The diagnostic core of multiple sclerosis(MS) always requires dissemination in space and time since the publication of the first criteria over 40 years ago.Though several modified clinical criterias have been proposed to diagnosis MS,no paitents must meet such condition in diagnostic criteria because of the reticular clinical manifestation of this disease.The diagnosis of MS is still based on clinical parameters including detailed history and a careful examination to exclude alternative disease.The effects of some disease modifying agents to MS have been confirmed by evidence-based medicine.But the intact treatment plan must contain aspects of acute attacks,prevention of relapses and progression,management of symptoms,and rehabilitation.The individualized treatment is needed according to the medical insurance,payment ability and other influencing factors in China.

Objective To investigate the therapeutic effect of modified S-P approach without disconnecting the rectus femoris in patients with Pipkin typeⅠandⅡfractures. Methods The clinical data of 58 patients with Pipkin type Ⅰ and Ⅱfractures were retrospectively analyzed. Among the patients, 29 patients were treated with conventional S-P approach (conventional group), and 29 patients were treated with modified S-P approach (modified group). The incision length, operation time, bleeding, visual analogue score (VAS), postoperative complications and hip joint function at the final follow-up were compared between 2 groups. Results The patients of 2 groups had not incision infection, and showed primary. X-ray of 3 months after surgery showed fracture healing. There was no statistical difference in the time of follow-up between conventional group and modified group:(16.1 ± 5.2) months vs. (15.8 ± 5.6) months, P>0.05. The incision length, bleeding, VAS 3 d and 4 weeks after surgery in modified group were significantly lower than that in conventional group:(8.1 ± 0.8) cm vs. (12.3 ± 1.2) cm, (144.3 ± 16.5) ml vs. (172.4 ± 21.6) ml, (4.5 ± 1.1) scores vs. (5.9 ± 1.5) scores and (1.6 ± 0.7) scores vs. (2.4 ± 0.8) scores, and there were statistical differences (P<0.05). There were no statistical differences in operation time, VAS 3 months after surgery, incidence of postoperative complications and excellent and good rate of hip joint function at the final follow-up between 2 groups (P>0.05). Conclusions The modified S-P approach without disconnecting the rectus femoris is a better method in patients with Pipkin type ⅠandⅡ fractures, and it has the advantages of revealing more clearly, minimal invasion, lower bleeding and slight postoperative pain.

Objective To observe the clinical effects of compound carraghenates cream on edema and pain after mixed hemorrhoid surgery. Methods 180 cases of patients with mixed hemorrhoids divided into the observation group and the control group, 90 cases in each group according to the random number table method. The control group was treated with Vaseline oil gauze to cover wounds after operation, and the observation group was treated with compound carraghenates cream after operation. The clinical efficacy, VAS pain score , the edema symptom scores and the pain relief time, edema symptom relief time, the wound healing time ,untoward effect were compared and observed after treatment between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group (95.56％ vs 85.56％) (P<0.05). The VAS pain scores of the observation group on the 1st day, 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05), and the edema symptom scores on the 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05). The time for pain relief, the time for edema relief and the wound healing time in the observation group were significantly shorter than those in the control group (P<0.05). Conclusion Compound carraghenates cream can effectively relieve edema and pain after mixed hemorrhoid surgery, and it also can shorten the course of disease and promote wound healing with safety.

[Objective]To prepare a cartilage acellular matrix scaffold and to explore its feasibility in cartilage tissue engineering. [Methods]Microparticles about 100 ?m~154 ?m were prepared after calf cartilage physically shattered and experienced gradient centrifugation,and then treated by a modified Courtman's four-step method which was improved to produce acellular cartilage matrix.After this treatment the microparticles were made into 3% suspension which was placed into moulds.With the freeze-drying method,3-D cartilage acellular matrix (CACM) was prepared.The scaffolds were cross-linked by a neotype crosslinking agent genepin for 48h,and then placed into glycine solution server times for removing redundant genepin.The freeze-drying method was used to prepare CACM.The scaffolds were investigated by gross observation,histological staining (haematoxylin-eosin,toluidine blue) ,scanning electron microscope (SEM) observation and porosity measurement,water absorption rate and degradation rate analysis.After being cultivated for ten days,bone marrow stranal cells (BMSCs) of rabbit were seeded into the scaffold.MTT test and SEM were done to assess the growth and proliferation of BMSCs.[Results]Gross observation showed the scaffolds had a loosely porous and dark blue appearance after being cross-linked by genepin.The histological staining (haematoxylin-eosin,toluidine blue staining) showed that there were no chondrocyte fragments in the scaffold.The CACM scaffold had 90% porosity,(1314?337) % water absorption rate,and (13.69?7.3)% or (25.99?8.9) % degradation rate at 2 or 4 weeks.MTT test showed that BMSCs grew well in the 3-D CACM scaffolds of logarithmic trend,supporting that the scaffolds had no cytotoxic effect on BMSCs.SEM micrographs indicated that the scaffolds were porous and the cells covered the scaffolds firmly with cell processes.[Conclusion]The improved Courtman's four-step method makes a more thoroughly acellular scaffold.The 3-D CACM scaffold retains most of extracelluar matrix.After being cross-linked by genepin,the 3-D CACM scaffold has good biocompatibility and degradation rate of the scaffolds is decreased,which makes it a suitable carrier for cartilage tissue engineering.

ObjectiveTo analyze the symmetry of multifocal visual evoked potential (mfVEP) between both eyes in normal subjects. Methods The monocular mfVEP of both eyes in thirty-six normal subjects (72 eyes) was tested with VERIS Science 4.0. The stimulus was the pattern reversal dart array consisted of 60 sectors each included 16 black-white reverse patterns. The visual stimulation was controlled by the binary pseudo-random m-sequences and subtended approximately 25 degrees. Results There existed no statistically significant difference of P1 latencies and amplitudes between correspondent quadrant visual field of both eyes. The data difference of the ipsilateral quadrant visual fields was greater than those of the correspondent quadrant visual field. The comparison among four quadrant visual fields in right eye or left eye each showed that there was statistically significant difference of P1 latencies between the superionasal quadrant visual field and inferiotemporal or inferionasal quadrant visual fields. Conclusions The symmetry of normal mfVEP is more dominant in retina than that in visual cortex.

[Objective]To compare the purity and extraction rate of four purecollagen type I products prepared from various biomaterials by a limited enzyme digestion method for the use in tissue engineering.[Method]Bovine cortical bone, bovine achilles tendon, porcine achilles tendon and porcine skin were splitted into pieces of 0.2-0.5 mm. After being immersed in glacial acetic acid, they were extracted with pepsin. Then the crude products were dissolved, centrifuged, dialyzed and freeze drying to prepare pure collagen type I. The final products were confirmed by absorbance, amino acid analysis and'SDS-PAGE electrophoresis comparing them with the products of Sigma Company.[Result]The wave length of maximum absorbance of the final products was 230 nm, and the amino acid analysis and SDS-PAGE electrophoresis confirmed that the final products were collagen type I. The purity of product extracted from bovine cortical bone was the highest (96.12%) and higher than that from Sigma Company. The extraction rate of bovine achilles tendon collagen was the highest (75.34%).[Conclusion]Collagen type I of higher purity and higher extraction rate can be prepared using a limited enzyme digestion method.And the product from bovine cortical bone is better than the others,which has a promising prospect.

[Objective]To observe the biological properties of a novel collagen/hydroxyapatite composite scaffold in vitro and to evaluate the possibility of application being used in tissue engineering for osteochondral repair.[Method]The scaffolds were constructed of collagen I and hydroxyapatite.The pore size and interpores of the scaffold were observed by scanning electronmicroscopy(SEM).The porosity was measured by liquid displacement method.Rabbit bone marrow stromal cells(BMSCs) were isolated and amplified,then inoculated onto the scaffold.By SEM scanning,the condition of the cells adhering onto the scaffold was observed.The proliferation of the cells on the scaffolds was examined using MTT method,and the growth curve was drawn.[Result]The scaffold possessed high porosity and proper pore size.The pore diameter of the collagen layer was about 90?m,the pore diameter of the HA layer was about 120?m,and the overall porosity of the composite scaffold was 75%.The proliferation of the cells on the scaffold was good.[Conclusion]The novel collagen/hydroxyapatite composite scaffold possesses desirable pore structure and good biocompatibility,and it can be used in tissue engineering for osteochondral repair.

0.05).[Conclusion]The osteochondral scaffold of the collagenⅠ-sodium hyaluronate-fbrin glue tri-copolymer scaffold bonding with antigen-extracted bovine cancellous bone has an appropriate structure and a good biocompatibility,which makes it a useful scaffold in the osteochondral tissue engineering.

Objective To investigate the characteristics of multifocal visual evoked potential (mf-VEP) in healthy individuals, and provide normal reference values for its clinical application. Methods The mf-VEP of 37 healthy individuals (70 eyes) were examined by VERIS Science TM 4.0. The visual stimulus was a dart board with patterns consisted of 60 patches spanning a 25? visual field. The length of m-sequence was 2 14-1. The results were recorded by bipolar occipital straddle. The signal was amplified 100 K and was put through a band-pass filter between 3 and 100 Hz. The first slice of the second order kernel was analyzed by VERIS software. The summed responses of fields with different stimulus were analyzed and compared according to different ages, genders and eyes. Results The latencies and response densities of amplitude had statistically significant differences both in dimidiate and quartered field(P 0.05). Conclusions The mf-VEP of healthy individuals can reflect the VEP at different field locations objectively with its specific physiological characteristics, which may provide normal reference values for its clinical application.

OBJECTIVE:To provide reference for investigating the disease burden of diabetic patients and promoting rational drug use. METHODS:Open-ended questionnaires were adopted to survey the willingness to pay(WTP)of some diabetic patients in Sichuan Provincial People’s Hospital and collect the data about personal information,health status,the affordability of disease and WTP,the data was sorted with Excel (version 2013) software by two operators and analyzed with SPSS 17.0 software by step-wise multiple linear regression to explore the influential factors of WTP values. RESULTS:Totally 120 questionnaires were sent out and 106 were effectively received with effective rate of 88.3%. The average age of respondents was (59.9 ± 13.9) years old,the average body mass index (BMI) of respondents was (24.5 ± 0.5) kg/m2,the highest proportion of monthly diabetes fees was no more than 300 yuan,followed by more than 300-500 yuan and more than 500-1 000 yuan;the awareness rates of fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PG) and glycated hemoglobin (HbA1c) were 95.3%,86.8% and 68.9%,respectively;and patients with more than 2 complications accounted for 29.5%. The WTP values of respondents to the complete recovery of HbA1c,FPG and 2 h PG were 1 604.1,1 617.9 and 1 683.7 yuan/month,the median values were 1 000 yuan/month;the WTP values of respondents to the 10% recovery were 867.4,908.5 and 877.9 yuan/month,the median values were 500,575 and 510 yuan/month,respectively. The influential factors with positive effects and significant differences on WTP values in step-wise multiple linear regression were total annual household income,complications,hospital experience,family history of di-abetes,diabetes mental status and cost of diabetes in the past months;those with negative effects and significant differences on WTP values were age,FPG level and education level. CONCLUSIONS:Diabetic patients,particularly,with peripheral neuropa-thy,high blood lipids or diabetic foot have higher WTP value,which shows they hole heavier mental burden and disease burden than others. Patients recovered 10% percent were closer to actual treatment state,which better show the influential factors of WTP values actually,and patients with a family history of diabetes,depressed mood,higher fees in the average monthly cost,and hospi-tal patients have higher WTP values.