Hybrid operating room is used and spread in China with the development of medical equipment and the integration of medical technology. As a new equipment and advanced technology, it faced some questions and challenges on its construction and development. We analyzed the definition, classification, construction and use which combined the development history and clinical application, and proposed some suggestions on how to strengthen the development and construction of hybrid operating room.

Background Streptozotocin (STZ)-induced type 1 diabetic model is an acceptable model and is often used to the study of diabetic retinopathy (DR).However,the model is often established using retinal digest preparation in vitro in albino rats,and therefore it is difficult to evaluate the change of retinal vessels by fundus fluorescein angiography (FFA) in vivo.Recently,pigmented rats are being used as the DR model.But the study on the comparison between albino rat model and pigmented rat model is seldom.Objective This study was to observe and compare the manifestations of FFA and retinal digest preparation in early diabetic pigmented diabetic rat and albino diabetic rat,and to select the right model of DR using FFA.Methods Type 1 diabetic models were induced in 15 six-week-old health male BN rats and 15 six-week-old health male SD rats by the injection of STZ (55 mg/kg) via tail vein.The models were thought to be successful in the rats with the blood glucose level ≥ 16.7 mmol/L.The right eyes of the rats were extracted 6 weeks after injection of STZ.Lens were examined by slit lamp microscope.Retinal vascular changes were examined by fundus photography,FFA and periodic acid Schiff staining of retinal digest preparation.The manifestations of FFA and retinal digest preparation were contrasted between BN rats and SD rats.The number of eyes with lens opacification was compared by Chi-square test and the ratio of vascular endothelial cells and perithelial cells (E/P) was compared between BN rats and SD rats.The use and care of experimental animals complied the Statement of Ethic Committee of Tianjin Medicine University.Results Six weeks after injection of STZ,11 BN rats and 10SD rats were included in this study.The blood levels were (24.73±2.98) mmol/L and (22.36±3.65) mmol/L in BN rats and SD rats,respectively,without significant difference between the 2 types of rats (t =7.873,P＞0.05).Lens opacification occurred in 6 BN rats and in 5 SD rats (P=0.717).FFA showed the clear retinal vascular under the brown background.Evident vessel disorder and fluorescence leakage like background stage of DR were seen in 9 eyes.However,in the SD rats,retinal vessel abnormality could not exhibited owing to the interference of choroid fluorescent light from choroidal vessels and vortex vein.Retinal digest preparation exhibited that unevenness of vessel diameter,decrease of perithelial cells and increase of endothelial cells in both types of rats.The E/P values were 11.50±3.68in the BN rats and 12.86±3.94 in the SD rats,without significant difference between them (t=9.785,P＞0.05).Conclusions The abnormality of fundus vascular morphology can be better displayed in pigmented diabetic rats than albino rats by FFA in vivo.

Objective To observe the survival of human umbilical cord derived mesenchymal stem cells (hUC-MSCs) after injection into the vitreous of rabbits,and the animal safety under those procedures.Methods Twenty-seven pigmented rabbits were randomly divided into 3 groups (intravitreal injection 1 week group,2 weeks group and 4 weeks group),each with 9 rabbits.For each animal the right eye was the experimental eye receiving hUC-MSCs injection,while the left eye was the control eye receiving cuhure medium.The rabbit eyes were examined by slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fundus fluorescence angiography(FFA)and Tono-pen tonometer before and after injection.hUC-MSCs were labeled by CM-Dil in vitro,and their survival status was measured by eonfocal fluorescence microscopy,light microscope and transmission electron microscope at 4 weeks after injection.Results Four weeks after injection,a large number of the hUC-MSCs were still alive in the vitreous cavity.The overall condition of those rabbits was good.The anterior segment and retina of experimental eyes were normal,without hyperfluorescence,hypofluorescenee and leakage in the retina at 1,2 and 4 weeks after injection.There was no significant difference on lOP before and after injection at different time points (P>0.05),and no obvious changes at cornea,anterior chamber angle,lens,retinal structure by.light microscope and transmission electron microscope examination.Conclusion hUC-MSCs can survive in the rabbit vitreous for four weeks;intravitreal injection of hUC-MSCs was safe and feasible.

BACKGROUND:Studies have found that Wudi Dan can suppress local inflammatory response of the lesioned joints to protect the articular cartilage. OBJECTIVE:To verify the effect of Wudi Dan on chondrocyte viability and apoptosis as wel as the therapeutic effect on osteoarthritis. METHODS:Rat chondrocytes were cultured in serum medium containing Wudi Dan, and the effects of Wudi Dan on cel viability and apoptosis were observed by comparison with the control group. Rabbit model of knee osteoarthritis was constructed using modified Hulth method. Rabbit models were divided into two groups:Wudi Dan group treated with Wudi Dan and control group treated with normal saline, twice a day, consecutively for 4 weeks. Therapeutic effect of Wudi Dan on knee osteoarthritis was observed;cel viability and apoptosis were observed under microscope;the levels of interleukin-1 and matrix metal oproteinase-3 were determined using immunohistochemical method. RESULTS AND CONCLUSION:The apoptotic rate of chondrocytes was significantly lower in the Wudi Dan group than the control group. Pathological findings of the rabbit knee joints showed that the control group had more severe damage to the articular cartilage than the Wudi Dan group. Immunohistochemical staining revealed that in the Wudi Dan group, the cytoplasm and extracel ular matrix were colored light and there were a smal number of positive cel s as wel as low expression of interleukin-1 and matrix metal oproteinase-3. The results suggest that Wudi Dan can effectively protect against articular cartilage lesions, reduce inflammation, and have a good therapeutic effect on osteoarthritis. Its mechanism may be related to inhibition of chondrocyte apoptosis, reduction of cytokine production and inhibition of protein expression of matrix metal oproteinase.

Objective To analyse the clinical features,imaging characteristics diversity of deep cerebral veins thrombosis (DCVT).Methods From 2004 to 2013,6 patients diagnosed as DCVT were recorded and a retrospective review of the cases were undertaken for the purpose of this analysis.Results Among the 6 patients with DCVT,4 were male and 2 were female,aged from 28 to 69 years old.The disease duration of 4 cases ranged from 2 to 7 days,remnants were 20 days and 3 months respectively.The first symptoms of 4 cases were headache,1 was feeblemindedness,and the other was hemiplegia.The secondary symptoms were disturbance of consciousness,apathy,diplopia and non-infectious fever.Non-contrast computed tomography showed low signal in the bilateral thalamus in four patients,high signal in the transverse sinus and straight sinus in one patient and high signal in torcular in one patient.Abnormal signal was found in bilateral thalamus on magnetic resonance imaging in all patients and some of them had abnormal signal in the mesencephalon or basal ganglia.The patients were definitely diagnosed as DCVT by magnetic resonance venography (MRV) or digital subtraction angiography (DSA).Among them,2 patients were confirmed by brain biopsy.Four patients were followed up with good outcome and 2 were lost to follow-up.Conclusions The clinical manifestations of DCVT are not specific.For acute-onset DCVT patients,the first symptoms are always headache and vomiting,while the main symptoms are declined cognition and slow reaction for chronic-onset ones.Along with the progress,the main symptoms of DCVT are disturbance of consciousness,psychiatric symptoms and intracranial hypertension.Changes in the bilateral thalamus and basal ganglia are especially main characteristics which are easily misdiagnosed as brain tumor according to the images.DCVT can be definitely diagnosed by no signal of deep cerebral veins on MRV or DSA.

Objective To evaluate the viability of adipocytes after they are subjected to different compressive stress in vitro for improvement of autologous fat graft and its clinical application.Methods Fat grafts were harvested from healthy patients who underwent liposuction for body contouring.Then the fat grafts were randomly divided into 5 experimental groups,including control group without any compressive stress,and continuous compressive stress groups (0,25,50,75,and 100 kPa),and the glucose transport test was performed at days 1,2,3 and 4.An MTT assay was also performed after 4 days with continuous compressive stress in each group with the same experimental protocol for control.Routine histological examination was done in all groups to examine possible structural destruction after compressive stress.Results As compared with the control group,the glucose transport test showed transported glucose concentration decreased with an increase in compressive stress in all of the other four groups (P＜0.01),and this effect would increase with action time.MTT assay showed absorbance (A492nm) also decreased with an increase in compressive stress in four days (P＜0.05),the similar fndings of MTT assay on the viability of fat grafts in all five groups and correlated with the glucose transport test (r=0.838,P＜0.01).Histology showed significantly distorted and fractured adipocytes and cell injury rate was to raise with an increase in compressive stress.Conclusions Our study demonstrates the harmful effect on the viability of fat grafts with an increase in compressive stress and therefore we should reduce this effect in clinical application of fat grafts.

Objective To investigate the tellurite resistance level,the presence of tellurite resistance (ter) gene cluster and their relationships in non-O157 Shiga toxin-producing Escherichia coli(STEC) isolates.Methods Tellurite resistance level was evaluated by plate dilution method and the ter gene cluster was tested by PCR.Results Only 5 of 39 non-O157 STEC isolates tested in this study were identified to have ter gene cluster,which showed relatively high levels of tellurite resistance ranging from 128 μg/ml to 512 μg/ml.In contrast,the other 34 isolates without ter gene cluster were sensitive to potassium tellurite and showed very low levels of tellurite resistance,the minimal inhibitory concentration (MIC) was ＜1 μg/ml for 29 isolates,8 μg/ml for 2 isolates and 2 μg/ml for 3 isolates.Conclusion Most non-O157 STEC isolates were sensitive to potassium tellurite.It could be concluded that much attention should be paid when screening the non-O157 STEC isolates using the selective medium supplemented with potassium tellurite.

Objective To study the therapeutic mechanism of Polygonum cuspidatum extract on the gouty arthritis induced by monosodium urate (MSU). Method Acute gouty arthritis rats model was induced by MSU. Twelve hours after modeling,the positive expression area and integral optical density of intercellular adhesion molecule-1 (ICAM-1) and nuclear factor-?B p65 protein (NF-?Bp65) in synovial membrane were observed by immunohistochemical assay. The effect of Polygonum cuspidatum extract on ICAM-1 and NF-?Bp65 was observed. Results There existed less expression of ICAM-1 and NF-?B p65 protein on synovial membrane in the normal group,and their expression was much increased in the model group. Polygonum cuspidatum extract in the dose of 360 mg/kg significantly reduced the positive expression area and integral optical density of ICAM-1 and NF-?Bp65 protein. Conclusion Polygonum cuspidatum extract can inhibit the abnormal expression and activation of ICAM-1 and NF-?Bp65 in synovial tissue,which may be an important therapeutic and preventive mechanism for gouty arthritis.

Objective To investigate the diagnostic value of diffusion-weighted imaging (DWI) in ovarian cystic or solid lesions with different b values.Methods 95 patients,total 105 lesions,including 61 benign lesions (53 cystic,19 solid) and 33 malignant lesions (10cystic,23 solid) with ovarian cystic or solid lesions underwent traditional MRI and DWI.The scan sequence of DWI was SE-EPI,with the b values of 0,500,1 000 s/mm2.The contrast to noise ratio (CNR) was calculated to evaluate the image quality.The apparent diffusion coefficient (ADC) value and exponent apparent diffusion coefficient (eADC) value of ovarian masses were measured.Results With the increase of b values,the signal and CNR of ovarian masses was decreased,and the intensity of cystic component was sharper than that of solid component.There was no signifi cant difference of the ADC values and eADC values between the benign and malignant ovarian cystic masses (P＞0.05).But the results had significant difference between the benign and malignant ovarian solid masses (P＜0.05).Conclusion Quantitative analysis of ADC and analysis the characteristic of CNR will help the differential diagnosis of some benign and malignant ovarian diseases.