Articular cartilage injuries are always difficult to repair, but g ene-enhanced cartilage tissue-engineering has proved to be a better alternativ e treatment. Tissue engineering consists of 3 elements; germ cells, signal facto rs (cytokine or growth factor) and biological materials (scaffolds). This paper highlights research on the gene transduction with signal factors into germ cells .

Objective To investigate the characteristic of rotavirus(RV) molecular epidemiology among infants and young children with nosoeomial diarrhea in Shanghai area. Methods Two hundred and twenty-six stool specimens collected from inpatients with nosocomial diarrhea from November 2006 to January 2008 were measured by colloidal gold assay and nested polymerase chain reaction (PCR). The positive samples were typed to investigate the clinical characteristics of patients. The data were shown with constituent ratio and positive detection rate. The analysis was done by using t test. Results RV was detected in 108 of 226 specimens (47.8%) by colloidal gold assay. The incidence was highest in infants younger than one year old. Neonatal cases with RV accounted for 32.4 % of all RV nosocomial infections recruited. The peak seasons were October and November. RV serotyping in 67 cases older than 1 year old by nested PCR showed that G3 was predominant and accounted for 46.3%, followed by G1 (23.9%), G2 (3.0%), G9 (1.5%), seven cases were coinfections with G1 and G3 (10.40%) and 10 couldn't be typed. Based on P typing, P [8] was predominant genotype with 90.0%, P[4] accounted for only 6.0% and 3 couldn't be typed. P[6], P[9] and P[10] haven't been detected. G3P[8] was the maior isolates which accounted for 61.2%, followed by G1P[8] (17.9 %), G1 and G3P[8] coinfection accounted for 9.5%. Two cases were infected with G2P[4] and G8P[9], respectively. Ten out of 32 neonatal specimens were typed successfully which were G1P [8]. Nosocomial RV diarrhea resulted in prolonged hospital stay and increased medical cost. Conclusions RV is the major etiological agent of nosoeomial diarrhea among infants and young children in Shanghai area. G3P[8] is the predominant serotype. And the outbreak of G1 epidemic strain infection should be monitored.

Objective To compare the influence of different feeding mode on the immunoprophylaxis efficacy of the babies born to hepatitis B (HB) carrier mothers. Methods The babies born to HB carrier mothers received HB vaccine alone routinely or HB immunoglobulin (HBIG) plus HB vaccine immunoprophylaxis were followed up. Among infants with HB vaccine alone, 21 were breastfed and 40 bottle-fed, among those with HBIG and HB vaccine, 33 were breastfed and 135 bottle-fed. Results Among babies receiving HB vaccine alone, the positive rates of anti-HBs at 1,3,6,12 month of age are 4.8%, 42.9%, 57.9%, 80.9% in breastfed group, and 12.2%, 26.3%, 60.5%, 73.2% in bottle-fed group. Among those with HBIG and HB vaccine, the positive rates of anti-HBs at 1, 4, 7, 12 month of age are 72.7%,75.8%,77.4%,90.9% in breastfed group, and 77.0%, 72.9%,76.2%,90.4% in bottle-fed group. With HB vaccine alone, 1 infant in breastfed group and 3 in bottle-fed group, and with HBIG and HB vaccine, 0 in breastfed group and 4 in bottle-fed group were chronically infected at 1-year of age. There are no significant differences of the incidence of anti-HBs and immunoprophylaxis failure between breastfed and bottle-fed babies. Conclusion Breastfeeding doesn't pose a negative influence on the response of anti-HBs and the failure rates of the HB immunoprophylaxis in the infants born to HB carrier mothers

Objective To evaluate the outcome of dorsal double locking compression plate (LCP) in treatment of stretched unstable distal radial fractures.Methods Fourteen cases of stretched unstable distal radial fractures were treated by reduction and internal fixation using straight or L-shaped anatomic LCP via dorsal approach.Wrist functional exercise was conducted immediately after operation.Follow up was made after operation to assess motion pain,functional score of wrist,and complication incidence at postoperative 12 weeks,24 weeks,and 1 year.Results Follow-up was lasted for 5-24 months.At postoperative 12 weeks,24 weeks and 1 year,mean visual analogue scale (VAS) was (1.88 ±0.26) points,(0.87 ± 0.14) points and (0.37 ± 0.06) points respectively and wrist functional score (Gartland-Werley score) was (6.45 ± 1.72) points,(2.73 ± 0.52) points and (2.10 ± 0.31) points respectively.According to Garfland-Werley score in the latest follow-up,the results were excellent in 10 cases,good in two,and fair in two.Besides,one case was combined with myotenositis of extensor pollicis longus muscle tendon and another case with myotenositis of extensor tendon.Conclusion Dorsal double LCP is one of the effective methods for stretched unstable distal radial fractures that can reconstruct anatomical structure of the wrist efficiently and attain satisfactory functional recovery,with no obvious pain.

Objective To detect fat emboli in cardiac chamber of the patients undergoing total knee arthroplasty(TKA) by transesophageal echocardiography(TEE), and to discuss the relevant clinical value.Methods Eleven female patients with 12 osteoarthritis(OA) knees were underwent TKA. According to whether using tourniquet or not,12 knees were divided into 2 groups at random:tourniquet-related group (6 knees) and control group(6 knees). Echo intensity and ultrasonic characteristics of fat emboli in cardiac chamber were studied dynamically by multiplane TEE in various periods of the whole operation. Results All of the patients were implanted knee prostheses successfully. In different periods of TKA, fat emboli appeared as isoechoic or hyperechoic particles, which were found in right atrium, but nothing could be found in left heart. The imaging of the particles was flowing with duration time of 10～600s, like dots, lines, "moving star" or "shower". While femur expanding(0～3mins),the particles in right atrium and ventricle became more and more, and the echo intensity became significantly higher than those in other periods. After releasing tourniquet(0～5mins),most particles with highest echo intensity were observed in right heart,showing like "snowstorm" in tourniquet-related group, and more emboli were still detected at the end of monitoring (10 min after releasing tourniquet) by TEE,compared to the control group. No patient suffered from fat embolism syndrome(FES) with clinical manifestation. Conclusions Fat emboli in cardiac chamber can be observed sensitively by real-time TEE dynamically during TKA. It should be encouraged and promoted to analyze ultrasonic characteristics to facilitate the early detection, early diagnosis and early clinical intervention for the subclinical type of FES.

Objective:To analyze the risk factors of first-episode hematogenous metastasis in patients with thoracic esophageal squamous cell carcinoma (ESCC) who received non-surgical treatment after radiotherapy and chemotherapy, and its impact on survival and prognosis.Methods:The clinical data of 230 ESCC patients who met the inclusion criteria and received radical radiotherapy in Tengzhou Central People′s Hospital and Affiliated Hospital of Xuzhou Medical University from January 2011 to October 2018 were retrospectively analyzed.Logistic regression analysis and survival were used to analyze the risk factors and prognosis of blood group metastasis after treatment.Results:In 230 patients with thoracic esophageal cancer, 70 cases (30.4%) developed hematogenous metastasis for the first time.Compared with patients without hematogenous metastasis, the median overall survival was 15 months and 20 months (χ 2=7.249, P=0.007), and the median progression free survival was 9 months and 13 months (95% CI was 7.2-10.8 months and 10.8-15.2 months, respectively χ 2=21.664, P<0.001). Logistic multivariate analysis showed that there was significant difference in the occurrence of hematogenous metastasis among different N stages (χ 2=30.764, P<0.001). N stage was an independent factor for judging hematogenous metastasis, and the increased N stage increased the risk of hematogenous metastasis (OR value were 6.000, 12.629 and 48.167, respectively; 95% CI were 1.712-21.025, 3.546-44.976 and 10.848-213.858, respectively; all P<0.05). The overall survival time of patients with concurrent chemoradiotherapy before hematogenous metastasis was longer than that of patients with sequential chemoradiotherapy and radiotherapy alone (χ 2=10.002, P=0.007). Stratified analysis showed that adjuvant chemotherapy after concurrent chemoradiotherapy could prolong the overall survival of patients with N2 and N3 (χ 2=11.025, P=0.001). Conclusion:N staging is an independent factor to judge the hematogenous metastasis.ESCC patients with hematogenous metastasis after chemoradiotherapy have poor prognosis.N2, N3 patients with concurrent chemoradiotherapy after adjuvant chemotherapy have clinical benefits.

OBJECTIVE:To optimize the methanol extraction technology of tripterine in the fruit of Celastrus monospermus. METHODS:HPLC was adopted to determine the content of tripterine. Using extraction time,extraction times,solid-liquid ratio as investigation factors,extraction rate of tripterine as investigation index,orthogonal test was designed,and verification test was con-ducted. RESULTS:The optimal methanol extraction technology was as follow as 45% methanol extracting 2 h each time with sol-id-liquid ratio of 1:8 for 3 times. In the verification test,the average extraction rate of tripterine was 0.917 mg/g(RSD=2.85%, n=3). CONCLUSIONS:The optimized methanol extraction technology is stable and feasible with high extraction rate,and is suit-able for the extraction of tripterine in the fruit of C. monospermus.

Objective To evaluate the effect of anterior minimally invasive plate osteosynthesis (MIPO) for treatment of middle humeral shaft fracture.Methods From November 2011 to March 2014,10 cases of middle humeral shaft fracture were treated using MIPO via the anterior approach (MIPO group).Another 26 cases treated by open reduction and internal fixation (ORIF) of the middle humeral shaft fracture between October 2010 and March 2014 were included as controls (ORIF group).Fracture fixation using the 4.5 mm locking compression plate (LCP) was performed in both groups.Parameter measurements included operative time,intraoperative fluoroscopy times,grafting rate,intraoperative blood loss,postoperative drainage,hospital stay,bone healing time and complications.Results MIPO and ORIF groups differed significantly with respect to intraoperative blood loss [(93.5 ± 25.6) ml vs (325.3 ± 158.3) ml],intraoperative fluoroscopy times [(13.2 ± 6.1) vs 4.0 (0-6.0)] and hospitalization [(11.9 ± 1.7)days vs (18.0 ±4.7)days] (P ＜0.05).Bone grafting and drainage were not performed in MIPO group,while bone grafting rate was 54％ and postoperative drainage volume was (120.4 ± 69.6) ml in ORIF group (P ＜0.05).MIPO and ORIF groups were comparable with respect to operative time [(79.0 ± 22.0) min vs (97.5 ± 30.8) min],bone healing time [(15.2 ± 2.5) weeks vs (18.2 ± 4.8)weeks] and postoperative complications (10％ vs23％) (P＞0.05).Conclusion Anterior MIPO is an effective procedure for treatment of middle humeral shaft fracture,with advantages of small trauma,less bleeding,low risk of nerve injury and high rate of fracture healing.

The functional experimental teaching reform plays a very important role in raising the teaching resources,consummating the experimental teaching management system,enhancing the student to practice the ability and so on and has obtained the good effect.But it also faces some problems waiting urgently to be solved and further perfected,to which this article has made the analysis and the discussion from the management science angle.The goal lies in deepening the educational reform in functional experiment unceasingly to provide the model.

1.The sagittal and transverse diameters of 1,456 transverse foramina in 728cervical vertebrae were measured.The data are as follows:transverse diameter(mm) sagittal diameter (mm)Left Right Left RightMale(702 cases) 6.0?1.0 5.9?1.1 5.4?1.2 5.3?1.1Female(754 cases) 5.9?1.0 5.8?1.1 5.3?1.1 5.1?1.12.Among the 710 transverse foramina of 357 cervical vertebrae observed,mostof them are of the elliptical type.3.19.3% of double transverse foramen were found in 710 transverse foraminawhich were mostly encountered at the 6 th cervical vertebra.4.The mean value of the external diameter of the cervical part of the vertebralartery is 4?0.7mm.in 40 sides of specimens.5.63.1% of the vertebral artery in the 710 transverse foramina were foundmedial to its accompanying vein.6.According to the relationship between the sagittal(X_1)and transversediameter(X_2)of the transverse foramen and the diameter(Y)of the vertebralartery,a formula,(?)=1.859+0.172 X_1+0.24 X_2,of multiple regression was formulatedThus,the estimated diameter of the vertebral artery from the sagittal diameter X_1and transverse diameter X_2 of the transverse foramen could be obtained and it maybe helpful for clinical practice.7.In case of arthrosis,the vertebral artery could be compressed by the unco-vertebral joint which are found mostly at the level of the 4～5th cervicalvertebrae.