Objective To confirm the vancomycin loaded gelatin/β-TCP composite porous scaffolds could be used as sustained-release system,and investigate its efficiency of eliminating infections and repairing bone defects for the treatment of infected bone defects in rabbit.Methods The biodegradable gelatin sponge containing different contents (0,10％,30％,50％) of β-tricalcium phosphate ceramic (β-TCP) was prepared for the controlled-release of vancomycin and labeled with G-0 TCP,G-10 TCP,G-30 TCP and G-50 TCP respectively.Examinations of scanning electron microscopy,porosity analyses and mechanical test were performed.The K-B method was used to investigate the controlled release of vancomycin.Chronic Methicillin-resistant Staphylococcus aureus osteomyelitis models of rabbit were established.After thorough debridement,the infected bone defects were treated in four different groups:blank control group,G-0 TCP group,G-10 TCP group,and G-30 TCP group.At 4 and 8 weeks after implantation,X-ray and histological examinations were carried out to investigate the efficiency of eliminating infections and repairing bone defects.Results The prepared gelatin/β-TCP scaffold exhibited a homogeneously interconnected-3-D porous structure.And the β-TCP granules were localized evenly on the walls of the composite scaffold.There were no significant differences in the pore size of different scaffolds.However,the β-TCP granules can improve the interconnection.The porosity exhibited an obvious increase in G-10 TCP and G-30 TCP composite scaffolds compared with G-0 TCP scaffold.In contrast,too high content of β-TCP granules decreased the porosity.And the porosity exhibited an obvious reduction in the G-50 TCP composite scaffold.The compressive modulus of the vancomycin loaded scaffolds increased with the increase of the β-TCP amount.The scaffold G-0 TCP exhibited the longest duration of vancomycin release and the duration reached 8 weeks.With the increased content of β-TCP granules,the release duration shortened obviously.Compared with the G-50 TCP composite scaffold,the G-10 TCP and G-30 TCP composite scaffolds revealed a better controlled release of the drugs,and the total amount of the drugs was released within 7 weeks.However,the total amount of vancomycin released from the G-50 TCP composite scaffold lasted for 3 weeks.In the treatment of chronic MRSA osteomyelitis of rabbits,the G-30 TCP composite scaffold showed a better performance in the eliminating infections and bone defects repair.At 8 weeks after implantation,signs of osteomyelitis,including osteolysis,development of periosteal reactions,and sequestral bone formation were observed in the animals of blank control group.Signs of infection were absent in other treatment group.In the group treated with G-30 TCP composite scaffold,the bonedefects were repaired completely at 8 weeks after implantation.However,in the groups treated with G-0 TCP and G-10 TCP composite scaffold,the bone defects were not repaired.Conclusion The composite scaffolds could achieve local therapeutic drug levels over an extended duration.And the gelatin with 30％ β-TCP granules composite scaffold had optimal porosity,interconnection,mechanical properties and controlled release performances.It exhibited good performances in infection control and bone defect repair in the chronic MRSA osteomyelitis model.

ObjectiveTo evaluate totally laparoscopic Meckel's diverticulectomy in comparison with laparoscopic-assisted or open diverticulectomy.MethodsThe clinical data of 58 cases of Meckel's diverticulum admitted between January 2006 and January 2011 were analyzed.Cases were divided into three groups according to different period of time. As a result,totally laparoscopic surgery was performed in 13 cases,laparoscopic-assisted resection in 25 cases and open diverticulectomy in 20 cases. Totally laparoscopic group was compared with the other two groups in operation time,flatus defecation time,the incidence of postoperative complications and postoperative hospital stay.ResultsThe mean length of incision was ( 1.6 ± 0.4 ) cm,the mean operation time was ( 41 ± 5 ) min,flatus defecation time was (21.2 ±3.7) h,and the postoperative hospital stay was (6.3 ± 1.2) d in totally laparoscopic group.While that was (2.5 ± 1.2 ) m,( 38 ± 2 ) cm,( 23.6 ± 4.2 ) h,( 6.5 ± 2.3 ) d,respectively in laparoscopicassisted group,and the mean length of incision was (5.0 ± 2.2 ) cm,the mean operation time was (51 ± 6 )min,flatus defecation time was (32.3 ± 6.7) h,the postoperative hospital stay was (8.4 ± 3.8) d in open surgery group.Compared with conventional laparotomy,laparoscopic techniques enjoy advantages of minimal invasion,shorter operative time,fewer complications,shorter recovery period and earlier gastrointestinal recovery(P ＜ 0.05). There were nosignificant differences in operative time, recovery period and complications between totally laparoscopic group and laparoscopic-assisted group.ConclusionsTotally laparoscopic Meckel's diverticulectomy is safe,effective and miniinvasive in experienced hands.

Objective:To investigate the association of 24 h urinary glucose between blood glucose fluctuation and islet function.Methods:A cross-sectional survey of 124 inpatients with type 2 diabetes was conducted,the clinical data were collected,dynamic blood glucose monitoring system(CGMS)was applied to assess blood glucose fluctuation,the pancreatic β cell secretion function was calculated,aiming to investigate the association of 24 h urinary glucose between blood glucose fluctuation and islet function.Objective:The average of the renal threshold for glucose(RTG)was 11.8 mmol/L and of which 75％were elevated(>10 mmol/L).24 h urinary glucose was 30.54 g.Correlation analysis demonstrated that 24 h urinary glucose was positively associated with fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),the mean blood glucose(MBG),fasting plasma(preprandial)glucose area under the curve(AUC2),postprandial glucose area under the curve(AUC1)and glomerular filtration rate(eGFR),there was a significantly negative relationship between 24 h urinary glucose and the mean amplitude of glucose excursions(MAGE)and RTG,but not associated with course of disease,gender,age of patient,body mass index(BMI),blood pressure、absolute means of daily differences(MODD),the pancreatic β cell secretion function and HbA1c.Multiple stepwise regression analysis showed that 24 h urine sugar was correlated with MAGE,MBG,FBG,eGFR,RTG and AUC2(absolute value of β' was-0.668,0.437,0.148,0.116,-0.107,and 0.086,respectively;P<0.05).Conclusions:The average of the renal threshold for glucose in patients with type 2 diabetes was elevated.The 24 h urinary glucose was related to blood glucose level,blood glucose fluctuations assessed by CGMS,eGFR and RTG,among which,MAGE influenced 24 h urinary glucose most.MAGE may be the most predictive risk factor for 24 h urinary glucose.

OBJECTIVETo analyze the gene expression profile of degenerated cervical intervertebral disc of Sprague Dawley rats on a large scale.

METHODSDegenerated models of Sprague Dawley rats of 9 months old (degeneration group, n=9) and normal Sprague Dawley rats of 3 months old (control group, n=9) were prepared, respectively. mRNA was obtained from the cervical intervertebral disc of rats in both groups, respectively, and then labelled by Cy5 and Cy3 fluorescence respectively after reverse transcription to obtain intervertebral disc cDNA probes. cDNA probes were hybridized with BiostarR-40s gene expression profile chips and scanned by laser scanner. The results were treated with portrait analysis, standardization management, and ratio analysis with softwares.

RESULTSCompared with the rats in the control group, 9.6% (381 pieces in total) gene expression changed obviously in the rats in the degeneration group, among which, the gene expression quantities of 171 pieces increased significantly (r=the ratio of the degeneration group to the control group>2.0), 52 pieces of which had certain function. While the gene expression quantities of 211 pieces decreased significantly (r<0.5), 41 pieces of which had certain function.

CONCLUSIONSGene chip technology can be used to analyze the gene expression profile of degenerated intervertebral disc of rats in parallel, in quantity and on a large scale, which helps to testify the representative genes and protein expression, and plays an important role in clarifying the pathogenesis of degenerated intervertebral disc.

Animals ; Cervical Vertebrae ; pathology ; Disease Models, Animal ; Gene Expression Profiling ; In Situ Hybridization ; Intervertebral Disc ; pathology ; Intervertebral Disc Displacement ; genetics ; Male ; Oligonucleotide Array Sequence Analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the expression features of glypican-3 (GPC-3) and its diagnostic and differential values in hepatocellular carcinoma (HCC).

METHODSRat hepatoma models were made and the dynamic expression features of GPC-3 protein and its gene were investigated by Western blotting and RT-PCR respectively. Liver specimens from 36 HCC patients were collected by self-control method and the expression and clinicopathological features of GPC-3 were analyzed by immunohistochemistry. Serum GPC-3 levels were quantitatively detected by ELISA and its efficiency for HCC diagnosis was evaluated in patients with liver diseases.

RESULTSThe incidence of GPC-3 was 0% in control, 83.3% in degeneration, 100% in precancerosis and 100% in canceration during dynamic formation of rat hepatoma, respectively. The positive GPC-3 was brown granule- like staining localized in membrane and cytoplasm in human HCC.

CONCLUSIONSThe GPC-3 positive rates were 80.6% in HCC, 41.7% in surrounding tissues and none in distal tissues (P < 0.01), respectively. No positive relationship presented between GPC-3 and differentiation grade or the number of tumor except of tumor size (Z = 2.941, P < 0.01). The incidence of serum GPC-3 was 52.8% in HCC patients except of one patient with cirrhosis. No significant differences were found between GPC-3 and sex, age, AFP, tumor number, Child classification or extrahepatic metastasis except of tumor size (χ² = 6.318, P < 0.05) and HBV infection (χ² = 23.362, P < 0.01). Combined detection of GPC-3 and AFP could rise up diagnosis of HCC. GPC-3 expression closely associated with HCC and might be useful for early diagnosis of HCC.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Carcinoma, Hepatocellular ; diagnosis ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Glypicans ; metabolism ; Humans ; Liver ; pathology ; Liver Neoplasms ; diagnosis ; metabolism ; pathology ; Male ; Middle Aged ; Rats ; Rats, Sprague-Dawley ; Young Adult

The traditional methods of skeletal age estimation mainly include Numeration, Atlas, and Counting scores. In recent years, other new methods were proposed by several scholars. Utilizing image logical characteristics of X-ray film to extrapolate skeletal age is a key means by present forensic medicine workers in evaluating skeletal age. However, there exist some variations when we present the conclusion of skeletal age as an "evidence" directly to the Justice Trial Authority. In order to enhance the accuracy of skeletal age determination, further investigation for appropriate methodology should be undertaken. After a collective study of pertinent domestic and international literatures, we present this review of the research and advancement on skeletal age evaluation methods of X-ray film.
Age Determination by Skeleton/trends* ; Carpal Bones/diagnostic imaging* ; Elbow/diagnostic imaging* ; Female ; Forensic Medicine/methods* ; Hand Bones/diagnostic imaging* ; Humans ; Image Processing, Computer-Assisted/methods* ; Male ; Radius/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; X-Ray Film

There are irreversible eyeball structural changes in high myopic patients. These changes include axial length, corneal radius, anterior chamber depth, fundus degeneration, macula thickness, etc. There is a close relationship between the damage degree of visual function and these changes. The incidence of complications, such as vitreous opacity, posterior vitreous detachment, cataract, glaucoma, posterior staphyloma and retina detachment, is also highly related to the myopia diopter. More and more researches have indicated that the myopia diopter and the level of visual function are affected by multiple factors. It is promising to detect all of these changes by different kinds of methods, and to assess visual function through these changes. By clarifying these changes, it is also useful to distinguish traumatic damage from disease to provide evidence for forensic assessment of eye injuries.
Eye/physiopathology* ; Forensic Medicine ; Humans ; Myopia/pathology* ; Vision, Ocular/physiology*

Atrial fibrillation is now the most frequent kind of adult arrhythmia in the world, with a prevalence rate at 2%-4%. In addition to the clinical symptoms of palpitation, shortness of breath, chest tightness, and decreased exercise tolerance, patients with atrial fibrillation have a 4 to 5 times higher risk of ischemic stroke than patients without atrial fibrillation, so anticoagulation therapy should be tailored to the CHA2DS2-VASc [congestive heart failure, hypertension, age≥75 years (doubled), diabetes mellitus, stroke (doubled)-vascular disease, age 65-74 years and sex category (female)] score. Oral anticoagulants not only prevent thrombosis, but also raise the risk of drug-related bleeding. This paper examines the assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism: A position paper from ESC/EHRA/AACA/APHRS, in order to provide readers with the most up-to-date research on anticoagulant bleeding risk management in patients with atrial fibrillation.

Objective:To analyze the characteristics of clinical distribution and change of aeroallergens in children with allergic diseases from 2015 to 2020.Methods:Children who visited Capital Institute of Pediatrics affiliated Children′s Hospital, suspected of allergic diseases and received serum aeroallergens specific immunoglobulin E (sIgE) test were retrospectively enrolled (1 to 14 years old). sIgE was detected by Phadia1000 system with radioallergosorbent test fluorescent enzyme-linked immunoassay. The characteristics and change of the aeroallergens among the 6 years was analyzed. Enumeration data were expressed by percentage and categorical variables were compared by the independent samples t-test and Pearson χ 2 test. Results:In total 4 608 tests (4 575 patients) of children were enrolled, the average age was (5.4±2.9) years old, with the median age of 5.0 years old. 3 176 were boys (68.9%), and 1 432 were girls (31.1%). 4 294 children were from the north of China (93.2%), 295 children were from the south of China (6.4%), and 19 children were from unknown regions (0.4%). In total the most common aeroallergen was mold mixture (1 956/4 457 tests, 43.9%) and Alternaria alternata (276/630 tests, 43.8%), followed by Artemisia (300/889 tests, 33.7%), Humulus scandens (12/38 tests, 31.6%) and grass mixture (909/2 874 tests, 31.6%). Among the 6 years, mold, grass pollen and tree pollen sensitization increased, and mold [38/130 (29.2%) vs 1 574/3 233 (48.7%)], grass pollen [11/77 (14.3%) vs 1 069/3 072 (34.8%)] increased significantly (χ 2 was 18.953 and 49.559, respectively, P=0.000). Positive rate of tree pollen increased [1/10 (10.0%) vs 516/2 122 (24.3%)], but did not have statistical significance (χ2=1.111, P=0.292). Dust mite [36/146 (24.7%) vs 321/1 408 (22.8%)] and hair of pets [7/33 (21.2%) vs 321/1 408 (17.1%)] sensitization didn′t change greatly (χ 2 =0.258, P =0.611; χ 2 =0.379, P =0.538). In 2015, the most common aeroallergens was mold (38/130, 29.2%), followed by dust mite (36/146, 24.7%), while in 2020, the most common aeroallergens was still mold (1 574/3 233, 48.7%), with grass pollen (1 069/3 072, 34.8%) and tree pollen (516/2 122, 24.3%) ranked after. Conclusion:Mold might be the most common aeroallergens in allergic children in Beijing area. With time went on, dust mite was gradually exceeded by grass pollen and tree pollen.

Objective:To analyze the characteristics of clinical distribution and change of aeroallergens in children with allergic diseases from 2015 to 2020.Methods:Children who visited Capital Institute of Pediatrics affiliated Children′s Hospital, suspected of allergic diseases and received serum aeroallergens specific immunoglobulin E (sIgE) test were retrospectively enrolled (1 to 14 years old). sIgE was detected by Phadia1000 system with radioallergosorbent test fluorescent enzyme-linked immunoassay. The characteristics and change of the aeroallergens among the 6 years was analyzed. Enumeration data were expressed by percentage and categorical variables were compared by the independent samples t-test and Pearson χ 2 test. Results:In total 4 608 tests (4 575 patients) of children were enrolled, the average age was (5.4±2.9) years old, with the median age of 5.0 years old. 3 176 were boys (68.9%), and 1 432 were girls (31.1%). 4 294 children were from the north of China (93.2%), 295 children were from the south of China (6.4%), and 19 children were from unknown regions (0.4%). In total the most common aeroallergen was mold mixture (1 956/4 457 tests, 43.9%) and Alternaria alternata (276/630 tests, 43.8%), followed by Artemisia (300/889 tests, 33.7%), Humulus scandens (12/38 tests, 31.6%) and grass mixture (909/2 874 tests, 31.6%). Among the 6 years, mold, grass pollen and tree pollen sensitization increased, and mold [38/130 (29.2%) vs 1 574/3 233 (48.7%)], grass pollen [11/77 (14.3%) vs 1 069/3 072 (34.8%)] increased significantly (χ 2 was 18.953 and 49.559, respectively, P=0.000). Positive rate of tree pollen increased [1/10 (10.0%) vs 516/2 122 (24.3%)], but did not have statistical significance (χ2=1.111, P=0.292). Dust mite [36/146 (24.7%) vs 321/1 408 (22.8%)] and hair of pets [7/33 (21.2%) vs 321/1 408 (17.1%)] sensitization didn′t change greatly (χ 2 =0.258, P =0.611; χ 2 =0.379, P =0.538). In 2015, the most common aeroallergens was mold (38/130, 29.2%), followed by dust mite (36/146, 24.7%), while in 2020, the most common aeroallergens was still mold (1 574/3 233, 48.7%), with grass pollen (1 069/3 072, 34.8%) and tree pollen (516/2 122, 24.3%) ranked after. Conclusion:Mold might be the most common aeroallergens in allergic children in Beijing area. With time went on, dust mite was gradually exceeded by grass pollen and tree pollen.