Objective To report the improved operative technique and clinical results of sural nerve nutritional vessel axial flap Methods Based on anatomical studies,the sural nerve nutritional vessel flap pedicle with the lowest perforating branch of the peroneal artery were performed to repair the soft tissue defects of the lower leg,the ankle and the foot Results The modified flaps were applied in 7 cases,all flaps survived completely The size of the flap ranged from 30 cm?10 cm to 23 cm?8 cm The length of pedicles were 1 6～3 0 cm The colour and texture of flaps were excellent,the outline and functional results were satisfactory after 6～12 months follow up Conclusions This new procedure can enlarge the survival and repairing area of the flap,it can also solve the distortion problem of fasciocutaneous pedicle The blood supply of this flap is reliable Flap elevation is easy and quick It is very useful in repairing large skin defects of the lower leg,the ankle and the foot

Objective: To develop titanium posted keeper removable magnetic attachment and to decrease its influence on magnetic resonance imaging(MRI). Methods: Pre fabricated soft magnetic alloy pin cap keeper(PSAPK), casting non precious alloycoping keeper(CNPAK), casting precious alloy coping keeper(CPACK), titanium post keeper(TPK) and titanium post(TP) were prepared and applied on the maxilla of a volunteer, MRI was taken and measured. Results: ①The attachments producing artifacts in MRI from the biggest to the smallest were listed in following rank: PSAPK, CNPAK, CPACK, TPK and TP. ②After removing the keeper from titanium post keeper, the post had no artifact on MRI. ③The artifact was the smallest taken with SE sequence. Conclusion: Titanium post keeper is an effective way to solve the artifact problem and will bring benefits to the patients who need MRI examination of head.

Objective To report the improved operative technique and clinical results of posterior neurocutaneous vascular axial flap in the forearm Methods A reversed posterior neurocutaneous vascular flap in the forearm pedicle with dorsal branch of anterior interossea vessel were designed to repair the skin defects of hand and wrist Results The modified flaps were applied in 8 cases,all flaps survived completely The colour and texture of flaps were good,the outline and functional results were satisfactory after 6～12 months follow up Conclusion This type of flap is easy to dissect,blood supply is reliable,and major vessels in the forearm is preserved,It is suitable for repairing large skin and soft tissue defects of first web, dorsal aspects of wrist and palmar

BACKGROUND:As a kind of adult stem cel s with low immunogenicity, mesenchymal stem cel s are able to differentiate into different cel lineages in the treatment of many diseases. Moreover, mesenchymal stem cel s have been extensively used in many fields such as stem cel transplantation, immune therapy, and tissue engineering. OBJECTIVE:To review the progress of homing mechanism and the strategies to promote mesenchymal stem cel homing, thus providing a theoretical basis for transplanting mesenchymal stem cel s safely and efficiently. METHODS:The CNKI and PubMed databases were retrieved by computer for articles regarding mesenchymal stem cel homing published from 2000 to 2016, including reviews, basic and clinical studies. The key words were“mesenchymal stem cel s, homing”in Chinese and English, respectively. Then 74 papers were suitable for final analysis. RESULTS AND CONCLUSION:Mesenchymal stem cel homing needs further research, especial y the molecular mechanism of cel mobilization. Therefore, basic research about mesenchymal stem cel s should be further developed, and a standardized homing system should be established in vitro. In addition, it is of great significance to study the in vivo effects of transplanted gene-transfected mesenchymal stem cel s.

Objective To evaluate the therapeutic value of total thyroidectomy in the thyroid carcinoma.Methods 87 patients of thyroid carcinoma were operated by one surgeon with total thyroidectomy from 1985-2000 in our hospital, We carried out a retrospective research for the complication rates and postoperative iodine 131 treatment. Results Observing after operation revealed that there were 2(2.3%) of recurrent laryngeal nerve damage, 1(1.1%) of thypocalecimia, 1(1.1%) of atelectasis, and no deaths, permanent laryngeal nerve damage, or permanent hypocalcemia.Conclusion Total thyroidectomy is safe and effective procedure in the treatment of thyroid carcinoma, this approach can offer the advantage of removal of tissue at risk for malignant transformation,and enhances the use of the postoperative iodine 131 treatment.

Objective:To investigate the role of Smad7 in the Hepatocellular carcinoma (HCC) migration and proliferation and its clinical significance.Methods:Through transfecting pcDNA3.1 (+)-Smad7 or siRNA Smad7 to overexpress or knockdown the Smad7 expression in HCC cell lines HepG2 and Huh7.The MTT assays were used to test the role of Smad7 in proliferation of HCC cells.Transwell and wound-healing assays were used to detect the effect of Smad7 on migratory ability in both tow cell lines.RT-PCR was used to test the Smad7 expression in 9 clinical HCC patients' specimens.Results:As the results,overexpression of Smad7 significantly inhibited the proliferation of cells compared with the control group,while knockdown Smad7 promoted the proliferation.At the same time,overexpression of Smad7 could inhibit the migratory ability of HCC cells compared with the control group,while knockdown smad7 could accelerate this ability.The expression of Smad7 in cancer tissue was significantly lower compared with normal mucosa tissue adjacent to cancer.Conclusions:Smad7 is a kind of anti-progressive molecule in HCC.

Objective To investigate the effect of ANX A1 on the biological characteristics of papillary thyroid carcinom cells by interfering with the expression of Annexina A1 (ANX A1) in papillary thyroid carcinoma cells through small interfering RNAs (siRNA).Methods The designed highly efficient siRNA was used to conduct the specific interfence on ANXA1 expression in the papillary thyroid carcinoma TPC-1 cells.The effect of ANXA1 on TPC-1 apoptosis in PTC was observed by flow cytometry.Results The designed siRAN could efficiently inhibit the expression of ANXA1 mRNA in PTC,enhanced the cell apoptosis in TPC-1 cells in vitro.Conclusion siRNA can interfere with the expression of ANXA1 and promote the apoptosis of papillary thyroid carcinoma which suggesting that ANXA1 may be an important biological target for the treatment of papillary thyroid carcinoma.

Objective To investigated the potential influences of poly(lactic-co-glycolicacid)(PLGA)scaffold as a platform on the differentiation of mouse bone-marrow stem cells to islet-like cells.Methods Mouse bonemarrow stem cells were grown and differentiated in culture with or without PLGA scaffold,and cell morphology and functions were compared within these groups.Results The PLGA scaffold showed fine biological compatibility.Differentiated islet-like cells were dithizone (DTZ) positive,insulin and C-peptide double positive,glucagon positive and somatostatin positive in both groups.Under electron microscope there were ultrastructures similar to that of islet β cells in cells of both groups.Cells with PLGA scaffold secreted more insulin under high level glucose stimulation (P＜0.01).Conclusions PLGA scaffold was biologically compatible and improved function of the differentiated islet-like cells.

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.

Objective To report the improved operative technique and clinical results of reversed saphenous neurocutaneous vascular flap. Method Under the guidance of Doppler flowmeter,a reversed saphenous neurocutaneous vascular flap pedicle with the perforating branches of the tibialis posterior artery were designed to repair the skin defects of the middle and lower leg,the ankle and the foot. Results The modified flaps were applied in 7 cases,all flaps survived completely. The size of the flaps ranged from 15cm?8cm to 5cm?4cm,the location of the perforating branches were 8～20 cm above the medial malleolus. The colour and texture of the flaps were excellent,the outline and functional results were satisfactory after 6～18 months follow up. Conclusions The flap is easy to design and dissect,blood supply is reliable,it is suitable for repairing the soft tissue defects of the middle and lower leg,the ankle and the foot. It is a new type of flap combining the neurocutaneous vascular flap with the perforator flap.