AIM: To discuss the clinical efficacy of fresh amniotic membrane ( AM ) during the microscopic adjustable suture surgery in children's intercommunity strabismus, in order to guide clinical treatment.
METHODS: With the clinical randomized control study (RCT), 60 (112 eyes) cases of patients in childhood who received microscopic strabismus surgery in our hospital were divided them into two different groups from Jan. 2010 to Oct. 2015. According to the application of AM on the basis of ophthalmology outpatient number, 30 cases (58 eyes) in group A were treated with rectus muscle recession surgery combined adjustable suture combined with AM. The other 30 cases (54 eyes) in group B were treated with rectus muscle recession surgery combined adjustable suture only. All patients in two groups were followed-up over 6mo after the strabismus surgery.
RESULTS:Twenty-seven cases ( 48 eyes ) of all the strabismus patients must be adjusted after strabismus surgery, and the eye position adjustment rate was 42.9%. At 1mo after surgery, eye position of 18 cases (29 eyes) can be adjusted in all patients, and 44. 8% (16 cases, 26 eyes ) in group A with the average of adjustment lengths was 2. 56±0. 64mm, and 5. 6% ( 2 cases, 3 eyes ) in group B, with the average of adjustment lengths was 0. 52±0. 28mm, the differences of the adjustment rate and the average of adjustment amount were both high statistically significant (χ2 =22.477, P<0. 01; t=16. 502, P<0. 01 ) between the two groups. Except of 3 cases who couldn't cooperate with eye position adjustment, they all received eye position adjustment in different degrees in one month after strabismus surgery,and after eye position adjustment, 27 cases (53 eyes) in group A got normal eye position, and the correction rate of eye position was 91. 4%, and 16 cases (28 eyes) in group B got normal eye position after eye position adjustment, the correction rate was 51. 9%, the differences of the correction rate were statistically significant (χ2=21. 827, P<0. 01) between the two groups.
CONCLUSION: The application of fresh AM in the microscopic adjustable suture strabismus surgery is exactly effective in treatment of children's intercommunity strabismus. It can significantly extend the adjustment time and increase the adjustment amount, and it also can statistically improve the controllability and achievement ratio for children's strabismus surgery.

Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.

Objective To explore, the effect of different dosage of pulmonary surfactant (PS) on the inci-dence of bronchopulmanary dysplasia. Method Four hundred and three premature infants with hyaline membrane disease were divided into 3 groups according to the dose of PS: low-dose group (L-PS group, ≤ 100 mg/kg, n =188) ,high-dose group(H-PS group, > 100 mg/kg, n = 94) and no-PS group (N-PS group, n = 121). The frac-tional inspired oxygen(FiO2) and ptlmonary oxygenating function before and after 6 hours treatment were observed and the durations of oxygen therapy and mechanical ventilation, frequency of repeated intubafion, length of hospi-talization and the incidence of BPD were compared among the three groups. Results After 6 hours PS administra-tion, the FiO2,oxygen index and duration of oxygen therapy and mechanical ventilation were significantly decreased (P <0.05), while PO2 and the arterio-alveolar partial pressure of oxygen were significantly increased (P <0.05)in the H-PS and L-PS groups, compared with the N-PS group. Compared with the L-PS and N-PS groups,the H-PS group showed a decreased incidence of BPD. Conclusions PS administration could improve the pul-monary oxygenation and prevent the development of BPD, especially in high-dose.

Objective To explore the predictive value of microvessel density(MVD)and blood vessel invasion(BVI)in hepatic metastasis from early-stage rectal cancer.Methods MVD and BVI in the tumor tissue from 380 patients with stage I and II rectal cancer was determined by immunohistochemical S-P method with anti-CDIOS antibody and anti-CD34 antibody,respectively.Multinomial logistic regression was performed to analyze the predictive value of MVD and BVI in hepatic metastasis from early-stage rectal cancer.Results CD105 was expressed in newborn blood vessels,not in normal blood veseels.in the rectal cancer tissue.MVD was correlated with histological type and infiltration depth(P＜0.05).Besides histological type and infiltration depth,BVI was also correlated with histological grade.Multivariate analysis revealed that histological type,tumor infiltration depth,BVI,adjuvant therapy,and MDV were independent predictors of hepatic metastasis from rectal cancer.The risk of hepatic metastasis in patients with postive expression of either MVD or BVI or both were significant higher than that in patients with low expression of MVD and those without BVI expression[hazard ratio(95%CI),4.210(2.182-11.214)].Conclusion BVI and MVD are independent predictors of hepatic metastasis from stage I and II rectal cancer.Combined detection of MVD and BVI may help to predict the clinical outcome of patients with early-stage rectal cancer.

BACKGROUND: Treatment of orthopedics diseases is largely based on reconstruction to restore the normal structure of the human motor system. However, the human body's ability to repair cannot meet clinical requirements for the treatment of some diseases. In order to solve the problem of tissue regeneration in life science, stem cell therapy has emerged in recent years. OBJECTIVE: To summarize the research progress of stem cells in orthopedics diseases. METHODS: A computer-based search of CNKI, WanFang and PubMed databases was performed for relevant articles concerning stem cell therapy for orthopedics diseases published from 2000 to 2017. Representative and innovative results were analyzed in result analysis. RESULTS AND CONCLUSION: Studies have shown that stem cells have advantages in the treatment of diseases involving the bone, cartilage, spinal cord injury, tendon and ligament injury, and degenerative disc disease. However, further investigations with large sample, long-term follow-up and higher evidence level are warranted. Meanwhile, a good understanding of the natural course of diseases is essential to better utilize stem cell therapy in clinical practice. Combination of stem cell therapy with traditional surgery can achieve better outcomes in patients.

BACKGROUND:The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are stil controversial. OBJECTIVE:To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement. METHODS:Total y 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees). RESULTS AND CONCLUSION:There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P>0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P<0.05). During fol ow-up at 1 year after replacement, no significant differences in range of motion, muscle strength of quadriceps and hospital for special surgery knee score were detected in patients of both groups (P>0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P<0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty.

Objective Negative pressure aspirator clogging ( OSAC) frequently occurs in orthopedic surgery .This study was to investigate the frequency , location , and mechanisms of OSAC in China by analysis of the current status and clinical observation of OSAC so as to provide evidence for the solution of the problem . Methods Using the two-stage random sampling method , we conduc-ted a questionnaire survey on OSAC among 738 clinical orthopedists during the 16th and 17th Chinese Orthopedic Association Confer-ences.Totally, 160 out 1200 orthopedic surgeries were randomly selected in the time order of operation , including 38 cases of total hip arthroplasty ( THA) , 39 cases of total knee arthroplasty ( TKA) , 43 cases of extremity and spinal fractures surgery , and 40 cases of other orthopedic surgeries .We also obtained the satisfaction scores with the existing aspirators from related medical professionals . Results Among the 738 respondents included into the analysis , 706 (95.7%) thought that OSAC often occurred during surgery , 631 (85.5%) considered THA to be the leading cause of OSAC , and 714 (96.7%) regarded the tip and hose joint of the aspirator as the common causes . The mean satisfaction score with the existing aspirators was 7.62 ±0.74.Clinical observation showed the mean frequency of OSAC to be 2.55 ±1.62 in THA, 1.95 ±1.33 in TKA, 1.52 ±1.18 in extremity and spinal fracture surgeries , and 0.95 ± 0.68 in other orthopedic surgeries , and the satisfaction score to be 7.36 ±0.84. Conclusion OSAC has a high incidence rate during orthopedic surgeries in China , thus affecting orthopedic surgery and reducing orthopedists'satisfaction with the aspirators . The current negative pressure aspirator system demands prompt improvement .

Based on the different permeability of DNA-intercalant dyes YO-PRO-1(YP) and propidium iodide (PI) to the membrane of viable, apoptotic and necrotic cells, cell samples were stained with 4?mol/L YP and 4?g/ml PI for 10 min, and the fluorescence intensity of both YP and PI were measured by fluorometer at Ex/Em wavelength of 485/538nm and 530/590nm, respectively. The correlation between YP fluorescence intensity and the apoptotic cell number was confirmed by fluorescence microscope and linear regression(r=0.999,P

The synthetic gene with 1640bp encoding for the anti-CD3/anti-CD20 bispecific single-chain antibody was designed and obtained by SOE (splicing by overlap extension) PCR. The cDNA was cloned into Flp-In expression vector pcDNA5/FRT and transfeced into Flp-In CHO cells to generate a stable expression cell line with a capacity for expressing anti-CD3/anti-CD20 bispecific single-chain antibody at 300 microg/L. The protein, which had a molecular weight of about 70 kD,was purified by Ni-NTA affinity chromatography and identified by SDS-PAGE and Western-blot analysis. Immunofluorescence assay and cellular rosetting showed that it can react specifically on Jurkat (CD3+) and Ramous (CD20+) cells. The lysis of human PBL against CD20-positive lymphoma Ramous cells in the presence of the anti-CD3/anti-CD20 bispecific single-chain antibody can observed by microscope. All these results would lighten the further study of its biological functions in vitro and in vivo.
Animals ; Antibodies, Bispecific ; biosynthesis ; genetics ; immunology ; Antibodies, Monoclonal ; immunology ; Antigens, CD20 ; immunology ; CD3 Complex ; immunology ; CHO Cells ; Cricetinae ; Cricetulus ; Humans ; Immunoglobulin Variable Region ; biosynthesis ; genetics ; immunology ; Lymphoma, B-Cell ; metabolism ; Recombinant Proteins ; Transfection ; Tumor Cells, Cultured

BACKGROUND:Autologous tissue-engineered bone marrow mesenchymal stem cel s (BMSCs) transplantation is one of the most common methods of treating early osteonecrosis of femoral head, but now there is stil no any special-purpose grafter available in the market. Such surgical transplantation is a laborious, time-consuming and tedious process, which goes against its clinical promotion. OBJECTIVE:To develop a supporting, efficient, special-purpose grafter, to solve the difficulty in stem cel s transplantation during core decompression of femoral head. METHODS:CAD software was used to perform solid modeling for this special-purpose grafter and print them by three-dimensional (3D) fast printing technology. The performance of this special-purpose grafter was tested by femoral head core decompression combined with BMSCs transplantation. It was compared with traditional surgical instrument in terms of duration of operation, intraoperative blood loss, visual analogue scale (VAS) of stem cel/biological fiber col agen complex omission amount and doctor’s satisfaction score. RESULTS AND CONCLUSION:(1) A kind of special-purpose grafter was developed by 3D printing technology rapidly. (2) Compared with the control group, duration of operation, intraoperative blood loss, VAS scores and doctor’s satisfaction scores were significantly improved in the trial group (P<0.05). (3) CAD software combined with 3D printing technology is a highly efficient means for front-line clinicians to perform independent development. The research and development of this special-purpose grafter provides a perfect solution to the laborious, time-consuming and tedious process of cel/biological col agen fiber transplantation.