Suture was a traditional method for tissue repair. However, sutures used in the closure of surgical wounds can induce inflammation and lead to scarring that appears as crosshatch marks. Threads used for sutures may cause immune response and surgical infection. In this review, we introduce a novel sutureless technique for wound repair, called photochemical tissue bonding (PTB). Absorption of visible light by a photosensitizing dye initiates photochemical reactions leading to covalent protein-protein crosslinks that bridge the wound surfaces, thus producing an immediate seal between the wound surfaces. This technique has been applied in various tissues including skin, cornea, nerve, blood vessels, et al. PTB reduces inflammation resulting in less scarring in skin. PTB dramatically improves the incidences of vascular anastomotic leakage and stricture. In addition, PTB enhances the recovery of nerve function after nerve repair.

OCT angiography (OCTA) is a non-invasive imaging technique for detecting blood flow information of the retina and choroid.Dye injection is not needed with OCTA,which is different from fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).OCTA is able to observe blood flow in different retinal and choroidal segmentation slab.This revolutionary breakthrough in OCTA algorithm provides more and more accurate blood flow informations in the diagnosis of ocular vessel diseases and the study on pathogenesis of some vessel-related eye diseases.However,like other biometric technology,OCTA has its limitations and shortcomings,for example,OCTA presents a smaller observational area than FFA and ICGA,and some factors affect the imaging quality and cause misdiagnosis during the examination and reading image.Fully understanding the principle of OCTA and its image features are helpful for eye doctors to better interpret the blood flow changes of retinal diseases,choroidal diseases,glaucoma and neuro-ophthalmic diseases.Ophthalmologists should correctly apply this imaging tool for a better monitoring and following up of these diseases.

BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological changes of mandibular condyle specimens under light microscope.RESULTS: The articular disc was adhered to the mandibular condyle after 3months. Temporal fossa adhered to the articular disc and mandibular condyle could still be observed in one specimen. Bifid condylar deformity was found in two specimens and no disc perforation was found. The adhesions became more severe after 6 months and bifid condylar deformity was formed in all the 3 specimens, with distinctly thickened discs. Light microscope observation:Three months after fracture, the adhesion between disc and condyle was obvious. There was no clear boundary between the surrounding tissues. The adhesion was composed of fibro-connective tissues, with a large number of chondrocytes in it. Fibro-connective tissues tightly adhered to the trabeculae were found in some adhesions. The fiber of disc became deranged and blood vessels and fatty cells were seen. Six months after fracture, blood vessels, a large number of fibroblasts and sparse chondrocytes were seen in the adhesions. The collagen fibers of the discs were arranged in whirlpool shape. There were a large number of fatty cells and blood vessels within it. The fiber-cartilage of the condylar surface was found thickened and the fiber deranged in the unadhered tissues. Proliferative changes were seen on disc surfaces.CONCLUSION: Childhood longitudinal fracture of the mandibular condyle causes severe secondary injury to TMJ, suggesting a close correlation between longitudinal fracture of the mandibular condyle and TMJ ankylosis.

Acetylcholine ; metabolism ; Animals ; Brain ; drug effects ; metabolism ; Choline O-Acetyltransferase ; metabolism ; Cholinergic Agonists ; pharmacology ; Epithelial Cells ; metabolism ; Kidney Tubules ; cytology ; metabolism ; Lateral Ventricles ; drug effects ; Male ; Natriuresis ; Rats ; Rats, Sprague-Dawley

Objective To study the shift handover experience of ICU clinical nurses. Method About 19 ICU nurses were enrolled in the investigation using semi-structured interviews and the results were analyzed with phenomenological analysis. Result Their shift handover experience were summarized into 6 themes, that is high recognition on the importance of shift handover, lack of standardized processes, incomplete contents of shift handover, frequent interruption, forgotten information and repeated information. Conclusions Shift handover is an important part of ICU nursing function but there are many problems in the practical operation. The nurse managers need to standard the handover process, stipulate handover contents and enhance the training on shift handover with specialist examination and positive results for the purpose of improving the quality of the shift handover.

BACKGROUND: Zein has excel ent solubility, heat resistance and biodegradability, but its biocompatibility and effect on periodontal defects repair are under discussion. OBJECTIVE: To analyze biocompatibility of zein and its effect on periodontal defect repair. METHODS: Zein scaffold was prepared by solvent casting/particulate leaching. In vitro test: Human periodontal ligament cel s were co-cultured with zein scaffold for 18 days, and cel growth was observed by scanning electron microscope. In vivo test: Eight Beagle dogs were enrol ed to establish periodontal defect models, which were randomly assigned to receive zein scaffold implantation as experimental group, or interrupted suture as control group. Afterwards, the defect region was observed by scanning electron microscope at 3 months. RESULTS AND CONCLUSION: In vitro results: Human periodontal ligament cel s adhered wel and tightly on the scaffold with a fusiform, and could grow around pores. In vivo results: In the experimental group the scaffold dissolved completely, bone trabecular arranged regularly, and mature tissues appeared, to be integrated with the surrounding tissues; in the control group, the defect region almost healed, but there were irregular fibers and obvious lacunae. Moreover, compared with the control group, the height of new alveolar bone and bone defect, as wel as the length of junctional epithelium were significantly decreased, and new cementum was significantly increased in the experimental group (P < 0.05). To conclude, zein scaffold has good biocompatibility and can promote periodontal defect repair.

ObjectiveTo evaluate the effect of selective posterior rhizotomy(SPR),local corrective surgery and the training of rehabilitation on the relief of limb spasm secondary to cerebral palsy.MethodsThe "open window" of bilateral vertebral lamina resection, the the posterior roots of L2-S1 were separated from anterior roots and splited into rootlets. The rootlets sensitive to lower threshold of electrical stimulation were sectioned. The ratios of cut root,acorrding to muscle tension, myodynamia, body weight, muscle function,were estimated and all of them <30%. The local plastic operation was performed for nonimprovement of lower limb spasm and the training of rehabilitation began at postoperation. ResultsThe SPR have been performed on 28 cases. The rate of spasticity relief was 90% and the rate of functional improvement was 80% with follow-up. ConclusionsIt is a successful way to treat spastic cerebral palsy with SPR and procedural method.

Objective To investigate the clinical value of clinical application in diagnosis of prostate cancer (PCa) by prostate biopsy guided by rectal ultrasound contrast guided biopsy.Methods One hundred and ninety-eight patients with prostate in Punan Hospital of Pudong New District of Shanghai were investigated.According to different detection methods, the research objects were divided into two groups, the patients were performed with the ultrasound contrast guided biopsy as the imaging group (n =96), the patients with Doppler ultrasound guided biopsy as the ultrasonic group(n =102).The puncture Results were compared with pathological diagnosis.The positive rate of PCa and number of puncture needle were compared with the two puncture methods.The value of the application of the prostate biopsy guided by rectal ultrasound in diagnosis of prostate cancer was evaluated.Result One hundred and ninety-eight patients were all received pathological diagnosis,78 cases benign lesions, 120 cases were diagnosed as PCa.Thirty-six cases of benign lesions were confirmed by pathological biopsy, 60 case PCa.There were 42 cases of benign lesions in ultrasonic group, 60 case PCa.The positive rate of PCa in the imaging groupwas 62.5％ (60/96), the ultrasonic group was 58.82％ (60/102).There was no difference in Pca positive rate between the ultrasound group and the contrast group(x2 =0.104, P=0.747).The positive number of Pca in the imaging group was 28.50％ (17/60), the difference was statistically significant higher than that of the common group(18.80％ (11/60), P =0.001).The average of the patients in the imaging group was 8.19 needle,less than the ultrasonic group per capita 11.31 needle less.When f/tPSA less than or equal to 0.15, Pca positive rate of the contrast group was 46.55％ (27/55), higher than the ultrasonic group(9.30％ (4/43)), the difference was statistically significant (P =0.001);when f/tPSA more than 0.15, the positive rate of Pca in the contrast group was 92.11％ (35/38), less than the ultrasound group (94.92 (56/59)), the difference was not statistically significant (P =0.89).Anal pain, hematuria and hematochezia in contrast group (7.29％ (7/96), 2.08％ (2/96), 10.42％ (10/96)) were significantly less than the ultrasound group(22.55％ (23/102), 8.82％ (9/102), 23.53％ (24/102)), the difference was statistically significant (P =0.003,0.039,0.014).Conclusion Under the guidance of ultrasound contrast, rectal biopsy has important diagnostic value for prostate cancer.Under the premise of reducing the number of puncture needle,can improvethe positive rate of Pca, reduce the pain of patients and the occurrence of complications after puncture.When f/tPSAless than or equal to 0.15,puncture positive rate in contrast group is higher than the ultrasonic group, puncture effect is better.

Objective To determine the role of extracellular signal-regulated kinases (ERK1/2) in aldosterone-induced rat mesangial cells (RMCs) proliferation. Methods RMCs were obtained from intact glomeruli of 4- to 6-week-old Sprague-Dawley rats and characterized according to published methods. RMCs between passages 5 and passages 10 were used. Protein levels of mineralocorticoid receptor (MR) in RMCs were analyzed by Western blotting. The cells were divided into the following groups: control group, PD98059 (10 (μmol/L) group, eplerenone (1 μmol/L) group, aldosterone (100 nmol/L) group, aldosterone (100 nmol/L) +PD98059 (10 μmol/L) group, aldosterone (100 nmol/L)+eplerenone (1 μmol/L) group. ERK1/2 activity was measured by Western blotting. Cell proliferation of RMCs was evaluated by [3H]-thymidine uptake measurements.Results MR protein expression in RMCs was confirmed by Western blotting. Aldosterone activated ERK1/2, and the maximal ERK1/2 activation induced by aldosterone was at a concentration of 100 nmol/L. Aldosterone (100 nmol/L)-induced activation of ERK1/2 peaked at 10 minutes (P＜0.05).Pretreatment with a selective MR antagonist eplerenone (1 μmol/L) significantly attenuated aldosterone-induced ERK1/2 phosphorylation. Aldosterone (100 nmol/L) treatment for 30 hours increased [3H]-thymidine incorporation of RMCs (135% ±8% of controls, P ＜0.05). Cellular proliferation induced by aldosterone could be prevented by pretreatment with eplerenone or an ERK (MEK) inhibitor PD988059. Conclusion Aldosterone induces RMCs proliferation through MR and ERK1/2 activation, which may contribute to the pathogenesis of glomerular mesangial injury.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; prevention & control ; Phytotherapy