Objective To evaluate free or pedicled perforator flaps for repairing chronic osteemylitis with soft-tissue defect in the distal lower extremity. Methods From May of 2006 to October of 2007, 28 consecutive patients of chronic osteomylitis with soft-tissue defect in the distal lower extremity underwent surgical debridement and reconstruction with free or pedicled perforator flaps. There were 13 free flaps. The free anterolateral thigh flaps were used in 2 cases to repair the soft defects in the front of leg, 3 cases in the front of the malleolus, 2 cases in the dorsum of foot, 2 cases in the heel. The free lateral crural flaps nourished by perone al artery were used in 4 cases to repair the soft defects in the dorsum of foot. There were 15 pedicled flaps. Posterior tibial artery perforator flaps were used in 4 cases to repair the soft defects in the front of leg, and 2 cases in the medial malleolus. Lateral retromalleolar perforator flaps nourished by peroneal artery were used in 6 cases to repair the soft-defects in the heel, 1 case in the lateral malleolus and 1 case in the dorsum of foot, the first dorsal metatarsal artery perforator flap was used to repair the proximal dorsum of hallux. The wound was closed with irrigation-suction in 7 cases and with vancomycin-impregnated gelatin in 8 cases. Results All 27 flaps were successfully survived except insuffcient vein refluence in 1 posterior tibial artery perforator flap, which resulted in a superficial necrosis and healed spontaneously. The follow-up period from 6 months to 2 years revealed that recurrence developed in two diffuse type patients and both were treated once and twice with success, respectively. The others healed without any signs of recurrences. No debulking procedure was necessary in any case. Secondary bone graft was performed in 3 cases. All patients were ambulatory and fully weight-bearing with normal clinical parameters at the time of last review. According to the evaluating criteria for the treatment of foot disease, the mean score was 84.5. Conclusion Free or pedicled perforator flap has been shown to be well vascularised, and it is feasible for the treatment of chronic osteomyelitis with soft-tissue defect in the distal lower extremity.

[ ABSTRACT] AIM:To investigate the changes of peroxisome proliferator-activated receptors ( PPAR)α/peroxi-some proliferator activated receptor coactivator 1 alpha ( PGC-1α) in doxorubicin ( DOX) induced dilated cardiomyopathy ( DCM) and its effect on the energy metabolism and myocardial function in mice .METHODS:Forty mice were randomly divided into 4 groups:control group, DOX group, PPARαinhibitor group and PPARαagonist group.The DCM model was established by injection of DOX.The protein levels of PPARα/PGC-1αwere detected.The PPARαinhibitor and PPARαagonist were used 2 weeks beforeinjection of DOX.The contents of adenine acid and phosphocreatine ( Pcr) in the mito-chondria were measured by high-performance liquid chromatography ( HPLC) .The ANT activity was analyzed by the atrac-tyloside-inhibitor stop technique.The changes of the echocardiography and hemodynamics were also observed.RESULTS:DOX induced DCM model was successfully established.The protein levels of PPARαand PGC-1αin control group were significantly higher than those in DOX group (P<0.05).Both of the high-energy phosphate contents and the transport ac-tivity of ANT were decreased in DOX group (P<0.05), and the hemodynamic parameters were disordered (P<0.01). Compared with DOX group, PPARαinhibitor pre-treatment significantly reduced the PPARα/PGC-1αexpression.Mean-while, high-energy phosphate contents in the mitochondria and the ANT transport activity of the mitochondria decreased, as well as the left ventricular function ( P<0.05) .On the other hand, PPARαagonist significantly increased the expression of PPARαand PGC-1α, and improved the transport activity of ANT.In addition, the hemodynamic parameters were amel-iorated, but the high-energy phosphate contents of the mitochondria did not significantly change.CONCLUSION:PPARα/PGC-1αplays an important role in the regulation of ANT transport activity in dilated cardiomyopathy induced by DOX, and the activation of PPARα/PGC-1αhas protective effects on the DCM induced by DOX.

Objective To explore whether hyperbaric oxygen could enhance the effects of the transplanted stem cell on treating myocardial infarction rats.Methods A total of 70 Sprague-Dawley (SD) Rats was randomly divided into four groups,sham operated,acute myocardial infarction (AMI),mesenchymal stem cells (MSCs) (Stem Cell Transplanting),and hyperbaric oxygen (HBO) + MSCs group,respectively.Myocardial infarction rat model was established,hyperbaric oxygen treatment was carried out every day at the first to 30 day after AMI.Human umbilical cord Wharton jelly mesenchyme cell was transplanted at the third day after AMI.The densities of polymorphonuclear neutrophils and macrophages in the infracted border zones and in the infarcted area of heart were determined with hematoxylin and eosin (HE) staining.The cardiac function was assessed with M-mode transthoracic echocardiography,in vivo.Results (1)Compared to MSCs group,the stem cell proliferation and survival rates were increased significantly at the forth week (276.6 ±73.8 versus 20.5 ± 12.3,P ＜0.01).(2)Compared to the AMI and MSCs groups,the infracted area and the number of inflammatory cell infiltration were significantly reduced in HBO alone and MSCs + HBO groups.(3) Compared to the AMI group,the cardiac function was significantly improved at the different degree in the other three groups;among these groups,cardiac function was significantly improved in the MSCs + HBO group (P ＜0.01),except for the volume of end-dilation (P ＞0.05).Conclusions Hyperbaric oxygenation could significantly promote the proliferation and survival rate of stem cells,and improve the cardiac function.Thus further enhance the effect of the transplanted stem cell on treating the infarcted heart.

Objective The controlled release BMP-2 and implantation into the acoustic bulla of the guineapig and the effects on the cochlea were observed.Methods The acellular cancellous bone was prepared,accompanied with BMP-2.The material accompanied with BMP-2 was implanted into one acoustic bulla of the animal,and the opposite side of the acoustic bulla was implanted with acellular cancellous bone without BMP-2.A total of 20 guinea-pigs were undergone this procedure.The ABR was tested on the animals before and after the operation immediately and 3 month after operation,respectively.3 month after operation,the animals were sacrificed.The osteogenesis induced by BMP-2,the acoustic bulla and the cochlea affected by BMP-2 were observed.The structures of hair cells were observed after being treated with silver nitrate.Results The animals recovered soon after surgery.The hearing thresholds of the animals reduced slightly after the operation,and recovered completely 3 month after.The bulla and the cochlea were normal in shape.The osteogenesis occurred in the pore of the acellular cancellous bone with BMP-2.No abnormal hyperplasia of bone in the hulla and the cochlea was found.The articulation between the stapes and oval window was not merged.The shape of the hair cells was normal and no obvious deletion of the hair cells was noted when compared with control group.Conclusion The controlled release BMP-2 could induce osteogenesis in the bulla of the animals.This material did not affect the shape of the bulla and the hearing thresholds.They did not induce any abnormal hyperplasia of bone in the bulla and might be used to reconstruct the affected ossicles.

The epidemic characteristics and genotype of Bacillus anthracis strains in Liaoning Province ,China was analyze in this study .Six Bacillus anthracis strains from 2001 to 2011 were studied with multiple‐locus variable‐number tandem repeat analysis (MLVA) .BioNumerics4 .0 software was used to analyze the DNA fingerprint of statistics ,and cluster analysis results were obtained .Clustering analysis found that the 6 strains could be divided into two genotypes .For anthrax outbreaks ,the ge‐netic markers of multiple‐locus variable‐number tandem repeat were highly similar .It's suggested that MLVA is quite useful for investigation of strain relatedness in regions of outbreaks .

Objective To evaluate the effect of sevoflurane on cognitive function of mice with Alzheimer's disease.Methods Twenty male mice carrying mnutations in amyloid precusor protein (APP) and presenilin 1 genes,weighing 30-40 g,aged 7 months,were divided into either sevoflurane group (group Sev) or control group (group C),with 20 mice in each group.Mice inhaled 3％ sevoflurane for 4 h in group Sev,and mice inhaled 30％ oxygen for 4 h in group C.At 1 month after inhaling sevoflurane or oxygen,the mice underwent continuous multiple-trail inhibitory avoidance training.The mice were then sacrificed and hippocampi were isolated for determination of the number of Aβ plaques (by immunohistochemistry) and expression of APP and Tau (S396) phosphorylation (by Western blot).Results Compared with group C,the memory lateucy was significantly shortened,the number of Aβ plaques was increased,the phosphorylation of Tau (S396) was increased,and the expression of APP was up-regulated in group Sev (P＜0.05).Conclusion Sevoflurane can decrease the cognitive function of mice with Alzheimer's disease.

Objective To evaluate the clinical outcome of cervical laminoplasty using titanium miniplate ( AO arch) for the treatment of multisegmental cervical spondylotic myelopathy (MCSM).Methods 21 patients with MCSM were operated by cervical posterior unilateral open-door laminoplasty combined with titanium miniplate internal fixation.The JOA score,sagittal diameter of the spinal canal in the midline (SD) and cervical curvature index according to the measurement of Penning method before surgery and at postoperative follow-up intervals were measured and compared by one-way analysis of variance.Results All patients were followed up for 9 ～48 months.There were no severe adverse events.CT sean showed bony fusion at hinge side since six months after operation.According to the JOA score evaluation system,al final follow-up period,9 cases were excellent,7 good,3 ordinary and 2 cases bad.Recovery rate was 62.5 ％ at final follow-up interval.Cervical SD before surgery and in posloperative one month were (9.2 ± 1.1 )mm,(13.5 ± 1.4) mm,respectively.The difference was significant between them( t =3.02,P ＜ 0.01 ),but there was no improvement since one month postoperatively ( P ＞ 0.05 ).Cervical curvature index was ( 12.6 ± 14.7 ) ° preoperatively,it was ( 17.1 ± 12.4 ) ° at final follow-up interval,indicating that cervical curvature index made obvious progress at final follow-up interval ( t =8.26,P ＜ 0.01 ),but there was no significant change within six months postoperatively ( P ＞ 0.05 ).Conclusions Cervical laminoplasty combined with titanium miniplate can enlarge and maintain cervical SD,ameliorate cervical curvature and neurological function,and it is an ideal alternative treatment for MCSM.

Objective To investigate the effects of Calpain inhibitor Ⅰ on glucocorticoid receptor and its transcript activation ability. Methods Raw-264.7 cells were treated respectively with Calpain inhibitor Ⅰ and dexamethasone or both for 24 h. The changes of glucocorticoid receptor were observed. COS-7 cells were co-transfected with PRsh-GR? and pMAMneo-CAT vectors, and then the effects of Calpain inhibitor Ⅰ on glucocorticoid receptor and its transcript activation ability were detected. Results The glucocorticoid receptors was decreased after Raw-264.7 cells were treated with dexamethasone for 24 h. Calpain inhibitor Ⅰ could inhibit this effect to some extent. Co-transfection experiment revealed that Calpain inhibitor Ⅰ could also promote glucocorticoid receptor transcript activation ability. Conclusion Calpain inhibitor Ⅰ can inhibit the down-regulation of dexamethasone on glucocorticoid receptor, but promote glucocorticoid receptor transcript activation ability.

Objective:Rosin alcohol two glycosidase (pinores inoldiglucoside, PDG) effect on the improvement of the osteoporosis in mice and the possible mechanism of action.Methods:A mouse model of osteoporosis was established by removing bilateral ovaries. According to the random number table method, 50 mice were divided into model (MOD) group (equal volume of normal saline), positive control (PC) group (0.2 mg/kg estradiol), PDG-low dose (L) group (5 mg/kg) PDG), PDG-high dose (H) group (10 mg/kg PDG by gavage) and PDG-H+ML385 group (10 mg/kg PDG by gavage after intramuscular injection of 30 mg·kg-1 ML385), 10 mice in each group; Another 10 mice without any ovarian treatment were selected as sham group (intragastric administration of the same amount of normal saline). After 3 weeks of drug intervention, the serum alkaline phosphatase (ALP), tartrate resistant acid phosphatase (TRAP), interleukin-6 (IL-6) and tumor necrosis factor were detected by enzyme-linked immunosorbent assay (ELISA) -α (TNF-α). The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by dual energy X-ray. The mRNA and protein expression levels of nuclear factor related factor 2 (Nrf2), oxidase heme oxygenase 1 (HO-1), quinone oxidoreductase 1 (NQO1) were detected by real-time fluorescence quantitative PCR (qRT-PCR) and Western blot, respectively.Results:The serum ALP levels in Sham, MOD, PC, PDG-L, PDG-H and PDG-H + ML385 groups were (25.88±3.42), (47.42±5.32), (36.20±3.37), (38.95±3.24), (29.66±2.64), (39.57±2.06) U/dL, respectively; The serum trap levels were (2.18±0.40), (4.69±0.83), (3.58±0.38), (3.67± 0.48), (2.93±0.26), (3.81±0.49) U/L, respectively; BMD (153.04±12.96), (86.25±6.71), (126.53±8.99), (119.77±8.84), (139.18±15.94), (92.09±4.17) mg/cm 2; The expression levels of Nrf2 mRNA were 1.00±0.00, 0.35±0.04, 0.67±0.05, 0.54±0.03, 0.82±0.08 and 0.48±0.04, respectively; The expression levels of HO-1 mRNA were 1.00±0.00, 0.25±0.03, 0.56±0.03, 0.47± 0.03, 0.71±0.04 and 0.37±0.04, respectively; The expression levels of nqo1mrna were 1.00±0.00, 0.38± 0.02, 0.63±0.03, 0.58±0.04, 0.79±0.05 and 0.44±0.03, respectively; Nrf2 protein expression levels were 0.98±0.08, 0.26±0.04, 0.52 ±0.06, 0.46±0.03, 0.86±0.07, 0.45±0.05. HO-1 protein expression levels were 0.39±0.02, 0.09±0.01, 0.15 ±0.03, 0.17±0.03, 0.26±0.03, 0.12±0.02. NQO1 protein expression levels were 0.53±0.03, 0.21±0.02, 0.38±0.04, 0.29±0.02, 0.55±0.03, 0.24±0.04, respectively; The levels of serum IL-6 were (104.25±11.35), (515.38±74.48), (351.78± 65.12), (364.73±36.64), (246.18±17.52), (408.93±32.56) pg/ml, respectively; The levels of serum TNF-α were (33.79±3.55), (170.11±19.24), (76.09±8.99), (84.95±6.12), (66.98±3.73), (119.04±9.75) pg/mL, respectively; The serum SOD levels were (258.47±19.25), (72.15±8.12), (187.60±14.63), (152.61±12.36), (204.22±19.65), (138.01±13.62) U/mL, respectively; The serum MDA levels were (2.02±0.27), (4.75±0.73), (3.19±0.46), (3.7±0.49), (2.91±0.42), (4.10 ±0.25) μmol/L respectively. There were significant differences between MOD group and Sham group, or PC, PDG-L, PDG-H, PDG-H+ML385 group and MOD group,or PDG-H+ML385 group and PDG-H ( P<0.05) . Conclusion:PDG can reduce bone inflammation and oxidative stress by activating Nrf2 pathway and improve the state of osteoporosis.