BACKGROUND:Recent development of bioengineering technology and tissue-engineered nerve brings a new hope for the treatment of peripheral nerve injuries, which has gradual y become a research spot. OBJECTIVE:To review the new progress in the repair of peripheral nerve injuries using seed cells, biomaterials and tissue-engineered nerve construction technology. METHODS:PubMed and CNKI were searched by the first authors for articles concerning nerve tissue engineering and repair of peripheral nerve injuries published prior to July 2013. The keywords were“tissue engineering, peripheral nerves, nerve injuries, stem cells, Schwann cells, scaffold, growth factor”in English and Chinese, respectively. The articles published recently or in the authorized journals were preferred in the same field. Final y, 63 articles were included in result analysis. RESULTS AND CONCLUSION:Up to now, there is a great advance in the tissue engineering technology for the repair of peripheral nerve injuries. However, most studies are stil in experimental step. For the clinical application of nerve tissue engineering, some problems to be solved include:(1) source and ethics of seed cells;(2) immunological rejection fol owing cellproliferation and transplantation;(3) stability and oncogenicity of transplanted cells;(4) degradation rate, optimal porosity, tube thickness and shape;(5) repair timing for in vitro tissue-engineered nerve construction;(6) local release and regulation of various neurobiological factors. With the development of science, many patients with nerve injuries can profit from the solve of these problems.

Myocardial infarction is one of the main factors causing heart failure and is associated with a high rate of morbidity and mortality in the developing countries.Due to infracted cardiac muscles,heart function will aggravate and myocardium will remodel leading to exacerbation of the disease.Current treatment modalities may not be adequate to prevent myocardial remodeling.It is necessary to explore a new approach to restore the damaged myocardium.Stem cell-based therapy is developing rapidly and has been used in the field of cardiovascular disease.There are many problems still to be solved.

Objective:To explore important signaling pathways and effects on neurovascular unit of Buyang-Huanwu Decoction in the treatment of ischemic stroke. Methods:Used TCMSP database, Chinese Medicine and Chemical Composition Database of Shanghai institute of Organic Chemistry and searched related literature to obtain and screen the active compounds and their targets of Buyang-Huanwu Decoction. DrugBank database, OMIM database, TTD database and GeneCards database were used to obtain targets of ischemic stroke. Metascape database was used to carry out KEGG pathway enrichment analysis on therapeutic targets. AlzData database was used to analyze the gene expression of therapeutic targets in different cells. Results:Through network analysis, the key targets of Buyang-Huanwu Decoction in the treatment of ischemic stroke were obtained, including PTGS2, PTGS1, CHRM1, ADRB2, CHRM2, F10, F7, HIF1A, PDE3A, ADRA1B and CHRM3, etc. Through enrichment analysis, multiple key signaling pathways of Buyang-Huanwu Decoction in the treatment of ischemic stroke were obtained, including PI3K-Akt signaling pathway, calcium signaling pathway, IL-17 signaling pathway, platelet activation, Apelin signaling pathway, NF-κB signaling pathway, AMPK signaling pathway and arachidonic acid metabolism, etc. Through gene expression analysis, the effect of Buyang-Huanwu Decoction on different cells was analyzed, and it was found that the targets regulate a variety of biological processes, cellular components and molecular functions in endothelial, astrocytes, microglia, oligodendrocytes, oligodendrocyte precursor cells (OPCs) and neurons. Conclusion:Buyang-Huanwu Decoction is characterized by multiple components, multiple targets, multiple pathways and complex connections in the treatment of ischemic stroke, and its effect is closely related to neurovascular units (NVU) at the cellular expression level of genes, and the mechanism of therapeutic effect included neuroprotection, neurogenesis, antithrombotic, vascular regeneration, glial cell regulation, etc.

To develop a portable medicine coffer for medical support in order to standardize the management of special medicine. The coffer with double-fingerprint cryptography and internal mechanical lock was com-posed of a body and a cap. The coffer had the body made of high-intensity plastics or light alloy, monitor made of high-intensity abrasion-resistant glass as well as rechargeable lithium battery. The coffer eliminated the deficiencies of traditional medicine chest. The portable coffer standardizes the management of special medicine for medical support.

Objective To apply the hydrocolloid dressings and hydrocolloid dressings combined GreenCream Dressing for central venous catheterization fixing, and to explore the effect of hydrocolloid dressings combined GreenCream Dressing in the prevention of venous catheter bacterial colonization and bacterial infection. Methods 470 patients who underwent the Inferior vena cava catheter were divided into 230 patients in the control group and 240 patients in the experimental group. The control group was fixed with hydrocolloid dressings after central venous catheter, and the experimental group was fixed with hydrocolloid dressings combined GreenCream Dressing after central vein catheter. The measurements included catheter bacterial colonization, catheter-related infections (CRIs) and catheter related blood stream infections (CR-BSIs), pathogenic bacteria colonization of the skin. At the same time, the skin safety was also confirmed. Results In the control group, 230 cases were retained for 1 419 catheter-days, and 240 cases in the experimental group were retained for 1 675 catheter-days. Compared with hydrocolloid dressings, hydrocolloid dressing combined GreenCream Dressing could reduce the incidence of CRIs from 1.8‰(3/1 675) to 0.7‰(1/1 675), and CR-BSIs from 2.4‰(4/1 675) to 0.7‰(1/1 675) respectively, with the statistically significant (χ2=6.39, 95%CI 1.30-31.41, andχ2=6.21, 95%CI 1.56-40.82;P<0.05). The results of bacterial colonization, CRIs and CR-BSIs showed that the most common bacteria were Staphylococcus and fungi. At the same time, compared with the hydrocolloid dressing, hydrocolloid dressing combined GreenCream dressing could reduce the incidence of skin pathogenic bacteria colonization, from 41.74%(96/230) to 28.33%(68/230),with the statistically significant (χ2=9.29,P=0.00);There was no difference between the two groups in the field of the incidence of abnormal skin manifestation (χ2=1.23, P=0.30), showing a good safety. Conclusions Hydrocolloid dressing combined GreenCream Dressing would be more effective to prevent bacterial colonization and bacterial infection of central venous catheter in department of neurosurgery.

To study the effect of mild hypothermiaon neurological function and oxidative stress in patients with acute massive cerebral infarction. Methods Sixty patients with acute massive cerebral infarction (within 12 hours of onset, the age < 70 years old) admitted to the First Hospital of Qinhuangdao from August 2017 to August 2018 were enrolled. Patients were divided into control group and observation group according to random number table method, with 30 patients in each group. The control group was given conventional treatment such as lowering intracranial pressure, anticoagulation, improving microcirculation, neurotrophy and anti-stress ulcer, while the observation group was received mild hypothermia (after 72 hours of treatment at 32-35 ℃, it increased about 1 ℃ every 6 hours until the normal temperature). The neurological impairment (the National Institutes of Health Stroke Scale, NIHSS), motor function (Fugl-Meyer score), daily living ability (Bathel index) and coma degree (Glasgow coma scale, GCS) were observed before treatment and 72 hours after treatment. The levels of plasma malondialdehyde (MDA), superoxide dismutase (SOD) and advanced oxidative protein products (AOPP) were measured at same time. After 72 hours of treatment, the therapeutic effect was judged according to the NIHSS score. Results There was no significant difference in NIHSS score, Fugl-Meyer score, Bathel index and GCS scores, and the levels of plasma MDA, SOD and AOPP between two groups before treatment. Compared with before treatment, NIHSS score and plasma MDA and AOPP levels in the two groups were significantly decreased after treatment, while Fugl-Meyer score, Bathel index, GCS score and plasma SOD activity were significantly increased; and the change of observation group was more significant than those of control group [NIHSS score: 9.78±3.24 vs. 13.44±2.63, MDA (mmol/L): 8.70±2.79 vs. 10.50±3.81, AOPP (μmol/L):51.10±17.81 vs. 72.60±18.71, Fugl-Meyer score: 55.68±8.38 vs. 46.25±3.92, Bathel index: 66.63±11.25 vs. 56.71±10.81, GCS score: 13.78±1.31 vs. 10.49±1.03, SOD (kU/L): 134.70±29.87 vs. 104.60±25.75, all P < 0.05]. The total effective rate of the observation group was significantly higher than that of the control group [93.3% (28/30) vs. 86.7% (26/30), χ2 = 6.119, P = 0.020]. Conclusions Mild hypothermia was effective in treating acute massive cerebral infarction. It could significantly improve the neurological function and oxidative stress of patients, improve the quality of life, and was safe and reliable.

Objective:To summarize the 10 year clinical experience of treating tibiafibular fractures with rectangle shaped intramedullary nails(RIN). Methods:From January 1987 to December 1996, 4 682 cases (3 278 male and 1 404 female) of tibiafibular fractures from 9 hospitals were treated with RIN . Three kinds of reduction methods including open reduction, semi open reduction and closed reduction were used during operation. Results:Results showed 2 173 cases (62.89%) got excellent result, 947 got good (27.40%), 214 got moderate (6.19%), 121 got poor (3.50%). The total healing rate was 90.29%. Conclusion:RIN has excellent biological characteristics which can provide a flexible interfixation when treating tibiafibular fractures, and the operation is simple, it also can be used for severe open fractures. RIN is one of the good techniques in treating tibiafibular fractures.

The effects of intramuscular or intracerebroventricular injection of penta-gastrin(PG) on the action potential amplitude (APA) of the myocardial cells and the heart rate(HR) were studied. The results were as follows:1 ) Injection of 10?g/10?l of PG into one of the lateral ventricles of the ratfailed to produce any effect on APA or HR. When the dosage of PG was doubled(20?g/10?l), then HR could be slowed down significantly (P

Objective:To investigate the value of 18F-fluorodeoxy glucose ( 18F-FDG) positron emission tomography/computed tomography (PET-CT) in predicting the epidermal growth factor receptor (EGFR) mutations in patients with lung squamous cell carcinoma. Methods:We retrospectively analyzed the clinical data and 18F-FDG PET-CT imaging data of 206 patients with lung squamous cell carcinoma confirmed by pathology and underwent EGFR mutation test in the First Affiliated Hospital of Nanjing Medical University from June 2013 to October 2018. Receiver operating characteristic (ROC) curve analysis was performed to quantify the predictive value of maximum standard uptake value (SUV max), metabolic tumor volume (MTV), total lesion glycolysis (TLG). The Chi- squared test was used to assess the difference in PET parameters. A multivariate Logistic regression analysis was performed to yield the parameters with statistic difference. Results:All of 206 patients with lung squamous cell carcinoma showed a high 18F-FDG uptake. The median of SUV max, MTV and TLG were 19.14, 37.69 cm 3 and 291.73, respectively. Among the 206 patients, EGFR mutations were identified in 14 cases, including 7 with exon 21 (L858R) mutation, 6 with exon 19 mutation and 1 with exon 20 mutation. ROC curve showed that the AUC of SUV max, MTV and TLG were 0.624 (95% CI=0.454-0.794, P=0.122), 0.892 (95% CI=0.811-0.973, P<0.001) and 0.860 (95% CI=0.768-0.952, P<0.001), respectively. The median SUV max (19.14) was used as the cutoff points due to the small value of AUC. The cutoff point of MTV was 20.09 cm 3, the cutoff point of TLG was 211.07. Univariate analysis showed that the sex, smoking history, M stage, MTV and TLG were associated with EGFR mutations (all P<0.05). Logistic multivariate analysis showed that the sex, smoking history and TLG were the independent predictors of EGFR mutation (all P<0.05). Conclusion:TLG detected by 18F-FDG PET/CT is an independent factor for predicting EGFR mutation in patients with lung squamous cell carcinoma, and has certain reference value for predicting EGFR mutation.

Objective:To investigate the value of 18F-fluorodeoxy glucose ( 18F-FDG) positron emission tomography/computed tomography (PET-CT) in predicting the epidermal growth factor receptor (EGFR) mutations in patients with lung squamous cell carcinoma. Methods:We retrospectively analyzed the clinical data and 18F-FDG PET-CT imaging data of 206 patients with lung squamous cell carcinoma confirmed by pathology and underwent EGFR mutation test in the First Affiliated Hospital of Nanjing Medical University from June 2013 to October 2018. Receiver operating characteristic (ROC) curve analysis was performed to quantify the predictive value of maximum standard uptake value (SUV max), metabolic tumor volume (MTV), total lesion glycolysis (TLG). The Chi- squared test was used to assess the difference in PET parameters. A multivariate Logistic regression analysis was performed to yield the parameters with statistic difference. Results:All of 206 patients with lung squamous cell carcinoma showed a high 18F-FDG uptake. The median of SUV max, MTV and TLG were 19.14, 37.69 cm 3 and 291.73, respectively. Among the 206 patients, EGFR mutations were identified in 14 cases, including 7 with exon 21 (L858R) mutation, 6 with exon 19 mutation and 1 with exon 20 mutation. ROC curve showed that the AUC of SUV max, MTV and TLG were 0.624 (95% CI=0.454-0.794, P=0.122), 0.892 (95% CI=0.811-0.973, P<0.001) and 0.860 (95% CI=0.768-0.952, P<0.001), respectively. The median SUV max (19.14) was used as the cutoff points due to the small value of AUC. The cutoff point of MTV was 20.09 cm 3, the cutoff point of TLG was 211.07. Univariate analysis showed that the sex, smoking history, M stage, MTV and TLG were associated with EGFR mutations (all P<0.05). Logistic multivariate analysis showed that the sex, smoking history and TLG were the independent predictors of EGFR mutation (all P<0.05). Conclusion:TLG detected by 18F-FDG PET/CT is an independent factor for predicting EGFR mutation in patients with lung squamous cell carcinoma, and has certain reference value for predicting EGFR mutation.