0.05),but for patients with mild disease,active angle reproduction

ObjectiveTo investigate the method of osteo-periosteal turned over orthotopically for treating chondromalacia patellae disease and observe the mid-long term efficacy postoperatively.Methods From April 1996 to June 2000,21 patients with chondromalacia patellae were treated in our hospital.Amone them,13 cases were performed osteo-periosteal turned over orthotopically,including 3 males,10 females; with the mean age of 59 years(range,47-65 years).HSS and Lysholm knee rating scale were employed to analysis the results.ResultsThe patients were followed up from 114 to 162 months(mean,133.2 months).One of the patients lost follow-up due to death.Before operation the HSS knee score was 20-58 (34.2±3.8),and 1 year,3 year,5 year,7 year,and 9 year after operation the HSS knee score were 55-70(60.0±7.0),55-82 (64.1±5.9),60-90 (70.1±3.2),50-85 (63.1±4.1),and 50-75 (57.3±2.9) respectively.And Lysholm knee rating scale also showed similar results.The chondromalacia patellae patients before and after operation were significant different.Bone periosteum transplant tissue and surrounding defective tissue healed perfectly,functions recovered perfectly.ConclusionThe method of osteo-periosteal turned over orthotopically has the capabilities to form cartilage.The therapeutic effect and facies articularis patellar is satisfactory.But it only can restore articular cartilage of patellar and does not help for genual malformation.

Objective To investigate the expression of MMP-2 and MMP-7 and their elinieopathologieal significance in eoloreetal carcinomas. Methods The expression of MMP-2 mRNA, MMP-7 mRNA and MMP-2, MMP-7 in 42 samples of eoloreetal carcinomas and its adjacent normal eoloreetal mueosa were examined using fluo-rescence quantitative RT-PCR (FQ-RT-PCR) and immunohistoehemistry. The relationship of their expression with some elinieopathologieal characteristics was analyzed. Results MMP-2 mRNA, MMP-7 mRNA and MMP-2, MMP-7 were significantly over-expressed in eoloreetal carcinomas compared with its adjacent normal eoloreetal mueosa( P < 0.05 ) , and they were positively associated with bowel wall invasion, the regional lymph node metastasis and Dukes stage. The expression of MMP-2 mRNA and MMP-7 mRNA was positively correlated with MMP-2 and MMP-7 in eoloreetal eareinornas. Conclusions MMP-2 and MMP-7 may play a key role in eoloreetal carcinogenesis,tumor in-vasion and metastasis. Examination of combined MMP-2 and MMP-7 expression may have an important significance to judge the malignant degree and biological behavior of human eoloreetal carcinoma and for evaluating the progno-sis.

Objective To study how design and harvest perforating artery free flaps in posterior region of thigh based on research of the anatomical features and distribution regularities of those perforating artery.Methods Using 8 fresh bodies specimen with latex leaded perfusion of inferior gluteal area to study perforator artery anatomy structure and distribution of rear thigh.Screen the fitting perforator arteries for perforator free flap both in caliber and length.Total 7 cases were performed with perforator free flap in posterior thigh,the flap size:from 3 cm × 8 cm-8 cm × 16 cm,and the first perforating artery flap carried out in 4 cases,the second perforating artery flap in 2 cases,the third perforating artery flap in Ⅰ case.Results Anatomic study showed that perforating artery suitable for free flap in this area were in teams of 4 to 5,the average diameter were in range of 0.4 to 2.8 mm,the average length was 2.2-9.0 cm.Seven cases had been applied with perforator flap and all survived.Followed-up from 5 to 11 months,the wounds repaired by the perforator flap of posterior thigh presented fine elasticity,thin flap,beautiful appearance.Conclusion The distribution,length and diameter of perforating artery in posterior region of thigh are suitable for perforator free flap.Being hidden,direct close the posterior region of thigh expected to acchive satisfactory clinical effects.

ObjectiveTo study the anatomy of the soleus muscle perforator flap and its clinical application.MethodsIn 6 cadavers specimen with 12 lower limbs,the cutaneous branches and soleus muscle perforator artery were dissected and their measurements were recorded.Fourteen patients with skin and soft tissue defects from July 2002 to October 2010 were repaired by the soleus muscle perforator flap.Of the 14 patients,eight for dorsal and anterior defects of foot,two for anterior defects of malleolus,two for hand defects,two for elbow defects.The size of the flaps was 5 cm × 6 cm - 12 cm × 20 cm.Flap success rates and postoperative course were evaluated. ResultsThe soleus musclocutaneous perforators mostly appeared within 5 - 24 cm length below the head of fibula.The diameter of the artery cutaneous perforator was( 1.08 ±0.22)mm,vena concomitants was (1.20 ± 0.32)mm.All flaps were survived completely and the wounds got primary closure in 14 cases.The flaps were not overstaffed,and their shape,texture and color were similar to normal.All of the 14 cases were evaluated as satisfactory after 6 months to 12 months follow-up. ConclusionThe free soleus muscle perforator flap is an ideal flap for repairing skin and soft tissue defects with the merit of simple procedure,minimal trauma and more physiological circulation established.

Objective To explore the efficacy and prognostic factors of postoperative intensity?modulated radiotherapy ( IMRT) with or without chemotherapy in rectal cancer. Methods A retrospective analysis was performed on the clinical data of 218 patients with rectal cancer, who underwent postoperative IMRT in our hospital from January 2009 to December 2013. The Kaplan?Meier method was used to calculate survival rate;the log?rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow?up rate was 97. 7%. The 1?and 3?year overall survival rates were 90. 8% and 75. 2%, respectively, the 1?and 3?year disease?free survival rates were 85. 3% and 70. 5%, respectively, and the 1?and 3?year locoregional recurrence?free survival rates were 96. 7% and 88. 1%, respectively. The incidence of grade 3?4 acute adverse reactions was 28. 4%, mainly manifested as leukopenia ( 13. 8%) and diarrhea ( 11. 0%) . Univariate prognostic analysis showed that preoperative carcinoembryonic antigen ( CEA) and CA199 levels, maximum tumor diameter, tumor location, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM stage, perineural invasion, surgical procedure, total mesorectal excision, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 006, 0. 000, 0. 000, 0. 017, 0. 000, 0. 016, 0. 000,0. 011,0. 001,0. 006,0. 037 and 0. 010) . Multivariate prognostic analysis showed that preoperative CEA level, tumor location, TNM stage, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 000,0. 000,0. 000,0. 001 and 0. 001) . Conclusions Postoperative IMRT with or without chemotherapy is an effective method for rectal cancer with mild adverse reactions and high compliance. Preoperative CEA level, tumor position, TNM stage, preoperative bowel obstruction, and preoperative anemia are independent prognostic factors for the overall survival.

Objective To sum up the application and the technique of CT-guided percutaneous puncture biopsy of thoracoabdominal masses.Methods 107 cases of thoracoabdominal masses were made percutaneous puncture biopsy,in which chest disease 81 cases,abdominal disease 26 cases.Biopsy was done using 18～20 G Franseen needle and 18 G coaxial automatic cutting needle.Routinely chose vertical plane angle,horizontal plane angle and vertical plane angle on one side of the body outline when needle was been entered.Results The successful rate by first puncture was 100%,and the total verification rate was 92.52%.The rate of thoracic complication was 11.11%.No obvious abdominal complication was found.Conclusion The technique of CT-guided percutaneous puncture biopsy of thoracoabdominal masses is simple,practical,high accuracy and only few complications.It should be emphasized that the needle angle should be having definite reference and the needles should be chosen accurately.

Objective To explore reconstructive methods for defects uf bone and soft tissue in traumatic injury uf medial malleolus.Methods A vascular iliac bone with a piece of faacial strip is used together with a local island flap or a free flap to reconstruct the defects of bone,triangular ligament and skin in medial malleolus al one or two stages.Results Follow-ups of 11 to 24 months proved that the stability and walking and weight loading functions uf ankle joint of the patients were restored satisfactorily and their normal varus range without abnormal articular motion was restored.Slight varus occurred during walking in one case,and pain appeared after fatigue in two cases.The X-grams showed no obvious absorption or areosis in the free iliac bone implanted.Conclusion In repair of defects of medial malleolus,combined transplantation of iliac bone and flap is rceommendable because it can keep the essential integrity of malleolus and achieve good Stability and functional recovery of ankle joint.

Objective To investigate the effect of ski gene in migration process of astrocytes in rats. Methods Astrocytes were obtained from rats' cerebral cortex and cultured in vitro. siRNA targeting ski gene and negative control sequences were prepared. The ski-siRNA group, siRNA negative control group and untreated group were set in this experiment. The specific siRNA targeting ski gene was transfected into astrocytes with Lipofectamine?RNAiMAX Reagent. Then the ski protein levels were determined with Western blotting. After transfec-tion, the changes in migration of astrocytes were measured with wound scratch assay and Transwell migration assay. Results Western blot-ting showed that the expression of ski protein was significantly lower in the ski-siRNA group than in the siRNA negative control group and untreated group (F=132.957, P<0.001). Transwell migration assay showed that the number of astrocytes crossing through chambers was less in the ski-siRNA group than in the siRNA negative control group and untreated group (F>47.197, P<0.05). Wound scratch assay showed that the wound healing rate was lower in the ski-siRNA group than in the control group one, two, three, four and five days after transfection (F>69.187, P<0.001). Conclusion Ski knocked down by siRNA could inhibit the migration ability of astrocytes. It is a reminding that ski may take part in the migration process of astrocytes, and moreover, ski may play an important role in the formation of glial scar.

Objective To explore how and where ski expresses under lipopolysaccharide (LPS) in rats' astrocytes. Methods Astrocytes were obtained from cerebral cortex of a newborn (within 3 days) Sprague-Dawley rat and cultured in vitro. Astrocytes were cultured with LPS in concentration of 0μg/ml, 0.001μg/ml, 0.01μg/ml, 0.1μg/ml, 1μg/ml, 10μg/ml and 100μg/ml for six hours;and cultured with LPS in concentration of 0.1μg/ml for 0 day, 2 days, 4 days, 6 days and 8 days. The level of ski was determined with Western blotting, and the lo-cation of ski was detected with indirect immunofluorescent staining. Results The expression of ski was induced by LPS, especially in the concentration of 0.1μg/ml. The expression of ski induced with 0.1μg/ml LPS peaked at 4 days of inducement and then decreased. Ski was mainly observed in nuclear in the normal astrocytes and the astrocytes induced with 0.1μg/ml LPS for 6 days. However, it was observed in cytoplasm 2 and 4 days of inducement. Conclusion LPS could induce the expression of ski in rats' astrocytes, which may participate in in-flammation.