Objective To investigate the effeet of eyclosporine A (CsA) on CD4+ Foxp3+ T cells in C57BL/6 mice and the underlying mechanism.Methods C57BL/6 mice, aging 8～ 10 weeks, were administered intraperitoneally with CsA at a dose of 20 mg· kg-1·d-1 for 2 weeks, while the control mice given sterile PBS.After 2 weeks, peripheral blood was collected, and splenoeytes and thymoeytes were prepared for the detection of CD4 + Foxp3 + T cells by using flow cytometry.Results The proportion of CD4+ Foxp3+ T cells in peripheral blood, spleen and thymus of CsA-treated mice was (0.581 ± 0.089) %, (2.189 ± 0.046) % and (0.472 ± 0.049) %, while that in PBS-treated mice was (1.751 ± 0.227) %, (3.684 ± 0.169) % and (1.412 ± 0.188) %, respectively (P < 0.001).Conclusion The reduction of CD4 + Foxp3+ T cells in CsA-treated mice suggests that CsA can inhibit the development of regulatory T cells.

Objective To evaluate the clinical efficacy of transplantation of autologous peripheral blood stem cells(PBSC) for the treatment of toe or heel ulcer and of rest pain in patients with lower limb arterial ischemic diseases.Methods To mobilize patients' own stem cells with G-CSF for 5 days.At the sixth day,PBSC are collected with a blood-cells separator.The PBSC were then intramuscularly injected into ischemic areas of the lower limbs.Results After transplantation,all patients are followed up from 3 to 24 months.The rest pain disappeares in 12 patients,while toe or heel ulcers are cicatrized in 11 cases.However,4 patients lost in following up.ConclusionTransplantation of autologous peripheral blood stem cells is an effective method for the treatment of arterial ischemic disease.

Objective 　To investigate methods for the diagnosis and treatment of primary angitis of central nervous system (PACNS). Methods　Radiological and clinical feature, operative resutls of 12 patients with mass lesion presentations of PACNS were analyzed retrospectively. Results　The lesions showed low density on CT and long T1 and long T2 signal on MRI. The ring-wall enhanced lesions on MRI were flowery in 7 patients. Gross total resection of the lesions were performed in 10 patients with excellent recovery postoperatively. Growth of lesions were observed in 2 patients who underwent subtotal resection. Conclusions　 Lesions of PACNS have special appearance on enhanced MRI. More patients with mass lesion presentations of PACNS could be diagnosed preoperatively according to radiological and clinical feature.For these patients, surgery is the optimal treatment at present.

Objective To study how to improve velopharyngeal ring ligafion procedure by using ring ligator in velopharyngeal ring ligatian procedure and settle the problem that there is no standard to measure the interspace of the cavity of pharynx.Methods Select some deft palate patients who were between 3 to 17 ages.Then made five groups according to age (3 to 5,6 to 8,9 to 11,12 to 14,15 to 17).Then made five different types of ring ligators accrding to the normal size of the cavity of pharynx of different ages.Results The ring ligators were easily used and all the patients were repaired satisfied.Conclusion The application of ring ligator in velopharyngeal ring ligation procedure is simple and feasible.

Objective To evaluate the effectiveness and safety of implantation of flexible open-loop anterior chamber intraocular lens (FOAC-IOLs) and scleral fixated posterior chamber intraocular lens (PC-IOLs).Methods Sixty-eight eyes of 68 patients with implanted intraocular lenses in the absence of posterior capsular support were reviewed retrospectively. According to the type of intraocular lens, patients were classified into two groups. In groupⅠ (30 eyes), FOAC-IOLs was implanted primarily or secondarily. In group Ⅱ (38 eyes), scleral fixated PC-IOLs was implanted primarily or secondarily. By gonioscopy and ultrasound biomicroscopy (UBM), accurate positions of IOLs' haptics and the relationship between the haptics and surrounding tissues were observed postoperatively and used to evaluate the influence of the two types of IOLs on ocular anterior segments. Follow-up was 6 to 20 months. Results Best corrected visual acuity of 20/40 or better was achieved in 27 eyes (90.0%) in group Ⅰ, and 35 eyes (92.1%) in group Ⅱ and the difference was not statistically significant (P>0.05). In group Ⅰ, 23 eyes (76.7%) had a total of 40 complications, while 13 eyes (34.2%) had 19 complications in group Ⅱ (P<0.05). Gonioscopy and ultrasound biomicroscopy showed that in group Ⅰ, all haptics of IOLs contacted with the iris completely and compressed the iris to different degrees, sometimes causing the anterior chamber angles to widen. Anterior synechia of the iris was caused by the haptics of FOAC-IOLs in 12 eyes. Among the 60 IOLs haptics, 39 foot plates of the haptics were properly fixed at the ciliary band; 21 haptics (12 eyes) penetrated through the iris into the stroma of the ciliary body with accompanying recurrent uveitis. In group Ⅱ, among the 76 IOLs haptics, 52 were adequately fixed in the ciliary sulcus regions, and 8 (8 eyes) were placed below the iris, causing goniosynechia. This type of angle closure was localized, with an open angle on each side of the haptics. The remaining 16 haptics were fixed onto the ciliary crown.Conclusions The current sutured mode of scleral fixated PC-IOLs can not ensure that IOLs haptics are placed in the ciliary sulcus. The haptics of FOAC-IOLs compress the iris and may penetrate through the iris into the stroma of the ciliary body. This can cause peripheral iris anterior synechia and chronic recurrent uveitis. The implantation of scleral fixated PC-IOLs is safer and shows better effects than that of FOAC-IOLs.

Massive rotator cuff tears, with mean tendon tears>5 cm or involving two or more tendons in a tear, often result in shoulder pain, stiffness, limited range of motion and impaired function, significantly impacting the patients′ quality of life. At present, massive rotator cuff tears are mainly treated surgically with joint cleaning, rotator cuff repair and patch graft repair, etc, but the problems such as tendon end retraction and high rotator tension after surgical repair lead to high postoperative retear rate. The autogenous long head of biceps tendon (LHBT), as an autograft which has the advantages of high accessibility and low cost, has been employed in the repair of massive rotator cuff tears. However, there is still controversy in the choice of specific surgical method. To this end, the authors reviewed the research progress on the application of LHBT in the repair of massive rotator cuff tears, aiming to provide reference for its clinical treatment.

Objective To explore the clinical characteristics of pattern of phlegm heat and bowel excess in acute stage of stroke involving meridian-collateral or involving zang-fu organs from the aspects of severity of neurological impairment, pattern distribution at different time points and duration of bowel excess.Methods The basic information,scores of National Institute of Health Stroke Scale(NIHSS), whether bowel qi being unobstructed or not,duration of bowel excess,and pattern distribution at different time points(onset for 1 d to 3 d,onset for 4 d to 7 d and onset for 8 d to 14 d)were inputted based on structured data by using retrospective analysis of medical records in 204 cases of pattern of phlegm heat and bowel excess of stroke involving meridian-collateral(meridian-collateral group)and 217 cases of pattern of phlegm heat and bowel excess of stroke involving zang-fu organs(zang-fu organ group).The clinical characteristics from the data were compared, analyzed and studied.Results The severity of neurological impairment except of conscious state was significantly higher in zang-fu organ group than that in meridian-collateral group(P<0.01).The average duration of unobstructed bowel qi was significantly longer in zang-fu organ group than that in meridian-collateral group(P<0.01), and the percentage of patients with throughout obstructed bowel qi was significantly higher in zang -fu organ group than that in meridian-collateral group in acute stage of stroke.The pattern of phlegm heat and bowel excess showed a decline trend after stroke onset for 1 d to 14 d in meridian-collateral group, and showed an ascending trend after stroke onset for 1 d to 7 d and a decling trend after stroke onset for 8 d to 14 d in zang-fu organ group.The cases of pattern of qi deficiency with blood stasis or pattern of collaterals blocked by wind -phlegm and static blood were significantly higher in meridian-collateral group at 4-14 d than those at 1-3 d,and cases of pattern of wind stirring due to yin deficiency,pattern of phlegm heat and blood stasis or pattern of wind phlegm and blood stasis were significantly higher in zang-fu organ group at 8 -14 d than those at time point 1.Conclusion The duration of pattern of phlegm heat and bowel excess is posi-tively correlated to the severity of stroke,that is,neurological impairment is more serious and duration is longer in patients with pattern of phlegm heat and bowel excess of stroke involving zang -fu organs.

Objective:To compare the efficacy of superior capsular reconstruction using a "sandwich" patch graft versus a fascia lata autograft in the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:A retrospective analysis was conducted on 50 patients with IMRCTs who underwent superior capsule reconstruction at Ningbo Medical Center Li Huili Hospital from January 2019 to May 2021. Patients were categorized into two groups based on the type of graft used: the "sandwich" group (27 patients), utilizing a "sandwich" patch graft, and the fascia lata group (23 patients), utilizing a simple fascia lata graft. The "sandwich" group consisted of 10 males and 17 females with a mean age of 65.6±5.7 years (range, 55-76 years), including 6 cases on the left shoulder and 21 cases on the right shoulder. The fascia lata group comprised 10 males and 13 females with a mean age of 65.5±4.2 years (range, 56-72 years), including 4 cases on the left shoulder and 19 cases on the right shoulder. Clinical outcomes were assessed preoperatively and at 1 week, 6 months, 1 year, and 2 years postoperatively using the American Shoulder and Elbow Surgeons (ASES) score, the University of California Los Angeles (UCLA) score, and the visual analogue scale (VAS) for pain and shoulder activity. Imaging outcomes, including acromio humeral distance (AHD) and graft status, were evaluated via radiographs or MRI.Results:The follow-up duration was 40.0±8.4 months (range, 26-54 months) for all patients. The "sandwich" group demonstrated significantly better outcomes compared to the fascia lata group. Improvements were noted in the ASES score (90.1±8.7 vs. 66.8±22.0), ASES score improvement (58.0±11.8 vs. 36.7±24.2), UCLA score (31.0±3.1 vs. 23.0±8.7), UCLA score improvement (20.1±4.5 vs. 12.7±9.2), active elevation (160.0°±21.3° vs. 124.8°±37.4°), active elevation improvement (70.2°±31.4° vs. 33.7°±42.4°), external rotation (35.0°±9.0° vs. 29.0°±6.9°), external rotation improvement (11.3°±7.3° vs. 7.2°±10.4°), AHD (6.4±1.5 mm vs. 4.4±1.0 mm), AHD improvement (3.0±1.6 mm vs. 1.5±1.0 mm), the difference was statistically significant ( P<0.05). The graft healing rate of the "sandwich" group reached 93%, which was higher than the 74% in the fascia lata group, but the difference was not statistically significant (χ 2=1.984, P=0.159). One case of subcutaneous hematoma was reported in the fascia lata group postoperatively. Additionally, two patients in the fascia lata group reported mild thigh discomfort at the last follow-up, which did not impair walking. No cases of infection, joint stiffness, or vascular or nerve damage were observed. Conclusion:Superior capsular reconstruction using a "sandwich" patch graft significantly enhances the healing rate of grafts and short-term postoperative clinical outcomes in patients with irreparable massive rotator cuff tears.