BACKGROUND:We have successfully established an animal model of small ear pig in southern Yunnan province with internal tension relieving technique combined with autologous Achilles tendon for anterior cruciate ligament reconstruction,and verified the stability and reliability of the model.However,whether internal tension relieving technique can promote the ligamentalization process of autologous Achilles tendon graft has not been studied. OBJECTIVE:To investigate the differences in the process of ligamentalization between conventional reconstruction and internal reduction reconstruction of the anterior cruciate ligament by gross view,histology and electron microscopy. METHODS:Thirty adult female small ear pigs in southern Yunnan province were selected.Anterior cruciate ligament reconstruction was performed on the left knee joint with the ipsilateral knee Achilles tendon(n=30 in the normal group),and anterior cruciate ligament reconstruction was performed on the right knee joint with the ipsilateral knee Achilles tendon combined with the internal relaxation and enhancement system(n=30 in the relaxation group).The autogenous right forelimb was used as the control group;the anterior cruciate ligament was exposed but not severed or surgically treated.At 12,24,and 48 weeks after surgery,10 animals were sacrificed,respectively.The left and right knee joint specimens were taken for gross morphological observation to evaluate the graft morphology.MAS score was used to evaluate the excellent and good rate of the ligament at each time point.Hematoxylin-eosin staining was used to evaluate the degree of ligament graft vascularization.Collagen fibers and nuclear morphology were observed,and nuclear morphology was scored.Ultrastructural remodeling was evaluated by scanning electron microscopy and transmission electron microscopy. RESULTS AND CONCLUSION:(1)The ligament healing shape of the relaxation group was better at various time points after surgery,and the excellent and good rate of MAS score was higher(P<0.05).Moreover,the relaxation group could obtain higher ligament vascularization score(P<0.05).(2)The arrangement of collagen bundles and fiber bundles in the two groups gradually tended to be orderly,and the transverse fiber connections between collagen gradually increased and thickened,suggesting that the strength and shape degree of the grafts were gradually improved,but the ligament remodeling in the relaxation group was always faster than that in the normal group at various time points after surgery.(3)The diameter,distribution density,and arrangement degree of collagen fibers in the relaxation group were better than those in the normal group at all time points,especially in the comparison of collagen fiber diameter between and within the relaxation group(P<0.05).

Objective To investigate the application of chromosome microarray analysis(CMA)in prenatal diagnosis of 18q deletion syndrome and to analyze the genotype-phenotype correlation of 18q deletion syndrome.Methods Prenatal diagnosis of three fetuses with 18q deletion syndrome was conducted through amniotic fluid karyotype analysis and CMA.Results Karyotype analysis results of the three fetuses were 46,XY,del(18)(q22);46,XY,-18,+mar;and 46,XX,del(18)(q21.2),respectively.The results of CMA showed that Case 1 had a deletion of 10.0 Mb in the 18q22.2q23 region,Case 2 had a deletion of 5.5 Mb in the 18p11.32p11.31 region and a deletion of 20.9 Mb in the 18q21.32q23 region,and Case 3 had a deletion of 24.1 Mb in the 18q21.2q23 region.Therefore,all the three fetuses had 18q deletion syndrome.Conclusion As a molecular diagnostic technique,CMA can accurately detect the location and size of pathogenic chromosome copy number,and identify the pathogenic genes.It can provide useful evidence for prenatal diagnosis and genetic counseling of 18q deletion syndrome.

Objective To investigate the application of chromosome microarray analysis(CMA)in prenatal diagnosis of 18q deletion syndrome and to analyze the genotype-phenotype correlation of 18q deletion syndrome.Methods Prenatal diagnosis of three fetuses with 18q deletion syndrome was conducted through amniotic fluid karyotype analysis and CMA.Results Karyotype analysis results of the three fetuses were 46,XY,del(18)(q22);46,XY,-18,+mar;and 46,XX,del(18)(q21.2),respectively.The results of CMA showed that Case 1 had a deletion of 10.0 Mb in the 18q22.2q23 region,Case 2 had a deletion of 5.5 Mb in the 18p11.32p11.31 region and a deletion of 20.9 Mb in the 18q21.32q23 region,and Case 3 had a deletion of 24.1 Mb in the 18q21.2q23 region.Therefore,all the three fetuses had 18q deletion syndrome.Conclusion As a molecular diagnostic technique,CMA can accurately detect the location and size of pathogenic chromosome copy number,and identify the pathogenic genes.It can provide useful evidence for prenatal diagnosis and genetic counseling of 18q deletion syndrome.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.

New quality productive forces are advanced productive forces in line with the new development concept,with the characteristics of high technology,high efficiency and high quality.It has a guiding role in realizing the high-quality and sustainable development of public hospitals.Starting from the basic connotation of the new quality productivity,it studies the core elements and implementation paths of establishing a lean management system that meets the requirements of high-quality development of public hospitals from the perspective of the leap in the combination of labourers,labour materials,labour objects and their optimisation.Combined with the actual situation of Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine,the specific application path is discussed,in order to be able to achieve the transformation and upgrading of public hospitals to provide experience to learn from.