Long-term outcome of percutaneous balloon aortic valvuloplasty for children with congenital aortic valve stenosis / 中华心血管病杂志

Objective: To assess the efficacy and long-term outcome of percutaneous balloon aortic valvuloplasty (PBAV) for children with congenital aortic stenosis (CAS) and to explore risk factors for significant aortic regurgitation (AR) and reintervention after PBAV during follow up. Methods: This was a retrospective study. Children (≤18 years old) with CAS, who underwent PBAV in Guangdong Provincial Hospital from January 2004 to December 2018, were included in this study. Demographic, preoperative transthoracic echocardiography (TTE) and surgical data were collected. Postoperative complications were closely observed, and the patients were followed up at 1, 6, 12 months after the operation, and then at one year interval thereafter. Endpoint events included significant AR and reintervention. Reintervention was defined as any intervention that needed to be performed on the valve for various reasons, including re-PBAV, surgical valvuloplasty and valve replacement. Significant AR was defined as AR grade≥3 by TTE criteria. The results of the last TTE examination before the end of the study were collected. The Kaplan-Meier curve for long-term AR-free and intervention-free survival was plotted. Cox regression model was used to further analyze the risk factors for significant AR and reintervention after PBAV in CAS patients. Results: A total of 55 patients were enrolled in this study, and the age was 4.6(1.6, 6.5) years, with 37(67.3%) males. The peak systolic valve gradient fell from (80.3±30.6)mmHg to (38.5±18.5)mmHg(P<0.001, 1 mmHg=0.133 kPa). Surgical success rate was 89% (49/55). Acute post-PBAV AR occurred in 18 patients, including 3 patients with RA≥3 grade. In-hospital complications occurred in 6 patients (2 deaths, 2 cases of transient arrhythmia, and 2 cases of femoral artery embolization). Fifty patients accomplished the follow-up and the follow-up time was 6.2(3.4, 8.5) years. Significant AR was found in 20 patients. Significant AR-free survival rate was 53% at 5 years and 19% at 10 years. Reintervention was performed in 11 patients (4 with valvuloplasty and 7 with valve replacement), and the 5-year and 10-year intervention-free survival rates were 87% and 62%, respectively. Multivariate Cox regression analysis showed that acute post-PBAV AR was a risk factor for long-term significant AR (HR=2.398, 95%CI 1.007-5.712, P=0.048). Post-PBAV residual pressure gradient ≥ 35 mmHg (HR=4.747, 95%CI 1.116-19.329, P=0.030)and acute post-PBAV AR (HR=5.104, 95%CI 1.083-24.065, P=0.039)were risk factors for re-intervention. Conclusions: PBAV is safe and effective in the treatment of CAS in children, but attention should be paid on significant AR post procedure. Acute post-PBAV AR is a risk factor for re-intervention and significant AR post PBAV, and high post-PBAV residual pressure gradient is a risk factor for re-intervention.

Predictors of operability in children with severe pulmonary hypertension associated with congenital heart disease / 中华医学杂志(英文版)

BACKGROUND@#Pulmonary artery hypertension associated with congenital heart disease (PAH-CHD) occurs predominantly among patients with uncorrected CHD. Treatment of severe pediatric PAH-CHD remains a major intractability. This study evaluated the predictors and prognoses of children with PAH-CHD who underwent surgical correction.@*METHODS@#The data for 59 children with severe PAH-CHD who underwent surgical correction, with or without postoperative medication, between May 2011 and June 2015 at the Guangdong Provincial People's Hospital were analyzed retrospectively. A regression analysis, receiver-operating characteristic (ROC) curves, and Kaplan-Meier curves were used for survival analysis.@*RESULTS@#Fifty-nine children with severe PAH-CHD underwent heart catheterization and correction, with or without specific anti-PAH drugs postoperatively, were included in this study. The pulmonary pressure, heart function, and ending events were observed and median observation period was 49 ± 20 months. Twenty-eight patients (50%) received at least one additional anti-PAH drug after correction. The survival rate after 2 years was 91.5% (54/59); two patients were in a critical condition, and three were lost to follow-up. Twelve patients (29%) still received over one additional PAH-specific therapy at follow-up, whereas 42 (75%) had successfully stopped drug treatment. Two patients (3.5%) died and one underwent a second thoracotomy to remove the ventricular septal defect patch. Acute vasoreactivity test (AVT) criteria had limited efficacy in predicting pediatric PAH-CHD, whereas pulmonary vascular resistance (PVR) ≤ 6.65 Wood units (WU)/m or PVR/systemic vascular resistance (SVR) ≤ 0.39 during AVT indicated a good prognosis after surgical correction with an AUC of 98.3% (95% confidence interval [CI]: 96.0-100%), 98.4% (95% CI: 96.0-100%) sensitivity of 100%, 100% and specificity of 82.1%, 92.9%, respectively.@*CONCLUSIONS@#Although the criteria for positive AVT currently used are unsuitable for pediatric patients with PAH-CHD, PVR and PVR/SVR during AVT are excellent predictors of outcome in pediatric PAH-CHD. Surgery aided by anti-PAH drugs is an effective strategy and should be recommended for severe pediatric PAH-CHD with PVR ≤ 6.65 WU/m and PVR/SVR ≤ 0.39 after iloprost aerosol inhalation.

Relationship between clustering of metabolic disorders and left ventricular hypertrophy in hypertensive children and adolescents / 中国学校卫生

Objective@#To examine the relationship between clustering of metabolic disorders and left ventricular hypertrophy (LVH) in hypertensive children and adolescents, and to provide the reference for preventing the damage to their heart structure.@*Methods@#Based on the data from the Twelfth Five-year National Science and Technology Support Program “Early Warning, Diagnosis and Treatment of Cardiovascular Disease in Children” from September 2012 to September 2014 in Jinan, 261 children and adolescents aged 6-17 years whose hypertensive status was confirmed based on appearance of elevated blood pressure across three different occasions were included. Covariance analysis was used to analyze the relationship of clustering of metabolic disorders with left ventricular mass index levels. Multivariable logistic regression model was used to examine the relationship of clustering of metabolic disorders with LVH.@*Results@#After adjustment for sex, age and blood pressure, LVMI levels were (33.21±1.85) (38.57±1.19) and (43.00±1.63)g/m2.7, respectively, for hypertensive children and adolescents carrying 0, 1 and ≥2 metabolic disorders; LVMI levels increased with the number of metabolic disorders in hypertensive children and adolescents (P<0.01). Compared with the hypertensive children and adolescents without any metabolic disorders, the risk for LVH increased in ones carrying 1 and ≥2 metabolic disorders, the odds ratios and 95% confidence intervals were 2.41(1.11-5.23) and 4.69(2.05-10.74), respectively.@*Conclusion@#The clustering of metabolic disorders was positively correlated with the LVMI levels and risk of LVH in hypertensive children and adolescents. Therefore, to prevent cardiac damage such as LVH in hypertensive children and adolescents, it is important to prevent and control metabolic disorders comprehensively.

Research progress in the role of small RNA fragments derived from tRNA in malignant tumors / 医学研究生学报

Noncoding small RNAs are the important regulators of vital processes. Through the high-throughput sequencing and analyses of small RNA fragments, a new class of non-coding small RNAs has been presented, which can be matched to the known tRNA gene. The different sources of tRFs are classified into various types depending on where they match on the parental tRNA. The tRFs can be expressed in a variety of organisms. Recent studies have found that the tRFs have a variety of biological functions in the regulation of gene expression, epigenetics，tumor suppression, neurodegeneration and so on. As a regulatory RNA, the tRFs play an important role in development and progression of tumors, and are known to play regulatory roles in the proliferation and metastasis of tumor cells. This article reviews the research progress on the classification，biological function and role of tRFs in malignant tumors.

Diagnosis and treatment of anomalous aortic origin of a coronary artery from the opposite sinus / 中华实用儿科临床杂志

Anomalous aortic origin of a coronary artery from the opposite sinus (AAOCA)is one of the con-genital coronary artery malformations that might cause syncope,myocardial ischemia and sudden cardiac death (SCD), particularly in adolescents and young people.The most important inducing factor of myocardial ischemia and syncope is strenuous exercise.In recent years,more and more young athletes SCD events have been reported,and SCD related to AAOCA is now becoming the hot issue of common concern. Now,the concept,classification,clinical manifestations, diagnosis,and treatment strategies of AAOCA were introduced.

Initial experience of using improved motion sensitized driven equilibrium prepared balanced steady-state free precession / 实用医学杂志

Objective To assess the application value of NCE-MRA using iMSDE prepared bSSFP sequence in lower limb in patients with diabetes. Methods This prospective study included a total of 35 patients with type II diabetes who underwent CE-MRA on the 1.5T MR scanner after the NCE-MRA. The obtained MIP images were independently rated by two radiologist with a four score table and using CE-MRA as a reference standard to evaluate the diagnostic accuracy of NCE-MRA for the narrowed arteries. The difference of the percent age of diagnostic arterial segments between NCE-MRA and CE-MRA on diabetic patients was evaluated by the χ2 test. Results Compared with CE-MRA, the diagnostic-value arterial segment ratio of pelvic arteries on NCE-MRA is decreased significantly. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of two readers in NCE-MRA were 95%/87%, 96%/95%, 57%/72%, 99%/99%, and 96%/95%(k=0.76), respectively. Conclusions The NCE-MRA using iMSDE prepared bSSFP sequence is capable of depicting vascu-lar lesions for the lower extremities in diabetic patients with the advantages of contrast agent free, short scan times and good diagnostic value in the thigh and calves.

Anti-tumor immunity and mechanism of microwave ablation / 国际外科学杂志

Microwave ablation,as a minimally invasive therapy,causes focal hyperthermic injury to ablated tumors.It also induces anti-tumor immunity which could contribute to another mechanism of tumor destruction.Combination with immunotherapy could further enhance the tumor-specific immunity,lead to stronger inhibitory effects on both primary and metastatic lesions and decrease recurrence and metastasis.Thus,combination of microwave ablation and immunotherapy is a promising approach in the treatment of solid tumors,especially for advanced cancers.This article reviews recent advances in the mechanism and application of immune effect induced by microwave ablation.

Application of arm infusion port in breast cancer patients with chemotherapy and the practice of remote management / 中国实用护理杂志

Objective To explore the application of arm infusion port in breast cancer patients with chemotherapy and the effect of remote management. Methods From May 2016 to September, 25 cases of female breast cancer patients treated with chemotherapy in our hospital were studied. Implanted arm port for chemotherapy drug infusion, the patient's bedside guidance given by a case nurse during hospitalization, after the discharge from the hospital to accept the management of arm port remote education and consultation project group. Results A total of 25 patients implanted with arm port have not occurred phlebitis, deep vein thrombosis, central venous catheter infection and other complications;Patient′s satisfaction degree of quality of life were 100%(25/25);patients and their families on the nursing staff to track service satisfaction were 100%(25/25), too. Conclusions The application and remote management of arm port in patients with breast cancer chemotherapy is worthy of clinical research.

CT and MRI findings of ovarian granulosa cell tumor / 实用放射学杂志

Objective To study the CT and MRI features of ovarian granulosa cell tumor(OGCT).Methods The clinical and imaging data of 12 cases with OGCT proved by pathology were analyzed retrospectively(10 cases were performed with CT,5 cases were performed with MRI,and 3 cases were performed with both CT and MRI).Results All lesions were solitary.The tumors presented round,oval, or lobulated with clear boundary.In 12 cases, 3 cases were multiple cystic masses with uneven thickness of cyst walls and septation.Mild enhancement of the cyst walls and septation was showed after contrast enhancement.7 cases were cystic and solid masses with multiple cysts, typically with sponge-like pattern,and most cases showed slightly to moderately enhancement.2 cases were solid mass with septation,1 case showed significant enhancement,and 1 case showed slightly enhancement.6 of 12 cases presented enlargement of the utreus and endometrium thickening,1 case was associated with endometrial carcinoma.Conclusion OGCT has characteristic CT and MRI features, and CT and MRI examinations combined with estrogen abnormality are helpful for diagnosis.

Application of specially-designed clothing in dressing the wound of patients after breast cancer surgery / 现代临床护理

Objective To investigate the preventive effect of specially-designed clothing on dressing the wound of panents after breast cancer surgery. Methods Using random number table, we divided 400 patients having undergone breast cancer surgery into the observation group and control group in equal number. In the control group, the patients wore ordinary patient clothing after dressing the chest wound with compression bandage,and in the observation group the patients wore the specially-designed clothing after the same treatment of the chest wound as that in the control.The two groups were compared in terms of the incidence of subcutaneous effusion,incidence of skin flap necrosis and the difference of patients'comfort. Results The incidences of subcutaneous effusion and skin flap necrosis were significantly lower than those in the control group.The patient was more comfortable than that the control group, with statistically significant differences (P<0.05,P<0.01). Conclusion After breast cancer surgery,the specially-designed clothing for the patients can effectively reduce the incidences of subcutaneous effusion and incidence of skin flap necrosis and improve the patient's comfort,and deserve clinical promotion.

Effect of miR-185 targeting Six1 on epithelial-mesenchymal transition in lung cancer and its mechanism / 临床与实验病理学杂志

Purpose To study the molecular mechanism of miR-185 affecting the migration and invasion of human lung cancer cell.Methods MiR-185 overexpression was obtained by transfection of miR-185 mimic in lung squamous cell carcinoma cell line H520 and A549,transwell assay and cell scratch assay were used to detection of cell migration and invasion.The luciferase reporter assay confirmed that miR-185 targets the Six1 gene.qRT-PCR and Western blot were used to detect the impact of miR-185 cells Six1 gene expression.Western blot was used to detect the effect of miR-185 overexpression on the epithelialmesenchymal transition of lung cancer cells.Results miR-185overexpression reduced migration and invasion of lung cancer cells (P ＜ 0.05),increased epithelial cell marker E-cadherin expression (P ＜ 0.01),and decreased the expression of mesenchymal cell markers vimentin of (P ＜ 0.01).After overexpression of miR-185 in H520 cells,the expression level of Six1gene was reduced (P＜0.01).MiR-185 regulated the migration and invasion of lung cancer cells by targeting the Six1 gene.Conclusion MiR-185 targets the Six1 gene to regulate the EMT pathway of human lung cancer cells.

Transcatheter Closure of Congenital Coronary Artery Fistulas with a Giant Coronary Artery Aneurysm in Children: Experiences from a Single Center / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transcatheter closure of congenital coronary artery fistulas (CCAFs) is an alternative therapy to surgery; however, data regarding transcatheter closure for CCAF with a giant coronary artery aneurysm (CAA) in pediatric patients are still limited due to the rarity of the disease. We aimed to evaluate the efficacy and safety of transcatheter closure for CCAF with a giant CAA in a pediatric population at a single center.</p><p><b>METHODS</b>Medical records of pediatric patients (<18 years old) who underwent transcatheter closure of CCAF with a giant CAA between April 2007 and September 2016 at Guangdong Cardiovascular Institute (Guangdong, China) were reviewed.</p><p><b>RESULTS</b>Twelve patients (median age, 6.1 years; range, 1.9-11.0 years) underwent successful transcatheter closure procedures. One patient underwent closure at both the entry and exit points of the CAA, three patients underwent closure at the exit point of the CAA, and eight patients underwent closure at the entry point of the CAA. After a mean follow-up of 7.2 years (range, 0.5-9.8 years), one patient (with closure at the exit point of the CAA) underwent transcatheter re-intervention because of a significant residual shunt. She eventually underwent a surgical procedure due to aneurysm dilation after the second intervention. One patient experienced thrombus formation within the CAA after the procedure. Among those with closure at the entry point of the CAA, a mild-to-moderate residual shunt was detected in three patients.</p><p><b>CONCLUSIONS</b>Transcatheter closure appears to be a safe and effective alternative therapy for CCAF with a giant CAA in the pediatric population. Closure at the entry point of the CAA, and closure at both the entry and exit points when feasible, may reduce the risk of postinterventional complications.</p>

Alterations of Whole Brain Networks Degree Centrality in Patients with Primary Insomnia after Acupuncture Therapy:A Voxel-based Resting-state fMRI Research / 中山大学学报(医学科学版)

[Objective]To investigate the value of degree centrality(DC),a novel resting-state fMRI parameter,in voxel-wise whole-brain functional networks analysis in primary insomnia(PI)after acupuncture therapy.[Methods]The resting state fMRI were performed in 29 PI patients and 22 age,education,and sex-matched normal healthy subjects. Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P<0.05).[Results]Compared with the control group,patients with PI showed significantly reduced DC value in middle temporal gyrus(MTG. R);hippocampus(HIP. B);parahippocampal gyrus(PHG. R);putamen(PUT. R);cuneus(CUN. L).[Conclusions]Changes of DC value occurred in some region of brain in the PI patient groups when compared with the control group. It was indicated that DC ,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks ,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.

Immediate Therapeutic Outcomes and Medium-term Follow-up of Percutaneous Balloon Pulmonary Valvuloplasty in Infants with Pulmonary Valve Stenosis: A Single-center Retrospective Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Percutaneous balloon pulmonary valvuloplasty (PBPV) is the preferred therapy for pulmonary valve stenosis (PVS). This study retrospectively reviewed recent PBPV outcomes in infants with PVS. The aim of this study was to evaluate factors associated with immediate therapeutic outcomes and restenosis during medium-term follow-up.</p><p><b>METHODS</b>The study included 158 infants with PVS who underwent PBPV from January 2009 to July 2015. Demographic characteristics and patient records were reviewed, including detailed hospitalization parameters, hemodynamic data before and immediately after balloon dilation, cineangiograms, and echocardiograms before PBPV and at each follow-up. All procedures were performed by more than two experienced operators.</p><p><b>RESULTS</b>Immediately after balloon dilation, the pressure gradient across the pulmonary valve decreased from 73.09 ± 21.89 mmHg (range: 43-151 mmHg) to 24.49 ± 17.00 mmHg (range: 3-92 mmHg; P < 0.001) and the right ventricular systolic pressure decreased from 95.34 ± 23.44 mmHg (range: 60-174 mmHg) to 52.07 ± 18.89 mmHg (range: 22-134 mmHg; P < 0.001). Residual transvalvular pressure gradients of 67.31 ± 15.19 mmHg (range: 50-92 mmHg) were found in 8.2% of patients, indicating poor therapeutic effects; 6.4% of patients had variable-staged restenosis at follow-up and 3.8% underwent reintervention by balloon dilation or surgical repairs. Further analysis demonstrated that the balloon/annulus ratio showed statistically significant differences (P < 0.05) among groups with different therapeutic effects and between the restenosis and no-stenosis groups. Binary logistic regression analysis further revealed that higher balloon/annulus ratio (odds ratio: 0.005, 95% confidence interval: 0-0.39) was an independent protective factor for restenosis. The rate of severe complications was 1.9%.</p><p><b>CONCLUSIONS</b>PBPV is a definitive therapy for infants with PVS based on its effectiveness, feasibility, and safety. Restenosis upon medium-term follow-up is relatively rare.</p>

Screening and verification of plasma biomarkers for stable angina pectoris: a differential proteomic analysis / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare and analyze the differentially expressed plasma proteome between patients with stable angina pectoris (SAP) and healthy donors to identify the biomarkers for early diagnosis of SAP.</p><p><b>METHODS</b>Plasma samples from 60 patients with SAP and 60 healthy controls were collected. Twenty samples (100 mL each) randomly selected from each group were pooled and after removing high-abundance proteins from the pooled plasma, two-dimensional gel electrophoresis (2DE) was performed to isolate the total proteins. The protein spots with more than 2 fold changes were selected after 2D analysis using software, and the differentially expressed proteins were identified by MALDI TOF/TOF mass spectrometer. ELISA was performed to detect hemoglobin subunit delta (HBD) levels in 40 randomly selected samples from each group for verification of the results of 2DE.</p><p><b>RESULTS</b>A total of 7 differentially expressed proteins were found in plasma samples from patients with SAP, including 3 up regulated proteins (serum albumin, hemoglobin subunit alpha and hemoglobin subunit delta,) and 4 down?regulated ones (apolipoprotein L1, apolipoprotein C3, apolipoprotein E and complement C4B). ELISA results showed that HBD level was increased in SAP plasma, which was consistent with the results of 2DE.</p><p><b>CONCLUSION</b>Patients with SAP have different plasma protein profiles from those of healthy controls, and HBD may serve as a potential specific biomarker for early diagnosis of SAP.</p>

A novel disposable circumcision device versus conventional surgery in the treatment of redundant prepuce and phimosis / 中华男科学杂志

Objective@#To compare the clinical effect of a novel disposable circumcision device Ring with that of conventional circumcision in the treatment of redundant prepuce and phimosis.@*METHODS@#Totally, 750 patients with redundant prepuce or phimosis underwent Ring circumcision (group A, n = 450) or conventional circumcision (group B, n = 300). We recorded the operation time, intraoperative blood loss, Visual Analogue Scale (VAS) intraoperative pain scores, postoperative complications, wound healing time, and patients' satisfaction with postoperative penile appearance, followed by comparison of the collected data between the two groups of patients.@*RESULTS@#All the operations were successfully completed. Group A, as compared with B, showed significantly shorter operation time (［3.78 ± 0.42］ vs ［26.24 ± 3.99］ min, P 0.05) or the postoperative incidence rate of edema (0.89% ［4/450］ vs 2.33% ［7/300］, P >0.05). There were no significant postoperative infections or delayed incision healing except for 1 case of wound dehiscence in each group.@*CONCLUSIONS@#Ring circumcision, with its advantages of shorter operation time, less blood loss and pain, higher safety, and better postoperative penile appearance, is easily accepted by the patients and deserves wide clinical application.

A novel disposable ring versus the suture device in circumcision / 中华男科学杂志

Objective@#To investigate the clinical effect of a novel disposable ring versus that of the suture device in circumcision for redundant prepuce and phimosis.@*METHODS@#We randomly assigned 470 male patients with redundant prepuce or phimosis to receive circumcision with a novel disposable ring (the DR group, n = 235) or the suture device (the SD group, n = 235) and compared the operation time, intraoperative blood loss, pain scores, wound healing time, and postoperative complications and penile appearance between the two groups of patients.@*RESULTS@#All the operations were completed smoothly. Compared with the SD group, the DR group showed significantly shorter operation time (［7.49 ± 1.84］ vs ［3.83 ± 0.42］ min, P 0.05) or while the staples scraping the underpants or at the ring removal (3.49 ± 1.22 vs 3.36 ± 1.41, P >0.05). No obvious postoperative infection or delayed healing was observed except for 3 cases of wound dehiscence (1 in the DR and 2 in the SD group) and 8 cases of delayed removal of the staples in the SD group.@*CONCLUSIONS@#The novel disposable ring, with its advantages of short operation time, less bleeding and pain, good penile appearance, high safety, and simple operation, is obviously superior to the suture device in circumcision and deserves to be applied and popularized clinically. .

Brain Micro-structural Alterations of Cough Syrup Abuse Addiction Patients Containing Codeine Under Resting State / 中山大学学报(医学科学版)

[Objective]To investigate the micro-structural alterations within whole brain white matter(WM) in cough syrup abuse addiction patients containing codeine,and to explore the correlation between aberrant WH and abuse time of cough medicine abuse patients.[Methods]Thirty cough syrup abuse addiction patients containing codeine and 30 controls participated in the study. Structural changes in FA and(mean diffusivity)MD were examined in cough syrup abuse addiction patients containing codeine which derived from DTI tractography. Pearson correlation analysis was performed to compare the mean FA value and duration of cough syrup abuse addiction in patients.[Results]Cough syrup abuse addiction patients containing codeine had lower FA value in bilateral anterior limb of internal capsule(ALIC)and higher MD in the bilateral hippocampus and insula,right anterior cingulate cortex(ACC)and superior temporal gyrus,compared to the controls. Cough syrup abuse addiction group also had positive correlation between mean FAvalues and duration of cough syrup abuse addiction in patients.[Conclusion]Micro-structural alterations within whole brain white matter(WM)are found in cough syrup abuse addiction patients containing codeine. This disturbance progresses as duration increases of cough syrup abuse addiction in patients.

Recent research of the disseminated tumor cells in breast cancer / 国际外科学杂志

The distant metastases is the major cause of death in patients with breast cancer.Metastasis of tumor cells is defined to be a series process including tumor cells shedding from the primary lesion,intruding and circulating in blood vessels,implantation into distant organs and developing into metastasis lesion,only complete the series process can eventually form a distant metastasis.Micrometastasis reters to exist in lymph nodes,peripheral blood and bone marrow,yet conventional testing method usually does not reveal it,the presence of tumor cells in blood called circulating tumor cells,and the tumor cells in bone marrow called disseminated tumor cells.In order to predict and prevent tumor spreading and acquire therapeutic strategy,many attempts are being made to detect small numbers of tumor cells that have shed from the primary lesions.This article presents the techniques used for disseminated tumor cells detection,clinical relevance and biological questions for the recent a few years.

Important role of orthoses in the management of postburn scar contracture / 中华烧伤杂志

Joints involved in deep burn often result in joint contracture, limb dysfunction, psychological disorder, or even loss of living and working abilities. The management of post-burn joint contracture will directly orientate the functional recovery of the patients. Comprehensive intervention may prevent the contracture process of the affected joints. Orthoses application is an important measure and should be maintained throughout the whole process of burn care, from positioning the joints at the early stage to maintaining the range of joint motion at the late stage. Orthoses should be used on the premise of protecting the joint functions. In order to maintain the tissue tension while enhancing the joint mobility and muscle strength, the static orthoses and the dynamic orthoses are often alternately used. It is showed in clinical practice that orthoses are designed and applied on the basis that biomechanics will lead to a better outcome.