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Cervical spondylotic myelopathy (CSM) is the most serious subtype of cervical spondylosis, which is the main cause of spinal cord dysfunction in middle-aged and elderly people, and the pathogenesis of this CSM is complex, mainly including degenerative aging, dynamic instability, spinal cord ischemia, spinal cord injury, inflammation, apoptosis, and other possible mechanisms. The clinical treatment of the CSM mainly includes conservative treatment and surgical treatment, conservative treatment includes drugs, acupuncture, moxibustion, traction, physical therapy and manual treatment, surgical treatment can be divided into anterior surgery, posterior surgery, anterior and posterior combined surgery according to the surgical approach. The choice of treatment regimen should be based on the patient's symptoms, signs, and the results of auxiliary examinations, but how to choose the appropriate treatment plan is still the focus of clinicians. This article focuses on the research progress of the pathogenesis and treatment methods of this disease, in order to provide a reference for the diagnosis and treatment of cervical myelopathy.

[ Objective ] The NAC transcription factor family is a class of transcription factors that is widely studied in plants. It plays an important role in regulating plant growth and development and responding to abiotic stress. Maize is one of the three major food crops , which faces various adverse stresses in growth and development. Salt stress is one of the main environmental factors limiting crop growth and produc- tion. Therefore , it is of great significance to identify maize salt resistance genes and analyze their salt re- sistance mechanism for breeding stress-resistant maize varieties. [ Methods ] This study cloned the maize transcription factor ZmNAC59 and analyzed its conserved domain and phylogenetic relationship using bioinformatics methods. The expression pattern of the gene in leaves under NaCl and MeJA treatments was analyzed using the quantitative real-time PCR method. The stable transgenic system was used to het- erologously express the gene in Arabidopsis thaliana for phenotype observation. At the same time , virus- induced silencing technology was used to silence the gene in maize , followed by phenotype observation un- der salt stress and enzyme activity detection. [ Results ] The qRT-PCR results showed that ZmNAC59 was up-regulated by NaCl and MeJA treatments. After virus-induced silencing of ZmNAC59 , the silenced strains were more sensitive to salt stress and accumulated more ROS. After over expression of ZmNAC59 in A . thaliana , the over expression lines had higher survival rate , less accumulation of ROS , and lower Na + / K + ratios under salt stress , indicating that ZmNAC59 , as a positive regulator of salt stress , can im- prove plant salt resistance by regulating ion homeostasis. qRT-PCR results showed that Na + and K + transport related genes were significantly up-regulated in A . thaliana overexpression lines. After transient expression of ZmNAC59 in maize protoplasts , the expression of ZmSOS1 , ZmNHX1 , and ZmNHX7 were significantly up-regulated after salt treatment. The Dual-LUC experiment showed that ZmSOS1 was the target gene of ZmNAC59. [ Conclusion ] This study finds that ZmNAC59 activates ZmSOS1 promoter and regulates its expression to promote ion transport under salt stress , thereby improving plant salt resist- ance. This provides a basis for the screening of maize stress resistant genes and variety cultivation.

The northern South China Sea continental margin is the key or critical segment of the Ocean-Continent Connection Zone (OCCZ) of the Great South China Block, the junction between the Tethyan and the (Paleo-) Pacific dynamic systems, and the interaction area between the Indian Ocean and the Pacific Ocean. However, due to the low-degree geophysical exploration in the past, the regional tectonic background, processes and mechanism of the transition between the Tethyan and the Pacific tectonic domains are unclear. Based on the latest large number of seismic profiles, we focus on the Cenozoic basin structure in the continental margin of the northern South China Sea and try to reveal the Mesozoic basement structures of the northern South China Sea continental margin, with the aim of exploring the pre-Cenozoic tectonic evolution and the Cenozoic opening, spreading, ridge fossil and closure of the South China Sea oceanic basin, so as to serve the accurate oil and gas exploration in this area at the same time. The seismic interpretation of the Pearl River Mouth Basin and the field structural investigation of the South China continental margin show that the OCCZ of the South China Block has experienced three processes: Mesozoic Indosinian collisional orogeny, Early Yanshanian accretionary orogeny and Late Yanshanian transpressive orogeny. During the Cenozoic era, it experienced the dispersive extension into basins under the control of NW-SE-directed normal extension in the early stage, the dextral pull-apart into basins under the control of NE-NNE-trending strike-slip faults in the middle stage, and the sinistral pull-apart into basins under the control of NW-WNW strike-slip faults in the late stage. In general, the transition process from the Tethyan to the Pacific tectonic systems can be subdivided into four stages: the transition from the Paleo-Tethyan to the Neo-Tethyan tectonic systems, the transition from the Neo-Tethyan to the Paleo-Pacific tectonic systems, the transition from the Neo-Tethyan to the Pacific tectonic systems, and the transition from the Paleo-Pacific to the Pacific tectonic systems. The tectonic transition of the East Asian OCCZ reflects the long-term mechanism of the Earth plate dynamic system driving the plate superconvergence in East Asia, in particular of the importance of the deep or submarine “Triple Poles”, the Southeast Asian U-shape subduction system, the Pacific LLSVP and the African LLSVP. More importantly, the Southeast Asian U-shape subduction system is also one of the important dynamic engines of the Earth plate motion.

Objective To study the role of DNA methylation in oral leukoplakia carcinogenesis. Methods DNA methylation was detected in forty cases of oral squamous cell carcinoma (OSCC), twenty-eight cases of oral leukoplakia (OLK) and forty cases of healthy oral mucosa. Download the expression profile data of OSCC, OLK and healthy oral mucosa from Gene Expression Omnibus (GEO) database. DNA methylation data and expression profile data were compared for repeatability, DNA methylation data for difference analysis and corresponding expression profile data for IPA pathway analysis. Results The data analysis showed that DNA methylation had greater flexibility and instability. Ingenuity Pathway Analysis (IPA) analysis showed that genes related to OLK differential methylation sites were mainly concentrated in the process of cell movement and differentiation. Genes related to differential methylation sites of OSCC are mainly enriched in cell proliferation, migration, oxidation regulation, and anti-apoptosis processes. The genes associated with OLK and OSCC differential methylation sites are co-enriched in phosphoinositol metabolism and phospholipase C signaling pathway. Conclusion DNA methylation is involved in the formation of oral squamous cell carcinoma, and the activation of phosphoinositol metabolism may promote oral leukinoma.

The preparation of spherical-like battery-grade ferric phosphate by co-precipitation--spray-drying method was investigated using ferrous sulfate heptahydrate (FeSO4, • 7H2O) and ammonium dihydrogen phosphate (NH4 H2 PO4) as raw materials. The effects of the addition of the surfactant cetyltrimethyl ammonium bromide (CTAB), reaction time, and solution pH on the physical phase and particle size of ferric phosphate were examined. The products were characterized by a laser particle sizer, X-ray powder diffractometer, thermogravimetric analyzer, and field emission scanning electron microscope. The results indicate that under the conditions of a Fe/P molar ratio of 1/1.01, CTAB addition of 0.04 g, reaction time of 1 h, and solution pH of 3.0, the ferric phosphate exhibits the smallest particle size distribution, ranging from 300 to 500 nm, and displays more uniform spherical morphology. Moreover, lithium iron phosphate is prepared by ball milling, mixing and sintering, using the spherical-like ferric phosphate as the precursor iron source. The specific discharge capacity of lithium iron phosphate is 150.14 mAh/g at 0.1 C and the retention rate is 98.9% after 200 cycles at 1 C, the performance is good. [ABSTRACT FROM AUTHOR]

To explore the dynamic characteristics of the rotors of labyrinth seal considering inlet preswirl, based on Murphy's small displacement principle, the governing equations of steam flow excitation force and rotor vortex displacement were established, and a multi-frequency elliptical vortex model was built by user-defined functions . The exciting forces of three labyrinth seals, straight tooth labyrinth seal(SLS), inclined tooth labyrinth seal (ILS), stepped tooth labyrinth sea l(STLS) were numerically solved under different inlet preswirl ratio, the seal dynamic characteristic coefficient was obtained by fast Fourier transform,and the stability of the rotor and the leakage of the seals were analyzed. The results show that the direct stiffness coefficients of the three labyrinth seals decrease first and then increase in the range of eddy frequency from 40 Hz to 180 Hz, showing a strong frequency correlation. While the influence of sealing structure and inlet preswirl on damping coefficient can be ignored.The damping coefficient slowly decreases to a negative value and then becomes stable with the increase of vortex frequency. STLS has the smallest damping coefficient and the worst stability,while ILS has the best stability. Increasing the inlet preswirl ratio will reduce the effective damping coefficient and lead to a decrease in leakage rate.STLS exhibits the best sealing performance under different preswirl conditions,with a 15% and 7% reduction in leakage compared to SLS and ILS, respectively. The cross stiffness of the three labyrinth seals increases from negative to positive in the studied vortex frequency range of 20 Hz to 200 Hz, while the effective damping decreases to negative. Therefore, the stability of the rotor system of the labyrinth seals is poor, which may induce rotor instability. [ABSTRACT FROM AUTHOR]

The model-based collaborative filtering algorithms need to analyze and extract the basic feature matrix of "user items"for user recommendation. Different user characteristics directly lead to different user first foundations. However, collaborative filtering algorithms for model purposes only consider the analysis and extraction of key factors that affect item characteristics, but not the important factors that affect user characteristics. This type of traditional model often initializes the user's latent feature vector randomly and assigns an assumed normal distribution, resulting in no data changes in these models that can have a direct impact on the results of the user's potential feature modeling. In addition, the user-based recommendation system model directly uses the user's comments and ratings as user characteristics. The reference methods of these data in the traditional recommendation system and the data itself are not enough to support the acquisition of the essential characteristics of users. The approximation of these features also cannot meet the needs of personalized recommendation. Aiming at the problems of existing recommendation algorithms that there is no analysis to extract the essential features of users and the insufficient extraction of essential features of items, and the recommendation results are difficult to reflect the user's personality, a recommendation model that integrates personality features is proposed. Firstly, according to the non-structure of users in the recommendation platform, the review text information is transformed, the personality characteristics are used as the direct influencing factors of the user characteristics, a neural network model is designed to calculate the BIG FIVE personality score of the review user, and the personality score is vectorized as the user characteristics; then the item characteristics are obtained through the project review text information. This paper designs a collaborative learning framework for personality perception, and defines a loss function to obtain the feature vectors of users and items. Finally, target users are recommended based on the results of user and item characterization. A comprehensive experimental verification is carried out on 3 datasets. The results show that the algorithm outperforms the comparison algorithms in terms of prediction accuracy, F1 value, AUC index, etc. Through personality modeling, it can recommend items that are more in line with users preferences. [ABSTRACT FROM AUTHOR]

Objective To compare the efficacy and safety of Mixed Protamine Zinc Recombinant Human Insulin Lispro Injection (50R) (WANBANG) and Humalog Mix 50 (Lilly) in the treatment of type 2 diabetes mellitus (T2DM). Methods A multicenter, randomized, parallel, positive control, phase III clinical trial was conducted. From August 30, 2018 to May 27, 2020, 612 patients with T2DM with poor glycemic control by oral hypoglycemic agents were enrolled from 36 centers nationwide, and were followed random number method assigned to the experimental group (WANBANG) and the control group (Lilly) according to 1:1 for 16 weeks. The glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), body weight, blood lipid, HbA1c compliance rate at the end, the incidence of hypoglycemic events and adverse events and the positive rate of insulin antibody were compared between the two groups before and after treatment. Results Of the 612 patients, 609 were included in the safety data set, including 305 in the experimental group and 304 in the control group; 534 cases were enrolled into the protocol set, including 267 cases in the experimental group and 267 cases in the control group. After 16 weeks of treatment, HbA1c decreased by 1.85%±1.23% and 1.90%±1.27%, respectively. FPG decreased by (3.56±2.99) and (3.72±3.26) mmol/L, 2hPG decreased by (6.94±5.41) and (7.07±5.10) mmol/L, respectively, there was no significant difference in the above indexes between the two groups (P>0.05). There was no significant difference in the overall incidence of hypoglycemia [51.15% (156/305) vs. 45.72% (139/304)], the incidence of adverse events [76.39% (233/305) vs. 77.63% (236/304)] and the positive conversion rate of insulin antibody [22.85% (61/267) vs. 19.10% (51/267)] between the experimental group and Humalog Mix 50 group (P>0.05). Conclusions The efficacy and safety of Mixed Protamine Zinc Recombinant Human Insulin Lispro Injection 50R (WANBANG) in treating T2DM is similar to that of Humalog Mix 50, and is well tolerated. This study has positive significance for reducing the medical burden of the country. [ABSTRACT FROM AUTHOR]

The effects of ramie fiber on compressive strength, flexural strength, autogenous shrinkage and electrical resistivity of cement-based materials were studied by incorporating ramie fiber into cement-based material and comparing steel fiber and polypropylene fiber. The experiment test results indicate that at age of 7 d. when cement-based materials with 0.3% and 0.6% ramie fibers were compared to pure cement-based materials, the compressive strength reduced by 1.2% and 3.0%. the autogenous shrinkage of the sample could be reduced by 13.4% and 30.8% respectively. At age of 28 d, the compressive strength of cement-based materials increased by 2.2% and 8.2% . and the flexural strength increased by 9.6% and 13.4%. Steel fiber and polypropylene fiber significantly improved the compressive and flexural strength of cement-based materials for 7 and 28 d, while ramie fiber was more conducive to the early autogenous shrinkage of cement-based materials. With the increase of ramie fiber content, in cement-based materials, the autogenous shinkage at 7 d and the electrical resistivity at 3 d decreased significantly. [ABSTRACT FROM AUTHOR]

As a kind of abiotic stress, drought stress is a common phenomena existing in the plant growth environment. Although drought could cause negative effects such as plant damaged, it also have a positive compensation effect or super compensation effect on physiological and biochemical metabolism during plant growth and development in a short re-watering period after certain drought stress condition, which could make up the loss or damage. Compensation effect, as an important self-regulation mechanism during plant defense responses or resistant to damage, was widely existed in plants and became an important physiological basis for available water regulation and water-saving high-efficiency agriculture realization. At present, drought is the universal phenomenon in spring, of which it in summer and spring-summer has been common and occurred more frequently and the degree was aggravated in recent years in our country. Therefore, in order to explore the metabolic of growth compensation effect and metabolic compensation effect on soybean drought stress and re-watering and establish the best water-saving irrigation mode, we analyzed the effect of drought stress and re-watering on growth, osmotic regulation, endogenous hormone regulation and anti-oxidation system during different stress periods, stress levels and processing times by weighing control the water content, with Sui Nong 14 as experimental material. The results showed that, plant height and leaf area of soybean were inhibited by drought stress, and the decreasing range was 12.50%-39.74%, 21.71%-52.87% and 16.93%-36.27%, 27.99%-47.80% in seeding stage and flowering stage at 0 d re-watering, respectively. The content of praline, soluble sugar and MDA were increased by 46.97%-131.57%, 99.56%-139.37%, 6.64%-22.82% and 31.68%-136.30%, 32.63%-184.51%, 15.82%-100.75% in seeding stage and flowering stage at 0 d re-watering, respectively. The activity of SOD was increased with a decreasing tendency under 10d severe drought stress. The content of ABA was increased, with GA and ZR decreasing, IAA decreased in seedling stage and increased in flowering period. After re-watering, the daily increasing of plant height and leaf area showed a rapid growth in short-term with the over growth compensation effect, metabolic indices in moderate drought stress and 5 d drought stress treatments returned to control levels with a equal or approximately equal metabolic compensation effect; of which these in serious drought stress and 10 d drought stress treatments were showed an approximately equal or partial metabolic compensation effect. This implied that the occurrence of compensation effect under drought stress after re-watering was conditional. The severe drought stress or long time drought stress could decreased the compensation effect and damaged the plant at last, while the appropriate drought treatments in seedling period could improve drought adaptability and compensation effect under once again the drought stress in flowering. Therefore, a moderate drought resistance exercise should be carried out in seedling stage in order to improve the adaptability with drought environment in the late growing, but not suitable for severe drought stress especially for long time. A best water-saving irrigation mode should be established by reasonable utilization of plant drought compensation effect mechanism so that it could be provide a theoretical for the analysis of compensation effect mechanism and cultivation techniques of drought resistance and high yield on soybean. [ABSTRACT FROM AUTHOR]

In view of the aesthetic problem and potential threat to safe drinking water caused by invertebrates, a series different depth of sand beds were located under granular activated carbon ( GAC) media in five pilot-GAC filtration (GACF) columns to restrict invertebrates' penetration into the distribution system. During the study period of 10 months, 7 groups of invertebrates (rotifers and crustaceans as the predominant species) were detected in the filtrates of the five GACF columns. The experimental results indicated that invertebrates could be removed effectively with the added sand beds compared with the sand bed-free GACF column. The mean abundances of invertebrates decreased significantly with the increase of the depth of sand beds. The 46. 6 % of rotifers and 85. 5% of larger invertebrates (size > 200 µm) could be removed from the- filtrate. Sand sizes had a greater impact on rotifers removal than larger invertebrates. Also increasing removal ratios of particle matter were detected with the sand beds added. Further data analysis showed that there was significant correlation between the mean values of particle counts and abundances of invertebrates in the filtrates. [ABSTRACT FROM AUTHOR]

Commingled producing strings with separated layer fracturing by packer is commonly used in multilayer production of Sulige gas field, which is featured by large tube diameter, poor liquid carrying ability for water-bearing gas zone, great risks of fracturing operation and not accustomed to separated layer fracturing in slim hole. Integrated technique of turning annulus separate layer to fracturing commingled producing in slim-tube with sandblasting perforation was studied and matched. The technique involves in a series of techniques such as sandblasting perforation in slim-tube, separated layer fracturing in annulus between tube and casing, secondary deflection fracturing and down-hole choke in slim tube. The whole treatment process of sandblasting perforation and separate layer fracturing and commingled producing was accomplished by using slim diameter string once, which greatly enhanced the liquid carrying ability of strings. With the technology, the effect of fracturing stimulation is improved, and the risk of fracturing construction is decreased. Meanwhile, less string cost, shorter construction period and well performance of separated layer fracturing in slim hole are also very impressive. Good results have been obtained in filed application, and the success is worthy further application and extension. [ABSTRACT FROM AUTHOR]

In order to study the effect of fermentation with a mixed starter culture of lactic acid bacteria on the quality of multigrain dough and steamed bread, yellow pea flour, naked oat flour, gluten flour and oat β-glucan (OBG) were mixed together to prepare dough and steamed bread with a direct vat set (DVS) mixed starter?culture of lactic acid bacteria. The acidifying capacity of lactic acid bacteria in dough was investigated, and the contents of OBG, resistant starch (RS) and free amino acids and the microstructure of dough were analyzed. Also, the quality and nutritional characteristics of steamed multigrain bread and steamed wheat bread before and after fermentation were compared. The results showed that lactic acid bacteria had strong acidifying capacity in fermented multigrain dough, and the contents of lactic acid and acetic acid were 24.85 and 8.98 mg/mL, respectively, after 24 hours of fermentation. Compared with unfermented multigrain dough, the OBG content in lactic acid bacteria fermented multigrain dough decreased by 32.56%, the RS content increased by 32.88%, the total amount of free amino acids increased by 1.46 times, the amino acid composition pattern was better, proteins and cellulose were partially degraded, and the gluten network was more compact and continuous. In terms of nutrition, the dietary fiber content of steamed multigrain bread was higher than 6% both before and after lactic acid bacteria fermentation, and the protein content was 40.35% and 38.38% in steamed unfermented and fermented multigrain bread, respectively, indicating that steamed multigrain bread is rich in dietary fiber and protein. Its dietary fiber and protein contents were higher than those of steamed wheat bread. Lactic acid bacteria fermented multigrain steamed bread had higher in vitro protein digestibility and specific volume, and the overall sensory score of steamed lactic acid bacteria fermented multigrain bread was significantly higher than that of steamed unfermented multigrain bread, and the overall acceptability was higher.

Using multi-walled carbon nanotubes (MWCNTs) as a novel sorbent and a new special anionic chromatographic column for pesticide residues, an ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed for the simultaneous direct determination of glufosinate ammonium and its metabolites 3-methylphosphino-propionic acid and N-acetylglufosinate ammonium in milk. The samples were extracted with methanol, cleaned up using MWCNTs, and degreased by high-speed centrifugation at low temperature. The analytes were separated on an Anionic Polar Pesticide (2.1 mm × 100 mm, 5 μm) column using a mobile phase containing 0.9% formic acid solution (A) and 0.9% formic acid solution-acetonitrile (B). The instrument was operated in the negative ion scanning mode with multiple reaction monitoring. Glufosinate ammonium was quantified by an internal standard method, and its two metabolites by an external standard method. The calibration curves for glufosinate ammonium and its two metabolites were linear in the concentration range of 1–50, 2–50 and 2–50 μg/L with correlation coefficient (R2) greater than 0.99. For these compounds, the limits of detection were 2.5, 5.0 and 5.0 μg/kg, and the limits of quantification were 5.0, 10.0 and 10.0 μg/kg, respectively. The recoveries ranged from 79.35% to 101.80%, with relative standard deviation (RSD) between 1.15% and 8.63%. The proposed method is characterized by simple pretreatment, stable chromatographic conditions, low impurity interference, high sensitivity and good accuracy, and is suitable for the determination of glufosinate ammonium and its metabolite residues in milk.

Objective: To evaluate the effectiveness of percutanous fixation with helical bridge combined fixation system (BCFS) for treatment of long split fractures involving the middle and upper humerus., Methods: Between February 2018 and February 2020, 15 patients of long split fractures involving the middle and upper humerus were treated. There were 6 males and 9 females, with an average age of 62 years (range, 37-82 years). The fractures were caused by slipping in 7 cases, falling from height in 3 cases, and traffic accident in 5 cases. According to AO classification, the shaft fractures were rated as type A in 4 cases, type B in 9 cases, and type C in 2 cases. And all fractures extended to proximal humerus; and the proximal fractures were rated as one-part fracture in 11 cases and two-part fracture in 4 cases according to Neer classification. The interval between injury and operation was 1-7 days (mean, 3.2 days). Nine patients underwent closed reduction and 6 patients underwent open reduction after lengthening the incisions. All fractures were percutaneously internal fixated with helical BCFS after reduction. The operation time, intraoperative blood loss, incision healing, and fracture healing were recorded. Constant-Murley score was used to evaluate shoulder joint function, and Mayo score was used to evaluate elbow joint function., Results: The operation time ranged from 55 to 175 minutes, with an average of 76.5 minutes; the intraoperative blood loss ranged from 80 to 300 mL, with an average of 185.5 mL. All incisions healed by first intention, without infection or radial nerve injury. All patients were followed up 12-23 months, with an average of 16 months. The fractures all reached clinical healing, and the healing time was 12-20 weeks, with an average of 14.5 weeks. At 1 year after operation, the Constant-Murley score of the affected side was 88.7±7.6, and there was no significant difference when compared with that of the healthy side (90.8±8.3) ( t =1.421, P =0.052). According to the elbow Mayo score, the score of the affected side was 97.6±6.5, and there was no significant difference when compared with the healthy side (97.7±7.3) ( t =0.433, P =0.913)., Conclusion: The helical BCFS can avoid the dissection of deltoid insertion and prevent the iatrogenic radial nerve injury. With satisfied effectiveness, it is suggested for minimally invasive surgical treatment of long split fractures involving the middle and upper humerus.

Objective: To observe the changes of regional saturation of cerebral oxygenation (rScO 2 ) and blood neuron specific enolase (NSE) in patients after cardiopulmonary resuscitation (CPR), and to explore its value in evaluating the prognosis of patients' neurological function., Methods: From January 2012 to December 2020, 97 patients with return of spontaneous circulation (ROSC) after cardiac arrest (CA) treated in the intensive care unit (ICU) of the Second Affiliated Hospital of Soochow University were selected. According to the prognosis, the patients were divided into two groups: good neurological function group [Glasgow-Pittsburgh Cerebral Performance Categories (CPC) 1-2, 20 cases] and neurological dysfunction group (CPC classification 3-5, 77 cases). The clinical data of gender, age, the number of patients with defibrillable rhythm, time of ROSC, the number of CA patients outside the hospital, acute physiology and chronic health evaluation II (APACHE II), Glasgow coma scale (GCS), global non-response scale (FOUR), body temperature, mean arterial pressure (MAP), blood lactic acid (Lac) and GCS at discharge, as well as the length of ICU stay, rScO 2 and blood NSE were collected. The differences of rScO 2 and NSE between the two groups were compared; and the receiver operator characteristic curve (ROC curve) was drawn to evaluate the value of rScO 2 and NSE alone or in combination in predicting the prognosis of patients with ROSC after CA., Results: The rScO 2 of good neurological function group was significantly higher than that of neurological dysfunction group at 1, 3, 6, 12, 24 and 48 hours (all P < 0.05). At 24 hours after admission, the rScO 2 on the left and right sides of good neurological function group was significantly higher than that in neurological dysfunction group [left: 0.65 (0.59, 0.76) vs. 0.55 (0.44, 0.67), right: 0.62 (0.61, 0.73) vs. 0.50 (0.30, 0.69), both P < 0.05], and NSE was significantly lower than that in the neurological dysfunction group [ng/L: 21.42 (15.38, 29.69) vs. 45.82 (24.05, 291.26), P < 0.05]. ROC curve analysis showed that both rScO 2 and NSE alone and combined detection had a certain value in predicting the prognosis of neurological function in patients with ROSC after CA, and the area under the ROC curve (AUC) detected by the combination was the largest, which was higher than the AUC predicted by rScO 2 or NSE (0.904 vs. 0.884, 0.792). When the cut-off value of combination was 0.83, the sensitivity and specificity were 75.7% and 100% respectively., Conclusions: Monitoring rScO 2 and NSE can predict the prognosis of neurological function after CPR, especially the combined evaluation of the two indexes, which can greatly improve the accuracy of diagnosis.

Objective: To investigate the effectiveness of internal and external lysis combined with Ilizarov external fixation technology for severe knee pathological flexion contracture deformity in children., Methods: A retrospective analysis was made on 12 children (12 knees) with severe knee pathological flexion contracture deformity who were treated with internal and external lysis and Ilizarov external fixation between August 2012 and January 2017. There were 9 boys and 3 girls with an age of 3-12 years (mean, 8.4 years). There were 8 cases of tuberculosis, 3 cases of haemophilia A, and 1 case of residual deformity after extensive hemangioma drug injection. The disease duration ranged from 5 months to 4 years, with an average of 20.3 months. The degree of knee contracture was (67.42±23.30)°, and the range of motion of knee was (38.33±14.98)°. The preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score was 78.42±15.57. The complication was observed after operation, and the degree of knee contracture, range of motion, and WOMAC score at 3 months and 1 year after operation were recorded and compared with those before operation., Results: The operations completed successfully in all children. All the 12 cases were followed up 9-24 months (mean, 14.5 months). All incisions healed by first intention after operation. The knee function of all children improved significantly and the weight-bearing walking function of the lower limbs restored. The degree of knee contracture, range of motion, and WOMAC score were significantly improved at 3 months and 1 year after operation ( P <0.05), but there was no significant difference between 3 months and 1 year after operation ( P >0.05)., Conclusion: For severe knee pathological flexion contracture deformity in children, application of internal and external lysis combined with Ilizarov external fixation has advantages, such as small trauma, rapid recovery, and early postoperative knee function training, and good effectiveness.

Objective: To establish cisplatin (CDDP)-resistant melanoma B16F10 (CDDP-R B16F10) cell line with stable expression of T-cadherin, and to study its biological characteristics.
 Methods: CDDP-R B16F10 cell line was exposure to high and gradually increased dose of CDDP. 3-(4.5-Dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) was used to test the proliferation of CDDP-R B16F10 cell line, and the sensitivity of CDDP-R B16F10 cell line to CDDP and paclitaxel was examined. The pEGFP-N1-T-cadherin, a plasmid vector encoding human T-cadherin, was generated by inserting T-cadherin cDNA into a pEGFP-N1 vector. The pEGFP-N1-T-cadherin was transfected into CDDP-R B16F10 cell line. The expression of T-cadherin mRNA and protein were measured by reverse transcription polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry SP method, respectively. The effect of T-cadherin combined with CDDP on proliferation of CDDP-R B16F10 cell line was determined by MTT assay. The sensitivity of CDDP-R B16F10 cell line with stably transfected T-cadherin to paclitaxel was examined by MTT assay.
 Results: The CDDP-R B16F10 cell line was established successfully. There was no difference in proliferation between the CDDP-R B16F10 cell line and B16F10 cell line (P>0.05). The IC50 of CDDP-R B16F10 cell line and B16F10 cell line to CDDP were 268.706 and 19.748 mg/L, respectively, and the resistance index was 13.61. The IC50 of CDDP-R B16F10 cell line and B16F10 cells to paclitaxel were 11.415 and 7.799 mg/L, respectively, and the resistance index was 1.46. The expression vector pEGFP-N1-T-cadherin was constructed successfully. RT-PCR, Western blotting and immunohistochemistry SP method showed that T-cadherin could be transcribed and expressed. MTT assay showed that T-cadherin combined with CDDP could inhibit the proliferation of CDDP-R B16F10 cell line (P<0.05). Factorial analysis showed that there was interaction between T-cadherin and CDDP in inhibiting the proliferation of CDDP-R B16F10 cell line (P<0.05). T-cadherin combined with paclitaxel could inhibit the proliferation of CDDP-R B16F10 cell line (P<0.05). Factorial analysis showed that there was no interaction between T-cadherin and paclitaxel in inhibiting the proliferation of CDDP-R B16F10 cell line (P>0.05). 
 Conclusion: The CDDP-R B16F10 cell line with stable expression of T-cadherin is established successfully. T-cadherin can reverse the CDDP resistance to CDDP-R B16F10 cell line, and promote its sensitivity to paclitaxel.

Objective: To investigate the effect of III-type phosphatidylinositide 3 kinase (PI3K) pathway adjusting autophagy on brain damage mechanism after cardiopulmonary resuscitation (CPR) and hypothermia treatment., Methods: The asphyxia induce cardiac arrest-CPR model was reproduced on healthy male Sprague-Dawley (SD) rats. Sixty rats after restoration of spontaneous circulation (ROSC) were randomly divided into normothermia group, therapeutic hypothermia group and PI3K inhibitor 3-methyl adenine (3-MA) pretreatment group, differentiated by 24 hours and 48 hours after ROSC. Each group had 10 rats at each time point. The anal temperature in the normothermia group was maintained at (37.0±0.2) centigrade, and the rats in the hypothermia group were given cooling treatment immediately after ROSC, and the target rectal temperature was 32-34 centigrade. In the 3-MA pretreatment group, 10 mmol/L 3-MA 5 μL was injected into the ventricle 20 minutes before asphyxia, and other groups were given the same amount of normal saline. Ten rats without CPR were included in Sham group only received anesthesia and catheterization. The rats were sacrificed at 24 hours and 48 hours after ROSC respectively, and the brain tissues were harvested, the brain water content (BWC) was measured by dry-wet weight method. Western Blot was used to determine the autophagy related proteins Beclin-1 and microtubule-associated protein 1 light chain 3 (LC3), apoptosis related proteins Bcl-2 and caspase-3, and the III-type PI3K pathway proteins Vps34 and Atg14. Ultrastructural changes in brain tissue were observed with transmission electron microscope. Neurological deficit scores (NDS) was obtained in each group at 48 hours after ROSC., Results: Compared with Sham group, the cortex at 24 hours after ROSC in normothermic group showed obvious edema, apoptosis and autophagy began to appear under transmission electron microscope, and the expressions of autophagy, apoptosis and III- type PI3K-related proteins in brain tissue were significantly increased in a time-dependent manner, and the neurological function at 48 hours after ROSC was significantly damaged. After hypothermia intervention, brain edema of rats was significantly reduced, no obvious apoptosis was found, but autophagy was increased, the expressions of autophagy-related proteins Vps34, Atg14 and III-type PI3K-related proteins Beclin-1 and LC3 at 48 hours after ROSC were further higher than those of normothermic group (Vps34/GAPDH: 0.25±0.03 vs. 0.15±0.04, Atg14/GAPDH: 0.12±0.03 vs. 0.05±0.04, Beclin-1/GAPDH: 0.060±0.002 vs. 0.018±0.002, LC3 -II/GAPDH: 0.160±0.010 vs. 0.050±0.010, all P < 0.05), the expressions of apoptosis related proteins Bcl-2 and caspase-3 were significantly lowered (Bcl-2/GAPDH: 0.05±0.03 vs. 0.20±0.04, caspase-3/GAPDH: 0.050±0.002 vs. 0.140±0.015, both P < 0.05), neurological function was significantly improved (NDS: 157±85 vs. 343±198, P < 0.05). Pretreatment with 3-MA inhibited the protective effect of hypothermia on brain tissues. The expressions of Vps34, Atg14, Beclin-1 and LC3 in brain tissues at 48 hours after ROSC in 3-MA pretreatment group was significantly lower than those in the hypothermia group (Vps34/GAPDH: 0.18±0.03 vs. 0.25±0.03, Atg14/GAPDH: 0.07±0.04 vs. 0.12±0.03, Beclin-1/GAPDH: 0.015±0.003 vs. 0.060±0.002, LC3-II/GAPDH: 0.045±0.030 vs. 0.160±0.010, all P < 0.05), the expressions of Bcl-2 and caspase-3 were significantly increased (Bcl-2/GAPDH: 0.15±0.04 vs. 0.05±0.03, caspase-3/GAPDH: 0.120±0.015 vs. 0.050±0.002, both P < 0.05), and NDS score was significantly increased (341±208 vs. 157±85, P < 0.05)., Conclusions: Hypothermia treatment reduced brain edema and ameliorated brain function after CPR, which might be related to increase autophagy and inhibit apoptosis adjustment by activating III-type PI3K pathway.

Ichthyosis refers to a group of skin diseases characterized by abnormal keratinization of the epidermis, resulting in dryness, roughness and scale of the skin. A girl with ichthyosis, who presented with skin ulcers and infection of the right dorsal foot, was admitted to our department. An autologous razor-thin skin grafting procedure was performed to repair the skin ulcers after debridement and vacuum sealing drain. After 8 months of follow-up, both the donor and recipient site healed well and there were no newly formed ulcers or infections. Although the skin quality of ichthyosis is poor, the lesion area can still be used as donor or recipient cite.

Biofilm associated Vibrio cholerae exhibits hypervirulence and supreme fitness against the harsh stresses during its infectious cycle. It is important to study the relationships between the regulation mechanism of V. cholerae biofilm development and its environmental adaption in host niche and aquatic habitat. Here, we summarize the recent advances in V. cholerae biofilm, including biofilm compositions, development and regulation. Particularly, we extensively discuss how V. cholerae fosters its biofilm architecture and assembly via sensing and responding various environmental determinants, such as bacterium self-produced molecules, natural environment components and host factors.

Objective: To investigate the effect of ultrasonic irradiation time on enhanced green fluorescent protein (EGFP) gene transfection efficiency and local tissue in bone defects using ultrasound-mediated microbubble destruction., Methods: Thirty 3-month-old New Zealand rabbits (2.5-3.0 kg in weight) were randomly divided into 5 groups ( n =6) and bone defect models were made on the right ulna. At 10 days after modeling, suspension of microbubbles and EGFP plasmids were locally injected (0.3 mL/kg) and then ultrasound was performed on defect at a frequency of 1 MHz, a intensity of 0.5 W/cm 2 , and a duty ratio of 20% for 1, 2, 3, 4, and 5 minutes respectively (in 1, 2, 3, 4, and 5 minutes groups respectively). The survival condition was observed. Rabbits were sacrificed for gross observation at 7 days after transfer. The gene expression was observed by fluorescence staining. HE staining and transmission electron microscopy were used to observe the local tissue damage., Results: The animals all survived. New soft tissue formed in bone defects area at 1 week after transfer, the surrounding muscle tissue was partly filled in it. Green fluorescence expression was observed in all rabbits. The expression was the strongest in 2 minutes group, and was the weakest in 1 minute group. The absorbance ( A ) value showed significant differences when compared 1 minute and 2 minutes groups with other groups ( P <0.05), but no significant difference was found between 3, 4, and 5 minutes groups ( P >0.05). Tissue damage was observed in all groups and it was aggravated with the increase of irradiation time., Conclusion: EGFP transfection efficiency in bone defect by ultrasound-mediated microbubble destruction is related to irradiation time. EGFP gene can be efficiently transfected without obvious toxicity at 1 MHz, 0.5W/cm 2 , and duty ratio of 20% for 2 minutes in bone defects of rabbits.

Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DI-COM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".

Objective: To compare the effectiveness of locking compression plate and elastic intramedullary nail for the treatment of benign long bone pathological fractures in children, so as to provide the evidence for clinical treatment., Methods: Seventy-two children with long bone pathological fractures who accorded with the inclusion criteria between January 2005 and July 2013 were randomly divided into 2 groups. Fracture was fixed with elastic intramedullary nail in 33 cases (group A) and with locking compression plate in 39 cases (group B). There was no significant difference in sex, age, body mass index, primary lesion, location of fracture, side of fracture, and interval between injury and operation between 2 groups (P > 0.05)., Results: Group A had shorter operation time, less intraoperative blood loss, and less overall costs than group B, showing significant differences (P < 0.05). Primary healing of incision was obtained. All the patients were followed up 1-7 years (mean, 3.4 years). Tumor lesions disappeared and the pathological fracture healed after operation by X-ray film observation, and group A had faster fracture healing time than group B (P < 0.05). There was no loosening and displacement of internal fixation, bone resorption, and bone defect nonunion in 2 groups. Recurrence was found in 2 cases (6.1%) of group A and 3 cases (7.7%) of group B, showing no significant difference (χ2 = 0.074, P = 0.580). Re-fracture was found in 1 patient with tibial bone cyst of group B after 3 months of operation, and healed after 1 year of open reduction and internal fixation. According to X-ray film and comprehensive function evaluation of shoulder, elbow, hip, knee, and ankle, the results were all excellent in 2 groups at last follow-up., Conclusion: Elastic intramedullary nail fixation should be the first choice, and locking compression plate should be the second choice for children with benign long bone pathological fractures.

Objective: Congenital heart defect is one of the most common birth defects. The isolated ventricular septal defect (VSD) has higher morbidity, and spontaneous closure may occur. Previously many studies about the prognosis of ventricular septal defect in childhood were conducted; in contrast, few studies on evolution and prognosis of ventricular septal defect from fetus to postnatal life have been available. This research aimed to determine the evolution of isolated ventricular septal defect during the period of fetus and postnatal life, and analyze the association between the diameter or location of VSD and the spontaneous closure of VSD., Method: All pregnant women seen at the prenatal diagnosis center of the West China Second Hospital were recruited. From June 2011 to June 2014, these participants underwent the fetal 2-dimensional and color Doppler echocardiographic examinations, and the fetuses with isolated VSD were included in the study, and those with other malformations or abnormal chromosome were excluded. This study was a prospective and longitudinal research. These fetuses were followed-up until the VSD closed spontaneously, or were surgically repaired or percutaneously closed. Outcomes of all the cases were recorded., Result: There were 234 fetuses with isolated VSD who were recruited in our research cohort. Twelve of 234 lost to follow-up, 5 of 234 were still in uterus. Totally 217 fetuses were followed up. One hundred eighty-nine of 217 (87.1%) cases were delivered. The pregnancies were terminated in 28 of 217 (12.9%) cases. Ten cases died after birth. Of the 179 delivered cases, the rate of VSD spontaneous closure was 45.2% (81/179), the VSD of 49 cases (27.4%, 49/179) spontaneously closed in uterus. The VSD of 17.9% (32/179) cases spontaneously closed after birth and those of 75% (24/32) cases closed in the first year of life. Furthermore, these participants were divided into 3 groups according to the diameter of VSD in fetus. There were 87 cases in ≤ 2.0 mm group, 51 spontaneously closed (59%, 51/87) and 30 of 84 spontaneously closed (36%, 30/84) in 2.1-5.0 mm group. There were no spontaneous closure in > 5.0 mm group. There was a significant difference in spontaneous closure rate between the 3 groups (χ(2) = 15.200, P = 0.001). Nevertheless, these participants were divided into 2 groups according to the location of VSD in fetus (perimembrane VSD (P-VSD) group and muscular VSD (M-VSD) group). There were 152 cases in P-VSD group, 69 spontaneously closed (45.4%, 69/152) and 12 of 27 spontaneously closed (44%, 12/27) in M-VSD group. There was no significant difference in spontaneous closure between P-VSD and M-VSD (χ(2) = 0.008, P = 0.950)., Conclusion: There was a high spontaneous closure rate of VSD in the period of late pregnancy. The most of postnatal VSD were spontaneously closed within one year of age. The spontaneous closure rates of fetal VSD with different diameter were different. The spontaneous closure rate of VSD with smaller diameter was higher.

Objective: To retrospectively analyze the serum enzymes in childhood amputees as a result of earthquake, and to discuss their clinical significance., Methods: From 150 children amputees who were victims of Sichuan Wenchuan earthquake in 2008 and Sichuan Lushan earthquake in 2013, 45 cases with complete records of serum enzymes examinations were reviewed retrospectively. They were divided into three groups: amputation group (n=6), fasciotomy decompression group (n=5), general trauma without injury to extremity group (n=34). Serum enzyme examination data were compared for statistical analysis to find the difference among groups. Ten children who were not victims of earthquake were selected from department of orthopaedics to serve as controls, and 20 adult amputees as a result of earthquake served as another control group., Results: There were significant differences in injury severity scale (ISS) and the contents of all serum enzymes, including aspartate transaminase (AST), alanine aminotransferase (ALT), creatine kinase (CK), lactate dehydrogenase (LDH), and hydroxybutyrate dehydrogenase (HBDH), between the amputation group and other patients (FISS=15.474, P<0.001; FAST=10.770, P<0.001; FALT=12.799, P<0.001; FCK=12.848, P<0.001; FLDH=13.126, P<0.001; FHBDH=13.186, P<0.001), and the difference in amputation group was even more significant. AST, LDH, HBDH in childhood amputees group were significantly higher than those in adult amputation group. The contents of ALT and CK were slightly increased. Serum enzyme contents were found to be significantly helpful for prediction of disease condition and prognosis. It was also found that CK was extremely helpful in assessing the degree of illness in patients with severe trauma, especially in patients complicated by severe soft tissue injury. In all the groups, of patients, it was found that CK rose from (129±62) U/L in non-earthquake induced trauma group to (44 208±39,788) U/L in earthquake amputation group, and it was thus increased more than 300 times. Its highest value even reached 117,513 U/L, which was more than 840 times of the normal. If a timely amputation or muscle compartment decompression was performed, CK might decline rapidly down to the normal value., Conclusions: The comprehensive and continuous assessment of serum enzymes is mandatory during the treatment of children with acute trauma. It is of important clinical significance to correctly judge the condition and to determine optional treatment measures.

Objective: To investigate the effectiveness of absorbable pins for reconstructing pelvic stability in Salter innominate osteotomy for treating development dysplasia of the hip (DDH)., Methods: Between January 2003 and December 2008, 392 patients (440 hips) with DDH underwent a Salter procedure. There were 68 boys (82 hips) and 324 girls (358 hips) with a mean age of 3 years and 3 months (range, 1 year and 6 months-5 years). According to Tonnis classification criteria, 13 hips were rated as grade I, 304 hips as grade II, 82 hips as grade III, and 41 hips as grade IV. Based on the degree of displacement of the femoral head and acetabular index on the anteroposterior pelvic X-ray film, operation method was selected before operation. A total of 341 hips were managed with open reduction and Salter innominate osteotomy, and 99 hips with Salter innominate osteotomy and femoral shortening rotating osteotomy. All cases underwent autologous iliac crest grafting and fixation between osteotomy sites and bone graft with 2 absorbable pins., Results: At 1 day after operation, anteroposterior pelvic X-ray examination showed concentric reduction in all hips, having no instability of the joint of the osteotomy sites or bone graft shifting. A total of 368 patients (413 hips) were followed up 1 to 7 years (mean, 3 years and 10 months). At 3 months after operation, no bone graft in stability or shift, and sliding or loosening of pins occurred. At last follow-up, concentric reduction rate was 100%; after hip loading, 358 patients had no claudication and limited hip activities, who had the stability of hips and negative Allis and Ortalani signs. No abnormal height growth was observed in all patients. According to Mckay's hip function evaluation criteria, the results were excellent in 390 hips, good in 16 hips, and fair in 7 hips, with an excellent and good rate of 98.3%; according to Severin X-ray criteria, the results were excellent in 386 hips, good in 17 hips, and fair in 10 hips, with an excellent and good rate of 97.6%., Conclusion: Absorbable pins can replace steel pins for fixation of the osteotomy sites and bone graft in Salter innoninate because of flexible and convenient operation without a need for reoperation of steel pins extraction.

Objective: To investigate the effectiveness of the acetabular reconstruction surgery in children pathological dislocation of the hip joint., Methods: Between January 2006 and January 2011, 59 patients (59 hips) with pathological dislocation were treated by open reduction combined with acetabular reconstruction surgery. There were 22 boys and 37 girls, aged from 1 to 15 years (mean, 4.9 years). There were 9 cases of hip subluxation and 50 cases of hip joint dislocation, which were caused by suppurative arthritis of the hip (33 cases) and tuberculosis of the hip (26 cases). The diseases duration ranged from 1 month to 10 years. At preoperation Harris hip score was 43-78 (mean, 61); 14 cases had normal acetabular index (AI), 32 cases had slightly increased AI, and 13 cases had significantly increased AI. The concomitant diseases included acetabular destruction in 28 cases; avascular necrosis of the femoral head in 25 cases, femoral head partial defect in 12 cases, femoral head complete defect in 6 cases, and femoral head and neck defects in 3 cases; 25 cases had increased anteversion angle; and 9 cases had varus deformity., Results: Immediately postoperative X-ray films showed center reduction in all the hips. Healing of incision by first intention was achieved in 55 cases, and delayed healing in 4 cases. Fifty-three children were followed up 2 to 5 years (mean, 3 years). No re-dislocation of the hip occurred during follow-up. Thirty-eight cases had normal AI, 15 cases had slightly increased AI. The anteversion angle was 15-25 degrees (mean, 20 degrees); the neck shaft angle was 110-140 degrees (mean, 125 degrees); and the anatomical relation between the head and neck returned to normal. After 2 years, 18 cases had normal function of the hip joint; 30 cases had mild limitation of flexion and rotation; and 5 cases had fibrous ankylosis. The Harris hip score was 62-95 (mean, 87)., Conclusion: Pathological dislocation caused by neonatal acute suppurative arthritis of the hip and the hip joint tuberculosis is often associated with severe bone destruction and deformity of the acetabular and femoral head and neck. Treatment should strictly follow the principle of individual. Proper acetabular reconstruction should be selected according to pathological changes of the hip; if combined with the femoral head and neck reconstruction processing, the satisfactory results can be obtained.

Objective: To investigate the operative procedure and the effectiveness of eosinophilic granuloma (EG) of long bones in children., Methods: Between January 2005 and December 2009, 14 patients with EG of long bones were treated. There were 9 boys and 5 girls, aged from 1 to 13 years (mean, 6.5 years). The locations were femur in 5 cases, humerus in 4 cases, tibia in 2 cases, fibula in 1 case, and femur complicated with tibia in 2 cases. The disease duration was 7 days to 10 months (median, 2 months). X-ray films showed that osteolytic destruction had clear boundary, which did not involve the epiphyseal plate. Of 14 cases, 12 cases of tumor were treated by curettage, autologous iliac bone or combined artificial bone graft repair, and 2 cases were treated by resection, autologous iliac reconstruction, plate and screw fixation. Five cases complicated with pathological fracture underwent reduction and fixation., Results: All cases were diagnosed pathologically as having EG. All incisions healed by first intention. A total of 12 patients were followed up 1 to 4 years (mean, 2 years). The X-ray films showed tumor focus and pathological fracture healed within 3 to 4 months (mean, 3.5 months). Tibial lesion was found in 1 case of femoral tumor after 8 months, and was cured after reoperation. No recurrence occurred in other 11 cases. According to comprehensive assessing standard of X-ray film and joint function, the results of all cases were excellent., Conclusion: EG of long bones in children is more common in the femur and humerus. Tumor curettage and autologous iliac bone graft repair is an effective method, and postoperative prognosis is good. There may be multiple lesions, so long-term follow-up is needed.

Objective: To investigate the pathogenesis, diagnosis, and treatment of unilateral gluteal muscle contracture., Methods: Between January 1990 and September 2009, 41 patients with unilateral gluteal muscle contracture were treated and the clinical data were retrospectively analysed. Among them, 24 were male and 17 were female with an age range from 6 to 29 years (mean, 12 years). Thirty-nine patients had a definite history of repeat intragluteal injection. The locations were the left side in 9 cases and the right side in 32 cases. The main clinical manifestations included lameness and abnormal gait. The medical examination showed pelvic oblique and relative inequality of lower limbs with a mean difference of 2.1 cm (range, 1.2-3.8 cm) in the distance form navel to malleolus medials. The X-ray films of pelvis showed outpouching trochanter of femur and pelvic oblique. The CT scans showed no abnormal finding except pelvic oblique and gluteal muscle contracture. The arc longitudinal incision was made into the posterolateral area nearby the greater trochanter and then lysis of the gluteal muscles was performed, followed by the skin traction of both legs and rehabilitation exercise., Results: All incisions healed by first intention. Forty-one patients were followed up 1-20 years (mean, 5 years), and the signs of gluteal muscle contracture disappeared. After 1 year of operation, 34 patients had equal leg length, 5 patients had mild pelvic oblique, and 2 patients had obvious pelvic oblique. According to LIU Guohui et al. evaluation standard, the results were excellent in 33 cases, good in 6 cases, and poor in 2 cases with an excellent and good rate of 95.12% at 1 year after operation., Conclusion: Unilateral gluteal muscle contracture leads to pelvic oblique and inequality of lower limbs, and it can be cured with the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateral area nearby the greater trochanter, combined with postoperative skin traction and rehabilitation exercises.

Objective: To investigate the operative procedure and the therapeutic effects of minimally invasive incision and percutaneous pinning in operative treatment of Gartland type III humeral supracondylar fracture in children., Methods: From September 2002 to July 2009, 189 patients with Gartland type III humeral supracondylar fracture were treated with minimally invasive incision and percutaneous pinning. There were 137 males and 52 females, aged from 1 to 13 years (6.2 years on average). Injury was caused by sports in 173 cases, by traffic accident in 9 cases, by falling from height in 5 cases, and by earthquake in 2 cases. All fractures were closed fractures, complicating others fracture in 11 cases, radial nerve injury in 36 cases, median nerve injury in 5 cases, ulnar nerve injury in 2 cases, and brachial artery injury in 2 cases. The time from injury to hospitalization was 1 hour to 10 days. Neurovascular repair was performed at the same period., Results: All incisions healed by first intention, no related complications occurred. A total of 143 patients were followed up 5 months to 5 years (12 months on average). X-ray films showed fracture healed within 2-4 months (2.5 months on average). Cubitus varus occurred in 6 cases, but the functions of elbow flexion and extension were good; 2 cases were given distal humeral wedge osteotomy and 4 cases continued keeping the functional training. According to the Flynn et al criteria, the results were excellent in 121 cases, good in 15 cases, and fair in 7 cases; the excellent and good rate was 95.1%. Only a small incision scar was found, the function returned to normal in the cases complicated by nerve and blood vessel injury., Conclusion: Minimally invasive incision and percutaneous pinning for operative treatment of Gartland type III humeral supracondylar fracture in children is a safe and effective surgical procedure, which has minimal trauma, short surgery time, quick recovery, simple operation, and can be effective in reducing the complications.

Objective: To investigate the curative effects of open reduction and internal fixation with Kirschner wire for Mason type-II radial head or neck fracture in children., Methods: From September 2007 to June 2009, 17 cases of Mason type-II radial head or neck fracture were treated, including 11 males and 6 females with an average age of 8.5 years (4-11 years). The locations were left side in 5 cases and right side in 12 cases. All fractures were caused by falling and classified as Mason type-II fracture. Two cases complicated by radial nerve deep branch injury. The time from injury to operation was 4 hours to 5 days. All cases received open reduction and internal fixation with Kirschner wire. They were evaluated by anteroposterior and lateral radiographs and functionally by Broberg criteria., Results: Wound healed primarily in all patients. According to Métaizeau criteria, the results were excellent in 15 patients and good in 2 patients, who achieved anatomical reduction. Seventeen patients were followed up for a mean time of 14 months (6-25 months). Function returned to normal in 2 cases complicated by radial nerve deep branch injury after 6 months of operation. No complications of infection and nerve injury occurred. The X-ray films showed that bony healing was achieved in all cases; the healing time was 2.0-3.5 months (mean 3 months). According to Broberg criteria, the outcome was excellent in 11 cases, good in 4 cases, and fair in 2 cases, the excellent and good rate was 88.2%., Conclusion: Open reduction and internal fixation with Kirschner wire has good effect, satisfactory functional recovery and less complication in the treatment of Mason type-II fracture of radial head or neck in children.

The main purpose of this paper is to describe the design and development of the near-infrared blood-oxygen monitor which is based on the theory of detecting the blood-oxygen parameters of tissue by near-infrared, and the monitor can detect the blood-oxygen parameters of two sides of the local brain tissue. The monitor uses two wavelength ultra-high light LED as lamp-house, and two sensors detect the light scattered by two sides of the local brain tissue, which make the monitor achieve the function of dual detector. The appearance of the monitor's detector is designed to reduce effectively the noise brought by the background and alleviate the discomfort feelings of the patient. At the same time, this apparatus can monitor continuously the brain blood-oxygen parameters of the patients in real time, and output the curves of the blood-oxygen and oxygen concentration of two sides of brain tissue. At last, the biological model experiments and the tests in clinical setting validate the monitor.

Objective: To investigate the pathogenesis, diagnosis, and treatment of the gluteal muscle contracture associated with an unequal leg length caused by the pelvis obliquity (GMC-PO)., Methods: The retrospective analysis was made on the clinical features and the follow-up results in 132 patients who had been admitted from January 1990 to December 2004 for GMC-PO. Among them, 73 were male and 59 were female with a range in age from 5 to 26 years (average, 11 yr). All the patients were characterized by unsymmetrical contracture of the gluteal muscles, including unilateral and bilateral contracture. Of the patients, 89 had a clear limping and 78 had a clearly-unequal leg length. The X-ray examination revealed pelvis obliquity in 97 cases and an increased angle of the femur neck in 11 cases. The arc longitudinal incision was made into the posterolateral area nearby the greater trochanter and then lysis of the gluteal muscles was performed, combined with the skin traction of both legs and exercise training., Results: Of the 132 patients with unequal gluteal muscle contracture before operation, 13 had a relative length difference of 0.5-1.5 cm between the 2 legs, 1 had a difference of 3.0 cm, and the remaining 118 patients had an equal leg length. Excellent and good results were achieved in 118 and 13 patients, respectively after the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateral area nearby the greater trochanter, combined with postoperative skin traction and functional exercises. Only 1 patient had a poor result. The follow-up for 3 months to 14 years showed that the cure rate was as high as 99.2%., Conclusion: The gluteal muscle contracture associated with an unequal leg length caused by the pelvis obliquity is a result of the unequal gluteal muscle contracture between the 2 hips and it can be cured with a comprehensive therapeutic method including the surgical release of the gluteal muscle contracture by the are longitudinal incision into the posterolateral area nearby the greater trochanter, and postoperative skin traction as well as the functional exercise.

Objective: To reinforce the recognization of deltoid contracture in children and probe its causes, pathomechanism, diagnosis and treatments., Methods: The Clinical data were summarized and analysed, including etiological factors, clinical situations, examinations and treatments from 9 child patients with deltoid contracture from 1992 to 2004. The 9 child patients were followed up to evaluate therapeutic efficacy., Results: Nine child patients with deltoid contracture included 4 boys and 5 girls, who aged from 5 to 14 years. The main clinical features were presented as abductive deformity, limitation of adduction of the shoulder, winging of the scapula, and dimpling of the skin with a palpable fibrous hard band in deltoid muscle. Four cases had a history of intramuscular injections in deltoid and 1 case was accompanied with bilateral gluteul contracture. Among the 9 patients, 8 cases were misdiagnosed before correct diagnosis and treatment. The misdiagnosis rate was up to 90%. All the cases received the operative treatments to release fibrous bands and were followed up for 8 months to 12 years. Abductive deformity disappeared and functions of the shoulders recovered in all patients, except 1 patient who had a lightly winged scapula., Conclusion: Deltoid contracture may be caused by multiple factors, but its clinical features are conductive to correct diagnosis and excellent therapeutic efficacy can be acquired by operation early.

The methods of purification, expanding, marking, conservation, induced differentiation and identification of neural stem cells (NSCs) in vitro were explored for further research and treatment of tethered cord syndrome in children and other neural system diseases. The cells derived from the cerebral cortex of frontal lobe in 14.5 d rat embryos were maintained in serum-free DMEM/F12 medium containing 20 ng/ml bFGF, 20 ng/ml EGF and B27 supplement. The NSCs of suspending single-cell-colon were isolated and passaged, were purified by limited dilution, and were expanded numerously with sub-colon in consecutive generations. Then, Nestin antigen expression was detected by immunohistochemistry techniques. The cells of the purified and expanded NSCs were frozen, recovered and incubated in BrdU, and the NSCs were induced to differentiate in serum or feeder layer. These revived NSCs from frozen cells could express Nestin antigen and could be induced in serum or feeder layer to differentiate into neurons and glias expressing tubulin-III and GFAP respectively. It is good and simple for purification and proliferation of NSCs numerously by the limited dilution and consecutive generations suspending single-cell-colon of NSCs from the cerebral cortex of frontal lobe in rat embryos. The NSCs could be induced on feeder layer to differentiate into neural cells numerously. BrdU can mark and trace NSCs for the research and treatment of the animal model of neural system diseases. By good command of the technlogies for the purification proliferation, and induced differentiation of NSCs in vitro, it is possible to find a new way for further research of the biologic specificity and the treatment of the disease in nervous system.

Objective: To observe the normal and abnormal insertions of the anterior tibial tendon and store up knowledge for clinical application., Methods: Forty-six antiseptic specimens of the foot of Chinese were selected for anatomical and histological studies on the insertions. The methods included taking the photos, adding up the numbers of the insertions that mainly attach to the first metatarsal os or the medial cuneiform os and measuring the length of the tendons from the line connecting the malleolus lateralis projection and malleolus medialis projection to the insertion., Results: The insertions could be categorized as three types: 28 (60.87%) insertions belonged to the bundle type; 14 (30.43%) insertions were of the medial type; 4 (8.7%) insertions were of the bifurcate type. 40 insertions mainly attached to the medial cuneiform os; 6 insertions mainly attached to the first metatarsal os. The length of the anterior tibial tendon of adults was determined to be 72.33 +/- 5.29 mm and the length of the children's tendon 56.77 +/- 4.54 mm., Conclusion: The aboved finding suggest that in clinical treatment the insertions of the bifurcate type should be cut off completely as the anterior tibial tendons of the bifurcate type are transferred into the lateral part of the feet. The insertions of the bundle type and bifurcate type are not suitable for the split anterior tibial tendon transfer, but the medial type cases are suitable for this kind of operation.