Objective To explore the home-made U-shaped retractor ’ s effect on reducing the traction injury of recurrent laryngeal nerve in the video-assistance thyroidectomy . Methods The patients with unilateral and unifocal papillary thyroid microcarcinoma , which were diagnosed by ultrasound preparation and by pathological postoperation , were enrolled .They all underwent the ipdilateral lobectomy , isthmus resection and the clearance of central lymph nodes with video-assistance technology .From January 2013 to June 2014, 79 cases ( control group ) were received conventional method , by which the thyroid lobe was elevated onto the trachea surface.From January 2015 to March 2016, 71 cases (U-shaped group) accepted the procedure which adopted home-made U-shaped retractor to pull the thyroid lobe to carotid artery horizontally .The operations were completed by the same surgeon .There were no significant differences between the two groups in age , gender and lesion size , which is comparable .The incidence rate of hoarseness was compared postoperation . Results Postoperative hoarseness of the U-shaped group occurred in 6 cases (8.5%) and the control group in 17 cases (21.5%), which show a significantly statistical difference (χ2 =4.919, P=0.027).And there was no significant difference in voice recovery time [median:16.5 d (8-31 d) vs.18 d (4-50 d), Z=-0.246, P=0.806]. Conclusion In the video-assisted thyroidectomy , using the U-shaped retractor to pull the thyroid lobe laterally and horizontally will be beneficial to reduce the recurrent laryngeal nerve tension and the incidence of the retract injury .

Objective To evaluate the incidence of cancer in children born with assisted reproductive technology (ART ) . Methods The literatures were obtained by computer through EBSCO full‐text database ,Pubmed ,Germany Springer journal data‐base ,Cochrane Libarary ,Chinese academic journals published in the pool of network (CNKI) ,Wanfang and Veipu Chinese Journal Full‐text databases ,and other search methods .ART and child health natural pregnancy cohort study were included .The Meta‐anal‐ysis was conducted by using RevMan5 .0 software .Results Sixteen studies were included according to the criteria ,and 89 894 cases of ART‐born offspring were collected .The results of Meta analysis revealed that there was no significant difference between ART and non‐ART children on the incidence of tumor (OR= 1 .85 ,P> 0 .05) .Conclusion This study showed that the probability of ART offspring suffering from malignant is basically the same with non‐ART children ,but the potential long‐term risks are not yet clear .

Objective] To sum up director doctor He Ruoping’s by stages treatment experience in treating bladder cancer. [Method]By learning from director doctor He Ruoping for many years and combining my own clinical experience, from the etiology and pathogenesis, therapeutic principle of TCM syndrome differentiation treatment characteristics, etc, it sums up the teacher He ’s unique feature of by stages treatment of bladder cancer, and with 1 case for detailed explanation. [Result]Teacher He advocating the combination of traditional Chinese medicine and western medicine, puts forward the principle of by stages treatment to bladder cancer:treatment of postoperative perfusion stage, treatment of following up stage without perfusion and treatment of palliative transfer stage, and makes prescriptions in line with the characteristics of each stage. [Conclusion] Teacher He ’s by stages treatment to bladder cancer obtains the good curative effect, having enlightenment meaning to clinical practice, with promotion value.

[Objective]To observe the effects of qing-nao-ding-tong decoction on the levels of IL-6 and TNF-? in subarachnoid hemorrhage.[Methods]Cases were randomly divided into integrated traditional Chinese and western medicine (TCW) groups,western medicine group and control group.After 2w treatment,the levels of IL-6 and TNF-? were contrasted.[Results]The levels of IL-6 and TNF-? were both raised.Combined with western medicine,qing-nao-ding-tong decoction could effectively reduce the levels of IL-6 and TNF-?.[Conclusion]Combined with western medicine,qing-nao-ding-tong decoction can effectively reduce the levels of IL-6 and TNF-? in patients with subarachnoid hemorrhage,and there is synergistic reaction between TCM and WM.

Objective In this study ,we constructed a series of recombinant plasmids carriers expressing shRNA targeting hTERT and Bi‐1 gene .These recombinant plasmids carriers were transfected into CNE‐2Z cell lines using Lip and continuously in‐duced the expression of shRNAs .Furthermore ,the shRNAs caused the degradation of mRNAs homologous in sequence with the target genes ,which lead to a sequence‐specific gene silencing .Methods The CNE‐2Z cells was divided into untreated group ,pEG‐FP‐N1 group and pEGFP‐N1/Lip group .Flow cytometry(FCM ) was applied to determine the transfection efficiency .The changes of hTERT and Bi‐1 gene expression were detected by Real‐time RT‐PCR and Western blotting .Results The best transfection effi‐ciency between plasmid and Lip was 2 .5 μg plasmid and 6 .25μL Lip .Conclusion We constructed several shRNA recombinant eu‐karyotic expression plasmids successfully .The recombinant plasmid can inhibit the expression of hTERT and Bi‐1 gene specifically and effectively .

BACKGROUND:With the development of three-dimensional (3D) printing technology, 3D printed porous titanium scaffolds as bone substitutes have become a research hotspot. OBJECTIVE:To introduce and discuss the effects of each parameter of 3D printed porous titanium scaffolds on bone ingrowth, and to sum out the optimal parameters for bone ingrowth. METHODS:The first author retrieved PubMed, Springerlink and Medline databases with“three-dimensional (3D) printing, scaffold, titanium, bone ingrowth”as keywords for relevant articles published from 2006 to 2016. 125 articles were retrieved initial y, and final y 42 eligible articles were included for analysis. RESULTS AND CONCLUSION:Pore size, porosity, pore structures and surface modifications of 3D printed porous titanium scaffolds al make effects on bone ingrowth or osteoblasts in scaffolds. Scaffolds with appropriate pore size and porosity can promote the vascularization and provide adequate nutrition and oxygen supplement, to ensure high cel viability. Regulations of cel performances, such as cel attachment, proliferation and differentiation, are also affected by pore structures and nano-scale surface modification. Herein, a detailed combination of the parameters, as mentioned above, can create a better porous scaffold for better bone ingrowth. Hence, the high-stability interface between bone and scaffolds may be obtained through the parameter adjustment.

Objective To explore the diagnostic value ofcerebrospinal fluid (CSF) lactic acid (LA) level in bacterial meningitis after craniotomy for cerebral hemorrhage in adults.Methods The clinical data of 162 patients with cerebral hemorrhage,admitted to and accepted craniotomy in our hospital from April 2013 to April 2018,were retrospectively collected;patients were divided into infected group (n=75) and non-infected group (n=87) according to whether postoperative bacterial meningitis occurred;univariate analysis was used to compare the differences of CSF-LA concentration and other indicators of CSF between patients of the two groups;multivariate Logistic regression analysis was used to screen the independent factors affecting the occurrence of postoperative bacterial meningitis;receiver operating characteristic (ROC) curve was used to analyze the predictive values of CSF-LA and other indicators in postoperative bacterial meningitis.Furthermore,17 patients with positive bacterial CSF were divided into Gram-positive (G+) bacteria group (n=9) and Gram-negative (G-) bacteria group (n=8);the predictive values of CSF-LA and other indicators for postoperative meningitis of G-bacteria patients were analyzed in the same way.Results (1) The CSF-LA concentration in infected group ([6.3±2.8] mmol/L) was significantly increased as compared with that in non-infected group ([3.3±1.6] mmol/L,P＜0.05);the results of multivariate Logistic regression analysis showed that CSF-LA was an independent influencing factor for postoperative bacterial meningitis (odd ratio=l.547,95％ confidence interval:1.029-2.326,P=0.036);ROC curve results revealed that the area under the curve of CSF-LA concentration in the diagnosis of bacterial meningitis after craniotomy was 0.854 (95％ confidence interval:0.790-0.904),and the optimal cut-off value was 4.61 mmol/L,with sensitivity of 69.3％,specificity of 92.0％,positive predictive value of 88.1％ and negative predictive value of 77.7％.(2) The CSF-LA concentration in G-bacteria group ([9.9±2.9] mmol/L) was significantly increased as compared with that in G+ bacteria group ([5.2±3.1] mmoi/L,P＜ 0.05);ROC curve results revealed that,in patients with positive bacterial CSF,the area under the curve of CSF-LA concentration in diagnosis of meningitis with G-bacteria after craniotomy was 0.861 (95％ confidence interval:0.610-0.978),and the optimal cut-off value was 7.20 mmol/L with sensitivity of 87.5％,specificity of 88.9％,positive predictive value of 87.5％,and negative predictive value of 88.9％.Conclusion Detection for concentration of CSF-LA can help predicting bacterial meningitis afier craniotomy for cerebral hemorrhage and identify G+ and G-bacteria meningitis.

Ameloblastoma in the tibia is rare. Limb reconstruction after tumor resection is challenging in terms of selection of the operative method. Here, we report a case of radical resection of an ameloblastoma in the mid-distal tibia combined with limb salvage using a three-dimensional (3D)-printed prosthesis replacement, with 1-year follow-up results. After receiving local institutional review board approval, a titanium alloy prosthesis was designed using a computer and manufactured with 3D-printing technology. During the operation, the stem of the prosthesis was inserted closely into the proximal tibial medullary cavity. Then, the metal ankle mortise and the talus were compacted closely. Radiographic results at 1-year follow up showed that the prosthesis was well placed, and no loosening was observed. The Musculoskeletal Tumor Society (MSTS) 93 functional score was 26 points, and the functional recovery percentage was 86.7%. Computer-assisted 3D-printing technology allowed for more volume and structural compatibility of the prosthesis, thereby ensuring a smooth operation and initial prosthetic stabilization. During the follow up, the presence of bone ingrowths on the porous surface of some segments of the prosthesis suggested good outcomes for long-term biological integration between the prosthesis and host bone.
Alloys ; Ameloblastoma ; Ankle ; Ethics Committees, Research ; Extremities ; Follow-Up Studies ; Limb Salvage ; Methods ; Prostheses and Implants ; Talus ; Tibia ; Titanium

Objective To investigate the effect of Genistein,a tyrosinase inhibitor,on retinal neovascularization in mice.Methods Thirty-six 7-day-old C57BL/6J mice were randomly assigned into hyperoxiainduced group,Genistein group,DMSO group and normal control group.The mice in the hyperoxia-induced group,Genistein group and DMSO group were fed in a static chamber with the oxygen volume fraction (75±2)％ for 5 days and then sent back to natural environment for 5 days to establish retinal neovascular models,and 1 μl Genistein diluted by 5％ dimethyl sulfoxide (DMSO) (400 mg/L) and 1 μl DMSO were intravitreally injected in the 12-dayold mice of Genistein group and DMSO group,respectively.The mice in the normal control group were bred in natural environment.The fluorescence angiography was carried out in 17-day-old mice (2 mice in each group) to prepare the whole retinal flatmounts,and the morphology of retinal vessels was observed under the fluorescence microscope.The other mice in various groups were sacrificed and the retinas were collected.The expressions of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in mRNA and protein levels were detected by realtime fluorescence quantitative PCR and Western blot,respectively.The use and care of the mice complied with regulations for the management of laboratory animals.Results Retinal vessels were normal in the mice of normal control group.In the mice of the hyperoxia-induced group and DMSO group,retinal vessels were tortuous,and neovacularization and non-perfusion areas were visible.In the Genistein group,retinal vessels were clearly visible,but non-perfusion areas were exhibited.The relative expression levels of VEGF mRNA in retinas were 0.64±0.25,0.37±0.23,0.03±0.02 and 0.04±0.02,and the relative expression levels of bFGF mRNA in retinas were 21.40±3.07,17.22±2.63,0.52±0.25 and 0.67±0.23,in the hyperoxia-induced group,DMSO group,Genistein group and normal control group,and the expressions of VEGF and bFGF in mRNA level in the hyperoxia-induced group and DMSO group were significantly higher than those in the Genistein group and normal control group (all at P＜0.05).The protein expression levels of VEGF and bFGF were 1.01 ±0.05 and 0.97±0.06 in the hyperoxia-induced group,1.06±0.07 and 1.03±0.08 in the DMSO group,0.73±0.05 and 0.76±0.07 in the Genistein group,0.52±0.05 and 0.56± 0.05 in the normal control group.The expressions of VEGF and bFGF in protein level in the hyperoxia-induced group and DMSO group were significantly higher than those in the Genistein group and normal control group (all at P＜0.05).Conclusions Genistein can inhibit hyperoxia-induced retinal neovascularization may be by downregulating the expressions of VEGF and bFGF in retinas.

Objective:To identify the development trajectories of self-neglect behavior in older adults and explore the associated influencing factors.Methods:A fixed cohort was constructed based on the data from three surveys of Chinese longitudinal healthy longevity survey (CLHLS) from 2011 to 2018. A total of eight variables from 4 dimensions including living environment, lifestyle, social interaction, and health care were selected to evaluate self-neglect. Group-based trajectory model was used to identify the development trajectory of self-neglect behavior in the older adults, and polynomial Logistic regression model was used to explore its influencing factors by Stata 16.1.Results:Finally, 2 754 older adults aged 60 and above were included.The development trajectory of self-neglect behavior in older adults, based on the group-based trajectory model, can be classified into stable-low group ( n=268, 9.7%), descending-moderate group ( n=2 224, 80.8%), and decreasing-high group ( n=262, 9.5%). Polynomial Logistic regression showed that, compared with stable-low group, living in rural areas ( B=1.116, OR=3.053, 95% CI= 2.278-4.091) and higher activities of daily living scores( B=0.137, OR=1.147, 95% CI=1.046-1.258) were the risk factors of descending-moderate group. Education levels with 1-6 years( B=-0.398, OR=0.672, 95% CI=0.469-0.963), >6 years( B=-1.072, OR=0.342, 95% CI=0.229-0.513), being married( B=-0.476, OR=0.621, 95% CI=0.444-0.870), self-reported good health( B=-0.808, OR=0.446, 95% CI= 0.213-0.932), improved health status( B=-0.704, OR=0.495, 95% CI=0.320-0.766), self-reported average economic status( B=-1.065, OR=0.345, 95% CI=0.148-0.802), self-reported good economic status( B=-1.634, OR=0.195, 95% CI=0.082-0.467), and a higher cognition score( B=-0.142, OR=0.867, 95% CI=0.798-0.942) served as protective factors of descending-moderate group. In addition to the above factors, being in the age group of 75-89 years( B=0.481, OR=1.617, 95% CI=1.057-2.473) was a risk factor for decreasing-high group compared to stable-low group. Conclusions:Three types of self-neglect behavior trajectories among older adults were identified in this study, suggesting that physical health and economy are the influencing factors of the development trajectory of self-neglect of the elderly.