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.

OBJECTIVETo study clinical effects of short-segment fixation and injured vertebra bone grafting through injured pedicle for the treatment of thoracolumbar burst fractures under MAST Quadrant retractor via a paraspinal muscle approach.

METHODSThe data of 42 patients with thoracolumbar burst fractures treated from June 2009 to September 2012 were reviewed. There were 19 males and 23 females, with an average age of (55.2±11.9) years old. The mean injury time was (5.8±4.3) days. Fracture segments included T10 in 3 cases, T11 in 6 cases, T12 in 13 cases, L1 in 9 cases, L2 in 7 cases, and L3 in 4 cases. According to Denis classification, 9 patients were type A, 21 patients were type B, 5 patiens were type C, 5 patients were type D, and 2 patients were type E. All the patients were treated with short-segment pedicle screw-rod system fixation under MAST Quadrant via the paraspinal muscle approach. The operative time, blood loss, complications and the height of vertebra, kyphosis Cobb angle, VAS scores, JOA scores were measured before and after treatment.

RESULTSAfter treatment, the vertebral height and kyphosis Cobb angle were restored. Compared with preoperative results, postoperative vertebral height and kyphosis Cobb angle, VAS scores and JOA scores were all improved. But there was no statistically significance in vertebral height, kyphosis Cobb angle between postoperative at 1 week and 1 year.

CONCLUSIONInternal fixation combined with injured vertebra bone grafting through the injured pedicle for the treatment of thoracolumbar burst fractures via the paraspinal intermuscular approach under MAST Quadrant is a safe, minimally invasive, effective and satisfactory method.

Adult ; Aged ; Aged, 80 and over ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

Aged ; Cell Dedifferentiation ; Chondrosarcoma ; pathology ; Humans ; Ribs ; pathology

Animals ; Brain ; drug effects ; metabolism ; Carbon Dioxide ; metabolism ; Chronic Disease ; Curcumin ; pharmacology ; Disease Models, Animal ; Fas Ligand Protein ; metabolism ; Hypoxia ; metabolism ; Male ; Oxygen ; metabolism ; Rats ; Rats, Sprague-Dawley ; fas Receptor ; metabolism

Mechanical loading is the main "instructive" factor of bone formation. The mechanism becomes the heat point in the field of bone science, biomedicine project and rehabilitation research. Mechanical vibration is one of the mechanic stimulation. Evidences show that vibration has obvious anabolic effect, and will have a broad landscape in the treatment of osteoporosis. But in the present studies, there were incorporated with the vibration frequency, and intensity, in particularly, few reports about the mechanism of vibration to bone. It will provide theoretic foundation for further systematic, sound research and its clinical application.
Animals ; Biomechanical Phenomena ; Bone Diseases ; physiopathology ; therapy ; Bone and Bones ; physiology ; physiopathology ; Humans ; Musculoskeletal Manipulations ; Osteogenesis ; Vibration ; therapeutic use

Objective To explore the clinical characteristics of cardiac involvement in children with mitochondriopathies.Methods The clinical data of 23 children with mitochondriopathies were reviewed.The changes of electrocardiography,echocardiography and heart enzymes were analyzed.Results In 15 cases of mitochondrial encephalomyopathy,lactic acidosis,and stroke-like episode(MELAS syndrome),electrocardiography was performed on 9 cases,6 of them showed abnormal electrocardiographic findings,including right bundle branch block,ST-T change,Wolff-Parkinson-White syndrome,et al.On echocardiographic examination in 9 MELAS syndrome ca-ses,only 1 case showed hypertrophy cardiomyopathy.Six cases had increased plasma creatine kinaseMB(CK-MB) mass and only one of 12 MELAS syndrome cases had increased cardiac troponin I(cTnI) level.In 8 cases of subacute necrotizing encephalomyopathy(Leigh syndrome),electrocardiography was performed on 5 cases,4 of them showed abnormal electrocardiographic findings,including sinus tachycardia,ST-T change and low voltage.Two cases showed normal electrocardiography.Three out of 6 cases with Leigh syndrome showed increased plasma CK-MB mass.The molecular genetic examinations were performed in 13 cases of MELAS syndrome and 6 cases of Leigh syndrome.The mitochondrial DNA nt 3243 A→G mutation was found in white blood cells of 9 MELAS syndrome cases,the mutation rate being 37%-60%.The mitochondrial DNA nt 8993 T→C mutation was found in white blood cells of 2 Leigh syndrome cases.Conclusion In children with mitochondriopathies,myocardiac involvement is comparatively common,and even cardiomyopathy can occur.

Background People recently realized that it is important for artificial vascular biodegradable graft to bionically mimic the functions of the native vessel.In order to overcome the high risk of thrombosis and keep the patency in the clinical small-diameter vascular graft (SDVG) transplantation,a double-layer bionic scaffold,which can offer anticoagulation and mechanical strength simultaneously,was designed and fabricated via electrospinning technique.Methods Heparin-conjugated polycaprolactone (hPCL) and polyurethane (PU)-collagen type Ⅰ composite was used as the inner and outer layers,respectively.The porosity and the burst pressure of SDVG were evaluated.Its biocompatibility was demonstrated by the 3-(4,5-dimethyl-2-thiazol)-2,5-diphenyl-2H tetrazolium bromide (MTT) test in vitro and subcutaneous implants in vivo respectively.The grafts of diameter 2.5 mm and length 4.0 cm were implanted to replace the femoral artery in Beagle dog model.Then,angiography was performed in the Beagle dogs to investigate the patency and aneurysm of grafts at 2,4,and 8 weeks post-transplantation.After angiography,the patent grafts were explanted for histological analysis.Results The double-layer bionic SDVG meet the clinical mechanical demand.Its good biocompatibility was proven by cytotoxicity experiment (the cell's relative growth rates (RGR) of PU-collagen outer layer were 102.8％,109.2％ and 103.5％,while the RGR of hPCL inner layer were 99.0％,100.0％ and 98.0％,on days 1,3,and 5,respectively) and the subdermal implants experiment in the Beagle dog.Arteriography showed that all the implanted SDVGs were patent without any aneurismal dilatation or obvious anastomotic stenosis at the 2nd,4th,and 8th week after the operation,except one SDVG that failed at the 2nd week.Histological analysis and SEM showed that the inner layer was covered by new endothelial-like cells.Conclusion The double-layer bionic SDVG is a promising candidate as a replacement of native small-diameter vascular graft.

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP).Methods MR imaging was performed in 12 patients with AIP proved histopathologically or clinically,of them CT was scanned in 10 patients and endoscopic retrograde cholangiopancreatography (ERCP)in 3.All imaging data were reviewed retrospectively.Results All 12 patients had enlargement of the pancreas either diffusely(n=9)or focally(n=3).The swollen pancreas was hypointense on T_1-weighted images and mildly hyperintense on T_2-weighted images.It also demonstrated decreased enhancement on artery phase of dynamic imaging and moderate enhancement on delayed phase images. Capsule-like enhanced rim was found around the swollen pancreas in 11 patients.Stricture of the distal common bile duct was found in 9 patients,and ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 3 cases.At follow-up,pancreatic abnormalities and common bile duct stricture resolved after steroid therapy in 7 patients.Conclusion AIP showed some characteristic imaging findings,and imaging examinations will play an important role in the diagnosis of AIP.

ncreatic enlargement, MRI is comparable to CT.

OBJECTIVETo evaluate the effect of dietary intervention on lipidemia in school-aged children.

METHODSThe levels of serum lipids profile were detected in 316 school children aged 7 - 11, from those the subjects of dietary intervention were selected by total cholesterol level above 4.26 mmol/L or low density lipoprotein cholesterol level above 2.23 mmol/L. The subjects were randomly divided into intervention group (120) and control group (40). Children in intervention group were fed with low-cholesterol and low-saturated fatty acid diet, and the control group with normal diet. The duration of intervention was three months. Before and after the intervention, the food intakes, health-related questionnaire and physical examination (height, weight, skinfolds thickness and so on) in the two groups were studied.

RESULTSCompared with the control group, serum cholesterol levels of children under intervention were not significantly changed (TC: 4.64 vs 4.68 mmol/L, P > 0.05; LDL-C: 2.66 vs 2.62 mmol/L, P > 0.05), but the apoA(1) level increased from 1,378.4 mg/L to 1,441.3 mg/L (P < 0.05). There were no changes for any serum lipids indexes in the control group while the dietary intakes of energy, cholesterol and SFA decreased markedly in the intervention group, with the percent of energy from fat decreased from 40.7% to 31.2% and SFA below to 10% (7.7%). Along with the increase of the scores of knowledge on health among children under intervention, the living and eating habit improved (the total scores increased from 24.6 to 27.4, P < 0.05). The increase of height was not significantly different between the two groups.

CONCLUSIONWith the family-based high-risk intervention strategy on the dietary adjustment, the knowledge on health, living and eating habit could be effectively improved in children with lipidemia. However, further research about the intervention effect on the serum cholesterol levels by strengthening the interventional degree, needs to be further studied.

Child ; Cholesterol ; blood ; Family ; Feeding Behavior ; Humans ; Hyperlipidemias ; blood ; diet therapy