Objective To provide an new operative method for ischemic necrosis of femoral head in children Method The disease was treated by comprehensive operation,which are transposition of posterior great trochanter periosteal flap pedicled with profound branches of medial circumflex femoral vessels and decompression of epiphasis of femoral head Results Forty two patients were performed in seven years The period of follow up is above one year in 37 cases and average three years and six months The good and excellent rate is 86 percent Conclusions This new operation can provide with effective decompression and blood circulation and various osteogenic factors It is suitable with patients of Catterall Ⅰ～Ⅳ

By incorporation of tritiated thymidine or 5-bromodeoxyuridine and using them as the markers,we found that the basal cells,Clara cells and type II alveolar epithelial cells in the pulmonary tissues may in some way behave like stem cells and can eventually differentiate into respiratory tract epithelium.The slow progress of researches on pulmonary stem cells up to date has its root in the complex structure of pulmonary tissues and respiratory tracts,which is demonstrated by the facts that the respiratory system is composed of at least 40 types of cells,plus that the growth,renewal,and regeneration rate or capacity of respiratory epithelium are extremely limited.Mean while,there have been no specific stem cell markers for pulmonary and lung cancer,so researchers rely on stem cell markers borrowed from other systems to search for stem cells in pulmonary system.At present,the studies of lung stem cell markers were focused on Sca-1,ABCG2 /Bcrp1,cell retaining marker,surface marker,cell keratin and CCSP.Recently the lung stem cells have been shown to be the targets of transformation during lung carcinogenesis,which has provide more thoughts and direction for the occurrence and treatment of lung cancer.

Objective To provide applied anatomic bases for the transplantation of scapular spine bone flap pedicled with supraspinous branch of suprascapular artery Methods The origin,course,branches and distribution were observed on 30 adult cadaver specimens;the operative designs were imitated on 6 specimens Results The supraspinous branch originated from suprascapular artery,went between supraspinatus muscle and scapular bone medially,and divided into 3～4 periosteal branches to scapular spine with a diameter of 0 5～0 8mm The length of stem of supraspinous branch was (4 8?0 6)cm Conclusions The transplantation of scapular spine bone flap pedicled with supraspinous branch of suprascapular artery is feasible

AIM: To observe the outcome of donor bone after vascularized allograft bone transplantation under immunoregulation. METHODS: The experiment was conducted at the Microsurgery Institute, Medical College, Wuhan University from December 2002 to March 2004. Totally 21 male flap-eared Japanese rabbits were selected as donor and 42 female ones as recipients. Recipients were composed of 21 rabbits in the experimental group and 21 rabbits in the control group. ①Anastomotic vascularized massive shaft of femur allograft was performed in Japanese flap-eared rabbits of either sex. ②The experimental animals were assigned into experimental group (treated with ciclosporin A, 25 mg orally, once a day, for 3 weeks) and control group (no any immunosuppressive agent). ③X-ray and histology examinations were performed at months 1, 4 and 9 after operation. Bone grafts were analyzed with Sry semi-quantitative polymerase chain reaction. RESULTS: A total of 42 rabbits were involved in the result analysis. ①X-ray manifestation at different time points after rabbit transplantation in the two groups: X-ray showed typical fracture healing mode at different phases after operation in the experimental group, whereas the increase of bone graft density, and around by a mass of bony callus in the control group. ②Histology manifestation of rabbits in the two groups after operation: At different time phases it showed typical fracture healing mode in the experimental group after operation, and 9 months later the marrow cavity was filled with myeloid tissues, and the internal and external cortex was flat; Haversian canal had revered to the normal size; Bone cells appeared in the bone lacuna; Peripheral cortex was wrapped with fibrous tissues. In the control group, it showed inflammatory cell infiltration with rejection, bone marrow necrosis in marrow cavity, formation of fibra tissues, bone cell loss in bone lacuna, and the bone grafts were wrapped with woven bone that was from recipients. ③Outcome of Sry semi-quantitative PCR analysis: The Sry semi-quantitative PCR analysis showed that the relation between the ratio of male DNA and the postoperative period was positive; the ratio of experimental group at month 9 postoperative was near to 100%, while control group only reached 11.8%. CONCLUSION: Under the immunoregulation, bone graft can unite with the recipient bone in an earlier postoperative period and replace by recipient bone rapidly in vascularized allograft bone transplantation.

Objective The clinical results of leukemia improved significantly due to the application of arsenic trioxide(As 2 O 3 ).This compound was used in inducing apoptosis on osteosarcoma cell lines and its mech anism was explored.Methods Human osteosarcoma MG-63cell line was cultured and treated with0.25,0.5,1,2,4and8?mol/L As 2 O 3 .The cell line was measured at24,48,72,96and120h after As 2 O 3 infiltration.MTT assay,phase contrast light microscopy,fluorescence staining,TUNEL,flow cytometry anal-ysis and RT -PCR were used to investigate the inducing apoptosis and inhibitative effect of As 2 O 3 on os-teosarcoma MG-63cell line.Results As 2 O 3 could inhibit the reproduction of osteosarcoma cell line MG-63significantly,the inhibitive rates of MG-63cell line treated with As 2 O 3 over1?mol/L reached70%.Un -der phase contrast light microscopy and fluorescence staining,osteosarcoma cells cultured with As 2 O 3 pre sent -ed typical apoptotic changes.The majority of cells cultured with As 2 O 3 were positive with TUNEL.Flow cy tometry analysis showed a time-dose dependent apoptosis rate and a remarkable G 2 /M phase arrest.The ex pression of c-myc was decreased in MG-63cells treated with As 2 O 3 .Conclusion As 2 O 3 is able to in duce osteosarcoma apoptosis effectively.The expression of decreasing c-myc is an important mechanism in induc-ing osteosarcoma MG-63cells apoptosis.

Objective TNF-related apoptosis-inducing ligand(TRAIL)was a new member of TNF family.It could quickly inactivate tumor cell originated from different tissues but no effects on normal tissue in vitro.Osteosarcoma was the most common primary malignant bone tumor with the survival rate of 5years no more than20%after simple surgical management.The induced apoptosis and selective cytotoxicity of human soluble TRAIL for MG -63cell line were investigated in order to explore the feasibility of sTRAIL in clinical treatment of osteosarcoma.Methods sTRAIL-mediated cytotoxicity by MTT assay in MG-63osteosarcoma cell line,MRC-5human diploid lung cell line and L-02fetus hepar cell line were assessed,apoptotic cellular morphological transformation by phase contrast microscope and electron micro-scope was observed.The expression of TRAIL receptors mRNA in the cell lines was examined by RT -PCR.The apoptotic rates of MG-63cell line were shown by flow cytometry.Moreover,the apoptosis of MG-63cell line induced by sTRAIL was confirmed by terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL).Results MG-63,MRC-5and L-02cell lines were treated for 24hours with dif ferent concentrations of sTRAIL and the inhibitive rates of sTRAIL were evaluated with MTT assay,the in hibitive rates of 500ng /ml,1?g /ml ,2?g /ml and5?g /ml TRAIL inducing MG-63osteosarcoma cell line were10.1%,24.3%,50.6%and more than95%respectively.By flow cytometry,an obvious apoptosis peak ahead the diploid peak was obtained when MG-63cell line incubating with2?g/ml TRAIL for 6hours,howev er,the consequences of MRC-5and L-02cell line were non-differentiated.Therefore,MG-63cell line was significantly sensitive to sTRAIL-mediated apoptosis,but MRC-5and L-02cell line were resistant to sTRAIL-induced cell death.Under phase contrast microscope,when MG-63cell line were treated by sTRAIL,some cells began to became small and round in3to8hours.In24hours a large number of cells exfoliated and drifted in culture medium.Moreover,karyopyknosis and crescent aggregation of chro-matin were observed by electron microscope.By RT-PCR,the expression of TRAIL-R1,R2and R3but not R4mRNA on MG -63and MRC -5cell line were observed,and there were the expression of TRAIL-R1,R2,R3and R4mRNA on L-02cell line.In TUNEL assay,the nucleus of the apoptotic cells became brown or yellow.Conclusion TRAIL is able quickly to kill MG-63osteosarcoma cell line in vit-ro.Fur thermore,TRAIL is non significant cy-totoxic for normal tissue.TRAIL or TRAIL com bined with chemotherapy and radiotherapy is a potential and valuable proposal for clinical treatment of osteosarcoma.

Idiopathic pulmonary fibrosis is a diffuse pulmonary fibrosis disease.At present,there are still no effective treatments for this disease,so the prognosis is poor and 5 years of survival rates was only 20%.Bone marrow mesenchymal stem cells(BMSCs),derived from bone marrow,is a kind of multipotent stem cells,which have potential to differentiate into many lineages of cells.So,they are considered to have great latent values in clinic.In recent years,related studies had found that BMSCs might participate in the repair of the lung injury,even they can reverse the pathological progress in idiopathic pulmonary fibrosis.But the mechanism is still unclear and needs more research to elucidate.

Objective To study retrospectively the results of minute tissue flap for repairing tissue defect of hand. Methods The transposition or transplantation of ten kinds of tissue flaps were applied to repair skin or bone or joint defect of hand in 102 cases. Results The period of follow-up was one to eighteen years. All skin flaps were live and appearance is excellent. The function of hand is good. The period of bone healing was three to four months and joint motion is satisfactory' Conclusions Microsurgical repair of skin defects of hand have shorter period and good results' Skin defect with naked bone and joint or tendon in hand should apply minute skin flap to repair in onestage. Various vascularized minute bone flaps may be choiced to repair non-union of scaphoideum or lunatum necrosis and metacarpal head defect.

Objective To provide the anetomic base for the transposition of spine of scapular flap pedicled with thoracoacromial artery Methods The course, branches and distribution of thoracoacromial artery were observed on 40 adult cadaver specimens Results The main branch of thoracoacromial artery was the acromial branch Its length was (5 1?0 1) cm, the originated diameter was (1 2?0 2) mm The deltoid muscular branch went outward intermuscular ditch between deltoid muscle anspectoralis major muscle, and anastomosed with anterior humeral circumflex artery constantly besides distributing to deltoid muscle and pectoralis major muscle, its diameter was (1 9?0 2) mm, the length form the originated dot to the entrancing muscular dot of deltoid muscle or pectoralis major muscle was (4 8?0 5) cm or (3,2?0 4) cm respectively Conclusion The transposition of lateral segment spine of scapular flap pedicled with the acromial branch of thoracoacromial artery or deltoid muscular branch acromial branch may be designed for repairing proximal humerus

Objective Provide a new operative method to treat ischemic necrosis of navicular.Methods Based on the anatomic study, the vascularized periosteal flat of the first cuneiform bone was designed to transplant into navicular.Results Two cases were treated by transposition of this periosteal flat , the time of follow-up was over 2 years, the results were satisfactory.Conclusions The operation is not only simple but also injury is little.It is secure and reliable. [