Objective Through detecting the levels of von willebrand factor (vWF) ,vWF-cleaving protease (vWF-cp)before and after percataneous coronary intervention (PCI) in patients with coronary atherosclerotic heart disease ,to evaluate the relationship between them .Methods According to the results of coronary angiography ,study objects were divided into control group (normal) and PCI group ( the diagnosis of coronary heart disease with PCI operation ) .Enzyme-linked immunosorbent assay (ELISA) was carrout to determin the levels of plasma vWF concentration and vWF-cp activity in plasma and statistical analysis .Results The pre-operative ,postoperative vWF levels in plasma in PCI group were significantly higher than that in the normal control group ;The plasma vWF levels after PCI were significantly higher than that in the group before PCI (P< 0 .05) ;vWF-cp level of the PCI group were lower than in the control group ,and postoperation is lower than preoperation ( P < 0 .05) .With the coronary artery lesion worsen ,the plasma level of vWF increased ,while the level of vWF-cp activity decreased .Conclusion vWF and vWF-cp levels with the severity of coronary atherosclerosis and thrombosis risk was increased in different decreased ,which may play an important role in the pathogenesis of acute coronary syndromes .Changes of vWF and vWF-cp level after PCI indicate that interventional therapy can increase the risk of thrombosis to some extent .

微小RNA（microRNA，miRNA）是一种内源性的长度为18~25个核苷酸的非编码RNA，通过与蛋白质编码基因的 mRNA结合来发挥重要的基因调控作用，与恶性肿瘤的发生发展密切相关。miR-32作为miRNA家族的重要成员，在不同肿瘤中 表达水平存在明显差异，因其与恶性肿瘤的相关性及本身表达的正反作用双向性， 在miRNA领域受到了更多的关注。近年来研 究发现，miR-32对恶性肿瘤细胞的增殖、迁移与侵袭、自噬和凋亡均有影响。此外，miR-32与其上游靶基因、肿瘤代谢及临床诊 断和治疗也有密切的关系。本文就miR-32在恶性肿瘤发生发展中的作用及其机制、临床诊治中应用等最新研究进展作一综述。

Objective To apply the three-dimensional pre-operative simulation and intra-operative real-time navigation in the reconstruction of old maxillofacial fractures so as to increase the surgical precision. Methods Six patients with old maxillofacial fractures were enrolled, and the diagnosis of unilateral old maxillofacial fractures was confirmed by clinical and imaging examinations. Virtual three-dimensional skull models were reconstructed from pre-operative CT images. The fractured bone was moved or rotated, and was reposed in a desired site according to the mirrored part from the healthy side. After patient-to-image registration, the surgical instruments and patients were tracked in real-time by optical tracking system during operation, and in this way the maxillofacial fractures were reposed satisfactorily guided by the virtual image. Results Three-dimensional simulation before operation and real-time navigation of patients and instruments during operation were realized. The error of registration was less than 1 mm. The post-operative CT examinations of these six patients revealed that the fracture reposition was same to the pre-operative planning, and the difference between them was less than 1.5 mm. The operations were minimally-invasive, with no complications. Conclusion Computer-aided surgical simulation and navigation system can effectively increase the surgical precision of reconstruction of old maxillofacial fractures.

Objective:To observe the up-regulation of nuclear Clusterin (nCLU)gene on the biological behaviors of human non-small cell lung cancer cell line A549 .Methods:Sense eukaryotic expression vector of nCLU was constructed by cloning the cDNA of nCLU into pIREShyg3 vector. A549 cells were transfected with pIRES-nCLU and pIREShyg3 vectors by lipofectAMINE~(TM) 2000 mediation, respectively. Stable transfected cells were selected by hygromycin B screening. CCK-8 assay was performed to evaluate the effect of nCLU over-expression on cell proliferation in vitro. The expression level of nGLU protein was examined by Western blotting. Cell cycle distribution was detected by FCM with PI staining. The alteration of migration and metastasis potential of A549 cells before and after nCLU gene transfection were assayed by cell chemotactic migration and invasion test. Results:The proliferation speed of the transfected A549 cell clones stably over-expressing nCLU was slowed down. FCM analyses revealed that the percentage of cells in G_0/G_1 phase dramatically increased from (33.54±2.10)% to (63.31±4.30)%. The cell chemotactic migration and invasion potentials were markedly reduced after nCLU gene transfection (P<0.05). Conclusion:Up-regulation of nCLU can greatly inhibited the proliferation and decreased the migration and invasion capabilities of A549 cells.

Objective To explore the clinical characteristics of monochorionic or dichorionic twin pregnancy and the high-risk factors for selective intrauterine growth restriction.Methods 460 women with twin pregnancy were divided into a monochorionic group and a dichorion group.The related clinical features were compared between the two groups.Logistic regression was used to analyze the high-risk factors for selective intrauterine growth restriction.Results The maternal age,conception way,and mode of delivery differed significantly between the two groups (P ＜ 0.05).There were significant differences in the rates of selective intrauterine growth restriction and preterm premature rupture of membranes (P ＜ 0.05).The neonatal weight (large or small) and the rate of neonatal transfer differed significantly (P ＜ 0.05).Logistic regression showed that gestational age and birth weight were the risk factors.Conclusions The chorionic nature plays an important role in the process and outcomes of maternal pregnancy.Monochorionic pregnancy is a high risk factor for selective intrauterine growth restriction,meaning the major cause of selective intrauterine growth restriction may originate from the placenta,with should be a placenta-derived disease.

ObjectiveTo evaluate the effects of diagnosis of cervical insufficiency and different management on pregnancy outcomes.MethodsFrom June 2004 to May 2010, a retrospective analysis was carried out on 554 patients with cervical insufficiency in nine hospitals in Guangdong Province, China. The patients were divided into two groups, the cervical cerclage surgical treatment group (surgical group,n=357) and the expectant treatment group (n=197). These patients were then re-diagnosed according to the unified diagnostic criteria by the American College of Obstetricians and Gynecologists (2014), and divided into the definite diagnosis group (n=425) and the indefinite diagnosis group (n=129). The two independent samplest-test andChi-square test were used to compare pregnancy outcomes between the definite and indefinite diagnosis groups, and the different treatment groups.ResultsThe full-term delivery rate in the surgical group was significantly higher than that in the expectant treatment group [40.3% (144/357) vs 23.4% (46/197),χ2=16.254, P=0.000], and the late abortion rate was lower in the surgical group than in the expectant treatment group [22.4%(80/357) vs 40.1% (79/197),χ2=19.419,P=0.000]. In women with a definite diagnosis of cervical insufficiency, full-term delivery rate [44.7% (117/262) vs 20.9% (34/163),χ2=24.844,P=0.000], and newborn body weight were significantly higher in the surgical group [(2 664.3±762.2) vs (2 416.9±845.0) g,t=1.160,P=0.014] than in the expectant treatment group and the late abortion rate was significantly lower [21.4% (56/262) vs 41.1% (67/163),χ2=19.021,P=0.000]. Cervical cerclage in the indefinite diagnosis group did not resulted in raising the full-term delivery rate [28.4% (27/95) vs 35.3% (12/34),χ2=0.561], preterm delivery rate [46.3%(44/95) vs 29.4% (10/34),χ2=2.940], late abortion rate [25.3% (24/95) vs 35.3% (12/34),χ2=1.252] and newborn body weight [(2 526.5±761.8) vs (2 683.4±725.8) g,t=0.004] compared with expectant treatment group (allP>0.05). Pregnancy outcomes in the surgical treatment group in relation to twin pregnancies were not significantly different in the≥28 weeks delivery rate [81.4% (37/46) vs 69.2% (18/26),χ2=1.156], late abortion rate [19.6% (9/46) vs 30.8% (8/26),χ2=1.156] and newborn birth weight [(2 003.2±621.0) vs (1 807.5±609.4) g, t=0.057] compared with those in the expectant treatment group (allP>0.05).ConclusionsIn accordance with the diagnostic criteria for cervical insufficiency and indications for cervical cerclage in surgical cases, cervical cerclage can effectively improve pregnancy outcome. But cervical cerclage is not recommended in twin pregnancies with cervical insufficiency.

The conventional design and fabrication of the dental splint (in orthognathic surgery) is based on the preoperative planning and model surgery so this process is of low precision and efficiency. In order to solve the problems and be up to the trend of computer-assisted surgery, we have developed a novel method to design and fabricate the dental splint--computer-generated dental splint, which is based on three-dimensional model simulation and rapid prototype technology. After the surgical planning and simulation of 3D model, we can modify the model to be superior in chewing action (functional) and overall facial appearance (aesthetic). Then, through the Boolean operation of the dental splint blank and the maxillofacial bone model the model of dental splint is formed. At last, the dental splint model is fabricated through rapid prototype machine and applied in clinic. The result indicates that, with the use of this method, the surgical precision and efficiency are improved.
Computer-Aided Design ; Dental Models ; Humans ; Imaging, Three-Dimensional ; Jaw ; surgery ; Models, Anatomic ; Occlusal Splints ; Orthodontic Appliance Design ; methods ; Surgery, Computer-Assisted ; methods

Objective:To explore pathogenesis,characteristic genes and immune infiltration of rheumatoid arthritis(RA)by bioinformatics and machine learning methods,and to find correlation between characteristic genes and immune cells.Methods:Chips related to RA were obtained from GEO database,gene differences were analyzed by R language,and GO and KEGG were enriched and analyzed;machine learning methods,namely LASSO regression and SVM-RFE were used to screen disease characteristic genes,ROC curve and sample chips were used to detect accuracy of characteristic genes,CIBERPORT algorithm was used to analyze immune infiltration of RA,and correlation between characteristic genes and immune cells was analyzed.Results:A total of 90 differen-tial genes were obtained from GSE12021 and GSE55235,including 64 up-regulated and 26 down-regulated differentially expressed genes.A total of 209 main items were obtained by GO analysis,mainly involving leukocyte activation,lymphocyte activation,B-cell receptor signaling pathway,etc;KEGG analysis showed that chemokine signaling pathway,IL-17 signaling pathway,Toll-like recep-tor signaling pathway and PPAR signaling pathway were closely related to RA;ten key genes such as IGHM,SLAMF8,CXCL10,FNDC4,AIM2,EGR1 and AKR1B10 were screened by mechanical learning method.Disease characteristic genes were IGHM,SLAMF8,CXCL10,AIM2 and AKR1B10 by ROC curve and sample chip;immune infiltration results showed that there were signifi-cant differences between synovial tissues of RA and normal tissues in 9 kinds of immune cells,such as plasma cells,CD8 T cell,CD4 T cell and T cell follicle helper.By analyzing correlation between disease characteristic genes and immune cells,it was found that there were significant correlations between 5 characteristic genes and some immune cells.Conclusion:There is a significant correla-tion between characteristic genes and immune cells of RA,which provides a preliminary basis for follow-up in-depth study of targeted diagnosis and treatment of RA.

Objective To investigate the influence of preoperative splenectomy on the prognosis after liver transplantation.Methods The retrospective cohort study was conducted.The clinical data of 95 patients who underwent liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University between January 2004 and January 2014 were collected.Thirty-five patients undergoing preoperative splenectomy and pericardial devascularization and 60 undergoing spleen-preserving liver transplantation were allocated into the study group and control group,respectively.All patients received modified piggyback liver transplantation by the same team.Observation indicators:(1) intra-and post-operative situations;(2) follow-up and survival.The follow-up using telephone interview and outpatient examination was performed once every a week within 3 months postoperatively,once every one month within 6 months postoperatively and once every 3 months after 1 year postoperatively up to January 2016,including routine blood test,plasma-drug concentration of immunosuppressive agent and function of liver and kidney.Ultrasound and abdominal CT were used to monitor the long-term complication and survival.The measurement data with normal distribution were represented as (x)±s,and comparison between groups was done by the t test.Comparison of count data was done by the chi-square test.Results (1) Intra-and post-operative situations:all patients underwent successful liver transplantation.The operation time,volumes of intraoperative blood loss and blood transfusion were (483 ± 136) minutes,(5 683±2 950) mL,(4 887±3 682) mL in the study group and (392± 103)minutes,(3 522± 1 885)mL,(3 455±2 630)mL in the control group,respectively,with statistically significant differences between groups (t=3.683,4.358,2.202,P＜0.05).Six patients in the study group had intraoperative portal vein thrombosis (PVT),including 4 in level 1,1 in level 2 and 1 in level 3,and no patients in the control group,showing a statistically significant difference between groups (x2 =1.979,P＜0.05).Five patients with PVT in level 1 or 2 underwent thrombectomy and then end-to-end anastomosis of PV.One patient with PVT in level 1 had PVT recurrence and was cured by postoperative thrombolytic therapy.One patient with PVT in level 3 received PV reconstruction using artificial blood vessels,and had PVT recurrence and then was cured.There was no PV stenosis between groups.The levels of platelet at 1,3 and 7 days postoperatively were (75±60)× 109/L,(71± 45)×109/L,(111±73)×109/L in the study group and (57±32) ×109/L,(52±46) ×109/L,(87±53)×109/L in the control group,respectively,with statistically significant difference between groups (t =1.909,1.957,1.848,P＜ 0.05).The levels of platelet at 14 and 30 days postoperatively were respectively (230± 152)× 109/L,(310± 140)× 109/L in the study group and (193± 125)× 109/L,(286±62)× 109/L in the control group,with no statistically significant difference between groups (t=1.284,1.199,P＞0.05).The cases with postoperative infection,acute rejection,new-onset PVT in level 1-2 and 3-4 and PV stenosis were respectively 23,0,2,0,2 in the study group and 35,1,2,0,1 in the control group,with no statistically significant difference between groups (x2 =1.171,0.590,0.547,1.184,P＞0.05).Patients with postoperative infection and acute rejection were improved by symptomatic treatment.Two patients in the study group with PVT underwent anticoagulant and thrombolytic therapy,including 1 receiving interventional thrombectomy therapy.Two patients in the control group with new-onset PVT were cured by anticoagulant and thrombolytic therapy.Three patients with PV stenosis underwent percutaneous transhepatic portography (PTA) for balloon dilation,including 1 in the study group with good improvement after stent implantation.(2) Follow-up and survival:95 patients were followed up for 3-24 months,with an average time of 18 months.During the follow-up,the rate of chronic rejection in study and control groups was 5.7％(2/35) and 5.0％(3/60),showing no statistically significant difference between groups (x2 =0.023,P＞0.05).The 1-and 2-year accumulative survival rates were respectively 91.4％ (32/35),82.9％ (29/35) in the study group and 93.3％ (56/60),76.7％(46/60) in the control group,with no statistically significant difference between groups (x2 =0.780,P＞0.05).Conclusion The splenectomy before liver transplantation is easy to form PVT,increase time and difficulty of transplantation surgery,however,it doesn't increase complication risk after transplantation and affect postoperative survival.

Objective:To explore the clinical efficacy of robot guided balloon tibial osteoplasty for the treatment of Schatzker II and III tibial plateau fractures.Methods:A retrospective analysis was conducted on the data of 59 patients admitted from January 2017 to December 2022. According to the surgical method, they were divided into two groups: robot guided percutaneous balloon tibial osteoplasty with "Jail" screw fixation group (study group) and open reduction and internal fixation group (control group). There were 28 cases in the study group, including 13 males and 15 females, with an average age of 44.21±9.70 years. In the study group, 8 cases were diagnosed of Schatzker II and 20 cases of Schatzker III. There were 31 cases in the control group, including 16 males and 15 females, with an average age 47.94±13.73 years. In the control group 7 cases were diagnosed of Schatzker II and 24 cases of Schatzker III. Between the two groups, demographics, surgical challenges and outcomes were all compared, including age, fracture classification, fracture collapse volume, surgical time, intraoperative bone graft volume, incision length, postoperative drainage volume, length of stay, fracture reduction quality (proportion of collapse area reduction volume evaluated by postoperative CT, Rasmussen radiology score), knee joint hospital for special surgery (HSS) score at 6 months after surgery, pain visual analogue scale (VAS) scores at before and 3 days after surgery and the final follow-up, complications.Results:All the patients were followed up for 116.92±6.08 months. The surgical time was 88.50±21.32 min in the study group, and 65.16±18.10 min in the control group with significant difference ( t=4.55, P<0.001). Between the study group and the control group, the intraoperative bone graft volume (3.04±1.15 cm 3vs. 5.87±2.03 cm 3), incision length (3.34±1.02 cm vs. 17.65±2.33 cm), postoperative drainage volume (13.04±19.45 ml vs. 85.16±41.54 ml), and length of hospital stay (11.64±3.07 d vs. 18.77±4.78 d) were all found to be significantly differently ( t=-6.69, P<0.001; t=-31.02, P<0.001; t=-8.67, P<0.001; t=-7.06, P<0.001). After 6 months of surgery, Rasmussen's radiological score was 17.32 ± 1.06 in the study group and 17.58 ± 0.85 in the control group with no significant difference ( t=-1.04, P=0.150). After 6 months of surgery, the HSS score in the study group was 93.75±2.22, and 92.71±2.19 in the control group with significant difference ( t=1.81, P=0.038). The VAS score between the study and control group was 7.04±0.92 vs. 7.00±0.97 before the surgery, 2.71±0.85 vs. 4.74±0.93 three days after surgery, and 0.21±0.49 vs. 0.26±0.51 at the final follow-up with significant pain relief at either three days or the final follow up within either group ( F=1884.53, P<0.001; F=55.98, P<0.001). Significant difference between the two groups was found at three days after the surgery ( t=-10.28, P<0.001), while no significant difference was found before surgery or at the final follow-up ( P>0.05). The wounds in the study group healed well, while in the control group, 4 cases had poor wound healing. One case in the study group had intraoperative balloon rupture and contrast agent leakage, while two cases had bone graft material leakage. There were no intraoperative complications in the open group. Conclusion:Robot guided balloon tibial osteoplasty for Schatzker II and III tibial plateau fractures had achieved satisfactory reduction, minimal bleeding, minimal trauma, short hospital stay, good knee joint function recovery, and satisfactory clinical results. However, attention should be paid to the issue of contrast agent leakage caused by balloon rupture.