This paper deals with the ultrastructure of the body wall of adult Pagumogonimus skrjabini by transmission electron microscopy. Infected crabs were collected from Siyen, Hubei Provine, and adult worms were obtained from the lungs of experimentally infected dogs 90 days post-infection.The normal structure of body wall of the P. skrjabini is composed of tegument, tegument cell, musele, muscle cell and protoplasmic tubules, all of which form together syncytium.The tegument contains external plasma membrane, tegument matrix and basal plasma membrane. The cell coat in fine granules is distributed over the whole external plasma membrane surface. The tegument matrix contains various secretory bodies, vesicles and mitochondria. The tegument cell is irregular in shape. Golgi complex, ribosome, autoly-sosome are seen in the cytoplasm. There are two layers of muscle, the external circular muscle and the inner longitudinal muscle layers. The nucleus of immature muscle cell has many heterochromatins, while the nucleus of mature muscle cell is large and round in shaps. Mitochondria and glyco-gen granules are transmitted from muscle cell proper to the muscle by protoplasmic tubules (Figs. 1-7).

Objective To provide anatomical basis for the free saphenous branch of descending genicular artery flap and evaluate its clinical outcomes for the hand soft-tissue defects. Methods Fifteen fresh cadavers injected with lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a spiral computed tomography scanner. The origin, course and distribution of the perforators of descending genicular artery were observed.From January 2005 to October 2011,seven patients with skin defect on the distant limbs were treated.The flap size was 5 cm × 6 cm-11 cm × 14 cm,vascular pedicle length 5.4 (4-7)cm. ResultsThe saphenous branch was consistent. It arised from the descending genicular artery (68％) or femoral artery(32％).The diameter of the saphenous branch was 1.5(1.1-1.7)mm at its origin above 9.0(4.0-16.0)cm from the medial epicondylar.Seven cases of flaps all survived,the average followup of 28 months,close to hand flap of skin texture,some sensory recovery,two-point discrimination 8-12mm. Conclusion Free saphenous branch of descending genicular artery flap is a reliable option for the treatment of soft tissue defect in hands. The pedicles were invariable of anatomy, thickness of the flaps is comparable,and procedure is simple and time saving.

BACKGROUND: Nano-hydroxyapatite/collagen (NHAC) has similar component, structure, and morphology to natural bone, characterizing by good biocompatibility, multiaperture, large aperture, high porosity, and high pore communication rate; therefore, NHAC is an ideal scaffold material for bone tissue engineering.OBJECTIVE: To explore the feasibility of rabbit bone marrow-derived mesenchymal stem cells (MSCs) and NHAC in constructing tissue-engineered bone.DESIGN, TIME AND SETTING: In vitro observational experiment was performed at Cell Laboratory of Jiangsu University from March to September 2006.MATERIALS: A one-month-old healthy male New Zealand rabbit was provided by Experimental Animal Center of Jiangsu University. NHAC was provided by Material Department of Tsinghua University.METHODS: Rabbit MSCs were isolated and purified in vitro, and the 3rd-generation MSCs were seeded onto NHAC. MAIN OUTCOME MEASURES: ① Morphology and growth curve of rabbit MSCs; ② adhesion grade at day 5 and 10 after culture under scanning electron microscopy; ③ the amount of MSCs that adhered with NHAC on the 5th and 10th days. RESULTS: Rabbit MSCs were grown adherently with great reproductive activity, and the auxodrome was in accordance with Logistic auxodrome. Scanning electron microscopy demonstrated that the amount of MSCs on the 10th day was significantly greater than the amount on the 5th day (P < 0.01).CONCLUSION: The adhesion degree of the compound of MSCs and NHAC is high.

BACKGROUND:The microcosmic and submicroscopic organizations of tissue engineering scaffold matedals’superficial structure have all important effect on the eell adhesion and growth.By means of nano.Technique and three-dimensional porous technique,the resultant nano-hydroxyapatite/collagen(n-HAC)call imitate the component and microstructure of natural bone.OBJECTIVE:To observe the biocompatibility of human bone m arrow mesenchymal stem cells(MSCs)cultured in vitro with nHAC.DESIGN,TIME AND SETTING :Single samples observation was performed in the Experimental Center of School ofMedical Technology,Jiangsu University from September 2005 to December 2006. MATERIALD:nHAc was provided by the Material Science and Engineering Department of Tsinghua University.Humanbone marrow mesenchymal stem cells were derived from healthy adult volunteers.All the subiects signed the informedconsents. METHODS:Whole bone marrow culture and successive adherence method was used to culture MSCs in vitro,and the cells were then induced to differentiate into the phenotype of osteoblasts by the revulsants(methylprednisolone,vitamin C,β-glycerophosphate and basic fibroblast growth factor).MSCs at passage 3 were co-cultured with nHACfor 14 days.MAIN OUTCOME MEASURES:The cytological characteristics of the osteoblast were identified throue,alkalinephosphatase immunohistochemistry method and Von Kossa stain.The growth condition with or without nHAC wasevaluated through invert microscope and scanning electron microscope,respectively.RESULTS:The cultured MSCs proliferated into uniform fibroblast-like cells rapidly.MSCs reached confluence and started to form multilayers averaging from 10 to 12 days,passaged stably as well.Then the MSCs passaged from 7 to 9 days.Cytochemistry evaluation showed that MSCs in induced culture were positive for alkaline phosphatase and Von Kossa stain,and deposited calcified matrix.It showed a typical ostcoblast feature in morphology and biology.In coculture model ofMSCs with nHAC,cells would attach to the inner surface of nHAC.At 8 days,the osteoblasts proliferated in the nHAC and the secretion of the matrix was observed.Lots ofcells adheredon the surfaceand pores of nHAC at 14 days.There wereextensive prominent connections among cells. CONCLUSION:THE nHAC is suitable for MSCs to adhere,grow and proliferate,with a good compatibility.

Objective To investigate the effect of pyrroloquinoline quinone(PQQ) on the aging of rat hippocampal neurons induced by D-galactose(D-gal).Methods Hippocampal neurons were cultured in vitro.The aging of the hippocampal neurons was induced by high dose D-gal,PQQ protection were used 30 min before D-gal.The metamorphosis of hippocampal neurons was observed under the microscope.The contents of free radical was measured.The incidence of apoptosis of hippocampus cells was tested with the flow cytometry.The expression of Bax was detected with immunohistochemical staining.Results After the cells cultured in vitro exposed to D-gal,the content of free radical and the expression of Bax of the hippocampal neurons increased.After pretreatment of the cultured neurons with PQQ,the contents of free radical and the expression of Bax decreased,the survival of hippocampal neurons increased.Conclusion PQQ may slow the aging progress of hippocamal neurons induced by D-gal.

Objective To investigate the results of defect reconstruction using anterolateral thigh free flap in medial and lateral approaches.Methods We reviewed the soft tissue defect reconstruction in 200 patients from February 2010 to June 2014 with anterolateral thigh flap in medial or lateral approach,to compare the operative time and donor site morbidity.Results The mean time of flap raising in medial group was (45 ± 4.5) minutes,while in lateral group was (65 ± 3.5) minutes.In medial group,fascial lata was closed directly in 39 cases (39％),while fascial lata was closed directly in all the cases (100％) in lateral group.All the 200 flaps survived uneventfully.All the donor sites healed smoothly.No infection occurred.An 8 to 32 months follow-up revealed a high satisfactory rate from the patients.No sensory deficit or functional impairment was noted in the donor sites.Conclusions Both in medial and lateral approach can achieve safely harvesting free anterolateral thigh flap.

Objective To analyze the periopemtive blood loss of elderly patients with intertrochanter fracture that fixed with proximal femoral nail-antirotation (PFNA),and to explore the risk factor influencing the perioperative blood loss following PFNA fixation.Methods The clinical data of 62 elderly patients with intemochanter fracture treated with PFNA were analyzed retrospectively to determine the perioperative obvious blood loss and hidden blood loss.The impact of gender,age and fracture type on blood loss was also analyzed.Results The obvious blood loss of 62 patients was (120.6 ±42.0) ml,which accounted for 15.5％ in total blood loss [(775.8 ± 129.6) ml].The hidden blood loss was (655.2 ± 109.1) ml,which accounted for 84.5％ in total blood loss.The hidden blood loss was much more than obvious blood loss (P＜ 0.01).The total blood loss,obvious blood loss,hidden blood loss was (773.3 ± 131.5),(122.5 ± 44.1),(650.8± 114.2) mlinmahgroup (20cases),(777.0± 124.7),(119.7±40.2),(657.3 ± 107.7) ml in female group (42 cases),and there was no significant difference between two groups (P ＞ 0.05).The total blood loss,obvious blood loss was (813.1 ± 107.5),(117.7 ±49.7) ml in advanced age group (35 cases),(727.4 ± 114.3),(124.4 ± 36.6) ml in non-advanced age group (27 cases),and there was no significant difference between two groups (P ＞0.05).The hidden blood loss was (695.4 ±74.1) ml in advanced age group,(603.0 ± 65.3) ml in non-advanced age group,and there was significant difference between two groups (P＜0.05).The total blood loss,obvious blood loss,hidden blood loss was (578.1 ±82.3),(68.5 ±23.1),(509.6 ±63.1) ml in stable group (14 cases),(833.5 ±84.1),(135.8 ±35.0),(697.7 ±79.3) ml in unstable group (48 cases),and there was significant difference between two groups (P ＜ 0.05).Conclusions Hidden blood loss is the major part of perioperative blood loss of elderly patients with intertrochanter fractures that fixed with PFNA.Advanced age and unstable fracture type are risk factors of hidden blood loss.

Objective To investigate the nutritional status of the pupils with cerebral palsy and the factors related with nutrition. Methods The height and weight of 139 cerebral palsy pupil (6~18 years old) were measured. The rate of stunting, wasting, overweight and obesity were calculated, and compared with the norm, and among the subjects with different cerebral palsy type, grade of Gross Motor Function Classification System (GMFCS), famiy background (urban or rural), age, etc. Results The rate of stunting and wasting was more than the norm, and the obesity was less. The rate of stunting negatively correlated with the grade of GMFCS. The rate of wasting negatively correlated with the age. Conclusion It is important to focus on the physical development delay and malnutrition of children with cerebral palsy.

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was <0 .05 .There was no statistical significance among group comparisons for other factors as the P was >0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

Objective:To explore the application value of free nail flaps in reconstruction of nail bed and fingertip defect.Methods:From January 2018 to June 2020, nine patients with free nail flap transplantation to treat fingertip injuries in Lishui People′s Hospital were included in this study. According to the Allen classification, 6 patients were characterized as type Ⅱ and 3 were characterized as type Ⅲ. Evaluation was based on the patients′ medical records and follow-up, including postoperative healing of recipient and donor sites, two-point discrimination, the Chinese Medical Association Hand Surgery Society′s evaluation of the function of severed finger replantation, and Michigan Hand Outcomes Questionnaire (MHQ) and Foot Function Index (FFI).Results:All patients successfully completed the operation, the operation time was 3.0-5.0 h (average 4.1 h), the intraoperative blood loss was 100-250 ml (average 178 ml), and the follow-up time was 12-40 months (average 25 months). The nails and flaps of all patients survived with primary healing. No complications were observed after surgery. The appearance of the reconstructed finger of 9 patients was similar to that of the uninfected side; the flap two-point discrimination was 5.0-7.5 mm; the replantation score and MHQ results were satisfactory. The toenail of the donor site grew well, and no deformity or pain with walking was noted.Conclusions:The free toenail flap was used to treat fingertip defects, with satisfactory clinical results in repairing tissue defects, reconstructing nail bed and maintaining finger length.