This paper introduces the structure and basic principle of an intelligent controller based on DSP,whose hardware takes TMS320F2812 as core. The expert control system is adopted in the software. This controller is integrated with pattern recognition systems and ultrasound emulsification instrument to introduce control theory and experts' experience into cataract operation, and then cataract operation can be automatized and intelligentized.

The relationship between soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) and imbalance of Th 1/Th 2 cytokines was investigated in patients with Graves′ disease. The results showed that sCTLA-4 was increased, IL-4 decreased. IFN-? did not significantly change, IFN-?/IL-4 was raised and there was a negative linear correlation between sCTLA-4 and IL-4, suggesting that imbalance of serum Th 1/Th 2 cytokines with a decline in Th 2 cytokine was associated with increased sCTLA-4.

Objective To study the causes and management of biliary complications after orthotopic liver transplantation.MethodsClinical data of 38 patients who have underwent orthotopic liver transplantation between May 2000 and January 2002 were studied retrospectively. ResultsPostoperative bililary complications occurred in 9 patients(24%), including simple biliary fistula in 4, stricture of hepatoenterostomy, intrahepatic cholelith, biliary stricture with sludge, biliary stricture with cholelith, and intrahepatic biloma and cholelith in one each. Two patients died of the complication, and seven were cured successfully. ConclusionsThe causes of biliary complications are complicated. Early diagnosis and timely management helps to decrease the mortality. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography is a valuable, less traumatic procedure.

Objective To investigate the efficacy of allograft bone in posterior spinal fusion in scoliosis. Methods From March 1995 to March 2000, 60 patients with scoliosis, who underwent posterior spinal instrumentation and fusion using allograft or autograft bone, were evaluated prospectively. All of the patients were randomized into group A (30 cases using only allograft bone) and group B(30 cases using autograft iliac bone).Among the patients in group A, there were 16 with congenital scoliosis, 12 with idiopathic scoliosis, 1 with neurofibromatsis scoliosis and Marfan syndrome respectively. The average age at surgery was 14 years 6 months. the average preoperative major curve was 86.6? with an average number of 8 fused segments (range, 4 to 10 segments). Whereas in group B, there were 15 with congenital scoliosis, 9 with idiopathic scoliosis, 5 with neurofibromtasis scoliosis and 1 with Marfan syndrome. The average age at surgery was 13 years and 8 months. The average preoperative major curve was 77.8? with an average number of 7 fused segments (range, 5 to 10 segments). The mean operative duration, average blood loss, complications and loss of correction between the two groups were analyzed comparatively. Results Each patient had a minimum 2-year follow-up with an average duration of 4 years 5 months. Group A was better than group B by a shorter operative duration, less blood loss. At last follow-up, the major curve measured an average of 44? (range, 31? to 72?) in group A and 41? (range, 24? to 68?) in group B respectively. There were 3 (10%) and 2 (6.7%) pseudoarthrosis occurred in group A and group B respectively. One superficial infection developed in group A. There was no significant difference of the average loss of correction and complication rate between the 2 groups. But there were 6 patients who had donor site pain in group B. Conclusion A satisfactory outcome can be achieved in posterior spinal fusion in scoliosis using allograft bone especially when a large amount of bone graft is needed.

Obiective To evaluate the value of allograft bone for acetab ular and femoral reconstruction in THA revision surgery. Methods A total of 19 p atients underwent reconstruction of acetabular and proximal femoral bone defects from June 1996 to December 2000 were reviewed. Eleven of the patients were men and 8 women with a mean age of 66.5 years and 63.2 years respectively at the t ime of resision surgery. According to AAOS system, the acetabular bone defects w ere classified into type I in 2 hips, type II 10 hips and type III 4 hips, and o n the femoral side, there were type I in 3 hips, type II 11 hips and type III 2 hips respectively. The reconstruction of bone defect of acetabulum included stru ctural allograft in 3 hips, impacted morselized allograft in 3 hips, and metal w ire mesh with morselized allograft in 3 hips. In all 3 of femoral segemental def ects, the reconstructions of the proximal femoral bone defects were done with st ructural allografts. Metalwire mesh with morselized allograft for femoral bone d efects were performed in 2 cases and morselized allogratts alone for femoral bon e defects in 4 cases; both acetabular and femoral bone defects were reconstruct ed with impacted morselized allografts in 6 cases (7 hips), and 4 patients with no bone grafts; Harris score system and radiograph were used for the final eva luation. Results Ninteen patients were followed up for an average period of 46 m onths (ranges, 6 to 68 months), Harris score improved from 42.7 points pre rev ision to 82.7 points at final follow up, the incorporation of allografts bone in 15 patients (16 hips) were noticed radiographically in all but one hip was fo und reabsorption of the structural allograft and radiolucents were found in the other 3 patients. No infection was encountered in this series. Conclusion If th e different types of bone defects were properly identified and suitable allogrft s adopted, reconstruction of bone defects with allografts during the THA revisi on surgery is a useful and reliable method. [

Objective To measure and compare the insertion torque and pullout strength of newly designed general spine system(GSS) screws with those of SOCON and CCD pedicle screws in normal human cadaver vertebrae, and to evaluate the screw purchase of GSS pedicle screws. Methods Twenty seven lumbar vertebral bodies obtained from 6 fresh normal male cadavers were classified into 3 groups randomly, 18 pedicles per group. GSS, SOCON and CCD pedicle screws were implanted into the pedicles of each group respectively. Pedicle screws were inserted with a torque screwdriver. Each screw was extracted axially from the pedicle at a rate of 5 mm/min until failure using a material testing machine(SWD-10, Changchun, China). Force data were recorded and analyzed using a one way ANOVA. P

0.05). In Group 2, the mean maximum pull out strength of the GSS screws was 127% of that of the CCD control screws, while the mean maximum pull out strength of the TSRH screws was 64% of that of the CCD control screws. The mean maximum pull out strength of the GSS screws was significantly higher than that of the TSRH screws (P0.05). Conclusion GSS screws offer better anchoring in revision surgery than most of the currently used screws do.

Objective To assess the association of serum resistin,TNF-? and insulin resistance in type 2 diabetes mellitus.Methods 42 cases of T2DM and 40 cases of control were involved in the study.Their waist circumference(WC),the levels of fasting serum resistin,TNF-?,fasting blood glucose(FBG) and fasting insulin(FINS)were measured.Results The levels of serum resistin,TNF-? and Homa-IR in T2DM group were significantly higher than those in control group,while serum FINS level was significantly lower than that in control group[(11.76?2.72)vs(8.65?3.00)?g/L,P

Objective To investigate the role of recombinant adenovirus Ad-PD-L1 on immunotolerance induction in mouse pancreatic islet transplantation. Methods Full-length mouse PD-L1 cDNA linked with an internal ribosome entry site (IRES)-GFP cassette was subcloned into pShuttle-GFP-CMV( - ) shuttle plasmid. The product was cut by certain restriction endonuclease and ligate with pAdxsi vector. The adenovirus bone plasmid was transformed into DH5α competent bacteria. The positive clone was identified by restriction endonuclease digestion and further confirmed by sequencing. After linearization, the recombined adenovirus DNA was transfected into 293 cells by liposome for package and amplification, which was purified by CsC1 density gradient centrifugation. Streptozocin was injected i.p. into C57BL/6 (H-2b) mouse to induce diabetic model recipient. Recipients were randomly divided into three groups, Group A was the control. Group B and group C were injected of Ad-EGFP and Ad-PD-L1 through tail vein respectively 1 day before islet transplantation. 300 to 400 islets of DBA/2 (H-2d) were transplanted into the renal subcapsular space of the diabetic model recipient. The level of blood sugar and the graft survival time were monitored. Results Recombinant adenovirns Ad-PD-L1 have high efficiency expression of PD-L1 in recipient mouse. The survival time of grafts of Ad-PD-L1 group (27.63 ± 3. 51 ) d was significantly longer than that of the control ( 7. 85 ± 0. 33 ) d and Ad-EGFP group ( 7. 67 ± 0. 59 ) d ( P < 0. 01 ). Mixed lymphocyte response showed a specific decrease reaction of recipient lymphocyte toward donor lymphocytes. Conclusion Recombinant adenovirus Ad-PD-L1 was successfully constructed. In mouse pancreatic islet transplantation, it can suppresses the activation of recipient T lymphocyte through PD-1/PD-L1 co-stimulatory pathway, and significantly prolong the survival time of grafts.

Objective To summary the experience of living donor liver transplantation (LDLT) in order to improve therapeutic effect of LDLT. Methods We retrospectively analyzed the clinical data of donors and recipients of 22 LDLT cases, evaluating patients' and donors' preoperative assessment, surgical strategies and postoperative complications. Results Donor's grafts harvested included 2 left lateral lobes, 6 left half livers, 1 extended left half liver, 5 right half livers and 8 extended right half livers. Postoperatively all donors recovered without severe post-transplantation complications. Among 13 adult and 9 child receipients, there were 8 recipients suffering from posttransplantation complications, including intra-abdominal severe infection in one case, delayed liver function recovery complicating incisional infection in one case, intra-abdominal hemorrage complicating thrombogenesis of the hepatic artery in one case. All these 3 patients died. One child recipient of hepatic failure died of heart and respiratory failure after operation. Other non-lethal complications were bile leakage in 2 cases, refractory ascites in one and deep venous thrombosis of the lower limb in one. These complications were cured without laparotomy. Finally 18 recipients were fully recovered and discharged. Late post-operative complications included strictures of biliary tract in 3 cases which were treated with PTCD and indwelling stent, the obstructive jaundice due to achalasia of sphincter of Oddi was treated with endoscopic sphincterotomy. These 4 patients' are on stable condition and the liver function is normal. Conclusions Select proper donor and optimal surgical strategy are extremely helpful to secure donors and recipients during the procedure of LDLT.