Building civilized environment is not only the inevitable hequirement of obeying the law of natrue and society and stick to scientific development orientation, but also the inevitable choice to give a impetus to the career of public health and national health care and finally realize the goal of a harmonious society.

Objective To study the therapeutic effect of percutaneous transluminial angiography (PTA) and expandable metal stent (EMS) on the treatment of Budd Chiari syndrome(BCS). Methods One hundred and twenty patients with BCS confirmed by color Doppler ultrasonography, inferior vena cava venography and hepatic veins venography. All the 120 patients underwent PTA and EMS. All the 120 patients were followed up for 6 to 108 months. Results The treatment results in 115 patients(95.8%) were satisfactory,and 5 cases had recurrent during follow up . Conclusions PTA with EMS is an excellent method to treat the cases of BCS with non long segment occlusion of IVC.

Objective To investigate the effects of CHIR99021 and Wnt3a, Wnt/β-catenin signaling pathway acti-vators, on cardiac differentiation of mouse embryonic stem cells ( mESCs ) . Methods The embryonic bodies ( EBs) were formed through suspension culture method, CHIR99021 or Wnt3a was added into differentiated medi-um from day 2 to 5, named CHIR99021 group or Wnt3a group, respectively. In addition, there was a control group in which EBs were automatically differentiated. The expression levels of Brachyury, the mesoderm specific target gene, and Nkx2. 5, cardiac-precursor marker, as well as the transcripts of cardiomyocyte markers,α-myosin heavychain (α-MHC ) , cardiac troponin T ( cTnT ) and connexin-43 ( Cx43 ) were analyzed through quantitative RT-PCR. Besides, the cardiac-specific proteins including α-MHC, cTNT and CX43 were detected by immunofluores-cence and Western blot. Results The mESCs in every group did differentiate into cardiomyocytes. The expression of Brachyury was substantially augmented by treatment with CHIR99021 and Wnt3a, showing a peak of expression at day 7. Similarly, CHIR99021 and Wnt3a dramatically increased the expression levels of Nkx2. 5,α-MHC, cT-nT and Cx43 with the time of differentiation, with the expression of target genes in CHIR99021 group and Wnt3a group was greater than that in the control group and CHIR99021 group was higher than Wnt3 a group at day 15 ( P<0. 05, P < 0. 01 ). Western blot analysis suggested that the expressions of α-MHC, cTNT and CX43 in CHIR99021 group and Wnt3a group were greater than those in the control group, and CHIR99021 group was higher than Wnt3 a group at day 15 . Conclusion Both CHIR99021 and Wnt3 a could improve cardiogenesis from mESCs through activate Wnt/β-catenin signaling pathway at the early stage of differentiation while the former is better than the latter.

Objective To investigate the blood supply of the expanded skin flap from medial up-per arm and its application in the reparation of cervical scar contracture due to sear resection. Methods The operation was carried out for three steps: (1) The expander was implanted under the superficial fascia. (2) The skin flap from medial upper arm was created with superior ulnar collateral artery as blood supply and attributive branches of basilica and axillary veins as blood collection. (3) After thes car contracture was released, the defect was covered with medial upper arm flap with maximal area of 25 cm×15 cm. Results Ten patients in all with cervical scar contracture were treated with the skin flap. All the skin flaps survived at last with nearly normal skin color, texture and contour. And the scar in donor sites seemed to be neglectable. Conclusions Reparation of cervical scar contracture with medial upper arm skin flap after expanding could be recommended. But 3 months long time and fixation of upper limb and head might be disadvantages.

Objective To introduce an efficient way to orientate S1 iliosacral screw guide-pin verified by CT.Methods The pelvic axial CT data in DICOM format of 180 adults between July 2017 and June 2018 were retrieved from the database of Imaging Center,Luoyang Orthopaedic Hospital of Henan Province.The data were input into the software Mimics 20.0 to display the axial,coronal and sagittal sectional views of the pelvis.On the axial CT sectional view displaying the largest osseous pathway in the S1 segment,a virtual iliosacral screw and its virtual guide-pin were accurately placed into the sacral body in an oblique fashion.In the design of ideal insertion,the virtual screw and guide-pin were truly in the pelvic transverse plane when they were located exactly in the pelvic axial CT sectional view,and they intersected the outer iliac table at the start-point which restricted the guide-pin's location,and angulated with the pelvic coronal plane (represented by a line connecting the most dorsal points of bilateral ilia) at an angle (α) which limited the guide-pin's orientation.After three-dimensional pelvic models of the standard lateral sacral view and the pelvic outlet and inlet views in each patient were calculated,they were displayed in a transparent manner using the software,followed by the virtual insertion of the screw and guide-pin.After the start-point was established on the standard lateral sacral view,the guide-pin was orientated into the pelvic transverse plane and at the guide-pin's α angle relative to the pelvic coronal plane,and subsequently inserted into the ilium shallowly for stabilization.The pelvic outlet and inlet views were taken to judge the guide-pin's orientation.If fine orientation was verified,the guide-pin was advanced to its final position,followed by virtual insertion of an iliosacral screw over the guide-pin.After the virtual insertion was completed,the axial,coronal and sagittal CT sectional views of the pelvis were scrutinized to evaluate the accuracy of insertion.Results After all the guide-pins were orientated in the 180 adults (360 sides) on the true sacral lateral view according to the above way,their orientations on the pelvic outlet and inlet views were 100％ fine,leaving further adjustment unnecessary.The intraosseous insertions of the virtual screws and guide-pins were 100％ accurate and safe on the CT sectional images.Conclusion The way introduced here can theoretically guarantee accurate orientations of the guide-pin on the pelvic outlet and inlet views with no more complex guide-pin adjustments,assuring insertion accuracy and enhancing surgical efficiency.