value of stimulation index and 1, conversely positive). Autogenic peripheral blood lymphocytes treated with the same way replaced donor stimulator, serving as control. Stimulation index of each specimen was calculated (Stimulation index=Experiment cmp/controlcpm), serving as control index. Peripheral blood T-cell subgroups (CD3+,CD4+,CD8+T cell), serum PRA, C-reactive protein and CK were detected in 20 persons in healthy control group;Twenty persons were randomly divided into 10 groups. Two persons in each group were used as donor and recipient mutually and performed MLR.MAIN OUTCOME MEASURES: ① Peripheral blood T cell subgrpups (CD3+,CD4+,CD8+T cell). ②PRA. ③ C-reactive protein. ④CK. ⑤MLR.RESULTS: ①CD3+,CD4+,CD8+T cell levels were obviously decreased within one week after operation. CD3+ and CD4+T cell levels both recovered to be the pre-operative levels, but CD8+ level exceeded pre-operative level significantly [CD3+: (66.43±4.56); CD4+: (30.55±3.94); CD8 +:(33.45 ±2.69)]. There was no significant difference between experiment group and control group. ②Serum PRA was 0 to 10%, there was no significant difference as compared with control group. ③ Serum C-reactive protein was 0 to 0.359 mg/L, there was no significant difference as compared with control group. ④ Serum CK was 25 to 170 mmol/L, and there was no significant difference as compared with control group. ⑤ MLR after transplantation was negative, and it turned into be positive 5 months later.They were all positive in control group.CONCLUSION: Short-term change and long-term redistribution of T cell subgroups are closely related to immunosuppressive agent, suggesting that immunosuppressive agent has obvious effect on T-cell subgroup following hand allotransplantation. Immuno-induction schedule make patients be in immune suppression state, which effectively avoid early rejection. But patients cannot bear specificity yet; they need the inhibition of immunosuppressive agents.

BACKGROUND: Scholars disagree with each other about the small saphenous vein effects on skin flap and how to dispose vascular proximal pedicles.OBJECTIVE: To analyze effects of different methods of the small saphenous vein disposal on flap survival using sural neurocutaneous island flap retrograde metastasis for repairing defects of soft tissue of instep, heelstick and ankle.DESIGN, TIME AND SETTING: The case control observation experiment was performed at the General Hospital of Guangzhou Military Area Command of Chinese PLA from March 1998 to April 2007.PARTICIPANTS: A total of 56 patients with defects of soft tissue of instep, heelstick and ankle were divided into 2 groups,small sapbenous vein deligation in proximal pedicle flap group (group A) (n=38), and proximal small saphenous vein and great saphenous vein or tributaries at recipient site anastomosis flap group (group B) (n=18).METHODS: During sural neurocutaneous island flap retrograde metastasis for repair,(3.5×4.0)cm-(4.0×4.5) cm flap was obtained in 35 cases, and (4.0×4.5) cm -(10.0×12.0) cm in 21 cases.MAIN OUTCOME MEASURES: Outcome of flap survival at different incision area and implanted methods.RESULTS: No vein articulo occurred in 21 cases, which flap areas were (4.0×4.5) cm -(10.0×12.0) cm. Five of 35 cases which flap areas were (3.5×4.0) cm -(4.0×4.5) cm developed vein articulo.The necrotic rate of flaps in group B was significantly lower compared to the group A (P=0.017 67).CONCLUSION: When the area of skin flap is smaller than (4.0×4.5) cm, the proximal end of the small saphenous vein should be anastomosed with the great saphenous vein or tributaries connecting with the great saphenous vein at recipient site.The small saphenous vein is not a superficial vein, which only cross the skin flap, but it has trophic action on the skin flap.

To explore and discuss the application of case teaching method for pharmaceutical administration science according to the actual teaching situation and the teaching experience of the authors. The teaching effects can be improved by the method, which is worthy of promotion and popularization.

Objective To investigate the clinical characteristics and operative treatment of humeral super-middle fracture combined with brachial artery injury. Methods 9 cases of humeral super-middle fracture combined with brachial artery injury have been treated in our department since 2000 with reduction, axial external fixation, and autotransplantation of great saphenous vein to repair brachial artery. Results All patients were followed up for 1 to 2 years. No stenosis occurred at the anastomosed veins and the limbs survived well. All fractures achieved clinical healing except 1 case who had nonunion following refracture and had to undergo secondary operation. Conclusion The operation is simple and easy, but effective in treatment of the humeral super-middle fracture combined with brachial artery injury.

ObjectiveTo find out the inhibitory effects of CD4 - CD8 - DNT cells on growth of which depresses the pancreatic cancer in vitro and in vivo.Methods The inhibitory effects of DNT cells on the growth of Panc- 1 were studied in vitro by MTT method.Eighteen BALB/c mice were divided into 3 groups randomly.Human pancreatic cancer xenografts were established in 2 groups randomly.The last group was injected the cell suspension which comprises DNT and Panc- 1 cells ( Panc- 1∶ DNT =1∶ 5 ).When the diameter of tumor was about 5 mm,the first 2 group mice were further divided into 2 groups randomly.One was control,treated with distilled water.The other was treated with celebrex (4 mg/d).The size of the tumors was calculated every 2 weeks and tumor growth curve was depicted.At the end of the treatments,the mice were sacrific and the tumors were harvested.The tumor inhibition rate was calculated.Results( 1 ) MTT study showed that DNT cells produced a dose- dependent inhibition of Panc- 1 proliferation in vitro.(2) The growth of transplanted pancreatic cancer was down-regulated by treatment of DNT cells.ConclusionDNT cells can inhibit the growth of pancreatic cancer in vitro and in vivo.

Aim To study the protective effects of sphingosine 1-phosphate (S1P) postconditioning on rat myocardial cells injured by hypoxia/reoxygenation in reperfusion injury salvage kinase ( RISK ) signal path-way. Methods The cultured rat H9c2 cells were ran-domly divided into seven groups: ( 1 ) control group;(2) hypoxia/reoxygenation (H/R) group; (3) S1P group;(4) S1P+LY294002 group(S1P+LY); (5) LY group; ( 6 ) S1 P +PD98059 group ( S1 P +PD );(7) PD group. The viability of H9c2 cells was detec-ted using MTT method. The content of MDA in the cultured medium and the activity of T-SOD and Mn-SOD were measured with colorimetry. The concentra-tion of intracellular free calcium ion was detected by confocal microscopy. The rate of cell apoptosis was de-termined by flow cytometric analysis. Western blot was used to assess phosphorylation of Akt and ERK1/2 in H9c2 cells. Results Compared with the H/R group, S1P significantly increased vaibility of cells, lowered the rate of apoptosis, decreased the content of MDA in the culture medium, increased the activity of T-SOD and Mn-SOD, reduced concentration of intracellular calcium and increased the phosphorylation of Akt and ERK1/2 . When added LY294002 or PD98059 , the effects of S1P above were inhibited. Conclusion S1P protects H9 c2 cells against hypoxia/reoxygenation inju-ry. The protection of S1P was inhibited by LY294002, the inhibitor of PI3 K/Akt and PD98059 , the inhibitor of ERK1/2 . S1 P protects H9 c2 cells against hypoxia/reoxygenation injury via RISK pathway.