Objective To investigate the satisfaction status of patients in the Community Health Service Center,and to provide the basis data for reform and development of the Community Health Service Center in future. Methods 481 patients and 9 Community Health Service Center in Shenyang were randomly recruited in this study by the cluster sampling survey.Several trained interviewers used questionnaires to collect requisite information.Results In the all community health professionals,including technical level,therapeutic efficacy,preventive health service, service attitude and requirement satiation,the trust status of patients was the highest,the rates of satisfaction and very satisfaction got to 92.8%.The satisfaction status for preventive health service was the lowest,only 67.7%.In analysis on influencing factors,medical insurance of patients was the important factor for their satisfaction status.There were significant differences in technical level (χ2 =22.61 ,P <0.01 ),therapeutic efficacy (χ2 =21 .52,P <0.01 ), preventive health service (χ2 =1 4.35,P <0.05),service attitude (χ2 =22.43,P <0.01 ),requirement satiation (χ2 =22.30,P <0.01 ),the trust status of patients (χ2 =1 7.81 ,P <0.01 ).In addition,age and education degree also were the factors on the satisfaction status of patients.There were significant differences among different age group in therapeutic efficacy (χ2 =33.38,P <0.01 ),preventive health service (χ2 =24.43,P <0.05 ),requirement satiation (χ2 =26.55,P <0.01 ),the trust status of patients (χ2 =22.39,P <0.05 ).There were significant differences among different education degree in therapeutic efficacy (χ2 =1 5.79,P <0.05),service attitude (χ2 =1 4.63,P <0.05)and the trust status of patients (χ2 =1 3.50,P <0.05).Conclusion The satisfaction status of patients for service attitude is the highest and age,education degree and medical insurance of patients are the important factors influencing satisfaction status of patients.

Objective To study the long term effect and practical value of unilateral cleft lip repair with extended Mohler surgery based on over 10 years experiences.Methods A lot of 320 cases with unilateral cleft lip were repaired with extended Mohler surgery at average age of 5 months and 20 days.65 repaired cases were followed up and long term treatment result was evaluated.26 cases were evaluated in 10.5 to 15 years after surgery.39 cases were evaluated in 6 to 24 months after surgery.And the details of surgery were described.Results Excellent results for most of cleft patients (63 cases, 97%) were achieved, which included unobvious vertical scar symmetric to unaffected philtrum column, symmetric cupid's bow, nostrils and intermedial nasal columellae.Conclusions Extended Mohler surgery is great valuable for unilateral cleft lip repair.Appropriate indications should be stressed.

Objective To detect the expression of Zbtb7 gene in Phorbol esters(PMA) induced differentiation of leukemia cell lines.Methods 50 nmol/L PMA was used to induce the differentiation of U937 and K562 cell lines.The expression of Zbtb7 was detected by real-time PCR in the cells after induction on day 0,1,3 and 5,respectively. Results The expression of Zbtb7 in leukemia cell lines was markedly enhanced after treated by PMA(P

BACKGROUND:Bioactive glass, a multi-phase composite material, has good biological activity, bone conductivity and biocompatibility, but as a bone repair material it cannot be completely degraded, and has low mechanical strength that is insufficient.
OBJECTIVE:To design a kind of bioactive glasses/chitosan composite scaffold, and to investigate its physicochemical properties and cellcompatibility.
METHODS:Hydrochloric acid solution containing 2.0%chitosan was mixed withβ-glycerophosphate at a radio of 7:1 to prepare chitosan solution. Bioactive glasses of 0.5, 1.0, 1.5 g were added into the prepared chitosan solution, and the mass ratios of chitosan and bioactive glass were 2:1, 1:1, and 1:1.5 respectively. The composite materials were immersed and mineralized in simulated body fluid for 7 days.
RESULTS AND CONCLUSION:Scanning electron microscopy showed that the composite scaffold had an interconnected porous structure with the porosity of 89%and the pore size of 100-300μm;bioactive glasses dispersed in a needle shape between the chitosan scaffolds, arranged evenly, and were ful y wrapped tightly by the scaffolds. With the increase in mass of bioactive glass, the porosity of the composites decreased, but the fracture strength gradual y increased. There was a positive correlation between the composite porosity and fracture strength. X-ray diffraction and Fourier transform infrared spectroscopy confirmed that the composite scaffold appeared to have no changes in the nature of single materials, and differential scanning calorimetry analysis showed no mass loss at normal body temperature. After 3 days of mineralization, hydroxyapatite forming on the material surface gradual y grew up as a vil ous shape, and also significantly increased in number. After 7 days of mineralization, hydroxyapatite changed from a vil ous shape to a needle shape, the amount of hydroxyapatite was increased further, and many mineralized products were in a spherical shape.

ObjectiveTo introduce the new method of full reconstruction for Ⅰ to Ⅲ-degree finger defect.MethodsFor reconstruction of Ⅰ to Ⅱ-degree finger defect, the surgery procedure was as follows:Harvest part of nail,skin and dorsal part of distal phalanx from hallux to form a composite flap,and then the flap was transplanted to the finger stump to reconstruct the defect part of the finger.The design of the composite flap was according to the recipient part. For reconstruction of Ⅲ-degree finger defect, the skin included in the flap could be designed according to the recipient part, but the bone can only be harvested from the fibulodoral part of the hallux and far from the insertion of the extensor hallucis longus tendon, which means the length was limited.If the bone length was not enough,one bone mass with appropriate size and shape was harvested from the iliac bone and connected with the bone of the composite flap. Some cases of Ⅲ-degree finger defect were reconstructed by harvesting interphalangeal joints from the second toes to reconstruct distal interphalangeal joints(DIP). The bone defect was reconstituted by bone mass from the iliac bone to conserve the contour of the second toe.The hallux wound was covered by a local flap or free flap transplantation.ResultsOne hundred and eighteen cases (126 fingers) of Ⅰ-degree defect, one hundred and eighty-seven cases (201 fingers) of Ⅱ-degree defect and 90 cases (111 fingers) of Ⅲ-degree finger defect were applied full reconstruction. All the reconstructed fingers survived completely and the configurations were similar to real fingers. Followed up our work on 150 fingers from a number of patients, between 1 and 11 years after the original surgery.Total ranges of motion of the reconstructed fingers got to over 180°.The reconstructed DIP joints had the range of motion of 15°-40°. The donor halluxes and toes were conserved with the normal length,relatively primary appearance and full function. ConclusionFull reconstruction for Ⅰ to Ⅲ-degree finger defect has great advantages in that the reconstructed finger has very realistic configuration as well as ideal function and the donor hallux is conserve well.

ObjectiveTo explore methods of donor repair of the great toe-nail flap in finger reconstruction surgery.MethodsFrom December 1998 to December 2010, various kinds of flaps were used in 511 donor sites to repair the great toe-nail flaps,including:32 dorsal pedal artery flaps;twenty-four first dorsal metatarsal artery flaps;twenty-one second dorsal metatarsal artery flaps;forteen anterior malleolar flaps;seventeen medial tarsal artery flaps;seventy-nine lateral tarsal artery flaps;one hundred and six plantar metatarsal flaps,seventy-nine flaps from second toe;fifteen flaps from mid/lower leg and 124 freed flaps.ResultsAfter postoperative 6 months to 11 years of follow-up, repaired donor sites of great toe-flaps all survived successfully,with ideal outlook and function.ConclusionThere are many kinds of methods for donor site repair of the great toe-nail flap,and each kind of method has its own advantages and disadvantages. Among these flaps, plantar pedal artery flap and free groin flap are amony the best ones.

Recombinant protein SMB(PRG4) containing two Somatomedin B domains and a small amount of glycosylation of repetitive sequences of proteoglycan 4 was cloned according to PGR4 gene polymorphism. Mature purification process was established and recombinant protein SMB(PRG4), with high-level expression was purified. By using size-exclusion chromatogaraphy and dynamic light scattering, we found that the recombinant protein self-aggregate to dimeric form. Structure prediction and non-reducing electrophoresis revealed that SMB(PRG4), was a non-covalently bonded dimer.
Glycosylation ; Protein Multimerization ; Proteoglycans ; chemistry ; Recombinant Proteins ; chemistry ; Somatomedins ; chemistry

OBJECTIVETo verify the existence and significance of calcium/calmodulin dependent serine protein kinase/inhibitors of differentiation 1 (CASK/Id1) pathway in fibroblasts of human keloid.

METHODSImmunofluorescence laser was used to confirm CASK and Id1 protein expression and localization in fibroblasts of the keloid and normal skin. RT-PCR and Western-blot were adopted to analysis the CASK and Id1 expression and differences between keloid and normal skin fibroblasts. The natural combination of CASK and Id1 protein of keloid fibroblasts was tested by immunoprecipitation.

RESULTSCASK and Id1 protein expression were both found in fibroblast cells of keloid and normal skin under normal circumstances. Most of CASK and Id1 were distributed in the cytoplasm and nucleus of fibroblasts. The results of RT-PCR showed that the expression of CASK mRNA in the keloid group was 0.658 +/- 0.024, which was lower than that in the normal control group (1.076 +/- 0.008, t = 11.159, P < 0.05). The expression of Id1 mRNA was 0.497 +/- 0.014, which was higher than that in the normal control group (0.307 +/- 0.017, t = 15.148, P < 0.05). The results of Western-blot showed that the expression level for CASK protein in the keloid group was 0.057 +/- 0.006, which was lower than that in the normal control group (0.168 +/- 0.012, t = 13.524, P < 0.05); the expression of Id1 protein was 0.812 +/- 0.035, which was higher than that in the normal control group (0.368 +/- 0.031, t = 16.356, P < 0.05). The results of immunoprecipitation showed that Id1 could be detected in the CASK precipitate, while CASK also could be detected in the Id1 precipitate. There was a natural binding of CASK and Id1 in keloid fibroblasts.

CONCLUSIONCASK/Id1 signal pathway may be existed and involved in the proliferation of keloid fibroblasts, which is related with the occurrence of keloid.

Cell Proliferation ; genetics ; Cyclin-Dependent Kinase Inhibitor Proteins ; genetics ; metabolism ; Fibroblasts ; metabolism ; Humans ; Inhibitor of Differentiation Protein 1 ; genetics ; metabolism ; Keloid ; metabolism ; pathology ; RNA, Messenger ; metabolism ; Signal Transduction

Objective To evaluate the clinical value of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage?Methods The clinical data of 217 cases of old patients with hypertensive cerebral hemorrhage, including 105 patients underwent continuous monitoring of intracranial pressure(monitoring group) and 112 patients without monitoring of intracranial pressure(control group),were retrospectively analyzed?The times and the total dosage of mannitol, the complications and prognosis of two groups were compared?Results The times and the total dosage of mannitol of monitoring group was respectively (42?1±5?4) times and ( 820?1±114?8) g,significantly less than that of control group((59?5±8?2) times, (1187?7±241?5) g;P=0?032,0?011)?The rate of pulmonary infection and stress ulcer showed no significant difference between two groups ( P = 0?608, 0?471 )?The rate of acute renal insufficiency and electrolyte disturbances was significantly lower in the monitoring group than that in the control group ( 11?4%( 12/104 ) vs?29?6%( 33/112 ) , 28?6%( 30/105 ) vs?41?9%( 47/112 );P = 0?004, 0?036 )?The prognosis of the monitoring group was better than that of the control group(72% vs?48%;χ2=13?02,P<0?01)?Conclusion Intracranial pressure monitoring has an important value for the treatment of old patients with hypertensive cerebral hemorrhage.

Objective To investigate the relationship between cathepsin L and apoptosis cell in rats after cerebral ischemia reperfusion.Methods Sixty healthy male Sprague-Dawley Rats (10-12 weeks old,260-300 g) were chosen.Based on the random number table method,the rats were randomly divided into sham-operated control group (Sham group,n =10),ischemia-reperfusion group (model group,n =25),and Z-FY-DMK intervention group (CLI group,n =25).Rats were randomly divided into 6 h,12 h,24 h,and 48 h four subgroups in model group and CLI group,respectively.Modified transient middle cerebral artery occlusion was made as Longa described,the intervention groups were injected intracerebroventricularly Z-FY-DMK (20 μg / 1μ1 ×5 μl) preoperative 30 min prior to surgery,Sham group and schemia reperfusion injury (IRI) group were injected intracerebroventricularly dimethyl sulfoxide (DMSO) 5 μ1 (10ml/L) at the same time.Cell apoptosis was detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) straining.Western blotting was used to detect the expression of cathepsin L and caspase-3.Results In the cortical area of ischemic brain,apoptosis cells of sham operation group were rare,while apoptosis of nerve cells of model group with 6 hours reperfusion were visible,and were gradually increased in the order of 12 hours,24 hours and 48 hours.At the same time point,the apoptosis cells of CL intervention group (6 h,12 h,24 h,48 h) were obviously less than model group (P ＜0.05).Western blotting found little visible cathepsin L protein expression in ischemic cerebral cortex preoptic in the sham group.For model group,the cathepsin L expression initially increased in sub groups with 6 hours reperfusion,reached to a peak in sub groups with 12 hours and 24 hours,and remained a high level in sub groups with 48 hours reperfusion.Compared to model group,the cathepsin L expressions of CL intervention group were obviously decreased at all time points (P ＜ O.05).Conclusions Cathepsin L may be involved in neuronal apoptosis by means of caspases 3 pathway.