BACKGROUND:Despite regular mesh hydroxyapatite has certain biocompatibility and bone conductivity, it cannot be absorbed by human body after transplantation, and wil affect the growth and eruption of maxila and fangs when using for filing the injured alveolar cleft. OBJECTIVE: To compare the effect of conventional and new mesh hydroxyapatite composites in repair of alveolar cleft defects. METHODS: Totaly 46 patients with cleft lip and palate were randomly and evenly divided into test and control groups, and al were arranged according to cleft lip and palate sequence treatment. After nasal soft tissue defect repair, new mesh hydroxyapatite composite bone material (hydroxyapatite and bone morphogenetic protein compound). Conventional mesh hydroxyapatite material was adopted in the test and control groups, respectively. Within 6 months after the repair, the vertical distance from the newly formed bone tissue plane to the top of alveolar ridge was observed. The clinical repair effect was comprehensively evaluated from the aspects of complications, alveolar cleft shape and size, calus formation and material absorption. RESULTS AND CONCLUSION: At 2, 4, 8, 12 and 24 weeks, the vertical distance from the newly formed bone tissue plane to the top of alveolar ridge in the test group was higher than that in the control group (P < 0.05). The clinical repairing significant efficiency and total effective rate were al higher than those in the control group (P< 0.05). These results show that new mesh hydroxyapatite composite bone materials in the repair of alveolar cleft defects have good bone osteoinductivity and biocompatibility, rare complications and rapid calus formation.

Objective To investigate the application effect of anterior clinoid process drilled off via epidural approach in posterior communicating artery aneurysm ( PCoAA) clipping. Methods The clinical data of 42 patients with PCoAA who underwent craniotomy from January 2012 to January 2014 were analyzed retrospectively,including 22 patients performed anterior clinoid process drilled off and 20 did not. The difficult or easy degree of intraoperative aneurysm clipping and postoperative efficacy were analyzed. Results The aneurysms in 22 patients underwent anterior clinoid process were clipped satisfactorily. The brain retractor was not used during the procedure. Only one patient had cerebral infarction after procedure. No patients had oculomotor nerve paralysis and incomplete clipping of aneurysms. Of the 20 patients without the anterior clinoid process drilled off,3 aneurysms were clipped incompletely because it was difficult to implant aneurysm clips, 2 had cerebral infarction, and 1 had oculomotor nerve paralysis. Conclusion Removing the anterior clinoid process drilled off via extradural approach may bring convenience for PCoAA clipping. It can effectively avoid the difficulty of implanting aneurysm clips during the procedure. Its application is safe and can reduce postoperative complications.

Objective To explore the clinical and histopathological characteristics and the diagnostic status of seborrheic keratosis (SK) Methods The clinical and pathological data of 286 cases were analyzed retrospectively.Results Among the 286 patients,the elderly patients accounted for the majority and more males were diagnosed with SK than females.The lesions were found among 46.2％ of patients in the exposure sites,such as face and neck.The most frequent types were hyperkeratosis and acanthosis.The clinical diagnosis consisted with pathologic diagnosis in 152 cases.The clinical misdiagnosis rate was 36.7％.Conclusion SK is related to gender,age,and sunlight.Histopathological examination is important in the diagnosis and differential diagnosis of SK.

Objective To investigate the correlation between the number of CD68+ and CD163+ macrophages infiltration and the clinical characteristics of oral squamous cell carcinoma (OSCC),and to investigate the role and significance of CD163+ and CD68+ macrophages in OSCC.Methods Forty-two cases of OSCC resected by operation and diagnosed by postoperative pathology with intact clinical data in our hospitals during 2013-2016 were selected.Other 12 cases of oral mamaxillofacial normal tissue served as controls.The number of CD68+ and CD163+ macrophages infiltration in OSCC was detected by immunohistochemistry.Its correlation with clinical characteristics was analyzed.Results The number of CD68+ and CD163+ macrophages infiltration in OSCC was significantly higher than that in the control group (P<0.05);the infiltration quantity of CD68+ and CD163+ macrophages in poor differentiation and moderate differentiation was significantly higher than that in high differentiation(P<0.05).The number of CD68+ macrophages in lymph node metastasis was significantly lower than that without lymph node metastasis (P<0.05).The number of CD163+ macrophages in the lymph node metastasis was significantly higher than that of CD68+ (P<0.05).The number of CD68+ and CD163+ macrophages had positive correlation in OSCC (r=0.48,P=0.00).Conclusion Tumor-associated macrophages (TAMs) and M2 macrophages may play an important role in OSCC,TAMs may inhibits lymph node metastasis in OSCC,while M2 marcophages may promote the lymphatic matastasis of OSCC.

Objective:To analyze bone strength index, osteoporosis and fracture in ankylosing spondylitis (AS) patients with radiologic hip involvement and explore the characteristics of bone strength in these patients.Methods:According to bath ankylosing spondylitis radiology hip index (BASRI-hip) score, 339 AS patients were divided into two groups. The differences of bone strength in each group were analyzed by t-test, Mann-Whitney U test and χ2 test. Logistic regression was used to analyze the risk factors of bone strength index. The correlation between quantitative ultrasound and dualenergy X-ray absorptiometry (DXA) (total hip, g/cm 2) was analyzed. Pearson correlation analysis was used. Results:①Bone strength index of quantitative ultrasound was positively correlated with bone mineral density of DXA (total hip, g/cm 2), r=0.553, P<0.01. ② The age of 27(23, 37) years old in radiographic hip involvement was lower than 37(28, 48) years old in non-radiographic hip involvement, and the difference was statistically significant ( Z=-5.986, P<0.01). There were no differences in gender and course of disease between the two groups ( P>0.05).③ The radiographic hip involvement in AS patients whose ages were younger than 50, when compared with non-radiographic hip involvement patients, the bone strength index was lower (78±18 vs 84±16), while bone strength was lower than patients at the same age (41.0% vs 18.4%), however, the incidences of osteoporosis (42.7% vs 28.8%) and fragility fracture (3.7% vs 0%) were significantly higher ( t=3.028, P<0.01; χ2=16.758, P<0.01; χ2=5.886, P=0.019; χ2=4.67, P=0.038). For AS patients whose ages were ≥50, there were no significant differences between the two groups ( P>0.05). ④ Multivariate analysis showed that radiographic hip involvement [ OR (95% CI)=1.912(1.05, 3.48)], age [ OR (95% CI)=0.94(0.911, 0.97)] and body mass index (BMI) (kg/m 2) [ OR (95% CI) =0.875(0.807, 0.948)] were associated with lower bone strength. Conclusion:There is positive correlation between the bone strength index of quantitative ultrasound and bone mineral density of DXA. AS patients with radiographic hip involvement are characterized by decreased bone strength and are more likely to develop osteoporosis and fragile fractures. The risk factors of low bone strength are radiographic hip involvement, age and BMI.

Objective To investigate the value of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction.Methods A retrospective study was conducted on 25 patients with Budd-Chiari syndrome (BCS) with hepatic vein obstruction treated from May 2011 to August 2014.The technique of guide-wire loop was used in these patients.The pressure of the hepatic vein was measured before and after treatment.The difference in the pressure was analyzed by the t test.Results All the patients were treated successfully using guide-wire loop angioplasty.No complications of bleeding,pericardial tamponade and liver capsule hemorrhage were observed.After treatment,the pressure of the hepatic vein reduced from (48.3± 8.0) cmH2O to (20.9 ± 3.8) cmH2O (t =26.82,P ＜ 0.05);The symptoms and physical signs of the patients were relieved or disappeared.BCS-related symptoms reappeared on follow-up in 4 patients,2 were treated by balloon dilation successfully.1 patient was treated with transjugular intrahepatic portosystemic shunt (TIPS) because of decompensated liver cirrhosis.1 patient with ankylosing spondylitis had treatment failure and the symptoms relapsed for the third time.Conclusion The technique of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction is safe and effective,and it can improve the overall success rate of treatment.

Objective To assess the feasibility and efficacy of robot-assisted laparoscopic simple prostatectomy (RALSP) for the treatment of benign prostatic hyperplasia (BPH) with large prostate.Methods From January 2014 to July 2015,16 patients with large prostate (≥80 ml) were treated by RALSP.The average patient's age was 69 years.The prostate volume was (98.3 ± 12.9) ml,preoperative residual urine was (78.0 ± 24.8) ml,the average IPSS was (22.9 ± 5.9),the average QOL was (4.8 ±1.5) and the average Qmax was (8.9 ± 3.7) ml/s,respectively.All patients agreed to accept RASP.The pre-operative and three months post-operative IPSS,QOL,residual urine and Qmax were compared and analyzed.Results All 16 patients underwent the surgeries uneventfully.The average operation time was (92.5 ± 15.5) minutes,the estimated blood loss was (125.5 ±25.5) ml,drainage time was (4.6 ±0.8)days,catheterization time was (7.9 ± 1.2) days and postoperative hospital stay was (5.1 ± 1.1) days.Three months after surgery,patient's IPSS was (11.8 ± 3.1),QOL was (1.6 ± 0.9),the average residual urine was (12.3 ± 2.6) ml and Qmax was (29.4 ± 11.6) ml/s,respectively.All the parameters significantly improved compared with the preoperative data (P ＜ 0.05).Conclusions Robot-assisted laparoscopic simple prostatectomy is a safe and effective method for the treatment of BPH patients with prostate volume larger than 80 ml.

Objective To discuss the treatment experience of adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The clinical data of 24 cases of AIMAH from August 1972 to December 2016 were retrospectively analyzed.The cases included 10 males and 14 females with a mean age of 43 (range 26 to 59) years.16 patients presented with typical Cushing syndrome (CS) and 8 patients had weight gain, hypertension or diabetes mellitus without any sign of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.The preoperative CT scan showed bilateral enlargement of the adrenal glands with multiple macmnodules.14 patients underwent open surgery, including 5 cases of unilateral adrenalectomy, 6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy simuhaneously.6 patients underwent conventional laparoscopic adrenalectomy,including 2 cases of unilateral adrenalectomy, 2 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 2 cases of bilateral adrenalectomy.4 patients underwent robot-assisted laparoscopic bilateral adrenalectomy.Results The postoperative pathological examination showed that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 68 months (range 3 to 192 months), the clinical symptoms of CS disappeared after surgery in all cases.7 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy simultaneously, 1 case died of adrenal crisis on the seventh day post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in other patients.Conclusions The use of bilateral adrenalectomy to treat AIMAH may involve risk.Unilateral adrenalectomy is recommended for an alternative treatment for AIMAH.Controlateral adrenalectomy with lifelong corticosteroid replacement or contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.

Objective To explore the efficacy and safety of minimal invasive adrenal sparing surgery for the treatment of Cushing syndrome caused by adrenocortical adenoma.Methods Patients who underwent minimal invasive adrenal surgery for adrenocortical adenoma in our institution from January 2010 to December 2015 were retrospectively analyzed.Preoperative, intraoperative, and postoperative variables were reviewed from the database.The mean patient age at diagnosis was 39 years and male:female ratio was 10:111.Of the 121 adenomas, 50 were located in the right adrenal and 71 in the left.The mean tumor size was 2.6 cm.84 cases had hypertension (69.4％), 36 cases had diabetes mellitus (29.8％), and 45 cases had obesity (37.2％).Postoperative follow-up was performed by evaluating adrenal gland function and imaging.Results Mininal invasive partial adrenalectomy was performed in 121 cases and the success rate of operation was 99.2％ (120/121).Sixty-two cases received operation through retroperitoneal approach,and 59 cases were through transperitoneal approach.The median operative time was 50 min with a median blood loss of 50 ml.The mean postoperative hospital stay were (5.0 ± 3.2) days.The vascular injury occurred in 2 cases (1 case in each surgical approach), while the abdominal organ injury occurred in 2 cases with 1 case of spleen injury and 1 case of liver injury (both in transperitoneal approach).Postoperative complications were observed in 6 cases:1 case of deep venous thrombosis, 1 case of wound hematoma, 4 cases of wound infection.Cortisol substitution was given in 2 to 12 months (mean 6.2 months)postoperatively.One year after operation, the remission rate of hypertension, diabetes and obesity was 58.3％ (49/84), 30.6％ (11/36) and 60.0％ (30/45), respectively.Conclusions Minimal invasive adrenal surgery using retroperitoneal and transperitoneal laparoscopic technique can be performed with low morbidity and achieve an excellent outcome.The perioperative hormone therapy may also play an important role.

OBJECTIVETo study the effects of skeletal muscle satellite cells implanted into infarcted myocardium on the volume of remnant myocytes.

METHODSThirty-six adult mongrel canines were divided randomly into implantation group and control group. In the implantation group, skeletal muscle satellite cells taken from the gluteus maximus muscles of the dogs were cultured, proliferated and labeled with 4',6-diamidino-2-phenylindone (DAPI) in vitro. In both groups, a model of acute myocardial infarction was established in every dog. In the implantation group, each dog was injected with M199 solution containing autologous skeletal muscle satellite cells. The dogs in the control group received M199 solution without skeletal muscle satellite cells. The dogs of both groups were killed 2, 4 and 8 weeks after implantation (six dogs in a separate group each time). Both infarcted myocardium and normal myocytes distal from the infracted regions isolated were observed under optical and fluorescent microscope. Their volumes were determined using a confocal microscopy image analysis system and analyzed using SAS. A P < 0.05 was considered significant.

RESULTSA portion of the implanted cells differentiated into muscle fiber with striations and were connected with intercalated discs. Cross-sectional area and cell volume were increased in normal myocardium. Hypertrophy of remnant myocytes in the infarcted site after skeletal muscle cell implantation was much more evident than in the control group. Cross-sectional area, cell area and cell volume differed significantly from those of the control group (P < 0.05). Hypertrophy of the cells occurred predominantly in terms of width and thickness, whereas cell length remained unchanged.

CONCLUSIONSkeletal muscle satellite cells implanted into infarct myocardium, could induce the hypertrophy of remnant myocyte cells in the infarcted site and could also aid in the recovery of the contractile force of the infarcted myocardium.

Animals ; Cell Size ; Dogs ; Myocardial Infarction ; pathology ; Myocardium ; pathology ; Myocytes, Cardiac ; cytology ; Random Allocation ; Satellite Cells, Skeletal Muscle ; cytology ; physiology