Objectives:This study was to evaluate the role of nasogastric feeding as early nutritional support in geriatric patients with brain injury. Methods:Thirty one geriatric patients with brain injury were randomly assigned to two groups,one supported with enteral nutrition(16 cases) and another with parenteral nutrition(15 cases).The serum glucose level,liver function and serum albumin levels were determined.The relative complications were recorded daily. Results:In early enteral nutrition group,there were less complications. Conclusions:The early enteral nutrition is well tolerated in the geriatric patients with brain injury.

Objective To analyse CT and MRI features of intracranial chondromas and review the literatures.9 cases of intracra-nial chondromas confirmed by operation and pathology were presented.Methods Among 9 cases,cerebral CT scan was performed in 8 cases(8/9),MRI scan in 4 cases(4/9)with spin-echo T1 WI,T2 WI,FLAIR,DWI sequences and enhanced T1 WI sequences.Results The lesions located at the skullbase in 8 cases,the dural convexity in 1 case.CT showed that the lesions were spot,strip or arc of fringe calcifications in 8 cases.MRI showed that the lesions were inhomogeneous low and moderate signal intensity on T1 WI and in-homogeneous high and moderate signal intensity on T2 WI in 4 cases(4/4).Multinodular or lobed high signal intensity was seen on T2 WI in 2 cases(2/4),coralline septal moderate signal intensity was seen on T2 WI ,which was obvious enhancement after adminis-tration of contrast medium on T1 WI in 2 cases(2/4),the envelope of the lesions was also obvious enhancement in 4 cases.Conclu-sion CT and MRI features of intracranial chondromas are marked.The MRI features of intracranial chondromas can reflect its path-ologic and histologic characteristics.

Purpose Median arcuate ligament (MAL) compression is the most common reason for celiac artery stenosis or occlusion, celiac artery compression of asymptomatic MAL is often misdiagnosed. This study aims to evaluate the multi-slice spiral CT manifestations of the celiac artery compression of median arcuate ligament. Materials and Methods CT features of 26 patients with celiac artery compression of median arcuate ligament were retrospectively studied. Eleven cases were symptomatic and fifteen cases were asymptomatic. Results In 14 cases (53.8%), the location of compression was at the level of superior 1/3 of the L1 vertebral body. There was statistic difference in location of the origin of compression between the celiac artery narrowing group and the non-narrowing group (P<0.05). CT manifestations included: narrowing of the celiac artery were observed in 26 patients on sagittal reformatted images with hollow on the anterior wall; a characteristic hooked appearance was observed. Narrowed celiac artery on the transverse images was seen in 21 patients, and a soft-tissue band extending across the anterior aspect of artery in 12 of them. Poststenotic dilatation was revealed in 20 patients. Collateral circulation was seen in 8 patients. Conclusion Multi-slice spiral CT can be helpful in demonstrating the location of celiac artery compression of median arcuate ligament and tell the characteristic imaging features.

The clinical application of arthroscopic minimally invasive treatment of shoulder joint disease technology has become a routine,and it has been widely carried out around the world.Compared with the traditional open surgery,it only needs to establish a few channels in the shoulder and then the diagnosis and treatment of the structure under the acromion and glenoid joint internal lesions can be completed through the arthroscopic technique under direct vision,of course,including local collection of pathological specimens.Shoulder arthroscopic surgery has the advantages of simple operation technique,small economic burden of patients,small tissue trauma,quick recovery and high accuracy of disease diagnosis.At present,there are two main options for shoulder arthroscopy:the beach chair position (BCP) and the lateral decubitus position (LDP).The choice of surgical position for surgeons is closely related to the intraoperative operation,the risk of complications,the efficacy of surgery,and the cost of setting the posture.Shoulder arthroscopy of these two positions have their own advantages and disadvantages:in the BCP,the surgeon gets a better anatomical operation experience,if necessary,can be converted into open surgery at any time.Without continuous traction,upper limb nerve and vascular damage caused by traction can be avoid.But the incidence of cerebral ischemic events in patients may increase in the BCP.There is also possibility of the nerve damage of the pillow small nerve,great auricular nerve,lateral femoral cutaneous nerve and other nerves.In theory the risk of air embolism in the patients will increase in the BCP,and the cost of setting the position is also higher than the LDP.While in the LDP due to the patient's forearm continuous traction,the surgeon can get a more extensive operating space,and the occurrence of cerebral ischemic events is very rare.In the treatment of anterior shoulder instability after shoulder arthroscopic surgery,there is a lower recurrence rate in the LDP.The cost of setting the position is also significantly lower than the BCP.Of course,the disadvantages of the LDP is also obvious.In the LDP,the brachial plexus and other nerves or vascular injury may increase due to the continuous traction of the forearm.Meanwhile sustained traction in the LDP is also a risk factor for thrombosis,and so on.Therefore,there is still a debate about the optimal location of the shoulder arthroscopy.Many clinicians choose shoulder arthroscopic position based on their own experience and habits.

Objective To investigate the expression levels of interferon-inducible genes (IFIT1,IFIT4,OAS1,OASL,ISG15) in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus(SLE).and the relations between these genes expression levels and disease activity are explored.Methods Sybr green dye based real-time quantitative PCR method was used to detect the expression levels (indicated as-△△Ct value) of WIT1,IFIT4.OAS1,OASL and ISG15 in 76 patients with SJJE and 54 controls.Their expression levels were compared with erythroeyte sedimentation rate (ESR),serum C reactive protein (CRP),complement C3,C4.antinuclear antibody (ANA).anti-double stranded DNA antibody.The associations between the expression levels of IFIT1,IFIT4,OASI.OASL,ISG15,ESR,CRP,complement C3,C4,ANA,anti-double stranded DNA antibody and SLEDAI scores in patients with SLE were analyzed.Results ① The expression levels of WIT1,IFIT4,OAS1,OASL and ISG15 in the SLE patients were significantly higher than those of the normal controls (P＜0.01).The expression levels of IFIT1,IFIT4,OAS1,OASL and ISG15 in active SLE patients were higher than those of inactive SLE patients (P＜0.05).The real time expression levels of IFIT1,IFIT4,OAS1.OASL and ISG15 showed positive correlations with each other (r＞0.5,P＜0.05) in patients with SLE.② The expression levels of IFIT1,IFIT4,OAS1,OASL and ISG15 were positively correlated with the SLEDAI scores (r＞0.5,P＜0.05).③ There was no correlation between ESR,CRP,complement C3,C4,ANA and the expression levels of IFIT1,IFIT4,OAS1,OASL,ISG15,SLEDAI scores except anti-double stranded DNA antibody (r＞0.5.P＜0.05).Conclusion The expression levels of IFIT1,IFIT4,OAS1,OASL and ISG15 in patients with SLE are significantly higher than those of the normal controls,and positively associated with SLEDAI scores,so they are helpful in evaluating SLE disease activity and severity.IFIT1,IFIT4,OAS1,OASL and ISG15 genes may be the potential treating targets for SLE.

Background: Replacing damaged anterior cruciate ligaments (ACLs) with tissue-engineered artificial ligaments is challenging because ligament scaffolds must have a multiregional structure that can guide stem cell differentiation. Here, we designed a biphasic scaffold and evaluated its effect on human marrow mesenchymal stem cells (MSCs) under dynamic culture conditions as well as rat ACL reconstruction model in vivo. Methods: We designed a novel dual-phase electrospinning strategy wherein the scaffolds comprised randomly arranged phases at the two ends and an aligned phase in the middle. The morphological, mechanical properties and scaffold degradation were investigated. MSCs proliferation, adhesion, morphology and fibroblast markers were evaluated under dynamic culturing. This scaffold were tested if they could induce ligament formation using a rodent model in vivo. Results: Compared with other materials, poly(D,L-lactide-co-glycolide)/poly(ε-caprolactone) (PLGA/PCL) with mass ratio of 1:5 showed appropriate mechanical properties and biodegradability that matched ACLs. After 28 days of dynamic culturing, MSCs were fusiform oriented in the aligned phase and randomly arranged in a paving-stone-like morphology in the random phase. The increased expression of fibroblastic markers demonstrated that only the alignment of nanofibers worked with mechanical stimulation to promote effective fibroblast differentiation. This scaffold was a dense collagenous structure, and there was minimal difference in collagen direction in the orientation phase. Conclusion Dual-phase electrospun scaffolds had mechanical properties and degradability similar to those of ACLs. They promoted differences in the morphology of MSCs and induced fibroblast differentiation under dynamic culture conditions. Animal experiments showed that ligamentous tissue regenerated well and supported joint stability.

Objective To investigate the correlation between the expression of the activator of HSP90 ATPase-1(AHA1),lysyl oxidase like-2 protein(LOXL2)in osteosarcoma tissues with mRNA expression of invasion and metastasis genes and their clinical significance.Methods A total of 90 osteosarcoma patients diagnosed and treated in North China Medical and Health Group Fengfeng General Hospital from February 2016 to March 2017 were selected as the research object.The expression of AHA1 mRNA,LOXL2 mRNA and invasion and metastasis genes Wnt family member 9A(Wnt9a)mRNA,zinc finger E-box binding homologous box 1(ZEB1)mRNA,zinc finger E-box binding homologous box 1(ZEB2)mRNA,N-cadherin(N-cad)mRNA,and vimentin(Vim)mRNA in tissues were detected by real-time fluorescence quantitative PCR.Pearson correlation analysis was used for correlation analysis.The differences in expression of AHA1 mRNA and LOXL2 mRNA in osteosarcoma patients among different clinical characteristics were compared.Kaplan-Meier survival analysis was used to analyze the effect of AHA1 mRNA and LOXL2 mRNA on the prognosis of osteosarcoma patients.The prognostic factors of osteosarcoma patients were analyzed by univariate and multivariate COX regression.Results The expressions of AHA1 mRNA(3.16±0.59),LOXL2 mRNA(2.84±0.44)and invasion and metastasis genes[Wnt9a mRNA(3.23±0.42),ZEB1 mRNA(2.73±0.39),ZEB2 mRNA(2.52±0.56),N-cad mRNA(2.71±0.65)and Vim mRNA(2.81±0.73)]in osteosarcoma tissues were higher than those in paracancerous tissues(1.10±0.21,0.95±0.18,0.79±0.15,0.64±0.11,0.98±0.19,0.68±0.14,0.72±0.15),and the differences were statissically significant(t=31.206,37.716,51.903,48.931,24.706,28.964,26.605,all P<0.05).There was a significant positive correlation between AHA1 mRNA and LOXL2 mRNA expression in osteosarcoma(r=0.712,P<0.05).The expressions of AHA1 mRNA and LOXL2 mRNA were significantly positively correlated with the expressions of invasion and metastasis genes(Wnt9a,ZEB1,ZEB2,N-cad,and Vim mRNA)in tumor tissue of osteosarcoma group(r=0.504～0.720,all P<0.05).The expressions of AHA1 mRNA and LOXL2 mRNA in osteosarcoma tissues with Eneeking stage Ⅲ,soft tissue infiltration,and lung metastasis were higher than those in patients with Eneeking stage Ⅰ～Ⅱ,no soft tissue infiltration,and no lung metastasis,with significant differences(t=14.122～171.054,all P<0.05).The 5-year survival rates of patients in the AHA1 mRNA high expression group and low expression group were 36.36%(16/44)and 78.26%(36/46),respectively.The 5-year cumulative survival rate of patients in the AHA1 mRNA high expression group was significantly lower than that in the low expression group(Log-rank χ2=16.081,P<0.05).The 5-year survival rates of patients with high and low expression of LOXL2 mRNA were 34.88%(15/43)and 78.72%(37/47),respectively.The 5-year cumulative survival rate of patients in the LOXL2 mRNA high expression group was significantly lower than that in the low expression group(Log-rank χ2=15.880,P<0.05).Lung metastasis(OR=1.921,P<0.05),Eneeking stage Ⅲ(OR=1.906,P<0.05),AHA1 mRNA high expression(OR=1.405,P<0.05),and LOXL2 mRNA high expression(OR=1.733,P<0.05)were independent risk factors affecting the poor survival prognosis of osteosarcoma patients.Conclusion The expressions of AHA1 mRNA and LOXL2 mRNA in osteosarcoma were increased,and they were correlated with the expression of invasion and metastasis genes,indicating they may be independent risk factors affecting the poor survival and prognosis of osteosarcoma patients.

Objective:To explore the necessity and feasibility of undergraduate tutorial system in clinical medical colleges.Methods:A questionnaire survey on the scientific research situation was conducted among 64 students from the long-term class and the base class of the Fourth Clinical Medical College of Capital Medical University from September 2015 to February 2018. The undergraduate tutorial system was tested in two classes for one year. After that, the questionnaire survey was conducted again to compare it with the system before implementation and analyze the trial situation of the tutorial system.Results:During the practice of the undergraduate tutorial system, it was found that most of the students wanted to participate in scientific research and were guided by tutors to improve their scientific research capabilities, but at the same time, it was also discovered that tutors were busy with their work and were unable to give insufficient guidance to the students. In terms of medical papers writing, from September 2015 to February 2018, 20 students in the long-term class participating in the tutorial system wrote 23 papers in total, and 9 students in the base class totally wrote 9 papers, with a significant difference ( P<0.05). From September 2015 to February 2018, 9 students from the base class wrote 9 papers, and from March 2018 to March 2019, there were 18 students from the base class who totally wrote 27 papers, with a significant difference ( P<0.05). Conclusion:It's feasible and necessary to implement the undergraduate tutorial system in clinical medical colleges.

Background: Replacing damaged anterior cruciate ligaments (ACLs) with tissue-engineered artificial ligaments is challenging because ligament scaffolds must have a multiregional structure that can guide stem cell differentiation. Here, we designed a biphasic scaffold and evaluated its effect on human marrow mesenchymal stem cells (MSCs) under dynamic culture conditions as well as rat ACL reconstruction model in vivo. Methods: We designed a novel dual-phase electrospinning strategy wherein the scaffolds comprised randomly arranged phases at the two ends and an aligned phase in the middle. The morphological, mechanical properties and scaffold degradation were investigated. MSCs proliferation, adhesion, morphology and fibroblast markers were evaluated under dynamic culturing. This scaffold were tested if they could induce ligament formation using a rodent model in vivo. Results: Compared with other materials, poly(D,L-lactide-co-glycolide)/poly(ε-caprolactone) (PLGA/PCL) with mass ratio of 1:5 showed appropriate mechanical properties and biodegradability that matched ACLs. After 28 days of dynamic culturing, MSCs were fusiform oriented in the aligned phase and randomly arranged in a paving-stone-like morphology in the random phase. The increased expression of fibroblastic markers demonstrated that only the alignment of nanofibers worked with mechanical stimulation to promote effective fibroblast differentiation. This scaffold was a dense collagenous structure, and there was minimal difference in collagen direction in the orientation phase. Conclusion Dual-phase electrospun scaffolds had mechanical properties and degradability similar to those of ACLs. They promoted differences in the morphology of MSCs and induced fibroblast differentiation under dynamic culture conditions. Animal experiments showed that ligamentous tissue regenerated well and supported joint stability.