[Closed percutaneous reduction and minimally invasive treatment of spastic hammery deformity]

Objective: To investigate the efficacy of percutaneous extensor tendon reconstruction in treating spastic hammery deformity. Methods: From February 2009 to July 2018, the clinicaldata of 36 patients with fresh sputum hammer fingers treated in Jinan People's Hospital were analyzed retrospectively. The tendon was percutaneously sutured with PDS Ⅱmonofilament suture and the distal end of the tendon was fixed to the base of the distal phalanx through the bone hole. Removal of the K-wire 6 weeks after the operation, the brace was used to fix the affected finger in the dorsal extension. For 8-10 weeks, only the brace was worn at night and the flexion and extension of the affected finger was gradually strengthened.The extension and flexion function of the interphalangeal joint of the finger was compared pre and post the operation with t test. Results: A total of 36 patients were enrolled but only 33 patientswere followed up for 6 to 15 months. The hammer-shaped deformity was corrected and there was no pain when moving fingers after the operation.The straightening angle of the interphalangeal joint of the finger improved from 46.2°±6.3° before surgery to 7.5°±0.6° after (t=35.12, P<0.05). The passive straightening angle decreased from 3.2°±0.3° before surgery to 0.9°±0.2° after (t=37.11, P<0.05). According to the Crawford functional assessment: excellent in 19 fingers, good in 10 fingers, can be in 4 fingers. The excellent rate was 87.9%. There was no knot exposure, skin necrosis and other complications. Conclusions: Percutaneous resection of the extensor tendon is fixed in the basal phalanx. It is a simple and feasible minimally invasive surgery for hammer-shaped deformity. It can obviously correct the hammer-shaped deformity and has fewer complications.

[Practical membrane anatomy of en bloc mesogastrium excision in lymph node dissection of gastric cancer]

Gastric cancer is a common malignant tumor of digestive system. D2 procedure is recognized as the standard operation for advanced gastric cancer at present. However, controversies still exist in the standardization and quality control of surgical procedures. Total mesorectal excision (TME) and complete mesocolic excision (CME) based on the membrane anatomy perfectly solve these problems in the treatment for colorectal cancer. However, the complexity of mesogastrium determines that TME and CME cannot be easily transplanted to the treatment of gastric cancer. The practical membrane anatomy in gastric cancer surgery is just emerging and its impact on the treatment of gastric cancer is immeasurable. By reviewing the evolution and embryonic development of digestive system, and combining with actual operation, this paper analyzes and redefines several key issues such as traditional Toldt space, Gerota fascia and complete mesenteric excision. On this basis, we propose a novel and feasible surgical procedure named regional en bloc mesogastrium excision (rEME) for distal gastric cancer. The concept of en bloc mesogastrium excision (EME) based on membrane anatomy may have some influences on the lymph node grouping from the 'Japanese Classification of Gastric Carcinoma'. Performance of EME may reduce the controversies about the group of lymph nodes and their borders. EME in the infra-pyloric region weakens the significance of subdivision of No.6 lymph nodes into No.6a, No.6v and No.6i. More studies are needed in the construction of a mature theoretical system for practical membrane anatomy in gastric surgery.

[Preliminary outcomes of percutaneously looped thread transection in the surgical treatment of stenosing tenosynovitis]

Objective: To investigate the percutaneously looped thread transection for treatment of stenosing tenosynovitis and evaluate its treatment outcome. Methods: From January 2014 to October 2016, Eighty-four patients with stenosing tenosynovitis were randomly divided into the open decompressionand group (42 cases) and percutaneously looped thread transection group (42 cases) in Department of Orthopedics, Affiliated Laiwu Hospital of Taishan Medical College. Incision near the digit horizontal stripes, tendon sheath were cut off in the open decompressionand group. Percutaneously looped thread transection was under the guidance of ultrasound, threading from the deep and shallow transverse tendon sheath, respectively, forming loops to cut off and decompressed the flexor tendon. Visual analog scale(VAS) was used to evaluate the extent of pain before the operation and 1 or 4 weeks after the operation, the comprehensive curative effect were evaluated 3 months after the operation. Results: In the two groups pain was alleviated. The VAS improved from (7.0±1.3)prior operation to(5.2±1.6) and (2.8±1.1)1 week and 4 weeks after the operation in the open decompressionand group , respectively. The difference before and after the operation was significant(P<0.05). The VAS improved from (7.1±1.4) prior operation to(2.7±1.3) and (0.6±0.2)1 week and 4 weeks after the operation in the percutaneously looped thread transection group, respectively. The difference before and after the operation was significant(P<0.05). The difference of VAS scores between two groups at 1 week and 4 weeks after the operation were different(P<0.05). The difference of the comprehensive curative effect between two groups at 3 months after the operation were not different(P>0.05). There were no infection, poor healing, blood vessel and nerve damage after operation in both two groups. Conclusion: Percutaneously looped thread transaction under ultrasound for the surgical treatment of stenosing tenosynovitis has less trauma and rapid recovery. It has such advantage as being effective, simple , and reach the same effects as the open decompression surgery.

Single-cycle strong terahertz pulse generation from a vacuum-plasma interface driven by intense laser pulses

Single-cycle strong terahertz pulses can be generated by irradiating ultrashort intense laser pulses onto a tenuous plasma slab. At the plasma surface, laser ponderomotive force accelerates electrons and induces net currents, which radiate terahertz pulses. Our theoretical model suggests that if tau_{L}>2pi/omega_{p}, with tau_{L} as the laser-pulse duration and omega_{p} as the plasma frequency, the emission frequency is around tau_{L};{-1}. On the other hand, the emission frequency is around omega_{p}/2pi if tau_{L}<2pi/omega_{p}. Our numerical simulations support the theoretical model, showing that such a terahertz source is capable of providing megawatt power, field strengths of MV/cm, and broad frequency tunability.

Response to environmental flows in the lower Tarim River, Xinjiang, China: ground water

In China's west since the 1950s large-scale ecosystem degeneration has occurred through water diversions for agricultural purposes. Since 2000, 1038 x 10(6) m(3) of water have been released into the Tarim River with the result that water reached the terminal Taitema Lake for the first time in 30 years. This environmental flow raised water-table levels along 350 km of the river. To assess the response of the water-table, a comparison "pristine" site is compared with downstream monitored sites. The results show huge changes in water-table levels. The study verifies that the water-table is extremely responsive to environmental flows, that strong internal similarities exist along the length of the river, and that the effect on the water-table and hence likely riparian vegetation recovery can be tentatively predicted. The actual impacts of the restoration strategy are less than those originally expected politically, socially and within the scientific community. We make recommendations on more effective release strategies.

Response to environmental flows in the Lower Tarim River, Xinjiang, China: an ecological interpretation of water-table dynamics

Increased water-dependent development and utilization have led to significant environmental and hydrological degradation of the Tarim River in western China and its dependent ecosystems. Between the 1950s and 1970s, 350 km of the lower reaches were drained and between 1960 and 1980 the water-table fell from between -2 and -3 m to between -8 and -10 m. Subsequently, riparian ecosystems were seriously degraded. In 2000, the Chinese government launched a program to restore the lower reaches of the river. Four environmental flows of 1034 x 10(6) m(3) were released from 2000 to 2002. This paper interprets and discusses the ecological significance of changes following the releases and identifies the relationship between water-table dynamics and vegetation responses. Short-term objectives for river restoration are proposed with possible monitoring parameters suggested.

[Reactivation of latent virus in corneas of quiescent recurrent herpes simplex keratitis (HSK)]

By immunohistochemical staining, all 20 corneal half-buttons of HSK quiescent for 4-60 months obtained from 20 cases undergoing penetrating keratoplasties were found negative of HSV-1 antigen. The other 20 corneal half-buttons were cultured for 3-4 weeks and 18 of them (90%) were found HSV-1 antigen positive. The 20 reactivated corneal half-buttons were co-cultured for 1 week with primary rabbit kidney (RK) cells and cellular pathological lesions appeared in the RK cells in 3 cultures which were also HSV-1 antigen positive. These results demonstrated that the latent virus might have been harbored in the corneal cells to escape immunohistochemical detection. In the view point of immunopathology and virology, penetrating keratoplasy can be performed on patients with HSK quiescent over 3 months.

[Morphological and functional studies on nerve regeneration after corneal nerve injuries]

Using gold chloride impregnation of nerves and horse-radish peroxidase (HRP) axoplasma retrograde tracing technique, we monitored nerve regeneration over a period of 6 months following penetrating perilimbal incisions and penetrating keratoplasties (PKP) in rabbits. Post-operatively, at 1 month after a 180 degrees perilimbal incision, loose unconnected subepithelial plexus were present in the limbus, at 2 months 1-2 bundles of deep stromal nerve were seen in the stroma and by 6 months only a few stromal nerves regenerated. There was no difference in nerve regeneration between post-operative autograft and allograft PKP. By 6 months, the quantity of HRP-labelled cells in the trigeminal ganglia was less than the normal level. The results indicated that nerve regeneration by 6 months after corneal nerve injuries was inadequate to restore a normal corneal nerve extent and function.

[Specular microscopy of the corneal endothelial cells in diabetes]

The corneal endothelia of 60 eyes of diabetic patients were studied by contact specular microscopy to find that the mean cell density differed insignificantly from that of the normal controls; however, the percentage of non-hexagonal cells was significantly higher in the diabetics than in normal controls. The disturbance in cellular structure might be the pathological basis of endothelial dysfunction in diabetes.

[An in vitro study on the activation of HSV-1 latent infection in the trigeminal ganglion]

Latent infection in the trigeminal ganglion (TG) was established by inoculating HSV-1 strain Mckrae on the cornea of New Zealand white rabbits. From PI day 30 to day 100, we removed the TG at intervals to establish primary cell cultures. HSV-1 antigen was positive in the TG culture cells on PI day 8 and CPE appeared on PI day 10. All latently infected TG culture cells showed spontaneous infection, while CPE and HSV-1 antigen were positive in PI 2 to 3 weeks. We thus established a cell model in which HSV-1 latent infection in TG was activated in vitro. This may serve as a new approach to study the mechanism of HSV-1 latent infection in TG.

[An evaluation of corneal endothelial damage following intraocular lens implantation]

60 eyes were examined by the contact specular photomicroscope 3 to 6 months after cataract extracapsular extraction and posterior chamber IOL implantation to find changes in corneal endothelial cells. The rate of endothelial cell loss was 13.58% in 45 eyes of senile cataract and 16.60% in 10 eyes of juvenile cataract. Taking the rate of endothelial cell loss as indicator, the present level of IOL implantation was evaluated and the risk of endothelial decompensation due to possible surgical mishap was discussed.

Investigation of herpes simplex virus type-1 latency in corneas

The recurrent rate of herpes simplex keratitis (HSK) was 4.17% after penetrating keratoplasty (PKP) was performed in 216 patients with HSK; the mean period of follow-up was 6.5 years. Immunohistochemical technique showed that HSV-1 antigens were present in the corneal stroma of rabbit eyes up to 45 days after primary corneal infection had subsided. No positive staining of HSV antigen was found in the sections of 18 human corneal buttons with quiescent herpetic lesions. However, after cocultured with primary rabbit kidney (PRK) cells, positive staining was noted in 6/9 human corneal buttons, and some PRK cells developed cytopathic effect. The detection of the sensitivity of cultured corneal cells to HSV-1 infection demonstrated that keratocytes were the most sensitive cells. These results suggest that the cornea may be another site of HSV-1 latency in addition to the trigeminal ganglion.

[Investigations on the latent infection of herpes simplex virus-1 in the cornea]

The relapsing rate in 216 patients of recurrent herpes simplex keratitis (HSK) treated with penetrating keratoplasty was 4.2% in 6.5 years, while experimental studies showed that HSV-1 antigens in the cornea disappeared 45 days after the primary corneal infection. Among 18 cases of quiescent HSK, HSV-1 antigens were negative in the corneal tissue, which however turned positive in 6 (66.7%) of 9 cases that were cultured for reactivation, and became infectious to primary rabbit kidney cells. Tests of susceptibility revealed that rabbit keratocytes were most sensitive to infection with HSV-1 strain Mckrae. The authors opined that the cornea might be an additional site to the trigeminal ganglion to harbor HSV-1.

[Evaluation of penetrating keratoplasty for the treatment of keratoconus]

22 cases (26 eyes) of keratoconus were performed penetrating keratoplasty and followed up 0.5-5 years. The disease was effectively controlled. The rate of graft transparency was 100%, and the immune rejection rate was 7.7%. Corrected vision was 0.4 or better in 23 cases after the operation. The authors regard keratoplasty the best choice for treatment of keratoconus.

Propagation of hepatitis A virus in human diploid fibroblast cells

Human hepatitis A virus (HAV) was propagated in human diploid fibroblast cultures (2BS cells) in vitro. Replication of the virus was followed by immunofluorescent staining (IF), indirect ELISA, and by immune electron microscopy. When 2BS cells were inoculated with faecal extracts containing HAV, synthesis of hepatitis A antigen (HAAg) could be detected in the cytoplasm by IF. Its concentration reached a maximum at four weeks post-inoculation. Measured by solid-phase indirect ELISA, the positive/negative (P/N) ratio for HAAg reached values of up to 7.7. The identity of newly synthesized virus particles with HAV was established by immune electron microscopy, IF-blocking, and neutralization with human convalescent serum. Infected cells showed no signs of a specific cytopathic effect. Two of the virus strains propagated in 2BS cells may prove useful as a source of antigen for serologic tests; one of them might be a candidate strain for HAV vaccine.