Objective To study the histologic characteristics of the capsule of breast implant. Methods Four miniprostheses were seperatelly implanted in four positions beneath the panniculus carnosus muscle in 30 rabbits. After 3 weeks, 1, 2, 3, 4, 6 and 12 months, capsular histology examination and the assay of capsular collagen content and type were performed. Results ⑴ Capsule was divided into two layers: the inner layer was dense and the outer loose connective tissues. Collagen component was more, cellular component was less and capsule was thicker (P0.05). ⑵ Capsular collagen content increased gradually in 3 months (P0.05). ⑶Collagen fibers were the most component, reticular fibers were second and elastic fibers were least. After 3 months, elastic fibers decreased, and collagen and reticular fibers became full layer gradually. ⑷ Capsular collagen type I in the capsule was gradually increased and type III decreased before 3 months. There were no significant changes after 3 months. Conclusions Histology of the implant capsule is similar to that of scar and the result of wound healing around implant.

Objective To investigate the clinical and laboratory characteristics of hematological malignancies with t(1 1;19)(q23;p13.1).Methods Chromosome specimens of bone marrow cell from a patient with hematological malignancy were collected.After short-term culture,and chromosome karyotype analysis was carried out by R banding technique.Results The chromosome karyotype of the patient diagnosed with AML M4+ was t (11;19)(q23;p13.1).The patient did not obtain complete remission after application of MA regimen chemotherapy.Conclusions t(11;19)(q23;p13.1) translocation is a rare and recurring chromosome abnormality,which is related with a specific type of AML.The prognosis of the AML patients with this chromosome abnormality is poor.

Objective To investigate periprosthetic femoral shaft remodeling with tapered femoral stems after total hip arthroplasty (THA) for elderly patients and evaluate the mid-term clinical outcomes.Methods The study involved 30 elderly (70-90 years) patients (34 hips) treated with femoral shaft remodeling with tapered stems after THA from January 2003 to January 2005. The postoperative X-ray images were collected and perioperative periprosthetic bone mineral density was analyzed by dual-energy X-ray absorptiometry (DEXA). The Harris score was applied in follow-up observation, and Kaplan-Meier method was used to evaluate the working life of the femoral prosthesis. Results Four patients were died of lung cancer. The remaining 26 patients ( 30 hips) were followed up for 5-7 years ( mean, six years). The postoperative X-ray measurements showed that total hip prosthesis subsidences were less than 1.5 mm within one year in 12 hips, with no prosthesis loosening observed. Bone proliferations were seen in Gruen zones 2, 3, 4, 5, 6, 11 and 12, and bone resorptions were seen in zones l and 7. DEXA showed that bone mineral density was increased in Gruen zones 2,3,4 and 5, but decreased mainly in Gruen zones 1,6 and 7. The increase of bone mineral density in zones 2 and 5 was faster compared to other sites six months after the operation ( P ＜ 0.05 ) and the change of bone mineral density was prone to be stable in two years ( P ＞ 0.05 ). Within one year after initial implantation, periprosthetic bone mineral density was significantly decreased ( P ＜ 0.05 ). Two years after the operation, rare changes of periprosthetic bone mineral density were found ( P ＞ 0.05 ), with only regional redistribution of bone mass from the proximal to the distal femur. The Harris score of hip joint function was increased from preoperative 38.56 ± 8.21 to 86.32 ± 6. 01 at the final follow-up. The 6-year survival rate of the prosthesis was 100%. Conclusion Femoral shaft remodeling with tapered stems after total hip arthroplasty for the elderly patients shows good periprosthetic bone remodeling and satisfactory mid-term clinical results.

OBJECTIVEThis study is conducted to explore new methods to perform surface biomodification of titanium implants and improve osteogenic efficiency.

METHODSAn RGD peptide and chitosan (CS) were combined by acylation reaction, forming RGD-CS. An RGD-CS/pDNA complex was subsequently prepared using a complex coacervation method and grafted on a pure titanium surface after physical and biochemical treatments were performed. The chemical structural characteristics of RGD-CS were evaluated using an infrared spectrometer and an elemental analyzer. The shape of this complex was then assessed by gel electrophoresis combined with atomic force microscopy. The grafting effect of this complex on the titanium surface was detected by EB staining.

RESULTSCS and RGD peptides were coupled by an amide bond. The RGD-CS/pDNA complex was completely composited at N/P > or = 2. Atomic force microscopy results showed that the morphology of this complex was mainly spherical. EB staining experiments showed that this complex was successfully grafted on the titanium plate.

CONCLUSIONRGD peptide-modified CS can be used as a titanium implant surface plasmid package carrier of pDNA.

Objective To investigate the ability of human exfoliated deciduous teeth-derived stem cells (SHED) to differentiate into odontoblast-like cells. Methods SHEDs were isolated by enzyme digestion method. The 3nd passage SHEDs were incubated with 25 ng/mL recombinant human TGF-β3 , or with TGF-β3 in combination with heparin. The DSPP expression was detected by Q-PCR and Western-blotting assay. Alizarin red staining, immunhistochemistry assay and alkaline phosphatase(AKP) activity assay were performed, respectively. Result The AKP activity was enhance by TGF-β3 in combination with heparin. Alizarin red staining was positive in TGF-β3-heparin groups, with the increase of DSPP expression at both mRNA and protein level. Conclusion TGF-β3 in combination with heparin can enhance the differentiation of human exfoliated deciduous teeth-derived stem cells into odontoblast-like cells.

BACKGROUND:Studies have reported that the superfamily of transforming growth factors exert a role in the mineralization of various stem cells, but the combination effects of transforming growth factorβ3 and heparin on proliferation and mineralization ability of stem cells from human exfoliated deciduous teeth remains to be studied. OBJECTIVE:To explore the effect of transforming growth factorβ3 on odontoblast-like differentiation of stem cells from human exfoliated deciduous teeth. METHODS:Human deciduous teeth were col ected using enzyme digestion. The 3rd cells were incubated with 25μg/L recombinant human transforming growth factorβ3, 10 U/mL heparin or their combination. The dentin sialophosphoprotein mRNA and dentinsialoprotein expressions were detected by Q-PCR and western blot assay. Alkaline phosphatase activity was determined using alkaline phosphatase kit. RESULTS AND CONCLUSION:Stem cells from human exfoliated deciduous teeth grew wel after induction. The activity of alkaline phosphatase in the combination group was significantly higher than that in the transforming growth factorβ3, heparin and control groups (P<0.01). After combination induction, the cells were strongly positive for alizarin red staining. Results fromα-PCR and western blot assay showed that the expressions of dentin sialophosphoprotein were both remarkably increased at mRNA and protein levels. In summary, stem cells from human exfoliated deciduous teeth can differentiate into odontoblast-like cells under the induction of transforming growth factorβ3 plus heparin.

Objective Cervical radiculopathy treatment experts' consensus to establish radiculopathy type by using the modified Delphi method. Methods Use document retrieval method to review information and articles about the treatment guidelines and articles of cervical radiculopathy including domestic and international areas, established a protocol about clini?cal consensus of the treatments for cervical radiculopathy. This protocol included 23 questions (the effective proportion of non?operating therapy, neck immobilization, physiotherapy, pharmacologic treatment, surgical indications, contraindications, anteri?or surgical decompression, anterior surgical implants). We performed a modified Delphi survey in which current professional opinions from experienced experts, representing from almost all of the Chinese provinces, were gathered. And then we modi?fied the protocol according to those professional opinions. Three rounds were performed and finally we established consensus. Consensus was achieved with ≥70% agreement. Results The panel included 30 experienced experts. The recycling question?naire's quantity of three rounds were 30(100%), 24(80%) and 16(53.3%) respectively. After three expert assessments, there were 18 questions which achieved with≥70%agreement and these questions accounted for 64.3%(18/28) of all the questions. Consen?sus of the treatments for cervical radiculopathy was reached on 7 aspects, including:the effective proportion of non?operating thera?py (1 question), neck immobilization (1 question), physiotherapy (1 question), pharmacologic treatment (5 questions), surgical indi?cations (3 questions), contraindications (4 questions), surgery (3 questions). Conclusion This modified Delphi study had reached a consensus concerning several treatment issues on cervical radiculopathy which had strong representativeness of experts and good convergence of opinions. In the absence of high?level evidence, at present, these experts' opinion findings will guide health care providers to define appropriate treatment in their regions. Areas with no consensus provide excellent insight for future research.

Objective:To evaluate the effects of periodontitis on the expression of apoptosis-related proteins in pancreas of rats with Type 2 Diabetes Mellitus.Methods:Spontaneously type 2 diabetic OLETF rats were randomly divided into 2 groups:diabetes with or without periodontitis(diabetes group and combination group).LETO rats with the same germline and the same age but having normal glucose tolerance were randomly divided into control group and periodontitis group.20 weeks after periodontitis were established,all the rats were sacrificed and the pancreas were pathologically examined by HE staining.The expression of Bax,Bcl-2 and Caspase-3 in the pancreas islet were detected by immunohistochemistry staining and semi-quantitative analysis.Results:The expression of Bax, Bcl-2 and Caspase-3 in the pancreas islet was no significant difference between control and periodontitis groups(P=0.324,P=0.091,P=0.852).Compared with diabetes group,the expression of Bax and Caspase-3 in combination group showed a significant increase(P=0.000,P=0.000),and the expression of Bcl-2 was significantly decreased(P=0.022).Conclusion:Under healthy conditions,periodontitis has no effect on the expression of apoptosis-related proteins in rat pancreas islet.However,in rats with diabe-tes,periodontitis may affect the expression of apoptosis-related proteins in pancreas islet.

Objective To evaluate the effectiveness of web-based mental health services.Methods Web-based mental health services were established in our hospital to offer continuing medical education on mental health and psychological assessments.The access of clinicians to psychiatric knowledge and consultation from psychiatry department was evaluated.Results A total of 803 medical staff took the continuing medical education,and 643 passed the examination.Five hundred and twenty-eight online psychological assessments were completed.The qualification rate of psychiatric examination was 83.3％ vs.31.7％ in educated and non-educated clinicians (x2=32.77,P＜0.01).The common consultation from psychiatry department of the educated group involved anxiety,depression/mania and delirium,of which anxiety and medically unexplained symptoms were comparatively higher while delirium was lower than the non-educated group (x2 values were 4.80,4.59 and 5.16,respectively; all P＜0.05).More use of online psychological assessments was found in the educated group (33.8％ vs.7.6％) before asking for a consultation from psychiatry department (x2=30.04,P＜0.01).Conclusions Online mental health continuing education and psychological assessment could improve psychiatric knowledge and recognition of anxiety and depression in clinicians.

The paper reviewed the history of drug price addition system and its impact on hospital management. Based on such facts,authors stated that the significance of abolishing drug price addition helped hospital management not to run their hospitals as a business, helped medical practitioners to make their clinical decisions based on medical needs, and to make the health care service deserve the professionals′value and contributions. Following the abolishment, the hospitals need to reform their internal operating mechanisms before they can achieve better performance.