Objective To investigate the plantar pressure distribution of the injuried limbs and the healthy side after the operation for Pilon fracture. Methods 31 patients with Pilon fractures were tested with Footscan USB2 system, including the maximum force and impulse of 10 zones of the feet 1 year after surgery. Results Compared with the contralateral feet, the maximum force reduced under the the first metatarsal bone, medial heel, and lateral heel (P<0.05), and it increased under the fourth, and fifth metatarsal bone (P<0.05) of the injured feet. The impulse reduced under the the first metatarsal bone, medial heel, and lateral heel (P<0.05), and increased under the fifth metatarsal bone and midfoot (P<0.05). Conclusion The load decreased on the heel and medial forefoot, and increased on the lateral forefoot of the injured limbs after Pilon fracture, while the lateral forefoot and midfoot tend to be injured.

Objective To analyze our clinical results of head and neck reconstruction using microsur- gical free flap transfer techniques.Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed,and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope.The un-buried free flap with a mo- nitoring window were harvest,and do double venous anastomoses in some flaps to ensure adequate venous out- flow.Results From May 1999 to March 2005,1066 consecutive free flap transfers were used to reconstruct head and neck defects.The overall success rate of free flap was 98.3%.The vessel thrombosis rate was 3.1%,and the flap salvage rate was 45.5%.Conclusion Head and neck reconstruetion using microsurgi- cal free flap transfer technique is safe and reliable,and good clinical results can be obtained.

AlM:To observe the changes of corneal endothelium after phacoemulsification cataract surgery in different types of cataract patients.
METHODS: Randomly selected age-related cataract, diabetic cataract and cataract of high myopia 30 eyes of 30 cases, respectively, in our hospital. All patients underwent phacoemulsification combined with intraocular lens implantation, corneal endothelial density and the percentage of hexagonal cells were measured by corneal endothelial cell instrument without touching before surgery and one week after surgery.
RESULTS: The difference of the preoperative corneal endothelial cell density and the percentage of hexagonal cells among three groups were not statistically significant (P>0. 05). One week after surgery, the cell density in three groups were respectively 2 496. 86 ± 298. 96/mm2 , 2 379. 51 ± 375. 13/mm2 , 2 425. 38 ± 312. 68/mm2 , the percentage of hexagonal cells were respectively ( 46. 20 ± 12. 03)%, (43. 44±13. 99)%, (44. 35±8. 13)%. Both the cell density and the percentage of hexagonal cells one week after surgery were lower than those before operation. There were significant difference in three groups ( P <0. 05). Both the measurements in diabetic cataract group and cataract of high myopia group after surgery were lower than those in age-related cataract group, the cell density and the percentage of hexagonal cells in diabetic cataract group were lower obviously compared with those in age- related cataract group and the difference was significant (P<0. 05).
CONCLUSlON:The tolerance of corneal endothelial cell to phacoemulsification cataract surgery is lower in cataract with diabetes and high myopia. Corneal endothelium should be assessed preoperatively and protected intraoperatively.

OBJECTIVETo observe the effect of Fn-TPO gene modification on human bone marrow mesenchymal stem cells (MSCs).

METHODSRetroviral vector containing Fn-TPO gene was constructed and bone marrow MSCs was modified by this vector. The transcription of Fn-TPO gene in MSCs was observed. The proliferation capacities, hematopoietic cells adhering capacities and TPO secretion capacities of gene modified MSCs were assayed respectively. Cord blood CD34 cells were seeded on the gene modified MSCs layers and several essential growth factors were added. After co-culturing in vitro for 7 days, the number of CD34 cells and their colony forming capacities were assayed by flow cytometry and semisolid culture assay.

RESULTSRetroviral vector containing Fn-TPO gene was successfully constructed and bone marrow MSCs were modified by this vector. Fn-TPO gene was expressed by bone marrow MSCs after gene modification. The viability of MSCs had no significant difference between pre- and post-gene-modification [(7.18 +/- 0.89) 10(4)/ml vs. (6.92 +/- 0.77) 10(4)/ml, P > 0.05]. The hematopoietic cells adhering ability of gene modified bone marrow MSCs was reinforced(0. 188 +/- 0.018 vs. 0.167 +/- 0.017, P < 0.01). The concentration of TPO in the MSCs culture supernatant raised from (5.58 +/- 0.37) ng/ml to (7.46 +/- 0.59) ng/ml (P < 0.01) and did not significantly decline in a short-time period, but influenced by the growth status of MSCs. After co-culturing with gene modified MSCs for 7 days, the absolute number of nucleated cells, the percentage of CD34+ cells and the colony numbers of BFU-E, CFU-GM, CFU-GEMM were (29.9 +/- 2.7) x 10(4), (33.3 +/- 2.8)% , 109.3 +/- 4.1, 163.7 +/- 7.1, 13.3 +/- 1.5, respectively, being significantly higher than that co-cultured with non-modified MSCs.

CONCLUSIONSFn-TPO gene modification can improve the capacity of human bone marrow MSCs for hematopoietic cells adhering, TPO secretion and cord blood CD34 cells amplification.

Bone Marrow Cells ; cytology ; metabolism ; Cell Adhesion ; Cell Proliferation ; Cells, Cultured ; Fibronectins ; genetics ; Gene Fusion ; Genetic Vectors ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Retroviridae ; genetics ; Thrombopoietin ; genetics ; metabolism ; Transfection

OBJECTIVETo evaluate the reliability and effectiveness of free flap transfer with double vein anastomosis for reconstruction of head and neck defects.

METHODSOne hundred and sixty-eight cases of free flap transfers with double vein anastomosis for head and neck reconstruction from September 1999 to April 2003 were reviewed. There were 92 males and 76 females. The age range was 11 to 79 years old, with the average of 44.6 years old. Data concerning the operation included site, stage and histology of tumor, defect description, design of free flap, recipient vessel free flap survival and complications.

RESULTSAmong 168 free flaps, there were 126 free fibula flaps, 32 radial forearm flaps, 7 rectus abdominis flaps, one scapular flap, one jejunal flap, and one anterolateral thigh flap. The overall success rate of free flap was 99.4%. One fibula flap was lost because of arterial thrombosis. No venous thrombosis occurred in this group.

CONCLUSIONFree flap transfer with double vein anantomosis for head and neck reconstruction improves the outflow of free flap, reduces the venous thrombosis rate, and ensures a high success rate of free flaps.

Adult ; Aged ; Female ; Free Tissue Flaps ; Head ; Head and Neck Neoplasms ; Humans ; Male ; Middle Aged ; Neck ; Reconstructive Surgical Procedures ; Reproducibility of Results ; Surgical Flaps

OBJECTIVETo compare the fracture surface of the machinable infiltrated ceramic (MIC) prepared in different conditions, and to relate its strength and toughness to the differences in their microstructures.

METHODSThe Al2O3 matrix were prepared, infiltrated by the machinable glass and crystallized. Based on sintering and infiltrating time and conditions, the specimens were divided into three groups: Perfect group, insufficiently infiltrated group, mal-sintered substrate group. Specimens were fabricated, three point flexural strength and elastic modulus were tested, and the microstructure of the MIC fracture surfaces was analyzed by means of scanning electron micrograph (SEM) observation.

RESULTSThe strength of the insufficiently infiltrated group and mal-sintered substrate group were lower than that of the perfect group, and faults in the microstructure of these two groups also proved this. The foreland of glass infiltrating in the Al2O3 and the interface of glass and complex demonstrated that the Al2O3 surface was smoother than the complex and there was a big crack in the glass but not in the complex which proved the crack resistibility of glass and Al2O3 were smaller than that of the complex (MIC).

CONCLUSIONCorrect preparing process could make the glass infiltrate into properly sintered Al2O3 sufficiently which ensured best mechanical properties of the complex.

Aluminum Oxide ; Ceramics ; Dental Porcelain ; Glass ; Materials Testing ; Microscopy, Electron, Scanning

OBJECTIVETo explore changes of Clara cell protein (CC16) and surfactant protein-D (SP-D) in the serum of patients with silicosis.

METHODThe concentrations of CC16 and SP-D were measured in the serum by sandwich enzyme-linked immunosorbent assays. The subjects consisted of 30 healthy volunteers and 90 silica-exposed workers including silica-exposed group, the silicosis of suspects group (0(+)) and the silicosis phase I group, 30 subjects each groups.

RESULTSThe concentrations of CC16 in the serum was significantly decreased in silica-exposed workers compared to controls (P < 0.01); The concentrations of CC16 in the serum were higher in lifelong nonsmokers than the current smokers in control subjects (P < 0.05), but they were no differences between lifelong nonsmokers and current smokers of 90 silica-exposed workers. Compared with control subjects, the levels of SP-D in the serum of silicosis suspects (0(+)) and silicosis phase I groups were significantly elevated (P < 0.01, respectively), which were also higher than silica-exposed group (P < 0.05 and P < 0.01, respectively), Discriminant equations set by CC16 and SP-D were used in diagnosis of silicosis, and the rate of accuracy in healthy volunteers, the silica-exposed group and the silicosis phase I group were 86.7%, 86.7% and 76.7%, respectively, The total rate of correct classification hit 84.2%.

CONCLUSIONThe serum CC16 of long-term silica-exposed workers is decreased, and SP-D is increased gradually.

Adult ; Case-Control Studies ; Epithelial Cells ; metabolism ; Humans ; Male ; Middle Aged ; Pulmonary Surfactant-Associated Protein D ; blood ; Silicosis ; blood ; Uteroglobin ; blood

OBJECTIVETo analyze the value and reliability of combined free flap and pedicled pectoralis major myocutaneous flap in the reconstruction of extensive composite head and neck defects.

METHODSNine consecutive cases of combined free flap and pedicled pectoralis major myocutaneous flap transfers for extensive head and neck defects from March 2002 to April 2005 were reviewed. Data concerning the operation included defect description, type of free flap, recipient vessel and complications.

RESULTSThere were 9 cases in this group, with 7 males and 2 females. Among the 9 free flaps, there were 6 radial forearm flaps, two fibula flaps, and one anterolateral thigh flap. The overall flap survival rate was 100% (all of 18 flaps), without partial or total flap necrosis. One radial forearm flap developed venous thrombosis 24 hours after operation, but salvaged by emergent exploration and reanastomosis of veins. The overall complication rate was 44.4%.

CONCLUSIONIn selected cases, the combined free flap and pedicled pectoralis major myocutaneous flap method provided satisfactory reconstruction for extensive head and neck defect, and simplified the double free flap method.

Female ; Free Tissue Flaps ; Head ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Myocutaneous Flap ; Neck ; Necrosis ; Reconstructive Surgical Procedures ; Reproducibility of Results ; Surgical Flaps

OBJECTIVETo investigate the chemical constituents of Ligularia xanthotricha.

METHODSilica gel column chromatography and preparative TLC were employed for the isolation and purification. The structures were identified on the basis of spectral data (IR, EI-MS, 1H-NMR, 13C-NMR, DEPT) and chemical evidence.

RESULTSeven compounds were isolated and identified as follows: lupeol (1), lupeol palmitate (2), 3, 28-dihydroxyl-lupeol (3), betulinic acid (4), taraxasterol (5), taraxasteryl palmitat (6) and taraxasteryl acetate(7).

CONCLUSIONAll the compounds were isolated from this plant for the first time.

Asteraceae ; chemistry ; Chromatography, Gel ; Chromatography, Thin Layer ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Pentacyclic Triterpenes ; Spectrometry, Mass, Electrospray Ionization ; Sterols ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVETo investigate the frequencies and distribution of CD4+ T cells and CD8+ T cells as well as the changes of immune activation in gastric mucosa of HIV-infected individuals.

METHODS42 HIV-infected individuals were recruited into this investigation, and 36 patients had definite diagnosis of clinical stage. Biopsy of gastric mucosal tissues was performed by fiberoptic gastroscope including 10 normal people as a control group. Then, immunohistochemistry was used to detect expression of CD4, CD8 and CD38 in gastric mucosa, and the distinctions among three groups were analyzed with LEICA Qwin image analysis system.

RESULTS(1) Compared with asymptomatic HIV carriers and control group, CD4 T cells remarkably decreased in the gastric mucosa of AIDS patients (P < 0.01). In gastric mucosa of asymptomatic HIV carriers, there were still some CD4+ T cells in lymphoid follicles and stroma where CD4+ T cells were unevenly distributed, the frequency of CD4+ T cells was not significantly different between asymptomatic HIV carriers and control group (P > 0.05); (2) Phenomenon of CD8+ T cells infiltrating mucosal epithelium and gland was general in HIV-infected individuals. CD8+ T cells took on local excessive hyperplasia in gastric mucosa of some individuals. As compared with control group, CD8+ T cells markedly increased in gastric mucosa of infected individuals (P < 0.01), but the distinction of asymptomatic HIV carriers and AIDS patients was not significant (P > 0.05); (3) CD38-expressing cells mainly distributed over gastric mucosal surface to superficial layer(1/3-2/3 layer) of HIV-infected individuals, and was more intensive than control group (P < or = 0.01), but there was not noticeable difference between asymptomatic HIV carriers and AIDS patients (P > 0.05).

CONCLUSIONThe frequencies and distribution of gastric mucosal CD4+ T cells of HIV-infected individuals were closely correlated with progression of disease. Disfunction of mucosal immune system which was resulted from HIV infection and injury of CD4+ T cells could be an important cause of CD8+ T cells increasing and CD38-expressing enhancement.

ADP-ribosyl Cyclase 1 ; genetics ; immunology ; Adult ; CD4-Positive T-Lymphocytes ; cytology ; immunology ; CD8-Positive T-Lymphocytes ; cytology ; immunology ; Female ; Gastric Mucosa ; immunology ; Gene Expression ; HIV Infections ; genetics ; immunology ; HIV-1 ; immunology ; Humans ; Lymphocyte Count ; Male ; Middle Aged