Abstract： Compared with mitral valve replacement, there areseveral advantages in mitral valvuloplasty, so recently more and more sights are caught on mitral valve repair. According to different etiology, the surgeon can apply annuloplasty, triangular resection, quadrangular resection, replacement or transposition of chordae tendineae and so on to treat mitral regurgitation(MR). With the development of minimally invasive surgical technology, robotic mitral valve reconstruction evolve rapidly and percutaneous interventional therapy also commence from lab to bedside.We believe surgeons can repair MR safely and successfully in the majority of patients with proficiency in the basic techniques.
Objective To explore the evaluation index and appointment mechanism of healthy professional titles. Methods We collected the data of people evaluated and appointed as advanced professional titles, and the evaluation and appointment documents in West China Hospital. We analyzed the evaluation index and appointment mechanism. Results A total of 400 people gained senior title promotion. The evaluation indexes focused on academic degrees, papers, research projects, patents, as well as awards and honors. The research achievements reduced of 80% people who had gained senior titles. Conclusion Current evaluation indexes prefer to inflexible index and ignore flexible index. The appointment mechanism lacks outcome evaluation, and the professional title will not be eliminated once appointed. In the future, we should improve the evaluation index and appointment mechanism focusing on the specific characteristics of healthy professional titles.
Objective To investigate the enhancing effect of ultrasound microbubbles on transfection of recombinant adenoassociated virus (rAAV) mediated green fluorecent protein (EGFP) gene into retinal ganglion cells (RGC) in vivo.Methods A total of 40 adult Sprague-Dawley (SD) rats were divided into four groups randomly (group A,B,C,D) with 10 rats in each. Group A was the normal control, in which the rats underwent intravitreal injection with 5 mu;l phosphate buffered solution. The rats in group B underwent intravitreal injection with 5 mu;l recombinant adenoassociated virus encoding EGFP gene (rAAV2-EGFP). The rats in group C underwent ultrasound irradiation on eyes right after intravitreal injection with 5 mu;l rAAV2-EGFP; The ultrasound irradiation was performed on the rats in group D right after intravitreal injection with the mixture solution of microbubbles and rAAV2-EGFP ultrasound. After 21 days, RGC were labeled retogradely with fluogold. Seven days after labeling, the retinal flatmounts and frozen sections were made from five rats in each group. Expression of EGFP reporter gene was observed by laser scanning confocal microscope and evaluated via average optical intensity (AOD) and RGC transfection rate. Labeled RGC were counted to evaluate the adverse effects.Results Green fluorescence can be observed exactly in labeled RGC in B，C，and D groups. The AOD and transfection rate in group D was （95.02plusmn;7.25）% and（20.10plusmn;0.74）% , respectively; which were higher than those in group B and C (F=25.970，25.799；P＜0.01). The difference of the number of RGC among the four groups was not significant(F=0.877,P＞0.05). Conclusion Under the condition of low frequency and with certain energy, ultrasoundmediated microbubble destruction can effectively and safely enhance rAAV delivery to RGC in rats.
Objective To investigate the protective effect and mechanism of erythropoietin (EPO) on injury of human retinal pigment epithelial (hRPE) cell induced by hydrogen peroxide (H2O2). Methods Take subcultured hFRPE cells as study target. They were treated with 800 mu;mol/L of H2O2 for 3 hours to establish the cell injury model. The cultured cells were divided into three groups：control group, simply injury group and therapeutic group which again divided into 10 IU/ml, 20 IU/ml, 40 IU/ml,60 IU/ml subgroups according to the concentration of recombinant human erythropoietin(rhEPO). NF-kappa;B was measured by immunohistochemistry. The content of Malondialdehyde(MDA) which was the product of cellular lipid peroxidation and the releasing rate of lactate dehydrogenase（LDH）were estimated by chromatometry. Results H2O2 could elevate the level of MDA and the releasing rate of LDH, compared simply injury group with control group, the differences were significant.(tLDH＝29.746,tMDA＝20.426,Plt;0.05); Compared all of therapeutics groups with simply injury group, the releasing rate of MAD and LDH were decreased obviously, the differences were significant.（LDH t10IU＝5.770，t20IU＝12.774，t40IU＝19.818，t60IU＝24.833，Plt;0.05；MDA t10IU＝5.345，t20IU＝10.278，t40IU＝18.571，t60IU＝20.247，Plt;0.05）; The correlative analysis results of each therapeutic subgroup were: ①the concentration of rhEPO had negative correlation with the relation rate of LDH and the content of MDA(r=-0.976，P=0.024； r=-0.968，P=0.032) ; ②the concentration of rhEPO had positive correlation with the nuclear translative rate of NF-kappa;B(r=0.998，P=0.002); ③the nuclear translative rate of NF-kappa;B had negative correlation with the content of MDA(r=－0.954，P=0.046). Conclusion EPO can protect hFRPE cells from the injury of H2O2, the mechanism may be related to the activation of NF-kappa;B.
Objective To evaluate the security and effectiveness of minimal invasive fixation with fluoroscopybased navigation in the management of pelvic fractures. Methods From April 2007 to June 2008, 22 patients with pelvic fractures were treated with percutaneous screw fixation under the guidance of a fluoroscopy-based navigation system after closed reduction. There were 13 males and 9 females, aged 21-65 years old. Fractures were caused by traffic accident in 17 cases, andfall ing from height in 5 cases. According to AO classification, there were 2 cases of A2.2 type, 2 cases of A2.3 type, 7 cases of B1.2 type, 3 cases of B2.2 type, 1 case of B3.3 type, 2 cases of C1.2 type, 3 cases of C1.3 type, and 2 cases of C2.3 type. The interval from injury to hospital ization was 4 hours to 3 days (mean 1.2 days). After 3-13 days of skeletal traction through tibial tubercle, the operation was performed. Results Totally 42 screws were inserted. The average time for operation was 20.4 minutes per screw. Forty-one screws were inserted correctly with a successful insertion rate of 97.6%, only 1 hollow screw was reinserted for deviation. No incision problem and implant failure occurred. All 22 patients were followed up 7 to 21 months with an average of 14.5 months. At last follow-up, fracture union was achieved in all patients with satisfactory screw fixation. According to Majeed functional scoring, the results were excellent in 18 cases and good in 4 cases, with an excellent and good rate of 100%. Conclusion The minimal invasive fixation with fluoroscopy-based navigation makes the surgery for the pelvic fracture more precise and time-saving, and improves cl inical results without an increasing rate of compl ications.
Objective To elucidate the new development and effects of three-dimensional correction techniques of idiopathic scol iosis (IS). Methods The related home and abroad l iterature concerning three-dimensional correction techniques of IS was extensively reviewed. Results With more and more attention to three-dimensional correction of IS, all kinds of surgery and developed techniques of correction are applied to the correction of IS. The effects of three-dimensional correction of IS are satisfied. Conclusion With more knowledge about IS and more developed theory of correction, more safe and effective techniques of correction is therefore the hot spot for future study.
Objective To investigate the development and metastasis of malignant choroidal melanoma cell strain OCM-1-gfp modified with green fluorescent protein(GFP) and the factors which affected the tumor biological behaviors. Methods GFP was transfected into malignant melanoma cell strain OCM-1.Melanoma cells with high and stable expression of GFP were injected into subretinal space and the subcutaneous space of hind leg of Balb/c nude mouse respectively in order to establish orthotopic and heterotopic transplanted tumor models.The development and metastasis process of orthotopic tumor models was observed directly by fluorescence microscope，and the size of the hypodermal tumor was measured by vernier.The expressions of 13 genes in melanoma were detected by means of immunohistochemistry staining. Results Malignant choroidal melanoma cell strain OCM-1 stably expressed GFP and preserved the characteristics of parental generation，OCM-1-gfp may develop melanoma and continue to metastasize in nude mouse.Positive expression of most of the antibodies，including Rb，p53，p21，E2F，NFkappa;B，cyclin D1，proliferation cellular nuclear antigen（PCNA），bcl2、bclXL/S，bax，and epithelial growth factor（EGF）and its receptor（EGFR），was found.While the staining of inhibition gene p16 was negative. Conclusions GFP is the marker for observing the development and metastasis of malignant choroidal melanoma in vivo.The rate of tumor formation and development process in orthotopic models does not differs much from which in heterotopic models of malignant choroidal melanoma.The expressions of lots of genes in malignant choroidal melanoma developed from OCM-1-gfp including p16、p53、NFkappa;B，cyclin D，PCNA，EGF，and EGFR are abnormal. (Chin J Ocul Fundus Dis, 2006, 22: 170-173)
ObjectiveTo investigate the expression of miR-195 and the underlying molecular mechanisms of miR-195 regulating HMGB1 in diabetic retinopathy (DR). MethodsExtract 5 ml venous blood from DR patients, diabetes mellitus (DM) patients and normal subjects, then extract and perificate plasma total RNA. MicroRNA array and real time polymerase chain reaction (RT-PCR) was used to screen out miRNAs which were expressed with significant differences in the serum of patients with DR. Bioinformatics was employed to predict the miR-195 related to high mobility group box 1 (HMGB1) regulation. Next, miR-195 was down-regulated or up-regulated in umbilical vein endothelial cells through transfection of miR-195 inhibitor and miR-29b mimics respectively.Then we analyzed expression of HMGB1 mRNA and protein by RT-PCR and Western blot. ResultsMicroRNA array results showed the expression of miR-195 in DR group is decreased by 8.34 times and 11.47 times compared with DM group and the normal group. RT-PCR verification results conforms to the microRNA array results. Compared with the DM group (F=0.034, t=8.057) and the normal group (F=0.370, t=9.522), the expression of miR-195 in DR group were significantly reduced, the differences were statistically significant (P < 0.05). RT-PCR showed that the expression of HMGB1 mRNA was significantly decreased in up-regulation group, compared with blank (F=0.023, t=11.287) and negative control group (F=0.365, t=7.471), the difference was statistically significant (P < 0.05). The expression of HMGB1 mRNA was significantly increased in down-regulation group, compared with blank (F=0.053, t=10.871) and negative control group (F=0.492, t=6.883), the difference was statistically significant (P < 0.05). Western blot showed that the expression of HMGB1 protein was significantly decreased in up-regulation group, compared with blank (F=0.021, t=8.820) and negative control group (F=0.039, t=7.401), the difference was statistically significant (P < 0.05); and significantly increased in down-regulation group, compared with blank (F=0.186, t=10.092) and negative control group (F=0.017, t=12.923), the difference was statistically significant (P < 0.05). ConclusionMiR-195 can inhibit the expression of HMGB1, reduce the inflammation and angiogenesis, thereby delaying or inhibiting the occurrence and development of DR.