Objective To evaluate the clinical results of flexor hallucis longus (FHL) tendon transfer in treatment of patients with Achilles tendon defects of more than 6 cm. Methods Between January 2005 to February 2009, 19 patients with Achilles tendon defects, 13 males and 6 females, were treated with FHL tendon transfer. Their ages ranged from 20 to 61 years, with an average of (42. 6 ± 8.2)years. Fifteen defects were found during tendonitis debridement, and 4 were old ruptures. Time from rupture to surgery ranged from 0 to 6 months (average, 2.6 months). Defects were 6 cm to 10 cm long. Procedures were performed in a two-incision manner. The postoperative ROM of ankle joint, American Orthopaedic Foot and Ankle Society(AOFAS) and visual analogue scale(VAS) scores were recorded at 3 months, 12 months,and the last follow-up. The results were statistically analyzed to evaluate the functional recovery. Results Follow-ups lasted from 12 to 48 months (average, 22. 2 months). At the last follow-up, the average ROM of ankle joint was 17.8°± 1.9° at dorsal flexion and 39.1°±2.3° at plantar flexion, and the last average AOFAS score was up to (91.8 ± 1.7), significantly different from those at 3 months after surgery (P＜0.05), but not significantly different from those at 12 months (P＞0.05). The difference were significant between the results of 3 months and 12 months (P＜0.05). The last average VAS score was (1.0±0.7),significantly different from those at 3 months and 12 months(P＜0.05) . There was also significant differences between the VAS scores of 3 months and 12 months (P＜0.05). Patient's satisfaction was 100%.Conclusion FHL tendon transfer is an efficient procedure for long Achilles tendon ruptures associated with tendonitis in relieving pain and maintaining the function of ankle joint.

Objective To evaluate the foot function after Lisfranc injury with local soft tissue in-jury. Methods From November 2000 to April 2006, 43 patients (at mean age of 32 years) with fresh Lisfranc injuries (45 sides) were managed with open reduction and internal fixation with screws, Kir-schner wires and AO plates. All patients had no joint surface damage and received no fusion surgery. Ac-cording to the Quenu-Kuss classification of Lisfranc injury, there were 14 patients with type-A injury, 21 with type-B and 10 with type-C. According to AO classification, there were 29 feet without severe soft tis-sue injury and 16 feet with severe soft tissue injury, of which 10 patients were combined with severe local soft tissue injury (one patient with Foot compartment syndrome). The period from injury to surgery was seven days. All patients received cast immobilization for 8-12 weeks and the foot function was evaluated by anteroposterior and lateral X-rays and American Orthopedic Foot and Ankle Society (AOFAS) score. Results All patients were followed up for 12-69 months (average 37 months), which showed that all pa-tients obtained anatomic reduction and 32 patients were satisfied with operative outcome. The average postoperative AOFAS score was 97 points for patients without severe soft tissue injury and 82 points for pa-tients with severe soft tissue injury (P<0.05). Conclusion After Lisfranc injury, the foot function is related to severity of both joint injury and local soft tissue injury.

OBJECTIVETo investigate clinical effects of arthroscopy in the treatment of medial meniscal cyst.

METHODSFrom June 2011 to January 2013, 7 patients with medial meniscal cyst were treated with arthroscopy. There were 3 males and 4 females,ranging in age from 27 to 63 years old,with a mean age of (43.93±2.10) years old. The cysts have been discovered for 3 to 30 months,with a mean time of (10.6±1.3) months. All the patients complained of knee pain,especially in the medial joint gap. The Pisani sign, Caklin sign and medial McMurray sign were all positive. Preoperative MRI examination confirmed the diagnosis. Lysholm score changes and clinical efficacy were observed through a six-month follow-up.

RESULTSThe postoperative Lysholm scores were all significantly higher than the preoperative scores. According to Sarimo standard, 6 patients got an excellent result, and 1 good.

CONCLUSIONArthroscopic treatment of medial meniscal cyst has replaced the traditional method, which could retain the normal meniscus as much as possible and repair the meniscus injury simultaneously, as well as get a good curative effect and a good recovery of knee function. This method is worthy of clinical application.

Adult ; Arthroscopy ; methods ; Cysts ; physiopathology ; surgery ; Female ; Humans ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged

The author analyzes the basic information in recent years,including overall students scale,students' age,application trends,etc.Some suggestions are made,regarding to recruiting plan,applicant qualification,recruiting mode,etc,in order to further improve the recruiting and graduate management.

Background The special pathological change of diabetic retinopathy(DR)is microvascular disorder.Angiopoietin-like protein 2(Ang-2)is a new protein associated with genesis of blood vessels.Quercetin has multiple pharmacological action,including improving the microcircularion and the permeability of blood capillary.However,the action mechanism of Ang-2 on DR was unclear.Objective The present study was to investigate the effects of quercetin on Ang-2 and its receptor Tie2 expression in retina with diabetes mellitus.Methods Sixty clean male Wistar rats were randomized into 7 groups and 10 rats for each group,and 10 rats served as blank control group.Streptozotocin of 35 mg/kg was intraperitoneally injected in 60 rats to establish the diabetic models.Quercetins encapsulated by liposome with the doses of 50,150 and 250 mg/(kg · d)(3-5 ml)were used to gavage in different groups of models for 12 weeks,and normal saline solution and calcium dobesilate were used at the same fashion as the negative control group and positive control group,respectively.Twelve weeks later,the animals were sacrificed and retinas were isolated.Expressions of Ang-2 protein and Tie2 mRNA in retinas were detected by ELISA and RT-PCR,respectively.The usage and rearing of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Sciences and Technology Commission.Results ELISA showed that the A450 of Ang-2 in 150 and 250 mg/(kg · d)quercetin groups was 0.796±0.057 and 0.842±0.043 respectively and was lower than that negative group(1.012±0.046),showing statistically significant differences(q =2.95,2.698,P＜0.05).RT-PCR assay showed that expression of Tie2 mRNA(Tie2 mRNA/GAPDH mRNA)in retinas was 0.712±0.092 and 0.821±0.087,presenting statistically significant differences in comparison with negative group(1.182±0.098)(q =3.497,2.852,P＜0.05).The expression levels of Ang-2 and Tie2 mRNA in retina were lowest in 150 mg/(kg · d)quercetin group.Conclusions Quercetin can improve the retinal microcirculation by downregulating the expressions of Ang-2 and its receptor in early period of diabetic rats.

Objective To evaluate the pharmacokinetics of remifentanil in adult patients undergoing general anesthesia.Methods Ten ASA Ⅰ or Ⅱ adult patients of either sex undergoing elective surgery under general anesthesia were enrolled in this study.The patients were premedicated with atropine 0.5 mg.Anesthesia was induced with fentany1-2 ?g?kg~(-1),lidocaine 0.5-1.0 mg?kg~(-1),propofol 1.5-2.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with isoflurane -O_2 inhalation and intermittent i.v.boluses of vecuronium after tracheal intubation.The patients were mechanically ventilated.P_(ET)CO_2 was maintained at 30-40 mm Hg. Remifentanil 5 ?g?kg~(-1) was injected i.v.over lmin after induction of anesthesia.Arterial blood samples were taken before(baseline)and at 1,2,3,5,7,10,15,20,25,30,45,60 and 90 rain after drug administration for determination of blood remifentanil concentration using high performance liquid chromatography/mass spectrometry. The data were analyzed using 3P87 pharmacokinetic program.Results The pharmacokinetic profile of remifentanil was best described by a “two-compartment” model.The distribution half-life(t_(1/2?))(1.6?0.5)min,the elimination half-life(t_(1/2?))(22?10)min,total clearance(CL)(2.1?0.4)L/min and the volume of distribution (V_d)(66?29)L.Conclusion The volume of distribution calculated in this study is significantly different from that reported in previous studies,indicating that there may be some difference in the pharmacokineties of remifentanil between different populations.

Adult ; Dental Implantation, Endosseous ; instrumentation ; Dental Implants ; Female ; Humans ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design

ObjectiveTo analysis the clinical features of thoracic spine and spinal cord injury (SCI) and summarize the inclusive standard of cellular transplant clinical trial for SCI.MethodsThe data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively.ResultsMean follow-up period was 20 months (6～48 months). There was no recovery in 12 spinal cord injury without radiographic abnormality (SCIWORA) patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B (sense recovery), rate of recovery was 9.6%; recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief.ConclusionIncidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.

OBJECTIVETo investigate the protective effect of melatonin on residual hair follicle cells of scald rats at early stage.

METHODSEighteen male Sprague-Dawley rats were randomly divided into scald group, treatment group, sham group , with 6 rats in each group. The rats in scald group and treatment group were subjected to 30% TBSA partial thickness scald on the back, and were resuscitated with balanced solution after 1 hour, while those in sham group were immersed in water at 37 degrees C for 25 s to simulate scald, and did not receive fluid replacement. Rats in treatment group were intraperitoneally injected with 10 mg/kg melatonin solution at 1 minute, 8 hours and 12 hours after scald, while those in sham group and scald group were given equal volume of 1% alcohol sodium-isotonic saline instead. Tissue samples were harvested at 6, 12 and 24 post scald hours (PSH) for determination of MDA and GSH levels. Apoptosis of residul hair follicle was detected by TUNEL method and immunohistochemistry of caspase-3.

RESULTSThe level of MDA in scald group at each time point was much higher than that in sham group (P < 0.01) and treatment group (P < 0.05), and it peaked at 12 PSH. The changes in GSH were just opposite to that of MDA. Under fluorescence microscope, the residual hair follicle cells were blue, and the apoptotic cells appeared green. The apoptosis rate in scald group at 6, 12, 24 PSH was obviously higher than that in sham (P < 0.01) and treatment groups (P < 0.05), which was (20.2 +/- 3.4)% vs (4.3 +/- 2.3)% vs (10.9 +/- 3.2)%, (31.2 +/- 3.6)% vs (5.1 +/- 2.5)% vs (19.1 +/- 3.7)%, (22.4 +/- 2.7)% vs (4.1 +/- 2.4)% vs (13.1 +/- 3.4)%, respectively. The score of caspase-3 positive cell in scald group was higher than those in sham group (P < 0.01) and treatment group (P < 0.05).

CONCLUSIONSThere is obvious correlation between oxidative stress and apoptosis rate of hair follicle cells in rats with partial thickness scald. Early administration of melatonin may have anti-apoptosis ability for residual hair follicle cells by attenuation of oxidative stress.

Animals ; Apoptosis ; Burns ; drug therapy ; metabolism ; Hair Follicle ; cytology ; metabolism ; Male ; Melatonin ; therapeutic use ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley