Objective To compare the clinical effects of one-stage modified capsular tension ring (MCTR) scleral fixation and second-stage capsular tension ring (CTR) capsular bag complex scleral fixation in the treatment of moderate and severe subluxation of lens.Methods Retrospective study.Thirty cases (43 eyes) of patients with moderate and severe subluxation of lens from January 2012 to December 2015 were collected.Those patients were treated with phacoemulsification cataract extraction and MCTR or CTR and IOL intracapsular implantation under local anesthesia.23 eyes in group A were treated with MCTR combined with IOL implantation and one-stage scleral fixation.20 eyes in group B were treated with one-phase CTR combined with IOL implantation and second-stage of CTR-capsular bag complex scleral fixation after 3 to 6 months.The best corrected visual acuity,location of the postoperative capsular bag complex and complication were observed at 6 months after surgery.Results Postoperative 6-month,the best corrected visual acuity ≥0.6 were in 87％,95％ of the patients m group B,and there was no statistical significance difference (P ＞ 0.05).All CTR and IOL were located in the capsular bag after surgery.Two eyes in group A and 1 eye in group B were observed with moderate contraction and off-center of capsular bag,there was no significant difference (P ＞ 0.05).All groups achieved response after YAG laser anterior capsule relaxing incisions.Early complications of postoperative (1 month):3 eyes in group A and 1 eye in group B were observed with exudative membrane in anterior chamber;5 eyes in group A and 2 eyes in group B were with transient high intraocular pressure,and there was no significant difference (all P ＞ 0.05).Long-term complications of postoperative (6 months):3 eyes in group A and 1 eye in group B were observed with after cataract,and there was no significant difference (P ＞ 0.05).All groups conducted YAG laser posterior capsulotomy.Conclusion The location stability of the capsular complex after one-stage MCTR scleral fixation or secondstage CTR capsular bag sclera fixation is good.And the treatment is effective for moderate and severe lens dislocation.

Objeetive To explore routine magnetic resonance imaging characteristics of newborn bilirubin encephalopathy(NBE).Methods MRI features and clinical data of 17 patients with Newbern bilirubin encephalopathy were retrospectively analyzed, globus pallidus (GP)and subthalamic signal intensity was evaluated.The increase of GP signal intensity and serum total bilirubin peak value were analyzed using pearson correlation analysis.Serum total bilimbin peak value between patients with high signal in the subthalamic nuclei on T1 WI and patients without high signal in the subthalamic nuclei were compared statistically.Results The main MRI presentation in the NBE group Was abnormally increased signal intensity in the GP on T1 WI,which was not apparent on T2 WI One patient showed abnormal high signal intensity in the postemmedial part of GP.Nine patients had high signal in the subthalamic nuclei on T1 WI and normal signal on T2 WI Four patients showed hiigh signal in the brainstem with sparing of dorsal pontine.The increase in value of GP signal intensity was 249.0-423.8 in 12 patients and their serum total bilirubin peak values were 366.0-983.3μmol/L A positive correlation Was found between increase of GP signal intensity and serum total bilirubin peak value.The serum total bilirubin level of abnormal subthalamic group and normal subthalamic group were 660.7±192.4 μmol/L and 513.3±107.5μmol/L respectively.The difference between the two groups was not statistically significant(t=1.914,P＞0.05).Conclusion The routine MRI has some characteristics and is useful in the diagnosis of newborn bilirubin encephalopathy.

Objective To analyze the differentially expressed genes in peripheral blood of human immunodeficiency(HIV)/tubercle bacilli co-infected patients and explore the biological regulatory mechanism and network of key proteins,so as to provide new evidence for early diagnosis and clinical treatment of HIV/TB co-infected patients. Methods Microarray gene chip data of HIV/TB co-infected patients were downloaded from public databases GEO and imported into the analysis software GEO,STRING,PANTHER,and GenClip. The gene expression profiles,protein interaction networks,processes of molecular biology,and gene functions were analyzed. Results The expression profiles of 15 529 genes between the two groups of patients were similar,and gene expression profiles from 44 subjects were highly correlated. The 251 differentially expressed genes had good diagnostic capabilities in the differential diagnosis of HIV/TB infection. RPLP1 might be a key gene in the diagnosis of HIV/TB infection. The differentially expressed genes and positive regulators showed certain functions such as external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological and other relevant functionalities. Meanwhile,they may also be involved in free radical-related apoptosis,inflammation,and activation pathways. Conclusions A total of 251 differentially expressed genes are found to be able to distinguish simple HIV infection from HIV/TB infection. Protein-protein interaction network of top 40 differential expression genes includes RPLP1 gene,which is possibly associated with HIV/TB co-infection and may be involved in and the positive regulation of external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological functions. These findings may provide certain evidence for the diagnosis and treatment of HIV/TB infection.

BACKGROUND:Core decompression can delay early osteonecrosis of the femoral head, but cannot completely repair the necrotic femoral head. Eventualy, femoral head colapse, even bone necrosis, wil occur. OBJECTIVE:To explore the curative effect of implantation of gelatin sponge carrying Foxc2-transfected bone marrow mesenchymal stem cels on the repair of experimental femoral head necrosis in rabbits. METHODS:Forty New Zealand white rabbits were selected, and femoral head necrosis models were prepared successfuly in 24 of 40 rabbits. Then, model rabbits were randomized into four groups: blank control group (n=4) with no treatment, core decompression group (n=4), GFP group (n=8) subjected to core decompression and implantation of gelatin sponge carrying GFP-transfected bone marrow mesenchymal stem cels, and Foxc2 group (n=8) subjected to core decompression and implantation of gelatin sponge carrying Foxc2-transfected bone marrow mesenchymal stem cels. At 1, 2, 4 weeks after implantation, ELISA was used to detect Foxc2 protein levels in the transplanted region. At 4, 8, 12 weeks after implantation, MRI scan of the hip was performed, and femoral head tissues were taken and sliced into sections for hematoxylin-eosin staining to observe bone growth. At 12 weeks after implantation, histomorphometry measurement and transmission electron microscope observation were carried out. RESULTS AND CONCLUSION:At 1, 2, 4 weeks after implantation, Foxc2 was highly expressed in the femoral head in the Foxc2 group, which was significantly higher than that in the GFP group. At 4, 8, 12 weeks, only a few of new bone formed in the core decompression group and GFP group; at 12 weeks, fibrous tissues formed in the decompression channel. New bone formation was evident in the Foxc2 group, and at 12 weeks, the necrotic region was repaired completely. MRI findings showed normal femoral head morphology and signals in the Foxc2 group at 12 weeks, but there were decreased signals of the femoral head in the core decompression group and GFP group. These findings indicate that Foxc2-transfected bone marrow mesenchymal stem cel transplantationvia core decompression has good curative effects on experimental femoral head necrosis in animals.

Objective To study NonO protein expression changes in murine erythroleukemia ( MEL ) cell differentiation induced by sodium butyrate .Methods Benzidine staining was used to test sodium butyrate-induced erythroid differentiation of MEL cells .We detected NonO protein expression changes in MEL cell differentiation induced by sodium butyrate and NonO protein localization in MEL cells by Western blotting and immunocytochemistry .Furthermore , we applied PCR technique to detect NonO RNA expression in differentiation process .Results We found that NonO protein was upregulated at gene and protein levels in the erythroid differentiation process of MEL cells induced by sodium butyrate and located in cytoplasm and nucleus in MEL cells .Conclusion These results show that NonO protein is closely related with MEL cell differentiation induced by sodium butyrate , which may provide important clues for further study of the mechanism of leukemia .

Objective To compare the clinical efficacy of uniportal complete thoracoscopic and conventional three -port thoracoscopic lobectomy in the treatment of lung cancer. Methods A total of 62 cases of lung cancer from January 2012 to January 2016 received lobectomy in our hospital.According to admission sequence number, the patients were randomly divided into either single-port group(n=31)or three-port group(n=31).The single-port group was given uniportal thoracoscopic lobectomy, and the three-port group was given traditional three-port operation of VATS lobectomy.We compared the two groups with intraoperative and postoperative conditions and follow-up outcomes. Results The operations were successfully completed in both groups.There were no significant differences between the two groups in operation time[(182.3 ±77.9)min vs.(177.6 ±69.2)min, t =0.251, P=0.803],intraoperative blood loss[(207.3 ±48.4)ml vs.(226.5 ±52.3)ml,t=-1.500, P=0.139], chest tube indwelling time[(5.5 ±1.6)d vs.(5.7 ±2.0)d, t=0.435, P=0.665], postoperative hospitalization time[(8.7 ±2.7)d vs.(9.0 ± 2.8)d,t=0.925,P=0.0.372],lymph node dissection number[(11.2 ±2.8)vs.(11.7 ±3.1),t=-0.666,P=0.508]and postoperative incidence of complications[9.7%(3/31)vs.12.9%(4/31),χ2=0.000,P=1.000].The VAS scores on the first and fifth postoperative day were(3.1 ±1.1)points and(1.0 ±0.7)points in the single-port group, which were significantly lower than those in the three-port group[(3.9 ±1.4)points,t=-2.502,P=0.015;(1.5 ±0.7)points,t=-2.812,P=0.007].The 62 cases were followed up for 12-36 months(mean,18.4 ±6.4 months)without recurrence and death. Conclusion Single-port thoracoscopic lobectomy for lung cancer has good curative effect and safety as compared with traditional method,being worthy of clinical application.

Objective To evaluate the clinical outcomes of severely resorbed edentulous mandibles with tilted implants and fixed prostheses. Methods Ten patients with severely resorbed edentulous mandibles were en-rolled. Each patient received 4 implants,two posteriors placed tilted implants. Immediate loading of tilted implants were applied in all cases using a fixed provisional prosthesis. All patients were finalized 3-4 months with fixed pros-theses. Results 40/40 implants with initial torque(>35N.cm)were followed 1-1.5 years presenting 100%surviv-al. Conclusion The method of using tilted implants and fixed prostheses in the cases of severely resorbed edentu-lous mandibles can achieve an ideal short-term and medium-term effects.

Objective To compare the clinical outcomes of dilator-kyphoplasty (DKP) and balloonkyphoplasty (BKP) in treatment of osteoporotic vertebral compression fractures. Methods From May 2007 to March 2009, 23 cases with 26 vertebrae were treated with DKP, while 29 cases with 29 vertebrae were treated with BKP procedures. The operating time, bleeding volume and injecting volume of cement were recorded during operation. The distribution of cement, the restoration of vertebral height and Cobb angle were observed. The patients' visual analogue scales (VAS) score and Oswestry disability index (ODI) score were evaluated after operation. Results There were no differences in operative time, bleeding volume of every vertebrae and cement injected volume between these two groups (P＞0.05). The vertebral height, Cobb angle, VAS and ODI scores were significantly improved than those of pre-operation in these two groups (P＜0.05). The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups (P＜ 0.05). There were 1 case (1 vertebra, 3.8%) underwent cement leakage in DKP groups and 5 cases (5 vertebrae, 17.2%) in BKP groups. Conclusion DKP and BKP were effective in the treatment of osteoporotic vertebral compression fractures. The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups.

Objective:To assess causes for revision total knee arthroplasty (TKA) in China using the data of revision TKA in the past 15 years in our single center andcompare the differences in survival time, operation time and blood loss among different revision reasons.Methods:Data of 337 patients (345 knees) with revision TKAs at our institution from January 2007 to December 2021 (15 years) were retrospectively analyzed. The included population consists of 57 males and 288 females. The causes for first revision TKA were identified and compared according to the time of revision surgery as early (up to 2 years) and late revision (more than 2 years). The reason for revision before 2012 and after 2012 was also compared. Furthermore, the differences of survival time, operation time and blood loss among different revision reasons were compared.Results:The most common reasons for revision of knee joints in 345 cases were periprosthetic infection (133 knees, 38.6%), followed by aseptic loosening (97 knees, 28.1%) and joint instability (35 knees, 10.1%). Early revisions were performed in 171 knees (49.6%), while late revisions were performed in 174 knees (50.4%). Periprosthetic infection (96 knees, 56.1%) and aseptic loosening (86 knees, 49.4%) were the most common reasons for early and late revisions, respectively. There were 59 revisions performed before 2012 and 286 revisions performed after 2012, with periprosthetic infection being the main reason for revision in both groups. The percentage of revisions due to infection decreased from 64.4% before 2012 to 33.2% after 2012, and this difference was statistically significant (χ 2=18.790, P<0.001). The proportion of revisions due to aseptic loosening was 15.3% before 2012, which was significantly lower than the proportion of 30.8% after 2012 (χ 2=5.083, P=0.024). The median survival time of the prostheses in the included patients was 30 months, with shorter survival time observed in patients with stiffness, patellar complications, and periprosthetic infection, and longer survival time observed in patients with polyethylene wear and aseptic loosening. There were significant differences in operation time and blood loss among different reasons for revision ( P<0.001). Conclusion:In our specialized arthroplasty center periprosthesis infection was the most common reason for revision. Periprosthesis infection and aseptic loosening needed to be considered for early or late-stage revision. With the development of technique of total knee arthroplasty, the proportion of periprosthesis infection is decreasing, while the incidence of aseptic loosening is increasing.

Objective: To study the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Methods: Electronic search was conducted to find studies about the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Data extraction and risk of bias assessment of included studies were conducted. RevMan5. 3 software was used fore Meta-analysis. Results: 6 clinical trials were qualified to the Meta-analysis. Compared to the control group, there was no significant change of skeletal measurments after treatment (P＞ 0. 05), and no significant change in dental measurments in chincup group (P＞ 0. 05) . While overbite, U1-PP (mm) and L1-MP (mm) were increased (P ＜ 0. 05), U1-NA (°) and L1-NB (°) decreased (P ＜ 0. 05) in the 3 groups of fixed palatal crib, bonded spur associated with the chincup and the removable palatal spur associated with the chincup. Conclusion: Chincup is not effective in the early treatment of the anterior open bite in patients with Angle class I malocclusion. But chincup combined with palatal spur or crib and have a positive effect on the closure of open bite through the palatal clination and extraction of the anterior teeth without influence of molar intrusion and skeletal change.