BACKGROUND: Nano-hydroxyapatite has been widely used as reconstructive and prosthetic material for osseous tissue, owing to its excellent biocompatibility and bioactivity. But, its brittleness is one of the most serious obstacles for its wider applications as load-bearing implants. Therefore, hydroxyapatite/chitosan composites have been widely studied as bone substitute, due to their excellent biocompatibUity and suitable mechanical properties.OBJECTIVE: To review various preparation methods of hydroxya patite/chitosan composites and the development trend in this field.METHODS: Articles were searched in Medline Database (1995-01/2009-03), VIP Database (1995-01/2009-03) and "qinghuatongfang" Database (1995-01/2009-03) with the keywords of "nano-hydroxyapatite, chitosan, preparation, development trend".RESULTS AND CONCLUSION: Total 2 034 related articles were collected, including 1 634 in Chinese and 670 in English. Following excluding earilier published, duplicate, and similar studies, we brought into 37 sub-standard literatures. Hydroxyapatite/chitosan composite in nanometer size, with similar structure as natural bone, has better biological function compared with corresponding micrometer composite. Simultaneously, optimized material composition, structure and technology will obtain more suitable bone substitute in mechanical property compared with natural bone. This paper reviews preparation methods at home and abroad in recent years, with the rapid development of biological materials, hydroxyapatite compositematerials have been wisely used in bone tissue repair and replacement surgery, but its poor mechanical properties limits its clinical application.

Objective To summarize the experience of diagnosis and treatment of the duodenal polys.Methods 14 patients of duodenal polys admitted between 1987 and 2006 were analyzed retrospectively.Results Clinical manifestations were melena,epigastric discomfort, abdominal pain,weight loss and abdominal distention.The ratio of correct diagnosis were 60% with duodenal endoscopy,56% with upper gastrointestinal radiography and 44% with CT.Most duodenal adenomas located at the second portion of the duodenum.8 duodenal adenomas turned into carcinoma and 2 cases recured in a year after operation.Conclusion Duodenal endoscopy and upper gastrointestinal radiography were effective for diagnosis of duodenal polys.Endoscopic ultrasound(EUS)helps to improve the diagnosis of the leions in submucosa.It should pay attention to the treatment of doudenal adenomas actively.The surgery remained the mainstay of the treatment.It needed attention for the screening and treatment of the duodenal adenomas.

Through investigating the hospital admission and hospital discharge of vagrant mental patients in Xi-aoshan Hospital from January 2011 to December 2015 , the present study found that there existed some ethical di-lemmas including the risk ofdiagnosing mental disorder but actually not, lack of the guarantee of patients' rights and interests and supervision mechanism without guardian, long-term retention in the wards, and so on. It is sug-gested to establish right protection and supervision committee for vagrant mental patients, reduce the misdiagnosis ofdiagnosing mental disorder but actually not through the error correction mechanism, ensure proper treatment and care, create retention way, protect the basic rights of the vagrant mental patients, reduce mental disability, avoid to stray again, so as to perfect the social management system.

Objective To investigate the diagnostic values of serum free fatty acids (FFA) and urine podocalyxin (PCX) in the patients with type 2 diabetic nephropathy(DN).Methods A total of 120 patients with type 2 diabetes mellitus (DM) were enrolled,and they were divided into three groups,normal albumin group(NA),microalbuminuria group(MA) and heavy albuminuria group(HA),based on the urinary albumin-creatinine ratio(UACR).In addition,40 healthy persons participated in medical examination were selected as the control group.Serum FFA levels were detected by a biochemical analyzer and urine PCX levels by ELISA.The correlation between them was analyzed by Pearson correlation,and their diagnostic values in type 2 DN were evaluated by the receiver operating characteristic curve (ROC).Results Serum FFA levels in the NA,MA,HA and control groups were (0.61 ± 0.14),(0.81 ± 0.13),(0.95 ± 0.18) and (0.49 ± 0.11) mmol/L,respectively,and urine PCX levels were (1.86 ± 0.45),(4.47 ± 1.48),(6.72 ± 1.40)and(1.38 ±0.24) ng/mL,respectively.The levels of serum FFA and urine PCX in type 2 DM patients were significantly higher than those in the control group(P ＜ 0.05),and increased with the progression of type 2 DM.Pearson correlation analysis showed that serum FFA levels were positively correlated with urine PCX levels(r =0.73,P ＜ 0.05).The sensitivity of serum FFA,urine PCX and combined detection in the diagnosis of type 2 DN were 74.1％,80.6％ and 89.5％,respectively,and the latter significantly higher than the former two (P ＜ 0.05).Conclusion Serum FFA and urine PCX levels increase significantly in diabetic patients with renal injury,and both of them have important clinical values in the diagnosis of type 2 DN.

Objective To evaluate the effects of color Doppler ultrasound guided percutaneous aspiration and absolute alcohol sclerotherapy on abdominal viscera cysts.Methods38 abdominal cysts in 33 cases were treated under Color Doppler ultrasound guided percutaneous aspiration and sclerotherapy with injection of absolute alcohol.Results After absolute alcohol treatment for 38 cysts in 33 cases,the cure rate was 89%,the efficacy rate was 100%.Con- clusion Color Doppler ultrasound Guided puncture sclerosing therapy of abdominal viscera cyst is a simple,safe and effective method.

BACKGROUND: Educative instruction is good for the improvement of learning and behavior disorder in children with learning disorder. If this educative instruction were individualized, i. e. different education is provided for different individual, it would receive even better effects.OBJECTIVE: To explore the method and effect of educative instruction for children with learning disorder to accumulate experiences for the development of their learning potentials.DESIGN: A paired(pairing the subjects with similar age and learning disorder) case analysis based on the suffers .SETTING: A medical college of some university.PARTICIPANTS: Eight children with learning disorder were selected from Zhenjiang City Dongwu Kindergarten or Zhenjiang City Dagang Central Primary School. These 8 cases suffered from 4 types of disorders including clumsiness, seclusive personality, language disorder, and poor learning ability. Eight cases were randomly divided into education group and control group.METHODS: Cases of control group received normal educations without specific interventions. Cases of education group received individual customized educative instructions. The educative effects were observed after 3 months.MAIN OUTCOME MEASURES: The improvement of clumsiness, seclusive personality, language disorder or poor learning ability in children with learning disorder.RESULTS: Cases of education group had better psychological and behavior improvements than that of control group after individual educative instruction.CONCLUSION: Individual educative instruction for children with learning disorder is an effective approach for the development of their learning potentials.

Objective To evaluate the efficacy of PET-CT brain imaging and resting-state fMRI in preoperative localization of temporal lobe epileptic (TLE)focus.Methods PET-CT and resting-state fMRI were performed in 17 patients with refractory TLE,who then underwent surgical treatment.Seventeen healthy volunteers matched with gender and age were recruited as the control group.The resting-state fMRI images were post processed by SPM5 software.Regional homogeneity(ReHo) values of the whole brain and bilateral hippocampus were obtained and analyzed.PET-CT images were analyzed by visual analysis method and asymmetry index method and the standardized uptake value (SUV) of bilateral hippocampus were obtained.The ReHo values and SUV of the bilateral hippocampus were compared by two independent samples t-test,and analyzed by receiver operating characteristic curve (ROC) for optimized diagnostic threshold.Pearson correlation analysis was employed for evaluating the correlation between the SUV and ReHo values of bilateral hippocampus.The consistency between the diagnostic accuracy of PET-CT and resting-state fMRI was assessed by Kappa consistency test.The outcome of the patient group was compared with that of the control group,and with the pathological results,to evaluate the diagnostic value of the two modalities for preoperative localization of temporal lobe epileptic focus.Results Regional or comprehensive low metabolism of 18F-FDG in temporal lobes was presented in all 17 patients,and 11 patients out of 17 showed lateral decreased ReHo value.The diagnostic accuracy of the two examinations was 70.6％ (12/17) and 64.7％ (11/17) for PET-CT and resting-state fMRI respectively compared with pathological results,and could be increased to 76.5％ (13/17) when the two methods were combined for diagnosis.The ReHo values of the TLE group (0.34 ± 0.12)were significantly lower than those of the control group (0.46 ± 0.07) (t =3.230,P =0.003).The sensitivity and specificity of resting-state fMRI were 88.2％ and 94.1％ respectively when the ReHo value was 0.36.There was significant difference between the SUV of the affected (4.17 ±0.63) and healthy side(4.77 ±0.56) of hippocampus in TLE group(t =2.930,P =0.006).The sensitivity and specificity of PET-CT were 88.2％ and 64.7％ respectively when SUV was 4.23.The two values could be used as a threshold in the localization of temporal lobe epileptic focus.Consistency of lesion detection was revealed between PET-CT and resting-state fMRI though it was not high,and the Kappa value was 0.49.However,no correlation was detected between the SUV and ReHo value using Pearson correlation test(r =0.280,P =0.314).Conclusion Combined PET-CT brain imaging and resting-state fMRI as a multi-modality imaging method might improve the diagnostic accuracy of the TLE focus's localization.

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

The work aims to study the drug metabolizing enzymes involved in the metabolism of butylphthalide and evaluate the induction and inhibition activities of butylphthalide on CYP450 isoenzymes by using in vitro (liver microsome incubation system of rats and human) and in vivo (CYP induced model of rats) method. Butylphthalide was incubated with selective inhibitors of CYP450, and its metabolic rate was determined to identify the metabolizing isoenzymes of NBP in rat (normal and induced rats) and human liver microsomes. The in vitro inhibition effect of butylphthalide on 6 main liver microsomal CYP450 isoenzymes was evaluated by using probe drugs; the induction and inhibition activities in vivo of butylphthalide on CYP450 isoenzymes were evaluated by NBP ig dosing (160 mg x kg(-1)) and iv dosing (20 mg x kg(-1)) in rats. After adding the specific inhibitors of CYP2C11, 2E1 and 3A 1/2 for rat, CYP2C19, 2E1 and 3A4/5 for human, the metabolism of NBP in rat and human liver microsomes were reduced 38.8%, 86.2%, 78.4% and 51.0%, 92.0%, 58.9% of control, respectively. The metabolic rates of NBP in CYP2E1 and 3A 1/2 induced rat liver microsomes were increased 25.5% and 68.9%. High concentration of NBP (≥ 200 μmol x L(-1), in vitro) could inhibit the activities of CYP1A2, 2C6, 2C11 and 2D2 in rats, and high concentration of NBP ( ≥ 15 μmol x L(-1), in vitro) could inhibit the activity of CYP2C19 in human. All the results indicated that NBP should be mainly metabolized by CYP2E1, 2C11 and 3A 1/2 in rats and CYP2E1, 2C19 and 3A4/5 in human. High concentration of NBP could inhibit human CYP2C19 in vitro. No significant induction/inhibition effects of NBP were observed on rat liver CYP450 isoforms after ig 160 mg x kg(-1) NBP or iv 20 mg x kg(-1) NBP.
Animals ; Benzofurans ; pharmacology ; Cytochrome P-450 Enzyme Inhibitors ; pharmacology ; Cytochrome P-450 Enzyme System ; metabolism ; Humans ; Isoenzymes ; metabolism ; Liver ; metabolism ; Microsomes, Liver ; metabolism ; Rats

Objective To investigate the feasibility of sigrnoid coloplasty for patients after resection of middle or low rectal carcinoma, and to evaluate the defecation function after the operation. Methods Forty-three patients with middle or low rectal cancer who had been admitted to the cancer Hospital of the Chinese Academy of Medical Sciences from January 2007 to January 2008 received sigrnoid coloplasty after rectal carcinoma resection (treatment group), and another 43 patients who had been admitted during the same period received colonic J pouch reconstruction (control group). The feasibility and safety of the 2 surgical procedures and postoperative defecation function were assessed. All data were processed by t test, chi-square test or Fisher exact probability. Results The sigmoid coloplasty was successfully performed in all patients in treatment group, while the reconstruction of the J pouch failed in 4 patients in the control group. Three patients in each group underwent temporary transverse colostomy. The incidences of postoperative complications in treatment group and control group were 7% (3/43) and 9% (4/43), respectively, with no statistical difference between the 2 groups (X2 =0. 282, P > 0.05). The median frequency of defecation in treatment group was 2.0 ± 1.5 per 24 hours, which was significantly less than 2.5 ± 1.0 in control group (X2 = 1. 242, P > 0.05). The fecal incontinence scores in treatment group and control group were 1.7 ± 0. 7 and 1.6 ± 0.8, respectively, with no statistical difference between the 2 groups (t = 0. 285, P > 0. 05). Conclusion Sigmoid coloplasty has similar benefits to colonic J pouch reconstruction, while sigmoid eoloplasty is relatively feasible, effective and safe for low colorectal or coloanal anastomosis.