Objectives To explore the process and regularity of graft after vascularized bone allograft. Methods An adult rabbit model of massive femoral defect was established and reconstmcted with vascularized bone allograft based by laterial rotating femoral vessel.The experiments were carried out in two groups,the experimental group(vascularized bone allograft)and the control group(nonvascularized bone allograft).Then observation on periosteum,cortex and marrow was performed after operation containing in ink-infused specimen. Results The revascularization in the experimental grouD was observed synchronicly on periosteum,cortex and marrow after operation,while the phenomenon of vascularization took place from periosteum to marrow in the control group.The density of micro-vessel in experimental group were 10.0±1.8,15.8±1.5 and 13.8±1.5,13.8±1.5 respectivly after 2,4,8 and 16 weeks.and those were 2.8±0.8,6.0±0.9,5.5±1.0,6.0±1.1 in control group.The ink-infused experiment demonstrated a better revascularization in the experimental group. Conclusion The vaseularization can promote revascularization of graft during bone allograft.

Objective To provide anatomic basis for transposition of vascularized radial midforearm flap. Methods On 40 adult cadaveric upper limber specimens injected with red dye, the origin, course, branchs, diameters and anastomosis of intermuscular branch of radial artery and its cutaneous branch were observed. Results Originating from radial artery, intermuscular branch of radial artery descended along periosteum closely between pronator teres and supinator, the main stem was (4.8?1.0) cm in length and (1.2?0.2) mm in diameter. After its periosteal branches were sent off to distribute over middle and inferior shaft of radius, its eutaneous branch perforated from intermuscle and deep fascia and anastomosed with some other cutaneous branches in the forearm. Perforating point of the cutaneous branch was located(11.1?1.3) cm beneath laleral epicondyle of humerus, its diameter was about(0.6?0.1)mm. Conclusion Radial midforrarm flap pedicled with intermuscular branch of radial artery can be transferred to repair soft tissue defect of elbow, forearm or hand.

Objective To investigate the status of microchimerism in recipients and the relation between microchimerism and immunologic tolerance after vascularized allograft bone transplantation. Methods X-ray and histological examinations were performed on recipients after massive vascularized shaft of femur from female Japanese white rabbit donors was transplanted to male recipients. Microchimerism in different organs and tissues were checked postoperatively using a semi-quantitative polymerase chain reaction (PCR) with a Y-chromosome specific primer at different time. Results X-ray and histological examinations showed typical bone union in the experiment group but irregular new bone calluses surrounded the transplanted bones, with high density sequestrum in the control group.Semiquantitative PCR with a Y-chyomosome specific primer indicated that the incidence of microchimerism in organs and tissues in the experiment group was higher than that in the control group postoperatively and increased with time. Conclusions After vascularized allograft bone transplantation, organs and tissues show microchimerism that has a positive correlation with the histocompatibility of the transplanted bones.

Objective The aim of this study was to explore the effect of low density lipoprotein ( LDL) on the proliferation and differentiation of MC3T3-E1 osteoblasts, as well as the expression of low density lipoprotein receptor-related protein 5(LRP5) and dickkopf-1(DKK1) mRNA of MC3T3-E1 osteoblasts. The possible mechanisms of the treatment of atorvastatin on LDL expression in MC3T3-E1 osteoblasts were also investigated. Methods Proliferation, osteocalcin expression, LRP5, and expression of DKK1 mRNA of MC3T3-E1 with interaction of LDL at 0. 05, 0. 10, 0. 20 mg/ml levels after 24 h, 48 h, 72 h were detected by CCK8, ELISA, and fluorescence quantitative PCR. Furthermore, proliferation, osteocalcin expression, LRP5 and DKK1 mRNA of MC3T3-E1 after the treatment of atorvastatin of 10-6 mol/L and 10-5 mol/L were also be studied, respectively. Results The effect of LDL on proliferation, expression of osteocalcin and expression of LRP5 and DKK1 mRNA in MC3T3-E1 osteoblasts was the most obvious under LDL with 0. 20 mg/ml level. Under that level, atorvastatin (10-6 mol/L or 10-5 mol/L) was able to make the proliferation of MC3T3-E1 osteoblasts in 48 h and 72 h be decreased, while significantly caused upregulation of osteocalcin, LRP5 mRNA expression; and down regulated DKK1 mRNA expression ( all P<0. 05). Conclusions Atorvastatin can reduce the inhibitory effect of LDL on the proliferation and differentiation of osteoblasts. The mechanisms of atorvastatin on osteoblasts are possibly related to the osteoblast proliferation and expression of LRP5 mRNA and DKK1 mRNA of osteoblasts of wnt signal pathway.

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Abstract There are many problems in emotion ability development of hearing impaired children, such as emotion recognition, emotion expression obstacle, emotion understanding limitation and emotion regulation impropriety, etc., which seriously affect their social adaptation and mental health. Making systematic and individualized intervention programs can effectively promote the development of emotion ability of hearing impaired children. Based on the analysis of the characteristics and influencing factors of the emotion ability development of hearing impaired children, this paper reviews the existing intervention studies, and proposes future research directions in view of the deficiencies of existing studies, in order to provide reference for the research on emotion ability intervention of hearing impaired children.

Abstract Emotion ability has substantial influence on individuals survival and development as well as mental health. Emotion ability development disorder has become a prominent performance of hearing impaired children, which has attracted the attention of researchers at home and abroad. From the four aspects of emotion recognition, emotion understanding, emotion expression and emotion regulation, this paper sorts out and comments on the previous studies, puts forward the intervention measures in the light of the concrete problems existing in the development, and proposes some suggestions for the curtent study limitations, in order to provide fundamental evidance for promotion of emotion ability of hearing impaired children.

Objective To provide applied anatomy basis for upper fibular bone flap pedieled with cir- cumflex fibular neck artery.Methods The origin,course,branches,distribution and anastomosis of cir- cumflex fibular neck artery were observed on 54 sides of adult cadaver lower limb speeimens perfused with red latex.Results The circumflex fibular neck artery derived from popliteal artery (3.3?1.1)cm beneath the tip level of fibular head,with its length of (1.4?1.0) cm and diameter of (1.4?0.5) mm.The ascending periosteal branches of circumflex fibular neck artery anastomosed consistently with the descending periosteal branches of inferior lateral genicular artery.Conclusion The transplanting operative design of upper fibular bone flap pedicled with circumflex fibular neck artery was feasible.

Objective To evaluate the effectiveness of bioelectrical impedance analysis(BIA) interventions on volume status in hemodialysis patient. Methods Searched The Cochrane Library, PubMed, EMbase, EBsco, Wanfang Data, China Biology Medicine, China National Knowledge Infrastructure to collect clinical trials. The retrieval time was from database to July 15, 2016. The studies were selected according to the inclusion and exclusion criteria and were critically appraised by two reviewers. Then the data of included studies were extracted. Meta-analysis was conducted by using RevMan 5.3 software and descriptive analysis. Results Ten clinical trials were included six random control trial, one controlled clinical trail, three longitudinal study, involving 2009 patients. The results of Meta-analysis showed that the effectiveness of BIA interventions on volume management could improve blood pressure (P=0.001), protect the heart function(left ventricular mass index,P=0.002), compared with the clinical evaluation method, the BIA assessment of dry weight of hemodialysis patients could reduce hospitalization rate 14%. Descriptive analysis showed that BIA intervention volume management had certain advantages for the survival benefit of patients, but the current research was still few, had not yet come to a certain conclusion. Conclusions BIA can improve the management of the volume status and dry weight of hemodialysis patients, so as to it can improve the clinical benefit and survival benefit of patients.Better methods and guidelines for assessing DW and using BIA need to be developed.We propose that experienced HD nursing staff be trained in the use of the BIA to help monitor patient over hydration and approximate dry weight in consultation with the nephrologists responsible for the care of these patients so as to obviate excessive residual over hydration between nephrology reviews.

OBJECTIVETo observe clinical therapeutic effect of acupuncture kinetotherapy for acute simple laryngitis of wind-heat type and to probe the mechanism.

METHODSEighty cases were randomly divided into a test group and a control group, 40 cases in each group. The test group were treated with acupuncture kinetotherapy (Acupuncture was given at Kaiyin point No. 1 combined with deep respiratory movement of the glottis), once daily. The control group were treated with ultrasonic aerosol inhalation of 0.9% sodium chloride injection, gentamicin sulfate injection 80 000 U and Dexamethasone injection 5mg, twice a day. The treatment was given for 5 days for the 2 groups.

RESULTSThe cured and markedly effective rate was 90.0% in the test group and 82.5% in the control group with no significant difference between the two groups (P>0.05); in the test group there was a very significant difference before and after treatment in the cumulative score of symptoms and the acoustic parameters (P<0.01).

CONCLUSIONAcupuncture kinetotherapy has obvious therapeutic effect on acute simple laryngitis of wind heat type, with no toxic and adverse effects.

Acupuncture Therapy ; Combined Modality Therapy ; Hot Temperature ; Humans ; Laryngitis ; Wind