Objective To explore adaptability of the patellofemoral joint after combined soft-tissue surgery in treatment of habitual patellar dislocation at different age. Methods Seventy-three children with habitual patellar dislocation were retrospectively reviewed from 2000 to 2007. There were 24 males and 49 females, with a mean age of 7.1 years(ranged 3-15). The mean follow-up period was 38 months (ranged 25-98). There were 24 patients with 30 knees aged from 3 to 8 years in A group and 49 cases with 69 knees aged from 8 to 15 years in B group. The combined soft-tissue surgery procedure consists of lateral capsular release, medial retinacular tightening of the knee, vastus medialis muscle transfer to the patella, medial and distal transfer of the half patellar tendon. Patella axial and knee lateral X-ray examination were obtained.Femoral trochlear angle,patellar height changes, patellofemoral congruence angle and patellar tilt angle (Laurin angle) were measured to evaluate adaptability of the patellofemoral joint. Results The data of 73 cases were complete. At the last visit, no recurrence of patellar lateral dislocation was found and two cases had patella medial dislocation. Femoral trochlear angle improved from 150.1°±5.1° preoperatively to 144.3°±6.0° postoperatively (P ＜0.05) in A group, while similar changes had not found (P ＞ 0.05) in B group. There were no difference in A and B group in regard to patellar height, congruence angle and Laurin angle. Conclusion The combined soft-tissue surgery had effect on patellofemoral joint remodel in children with habitual patellar dislocation. These procedures can significantly promote development of the femoral condyle, decrease femoral trochlear angle and improve adaptability of the patellofemoral joint in children under the age of 8 years. But it had no obvious influence on older than 8-year-old children.

Objective To study the effects of interferon γ(IFN-γ) on terminal erythroid differentiation.Methods RT-qPCR was used to detect the expression of IFN-γ receptors during erythroid differentiation of K562 induced by hemin.Both hemin-induced K562 cells and human umbilical cord CD34+ cell derived primary erythroid cells were treated with IFN-γ.Erythroid differentiation of the cells was evaluated using RT-qPCR to detect the mRNA level of erythroid specific surface markers CD71 and CD235a,and benzidine staining assay was applied to explore the change of hemoglobin expression.Results The expression of IFN-γ receptors in K562 cells decreased and climbed up again after reaching the lowest point at 48 h of hemin induction.IFN-γ treatment increased CD71 and CD235a expression in both hemin-induced K562 cells and the later stage (E15D) primary erythroid cells.Benzidine staining showing increased globin protein expression in hemin-induced K562 cells after IFN-γstimulation.Furthermore,our results indicated that IFN-γ promoted hemin-induced K562 erythroid differentiation in a time dependent manner.Mechanistically,the results showed that IFN-γ treatment stimulated the expression of erythroid transcription factors NFE2,which was critically for erythroid maturation.Conclusions IFN-γaccelerates terminal erythroid differentiation in hemin-induced K562 cells and human umbilical cord CD34+ derived primary erythroid cells.

Objective To analyze the clinicopathological characteristics and the prognostic survival factors of young patients who have undergone hepatectomy for primary hepatic carcinoma.Methods Clinicopathological da-ta and treatment outcomes in 79 young (≤40 years old)and 67 elderly (≥65 years old)patients who underwent hep-atectomy for primary hepatic carcinoma between 2008 and 2012 were retrospectively collected and compared using various parameters.Then the survival rate and prognostic factors of the younger patients were analyzed using Kap-lan-Meier and COX multivariate proportional hazards model.Results The positive rate of HBs-antigen and alpha-fetoprotein level were significantly higher in the younger patients than in the elderly patients (P<0.05).However, the positive rate of Anti-HCV-Ab was markedly lower in the younger patients (P<0 .0 5 ).The two groups did not significantly differ in gender,clinical symptoms,intraoperative parameters or pathological features (P>0.05).The overall survival rate was similar between the two groups.COX multivariate proportional hazards model analysis showed that the independent prognostic factors of overall survival were pre-operative albumin level <3 5 g/L and maximum tumor diameter ≥5 cm.Conclusion Hepatectomy is a safe and feasible treatment for young and elderly patients with primary hepatic carcinoma.The independent prognostic factors of survival for young patients are pre-operative albumin level <3 5 g/L and the maximum tumor diameter ≥5 cm.

Objective To investigate the immunophenotype and molecular genetics of mature aggressive B-cell lymphomas in Chinese pediatric patients and provide the criteris for the diagnosis of them.Methods We collected 97 paraffin-embeded tissue samples of pediatric cases of mature aggressive B-cell lymphomas including 81 Burkitt lymphoma (BL) cases, 8 diffuse large B cell lymphoma (DLBCL) cases and 8unclassifiable B cell lymphoma with featares intermediate between BL and DLBCL (BL/DLBCL) cases. The immunophenotype and genetic features of them were detected by immunohistochemistry and interphase FISH.Results The expression of bcl-2 [3 %(2/66) in BL, 50 % (4/8) in DLBCL, 50 % (4/8) in BL/DLBCL], MUM1 [17 % (12/71) in BL, 63 % (5/8) in DLBCL, 63 % (5/8) in BL/DLBCL] and mean Ki-67 proliferation index [(93±4.4)% in BL, (83±14.3)% in DLBCL, (80±11.5)% in BL/DLBCL] were significantly different between BL and DLBCL and between BL and BL/DLBCL. The frequency of c-myc rearrangement [98 % (79/81) in BL,38 % (3/8) in DLBCL, 50 % (4/8) in BL/DLBCL] and an extra copy of bcl-6 [0 % in BL, 38 % (3/8) in DLBCL, 25 % (2/8) in BL/DLBCL] were also significantly different between BL and DLBCL and between BL and BL/DLBCL. Conclusion Diagnosis of the mature aggressive B cell lymphomas in pediatrics should be based on the comprehensive review and integration of morphologic, immunohistochemical and molecular genetic features. BL/DLBCL is more likely a subgroup of the DLBCL in pediatric population. The expression of CD10 and bcl-6 but not bcl-2, a high Ki-67 PI (＞90 %) and a c-myc rearrangement but not bcl-2 or bcl-6rearrangement are the features of BL. Regardless of the expression of CD10 and bcl-6, positive staining for bcl2, Ki-67 PI below 90 % and an extra copy of the bcl-6 favor a diagnosis of DLBCL or BL/DLBCL.

Objective To explore the clinical value of intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation. Methods Routine color doppler imaging (CDI) was used to detect hepatic artery thrombosis (HAT) after liver transplantation in 160 cases. Suspected patients were further confirmed by immediate angiography. Four cases of HAT were diagnosed and treated by intra-arterial thrombolysis. Two cases received repeatable transcatheter hepatic arterial thrombolysis with a low dose of urokinase. Results Hepatic artery recanalization was achieved in 3 cases. Among the 3 cases, multiple HAT occurred in 1 case, intra-arterial thrombolysis was successfully completed in the end. Two cases had intra-abdominal hemorrhage, which was cured by conservative treatment. One case received retransplantation because of interventional thrombolysis failure and intra-abdominal hemorrhage. Conclusion Intra-arterial thrombolytic therapy may be a promising method in the treatment of HAT. Transcatheter hepatic arterial thrombolysis shows a significant result.

Objective To investigate the effect of Emodin on intracellular calcium concentration ([Ca~(2+)]i) and apoptosis of hepatic cells after simulated cold ischemia-reperfusion. Methods Glucose-oxygen deprivation, low temperature, subsequent reoxygenation and rewarming were used to induce ischemia-reperfusion injury model in cultured hepatic cells which were divided into 4 groups: control group and Emodin-treated group(100, 10 and apoptosis rate were determined by flow cytometry (FCM) respectively; the content of lactate dehydrogenase (LDH) in supernatant was tested. Results Intracellular calcium fluorescence intensity in Emodin-treated groups of high, medium and low density was 24.12±0.51, 26.35±1.34 and 39.12±1.94, respectively, which were significantly lower than 105.29±1.01 in control group(P<0.01). Apoptosis rate in Emodin-treated groups of high, (179.67±18.57)u/L in Emodin-treated groups of medium and high density respectively, which were significantly lower than (351.33±34.16)u/L in control group(P<0.01). Conclusion Emodin could reduce [Ca~(2+)]i and inhibit apoptosis of hepatic cells after simulated cold ischemia-reperfusion, thus protecting hepatic cells effectively.

Objective To design a new type of biliary stent to be used in the common bile duct probe and evaluate its biocompatibility, safety and effectiveness in a canine model.Methods Magnesium alloy (AZ 31B) was used to make biliary stents.A canine model of acute obstructive jaundice was established by ligating the distal end of the common bile duct.These dogs were divided into two groups with either placement of magnesium stent or not.The incidence of bile duct leakage and survival were evaluated.Meanwhile, we determined the concentration of magnesium in various body fluids and organs, liver function test, and ultrasonic and histological studies.Results The concentrations of magnesium in the blood, feces, liver, heart, brain and lungs were similar between the two groups.Bile leakage rate in experimental group and control group was 0％ and 16.7％, respectively.The mortality was 16.7％ and 33.3％.There were no significant differences in ALP and TBIL between experimental group and control group (P>0.05) before building and bile duct exploration.There were significant differences in ALP andTBIL between the two groups one and three months after bile duct probe (P<0.05).Biliary tract specimens showed obviously anastomotic stenosis performances and expansion performances of extrahepatic biliary in the control group, but in experimental group such changes were not observed.Ultrasonography showed that the patency of biliary anastomosis was good and there was no anastomotic biliary stricture in experimental group.However, progressive stenosis and expansion performances of extrahepatic biliary occurred in control group.There were fewer collagen fibers but more muscle fibers in experimental group than in control group.Conclusion Biliary stent made of magnesium alloy is of good biocompatibility and has the potential to prevent the postoperative stenosis in the common bile duct probe.

Objective To report the combined Aspergillus and Mucor infections in surgical site after orthotopic liver transplantation. Methods We retrospectively analyzed clinical data of two liver transplantation recipients suffering from postoperative combined Aspergillus and Mucor infections and evaluate the symptoms, diagnosis and treatment. Results In the first patient the graft arteries suddenly ruptured on the 8th day postop caused by Aspergillus and Mucor infection failing an emergency surgical rescue. The patient eventually died of multiple organ failure. In the second recipient deep surgical site infection was diagnosed on the 10th day postop. Combination infection of Aspergillus and Mucor was identified by pathology. Despite of aggressive anti-fungal treatment and support, the general condition continued to deteriorate and the patient eventually died of systemic severe infection and respiratory failure. Conclusion Combined Aspergillus and Mucor infections in operative location is a rare complication of liver transplantation, which was usually occult in onset, and the prognosis is poor.

In this study we calculate theoretically and use FEM to simulate the effect of plate position relative to bending direction on the overall bending stiffness of the composite system plate-bone. The results show that for different bending directions the effect of the modulus of elasticity of the plate is negligible. Changing the position of a plate will often alter the stress obviously. During the operation, the steel plate should be assigned onto the tension side of the bone.
Bone Plates ; Finite Element Analysis ; Fracture Fixation, Internal ; methods ; Models, Biological ; Stainless Steel ; Stress, Mechanical ; Tensile Strength

OBJECTIVETo develop a method for preparing a decellularized scaffold based on human liver tissue.

METHODSA surgical specimen of the left lateral lobe of the liver was obtained from a patients with hepatic hemangioma. The decellularization process was performed by repeated freezing-thawing, sequential perfusion with 0.01% SDS, 0.1% SDS and 1% Triton X-100 through the portal vein, and sterilization with peracetic acid. L-02 cells were then engrafted onto the decellularized liver scaffold.

RESULTSHE staining, DAPI staining and scanning electron microscopy all verified the absence of residual cellular components in the decellularized scaffold. The residual DNA content in the decellularized scaffolds was 25.3∓14.6 ng/mg (dry weight), which was less than 1% of the total DNA content in a fresh human liver. Immunohistochemistry demonstrated that type I and IV collagens, fibronectin and elastin were all retained in the scaffold. The engrafted L-02 cells survived well on the scaffold with active proliferation and expressed albumin and G6pc.

CONCLUSIONIt is feasible to prepare decellularized scaffolds using surgical specimens of human liver, which can be a new approach to constructing a tissue-engineered liver for clinical purposes.