Objective To determine the effect of peripheral nerve regeneration through NGF ·HAMM (Nerve growth factor and Human Ammion membrane Matrix) grafts. MethodsA 1.2 cm defect of the left sciatic nerve were made and then repaired randomly by means of autogenous nerve bridging (group N),NGF · HAMM microporous conduit bridging (group NH) or HAMM microporous conduit bridging (group H) in 60 adult Wistar rats. There were 20 animals in every group. At 1,2 and 3months post operation,the following items as qualitative histology,quatitative histomorphometry,electrophysiology and functional assessments of end-organ reconnection were determined. ResultsAt 2and 3 months post operation,Motor nerve conduction velocity (MNCV) of the nerve repaired with HAMM were lower than that of the nerve repaired with autograft and NGF · HAMM. At 3 months post operation,there was no significant difference between NH group and N group in nerve conduction velocity (P>0. 05). At 2 and 3 months post operation,both NGF · HAMM conduit and nerve autograft groups showed more nerve fibers,bigger axon diameter and thicker meylin sheaths than H group.Conclution The combination of HAMM and NGF world enhance nerve regeneration and myeliogeny,as well as could cooperatively promote the functional recovery of injured nerves and limbs. Our results indicate that the NGF · HAMM microporous conduit is a promising tool for use as a nerve guide tube in peripheral nerve regeneration.

Objective To observe the effect of H shaped decalcified bone grafting on spinal fusion and anti conglutination by posterior approach and to evaluate its values in the application in spinal posterior approach surgery. Methods Total laminectomy was performed on 23 cases of severe spinal stenosis and 31 cases of intraspinal tumor for decompression. Thorough decompression of the nerve roots was performed on the former following total laminectomy while exploration and excision of the neoplasm were done on the latter. Then, H shaped decalcified bone grafts were inlaid between spinous processes and transverse processes to cover the lamina defection and overlap the adjacent segments in all cases. At last, the spinal internal fixation or plaster external fixation were used to stabilize vertebral segments according to the economic status of patients. The average time of follow up was 21 months (18～31 months). Results All patients got successful segmental spinal fusion within 8 months. Clinical symptoms were obviously alleviated in 43 cases at the end of follow up but symptoms recurred 12 months after operation in other 11 cases(all were tumor patients). Conclusion H shaped decalcified bone graft is valuable in spinal fusion and anti conglutination in spinal posterior approach surgery.

Objective　To investigate the surgical management of a gun shot wound of blood vessels and immersied, and evaluate its primary effect. Methods　100 rabbits were divided randomly into simple wounded group(SWG,n=50) and seawater immersion group(SIG,n=50).F emoral arteries were impacted by 0.38 gram steel spheres with velocity of 600 ～800 meters per second fired by 7.62 mm rifle. Animals in SIG were immersed in artificial seawater (pH 8.2～8.4, salinity 25.4,temperature 21℃) for 60 min, o f which those in SWG were spared. Grossly injuried artery was excised and restor ation of blood flow was reconstructed by end-to-end anastomosis or reversed au togenous venous grafting or cryopreserved arterial allografting. At 24 h,7,1 4,21 days after operation, blood flow was examined by Doppler ultrasonic detecti on and part of anastomotic sites and graft were collected for pathological obser vation. Results　In completely transected injury, the patency in SIG was 80.00%,while that in SWG was 86.67% in the first 3 weeks. In arterial c ontused injury ,patency in SIG was 86.67%,and that in SWG was 82.35% at the same time. Thrombosis occurred mostly in the first postoperative week. Atypical endo thelial cells were found at the anastomosis sites in the first postoperative week, and the anastomosis sites were lined with endothelium in 3 weeks postopera tively. Conclusion　Early curative effect could be obtained. Whe n grossly injuried artery is excised and followed by a routine surgical procedur e in the treating gunshot wounds immersed in seawater.

Objective The purpose of this study is to construct eukaryotic gene vector of herpes simplex virus type 1 thymidine kinase(HSV1-tk)and to observe the expression of HSV1-tk in lung adenocarcinoma AGZY cell line.Methods The full length HSV1-tk gene was amplified by PCR from plasmid pHSV 106 and was inserted into pMD18-T.The recombinant plasmid was recombined with eukaryotic vector plRES 2-EGFP u-sing gene recombinant technique .HSV1 -tk was transfected into adenocarcinoma AGZY cell line with Lipo-fectamineTM 2 000.Fluorescence microscopy was used to detect the transfection and expression of HSV 1-tk.RT-PCR was used to detect the mRNA levels of HSV 1-tk.The cell proliferation was measured by MTT assay .Re-sults A length of 1 130 bp gene sequence was obtained by PCR .The expressions of HSV 1-tk at mRNA and protein levels were displayed by RT -PCR and Western blot .MTT analysis showed that there were no significant changes cell survival on after transfection .Conclusion The eukaryotic expression vector of HSV 1 -tk report gene is successfully constructed and HSV 1-tk is effectively expressed in transfected AGZY cells .

Objective To investigate the clinical efficacy of Xinmailong on heart failure in coronary heart disease and on the levels of hs-C-reactive protein (hs-CRP)and N-terminal B-type natriuretic peptide (NT-proBNP).Methods 84 elderly patients diagnosed with heart failure in coronary heart disease were enrolled in this study at our hospital from October 2014 to October 2015.All patients were randomly divided into the control group with conventional treatment(n=42) and observation group with conventional plus Xinmailong treatment(n =42).The Lee's heart failure score,cardiac function grade,quality of life score and the changes of plasma hs-CRP and NT-proBNP after one week of therapy were compared between the two groups before versus after treatment.The adverse reactions were observed during the treatment.Results The clinical efficacy rate of heart failure after treatment was significantly higher in the observation group (83.3％,35 cases)than in control group(54.7 ％,23 cases) (x2 =8.016,P =0.033).The clinical efficacy of heart function after treatment was significantly higher in the observation group(80.9 ％,34 cases)than in the control group (59.5 ％,25 cases) (x2 =6.219,P =0.019).After treatment,the quality of life score was significantly lower in observation group (15.89 ± 3.39) than in the control group (23.80 ± 5.66) (t =7.266,P =0.026).The plasma levels of NT-proBNP and hs-CRP were significantly lower after than before treatment in NT-proBNP[(1 136.6±236.8)ng/L and (2 266.9±260.9)ng/L],and in hs-CRP[(3.06 ±0.26)mg/L and (3.56±0.29)mg/L] (t=6.608、5.106,P=0.019、0.009).There were no serious adverse reactions in both groups during the treatment.Conclusions Xinmailong can not only improve safely and effectively the quality of life of patients,but also block the atherosclerosis of the inflammatory response.

OBJECTIVE:To prepare Xuangui zhitong dispersible tablets and optimize its formulation technology. METHODS:Using disintegration time as index,single factor test was conducted for filler,disintegrating agent,the types and amount of adhe-sives and compression pressure. The amount of mixed disintegrating agent,avicel and gum arabic were optimized by orthogonal test. The tablet quality by optimized formulation was detected,and disintegration time,the content and dissolution rate of tetrahy-dropalmatine were determined;the similarity of in vitro dissolution rate of dispersible tablets and dropping pills were evaluated by similarity factor test. RESULTS:The optimized formulation was composed of 25% MCC as fillers,9% PVPP and 9% L-HPC as mixed disintegrants,85% ethanol solution as adhesives,micro-silica gel 2%,compression pressure of 3.0 kg/cm2. The average dis-integration time was 1.22 min,and the content of tetrahydropalmatine was 1.097 mg/g. The accumulative dissolution rate was more than 80% at 10 min and more than 90% at 15 min. The similarity factor f2 of dissolution curve was 62,using dropping pills as ref-erence preparation. CONCLUSIONS:Xuangui zhitong dispersible tablet had a rapid disintegration and the behavior of dissolution is similar to Xuangui zhitong dropping pills.

Objective:To observe the effect of Er Chen Tang on CYP2E1 and mitochondrial energy metabolism in nonalcoholic fat-ty liver disease ( NAFLD) to explore the role of Pinellinae Rhizoma Praeparata ( PRP) and Citri reticulatae pericarpium ( CRP) in the treatment of nonalcoholic fatty liver disease. Methods:Er ChenTang and the prescription without PRP or CRP was respectively given the animal models by gastric gavage. The serum levels of ALT, AST, triglyceride, cholesterol, SOD and MDA in hepatic tissue, and the contents of liver tissue CYP2E1 and ATP were detected in the mice. Results:The CYP2E1 levels in NAFLD mice increased signif-icantly with abnormal mitochondrial energy metabolism. Compared with those in the model group, the levels of ALT, AST, triglyceride and cholesterol were significantly reduced by Er Chen Tang, meanwhile, the content of CYP2E1 was reduced and also restored liver en-ergy metabolism. The treatment effect significantly decreased when the lack of PRP or CRP, and the ability of restoring liver mitochon-drial energy metabolism of Er Chen Tang decreased significantly when the lack of PRP (P<0. 05). After the removal of CRP, the in-hibition ability of Er Chen Tang to CYP2E1 levels significantly decreased (P<0. 05). Conclusion:Er Chen Tang can effectively im-prove nonalcoholic fatty liver diseases, and effectively reduce the content of CYP2E1 in liver tissue of mice and restore the mitochondri-al energy metabolism.

Objective To determine the clinical implications of internal mammary node biopsy for neoplasm stage,treatment,and prognosis in patients with breast cancer.Methods Internal mammary node biopsy via intercostal space was performed in 229 cases of breast cancer.Anatomical location of internal mammary nodes was recorded.Results Internal mammary node biopsy was successfully finished in 220 patients.There were 56 cases (24.45％ ) with internal mammary nodes metastasis,126 cases (55.02％ ) with axillary nodes metastasis,43 cases (34.13％ ) with regional metastases in both the axillary and internal mammary lymph nodes and 13 cases ( 12.62％ ) with internal mammary node metastasis only.Internal mammary node metastasis rate in patients with the number of positive axillary nodes ≥4 was 49.32％ (36/73).pN stage migration was seen in 56 patients with positive internal mammary nodes.There was no statistic relation between internal mammary nodes metastases and tumor location ( x2 =0.661,P =0.719).70.7％ patients with medial/central tumors and 50.7％ patients with the number of positive axillary nodes ≥4 were free from internal mammary node radiotherapy on account of internal mammary node biopsy.There was no complication such as pneumothorax or haemorrhagia.Conclusions Internal mammary node biopsy from intercostal space is a reliable surgical technique and can improve pN stage in some breast cancer patients.With internal mammary node biopsy,patients with a negative internal mammary node can be prevented from radiation to internal mammary nodal areas.

Objective To explore the best operation method in the patients with papillary thyroid microcarcinoma.Methods A total of 139 patients with papillary thjroid microcarcinoma were treated at our institute between Jan.2000 and Jan.2010.The data on the clinicopathological characteristics of patients and treatment were collected.Results The mean tumor size was (0.45 ± 0.24) cm.Of the 139 patients,30.2％ had multifocal tumors,19.4％ had bilateral tumors,42.4％ neck lymph node metastases.The number of eases of lymph node metastasis in level Ⅵ,Ⅱa,Ⅲ and Ⅳ was 58(41.7％),3(2.2％),10(7.9％),5(3.6％),respectively.Only one had lymph node metastasis in Level Ⅲ Microscopic extrathyroid extension was associated with neck lymph node metastases in papillary thyroid microcareinoma patients (x2 =38.39,P ＜0.001).No one developed permanent hypoparathyroidism.The median follow-up time was 103 (range,30-154) months,and local recurrence in the thyoid was diagnosed in 2 patients who underwent hemi-or subtotal thyroidectomy.Follow-up of 10 years was done in 16 cases,and the survival rate of 139 patients for 10-year was 100％.Conclusions It suggested that patients with papillary thyroid microcarcinoma has uniform clinicopathologic characteristics and the pattern of lymph node metastasis from those with papillary thyroid carcinoma.Total thyroidectomy plus level Ⅵ dissection is the optimal surgical treatment of papillary thyroid microcarcinoma.

OBJECTIVE: To study the influence of polar patel-lectomy and the site of reanchored the patellar tendon on femoral quadriceps extensing force. METHODS: The experiment was designed by using 5 lower limbs of cadavers for extracorporal biodynamic test. The maximal fixing force of the double stainless steel wire (0.4 mm in diameter) reanchoring the patellar ligament to the patellar cortical edge was measured. Clinically 21 patients with polar fractures were treated by removing the small fragments and reanchoring the patellar ligament to the cortical edge of the patella using the wires. RESULTS: Resection of the lower 1/4 part of the patella and the patellar ligament reanchored to cortical edge of the patella would not increase femoral quadriceps contracting force arm. But if the patellar tendon reanchored near the joint surface, much more extending force would be needed than the former (P<0.001). The maximal fixing force of the wires is 67.4 kg (60.9-72.5 kg). All the patients using this modified procedure gained satisfactory functional recovery. CONCLUSIONS: The modified partial patellecomy is a simple and effective procedure for choice.