[Objective]To probe the probability of autologous platelet-rich glue(PRG) combined with particulate of cancellous bone in treating the aseptic tibial nonunion.[Method]Sixty patients with tibial nonunion in distal 1/3 fragment were randomly divided into 2 groups.Each group had thirty patients.PRG combined with particulate of autogenous cancellous bone was transplanted in the experimental group while particulate of cancellous bone was applied in the control group.The mean time to the operation was 10.5 months(7-36 months) and the average age were 38 years old.The postoperative systemic and local reaction,and X-ray finings of tibial nonunion were observed.The average follow-up was 22 months.According to the Johner-Wruh scoring system the results were statistically analyzed.[Result]At 8 months bony union was all achieved.There was a remarkable difference between those of experimental and control groups.[Conclusion]PRG had an important role in speeding bone healing,and the combination of PRG and particulate of autogenous cancellous bone is an ideal alternative of bone transplantation.

Objective To evaluate effects of maternal hypothermic cardiopulmonary bypass on fetal homodynamic and carbohydrate metabolism. Methods Twenty pregnant sheep were divided into four groups randomly: control group(n=5),normothermic group (35-36℃)(n=5), mild hypothermic group(32-34℃)(n=5) and moderate hypothermic group (28-31℃)(n=5).Thoracotomy was performed without CPB in the control group. Routine CPB was established with different temperature in other three groups. The temperature of normothermic group was kept normal; the left two groups were cooled down to the set point of temperature and then rewarmed back to normal level. Fetal and maternal temperatures, heart rate,mean blood pressure(BP), pulse index (PI) of fetal umbilical artery (UA) and internal carotid artery (CA) were evaluated at cooling and rewarming stages. Biochemical indicators including blood glucose and lactic acid were also measured at the same time. Results There are no differences in mesn BP of ewas and fetal lambs between the different groups (P＞0.05). CA PI value of mild hypothermic group and moderate hypothermic group were significantly higher than those of control group and normothermic group (P＜0.05). There was no difference of UA PI in the four groups, but PI increased following the prolonged duration of CPB. There was no difference change of blood glucose in the four group of fetus, which was significantly lower than the ewe groups. An upward trend of fetal blood lactic acid with time was observed in three CPB groups. The whole level of fetal blood lactic acid was much higher than that of maternal blood of lactic acid. Conclusion Cooling of maternal bypsss decreases fetal heart rate significantly,and fetal heart rate recovered to base line following rewarming phase. There was no signicant effect of CPB on fetal mean BP. However, CPB impacted on the blood flow of fetal brain and umbilical artey. Hypothermia CPB can increase fetal blood glucose and blood lactic acid dramatically.

Aspirin ; administration & dosage ; therapeutic use ; Brain ; diagnostic imaging ; pathology ; Cerebral Infarction ; diagnosis ; drug therapy ; etiology ; Epilepsy ; diagnosis ; drug therapy ; etiology ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; drug therapy ; Tomography, X-Ray Computed

Adult ; Endoscopy ; Eye Foreign Bodies ; surgery ; Humans ; Male ; Orbit

Bacteremia ; etiology ; Catheterization ; adverse effects ; Child ; Coagulase ; metabolism ; Cross Infection ; etiology ; Drug Resistance, Bacterial ; drug effects ; Endocarditis, Bacterial ; etiology ; Humans ; Methicillin ; pharmacology ; Quinolones ; pharmacology ; Staphylococcal Infections ; complications ; drug therapy ; microbiology ; Staphylococcus ; classification ; drug effects ; pathogenicity ; Urinary Tract Infections ; etiology ; Vancomycin ; pharmacology

AIM: To investigate the expression of connective tissue growth factor (CTGF) and α-SMA in human lens epithelium cell (HLEC) line B3 after transfection by liposome-coated siRNA targeting CTGF.METHODS: HLECs were transfected with small interfering RNA (siRNA) targeting CTGF,labeled with 5`-fluorescein isothiocyanate (5`-FITC) and coated with lipofectamine.The transfection ratio was evaluated via fluorescence intensity.Cell counting kit-8 (CCK-8) assay was performed to assess cytoviability of both non-transfected and transfected HLECs.Quantitative RT-PCR,cell immunochemistry and Western blot analysis were conducted to detect the expression changes of CTGF and α-SMA after transfection.RESULTS: A highly effective transfection ratio was observed in siRNA co-transfected with lipofectamine.The transfection ratio reached 95% at 24h.The proliferation of HLECs was inhibited by siRNA after 72h transfection.The expression of CTGF and α-SMA significantly decreased in HLECs after transfected by CTGF siRNA for 24h.This effect was not found in negative control siRNA.CONCLUSIONS: SiRNA targeting CTGF decreased CTGF and α-SMA expression in HLECs,which is a potential therapeutic strategy for posterior capsular opacification.

Objective The aim of this article is to review and analyze the timing and surgical management of mediate and severe atrioventricular valve regurgitation(AVVR) in single-ventricle patients.Methods Between June 2006 and October 2011,twenty-three cases of single-ventricle patients accompanied with AVVR underwent atrioventricular valve plasty or replacement.There were 17 males and 6 females.Their ages ranged from 2.1 to 22.0 years,and their weight from 12.5 to 59.0 kg.There were 3 cases of A type of single ventricle,17 of B type,2 of C type,and 1 of D type.All cases had one atrioventricular valve except one of D type with 2 groups of atrioventricular valves.There were 18 patients with sever AVVR and 5 with the moderate.Before the management of AVVR,12 patients had undergone the first stage palliation,including B-D Glenn procedure 11 cases and A-P shunt 1 case.The periods between the two stages operations were 7-96 months.Among the all,there were 7 cases of atrioventricular valve replacement ; 3 cases of atrioventricular valve replacement and TCPC ; 5 cases of atrioventricular valve replacement and B-D Glenn procedure ; 2 cases of atrioventricular valve repair and TCPC ; 4 cases of atrioventricula repair and B-D Glenn procedure; 1 case of atrioventricular valve repair,B-D Glenn procedure and TAPVC repair; 1 case of atrioventricular valve repair,B-D Glenn procedure,PA Banding and TAPVC repair.Results In this group,there were 65.2％ patients who underwent atrioventricular valve replacement.The ones with moderate regurgitation underwent atrioventricular valve repair.Only 3 of the 18 cases with severe regurgitation could underwent atrioventricular valve repair(P =0.002).Three cases died.The mortality was 13％.All cases undergone atrioventricular valve repair were alive.The mortality of atrioventricular valve replacement was 20％.All the post-operative alive were followed up.Their follow-up period were between 0.8-6.3 years,withoud a dead case.Conclusion The regurgitation with single ventricle should be managed before the image of myocardium occurred.It is the best time to manage the atrioventricular valve when the regurgitation was moderate.The atrioventricular valve replacement is effective to the cases of single ventricle with severe AVVR.

Objective To investigate the difference of cerebral inter-hemispheric functional connectivity between the patients with amyotrophic lateral sclerosis ( ALS) and healthy controls ( HC) by a newly developed voxel-mirrored homotopic connectivity ( VMHC) method based on resting-state functional MRI ( rs-fMRI) , as well as its correlation to the structural imaging indices and clinical neurological scales .Methods Twenty patients with ALS ( ALS group ) and 20 age-, and sex-matched healthy controls ( HC group) were examined by rs-fMRI and diffusion tensor imaging ( DTI ) on 3.0 T MR imaging system ( Siemens Trio Tim ).The rs-fMRI data preprocessing were performed using data processing assistant for rs-fMRI ( DPARSF) based on Matlab 2009a, and the rs-fMRI data analysis toolkit ( REST) with an automated VMHC approach was utilized to calculate and compare the VMHC correlation coefficients between the ALS group and the HC group[P<0.05, corrected with false discovery rate (FDR)].Region of interest (ROIs) were prescribed on the regions which showed abnormal VMHC coefficients in ALS group , then the mean time series of the ROIs were extracted to examine the difference of the seed ( ROIs)-based functional connectivity between the ALS and HC groups.At last, linear correlations were performed to assess the relationships among the VMHC coefficients and clinical measures including the revised amyotrophic lateral sclerosis functional rating scale ( ALSFRS-r) score, disease duration , the rate of disease progression and fractional anisotropy ( FA) values of the corpus callosum ( CC).Results Compared with HC group , the patients with ALS showed lower VMHC coefficients in the precentral gyrus ( M1 ) , postcentral gyrus ( PCG ) , inferior parietal lobule (IPL), cuneus/precuneus (Cu/Pcu), and anterior cingulate gyrus (ACC).Higher VMHC coefficients were found in the supplementary motor area , superior frontal gyrus , and middle occipital gyrus (P<0.05,FDR corrected).Significant functional connectivity alterations were detected in motor cortex and frontal/temporal/occipital lobe between the ALS and HC groups using seed ( ROIs )-based functional connectivity based on the regions which showed abnormal VMHC coefficients in ALS group ( P <0.05, AlphaSim corrected, clusters≥228 voxels).Significant positive correlation was detected between the VMHC coefficients (0.311 ±0.108) of M1 and FA values (0.394 ±0.016) of CC III region (r=0.530, P=0.016), between the VMHC coefficients (0.767 ±0.043) of ACC and FA values (0.360 ±0.105) of CC I region (r=0.513, P=0.021), respectively.Significant positive correlation was observed between VMHC coefficients (0.311 ±0.108) of M1 and the ALSFRS-r score (35.4 ±2.5) in ALS patients(r=0.447, P=0.048).There was not significant correlation observed between the VMHC coefficients and disease duration , or the ratio of disease prognosis (P>0.05).Conclusions Abnormal VMHC coefficients were detected in ALS patients.The decreased VMHC in ACC and M1 are associated with the reduced micro-structure integrity of CC, meanwhile, and they may be related to disease severity.

Objective The aim of this study is to retrospectively analyze surgical management of absent pulmonary valve syndrome(APVS).Methods Between January 2005 and January 2012,totally 11 children with APVS underwent primary surgical correction.There were 7 boys and 4 girls.Age at surgeries range from 1 to 5 years,and wcight from 10.2-17.5 kg,with average (12.3 ± 3.4) kg.Surgical procedures include VSD repair,pulmonary arteries reconstruction and RVOT reconstruction with monocusp valve.5 cases chose Lecompte maneuver as an option to release compression to bronchus,5 cases underwent fibroscopy inspection and airway secretion suction,and 4 cases adapted deep hypothermic circulatory arrest (DHCA)during correction procedures.All survivors are routinely followed-up with echocardiogram.Results All 11 cases survived,2 of them suffered from frequent lungs infections during the first year post surgery.No case exists bronchus or pulmonary arteries compression.Conclusion APVS is a rare congenital heart defect,which may challenge perioperative managements and operations.Ideal surgical correctiou includes RVOT reconstruction,decompression of bilateral bronchus,and airway inspection with fibroscopy.However,compression of intrapulmonary bronchi by abnormally branching pulmonary arteries may expose patients to a relative long time of medication therapy after surgical correction.A large number of patients with long-term follow-up are needed to draw definitive conclusions on this strategy' s effectiveness.

Objective Retrospectively analyze primary experences of surgical correction of complicated aortic arch anomaly with autologous palmonary artery.Methods Between July 2010 and December 2012,13 cases of complicated aortic arch anomaly underwent reconstruction of aortic arch with autologous pulmonary artery.Classifications of aortic arch anomaly were interrupted aortic arch with ventricular septal defect in 4 patients,ventricular septal defect associated with coarctation in nine patients.There were 7 males and 6 females.Their age at surgeries ranged from 1 month to 16 years,and the body weight were from 3.5 kg to 52.0 kg with median weight of 12.6 kg.Cardiopulmonary bapass was estabished with dual arterial cannulations in patients with interrupted aortic arch.During cooling to deep hypothermia(rectal temperature was 18 ℃),intracardiac defects were totally corrected.Arch anomaly was reconstructed under deep hypothermia,including deep hypothermic cardiac arrest(DHCA) in 9 patients,deep hypothermia with regional perfusion in 4 patients.Anterior wall of pulmonary artery was excised in all of 13 patients.In 4 cases,the excised wall of anterior wall of pulmonary artery was sutured to form a conduit with different diameters according to the patient's bady surface area.Two ends of the conduit were anastomosed the aortic arch and desceding aorta respectively.In another 9 patients,aortic arch was augmented with tailored pulmonary artery patch in oval shape.The defect of pulmonary artery was repaired with autologous pericardial patch.Results There was only 1 death due tomutiple organ failure postoperatively.Another 12 patients survived without neurologic complications.Differences of arterial pressures between upper and lower extremeties were not monitored in all cases.During follow-up,routine echocardiogram showed satisfactory results with unobstructive blood flow at the aortic arch.Conclusion Autologous pulmonary artery can be used to relieved complicated aortic arch anomaly completely without any tension of anastomosis site and compression of left main bronchea postoperatively.More patients with long-term follow-up are necessary to draw an accurate conclusion of this technique.