Objective:To investigate the correlation between cranial imaging changes and clinical detection indicators in newborns infected with human cytomegalovirus（HCMV），and to provide a basis for the assessment and monitoring of clinical HCMV infection.Methods:A total of 87 newborns with HCMV infection treated in Shengjing Hospital of China Medical University from August 2016 to December 2017 were selected.According to the cranial imaging examination results，they were divided into an abnormal group（25 cases）and a normal group（62 cases）.The HCMV-DNA copy number of peripheral blood mononuclear cell（PBMC）was detected by real time PCR，and the clinical data of two groups of newborns were analyzed.Logistic regression was used for multivariate analysis，and drawed receiver operating characteristic（ROC）curve to evaluate the predictive value of each indicator for cranial imaging examination results.Results:Compared with the normal group，the newborns in abnormal cranial imaging group had smaller gestational age（29.29w vs 33.00w， P=0.004），lower birth weight（1 393.00g vs 1 835.00g， P=0.003），lower hemoglobin levels（87.00 g/L vs 98.00 g/L， P=0.025），and significantly higher PBMC HCMV-DNA copy number（80.00% vs 51.61%， P=0.015），with statistically significant differences.The area under the ROC curve of the predictive value of PBMC HCMV-DNA quantitative detection for cranial imaging results was 0.671（ P=0.016），with high sensitivity compared with HCMV-IgM antibody and urinary HCMV-DNA quantification.Logistic regression analysis showed that there was a certain correlation between PBMC HCMV-DNA quantification，gender，and total bilirubin levels and changes in cranial imaging（ P<0.05）.Three indicators combined to predict the area under ROC curve of abnormal cranial imaging results was 0.860（95% CI：0.743~0.976）. Conclusion:PBMC HCMV-DNA quantitative detection has a certain correlation with the cranial imaging changes of newborns with symptomatic HCMV infection，which can provide a reference for risk assessment of nervous system injury.

In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.

Objective: To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery. Methods: A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method. Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality. Students in both groups received assessment and questionnaires at the end of training. Results: Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group (P<0.05). The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group (P<0.05). Students-teacher satisfaction degree in the research group was higher than that in the control group (P<0.05). Conclusion Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach, with good feedback.

Objective: To investigate the molecules of cytokine in the serum and cerebrospinal fluid of newborns infected with human cytomegalovirus (HCMV) by using protein chip technology and to analyze the changes of specific cytokine in serum and cerebrospinal fluid caused by HCMV infection, in order to provide a reliable index for predicting nervous system injury caused by HCMV infection. Methods: Serum and cerebrospinal fluid in 4 newborns with HCMV infection and central nervous system injury (HCMV-infected group), and 4 newborns without HCMV infection and central nervous system infection (control group) were collected in Shengjing Hospital of China Medical University from June 2016 to December 2017, and protein chip was used to screen the differentially expressed cytokines in newborns serum and cerebrospinal fluid.The samples were further expanded to collect cerebrospinal fluid from 30 newborns HCMV infection group and 30 newborns in the control group, and the expression of differentially proteins was verified by adopting enzyme linked immunosorbent assay(ELISA) method. Results: The results of protein chip analysis showed that newborns in HCMV infection group, compared with the control group, had 3 differentially expressed cytokines in the cerebrospinal fluid sample: adipocyte complement-related protein of 30 kD(Acrp30), interleukin-1 alpha(IL-1α), and matrix metallo protein-3(MMP3) (all P<0.05). Newborns in the HCMV-infected group, compared with the control group, had no differential cytokine expression in the serum.The results of ELISA showed that expression of Acrp30 was significantly higher in the cerebrospinal fluid of newborns with HCMV infection and central nervous system injury [(39.76±2.01) ng/L vs.(7.75±0.10) ng/L, t=87.09, P<0.001], and MMP3 expression was higher than that of control group [(1.40±2.13) ng/L vs.(0.18±0.45) ng/L, t=3.07, P=0.003], while the expression of IL-1α was significantly lower than that of the control group [(2.36±0.99) ng/L vs.(2.91±0.78) ng/L, t=2.39, P=0.020], and the differences were statistically significant. Conclusions The changes of cytokine in cerebrospinal fluid of HCMV infected newborn children may provide a reliable index for predicting injury degree of central nervous system in HCMV, and may further assist clinicians to give timely and appropriate treatment to newborns, and further assist clinicians to improve the prognosis for newborns.

Objective To evaluate the diagnostic value of fluorescent quantitative polymerase chain reaction(FQ-PCR) assay in human cytomegalovirus (HCMV) infection by detecting quantitatively HCMV DNA in peripheral blood mononuclear cell ( PBMC) of newborns,to evaluate the choice of detection methods for neonatal HCMV infection,and to provide a reasonable diagnosis basis for the clinic. Methods The urina-ry HCMV-DNA levels in 102 neonates with suspected HCMV infection were detected by FQ-PCR. The HCMV-DNA in PBMC was detected by FQ-PCR,and serum HCMV-IgM antibody was detected by chemilu-minescence immunoassay ( CLIA) . Then the sensitivity, specificity, coincidence rate and other indicators in the three kinds of detection methods were compared. Results Among 102 cases of suspected HCMV-infec-ted newborns,56 cases were symptomatic and 46 cases were non-symptomatic. The positive rate of HCMV-DNA in urine[87. 3％(89/102)] was significantly higher than that of PBMC HCMV-DNA [58. 8％ (60/102)] and serum HCMV-IgM antibody [40. 2％ (41/102)](all P<0. 01). For symptomatic HCMV-infec-ted newborns, PBMC HCMV-DNA quantitative detection sensitivity ( 71. 4％) was higher than serum HCMV-IgM antibody (57. 1％), and the specificity (56. 5％) was higher than urine HCMV-DNA quantifi-cation (8. 7％). The area under receiver operating characteristic(ROC) curve of PBMC HCMV-DNA quan-tification and HCMV-IgM antibody detection were 0. 642 (P=0. 014) and 0. 659 (P=0. 006),respectively;therefore PBMC HCMV-DNA and HCMV-IgM antibodies were of great importance in diagnosing symptom-atic HCMV infection in neonates. The area under the ROC curve of urinary HCMV-DNA quantification was 0. 461 ( P =0. 496 ) , and there was no significant difference between symptomatic and non-symptomatic HCMV infections in neonates. Conclusion HCMV-DNA detection in PBMC has higher sensitivity compared with HCMV-DNA detection in urine and higher specificity compared with IgM antibody detection in serum. It can be used to detect the early infection of HCMV in newborns. The rate of detection of HCMV infection can be improved by combination of the three methods.

At present,ultrasonic treatment technology develops rapidly and has been applied in many medical fields.Focusing ultrasound (FUS) technology can focus ultrasound,which penetrates the skull into the lesions to play therapeutic role.In this paper,the mechanism of FUS therapy and its application in the treatment of central nervous system diseases,such as epilepsy,are summarized as follows.

Objective To screen a human fetal brain cDNA library for proteins that can interact with HCMV UL145 using a yeast two-hybrid system.Methods A bait plasmid (pGBKT7-UL145) was constructed.Using HCMV UL145 as bait,a human fetal brain cDNA library was screened and proteins interacting with UL145 were identified using bioinformatic methods to sequence and analyze the positive clones.Results Three clones interacting with HCMV UL145 were found,and identified as FOXG1.Conclusion Several proteins interacting with HCMV UL145 in the human fetal brain cDNA library were identified as FOXG1,indicating that this protein may play an important role in the course of HCMV infection.

Objective:To screen the proteins interacting with the human cytomegalovirus(HCMV)UL132 protein from the human fetus brain cDNA library by using Yeast Two-Hybrid System, and to elucidate the possible mechanism of UL132 protein in congenital cytomegalovirus infection.Methods:The HCMV UL132 fragment was amplified by polymerase chain reaction,the amplified HCMV UL132 fragment and expression vector pGBKT7 were digested and purified,and the HCMV UL132 fragment was linked to the vector pGBKT7.The pGBKT7-UL132 was constructed and transformed to yeast AH109, then the Human Fetal Brain DNA Library DNA was transformed into AH109 yeast.Using HCMV UL132 as abait, a human fetus brain cDNA was screened and the proteins interacting with UL132 protein were searched, the positive clone was sequenced and analyzed by bioinformatics methods.Results:The bait expression vector pGBKT7-UL132 was successfully constructed.The results of double enzyme digestion showed that there were two visible bands of 800 and 7 000 bp, respectively.After transformation of library plasmid, the transformation efficiency was calculated, and the transformation efficiency was 6.6×103 cfu· μg-1.There were 95 blue clones by X-gal coloration reactionsequencing and there were 10 clones interacting with the protein encoded by UL141 protein.The BLAST analysis showed that 7 of them were highly homologous with CAML.Conclusion:CAML might be one interaction protein with HCMV UL132 in Human Fetus Brain cDNA Library,suggesting that the interaction may be associated with the invasion and proliferation of the HCMV.

Objective To investigate the effect of small interfering RNA (siRNA) targeting cytoplasmic domain of tissue factor on apoptosis of vascular endothelial cells. Methods Specific siRNA targeting cytoplasmic domain of tissue factor were designed, and synthetic oligos were inserted into plasmid DNA. The siRNA constructs were transfected into human umbilical vascular endothelial cells (HUVEC) with liposome. The HUVEC were transfected with the constructs encoding siRNA Ⅰ, siRNA Ⅱ and pcDNA~(TM)6.2 GW/-miR plasmid separately. The transfected HUVEC were mixed with CD8~+ T lymphocytes. The apoptotic rate of tranfected HUVEC mixed with lymphocytes was analyzed by flow cytometry. Magnetic beads were used to measure PT of the supematant in the mixed lymphocytes culture. Results The siRNA constructs were confirmed by DNA sequence analysis. The apoptotic rate of HUVEC transfected with siRNA Ⅰ and Ⅱ plasmids was decreased significantly as compared with the empty control group (P<0.01). The apoptosis rate of HUVEC transfected with siRNA Ⅰ plasmid was lower than that of HUVEC transfected with siRNA Ⅱ plasmid (P<0.05). APTT of the culture supernatants in the three transfection groups was lower in the control groups (P <0.05), but there was significant difference among the three transfection groups. Conclusion The siRNA targeting cytoplasmic domain of tissue factor were successfully constructed, siRNA can protect HUVEC, and reduce the apoptotic rate of endothelial cells in mixed lymphocyte reaction without influencing the coagulation function.

To investigate the option of treatments for bone defect in femoral revision after total hip replacement (THR), 29 patients (29 hips) who had undergone hip replacement 13.7 years previously were hospitalized again to undergo revisions. 3 patients were given cement protheses and the other 24 patients were given non-cement protheses. In 3 cases were used Synergy+Reflection protheses, and in the others were used CLS +ALLOFIT. All of the patients have got primary healing without early infection symptoms post-operatively. We have been following up 25 cases (25 hips) for 58 months averagely. All the hip joints functioned well. Harris score increased from preoperative 36.8 to postoperative 93.2. In our experience, if there exist significant bone defect in acetabular bone and the coverage of the cup by the graft is more than 80%, bone graft is not needful. If the coverage is between 50% and 80%, bone grains combining bone segment grafts are needful. If the coverage is less than 50%, bone segment grafts be likely to give good effect. In summary, compacted bone grains grafts combining allograft osintegumentale plate could gain satisfactory outcome for femoral bone defect.
Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Bone Transplantation ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Osteolysis ; Prosthesis Failure ; Reconstructive Surgical Procedures ; methods ; Reoperation