Objective To evaluate the effects of locking calcaneal plate in the treatment of SandersⅢ～Ⅳcalcaneal fractures.Methods 15 feet of 12 patients of SandersⅢ～Ⅳcalcaneal fractures received the treatment of internal fixation reduction with locking calcaneal plate and hone graft.Results All the patients were followed up for 4 to 21 months(average 11 months) with the results that according to Maryland foot score,4 feet were reported ex- cellent,6 good,1 average and 1 poor,with total excellent and good rate of 83.3 %.Conclusion Using locking cal- caneat plate in the treatment of complicated calcaneal fractures was proved to be a good method and had satisfactory effects.

Objective To sum up experience with surgical excision of isolated local recurrence for renal cell carcinoma. Methods From March 2004 to November 2007, 7 patients (five cases un-derwent radical nephrectomy and two nephron-sparing surgery) with isolated local recurrence of renal cell carcinoma were treated at our department. All patients underwent extensive surgery for local re-currence. Results The mean patient age was 42 years (range 19 to 6). The mean time to local re-currence was 23.3 months (range 12 to 54). The Mean size of the recurrent tumor was 5.2 cm(range 2.5 to 10.5). Peritoneal exploration was performed in 7 patients and 5 had complete en bloc excision of the renal cell carcinoma mass. 2 patients gross disease was excised. The mean blood loss was 1050 (150-3000) ml. Surgical complications occurred in 2 patients, iliohypogastric nerve injure in one and ileus performation in another one. All patients recovered finally. Six patients were followed and one lost follow-up. Mean follow-up time was 13(8-27) months. One patient died of metastatic disease at 22 months after excision of the renal cell carcinoma mass. Conelusion En bloc excision of isolated locally recurrent renal cell carcinoma is possible, and complete surgical resection could lead to pro-longed disease-free survival.

Connexin43 has been shown to play a pivotal role in wound healing process. Wound repair is enhanced by acute downregulation of connexin43, by increasing proliferation and migration of keratinocyte and fibroblast. Angiogenesis is also a central feature of wound repair, but little is known about the effects of connexin43 modulation on functions of endothelial cells. We used connexin43 specific small interference RNA (siRNA) to reduce the expression of connexin43 in human umbilical vein endothelial cell (HUVEC), and investigated the effects of connexin43 downregulation on intercellular communication, viability, proliferation, migration and angiogenic activity of HUVEC. Treatment of siRNA markedly reduced the expression of connexin43 by -80% in HUVEC (P < 0.05), and decreased the intercellular communication by -65% (P < 0.05). The viability, proliferation, migration and angiogenic activity of HUVEC decreased significantly (P < 0.05), compared with that of the normal cells. The results suggest that temporally downregulation of connexin43 expression at early stage of wound to inhibit the abnormal angiogenesis characterized with leaky and inflamed blood vessels, maybe a prerequisite for coordinated normal healing process.
Cell Movement ; Cell Proliferation ; Cell Survival ; Connexin 43 ; metabolism ; Down-Regulation ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Neovascularization, Physiologic ; Umbilical Veins ; cytology ; Wound Healing

BACKGROUND:Bone marrow mesenchymal stem cels play an osteogenic role under the assistance of scaffold materials. The scaffold cannot only deliver the cels to the bone defect area, but also act as a new bone growth framework. Colagen-chitosan composite is one of ideal scaffold materials in bone tissue engineering, which has osteoinductive ability and better osteogenic ability than conventional scaffolds. Bone transport technology has been widely used in the clinical repair of long bone defects, but it has some deficiencies, such as slow osteogenesis, long time for external fixation and nonunion. How to further accelerate bone formation and reduce complications has become the current problem to be solved. Here, it is hypothesized that bone marrow mesenchymal stem cels/ colagen/chitosan composite scaffold can increase the therapeutic effect of bone transport in the repair of tibial bone defects.
METHODS/DESIGN:This study is a randomized controled animal experiment, includingin vitro andin vivo tests.In vitro test: Bone marrow mesenchymal stem cels are isolated from the bone marrow of New Zealand rabbits aged 1-2 months, and passaged to the third generation. Then, cel suspension is added onto the colagen-chitosan scaffold to construct the bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold.In vivo test: Twenty-four New Zealand rabbits at 3-4 months are selected and randomly assigned to receive bone transport, scaffold implantation, bone transport+scaffold implantation, respectively. The primary outcome measures are the growth of implant materials and bone defect interface, X-ray detection of bone defect repair, hematoxylin-eosin staining and scanning electron microscope observation of bone formation in the bone defect region, immunohistochemical detection of type I colage expression in the osteogenic region, scanning electron microscope observation of interface bonding between implant materials and host bone, ultrastructure and bone formation.
DISCUSSION:The results from this animal experiment wil help to determine the feasibility of bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold to accelerate bone repair during bone defect repair using bone transport technology.

Objective To investigate expression of β-site APP-cleaving enzymel(BACE1) and Aβ in brain of diabetes mellitus of Wistar rats,to study pathophysiological mechanism of Alzheimer disease from diabetic metabolic disorder. Methods Animal model of diabetes mellitus was established by streptozocin with intraperitoneal injection. Wistar rats were randomly divided into normal group (N), sham-operation group (S), 4 weeks diabetes mellitus model group (M4), 6 weeks diabetes mellitus model group (M6) and 8 weeks diabetes mellitus model group (M8). Behaviour was tested with Morris water maze and shuttle box test. Expression of Aβ was measured by enzyme linked immunosorbent assay and BACE1 by immunohistochemistry, enzyme linked immunosorbent assay, Western blotting and RT-PCR. The absorbance value was measured by imaging analysis. Results The electric times and latancy of memory and study were more increased in model group than that in N and S group but the times of escape more decreased(P<0.01). The expression of Aβ_(1-40) increased from (64.13±6.76)pg/mg in normal group to (86.43±7.03)pg/mg in model group by ELISA(P<0.001) and Aβ_(1-42) from (67.43±5.12 )pg/mg in normal group to (89.45±5.28) pg/mg (P<0.001) in model group. The expression of BACE1 increased from (116.46±8.10)pg/mg in normal group to (158.73±6.24)pg/mg in model group by ELISA and from 0.61±0.11 in normal group to 1.52±0.16 by Western blotting absorbance valule and from 1.62±0.26 in normal group to 3.61±0.32 by RT-PCR absorbance valule and from 0.81±0.21 in normal group to 2.01±0.36 by immunohistochemistry absorbance valule (P<0.001). The expression of BACE1 and Aβ in MT group was higher than that of in N and S group (P<0.01). The level of BACE1 and Aβ had positive correlation with cognitive impairment.Conclusion The expression of BACE1 and Aβ is increased in diabetes mellitus rats. Diabetes mellitus contributes to Alzheimer diseases that.

Objective To provide reliable technical method by identifying referential anatomic landmarks for retroperitoneal laparoscopic renal surgery,with respect to the renal hilum and renal artery.Methods The regional anatomy of the posterior abdominal wall was studied in 35 cases of retroperitoneal laparoscopic renal surgery from January to August 2010.These included 27 cases of renal cancer,6 cases of renal pelvis cancer and 2 cases of renal tuberculosis.Distended the retroperitoneal space using balloon dilation along with sharp and dull dissection.We recorded the forms and positions of the posterior abdominal cavity's anatomical landmarks and evaluated the relationship between each anatomical landmark with respect to the renal hilum and renal artery.Results The perirenal fascia posterior layer and perinephric fat on the renal side were observed,and several anatomical landmarks gradually appeared on the posterior abdominal wall.The diaphragm extended across the upper retroperitoneal space near the superior pole of the kidney,and the psoas major and the quadratus lumborum muscles were located at the lower retroperitoneal space,near the inferior part of the kidney.The intersection of the upper diaphragm muscle with the lower psoas major and quadratus lumborum muscles were bordered by the lateral and medial arcuate ligaments.The lateral arcuate ligament arched across the upper part of quadratus lumborum,while the medial arcuate ligament arched across the upper part of psoas major.The medial arcuate ligament points extended towards the upper border of the renal hilum.These landmarks enable us to locate the position of the kidney,reach the renal hilum and identify the renal vessels in all 35 cases.Conclusions The relative position of the muscles and ligaments of the posterior abdominal wall are consistent and can be clearly seen under retroperitoneoscopy.Based on the position of the diaphragm and psoas major,the kidney can be located.In addition,based on the position of the medial arcuate ligament,the renal hilum and renal artery can be located.Assistance from these anatomical landmarks will simplify the retroperitoneal laparoscopic renal surgery.

AIM:To discuss Daidzein intravitreal injection whether has protective and recovery effects on acute nerve damages.
METHODS:After the crush models of acute optic nerve were set up, 72 males SD rats were divided into 4 groups randomly as common group without surgery, FBS negative control group, Daidzein treatment group ( 10μmol/L, 100μmol/L, 1000μmol/L ) and positive control group using rats nerve growth factor ( mNGF, 100ng/mL ). Three days after interference, all experimental animals were executed. HE staining was used to evaluate morphologic change of the retina, immunohisochemical staining and western-blot tests for identifying and quantifying the distinct expression of Caspase-3 and GAP-43 among the groups.
RESULTS: Compared with the normal group and negative control group, retinal morphology of different concentrations of each Daidzein treatment group and positive control group was more complete, the expression of Caspase-3 protein was relatively lower, the expression of GAP-43 protein was relatively higher, the differences have statistically significance (P<0. 05).CONCLUSION: Daizein injection in the vitreous cavity has the capacity of protection and restoration in rat's acute nerve damages.

Objective To analyze the characteristics of Behcet's disease (BD) with intestinal lesions to provides further reference for the diagnosis and treatment.Methods Four hundred and one cases of BD patients' data were collected including basic data,colonoscopy report,pathology diagnosis and hematologic examination.Statistical description of intestinal lesions was applied and analyzed for the differences between the locations and blood examinations of intestinal lesions.Results Within these 401 BD patients,88 (21.95 ％) with intestinal lesions.Intestinal ulcerations,including both active and inactive phase,appeared in 52 cases (12.97％) mostly founded in ileocecum,in which 62.86％ (22/ 401,5.49％ of all BD patients) without the abdominal discomfort.Compared with inactive phase,the active phase intestinal BD patients have higher inflammation indexes with C reactive protein (CRP) increased of statistical significance (P =0.028).Thirty-three cases (8.23 ％) with adenomas were founded,including tubular adenoma,serrated adenoma and villous adenoma.Mostly occurred in rectum,sigmoid colon,especially the sigmoid colon rectum junction.Adenomas were seen in eider patients with statistical significance compared to BD patients without intestinal lesion or with intestinal ulceration (P =0.022,0.000),and exhibited elder changes of lab tests,such as increas in aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT) and uric acid (UA).In addition,2 cases of melanosis coli and 1 case of caecal diverticulum were also founded.Conclusions BD patients with intestinal ulcer or adenoma takes a fairly high ratio,and most intestinal BD and BD with adenoma patients did not complaint related symptoms,so colonoscopy as a screening method for diagnosis and treatment of BD is necessary.

Regulatory T cells (Treg) are functionally mature T cell subpopulations which are key players of maintaining the balance of immunological defense system. Treg can proliferate in vivo or in vitro by antigen specific way or non-antigen specific way, and actively control the properties of other immune cells by suppressing their functional activity and their proliferation as well.
Humans ; Immune Tolerance ; T-Lymphocytes, Regulatory ; immunology

Objective : To study the damage effect of sunlight ultraviolet exposure on skin. Methods : No exposure group, low exposure group and high exposure group were set up with 10 mice in each. The exposure doses of sunlight ultraviolet were 0, 10 J/cm2 and 20 J/cm2, respectively. The skin of mice was irradiated by a sunlight ultraviolet simulator for 5 days a week, 13 weeks. At the end of the experiment, the skin appearance of mice was examined; the skin moisture, oil content, texture density, hydroxyproline ( HYP ), hyaluronic acid (HA), malondialdehyde ( MDA ), glutathione ( GSH ) and superoxide dismutase ( SOD ) activities were detected; and the skin tissue morphology, collagen fiber morphology and elastic fiber morphology were observed. Results : The skin appearance of mice in the no exposure group was normal; in the low exposure group, only one mouse had mild skin desquamation; in the high exposure group, the skin was loose and wrinkled, dry and desquamated, local thickening and erythema formation. Compared with the no exposure group, the contents of skin moisture, HYP, HA and SOD activity were lower, texture density, MDA content, morphological scores of skin tissue, collagen fiber tissue and elastic fiber tissue were higher in the high exposure group ( all P<0.05 ). Compared with the low exposure group, the HA content and SOD activity were lower, the skin texture density, MDA content, and histomorphological scores of skin tissue and collagen fibers were higher in the high exposure group ( all P<0.05 ). Conclusion Exposure to 20 J/cm2 sunlight ultraviolet can significantly lead to abnormal skin appearance and function in mice.