BACKGROUND: Tendon derived stem cells exist in the tendon and have unique functions for tendon repair. Different cytokines have different effects on the proliferation and differentiation of tendon derived stem cells. Platelet-rich plasma refers to the blood product obtained from the whole blood through gradient centrifugation and stratification, which contains a variety of cytokines that could help to promote the regeneration of ligaments and tendons. OBJECTIVE: To investigate the latest progress of effects of cytokines and platelet-rich plasma on proliferation and differentiation of tendon derived stem cells. METHODS: Using “tendon derived stem cells, tendon stem/progenitor cells, tendon stem cell, platelet-rich plasma, ligament injury” as keywords in English and “tendon derived stem cells, platelet-rich plasma, ligament injury” in Chinese, the first author searched PubMed, CNKI, and Wanfang for relevant articles published from 2007 to 2019. Literature unrelated to the purpose of the study and repetitive literature were excluded, and 83 articles that meet the criteria were included for review. RESULTS AND CONCLUSION: Tendon derived stem cells are ideal cells for the treatment of tendon injury in cell transplantation. Its proliferation and differentiation are influenced by cytokines. Platelet-rich plasma contains a large number of cytokines, which can stimulate the proliferation and differentiation of tendon derived stem cells and have the potential to become a carrier of cell transplantation. Exploring the relationship between cytokines and proliferation and differentiation of tendon stem cells will provide a new approach for the clinical application of tendon derived stem cells.

ObjectiveTo investigate the effects of aconitine, mesaconitine and hypaconitine on calcium release in isolated adult rat cardiac myocytes.MethodsThe left ventricular cardiac myocytes isolated from adult Sprague-Dawley rats were perfused withacnitine, mesaconitine and hypaconitine at 0.3 μmol/L, 1μmol/L, 3 μmol/L for 12 min. The spontaneous calcium release (SCR) rate, the end-diastolic[Ca2+](F0) and the calcium transient amplitude (ΔF) were detected 4 min, 8 min and 12 min after the perfusion. 12 min after the perfusion with acnitine, mesaconitine and hypaconitine at 0.3 μmol/L, the changes of systolic dynamics and calcium transient were detected for the positive inotropic effect. Results Any of aconitine, mesaconitine and hypaconitine induced SCR, mesconitine-induced SCR rate was highest at low concentration (0.3 μmol/L), and aconitine-induced SCR rate highest at high concentration (3 μmol/L). Compared with the control, 12 min after the perfusion with acnitine, mesaconitine and hypaconitine at 3 μmol/L elevated F0 (1.459 ± 0.379, 1.585 ± 0.493, 1.213 ± 0.254vs.1.079 ± 0.108, allP<0.05) and ΔF(1.615 ± 0.455, 2.210 ± 0.756, 1.528 ± 0.422vs. 1.036 ± 0.125, allP<0.05), mesaconitine with ΔF higher than aconitine and hypaconitine. At low concentration (0.3 μmol/L), compared with control, aconitine, mesaconitine and hypaconitine increased ΔF (0.409 ± 0.127, 0.423 ± 0.107, 0.414 ± 0.118vs.0.260 ± 0.065;P<0.05 orP<0.01) and contraction amplitudes (5.464% ± 2.239%, 7.449% ± 2.548%, 5.524% ± 1.645%vs.3.428% ± 0.911%;P<0.05 orP<0.01), prolonged the time to peak of calcium transient (0.041 ± 0.016 s, 0.039 ± 0.009 s, 0.038 ± 0.011 svs.0.032 ± 0.007 s;P<0.05 or P<0.01); compared with aconitine, mesaconitine and hypaconitine decreased calcium transient time constant (0.301 ± 0.054 s, 0.324 ± 0.064 svs.0.361 ± 0.076 s;P<0.05 orP<0.01) and diastolic t50 (0.124 ± 0.035 s, 0.126 ± 0.040 svs.0.157 ± 0.056 s;P<0.05 orP<0.01).ConclusionsAconitine, mesaconitine and hypaconitine reveal the positive inotropic effects couple with the toxic effects. Increased[Ca2+]in cardiac myocytes is the key factor for the positive inotropic effects, but also the risk factor for SCR.

Objective To compare the safety and feasibility of thoracoscopic extrapleural Nuss procedure with traditional intrapleural Nuss procedure. Methods Total 252 patients with pectus excavatum received Nuss surgery from July 2008 to June 2009 in Beijing children' s hospital. Patients had following condition were excluded; (1) recurrent pectus excavatum; (2) complicated with other diseases, and need simultaneous surgery; (3) older than 13-year-old; (4) extensive depression, and need two Nuss bar; or (5) extreme severe or severe unsymmetric. 131 cases were selected in our study and they were randomly divided into two groups, thoracoscopic extrapleural Nuss procedure ( n = 62 ) and traditional intrapleural Nuss procedure ( n =69). Perioperative information, postoperative complications, effectiveness and the location of the Nuss bar were compared between two groups. Results All the 131 patients had completed the procedure successfully. There were no significant differences in age, Haller index; surgical effects, operation time, blood loss, and hospital stay, between two groups. Postoperative complications between the two groups are not significant. 131 patients were followed up from 14 to 26 months, and no recurrence and long-term complications occurred. About more than half cases of extrapleural Nuss procedure group were break the pleural into thoracic cavity. Conclusion Both extrapleural and intrapleural Nuss procedure are safe and effective for pectus excavatum, but extrapleural Nuss procedure have no advantage to the intrapleural Nuss procedure, also it' s hard to observe the other side of thoracic cavity during the surgery, and not easy to grasp and to promote.

Objective To verify the safety of non-thoracoscopic Nuss procedure,and review our experience in correction of pectus excavatum by Nuss procedure with post-implantation thoracoscopic assistance.Methods 191 patients with pectus excavatum were surgically corrected by Nuss procedure with post-implantation thoracoscopic assistance.There were 146 boys and 45 girls,The age ranged from 2.8 to 20 years with mean age was ( 6.46 ± 3.36) years.Hailer' s index was 4.68 ± 1.84.The operation was performed under Non-thoracoscopic assistance first and then with thoracoscopic observation.Results The operation in all patients had been performed successfully.The time of the operation ranged from 27 to 50 minutes with mean time was ( 32.49 ± 2.79) minutes.The average bleeding volume during procedure was ( 2.19 ± 0.87 ) ml.The durstion of follow-up was 10 to 23 months.All patients have been satisfied with their surgical correction.The postoperative complication was 13 cases( 6.81％ ).The bar outsides the pleura in both sides was 18 cases( 9.42％ ).The bar outsides the right pleura was 23cases( 12.0％ ).The bar outsides the left pleura was 17 cases( 8.90％ ).Conclusion Nuss procedure with non-thoracoscopic assistance for correction of poctus excavatum is safety if the surgeon experienced and have certain methods.Post-implantation thoracoscopic Nuss procedure is safer,and can deal with the damage caused by non-thoracoscopic assistance.

Objective To summarize the experience of diagnosis and treatment of pectus excavatum associated with congenital pulmonary disease in children.Methods The data of 91 patients with pectus excavatum associated with congenital pulmonary disease was collected from July 2002 to August 2010 in Beijing Children's Hospital.There were 64 males and 27 females.30 patients with pectus excavatum associated with congenital pulmonary cyst,congenital cystic adenomatoid malformation,pulmonary sequestration,and some severe cases of congenital lobar emphysema received the Nuss surgery and lobectomy simultaneously.Results 30 cases with pectus excavatum asseeiated with congenital pulmonary disease received simultaneous Nuss procedure and lobectomy.All cases were confirmed by pathology and recovered uneventfully.Conclusion Chest CT scan is an effective way to evaluate pectus excavatum associated with pulmonary diseases.Whether surgery is needed for the pulmonary disease depend on the specific types of disease,age and other various factors.Simultaneous surgery for pectus excavatum and pulmonary disease can lower the risk of the multiple operations,and reduce the financial burden of famihes.

Objective To access the development of thoracic volume of pectus excavatum use of Nuss operation used CT-basedpulmonary volumetric evaluation.Methods 98 patients with pectus excavatum in Beijing Children's Hospital under Nuss operation were documented.All patients had CT scan pre-and postopration.The CT-scan's data were calculated as lung's volume by handdraw-layers summation method.The lung's volume result was compared,and enquiry the position in CT lung volume developmental scale.Results The lung's volume was elevated 28.3％ after operation.The development of thoracic volume was keep with age,70％ was maintained and 15％ was elevated.Conclusion Nuss operation can prevent the decrease of thoracic volume in pectus excavatum.

Purpose: Central lymph node metastasis (CNM) are highly prevalent but hard to detect preoperatively in papillary thyroid carcinoma (PTC) patients, while the significance of prophylactic compartment central lymph node dissection (CLND) remains controversial as a treatment option. We aim to establish a nomogram assessing risks of CNM in PTC patients, and explore whether prophylactic CLND should be recommended. Materials and Methods: One thousand four hundred thirty-eight patients from two clinical centers that underwent thyroidectomy with CLND for PTC within the period 2016–2019 were retrospectively analyzed. Univariate and multivariate analysis were performed to examine risk factors associated with CNM. A nomogram for predicting CNM was established, thereafter internally and externally validated. Results: Seven variables were found to be significantly associated with CNM and were used to construct the model. These were as follows: thyroid capsular invasion, multifocality, creatinine > 70 μmol/L, age < 40, tumor size > 1 cm, body mass index < 22, and carcinoembryonic antigen > 1 ng/mL. The nomogram had good discrimination with a concordance index of 0.854 (95% confidence interval [CI], 0.843 to 0.867), supported by an external validation point estimate of 0.825 (95% CI, 0.793 to 0.857). A decision curve analysis was made to evaluate nomogram and ultrasonography for predicting CNM. Conclusion A validated nomogram utilizing readily available preoperative variables was developed to predict the probability of central lymph node metastases in patients presenting with PTC. This nomogram may help surgeons make appropriate surgical decisions in the management of PTC, especially in terms of whether prophylactic CLND is warranted.

OBJECTIVE: To study the correlation between dosage and curative effect of blood coagulation factor VIII in the prevention and treatment of haemophilia A in children and to determine the suitable dose for prevention of hemophilia in developing countries. METHODS: For different body weights of child patient, every time we used the same dosage of blood coagulation factor VIII (250 U each time, 3 times a week) and observed and recorded the number of hemorrhages in child patients. Then we compared the number of hemorrhages with children without treatment to determine the curative effect. According to the different body weights, we calculated the dosage of VIII factor of blood coagulation per kilogram (hereinafter referred to as the dose), and used Spearman correlation coefficient to study the correlation between dose and curative effect. RESULTS: The number of hemorrhages in 58 child patients before the treatment was 4.36 ± 1.78, while after the treatment was 2.22 ± 1.04 (t=7.91, P<0.001). The Spearman correlation coefficient of child patients of 5-10 U/kg was -0.421 (P=0.005); the Spearman correlation coefficient of child patients of 10-15 U/kg was -0.331 (P=0.030); the Spearman correlation coefficient of child patients over 15 U/kg was -0.16 (P=0.325). CONCLUSION Prevention and treatment can significantly reduce the times of hemorrhage in hemophilia patients.
Blood Coagulation ; Child ; Factor VIII ; administration & dosage ; therapeutic use ; Hemophilia A ; therapy ; Hemorrhage ; prevention & control ; Humans

Objective The purpose of the study is introducing the concept and classification of congenital pulmonary airway malformation(CPAM),and summarizing the clinical features,imaging,pathological features and treatment methods of congenital pulmonary airway malformation.Methods 283 cases were retrospectively analyzed from April 2012 to November 2017,which were treated by thoracic surgery,pathological diagnosis were isolated congenital pulmonary airway abnormalities except combination of other deformity surgery at the same time.we analyze the clinical data,surgical methods,operation and postoperative pathology classification.Results All the 283 cases were successfully performed without severe surgical complications and secondary thoracotomy.There were 167 males and 116 females,male∶ female =1.44∶1;Age:0.77-166 months,median age 20.67 months;The operation time was 25-220 min,median time was 75min,and the bleeding volume was 1-250 ml,and the median blood volume was 5 ml.Among them,80 patients underwent thoracotomy,203 cases of thoracoscopic surgery,19 cases were transferred.Postoperative pathology 57 cases of type 1,194 cases of type 2,5 cases of type 3,9 cases of type 4.Conclusion CCAM has been renamed as congenital pulmonary airway malformation (CPAM) and has been reclassified.CPAM can be detected by imaging examination,and the diagnosis is based on histopathological examination,and the prognosis is better after the complete surgical resection of lung lesions.Thoracoscopic minimally invasive surgery could make less surgical trauma,small and beautiful wound,which is suggested to be promoted widely.

Objective To explore the establishment of 3D thoracic model by finite element methods,and study the mechanical mechanism of minimally invasive surgery for correcting the chest wall deformity,and provide personalized surgery solution in the future.Methods According to admission and exclusion criteria,we selected 10 cases of pectus carinatum that received chest CT scan.The finite element model of pectus carinatum was established and analyzed by Mimics,ABAQUS,etc.The validity of finite element method for chest wall was verified by comparing the sternal displacement between the simulated values and actual values with the same force.Results The 3D finite element model of pectus carinatum was successfully established and analyzed.The stress distribution of the 10 cases in the posterior ribs was mainly in the 1-6 ribs on both sides,mostly concentrated in the 4th to 6th ribs,and the stress was symmetrical on both sides.Statistical analysis showed that the displacement value of the sternum was correlated,and the validity of the model was verified.Conclusion Mimics,ABAQUS and other finite element modeling and analysis software can effectively establish the thoracic 3D finite element model and mechanical analysis,which can help the further development of personalized minimally invasive surgery for correcting chest wall deformities.