The ideal treatment of osteonosus and bone tumor is individualized treatment with individualized implants on the basis of patient's geometrical anatomic condition.Traditional metal implants are lack of individual matching.The new individualized metal implant is based on reverse engineering and rapid prototyping technique,and has solved the problems of long period manufactural procedure in the traditional technique.New type of material is applied for rapid prototyping directly.It would be the developing tendency in orthopedic application.

Objective To introduce the super minimally invasive transintercostal device closure of ventricular septal defect (VSD) and summarize it's therapeutic effect.Methods Nine patiens with VSD from August 2014 to December 2014 in our hospital were enrolled,which performed super minimally invasive transintercostal device closure of VSD.All patients were followed up prudently post-operation.Echocardiography was scheduled according to the protocol.Results All cases were successfully occluded.There was no death case in the peri-operation period and severe complications after operation.Conclusions The super minimally invasive transintercostal device closure of VSD is safe and reliable.

Objective To compare the levels of murine basophils distribution in different organs and analyze the characteristics of CD4+T cells activation/differentiation regulated by basophils.Methods Firstly,the mononuclear leukocytes were isolated separately from periphery blood,liver,spleen,lung and lymph nodes and the percentages of FcεR I+CD49b+ basophils in different organs were investigated.Secondly,liver basophils were purified by immuno-microbead strategy and co-clutured with different cytokines for 24 h.Apoptosis status of basophils was detected by Annexin V straining method.Thirdly,Mice were subcutaneously implanted with a miniosmotic pump containing 5 μg IL-3.At day 7 after implantation,liver mononuclear cells were harvested and the percentages of basophils were analyzed.Finally,Th1/Th2 polarization influenced by basophils orientated cytokines was investigated when naive OT-Ⅱ CD4 T cells were stimulated with spleen dentritic cells and OVA peptides.Results The percentage of murine basophils in mononuclear leukocytes of liver was significantly higher than that of periphery blood,spleen,lung and lymph nodes under physiological condition.Both of in vitro and ex vivo experiments showed that IL-3 played an inhibitory role on apoptosis of basophils.Cytokines secreted by basophils was investigated to induce Th2 polarization and inhibit Th1 response when naive OT-Ⅱ CD4 T cells were co-cultured with spleen dentritic cells and OVA peptides.Conclusion Th2 response was enhanced and Th1 response was down-regulated by murine basophils,which implied that basophils might participate in the construction of liver specific physiological immuno-tolerant microenvironment.

Marginal liver donor,a way to expand the liver pool,has been maximized in the unique position due to the shortage of donors.But the definition of marginal donor liver varies from center to center and the standard is very complex.With the enhancement of organ perfusion solution,preservation methods and surgical techniques,the edge donor criteria are also gradually expanding.What decision should we make,facing such clinical controversies.This paper makes a review on the marginal liver donor in the donation after citizen deceased,so as to improve its clinical application.

Objective To compare the clinical efficacy of single and double locking compressing plates(LCP)treatment for Schatzker type Ⅵ tibial plateau fractures.Methods Patients(n=90)with Schatzker type Ⅵ tibial plateau fractures were randomly divided into two groups according to the treatment methods (single LCP group and double LCP group;45 patients in each group) and analyzed retrospectively.Operative duration,intraoperative bleeding volume,postoperative wound infection,Rasmussen anatomical score and functional score were measured and compared between the two groups.Results More favorable results were achieved in the single LCP group than in the double LCP group in operative duration [(51.4 ± 4.03)h vs.(76.2±5.5)h(t=24.514,P＜0.001)]and intraoperative bleeding volume[(173.7±8.8) ml vs.(212.4 ± 4.9) ml (t =25.911,P ＜ 0.001,respectively)].Further more,three cases of postoperative woundin fection were seen in the double LCP group,while none was observed in the single LCP group.There was no significant difference in the percentage of satisfactory Rasmussenanatomical scores and functional scores between the two groups one year afteroperation(~ =-0.442,P=0.659).Conclusions Compared with double LCP fixation,single LCP fixation is more advantageous for the treatment of Schatzker type Ⅵ tibial plateau fractures.

OBJECTIVE: To summarize the biocharacteristics, separation and purification as well as the culture technique of bone marrow mesenchymal stem cell, which has the potentiality of multiple cellular differentiations, locatedinduced differentiation of bone and cartilage, cellular carrying tray and application in bone tissue engineering.DATA SOURCES: Relative articles were retrieved through Medline database according to the key words of "mesenchymal stem cell, tissue engineer" in English between January 1990 and December 2004. Meanwhile,relative articles were also retrieved in Chinese journal full-text database and Wanfang database with the same key words in Chinese between January 1994 and December 2004.STUDY SELECTION: Articles were retrieved first to select those references which were related to the aspects of biology, isolation and culture of mesenchymal stem cell in tissue engineering. Representative and lated references were included; however, researches on non-bone tissue engineering and repetitive studies were excluded. The rest of articles were looked up for their full text.DATA EXTRACTION: There were 78 articles on mesenchymal stem cell in tissue engineering. Among them, 31 papers were included; the otherbut 47 papers including 13 articles of similar contents and 34 studies on nonbone tissue engineering were excluded.DATA SYNTHESIS: Mesenchymal stem cell mainly existed in bone marrow and could differentiated into multiple tissue cells and increase in vitro.① There were three methods for separation, purification and culture of mesenchymal stem cells: density gradient centrifugation, flow cytometry and adherent screening method. Other scholars obtained cell strain of mesenchymal stem cell through single-cell cloning technique, but this way was more difficult to obtain multiple seed cells. At present, density gradient centrifugation was widely used. ② Mesenchymal stem cell could differentiate into bone cells and cartilae cells through adding inductor into eligible culture medium. Ideal scaffolds could carry and retain the vitality of cells, support rapid endogeny of vessels and be benefit for observing new bone formation under X ray. New bone might be absorbed and replaced in bone rebuilding and form or increase conductive bridging of host bone. Functions of differentiated cells could be maintained by the interaction between scaffolds surface and cells, and the histocompatibility was well. ③ Mesenchymal stem cell was an kind of ideal target cells for gene therapy. It could shift growth factor or cytokine and express foreign protein after multiple desintegration in vitro. It was successful in bone tissue engineering.CONCLUSION: Modern tissue engineering which is presented by stem cells develops quickly at present, but tissue engineering of mesenchymal stem cell starts just now. Bone marrow mesenchymal stem cell is characterized by easily materializing, potentiality of multiple tissue differentiation, stable genetic background, non-rejection in implant button and high proliferation. All properties determine that it will be a useful thing in cell and gene therapy as well as tissue engineering.

Under the shaking-flask culture, fermentation medium of honggumycin produced by Streptomyces 702 were studied.The experiment was used response surface methodology to optimize the shaking-flask fermentation medium.Firstly, we applied full factorial design to screen important factors soybean meal and industrial peptone which affected hongmycin produced by Streptomyces 702.Furthermore, we designed experiment to obtain the steepest ascent path and optimal level by the central composite design.The optimum medium consisted of (g/L): maize starch 20, maize meal 20, glucose 20, soybean meal 23, industrial peptone 9, KNO_ 3 2.5, (NH_ 4 )_ 2 SO_ 4 2.5 KH_ 2 PO_ 4 0.3, NaCl 3, CaCO_ 3 6, bean oil 5mL/L.Under the optimal medium, the yield of honggumycin was up to 1500 g/mL, which was increased by 308% than the original medium.

Objective To investigate the double T tube drainage method in the treatment of hepatic echinococcosis which ruptured into the common bile duct.Methods A retrospective study was conducted on 86 patients who were treated surgically for hepatic echinococcosis which had ruptured into the common bile duct at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to December 2014.The average postoperative hospitalization,postoperative complications (residual cavity bile leakage and residual cavity effusion,residual cavity infection) and biliary complications of biliary tract infection were analyzed.Results Significant differences were found on the postoperative residual cavity complications in group A:(2,7.1％) when compared with Group B:(9,15.5 ％),and also on the postoperative hospitalization between the double T tube drainage group [group A:(7.1 ± 1.3) d] and the traditional T type tube decompression group [B group:(8.2 ± 1.5) d] (P ＜ 0.05).Conclusions The doubleT tube drainage in the treatment of hepatic echinococcosis which had ruptured into the common bile duct was simple,safe and effective.This treatment could completely cure residual cavity bile leakage,and it had the advantage of avoiding occurrence of common bile duct related complications caused by the traditional suture method for bile leakage.

Objective To investigate the application value of Calot triangle hollowing-out maneuver in laparoscopic cholecystectomy (LC) for preventing bile duct injury.Methods The retrospective cross-sectional study was conducted.The clinical data of 537 patients who underwent LC in the Dexing People's Hospital between January 2011 and December 2015 were collected.The tissues in Calot triangle were hollowed out,and cystic ducts were cut off and then gall bladders were resected.Observation indicators:(1) operation situations:anatomy of the Calot triangle and operation time;(2) postoperative recovery situations:postoperative complications and bile duct injury;(3) follow-up situation.The follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and occurrence of cholangitis up to May 2016.Results (1) Operation situations:of 537 patients with LC,anatomical relation among cystic duct,common hepatic duct and common bile duct (three-duct relation for short) could be seen in 165 patients without dissection,and three-duct relation cannot be seen in other 372 patients.Of 372 patients,16 were operated on with the gallbladder open due to the difficult dissection of Calot triangle,7 were converted to open surgery due to local severe adhesion and unclear structure,1 was converted to open surgery due to intraoperative varices induced bleeding in Calot triangle,and other 348 patients underwent successful LC using Calot triangle hollowing-out maneuver.Operation time was 15-190 minutes,with an average time of 28 minutes.(2) Postoperative situations:2 patients were complicated with biliary colic pain,showing stones in the distal common bile duct via magnetic resonance imaging scans,and then received endoscopic sphincterotomy (EST);3 had subxyphoid puncture hole infection,1 had a small amount of postoperative bleeding due to hepatocirrhosis,3 had pulmonary infection,and they were improved by symptomatic treatment;1 had chylous fistula and were improved through drainage and low fat diet intake for 1 week;2 with mild bile leakage was improved through peritoneal drainage.No bile duct injury was detected.(3) Follow-up situation:348 patients were followed up for 12-18 months,with a median time of 16 months.During the followup,348 patients with follow-up had survival without manifestation of cholangitis.Conclusion Calot triangle hollowing-out maneuver could effectively prevent bile duct injury in LC.

Objective To investigate the clinical outcomes of intertrochanteric fracture by the fixation using proximal femoral nail (PFN/PFNA).Methods From Jan.2008 to Dec.2010,56 cases with intertrochanteric fracture,including 18 males and 38 females with an average age of 76 years (range,67 -94 ),were treated by fixation with PFN or PFNA.All patients had closed fractures in the shaft of femur.The average time from injury to operation was 3.2 days (ranging from 2.0 days to 10.0 days).All the patients were followed for 1,2,3,6,12 month after surgery,respectively,and then at least once per year.The clinical outcomes were evaluated according to Harris criteria and radiological examinations.Results The mean operating time of all cases was 55 minutes ( ranging from 40 to 80 minutes),and the mean blood loss during surgery was 80 ml (range,50 - 150 ml).All patients was able to walk with walking aid 3 -7 days after surgery.All the patients with fracture healed after 3.5 - 6.0 months ( mean:4 months ).No complications such as infection,lower limb vein infarction,cut-out or breakage of the implants occurred.Four cases had coxa vara shortening deformation,According to Harris criteria,the clinical results were excellent in 43 cases,good in 9,and moderate in 4,with the rate of patients in excellent and good condition was 92.86％ (52/56).Conclusion PFN/PFNA is an effective and minimally invasive method for intertrochanteric fracture,with minimal invasion,high fixation-strength and optimal biomechanics characteristics.This treatment technique produces a high rate of bone re-union,early functional recovery and less complications.