ObjectiveAim at the problems in the treatments of the children malignant bone tumor of distal femur,we put forward the concept of the dual mobility hemi-knee prosthesis and try to perform the motion parameters analysis and the pilot clinical trials.MethodsBase on the CT data from samples of knee joint in adult,we adopted the Mimics/Geomagic/Pro-E software and computer numerical control milling machine technology to design and produce the dual mobility hemi-knee artificial prosthesis,and then motion parameters was analyzed in vitro test,and at last pilot clinical trial was performed.ResultsIn vitro experiment showed that the displacement of the internal femoral condyle flexion facet center was(2.59±0.43) mm in normal knee group,(2.22±0.52) mm in dual mobility hemi-knee prosthesis group,and (1.18±0.43) mm in total knee arthroplasty group; the displacement of the external femoral condyle flexion facet center was (11.95±6.62) mm in normal group,(11.25±6.19) mm in dual mobility hemi-knee prosthesis group,and (1.26±0.42) mm in total knee arthroplasty group; the maximum relative rotation angle was 13.17°±7.58° in normal knee group,11.69°±6.49° in dual mobility hemi-knee prosthesis group,and 5.40°±1.29° in total knee arthroplasty group.After that,we accomplished the pilot clinical trials successfully for a patient with malignant bone tumor in distal femur.The patient recovered well and the treatment outcome was satisfactory.ConclusionThe motion parameters analysis showed that the motion mode of the dual mobility hemi-knee prosthesis is similar with that of the normal knee.The dual mobility hemi-knee prosthesis provides a whole new concept and method for the treatment of malignant bone tumor of distal femur in children,and the device and concept of ligament reattachment provide a solution to the reconstruction of knee ligament.

Objective To explore the effects of hsa-miR-96 to A549. Method A549 were transfected with miR-96 inhibitor/mimics and shRNA-mTOR. The proliferation were detected by MTT,the expression of p21, cyclin D1,p-4E-BP,S6K were detected via RT-PCR and WB. The luciferase assay were used to anaylse the target of miR-96. Result With or without metformin treated,up-regulated the expression of miR-96 could inhibit A549 proliferation,increase p21 expression and decrease cyclin D1 expression instead. The results may related with G1 arrest which induced by miR-96 up-regulation. The ratio of firefly fluorescence value/Renilla fluorescence value was lower than that in wild type NC or mutant group. Conclusion miR-96 target with mTOR to inhibit the growth of A549.

AIM:To explore relationship between the normal strehl ratio ( SR ) values of total aberrations/SR values of total higher-order aberrations and modulation transfer function ( MTF ) at total corneal at different pupil diameters in normal population.
METHODS: To exam the SR values of total aberrations and SR values of total higher-order aberrations of total corneals in 200 people ( 400 eyes ) using SIRIUS 3D topography system and analysis the corresponding root-mean-square ( RMS) .
RESULTS: The subjects with different pupil diameters (3. 0, 5. 0, 6. 0, 7. 0mm)'s exam results of total corneal were as following:SR value of total aberrations 100’(0. 45±0. 12), (0. 25±0. 06), (0. 17±0. 05), (0. 13±0. 04); SR value of total higher order ab cerrations 100’(0. 69±0. 14), (0. 34±0. 07), (0. 24±0. 05), (0. 16±0. 04);SR value of total aberrations 200’(0. 45±0. 12), (0. 24±0. 06), (0. 20±0. 04), (0. 16±0. 03); SR value of total higher order aberrations 200’(0.70±0. 13), (0. 35±0. 07), (0. 27±0. 06), (0. 20±0.04 ) . The SR values of each group decreases with the increases of pupil diameters. The SR values of total aberrations and SR values of total higher - order aberrations at total corneals are negatively correlated with corresponding RMS value. When the pupil diameter is small, the SR value of total aberrations is more related to higher frequency region of MTF. When the pupil diameter is big, the SR value of total aberrations is more related to lower frequency region of MTF.
CONCLUSION: The visual performance of normal people can be well reflected by SR values of total aberrations and SR values of total higher - order aberrations at total corneal.

AIM: To report a two- year's results of iontophoresis-assisted transepithelial corneal cross-linking (I-CXL) for progressive keratoconus.
METHODS: Thirty - four eyes in 24 patients with progressive keratoconus ( mean age 21. 0 ± 5. 6 years;range: 14-32 years) were treated. After 1g/ L riboflavin-distilled water solution was administered by iontophoresis-assited (current 1mA) transepithelial method for 5min in total, standard surface UVA irradiation ( 370nm, 3mW/cm2 ) was performed at a 1 - cm distance for 30min. The best corrected visual acuity ( BCVA ) measured as LogMAR number, corneal refractive astigmatism, K1, K2, Kmean, Kmax, intraocular pressure, endothelial cell density, the thickness at corneal apex and the thinnest point were measured preoperatively and 2a postoperatively.
RESULTS:At 2a after the procedure, BCVA (LogMAR) improved from 0. 32 ± 0. 25 to 0. 25 ± 0. 19 ( t = 2. 849, P =0. 015). K1 decreased from 47. 12±4. 33 to 46. 06±4. 77 (t =2. 652, P= 0. 015). K2 decreased from 51. 36±5. 59 to 50. 40±6. 16 (t= 2. 121, P= 0. 047). Kmean decreased from 49. 12±4. 76 to 48. 10±5. 25(t = 2. 663, P = 0. 015). Kmax decreased from 57. 57±8. 30 to 55. 91±8. 14 (t = 2. 398, P = 0. 026). The corneal apex thickness decreased from 476. 90±38. 71μ m to 454. 43 ± 40. 86μ m ( t = 2. 853, P = 0. 010 ). The thinnest thickness decreased from 464. 38 ± 39. 92μ m to 433. 86 ±50. 78μ m ( t = 3. 485, P = 0. 002 ). Corneal refractive astigmatism, intraocular pressure and endothelial cell density did not show significant changes.
CONCLUSION: I - CXL for progressive keratoconus is safe and effective which can prevent deterioration of progressive keratoconus within 2a, but further long-term studies are necessary still.

This paper was aim to optimize the purification technology of Rehmanniae Radix Praeparata extract with macroporous adsorption resin. With the content of manninotriose as index, the absorptive flow and time were investigated, as well as kinds, amount, flow of eluent. D-101 type macroporous adsorption resin was the best choice for the purification of manninotriose. The optimized parameters were as follows: the content of manninotriose at 161.16-53.72 mg x g(-1), absorption time 240 min, eluting solvent of purified water, volume flow at 1.5 BV x h(-1), and eluant volume at 6 BV. D-101 type macroporous adsorption resin could significantly increase the purity of Rehmanniae Radix Praeparata extract with the advantage of high absorption, remove most part of impurity, and the effect of semi-works production was better.
Adsorption ; Chemical Fractionation ; Chromatography, Liquid ; instrumentation ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Rehmannia ; chemistry ; Resins, Synthetic ; chemistry

BACKGROUND: Osteoblasts derived from bone marrow stromal stem cells are the main force of the cells In bone marrow cavity.In the artificial joint replacement cases, their life situation is closely related to conductive pressure of prosthesis.OBJECTIVE: To observe the continuous pressure on the proliferation of rabbit's bone marrow stromal stem cells, and to reveal the biomechanism of continuous pressure causing loosening and sinking of prosthesis and its activity after replacement.DESIGN, TIME AND SE'I-I'ING: A randomized study based on cytology was performed at the Institute of Othorpaedics, the Fourth Military Medical University of Chinese PLA from February 2004 to October 2007.MATERIALS: One New Zealand rabbit aging 1 month and weighing 0.5 kg was used to extract the bone marrow stromal calls.METHODS: The third-passaged bone marrow stromal stem cells were inoculated in seven 24-well culture plates at the density of 1 × 104 cells/well. After 14 hours, cells were adherent completely and cultured in DMEM culture media containing 10% fetal bovine serum. Thereafter, the four culture plates were randomly divided into 4 experimental groups, including control group without any pressure, and continuous pressure (20, 60, and 100 kPa) groups. The continuous pressure was performed for 3 hours every day.MAIN OUTCOME MEASURES: Absorbance was detected at day 1, 3, 5, and 7 after culture using MTT assay.RESULTS: Absorbance of the three pressure groups after 3, 5 and 7 days was significantly lower than the control group (P < 0.01). There was no significant difference in absorbance between 20 kPa continuous pressure group and 60 kPa continuous pressure group on the third day (P >0.05); but the absorbance was significantly higher than 100 kPa continuous pressure group (P < 0.05). On the fifth day, there was significant difference in absorbance between paired continuous pressure groups (P < 0.05),i.e., the higher the continuous pressure was, the lower the absorbance was. On the seventh day, the absorbance of the 100 kPa continuous pressure group was significantly lower than 20 kPa continuous pressure group (P < 0.05).CONCLUSION: Patients with eady post-joint replacement had better not stand on the ground; otherwise, a continuous stress will be caused so as to induce the restrain of bone marrow stromal stem calls in the bone marrow cavity, which is not helpful for bone healing and easily causes subsidence and loosening of prosthesis.

Objective To investigate the protective mechanism of octahedral montone in rats with acute pancreatitis.Methods Seventy-two SD rats were randomly divided into a sham-operation ( SO) group, a severe acute pancreatitis (SAP) group and a treatment with octahedral montone group.Retrograde pancreatic ductal injection of 5% cholate sodium in rats was used to establish SAP models.Sham operation was done with intraperitoneal injection of normal saline.In the treated group octahedral montone was given through enema half hour before inducing SAP model.Then, we evaluate the pancreatic injury and detect the level of TNF-alpha, diamine oxidase ( DAO) and endotoxin.Western blot and RT-PCR were used to determine the expressions of the tight junction protein occludin in the endothelial cells of intestinal mucosa at the time of hour 3,6, 12 after operation.Results ( 1 ) The pathological scores of pancreatitis were significantly higher in the SAP group than those in the treatment group and SO group (P < 0.05 ).(2) Compared with the SO group, the level of TNF-alpha in the SAP group and the treatment group was much higher ( P < 0.05 ) , but the level in the treatment group was lower than that in the SAP group ( P < 0.05 ).(3) The serum concentration of DAO and endotoxin was significantly increased in the SAP group, and the concentration in treatment group was higher than that in the SO group (P <0.01) , but lower than that in the SAP group ( P <0.01 ).The occludin protein and mRNA expression in the SAP group was the lowest and the expression in the treatment group was higher than that in the SAP group (P <0.01) ,but lower than that in the SO group (P < 0.01).Conclusions Octahedral montone can improve the colonic barrier function, reduce the endotoxemia, and ameliorate the inflammation during acute pancreatitis.

Objective To understand the status of accidental injury children in emergency department of children' s hospital and discuss the risk factors of accidental injury in children to provide a scientific basis of prevention. Methods This study investigate parents on-site by questionnaire. We investigate 68 cases whose ages were 0~10 years. They came to emergency department due to accident. The investigation includes the incidence of accidental injuries, risk factors, and then a multi-factor logistic regression analysis would be done.Results The protective factor for children is mothers with high education level and children attending school.Children who have been injured in accident is the risk factor. Conclusions The occurrence of accidental injuries of children is the result of interaction of multiple factors, each factor should be taken for comprehensive preventive measures.

Pulmonary embolism (PE)remains a major contributor to global disease burden.In recent years,it has made great progress in treatment of PE,including new oral anticoagulant,primary systemic fibrinolysis and cathe-ter-directed techniques,but there are still some remaining areas of uncertainty to be studied.The present article made a review on progress in therapeutic methods of PE in recent years.

Objective To explore the feasibility and clinical efficacy of long-segmental bone defects after en bloc tumor resection of lower limb segment with composite of titanium alloy 3D printed prosthesis and vascularized fibular autograft and bioceramics.Methods 5 patients with lower extremity tumor (1 high grade chondrosarcoma,1 Ewing sarcoma,1 single metastatic tumor and 2 osteosarcoma) were treated by en bloc resection and precise reconstruction with segmental 3D-printed,custom-made prosthesis from August 2015 to November 2016,which composed of 1 male and 4 females,ranged from 16 to 56 years old,the average was 32± 19.3 years old.Three-dimensional computed tomography reconstructed images of patients' tumors were built before surgery.Custom-made prostheses were manufactured based on the patients' reconstructed images with micro-pores on the surface.After en bloc tumor resection with the help of osteotomy guide plate,the defects were reconstructed with 3D-printed,custom-made prostheses.Vascularized fibular autografts were put inside the prostheses,and the interval space among them was filled with bioceramics.Results All the 5 cases were performed surgical planning before the surgery with prosthesis and guide plate were designed at the same time.After verification of the finite element analysis SLM (2 cases) and the EBM (3 cases) were used to process prosthesis,and were designed into porous sharp with 210.98±66.16 mm in length and 26 901.76±12 903.96 mm3 in volume.Then the prosthesis would be cleaned and sterilized.All 5 operation were proceeded according to the plan of preoperative.The intra-operative guide plate were installed on the bone surface stably.The bone cutting was guided according to the plan of preoperative.By intra-operative frozen pathological examination,there were no malignant tissues in near and far marrow cavity.Unfolded fibular flap with 168.75±49.07 mm in length and porous tricalcium phosphate particle composite implants with 10±4.08 g were used in 4 cases and bone cement was used in 1 cases of metastatic tumor.The average operation time was 261±85 min and average blood loss was 540±182 ml.After a mean follow-up time of 6.4 months (1-15 months),all 5 cases survived with no local recurrence and pulmonary metastasis tumor.2 cases with vascular pedicle fibular transplant confirmed the survival of fibula via bone scan 3 months after operation.All cases were no infection,fractures,prosthesis loosening,except broken screw in 1 case.The Musculoskeletal Tumor Society (MSTS) 93 score was 17-26.Conclusion Long segment tubular titanium alloy 3D printed prosthesis with vascularized fibular autograft and bioceramics could reconstruct the segmental defects caused by tumor resection.