Objective To evaluate the effeciency and safety of the implantation of phakic iris-fixated intraocular lens for high myopia.Methods 12 cases(18 eyes)with the mean spherieal equivalent refraction was(-15.12?5.23)diopters of myopia,following up 3~6 months after surgery(averaging 5.1 months)were enrolled.Visual acuity,intraocular pressure,contrast sensitivity,glare sensitivity,corneal endothelium and the stable of intraocular lens and the turbid level of lens were observed.Results A postoperation uncorrected visual acuity of(0.73?0.21)was observed in 18 eyes at 6 months.There was significant difference as compared with preoperation corrected visual acuity of(0.52?0.17)(P

Objective: To observe the improving effect of muscle regions of meridians needling method on the upper limb function in children with cerebral palsy of spastic hemiplegic type. Methods: A total of 100 children with cerebral palsy of spastic hemiplegia type were divided into a treatment group and a control group according to the visiting sequence, with 50 cases in each group. The control group was treated with conventional rehabilitation plus conventional acupuncture treatment. The treatment group was treated with conventional rehabilitation plus muscle regions of meridians needling method. The electromyography (EMG) signal values of triceps brachii and pronator teres were detected before treatment, and 3 months and 6 months after treatment. The clinical efficacy was evaluated by Peabody developmental motor scale-fine motor (PDMS-FM) and fine motor function measure (FMFM). Results: Three and six months after treatment, the EMG signal values of triceps brachii and pronator teres, grasping scores and visual-motor integrated scores of PDMS-FM and the FMFM scores in both groups increased to varying degrees compared with the same group before treatment, and the intra-group differences were all statistically significant (all P<0.05). Six months after treatment, the results of the above three items in the treatment group were all better than those in the control group, and the differences between the groups were statistically significant (all P<0.05). Conclusion: Muscle regions of meridians needling method added on the basis of conventional rehabilitation can effectively reduce the muscle tone of upper limb and enhance the muscle strength, and improve the upper limb function in children with cerebral palsy of spastic hemiplegia type. The efficacy is superior to that of the conventional rehabilitation plus conventional acupuncture treatment.

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

OBJECTIVETo evaluate preoperative application of recombinant human erythropoietin (rHuEPO) in reducing transfusion requirements in elderly patients undergoing elective surgery for femoral intertrochanteric fractures.

METHODSFrom January 2011 to December 2013,442 cases of elderly patients with femoral intertrochanteric fracture were retrospectively reviewed. According to inclusion and exclusion criteria, 119 cases were eventually included and divided into the treatment group and the control group. There were 12 males and 40 females, with a mean age (71.4 ± 12.8) years old, and the patients received preoperative administration of rHuEPO 10,000 U qod combined with iron dextran 200 mg (3 times each day). While 16 males and 51 females in control group, with a mean age (70.9 ± 16.2) years old, and the patients only received preoperative administration of iron dextran 200 mg (3 times each day). All the patients received closed reduction and PFNA-II or Internal fixation surgeries. The perioperative blood transfusion rate, average amount of blood transfusion, postoperative complications, the length of hospital stay and mortality within 30 days were compared between the two groups.

RESULTSThere were no statistical differences between two groups in the baseline indexes (P > 0.05). Overall,71 of 119 patients (59.7%) received at least one unit allogeneic blood transfusion (ABT). However,there were significant differences in perioperative ABT rates (48.1% vs 68.7%, χ2 = 4.77, P < 0.05) and the average amount of blood transfusion between treatment group and control group, which were (1.8 ± 0.4) U/pte vs (3.6 ± 1.1) U/pte (t = 2.244, P < 0.05). Postoperative hemoglobin (Hb) on postoperative days 7 and 30 was higher in treatment group than that in control group. In addition, in treatment group, Hb levels were higher on postoperative day 30 than those on admission, which were (128.2 ± 20.6) g/L vs (118.2 ± 18.9) g/L (t = 2.133, P < 0.05). There were no statistical differences in postoperative complications, the length of hospital stay and mortality within 30 days.

CONCLUSIONFor elderly patients with femoral intertrochanteric fractures undergoing elective surgery, preoperative application of rHuEPO can significantly reduce perioperative transfusion requirements, and is likely to reduce ABT-related infection, but its long-term safety remains to be evaluated.

Aged ; Aged, 80 and over ; Blood Transfusion ; Case-Control Studies ; Erythropoietin ; administration & dosage ; Female ; Femoral Fractures ; blood ; surgery ; therapy ; Fracture Fixation, Internal ; Hemoglobins ; analysis ; Hip Fractures ; blood ; surgery ; therapy ; Humans ; Male ; Preoperative Care ; Retrospective Studies

HSP90, which is the biomarker of cell stress and endogenous protective protein, functions as a molecular chaperone. Many client proteins of HSP90, including EGFR, Met, Raf-1, IKK and p53, play important roles in the occurrence and development of tumor. Binding of HSP90 inhibitors triggers the deactivation of HSP90, resulting in client protein degradation, and hence inhibits the tumor growth by blocking multiple targets involved in signaling of tumor proliferation. This review summarizes recent development of small molecule inhibitors bound to N-terminal of HSP90.
Antineoplastic Agents ; chemistry ; HSP90 Heat-Shock Proteins ; antagonists & inhibitors ; Humans ; Neoplasms ; Signal Transduction

OBJECTIVETo investigate the early clinical efficacy of induced membrane technique for reconstruction of large bone defects after debridement in adults with chronic osteomyelitis of limbs.

METHODSFrom March 2010 to March 2012,a total of 23 adult patients with chronic osteomyelitis of limbs were treated in our department. There were 15 males and 8 females, with a mean age 35.2 years old (ranged from 26 to 49 years old). Sixteen patients had open fracture history. According to the lesion site, there were 12 cases of tibia, 7 cases of femur, 3 cases of humerus, and 1 case of both radius and ulna. Among them, 19 patients had diseases in diaphysis and 4 patients in the metaphysis. The mean interval from infection to operation was 6.9 months (ranged from 4 to 13 months). All the patients were treated by using induced membrane technique. The follow-up evaluation included clinical complications, time of bone healing and limbs function. The Chinese version of SF-36 scores was used in the assessment of quality of life pre- and post-operation.

RESULTSThe average duration of follow-up was (27.6 ± 5.3) months (ranged from 18 to 43 months). Two patients had postoperative flap edge necrosis, 1 patient had superficial iliac incision infection, no obvious complications were recorded. Twenty patients obtained radiological union at a mean time of 4.6 months (ranged from 3 to 7 months). Among them, 16 patients treated with lower limbs surgery achieved full weight-bearing at about 5.2 months (ranged from 4 to 8 months) postoperatively. Four patients suffered from reinfection during follow-up, but 3 of them achieved complete bone healing after the second surgeries with induced membrane technique. At the final follow-up, there was a substantial improvement in each dimension scores and total scores of SF-36 as compared with those before surgery.

CONCLUSIONWhen treating with adult chronic osteomyelitis of limbs, the induced membrane technique can effectively reconstruct large bone defects after debridement, significantly shorten treatment cycle, provide satisfactory results with minimal complications, promote good recovery of limbs function and require relatively simple operation technique.

Adult ; Chronic Disease ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo evaluate the clinical outcome of accessory navicular fusion for treatment of the painful accessory navicular bone of type II in adults.

METHODSFrom June 2006 to June 2012, a total of 38 feet (in 35 adult patients) with painful accessory navicular with type I underwent an fusion operation of the primary and accessory navicular bones,including 26 males and 9 females with a mean age of (32.4±7.3) years old ranging from 18 to 44 years old. The course of disease ranged from 3 to 10 months. The perioperative complications and radiological outcomes were observed and recorded. The foot function before and after operation were assessed by the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score, and the easement of the pain was evaluated by visual analog score (VAS).

RESULTSTwo patients had transient superficial inflammation of the incision, no obvious perioperative complications occurred. All patients were follow-up for (53.5±14.7) months (12 to 84 months). Bone union was confirmed on plain radiography in 32 cases (35 feet). The mean time from the operation to union was (13.7±2.3) weeks (9 to 18 weeks). Postoperative pain VAS score was improved obviosly than preoperative (V=12.14,P< 0.01). The talar-to-first metatarsal angle [(9.4±3.5)° vs (8.3±2.7)°, t=0.736, P>0.05)], calcaneal tilt angle [(17.7±2.2)° vs (18.9±3.4)°, t=0.794, P>0.05],talonavicular uncoverage angle [(14.3±3.4)° vs(12.5?4.6)°,t=0.947, P>0.05) ],and height of the first tarsometatarsal joint [(14.8±3.1) mm vs (15.9±2.8) mm,t=0.814,P>0.05)] before and after operations had no statistic difference. The AOFAS midfoot score was improced from preoperative 45.6±5.3 to postoperative 82.5±7.4 (t=3.214,P< 0.01).

CONCLUSIONFor the painful accessory navicular bone of type II in adults, if the patient has a large navicular bone and not complicated with rigid flatfoot, once the conservative treatment fails, fusion of the primary and accessory naviculars may be a successful intervention. Overall, the procedure provides reliable pain relief, definite foot function improvement, and good patient satisfaction.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Foot Diseases ; physiopathology ; surgery ; Humans ; Male ; Tarsal Bones ; abnormalities ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

Upper urinary tract calculi with infection is a quite difficult acute urologic emergency.And what is more, upper urinary tract obstruction after radical cystectomy following urinary diversion may be fatal in the vulnerable patients with this kind of situation.Postoperative anatomy and other factors affect the upper urinary tract calculi, and urinary tract infection greatly increased the risk.But it is particularly difficult to handle with patients with poor general condition and septic shock treatment, so how to optimize the selection program is worth further studying.A 65-year-old man was admitted to hospital for combining with renal and ureteral calculi after radical cystectomy (Bricker) in March 2017.The patient underwent transurethral resection of bladder tumor in the outer court because of the discovery of bladder tumor one year before, The postoperative pathology was high-grade papillary urothelial carcinoma and he underwent regular irrigation of the bladder.Because of tumor recurrence, he came to Peking University Third Hospital for further treatment in August 2016, and the examination of urinary tract CT indicated bladder can-cer;for bilateral multiple renal pelvis and renal calices calculi, he was given laparoscopic radical cystecto-my.After four months, due to sudden chill fever, he was hospitalized.After definite diagnosis, anti-inflammatory treatment combined with left nephrostomy was given.The two-stage lithotripsy was performed.After expansion of the original left renal fistula to 24 F(1 F=0.33 mm), 24 F sheath was inducted into the kidney.We introduced a flexible ureteroscopy into the channel down to the ureteral obstruction, where we found a 1 cm oval black brown stone obstructed.A guide wire was inducted through the stones down to ileal conduit in the right lower quadrant.Through the ureteroscopy, we made ureteral calculi broken into powder, and replaced the residual stones into the renal pelvis.Then we used the nephroscopy for lithotropsy in the pelvis, and finally we introduced a flexible cystoscopy for the residual stone.The operation was successful, the operation time was 181 min, and intraoperative bleeding was 10 mL.After operation, no residual stones were found in kidney, ureter, bladder (KUB) plain films.No operation complications were related to the urinary tract.Therefore, multiple endoscopy with combination therapy of upper urinary tract calculi following urinary diversion is safe and effective, and the reasonable choice with the advantages of each instrument can improve the stone clearance rate and shorten the operation time.This can be used as a useful complement to traditional treatment.

BACKGROUND: Construction of recombinant adenovirus plasmid plays a central role in preparation of recombinant adenovirus.However, conventionally intracellular homologous recombination method is limited by complex procedures, low successful ratio,and long experimental cycle.OBJECTIVE: To construct the recombinant replication-defective adenovirus vector containing interleukin-10 (Ad.dL-10) in a SD rat, and to provide experimental evidences for eukaryotic expression and animat model studying.DESIGN, TIME AND SEI-FING: Opening study was conducted in the First Affiliated Hospital of Sun Yat-sen University from July 2005 to April 2006.MATERIALS: A SD rat, AdEasy system (USA), ThermoscdptTMRT kit & Tdzol (USA), and HEK-293 (Guangzhou, China) were used in this study. The primer of rlL-10 gene of clone rat was synthesized and sequenced in Shanghai, China.METHODS: rlL-10 gene was cloned from total RNA of healthy SD rat spleen tissue with RT-PCR, and then recombinant adenovirus plasmid named pAd.rlL-10 was obtained by homologous recombination within E.ColiBJ5183 carded with AdEasy-1 system. Last, the recombinant adenovirus was packaged, proliferated by HEK-293 cells and purified.MAIN OUTCOME MEASURES: The Ad.rlL-10 was identified using Western blot and RT-PCR methods.RESULTS: rlL-10 gene was successfully cloned from fresh spleen tissue of a SD rat and incorporated into recombinant adenovirus plasmid pad in order to obtain the Ad.rlL-10. Western blot and RT-PCR showed the rlL-10 gene and protein expressions in the cells. Finally, the rlL-10 recombinant adenovirus was obtained with the titers of 1.0x1014 pfu/mL after amplification and purification.CONCLUSION: AdEasy-1 system characterizing by simple operation and reliable results is commonly used to obtain enough quantity and quality adenovirus after homologous recombination, and HEK-293-induced package, amplification, and purification.

Objective To study the effects of oxymatrine as inhibitor of hemorrhagic fever with renal syndrome virus (HFRSV) infection in vitro and in vivo.Methods In vitro studies,a dose of oxymatrine without cytotoxicity and 76-118 strain of HFRSV was taken to treat Vero cells in three ways:①After treated with oxymatrine for 48 h,Vero cells were attacked by HFRSV at dilution of 10-1 ～ 10-6,respectively for 24 h before changing to maintenance medium; ②Vero cells were first attacked by HFRSV of 10-1 ～ 10-6 dilution respectively,then oxymatrine was used for 48 h before changing to maintenance medium; ③Vero cells were attacked by HFRSV at dilution of 10-1 ～ 10-6 respectively,and meanwhile treated with oxymatrine for 48 h before changing to maintenance mcdium.Each dilution handled four porocytes,and four positive controls were set up at the same time.Indirect immunofluorescence assay (IFA) was performed to determine the inhibitory effect of oxymatrine in experimental group and positive control.In vivo studies,thirty 2-week-old hamsters,weighing about 30-40 g,were divided into experimental and control groups according to body weight,n =15.These aninals were inoculated intraperitoneally with HFRSV in 100TCID50(0.1 ml each); on days 4-13,0.1 ml of oxymatrine 1:100 were given to each hamster in experimental group daily by intraperitoneal injection,while the same amount of saline was given to the control ones.Lung tissue of hamsters was then dissected out to slice to be identified by immunofluorcscence stain.Results It was demonstrated that oxymatrine with the diluted fractions of 1:8 was safe in vitro.When the virus dilution of HFRSV was l0-4,compared with control groups,the differences were statistically significant in method 2 and 3 (z =-2.53,-2.53,all P ＜ 0.05),while no statistical significance in method 1 (z＝5.36,P＞ 0.05).When the virus dilution of HFRSV was 10-1 ～ 10-3,10-5,10-6,the differences were not statistically significant (z--0.00,-0.32,-0.19,4.21,4.21,all P ＞ 0.05).In vivo studies,compared with control group,the differences were statistically significant in experimental group (z =-3.85,P ＜ 0.05).Conclusion Oxymatrine significantly inhibites HFRSV.