Typical hemophagocytic syndrome associated with cytomegalovirus infection in an immunocompetent patient: a case report and literature review / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Cytomegalovirus (CMV) infection is currently prevalent in populations throughout the world, and 56%‍-94% of the global population is seropositive for CMV. CMV infection mainly affects immunocompromised hosts. In these cases, it can cause significant symptoms, tissue-invasive disease, and many sequelae including death (Dioverti and Razonable, 2016). The vast majority of healthy adults with CMV infection experience an asymptomatic course; when symptomatic, it manifests as a mononucleosis-like syndrome in approximately 10% of patients (Sridhar et al., 2018). The gastrointestinal tract and central nervous system appear to be the most frequent sites of severe CMV infection in immunocompetent individuals (Rafailidis et al., 2008). However, CMV infection is relatively rarely recorded in immunocompetent hosts.

CD7 expression and its prognostic significance in acute myeloid leukemia patients with wild-type or mutant CEBPA / 中华血液学杂志

Objective: To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7(+) in AML patients with wild-type (WT) or mutant-type (MT) CEBPA. Methods: The clinical data of 298 newly diagnosed non-M(3) AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7(+) and CD7(-) patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7(+) group by Kaplan-Meier method. Results: In CD7(+) group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7(-) group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7(+) group comparing to those of CD7(-) group in AML patients with wild type CEBPA. There were no statistical difference between CD7(+) group and CD7(-) group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7(+) group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7(+)-CEBPA MT group, CD7(-) and CD7(+)-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) . Conclusion: The CEBPA mutation rate was higher in CD7(+) AML patients then that of CD7(-) patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.

CD7 expression and its prognostic significance in acute myeloid leukemia patients with wild-type or mutant CEBPA / 中华血液学杂志

Objective@#To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7+ in AML patients with wild-type (WT) or mutant-type (MT) CEBPA.@*Methods@#The clinical data of 298 newly diagnosed non-M3 AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7+ and CD7- patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7+ group by Kaplan-Meier method.@*Results@#In CD7+ group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7- group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7+ group comparing to those of CD7- group in AML patients with wild type CEBPA. There were no statistical difference between CD7+ group and CD7- group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7+ group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7+-CEBPA MT group, CD7- and CD7+-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) .@*Conclusion@#The CEBPA mutation rate was higher in CD7+ AML patients then that of CD7- patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.

Curative effect of anterolateral spinal canal decompression combined with short segment screw fixation with posterior approach for severe thoracolumbar burst fractures with spinal cord injury / 中国骨伤

OBJECTIVE@#To explore the effect of anterolateral spinal canal decompression combined with short segment screw fixation with posterior approach for severe thoracolumbar burst fractures with spinal cord injury.@*METHODS@#From January 2016 to June 2018, 16 patients with severe thoracolumbar burst fractures (more than 50% of ratio of spinal canal encroachment, reverse fragment at the posterior edge of the vertebral body) with spinal cord injury were retrospectively analyzed, including 10 males and 6 females, ranging in age from 19 to 57 years old. Causes of injury:8 cases of fall injury, 6 cases of traffic accident injury and 2 cases of other injuries. Fracture site:T@*RESULTS@#All 16 patients were followed up, and the average follow up time was (15.9±5.4) months. The average operation time was (234±41) minutes and the average amount of bleeding was (431±93) ml. The loss of anterior height of injured vertebrae was (52.25±10.10)% before operation, (8.93± 3.61)% at 3 days after operation, and (9.25±2.88)% at the latest follow up. The results of 3 days after operation and the latest follow up were better than that before operation, and there was no significant differencesbetween results at the latest follow up and 3 days after operation (@*CONCLUSION@#For severe thoracolumbar burst fracture and spinal cord injury, with more than 50% of ratio of spinal canal encroachment and reverse fragment at the posterior edge of the vertebral body, the anterolateral spinal canal decompression combined with short segment screw fixation with posterior approach has the characteristics of accurate reduction, complete decompression and firm fixation, and the clinical effect is satisfactory.

Molecular identification and genetic relationship of Fritillaria cirrhosa and related species based on DNA barcode / 药学学报

Based on the ITS2 and psbA-trnHsequences, molecular biological identification and genetic relationship of Fritillaria cirrhosa with its relative species were carried out. In this paper, the PCR-RFLP method specified by the Chinese Pharmacopoeia was performed on all samples at first. Secondly, the ITS2 and psbA-trnH sequences of all samples were amplified. Then, the amplified products were used to analyze the genetic distance, construct the phylogenetic tree, assess the identification efficiency, and evaluate the genetic relationship as well. The result showed that all the samples were divided into two groups by PCR-RFLP method. The samples in the first group, including Fritillaria ussuriensis, Fritillaria thunbergii and Fritillaria pallidiflora, could not be digested by SmaI, while the other samples in the second group, including Fritillaria mellea, Fritillaria sinica, Fritillaria cirrhosa var. ecirrhosa Franch, Fritillaria unibracteata var. longinectarea and Fritillaria cirrhosa, could be digested by SmaI. Then, ITS2 and psbA-trnH sequences of all samples were obtained. The length of various ITS2 sequences were distributed from 235 to 239 bp, and the average intra- and inter-specific genetic distance were 0.001 and 0.022, respectively. NJ tree showed that all samples were separated into "Northern Fritillaria" group (Fritillaria ussuriensis and Fritillaria pallidiflora) and "Southern Fritillaria" group (Fritillaria thunbergii, Fritillaria mellea, Fritillaria sinica, Fritillaria cirrhosa var. ecirrhosa Franch, Fritillaria unibracteata var. longinectarea and Fritillaria cirrhosa). The latter group could be further divided into Fritillaria thunbergii and Fritillaria cirrhosa subgroup, and the species in Fritillaria cirrhosa subgroup had close phylogenetic relationships. The length of psbA-trnH sequences was distributed from 337 to 373 bp, and the intra- and inter-specific genetic distance were 0.263 and 0.329, respectively. The samples in this paper could not be clustered effectively by NJ tree. This indicated that the ITS2 sequences were not only able to identify Fritillaria cirrhosa with its partial relative species quickly and accurately, but also clarify the relationship between different Fritillaria species. Therefore, it provided an important theoretical foundation for the development of molecular markers, effective protection, and rational development and utilization of Fritillaria resources.

Methylation Status of Transcriptional Modulatory Genes Associated with Colorectal Cancer in Northeast China

BACKGROUND/AIMS: Methylation status plays a causal role in carcinogenesis in targeted tissues. However, the relationship between the DNA methylation status of multiple genes in blood leukocytes and colorectal cancer (CRC) susceptibility as well as interactions between dietary factors and CRC risks are unclear. METHODS: We performed a case-control study with 466 CRC patients and 507 cancer-free controls to investigate the association among the methylation status of individual genes, multiple CpG site methylation (MCSM), multiple CpG site heterogeneous methylation and CRC susceptibility. Peripheral blood DNA methylation levels were detected by performing methylation-sensitive high-resolution melting. RESULTS: Total heterogeneous methylation of CA10 and WT1 conferred a significantly higher risk of CRC (adjusted odds ratio [OR(adjusted)], 5.445; 95% confidence interval [CI], 3.075 to 9.643; OR(adjusted), 1.831; 95% CI, 1.100 to 3.047; respectively). Subjects with high-level MCSM (MCSM-H) status demonstrated a higher risk of CRC (OR(adjusted), 4.318; 95% CI, 1.529 to 12.197). Additionally, interactions between the high-level intake of fruit and CRH, WT1, and MCSM on CRC were statistically significant. CONCLUSIONS: The gene methylation status of blood leukocytes may be associated with CRC risk. MCSM-H of blood leukocytes was associated with CRC, especially in younger people. Some dietary factors may affect hypermethylation status and influence susceptibility to CRC.

Effects of Hybrid Coat on shear bond strength of five cements: an in vitro study

PURPOSE: To evaluate the sealing performance of Hybrid Coat and its influence on the shear bond strength of five dentin surface cements. MATERIALS AND METHODS: Six premolars were pretreated to expose the dentin surface prior to the application of Hybrid Coat. The microscopic characteristics of the dentinal surfaces were examined with scanning electron microscopy (SEM). Then, 40 premolars were sectioned longitudinally, and 80 semi-sections were divided into a control group (untreated) and a study group (treated by Hybrid Coat). Alloy restoration was bonded to the teeth specimen using five different cements. Shear bond strength was measured by the universal testing machine. The fracture patterns and the adhesive interface were observed using astereomicroscope. RESULTS: SEM revealed that the lumens of dentinal tubules were completely occluded by Hybrid Coat. The Hybrid Coat significantly improved the shear bond strength of resin-modified glass ionomer cement (RMGIC) and resin cement (RC) but weakened the performance of zinc phosphate cement (ZPC), zinc polycarboxylate cement (ZPCC) and glass ionomer cement (GIC). CONCLUSION: Hybrid Coat is an effective dentinal tubule sealant, and therefore its combined use with resin or resin-modified glass ionomer cements can be applied for the prostheses attachment purpose.

Comparative Genomic Analysis of Enterovirus 71 Revealed Six New Potential Neurovirulence-associated Sites / 生物医学与环境科学（英文）

In the present study, the complete genomes of four common (4/EV71/Wenzhou/CHN/2014, 15/ EV71/Wenzhou/CHN/2014, 116/EV71/Wenzhou/ CHN/2014, and 120/EV71/Wenzhou/CHN/2014) and two virulent (11/EV71/Wenzhou/CHN/2014 and 109/EV71/Wenzhou/CHN/2014) enterovirus 71 (EV71) isolates were sequenced and described. They are 7405 bp in length and belong to EV71 sub-genotype C4 (C4a cluster). Nucleotide sequence alignment revealed six nucleotide variations (GP151→TP151, GP199→AP199, GP261→TP261, AP328→CP328, GP422→AP422, and GP437→TP437) in the two virulent isolates within the 5'UTR of the IRES element. RNA secondary structure predictions of IRES and FCE indicated that the common isolates shared similar structures, which were different from those of the virulent isolates. Moreover, the GP114→CP114 and GP151→TP151 mutations in the virulent isolates contributed to the formation of the unique RNA secondary structures in SL II. Furthermore, nucleotide/amino acid sequence alignments of 82 EV71 isolates indicated that six sites (TP488 and CP577 in the 5'UTR; AsnP57 in 2A; IleP56 in 3C; CP10 and AP47 in the 3'UTR) are potentially associated with the neurovirulence of EV71. Finally, the 3D structures of 2A were analogous, whereas the structures of VP1 and 3C were variable.

Short-term effects of hemogram in healthy donors after peripheral blood stem cell collection / 中华血液学杂志

<p><b>OBJECTIVE</b>To observe the short- term effects of hemogram in donors after peripheral blood stem cell（PBSC）collection and donors' tolerance.</p><p><b>METHODS</b>A total of 166 related allogeneic donors were selected from The First Affiliated Hospital of Medical School of Zhejiang University between January 2013 and December 2014, including 86 male and 80 female. All donors accepted granulocytecolony- stimulating factor（G-CSF）5-10 μg·kg⁻¹·d⁻¹ until collection finished and were measured by blood cells count before and after PBSC collection.</p><p><b>RESULTS</b>After PBSC collection, the hemoglobin level decreased from 145（94-181）g/L to 138（93-167）g/L, and the platelet counts decreased in all donors from 231（105- 490）× 10⁹/L to 95（39- 210）× 10⁹/L. The amount of hemoglobin contamination in collection products was weak correlated with the decreased hemoglobin in peripheral blood（r=0.297, P=0.017）, and the platelet contamination was high correlated with that decreased in peripheral blood（r=0.719, P<0.001）. The decline of hemoglobin level after twice PBSC collection was of no significant difference between four groups in different ages（P≥0.05）. The decline of platelet counts was out of a significant difference（P> 0.05）. In addition, the decline of hemoglobin level after once and twice PBSC collection was of a significant difference between four groups in different body mass index（BMI）（P=0.003 and P<0.001）, especially in thinner group with obvious decrease. But the decline of platelet counts was out of a significant difference （P>0.05）.</p><p><b>CONCLUSION</b>The hemoglobin level decreased mildly in healthy allogeneic hematopoietic stem cell donors after PBSC collection and it is better to adjust parameters every time to ensure their safety for thinner donors. However, it will increase the risk of platelet decline, which is unrelated with ages and BMI and can be tolerated.</p>

Expression of NF-κB and osteopontin of synovial fluid of patients with knee osteoarthritis

OBJECTIVE@#To explore the significance of osteopontin and nuclear factor κB (NF-κB) expression in patients with knee osteoarthritis.@*METHODS@#RT-PCR and enzyme-linked immunosorbent assay were used to measure the Osteopontin (OPN) and NF-κB concentration of knee joint synovial fluid of patients with knee osteoarthritis and trauma fractures, and analyze the relationship between the expressiones of them.@*RESULTS@#OPN and NF-κB expression at the mRNA and protein levels of patients with knee osteoarthritis were significantly higher than the control group. the result showed statistical significance (P<0.05). There was a positive correlation between the OPN levels in synovial fluid of patients with knee osteoarthritis and NF-κB expression levels (P<0.05).@*CONCLUSIONS@#The high expression of OPN and NF-κB are closely related to occurrence and development of knee osteoarthritis.

Which vessel, the artery or the vein is more important in vascular supercharge: an investigation of vascular changes on rat abdominal supercharging flap models / 中华整形外科杂志

<p><b>OBJECTIVE</b>The study was to reveal the vascular changes in three different supercharging flap models. From this study, we want to investigate which vessel, the artery or the vein is more important in elongating perforator flap survival and why.</p><p><b>METHODS</b>Twelve rats were divided into three experimental groups. The left side flaps in all groups were pedicle using xiphoid perforator as control group. The right side flaps were supercharging experimental group. Group I, flap supercharged based on artery and vein of pubis perforator. Group II, flaps supercharged based on artery of pubis perforator. Group III, flaps supercharged based on vein of pubis perforator. Near-infrared fluorescent angiography was performed using SPY imaging system pre-and-aft operation and all angiography videos were compared and analyzed.</p><p><b>RESULTS</b>Showed in angiography video of SPY, in control group and vein supercharging group, blood supply could be observed the immediately reducing, and almost be disappeared the amount of perfusion to distal area. It shows relatively constant necrosis in the distal side of control group and vein supercharging group, and the necrosis of vein supercharging group smaller than these of control group. In artery, vein supercharging group and artery supercharging group, blood perfusion could be observed separately perfusion in the upper and low area of flap. There are complete survival showed on the artery supercharging group and artery and vein supercharging group.</p><p><b>CONCLUSIONS</b>These findings indicated that congestive flap necrosis attribute to insufficiency of arterial blood. Arterial inflow was demonstrated more important for improved survival of distal flap than venous outflow.</p>

Clinical value of acoustic radiation force impulse imaging for quantitative evaluation of degree of liver fibrosis in chronic hepatitis C patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value of acoustic radiation force impulse (ARFI) imaging technology for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients.</p><p><b>METHODS</b>One-hundred-and-eight CHC patients were examined by real-time ultrasound elastography using the Acuson S2000 ARFI instrument (Siemens Healthcare) and underwent liver biopsy for pathohistological analysis. The correlation between liver fibrosis grades determined by the two approaches was analyzed. The cut-off values for diagnosis by ARFI (S more than 2, S more than 3 and S = 4) were determined by generating a receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>The spectrum of liver stiffness detected by ARFI sonoelastography included S1 at (1.26+/-0.27) m/s (n = 36), S2 at (1.45+/-0.51) m/s (n = 31), S3 at (2.01+/-0.54) m/s (n = 27), and S4 at (2.28+/-0.82) m/s (n = 14). The ARFI values were significantly different among the four different stages of liver fibrosis (P less than 0.001). The liver stiffness detected by ARFI sonoelastography was significantly correlated with the liver fibrosis stage determined by the gold standard pathohistological analysis (Spearman's rank coefficient: 0.61, P less than 0.001). Using the ARFI technology for assessment of liver fibrosis gave areas under the ROC curve of 0.779 for S more than 2 patients, of 0.863 for S more than 3 patients, and of 0.0880 for S = 4 patients.</p><p><b>CONCLUSION</b>The real-time ultrasound elastography ARFI technology can show the elasticity modulus of liver, and its data values positively correlate with the patho-histology grade of liver fibrosis in CHC patients. ARFI technology is easy to operate, non-invasive, and quantitative, and has potential clinical value for assessing liver fibrosis in CHC.</p>

Penile augmentation and elongation using autologous dermal-fat strip grafting / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of autologous dermal-fat strip grafting in penile augmentation and elongation.</p><p><b>METHODS</b>From May 2004 to December 2010, 24 patients underwent penile enhancement with free dermal-fat strip grafting. Through suprapubic incision, the superior suspensory ligament and part deep suspensory ligament are cutted off to lengthen the penis. The resulted dead space is filled with the autologous dermal-fat strip (6.0-9.5 cm in length, 1.2-1.5 cm in width and 0.6-0.8 cm in depth) to enhance the penis.</p><p><b>RESULTS</b>Primary healing was achieved in 23 cases. Incisional fat liquefaction happened in one case which healed after dressing change. The penile appearance was satisfactory both at rest or erection. The penile length and circumference increased by 2.5-4.8 cm (average, 3.2 cm) and 1.8-3.0 cm (average, 2.4 cm), respectively. 18 patients were followed up for 3 months to 5 years. All the patients were satisfactory on the cosmetic and functional results. No complication happened.</p><p><b>CONCLUSIONS</b>It is safe and effective for penile augmention and elongation with autologous dermal-fat strip grafting and disconnection of penile suspensory ligament.</p>

Expression of CAS in hepatocellular carcinoma tissues and its relationship with HBV infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore whether the cellular apoptosis susceptibility (CAS) protein could serve as a pathologic marker for HCC diagnosis and the roles of CAS expression in HBV infection associated HCC.</p><p><b>METHODS</b>The expression of CAS protein in HCC and its paracarcinoma tissues, non-tumor liver cirrhosis and hepatitis tissues were detected by immunohistochemistry. Meanwhile, HBsAg, HBcAg and HBV DNA in HCC tissues with HBV infection were examined by immunohistochemistry and in situ hybridization respectively.</p><p><b>RESULTS</b>The expression of CAS protein was significantly higher in HCC than in its paracarcinomas tissues (P < 0.01), and higher in paracarcinomas tissues than in non-tumor liver cirrhosis and hepatitis tissues (P < 0.01). Poorly differentiated tumors immunochemically stained stronger than moderately or well differentiated (P < 0.01). CAS protein expression was significantly higher in HBV-infected HCC tissues than that of in non-HBV infection (P < 0.01). Meanwhile, in HBV-infected HCC tissues, the staining intensity score of CAS protein in HBV DNA positive HCC tissues was significantly higher than HBV DNA negative tissues (P < 0.05).</p><p><b>CONCLUSIONS</b>Higher expression of CAS protein is found in HCC tissues,and the intensity of CAS protein expression is related closely to tumor differentiation. We suggested that CAS protein might serve as a marker for HCC diagnosis and differentiation estimation, and deduced that CAS might play an important role in the initiation of HBV infection associated HCC through upregulating expression of CAS.</p>

Hair cells apoptosis and the activation of P53 protein in intensive impulse noise induced cochlear lesion / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the pattern of hair cell injury and expression of P53 apoptosis protein in intensive impulse noise injured cochlear hair cells in guinea pigs.</p><p><b>METHODS</b>Twelve adult guinea pigs were exposed to a series of 40 pairs of impulse noise (2 second intervals) at the intensity of 168 dB (SPL). Animals were terminated at 3, 6 and 12 hours after noise exposure, respectively. Cochlear surface preparations were performed with a double staining of FITC-conjugated phalloidin and propidium iodide for the observations of the stereocilia and the nucleus. P53 immunochemical staining was also performed 12 hours post-noise exposure to observe if there was expression of p53 protein in injured hair cells. Results Three hours after noise exposure, the outer hair cells at the end of basal turn and beginning of second turn were destroyed first with a character of nuclear condensation. Six hours post-noise exposure, many hair cells in the center of damage region had nuclear fragmentations, and the damaging area expanded towards to basal turn and apical turn. Twelve hours after noise exposure, the nucleus in most outer hair cells and inner hair cells at the region of damage center were missing. The nuclear condensation and fragmentation were appeared in hair cells in both sides of the center region of degeneration. P53 immunoreactive products were also found in damaged hair cells, not only in the central damage area, but also in the basal turn and the third turn.</p><p><b>CONCLUSIONS</b>Intensive impulse noise resulted in apoptosis of cochlear hair cells that initiated between the end of basal turn and the beginning of second turn. Hair cell degeneration spread to basal and third turn along the basilar membrane. P53 may play an important role in impulse noise induced-hair cell apoptosis.</p>

Application of tunica vaginalis flap for multi-fistulas after urethroplasty in hypospadias / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discussed a new technique for multi-fistulas after urethroplasty in hypospadias.</p><p><b>METHODS</b>8 cases with postoperative multi-fistulas, which were not successfully repaired by previous treatment, were reoperated with tunica vaginalis flap combined with urethral stent and elastic dressing. The multi-fistulas were located between glan and scrotum. The number of fistulas was 3-7 (median, 5).</p><p><b>RESULTS</b>Primary healing was achieved in all the 8 cases. The micturition and esthetic result were satisfied. 5 cases were followed up for 8-10 months with no recurrence of fistula. There was also no dysuria and penile curvature.</p><p><b>CONCLUSIONS</b>Tunica vaginalis flap combined with urethral stent and elastic dressing is an effective technique for multi-fistulas after urethroplasty. It is easily performed with reliable result.</p>

Application of enzyme assay and gene analysis in the prenatal diagnosis for a family with glycogen storage disease type II / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To carry out prenatal diagnosis for a glycogen storage disease type II (GSD II ) affected family.</p><p><b>METHODS</b>The acid-α -glucosidase (GAA) activity was measured in whole leukocytes and cultured amniocytes with 4-methylumbelliferyl-α -D-glucopyranoside as substrate and with acarbose as inhibitor. The coding regions of GAA gene were amplified by polymerase chain reaction and analyzed by direct DNA sequencing.</p><p><b>RESULTS</b>The proband and the fetus had low GAA activity (12.3% and 1.1% of the average normal range, respectively). Mutation analysis of the GAA gene revealed a novel nonsense mutation p.W738X and a reported nonsense mutation p.E888X in both the proband and the fetus; the reported pseudodeficiency allele c.[1726G to A: 2065G to A] was found in the proband, the mother and the fetus.</p><p><b>CONCLUSION</b>The proband and the fetus were both GSD II affected. A combination of GAA activity analysis and mutation analysis is efficient for the prenatal diagnosis of GSD II. Mutation analysis should be a routine method in the prenatal diagnosis of GSD II in Asian population, where pseudodeficiency allele can cause low GAA activity in normal individuals which is relatively common in Asian.</p>

Investigation of Families with Cerebral Palsy High-risk Infants on Knowledge, Attitudes and Behavior for Cerebral Palsy and Early Intervention / 中国康复理论与实践

@#Objective To investigate the families with cerebral palsy high-risk infants on knowledge, attitudes and behavior of cerebralpalsy and early intervention. Methods 200 family members of cerebral palsy high-risk infants were investigated with their knowledge, attitudesand behavior on cerebral palsy and early Intervention. Results Their knowledge of cerebral palsy, including related risk factors andearly features, was poor; the attitude to early intervention was not positive and the behavior is not reasonable. Conclusion The education tothe families with cerebral palsy high-risk infants is important for the prevention and treatment of cerebral palsy.

Application of temporal-zygomatic expanded flaps pedicled with orbicularis oculi muscle for sub-orbital defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of temporal-zygomatic expanded flaps pedicled with orbicularis oculi muscle (00M) for sub-orbital defects.</p><p><b>METHODS</b>16 cases with sub-orbital defects were treated. The expanders were implanted at temporal-zygomatic region at the first stage. At the second stage, temporal-zygomatic expanded flaps pedicled with OOM were designed and transferred to repair the suborbital defects.</p><p><b>RESULTS</b>All the expanded flaps survived completely. 11 cases were followed up for 3 months to 3 years. The flaps had no contracture with a good match of color and texture with surrounding tissue. The scar was also inconspicious.</p><p><b>CONCLUSIONS</b>The temporal-zygomatic expanded flaps can be used for large size defects below orbit. It is very flexible, leaving minimal morbidity for the whole face.</p>

Exploring the mechanism of children elbow joint injury led to elbow varus / 中国骨伤

<p><b>OBJECTIVE</b>To explore the causes and mechanisms of children elbow joint injury led to elbow varus.</p><p><b>METHODS</b>One hundred children with elbow varus causded by elbow joint injuries were retrospectively studied during January 2005 to April 2008 in department of child orthopedics involving 54 males and 46 females with an average age of 9.7 years old ranging from 7 to 16 years. The anterior-posterior and lateral position X-ray films of elbow joint continuous 12 to 18 months (means 15 months) of all the cases were collected. The postoperative X-ray films were observed to analyze the cause of elbow varus.</p><p><b>RESULTS</b>There were 81 cases caused by epiphyseal dysplasia, growth imbalance, included 47 cases of humeral supracondylar fractures, 16 cases of entire epiphysis separation of distal humerus, 11 cases of humeral lateral condyle fractures, 7 cases of humeral medial condyle fractures. There were 19 cases caused by ulna drift and rotation of the distal fracture end,the ulnaris cortibal bone crushing and collapse involving 11 of humeral supracondylar fractures, 2 of entire epiphysis separation of distal humerus, 5 of humeral lateral condyle fractures, 1 of humeral medial condyle fractures.</p><p><b>CONCLUSION</b>There are two main factors of formation for the children elbow varus deformity: the main causes is epiphysial dysplasia after fracture and imbalance growth of epiphysis; the secondary reasons is ulnar inclination of the distal fracture, rotation of the distal fracture, fracture shift such as ulnar bone cortical extrusion collapse.</p>