Objective: To prepare 2 composites using different proportions of hydroxyapatite and collagen and to assess their structural and biological properties, so as to pave a way for preparing tissue engineering chest wall scaffold. Methods: Two kinds of hydroxyapatite/collagen composites were prepared according to the weight ratios of 1:1 and 1:2; collagen sponge served as control. Then the structures of the 2 composites and the collagen sponge were observed under SEM. In vivo study was conducted to assess the biocompatibility and biodegradation of the composites by gross inspection and histological examination. Results: The collagen sponge had a 3-D network structure with fluey collagen fibers and poor mechanical strength, and its structure was damaged within 2 weeks after implantation and was completely absorbed 4 weeks later. The hydroxyapatite and collagen were well mixed in the composite with a hydroxyapatite to collagen ratio of 1:2; the composite had homogeneous 3-D porous structure (size of the pore being 100-400 m) and showed good biocompatibility: maintained its porous structure 4 weeks after implantation and was absorbed within 8 weeks. In composite with hydroxyapatite to collagen ratio of 1:1, the hydroxyapatite particles were separated from collagen fiber and conglomerated into masses, and the composite resulted in severe tissue reaction after implantation. Conclusion: When mixed with a reasonable proportion of hydroxyapatite, the collagen sponge has improved structure, biodegradable performance, and biocompatibility; the composite may be a novel scaffold for tissue engineering chest wall reconstruction.

Objective: To prepare a novel surgery mesh made of polydioxanone(PDO) and to study its in vivo degradation properties and the related tissue reaction, so as to provide reference for future clinical application. Methods: PDO mesh was plain-woven and was coated with collagen and chitosan, then they were implanted into the dorsal muscle of rabbits for 2, 4, 8, 12, 16, and 24 weeks. Rabbits implanted with pure PDO mesh served as control. The degradation process of implanted materials, tissue-material interface, and the biological influence of the coating on the mesh were observed; tissue reaction was observed and evaluated by histological means and TEM. Results: Implantation of pure PDO mesh resulted in mild inflammation and fibrous tissues infiltrated into the mesh; degradation occurred during the 8th to the 12th week and degraded completely within 24 weeks; there was no denaturalization, necrosis, and abnormal hyperplasia in the surrounding tissues. Collagen coating stimulated a fibroblastic proliferation and was reabsorbed within 4 weeks; and the naked mesh was infiltrated by fibrous tissues. The chitosan coating showed a strong inhibitory effect on the growth of the surrounding connective tissues. Conclusion: The biodegradable polydioxanone mesh has an excellent biocompatibility, a friendly tissue-material interface and a proper degradation rate matching to the tissue regeneration rate. The biological characteristics of the mesh can be modified by different coatings, making it a very promising degradable surgical mesh.

Chest wall resection and reconstruction remains a severe challenge for reconstructive surgeons, which often leads to conservative treatment regimens in clinical practice, consequently resulting in poor outcomes (high morbidity and mortality). In recent 20 years, advances in muscle flap surgery and availability of chest reconstructive prosthesis have encouraged the surgeons to take an active attitude toward chest wall resection; many "unresectable" lesions now have a chance to be resected and cured. This article reviews the problems concerning the principles for chest wall resection, reconstruction, prosthesis selection, etc. in chest wall reconstruction.

OBJECTIVETo analyse the preoperative conditions and intraoperative anesthetic managements of parturients who underwent Caesarean section and explore possible relationship between perianesthetic managements and prognosis of parturients and fetuses.

METHODSA group of 30 parturients who underwent Caesarean sections under general anesthesia were analysed retrospectively.

RESULTSAll the 30 Caesarean sections were smooth in terms of both procedure and anesthesia.

CONCLUSIONSGeneral anesthesia is still indicated in Caesarean section, although multiple risks may still exist. Considerate perinatal planning, careful preoperative preparations, and delicate intraoperative managements positively contribute to the good prognosis of parturient and fetus.

Adult ; Anesthesia, General ; Anesthesia, Obstetrical ; Apgar Score ; Cesarean Section ; Female ; Humans ; Pregnancy ; Retrospective Studies

In July 1997, a strain (GB30) of virus was isolated from 60 samples of brain tissues of Murina aurata (Chiroptera: Vespertilionidae) co llec ted in Gengma county, Yunnan province, China. Isolation of virus was negative fr om 4 samples of brain tissues of Rousettus leschenaulti (Chiroptera: Pteropo did ae) collected in Gengma. GB30 virus strain could regularly cause illness and dea th in suckling mice, produced evident CPE in BHK21 cells. It agglutinated red b lood cells of dove at pH5.75～7.4. This virus has been identified serologically by hemagglutination inhibition and immunofluorescent tests using Japanese enceph alitis (JE), dengue (DEN) type 1,2,3,4, and chikungunya (CHIK) viruses monoclona l antibodies, and JE and sindbis (SIN) viruses immune sera. It showed specific r eaction to JE virus only and no reaction with DEN 1～4, CHIK and SIN viruses. Th erefore it can be identified as JE virus. This is the first report on the isolat ion of JE virus from Murina aurata. The results showed that bats are conside red as the reservoir and amplifier host of JE virus transmission in nature.

Objective:To establish a human lung squamous carcinoma cell line and to study its biological characteristics. Methods:Lung squamous carcinoma specimens were freshly resected during operation;the tissues were incubated in vitro and the cell line was named CHLH-1.The biological characteristics of the cells were studied by light microscopy,electron microsco- py,chromosome analysis and transplantation experiment.Results:Cells from the specimens of the primary tumor,the CHLC- 1 cell line and the cells from transplanted tumor possessed the characteristics of malignant squamous epithelium under light and electron microscope.The cell growth curve,doubling time and mitotic index were also observed in vitro.Nuclear chromosome analysis revealed that the tumor was a subtriploid with a mode of 60-68 per cell.Tumor nodes were observed under the skin of nude mice by heterogenic transplantation.Conclusion:The characteristics of the established cell line suggest that it is a newly established human squamous carcinoma cell line.

OBJECTIVETo compare the perioperative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of complex coronary artery disease and left ventricular dysfunction.

METHDOSThe clinical data of 966 patients admitted to our hospital from January 2003 to December 2013 with coronary artery disease and left ventricular dysfunction (ejection fraction ≤50%) were retrospectively reviewed. Among the patients, 386 underwent CABG and 580 received PCI. After matching for EuroSCORE risk factors and preoperative echocardiographic parameters, 135 patients with CABG and 135 with PCI were enrolled in this study. With hospital mortality and perioperative major complications as the endpoints, the early outcomes of the procedures were evaluated. Perioperative echocardiography was performed to evaluate the change of left ventricular geometry and function.

RESULTSCompared with CABG group, PCI group had significantly higher incidences of chronic lung disease (8.1% vs 0.7%, P=0.003) and recent myocardial infarction (64.4% vs 31.9%, P=0.000) but significantly lower left-main disease (12.6% vs 23.7%, P=0.018); the other baseline characteristics were comparable between the two groups. Patients with CABG had a greater number of treated target vessels than those with PCI (2.90±0.81 vs 1.67±0.73, P=0.000), and complete revascularization was more common in CABG group (94.8% vs 51.8%, P=0.000). No significant difference was found in perioperative variations of LVEF between the two groups, but patients with CABG had a greater variation in LVEDD than those with PCI. The hospital mortality and other major complications were similar between the two groups.

CONCLUSIONBoth CABG and PCI are safe and reliable revascularization strategies for complex coronary artery disease and left ventricular dysfunction, but CABG can achieve a higher rate of complete revascularization and better improves the left ventricular function.

Coronary Artery Bypass ; Coronary Artery Disease ; surgery ; therapy ; Echocardiography ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ventricular Dysfunction, Left ; therapy ; Ventricular Function, Left

OBJECTIVETo investigate the fine needle aspiration cytology (FNAC) features and differential diagnosis of eyelid sebaceous gland carcinoma.

METHODSFour cases of eyelid sebaceous gland carcinoma diagnosed by FNAC were reported and confirmed by biopsy. Three of the cases were in early stages with tumor sizes smaller than 10 mm in diameter and without metastasis. The smears were stained by routine H & E and SudanIII methods. The cytologic findings were described and compared to corresponding histological features, and moreover, compared to chalazion, pilomatrixoma and eyelid basal cell carcinoma.

RESULTSNeither hemorrhage nor infection were found after the examination. Abundant cells were observed in the sebaceous carcinoma FNAC smears. Two types of tumor cells were found: one showed tumor cells differentiating toward sebaceous gland, with large pale cells and vacuolated cytoplasm, the other demonstrated poorly-differentiated cell with dark and irregular nuclei. Numerous vacuoles with inequality of size were found in cytoplasm or in background in all four cases, and the SudanIII stain showed that these vacuoles contained lipid. Some smears demonstrated cells with basaloid, fusiform or squamous features, corresponding to various histopathological types. In contrast, smears of chalazion displayed inflammatory granuloma, containing several types of inflammatory cells without malignant cells. Smears of pilomatrixoma were cellular with three cell populations, which included bland sheets of basaloid cells, nucleated basophilic cells and anucleated keratinized "ghost cells", along with calcific debris. The smears of basal cell carcinoma were typically less cellular, more tightly cohesive and had smaller clusters of uniform hyperchromatic basaloid cells without vacuolization in cytoplasm or background. Overall, the cytological features of eyelid sebaceous carcinoma were distinct from those of chalazion, pilomatricoma and basal cell carcinoma.

CONCLUSIONSFNAC is a safe and effective approach for the diagnosis of eyelid sebaceous carcinoma and lipid stain is useful in differential diagnosis. The application of FNAC may be important in reaching an early diagnosis and initial treatment of eyelid nodule.

Adult ; Aged ; Biopsy, Needle ; Diagnosis, Differential ; Eyelid Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Male ; Middle Aged ; Sebaceous Gland Neoplasms ; diagnosis ; pathology

Objective:To compare the safety and effectiveness of two minimally invasive approaches for multi-vessel coronary revascularization.Methods:From August 2014 to February 2017,70 consecutive patients who underwent minimally invasive coronary artery bypass grafting in Peking University Third Hospital were randomly divided into two groups.In one group,40 patients underwent staged-hybrid coronary revascularization (staged-HCR) treatment;in the other group,30 patients underwent minimally invasive total arterial revascularization with bilateral internal thoracic artery (BITA).In staged-HCR group,the patients underwent minimally invasive direct coronary artery bypass grafting (MIDCAB) and percutaneous coronary intervention (PCI) procedure for treatment of multi-vessel disease.In BITA group,the patients underwent total arterial coronary artery bypass grafting with composite "Y" BITA graft.Preoperative and postoperative data of the two groups,including postoperative blood usage,mechanical ventilation time,domiciling duration in intensive care unit (ICU),major adverse cerebral and cardiovascular event (MACCE),and postoperative coronary angiography results were compared,in order to evaluate the safety and effectiveness of these surgical approaches.Results:The preoperative characteristics of 70 patients in the two groups showed no significant difference.All the patients underwent successfully,elective minimally invasive multi-vessel coronary artery bypass grafting as scheduled preoperatively.Postoperative result showed the patients in staged-HCR group took advantages in less postoperative mechanical ventilation time [Staged-HCR group (11.2 ± 8.7) h vs.BITA group (18.3 ± 9.1) h,P =0.013],shorter domiciling duration in ICU [Staged-HCR group (26.29 ± 4.05) h vs.BITA group (44.74 ± 28.75) h,P =0.022],and less total drainage [Staged-HCR group (695.57 ± 250.46) mL vs.BITA group (1 103.26±547.44) mL,P =0.03] than the patients in the group of minimally invasive total arterial revascularization with BITA.Postoperative in hospital coronary angiography showed satisfactory graft patency rates in both groups [97.5％ in Staged-HCR group vs.97.8％ in BITA group].No MACCE occurred in both groups during hospitalization.Conclusion:Staged-HCR is a feasible method for the treatment of multi-vessel revascularization involving right coronary artery.Minimally coronary revascularization with BITA is associated with superior long-term graft patency and it's recommended for patients who could not tolerate dual-antiplatelet therapy.This study shows that both minimally invasive surgical approaches are safe and effective for treatment of patients with multi-vessel coronary artery disease.

Objective To discuss the clinical features of cerebral schistosomiasis. Methods The clinical data of fourteen patients with cerebral schistosomiasis from March 2010 to March 2016 were collected and analyzed retrospectively. Results The schistosomiasis immunological tests of sera and cerebrospinal fluids from the fourteen patients were all positive. Eosinophils increased in ten cases,and the proportion was 5.1％-60.3％. Schistosoma eggs were found in seven cases by the fecal Kato-Katz method. Fourteen cases were all infected with Schistosome japonicum. Twelve cases were diagnosed as chronic type,and two cas-es as acute type. Thirteen patients received medical treatment,of which twelve were cured,and one improved. One patient re-ceived the surgical resection of the lesion. Conclusion The clinical manifestations of cerebral schistosomiasis mainly include seizure,headache,dizziness and fever. In the enhanced head magnetic resonance imaging(MRI),the lesions are clustered and merged into lumps,which is the characteristic image of cerebral schistosomiasis japonica. The praziquantel treatment can achieve a good prognosis.