Objective To explore the baggy eyelids anaplasty through posterior orbital septum fat displacement. Methods Orbital septum and posterior orbital septum fat were exposed through palpebral margin incision, internal orbital septum fat was released and sutured with arcuate expansion of capsulopalpebral fascia at the middle lower eyelid, which was taken as the function of tighting the flaccid lower eyelid at transverse direction. On such a basis, the muscle and skin were repaired and so did orbital septum and baggy eyelids.Results Ofthe 38 patients with this operation, baggy eyelids anaplasty was performed with satisfactory results.Conclusion The method of baggy eyelids plasty through posterior orbital septum fat displacement could reduce hemorrhage, prevent enophthalmos and decrease baggy eye palindromia, with better long-term effects.

Objective To explore the risk factors causing tetany in patients with hyperventilation syndrome. Meth?ods A total of 103 patients with hyperventilation syndrome treated in our hospital were included in this study. According to whether there was tetany, patients were divided into tetany group and non-tetany group. Values of gender, age, electrolyte, pH and p(CO2) were analysed between two groups. The factors of P<0.1 were engaged in binary Logistic regression. Logistic regression (Forward Wald) was used to analyze the risk factors of tetany in patients with hyperventilation syndrome. Re?sults In 103 patients there were 70 patients with tetany (68%), 33 patients without tetany(32%). The serum K+, serum phos?phorus and p(CO2) values were significantly lower in tetany group than those of non-tetany group (P<0.01), while the pH value was significantly higher in tetany group than those of non-tetany group (P<0.01). There were no significant differences in gen?der, age, serum Na+, serum Cl-, serum calcium (bound calcium and ionized calcium), ionized calcium and serum Mg2+levels be?tween two groups (P>0.05). It was revealed that the younger age, the lower level of the serum K+, serum phosphorus and p(CO2) were the risk factors of tetany through binary Logistic regression analysis. Conclusion The risk factors of tetany in patients with hyperventilation syndrome include younger age, lower level of serum K+and serum phosphorus and reduced p(CO2).

Objective:To construct bispecific minibody by using anti HBsAg and anti RBC single chain Fv(ScFv).Methods:A “knob” variant T366W was first obtained by replacement of a small amino acid with a larger one in the human IgG1 CH 3 domain.The knob was designed to insert into a “hole” in another CH 3 domain which was created by replacement of three large residues with three smaller residues:T366S:L368A:Y407V.The “knob into hole” mutation:S354C:T366W/Y349C:T366S:L368A:Y407V.Then a disulfide bond was engineered in combination with previously designed “knob” or “hole” CH 3 was connected to anti HBsAg or anti RBC ScFv genes respectively.Then the two genes were combined together to form a bispecific minibody expression vector.The bispecific minibodies were expressed in E.coli.Results:Three different form of anti HBsAg and anti RBC minibody expression vectors were constructed.They contained wild type CH 3,“knob into hole”CH 3 or “knob into hole” plus disulfide bond CH 3 respectively.The results indicated that these three different types of bacterially expressed minibodies had similar HBsAg and RBC binding activities.The second and third type of minibody could cause agglutination of human RBC when HBsAg was present,which demonstrated bispecific function.Conclusion:Engineered interface of CH 3 can promote formation of heterodimers of different antibodies and faciliates the formation of bispecific antibodies(bispecific minibody) in E.coli expression system.

A PCR method was used to amplify the sequence encoding the mature peptide of?-mannanase of Bacillus subtilis. The gene was inserted into the Pichia pastoris vector pPIC9K, downstream of?-factor signal peptide sequence. The resultant recombinant plasmid pPIC9K-MAN was lineared by BglII digestion and introduced into the host Pichia pastoris GS115 by PEG method. After screen, the recombinant P. pastoris strain MAN22 was obtained and fermented in large scale 5L fermenter. The recombinant mannanase activity could reach to 1102IU/ml. The properties of the recombinant mannanase were characterized.

Objective To discuss the therapeutic strategy and the clinical efficacy of percutaneous cholecystostomy in treating high-risk patients with acute cholecystitis. Methods During the period of Jan. 2006-June 2008,percutaneous cholecystostomy was performed in 27 high-risk patients with acute cholecystitis,consisting of lithic cholecystitis (n = 21) and non-lithic cholecystitis (n = 6). Of 27 patients,percutaneous cholecystostomy via transhepatic approach was performed in 22 and via transperitoneal approach in 5. The 7 F drainage catheter was used. Cholecystography was conducted before the drainage catheter was extracted. Results Percutaneous cholecystostomy was successfully accomplished in all 27 cases,with a technical success rate of 100%. Postoperative patency of gallbladder drainage was obtained in 25 patients,with the relieving or subsiding of abdominal pain and the restoring of temperature and leukocyte account to normal range within 72 hours. In one patient,as the abdominal pain relief was not obvious 72 hours after the procedure,cholecystography was employed and it revealed the obstruction of the drainage catheter. After reopening of the drainage catheter,the abdominal pain was relieved. In another case,cholecystography was carried out because the abdominal pain became worse after the procedure,and minor bile leak was demonstrated. After powerful anti-infective and symptomatic medication,the abdominal pain was alleviated. The drainage catheter was extracted in 25 patients 6-7 weeks after the treatment. Of these 25 patients,12 accepted selective cholecystectomy,7 received percutaneous cholecystolithotomy and 6 with non-lithic cholecystitis did not get any additional surgery. The remaining two patients were living with long-term retention of the indwelling drainage-catheter. Conclusion Percutaneous cholecystostomy is a simple,safe and effective treatment for acute cholecystitis in high-risk patients. This technique is of great value in clinical practice.

Anal Canal/surgery* ; Anorectal Malformations ; Constriction ; Fecal Incontinence ; Humans ; Rectal Prolapse

Objective Acute type A aortic dissection associated pregnancy severely threatens the lives of both the mother and her ferus.We retrospectively reviewed our clinical experience with this life-threatening condition in six cases.Methods Between January 2007 and February 2012,6 women with acute type A aotic dissection associated pregnancy were treated by our group,with an average of 3 1 years (range 24 -37 weeks)and a mean gestation weeks of 24.5 (range,12 -38 weeks ).The etiology was Marfan syndrome in 4 cases and gestational hypertension in 2.The pathology was the modified Stanford type A3S in I case,A2C in 2 and A3C in 3.- Five patients were treated surgically and 1 medically.Surgical operations were performed under hypothermic cardiopulmonary bypass or deep hypothermic circulatory arrest,including Bentall procedure in 1case,Bentall + Sun's procedure in 2,ascending aortic replacement + Sun's procedure in 2.Results The woman treated medically and her fetus died from aortic rupture 9 days after admission.The cardiopulmonary bypass and cross clamp time and circulatory arrest time averaged 167 rninites(range,75 -210 minites) and 98 minites(range,83 - 145 minites) and 23.5minites(range,19 -27 minutes),respectively.Five patients treaed surgically survived the operation.Three fetuses survived rand two fetuses died.After a mean follow-up of 2.2 years (range,1 - 3.5 years ),5 patients were doing well.CT angiogram detected nonmal aortic and valvular structures,with no signs of distal dilation.Three babies were normal in development and neurocognitive functios.Conclusion Palients with aortic dissection associated with pregnancy should be operated on ugently and medical treatment carries high risks of aortic rupture and maternal and fetal death.Methods of surgical repair,peffusion techniques and delivery should be chosen based on the underlying aortic pathology and gestational age,so as to maximize the safety of the mother and her baby.

BACKGROUND: Recent experimental studies have found ultrasound mediated microbubbles potentiate stem cell therapy in myocardial infarction (MI)-induced heart failure, indicating a good application prospect. But whether ultrasound mediated nitric oxide (NO) microbubbles also have the same effect in the intracoronary transplantation of bone marrow mesenchymal stem cells (BMSCs) for treatment of large animals with MI is still unknown. OBJECTIVE: To investigate the effectiveness and possible mechanism of ultrasound mediated NO microbubbles in potentiating intracoronally transplanted BMSCs homing to the infarcted area in a MI pig model.METHODS: Density gradient centrifugation culture method was used in the isolation and cultivation of BMSCs. CM-Dil was used to label BMSCs in vitro. Twenty-four pigs were used to make MI models by blocking the left anterior descending coronary artery, and then were divided into PBS group, BMSCs group, ultrasound+microbubbles+BMSCs(MB) group, ultrasound+NO microbubbles+BMSCs (NO-MB) group(n=6 per group). In the PBS group, 10 mL of PBS was intracoronally injected. In the BMSCs group, about 1×107 BMSCs were diluted in 10 mL of PBS and then intracoronally infused. In the MB group, 0.1 mL/kg sulphur hexafluoride microbubbles (Sono Vue) was intracoronally injected together with ultrasound treatment (1 MHz, 2 W/cm2, 2 minutes), followed by intracoronary infusion of about 1×107 BMSCs that were diluted in 10 mL of PBS. In the NO-MB group, all methods and conditions were identical to those in the MB group except only 0.1 mL/kg of Sono Vue was replaced by 0.1 mL/kg NO microbubbles. Three pigs were sacrificed in each group 48 hours after CM-Dil positive BMSCs transplantation. The labeled BMSCs were observed and counted by fluorescent microscope after frozen sectioning of the infarct area. We assessed and compared left ventricular systolic function with M-mode ultrasound among groups at 4 weeks after intervention. After cardiac function test, the rest pigs were sacrificed and capillary density in the myocardial ischemic area was counted and compared after hematoxylin-eosin staining. RESULTS AND CONCLUSION: (1) The number of CM-Dil positive cells in the area of MI in the NO-MB group was much more than that in the MB group and BMSCs group with statistical significance (P < 0.05). (2) The left ventricle systolic function was significantly improved in the NO-MB group as compared with the MB group (P < 0.05). The same trend was observed between NO-MB group and BMSCs group as well as between NO-MB group and PBS group (P < 0.05). (3) The density of capillaries increased significantly in the NO-MB group compared with the MB group, BMSCs group and PBS group, respectively. To conclude, ultrasound mediated NO microbubble combined with intracoronary BMSCs transplantation can improve the left ventricular systolic function. The possible mechanism could be that ultrasoundmediated NO mocrobubbles promote the homing of transplanted BMSCs to the myocardial ischemia area as well as improve local angiogenesis.

Objective To explore the value of 18F-FDG PET/CT in predicting tumor recurrence for hepatocellular carcinoma (HCC) after liver transplantation (LT).Method We respectively analyzed 52 patients with HCC who underwent the 18F-FDG PET/CT examination before LT.In terms of tumor recurrence,all patients were divided into recurrence group and non-recurrence group.According to the degree of 18F-FDG uptake,all patients were divided into PET(-) group and PET (+) group.The SUVmax of primary tumor/the SUVmax of normal-liver background (T/B) was calculated by 18F FDG PET/CT.All patients were then divided into T/B≤1.15 group and T/B＞1.15 group.Result During the follow-up period,25 out of 52 patients (48.1％) developed posttransplant HCC recurrence and 27 (51.9％) had no recurrence.T/B of patients with recurrence (2.51 ± 0.95) was significantly higher than that of patients with non-recurrence (1.37 ± 0.46),t =4.12,P＜0.001.The disease-free survival rate of 0.5 year,1 year,2 years and 3 years after LT in PET(-) group and PET(+) group was 100.0％,92.3％,92.3％ and 92.3％,and 89.7％,59.0％,43.6％ and 35.7％ respectively.Log-rank test revealed that disease-free survival rate in PET(-) group was significantly higher than that in PET(+) group,x2 =17.8,P=0.003.The disease-free survival rate of 0.5 year,1 year,2 years and 3 years after LT in T/B≤1.15 group and T/B＞1.15 group was 100.0％,92.3％,92.3％ and 92.3％,and 89.5％,59.7％,42.1％ and 33.7％ respectively.Log-rank test showed that disease-free survival rate of T/B≤1.15 group was significantly higher than that of T/B＞1.15 group,x2 =10.24,P =0.001.Conclusion 18F-FDG PET/CT can predict HCC recurrence after LT.PET(-)and T/B≤1.15 of the 18F-FDG PET/CT in patients with HCC after LT were associated with a good prognosis,and PET(+) and T/B＞1.15 of the 18F-FDG PET/CT in patients with HCC after LT with a poor prognosis.

ToprovidethemethodologyforrapidqualityevaluationofLonicerajaponica,wehaveestablished the stable quantitative model of near infrared spectroscopy ( NIR) . The performance of Bagging partial least squares (Bagging-PLS) model and Boosting partial least squares (Boosting-PLS) model was compared with that partial least squares ( PLS ) model based on the NIR data of ethanol precipitation process of Lonicera japonica. On this basis, the performance of these two models after variables selection was also studied by the methods of siPLS ( synergy interval partial least squares ) and CARS ( competitive adaptive reweighted sampling) . The experimental results showed that the prediction performance of Bagging-PLS and Boosting-PLS models was superior to PLS model with the latent factor of 10 . The band of 820-1029 . 5 nm and 1030-1239. 5 nm for the first batch was selected by the method of siPLS. In addition, the band of 820-1029. 5 nm and 1030-1239. 5 nm was selected for the second batch sample in the same method. Furthermore, the method of CARS was taken to select variables for the two batches samples with 5-fold cross-validation and 10-fold cross-validation. And the lowest RMSECV( root mean square error of cross-validation) values were used to take subset. Compared to the model performance without the method of CARS, the RMSEP value of the Bagging-PLS model and Boosting-PLS model for the concentration of chlorogenic acid reduced by 0 . 02-0 . 04 g/L and rp(correlation coefficient of prediction)value increased by 4%-5%. Generally, Bagging-PLS and Boosting-PLS could be regarded as rapid prediction methodsfor NIR quantitative models of ethanol precipitation process of Lonicera japonica.