Objective To treat the sunken upper eyelids in the midd le and older patients with a modified procedure so as to improve esthetic appeara nce of the patients. Methods Autolipoparticles collected from patients' abdomen were injected into the sunken upper eyelids beneath the o rbital septum. 3ml of the lipoparticles were injected for each upper eyelid as u sual. The blepharoplasty was also performed for most of the patients with lower eyelids bag before or during the operation. Results The decrepit phenomena of eyes in all the patients were improved by the operations. Owing to the phenomena that the sunken upper eyelids were associated with the fa t bags of lower eyelid in most patients, it was inferable that the sunken upper eyelids were probably caused by the tissues ptosis in the orbit. Con clusions The sunken upper eyelids associated with fat bags of lower eyelids are the decrepit phenomena of eyes in middle age and old people. The sun ken upper eyelids can be corrected by the method of autolipoparticle injection. After the operation the appearance of patients' eyes is obviously improved. The method is easily performed and its curative effect is reliable.

BACKGROUND:Bone marrow mesenchymal stem cells as non-hematopoietic stem cells from the mesoderm mostly come from the bone marrow, which have a stronger self-renewal ability, multilineage differentiation ability and low immunogenicity and are easy to receive the introduction of foreign genes. Therefore this kind of cells have become the research hotspot in recent years. OBJECTIVE:To summarize the latest clinical application and advancement of bone marrow mesenchymal stem cels in the treatment of various diseases. METHODS: PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and SinoMed (http://www.sinomed.ac.cn/zh/) databases were searched by the first author using the keywords of bone marrow mesenchymal stem cells, therapy to identify the relevant articles published in English and Chinese, respectively, from 2011 to 2016. After excluding repetitive, irrelevant or Meta-analysis literatures, we enrolled 49 literatures for final analysis. RESULTS AND CONCLUSION:Studies on bone marrow mesenchymal stem cells have achieved new grades in the treatment of respiratory system disease, cardiovascular disease, urinary system disease, nervous system disease, liver disease, diabetes mellitus, hematological system disease, autoimmune disease, graft-versus-host disease, motor system disease, although its application has the risk of oncogenicity. Further investigation on the oncogenicity of bone marrow mesenchymal stem cells will be gradually explored, aiming to a better clinical use of bone marrow mesenchymal stem cells.

Objective To analyze the long term results of thoracolumbar burst fractures treated with short segment pedicle instrumentation. Methods Sixty eight cases of thoracolumbar burst fractures fixed with short segment pedicle instrumentation were followed up for at least 5 years (5-13 years, average 8 years). All of them were checked with radiography pre and post operation and before implant removal. At final follow up assessment, all were examined with radiography, 18 cases were checked with CT scan as well. Results 1) Neurological status improved at least 1 Frankel grade in 90.3% of the patients who had preoperative incomplete paraplegia, while no improvement was obtained in those who had preoperative complete paraplegia. Low back pain was evaluated according to Denis Pain Scale, the results showed P1 41 cases (60.3%), P2 24 cases (35.3%), P3 3 cases (4.4%). 2) The shortest distances between the upper and lower pedicle screws tips shortened for 0-6.5 mm (average 2.5 mm) before removal in contrast to that at post operative immediately. Of the 68 cases, nuts loosened in 1 case, pedicle screws loosened in 1 case, bent in 2 cases and broken in 5 cases. Of the 8 cases whose implants were not removed timely, screw broke in 2 cases, and seepage occurred through incision in 2 cases. 3) At final follow up, the correction of anterior vertebral body height averaged 30.5%, and Cobb angle 5.8?, despite a mean correction loss of Cobb angle 12.1?. Correction loss was most evident at the above disc spaces, then the below disc spaces. Correction loss of vertebral body height averaged 1.9% in the anterior, and 6.0% in the middle part. 4) The collapse of vertebral body was most serious in the middle part. The deformity of "codfish vertebrae" occurred in the superior part of vertebrae body in 21 cases, among them the upper adjacent vertebral body sank into the injured body in 5 cases, 3 of whom engendered kyphoses greater than 25?. Evident intra corporeal gaps were found in 16 of 18 patients who were checked with CT, and the gaps communicated with the above disc space. The fractured body could have a deformity of the "cup" after reduction. 5) Degeneration and narrowing of the disc spaces next to fractured vertebrae were very common, and the above space disappeared in 27 cases, while the lower space disappeared in 14 cases. The upper disc space adjacent to fixation levels degenerated in 1 of 8 cases whose implants were not removed timely. Five patients had Cobb angle greater than 20?, three of them had low back pain, and one had mild symptom of nerve compromise. Low back pain was not correlated with degeneration of discs. Conclusion Short segment pedicle instrumentation provides satisfying stability for thoracolumbar burst fractures. It helps physiologic postural contour restoration and facilitates neural recovery, but is associated with relatively high rates of implant failure and correction loss which is most evident at adjacent discs spaces. Deficiency of bone grafting and delayed implant removal are the most probable causes for correction loss.

BACKGROUND: Minimally invasive transforaminal interbody fusion (Mis-TLIF) for spondylolisthesis has been introduced to reduce muscle trauma, minimize blood loss, and achieve earlier rehabilitation. However, there is a lack of evidence-based medicine concerning the therapeutic efficacy of Mis-TLIF versus open TLIF for spondylolisthesis. OBJECTIVE: To systematically evaluate the clinical efficacy and safety of Mis-TLIF versus open TLIF for spondylolisthesis.METHODS: WanFang, CNKI, PubMed, and Cochrane Library databases were searched using the keywords of spondylolisthesis, minimally invasive transforaminal interbody fusion, open transforaminal interbody fusion in English and Chinese, respectively. The quality evaluation and data extraction of the included literatures were conducted by two authors independently. A meta-analysis was performed on RevMan 5.3 software.RESULTS AND CONCLUSION: Ten literatures were included, including 7 retrospective and 3 randomized controlled trials; 963 cases were enrolled (489 cases of Mis-TLIF, 474 cases of open TLIF). (1) Meta-analysis results showed that there were no significant differences in the operation time, postoperative complication rate, and fusion rate at the last follow-up between two groups, suggesting that the two methods expose analogical effects on the pain relief and functional recovery. (2) There were significant differences in the intraoperative blood loss and radiological times between two methods. (3) To conclude, Mis-TLIF holds similar operation time, incidence of complications and functional recovery with open TLIF, accompanied by minimized trauma, and reduced intraoperative and postoperative blood loss, which is considered as a safe and effective surgical method.

Objective To investigate the application of PKH26 and molecular light imaging system in cartilage en?gineering. Methods Canine chondrocyte was labeled by fluorescent dye PKH26 and seeded into the porous cartilage acel?lular matrix scaffold. The cells/scaffold constructs were cultured in vitro for 1 week. Then the constructs were implanted into the dorsal pocket of nude mice. We utilized a molecular light imaging system to macroscopically observe cells/scaffold con?structs in vivo with fluorescence at the 4th weeks, and compared with X-rays taken at the same position. The fluorescence im?ages were compared with the immunohistochemical and immunofluorescent results of cartilage-like tissue in vivo. Results Luminescent images were acquired at the 4th weeks, a red color enhanced overlay of the luminescent image over X-ray photo?graphic image demonstrated the location of the implants and the cell viability and cell growth on porous CACM scaffold in vivo were very well. Histological results show that the safranin O, anti-collagenⅡimmunohistochemistry and toluidine blue stain of cartilage-like tissue is positive. Immunofluorescence examination demonstrated chondrocytes in the constructs whitch is showen red fluorescence, and anti-collagenⅡimmunofluorescent staining was showen in green while the overlap?ping image is showen in yellow. Conclusion This study outlines an applicable non-destructive method to evaluate cell growth in tissue engineering constructs in vivo using PKH26 and molecular light imaging system.

Objective To provide information and assistance for research of bile duct injury in OLT through endoscopic observation and treatment of biliary complications after liver transplantation.Methods After OLT, all the cases in normal group, bile duct injury group and hepatic artery injury group were observed, diagnosed and recorded respectively. Meanwhile, the biopsy was performed through the endoscopy for pathological examination. For those cases without T tube, the biopsy was conducted by choledochoscopy in combination with duodenoscopy. Results The exterior and interior bile duct anatomy of the 9 cases in the normal group was normal. They had no bile duct stenosis and scar, their bile duct mucous membrane looked good and the anastomosis of the donor-receptor bile duct healed well. Restored mucous tissue coating with intact epithelium was found by pathological examination. Fibrous tissue and small vascular proliferation happened under epithelium scattered with plasmocyte and lymphocyte. Various kinds of bile duct stones-simple, multiple and casting mould type, were found in 12 cases with bile duct injury. Bile duet mucous membrane injured in different degrees was repaired after stone removed and obstruction relieved by endoscope. Bile duct tree becoming normal was seen by pacification examination. Three cases in the hepatic injury group had bile duct ischemic necrosis, losing of normal structure without bile duct wall and mucous membrane. Conclusion Bile ducts are injured in different degrees in OLT. The choledochofibroscopy is of the first choice for diagnosis and treatment of complications after OLT.

Objective To investigate the feasibility of percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. Methods One patient with thoracic disc herniation involved the level of vertebral segment in T11/12 was treated with percutaneous transforaminal endoscopic spine system and followed up for 1 month. The targeted puncture was performed under local anesthesia and fluoroscopic guidance with patient in prone position. The foramen of T 11/12 was enlarged gradually with four trephinations, and the working cannula was inserted transforaminal into the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The dural sac was exposed and released adequately. Drainage was placed during operation. Results The procedure was successfully carried out and the dural sac was completely released. The drainage was removed in the second day of operation. The patient could walk in the third day after operation with obvious relief of back and leg pain. At the follow-up of one month postoperation, the visual analogue scale of leg pain decreased from 8 to 1, and the Oswestry disability index (ODI) decreased from 64 to 4. According to MacNab scale, excellent result was acquired. Conclusion There is the feasibility of the percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. It is a good minimal invasive technique with good results and high technical requirements for surgeons.

Objective To evaluate and compare the immunopathological changes of lumbar disc herniation and discogenic pain. Methods Seventy-one lumbar disc nucleuses were collected intra-operation,and they were divided into four groups. Group A: 30 cases of disc herniation, Group B: 22 cases of sequestered disc herniation, and the patients in Group A and B received discectomy; Group C: 10 cases of discogenic pain were confirmed by discography, and the painful disc was excised through anterior retroperitoneal approach; Group D: 9 cases of lumbar bust fracture who received anterior subtotal corpectomy and discectomy, and the nearly normal caudal disc was collected as control. The disc nucleuses were processed in the following methods: 1) HE stain and pathological observation; 2) Immunocytochemical test using monoclonal antibodies to CD68 and CD45RO molecule for macrophage and T lymphocytes, respectively. The positive cells were counted and analyzed with statistic method. Results 1) Pathological observation with HE stain: compare to control group, the degeneration of nucleus cell was evident in the other groups. There were obvious infiltration of inflammatory cells and focal neovascularization in group A and especially in Group B.In Group C, only diffuse inflammatory cells was found without neovascularization, but the degeneration of matrix was more severe. 2) Positive rate of CD68 cells: Group B (63.6%)＞Group C (40.0%)＞Group A (26.7%)＞Group D (0%). There were significant differences among groups (P＜0.05). 3) Positive rate of CD45RO cells:Group B (59.1%)＞Group A (13.3%), Group C and D were negative, and the positive cell were found in slice of the same site of positive CD68 cells. The differences between each group were significant (P＜0.05). Conclusion The nucleus of herniated disc has evident inflammatory and autoimmunity reaction. The nucleus of discogenic pain is infiltrated with diffuse inflammatory cells and some macrophages, without T lymphocyte and neovasularization, so the autoimmunity course is not evident.

Objective To analyze the distribution of B-cell subtypes and IgG subclasses in pa-tients with non-small cell lung cancer ( NSCLC) and to investigate their potential functions in the progress of NSCLC.Methods Flow cytometry analysis was used to detect the distribution of immature B cells, memory B cells and mature B cells in 25 healthy subjects and 55 patients who were at different clinical stages of NSCLC.Enzyme-linked immune-sorbent assay ( ELASA) was performed to measure the concentrations of IgG1, IgG2, IgG3, IgG4 and total IgG, as well as the ratio of each IgG subclass in total IgG.Results The percentages of immature and memory B cells in CD19+B cells were positively correlated with the progress of NSCLC.The ratio of IgG4/IgG gradually increased along with the development of NSCLC, while that of the other three IgG subclasses showed no significant changes as compared with that of the control group.Conclu-sion The imbalanced distribution of B-cell subtypes and the up-regulated ratio of IgG4/IgG were closely as-sociated with the development of NSCLC.This study paved the way for further investigation on more effective immune therapy strategies targeting NSCLC.

With the rapid development of medical sciences in recent years,tissue engineering technology has made great achievements,while the choosing of seed cells has been a major focus of the field.Adipose-derived cells have the advantages of rapid expansion,good stability,no immune rejection and potential of multiplex differentiation.They can differentiate into cells originated from different germ layers such as:adipocytes,osteoblasts,chondrocytes,endothelial cells,myocytes,neuronal cells and so on.Besides,adipose tissue can be harvested easily and substantially with small trauma to human body.So ADSCs are expected to be an ideal choice of seed cells in tissue engineering.This article introduces the research progress of ADSCs in osteochondral tissue engineering.