Objective To introduce the technique.indication and outcome of treatment of degenerative Achilles'rupture with transfer of flexor hallucis longus tendon and V-Y tendinous flap. Methods From October 2003 to May 2006,21 cases of degenerative Achilles'tendon rupture were treated in our department using transfer of flexor hallucis longus tendon and V-Y tendinous flap.Rivets were used in 17 cases and surface screws in 4.They were followed up for 12 to 18 months(average,14). Results According to the Arner-Lindholm criteria for curative results,19 of the 21 cases were excellent and 2 good.Follow-ups revealed no Achilles'tendon re-rupture,infection,skin necrosis,stiff ankle,or injury to nerves and vessels.Walking gaits nearly recovered to normal.The repair strength allowed early functional exercise of the Achilles'tendon. Conclusion Transfer of flexor hallucis longus tendon combined with V-Y tendinous flap can cure the degenerative Achilles'tendon ruptures and defects of Achilles'tendon within 3 cm.

Purpose:To study whether the inhibition of phosphatidylinositol 3-kinase (PI3K)/Akt survival pathway could sensitize the response of tumor cells to some chemotherapyeutic agents. Methods:The different tumor cells has been treated with the combination of isoform specific Akt inhibitor and either adriamycin or camptothecin; the quantitation of the induction of apoptosis by drugs has been estimated with caspase 3 assay; immunoprecipitation western blotting has been used to evaluate the inhibition of the phosphorylation of different isoforms of Akt after the treatment. Results:①The inhibitors could reduce the phosphorylation of Threonine 308 and Serine 473 of isoform specific Akt. ②The inhibition of any one isoform specific Akt could not reverse the resistance of tumor cells tested to chemotherapeutic drugs, but it is not the same case if blocking of two isoforms of both Akt1 and Akt2 was done at the same time. ③The synergistic effects of Akt inhibitors is maybe relative to the level of endogenous PTEN(phosphatase and tensin homolog deleted on chromosome 10) expression. Conclusions:It is required to inhibit two isoforms of both Akt1 and Akt2 in order to maximally sensitize the tumor cells to chemotherapy.

Objective To evaluate the effects of treatment for the distal radial osteoporotic fractures in elder patients with Volar Locking Compression Plating (LCP)fixation. Methods 30 old patients who suffered from the severe osteoporotic distal radial fractures were treated with LCP. In this group all the fractures were more severe than type 2B according to Melone classification. The results of treatment were evaluated by comparing pre and post operative functions and X rays of involved wrists. Results 26 of the 30 patients experienced no wrist pain and were satisfied with the functions of the suffered wrists in their daily postoperative activities. 2 patients still felt wrist pain and needed to take some pain killers and other 2 experienced mild finger movement limitations. These data were improved postoperatively to the average palmar tilt of 3.38 degrees, radial inclination of 18.9 degrees and the radial length 0.9cm longer between the ulnar head and the tip of the radial styloid. The radial length was found 0.2 mm shorter in 2 cases in the latest follow up than that measured before. No severe complications were found in this group. Conclusion For the unstable distal radial osteoporotic fractures in the elderly patients, Volar Locking Compression plating (LCP)fixation is one of the effective treatments, because this procedure can restore and sustain the distal radial length and smooth articular surface after the fracture reduction.

Objective To explore an effective method for preventing and treating oral mucosal complications of radiotherapy for head and neck cancer. Methods Fifty head and neck cancer patients who were receiving radiotherapy were enrolled between March, 2008 and March, 2010. These patients were randomly assigned to the treatment group and the control group. During the radiotherapy, patients in the treatment group were given IL-11 in the form of atomization inhalation,whereas patients in the control group were not. Results IL-1 1 was well tolerated by the patients. It significantly decreased the level of oral mucosal complications and pains and improved patients' appetites ( P < 0.05 ). In addition, the duration of pain was significantly ( P <0.05 ) reduced from 4.5 ± 1.3 days ( in control group) to 2.3 ± 1.0 ( in treatment group), and the healing period was also significantly ( P < 0.05) reduced from 7.3 ± 1.5 days ( in control group) to 4.1 ± 1.7 ( in treatment group). Conclusion IL-11 is effective in preventing and treating oral mucosal complications of radiotherapy for head and neck cancer,relieving associated pains, and therefore improving patients' quality of life.

The relationship between bone mineral density (BMD) and Zn, Cu, Ca levels in the meal and hair of urban and rural elderly people were studied. 470 subjects above 60 years old (urban 205 and rural 265), 178 males with an average age of 65.70 +/- 3.48 and 292 females with an average age of 65.90 +/- 4.02, were inquired. The BMD and Zn, Cu, Ca levels in the meal and hair were measured. The detected BMD in urban and rural female old people was significantly lower than that of the males; The contents of Ca and Zn in the meal of the urban females were significantly lower than those of the urban males; The Ca, Zn in the meal and Zn in the hair of the rural females were significantly lower than those of rural males (P < 0.05 or 0.01). The BMD, Ca intakes, Ca and Zn in the hair of the rural old people were significantly lower than those of the urban old people (P < 0.05 or 0.01). There was a correlation between BMD with the Ca, Zn of the hair and dietary Ca, Zn, Cu or between dietary Zn with Ca, Zn in the hair and Ca, Cu intakes. The Zn, Cu and Ca levels in the meal nutrients were correlated with BMD to some degrees. Lack of Ca and Zn in the meal can cause the reduction of BMD.
Bone Density ; Cadmium/*analysis ; Copper/*analysis ; Diet Surveys ; Hair/*chemistry ; Nutritional Status ; Osteoporosis/prevention & control ; Rural Health ; Zinc/*analysis

Objective To investigate the surgical technique,postoperative function and dislocation incidence of proximal humerus reconstruction with metallic endoprostheses and polypropylene knitted nonabsorbable mesh after proximal humeral tumor resection.Methods Twenty patients with proximal humeral tumor were retrospectively reviewed.They were performed proximal humerus reconstruction with proximal humeral prosthesis and polypropylene knitted non-absorbable mesh from February 2006 to January 2009.There were 5 women and 7 men with a mean age of 38 years(range,21-55 years)at the time of surgery,and giant cell tumor in 9 patients(including Campanacci Ⅱ for 3,Campanacci Ⅲ for 6),osteosarcoma in 1(Enneking ⅡB).and chondrosarcoma in 2 (Enneking ⅡA).The operative time,blood loss,and shoulder movement postoperation were analysed.According to the assessment system by MSTS,the function of limb after surgery was assessed.Results Patients were followed clinically and radiographically for a minimum of 24 months (mean,35 months;range,24-52 months).The mean operative time was 172 min(range,150-200min).The mean blood loss was 254 ml (range,150-500 ml).There were no shoulder dislocations at final follow-up.The mean shoulder flexion was 41°(range,20°-60°)and mean shoulder abduction was 42°(range,20°-70°).The mean postoperative functional assessment score of the limb was 66%(range,53%-77%).None of the Datients had a wound infection,traction neuropraxia or died after the surgical procedure.Conclnsion The data suggests that the use of a polypropylene knitted non-absorbable mesh for proximal humerus reconstruction may reduce dislocations and facilitate soft tissue attachment after tumor resection.

Objective To primarily study the possible biological significance of yon Willebrand factor (vWF) expression at the fracture site in the mechanism of fracture healing. Methods A total of 28 male SD rats were selected to set up femoral fracture models. Then, tissue samples from fracture site were randomly taken at days 2, 3, 5, 7, 10, 14 and 21 after establishment of the models, with 4 rats at each time point, vWF expression at fracture site and the relationship of vWF expression with osteoblasts and chondroblasts were observed by using computer image analysis system. The biological significance of vWF expression at fracture site in mechanism of fracture healing were analysed based on the results of vWF expression of in vitro cultured rat osteoblasts. Results The expression of vWF at every time point was positive and distributed disproportionally irregular at bone trabecula and soft tissue of the fracture site. vWF expressed positively in the extracellular matrix around the chondroblasts. Conclusions During the course of fracture healing, there may be vWF-platelet activation pathway that can regulate differentiation and proliferation of local osteoblasts and chondrocytes and activate platelets secreting growth factors such as PDGF, IGF-1, EGF and TGF-a, as creates a sound microenvironment for fracture healing.

0.05). Conclusions The therapeatic effect of breast-conserving therapy of stage I,and IIa breast cancer located ≥3cm of the nipple is similar to that of modified radical mastectomy. Breast-conserving therapy can gradually become the operation of first choice for stage I and IIa breast cancer.

Objective To investigate the expression of oncogene survivin,p53 in breast cancer and its ~prognostic significance. Methods The expression of survivin,p53 in breast cancer tissues of 80 cases were detected by immunohistochemistry S-P method, and its correlation with axillary lymph node metastasis and ~5-year disease free survival (DFS) was analysed.Results In breast cancer tissues,survivin gene positive ~expression rate was 68.75%(55/80), p53 gene positive expression rate was 46.25%(37/80), and both had a positive correlation with axillary lymph node metastasis but negative correlation to 5 years DFS(P0.05);survivin and p53 genes expression have positive corrlation(P

Objective To investigate the correlative factors of sentinel lymph node(SN) metastasis status in breast cancer.Methods The clinical data of 115 patients with breast cancer who underwent sentinel lymph node biopsy(SLNB) and axillary lymph node dissection(ALND) during June 2004 through April 2006 were retrospectively analysed.The SN metastasis were evaluated with regard to tumor size(≤2cm, 2.1cm~4cm)and C-erbB-2、p53、nm23、ER、PR status.Results Of the 115 patients SN was identified in 110(95.65%).An average of 1.97 SNs were examined per patient.Ninety-five(86.37%)of 110 patients were correctiy diagnosed in SN and AN.Thirty-six(37.89%)of 95 patients were SN positive,and 59(62.11%)were SN negative.Among the patients,SN metastasis rate in tumors 2.1cm~4cm((50.94)%) in diameter was highter compared with those ≤2cm(23.43%) in size(P0.05).Conclusions Tumor size and C-erbB-2 status were significantly associated with SN metastasis and may be used to predict SN metastasis in invasive breast cancer.