Basic fibroblast growth factor is one of the most important grow th factors with broad distribution and powerful bioactivities. Since it has positi vely inductive or stimulative effects on tissues, such as bone, cartilage, muscl e, vessel, and nerve, it will have extensive applications in orthopaedics in the future. The current review introduces new advances in the applications of bFGF in orthopaedics.

Objective To compare and evaluate the differences of potentialities, biological characteristics and results between periosteum transplant, cartilage transplant and subchondral bone drilling in repairing full-thickness defects of articular cartilage in weight-bearing joints, for the purpose of proposing the experimental basis for clinical application. Methods By using the repeated measure design of Latin Square, 32 adult male rabbits were divided into groups randomly based on three factors and four levels. Autologous periosteum transplant, allogenic cartilage transplant and subchondral bone drilling were applied for repairing of size-matched, full-thickness articular cartilage defects on the femoral condyle of the knees. The reconstructed tissues were observed by gross, optical and electronic microscopic view and analysed morphologically at 2, 4, 8, 12 weeks respectively. Results All of these three methods could repair the lesions by hyaline-like cartilage at 12 weeks, while the control groups were filled with fibrous tissue. The height of the repairing tissue compared with the normal cartilage and the light density data indicated that the cartilage transplant groups were better than others; periosteum transplant and bone drilling groups were better than the control groups as well. No evidence of immune rejection was observed. Based on the statistical analysis, the lesion size was not a significantly important factor for the repair. While the time was in a contrary way. Conclusion Autologous periosteum transplant, allogenic cartilage transplant and subchondral bone drilling are feasible for repairing of the full-thickness articular cartilage defects. These methods are beneficial options for clinical application, among which cartilage transplant is the best. The reconstructed tissue of subchondral bone drilling is insufficient for bigger defects.

OBJECTIVETo explore the advantages of minimally invasive expandable in surgery of lumbar discectomy and interbody fusion and internal fixation.

METHODSThe clinical data of 48 patients who underwent lumbar discectomy and interbody fusion and internal fixation from January 2010 to March 2016 was retrospectively analyzed. According to the admission queue, the patients were randomly assigned into channel group (26 cases) or traditional group (22 cases). In channel group, surgical approach of minimally invasive expandable channel was applied, and in traditional group, open posterior operation approach (including posterior lumbar interbody fusion and transforaminal lumbar interbody fusion, etc.) was applied. In channel group, there were 20 males and 6 females, aged from 43 to 74 years with an average of(56.6±5.1) years; course of disease was ranged from 4 to 22 months with an average of (6.7±1.8) months; 1 case was complicated with diabetes, 6 cases were complicated with hypertensive disease, and 2 cases were complicated with arrhythmia. In traditional group, there were 15 males and 7 females, aged from 43 to 73 years with an average of(55.9±4.6) years; course of disease was ranged from 4 to 26 months with an average of (6.2±2.1) months; 2 cases were complicated with diabetes, 5 cases were complicated with hypertensive disease, and 1 case was complicated with arrhythmia. Operation time, bleeding volume, and hospitalization time were compared between two groups and visual analogue scale(VAS), Oswestry Disability Index(ODI), bone fusion information, and complications correlated with incision were observed in two groups.

RESULTSAll 48 patients were followed up for more than 6 months. Postoperative VAS and ODI were significantly improved (<0.01), but 3 and 6 months after operation, there was no significant difference in VAS between two groups, and ODI score of channel group was lower than that of traditional group(<0.01). Operation time, bleeding volume, hospitalization time in channel group respectively were (167.3±30.2) min, (786.8±147.8) ml, (12.3±2.4) d, and in traditional group were (197.5±48.7) min, (786.8±147.8) ml, (16.5±3.8) d, there was significant differences between two groups. There was no significant difference in fusion rate and fusion time between two groups. There were 4 cases and 7 cases developed incision related complications in channel group and traditional group, respectively. The difference between two groups was significant(<0.01).

CONCLUSIONSCompared with conventional surgery minimally invasive lumbar discectomy and interbody fusion and internal fixation has advantages of less trauma, shorter operative time and better functional recovery.

objective To construct the recombinant adenovirus containing p53 up-regulated modulator of apoptosis(Ad-PUMA)and investigate its growth inhibition effect on pancreatic callCer cells in vitro and in vivo.Methodls Ad-Easy system was used to construct Ad-PUMA by recombination in E.coli.The virus was Dackaged in 293 cells and subsequently identified valid.The AsPC-1 cells were infected with AdPUMA.Before and after Ad-PUMA infection,the expression of PUMA protein wag investigated by western blot,the inhibition rate of AsPC-1 cells was examined by MTY assay.The in vivo tumor suppressive effect was detected in nude mice with human AsPC-1 xenograft.PUMA protein and the apoptosis of AsPC-1 xenograft were detected by western blot and TUNEL(terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling)method.Results In vitro,the expression of PUMA protein was increased with titer of Ad-PUMA,the proliferation of AsPC.1 cells were suppressed,significantly,and the effect was in a viral dose-dependent nlanner.In vivo,the growth in nude mice of AsPC-1 infected with Ad-PUMA was significantly inhibited with an inhibition rate of 44.2%.The expression of PUMA was significantly up-regulated,and the apoptosis index wa8 significantiv increased in tumor after Ad-PUMA infection as determined by western blot and TUNEL.Conclusion The expression of PUMA call inhibit the proliferation of pancreatic cancer in vitro and in vivo,and may be used 88 a potential tool for cancer therapy

Objective To study the relationship between the serum levels of thyroid hormone and the degree of the congestive heart failure as well as the effects of thyroxine on elderly patients with chronic severe congestive heart failure(CHF). Methods 140 cases were divided into group A (60 cases of CHF classes Ⅰ and Ⅱ) and group B (80 cases of CHF classes Ⅲ and Ⅳ) according to the NYHA classification of severity of heart failure. The group B was divided into the observation group (50 cases) and the control group (30 cases) . All patients were treated with conventional methods and thyroxine 20-40 ?g every morning was added in the observation group for 4 weeks. The serum FT 3 ,FT 4 ,TSH,HR,echocardiography and heart function were examined before and after treatment. Results ⑴ Both group A and B had lower base line serum FT 3 and FT 4 ,which were significantly lower in the group B than those in the group A 〔FT 3 : (4.22?0.61) pmol/L vs(3.07?1.10)pmol/L,P

BACKGROUND:Excessive mechanical stimulation can lead to endoplasmic reticulum stress. Endoplasmic reticulum stress plays an important role in the occurrence and development of degenerative diseases. Caspase-12 is a specific molecule of endoplasmic reticulum stress, and the intensity of endoplasmic reticulum stress can be reflected by caspase-12 expression. OBJECTIVE:To observe the expression rule of Caspase-12 in chondrocytes under the cyclic tensile stress. METHODS:Human chondrocytes were used as test subjects. After group assignment, mechanical loading system was used. The loading group and corresponding Z-ATAD-FMK inhibitor group received 2, 12, 24, 36, and 48 hours of mechanical stimulation. The blank group (0 hour) and the paired Z-ATAD-FMK inhibitor group received the same process as the loading group except the loading. After loading, cel morphology and growth were observed under the microscope. RT-PCR and western blot assay were used to detect the expression changes of caspase-12 gene and protein in each group. RESULTS AND CONCLUSION:(1) Morphological observation results demonstrated that apoptosis appeared at 2 hours after loading, peaked at 24 hours. With prolonged time, cel growth showed the trend along stress, but apoptosis weakened. It is indicated that cyclic tensile stress could make chondrocyte apoptosis. Endoplasmic reticulum stress might be activated. The model of cel s in vitro was established successful y. (2) Caspase-12 gene and protein expression showed consistent trend, and peaked at 24 hours, which showed significant differences as compared with the blank and inhibitor groups (P<0.05). (3) Cyclic tensile stress can induce chondrocyte endoplasmic reticulum stress, and affect caspase-12 expression.

[Objective]To discuss the results of the GIEBEL system in high tibial osteotomy to treat varus knee.[Method]Nineteen patients with medium varus knee were selected to be treated with osteotomy.Preoperatively,the mean varus angle was 12.29?,without deformity in other department of the knee joint.The main symptom was the pain in medial department.Accurate high tibial osteotomy with GIEBEL system fixation was performed in 31 knees of these patients.Weight-bearing extremity X-ray testing,varus angle,mechanical axle and anatomical axle were marked preoperatively and postoperatively.Joint space discrepancy between lateral and medial joint,the range of motion,Lysholm assessment and objective satisfactory survey were also performed to determine the outcome of the treatment.[Result]The mean follow-up of nineteen patients was 22 months.During this period,one case of temporary common fibular nerve paralysis occurred and healed at several days.All of the osteomy interface achieved bony healing.The corrected abnormality was 12.32?.The mechanism axle of the extremity maintained as the level just after operation during the follow-up and no degeneration of the joint space aggravated.The excellent and good rate of the treatment was 89.5%,and 84.2% of the patients expressed satisfactory for the operation.No difference of the range of motion was found before and after operation,but the Lysholm score,joint space discrepancy between lateral and medial joint and varus angle were improved after the osteotomy.[Conclusion]The GIEBEL system can fixate the bony interface of the high tibial osteotomy effectively,and possess the advantages of minimal invasion,stronger intensity and higher healing rate.

Objective To evaluate the effect of TBL (team-based learning) method in pharmacology teaching for the foreign students of clinical medicine. Methods In the course of pharmacology teaching of the foreign students of clinical medicine, TBL method was performed in the 2012-year students and tradi-tional teaching method was performed in the 2011-year students. After the teaching, students' grades in the ordinary performance, their final exam scores and their evaluation of the two teaching methods were com-pared. Graph pad 5 was used to analyze the data and the t test was performed. Results The average ordi-nary performance of the students with TBL was significantly higher than that with the traditional teaching [(84.94 ±12.66) vs. (72.30 ±4.90), P=0.000] and the final examination scores were significantly im-proved [(74.00±6.76) vs. (69.00±6.20), P=0.023]. The survey showed students were more satisfied with the TBL teaching mode than traditional teaching mode [(8.40±0.71) vs. (7.12±1.07), P=0.000]. Conclusion TBL teach-ing mode can effectively improve the pharmacology teaching effect of foreign students.

Thalidomide and its analogues ( lenalidomide and po-malidomide) are small glutamic acid derivatives with strong im- ＜br> munomodulatory effects, belonging to immunomodulatory drug ( IMiD ) class . In addition , these thalidomide analogues demon- ＜br> strate an overlapping and diverse range of biological activities, including anti-angiogenesis and anti-teratogenicity. Importantly, the IMiDs exert anticancer effects such as inhibiting tumor cell proliferation and promoting tumor cell apoptosis and play impor-tant roles especially in clinical treatment of multiple myeloma. Recently, the screening and discovery of thalidomide binding protein, CRBN provides new clues to the research of its pharma-cological mechanisms and the develop ment of new generation of ＜br> thalidomide derivatives with less toxic side effects and more anti-tumor potency. This review briefly discusses the underlying mechanism of thalidomide and their derivatives’ action and their new identified target, as well as their contribution to the treat-ment of multiple myeloma.

Objective:To investigate whether ghrelin, a novel endogenous ligand of growth hormone secretagogue receptor ( GHS-R) , was expressed in the thyroid tissues of different thyroid diseases, and its implication. Methods:The paraffin-embedded specimens of thyroid tissues from 2000 to 2004 were obtained from 57 patients with different thyroid diseases, including 5 subacute thyroiditis, 8 Hashimoto' s thyroiditis, 7 hyperthyroidism (Graves disease) , 8 nodular goiter, 5 thyroid adenoma, 3 thyroid lympho-ma, 8 papillary carcinoma, 3 follicular carcinoma, 5 medullary carcinoma and 5 undifferentiated carcinoma cases. The specimens of normal peri-adenoma thyroid tissues served as controls. Immunohistochemi-cal staining was used to detect ghrelin expression. Results:(1) ghrelin expression was undetectable in the thyroid tissues of normal control, subacute thyroiditis, Hashimoto' s thyroiditis and Graves disease. (2) ghrelin expression was also undetected in the tissues of nodular goiter, thyroid adenoma and thyroid lymphoma. (3 ) ghrelin-positive staining was found in the tumor cells of different types of thyroid carcin-moma. Five cases were positive within 8 cases in papillary carcinoma, 2 cases were positive within 3 cases in follicular carcinoma, 3 cases were positive within 5 cases in medullary carcinoma, 3 cases were positive within 5 cases in undifferentiated carcinoma. Conclusion:Ghrelin is expressed in malignant epithelial thyroid neoplasmas, but not in autoimmune or inflammatory thyroid diseases and benign nodular thyroid diseases. The results indicate that ghrelin expression may play an important role in the occurrence and development of thyroid carcinoma.