Objective To explore the psychological intervention combined with intracapsular injection of kidney fat in the treatment of nephropathy clinical analysis, looking for effective treatment.Methods 140 patients with nephropathy were enrolled in our hospital from March 2014 to September 2016.Patients were randomly divided into study group(n=70) and control group(n=70) according to the international character table method.Group of patients with a single renal fat capsule drug injection therapy, the study group to be combined with psychological intervention + kidney fat intracapsular injection of drug treatment, the treatment cycle after the end of two groups of patients compared with 24 hours of urine protein quantification, urine microalbumin;The incidence of adverse events in the two groups of patients was compared between the two groups of patients with emotional status(SAS, SDS scale).Results The levels of urinary albumin in the study group were(139.75±20.04) μg/min, and the 24h urine protein level was(1.43±0.59) g/24h significantly lower than the control group(189.74±19.54) μg / min,(4.77±2.14) g / 24h(P<0.05).The incidence of adverse reactions in the study group was 4.29%, which was lower than that of the control group(7.14%).However, there was no significant difference between the two groups.The self-rating scale of the study group(32.35±2.19)(38.65±3.54) points were lower than the control group(55.97±2.14) points,(54.21±7.89) points(P<0.05).Conclusion Psychological intervention combined with intracapsular injection of renal capsule can significantly improve the renal function of patients, can interfere with the patient's bad mood, and high security, health care workers can be promoted.

Objective To study and observe the application effect of debridement adhesive combined with comfeel silver ion dressing in the treatment of wound after the total cystectomy.Methods 90 patients with total cystectomy in Cixi People's Hospital from July 2014 to June 2016 were selected as the research object, and all the patients were randomly divided into control group 45 cases and observation group 45 cases, the control group were treated with conventional treatment of postoperative wound, the observation group were treated with debridement adhesive combined with comfeel silver ion dressing on the treatment of control group, then the infection rates, degree of edema and local comfort, life quality and local microcirculation state before and after the intervention of two groups were respectively analyzed and compared .Results The infection rates of observation group were higher than those of control group, the degree of edema and local comfort, life quality and local microcirculation state after the intervention were all significantly better than those of control group, the difference was all statistically significant ( P <0.05 ).Conclusion The application effect of debridement adhesive combined with comfeel silver ion dressing in the treatment of wound after the total cystectomy is better , and it has active role for the improvement of discomfortableness and microcirculation state.

Objective TNF-related apoptosis-inducing ligand(TRAIL)was a new member of TNF family.It could quickly inactivate tumor cell originated from different tissues but no effects on normal tissue in vitro.Osteosarcoma was the most common primary malignant bone tumor with the survival rate of 5years no more than20%after simple surgical management.The induced apoptosis and selective cytotoxicity of human soluble TRAIL for MG -63cell line were investigated in order to explore the feasibility of sTRAIL in clinical treatment of osteosarcoma.Methods sTRAIL-mediated cytotoxicity by MTT assay in MG-63osteosarcoma cell line,MRC-5human diploid lung cell line and L-02fetus hepar cell line were assessed,apoptotic cellular morphological transformation by phase contrast microscope and electron micro-scope was observed.The expression of TRAIL receptors mRNA in the cell lines was examined by RT -PCR.The apoptotic rates of MG-63cell line were shown by flow cytometry.Moreover,the apoptosis of MG-63cell line induced by sTRAIL was confirmed by terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL).Results MG-63,MRC-5and L-02cell lines were treated for 24hours with dif ferent concentrations of sTRAIL and the inhibitive rates of sTRAIL were evaluated with MTT assay,the in hibitive rates of 500ng /ml,1?g /ml ,2?g /ml and5?g /ml TRAIL inducing MG-63osteosarcoma cell line were10.1%,24.3%,50.6%and more than95%respectively.By flow cytometry,an obvious apoptosis peak ahead the diploid peak was obtained when MG-63cell line incubating with2?g/ml TRAIL for 6hours,howev er,the consequences of MRC-5and L-02cell line were non-differentiated.Therefore,MG-63cell line was significantly sensitive to sTRAIL-mediated apoptosis,but MRC-5and L-02cell line were resistant to sTRAIL-induced cell death.Under phase contrast microscope,when MG-63cell line were treated by sTRAIL,some cells began to became small and round in3to8hours.In24hours a large number of cells exfoliated and drifted in culture medium.Moreover,karyopyknosis and crescent aggregation of chro-matin were observed by electron microscope.By RT-PCR,the expression of TRAIL-R1,R2and R3but not R4mRNA on MG -63and MRC -5cell line were observed,and there were the expression of TRAIL-R1,R2,R3and R4mRNA on L-02cell line.In TUNEL assay,the nucleus of the apoptotic cells became brown or yellow.Conclusion TRAIL is able quickly to kill MG-63osteosarcoma cell line in vit-ro.Fur thermore,TRAIL is non significant cy-totoxic for normal tissue.TRAIL or TRAIL com bined with chemotherapy and radiotherapy is a potential and valuable proposal for clinical treatment of osteosarcoma.

The purpose of this paper is to study the pattern of change which are age associated,so as to provide a new method of age estimation by bone for forensic medicine and anthropology.The middle one third of right ribs were collected from 67 Chinese females living in North China.Decalcified cross section slides were histomorphometrically examined by using an image analyzer.Then the parameters were subjected to multiple stepwise regression analysis to produce an equation:=31 264+0 868X 2+286 693X 4+0 689 X 7-778 874X 8-0 006X 9.The multiple correlation coefficient and standard error of estimate were 0 923 and 4 08,respectively.When the formula was checked by 25 specimens,84% of the estimated ages fall within ?5 years of actual ages,and 100% of the estimated ages fall within ?8 years of actual ages.This showed that female ages could be deter mined by the histomorphometry of ribs.

Objective To observe the curative effect of the treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.Methods Twenty-nine cases were investigated.In which Garden type Ⅲ were 10 and type IV 19.There were 12 ca$,e8 of fresh fractures and 17 old fractures.According to the X-ray films of old fractures,caput femoris necrosis occurred in 7 patients.Tibial tubercle traction was carried out as preoperative preparation as soon as the patients were sent to hospital.The operation was performed by combining hollow-lag-svcrews fixing with vascularized great trochanter bone flap transposition.Results The foUow-up lasted 39 to 84 months,with an average of 54 months.The patients suffering from fresh femoral neck fractures all recovered and no necrosis WaS found.The healing time was between 4 to 6 months,with an average of 4.5 months or so.And old fractures were all healed up almost within the same time.The recovery time of patients who suffered from fractures and necrosis was with an average of 12.5 months.Of 10 cases of old fractures without caput femoris necrosis prior to operation,necrosis occurred in 3 c88es.The functions of hip joints of 15 cases completely recoveTed,and 12 patients were partially restricted.Another 2 patients could not squat because the flexion function was seriously restricted.The crispation of limbs was well corrected.According to Harris standard.the postoperative mean SCOre is 89.2.Concision It is good for treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.

Objective To investigate cause,diagnosis,treatment and prevention of vertebral artery injury in cervical spine surgery.Methods Data of 7 patients with vertebral artery injury caused by cervical spine surgery from October 2002 to April 2012 were retrospectively analyzed.There were 6 males and 1 female,aged from 23 to 65 years (average,48.9 years).The reasons of cervical spine surgery were as follows:cervical spondylotic myelopathy (5 cases),traumatic subluxation of C4 and C5 (1 case),and cervical spinal stenosis due to skeletal fluorosis (1 case).All cases had unilateral vertebral artery injury,including 4 cases in the left side and 3 cases in the right side.The cause,treatment and prognosis of vertebral artery injury in 7 patients were analyzed.Results Four patients suffered from vertebral artery injury during anterior cervical spine surgery; 2 cases were caused by excessive lateral trepanation,1 by excessive lateral discectomy using a curette,and 1 by Kerrison punch during decompression in a patient with anomalous vertebral artery due to traumatic subluxation of C4 and C5.Three patients suffered from vertebral artery injury during posterior surgery; 2 cases were caused by a drill bit during drilling lateral mass of C4 and 1 by a rongeur during removing posterior C1 arch in a patient with cervical spinal stenosis due to skeletal fluorosis.After vertebral artery injury,all patients were immediately treated by hemostatic tamponade,and then the incisions were closed.However,1 patient occurred delayed cervical hemorrhage 4 weeks after operation.Then he underwent vertebral artery angiography,balloon embolization and evacuation of hematoma.All cases had no cerebral infarction.However,two of them had postoperative temporary dizziness.Conclusion Vertebral artery injury in cervical spine surgery is a rare but serious complication,which is associated with surgical mistakes and anatomical variations.Hemostatic tamponade and embolization are effective for this complication.

Objective To study the clinical value of HRCT in staging of lung interstitial disease(LID) in connective tissue disease(CTD).Methods 222 patients with CTD confirmed clinically underwent HRCT scan.The staging of LID according to the HRCT features of LID were done and the therapeutic effect was compared between each stage.Results In 222 cases ,64 cases were negative on HRCT as stage 0,158 cases had disseminated LID in different degree,including stage Ⅰ in 107,stage Ⅱ in 36 and stage Ⅲ in 15.There were significant statistically between the therapeutic effect and staging of LID.Conclusion The staging of CTD with LID by HRCT is helpful for judging the extent of LID and clinical treatment.

Objective To explore indications for replantation and amputation of complex severed lower legs. Methods Fifteen lower legs in 25 cases with complex severed lower limbs were replanted including four finally amputated again, and other 10 legs were amputated directly after trauma. Those with successful replantation were repaired with microsurgical technology and limb lengthening procedure for complications such as soft tissue defect, bone defect and limb shortening. The amputated cases were fitted with prosthetic limb after wound healing. Results All cases were followed-up for three to 10 years (6.4 years in average), and 11 lower legs were survived in 15 replanted cases and other four were finally amputated and fitted with prosthetic replacement. The limbs of those with successfully replantation shortened to varied extent, and one can be categorized as grade Ⅰ, four as grade Ⅱ, four as grade Ⅲ and two as grade Ⅳ, according to Chen's classification of function evaluation for replanted limbs. Appearance of prosthetic limbs in 14 cases had no significant difference from the normal, and 12 of them could walk with load and two had slight claudication. Those with prosthetic limbs were more satisfactory than those with replantation of the limbs. Conclusion Replantation for complex severed lower legs should be comprehensively considered based on mangled extremity severity score (MESS), their local condition and function prognosis.

Objective To investigate the experiment effects of rabbit joint articular cartilage defects repaired by thermosensitive CS/PVA composite hydrogel engineered hTGF-β1 transfected bone marrow mesenchymal stem cells. Methods Bone marrow mesenchymal stem cells were isolated and cultured in vitro. The positive rate of transfection was defected by cell immunohistochemistry methods after Ad-hTGF-β1 transfected for 1 week. Twenty-four adult New Zealand white rabbits with full articular cartilage defects were randomly divided into 4 groups, each group had 6 animals, both hind limbs were used in the experiment. Group A: hydrogel combined with transfected cells; Group B: hydrogel combined with untransfected cells; Group C: hydrogel group; Group D: blank control group. Specimens and histological observation were used to evaluate the repair effect after 16 weeks according to Pineda's score. Results The positive rate of hTGF-β1 expression in BMSCs was about 85.4% after transfection. After 16 weeks the defects of group A were repaired by cartilage-like tissue, the cell arrangement and densities of regenerated cartilage were similar to normal cartilage, type Ⅱ collagen immunohistochemistry were positive. There was a significant difference in Pineda's score compaired with other groups (P ＜ 0.05). Conclusion Rabbit articiular cartilage defects could be repaired by CS/PVA hydrogel engineered hTGF-β1-transfected bone marrow mesenchymal stem cells.

Objective To assessed the ability of FK506 and antilymphocyte serum(ALS) to induce mixed chimerism and tolerance for knee composite tissue allograft in rabbits without chronic immunosuppression. Methods Male Flap-eared rabbits were used as donors,and female New Zealand white rabbits were used as recipients. Vascularized heterotopic knee allotransplantation was performed. Treatment consisted of ALS(1 ml/kg) only,FK506(0.5 mg/kg) only and a combination of FK506 and ALS which were administered 24h before transplantation. ALS was administered intraperitoneally every day in the first three days. FK506 was administered gastric intubation every day for fifteen days. Survival times of knee allografts were observed. Donor specific hematopoietic chimerism and histology sections were tested. Results Survial time of knee allografts with ALS single was(17.4?1.8)d,and(23.8?1.5)d with FK506 single,(40.4?2.9)d with FK506 and ALS,contrasting with(13.6?0.8)d of control. Chimerism rate show a stabilization of 3 weeks above 10% after protocol discontinue in groups with FK506 and ALS. Conclusions Short-term administration of FK506 and ALS in this ways prolong survival time of vascularized knee allograft in rabbits and could maintain mixed chimerism and tolerance for 3 weeks.