Objective To explore the anatomy and the adjacent of the medial malleolus,the operative approach of soluting the tibial nerve in endoscopy and the significance of making use of it in operation. Methods The five cadaver feet were dissected,the tibial nerve and the fiber diaphragm in the middle of me- dial and lateral plantar tunnels in the ten cadaver feet were soluted in endoscopic.Results The operative approach was designed on the basis of the anatomy data (the three-portal approach:The perpendicular bisetor which was the medial malleolus pointed to the medial margin of tendon calcaneus insertion was 4.5cm;The midpoint of the medial malleolus pointed to the calcaneus tubercle;The midpoint of the calcaneus tubercle to the medial margin of the first metatarsophalangeal joint).It was succeed that soluted the tibial nerve and the fiber diaphragm in the middle of medial and lateral plantar tunnels.Conclusion The operative approach on the basis of the anatomy data is design,and testfy the feasibility of exploring curved tunnel in endoscopic.

Background The key premise of genetic research and treatment is to select the desired gene vector,ultrasound microbubbles as a new type of gene vector can safe,fast and effectively enhance the gene transfection and expression by reversibility increasing the permeability of cells. Objective This study was to observe the effects of ciliary neurotrophic factor(CNTF)gene mediated by ultrasound microbubbles intraocular transfer on visual function and retinal ganglion cell(BGCs)after optic nerve injury. Methods Fifty-five adult Sprague-Dawley(SD)rats were divided into 6 groups randomly,including normal control group(n=5),sham injury group(n=10),simple injury group(n=10),naked plasmid group(n=10),plasmid+ultrasonic irradiation group(n=10)and ultrasound microbubbles group(n=10).The model of optic nerve injury Was made by forceps clip on the fight optic nerve.and the corresponding intervene was performed in different groups.Flash visual evoked potential(F

Adult ; Dust ; Female ; Glass ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Prevalence ; Skin Diseases ; epidemiology ; Young Adult

Objective To discuss the surgical treatment for huge hepatoblastoma in children,and the technique of hepatectomy without blockade of the blood supply to the remained liver lobes.Methods We reviewed 12 cases of huge hepatoblastorna who had been operated from July 2001 to January 2009 in our hospital.The mean age of the children was 3.2 years(range,11 months to 12 years).The diameter of the tumor was from 10 to 23 cm.3～7 cycles of chemotherapy was routinely administrated before operation.When the tumor reduced to a certain size that radical resection could be performed safely,regular hepatectomy was conducted.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes was performed in every patient.Results The operations were successfully accomplished in all the 12 children.5 cases received right trihepatectomy (segment Ⅳ,Ⅴ～Ⅷ),4 cases received right hemihepatectomy(segment Ⅴ～Ⅷ),and the other 3 cases received Ⅳ,Ⅶ,Ⅷ segmentectomy,right Ⅴ,Ⅵ segmentectomy,and left hemihepatectomy respectively.The intraoperative hemodynamic parameters were stable,and there was no perioperative mortality.Postoperative chemotherapy wag routinely administrated.The follow-up period varied from 2 to 92 months.11 children survived and were disease free,among those 6 children have survived for more than 5 years.One child had brain and lung metastasis 5 months post operation,and died 7 months post operation. Conclusion Preoperative chemotherapy administrated to children with huge hepatoblastoma can reduce the tumor size and render tumor reseetable.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes is a safe and feasible surgical technique.

Objective To evaluate the clinical application and the therapeutic effect of the Fresnel press-on prism for children ocular torticollis.Design Retrospective case series.Participants 64 patients with ocular torticollis.Methods All the patients with ocular torticollis wore Fresnel press-on prism on glasses for 6-12 months to correct small angle vertical paralytic heterotropia.Main Outcome Measures Changes of abnormal head position and stereoscopic vision when naked and glasses-wearing.Results Fresnel press-on prism could provide an improvement in the correction of symptoms in children ocular torticollis.58 patients(90.6%) had improvement of abnormal head position and three-grade binocular vision.All 55 cases(100.0%)matching examination after wearing prism showed simultaneous perception,52 eases(94.5%)had fusion,and 50 cases(90.9%)had stereoscopic vision.Chi square test showed significant difference from pre-wearing prism(P

A secretive expression vector of Pichia pastoris system which can be used for the direct cloning of PCR products was constructed,and was verified through the expression of recombinant cellobiohydrolase II in Pichia pastoris.A randomly selected fragment was amplified with properly designed primers by PCR.The XhoI and Eam1105Ⅰ restriction sites were included in the 5'end of the fragment,and the Eam1105Ⅰ and XbaI restriction sites were included in its 3'end.The PCR amplified product was inserted into the P.pastoris expression plasmid pPICZ?A through XhoI and XbaI restriction sites and the resultant plasmid was digested with Eam1105Ⅰ,and lastly the big fragment was recovered,generating the P.pastoris expressive Tvector pPICZ?T.Then the cellobiohydrolase II of T.reesei was successfully expressed in P.pastoris with this expressive Tvector.Such results indicated that the constructed expression Tvector was convenient for PCR product cloning,and was effective for heterologous protein expression in P.pastoris.On the other hand,the application of the expression Tvector avoided the introduction of additional amino acids at the Nterminus of the expressed protein,which generally occurred when normal expression vectors were used in secretive expression system.

Objective To investigate the differences in dosimetry between conformal radiotherapy (CRT),field-in-field intensity-modulated radiotherapy (FIF-IMRT),and intensity-modulated radiotherapy (IMRT) after breast-conserving surgery for left-sided breast cancer.Methods A total of 31 patients who underwent breast-conserving surgery for left-sided breast cancer were randomly selected,and the plans for CRT,FIF-IMRT,and IMRT were developed.The dose-volume histogram (DVH) was used for self-control study,and the non-parametric test was used to compare the differences in target volume and doses to organs at risk (OARs).Results All the three methods met the requirements of the prescribed doses.The CRT group had a higher V105 of the target volume and higher heart V30 and Dmax (P=0.000,0.000,0.000).The IMRT group had higher V5 and Dmean (P=0.000,0.000),as well as a higher lung V5 and a lower lung V40 (P=0.000,0.000).The FIF-IMRT group had the lowest Dmean (P=0.000),and the IMRT group had significantly higher Dmean and Dmax of the right lung and the spinal cord than the other two groups (P=0.000,0.000,0.000,0.000).The FIF-IMRT group had a significantly lower single hop count than the other two groups (P=0.000).Conclusions CRT has a good dose distribution in the target volume,but greatly injures the surrounding tissues.FIF-IMRT can well protect OARs and cause less damage to the device.

OBJECTIVE: To investigate the value of combination of thyroid imaging reporting and data system (TI-RADS) and enhanced flow (e-Flow) in the qualitative diagnosis of thyroid nodules; and to compare the diagnostic efficiency between e-Flow and color doppler flow imaging (CDFI. METHOD: The study chose 133 patients with 179 nodules (127 benign, 52 malignant nodules) who had per-operative ultrasound examination of their thyroid using grey-scale ultrasound, CDFI, e-Flow, and their noudles were graded by TI-RADS. Then the ultrasound diagnostic value were compared with their surgical pathology results by TI-RADS; TI-RADS and CDFI; TI-RADS and e-Flow, and diagnostic efficiency between e-Flow and CDFI were compared. RESULT: The results revealed that combination of TI-RADS and e-Flow had a higher sensitivity (94.23%, P < 0.05). There was no statistically significant difference between TI-RADS and the combination of TI-RADS and CDFI. Likewise, there was no significant difference between the combination of TI-RADS and e-Flow and the combination of TI-RADS and CDFI. The e-Flow showed a higher sensitivity, specificity and accuracy compare to the CDFI. CONCLUSION Combining e-Flow and TI-RADS could improve the sensitivity in qualitative diagnosis of thyroid nodules. Also, e-Flow has a better diagnostic efficiency of thyroid nodules.
Diagnosis, Differential ; Diagnostic Imaging ; Humans ; Sensitivity and Specificity ; Thyroid Nodule ; diagnosis ; diagnostic imaging ; Ultrasonography

Objective To discuss the role of leukocyte activation and inflammatory processes in the disease of chronic venous insufficiency(CVI).Methods The relevant literatures about the role of leukocyte activation and in- flammatory reaction in CVI were reviewed.Results The role of inflammatory reaction in occurrence and develop- ment of venous diseases has been studied a lot in recent years.It was found that the leukocyte activation and inflam- matory reaction are involved in the structural remodeling of venous valves and walls,leading to valvular incompe- tence and formation of varicose veins.Conclusion Leukocyte activation and inflammatory processes take important roles in the occurrence and progression of CVI.

Objective To investigate the pathological changes in neonatal rats after hypoxic-ischemic insults. Methods 70 normal 7-day-old Wistar rats were divided into two groups randomly: hypoxic-ischemic and control group. The left carotid arteries were permanently ligated and cut in hypoxic-ischemic group. All the animals were exposed hypoxia (92% N2, 8% O2) for 2 h in a constant thermal environment. All the brain tissues were observed with electronmicroscopy, HE and immunohistochemistry stain 7 d, 14 d and 30 d after injury. Results HE stain showed that neurocytes arranged disorder in the side of the carotid ligation 7 d after injury. Some degenerated neurocytes, swelled cells and inflammatory cell infiltration also visualized. Many capsular spaces were observed in the side of the carotid ligation 30 d after injury. Immunohistochemistry staining showed Myelin basic protein (MBP) positive neurocytes gradually decreased, and glia fibrillary acidic protein (GFAP) positive neurocytes gradually inreased in the periventricular zone with the time lapsed. It was observed that the neurocytes were edema, many mitochondrias were vacuolus, caryotins were condensed under transmission electron microscope 7 d after operation. The morphocytology of the neurocytes were irregulated obviously, part of nuclear membranes were broken down with the content leakaged 30 d after operation. Conclusion The characteristics of periventricular leukomalacia can be developed after hypoxic-ischemic insults in the rats.