Attention is being paid to the treatment of hyperopia(presbyopia) with laser thermokeratoplasty.This article mainly presents the theory of laser thermokeratoplasty(LTK),equipment configuration and some key techniques in laser delivery system.

Objective To establish a method for ex vivo cord blood stem cell expansion,increase the number of the stem/progenitor,especially megakaryocyte progenitors so as to decrease the thrombocytopenia period after CBT.Methods Mononuclear cells (MNC) from 20 cord blood samples were cultured in presence of different cytokines:group 1:IL 3,IL 6,group 2:IL 3,IL 6,TPO,group 3:IL 3,IL 6,TPO and cord blood plasma.The final concentration of the cytokines was 50ng/ml.The control group had all medium except the cytokines and cord blood plasma.The cells were cultured for 21 days.At every 7 days,tests were done for nucleate cells number,CFU GM,CFU Mk,and CFU GEMM.Results At different times and in different groups,there were different changes.For NC,maximal increase were obtained in group 3 on day 21,which was 239.65?153.48.For CFU GM,the biggest expansion occurred on day 21 in group 3,the number being 184.17?140.40.For CFU Mk,the biggest expansion was obtained on day 14 in group 3,with the number of 135.34?105.20. The immature progenitor CFU GEMM achieved the max increase in group 3 on day 14,the number was 49.39?36.68. Conclusion The expansion of CFU Mk progenitor cells can be obtained in the presence of IL 3,IL 6,TPO.This combination also enhances the expansion of CFU GM and CFU GEMM.Addition of cord blood plasma can promote the expansion of mature and immature progenitor cells.

Objective To discuss the etiology and treatment of extrahepatic biliary stenosis due to iatrogenic bile duct injuries. Methods A total of 12 cases of extrahepatic biliary stenosis after iatrogenic bile duct injuries(including 5 cases of open cholecystectomy and 7 cases of laparoscopic cholecystectomy) from January 1998 to January 2005 in this hospital was reviewed.After the establishment of a percutaneous transhepatic access,choledochoscopic stone removal,balloon dilatation,and drainage stent placement were performed for treating biliary stenosis.Results A F_(20) Gruntzig balloon catheter was employed for bile duct dilatation.The plastic drainage stent at 6~8 mm in diameter was successfully placed after 2 times of dilatation in 8 cases and after 3 times of dilatation in 4 cases,for 6~12 months of indwelling.Follow-up observations in the 12 cases for 2~3 years (mean,2.6 years) found no abdominal pain,fever,or jaundice.B-ultrasonography and MRCP findings showed no biliary stenosis and recurrent stones.Conclusions Choledochoscopic stone removal,balloon dilatation,and drainage stent placement are minimally invasive,safe,and effective in the treatment of extrahepatic biliary stenosis.

Objective To investigate methods and effects of percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma in the treatment of recurrent intrahepatic biliary duct stones. Methods Eight cases of recurrent intrahepatic biliary duct stones after a Roux-en-Y cholangiojejunostomy from January 2000 to February 2005 were treated with percutaneous choledochoscopy. An enterostomy was made at the afferent jejunal loop. Then a choledochoscope was introduced into the intrahepatic biliary ducts by way of the cholangio-jejunal anastomotic stoma for stone removal and intrahepatic duct or anastomotic stoma dilatation. Results The intrahepatic stones were thoroughly removed in all the 8 cases. The biliary duct stenosis in 4 cases and the anastomotic stoma stenosis in 2 cases were relieved. Follow-up checkups in the 8 cases for 1~3 years revealed no recurrence of intrahepatic stones or stenosis. Conclusions Percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma is minimally-invasive, safe, feasible, and effective in the treatment of recurrent intrahepatic biliary duct stones.

Objective: To investigate the characteristics of volunteer blood donors with regular apheresis platelets in Zhoushan City, Zhejiang Province, so as to provide insights into recruitment of regular blood donors. Methods: Gender, age, occupation, educational level, and volume and times of blood donation were collected from volunteer blood donors with apheresis platelets in Zhoushan Central Blood Station during the period from 2019 to 2021 through the Zhejiang Provincial Blood Management Information System BIS version 3.0, and the willingness of blood donation, routes for acquiring blood donation knowledge and cause of blood donation were collected from volunteer blood donors with regular apheresis platelets using questionnaire surveys. The factors affecting regular apheresis platelets were identified among volunteer blood donors using a multivariable logistic regression model. Results: Totally 236 volunteer blood donors participated in regular apheresis platelets in Zhoushan City from 2019 to 2021, accounting for 51.08% of all volunteer blood donors with regular apheresis platelets, and there were 1 488 blood donations, accounting for 71.23% of all volunteer blood donations with apheresis platelets. A total of 2 086.00 U platelets were donated, accounting for 71.82% of all volumes of volunteer blood donations with apheresis platelets. The volunteer blood donors included 160 men (67.80%) and 76 women (32.20%) and had an age of 35 (17) years. There were 63 employees (26.69%) and 111 with a bachelor degree and above (47.03%). Multivariable logistic regression analysis showed a high proportion of regular blood donations among participants at ages of 31 to 60 years (OR:1.767-3.257, 95%CI: 1.010-6.250), university students (OR=2.598, 95%CI: 1.238-5.450) and civil servants (OR=2.733, 95%CI: 1.193-6.263). There were 228 participants with willingness to continue to participate in volunteer blood donation with regular apheresis platelets (96.61%), and 215 participants with a history of participating in volunteer blood donation surveys (91.10%). Internet was the predominant route for acquiring knowledge about apheresis platelet donation (41.10%), and “think that blood donation is a meaningful thing” was the predominant cause of participating in volunteer apheresis platelet donation (33.05%). Conclusions There is a high proportion of regular blood donation among civil servants and university students.

Objective To explore the clinicopathological features ,diagnosis and differential diagnosis of pleuropulmonary blasto-ma(PPB) .Methods A case of PPB was reported by light microscopic observation ,immunohistochemistry and molecular pathology study with review of related literature .Results A 45-year-old female was admitted to the hospital because of cough and dyspnea . Chest radiogram revealed a solid mass in the left lung .Grossly ,the tumor was described as a firm lesion with lumina or multicystic components and well-circumscribed margins .Microscopically ,the tumor was composed of sheets of malignant primitive small cells and fascicles of embryonal rhabdomyosarcoma-like cells with foci hyalinized stroma .Beneath the benign epithelium ,the primitive mesenchymal cells showed as mixed blastematous and sarcomatous characteristics that plump spindle shaped cells presented poor differention with abundant eosinophilic cytoplasms and brisk mitotic activities .Immunohistochemically ,vimentin and MyoD-1 were positive in malignant small cells but some epithelial markers are negative .Meanwhile ,K-RAS extron 3 mutation was detected by high resolution melting analysis(HRMA) .Conclusion Pleuropulmonary blastoma(PPB) is a rare malignant tumor with unique clinicopathological features .It should be distinguished from some mimics such as pulmonary blastoma and embryonal rhabdomyo-sarcoma .

BACKGROUND:In vitro and in vivo studies of cel response to a variety of mechanical loadings have demonstrated the stimulation of bone formation by loads. However, the effects of different mechanical strains on the same cel s have never been adequately studied by far.
OBJECTIVE:To investigate the effects of different mechanical strains on rat bone marrow mesenchymal stem cel s.
METHODS:Rat bone marrow mesenchymal stem cel s were isolated and cultured in vitro. Bone marrow mesenchymal stem cel s were subjected to different stimulations including dynamic stretch, static stretch and hybrid stretch through the use of custom-made mechanical stretch device. Cel ular proliferation, alkaline phosphatase activity and mRNA expression of Runx2 of bone marrow mesenchymal stem cel s were detected and the secretion of osteocalcin was evaluated under three different stretch modes respectively.
RESULTS AND CONCLUSION:Compared to the control group, cel proliferation increased by 18.67%, however, alkaline phosphatase activity, Runx2 expression and osteocalcin secretion were not changed obviously in the static stretchgroup. Compared to the control group, alkaline phosphatase activity, Runx2 expression and osteocalcin secretion increased by 60.33%, 49.67%and 48%respectively;however, cel proliferation was inhibited, in the dynamic stretch group. Compared to the control group, cel proliferation was slightly, but not significantly, increased in the hybrid stretch group, and the alkaline phosphatase activity, Runx2 expression and osteocalcin secretion increased although the increases were not as apparent as those in the dynamic stretch group. These findings suggest that static mechanical strain can significantly promote cel proliferation, the dynamic mechanical strain more greatly promotes osteogenic differentiation of bone marrow mesenchymal stem cel s, and the hybrid mechanical strain promotes the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cel s.

Objective To analyse effect of berberine combined with levofloxacin on myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea.Methods 58 patients who were diagnosed with pediatric infectious diarrhea in our hospital were collected.All patients were randomly divided into experimental group and control group, 29 cases in each group.two groups of patients were given routine treatment, including infusion, maintaining water and electrolyte balance, supplemental calories etc.On the basis of routine treatment, control group was intravenous dripped with levofloxacin injection 200mL,one times per day,and experimental group was treated with berberine hydrochloride tables 0.2 g orally on the basis of control group.The treatment period was one week of two group.After one week of treatment, the serum levels of myocardial enzymes, isozymes, inflammatory factors and clinical curative effect were detected in all patients.Results Compared with control group post-treatment,the serum AST,ALT and LDH levels were lower than that of experimental group(P<0.05);the serum CK and CK-MB levels were lower than that of experimental group(P<0.05);the serum TNF-α,IL-6 and IL-10 levels were lower than that of experimental group(P<0.05);the total effective rate was higher in experimental group(P<0.05).Conclusion The berberine combined with levofloxacin can significantly reduce the serum myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea, improve clinical curative effect.