Objective Based on the disadvantages of NUSS procedure, we design a new type of funnel chest orthodontic steel bars for clinical application to simplify surgery operation , reduce the surgical trauma, improve operation effect, enhance the safety of operation, and relieve the suffering of the patients, etc.Methods From June 2010 to July 2015, 1020 patients used the new type of funnel chest orthodontic metal plates, including 706 cases of males and 314 cases of females, aged 3-40(aver-age age 11.38 ±5.31).Haller index of 3.36 to 15.45(average index 4.97 ±1.58).668 symmetrical funnel chest cases, 281 cases of asymmetry and 71 recurrent funnel chest cases are involved.Surgical steel bars, having 15 specifications, are arc-shaped, the lengths of which are from 12cm to 26cm.The two ends of steel bars have fixed piece, one end of the bar was fused with a stabilizer and the other end connected to an introducer or a stabilizer and use screws to fix two ends .Steel plates, as the design product, are finalized in the factory.Therefore we need not make intraoperative reprocess.Front tip of introducer and the back-end can be connected to the metal plate.Patients were placed supine position under general anesthesia.Two inci-sions, with length about 2cm and deep to the rib periosteum were made along axillary midline line on the both sides .In the di-rection of high blunt slightly medial free for subcutaneous tunnel to the highest point .Fixed wires were worn around the ribs on both sides.A thoracoscope to guide the bar was inserted from the highest point on the right side of the rear of the medial by sternum low into the chest from the left corresponds to the highest point of the medial , remove the introducer to connect another stator, use screws to fix the connection, with a fixed stator and steel plate stabilized.At the end of the surgery, the stabilizer on either side was secured with sutures.Results The median first operation time was 23 -45(32.31 ±3.57)min, second op-eration time was about 34-147(68.27 ±30.25)min..The bleeding volume(first operation) was 0-2(0.40 ±0.36)ml, the bleeding of second operation time was 1-630(144.00 ±57.00)ml.The hospital stay was 3-9(4.22 ±0.61)days after the operation.All the cases were followed up for 34-48(34.4 ±6.1)months.Steel plate was fixed at the bottom of the sternum in 957 of them,with slight shifting in 58 patients.There was another 5 cases who need re-operation because of the obvious shift-ing.Conclusion The new type of funnel chest orthodontic steel bars simplify surgery operation, reduce the surgical trauma, improve operation effect, relieve the suffering of the patients and enhance the safety of operation.

BACKGROUND:At present,a large number of studies have found that Liuwei Dihuang Pill can be used to treat osteoporosis,but there are few related studies on the differentiation and mineralization of osteoblasts induced by wear particles using Liuwei Dihuang Pill. OBJECTIVE:To investigate the positive effect of different concentrations of Liuwei Dihuang Pill-containing serum on titanium particle-induced mouse MC3T3-E1 osteoblast in vitro osteolysis model. METHODS:Drug-containing serum was extracted after oral administration of Liuwei Dihuang Pill.The best concentration of Liuwei Dihuang Pill-containing serum and titanium particles on the viability of MC3T3-E1 cells was screened.MC3T3-E1 cells were divided into three groups.The blank group was given osteoblastic differentiation culture.The model group was given titanium particles(5 μg/mL)ossification culture.The drug-containing serum group was given titanium particles(5 μg/mL)+ Liuwei Dihuang Pill-containing serum(10%,15%and 20%doses).Osteoblast viability was detected by CCK-8 assay.Cell alkaline phosphatase activity was detected by alkaline phosphatase staining.Cell mineralization was detected by silver nitrate(Von Kossa)and alizarin red staining.Expression levels of bone differentiation-related genes Runx-2,Osterix,Ocn,Axin,Alp,and Opn were detected by qRT-PCR.Wnt/β-catenin signaling pathways β-catenin,p-GSK-3β,GSK-3β,Runx2 and Osterix protein expression levels were detected by western blot assay. RESULTS AND CONCLUSION:(1)Liuwei Dihuang Pill-containing serum culture reversed the decrease in alkaline phosphatase activity of MC3T3E-1 cells induced by titanium particles,increased the alizarin red staining and calcification of MC3T3E-1 cells,increased the expression of osteogenesis-related genes in MC3T3E-1 cells,and increased the expression of proteins related to the Wnt/β-catenin signaling pathway.(2)These findings indicate that Liuwei Dihuang Pill-containing serum can reverse the inhibitory effect of titanium particles on the differentiation and mineralization of osteoblasts,upregulate the expression of osteogenesis-related genes,and its mechanism is related to the regulation of Wnt/β-catenin signaling pathway,suggesting that Liuwei Dihuang Pill is expected to become an effective drug for preventing aseptic loosening of artificial joints.

Objective    To explore the feasibility and efficacy in therapy of pectus excavatum using novel modified Nuss procedure after congenital heart disease (CHD) operation. Methods    Thirty-six children (including 22 males and 14 females with an average age of 4.5±2.2 years ranging 2.8-18.0 years) with pectus excavatum after CHD operation from January 2011 to March 2015 were selected as an observation group. Thirty-eight pectus excavatum children (including 24 males and 14 females with an average age of 4.0±2.5 years ranging 2.8-20.0 years) without CHD from July to September 2013 were selected as a control group. The novel modified Nuss procedure was performed on the patients in both groups. The operation time, intraoperative blood loss, hospital stay as well as postoperative complications between two groups were reviewed and analyzed. Results    In the observation group, the operation time was 50-72 (60.50±3.60) min and hospital stay was 4-6 (4.41±0.80) d. Meanwhile, the intraoperative blood loss was 5-10 (5.82±0.35) ml. In the control group, the operation time was 12-45 (20.15±0.68) min, hospital stay was 4-7 (4.61±0.63) d and the intraoperative blood loss was 3-8 (4.62±0.28) ml. The operation time was significantly longer in the observation group than that in the control group (P<0.05). But there was no significant difference in intraoperative blood loss or hospital stay between the two groups (P>0.05). No cardiac rupture happened in the two groups. Conclusion    The novel modified Nuss procedure is safe and feasible for pectus excavatum after CHD operation with optimal outcomes.