Objective The mechanism of delaying flap with the minimal invasive surgery was approached to understand its effects on the whole delayed survival of skin flaps thoroughly so as to provide the rationale for its clinical use.Methods 80 male or female Wistar rats were randomly subdivided into two groups:delayed by the minimal invasive surgery,and immediately transfer without delay.Flaps in each group delayed were cut at 1,2,3 and 4 weeks,respectively.The flap was designed at the lower back of rat,with the size of 5 cm × 1 cm,crossing the middle area for 2.5 cm and including stem of iliac branch from iliolumbar artery.2 weeks after second operation,the survival area,capillary density and content of lactic acid of the flaps in each group were examined,and the survival of the falps delayed by the minimal invasive surgery was compared.Results The longer delaying time,and the higher survival rate were observed in the experimental group.Delaying for 3 weeks and 4 weeks,the survival rate was (86.13 ±1.13) ％,(93.49 ± 1.15) ％,respectively,in the experimental group.While in control group,the survival rate was no more than 63％.The longer delaying time,the higher the capillary density were noted in two groups,but 3 weeks delayed group equally matched to the 4 weeks delayed group.In the experimental group,the content of lactic acid increased peaked in 1 week delayed group,then fell-down gradually,but kept steady in 3 and 4 weeks delayed group.The content of lactic acid in the control group kept steady.Conclusions The experimental model is selected as cross-area axial flap on the lower back of rats.The minimal invasive surgery plays the same role as in delaying flaps,which causes vasoconstriction,resulting in disorder of internal environment,ischemia and hypoxia,finally vasodilatation.The more ramus anastomosis,the more survival rate of the flap.

Objective To study the effect of mini percutaneous nephrolithotripsy (MPCNL) for non-nephredema kidney calculi. Methods A total of 47 patients with non-nephredema kidney calculi were enrolled in this study. Physiological saline solution was infused into the kidney through a ureteral catheter to induce hydronephrosis. C-arm X-ray machine was employed in percutaneous puncture and Wolf EMS was used to smash the calculi. Results The mean operation time was (120?35) min.The calculi were removed through one passage in 38 cases,through two passages in 6, and three passages in 3. Among the 47 patients, the MPCNL was performed once in 35, and twice in 12. The stone-free rate was 83.0% (39/47) and final stone-free rate was 93.6% (44/47). No complications were noted in all the patients. Conclusions Highly skilled technique is necessary in MPCNL for non-nephredema kidney calculi. The MPCNL is a safe, minimally invasive, and effective method. By using MPCNL, patients have less trauma, lower rate of calculi remaining, and quick recovery. As long as the surgeons are familiar with the technique of MPCNL and the anatomy of non-nephredema kidney, the therapeutic outcome can be as good as that in the patients with nephredema renal calculi.

Objective: To investigate the effects of ?-melanocyte-stimulating hormone(?-MSH) on TGF-?_1 secretion of fibroblasts from keloids so as to find a novel evidence to research etiology of keloids.Methods:Fibroblasts isolated from human keloids were cultured in DMEM medium with 15% bovine serum and treated with ?-MSH. The level of TGF-?_1 was measured with ELISA method. Results: ?-MSH at the concentration of 10 -6 mmol/L triggered the TGF-?_1 secretion of fibroblasts. Conclusion:?-MSH possesses the effect of triggering human keloid fibroblasts to secrete TGF-?_1, and its effective concentration is 10 -6mmol/L.

To date,the clustered regularly interspaced short palindromic repeat (CRISPR)/Cas9 system has been widely used to edit the genome in many species and cells.The system is the third generation of artificial endonuclease,which can edit DNA by recognizing short DNA sequences.This paper reviews the structural features of the system and its application in virus research,such as the functional studies of virus-related genes and the exploration of antiviral therapies (including HIV,HBV,and EB virus),looking forward to the future direc-tion of virus research.

Objective To evaluate modified retroperitoneal laparoscopic resection of renal cyst. Method Thirty-six patients with renal cyst were treated by modified retroperitoneal laparoscopic resection of renal cyst,summarized the clinic data and follow-up the effect. Results All 36 cases were operated suc-cessfuUy without changing to opening operation,average operation time (50 ± 35)min,no complications oc-curred and no recurrence was found. Conclusions The modified retroperitoneal laparoscopic resection of renal cyst with two 5 mm-trocars and one 10 mm-trocar has less trauma than classic laparoscopic operation. It is one of mini-trauma operation method which is worth to be popularized in clinic.

Objective To study the clinical features of invasive pneumococcus disease (IPD) with resistance to antimicrobial agents in children,and to improve the diagnosis and treatment of this disease.Methods The clinical data from 21 IPD patients younger than 13 years old were collected from January 2008 through December 2010 in Pediatric Intensive Care Unit in Beijing Children's Hospital for retrospective analysis. Specimens of blood,pleural effusion,cerebrospinal fluid and soft tissue aspirated were collected from these children,and 23 strains of streptococcus pneumonia (SP) were cultured,isolated and confirmed,and the antibiotics susceptibility to penicillin and other antibiotics of these strains were assayed.Results Among the 21 IPD children,the ratio of male to female was 0.9∶1,and the age was 5 months to 13 years,with 61.9％ of them under 2 years.Of them,12 patients (57.1％ ) had purulent pleurisy,and 1 (4.8％ )patient had an underlying disease diagnosed to be X - linked agammaglobulinemia (XLA).There was no seasonal difference in the occurrence rate of this disease. Eight (38.1％) patients were cured,11(52.4％ ) were improved,while 2 (9.5％ ) patients not improved without death.There was no statistically significant difference in the annual detection rate of invasive SP (x2 =3.711,P =0.156).The incidences of penicillin-intermediate susceptibility SP (PISP) and penicillin-resistant SP (PRSP) were 47.8％ and 26.1％ respectively.The rate of resistance to multiple antibiotics was 91.3％.Conclusions Children aged less than 5 years,especially younger than 2 years,are prone to IPD,and purulent pleurisy and septicemia are often seen in this disease. Some patients had the underlying diseases.The complications included hemophagocytic syndrome,acute respiratory distress syndrome,septic shock,bronchial pleural fistula and so on.The multidrug resistance rate was 91.3％.It is important to put great emphasis on the monitoring antibiotics resistance to invasive pneumococcal disease.

10.3969/j.issn.2095-4344.2013.25.010

Objective To assess the therapeutic effect and opportune time of surgical treatment of hepaticolithiasis . Methods The clinical data of 92 patients with hepaticolithiasis who underwent surgical treatment were analyzed retrospectively. Results (1) The incidence of postoperative complications was 14.1% (13/92 cases), in choledochoscopy group it was 9.3%(4/43 cases) and in the non choledochoscopy group 18.4%(9/49 cases) ; in the emergency operation group it was 36%(9/25 cases) and in selective operation group 5.97%(4/67 cases) . (2) The incidence of residual stones was 22.9%(21/92 cases); in choledochoscopy group it was 13.9%(6/43 cases) and the non choledochoscopy group 30.6%(15/49 cases); in emergency surgery group it was 36%(9/25 cases) and in selective operation group 17.9%(12/67 cases).(3)One pationt died from ACST two days after operation . All of the patients were followed up for 4-10 years; there were 80 cases (86.9%) who had a good therapeutic outcome. Conclusions Logical surgical procedure associated with choledochoscopy and appropriate timing of surgical intervention can markedly improve the effect of surgical treatment of hepaticolithiasis and reduce the incidence of postoperative complications.

In this paper, the definition of NURBS curve and a speed-controlled interpolation in which the feed rate is automatically adjusted in order to meet the specified chord error limit were discussed. Besides those, a definition of linear interpolation error of post-processed data was proposed, which should be paid more attention to because it will not only reduce quality of the surface but also may cause interference and other unexpected trouble. In order to control the error, a robust algorithm was proposed, which successfully met a desired error limit through interpolating some essential CL data. The excellence of the proposed algorithm, in terms of its reliability and self-adaptiveness, has been proved by simulation results.

Objective To explore the safety of the human bone marrow‐derived mesenchymal stem cells (hBMSCs) after silencing of human leukocyte antigen A2 expression .Methods We divided the cells into three groups:normal cultured cells of the 8th passage served as control group , and hBMSCs after HLA A2 silencing expression of the 5th and 15th passage as experimental groups 1 and 2 ,respectively .The hBMSCs were recultured by sterile methods .The growth curve ,telomerase activation ,and expressions of P27 ,cyclin D2 and cyclin‐dependent kinase 4 (CDK4) were utilized to explore the safety of the hBMSCs induced by LV‐siRNA‐HLA A2 .The BMSCs were transplanted to the subcutaneous layer of nude mice .Tissue types were detected 24 weeks after transplantation . Results The cell curves had no obvious left or right shift in all the groups . The telomerease activation in experimental groups 1 and 2 did not significantly differ from those in control group . The expressions of anti‐oncogene P27 ,cyclin D2 and CDK4 had no obvious difference between the two experimental groups and control group , either . There was only ectopic osteogenesis 24 weeks after the BMSCs (HLA A2 gene silenced ) were transplanted to the subcutaneous layer of the nude mice .Conclusion There was no obvious evidence to support that hBMSCs had undergone change in safety after the silencing of HLA A 2 expression .