Objective:To investigate the methods and effect of wound repair after partial skin and soft tissue necrosis of middle and lower leg fracture surgery.Methods:Three kinds of island flaps were used to repair the wound after skin and soft tissue necrosis of middle and lower leg fracture surgery in 22 patients. Nine patients were repaired with sural neurotrophic fascial flaps, 7 patients with posterior tibial artery perforator flaps, and 6 patients with peroneal artery perforator flaps. The area of wound defect was 3.0 cm×3.8 cm to 12.0 cm×9.0 cm. The donor area was directly sutured, or free skin grafted.Results:All patients were the cases after partial skin and soft tissue necrosis of middle and lower leg fracture surgery, with bone, internal fixation plate or tendon exposed. The skin flaps in 21 patients were survived, and the wound healed by first intention. The sural neurotrophic fascial flap necrosis in one patient was due to hematoma and entrapment in vascular pedicle. After 5 to 24 months (mean 9 months) follow-up, texture of flaps was good, no ulcer occured, and outlook of the repaired wound was satisfied. The sutured wound of donor site and skin-grafting had healed by first stage intention.Conclusions:Repair with island flap is an ideal way to the defect wound after skin and soft tissue necrosis of middle and lower leg fracture surgery.

Objective: To compare the hyoid bone position among patients with different sagittal skeletal malocclusions to provide a reference for clinicians to formulate treatment plans. Methods: Lateral cephalograms of 284 orthodontic patients were selected. According to ANB angles, the types of skeletal malocclusion of patients were determined as follows: Class Ⅰ (1° ≤ ANB ≤ 5°), Class Ⅱ (ANB>5°) and Class Ⅲ (ANB<1°). Ten parameters were used to determine hyoid positions. After comparing the hyoid positions of the three groups, stratified analyses based on sex and age were conducted. Results : No significant differences in demographic and vertical facial type features among skeletal Classes Ⅰ, Ⅱ and Ⅲ patients were observed (P>0.05). The angle between the Gonion-hyoid point line and the hyoid point-Menton line (Go-Hy-Me) of Class Ⅱ patients was significantly smaller than that of Class Ⅰ patients, and the angle between the most anterior and inferior point of the third cervical vertebra-hyoid point line and the hyoid point-Sella line (C3-Hy-S) of Class Ⅲ patients was smaller than that of Class I patients (P<0.05). Age-stratified analysis showed that in the juvenile group, the C3-Hy-S of Class Ⅲ patients was significantly smaller than that of Class Ⅰ patients in males and females (P<0.05). In the adult female group, the Go-Hy-Me of Class Ⅱ patients was significantly smaller, and the distance from the hyoid point to the mandibular plane (Hy-MP) was larger than that noted in Class Ⅰ patients (P<0.05); no significant difference in hyoid position between male Class Ⅱ and I patients was observed (P>0.05). Conclusions Compared with Class Ⅰ patients, the hyoid bone of Class Ⅱ patients in adult females was farther away from the mandible and that of Class Ⅲ patients in juveniles was farther away from the cervical vertebra and posterior cranial base.

Objective To investigate the condition of nutrition in child with cerebral palsy (CP) and the effect of nutritional intervention. Methods 49 CP children and other 60 health children (controls) were measured their bodies, hemoglobin, serum trace elements, and bone mineral density (with ultrasonic), and the feeding behavior was also investigated. Results The incidence of malnutrition was 48.97%, in which 26.53% for low weight. The levels of serum iron and zinc were poor in the CP children, and the incidence of iron deficiency anemia was 34.67% in the CP children, different from the controls (P<0.05), while the incidence of low bone mineral density was 30.61%, not significantly different from the controls (P>0.05). Feeding problems were found in 44.9% of CP children. About 50% of malnutrition was corrected, especially the body weight after 4 months of Intervention, with anemia corrected in 88.2%, and bone mineral density recovered in 50%. Conclusion It is a problem for many CP children with malnutrition and nutritional disorders, and need nutrition intervention as the content of the rehabilitation.

ObjectiveTo investigate the effect of volume embolization ratio(VER) in evaluating the embolization efficacy of aneurysms.MethodsFifty-three patients who received intracranial aneurysm embolization surgery were all treated with detachable coils endovascular embolization,While fifty-seven intracranial aneurysms were treated.The VER was calculated and the relationships between the VER values and the size,the neck,embolization degree of intracranial aneurysm were analyzed.ResultsThe VER of small,medium,large,and giant aneurysms were (40.8 ± 26.5 )％,( 18.6 ± 16.1 )％,(2.3 ± 2.1 )％,(0.4 ±0.1 )％,respectively,which had statistical significance (F =7.091,P ＜ 0.01 ).The VER of wide-necked and narrow-necked aneurysms were (27.5 ± 23.1 )％,(29.4 ± 26.6)％,which had no statistical significance(P ＞0.05 ).The VER of complete embolization,neck residual and partial embolization were (41.8 ± 29.3 )％,(31.4 ± 21.2)％,( 12.3 ± 15.1 )％,respectively,which had statistical differences (F =7.970,P ＜ 0.01 ).ConclusionsThe VER is an objective index to evaluate the embolization degree of aneurysms.It has certain prediction significance for the efficacy judgement of embolization of aneurysms.

Epidermal growth factor receptor (EGFR) is found to express at high levels in a variety of solid tumors including gliomas. This study was to examine the effect of an EGFR-tyrosine kinase inhibitor (AG1478) alone or in combination with cisplatin (CDDP) on the growth of glioma cells (U87). U87 glioma cells were treated with AG1478 (10 μmol/L) or CDDP (25 μmol/L) as a single agent or in combination for 24 or 48 h. The expression of EGFR and the components in its downstream signaling pathway [extracellular signal-regulated kinase (ERK), protein kinase B (AKT)] in U87 glioma cells was detected by Western blotting. Cell growth, cell cycle distribution and cell apoptosis were determined by MTT method and flow cytometry, respectively. The results showed that CDDP could induce the activation of EGFR and the components in its downstream signaling pathways in a concentration-dependent manner. The combined treatment of AG1478 with CDDP could inhibit the proliferation of U87 glioma cells, arrest the cell cycle and promote cell apoptosis. In the EGFR signaling pathway, AG1478 decreased the phosphorylation of ERK, AKT and EGFR in U87 glioma cells. It was concluded that the combined treatment of AG1478 and CDDP may exert synergistic inhibitory effects on the growth of glioma cells by suppressing the activities of EGFR, AKT and ERK.

Epidermal growth factor receptor (EGFR) is found to express at high levels in a variety of　solid tumors including gliomas.This study was to examine the effect of an EGFR-tyrosine kinase inhibitor (AG1478) alone or in combination with cisplatin (CDDP) on the growth of glioma cells (U87).U87 glioma cells were treated with AG1478 (10 μmol/L) or CDDP (25 μmol/L) as a single agent or in　combination for 24 or 48 h.The expression of EGFR and the components in its downstream signaling　pathway [extracellular signal-regulated kinase (ERK),protein kinase B (AKT)] in U87 glioma cells was　detected by Western blotting.Cell growth,cell cycle distribution and cell apoptosis were determined by　MTT method and flow cytometry,respectively.The results showed that CDDP could induce the activation of EGFR and the components in its downstream signaling pathways in a concentration-dependent　manner.The combined treatment of AG 1478 with CDDP could inhibit the proliferation of U87 glioma　cells,arrest the cell cycle and promote cell apoptosis.In the EGFR signaling pathway,AG1478 decreased the phosphorylation of ERK,AKT and EGFR in U87 glioma cells.It was concluded that the　combined treatment of AG1478 and CDDP may exert synergistic inhibitory effects on the growth of　glioma cells by suppressing the activities of EGFR,AKT and ERK.

Objective To evaluate the efficacy of surgical excision combined with iodine-125 implants intmcavitary radiotherapy for neumglioma Method After excision,27 patients with nenroglioma were implanted with the iodine-125 into the tumor bed or the residual tumor tissues.Results Of all cases,there were no operative mortality and no serious complication.The survival time of 25 cases exceeded 6 months and 1 glioblastoma recurrence,22 cases exceeded 12 months,3 glioblastoma and 1 astrocytoma Ⅲgrade recurrence.There were 19 cases exceeding 24 months,15 cases no recurrence,3 cases died for cere bral hernia because of giving.up further tremment,1 case surviving.Conclusions Surgical excision Combined with iodine-125 implants intracavitary radiotherapy can improve partial control rate,prolonged the survival time of patients with neuroglioma,and complications is rare.It is an efficient therapy for neu roglioma