BACKGROUND:Calcium sulfate bone substitute material has a good safety and biocompatibility, and possesses good strength after implantation to restore thoracolumbar mechanical strength and reduce vertebral height loss, and moreover, it may gradual y be degraded and absorbed. OBJECTIVE:To explore the influence of posterior pedicle screw fixation combined with calcium sulfate bone substitute material on the recovery of vertebral height after thoracolumbar vertebral compression fractures. METHODS:Forty-two patients with thoracolumbar vertebral compression fractures (T12-L3) were enrol ed to receive posterior pedicle screw fixation combined with calcium sulfate bone substitute, including 27 males and 15 females, aged 21-57 years. Al patients were fol owed-up for 12 months, and then anterior vertebral height, kyphosis Cobb angle, Oswestry disability index score and visual analog scale score before and after treatment were determined and compared. RESULTS AND CONCLUSION:At the end of fol ow-up, no local complications, no coagulation, no immune response and no screw breakage occurred;the anterior vertebral height, kyphosis Cobb angle, Oswestry disability index score and visual analog scale score were significantly improved (P<0.05). These findings indicate that the posterior pedicle screw fixation combined with calcium sulfate bone substitute can restore the vertebral height and promote functional recovery of patients with thoracolumbar vertebral compression fractures.

BACKGROUND: Vascular endothelial growth factors are a family of multifunctional cytokines that can enhance vascular permeability, induce angiogenesis, promote endothelial cel growth and migration, and inhibit cel apoptosis.
OBJECTIVE:To elaborate the latest progress in the role of vascular endothelial growth factor and its receptors in the corneal tissue.
METHODS:A computer-based search of PubMed databases was performed for relevant articles published from 2005 to 2015. The key words were “vascular endothelial growth factor, cornea”. According to the inclusion and exclusion criteria, 43 articles were included in result analysis.
RESULTS AND CONCLUSION:Vascular endothelial growth factor and its receptors are involved in the regulation of corneal neovascularization by causing Tip cel activation that affects the Notch signaling pathways. Corneal lymphatic regeneration mainly relies on macrophages to secrete vascular endothelial growth factor-C or vascular endothelial growth factor-D that further activate vascular endothelial growth factor receptor-3 in the lymphatic endothelial cels to cause cel proliferation and migration, and eventualy lead to the formation of new lymphatic vessels. But herpes simplex keratitis HSK induces the corneal lymphatic regeneration by vascular endothelial growth factor-A/vascular endothelial growth factor receptor-2 pathway. Vascular endothelial growth factor family can significantly improve the damaged corneal nerve endings, epithelium and corneal sensitivity, has the function of nerve nutrition and promote restoration of the corneal epithelium.

The working condition of the high frequency electronic knife is quite complicated.How to ensure it to run unfailingly is an important demand in the design of the control system of the high frequency electronic knife.This paper introduces the anti-disturbance method and measure of the control system of the high frequency elec-tronic knife briefly.The hardware measure and software method are introduced mainly.In the aspect of hardware,the techniques include choosing microprocessor correctly,distributing printed-plank area reasonably,noise shield,etc.IN software,there are such as establishing the trap of program,designing program for Watchdog,digital filtering,Owing to adopting above anti-disturbance techniques,the safety and reliability of the whole system are improved.

Background Interleukin-6 (IL-6) is a pleiotropic cytokine involving in inflammation and wound healing.Previous report found that IL-6 increases phosphorylated STAT3 (p-STAT3) level and promotes corneal epithelial wound healing by stimulating migration.However,the essential role of IL-6 in corneal epithelial wound healing and the expression changes in diabetic mellitus remains unknown.Objective This study was to explore the roles of IL-6 in corneal epithelial proliferation and wound healing in both normal and diabetic mice.Methods Fifty-two normal C57BL/6 mice were randomized into normal control group (32 mice) and diabetic group (20 mice).Type 1 diabetic mellitus was induced by intraperitoneal injections of 50 mg/kg streptozotocin once per day for consecutive 5 days in the mice of the diabetic group.Whole corneal epithelium was scraped in all mice,and the corneal epithelial defect area was examined by fluorescein staining in 24,48 and 72 hours after corneal epithelium removal.Recombinant mouse IL-6 or anti-IL-6 blocking antibody of 5 μl were subconjunctivally injected according to the grouping and contrasted with PBS injection group or isotype control antibody group,respectively.TKE2 cells,a mouse corneal epithelial stem/progenitor cell line,were trypsinized and incubated in the KSFM with different concentrations of IL-6 or without IL-6,and colony formation efficency (CFE) was examined by crystal violet staining.The expressions of △NP63 and Ki67,specific makers of stem cells,were detected by immunofluorescine technology.The expressions of △NP63,Ki67 and p-STAT3 proteins were assayed in the cells by Western blot,respectively.The expression of IL-6 mRNA and protein in the regenerated corneal epithelium was detected by real time quantitative PCR and ELISA.The use and care of the mice complied with the Statement of Association for Research in Vision and Ophthalmology.Results The percentage of residual corneal epithelium defect area with initial detect area was gradually shrinked over time after PBS and IL-6 injection in both normal control mice and diabetic mice,and the percentage of residual corneal epithelium defect area was significantly reduced in the IL-6 injected group compared with the PBS injected group (normal control group:Fgroup =19.982,P ＜ 0.01;Ftime =589.350,P ＜ 0.01;Diabetic group:Fgroup =25.411,P＜0.01;Ftime =334.807,P＜0.01).The CFE was (13.23± 1.12)％,(15.87± 1.30)％,(21.69±1.62)％,(25.33±1.28)％ and (18.67±1.54)％ in the blank control group and 10,20,50,100 ng/ml IL-6-treated groups,respectively,showing a gradual increase of CFE dependent upon IL-6 concetrations (F =35.547,P＜0.01).The expressions of △NP63,Ki67,p-STAT3 proteins in the cells were gradually increased over time after 50 ng/ml IL-6 treated for 5,10,15,30 and 60 minutes,and the relative expression level of the cytokines was significnatly higher in the IL-6 cultured groups than that without IL-6 culture group (all at P＜0.05).The relative expression of IL-6 mRNA in the regenerated corneal epithelilum was 0.45±0.21 and 1.00±0.16 in the diabetic group and normal control group,respectively,and compared with the normal control group,the expression of IL-6 mRNA reduced by 56％ (t=3.42,P=0.03).The content of IL-6 protein in regenerated corneal epithelium of the diabetic group was (257±12) ng/μl,which was significantly lower than (323 ± 17) ng/μl of the normal control group (t =5.60,P＜0.01).Conclusions IL-6 promotes the proliferation and regeneration of corneal limbal stem cells to repair defected corneal epithelium by activating STAT3 signaling pathway in both normal and diabetic mice,while the blocking of endogenous IL-6 impairs the corneal epithelial cell activation and wound healing.

Objective To investigate the clinical features of complex posterior communicating artery aneurysms and the outcome of microsurgical clipping.Methods The clinical and imaging data of the patients with posterior communicating artery aneurysm treated by craniotomy microsurgical clipping were analyzed retrospectively.The patients were divided into either a complex type group or a simple type group according to whether they had complex factors of surgical clipping or not.They were divided into a good outcome group and a poor outcome group according to their Glasgow Outcome Scale scores.Results A total of 55 patients with posterior communicating artery aneurysm were enrolled,and 17 (30.9％) of them were in the simple type group and 38 (69.1％) were in the complex type group.The proportion of higher Fisher grade in the patients of the simple type group was significantly lower than that of the complex type group (Z =-2.068,P=0.019).However,there were no significant differences in the proportions of age,sex,preoperative rupture,and Hunt-Hess grade between the two groups (all P ＞ 0.05).In the complex type group,the complex clipping (73.68％) and anterior clinoidectomy (42.11％) were the most common complex factors.Twenty-four patients (63.16％) had a number of complex factors.In the complex type cases,32 had good outcome,6 had poor outcome (3 of them died); in the simple type cases,15 had good outcome,2 had poor outcome (1 of them died).There was no significant difference in the good outcome rate between the complex type group and the simple type group (84.21％ vs.88.24％;x2 =0.153,P=0.696).In 55 patients with posterior communicating artery aneurysm,the age of the good outcome group was significantly lower than that of the poor outcome group (58.23 ± 12.41 years vs.68.38 ± 8.68 years,t =-2.212; P =0.031),and there were no significant differences in sex,Fisher grade,Hunt-Hess grade,factors of surgical complexity,and surgical clipping level (all P ＞ 0.05).Multivariate logistic regression analysis showed that only age was the independent risk factor for poor outcome of the complex posterior communicating artery aneurysm (odds ratio 1.142,95％ confidence interval 1.029-1.266; P =0.012).Conclusions Using the advanced microsurgical techniques,such as anterior clinoidectomy,anterior choroidal artery microdissection,and complex clipping for the treatment of complex posterior communicating artery aneurysm are no less favorable than the simple type,and age is an independent risk factor for the poor outcome of posterior communicating artery aneurysm.

ObjectiveTo explore the role of autofluorescence bronchoscopy in lung cancer operation and the meaning of choice lung cancer operation mode.MethodsTo retrospectively analyze 32 non-small cell lung cancer patients.Before lung cancer operation,white light bronchoscopy (WLB) and autofluorescence bronchoscopy (AFB) had been done routinely.Compared the different invasive tumor conditions by WLB and AFB,operation modes were decided by the edge of the tumor which were proved by biopsy pathology.ResultsIn 32 cases,19 cases underwent pulmonary lobectomy.One case underwent carinal resection and reconstruction.8 cases underwent sleeve lobectomy.4 cases underwent other therapy because of tumor airway metastasis.In 8 cases which underwent sleeve lobectomy,3 ca ses were found by WLB and AFB together,5 cases were found only by AFB.In 4 cases who had no operation chance,2 cases were found by WLB and AFB together,2 cases were only by AFB.The sensitivity for the detection of bronchial premalignant lesions was extremelyhigher withthe addition of AFB than WLBalone ( P ＜ 0.05 ).ConclusionAutofluorescence bronchoscopy is a safe and efficient technique which could improve the sensitivity of diagnosis in lung cancer than WLB.It is important to select operation mode.

Objective To evaluate laparoscopic splenectomy through amputation of secondary splenic pedicles.Methods From February 2010 to March 2016 33 patients underwent laparoscopic splenectomy.Patients were followed up by outpatient examination and telephone interview.Follow-up period ended in April 2016.Results All the 33 patients successfully underwent laparoscopic amputation of secondary splenic pedicle splenectomy.The operation time and volume of intraoperative blood loss were (155 ± 42) min and (210 ± 50) ml.Three patients had postoperative complications including two with ascites sand one with small amount splenic fossa bleeding.All the patients were followed up for a median time of 21 months (range,1-65 months).During the follow-up,1 patient died of hepatic encephalopathy and 32 patients were doing well.Conclusion Laparoscopic amputation of secondary splenic pedicle splenectomy is safe and feasible.

Objective To investigate the clinical efficacy of precise liver resection of liver tumors adjacent to the main pipeline.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients who underwent precise resection of liver tumors adjacent to the main pipeline in the Affiliated Tumor Hospital of Zhengzhou University between December 2014 and June 2016 were collected.According to preoperative precise evaluation and fully intraoperative exposed tumors,different methods of blood flow occlusion were choosed timely,and then precise resection of the liver was evaluated based on tumor location and size,relationship between tumor and blood vessels and the degree of liver cirrhosis.The operation procedures,operation time,time of liver resection,volume of intraoperative blood loss,number of patients with perioperative blood transfusion,postoperative complications,duration of postoperative hospital stay and follow-up were observed.The follow-up was performed by outpatient examination and telephone interview up to September 2016.Tumor recurrence of patients with hepatocellular carcinoma (HCC) was monthly detected by alpha-fetoprotein retest and color Doppler ultrasound of the liver or computed tomography (CT) within 3 months postoperatively.Tumor recurrence of patients with cholangiocarcinoma was monthly detected by tumor marker retests,color Doppler ultrasound of the liver or CT,and then patients without tumor recurrence received reexamination once every 2 months after 3 months.Patients with liver hemangioma were followed up once every 2-3 months and once every 6 months after half a year,and follow-up included the liver function,ultrasound and other imaging examinations to detect the tumor recurrence.Measurement data with normal distribution were represented as-x±s.Results All the 22 patients underwent successful precise resection of liver tumors.Twenty patients received intraoperative ultrasound localization.Blood flow occlusion of 22 patients:Pringle was conducted in 6 patients,treatment of the corresponding hepatic pedicle in 3 patients,selective hepatic blood flow occlusion in 8 patients,total hepatic blood flow occlusion in 2 patients and non-hepatic portal occlusion in 3 patients.Precise resection of the liver of 22 patients:1 patient underwent right trisegrnentectomy,2 underwent left hepatectomy,2 underwent segment Ⅳ a resection of the liver,2 underwent segment Ⅳ resection of the liver,3 underwent segment Ⅴ resection of the liver,3 underwent segment Ⅷ resection of the liver,1 underwent middle lobe resection of the liver and 8 underwent partial resection of the liver.Operation time,time of liver resection,volume of intraoperative blood loss and number of patients with perioperative blood transfusion were (213±39) minutes,(57± 19) minutes,(518± 98) mL and 3,respectively.Of 22 patients,5 with postoperative complications were improved after symptomatic treatment,including 2 with effusion at surgical site,2 with right pleural effusion and 1 with bile leakage.The duration of postoperative hospital stay of 22 patients was (8.9± 1.6)days.Twenty-one patients were followed up for 3-20 months,with a median time of 12 months.Two of 22 patients had recurrence during the follow-up,and no recurrence at surgical site was detected.Conclusion Precise resection of liver tumors adjacent to the first and second hepatic hilum is safe and feasible,with the advantages of less intraoperative bleeding and low incidence of postoperative complications.

Objective To explore the clinical efficacy of artificial blood vessel sheath around re-nal vein for the treatment of left renal vein entrapment syndrome. Methods Eight cases with left re-nal vein entrapment syndrome (7 males and 1 female, mean age, 16 years) with history of gross hema-turia for 6 to 36 months were reviewed. Doppler ultrasound reports suggested compression of the left renal vein at mesenteric angle in all eases. CT scan showed the abnormal angle between aorta and su-perior mesenterie artery in 5 cases. Cystscopy showed hematuria from the left ureteral orifice in 5 ca-ses. All cases with left renal vein entrapment syndrome were treated ,with the method of putting artifi-cial blood vessel as a sheath around left renal vein. Results The operations were all successful. The average operation time was 150 min, the average blood loss was 50 ml, and the average hospital stay after operation was 9 d. No surgical complications occurred. The gross hcmaturia disappeared in 6 ca-ses and Doppler ultrasound showed that left renal vein outflow was normal in 7 when the patients dis-charged from the hospital. The gross hematuria disappeared during 2-24 months' follow-up in 7 pa-tients. Conclusions The surgical aim of renal vein entrapment syndrome is to reduce the compres-sion of renal vein. The method of putting artificial blood vessel around renal vein could be a simple, safe and effective method.

Objective To investigate the effect of miR-10b on migration and invasion of human hepatocellular carcinoma (HCC) cell lines.Methods Transwell assay was used to evaluate the motility and invasiveness in different HCC cell lines,qRT-PCR was then used to detect the expression levels of miR-10b in different HCC cell lines.Artificial mimics of miR-10b were transiently transfected into HepG2 cells,which have low expression of miR-10b,and then the changes in migration and invasion were evaluated by Transwell assay.Antagomirs of miR-10b (miR-10b-AS) were transiently transfected into MHCC97H cells,which have high expression of miR-10b,and then the changes in migration and invasion were evaluated as well.Cell morphology changes were detected by immunofluorescence and electron microscopy,Results There was a significant correlation of miR-10b expression level with cell motility and invasiveness.Low-level expression of miR-10b was observed in HepG2 cells,which exhibited weak motility and invasiveness; whereas high-level expression of miR-10b was observed in MHCC97H cells,which exhibited strong motility and invasiveness.Up-regulation of miR-10b expression in HepG2 cells increased cell motility and invasiveness,whereas inhibition of miR-10b reduced cell motility and invasiveness in MHCC97H cells.Immunofluorescence and electron microscopy results showed that up-regulation of miR-10b in HepG2 cells significantly increased proliferation of filopodia and lamellipodia,whereas inhibition of miR-10b decreased filopodia and lamellipodia amount in MHCC97H cells.Conclusion miR-10b is involved in the invasion and metastasis of HCC cell through regulation of cytoskeleton in vitro and inhibition of miR-10b is likely to be a new molecular target to block metastasis.