BACKGROUND:The colagen and chitosan composite membrane made at a certain percentage can reduce the positive charge of chitosan, improve the adsorption force of chitosan, promote the cel adhesion and growth, migration and proliferation, and enhance the biological properties of chitosan, which has become a very excelent biological material. OBJECTIVE:To prepare chitosan-colagen composite membrane and observe its histocompatibility with corneal stroma layer. METHODS:Chitosan-colagen composite membrane was prepared. Totaly 16 New Zealand rabbits were randomly divided into experimental and control groups. The chitosan-colagen composite membrane was implanted into right eye cornea stroma bag in the experimental group, and the chitosan membrane was implanted into right eye cornea stroma bag in the control group. The slit lamp microscope, anterior segment optical coherence tomography and histological observation were conducted after transplantation. RESULTS AND CONCLUSION: Slit lamp microscope observation results showed that after 8 weeks of transplantation, degradation infiltration was visible in the center of the diaphragm, crease buckling was not obvious in the experimental group; the diaphragm was infiltrated completely and crease buckling was notable in the control group. The anterior segment optical coherence tomography results showed that at the 6thweek after transplantation, the composite membrane boundary was fuzzy, its density was very close to the normal corneal tissue, and the corneal shape recovered to normal in the experimental group. The histological findings showed that after 8 weeks of transplantation, in the experimental group, the membrane surface was degraded a little; biodegradable materials were fused with the corneal stroma; there were a smal amount of inflammatory cels infiltrated on the corneal stroma around the iris. In the control group, the membrane degradation was greater than that of the experimental group; degradable substances intertwined and fused with corneal stroma; there were more inflammatory cels infiltrated on the corneal stroma around the iris. These results demonstrate that chitosan-colagen composite membrane has degradability and good histocompatibility.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Sciatica ; therapy

Objective To study the influence of different dosages of atorvastatin in acute coronary syndrome female patients on vascular endothelial growth factor(VEGF) and brain natriuretic peptide(BNP).Methods 60 female cases of ACS patients were divided into A and B group.30 patients in the A group were given atorvastatin 20mg per night,while the other 30 patients in the B group were taken 40mg per night.The patients were followed four weeks by evaluating serum VEGF and BNP concentration.Results After treatment for four weeks,the patients in the two groups showed significant reduction in VEGF and BNP,however,the therapeutic group showed significant difference between the two groups.Additionally,the B group further showed significant reduction in VEGF and BNP.Conclusion Using high-dose atorvastatin lowers VEGF and BNP significantly,which could reduce female cardiovascμlar events.

Through the study and analysis of doctor-patient relationship in the morden medical conditions in China,in this article,the author,combing with her medical praltice for many years,points out some principal problems existing in the relationship,and also puts forward some feasible countermeasures which will be helpful to set up harmonious doctor-patient relationship and ensure the durable and normal development of Chinese medical and healthy cause.

BACKGROUND:Effects of pedicle screw placement on fracture reduction or stability of mechanics are influenced by various factors. Pedicle screw fixation failure is mainly due to fracture, loosening and fatigue. The main influential factors for biomechanical stability of pedicle screw are length and diameter. The research on the depth is less. OBJECTIVE:To analyze the relationship between pedicle screw placement depth of vertebral body and the fixed stability based on the biomechanics. METHODS: A model of single vertebral compression fractures was made in 15 pigs aged 5 months on L2 vertebral specimen. According to the length of anteroposterior diameter, vertebral pedicle screws were inserted in different depths (80%, 90% and 100% of anteroposterior diameter). After fixation, specimens were loaded 10 000 times at the frequency of 0.5 Hz (340±125) N on a WDT-10KN type universal material testing machine. Ranges of motion at anteflexion, backward extension, left bending and right bending and the maximum axial pulout force were measured in each group, and the difference of intergroup data was compared. RESULTS AND CONCLUSION:(1) Ranges of motion at anteflexion, backward extension, left bending and right bending in each group were significantly smaler in the 100% and 90% groups than in the 80% group (P < 0.05), and above parameters were smaler in the 100% group than in the 90% group (P< 0.05). (2) After fatigue test, the maximum axial pulout force was significantly larger in the 100% and 90% groups than in the 80% group (P< 0.05), and above data were significantly larger in the 100% group than in the 90% group (P < 0.05). (3) Results indicate that the depth into the vertebral body was significantly associated with its fixed stability. The deeper the depth into the vertebral body, the stronger the vertebral stability was: 100% group > 90% group > 80% group.

BACKGROUND:How to improve the stability of artificial cornea in the host and reduce the complications is the current key issues to be solved.Therefore,looking for an ideal biocompatible scaffold material is still the focus of the study.OBJECTIVE:To explore the biocompatibility of nano-hydroxyapatite (nHA)/polyvinyl alcohol (PVA) porous composite hydrogel and pure PVA hydrogel as artificial corneal materials.METHODS:Inverted microscope was used to observe cell growth of rabbit corneal stromal fibroblasts when cultured with nHA/PVA composite hydrogel extract or PVA extract for 48 hours.MTT method was used to detect the relative proliferation rate of rabbit corneal stromal fibroblasts cultured with nHA/PVA composite hydrogel extract or PVA extract.Systemic toxicity,allergies,pyrogen reaction and deaths were observed in New Zealand white rabbits at 48 hours after artificial corneal implantation.ELISA and hematoxylin-eosin staining were used to detect changes in serum inflammatory factors at 4 weeks after artificial corneal implantation.Slit-lamp examination was performed to observe corneal or conjunctival hyperemia/edema and corneal neovascularization at 1-4 weeks after corneal implantation.Corneal neovascularization time and neovascularization area were detected after the two materials were implanted.RESULTS AND CONCLUSION:The cells were sparse and grew slowly at 48 hours after culture in nHA/PVA composite hydrogel or PVA extract as compared with the blank control group.The cell growth in the nHA/PVA composite hydrogel group was better than that in the PVA group.The relative cell proliferation rate was significantly decreased at different time after culture in nHA/PVA composite hydrogel or PVA extract compared with the blank control group (P ＜ 0.05),and the relative cell proliferation rate in the nHA/PVA composite hydrogel group was significantly higher than that in the PVA group (P ＜ 0.05).There were two rabbits appearing to have allergic reaction,but no one presenting with pyrogen reaction and death in the nHA/PVA composite hydrogel group;and there were two rabbits appearing to have allergic reaction,and two appearing to have pyrogen reaction,but no death in the PVA group at 48 hours after implantation.The inflammatory factor levels were increased significantly in the nHA/PVA composite hydrogel group and PVA group compared with the control group (P ＜ 0.05),and inflammatory infiltration was milder in the nHA/PVA composite hydrogel group than the PVA group at 4 weeks after implantation (P ＜ 0.05).Corneal neovascularization appeared later in the nHA/PVA composite hydrogel group than the PVA group,and the neovascularization area was also smaller in the nHA/PVA composite hydrogel group than the PVA group (P ＜ 0.05).Taken together,the biocompatibility of nHA/PVA composite hydrogel is superior to that of pure PVA when they are used as artificial cornea materials,which provides a scientific basis for artificial cornea material innovation and extensive clinical application.

Objective To investigate the protective effects of piceatannol on retinal ganglion cells (RGCs) in rats with glaucoma.Methods Forty rats were randomly divided into 4 groups:control group,model group,low dose piceatannol treatment group and high dose piceatannol treatment group.Photocoagulation method was used to establish the experimental glaucoma model in rats,and then rats were given 100 mg· kg-1 or 200 mg · kg-1 of piceatannol by gavage.The intraocular pressure was measured before and after the model was established.Rat retinal ganglion cells were labeled and counted using FG staining.Retinal tissue pathological morphology was observed by HE staining.The protein expression of p-JNK,p-c-Jun,p-ERK,p-p38 MAPK and TNF-α were measured by western blot.Results Compared with control group,the intraocular pressure,the protein expressions of p-JNK,p-c-Jun p-ERK,p-p38 MAPK and TNF-α were significantly increased in model group (all P ＜ 0.05).However,the number of RGCs were lower in model group(P ＜0.05).Furthermore,there were cavitation and edema changes in retinal tissue of model group.Compared with model group,piceatannol treatment markediy increased the number of RGCs(P =0.003,0.002),improved the pathological morphology of retinal tissue,and reduced the protein expressions of p-JNK,p-c-Jun p-ERK,p-p38 MAPK and TNF-α (all P ＜ 0.05),especially for the high concentration.Conclusion Piceatannol can protect against RGCs injury in glaucoma rats,and the mechanism may be associated with inhibition of MARK signaling pathway.

Objective:To establish experimental periodontitis model in Wistar rats by prednisolone acetate injection and ligature of their left second maxillary molars with steel-wire. Methods:Twenty Wistar rats were randomly divided into two groups, control group and experimental group. Muscle injection with saline was regarded as the control group. Prednisolone injection plus ligature of left second maxillary molar with steel-wire was used as the experimental group.The rats were killed after 6 and 8 weeks. Results:The rats in experimental group showed bad appetite and did not want to move after 4 days of injection. These symptoms were agreement with "shen-xu" in traditional Chinese medicine. The osteoporotic changes in alveolar bone, the absorption of alveolar ridge, the formation of periodontal pocket and osteoclastic activity were found in treatment group. None of above pathological changes occurred in periodontal tissue of the control group.Conclusion: Experimental periodontitis model could be successfully established in Wistar rats by ligature with steel-wire plus prednisolone injection, and this animal model offers a good means for the study of periodontitis.

Objective To survey the social support status and demands for family caregivers of the disabled elderly.Methods A cross-sectional survey based on convenience sampling was conducted among 779 disabled elderly and their family caregivers from May to June 2013 in five communities of Beijing Dongcheng District.Barthel index was used to measure the degree of functional impairment of the elderly.Self-rating Depression Scales (SDS) was used to evaluate depression symptoms of caregivers.Social Support Rating Scale (SSRS) and social support demand questionnaire were used to measure the social support status and social support demands of caregivers,respectively.Multiple linear regression analysis was used to analyze the influence factors of social support.Results Total 779 caregivers were identified and 744 caregivers completed the questionnaires with a valid response rate of 95.5％.Among 744 family caregivers the social support levels were low with an average SSRS score of 31.16 ± 6.86.There were significant differences in SSRS scores among caregivers of disabled elderly with different characteristics (age,married status and the Barthel index score) (all P ＜ 0.05);and there were significant differences in SSRS scores among caregivers with different characteristics (age,educational level,married status,current employment,relationship with patients,caregiving time daily,subjective care burden,living with patients,number of caregivers and depression status) (all P ＜ 0.05).Multiple linear regression analysis showed that the Barthel index score of the disabled elderly,the relationship with the elderly,depression status of the caregivers and the subjective care burden were correlated with the social support level of family caregivers (all P ＜0.05);the standard regression coefficients of above significant factors were 0.098,0.190,0.134 and 0.155,respectively.The social support demands of family caregivers were various;the average score was 2.44 ± 0.64,the top three demands were provision of care subsidy for the disabled elderly (average score was 2.95 ± 0.93),provision of care allowance for family caregivers (average score was 2.90 ± 0.93) and the guidance of safe medication (average score was 2.83 ± 0.83).Conclusions Family caregivers for the disabled elderly obtain low level social support in the surveyed area.Since the earegivers have various social support demands,the social support and assistance for them should be specific,effective and comprehensive.

Objective To explore the correlation among serum immunoglobulin G4 (IgG4),transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF) and Hashimoto thyroiditis (HT) thyroid fibrosis.Methods Case-control study.A total of 159 patients with HT visiting the Wuhan Union Hospital were collected from May 2013 to March 2015.All patients were divided into IgG4 HT group (IgG4≥1.35 g/L,n =39) and non-IgG4 HT group (IgG4 ＜ 1.35 g/L,n =120).The serum IgG4,TGF-β1 and CTGF were determined by enzyme-linked immunosorbent assays.The levels of serum thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured by electrochemiluminescence immunoassay.Meanwhile,ultrasound of the thyroid gland was performed.Statistical analysis was performed by use of SPSS 17.0 software.The Mann-Whitney U test was used to compare two independent samples of non-normal distribution data,Fisher's exact test was employed to analyze thyroid imaging differences,correlation test was performed to examine various correlations,multivariate Logistic regression analysis was used to evaluate thyroid fibrosis risk factors.Results Compared with that of non-IgG4 HT group,IgG4 HT group:TPOAb [(455.2 ± 169.7) vs.(186.5 ± 102.3),U =27.0,P=0.003],TgAb [(984.6±452.7) vs.(289.3 ±245.1),U=30.5,P=0.017],TGF-β1 [(1.45±0.97) vs.(0.30±0.22),U=119.0,P=0.035] andCTGF [(88.65±14.39) vs.(62.21± 8.76),U =69.0,P =0.039] were significantly higher,thyroid ultrasound showed obvious fibrosis (35/4 vs.32/88,x2 =48.03,P =0.000);significant positive linear correlation between IgG4 and TPOAb (r =0.719,P =0.000),CTGF and TGF-β1 (r =0.500,P ＜ 0.01) respectively.Logistic regression analysis indicated that all the serum IgG4,TPOAb,TGF-β1 and CTGF were independent risk factors of thyroid fibrosis [IgG4,odds ratio (OR) =1.968,P =0.014,95％ confidence interval (CI) =1.287-2.041;TPOAb,OR =2.537,P =0.012,CI =1.322-2.869;TGF-β1,OR =1.549,P =0.023,CI =1.105-1.498;CTGF,OR =1.185,P =0.046,CI =1.204-1.625].Conclusion The highlevel of circulating antibodies,IgG4,TGF-β1 and CTGF were significantly associated with thyroid fibrosis,and were independent risk factors of HT fibrosis.