OBJECTIVEThis study is performed to investigate the cell topographies and biomechanical properties of two different types of temporomandibular joint (TMJ) discs from goats by using JPK Nano Wizard 3 biological atomic force microscopy (AFM). This process provides a guideline for selecting seed cells for TMJ disc tissue engineering.

METHODSTMJ disc cells from primary goats were cultured by monolayer culture method. AFM was used to contact scan the topographies of the two types of TMJ disc cells under physiological environment. Approximately 20 chondrocyte-like and fibroblast-like cells were selected randomly to plot the force-versus-distance curves of the cytoplasm and nucleus. Young's modulus and adhesion were analyzed by JPK Data Processing.

RESULTSThe triangle-shapednucleus of the chondrocyte-like cell occupied a large portion of the cell. Cytoskeleton was arranged dendritically on the surface. Pseudopodia were extended from cell edges. The spindle-shaped nucleus of the fibroblast-like cell occupied a significantly larger region compared with the cytoplasmic region. Cytoskeleton was arranged regularly. Cell edges were smooth with less pseudopodia extended. No difference was found in the surface roughness between the two types of cells. According to the force-versus-distance curves, the Young's moduli of the two types of cells were not statistically different (P>0.05), but differences were found in the cytoplasmic regions (P=0.047). No statistical difference was found in the adhesions between the two types of cells (P>0.05).

CONCLUSIONThe AFM topography and curves were compared and analyzed. The two types of TMJ disc cells exhibited significantly different topographies, but only slight difference in their mechanical abilities.

Animals ; Chondrocytes ; Elastic Modulus ; Fibroblasts ; Goats ; Temporomandibular Joint Disc ; Tissue Engineering

Objective To apply color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) to the follow-up observation of the changes of cervical vessel,intracranial hemodynamics and cerebrovascular reserve capacity (CVR) of the patients after carotid artery stent implantation.Methods Totally 96 patients with carotid artery stent implantation underwent CDFI and TCD examinations,and the changes of hemodynamics were compared before and 1 month,6 months,1 a and 2 a after implantation.Results The values of peak systolic velocity (PSV) and resistance index (RI) at the areas of carotid stenosis were lower significantly than those before implantation,while the values of PSV,pulsatility index (PI) and CVR of the middle cerebral artery were obviously higher than those before implantation (P＜0.05).There were no significant differences between the cervical and intracranial hemodynamics indexes 1 month,6 months,1 a and 2 a after treatment.Two-year follow-up found 4 cases of restenoses after implantation,and the rate for restenosis was 4.2％.Conclusion Carotid artery stent implantation improves significantly cervical and intracranial blood supply as well as CVR of the carotid stenosis patient,and CDFI combined with TCD can be used for the accurate evaluation of the efficacy and postoperative follow-up of carotid artery stent implantation.

Objective It has been known that hepatopulmonary syndrome(HPS) is related to the imbalance between vasoconstrictors and vasodilators. The aim of the study is to examine the levels of plasma calcitonin gene related peptide (CGRP) and endothelin(ET) in patients with HPS for exploring their roles in HPS formation. Methods The levels of CGRP and ET were measured by radioimmunoassay in 16 cases of HPS, 30 cases of liver cirrhosis without HPS and 15 normal controls. Results The levels of plasma CGRP ((65?15)pg/ml) and ET((78?21)pg/ml) in 16 cases of HPS were significantly higher than those in liver cirrhosis (CGRP (51?15) pg/ml, ET (60?14) pg/ml) and in healthy controls (CGRP (32?12) pg/ml, ET (36?11) pg/ml) ( P 0.05). Conclusions The increase of plasma CGRP and ET is closely associated with the intrapulmonar vascular dilation of HPS and hypoxemia. The levels of plasma CGRP and ET in liver cirrhosis were significantly higher than those in healthy controls ( P

Objective:To investigate the intra- and inter-observer agreements of different experiencers using the Ovaria-adnexal Reporting and Data System (O-RADS) in the evaluation of adnexal masses.Methods:Totally 48 patients with adnexal masses (48 masses, mean size 9.5±4.7 cm, range 2.3-18.6 cm) found by ultrasound examination in the Third Affiliated Hospital of Sun Yat-sen University, from May 2019 to March 2020 were retrospectively analyzed. All the masses were confirmed by pathology or surgery. Four observers were divided into 2 senior doctors (Doctor 1 and Doctor 2) and 2 junior doctors (Doctor 3 and Doctor 4). Each observer independently evaluated adnexal masses twice using ultrasound O-RADS before and after systematic training, with an interval of 60 days. The intra-observer and inter-observer agreements were analyzed before and after training.Results:The inter-observer agreement between senior doctors were both excellent before and after systematic training (weight Kappa: 0.833 vs 0.802, percentage of agreement: 83.3% vs 81.3%). Whereas there was difference in the inter-observer agreement between non-experienced observers before and after training (weight Kappa: 0.399 vs 0.824, percentage of agreement: 50.0% vs 77.1%). After training, inter-observer agreement between junior doctors was significantly improved and comparable to senior (weight Kappa: 0.824 vs 0.802, percentage of agreement: 77.1% vs 81.3%). Before and after systematic training, the intra-observer agreements of the same doctor, the senior physicians were better than the junior (weight Kappa: 0.882 and 0.843 vs 0.440 and 0.605; percentage of agreement: 87.5% and 83.3% vs 58.3% and 54.2%).Conclusions:O-RADS risk classification system is a highly reproducible method in the subjective assessment of an adnexal mass among observers with varying levels of expertise. However, systematic training before clinical application is necessary and effective for non-experienced observers.

Objective:To build a three-dimensional evaluation model of single bed efficiency in an obstetrics and gynecology hospital and provide reference for bed management in hospital.Methods:The sample ward and key indicators were determined through interviews. A two-level database was built according to patients′ data from hospital information system. K-means cluster analysis was used to get the beds classified by annual average vacancy(x), annual average turnover(y) and annual average case-mix index per capita(z). The authors built the three-dimensional bed efficiency model with x, y, z as boundaries and analyzed the bed efficiency by comparing the within group average point A k( x k, y k, z k) with the overall average point A0( x, y, z). Whereafter the bed efficiency of each medical work team was analyzed. Results:Thirty-six beds were classified into 4 categories according to utilization efficiency. 50% of the beds(18 beds) were well used, 28%(10 beds) had room for improvement, and 19%(7 beds) may have resource waste. Significant differences existed in bed efficiency among medical work teams.Conclusions:The model in our study can realize in-depth exploration by evaluating bed efficiency from two aspects of the whole ward and each medical work team. This model, which is mainly applicable to the situation where beds are under the charge of fixed medical work groups or doctors, can be adjusted and extended to meet different strategic needs of hospitals.

Objective: To observe the relationship between hyperthyroidism and vascular endothelial injury. Methods: From 2016 to 2017, data of 60 patients with simple hyperthyroidism, autoimmune thyroid disease, cardiovascular and cerebrovascular diseases were collected from the Second Affiliated Hospital of Harbin Medical University. And 60 healthy subjects were enrolled in the same period as a healthycontrol group. The enzyme-linked immunosorbent assay (ELISA) was used to detect the content of vascular endothelial injury markers (vWF), thrombomodulin (TM), endothelin-1 (ET-1), P-selectin in serum of all subjects, as well as the serum thyroid stimulating hormone (TSH), free triiodothyronine (FT₃), free thyroxine (FT₄), anti-thyroglobulin antibody (TgAb), and anti-thyroid peroxidase antibody (TPOAb) in patients with cardiovascular and cerebrovascular diseases levels. The correlation analysis of vascular endothelial injury in the simple hyperthyroidism group, autoimmune thyroid disease group, cardiovascular and cerebrovascular diseases group and healthy control group was conducted. Results: There were statistically significant differences between the healthy control group, the simple hyperthyroidism group, the autoimmune thyroid disease group and the cardiovascular and cerebrovascular diseases group in the serum levels of vWF, TM, ET-1 and P-selectin, respectively(F = 6.56, 9.19, 7.88, 12.45, P < 0.05), and the simple hyperthyroidism group, autoimmune thyroid disease group, cardiovascular and cerebrovascular diseases group were significantly higher than the healthy control group (P < 0.05). Correlation analysis showed that the vascular endothelial injury in the patients with simple hyperthyroidism, autoimmune thyroid disease, and cardiovascular and cerebrovascular diseases groups was statistically significantly different compared with the healthy control group, respectively(χ² = 5.08, 5.08, 8.16, P < 0.05); the risk of vascular endothelial injury in each diseased group was 2.37, 2.37, and 3.07 times higher than that of the healthy control group, respectively. The abnormal rates of TSH, FT₃, FT₄, TgAb and TPOAb in patients with cardiovascular and cerebrovascular diseases were 18.33% (11/60), 15.00% (9/60), 15.00% (9/60), 10.00% (6/60) and 11.7% (7/60), respectively. Conclusion Simple hyperthyroidism and autoimmune thyroid disease are risk factors of vascular endothelial injury.