BACKGROUND:Atlantal lateral mass screw fixation contains lateral mass screw fixation under the posterior arch of the atlas and lateral mass screw fixation via the posterior arch of atlas (also cal ed atlas pedicle screw fixation) according to different insertion points. The two methods have their advantages and disadvantages. There are lacks of the comparative studies on bony anatomy feasibility by two kinds of atlantal lateral mass screw fixation.
OBJECTIVE:To compare the feasibility associated with two kinds of atlantal lateral mass screw fixations taking Chinese data of atlantal bony anatomy as evidence.
METHODS:Data of CT scans in 30 adults with cervical spondylosis (60 sides) were col ected, and data were reconstructed using CT workstation. We measured key bone anatomy structure after atlantal lateral mass screw fixation. The atlantal lateral mass was suitable for lateral mass screw fixation via the posterior arch of atlas if its height and width of vertebral artery groove at the posterior arch ≥ 4 mm. It was suitable for lateral mass screw fixation under the posterior arch of the atlas if the height of posterior arch of atlas lateral mass ≥ 4 mm.
RESULTS AND CONCLUSION:The height of vertebral artery groove at the posterior arch was (4.54±1.17) mm. The width of vertebral artery groove at the posterior arch was (8.69±1.12) mm. The height of posterior arch of atlas lateral mass was (4.98±1.07) mm. There were 41 cases with the height of vertebral artery groove at the posterior arch>4 mm (suitable for lateral mass screw fixation via the posterior arch of atlas, occupying 68%. There were 52 cases with the height of posterior arch of atlas lateral mass>4 mm (suitable for lateral mass screw fixation under the posterior arch of the atlas), occupying 87%. There were significant differences in the differences between the two groups (P<0.05). These results indicated that lateral mass screw fixation under the posterior arch of the atlas was more feasible compared with lateral mass screw fixation via the posterior arch of atlas. Preoperative CT measure for key anatomic structure was significant for making personalized surgical plan.

Objective An incentive system was established to promote the rapid development of scientific research and to improve the scientific management ability.Methods The research incentive system, which including research awards, research fund management, research fund matching, and performance management, was implemented in our hospital, aimed to develop a clear quantitative assessment index to encourage research activity, and maximize the research outcome.Results It is clear that the research project application and output in output have been increased;and it positively associated with the number of years of implementation with the statistical significance.Conclusions Establishment of the research incentive system has encouraged the clinicians to make effort to conduct research projects which has largely increased the number of research projects and produced better outcomes.Applying such system has enhanced the capacity of core research of the hospital.

Objective:To study the relationship between the expression of carnitine palmitoyltransferase 1α (CPT1α) and progression of renal interstitial fibrosis and chronic kidney disease (CKD), and to evaluate the value of CPT1α as a biomarker in pathological diagnosis of renal interstitial fibrosis and CKD.Methods:As a retrospective cohort study, information of CKD patients dignosed with tubulointerstitial fibrosis by renal biopsy and receiving follow-up from March 1, 2010 to July 30, 2017 in the Second Affiliated Hospital of Nanjing Medical University were collected. Renal tissues were stained by immunohistochemistry to detect the expression of CPT1α protein and then divided into three groups according to the quartile of proportion of CPT1α positive staining cells, including group Q1(>67.89%), group Q2(49.84%-67.89%) and group Q3(<49.84%). The degree of renal interstitial fibrosis was measured by Masson staining and lipid deposition was represented by Bodipy staining. Messenger RNA of CPT1α and collagen as well as other extracellular matrix genes were detected by real time-PCR. Relationships between proportion of CPT1α positive staining cells and renal interstitial fibrosis and renal function were analyzed by linear regression analysis. The relationship between CPT1α positive cell number ratio and renal function progression was measured by Pearson correlation analysis and generalized linear model. The effect of lipid-lowering medicine on renal function of CKD patients was analyzed by paired comparative analysis.Results:Ninety patients with CKD were included in this study. Renal interstitial fibrosis and lipid droplets deposition area increased in Q2/Q3 group compared with Q1 group by Masson and Bodipy staining (all P<0.05). Messenger RNA level of extracellular matrix-related proteins increased in Q2/Q3 group by real time-PCR than those of Q1 group (all P<0.05). Linear regression analysis showed that fibrosis area was negatively correlated with the proportion of CPT1α positive staining cells ( r=-0.309, P<0.01). The baseline expression of CPT1α in renal issues was negatively related with serum creatinine (Scr) ( r=-2.801, P<0.001), positively related with estimated glomerular filtration rate (eGFR) ( r=1.240, P<0.001). After a medium follow-up of 3.47 years, CPT1α positive cell number ratio was positively correlated with eGFR change rate by Pearson analysis ( r=0.220, P=0.038). Paired stratified analysis showed that taking lipid-lowering medicines attenuated the decrease of eGFR in Q2 group and Q3 group but not in Q1 group (both P<0.05). Conclusions:The decline of CPT1α in renal tissues of CKD patients is associated with the increase of Scr, the decrease of eGFR and renal interstitial fibrosis. CPT1α is a promising molecular marker to evaluate the degree of renal fibrosis and the progression of CKD.

BACKGROUND:The reported time of bone marrow mesenchymal stem cel s induced to differentiate into chondrocytes is different. Few studies have observed and compared the cel s’ dynamic transformation during the induction process.
OBJECTIVE:To observe the dynamic differentiation and the mature time of rabbit bone marrow mesenchymal stem cel s which were directional y induced to chondroblasts for 8, 11, 14, 17, 20 days.
METHODS:Bone marrow was aspirated from the femur of New Zeal rabbits, and bone marrow mesenchymal stem cel s were isolated by gradient centrifugation. After cultivation and amplification, bone marrow mesenchymal stem cel s at passage 3 were directional y induced to chondrocytes by the serum-free medium containing transforming growth factor beta-1. The experiments were divided into five groups according to different induction time points:8 days, 11 days, 14 days, 17 days, 20 days. Then cel ular morphology, toluidine blue staining, typeⅡ col agen immunohistochemistry, aggrecan content in induction medium, and chondrogenic differentiation in each group were observed and compared.
RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s had apparently transformed in morphology at 8 days of induction, and presented obvious chondrocytes’ morphology at 14 days. The aggrecan in induction medium could be detected at a low level at 4 days, significantly increased at 8 days, and maintained slow increasing at 20 days. At 14 days, the metachromatic particles could be found by toluidine blue staining, and the col agen type Ⅱimmunohistochemistry was significantly positive in cel climbing slice. Experimental findings indicate that, bone marrow mesenchymal stem cel s that are monolayer cultured in a high density can be induced into chondroblasts at the effect of transforming growth factor beta-1 and other factors. There are a few chondroblasts in the early induction process, then cel s begin to have chondrocytes morphology and function after induced for 8 days, and may differentiate to mature chondrocytes at 14 days. In addition, they can keep a high biological activity in the induction process.

Background:TLR4 can mediate immune and inflammatory responses,TFF3,MUC2 are the intestinal mucosa protection factor and can maintain the intestinal barrier function. Aims:To investigate the effect of Anchang Yuyang decoction on colon tissue TFF3,MUC2 and TLR4 gene expressions in rats with ulcerative colitis. Methods:TNBS was used to establish ulcerative colitis model in rats. Ninety Wistar rats were randomly divided into normal control group,model group,low,moderate and high dose Anchang Yuyang decoction groups and mesalazine group,and distilled water,different concentrations of Anchang Yuyang decoction and mesalazine were given respectively. All the rats were sacrificed after 21 days. Colonic histopathological score was assessed,and RT-PCR was used to detect gene expressions of colon tissue TFF3, MUC2 and TLR4. Results:Compared with model group,histopathological score and TLR4 expression were significantly decreased in moderate,high dose Anchang Yuyang decoction groups and mesalazine group(P < 0. 05),expressions of TFF3 and MUC2 were significantly increased( P < 0. 05). Compared with moderate dose Anchang Yuyang decoction group,histopathological score in high dose Anchang Yuyang decoction group and mesalazine group was significantly decreased(P < 0. 05),and TFF3 expression was significantly increased( P < 0. 01). Compared with moderate dose Anchang Yuyang decoction group and mesalazine group,MUC2 expression in high dose Anchang Yuyang decoction group was significantly increased(P < 0. 01),and TLR4 expression was significantly decreased( P < 0. 01). Conclusions:Anchang Yuyang decoction can promote the repair of colonic mucosa in rats with ulcerative colitis,and its mechanism may be related to the increase of TFF3 and MUC2 gene expressions and down regulation of TLR4 gene expression.

Objective Through the root cause analysis of a particular hospital award-winning achievements during 2004-2015 to find out a way to improve and guide medical research output,especially the new ideas,new methods of scientific research management.Methods Using SPSS18.0 sta tistical analysis software to conduct analysis of the 97 winning outputs of the hospital during 2004 2015,indicators including the numbers and grades,the types of research,discipline distribution and other 6 aspects were comprehensively analyzed.Results Since 2012,the hospital administrative policies went through an evolving process of "repeal,change,establish",research management entities adjustment management policies to match the current situation in a timely manner,fine management of research were adopted,as a result,the achievements output is increased and becoming more balanced distribution of subjects.Conclusions To maintain a well-developing position of the research output,we must combine the national policy on scientific research with the management of our own development;bring in the competition for talent,as well as both positive and negative incentives.Strengthen the scientific and technological talent team building to establish a team good at medical practice and research,to form a connected effect based on the advantage subject,promote the balanced development of various disciplines,thereby further improving the hospital research outputs.

Objective 600 questionnaires from hospital employee were collected and conducted statistical analysis to identify the internal and external factors that have influence on the staff develop ment of scientific research level,which also aimed to figure out the way to raise employee awareness of scientific research,as well as enhancing the scientific and technological development in hospital.Methods Questionnaire survey was conducted to establish a database,SPSS18.0 survey data descriptive analysis applied,variance analysis using x2 test,P ＜0.05 was considered statistically significant.Results Statistical analysis and comparative study were conducted to figure out the awareness of hospital scientific and technology development from employees from different positions with different education levels,the difference was statistically significant (P ＜0.05).Hospital staff have generally high level awareness of scientific research,obey the normal distribution basically,recognition rate is more than 93.5％,particularly,higher education staff have a better awareness and contribution to the development of the hospital.Conclusions According to the analysis,this paper proposed to build a platform for the establishment of performance evaluation and incentive system,to improve the management system and other measures to further enhancing the research and development of hospital staff awareness,thereby increasing the overall scientific research level of the hospital.

Objective To measure the number of lymphocytes, B lymphocytes, CD5+B lymphocytes and level of IL-10 in peripheral blood of patients with systemic lupus erythematosus (SLE), and analyze their effects in the disease. Methods In this study, 84 cases of patients with SLE were randomly selected and evaluated according to the activity index (SLEDAI). These cases were divided into low activity group (SLEDAI<9) and high activity group (SLEDAI≥9). Ten healthy individuals were selected as the control group at the same time. The number of peripheral blood lymphocytes, B lymphocytes, CD5 + B lymphocytes, erythrocyte sedimentation rate (ESR), C3, C4 and interleukin (IL)-10 levels in serum were measured respectively and the correlation between the above indexes and SLEDAI and complement levels were analyzed. Pair-wise comparison of means of groups was conducted with one-way ANOVA. Comparison between the two groups was conducted by LSD-t test. Correlations between variables were carried out using Spearman's rank correlation test. Results The total number of lymphocytes in SLE group was lower than that in normal control group ( F=7.216, P<0.001); The number of CD19+ B lymphocytes in SLE group was higher than that in normal control group (F=3.589, P=0.036). The number of CD5+B lymphocytes of peripheral blood [(2.5±0.6)%] in patients with systemic lupus erythematosus was significantly lower than that in the normal control group [(3.2 ±0.8)%], but the difference was not statistically significant (t=3.412, P=0.698). The number of CD5+B lymphocytes in the high activity group was significantly lower than that in the low activity group (t=7.365, P=0.027)and the normal control group (t=5.649, P=0.002). The number of CD5+ B lymphocytes was negatively correlated with SLEDAI score (r=-0.692, P=0.001) and positively associated with the level of complement 3 (r=0.305, P=0.038), but not with complement 4 and ESR (P>0.05). In addition, the level of serum IL-10 in whether the low activity group (t=1.935, P=0.031) or the high activity group (t=3.048, P=0.012) was all higher than the normal control group. The level of serum IL-10 in patients with systemic lupus erythematosus was positively associated with SLEDAI score (r=0.425, P=0.024) and ESR (r=0.479, P=0.008), but was negatively correlated with complement 4 (r=-0.359, P=0.031). Conclusion The total number of lymphocytes in patients with SLE decreases significantly, while B lymphocytes increases significantly. The number of CD5+ B lymphocytes and the serum IL-10 level are also changed. It maybe related to the patient's inflammatory environment, and the number of CD5+B lymphocytes and the serum IL-10 level may be associated with disease activity.

Objective To investigate the relationships between the C6 glioma haemodynamic response and basal blood perfusion parameters.Methods Ten Wistar rats with C6 gliomas implanted subcutaneously have undergone Carbogen-induced steady state free precession functional MRI (SSFP fMRI)examination,followed dynamic contrast enhancement MRI (DCE-MRI)examination in the normal air breathing.For each glioma,5 regions of interest(ROI)were drawed randomly on SSFP fMRI images,and the percentage of signal change(PSC)of each ROI was calculated with the analysis of functional neuroimages (AFNI)software.The dynamic signal intensity of ROI in DCE-MRI on the same space and location was fitted by Hoffmann model in R language software,thus to obtain basal blood perfusion parameters (Akep and kel).Distribution-free and small-sample-size-oriented permutation test was used to investigate the relationships between PSC and basal blood perfusion parameters.Results 50 ROI were drawed randomly from 10 glioma. There were no statistically relationship between PSC and Akep,or between PSC and kel (F=0.629 8,P=0.431 3;F=1.859,P=0.179 1).Conclusion The glioma basal blood perfusion could not predict the PSC of SSFP fMRI.

Objective:According to the requirements of high-quality development of public hospitals, to explore the innovative incentive path for medical youth based on the two-factor theory, and provide a reference for promoting the high-quality development of public hospitals.Methods:Using the literature analysis method, the two-factor theory, hospital scientific research incentive mechanism, and scientific research incentive mechanism for young talents were investigated. Meanwhile, combining the two-factor theory and practical experience, the problems that existed in the innovation incentive policy of public hospitals for young medical talents were analyzed, and the corresponding countermeasures were proposed to build the innovation incentive path of young medical talents under the two-factor theory.Results:Based on analyzing the demand characteristics of young medical talents, managers should distinguish health care factors and incentive factors, and implement incentives from both aspects. Provide incentives through improving the personal sense of achievement, creating a personal growth environment, and promoting professional titles to stimulate young talents' innovation motivation; implement health care factors from aspects of working conditions, material benefits, salary levels, etc.Conclusions:As a new concept of development, high-quality development is not only reflected in scientific and technological innovation-driven, but also in the innovation of management mechanisms so that institutional innovation becomes the driving force for high-quality development.