BACKGROUND:. Growth factor starts a new epoch of the research and application of wound healing, and the effect of the combination of Chinese tradition medicine and biomedicine in wound healing is still in the discussion.OBJECTIVE: To observe the effect in promoting wound healing of rats with bletilla colloid, a Chinese herbal medicine, as a carrier of exogenous high molecular weight nerve growth factor (HMW-NGF).DESIGN: The single sample observation was adopted in the identification of activities of HMW-NGF; The randomized control experiment with animal as subjects was adopted in the observation of the effect of the HMW-NGF mixed with the bletilla colloid as a carrier in promoting wound healing.SETTING: Department of Orthopaedics, Shenzhen Buji People's Hospital,and Department of Orthopaedics, Tongji Hospital Affiliated to Huazhong University of Science and Technology.MATERIALS: Forty SD rats aged 90-120 days of either gender were employed, with the body mass of 220-280 g; The freeze dried preparation of cattle seminal fluid with HMW-NGF with 1mg each.METHODS: From September 2001 to December 2004, the experiment was carried out in the Department of Orthopaedics in Shenzhen Buji People's Hospital and Central Laboratory of Department of Orthopaedics in Tongji Hospital Affiliated to Huazhong University of Science and Technolcolloid, HMW-NGF, HMW-NGF+ bletilla colloid were added into the serum-free medium (SFM), and the influences of them on the dorsal root lected and divided into 4 groups with 10 rats in each group. The rats of normal control group had no medicine on the wound. In the bletilla colloid group, the HMW-NGF group and the HMW-NGF+bletilla colloid group, incision size 2 cm was made at the back of each rat, and bletilla colloid,HMW-NGF, HMW-NGF+ bletilla colloid were applied respectively on the wound, once per day. The wound area was measured at day 3 and 10 after treatment, and the wound area was calculated by the image analysator. The category and the quantity of the emigrated cells were observed with light microscope, and the healing time of the wound was observed.tion under light microscope.the DRG of chick embryo was cultured, the reaction of evection growth around the ganglion in the HMW-NGF, HMW-NGF+ bletilla colloid with the dilution desity of 1:106-1: 108 was most significant, which was not seen in healing with HMW-NGF + bletilla colloid was significantly increased as compared with that in normal control group, the bletilla colloid group and the The healing time of the wound of the normal control group, the bletilla colloid group and the HMW-NGF group and the HMW-NGF+ bletilla colloid group were (19.5±0.7), (17.3±0.6), ( 16.6±0.7 )and ( 14.9±0.4 ) days respecvation of cut sheets 3 days after treatment: The quantity of polymorphonuclear leucocytes, histoleueocyteand fibroblast in the bletilla colloid group,the HMW-NGF group and the HMW-NGF+ bletilla colloid group were significantly larger than that in the normal control group, and the micrangium could be seen in the HMW-NGF group and the HMW-NGF+ bletilla colloid group. The observation of cut sheets 10 days after treatment: The granulation tissue in the HMW-NGF group and the HMW-NGF+ bletilla colloid group was compacter and had more micrangium as compared with the normal control group and the bletilla colloid group.CONCLUSION: HMW-NGF+ bletilla colloid has significant effect on promoting the healing of the wound at the earlier and later period, and the effect is better than that of bletilla colloid or HMW-NGF.

Objective To evaluate the different effects of the treatment of thoracolumbar fractures by pedicle of vertebral arch Tenor system and Harrington device.Methods The clinical data of 35 cases of thoracolumbar fractures were analyzed retrospectively, 23 of them were operated with Harrington device and 12 with Tenor system.Results These cases were followed up for 6 months to 2 years. The fractures treated with Tenor system got satisfied reduction, reached about 96 7% of normal vertebral height. The deformities were completely corrected and complications were significant lower than those derived from Harrington device treatment, and no delayed neurologic damage was found. Most cases got reduction with one to three Frankel grades of neurologic recovery.Conclusion The Tenor pedicle system is more effective in treatment of thoracolumbar fracture than non-pedicle device. It can get satisfied fracture reduction , reliable fixation and less complications.

[Objective]To measure adult normal femur specimen in order to obtain accurate femoral resection and match the distal femoral in total knee arthroplasty.[Method](1)Forty-seven adult normal femur specimens of central Chinese were used for taking digital pictures in both anteroposterior and medialateral position.Five angles were measured through drawing lines of fixed point.(2)The exact position of the entry point was defined by the two wires on the specimens.[Result](1)The five angles reflect distal femoral anatomy features on the frontal plane and sagittal plane.(2)The mean value of distance from the entry point to the center of the intercondylar notch was 6.21 mm and the distance from the entry point to the anterior margin of the femoral posterior cruciate ligament(PCL) insertion is found to be 6.7 mm.[Conclusion](1)The distal one-third of femora was found to be outward bowing on frontal plane and forward bowing on Sagittal plane.Especially,the forward bowing is more remarkable than Outward bowing.So,when the position of intramedullary guide stick is decided by distal femoral anatomy,the axis alignments on frontal and Sagittal planes are both important.(2)During total knee afthroplasty the exact position of entry point may be defined by the Center of the intefcondylar notch and femoral PCL insertion.

Objective We established a model of human breast cancer in nude mice, to discuss the feature of pathology and biology of breast cancer,and give help to establish tools of pathogen research. Methods Human breast cancer cells MCF-7 were subcutaneously injected into the right armpit of nude mice to establish human breast cancer models.The mice were divided into composite group, estrogen group, leptin group and the blank group (30 in each). In the composite group,estrogen and leptin were injected into peripheral region of the tumor daily.In the estrogen group,estrogen was injected.In the leptin group, leptin was injected.In the blank group, physiological saline was injected.Tumor growth was observed, and the volume of the tumor was recorded.The tumor tissues obtained from the mice were pathologically examined. Results (1)The tumor-taking rate of leptin group and the blank group were 46.7% (14/30)and33.3% (10/30) ,and the mode is failure.In composite group and estrogen group they were 96.7% (29/30) and 70% (28/30).There was not significant difference between them ( P < 0.05).(2) The differences of average diameter and volume were statistically significant between the composite group and the estrogen group (P < 0.05).(3) Pathology diagnosis was invasive ductal carcinoma. Conclusions (1) Establishing human breast cancer model in nude mice need the stimulation of estrogen. The tumor-taking rate of nude mice has no relationship with leptin.(2) In the study in vivo, leptin as same as estrogen has stimulating effect on MCF-7 cells proliferation.(3) The transplanted cancer cell partly have the pathology and biology features of the human breast cancer cells and give help to establish tools of pathogen research.

Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P ＜ 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P ＞ 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00％ and 7.69％,respectively,there was no significant difference between the two groups (x2 =0.003,P ＞ 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.

Objective To respectively investigate the impact of perioperative use of antibiotics on incision healing of simple upper limb closed fracture.Methods The study enrolled 124 patients with simple upper limb closed fracture treated from October 2012 to June 2013,including fracture of humerus (surgical neck,shaft,and supracondyla),fracture of forearm (ulna,olecranon,and radius)and fracture of metacarpus.The patients were allocated to non-antibiotic group (n =73) and antibiotictreated group (n =51) according to the random number table.Between-group analysis was made on body temperature,peripheral white blood cell count,C-reactive protein level,drainage fluid culture and incision healing.Results Sex,age,disease entity and operation time were similar between the two groups (P ＞ 0.05).Non-antibiotic and antibiotic-treated groups showed no significant differences in body temperature [preoperation:(36.50 ± 0.27) ℃ vs (36.70 ± 0.39) ℃ ; postoperation:(37.64 ± 0.37) ℃vs (37.41 ±0.41)℃],peripheral white blood cell count [preoperation:(6.1 ±1.0) × 109 mol/L vs (6.5 ±0.8) × 109 mol/L; postoperation:(12.1 ±0.7) × 109 mol/L vs (11.3 ±0.6) × 109mol/L] and C-reactive protein level [preoperation:(7.2 ±0.9)mg/L vs (6.7 ±0.7)mg/L; postoperation:(12.0 ± 1.3) mg/L vs (13.4 ±0.9)mg/L] (P ＞0.05).Incisional infection occurred in 1 case (1％) in non-antibiotic group,but none in antibiotic-treated group (P ＞ 0.05).Conclusions For simple upper limb closed fracture,perioperative use of antibiotic has advantages of slight trauma,short operation time and few bleeding.Likewise,satisfactory bone healing is achieved in the absence of antibiotics during perioperative period.

Objective To investigate the incidence of renal dysfunction among patients received radical nephrectomy during 5-year follow-up and to discover the risk factors for chronic kidney dysfunction (CKD).Methods Data of 339 patients who underwent radical nephrectomy for renal cell carcinoma between Jan.2006 to Dec.2007 were investigated,and those who suffered renal dysfuntion before surgery or lost follow-up were excluded.Finally,148 patients were enrolled in this retrospective study.GFR after surgery were replaced by eGFR which were calculated with the abbreviated equation of MDRD.It will be defined as CKD when eGFR was less than 60 ml/(min · 1.73 m2).Postoperative occurence rate of CKD was estimated using the Kaplan-Meier methods.Rank sum test and chi-square test were used for the univariate analysis in term of CKD between groups.Multivariate Logistic regression analysis was used to judge the independent risk factors for CKD.Results Patients were followed up for 42-60 months.CKD occurred in 58 cases,and the 5 year cumulative incidence of CKD was 42.7％.As many as 17.4％ of the patients with a normal eGFR during the first 3 months follow-up would progress to CKD 5 years later.Clinical characteristics,including age at surgery,weight,body mass index,hypertension,preoperative total GFR and contralateral GFR,complications,size of tumor,pathologic type,eGFR calculated shortly after operation,were significantly different between the CKD group and the normal group (P＜0.05).Multivariate Logistic regression analysis shows that age at surgery (P =0.016,OR =1.106),size of tumor (P =0.048,OR =0.680) and eGFR calculated within one week postoperatively (P=0.002,OR=0.874) were the independent risk factors for postoperative CKD.Conclusions The incidence of CKD after radical nephrectomy in patients with renal cell carcinoma is not uncommon.The of age at surgery,size of tumor and eGFR value calculated within one week postroperatively have a close relation with the incidence of postoperative CKD.

Objective To investigate the satisfaction degree of students and teachers towards PBL teaching method and to provide a basis for continuing to carry out PBL teaching.Methods Anonymous questionnaires of PBL teaching method in teaching plan and procedure was conducted among 49students (2008 grade) and teachers.SPSS 13.0 software package was used to analyze the data and P ＜ 0.05 stands for statistically significant differences.Results Both students and teachers were satisfied.Teachers' evaluation scores of 17 projects were all higher than 4 points and students' evaluation scores of 13 projects were all higher than 4 points; scores for the rest projects were all higher than 3 points.Conclusions PBL teaching method combined with stomatology is effective and measures should be taken to strengthen the management of PBL teaching in stomatology.

BACKGROUND: There have been no effective means for clinical treatment of large regions of bone defects.Nano-hydroxyapatite/collagen(nHAC)composite would provide a new pathway for repair of bone defects owing to its similar structure to natural skeleton and better biocompatibility.OBJECTIVE: To investigate the role of nHAC composite co-cultured with bone marrow-derived mesenchymal stem cells(BMSCs)in repair of bone defects.METHODS: Following isolation and culture,human BMSCs were co-cultured with nHAC composite.Gross observation,histological analysis,and electron microscope observation were performed to analyze osteogenesis for repair of bone defects in the clinic.RESULTS AND CONCLUSION: Human nHAC could greatly proliferate in vitro.X-ray photography revealed that bone defects well healed after implantation of nHAC/BMSCs composite.These findings indicate that BMSCs exhibit osteogenic potential and nHAC is a satisfactory scaffold material for construction of tissue-engineered bone.

BACKGROUND: Some researches suggest that placenta is regarded as a new source of mesemchymal stem cells (MSCs). Adherent cells derived from placenta tissue have similar morphological characteristics and surface markers to MSCs; meanwhile, they can differentiate into osteoblasts and nerve cells.OBJECTIVE: To find a new source and way for MSCs separation.DESIGN: Observational study.SETTING: The Third People's Hospital of Wuxi.MATERIALS: Placenta was sourced from cesarean in our department of obstetrics and gynecology and provided confirmed consent from the relatives and ethics committee. The main reagents contained culture medium, sABC kit, DAB staining kit, caprine-anti-rat FITC, recombinant human basic fibroblast growth factor (rh-bFGF), rabbit-anti-human glial fibriliary acidic protein (GFAP).METHODS: The experiment was carried out in the Laboratory of Cells & Molecular Biology, the Third People's Hospital of Wuxi from May 2005 to August 2006. Placenta entity tissue was digested, adherent cells were cultured, morphological characteristics were observed, and growth curves of placenta-derived multipotent cells (PDMCs) in various generations were drawn. On the 1st and 7th days, supernatant was derived from cells in primary culture to measure content of β-glycerophosphate disodium (β-HCG) with chemiluminescence technique. In addition, expression of surface antigen and differentiating potency were detected at the same time. At 24 hours (at phase of nerve cells) and 2 weeks (at phase of osteoblasts) after inducible differentiation, cultured cells were dealt with routine immunocytochemical stain, and then they were observed under routine microscope or fluorescence microscope.MAIN OUTCOME MEASURES: ① Morphological indexes and growth curves of PDMCs; ② measurement of β-HCG in supernatant of PDMCs and expression of antigen of PDMCs with flow cytometer; ③ immunohistochemical analysis of PDMCs during and after inducible differentiation.RESULTS: ① Primary culture of PDMCs: After digestion of placenta tissue, a few of adherent cells were obtained and gradually formed thin and flat monolayer cells two weeks later. The monolayer cells grew like whirlpool or cluster. With the increase of cell density, soma was slenderer and slenderer and like fibroblast. ② Growth curves of PDMCs: Growth latency ranged from 2 to 8 days after cell inoculation. During this period, adherence was observed gradually but not obviously amplified. Eight days later, cells entered log growth phase. During this period, proliferation was active and cell process surrounding extended under phase contrast microscope. A lot of MSCs were observed in division phase between two nuclei. In addition, density was increased and cells connected to each other. Within 11-14 days, growth curve gradually entered platform phase. MSCs covered the bottom of bottle, cells slowly expanded, and primary culture stopped. ③ Measurement of β-HCG: Expression of β-HCG was not detected in supernatant at two time points. ④ Characteristics of surface antigen of PDMCs: PDMCs could express CD29, CD44 and CD105, but not CD34, CD45,CD19 and CD106. ⑤ Inducible differentiation of PDMCs: At 24 hours after inducing to nerve cells, form of PDMCs obviously changed, soma rebounded, refraction of nucleus was partially reinforced, structure was similar to dendrite and axis-cylinder, and positive neuro-specific enolase and GFAP were observed after staining.CONCLUSION:Placenta tissue contains PDMCs whose morphological function is similar to MSCs; in addition, placenta is regarded as an effective source of MSCs.