Recent years,progress has been made on the basic researches and clinical applications of ocular surface reconstruction with autologous or allogeneic limbal stem cells,oral mucosa epithelium and ex vivo cultured limbal stem cells.However,there are several issues,including the successful treatment for severe ocular damage,longterm follow-up and evaluation of clinical outcome,and the in vivo tracking of donor stem cells,remained to have definitive conclusions.Future studies should address the questions and challenges based on the basic research of limbal stem cell deficiency and standardized evaluation of clinical outcome.

Objective To evaluate the feasibility of trans-umbilicus two-port laparoscopic procedures in pediatric surgery.Methods Sixty children (age, 3 months～14 years; mean, 3.5 years) with indirect inguinal hernia and 40 children (age, 2.5～14 years; mean, 6.3 years) with appendicitis underwent supra-high ligation and appendectomy, respectively, by using mini laparoscope from January 2003 to December 2003. During the supra-high ligation, the camera and forceps were respectively introduced via the left and right side of umbilical ring, and a hernial-ring needle with suture was brought in at the site of body surface projection of internal ring to apply external knotting. During the appendectomy, laparoscopic instruments were put through the site of right McBurney’s point, and explorations for contralateral hernia or other digestive tract malformations were applied simultaneously. Results All the operations were completed smoothly. The mean operating time was 8.5 min and 55.7 min in hernia repair (per side) and appendectomy, respectively. The mean postoperative hospital stay was 1～2 days in children with indirect inguinal hernia and 5～7 days in children with appendicitis. Follow-up for 3～12 months showed no recurrence of hernia except for 1 case of intraoperatively misdiagnosed latent hernia, which relapsed 2 months after the surgery. Postoperative abdominal cavity infection took place in 2 cases of perforated appendicitis. Conclusions Trans-umbilicus two-port laparoscopic technique is simple to perform, safe and minimally invasive. The technique has fewer complications and gives satisfactory cosmetic results, being highly recommended.

Bile Duct Neoplasms ; diagnosis ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Transplantation ; Prognosis

Objective To summarize clinical data of 33 patients with off-pumb coronary artery bypass grafting(OPCABG) procedure and analyze the benefit and curative effects of OPCABG procedure. Methods From February 2002 to June 2005,33 patients with cardiac function in class Ⅱ-Ⅲ (NYHA) and left ventricular ejection fraction(LVEF) was 34%-68%,and all of them underwent coronary artery bypass grafting(CABG) surgery without cardiopulmonary bypass. Results After operation,There was no death, the cardiac function improved in various degree. Preoperative angina disappeared. Conclusion OPCABG procedure is a safe, available, effective method for coronary artery disease.

Objective To assess the efficacy and clinical resuhs of thoracic endovascular aortic repair (TEVAR) in Stanford type B aortic dissection,and to explore the therapentic strategy and prevention of complication.Methods Fifty-eight patients with Stanford type B aortic dissection underwent TEVAR were enrolled,and were followed up regularly.Results The technical feasibility and success with deployment proximal to the entry tear was 100.0％(58/58),requiring partial coverage of the left subclavian artery in 20 patients and total coverage in 4 patients,and 2 patients used chimney stents.Hospital mortality was 5.2％ (3/58).Type Ⅰ endoleak was found in 11 patients (19.0％,11/58).In 55 survival patients,48 patients occurred thrombosis in pseudocoele and 2 patients' endoleak disappeared.Seven patients' endoleak appeared blood flow.Forty-eight patients(87.3 ％,48/55) were followed up for 3-68 months.Two patients died,and 2 patients' endoleak disappeared,with total suberization in pseudocoele.Other 5 patients' endoleak relieved,with partial suberization in pseudocoele.One patient had new intimal tear at the distal end of the stent-graft and required a second stent implantation.Conclusion TEVAR is safe and effective for the treatment of Stanford type B aortic dissection.

Objective To summarize the experience of surgical treatment of venous drug-induced infective endocarditis(IE). Methods The 17 cases of drug-induced IE were found to have valvular vegetations,16 patients had involvement of tricuspid valve, 1 mitral valve associated with ventrieular septal defect. Preoperative blood culture was positive in 8 patients. The operations included tricuspid valve repair (6 cases),tricuspid valve replacement(8 cases), mitral valve replacement and VSD closure(1 cases). Results All patients were alive and discharges. After follow-up of 6 months to 6 years, 1 case had severd tricuspid alve regurgitation, 1 had haemoptysis because of incorrect anticoagulation. Conclusions This study indicated surgical intervention is effective treatment of venous drug-induced infective endocarditis.

Aortic Valve ; pathology ; Calcinosis ; Heart Defects, Congenital ; pathology ; Heart Valve Diseases ; pathology ; Humans

Objective To investigate changes of serum cystatin C(Cys C),uric acid,HsCRP, IL-6,TNF-?,and lipids in patients with primary and secondary type Ⅱ b hyperhpidemia.Methods Seventy- five patients with primary and secondary type Ⅱb hyperlipidemia and 75 healthy controls were included in this study.Serum levels of TC,TG,HDL-C,LDL-C,apoAI,apoB,Lp(a),Cys C,UA,HsCRP were measured by immunoturbidimetric assay on AU-640,and IL-6,TNF-? were detected.Results Patients showed higher serum TC,TG,LDL-C,apoB,UA,Cys C and HsCRP than the controls.The levels in patients were(3.70? 0.66)mmol/L,(9.50?0.92)mmol/L,(4.50?0.31)mmol/L,(1.70?0.21)g/L,(1.21?0.17) mg/L,(441.4?114.7)?mol/L,(11.5?3.2)mg/L respectively,while levels in controls were(1.88? 0.66)mmol/L,(4.00?0.66)mmol/L,(2.80?0.33)mmol/L,(0.74?0.23)g/L,(0.71?0.18) mg/L,(343.0?113.9)?mol/L,(1.8?0.7)g/L respectively.Serum Cys C was positively correlated with HsCRP and UA(P

Humans ; Lung ; pathology ; Physical Examination ; Pneumoconiosis ; diagnosis ; Thoracotomy

Objective To investigate the genetic variation and molecular evolution of human bo-cavirus 1 (HBoV1) strains isolated during 2009 to 2014 in Hangzhou, China.Methods Throat swab sam-ples were collected from children with acute respiratory tract infections in the Children′s Hospital Affiliated to the Zhejiang University School of Medicine from 2009 to 2014.Real-time PCR was performed for the detec-tion of HBoV1 strains.Fifteen HBoV1 strains with high virus load were screened out for the amplification and sequencing of complete genomes.The complete genomes were submitted to GenBank for further analysis with bioinformatics software.Results A total of 48 nucleotide mutations were detected in the complete genomes of 15 HBoV1 strains, resulting in 11 amino acid mutations with 5 of them located in the active region of phospholipase A2 ( PLA2) .The 15 HBoV1 isolates along with 16 HBoV1 strains in GenBank were classified into three clusters as indicated by the phylogenetic analysis based on their complete coding sequences.All of the 15 strains were belonged to clusterⅠ, the representative strain of which was the Sweden prototype strain ST2.The phylogenetic trees constructed using genes encoding the capsid proteins VP1 and VP2 were highly similar to those based on the complete coding sequences.The estimated mean evolutionary rate of HBoV1 with regard to the complete coding sequence was 3.03×10-4(95%HPD, 2.14×10-4-3.92×10-4 ) substitu-tions per site per year.With regard to each gene, the NS1 gene was considered to the most conserved gene while the NP1 gene showed the highest substitution rate.The dN/dS ratios (ω) of the four genes were all less than 1, indicating that all of them were under negative selection.Moreover, the VP2 gene was under the strongest negative selection, while the NP1 gene was under the weakest negative selection.Conclusion All of the HBoV1 isolates circulating in Hangzhou province during 2009 to 2014 were belonged to ST2 genotype with a relatively high mutation in the area of PLA2.Despite the complete genome was conservative, its evo-lutionary rate was high.Among the four genes, the NP1 gene showed the highest substitution rate.All of the four genes were under negative selection, of which the VP2 gene was under the strongest negative selection.