ObjectiveTo retrospectively analyze the clinical outcome of patients with iatrogenic peripheral nerve injury so as to summarize the experiences and lessons.MethodsA retrospective study was performed on 72 patients with iatrogenic peripheral nerve injury treated in our hospital from 2004 to 2010.Therapy methods included conservative treatment in 24 patients,surgical release in 21 and nerve anastomosis in 27.Results All the patients were followed up for average 10 months ( range,3-24months).The neurological recovery was excellent in 24 patients,good in 21,fair in 16 and poor in 11,with excellent rate of 64％,according to the trial standard of upper limb functional assessment established by Chinese Medical Society of Hand Surgery.ConclusionsRisk awareness should be strengthened on the iatrogenic peripheral nerve injury,especially the minimally invasive treatment of fractures in recent years,which has increased the risk of nerve injury.For patients who may be presented with iatrogenic injury,we should develop a detailed preoperative surgical plan for early one stage treatment as possible.

BACKGROUND:Titanium al oy with good biocompatibility, corrosion resistance and mechanical properties have been widely used in clinic. How to give its excel ent antibacterial properties so as to cope with plant-associated infections has become a research focus in recent years. OBJECTIVE:To review the principle, techniques, classification and relative merits of antimicrobial coating. METHODS:A computer-based search of Scopus database and VIP database was performed by the first author to retrieve relevant articles published from January 1990 to January 2014 using the keywords of“titanium al oy, plant, antibacterial, coating”. RESULTS AND CONCLUSION:Coatings can be classified into antibiotic coating, non-antibiotic organic antimicrobial coating, inorganic antibacterial coating, anti-adhesion coating, antibacterial bioactive polymer coating, al of which have better biocompatibility, but also have their limitations. Current studies concerning antimicrobial coatings mainly focus on how to enhance the binding force between antimicrobial coating and the substrate as wel as how to get a good anti-bacterial ability, biocompatibility, high wear resistance and persistence;antibacterial phase structure and distribution effects on the bacterial colonization. The antibacterial phase structure and distribution is the key factor for the antimicrobial properties of titanium al oys with either entirely added anti-bacterial elements or surface coating.

BACKGROUND: Current numerous studies have confirmed that silver nanoparticles have been extensively applied due to their good anti-bacterial performances. OBJECTIVE: To summarize the overseas and domestic research and development of anti-bacterial silver coating based on the anti-bacterial mechanism and bio-safety of silver nanoparticles as wel as progression of anti-bacterial silver coating. METHODS: The first author retrieved the databases of Web of Science, PubMed and CNKI for relative articles published from January 1976 to January 2015. The keywords were “silver nanoparticles, titanium al oy, implant, antibacterial properties, biosecurity, coating” in English and Chinese, respectively. RESULTS AND CONCLUSION: Because of their smal dimension and quantum effects, as wel as great specific surface area, silver nanoparticles can be in close contact with pathogenic microorganisms to exert biological effects. Additional y, silver nanoparticles exhibit the excellent resistance to bacteria, fungi, viruses and cancer cel s. However, most of their mechanisms of biological effects remain unclear, and there are unresolved problems about the slow-release time of silver nanoparticles in vivo and how to control the slow-release silver ions. Besides, there are fewer long-term animal experiments. Therefore, a large number of laboratory and clinical studies are needed to ensure that silver nanoparticles cannot cause adverse reactions during long-term administration and how to reduce their toxicity.

BACKGROUND: Tibiotalar joint fusion ways are various, and it is a difficulty in necrotic tibiotalar joint fusion. There are few comparative studies on the repair outcomes of each implant. OBJECTIVE: To compare the effectiveness and safety of modified sliding chute bone graft plus hollow screw fixation with simple screw internal fixation and plate internal fixation for tibiotalar joint fusion. METHODS: Fifty-six patients who underwent tibiotalar joint fusion were Included, Including 16 cases of screw fixation, 22 cases of plate fixation and 18 cases of modified sliding chute bone graft plus hollow screw fixation. Ankle function was compared after simple screw internal fixation, plate internal fixation and modified sliding chute bone graft plus hollow screw fixation. The ankle foot scoring system of American Orthopedic Foot and Anlde Society was used for evaluation. At the same time, the operation time, brace fixation time and fusion time of the three surgical methods ware compared. The gait at the last follow-up was compared. The average follow-up time was 2.4 years. The experiment met the ethical requirements of the First Affiliated Hospital of Harbin Medical University. All patients provided written informed consent for study participation. RESULTS AND CONCLUSION: (1) All the patients obtained exactly bony fusion. Compared with the plate fixation group, the slide bone grafting group had significant advantages in the fusion time and the last gait (P < 0.05), and the screw fixation group had significant advantages in the operation time (P < 0.05). (2) Using the ankle foot scoring system of American Orthopedic Foot and Ankle society, there was no significant difference between the sliding chute bone graft group and the plate fixation group, but both groups were significantly better than the screw fixation group (P < 0.05). (3) Adverse events had not been found in each group. (4) These results suggest that modified sliding chute bone graft plus hollow screw fixation for anlde joint lusion can effectively improve ankle joint fusion rate compared with single screw fixation, which is effective and safe.

Objective To investigate the potential role of disc repositioning and condyle restoration in the treatment of type Ⅲ traumatogenic temporomandibular joint (TMJ) ankylosis. Methods Eight patients including four females and four males at age range of 7-22 years (mean 13.6 years) were enrolled in this study. The patients suffered from traumatogenic TMJ ankylosis for 1-12 years. The preoperative interincisal opening distances ranged from 2 mm to 10 mm. During surgery, the traumatogenic callus of the lateral condyle process was removed, the condyle process was formed, and then the dislocated disc was sutured to the articular capsule or soft tissues around. Results All patients were followed up for 6-38 months and the last follow-up examination showed that the average interincisal opening distance was 30 mm. No recurrence or TMJ symptoms were found during the period of follow-up. Conclusions Disc repositioning and condyle restoration has the advantages of simple procedures, minor trauma and little recurrence and proves to be a feasible and effective method for the treatment of type Ⅲ traumatogenic TMJ ankylosis.

Objective To investigate biomechanical properties of the patella tension plating system in order to provide a theoretical basis for its clinical application. Methods Thirty-six models of artificial patella were randomly divided into 3 groups ( n=12 ) . After transverse patellar fractures were created in the models, the 3 groups were subjected to fixation respectively with Kirschner wire tension band ( tension band group ) , patellar concentrator ( concentrator group ) and patellar tension plate ( tension plate group ) . Next, 6 specimens from each group were placed on a mechanical testing machine to measure the fracture displacements after 100 cycles of simulated knee flexion and extension movements. Tensile strength tests were performed on the remaining 6 specimens in each group to measure the maximum load at fixation failure. Results The fracture displacement in the tension plate group ( 0. 40 ± 0. 26 mm ) was significantly smaller than those in the tension band group ( 2. 58 ± 0. 72 mm ) and in the concentrator group ( 1. 25 ± 0. 74 mm ) ( P < 0. 05 );the maximum load at fixation failure in the tension plate group ( 1 , 709 ± 206 N ) was significantly greater than those in the tension band group ( 581 ± 122 N ) and in the concentrator group ( 1, 003 ± 211 N ) ( P <0. 05 ) . Conclusion As a new treatment for patellar fractures, the patellar tension plating system can perform better in biomechanical properties than Kirschner wire tension band and patellar concentrator.

Objective: To analyze the expression and prognostic significance of esophageal squamous cell carcinoma associated long non-coding RNA-1 (ESCCAL-1) in esophageal squamous cell carcinoma (ESCC) tissues. Methods: From August 2011 to May 2013, 73 patients with ESCC, who received radical resection in The First Affiliated Hospital of Zhengzhou University and Henan Cancer Hospital, were enrolled. The expressions of ESCCAL-1 in esophageal tumor tissues and corresponding adjacent non-tumor tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). T test, chi square test and multivariate analysis were performed for statistical analysis. Results: The expression of ESCCAL-1 was 28.03±9.37 in esophageal tumor tissues of patients with ESCC, which was higher than that in corresponding adjacent normal tissues (11.39±4.15), and the difference was statistically significant (t=2.964, P<0.01). However there were no statistically significant differences in the expressions of ESCCAL-1 among the patients with different age, gender, histological grade, classification of Union for International Cancer Control (UICC), T stage or lymph nodes metastasis (all P>0.05). The median disease-free survival (DFS) time and overall survival (OS) time of patients with low ESCCAL-1 expression were 39 months and 42 months, respectively, which were longer than those of patients with high ESCCAL-1 expression (30 months and 37 months), and the differences were statistically significant (χ²=9.049, P=0.003; χ²=10.165, P=0.001). The results of multivariate analysis showed that ESCCAL-1 expression was the independent risk factor of DFS and OS (high risk (HR)=2.45, 95% confidence interval (CI) 1.22 to 4.93, P=0.012; HR=2.29, 95%CI 1.14 to 4.59, P=0.019). Conclusions ESCCAL-1 may be involved the genesis and development of ESCC. The expression of ESCCAL-1 in esophageal tumor tissues may be a prognostic parameter for patients with ESCC receiving radical resection.

Objective To understand the status of mental health among left-behind children in rural area and to explore its relationship with social capital.Methods A sample of 1 031 leftbehind children,aged 10-18 years,was randomly selected from six schools of two townships in Macheng city of Hubei province where large number of rural parents were working in the urban area.Data from a cross-sectional survey was collected among the sampled students from primary,middle and high schools,using self-designed questionnaires which targeting the ‘ left-behind’ condition and social capital Mental Health Inventory of Middle-School Students (MMHI-60).Chi-square test was used to compare the differences in mental health among different groups.Spearman correlation and logistical regression analysis were applied to assess the relationship between social capital and mental health.Results The prevalence of mental problems was 54.12％.Results from linear x2 test indicated that the detection rates of mental problems were parallel with the monthly pocket money and the reduction in the frequency of contacting migrant father/mother (P＜0.01).Results from the multiple logistic regression analysis indicated that students who were senior (OR=2.410-2.682,P＜0.001),and who reported not caring about their parents (OR =2.048-2.420,P＜ 0.001) were at increased risks for mental health problems.After controlling the demographic characteristics and conditions of staying relevant factors,family social capital (OR =0.845,95％ CI:0.801-0.891),neighborhood social capital (OR=0.867,95％CI:0.826-0.910) and school social capital (OR=0.893,95％CI:0.863-0.923) were all associated with declined risks of mental health problems,in which the family social capital was the most important one.Conclusion The prevalence of mental health problems was high among the left-behind children in rural area.Much attention should be paid to assist these children in improving their mental health status.One promising approach appeared to be improving social capitals which would include family social capital,neighborhood social capital,and school social capital to assist these children from avoiding mental health problems.

Objective: To investigate the relationship of heterogeneity of esophageal squamous cell carcinoma (ESCC) and chemotherapy sensitivity. Methods: Five different region specimens isolated from primary tumor(R1~R5)and 1 specimen(R6)isolated from adjacent non-neoplastic tissue from 10 ESCC patients who underwent surgical treatment were cultured in vitro. The inhibitory effect of cisplatin on proliferation of ESCC cells from different regions was determined by methyl thiazolyl tetrazolium (MTT). The cell cycle and apoptosis induced by cisplatin was determined by flow cytometry (FCM) analysis. The mRNA levels of ATP7A and ATP7B were determined by quantitive RT-PCR (qRT-PCR). Results: The result showed that different regions of each specimen exhibited different chemotherapy sensitivity to cisplatin, and the cell survival rates of region R6 of each specimen were higher than other regions from the same specimen. The cell survival rate of region R3 from the tenth specimen was (81.42±8.84)%, which is significantly higher than (11.90±2.75)% of region R5 (P<0.01). FCM analysis showed that significant differences of early apoptosis and later apoptosis were observed in six specimens induced by cisplatin (P<0.05), and significant differences of cell cycle and G₁ period were observed in seven specimens (P<0.05). The qRT-PCR results showed that the mRNA level of ATP7A in region R1, R2, R3, R4 and R5 was (100.00±3.42)%, (118.10±2.21)%, (75.40±4.15)%, (95.40±3.32)% and (41.70±2.57)%, respectively, with significant differences (P<0.05). The mRNA level of ATP7A in region R6 was (175.20±5.32)%, significantly higher than those of regions from R1 to R5 (P<0.05). The mRNA level of ATP7B in region R1, R2, R3, R4 and R5 was (100.00±4.89)%, (73.60±2.65)%, (175.60±6.12)%, (46.10±4.62)% and (363.70±8.67)%, respectively, with significant differences (P<0.05). The mRNA level of ATP7B in region R6 was (1 165.40±7.25)%, significantly higher than those of regions from R1 to R5 (P<0.05). Conclusion The intratumor heterogeneity of ESCC results in the heterogeneity of resistance to cisplatin, which affects the chemotherapeutic effect.