Objective To probe the application of superimposed flaps in hand surgery. Methods Form March 1998 to December 2003, we repaired 35 cases of skin defects with non trunk blood flaps and neurocutaneous vascular flaps. The area of flaps ranged from 1cm?1cm to 6cm?8cm. Results After operation, the flaps in 33 cases survived, but died in 2 cases due to unsuitable design. The follow ups ranging from 6 to 12 months showed that the quality and color of the survived flaps were similar to those of the normal tissue around. No swelling was found. Conclusion The superimposed flaps have reliable blood supply so that they are an ideal means to repair skin defects of hand.

Objective To establish small-for-size (SFS) graft injury models in miniature pigs with high standardization, reproducibility and similarity to clinical situation. Methods Ba-Ma miniature pigs were introduced in this study and orthotopic liver transplantations (OLTs) were performed in 12 pigs with 30% liver volume allogeneil grafts (small portion of right paramedian lobe, right lateral lobe and caudate lobe) without veno-venous bypass. The profiles of intra-operational hemodynamics and metabolism were investigated. Animals were observed for 7 days with daily serum biochemistry and coagulation function exam. The survival rate related to operation itself and the SFS grafts were respectively calculated as well as the graft regenerative ratio at post-operational day (POD) 7. Results Graft weight as a percentage of the recipient's native liver weight (GW/RLW) and the total body weight (GW/BW) were (28. 63±4. 42)% and (0. 73±0.06)%. The mean operation time, anhepatic phase, and the time of blockage of infra-hepatic IVC were (191. 7±14. 2) min, (28. 3±3. 6) min, and (45. 0±5. 8) min. The survival rate related to the operation itself and the SFS graft were 83. 33% (10/12) and 40% (4/10), and the graft regenerative ratio at POD7 was (278. 06±42. 95) %. Contrast to the remarkable increase of heart rate and serum potassium during anhepatic phase, the mean arterial pressure, central venous pressure, rectal temperature, PH value and buffer excess had a significant decrease (P<0.01) with a gradual recovery after reperfusioa Serum ALT, AST, PT, Cr, and TB were significantly increased with a peak level at POD1 for the former 4 and POD2 for TB, and then began to decrease and favorably recovered at POD7, but TB, PT, and AST levels were still high when compared to those of prereperfusion (P<0. 05). Conclusion This model of OLT performed with 30% liver volume graft without veno-venous bypass was an ideal large animal model for series studies related to SFS graft injury.

OBJECTIVETo establish a near-infrared qualitative analysis model to identify the authenticity of Polygonum multiflo- rum and distinguish processed products Polygoni Multiflori Radix.

METHODThe NIR spectra were peformed on over 30 batches of P. multiflorum and Polygoni Multiflori Radix samples and the adulterants Cynanchum bungei, Pteroxygonum giraldii, Polygonum cillinerve to establish the qualitative discriminant model and the conformity test model of Polygonum multifiorum , and cluster analysis was used to analyze the samples from different origins.

RESULTThe model is able to identify correctly P. multiflorum with its counterfeit, and distinguish between P. multiflorum and Polygoni multiflori Radix.

CONCLUSIONNear-infrared spectroscopy can be applied in the identification of P. multiflorum, which could be used to screen Chinese herbal medicine preliminarily.

Drugs, Chinese Herbal ; chemistry ; Plant Roots ; chemistry ; Polygonum ; chemistry ; Spectroscopy, Near-Infrared ; methods

Acromioclavicular Joint ; injuries ; External Fixators ; Humans ; Joint Dislocations ; surgery ; therapy ; Laparoscopy ; Thinking

Objective To study the effect of antiapoptosis factors PED/PEA-15 and XIAP on prostate cancer cells(PC-3)apoptosis.Methods The expressions of XIAP and PED/PEA-15 in prostate cancer cells(PC-3)were respectively assayed using the RT-PCR technique.XIAP and PED/ PEA-15 specific siRNA vectors were designed and constructed and then were transiently cotransfected into PC-3 cells under induction of liposome.The effects of siRNA vectors on PED/PEA-15 and XIAP transcription were assayed by RT-PCR technique,and the effect of XIAP and PED/PEA-15 on cancer cell apoptosis were determined by flow cytometry and microscope observation.Results PED/PEA- 15 and XIAP were both highly expressed in PC-3 cells.Enzyme digestion analysis and DNA sequencing confirmed that the PED/PEA-15 and XIAP-specific siRNA expression vectors were constructed successfully.The designed siRNA sequences of PED/PEA-15 and XIAP could specifically inhibit their transcription.The PC-3 cells which were cotransfected with PED/PEA-15 and XIAP- specific siRNA vectors were more sensitive to doxorubicin.The apoptosis rate of cotransfected cells was significantly increased.Conclusions PED/PEA-15 and XIAP might be involved in the development of prostate cancer.

Objective To evaluate the effects of bone morphogenetic protein 2(BMP-2)gene modified tissue engineering bone combined with vascular bundle implantation in repairing segmental bone defect.Methods The isolated rabbit hone marrow stromal cells(MSCs),after being transfected by adenovirus carrying BMP-2 gene(Ad-BMP-2),were seeded on bovine cancellous bone scaffolds(BCB) to construct gone modified tissue engineering hone.The rabbit models with radial defects(2.0 cm long) were made and repaired with four methods including gene modified tissue engineering bone with vascular bundle implantation(Group A),gene modified tissue engineering bone(Group B),nongene modified tissue engineering bone with vascular bundle implantation(Group C),and only BCB scaffolds(Group D).After 4,8,and 12 weeks of operation,X-ray,histological examination,biomechanics analysis and capillary vessel ink infusion were conducted to observe angiopoiesis and osteogenesis.Results Group A gained better effect in the volume and activity of new bones than other groups,with vascular bundle sending out new branches into the transplanted bones and productive regeneration of capillary vessel.The defect in Group A was repaired satisfactorily.Group B showed better effect in speed and quality of bone formation than Group C under induction of BMP-2 gent.Mainly fibrous tissues but not new bones were observed in Group D.Conclusion BMP-2 gene therapy with vascular bundle implantation has very strong osteoinduction ability and quite good vascularization effect and is of great value to the treatment of bone nonunion and bone defects.

Objective To evaluate the clinical value of 18floro-deoxyglucose positron emission tomography-CY(~(18)FDG PET-CT)in the diagnosis of lymph node metastasis from advanced esophageal carcinoma. Methods A prospective study is perfonued here to assess whether ~(18)FDG PET-CT can improve the diagnostic accuracy in lymph node metastasis for patients with advanced esophageal carcinoma.Thirty patients had undergone esophagectomy with extensive lymph node dissection.PET-CT findings were compared with that d CT with pathological finding as the final say.Results All patients were operated successfully without peri-operative complications.The pathological examination conformed metastasis in 22 patients and 49 out of 243 excised lymph nodes.In CT analysis,the sensitivity was 40.8%,specificity was 96.9%,with a diagnostic accuracy of 85.6%, The positive and negative predictive value was 76.9%,86.4% respectively;PET-CT resulted in a sensitivity of 93.9%,specificity of 91.2%,accuracy of 91.8%.The positive predictive value was 73.0% and negative predictive value was 98.3%,The difference of sensitivity(P＜0.001),accuracy(P＜0.05)and negative predictive value between the two radiological modalities was statistically significant(P＜0.001).Conclusions With a high sensitivity and accuracy in the diagnosis of lymph node metastasis,PET-CT appears necessary in preoperative examination for advanced esophageal carcinoma in the hope that surgical treatment be guided by the results of PET-CT,especially for the elder patients with poor pulmonary function or heart or brain complications. Moreover,it could be used as the basis of the conformal radiation therapy planning for inoperable patients.

Objective To evaluate the clinical value of 18-fluoro-deoxyglucose positron emission tomography-CT(~(18)FDG PET-CT) for recurrence and metastasis in treated esophageal carcinoma (EC). Methods A retrospective study is done on 37 previously treated EC patients who underwent PET-CT scans to detect recurrent or metastatic lesions.The diagnostic accuracy of ~(18)FDG PET-CT was assessed with the help of pathological finding as well as clinical or follow-up data.Results Fourty-six sites of recurrence were finally confirmed in 37 patients by cytology,pathology or follow-up data.The sensitivity,specificity and accuracy of PET-CT in detecting recurrence of all sites were 93.5% (43/46),76.9% (20/26) and 87.5% (63/72),respectively.Two false-positive findings were found both at the anastomosis and hilar nodes,which caused the decrease in the overall specificity,especially that locally.The analysis of standard uptake value (SUV) demonstrated that patients with recurrence or who died during follow-up had higher SU- Vs compared with the control group.Condusions ~(18)FDG PET-CT is highly effective in detecting recur- rence in previously treated EC patients despite the low specificity at local sites.The analysis of stardard up- take value(SUV) provides incremental value in prognosis for this patient cohart.

OBJECTIVETo compare the difference in the clinical efficacy on cervical spondylosis of vertebral artery type (CSA) treated with thermosensitive moxibustion at different dosages.

METHODSSixty cases of CSA were randomized into a saturated moxa dosage group and a regular moxa dosage group, 30 cases in each one. The thermosensitive moxibustion was adopted in the two groups. The mild suspended moxibustion was applied at two acupoints with the strongest thermosensitization. In the saturated moxa dosage group, the moxibustion time was determined by the disappearance of thermosensitization. In the regular moxa dosage group, 15 min was required on each acupoint. The treatment was given twice a day for first 4 days in the two groups. Since the 5th day, the treatment was given once a day, continuously for 10 times, and totally 14 days were required. The score of symptoms and function and clinical efficacy were compared between the two groups before and after treatment as well as 6-month follow-up after treatment.

RESULTSThe curative and effective rate was 56.7% (17/30) after treatment and 60.0% (18/30) in 6-month follow-up after treatment in the saturated moxa dosage group, which were superior to 26.7% (8/30) and 30.0% (9/30) in the regular moxa dosage group respectively (P < 0.01, P < 0.05). The scores of clinical symptoms and function after treatment and in follow-up were improved apparently as compared with those before treatment in both groups (all P < 0.01). The scores of clinical symptoms and function after treatment and in follow-up in the saturated moxa dosage group were increased much more apparently than those in the regular moxa dosage group (after treatment: 22.32 +/- 4.64 vs 17.43 +/- 3.21; in follow-up: 23.01 +/- 4.76 vs 18.32 +/- 2.13, both P < 0.01).

CONCLUSIONThe thermosensitization moxibustion of saturated dosage achieves the superior short-term and long-term efficacies in the treatment of CSA as compared with the regular moxibustion dosage.

Acupuncture Points ; Adult ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Spondylosis ; physiopathology ; therapy ; Vertebral Artery ; physiopathology

OBJECTIVETo analyze effect of treatment of lumbar intervertebral disc herniation with nucleus pulposus resection through small incision and lamina fenestration,and to explore operative advantage and mattars needing attention.

METHODSNinety-six patients with lumbar intervertebral disc herniation, including 48 males and 48 females with an average age of 46.4 years (ranging for 16-75 years) and an average course of 5 years (ranging from 1 month to 30 years), were treated with nucleus pulposus resection through small incision and lamina fenestration. The clinical effects were analyzed according to JOA scoring criteria of lower back pain.

RESULTSAll patients were followed up from 6 months to 3.5 years with an average of 1.2 years. According to JOA scoring criteria, 34 cases obtained excellent result, 55 good, fair 7. The rate of excellent and good was 92.71% and the mean improvement rate was 54.53%.

CONCLUSIONNucleus pulposus resection through small incision and lamina fenestration can obtain satisfactory outcome in treating lumbar intertebral disc herniation. The incidence of lumbar instability and postoperative complications were low. It is one of the better method for the treatment of lumbar intertebral disc herniation.

Adolescent ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Young Adult