Objective To summarize the experiences with minimally invasive pectus repair (Nuss procedure) for recurrent and acquired pectus excavatum after open thoracic surgery.Methods From Jun 2004 to Sep 2011,eighteen patients with recurrent or acquired pectus excavatum underwent Nuss procedure,including 12 males and 6 females The age ranged from 3.1to 14.8 years with mean age of (8.8 ±4.0) years.The body weight was 11 to 55kg with mean weight of (30.2 ±14.8 ) kg.Ten cases were recurrent pectus excavatum with previously failed open surgery repair,eight were acquired pectus excavatum after other open thoracic surgery.Sixteen cases had symmetrical and 2 had asymmetrical pectus excavatum.Haller' s index was 5.4 ± 3.4.The operation was performed with thoracoscopic assistance.Results All patients had successful operation with one bar insertion in each patient,one stabilizer was put on right side in seventeen and double stabilizers were put in one case.Therapeutic results evaluation was excellent in 16 cases and good in 2.Percentage of excellent and good was the same with that in our primary Nuss procedure ( P ＞ 0.05 ).Chest drainage duration was 1 to 4 days.One case had bar displacement revision 5 months later.Heart perforation occurred in one on whom a sternotomy and perforation repair were immediately performed.The echocardiography exam shows normal cardiac function after operation,and no nerve system complications were detected.One developed pneumothorax on operative day and one had pleural effusion three days later,both were treated by chest tube drainage.Twelve patients' bars were removed after 24 - 45 months of stagnation period.Anatomic results at bar removal were 10 excellent and 2 good,there were no recurrent cases.Conclusion Nuss procedure is an effective method and has good results on recurrent and acquired pectus excavatum.Safety of patients and complications minimization is always the first to be considered.

ObjectiveTo discuss the operative techniques and results of coarctation resection plus aortoplasty with pulmonary autograft patch for coarctation of the aorta combined with hypoplastic aortic arch in infant.MethodsBetween May 2007 and Dec 2009,14 cases including 9 males and 5 females with caorctation of the aorta and hypoplastic aortic arch underwent coarctation resection plus aortoplasty with pulmonary autograft patch in our hospital.The age ranged from 23 days to 17 months,with a median of 4.33 months.The mean body weight was (6.14 ±2.36) kg.All patients were diagnosed as aortic coarctation combined with VSD and hypoplastic aortic arch.The surgery was performed under deep hypothermia cardiopulmonary bypass with selective cerebral perfusion in 8 cases and circulation arrest in 6 cases.Fresh pulmonary autograft patch harvested from the main pulmonary artery was used for aortoplasty.The associated VSD was repaired in the same stage.ResultsAll patients survived except one died from circulatory failure during the perioperative period.Low cardiac output syndrome occurred in another case who was cured afterwards by correspondent treatments.No residual obstruction was detected by echocar-diography after the operation.Follow-up was carried out in 13 cases from 4 months to 3 years.Echocardiographic examination showed that the pressure gradient across the aortic arch was less than 16 mm Hg in all cases.The blood velocity at the descending aortic arch was not significantly changed during the follow-up period as compared with that of the immediate after operation.Computed tomography showed that the morphology of aortic arch was normal.The left bronchus compression was relieved obviously or totally disappeared in patients who suffered from left bronchus stenosis before operation,and no aortic aneurysm were detected in these patients.ConclusionConclusion Coarctation resection plus aortoplasty with pulmonary autograft patch is the optimal surgical method for treating coarctation of the aorta combined with hypoplastic aortic arch in infant.

Objectives To evaluate the efficacy and safety of single-incision versus conventional laparoscopic cholecystectomy.Methods We searched electronic databases (PubMed,EMBASE,Cochrane Library,Chinese Biomedicine databases) from January 2000 to April 2012.Personal contact with experts in the field of laparoscopic cholecystectomy was performed to identify further potentially relevant clinical trials.Randomized controlled trials conducted on single-incision versus conventional laparoscopic cholecystectomy were analysed to compare conversion rates,blood loss,operation time,postoperative complications,wound satisfaction score,postoperative pain score and postoperative duration of hospitalization.Data were extracted by two reviewers independently.Statistical analysis was performed by using the RevMan 5.1 software.Results Twelve studies involving 915 patients met the inclusion criteria.When compared with conventional laparoscopic cholecystectomy (LC),the singleincision laparoscopic cholecystectomy (SILC) group showed no significant difference in conversion rate (OR=0.70,95％CI: 0.13～3.77,P=0.68),postoperative complications (OR=1.13,95％CI:0.72～1.78,P＝0.59) and postoperative pain scores (WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57) . There was a significant increase in operative blood loss (WMD ＝ 1.43,95 ％ CI: 0.09 ～2.78,P＜0.05),increase in operative time (WMD=16.79,95％CI: 9.05～24.52,P＜0.01),but an increase in wound satisfaction score (WMD=1.28,95％CI..1.09～1.47,P＜0.01).The postoperative duration of hospitalization was significantly shorter (WMD =-0.30,95％ CI:-0.58 ～-0.02,P＜0.05).Conclusions Current evidence suggests that there is no significant difference in conversion rate or postoperative complications between SILC and LC.Although SILC requires a longer operative time and there is more blood loss when compared with LC,the SILC is superior in wound satisfaction score and in duration of hospitalization.

ObjectiveTo investigate the effect of Genistein (GST) on cell cycle and apoptosis in PC12 cells transfected App695MT gene.MethodsPC12 cells were transfected with pIRES2-EGFP plasmid or pIRES2-EGFP/APP695MT expression plasmid,and then were divided into control vectortransfected group,APP695 transfected group and GST treatment group.Flow cytometry was applied to detect cell cycle and apoptosis,laser confocal microscope was used to observe morphological changes of cell apoptosis.ResultsCompared with control vectortransfected group,PC12 cells in APP695 transfected group increased significantly in G0 and G1 phase,and less into S phase,cell proliferation index was decreased significantly( (55.6 ±0.57)％,P＜0.0l ),apoptosis rate was increased significantly( (77.10 ± 12.53)％,P＜0.01 ).Emitted red fluorescence increased significantly when cell death,cell body swelling,organelle disintegration,nuclear condensation or fragmentation.Compared with APP695 transfected group,PC12 cells in GST( 15μ mol/L) treatment group,decreased significantly in G0 and G1 phase,and more into S phase,cell proliferation index was increased significantly ( ( 61.57 ± 0.47 ) ％,P ＜ 0.01 ),apoptosis rate was decreased significantly ( (46.00 ± 8.43 ) ％,P ＜ 0.01 ).Cell death was significantly reduced red fluorescence,emitted green fluorescence was significantly enhanced,compared with APP695 transfected group cell morphology improved.ConclusionGST can improve APP695MT gene caused cell cycle arrest,promote cell to S phase transition,reduce apoptosis rate in PC12 cells,and have a protective effect on transfected cells.

Cation exchange (CX) reaction for the non-fluorescent ZnS nanocrystal clusters (NCCs) can be used to detect trace biomolecules . Nano clusters synthetized by hydrothermal synthesis are porous. So they can quickly release large amounts of Zn2+ from through cation exchange ( CX) reaction and nano cluster, generate fluorescent signal under the action of zinc reagent to detect fluorescence. The relationship between the release efficiency, target binding force of Zn2+ and its average diamete was investigated when the average diameter was 44 nm, 86 nm and 144 nm in this experiment. Results showed that the smallest nano cluster exhibited the highest cation exchange efficiency, and 71 percent of Zn2+ closed could be released by microwave radiation within 2 min. When the sandwich method of NCCs of 44-nm was used to detect immunoglobulin E (IgE) in a sandwich assay, the limit of detection (LOD) was 5 ng / L, which was 1000 times lower than that of ELISA. It turns out that CX for the ZnS NCCs is superior to the conventional signaling strategies in its high amplification efficiency, robustness, and biocompatibility.

AIM: The purpose of the present study was to detect intracellular Ca 2+ changes in living brain slices during focal cerebral ischemia/reperfusion (I/R) and reveal the role of intracellular Ca 2+ in the cerebral I/R injury. METHODS: The model of focal cerebral I/R was established in rats by reversible inserting a nylon thread, and dynamic change of intracellular Ca 2+ in brain slices was determined using laser confocal imaging system. RESULTS: ① Ca 2+ gradually enhanced with increase in ischemic time in cortex and striatum. ②At 1 h ischemia/ 10 min reperfusion, Ca 2+ increased significantly in striatum, but Ca 2+ decreased at 3 h reperfusion compared with 10 min reperfusion. ③ Ca 2+ markedly enhanced at 6 h ischemia compared with 1 h ischemia, and after 3 h reperfusion Ca 2+ decreased, but was still higher than that in sham-operation group. ④The striatum is more sensitive than cortex to ischemia/reperfusion. CONCLUSION: Ca 2+ overload in the area of cortex and striatum may play an important role in cerebral ischemia/reperfusion injury in rats.

Objective To clone E-cadherin and N-cadherin promoters and insert them into a luciferase reporter gene vector, and to characterize the promoter activity of E-cadherin and N-cadherin.Methods E-cadherin and N-cadherin pro-moter were cloned into pGL 4-basic.The resulting plasmids were determined by DNA sequencing .The promoter activity was analyzed in breast cancer cell line ZR 75-1 and hepatocarcinoma cell line HepG 2.Results DNA sequencing showed that the sequences of the cloned promoter regions were correct .Analysis of the reporter gene activity indicated that the E-cad-herin and N-cadherin promoters had the highest transcriptional activity in ZR 75-1 and HepG2 cells.Conclusion The E-cadherin and N-cadherin promoter genes are cloned successfully , contributing much to screening transcription factors that regulate E-cadherin and N-cadherin expression .

BACKGROUND:After years of development, various in vitro loading devices for vascular tension stress have been created both at home and abroad, mainly including rectangular base stretching method, circular base deformation method and four-point bending beam load method. Although the circular base deformation method can wel reflect the real situations in vivo such as the expansion of the alveoli and vascular pulsation, the strain on the membrane is actinomorphic. The four-point bending beam load method can just bring limited strain range and load time, along with a difficult strain regulation.
OBJECTIVE: To develop anin vitro loading device for vascular tension stress using the rectangular base stretching method.
METHODS:Thisin vitro loading device for vascular tension stress developed according to mechatronics design consisted of power supply module, control module, drive module and data acquisition module. The device could achieve the tensile control on silicon diaphragm by high-precision control of the motor rotation angle and rotational speed.
RESULTS AND CONCLUSION: Through tests and experiments, the device could meet the required range of parameters and simulatein vitro human tensile stress environment, which is preliminarily considered to develop successfuly, achieving that: (1) two work patterns: stress mode and strain mode so as to solve the standardization of silicone substrate as loading device; (2) tensile stress can be adjusted in a range of 0-5×105 Pa; (3) tensile strain can be adjusted in 0-40% range; (4) stretching frequency can be in the regulation of 0-80 times/min and the stretching time can be controled.

Objective:To explore the diagnostic value of C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology in the differential diagnosis of thyroid nodules.Methods:A total of 237 thyroid nodules patients (237 thyroid nodules)with ultrasound examination and definitive pathologic results in Henan Cancer Hospital from April to September 2020 were retrospectively analyzed. The nodules were diagnosed according to C-TIRADS guidelines, and then by S-Detect technology combined with C-TIRADS guidelines. The ROC curve was plotted with the pathological results as the gold standard, and the area under the ROC curve, sensitivity, specificity and accuracy of the diagnosis results between the two groups were compared.Results:Among the 237 thyroid nodules, 105 were benign and 132 were malignant.The area under the ROC curve of C-TIRADS diagnosis alone and C-TIRADS diagnosis combined with artificial intelligence were 0.869 and 0.942 respectively, the difference between the two groups was statistically significant (χ 2=36.11, P<0.001); When Category 4A was used as the cutoff value of benign and malignant differential diagnosis, the specificity and accuracy of C-TIRADS classification of artificial intelligence-assisted diagnosis was significantly higher than that of C-TIRADS alone, and the difference was statistically significant(83.81% vs 47.62%, 90.72% vs 75.53%, all P<0.05). Conclusions:C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology has a high efficiency in the diagnosis of thyroid nodules and can improve the specificity and accuracy of thyroid nodules diagnosis and reduce unnecessary biopsy.

Objective To investigate the effect of genistein on the expression of Bax and Bcl-2 protein in PC12 cells transfected with mutant APP695 Type.Methods PC12 cells were transfected with pIRES2-EGFP plasmid or pIRES2-EGFP/APP695MT expression plasmid,and then divided into normal control group,Unladen group,APP695 transfected group,GST treatment group(5 μmol/L,15 μmol/L).The Bax and Bcl-2 protein expression in PC12 cells was measured by Immunocytochemistry SABC and Western-blot.Results Immunocyto-chemistry SABC showed that:compared with the normal control group,the expression of bax protein in APP695 transfected group was strongly increased((78.02 ± 1.26) ％,P＜0.01)) and the expression of bcl-2 protein was very weak oppositely ((15.40 ± 0.72) ％,P＜0.01)).Compared with APP695 transfected group,the expression of bax protein in cells of 15umol/L GST treatment group was significantly decreased((22.35 ± 0.49) ％,P＜0.01))and the expression of bcl-2 protein in these cells was strongly increased ((68.11 ± 0.24) ％,P ＜0.01)).Western-Blot showed that:compared with the normal control group,the expression of bax protein in APP695 transfected group was markedly increased and the expression of Bcl-2 protein was significantly decreased.Compared with the APP695 transfected group,the expression of Bax protein was markedly decreased and the expression of Bcl-2 protein was significantly increased in the cells of the GST treatment groups.Conclusion GST can reduce the expression of bax protein and the increased expression of Bcl-2 protein has protective effect on PC12 cells transfected with APP696MT.