Objective To study the clinical results of grafting of vascularized fibular and ilium to repair bone defects of limbs. Methods From January 1992 to January 2004, 49 cases of bone defects of limbs were treated with vascularized fibular grafting (33 cases) and vascularized iliac grafting (16 cases). Their limb functions were graded according to Ennekings system. The changes of the vascularized fibular and iliac grafts were evaluated radiographically according to the International Symposium on Limb Salvage. Results All the patients were followed up for 1 to 12 years. In the vascularized fibular group, the recovery rate for the operated limbs was 82.7%, the average healing time of the bone was 16.8 weeks and the healing rate of the bone was 87.9%. In the other group, the recovery rate of the operated limbs was 88%, the average healing time of the bone was 15.2 weeks and the healing rate of the bone was 93.8%. Conclusion The vascularized fibular graft can be adopted to repair long bone defects of lower limbs and distal radius, while the vascularized iliac graft can be adopted to repair the bone defects of upper limbs.

BACKGROUND: Due to a new finding in the in vitro proliferation and differentiation of neural stem cells, neural stem cells are regarded as optimal materials for repairing and replacing the injured neural tissues. But how to enhance the proliferation of neural stem cells and how to induce neural stem cells to differentiate into certain phenotypes remain objects for discussing.OBJECTIVE: To investigate the frozen/nonfrozen storage techniques in isolation and cultivation of neural stem cells isolated from human brain and to discuss the conditions suitable for their differentiation.DESIGN: A single sample based on cells.SETTING: Urinology Institute of Jiangxi Medical University and Neurosurgery Department of Second Hospital Affiliated to Jiangxi Medical College.MATERIALS: From December 2003 to June 2004, this study was conducted at the Urinology Institute of Jiangxi Medical College. Brain tissues removed from sixteen-week-old embryos were studied.METHODS: After being digested with trypsin, cells were separated from the brains of embryos. They were cultured in the serum-free media, stimulated by basic fibroblast growth factor and epidermal growth factor and were induced to differentiate using serum. Immunofluorescent cytochemical staining technique was adopted to detect the expressions of the Nestin and the neuron-specific enolase(the marker for mature neural cells) in these cells. The influence of basic fibroblast growth factor, epidermal growth factor and serum on the proliferation and differentiation of the neural stem cells were investigated.MAIN OUTCOME MEASURES: The main outcome measurements in this tification of the Nestin and the neuron-specific enolase in these cells.bryo brain successfully. The embryo brain cells in primary culture were clear and round. After 3 days some cells aggregated to form neurospheres and some others suspended. Two weeks later, the neurospheres enlarged and a part of cells in it expanded into folds with strong reflection and proliferation. The continuous cultured cells inherited these characteristics and kept the morphological properties. The clones were cultured in the medium with serum. Twenty-four hours later, most of the cells were attached to the bottom of the plates. Cells were dissociated from the neurospheres and became irregular. Forty-eight hours later, most of the cells differentiated into many scattered patches of astrocytes with various shapes and neurites and many isolated neural stem cells were continuously cultured in vitro and they expressed Nestin, the marker of neural stem cells. After being cultured in medium with serum for 48 hours, the differentiated cells mainly expressed freeze-thaw cells were alive. Their living status had no significant difference compared to that of the fresh isolated cells.CONCLUSION: Serum-free culture medium, together with basic fibroblast growth factor and epidermal growth factor, enables the in vitro culture, proliferation and purification of the neural stem cells. The feasibility of the method is confirmed. Meanwhile, the comparison between the cultures of freeze-thaw cells and fresh isolated cells indicated that frozen storage can be used as a way to preserve the human embryo brain cells, which will be available for study after thaw.

Objective To investigate the expression of astrocyte elevated gene 1(AEG-1) in non-small cell lung cancer(NSCLC) and its clinicalpathological significance .Methods The expression of AEG-1 in NSCLC tissues and adjacent normal lung tissues was detected by RT-PCR and Western blot .The expression of AEG-1 in 87 NSCLC samples and 54 non-cancerous lung tissues was ex-amined with immunohistochemistry .Results RT-PCR and Western blot indicated that AEG-1 was more expressed in NSCLC tis-sues compared with adjacent normal lung tissues .The positive rate of AEG-1 in NSCLC tissues was 52 .9% ,which was significantly higher than that in non-cancerous lung tissues .The difference between the two groups was significant (P=0 .007) .Relevance was analyzed between the expression of AEG-1 and clinicalpathological characteristic .The expression of AEG-1 was positively correlated with T stage and N stage(P<0 .05) .Conclusion AEG-1 was specifically up-regulated in NSCLC tissues compared with non-can-cerous lung tissues ,suggesting that AEG-1 may play an important role in tumor development and progression ,and could be identi-fied as a biomarker for diagnosis of NSCLC .

Objective:To evaluate effect of different induction chemotherapy on the clinical efficacy of concurrent intensity-modulated radiotherapy (IMRT) and chemotherapy and identify the prognostic factors in non-endemic locally-advanced nasopharyngeal carcinoma patients.Methods:Clinical data of 210 patients with stage Ⅲ-Ⅳ B(excluding stage T 3-4N 0M 0) nasopharyngeal carcinoma treated in our hospital from 2012 to 2017 were retrospectively analyzed. According to the efficacy of different induction chemotherapy, all patients were divided into the effective group (14 cases of complete remission and 165 cases of partial remission) and ineffective group (31 cases of stability and 0 case of progression). Survival analysis was performed by Kaplan- Meier method. Multivariate analysis was conducted by using Cox′s regression model. Results:Compared with the ineffective group, the 3-year overall survival (OS)(89.2% vs. 74.2%, P=0.005), recurrence-free survival (RFS)(93.0% vs. 81.9%, P=0.010) and progression-free survival (PFS)(80.2% vs. 58.1%, P=0.005) were significantly higher in the effective group, whereas the distant metastasis-free survival did not significantly differ between two groups (84.1% vs.69.7%, P=0.070). Multivariate analysis showed that the tumor response to induction chemotherapy was an independent prognostic factor for OS, RFS and PFS. Conclusions:Tumor response to induction chemotherapy might be a prognostic factor for non-endemic locally-advanced nasopharyngeal carcinoma patients. Clinical prognosis of patients with poor response to induction chemotherapy is even worse. More intensive treatment and closer follow-up may be needed for these patients.

Objective To investigate the effect of Miao medicine Jinwu Jiangu decoction containing serum freeze-dried powder on levels of IL-17,ACT1 and TRAF6 in human rheumatoid arthritis fibroblast like synoviocytes (RA-HFLS).Methods Rabbits were randomly divided into blank control group (recieving normal saline of the same volume),Jinwu Jiangu decoction high-dose,medium-dose and low-dose group (intragastrically administrated with Jinwu Jiangu decoction at doses of 14.4,4.8 and 2.4 g·kg-1,respectively),tripterygium glycosides group and prednisone group (treated with human equivalent dosage).RA-HFLS primary cell model was established in the experiment.ELISA method was used to detect effect of lyophilized powder on IL-17 secretion.Expression of ACT1,TRAF6 mRNA was detected by RT-PCR.Results Compared with the blank control gorup,IL-17 in the supernatant of each medication administration group was significantly decreased (all P<0.01),and it was decreased most significantly in Jinwu Jiangu decoction high-dose and medium-dose group.IL-17 was down-regulated more significantly in high-dose group than that in tripterygium glycosides group (P<0.01).Compared with the blank control group,TRAF6 and ACT1 mRNA expression level of each medication administration group were significantly decreased (all P<0.01),and in the high-dose group that were decreased most significantly,but not significantly different as compared with tripterygium glycosides group and prednisone group (P>0.05).Conclusion Freeze-dried powder of Jinwu Jiangu decoction can decrease the secretion of IL-17 and down-regulate expression of ACT1,TRAF6 with RA-HFLS.

Objective To investigate the clinical values of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) and magnetic resonance imaging (MRI) in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma.Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery.The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy.The gross tumor volume (GTV) and clinical target volume (CTV) determined by PET-CT and MRI were compared;the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test.Results Fourteen patients had residual lesions after surgery.The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI (92.86%, 94.87%, 86.67%, 97.37%, and 94.34% vs.57.14%, 76.92%, 47.06%, 83.34%, and 71.70%, all P<0.05);the specificity, positive predictive value, and accuracy of PET-CT in detecting lymph node metastases were also significantly higher than those of MRI (all P<0.05), except for the sensitivity and negative predictive value (P>0.05).For the 14 patients with residual lesions, GTVPET/CT was significantly smaller than GTVMRI(45.62±22.13 cm3 vs.60.61±23.12 cm3, P=0.034), so did CTV (125.54±17.53 cm3 vs.142.18±21.22 cm3, P=0.011).There was no significant difference between CTVPET-CT and CTVMRI in 39 patients without residual lesions after surgery (117.87±17.66 cm3 vs.128.05±20.65, P=0.099).Conclusions PET-CT is superior to MRI in detecting the residual lesions and lymph node metastases after surgery in patients with oropharyngeal squamous cell carcinoma, which provides valuable information for radiotherapy planning.

BACKGROUND: Bone marrow cell transplantation is a simple and effective treatment to promote angiogenesis. The neovascularization and reestablishment of blood circulation is crucial to the repair of injured but still living neurons as well as to the survival and differentiation of the implanted tissues and cells. However,it is not clearly known whether autologous bone marrow cells implantation could promote neovascularization and facilitate reestablishment of circulation in ischemic regions of the brain.OBJECTIVE: To investigate the effect of autologous bone marrow cell transplantation via the carotid artery on angiogenesis in the ischemic regions of the brain.DESIGN: A randomized controlled experiment based on experimental animals.SETTING: Department of neurosurgery and institute of urinary surgery in a university hospital.MATERIALS: The experiment was conducted in the Laboratory of the Department of Neurosurgery,Second Affiliated Hospital,and the Institute of Urinary Surgery,Jiangxi Medical College during the period from September 2002 to April 2003,using 10 specific pathogen-free male SD rats weighing 250 - 300 g.INTERVENTIONS: Rat models of focal cerebral ischemia model were established and randomized equally into two groups. The rats in the transplantation group were injected with autologous bone marrow cells via the carotid artery and those in the control group normal saline injection. The angiogenesis in the ischemic regions of the brain was observed with immunohistochemical staining for microvessel counting.MAIN OUTCOME MEASURES: The density of microvessels. Immunohistochemical staining for F8.RESULTS: Greater density of the microvessels was found in the ischemic regions after bone marrow cell transplantation than in the control group[(159. 15 ±40.4)/mm2 vs(81.70 ± 32. 18)/mm2,P ＜ 0. 05] . Numerous endothelial cells were found scattered in the ischemic cortex of the transplantation group,but scarcely in the control group.CONCLUSION: Autologous bone marrow cell transplantation via the carotid artery can promote angiogenesis in the ischemic regions of the brain.

Objective To introduce a new method for correcting prominent malar complex deformity. Methods Through an intraoral incision, the highest area of zygomatic body marked preoperatively was grinded. Then an L shape incomplete osteotomy of the zygomatic body was performed with a reciprocating saw, and a complete osteotomy just 1 cm anterior to the articular tubercle of the zygomatic arch was made. Light pressure on the posterior part of the arch produced a greenstick fracture of the anterior osteotomy site, resulting in posterior-inward repositioning of the malar complex. Internal fixation was unnecessary. Results Operative procedures for reductive malar complex plasty were performed in 650 cases, which included 60 males and 590 females whose age ranged from 19 to 39 years.Incisions of all cases healed well. One case had maxillary sinusitis 2 weeks postoperatively, and recovered after 1 week by using antibiotics and drainage. There was 1 case with skin necrosis about 1 cm in diameter in the area of zygomatic body because of local liposuction, and the wound was healed by changing dressing. The forehead wrinkle of one side had disappeared in 1 case 1 week postoperatively, but had recovered 2 weeks later. Postoperative follow-up for 2-24 months showed satisfactory results.Conclusions This modified method has many advantages, such as simplicity, without internal fixation, short operation and recovery time, and little complications. The authors conclude that this technique is an effective and safe method of reduction malarplasty.

Objective To assess the therapeutic efficacy of colonic tumor with targeted microbubbles encapsulated VEGFR2 monoantibody (mAb) combined with ultrasonic abrupted destroy.Methods Seventeen Balb/C nude mice with subcutaneous colonic carcinoma xenografts were divided into three groups:group A (5 mice) underwent contrast-enhanced ultrasonography (CEUS) examination and sham ultrasonic abrupted destroy;group B (6 mice) underwent lipid-microbubbles administration combined with ultrasonic irradiation;group C (6 mice) underwent VEGFR2 monoantibody-loaded microbubbles injection combined with ultrasonic irradiation.Red fluorescent protein(RFP) was labeled to all the nude mice model.Both CEUS and flurography were performed before and one week after abrupted destroy.The size,fluroscent area and fluroscent intensity(FI) and vessel density (VD) of each tumor were measured and compared.Results The parameters of length,fluroseent area,FI and VD of each tumor before abrupted destroy were no significant difference among three groups ( P ＞0.05).Parameters of post-sham ultrasonic abrupted destroy in group A were higher than those before sham ultrasonic abrupted destroy ( P ＜0.05).FI and VD in group B were significantly lower than those after abrupted destroy( P ＜0.05).There were no difference of length,fluroscent area of tumor in group B between pre- and post- ultrasonic abrupted destroy (P ＞0.05).Length,fluroscent area,FI and VD of each tumor in groups C were decreased significantly compared with post ultrasonic abrupted destroy ( P ＜0.01 ).There were significant difference of length,fluroscent area,FI and VD of each tumor among groups after ultrasonic abrupted destroy( P ＜0.05).Conclusions VEGFR2 mAb-loaded lipid microbubble combined with ultrasonic abrupted destroy can improve the therapeutic efficacy of colonic tumor.

Objective To observe the effects of Chinese medicine ingredient ginger phenol on expressions of IL-17 and IL-23 in collagen-induced arthritis (CIA) rats;To investigate the role and mechanism of ginger phenol in CIA rats.Methods Forty female Wistar rats were randomly divided into 4 groups:blank group, model control group, ginger phenol treatment group and tripterygium glucosides control group. After CIA was established in rats successfully, ginger phenol treatment group and tripterygium glycosides control group were treated with ginger phenol and tripterygium glycosides by gavage, while the control group and model control group were fed with the same amount of saline. Four weeks after the treatment, the rats were collected serum and sacrificed. The pathological of CIA joint synovial was observed by electron microscope. The expressions of IL-17 and IL-23 in serum were detected by ELISA.Results The hyperplasia of synovial tissue and angiogenesis was reduced in gingerol phenol treatment group. Infiltration of inflammatory cells and edema was improved. IL-17 and IL-23 expressions of in serum of CIA rats were significantly higher than those of the blank group (P<0.01). Ginger phenol and tripterygium glycosides down-regulated the expressions of IL-23 and IL-17 (P<0.05,P<0.01). Ginger phenol group was better than that of tripterygium glycosides control group (P<0.05).Conclusion Chinese medicine ingredient ginger phenol can reduce expressions IL-17 and IL-23 in serum of CIA rats.