Objective To compare the clinical effect of the peripheral balloon closure with surgical intervention for developed retroperitoneal hematoma(RPH) caused by femoral artery perforation .Methods A retrospecive analysis was performed on 2 492 consecutive patients underwent PCI from January 2005 to December 2013 in Guangdong people′s hospital .Twenty -four cases of developed RPH caused by femoral artery puncture operation for PCI were retrospectively analyzed ,13 cases of patients who took peripheral balloon closure were divided into balloon block group and the other 11 patients adopted surgery vascular repair process‐ing ,were enrolled in the surgical treatment group .Comparison was done among the hemostatic effect and the time ,and postoperative adverse events ,including lower limb blood supply obstacles for puncture side postoperative ,major adverse cardiovascular events (MACE) during hospitalization ,all‐cause mortality ;Multivariate logistic regression was used to assesse the RPH risk factors .Re‐sults The incidence of RPH caused by femoral artery perforation was about 0 .96% .During coronary intervention ,the following variables were found to be independent predictors of RPH caused by femoral artery perforation:female gender(OR=8 .94 ,95% CI:3 .75-21 .98 ,P< 0 .01) ,femoral artery ulcer(OR= 6 .43 ,P<0 .05) and multiple puncture (> 3 times) (OR= 7 .39 ,95% CI:2 .74-13 .76 ,P<0 .01) .Hemostatic success rates of the two groups were all 100% ;the average times of processing perforation were (76 .8 ± 34 .6) min and ((88 .5 ± 37 .3) min ,P<0 .05 ,the difference was statistically significant ;3 cases (23 .1% ) and 2 cases (18 .2% ) developed into postoperative severe anemia (Hgb<60 g/L) in each group ,P>0 .05;Each group had 1 case for in‐hospital MACE (7 .7% vs .9 .1 % ,P>0 .05);In the two groups ,there was no lower limb blood supply obstacles and death case .Conclusion For progress RPH caused by femoral artery perforation ,peripheral balloon closure can be a faster ,better sealing hemostatic ,and shorten the rescue time ,and the success rate is high ,and there is less postoperative adverse events .The safety and effectiveness be‐have good .

Objective To compare the clinical effects of dynamic hip screw(DHS),Gamma interlocking intramedullary nail and proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric femoral fractures in elderly patients.Methods From January 2008 to June 2015,103 elderly patients with intertrochanteric femoral fracture were treated with DHS (DHS group,33 cases),Gamma nails (Gamma group,30 cases),or PFNA (PFNA group,40 cases).By the AO classification,there were 44 cases of type 31-Al,30 cases of type 31-A2 and 29 cases of type 31-A3.The 3 groups were compared in terms of incision length,operation time,intraoperative blood loss,fracture healing time,postoperative weight-bearing time,Harris scoring,and incidence of postoperative complications.Results PFNA group incurred significantly shorter incision length (5.4 ±0.5 cm) and operation time (70.8 ± 16.2 min) than DHS group (12.6 ±2.7 cm and 102.6±17.4min) and Gamma group (7.5±0.8 cmand93.0±35.9 min) (P ＜0.05).The intraoperative blood loss in PFNA group (163.2 ± 60.6 mL) was significantly less than in DHS group (280.5 ±89.8 mL) and in Gamma group (204.9 ±62.2 mL),and that in Gamma group was also significantly less than in DHS group (P ＜ O.05).PFNA group had significantly shorter weight-beating time (11.0 ± 0.8 weeks),fracture healing time(13.6 ± 1.5 weeks) and significantly higher Harris good to excellent rate (92.5％) than DHSgroup (13.3±1.0weeks,15.8 ± 1.2 weeks and 84.8％) and Gamma group (12.5±1.3 weeks,14.2 ± 1.0 weeks and 86.7％) (P ＜ 0.05).The incidence of postoperative complications in DHS group (21.2％)was significantly higher than in Gamma group(10.0％) and in PFNA group (7.5％) (P ＜ 0.05).Conclusions DHS,Gamma nail and PFNA are effective means for the treatment of intertrochanteric femoral fractures in the elderly.Intramedullary fixation,especially by PFNA,shows superiority in the clinical outcomes.

BACKGROUND:In view of the unavoidable problems of autogenous and al ogenous bone grafts, it is an urgent need to develop biodegradable bone substitute materials, among which is calcium phosphate material that has become a hot spot in the domestic and foreign research. OBJECTIVE:To develop a biodegradable calcium phosphate material for bone repair based on tetracalcium phosphate (TTCP). METHODS:The biodegradable calcium phosphate cement made from TTCP, dicalcium phosphate anhydrous and different constituents of curing liquids was prepared under room temperature (about 25 ℃). The effects of solid components, liquid components as well as calcinations and drying temperature on the physical and biological performances were detected through X-ray diffraction test, hardness test, decay in a simulated body fluid, hemolysis and cytotoxicity tests, respectively, to select the bone repair material with excel ent performances. RESULTS AND CONCLUSION:When the calcination temperature was lower than 1300 ℃, TTCP was rarely available;only close to 1400 ℃, the relatively pure TTCP was gained. A large number of pure TTCP were gained by rapid cooling because of avoidance of the moisture impact, but slow cooling made the main products to be hydroxyapatite, suggesting that rapid cooling is essential to obtain pure TTCP. With the increase of the proportion of citric acid solution in the liquid phase, the pH values and the hemolysis rate in the bone cement soak solution were increased gradually, illustrating that citric acid solution is easy to induce hemolysis. In vitro cel experiments showed that the hemolysis rate of bone cement with a solution of 2:1 NH4/Na ratio was the lowest, and the biocompatibility was the best, which was the most favorable to cel growth. Cements was made of calcined powders sieved at 1400 ℃ and showed the shortest initial setting time, least effect on pH values, lowest disintegration rate and hemolysis rate, and slightest inhibition effect on the cel proliferation, indicating that the bone cements made of sieved powder after 1400 ℃ calcination is more suitable for clinical application.

BACKGROUND: Exercise has been proved to accelerate the proliferation of intervertebral disc cells and extracellular matrix production in healthy rats. For the degenerative intervertebral disc, whether exercise also has positive effects on its cell proliferation, extracellular matrix production or pain relief remains unclear. OBJECTIVE: To investigate the effect of exercise on the extracellular matrix production in a rat model of intervertebral disc degeneration.METHODS: A rat model of intervertebral disc degeneration was prepared by Freund's complete adjuvant injection into the intervertebral disc at L5-6 levels. Then, the model rats were allowed to have a rest for 2 weeks. All rats were then randomly divided into exercise and control groups. Rats in the exercise group were forced to run every day, while the controls allowed free activities in the cage. The behavioral tests were performed at 7, 14, 28, 42, 56 and 70 days after modeling; meanwhile, the intervertebral disc samples were collected used for alcian blue staining and immunohistochemical staining to detect the levels of proteoglycan, aggrecan and collagen type Ⅱ in the intervertebral disc cells, respectively.RESULTS AND CONCLUSION: Vocalization threshold on the rat back of punctured disc was significantly decreased, while grooming and wet-dog shaking were significantly increased at 7 days after modeling compared with the baseline (P < 0.05), suggesting that Freund's complete adjuvant injection successfully induces disc degeneration, hyperalgesia and abnormal behaviors. Further, the vocalization threshold and wet-dog shaking in the exercise group showed significant improvement compared with the control group after 14 days of exercise (P < 0.05), while the grooming was significantly reduced until the 28th day (P < 0.01), indicating that exercise can alleviate pain caused by disc degeneration in model rats. At 21 days after modeling, the levels of proteoglycan, aggrecan and collagen type Ⅱ in the nucleus pulposus and annulus fibrosus were significantly decreased compared with the baseline (P < 0.01), indicating the occurrence of disc degeneration. After 14 days of training, the levels of proteoglycan, aggrecan, and collagen type Ⅱ in the nucleus pulposus and annulus fibrosus in the exercise group were significantly increased compared with the control group (P < 0.01). Moreover, after 8-week exercise, the level of proteoglycan in the nucleus pulposus and annulus fibrosus in the exercise group was increased by 4-5 times compared with the control group, and levels of aggrecan and collagen type Ⅱ in the nucleus pulposus in the exercise group also was increased by 3-4 times compared with the control group. To conclude, exercise can promote extracellular matrix increased by production by increasing the levels of proteoglycan, aggrecan, and collagen type II in the degenerative intervertebral disc.

ObjectiveTo investigate the changes of serum concentration of parathyroid hormone (PTH) and calcium after thyroid surgery and compare the changes among different modes of operation. MethodsFrom Aug. 2006 to Dec. 2009, 470 patients accepted thyroid surgery. The serum concentration of PTH and calcium in different groups was measured and compared before and 1 day after surgery. According to the extent and similarity of the surgery, patients were classified into 7 groups and they were compared in terms of postoperative changes of PTH and serum calcium. Statistical analysis was performed. ResultsThe serum concentration of PTH and calciurn decreased significantly after surgery in all patients except for those receiving unilateral and bilateral partial thyroidectomy. Compared with unilateral lobectomy, surgeries such as bilateral subtotal thyroidectomy, unilateral thyroidectomy with contralateral subtotal thyroidectomy, bilateral near-total thyroidectomy and total thyroidectomy resulted in more dramatic decreases of serum concentration of PTH and calcium and higher incidence of hypocalcemia ( P ＜ 0.05 ). The comparison between patients receiving CLND or not had the same result. Conclusions Almost all kinds of thyroid surgery affect the parathyroid function. The wider the surgery, the higher the possibility of postoperative hypoparathyroidism. The indications and criteria of different types of thyroid surgery are essential for hypoparathyroidism prevention. In some cases, vitamin D and calcium are recommended for preventive purpose.

This article reports a case, happened in July 2019, of 9 severed segments of 2nd-5th fingers in left hand treated in the Department of Repair and Microsurgery, Zhengzhou Renji Hospital. Through the unified management before surgery, team surgery, three or four fixed-point mattress eversion suture and close observation after surgery. It can effectively prevent the occurrence of vascular compromise. All the replanted fingers survived after the surgery. And the function of the fingers recovered well at 2 years after surgery through early and continuous rehabilitation exercise.

Objective:To observe the imaging features of fundus lesions associated with COVID-19.Methods:A observational case series study. Twenty eyes of 10 patients with fundus lesions associated with COVID-19 at Xiamen Eye Center of Xiamen University from December 10, 2022 to January 20, 2023 were included in this study. There were 1 males and 9 females, aged from 17 to 49 years, with the median age of 26 years. The time of ocular symptoms after the diagnosis of COVID-19 was 0-2 days. The time from the onset of ocular symptoms to seeing a doctor was 1-14 days. All patients were examined by best-corrected visual acuity (BCVA), intraocular pressure, color fundus photography, infra-red fundus photography (IR), optical coherence tomography (OCT). Serum D-dimer examination was performed in 3 patients. The median BCVA was 0.4. There was no abnormalities in intraocular pressure and anterior segment examination. Among 20 eyes of 10 patients, there were 10 eyes of 5 patients with acute macular neuroretinopathy (AMN), 6 eyes of 3 patients with Purtscher-like retinopathy (PLR), 4 eyes of 2 patients with central retinal vein occlusion (CRVO). The imaging features of fundus were observed and analyzed.Results:Retinal lesions included AMN, paramacular central medial retinopathy (PAMM), PLR, cotton wool spots, hemorrhage, optic disc edema, macular edema. AMN was found in 10 eyes, with reddish-brown and wedge-shaped lesion in the fovea, dark area in IR and hyper reflectivity in outer nuclear layer and outer plexiform layer by OCT. The cotton wool spot showed hyper reflectivity on retinal nerve fiber layer whereas PAMM showed band-shape hyper reflectivity in inner nuclear layer by OCT. The Purtscher spot was seen at the posterior pole and/or peripapillary in 6 eyes of PLR. By OCT examination, the retinal nerve fiber layer corresponding to Purtscher flecken was significantly thickened and the reflex was enhanced. Among 6 eyes of PLR, there were 4 eyes combined with AMN, 1 eye with PAMM and macular edema. In 4 eyes of CRVO, vitreous cells, optic disc edema, retinal flame, spot hemorrhage, and atypical cotton wool spots were seen in 2 eyes.Conclusions:The manifestations of fundus lesions associated with COVID-19 are varied. The multilayer structure of retina is involved, and the microvessels of retina and choroidal capillary layer are damaged.

Leaf water potential of peanut subjected to drought stress is positively related to the oil content of peanut kernels. The aim of this study was to directly screen the high oil mutants of peanut and create the new peanut varieties using hydroxyproline as water potential regulator. In vitro mutagenesis was carried out with the embryonic leaflets of peanut variety Huayu 20 as explants and pingyangmycin as a mutagen added into the somatic embryo formation medium. The formed somatic embryos were successively transferred to somatic embryo germination and selection medium containing 6 mmol/L hydroxyproline (at -2.079 MPa water potential ) to induce regeneration and directionally screen high oil content mutants. After that, these plantlets were grafted and transplanted to the experimental field and 132 high oil mutants with oil content over 55% were obtained from the offspring of regenerated plants. Finally, among them, the oil contents of 27 lines were higher than 58% and of 2 lines were higher than 60%. A new peanut variety Yuhua 9 with high yield and oil content was bred from the regenerated plant progenies combining the pedigree breeding method. The yield was 14.0% higher than that of the control cultivar in the testing new peanut varieties of Liaoning province, and also it has passed the national registration of non-major crop varieties. Yuhua 9 with an oil content of 61.05%, which was 11.55 percentage points higher than that of the parent Huayu 20, was the peanut cultivar with the highest oil content in the world. The result showed that it was an effective way for directional breeding of high oil peanut varieties by means of the three-step technique including in vitro mutagenesis, directional screening by reducing water potential in medium and pedigree selection of regenerated plant progenies.
Arachis ; Droughts ; Germination ; Mutagenesis ; Plant Breeding

Cleft lip and/or palate (CLP) are the most common craniofacial malformations in humans. Speech problems often persist even after cleft repair, such that follow-up articulation training is usually required. However, the neural mechanism behind effective articulation training remains largely unknown. We used fMRI to investigate the differences in brain activation, functional connectivity, and effective connectivity across CLP patients with and without articulation training and matched normal participants. We found that training promoted task-related brain activation among the articulation-related brain networks, as well as the global attributes and nodal efficiency in the functional-connectivity-based graph of the network. Our results reveal the neural correlates of effective articulation training in CLP patients, and this could contribute to the future improvement of the post-repair articulation training program.
Brain/diagnostic imaging* ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Humans ; Magnetic Resonance Imaging ; Reading