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This paper describes a novel surgical technique for successful repair of intractable corneoscleral necrosis caused by severe ocular burns. In this prospective case series, nineteen eyes of fifteen consecutive patients with sectional scleral necrosis and persistent corneal epithelial defects were treated with tenonplasty and amniotic membrane transplantation. The main outcome measure was the stability of the ocular surface after reepithelialization and repair of defects. All patients underwent successful combined surgery involving tenonplasty and amniotic membrane transplantation, in which the conjunctival and corneal surfaces were reconstructed. The interval from injury to surgery was 37.4 ± 24.5 days (3-91 days), and the ocular surfaces became stabilized in 82.2 ± 35.4 days (26-156 days, median 87 days). At the final visit, all cases presented with corneal opacity and neovascularization to various degrees. The best-corrected visual acuity decreased from 2.83 ± 1.02 LogMAR preoperatively to 2.87 ± 1.31 LogMAR postoperatively. The results imply that tenonplasty combined with amniotic membrane transplantation could provide vascular supply to the ischemic sclera, repair defects in the conjunctiva, and promote corneal reepithelialization, thus facilitating ocular surface stabilization after burns. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Burn Association.The aim of the study was to investigate the effects of the rhGM-CSF gel on third degree frostbite wounds. 62 patients who had suffered third degree frostbite on their hand or foot (91 wounds in total ) were selected using a convenience sampling method and randomly allocated to two groups the rhGM-CSF group(31patients,45 frostbite wounds) received the rhGM-CSF gel when wound dressing change daily, however, the control group (31patients, 46 frostbite wounds) received aloe glue. The wound healing time , the score of inflammation about the wound and the positive bacterial culture of wound secretions was used to measure outcomes respectively. Data were analyzed using SPSS (25.0), student’s t test or Mann-Whitney U test and Chi-square test or Fisher exact test were selected, as appropriate. The healing time of the rhGM-CSF group was (12.2±5.0) days, which was significantly shorter than that of the control group (15.5±4.7) days (P less then 0.0001). The rhGM-CSF group’s wound inflammation scores on the 7th and 14th day of treatment were (0.96±0.21) and (1.88±0.29) respectively, which were better than those of the control group (1.12±0.24) and (1.38±0.15) (both P less then 0.0001). The positive bacterial culture of wound secretions in the rhGM-CSF group was also better than that in the control group on the 3rd , 7th and 14th day after treatment (P =0.027, 0.004, 0.030 respectively). According to the results, using rhGM-CSF gel considerably increases the speed of frostbite wounds healing, and have an effect on protecting third degree frostbite wounds regarding the positive effects. © American Burn Association 2020. All rights reserved. For permissions, please e-mail [email protected] is a remarkable prognostic biomarker of chronic lymphocytic leukemia (CLL). The extensively validated 30% of positive CLL cells cut-off value is able to separate CLL patients into two subgroups with different prognosis, but it does not consider the pattern of CD49d expression. find more In the present study, we analysed a cohort of 1,630 CLL samples and identified the presence of ~20% of CLL cases (n=313) characterized by a bimodal expression of CD49d, i.e. concomitant presence of a CD49dpos sub-population and a CD49dneg sub-population. At variance with the highly stable CD49d expression observed in CLL patients with a homogeneous pattern of CD49d expression, CD49d bimodal CLL showed a higher level of variability in sequential samples, and an increase in the CD49dpos sub-population over time after therapy. The CD49dpos sub-population from CD49d bimodal CLL displayed higher levels of proliferation compared to the CD49dneg cells, was more highly represented in the bone marrow compared to peripheral blood (PB), and in PB CLL subsets expressing the CXCR4dim/CD5bright phenotype, known to be enriched in proliferative cells. From a clinical standpoint, CLL patients with CD49d bimodal expression, regardless of whether the CD49dpos sub-population exceeded or not the 30% cut-off, experienced a clinical behavior similar to CD49dpos CLL, both in the chemo-immunotherapy (n=1,522) and in the ibrutinib (n=158) settings. Altogether, these results suggest that CD49d can drive disease progression in CLL, and that the pattern of CD49d expression should be also considered to improve the prognostic impact of this biomarker in CLL. Copyright © 2020 American Society of Hematology.Nobel Laureate von Békésy first discovered travelling wave vibration of the basilar membrane (BM) in cochlea in1960, and thus the mysterious veil of passive phonoreceptive mechanism of human cochlea was unveiled. However, the interpretation of active phonoreceptive mechanism of human cochlea has been a major medical problem for mankind, which has received wide attention from scientists. The active mechanism can be reflected in structures and the lymph where a series of complex coupling nonlinear motion process is observed in the cochlea. Because the cochlea is small and complex, vibration data of the whole BM are not yet available from existing experiments. To address the problem, firstly, the motion equations of the organ of Corti (OHC) is established, and the circuit equations of the outer hair cells (OHCs) in the lymph and the relationship between the motion of the outer hair cells and the electrostatic force are derived. Then the active feedback force onto the BM is obtained. Finally, a analytical-numerical combination model of cochlea, where both macro structures and micro structures of cochlea are considered, is established. The model not only vividly depict the spatial helical body and biological materials of the cochlea, but also reflect the fluid-solid coupling nonlinear motion of cochlear structures in the electrical environment. Thus, the active process of cochlea is revealed. Copyright (c) 2020 by ASME.