Objective To evaluate transoropharyngeal atlantoaxial reduction plate system (TARP) and its preliminary clinical effect. Methods The TARP system was designed to consist of a butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other surgical instruments. The system was applied clinically to five irreducible atlantoaxial dislocations as a result of injury or congenital disorders. During the operation, the reduction was achieved through the combination of the plate and the atlantoaxial reductor after the transoropharyngeal brisement and decompression. Bone graft was implanted between the lateral atlantoaxial joints. Results The reduction mechanism of the TARP system was well designed. Its clinical application to five cases of irreducible atlantoaxial dislocation proved that TARP had the function of instant reduction and that the operation was feasible and had laudable effect. Conclusion TARP design is a novel strategy. Its operative procedure is simple and feasible. Both the instant reduction and stable fixation can be obtained during the operation. TARP is creative and has excellent prospect.

Objective To investigate the accuracy of liver volume measurement in patients with primary hepatocellular carcinoma by using the 3D + medical imaging visualization processing system. Methods Thirty patients who were clinically diagnosed as primary hepatocellular carcinoma and underwent surgical resection before preoperative assessment were selected from January 2016 to November 2016. Preoperative thin-slice CT images were transferred into the 3D + medical imaging visualization processing system for hepatic volume measurement, the predictive resection volume were measured and statistically analyzed with that of intraoperative specimen according to water measurement method. Results All patients had complete resection of tumor, the average volume of predictive resection calculated by the 3D software was (408.84 ± 177.07) ml, the average volume of intraoperative specimen measured by the water test was (399.95 ± 176.15) ml, the difference was not statistically significant (t=1.502, P=0.144), and the average percentage error was (6.21 ± 4.73) %. Pearson correlation analysis showed that there was significant correlation between them (r=0.983, P<0.05). Conclusion 3D+medical image visualization processing system is a simple, intuitive and accurate method for liver volume measurement, which can provide the basis for the accurate measurement of liver volume and the implementation of complex hepatectomy, and guide the precise hepatectomy.

Nampt is a rate -limiting enzyme in the mammalian salvaging pathway for the synthesis of NAD that is involved in cell metabolism and proliferation .In recent years,growing research has elucidated that Nampt is correlated to various malignant tumors .It has a complex functions including regulation of energy metabo-lism and genome instability,promotion of proliferation and angiogenesis ,tumor-promoting inflammation and a-voidance of immune destruction .Recent reports indicate that Nampt is highly expressed in gliomas ,and it is close-ly related to the proliferation ,migration,invasion and prognosis of gliomas ,which will provide a new target for the glioma research and therapy .

Neuroglobin is a newly discovered member of globulin family.It has neuronprotec- tive effect under the hypoxic and ischemic conditions.In order to make the acting mechanism of globulin clear,many theories have been raised,and corresponding experiments have been done. This article reviews the latest advances systematically in this field,and puts forward possible research directions in the future.

?AIM: To observed the clinical effect of twice fluid-gas exchange in vitrectomy for retinal detachment at the equator.?METHODS: The retrospective analysis of the 74 cases (74 eyes) with retinal detachment at the equator from January 2014 to September 2015 were reviewed. All these patients were performed standard three channel 23G vitrectomy under a wide angle lens, in which, the 37 cases ( 37 eyes ) were randomly selected and performed single fluid-gas exchange, and the other 37 cases ( 37 eyes) were performed twice fluid-gas exchange. The intraoperative surgical complications and the postoperative success rate of retinal reposition in 1wk, 1, 3mo after surgery of the two group patients were observed.? RESULTS: The intraoperative surgical complication rates of the twice fluid-gas exchange group were less than that of the single fluid-gas exchange group. The postoperative success rate of retinal reposition in the twice fluid-gas exchange group significantly increased in 1wk and 1mo after surgery, and the difference was statistically significant (P<0. 05). But the postoperative success rate of retinal reposition in 3mo after surgery had no significant difference (P>0. 05).?CONCLUSION:The twice fluid-gas exchange operation was simple and it was beneficial for beginners to master. The incomplete drainage of the single fluid-gas exchange and the pore drainage in the posterior pole or in the peripheral part of the retina were avoided during the surgery. The intraoperative surgical complication rates were reduced and the postoperative success rate of retinal reposition were improved. This operation method had great application value in clinic.

Female ; Humans ; Infant, Newborn ; Maple Syrup Urine Disease ; diagnosis ; therapy

ObjectiveTo investigate the clinical effect and treatment experience of complicated acetabular fractures treated with open reduction with combined ilio-inguinal and Kocher-Langenbeck (K-L) approaches.MethodsSixty-six patients with complicated acetabular fractures were treated surgically with combined ilio-inguinal and K-L approaches from February 2004 to December 2009.Among them,45 cases were followed up for 8-45 months,with the average 26 months.ResultsOperation time was 1.4-5.7 h,with the average of 2.8 h.Intraoperative blood loss was 530-2300 ml,with the average of 1250 ml.According to Matta's score system,the excellent and good rate was 86.7％.According to modified Merle d' Aubigne and Postel score system,the excellent and good rate of function of hip was 86.7％.According to Brooker heterotopic ossification standard assessment system:Ⅰ degrees in 6,Ⅱ degrees in 3.According to Letournel and Judet clinical classification system,postoperative traumatic arthritis were 6 patients.Among them,3 patients with Ⅲ- Ⅴ period with symptoms of serious hip pain and joint activities obstacles were treated with total hip replacement secondly.Six cases of sciatic nerve injury and 9 cases of lateral femoral cutaneous nerve damage were recovered gradually after six months to a year.All incisions healed primarily.All got bony union,the healing time was 8 to 16 weeks,with the average of 10.4 weeks.None was complicated with femoral head necrosis.ConclusionFor the patients with complicated acetabular fractures,open reduction with combined ilio-inguinal and K-L approaches can get clinical advantages of revealed fully,fracture restoration convenient,fixed tightly,fewer complications and satisfactory result.

Objective To explore the expressions of Survivin and VEGF and relationship between them in hepatocellular carcinoma(HCC).Methods The expressions of Survivin protein and VEGF protein in 50 HCC.30 cirrhosis and 10 normal tissues were assessed by immunohistochemical method.The expressions of Survivin mRNA and VEGF mRNA in 50 HCC,30 cirrhosis and 10 normal tissues were assessed by in situ hybridization.Results The expressions of Survivin and VEGF in cancer tissues,cirrhosis tissues,normal tissues weresignificantly different. The expression of Survivin in HCC tissues was stronger than that in cirrhosis,but the expreesion of VEGF in cirrho- sis was stronger than that in HCC tissues.Conclusion The expression of survivin.is closely associated with the ex- pression of VEGF in HCC and they take positive correlation.The abnormal expressions of Survivin and VEGF are closely associated with the development of HCC.They may play important roles in the development of HCC.

Intraperitoneal glucose tolerance test was performed in the streptozotocin- and high fat-induced diabetic rats and normal rats.The results of RT-PCR and Western blot showed that the expression of 11?- hydroxysleroid dehydrogenase type 1 (11?-HSD1) was higher in the diabetic rats than that in control and was correlated with fasting plasma glucose,insulin and AUC-I/G with respective correlation coefficient (r) of 0.870, - 0.799,- 0.850,suggesting that increased expression of 11?-HSD1 appears to damage?-cell function through magnifying the local effect of glucocorticoids.