BACKGROUND:As bone marrow mesenchymal stem cel s can be differentiated into osteoblasts under certain induction conditions, autologous bone marrow mesenchymal stem cel s can be implanted into the bone nonunion site of bone fracture. This new technology garners increasing attention of orthopedic clinicians.
OBJECTIVE:To summarize the clinical efficacy of transplantation of bone marrow mesenchymal stem cel s in the treatment of bone nonunion of limb fractures.
METHODS:A computer-based search of Foreign Medical Journal Ful-Text Service and CNKI databases was performed for articles related to bone marrow mesenchymal stem cel s for treatment of bone nonunion of limb fractures published from 1998 to 2014 using the keywords of“bone marrow stem cel s (BMSCs), stem cel transplantation (SCT), nonunions, tissue engineering”in English and Chinese, respectively. Literatures with repetitive content and lack of originality were excluded. A total of 36 literatures were obtained for further analysis. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s are transplanted into the end of bone nonunion, and then can be induced to differentiate into osteoblasts to repair bone nonunion and bone defects,
laying a theoretical basis for clinical application. Bone marrow mesenchymal stem cel s can repair bone defects, which provides an effective method and material to promote fracture healing. Transplantation of bone marrow mesenchymal stem cel s is safe and effective for treatment of bone nonunion of limb fracture.

Objective To study teaching cases of health economics in the context of health reform and development in China.Method Preparing for lessons in groups,information collection,experiences summary,and field research.Result Three productions:a teaching plan,a case collection,and a guideline of case teaching.Discuss It is useful to improving students’ ability to contact theory with practices and enhance teacher’s teaching and researching ability,but it also needs further improvement.

BACKGROUND: Hydroxyapatite has favorable biocompatibility, can protect pulp tissue and promote the formation of osteoid dentin and the concrescence of pulp tissue. However, hydroxyapatite has no capability of anti-infection. Increasing scholars deem that antibacterials should be added with the hydroxyapatite during the treatment of vital pulp conservation to elevate curative effects.OBJECTIVE: To observe the curative effects of self-solidifying hydroxyapatite/norvancomycin composite as pulp capping material and to make a comparison with calcium hydroxide.DESIGN, TIME AND SETTING: The present randomized controlled observation experiment was performed at the General Dental Clinic, the Ninth People's Hospital, Shanghai Jiao Tong University Medical College between January 2004 and June 2005.PARTICIPANTS AND MATERIALS: A total of 60 patients (60 teeth) that suffered from deep caries or pulp exposure, could return visit on time, and agreed to sign informed consents were selected for this study. These patients comprised of 28 males and 32 females, aged 9-40 years. Diagnosis criteria: Teeth with food impaction pain and/or caloric stimulation pain which can relieve after stimulation removal; in addition, with no spontaneous pain, radiating pain, and hypnalgia. Self-solidifying hydroxyapatite/2.5% norvancomycin composite were prepared in the Department of Dental Material, Shanghai Second Hospital. Self-hardening calcium hydroxide was provided by Dentsply Company, USA.METHODS: All 60 patients were randomly divided into an experimental group and a control group, with 30 patients (30 teeth) per group. Self-solidifying hydroxyapatite/2.5% norvancomycin composite and self-hardening calcium hydroxide were applied as pulp capping agents in the experimental and control groups, respectively. Pulpal tissue reactions were assessed after 8 weeks. Teeth with normal response were restored permanently, and the others were given root canal treatment.MAIN OUTCOME MEASURES: Pulpal tissue reaction of patients.RESULTS: In the experimental group, one case showed vague pain after 1-week pulp capping and received root canal therapy, with success rate of 97%. In the control group, two cases presented with vague pain after 3-day and 1-week pulp capping, respectively, and also received root canal therapy, with success rate of 93%.CONCLUSION: Self-solidifying hydroxyapatite/norvancomycin composite acquires a high success rate of pulp capping, with curative effects similar to calcium hydroxide, it is a good pulp capping agent for vital pulp preservation.

To push on the process of the effective link between graduate education for profes-sional master degree of oral medicine and resident standardized training, a professional curricular con-struction was explored. The system contents included drawing up teaching program, writing reference books and building examination question bank. To realize the objective that combine theory study and clinical practice for graduate education and resident standardized training, the main courses were des-ignated for base professional knowledge, clinical operative skills and research progresses of oral medi-cine, by making multimedia courseware and lectures video frequency.

BACKGROUND:Rabbit bone marrow mesenchymal stem cels as a kind of adult stem cels with strong proliferation and multilineage differentiation potential exhibit a tremendous application potential in tissue engineering and biological therapy.
OBJECTIVE:To in vitro culture, proliferate and identify rabbit bone marrow mesenchymal stem cels and to observe cel biological characteristics.
MEHTODS:Bone marrow of rabbits was extracted under sterile conditions to separate bone marrow mesenchymal stem cels using the whole bone marrow adherence method and Percol density gradient centrifugation method. Afterwards, the cels were purified and proliferated using differential adherence method. Morphology and growth pattern of cels were observed under microscope, and expression of cel surface antigen markers was detected by flow cytometry.
RESULTS AND CONCLUSION:Rabbit bone marrow mesenchymal stem cels presented with short adherent time and fast growth. After passage and purification, impurities cel counts were decreased. Primary cels presented with triangular, fusiform and spindly shapes. Passage 5 cels with single shape showed the typical polar swirling growth, and could not express CD34 and CD45, but expressed CD29 and CD44. These findings indicate that the cels cultured using the whole bone marrow adherence method and Percol density gradient centrifugation method possess stem cel characteristics in morphology, surface markers and multilineage differentiation, which have been identified as bone marrow mesenchymal stem cels by flow cytometry.

The O152 antigens of Escherichia coli contains a Glc-β-1,3-GlcNAc linkage within the repeating unit. The wfgD gene in E. coli O152 O antigen gene cluster had been demonstrated utilizing NMR technique to encode a glucosyltransferase which is responsible for the synthesis of Glc-β-1,3-GlcNAc linkage. In this study, a synthetic substrate analog of the natural acceptor substrate undecaprenol-pyrophosphate-lipid [GlcNAc-α-PO_3-PO_3-(CH_2)_(11))-O-phenyl]) was used as an acceptor and UDP-Glc as a donor substrate, and electrospray ionization tandem mass spectrometry(ESI-MS-MS) was used for the detailed structural characte-)rization) of the enzyme product. A systematic study was conducted on product to allow rationalization of the fragmentation) processes. The major fragments observed in the ESI-MS-MS spectra result from cleavage of glycosidic) bond and diphosphate moiety. The fragment originating from the nonreducing end of the product yields information on sequence). Cross-ring cleavages, which are very informative of the linkages of the monosaccharide residues constituting) the product, and "internal" cleavage ions which are derived from elimination of substituents from around) the pyranose ring, were also observed. This extensive fragmentation was shown that the expected Glc-β-1,3-GlcNAc linkage in the product, confirming that wfgD is in the form of UDP-Glc: GlcNAc-pyrophosphate-lipid β-1,3-glucosyltransferase.)

Objective To investigate the effect of lung ischemic preconditioning (IP) on the expression of aquaporin-1 (AQP1) during lung ischemia-reperfusion (I/R) induced by cardiopulmonary bypass (CPB) in dogs.Methods Twelve adult mongrel dogs,weighing 15-20 kg,were randomly divided into 2 groups (n =6 each):lung I/R (group I/R) and ischemic preconditioning group (group IP).The left pulmonary artery was occluded at 10 min of off-pump CPB and mechanical ventilation was stopped in the left lung,60 min later occlusion was released,and mechanical ventilation was recovered to establish the model of left lung ischemia-reperfusion injury induced by CPB.In group IP,lung ischemic preconditioning was induced by 2 cycles of 5 min ischemia followed by 5 min reperfusion before occlusion of the left pulmonary artery.Before CPB (T1),immediately after occlusion of the left pulmonary artery (T2),at the end of CPB (T3),and at 2 h after the end of CPB (T4),pulmonary specimens were collected for determination of wet to dry lung weight ratio (W/D ratio) and expression of AQP1 and for examination of the pathological changes of lungs which were scored.Respiration index (RI),oxygenation index (OI),and alveolar-arterial oxygen tension difference (P(A-a)O2) were calculated at T1,T3 and T4,and the left pulmonary alveolar fluid clearance (AFC) was calculated at T4.Results Compared with group I/R,P(A-a) O2 and RI were significantly decreased,OI was increased,W/D ratio and pathological scores were decreased,the expression of AQP1 was up-regulated,and the AFC was increased at T3 and T4 in group IP.The pathological changes of the lung were significantly attenuated in group IP as compared with group I/R.Conclusion The mechanism by which lung ischemic preconditioning mitigates lung I/R injury induced by CPB is related to upregulation of the expression of AQP1 in dog lung tissues.

Objective This study was to investigate the value of CT guided 125iodine implantation combining transcatheter arterial chemoembolization(TACE) to prevent digestive tract bleeding in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods Forty patients with portal vein tumor thrombus which were diagnosed to have primary hepatocellular carcinomas by diagnostic criteria of Chinese Anti-Cancer Association were collected prospectively. They were divided into the treatment group and the control group, with 20 patients in each group. The treatment group was treated by TACE for hepatic tumor and 125iodine seed implantation for portal vein tumor thrombus, while the control group was treated by TACE for hepatic tumor and only given β-blockers medicines after treatment. Intraoperative and postoperative surgery-related complications were observed. Three months after surgery, enhanced abdominal CT scanning was performed to evaluate treatment effects which were divided into complete response (CR), partial response (PR), and progressive disease (PD) and stable of disease (SD), and the local tumor control rates were calculated. The bleeding rates and mortality after 3 months, 6 months, 12 months were recorded. Treatment effects of the two groups were compared with continuously correction Chi-square test, bleeding rates were compared with Fisher test, and survival rates were analyzed with Kaplan-Meier survival curve and compared with Log-rank test. Results Overall the 40 patients were treated successfully without serious surgery-related complications. In the treatment group, there were 8 patients with PR, 6 with SD and 6 with PD, and the local control rates were 40% (8/20). In the control group, there were 1 patient with PR, 6 patients with SD and 13 with PD. The difference of the local control rates was statistically significant (χ2=5.161, P=0.023).The bleeding rates at 3, 6 and 12 months were 2, 2 and 3 cases in the treatment group, for control group they were 2, 6 and 10 cases respectively. There was no statistical difference between the 3 months and 6 months bleeding rates (P values were 1.000 and 0.235), but for 12 months bleeding rates, the difference was statistically significant (P=0.041).The 1 year cumulative survival rates of the treatment group and control group were 70% (14/20) and 40% (8/20), and the difference was statistically significant (χ2=4.675, P=0.031). Conclusion The treatment of 125iodine implantation combining transcatheter arterial chemoembolization in patients with portal vein tumor thrombus in primary hepatocellular carcinoma can reduce variceal bleeding rate and improve survival rate.

Objective To evaluate the result of early repair for urinary fistula caused by iatrogenic injury to ureter,bladder and urethra during resection of rectal cancer.Methods We retrospectively analyzed 26 cases of urinary fistula after resection of rectal cancer patients encountered in Department of General Surgery,Henan Tumor Hospital from October 2005 to May 2016.Urinary fistula was divided into four types according to the site of fistula.Results Surgery was performed ever after the diagnosis of the fistula was identified.In type Ⅰ fistula (6 cases of posterior urethral fistula) the treatment was stent placement and packing of the greater omentum.2 cases of bladder top fistula (type Ⅱ),were treated by fistula repair and cystostomy.Type Ⅲ involved 12 cases (bladder triangle fistula).The treatment was ureter stenting replantation,and cystostomy Type Ⅳ:ureteral fistula in 6 cases,the treatment was end-to-end anastomosis and stenting.After surgery 24 cases were cured and 2 cases (all of type Ⅲ fistula) ended up with permanent bilateral ureterocutaneostomy.Conclusion It is safe and effective to make early remedy repair for ureter,bladder and urethral fistula iatrogenically during rectal cancer resection.

Objective To investigate the application value of the curved cutter stapler device combined with trans-orally inserted anvil (OrVil) in the radical resection of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 206 patients with Siewert type Ⅱ AEG who were admitted to the Henan Tumor Hospital between March 2011 and March 2016 were collected.All the 206 patients underwent radical resection and 3-step clock wise total gastrectomy + D2 lymph node dissection.Observation indicators:(1) surgery and postoperative recovery situations:surgical approach,overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation,postoperative complications and duration of postoperative hospital stay;(2) postoperative pathological examination and chemotherapy;(3) follow-up and survival situations.Follow-up using telephone interview and outpatient examination was performed to detect tumor-free survival of patients up to April 2016.Measurement data with normal distribution were represented as x±s.The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgery and postoperative recovery situations:all the 206 patients received successful operations,including 85 with abdominal operation,50 with abdominal incision through the diaphragmatic muscle into thoracic surgery and 71 with thoracic-abdominal surgery.Overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation and duration of hospital stay were (113.7± 15.4)minutes,(3.5± 1.2)minutes,(10.4±2.9)minutes,(128±25) mL,32± 6,(2.4 ± 0.9) days and (12.3 ± 1.9) days,respectively.Of 206 patients,15 with postoperative complications were cured by conservative treatment,including 6 with implicit anastomotic fistula,3 with dominant anastomotic fistula,2 with pancreatic leakage,2 with intestinal obstruction,1 with anastomotic stenosis and 1 with thoracic and abdominal infection.There was no reoperation due to perioperative complications.(2) Postoperative pathological examination and chemotherapy:postoperative pathological results showed that distance from resection margin of the esophagus to tumor was (5.2±0.4) cm,without cancer cells in the resection margin.Among 206 patients,171 received postoperative chemotherapy by S1 single agent combined with oxaliplatin for 6-8 cycles or oral S1 single agent for 1 year.(3) Follow-up and survival situations:206 patients were followed up for (2.7± 0.3)years,with a tumor-free 3-year survival rate of 58％.During the follow-up,there was no recurrent anastomotic tumor.Conclusion The curved cutter stapler device combined with OrVil in the radical resection of Siewert type Ⅱ AEG can simplify the difficulty of esophagojejunal anastomosis and guarantee the safe resection margin of the lower esophagus.