OBJECTIVE: To explore the principles of donor site selection for defects of the hypopharynx and/or cervical-esophagus based on a novel defect classification system and treatment outcome of this series. METHOD: Thirty-nine patients underwent reconstruction of their defects of the hypopharynx and/or cervical-esophagus from January 2007 to June 2012 were retrospectively studied. 23 hypopharngeal and/or cervical-esophageal defects were circumferential or near circumferential (group A), 16 were partial(group B). 22 patients had compromised neck vascular status, while the other 17 patients had normal neck vascular status. Selection of the donor sites was based on extent of the defects and neck vascular status. Donor sites for reconstruction of the defects of group A included anterolateral thigh flap (n = 8), gastric pull-up (n = 6), radial forearm flap (n = 3), jejunum flap (n = 3), and pectoralis major myocutaneous flap (n = 3). For goup B, Infrahyoid myocutaceous flaps, radial forearm flaps, and pectoralis major myocutaneous flaps were used in 8, 3, and 5 cases, respectively. Flap survival, surgical complications, function outcome, and tumor control were observed. RESULT: Overall complication rate was 12.8% (5/39) in this series. In group A, three flap necroses occurred in jejunum flap (n = 1), anterolateral thigh flap (n = 1), and pectoralis major flap (n = 1). All these flap necroses occurred in the compromised neck vascular status group. One case of pharyngeal fistula without flap necrosis occurred in Group B. All except 2 patients restored oral intake postoperatively; 16 patients with laryngeal preservation had good phonation postoperatively. 2-year and 3-year survival of this series were 72.1% and 65.2%, respectively. CONCLUSION Selection of an appropriate donor site for reconstruction of the defects of hypopharynx and /or cervical-esophagus should be based on the extent of the defects, neck vascular status, and clinical features of the flap. Individualized donor site selection for hypopharyngeal and cervical esophageal defects reconstruction can result in good clinical outcome.
Adult ; Aged ; Esophagoplasty ; methods ; Esophagus ; surgery ; Graft Survival ; Humans ; Hypopharynx ; surgery ; Male ; Middle Aged ; Neck ; blood supply ; Necrosis ; Retrospective Studies ; Surgical Flaps ; pathology ; Transplant Donor Site ; anatomy & histology ; Treatment Outcome

Objective The purpose of this study was to assess isokinetic strength of lower extremities and find out weak muscles in Chinese elite fencers. Methods Bilateral peak torque of flexors and extensors of hip, knee and ankle in 26 national fencers,aged 23.1±2.36 yrs,were tested isokinetically at speeds of 60 and 240 deg/sec. Results (1)Hip: compared with 60 deg/sec,peak torques of bilateral extensors significantly decreased at 240 deg/sec (P<0.05), no significant difference in flexors(P>0.05); At two velocities, flexor peak torques in leading leg of men fencers were significantly higher than trailing one(P<0.05),no significant difference was found in women(P>0.05);Flexor/extensor torque ratio was lower than normal at two velocities in all fencers. (2)Knee: strength of flexors and extensors in 60 deg/ sec and extensor in 240 deg/sec of men fencers were significantly different between leading and trailing legs (P<0.05); No difference at two velocities were found in women fencers;knee flexor/extensor ratio of both legs were 0.56,0.54 for women and 0.6,0.67 for men respectively at 60 deg/sec;knee flexor/extensor ratio were within normal range at 240 deg/sec. (3)Ankle:men's peak torque in leading ankle of flexor and extensor were significantly higher than trailing leg at 60 deg/sec(P<0.05);no difference were found at 240 deg/sec for men and women (P>0.05); ankle flexor/extensor ratio were lower than normal at two velocities in all fencers. Conclusion (1)Bilateral asymmetry in isokinetic muscle strength exists in men fencers,but not obvious in women fencers. (2)Weak muscles for fencers were hip extensor,knee flexor,especially in leading knee and ankle extensor.

Objective To analyze the bone mineral density(BMD)and the correlated influence factors ingirls. Methods BMD and partial physical development variables of 714 girls, aged 9 to 16, were examined in Guangdong and Guangxi province and a questionnaire was administered to all subjects to determine their milk intake, physical activity, menarche, and regularity of menstruation. Results BMD in girls increased by 4.4% at age of 9～12, increased by 6.0% at age of 12～14, and increased by 2.5% at age of 14～16. Compared with girls having less than six-hour outdoor exercise, those having more than six-hour outdoor exercise revealed higher BMD levels (P200ml/day) might be effective for promoting BMD of girls during puberty.

This study was aimed to explore pharmacological effects of epimedium pubescen flavonoid (EPF) on biomechanical properties among ovariectomized rats. Sixty female Sprague-Dawley (SD) rats (aged 2-month-old) were randomly divided into six groups (n = 10), which were the sham control group (Group A), the model group (GroupB), the standard group (Group C), the treated 1 group (Group D), the treated 2 group (Group E), and the treated 3 group (Group F). Except the sham control group (Group A), rats in other groups had been ovariectomized. All rats were given the same feedstuff. Meanwhile, Group C was given calcium 75 mg·kg-1 combined with VitD3 21 IU·kg-1 by gastrogavage every day for 4 months; Group D was given EPF 75 mg·kg-1; Group E was given EPF 150 mg·kg-1;Group F was given EPF 300 mg·kg-1. At the end of the 4th month, all rats were sacrificed. Bones, which included tibia, femur and humerus of both sides and all lumbar vertebra bodies, had been taken out. Measurement was made on the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of biomechanical properties of the fourth lumbar vertebra body (LV4); the maximum loading capability, bone break load, potential energy of deformation, structural rigidity of the structural dynamics properties of the femur com-pact bone; the elastic modulus, maximum stress, maximum inherent strain, bone break stress, and bone break strain of the mechanical properties of a material of the femur compact bone in the experimental rats. The results showed that compared with Group B, the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of LV4; the maximum loading capability, bone break load, potential energy of de-formation, structural rigidity of the structural dynamics properties of the femur compact bone; the elastic modulus, maximum stress, maximum inherent strain, and bone break strain of the mechanical properties of a material of the fe-mur compact bone were obviously increased in Group A, D, E and F (P< 0.05). Group C had increasing tendency. There were no statistical differences among Group A, C, D, E and F. Group D, E, and F had increased with EPF dose-dependently. However, there were no statistical differences among them. There were no statistical differences on bone break strain of the mechanical properties of a material of the femur compact bone among Group A, C, D, E, and F. It showed that ovariectomization reduced the biomechanical properties of vertebra bodies, structural dynamics properties of the femur compact bone, and the mechanical properties of a material of the femur compact bone. The application of EPF can effectively prevent and treat the decreasing of biomechanical properties of ovariectomized rats, so as to keep them in a relatively higher level.

OBJECTIVE: To retrospectively evaluate the effect of locking compression plate (LCP) combined with scaled cancellous bone graft on postoperative nonunion of humeral shaft fracture. METHODS: A total of 19 cases with postoperative nonunion of humeral shaft fracture were collected from Department of Orthopaedics, Affiliated Hospital, Xiangnan University between August 2005 and January 2009. There were 12 males and 7 females, aging 28-59 years with the mean age of 36 years. All patients were treated with LCP fixation combined with scaled cancellous bone graft. The key points of the operation were as follows: beck-median or lateral approach, protection of the radial nerve and ulnar nerve, removal of the cicatrix, reopening of humeral canal, and limited periosteum striping. For minimally invasive plate osteosynthesis technique, length of LCP was appropriate, 3-4 locking screws at least were used on either stump, and double cortices were penetrated with locking screws and treated with scaled cancellous bone graft. RESULTS: All the fractures healed with a mean period of 7.2 months (from 6 to 8 months). Two cases showed temporary radial nerve palsy after the operation, which gradually recovered 3 and 6 weeks, respectively after appropriate treatment. Shoulder and elbow functions were somewhat impaired in 7 cases, but the dysfunction could not influence daily living. Infection, screw loosening, blade plate breakage, and other complications were not found. CONCLUSION:The integrity of locking screws and plate prevents screw breakage and plate loosening. The combination of autoallergic cancellous bone graft and scaled decorticating technique can improve healing of humeral shaft fracture.

AIM:To explore the effect of peptidyl-prolyl cis/trans isomerase (Pin1) inhibitor juglone on apop-tosis of human cervical cancer SiHa cells.METHODS:Cultured SiHa cells were incubated with juglone at concentrations of 10, 20, 50, 80 and 100 μmol/L for 24 h.The SiHa cell activity was detected by methyl thiazolyl tetrazolium ( MTT) assay.The cell apoptosis was analyzed by flow cytometry with Hoechst 33258 staining.The protein levels of cleaved caspase-3,8,9 and PTEN was determined by Western blotting.RESULTS:In different doses of juglone groups, the SiHa cell growth was greatly inhibited ( P<0.05) in a dose-dependent manner as compared with control group.The IC50 of ju-glone was 20.4 μmol/L.After treatment with juglone at concentration of 20 μmol/L for 12 h, the apoptosis of SiHa cells was induced, and the typical morphological changes of cell apoptosis such as karyopyknotic pyknic hyperfluorescence bolus, nuclear fragmentation and apoptotic body were observed by Hoechst 33258 staining.The early apoptotic rate was increased significantly as compared with the control.The protein levels of cleaved caspase-3, 8, 9 and PTEN were also increased sig-nificantly as compared with control group.CONCLUSION:Juglone significantly inhibits the cell activity and induces the apoptosis of SiHa cells in vitro by inhibiting the caspase pathway and increasing the expression of anti-oncogene.

Objective To develop and evaluate an aptamer based biosensor (aptasensor) for rapid colorimetric detection of enteropathogenic Escherichia coli (EPEC). Method The aptasensor was fabricated by modifying the truncated LPS-binding aptamer on the surface of nanoscale polydiacetylene vesicles using peptide bonding between the carboxyl group of the vesicle and the amine group of the aptamer. Molecular recognition between EPEC and aptamer at the interface of the vesicle led to blue-red transition of polydiacetylene which was readily visible to the naked eyes and could be quantified by colorimetric responses (CR). Transmission electron microscopy (TEM) was used to confirm the specific interactions between EPEC and polydiacetylene vesicles. Result Truncated aptamer showed the similar LPS-binding activity. The aptasensor could detect the target bacteria in a range of 105-108 colony-forming units (CFU)/ml within less than 30 minutes and its specificity was 100% for detection of EPEC O111. The sensor reproducibiliry obtained at 106 CFU/ml was 6. 08% R. S. D. The results of TEM confirmed that the specific interactions between EPEC and polydiacetylene vesicles. Conclusion A new aptasensor was developed successfully for rapid colorimetric detection of EPEC.

Objective:To explore the mechanism of promotion effect of juglone combined with cisplatin on the apoptosis of human cervical cancer HeLa cells,and to clarify the effects of its associated signal transduction pathways.Methods:The HeLa cells at logarithmic growth phase were divided into control group,juglone group, cisplatin group and juglone combined with cisplatin group (combined treatment group).The inhibitory rates of proliferation of HeLa cells were detected by MTT assay.The apoptosis was detected by Hoechst 33258 staining. The expressions of Bcl-2, Bax and caspase-3, AKt, and pAKt were detected by Western blotting method. Results:The MTT results showed that the HeLa cell proliferation at 24,48 72 h in each drug group was inhibited;compared with control group,the profileration of HeLa cells in juglone group and cisplatin group was significantly inhibited,especially in combined group. Compared with single drug group,the inhibitory effect in combined treatment group was more significantly.After treatment for 12 h,the typical morphological changes of apoptosis were found in juglone group and cisplatin group by Hoechst 33258 staining,especially in combined treatment group. The Western blotting results showed that the expression levels of Bcl-2 and pAKt in HeLa cells in juglone group and cisplatin group 12 h after treatment were decreased obviously,whereas the expression levels of Bax,Caspase-3,and AKt were increased significantly, especially in combined treatment group compared with control group. Conclusion:Juglone combined with cisplatin could inhibit the PI3K/AKt pathway,thereby promoting the apoptpsis of HeLa cells.

Objective To compare clinicopathological characteristics and prognosis between triple-negative and HER-2-overexpressed breast cancer patients.Methods From Jan.1997 to Jan.2007,data of 725 cases of primary breast cancer patients undergoing surgical treatment were analyzed.The patients were classified into triple-negative and HER-2-overexpressed phenotypes based on immunohistochemistry results.The clinicopathological characteristics and survival of the 2 groups were compared.Results Of the 725 cases,triple-negative and HER-2-overexpressed phenotypes accounted for 12.29%and 24.96%respectively.Compared with HER-2-overexpressed group,the triple-negative group had significantly higher proportion of familial history of malignancy (18.4% vs 5.5%,P=0.001)and higher proportion of patients'histological grade reaching grade 3(54.0% vs 42.0%,P=0.01).There were more lymph node metastasis in triple-negative group than that in HER-2-overexpression group(N1+N2+N3:74.7%vs 64.6%,P=0.045).The recurrence and metastasis rate within 2 years and brain metastasis rate in triple-negative group were higher than those in HER-2-overexpressed group (25.3%,8.0%vs 8.8%,2.2%,respectively,P<0.05).The 5-year disease-free survival rate in triple-negative group was significantly lower than that in HER-2-overexpressed group(55.6%vs 69.8%,P=0.041).There was no statistical difference between the 2 groups in terms of age,menopausal status,tumor size,pathological stage,surgcal procedure,pathological type,adjuvant radio-chemotherapy,the proportion of metastasis to liver,lung and bone as well as overall survival rate(P>0.05).Conclusion Compared to HER-2-overexpressed group,patients with triple-negative breast cancer show higher rate of familial history of malignancy,and they are associated with higher histological grade and poor prognosis.

BACKGROUND:Active surgical treatments are preferred for elderly hip fractures. Individual fixation method is chosen according to fracture site, type, age and whether there are basic diseases in internal medicine, which plays an important role in the successful treatment of elderly hip fractures.
OBJECTIVE:To explore the effects of optimized surgical treatment on osteoporotic hip fracture in the elderly.
METHODS: Totally 176 patients with osteoporotic hip fracture were treated by different methods between January 2000 and January 2012, including 63 males and 113 females, with a mean age of (76.7±6.3) years. Out of the 84 cases of interchanteric fracture, seven cases were treated with conservative methods, 34 cases were treated with dynamic hip screw internal fixation, 18 cases were treated with cannulated screw internal fixation, seven cases were treated with anatomical plate internal fixation, 12 cases were treated with bipolar femoral placement, and six cases were treated with total hip arthroplasty. Out of the 92 cases with femoral neck fractures, 40 cases were treated with bipolar femoral placement, 37 cases were treated with total hip arthroplasty and 15 cases were treated with cannulated screw internal fixation. Modified Harris hip function scores were used to evaluate the therapeutic effects of different treatment methods. Complications were observed.
RESULTS AND CONCLUSION:Seventy-six cases of interchanteric fractures and 85 cases of femoral neck fractures were fol owed-up for 8-26 months with an average of (5.7±1.3) months. Three cases suffered from post-operative infection, and one case died due to cardio-pulmonary failure in 10 days after operation. Both intraoperation and postoperative complications included femoral head cutting, intraoperative fracture, internal fixation and prosthetic loosening, postoperative fracture, avascular necrosis of femoral head, coxa vara, legs shorten, and delayed fracture healing. The incidence rates of complications in patients undergoing bipolar femoral placement and total hip arthroplasty were significantly lower than those treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P<0.05). The outcomes of the treatment according to Harris scoring criterion were better in patients treated with bipolar femoral placement and total hip arthroplasty than in patients treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P<0.05). No significant differences were found in the incidence rate of complications and Harris scores among patients treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P>0.05). No significant differences were found in the incidence rate of complications and Harris scores between patients treated with bipolar femoral placement and total hip arthroplasty (P>0.05). These findings indicate that the treatment of osteoporotic hip fracture in the elderly can achieve satisfactory results if the comprehensive therapies are given. Bipolar femoral placement and total hip arthroplasty are preferred for elderly femoral neck fractures.