BACKGROUND:Autologous peripheral blood stem cels have pluripotent characteristics, promote ischemic limb angiogenesis, improve and restore the blood supply to the affected limb.
OBJECTIVE:To observe the therapeutic effect of autologous peripheral blood mononuclear cel transplantation in rats with thromboangitis obliterans.
METHODS:Twenty-four rats were randomized into control, model and granulocyte colony stimulating factor (G-CSF) groups. In the latter two groups, animal models of thromboangitis obliterans were established by femoral arterial injection of sodium laurate. In the G-CSF group, rats were injected with recombinant human G-CSF for 5 successive days for peripheral blood mononuclear cel mobilization, and then underwent peripheral blood mononuclear cel transplantation at day 7. In the control and model groups, rats were given normal saline injection.
RESULTS AND CONCLUSION:After modeling, foot dorsum temperature and the percentage of CD4+CD25+ regulatory T cels decreased significantly in the model and G-CSF groups, and the area of leg ulcers was enlarged notably in these two groups. In the G-CSF group, the number of white cels and percentage of CD34+ cels to mononuclear cels were increased at 6 days after mobilization; the foot dorsum temperature and the percentage of CD4+CD25+ regulatory T cels increased significantly at 1 month after peripheral blood mononuclear cel transplantation, which were close to the normal values. These findings indicate that autologous peripheral blood mononuclear cel transplantation folowing cel mobilization increases the percentage of CD4+CD25+ regulatory T cels in rats with thromboangitis obliterans, thus promoting relief of symptoms and ulcer healing.

BACKGROUND:Studies have shown that neural stem cel transplantation has a certain effect on neuropathic pain, but the efficacy of transplanted cel number on neuropathic pain is not exactly understood. OBJECTIVE:To observe the effect of different amount of neural stem cels administered intrathecaly on the neuropathic pain and expression of glial-derived neurotrophic factor in the spinal cord dorsal horn and dorsal root ganglion in rats after partial sciatic nerve transaction. METHODS:A Sprague-Dawley rat at 14-16 days of pregnancy was used to prepare neural stem cel suspensions that were injected intrathecaly into rat models of partial sciatic nerve transaction at doses of 1×103, 1×104, 1×105, 1×106, 1×107cels per 30 μL, respectively. Additionaly, model group and sham-operated group were set up. Threshold values of mechanical and thermal pain were recorded 1 day before operation, 1, 3, 7, 14, 21 days after operation. Expressions of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were detected by immunohistochemistry and RT-PCR, respectively, at 7 and 21 days after partial sciatic nerve transaction. RESULTS AND CONCLUSION: Pain threshold values were decreased in al the groups except the sham-operated group at 1 day after operation, and reached the peak at 7 and 14 days after operation (P < 0.05). Compared with the model group, the pain threshold values and the expression of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were increased gradualy in a dose-dependent manner in the 1×104, 1×105, 1×106, 1×107 groups at 7 days after operation (P < 0.05). At 21 days post-operation, the pain threshold values showed no differences from the preoperative findings in the 1×105, 1×106, 1×107 groups, but the expression of glial-derived neurotrophic factor was significantly higher in the 1×105 group than the other groups (P < 0.05). Taken together, intrathecal transplantation of neural stem cels at a dose of 1×105 is the most effective in aleviating partial sciatic nerve transaction-induced neuropathic pain in rats.

Objective To evaluate the curative effect and safety of Niaoshit on g pill in the treatment of urinary calculus.Method Multi- center randomized co ntrolled clinical trial was adopted. Three hundred and twenty cases were accepte d to the study, in which 200 cases were treated by Niaoshitong pill and 120 case s by Shilintong tablet as control. The effect of both groups was observed. Resul t 107 cases (53.5 % ) were cured, 53 cases(26.5 % ) effective, the total effe ctive rate being 80.0 % in the treatment group, and 27 cases(24.5 % ), 42 cas es (38.2 % ), and 62.7 % respectively in the control group. In a open group of 120 cases ,54 cases (45.0 % ) were cured, 44 cases (36.6 % ) were effective , the total effective rate being 81,6 % .Conclusion Niaoshitong pill can mark edly improve the clinical symptoms and exerts a strong lithagogue effect. It can promote the elimination of calculi after external blast lithotrity or ureterosc opic lithotrity, prevent the formation of 'stone street', and reduce the strictu re formed by the damage of ureter.

Objective: Combined with the metrological verification in order to strengthen the quality control of medical ultrasonic diagnostic instrument, to ensure the image quality of instruments and medical safety. Methods: Measure output sound intensity, patient leakage current, metrological verification parameters detection depth, resolution, geometric position error value, cystic focal diameter error, blind area and so on. Results: Through analyzing the data of metrological verification results, and in combination with the practical situation of hospital ultrasonic diagnostic instrument calibration, approved metrological verification instrument performance detection technology as the basis. Conclusion: The combination of metrological verification, strengthen training, maintenance, etc, to ensure the operation and safety of instruments, to achieve good quality control in the device.

[Objective]To evaluate the biomechanical features of Ni-Ti shape memory alloy stemless femoral prosthesis.[Method]Using CT(computer tomography) scanning photographs of adult femur,three-dimensional model of the femur was built by CAD(computer aided design) software.Based on the the structure of femoral model,shape memory alloy stemless femoral prosthesis was designed.Three-dimensional finite element model was created for the normal femur,Ni-Ti shape memory alloy stemless femoral prosthesis,and traditional stemmed hip prosthesis.Under static loads and walking loads,the Von Mises stress distributions of each model were analyzed and compared.[Result]The stress distribution of shape memory alloy stemless femoral prosthesis was not obviously different from normal femur,stemless femoral prosthesis's proximal femoral stress was close to that of normal femoral model but significantly higher than traditional stemmed hip prosthesis.Von Mises stress of memory alloy claws was distributed evenly,and the Max was only 13.23Mpa,there was no stress concentration.[Conclusion](1) Ni-Ti shape memory alloy stemless femoral prosthesis has great biomechanical properties,may reduce the stress-shieding effect of the proximal femur.The fixed method that use memory alloy claws can make prosthesis fixed firmly to the bone and reduce stress concentration.

Objective To evaluate the efficacy of telbivudine in HBeAg-positive chronic hepatitis B (CHB) patients by comparing the efficacy of initial telbivudine therapy in treatment-naive patients with sequential telbivudine therapy in patients with poor response to adefovir.Methods A total of 90 HBeAg-positive CHB patients were assigned to receive sequential telbivudine therapy following poor response to adefovir dipivoxil (n=45),or initial telbivudine therapy in antiviral treatment-naive patients (n=45).All patients were treated with telbivudine 600 mg daily for 104 weeks.The efficacy was evaluated in terms of liver function tests,serum HBV markers,HBV DNA and antiviral drug resistance.Results Telbivudine showed good overall efficacy after treatment for 104 weeks in terms of alanine aminotransferase normalization rate (91.1％),HBV DNA negative conversion rate (80.0％),HBeAg loss rate (57.8％),and HBeAg/HBeAb seroconversion rate (30.0％).The HBV DNA negative conversion rate in initial treatment group was significantly higher than that in sequential treatment group (P＜0.05).However,among the patients with early response,the efficacy did not show significant difference between groups (P＞0.05).The patients with early response showed significantly better efficacy than those without early response,in terms of higher HBV DNA negative conversion rate,higher HBeAg loss rate and HBeAg/ HBeAb seroconversion rate (P＜0.000 1 or P＜0.05),but lower virological breakthrough rate (P＜0.05).Conclusions Telbivudine has shown reliable efficacy in CHB patients.Initial telbivudine therapy is better than sequential therapy in CHB patients with poor response to adefovir.However,for patients with early response to telbivudine,no statistical difference is found between initial and sequential therapy in long-term treatment efficacy (104 weeks).The patients receiving sequential telbivudine therapy should be monitored closely for early antiviral response to optimize treatment.

Lymphatic metastasis is one of the main routes of tumor metastasis. The limitation of traditional medicine in the treatment of lymphatic tumor metastasis lies in the low concentration of the drug in lymphatic metastases resulting in poor efficacy. Nanocarrier-based drug delivery system plays an important role in enhancing drug targeting, improving drug bioavailability, and reducing side effects. This review introduces the composition and function of the lymphatic system as well as its role in tumor metastasis, enumerates the present therapeutic means and limitations of anti-tumor lymphatic metastasis, and focuses on the recent advances in the passive, active and antigen-presenting cell-mediated lymphatic targeted drug delivery systems in tumor metastasis are highlighted.

A summary will be made in this article concerning foreign seniors’ probation of Cardiology. These points as follows are vital to the successful teaching: making sufficient preparations before practice; analyzing the emphasis and difficulties, encouraging students to become the subject of class by making inquiry, doing physical examination by themselves and discussing the cases, paying great attention to the education of medical morality nurturance and correcting the students’ case records seriously.

Objective To evaluate the effects of different doses of ephedrine combined with hydroxyethyl starch as a volume preload for preventing hypotension in caesarean section before combined spinal and epidural anesthesia.Methods 250 pregnant wemen undergoing cesarean section were randomly allocated into the control group (n =50) and the observation group(n =200)(group was divided into A,B,C,D group,each group 50 cases).Control group preloaded Lactated Ringer's solution 250ml before CSEA.A group preloaded hydroxyethyl starch combined with 5mg ephedrine; B group preloaded hydroxyethyl starch combined with 10mg ephedrine.C group preloaded hydroxyethyl starch combined with 15mg ephedrine; D group preloaded hydroxyethyl starch combined with 15mg ephedrine.The parturient SBP,HR and untoward reaction were monitored in five experimental groups.Results Compared with T0 A group parturient SBP was lower at T1,T2,T5 [(111.8 ± 17.18)mm Hg,(114.58 ± 19.80)mm Hg,(115.06 ± 10.39) mum Hg vs (120.88 ± 13.24) mm Hg,all P ＜ 0.05)].Compared with B,C,D group,statistical differences were found at T1,T4,T6[(111.8 ± 17.18)mm Hg vs (120.78 ± 14.47)mm Hg,(118.56 ± 14.25)mm Hg,(118.42 ± 18.71)mm Hg.(125.58 ± 14.45) mm Hg vs (120.02 ±21.15)mm Hg,(115.92 ± 17.56)mm Hg,(119.00 ±12.49)mm Hg.(118.08 ±9.09)mm Hg vs (121.52 ± 10.92) mm Hg,(116.04 ± 11.61)mm Hg,(124.98 ± 9.16) mm Hg,all P ＜ 0.05].Compared with T0 parturient HR was undulation at T1,T5 (P ＜ 0.05).Compared with C,D group,statistical differences were found at T1,T3,T4,T6 [(82.92 ± 19.55) times/min vs (98.86 ±17.82)times/min,(96.72 ± 17.91) times/min.(89.04 ± 16.68) times/min vs (92.10 ± 16.55) times/min,(98.46 ± 19.49) times/min.(87.56 ± 17.13) times/min vs (98.86 ± 16.76) times/min,(88.58 ± 19.22) times/min.(93.20 ± 14.07) times/min vs (98.80 ± 11.69) times/min,(90.98 ± 10.93) times/min.all P ＜ 0.05].In B and C group,parturient SBP and HR were steady and the untoward reaction was very few.Although parturient SBP of D group was steady,but HR obviously fast during operation (P ＜ 0.05).Compared with B,C group,statistical differences were found at T4,T6 (P ＜ 0.01).Conclusion The optimum dose is 10 ～ 15 mg of ephedrine.It combined with hydroxyethyl starch as a volume preload can keep the stable of blood circulation.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.