Objective To investigate the expression of vascular endothial growth faetor(VEGF) proliferating cell nudear antigen(PCNA) and their biological significance was studied in papillary thyroid carcinoma and normal thyroid tissues. Methods Immuohistochemismy S-P technique was used to examine the expression of VEGF and PCNA in specimens of 58 papillary thyroid carcinoma and 19 normal thyroid tissues. Results The positive rates of VEGF and PCNA in papillary thyroid were higher than those in normal thyroid tissues( P＜0.01 ), and a positive correlation between these two expressions existed in papillary thyroid carcinoma. Conclusion VEGF and PCNA could be regarded as parameters to evaluate the biological behavior and they might be the indices for juvant diagnosis and evaluation of papillary thyroid cancer.

BACKGROUND: Cervical lymph nodes are draining region of cornea. It is believed that aqueous fluid goes through a minor pathway named uveoscleral drainage, which will allow passage of antigen-presenting cells (APC) directly to the draining lymph nodes and induce allograft rejection after keratoplasty.OBJECTIVE: To explore the inhibitory effects of cervical lymphadenectomy in alkali induced high-risk corneal transplantation.DESIGN: A randomized controlled animal experiment.SETTING: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University.MATERIALS: The experiment was performed in the State Key Laboratory of Ophthalmology (No. 2006DA105054), Zhongshan Ophthalmic Center, Sun Yat-sen University from May 2005 to February 2007. 144 male animals (1-2 months old) including 104 SD rats and 40 Wistar rats were provided by the animal experimental center of Sun Yat-sen University. Sandwich enzyme-linked immunosorbent assay (ELISA) kits for interleukin-2 (IL-2) and interferon-γ (IFN-γ) were brought from BioSource International company (USA). The animal treatment in the experiment was accorded with the statement in Association for Research in Vision and Ophthalmology (ARVO) for animals.METHODS: With the SD rats as recipients, and Wistar rats as donors, all rats were subjected to corneal allografting. The recipient rats were randomly divided into 4 groups (n=20): group A (control group) which underwent corneal transplantation; group B which was subjected to bilateral cervical lymphadenectomy; group C, corneal transplantation 21 days after the alkali burn injury; group D, cervical lymphadenectomy following group C. The immune rejection of grafts was evaluated by detecting the expression of IFN-γ and IL-2 using ELISA. The time when allograft rejection occurred was recorded and mean survival time (MST) was compared among the groups. The development of corneal inflammation and new vessels was examined by slit lamp microscope and histopathological examination.MAIN OUTCOME MEASURES: ①The development of corneal inflammation after corneal alkaline burns. ②MST of rats in each group following transplant. ③The expression of IL-2 and IFN-γ in grafts of each group. RESULTS: ①Normal rat cornea was transparent without inflammation or neovascularization. There were many inflammatory cells invading to stroma on day 3 after burn. Then, the inflammation of cornea resolved gradually 3 weeks after the burn, but corneal neovascularization reached the peak at that time. Corneal blood vessels regressed completely at the end of 8 weeks after the burn. ②The MST of group A, B, C, and D was (10.40±1.14), (46.30±9.46), (7.00±1.58), and (15.00±3.39) days, respectively. Compared with the group A, the MST of group B was significantly longer (P < 0.05), and the MST of grafts in group D was also significantly longer than group C (P < 0.05). ③The expression of IFN-γ and IL-2 proteins was absent in group B. Compared with group C, the expression of IL-2 and IFN-γ proteins in group D significantly decreased on days 3, 7, 10, and 14 after keratoplasty (P < 0.05). CONCLUSION: Cervical lymphadenectomy therapy can effectively inhibit corneal allograft rejection in normal and high-risk corneal beds after alkali burn injury.

Objective To characterize the spinal motion of 6 degrees of freedom (6DOF) under the fulcrum bending in Lenke type 1 adolescent idiopathic scoliosis (AIS) patients using 3D image volume fusion technique.Methods Ten volunteers with Lenke type 1 AIS were examined by the Gemstone Spectral Imaging to obtain their T1-S1 vertebral morphological data in the supine position and fulcrum bending position.With the computer software,images of 2 different positions were fused with the 3D image to obtain in vivo kinematics data of each vertebral body in the target area.Results In the apical vertebrae (AV) region,the main range of motion in the fulcrum bending position ranged from-2.57°± 0.95° to-1.37°± 0.65°,showing significant differences between segments (P ＜ 0.05);along the vertical axis the coupling rotation ranged from-2.71° ± 0.48° to-1.27° ± 0.49°;along the coronal axis,the coupling flexion and extension ranged from 0.19° ± 0.85° to 1.51° ± 0.42°.In the upper end vertebrae (UEV) area,the main ROM ranged from-2.20° ± 1.13° to-1.91° ± 0.76°,showing no significant differences between the 3 segments (P ＞ 0.05);along the vertical axis,coupling rotation ranged from 0.18°±0.47° to 1.35°±0.52°;along the coronal axis,coupling flexion and extension ranged from 1.62° ± 0.41° to 2.07° ± 0.37°.In the lower end vertebrae (LEV) region,the main movement ranged from-0.79°± 0.63° to 0.73°± 1.09°,showing significant differences between the 3 segments (P ＜ 0.05);along the vertical axis,the coupling rotation ranged from-1.62°± 1.05° to-0.60°± 0.60°;along the coronal axis,the coupling flexion extension ranged from -1.41° ± 0.87° to-0.75° ± 0.66°.Conclusionts In the fulcrum bending position,Lenke type 1 AIS shows a unique motion and coupling mechanism in the spine.The coupling rotational movement in the UEV region is at the same side as the lateral flexion movement.The coupling rotational motion in the AV and LEV regions is opposite the lateral flexion movement.

Objective To investigate and analyze the clinical effect of laryngeal mask airway inhalation anesthe-sia with sevoflurane on pediatric colic surgery.Methods From July 2014 to November 2016,92 cases with pediatric hernia in Jiaxing Hospital of Zhejiang Corps of Armed Police Force were randomly divided into study group and control group according to the digital table ,with 46 patients in each group.All patients were selected according to the specific circumstances given hernia surgery ,sevoflurane inhalation anesthesia with laryngeal mask airway in the study group in the operation,the control group was given tracheal intubation anesthesia.The changes of vital signs ,the anesthesia effect and treatment satisfaction etc.were observed and analyzed.Results All the patients were treated by surgery , the heart rate (HR) and mean arterial pressure(MAP) changes in the study group were significantly better than those in the control group(all P＜0.05).The eye opening time and awake time in the study group were (7.28 ±1.07)min, (12.96 ±1.38 ) min, respectively, which were significantly better than those in the control group [ ( 13.02 ± 1.75)min,(21.13 ±2.82)min] (t＝18.979,P＝0.001;t＝17.649,P＝0.001).The total satisfaction rate of the study group was 97.83%,which was significantly higher than 82.61%of the control group (χ2＝13.126＝0.002). Conclusion The application of laryngeal surgery in children with hernia in mask ventilation of sevoflurane anesthe -sia,has good anesthetic effect ,it has less influence on hemodynamics in children ,and rapid postoperative recovery.

Objective To investigate the effectiveness of digital technology in repairing wounds of the lower leg and foot with perforator pedicled propeller flaps.Methods Eighteen patients with wounds of the lower leg and foot were returned to the hospital for review and evaluated retrospectively.The wounds were repaired by using the perforator pedicled propeller flaps from January,2013 to February,2014.There were 11 males and 7 females,with an average age of 27 years (range,6-48 years).Including 6 cases of injuries caused by the spokes and the Achilles heel of soft tissue defects.Five cases of infection after internal fixation of calcaneal fractures induced skin necrosis,2 cases of dorsal skin defects caused by heavy injured,5 cases of foot and ankle soft tissue defects caused by car accidents.All wounds were associated with exposure of tendon.The wounds area were ranged from 2.5 cm×5.0 cmn to 4.0 cm× 15.0 cm.The course of disease was from 3 hour to 35 days.Computed tomography angiography (CTA) was performed preoperatively,the appropriate perforator was selected and the CTA data were imported into the Mimics 15.0 software for the location of the perforator vessel and the design of the propeller flap,and simulate flap cut and transfer.The flap was obtained according to preoperative plan during operation.The flap size ranged from 4.0 cm×7.0 cm to 5.0 cm ×20.5 cm.These flaps included terminal branch of the peroneal artery perforator in 14 cases,posterior tibia artery perforator in 4 cases.All patients were followed up at regular intervals.Results The reconstruction of Mimics 15.0 software could confirm the perforator vessels origin,vascular distribution,diameter,and the cutting length.The rotation direction of the flap could be simulated preoperatively,which was consistent with the actual observation intraoperative.The donor sites were sutured directly.One case suffered from vascular crisis in 1 day was cured by the removal of part of the suture,massage and bloodletting.All cases were followed-up for 1 month to 16 months,and all flaps survived well and pediele were smooth with a satisfied appearance.The patient were extremely satisfied with the results for repair.Conclusion The preoperative individualization design of the perforator pedicled propeller flaps can be realized through CTA combined with Mimics 15.0 software.It can reduce the risk of operation.

In order to better control the quality of Flos Puerariae(FP),qualitative and quantitative analyses were initially performed by using chemical fingerprint and chemometrics methods in this study.First,the fingerprint of FP was developed by HPLC and the chemical markers were screened out by similarity analysis(SA),hierarchical clustering analysis(HCA),principal components analysis(PCA),and orthogonal partial least squares discriminant analysis(OPLS-DA).Next,the chemical constituents in FP were profiled and identified by HPLC coupled to Fourier transform ion cyclotron resonance mass spectrometry(HPLC-FT-ICR MS).Then,the characteristic constituents in FP were quantitatively analyzed by HPLC.As a result,31 common peaks were assigned in the fingerprint and 6 of them were considered as qualitative markers.A total of 35 chemical constituents were detected by HPLC-FT-ICR MS and 16 of them were unambiguously identified by comparing retention time,UV absorption wavelength,accurate mass,and MS/MS data with those of reference standards.Subsequently,the contents of glycitin,genistin,tectoridin,glycitein,genistein,and tectorigenin in 13 batches of FP were detected,ranging from 0.4438 to 11.06 mg/g,0.955 to 1.726 mg/g,9.81 to 57.22 mg/g,3.349 to 41.60 mg/g,0.3576 to 0.989 mg/g,and 2.126 to 9.99 mg/g,respectively.In conclusion,fingerprint analysis in combination with chemometrics methods could discover chemical markers for improving the quality control standard of FP.It is expected that the strategy applied in this study will be valuable for further quality control of other traditional Chinese medicines.

[Objective]To explore the etiology,pathogenesis and clinical treatment of histiocytic necrotizing lymphadenitis(HNL)based on the insidious pathogen warm disease theory.[Methods]To analyze the etiology,pathogenesis,characteristics of symptoms and transmission of the disease in Chinese medicine,and summarize the treatment principles based on the descriptions about insidious pathogen warm disease in ancient literature and modern researches on HNL,and cite a clinical case for verification.[Results]The pathogenesis of the HNL is mainly characterized by deficient healthy Qi leading to latent evil.The specific manifestation is that exogenous evils are latent in the Moyuan,which causes Yang Qi to be blocked and depressed and turns into heat.Evil heat spreads from the Moyuan to the Shaoyang tri-Jiao,leading to the generation of phlegm,static blood,turbid evil and toxin in the body,which in turn leads to disease.In terms of treatment,supporting healthy Qi and eliminating the evil is regarded as the law of treatment,and the emphasis is eliminating the evil.Aiming at the three pathogenetic links of latent evil,depressed heat and internal production of pathological products,the following treatment principles are formulated:expelling evils from Moyuan,dredging tri-Jiao and promoting the flow of Qi to make the evil heat go out,clearing away endogenous pathological products,removing toxin and dispersing knots.The focus of supporting healthy Qi is the protection of Qi and Yin as well as recuperation after recovery,which prevents evil Qi from remaining and causing the disease to reoccur.The medical case cited was a patient with HNL treated by applying the theory of insidious pathogen warm disease.Damp-heat and toxin brewing,phlegm combined with static blood was the traditional Chinese medicine(TCM)pattern of this case.The the prescriptions were based on Shengjiang Powder combined with Sanren Decoction,and Ganlu Xiaodu Pill successively,added and subtracted according to the syndrome,and the case achieved a significant effect.[Conclusion]The effect of treating HNL based on the insidious pathogen warm disease theory is quite good,which can provide new ideas and methods for the diagnosis and treatment of HNL.

Objective:To explore the morphology and vessel distribution of the scapholunate interosseous ligament and anatomical basis for the clinical reconstruction of scapholunate interosseous ligament.Methods:From October, 2018 to December, 2018, 12 fresh wrist joint specimens were perfused with gelatin-lead oxide solution from ulnar or radial artery and scanned under micro-CT. The morphology of scapholunate interosseous ligament in neutral position and the distribution of nutrient vessels in the ligament were observed on reconstructed 3D images by Mimics. The width, length and thickness of palmar, dorsal and proximal ligaments were measured. The anatomical parameters at the entrance of nutrient vessels in the scapholunate interosseous ligament were taken and their relationship with the blood supply to the scapholunate was analyzed.Results:①For scapholunate interosseous ligament, it was found that the average length of the proximal sub-region was the longest, the length of palmar and dorsal sides was similar to each other and the widest and thinnest was in palmar side, while the thickness and width of dorsal and proximal were similar. ②There was no nutrient vessel in the proximal part of the scapholunate interosseous ligament. But there were abundant nutrient vessels in the palmar and dorsal scapholunate interosseous ligament, and there was no significant difference in blood supply to palmar and dorsal scapholunate interosseous ligament ( P>0.05). ③The palmar and dorsal medial nutrient vessels that supply to the scapholunate interosseous ligament enter the scapholunate from the attachment of ligament of scapholunate interosseous joint. Conclusion:The palmar side of the scapholunate interosseous ligament is wider and thinner than that of the other subareas, which makes it more vulnerable to injury from an anatomical point of view. There is abundant blood supply to the palmar and dorsal subareas of the scapholunate interosseous ligament and the supplying vessels anastomose inside the scapholunate bone. There is no distribution of blood vessel at the proximal part of scapholunate interosseous ligament, hence is difficult to heal. An injury of palmar and dorsal ligaments may affect the blood supply of scapholunate.

Objective:To develop an intelligent vision examination and management system based on mobile terminal, and evaluate its practical application.Methods:A diagnostic test study was adopted.Fifty children and adolescents (100 eyes) aged from 3 to 14 years, with an average age of (8.16±4.58) years, were enrolled in Zhongshan Ophthalmic Center from March to May, 2020.An intelligent vision examination and management system for Android and IOS devices, which applied technologies of real-time range measurement, speech recognition, and gesture recognition to achieve the real-time interaction in the vision examination, was developed using JAVA language and xcode11.The uncorrected visual acuity of subjects was tested with the intelligent vision system and the standard eye chart in hospital.The difference in the number of cooperative eyes between the two methods was analyzed by χ2 test.The LogMAR acuity of the two methods were compared by Wilcoxon rank sum test and the consistency between the two methods was analyzed by Kappa test.The study adhered to the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center (No.2020KYPJ095). Written informed consent was obtained from guardians of each subject prior to any examination. Results:The intelligent vision examination and management system was successfully developed for Android and IOS devices, which was loaded with precise vision examination at 3 meters, intelligent interaction, result output and automatic filing functionalities.The inspection range of visual acuity was from 0.1 to 1.5.The size and resolution of eye chart met the national standard.There was no significant difference in the number of cooperative eyes during examination between traditional eye chart (99/100) and intelligent vision examination system (98/100) ( χ2=0.338, P=0.561). There was no significant difference in examination results between traditional eye chart 0.3 (0.2, 0.5) LogMAR and intelligent vision examination system 0.3 (0.2, 0.5) LogMAR ( Z=-1.602, P=0.109), and there was a high consistency between the two methods (Kappa coefficient=0.885). Conclusions:The intelligent vision examination and management system based on the mobile terminal is of high accuracy and practicability, which can effectively meet the public demand for at-home vision testing and long-term tracking.The system can be promoted and applied as a new mode for personalized eye health management.

Objective:To investigate the value of MRI radiomics features in predicting breast cancer lymphovascular invasion (LVI).Methods:Totally of 216 patients with breast invasive ductal carcinoma who underwent preoperative MR examination confirmed by postoperative pathology from January to July 2021 in Liaoning Cancer Hospital were analyzed retrospectively. The patients were all females and ranged in age from 27 to 80 (53±11). Among them, 68 patients had LVI and 148 patients had no LVI. Patients were divided into the training set and the validation set in a ratio of 7∶3. The clinical features model was constructed with independent risk factors for LVI. The factors were extracted based on the clinical and MRI performance. Regions of interest in the tumor and peritumoral 1, 2, 3 mm annular region were delineated in the second phase of dynamic contrast-enhanced (DCE) MRI and DWI, respectively, and radiomics features extraction and screening were performed to construct a radiomics feature model. Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic efficacy of models.Results:Apparent diffusion coefficient value (ADC) (OR=0.09, 95%CI 0.01-0.97, P=0.047), the axillary lymph node enlargement (OR=2.51, 95%CI 1.18-5.37, P=0.017), the peritumoral edema (OR=2.34, 95%CI 1.15-4.75, P=0.019) were independent risk factors for LVI. The clinical feature model was established with ADC value, the axillary lymph node enlargement and the peritumoral edema. At last, 10 radiomics features were selected to construct the DCE-MRI tumor model, 8 radiomics features were selected to construct the DCE-MRI peritumoral 1 mm model, 9 radiomics features were selected to construct the DCE-MRI peritumoral 2 mm model, 5 radiomics features were selected to construct the DCE-MRI peritumoral 3 mm model, 8 radiomics features were selected to construct the DWI tumor model, 5 radiomics features were selected to construct the DWI peritumoral 1 mm model, 10 radiomics features were selected to construct the DWI peritumoral 2 mm model, 9 radiomics features were selected to construct the DWI peritumoral 3 mm model. The ROC curve analysis showed that DWI peritumoral 1 mm model had the largest area under curve values for predicting breast cancer LVI status both in the training set (0.928) and the validation set (0.907), and there were significant differences compared with other models ( P<0.05). Conclusion:MRI radiomics features can effectively predict LVI of breast invasive ductal carcinoma, and DWI peritumoral 1 mm radiomics features model have the highest prediction efficiency for LVI.