Objective To investigate the therapeutic effect of modified S-P approach without disconnecting the rectus femoris in patients with Pipkin typeⅠandⅡfractures. Methods The clinical data of 58 patients with Pipkin type Ⅰ and Ⅱfractures were retrospectively analyzed. Among the patients, 29 patients were treated with conventional S-P approach (conventional group), and 29 patients were treated with modified S-P approach (modified group). The incision length, operation time, bleeding, visual analogue score (VAS), postoperative complications and hip joint function at the final follow-up were compared between 2 groups. Results The patients of 2 groups had not incision infection, and showed primary. X-ray of 3 months after surgery showed fracture healing. There was no statistical difference in the time of follow-up between conventional group and modified group:(16.1 ± 5.2) months vs. (15.8 ± 5.6) months, P>0.05. The incision length, bleeding, VAS 3 d and 4 weeks after surgery in modified group were significantly lower than that in conventional group:(8.1 ± 0.8) cm vs. (12.3 ± 1.2) cm, (144.3 ± 16.5) ml vs. (172.4 ± 21.6) ml, (4.5 ± 1.1) scores vs. (5.9 ± 1.5) scores and (1.6 ± 0.7) scores vs. (2.4 ± 0.8) scores, and there were statistical differences (P<0.05). There were no statistical differences in operation time, VAS 3 months after surgery, incidence of postoperative complications and excellent and good rate of hip joint function at the final follow-up between 2 groups (P>0.05). Conclusions The modified S-P approach without disconnecting the rectus femoris is a better method in patients with Pipkin type ⅠandⅡ fractures, and it has the advantages of revealing more clearly, minimal invasion, lower bleeding and slight postoperative pain.

Objective To observe the clinical effects of compound carraghenates cream on edema and pain after mixed hemorrhoid surgery. Methods 180 cases of patients with mixed hemorrhoids divided into the observation group and the control group, 90 cases in each group according to the random number table method. The control group was treated with Vaseline oil gauze to cover wounds after operation, and the observation group was treated with compound carraghenates cream after operation. The clinical efficacy, VAS pain score , the edema symptom scores and the pain relief time, edema symptom relief time, the wound healing time ,untoward effect were compared and observed after treatment between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group (95.56％ vs 85.56％) (P<0.05). The VAS pain scores of the observation group on the 1st day, 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05), and the edema symptom scores on the 3rd day and 7th day after treatment were significantly lower than those of the control group (P<0.05). The time for pain relief, the time for edema relief and the wound healing time in the observation group were significantly shorter than those in the control group (P<0.05). Conclusion Compound carraghenates cream can effectively relieve edema and pain after mixed hemorrhoid surgery, and it also can shorten the course of disease and promote wound healing with safety.

The diagnostic core of multiple sclerosis(MS) always requires dissemination in space and time since the publication of the first criteria over 40 years ago.Though several modified clinical criterias have been proposed to diagnosis MS,no paitents must meet such condition in diagnostic criteria because of the reticular clinical manifestation of this disease.The diagnosis of MS is still based on clinical parameters including detailed history and a careful examination to exclude alternative disease.The effects of some disease modifying agents to MS have been confirmed by evidence-based medicine.But the intact treatment plan must contain aspects of acute attacks,prevention of relapses and progression,management of symptoms,and rehabilitation.The individualized treatment is needed according to the medical insurance,payment ability and other influencing factors in China.

[Objective]To prepare a cartilage acellular matrix scaffold and to explore its feasibility in cartilage tissue engineering. [Methods]Microparticles about 100 ?m~154 ?m were prepared after calf cartilage physically shattered and experienced gradient centrifugation,and then treated by a modified Courtman's four-step method which was improved to produce acellular cartilage matrix.After this treatment the microparticles were made into 3% suspension which was placed into moulds.With the freeze-drying method,3-D cartilage acellular matrix (CACM) was prepared.The scaffolds were cross-linked by a neotype crosslinking agent genepin for 48h,and then placed into glycine solution server times for removing redundant genepin.The freeze-drying method was used to prepare CACM.The scaffolds were investigated by gross observation,histological staining (haematoxylin-eosin,toluidine blue) ,scanning electron microscope (SEM) observation and porosity measurement,water absorption rate and degradation rate analysis.After being cultivated for ten days,bone marrow stranal cells (BMSCs) of rabbit were seeded into the scaffold.MTT test and SEM were done to assess the growth and proliferation of BMSCs.[Results]Gross observation showed the scaffolds had a loosely porous and dark blue appearance after being cross-linked by genepin.The histological staining (haematoxylin-eosin,toluidine blue staining) showed that there were no chondrocyte fragments in the scaffold.The CACM scaffold had 90% porosity,(1314?337) % water absorption rate,and (13.69?7.3)% or (25.99?8.9) % degradation rate at 2 or 4 weeks.MTT test showed that BMSCs grew well in the 3-D CACM scaffolds of logarithmic trend,supporting that the scaffolds had no cytotoxic effect on BMSCs.SEM micrographs indicated that the scaffolds were porous and the cells covered the scaffolds firmly with cell processes.[Conclusion]The improved Courtman's four-step method makes a more thoroughly acellular scaffold.The 3-D CACM scaffold retains most of extracelluar matrix.After being cross-linked by genepin,the 3-D CACM scaffold has good biocompatibility and degradation rate of the scaffolds is decreased,which makes it a suitable carrier for cartilage tissue engineering.

Twenty two patients with outlet obstructive constipation (OOC) underwent pelvic fourcontrast defecography preoperatively and postoperatively. Functional outcome and the findings on defecography were analyzed. The inconsistent signs between preoperative and postoperative defecography findings were shown in all patients. Some new abnormal findings, including 5 cases with pelvic floor hernia, 4 with cystocele, 4 with vagina prolapse, 3 with uterine prolapse,2 with rectal prolapsed and 1 with spastic pelvic floor syndrome were present in 5 patients with ineffective surgical treatment and 9 patients with effective surgical treatment. Reduced abnormal signs were showed in the 9 effective patients, but other new abnormalities appeared. The abnormal signs were reduced or disappeared in 8 obviously effective patients and there were no new abnormalities present in those patients. Results indicate that pelvic four-contrast defecography can provide valuable information for patients with OOC postoperatively.

Objective To establish a method to detect neuromyelitis optiea (NMO)-IgG in patients serum using indirect immunofluorescence assay (IFA). Methods The normal tissues (cerebellum/ midbrain, kidney and stomach) from C57 mice were cryosectioned onto microscope slides as detective substrate. For NMO-IgG detection, isolated serum from patient with NMO, multiple sclerosis (MS), optic neuritis or myelitis was incubated with the tissue sections on the slide at 4℃ overnight and subsequently incubated with a fluorochrome-cojugated lgG specific for human. For double immunostaining with aquaporius-4 (AQP4), the slides were incubated with primary antibody of AQP4 and secondary antibody of IgG-TRITC. Detection of NMO-IgG and its co-localization with AQP4 was analyzed using fluorescence microscope. Results All 182 serum samples from patients were tested using IFA. Some samples revealed a characteristic immunohistochemical staining of NMO-IgG in mouse CNS tissues, predominately in pia and subpia, and capillaries in white and grey matter in the cerebellum, midbrain, and spinal cord. Double immunostaining with AQP4 demonstrated the co-localization of NMO-IgG with AQP4. Conclusions We established an IFA using a substrate from C57 mouse cerebellum/midbrain, kidney and stomach tissue to detect NMO-IgG in patient serum. This method is specific and efficient in detection and may be useful in diagnosis and differential diagnosis of neuromyelitis optica.

OBJECTIVE:To provide reference for investigating the disease burden of diabetic patients and promoting rational drug use. METHODS:Open-ended questionnaires were adopted to survey the willingness to pay(WTP)of some diabetic patients in Sichuan Provincial People’s Hospital and collect the data about personal information,health status,the affordability of disease and WTP,the data was sorted with Excel (version 2013) software by two operators and analyzed with SPSS 17.0 software by step-wise multiple linear regression to explore the influential factors of WTP values. RESULTS:Totally 120 questionnaires were sent out and 106 were effectively received with effective rate of 88.3%. The average age of respondents was (59.9 ± 13.9) years old,the average body mass index (BMI) of respondents was (24.5 ± 0.5) kg/m2,the highest proportion of monthly diabetes fees was no more than 300 yuan,followed by more than 300-500 yuan and more than 500-1 000 yuan;the awareness rates of fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PG) and glycated hemoglobin (HbA1c) were 95.3%,86.8% and 68.9%,respectively;and patients with more than 2 complications accounted for 29.5%. The WTP values of respondents to the complete recovery of HbA1c,FPG and 2 h PG were 1 604.1,1 617.9 and 1 683.7 yuan/month,the median values were 1 000 yuan/month;the WTP values of respondents to the 10% recovery were 867.4,908.5 and 877.9 yuan/month,the median values were 500,575 and 510 yuan/month,respectively. The influential factors with positive effects and significant differences on WTP values in step-wise multiple linear regression were total annual household income,complications,hospital experience,family history of di-abetes,diabetes mental status and cost of diabetes in the past months;those with negative effects and significant differences on WTP values were age,FPG level and education level. CONCLUSIONS:Diabetic patients,particularly,with peripheral neuropa-thy,high blood lipids or diabetic foot have higher WTP value,which shows they hole heavier mental burden and disease burden than others. Patients recovered 10% percent were closer to actual treatment state,which better show the influential factors of WTP values actually,and patients with a family history of diabetes,depressed mood,higher fees in the average monthly cost,and hospi-tal patients have higher WTP values.

BACKGROUND:Bioglass has good biocompatibility and biological activity, which can be combined with calcium phosphate bone cement to form an absorbable bioglass that has the advantages of both materials and is expected to have a better use of space. OBJECTIVE:To explore the mechamism of the new type of absorbable bioglass injection for vertebral body supporting and osteogenic induction in osteoporosis rats. METHODS:Twenty-seven female Sprague-Dawley rats were selected to make osteoporosis models by bilateral ovariectomy, and after 1 month, the rats were randomized into three groups. Bone defect models were established in the lumbar L4 segment of al the rats. Rats in the experimental group were subjected to absorbable bioglass injection; rats in the control group 1 underwent polymethylmethacrylate bone cement injection; and rats in the control group 2 were given injectable calcium phosphate. Twelve weeks after implantation, the compressive strength, degradation and osteogenesis of the implant materials were detected, and levels of serum bone morphogenetic protein-2 and transforming growth factor-β were measured. RESULTSAND CONCLUSION: The compressive strength, hydroxyapatite deposition amount, and weight loss ratio in the experimental group were significantly higher than those in the two control groups (P < 0.05); the relative volume, thickness and number of bone trabeculae in the experimental group were significantly higher than those in the control groups (P < 0.05); the bone morphogenetic protein-2 and transforming growth factor-β protein levels in the experimental group were significantly higher than those in the two control groups (P < 0.05). These findings indicate that the new-type absorbable bioglass can greatly strengthen the vertebral body supporting and promote osteogenic effect in osteoporosis by enhancing the bone morphogenetic protein-2 and transforming growth factor-β protein levels.

Objective In order to protect the natural resources of Swertia bimaculata which has been destroyed seriously,the method of artificial propagation by way of tissue culture have been systematically studied.Methods The stems,leaves,and stems with buds which were from the seedlings germinated from the seeds on the initial medium were taken as explants.These explants were cultured on MS culture media by adding different portions of hormones at various cultural conditions.Results The stems were the best material in speeding propagation among the three explants.The proper initial medium for the stems was MS+ BA 0.5 mg/L+saccharose 3.0%,the optimum medium for proliferation was MS+BA 0.5 mg/L+IBA 0.1 mg/L+saccharose 3.0%,and the best medium for rooting was 1/2MS+NAA 0.5 mg/L+saccharose 1.5%.Conclusion Tissue culture of S.bimaculata could make its propagation rapid,its resources preserved,and its utilization last.

[Objective]To observe the biological properties of a novel collagen/hydroxyapatite composite scaffold in vitro and to evaluate the possibility of application being used in tissue engineering for osteochondral repair.[Method]The scaffolds were constructed of collagen I and hydroxyapatite.The pore size and interpores of the scaffold were observed by scanning electronmicroscopy(SEM).The porosity was measured by liquid displacement method.Rabbit bone marrow stromal cells(BMSCs) were isolated and amplified,then inoculated onto the scaffold.By SEM scanning,the condition of the cells adhering onto the scaffold was observed.The proliferation of the cells on the scaffolds was examined using MTT method,and the growth curve was drawn.[Result]The scaffold possessed high porosity and proper pore size.The pore diameter of the collagen layer was about 90?m,the pore diameter of the HA layer was about 120?m,and the overall porosity of the composite scaffold was 75%.The proliferation of the cells on the scaffold was good.[Conclusion]The novel collagen/hydroxyapatite composite scaffold possesses desirable pore structure and good biocompatibility,and it can be used in tissue engineering for osteochondral repair.