BACKGROUND:Bio-Gide col agen membranes show a good biocompatibility with stem cells. But the research on the osteogenetic differentiation of bone marrow mesenchymal stem cells cultured on the Bio-Gide col agen membranes is rarely reported. OBJECTIVE:To observe the effect of Bio-Gide col agen membranes on the proliferation and the osteogenetic differentiation of bone marrow mesenchymal stem cells. METHODS:Bone marrow mesenchymal stem cells from rabbits were isolated and cultured by using the whole bone marrow adherence method in vitro. Passage 3 bone marrow mesenchymal stem cells were selected and seeded on the Bio-Gide col agen membrane pretreated petri dish (experimental group) and simple petri dish (control group). The proliferation of bone marrow mesenchymal stem cells was detected by cellCounting Kit-8 at 1, 4, 7, 14 days. The supernatant of the cells cultured in osteogenic differentiation medium were col ected to detect the activity of alkaline phosphatase at 1, 4, 7, 14 days. RESULTS AND CONCLUSION:The number of bone marrow mesenchymal stem cells in the two groups was increased with the increasing time, and the control group had more cells than the experimental group at 7 days (P<0.05). There was no significant difference between the two groups at other time points. The alkaline phosphatase activity was increased with the increasing culture time, and the experimental group had a higher activity than the control group at 14 days (P<0.05). There was no significant difference between the two groups at other time points. Experimental findings indicate that Bio-Gide col agen membranes can promote the proliferation and the osteogenetic differentiation of bone marrow mesenchymal stem cells.

Objective To discuss the clinical value of procalcitonin (PCT) in guiding antibiotics use in children with severe diseases. Methods The clinical data of patients admitted to intensive care unit from January 2012 to July 2012 were retrospectively analyzed. The patients without antibiotics use before admission and with procalcitonin level less than 0.5 ng/ml on admission were selected. The body temperature, infection indicators and prognosis were compared between patients with and without antibiotics use during hospitalization. Results There was no difference in body temperature, PCT, C-reactive pro-tein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) on admission between patients with and without antibiotics use during hospitalization. The PCT level was increased signiifcantly (P<0.05) on the day of starting the an-tibiotics when compared with that on admission in 60 patients while there was no change in the levels of WBC and CRP. Com-pared with the day of starting the antibiotics, body temperature declined (P<0.05) and PCT level in 56 patients reexamined was decreased (P<0.05) at 3 days after antibiotics use. Two hundred and eleven patients (98.14%) had favorable prognosis. Conclu-sions Monitoring PCT can guiding the clinical use of antibiotics.

Objective To compare the clinical results of endovenous laser treatment(EVLT),radiofrequency endovenous occlusion(RFO)and conventional stripping combined with transilluminated powered phlebectomy(TIPP)for lower extremity varicose vein.Methods From Jun 2004 to Jan 2007,200 cases(232 limbs)were treated by EVLT with TIPP,80 cases(88 limbs)by RFO with TIPP,and 180 cases(202 limbs)by conventional stripping with TIPP.Operation time,number of the incision made,intraoperative bleeding,postoperative hospital stay,complications,and one-year recurrence rate were compared with each other. Results Operation time was longer(41±8)min in RFO group than that in other two groups.Postoperative hospital stay was shorter in EVLT group(1.2±0.4 d)and RFO group (2.1±0.8 d)than that in stripping and TIPP group(P＜0.05).Patients in stripping group also suffered from more intra-operative bleeding more often incidental nervus saphenus injury and more incision numbers when compared with other two groups(P＜0.05).There was no significant difierence in one-year recurrence rate among patients in the three groups. Conclusions The clinical efficacy is almost the same among the three groups in terms of eradication of the varicose veins.EVLT and RFO are safe and minimal invasive for the treatment of lower extremity varicose vein.

Objective To detect the expression of miR-10b in hepatocellular carcinoma (HCC) tissue samples,and to explore its association with clinicopathologic features.Methods qRT-PCR analysis was used to detect expression of miR-10b in 58 HCC tissues (Among them,32 cases were diagnosed with metastasis by pathological analysis,26 cases without metastases at the time of resection) and 10 normal liver tissues.Statistical analysis was used to determine the association of miR-10b expression with clinicopathologic features and prognosis of patients.Results miR-10b was up-regulated both in metastasis-free and metastatic HCC tissues,but its up-regulated degree was much more significant in metastatic HCC tissues (P＜0.05).High miR-10b expression was strongly correlated with the metastasis (P＜0.01) and AJCC stage(P=0.016).But it was not correlated with age,gender,hepatitis B,cirrhosis,tumor size,degree of differentiation,and tumor number.Patients with high miR-10b expression had significantly poorer overall survival(P＜0.01).High miR-10b expression was independent prognostic factors for overall survival (P=0.016).Conclusions The expression of miR-10b is highly up-regulated in HCC tissues,especially in metastatic HCC tissues,indicating that high miR-10b expression may be involved in the process of metastasis and is expected to become a new prognosis reference of HCC.

Objective To discuss the signiifcance of serum albumin level in assessing severity, progress and prognosis of sepsis in children. Methods The clinical data of 212 patients diagnosed with sepsis admitted to PICU from February 2010 to July 2010 were retrospectively analyzed, and 52 patients had severe sepsis and 31 patients had septic shock. Meanwhile, 110 non-sepsis patients were selected as controls. The relationships of hypoalbuminemia with pediatric critical illness score (PCIS), pediatric risk of mortality III (PRISM III) and prognosis were evaluated, and the change of albumin level in patients with dif-ferent severity of sepsis was observed. Relative factors analysis of albumin level ≤25 g/L was performed. Results As the serum albumin level was decreased, the PCIS was signiifcantly decreased while the PRISM III was increased (P<0.01). The se-rum albumin level was signiifcantly different among children with septic shock, severe sepsis and sepsis and controls (F=13.938, P=0.000). The results of relative factors analysis showed that sepsis children with an albumin level≤25 g/L had more organ failures, higher mortality, longer hospital and PICU stay and more likelihood for ventilator support (P<0.01). Lower albumin levels were accompanied with lower rates of recovery and improvement but higher mortality (rs=-0.161, P=0.000). Conclusions Hypoalbuminemia can be used as indirect indicator for severity of infection. The albumin level≤25 g/L indicated the severity of illness and prognosis in children with sepsis.

Objective To observe the effects of angiotensin Ⅱ( Ang Ⅱ) blockade on renal function, renal blood flow and renal oxygen consumption in chronic renal failure ( CRF) rats induced by 5/6th kidney ablation /infarction (5/6A/I).Methods Sprague-Dawley rats were randomly divided into 3 groups:the normal group (group A, n =14), mod-el group (group B, n=14) and angiotensin II blockade (Cozaar with Monopril) treatment group (group C, n =14).The chronic renal failure ( CRF) rat models were induced by 5/6th kidney ablation/infarction.The tail artery systolic pressure (SBP), diastolic blood pressure (DBP) and tail vein serum creatinine (Scr), blood urea nitrogen (BUN), hemoglobin ( Hb) and creatinine clearance rate ( Ccr) were assessed before and after intervention.The course of treatment was sixty days.The renal blood flow ( RBF) , blood gas analysis of abdominal aortic and renal vein, left renal vein pressure ( RV-pO2 ) were detected and remnant renal oxygen consumption ( QO2/TNa ) was calculated, and the pathological changes of remnant kidney were observed after the 60 d intervention.Results (1) Compared with the group A, the levels of Scr, BUN and tail artery SBP, DBP were significantly increased ( P<0.01 for all) , and the levels of Ccr and Hb were signifi-cantly decreased ( P<0.01) in the groups B and C, demonstrating the successful modeling.(2) Compared with the group B, the levels of Scr, tail artery SBP, DBP and QO2/TNa were significantly decreased (P<0.01 for all), the levels of BUN were decreased (P<0.05), the levels of Hb, Ccr and RVpO2 were significantly increased (P<0.01 for all), the level of RBF was increased ( P<0.05) in the group C after intervention.(3) The histopathological examination of the remnant re-nal tissue showed that the pathological changes in the group C were apparently reduced, better than those of the Group B. Conclusions Angiotensin II blockade can increase RBF, reduce renal oxygen consumption, improve renal function, and reduce the renal pathological changes in CRF rats.The mechanism of renal protection may be related to the regulation of cellular energy metabolism and improvement of renal oxygen consumption.

Objective To investigate the clinical outcomes in the treatment of complex acetabular fractures through a single supra-ilioinguinal approach after the application of preoperative 3D printing and rapid prototyping simulating the operative procedure.Methods From January 2013 to January 2016,24 cases of complex pelvic and acetabular fractures in our hospital were retrospectively analyzed.Among them 18 cases were male and 6 were female.The average age was 39.2+±13.8 years (range,24-68 years).According to Letoumel-Judet's classification,there were 6 cases of transverse,4 cases of T shaped,4 cases of combined anterior column and posterior hemi-transverse (ACPHT) and 10 cases of 2-column fractures.The time from injured to operation averaged 9 days (range,4-18 days).Before operation,pelvic AP view,three-dimensional CT as well as CTA of iliac blood vessels was taken routinely in all cases.The CT and CTA scan data were then imported into Mimics software for 3D reconstruction.Surgical simulation and optimal placement of internal fixations were performed on computer.After that,the individual simulated model of the pelvis was printed by the use of 3D printing and rapid prototyping technique.The order of reduction,selection and optimal position of the implants were determined.The plates were bent before operation and the length and direction of the screws were recorded.A uniform supra-ilioinguinal approach was used in all cases.Results The length of incision averaged 9 cm (range,8-13 cm).The operative time average 130 min (range,90-220 min).The blood loss averaged 600 ml (range,300-1 500 ml).Once a satisfactory reduction was obtained,single placement of the plates was achieved.In accordance with the preoperative plan,the plates were perfectly fitted to the bone surface.The 24 patients were followed for an average time of 18.3 months (range,15-30 months).The fractures healed in all cases.The average healing time was 4.2 months (range,3-6 months).According to Matta criteria,there were 16 cases of excellent,6 cases of good,2 cases of poor and the excellent rate was 91.7％ (22/24).The average modified Merle d'Aubigne score was 16.5 (range,13-18).The functional outcome was excellent in 13 cases,good in 6 cases and poor in 5 cases.The excellent rate of hip functions was 79.2％ (19/24).There were 2 cases of femoral lateral cutaneous nerve injury (recovered one month later) and another 1 case of fat liquefaction of the incision happened three days postoperatively (the wound healed completely after several dressing changes).No inguinal hernia or abdominal wall hemias was found.No other postoperative complications was found.Conclusion The application of 3D printing and rapid prototyping technique allows preoperatively simulating reduction in vitro,determining the optimal position of the implants,bending the plates and measuring the length of the screws in advance,which could largely reduce the operative time,intraoperative blood loss and occurrence of postoperative complications.Adopting supra-ilioinguinal approach for the treatment of complex acetabular fractures with a small incision and less trauma,a full exposure could be obtained,so the reduction and fixation of the anterior,posterior and middle column (also named pubo-ischiatic column) could be completed in a direct visualization,resulting in a satisfactory clinical outcomes.

OBJECTIVETo study the immunohistochemical classification and prognosis of diffuse large B-cell lymphoma (DLBCL).

METHODSA total of 148 cases of DLBCL were classified into germinal center B-cell-like (GCB) and non-GCB/activated B-cell-like (ABC) subtypes by Hans, Choi and Tally immunohistochemical stain algorithms. The clinical features and survival data of GCB and non-GCB/ABC subtypes were compared. Multivariate analysis about clinical features and results of immunohistochemical stain algorithms was carried out by using Cox regression, with overall survival as the outcome.

RESULTSThe prevalence of GCB subtype was significantly lower than that of non-GCB/ABC subtype, as classified by whichever algorithms in the 148 DLBCL cases studied. The prevalence of GCB subtype by Tally algorithm was lowest. The prevalence of GCB subtype (19 cases, 16.7%) was also significantly lower than non-GCB/ABC subtype (95 cases, 83.3%; P = 0.000 1) in the 114 (77.0%) concordant cases by the three algorithms. There was no difference between GCB and non-GCB/ABC subtypes by the three algorithms in five-year overall survival rate and survival curve of the 80 DLBCL patients with follow-up data available (P > 0.05). Primary gastric DLBCL tended to show a higher prevalence of GCB subtype, a better five-year overall survival rate and survival curve than the other groups. Multivariate analysis showed that patient age (HR = 1.036, P = 0.001) and tumor stage (HR = 1.997, P = 0) were also significantly adverse predictors of overall survival.

CONCLUSIONThe Hans, Choi and Tally immunohistochemical stain algorithms cannot effectively classify Chinese DLBCL into different prognostic subtypes. Primary gastric DLBCL has different immunophenotype and outcome, as compared with DLCBL in other sites.

B-Lymphocytes ; pathology ; China ; Humans ; Immunophenotyping ; Lymphoma, Large B-Cell, Diffuse ; classification ; diagnosis ; Lymphoma, Non-Hodgkin ; diagnosis ; Prognosis ; Stomach Neoplasms ; diagnosis ; Survival Rate

This study explores the application effect of the case-based teaching method based on Xuexitong learning platform in the online teaching of Digestive System, and analyzes the learner's emotional experience, learning behavior, and learning effect in the case-based online teaching. The results of the study show that the case-based online teaching model based on Xuexitong learning platform improves students' online learning interest, and the students have good emotional experience, high learning enthusiasm, good classroom interaction, enhanced self-learning ability before and after class, and good learning effect. In addition, precise teaching can be used for individual students who are not enthusiastic about online learning.

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.