Objective To explore the biocompatibility of nano-hydroxyapatite/polyamide 66 (nHA/PA66) with human bone mesenchymal stem cells (hBMSCs) after osteogenic induction.Methods After hBMSCs were isolated and cultured in vitro,the experiment was conducted in 3 groups.Group A were hBMSCs subjected to no osteogenic induction,group B hBMSCs subjected to osteogenic induction,and group C was the composite of nHA/PA66 with hBMSCs subjected to osteogenic induction.Adhesion of the cells onto the nHA/PA66 in group C was observed by electron microscope scanning.Growth and proliferation of the cells in groups B and C were detected by MTI test at 1,2 and 3 weeks.The ability of osteogenic differentiation of hBMSCs in vitro was analyzed by alkaline phosphatase (ALP) activity and alizarin red staining.The ability of osteogenic differentiation of hBMSCs on nHA/PA66 was tested by ALP activity.Results Electron microscope scanning showed that the cells spread and attached well on the surface of the composite scaffold in group C;the proliferation of the cells in groups B and C showed no significant difference (P ＞ O.05).These suggested that the proliferation of hBMSCs was not affected by nHA/PA66.The number of mineralized nodules in group B was significantly larger than in group A (P ＜ O.05);the ALP activity of the cells in group A was significantly lower than in group B at 6 and 12 days (P ＜ 0.05);no significant differences were observed between groups B and C (P ＞ 0.05).These indicated that the hBMSCs were capable of osteogenic differentiation which was not affected by nHA/PA66.In groups B and C,the ALP activity of the cells at 12 days was significantly higher than at 6 days,indicating the ALP activity increased with increased induction time (P ＜ 0.05).Conclusion nHA/PA66 can be used as a carrier of hBMSCs in bone tissue engineering because hBMSCs can well adhere to,proliferate,and differentiate into bone on nHA/PA66 scaffolds.

BACKGROUND:Orthopedists should pay more attentions to nonunion prevention in view of nonunion treatment, that is, active interventions should be taken to avoid bone delayed union and nonunion.
OBJECTIVE:To explore the effect of composite tissue-engineered scaffold constructed by nano-hydroxyapatite/polyamide 66 (nHA/PA 66) combined with bone marrow mesenchymal stem cels to repair a femoral fracture with severe nonunion.
METHODS:Rat bone marrow mesenchymal stem cels were isolated and culturedin vitro, and then they were divided into three groups: bone marrow mesenchymal stem cels without osteogenic induction, with osteogenic induction or combined with nHA/PA 66 folowed by osteogenic induction as control group, test group or composite group, respectively. Then osteogenic differentiation of bone marrow mesenchymal stem celsin vitrowas analyzed by measuring alkaline phosphatase activity and alizarin red staining, cel adhesion on the nHA/PA 66 was observed using scanning electron microscopy, and the celgrowth and proliferation were detected by MTT assay. In the meanwhile, established Sprague-Dawley rat femur nonunion models were randomly divided into three groups: the areas of nonunion were implanted with nothing as blank control group,those were with nHA/PA 66 as simple scaffold group, and the others were with nHA/PA 66 combined with bone marrow mesenchymal stem cels as composite scaffold group. Afterwards, X-ray examination, micro-CT and Masson staining were used to evaluate the femoral healing.
RESULTS AND CONCLUSION:At 6 and 12 days after osteogenic induction, alkaline phosphatase activity in the test group was significantly higher than that in the control group; at 14 days, compared with the control group, the amount of mineralized nodules in the test group was significantly higher, which indicated that bone marrow mesenchymal stem cels after osteogenic induction could differentiate into osteoblasts. Attached cels spread wel on the scaffold with good proliferation activity, suggesting that nHA/PA 66 is suitable for cel adherence, proliferation and osteogenic differentiation. Besides, at 12 weeks after modeling, in the blank control group, no calus appeared in the nonunion region. In the simple scaffold group, the broken femur did not heal at 8 and 12 weeks after surgery. In the composite scaffold group, the broken femur did not heal at 8 weeks, but a lot of calus appeared; at 12 weeks, bone healing achieved and the scaffold was encased and absorbed.These findings demonstrate that the tissue-engineered bone scaffolds constructed by bone marrow mesenchymal stem cels and nHA/PA 66 effectively prevent bone nonunion by accelerating femoral healing in a rat femur nonunion model.

Objective To assess the safety and effectiveness of artificial ascites assisted thermal ablation for hepatic tumors adjacent to the gastrointestinal tract in patients with a history of abdominal surgery . Methods Thirty‐two patients (33 lesions located adjacent to the gastrointestinal tract) with a history of abdominal surgery were included in the study . Method ① :normal saline was injected into abdominal cavity to form water insulation band between liver and gastrointestinal tract . Method② :normal saline was injected with appropriate pressure to form local water insulation band between the liver and gastrointestinal tract . Method③ :normal saline was injected continuously at the interval between liver and gastrointestinal tract to flush away heat energy caused by ablation . All the patients were checked for gastrointestinal tract injury after ablation . During one month after ablation ,CT /MR was performed to evaluate whether the lesions were completely ablated . Results Respectively ,the numbers of lesion received method ① ,② and ③ were 27(81 .8% ) ,4(12 .1% ) and 2(6 .1% ) ,while the usage of normal saline were 400~2 000 ml ,600~800 ml and 1 000~1 500 ml . No gastrointestinal tract injury occurred . CT/MR scan during one month after ablation showed that all the 33 lesions had been completely ablated . Conclusions In patients with a history of abdominal surgery ,artificial ascites is a safe and effective method in assistance of thermal ablation for hepatic tumors adjacent to the gastrointestinal tract .

Objective To explore the effects of arm venous port new technology standard operating procedure (SOP) in breast cancer with chemotherapy.Methods The arm venous port SOP was established from infusing to drawing.It was completed by doctor and nurse from infusing to venous port drawing.Patients received bed nursing by nurses in individual case during hospital,and then they were treated with "arm venous port group" management of department post discharge.The SOP was carried out in 100 female breast cancer patients with chemotherapy of the First Affiliated Hospital of Nanjing Medical University from May 2016 to February 2017.The arm venous port was infused one day before chemotherapy.It was used for infusing chemotherapy agents and other ancillary drugs.The overall recheck was conducted three months after the completion of chemotherapy.The arm venous port was drawn after being confirmed it had no further use.Results A total of 100 patients successfully completed 8 times of chemotherapy and the arm venous port was drawn successfully.During being with port,there were two patients with bad healing of surgical wound around port along with sewing up again;there were one patient with capsular bag infection after the fourth chemotherapy along with anti-infective therapy.The satisfaction of patients and their family members for operative technique and tracking service by doctors and nurses was 100％.Conclusions The application of SOP in arm venous port new technology can ensure high satisfaction of patients and reduce complications.It is suitable for clinical generalization.

Objective? To study the effect of applying rehabilitation nursing intervention for breast cancer patients. Methods? By convenience sampling, 79 breast cancer patients in Daqing LongNan Hospital of Heilongjiang Province were selected from March to November of 2018 as participants in this study and divided into the observation group(n=39) and control group (n=40) by random number table. The control group received conventional nursing care while the observation group received the combination nursing care of the conventional and rehabilitation nursing intervention. The two groups were compared in the rehabilitation effects,anxiety and depressive emotion and quality of life. Results? The observation group had better upper limb function than the control group after intervention with statistical difference (P＜ 0.05). The observation group had lower score in anxiety and depression than the control group after intervention with statistical difference (P＜ 0.05). The observation group had higher score in each dimensions of life quality than the control group after intervention with statistical difference (P＜ 0.05). Conclusion? Rehabilitation nursing intervention for breast cancer patients is of high clinical value and can be widely applied.

Objective To evaluate the value of intracavitary contrast-enhanced ultrasound in the diagnosis of biliary-bronchial fistula after hepatocellular carcinoma ablation. Methods Clinical data of 1 case with biliary-bronchial ifstula after hepatocellular carcinoma ablation in the Third Afifliated Hospital of Sun Yat-sen University were retrospectively analyzed. The informed consent was obtained and the local ethical committee approval had been received. The male patient, aged 56 years, underwent ultrasound-guided hepatocellular carcinoma radiofrequency ablation in September 2010. Examination revealed the tumor was completely ablated and no recurrence was detected 1 month after ablation. Ten months after operation, the patient suffered from recurrent fever and developed coughing up of bile-stained sputum at 17 months after ablation. MRI examination indicated the formation of a bile lake at the ablation site and percutaneous catheter drainage was performed. The diagnosis was conifrmed by lfuoroscopic and intracavitary contrast-enhanced ultrasound examination. Results The biliary fistula tract was found connected to the right chest by intracavitary contrast-enhanced ultrasound examination. After drainage the patients' symptoms were relieved. The biliary ifstula tract disappeared when checked by intracavitary contrast-enhanced ultrasound but the bile lake still existed. Right hemihepatectomy was performed subsequently. The patient was cured and discharged. Conclusions Biliary-bronchial fistula is a rare complication after hepatocellular carcinoma ablation. Intracavitary contrast-enhanced ultrasound could serve as a useful complementary method for the diagnosis and treatment of biliary-bronchial ifstula.

Objective: To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students. Methods: From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi stage cluster random sampling method. Self designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted. Results: Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother s educational level, family residence,family harmony and children s past health among the students with or without left behind experience ( χ 2=28.17, 52.40, 96.31, 29.75 , 19.10, P <0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left behind experience ( χ 2=0.02-4.32, P >0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67,1.58), interpersonal sensitivity (2.00,1.89), anxiety (1.90,1.70), obsessive compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience ( Z=-5.15 to -2.84, P <0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56,2.67)，2.00(1.44,2.56)], paranoia [1.83(1.33,2.50)，1.83(1.33,2.33)] and psychoticism [1.70(1.30,2.30)，1.70(1.20,2.20)] in SCL- 90 among secondary vocational students with or without left behind experience ( Z=-2.45, -2.12, -2.23, P <0.05). Conclusion The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.

Objective To determine the level of soluble B7-H1 (sB7-H1) in serum of patients with colorectal cancer ( CRC) , and to investigate its clinical application value in CRC .Methods 152 cases of CRC, 57 cases of benign colorectal diseases and 59 healthy subjects were enrolled .ELISA was used to determine the sB7-H1 level in serum.The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 72-4 (CA72-4) were determined by electrochemiluminescence. The level of carbohydrate antigen 50 (CA-50) was determined by chemiluminescence.ROC curve was used to evaluate the diagnostic efficiency of sB 7-H1 alone or combined with other tumor markers in CRC .It also analyzed the correlation between serum sB 7-H1 level and some clinicopathological characteristics including tumor location , depth of invasion , lymph node metastasis status , distant metastasis status and tumor stages.Results (1)The differences of sB7-H1 level among CRC group, colorectal benign disease group and healthy control group ( compared with each other respectively ) were statistically significant ( P<0.001 ) . Levels of CEA, CA19-9, CA72-4 and CA-50 were significantly different between CRC group and benign colorectal disease group ( P<0.05 ) , while there was no significant difference between benign colorectal disease group and healthy control group (P>0.05).(2)The diagnosis ability of sB7-H1, CEA, CA19-9,CA72-4, and CA-50 were determined by the area under curve (AUC), which was 0.730, 0.772, 0.639, 0.663 and 0.635, respectively.The combination of sB7-H1 and CEA showed the best effect , and the AUC reached 0.831.(3)There was no significant correlation between the levels of sB 7-H1 and CEA, or CA19-9, CA72-4, CA-50.(4) Immunohistochemistry result showed that the positive rate of CRC group was 52％, while that of benign disease group was 6.3％.The difference of the positive rate between two groups was statistically significant (P<0.01).And there was a significant correlation between the positive rate of sB 7-H1 level in serum and tumor tissues of CRC patients ( P<0.05 ) .( 5 ) The serum sB7-H1 level in CRC patients was related to lymph node metastasis status (P<0.05).But there was no relationship between sB7-H1 level and other clinicopathological characteristics ( including tumor location , depth of invasion , distant metastasis status and tumor stage ) (P>0.05).Conclusion Serum sB7-H1 has a high clinical application value and could serve as a new tumor marker in CRC .

Objective To investigate the effectiveness and safety of thermal ablation of patients with 3－5 cm hepatocellular carcinoma ( HCC ) under the assistance of ultrasound fusion imaging . Methods From December 2010 to December 2017 ,76 HCC patients with 78 medium‐size ( 3 －5 cm ) lesions who underwent radiofrequency ablation ( RFA ) or microwave ablation ( M WA ) were included in the study . Ultrasound fusion imaging was used to assist the ablation procedures and assess the technical success immediately ,then guided supplementary ablation . Contrast‐enhanced CT/M R was performed one month after ablation to assess the technique efficacy rate . T he complication ,local tumor progression ( L T P ) rate were followed up . Results According to the ultrasound fusion imaging evaluation ,24 lesions ( 30 .8% , 24/78) received supplementary ablation immediately during the ablation procedure . Seventy‐one of 78 liver tumors were evaluated to achieve 5 mm ablative margin while the other 7 liver tumors were not achieved . T here were no ablation‐related deaths ,and the major complication rate was 6 .6% ( 5/76 ) .T he technique efficacy rate was 100% ( 78/78) according to the contrast‐enhanced CT/M R one‐month later . Patients were followed up from 6 to 79 months with a median time of 22 months . L T P occurred in 4 lesions and the LT P rate was 5 .1% ( 4/78) . Conclusions With the assistance of ultrasound fusion imaging ,thermal ablation of medium‐sized HCC is effective and safe w hich could achieve a higher technique efficacy rate and a lower L T P rate .

Objective To explore the comorbidity patterns of chronic diseases and their associat-ed factors in the elderly population aged 60 and above in China.Methods Based on the data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),the Apriori algorithm in R4.0.4 software was used to extract frequent itemsets and construct an association rule model between chronic diseases and their associated factors,targeting the information on 14 chronic diseases in people aged 60 and above in the database.Results Among the 13 206 participants,3 691 cases(27.90％)suffered from at least one chronic disease,while 6 217 cases(47.08％)suffered from two or more chronic diseases.Analysis of association rules showed that the most common comorbidity patterns in-cluded heart disease and hypertension,dyslipidemia and hypertension,diabetes and hypertension,as well as"heart disease,arthritis→high blood pressure""high blood pressure,stomach disease→arthri-tis""dyslipidemia,arthritis→hypertension",with support degrees of 8.93％,8.29％,5.44％,3.82％,3.71％and 3.22％,and confidence degrees of 55.15％,59.64％,60.13％,53.67％,51.58％and 60.11％respectively.Irregular sleep patterns,urban living backgrounds,and high so-cial participation were strongly associated with hypertension;while irregular sleep patterns,rural resi-dency,and female were highly associated with arthritis.Conclusion Given the universality of hyper-tension in multiple chronic disease comorbidity patterns,the prevention and screening of hypertension and its complications in the elderly population should be strengthened.For the comorbidity patterns of chronic diseases coexisting with hypertension,special attention should be paid to the daily disease screening and management of the elderly who participate in social activities in cities.At the same time,for elderly women,poor sleep qual ity,and rural residents,the screening and attention to the comorbidity patterns of chronic diseases with arthritis need to be strengthened.