BACKGROUND: Adipose-derived stem cells are easy to access and have strong proliferative capacity, which are considered as ideal seed cells for bone defect repair. The bone tissue engineering research progress reveals that bioscaffold material modification can directly regulate the osteogenic differentiation of stem cells. OBJECTIVE: To review various biological scaffold materials that can regulate the osteogenic differentiation of adipose-derived stem cells. METHODS: The first author searched the articles in CNKI, WanFang, VIP, PubMed, Embase and Web of Science databases published from January 2016 to May 2019. The search terms were “adipose derived stem cells, scaffold, osteogenic, metal, Ti” in Chinese and English, respectively. Finally 62 eligible articles were selected. RESULTS AND CONCLUSION: Scaffold materials for bone tissue engineering are classified into inorganic materials (hydroxyapatite, tricalcium phosphate, bioglass, titanium, and magnesium), natural polymer materials (collagen, silk fibroin, and chitosan) and synthetic polymer materials (polycaprolactone, polylactic acid, polyglycolic acid and poly(lactic-co-glycolic acid)). The studies on materials that interact with cells to guide their biological response and bone differentiation are increasing. But how to create a safe, rational, and close to the micro-environment of cell growth in vivo is a challenge. Modification of bioscaffold materials can directly regulate osteogenic differentiation of stem cells. Moreover, vascularization and post-implantation infections are issues of concern.

OBJECTIVE: To evaluate the use and tendency of anti-rejection drugs in six cities in the Yangtze valley.METHODS: The consumption data for anti-rejection drugs in the Yangtze areas during the period 2004～2006 were analyzed statistically by the method of order of consumption sum.RESULTS: The anti-rejection drugs used in the Yangtze valley increased year by year,up 28.4% in 2005 and 23.9% in 2006 over the previous year.On the list of consumption sum for the six cities in Yangtze valley,the proportions for Shanghai over the 3 years were 67.1%,62.5% and 65.4%;those for Hangzhou were 12.6%,16.7% and 14.7%;5.3%,4.6%,4.6% for Nanjing;7.6%,9.0% and 7.4% for Wuhan;4.9%,4.5%,5.0%for Chendu,and 2.5%,2.7% and 2.9% for Chongqing.CONCLUSION: The consumption of anti-rejection drugs was unbalanced among the 6 cities in the Yangtze areas,but its clinical application was basically in line with the marketing of new drug both at home and abroad.The import drugs occupied the biggest market share,while the market share of the domestic drugs increased slowly but steadily.The prices for anti-rejection drugs were still very high,which should be lowered to reduce patients' economic burden.

Objective To investigate the curative effect of synchronous radio-chemotherapy in medium-term and advanced cervical carcinoma. Methods 168 cases of medium-term and advanced cervical carcinoma were selected. The treatment group(grout A) included 84 pathologically verified cases of stage Ⅱ～Ⅳ cervical carcinoma. Each patient was given DDP with hydration at the dose of 40 mg/m2 intravenously.The treatment cycle was performed once every week for 3--4 circles. Radiotherapy was given at the same time. 60Co was used for external radiation with a total dose of 50 Gy, 192 Ir afterloading unit was used for brachytherapy at the dose of 7 Gy per week at point A with a total dose of 42 Gy. The control group (group B)included 84 cases of cervical carcinoma at the same stage in the corresponding period who received radiotherapy only.Short-term effect ,2-year survival rate and complications were observed. Results Effective rate was 92.85 %(78/84) in group A and 79.76 %(67/84) in group B respectively 3 months after radiotherapy, showing a significant difference(χ2 =6.10,P <0.05). 2-year survival rate was higher in group A (83.95 %) than in Group B(60.98 %) (χ2 =9.4,P<0.05). Local recurrent and distant metastasis were lower in Group A than Group B. In group A, there were tolerable bone marrow inhibition and reaction of digestive tract. Conclusion Synchronous radiotherapy and chemotherapy can remarkably improve the survival rate of medium-term and advanced cervical carcinoma. The application of DDP is effective and safe,and its side effect can be accepted by patients, but the long-term effect needs further observation.

Objective To evaluate the diagnostic value of 2D ultrasound (2DUS)-based composite score method and contrast enhanced ultrasound (CEUS) in differentiation between thyroid microcarcinomas and benign micronodules. Methods A total of 216 consecutive patients with 258 thyroid micronodules underwent 2DUS and CEUS examinations before thyroidectomy from June 2011 to October 2013. The scoring of each nodule was based on five 2DUS features including hypoechogencity, irregular shape, macrocalcification, and taller than wide in shape. Microcalciifcation was assigned as 2 points and the remaining features were assigned as 1 point. A composite score was ifnally given to each thyroid nodule ranging from 0 to 6 points. The sensitivity, specificity and accuracy of diagnosing thyroid microcarcinoma by 2DUS composite score method and CEUS were calculated. Results The histopathologic results of all 258 nodules were acquired, including 125 papillary microcarcinomas and 133 benign micronodules. Each nodule′s 2DUS compostie score was ranging from 0 to 6 points. The area of receiver operating characteristic (ROC) curve of 2DUS in diagnosing thyroid microcarcinoma was 0.81. The 2DUS composite score method predicted the thyroid microcarcinoma with sensitivity of 78.4%(98/125), speciifcity of 72.9%(97/133), accuracy of 75.6%(195/258), when the nodule with a score greater than or equal to 3 points was deifned as malignant. Thyroid micronodules′enhancement pattern were divided into 7 types, including early hypoenhancement, hypoenhancement, isoenhancement, hyperenhancement, local nonenhancement, nonenhancement, and ring margin ring enhancement. CEUS predicted thyroid malignant micronodules with sensitivity of 87.2%(109/125), specificity of 75.9%(101/133), and accuracy of 81.4%(210/258), when early hypoenhancement and hypoenhancement pattern was defined as malignant patterns. There were no differences in sensitivity, specificity, and accuracy between 2DUS cumulative score method and CEUS in diagnosing thyroid microcarcinoma (McNemar test, P=0.099, 0.608, 0.096). Conclusion Early hypoenhancement and hypoenhancement are CEUS characteristic enhancement pattern for thyroid microcarcinoma, CEUS has higher sensitivity, speciifcity in diagnosis than 2DUS composite score method, while there are no statistical differences.

BACKGROUND; Authors have proposed the hypothesis that, the mechanism change may result in the mismatch between the energy production and energy consumption during the aerobic exercise, and pyruvate can be transformed into lactic acid, which may prevent the accumulation of pyruvate in cytoplasm and in the energy production of glycolysis so as to ensure the fast energy supply in zymolysis; the mechanism of this biochemical event may be the adjustment of energizing velocity via glycomechanism zymolysis.OBJECTIVE: To observe the effect of oxygen inhalation on metabolic transition, study the mechanism of metabolic transition under the lactate threshold intensity in human body and animal, and verify the result consistency between the two.DESIGN: Randomized control observation.SETTING: Department of Physical Education, Hebei Normal University; Department of Physical Education, Langfang Teachers College.PARTICIPANTS: A total of 24 male university students majoring physical education were adopted, weight (58±4) kg,height (175±6) cm, age (21 ±2) years. They were consisted of 12 Level B national athletes and12 common students.Additionally 30 SD male rats were used.METHODS: The experiment was carried out in the Laboratory of Physical and Physiological Function, Department of Physical Education in Hebei Normal University from April to June in 2006. Twenty-four students were recruited to exercise incrementally in ergometer; in addition, thirty SD rats were assigned to swim incrementally, 15 rats in each group. First, the intensities of metabolic transition were determined, then the exercise protocol was repeated on the conditions of inhaling and not inhaling oxygen. For student group, 50 W loading was incremented every 2 minutes, while the rats were added with 1% of their weights until unacceptable. Gradually incremented loading was used to transform the aerobic mechanism to anaerobic mechanism. The vein blood oxygen partial pressure, pyruvate and lactate contents were measured before and during the exercise (lactate threshold intensity) to evidence the reliability and validity of hypothesis.MAIN OUTCOME MEASURES: The vein blood oxygen partial pressure, pyruvate and lactate contents under lactate threshold intensity and oxygen inhaling supplementary.RESULTS: All 24 testees and 30 rats were involved in the result analysis. ①During the gradually incremented exercise,the lactic acid curve obtained at the end of 2-minute loading showed the difference of metabolic transition intensity and training level in accordance with individual lactic acid threshold, which was obviously lower in the trained exercisers.②Under the lactate threshold intensity, the blood lactate was not correlated to the oxygen partial pressure whether in human body or rats and whether inhaling oxygen or not [(3.61±0.56), (5.43±0.55) mmol/L; (4.46±0.86), (7.80±0.27) kPa,r =0.31, 0.31, P ＞ 0.05]; there was significant difference between the blood lactate and pyruvate contents [(1.04±0.16),(0.91±0.37) mmol/L, P ＜ 0.001]. The human body's saturation of blood oxygen was no less than 98% during the entire protocol. ③Under the repeated exercise and lactate threshold intensity, the pyruvate average value was (0.97±0.17),(1.04±0.16) mmol/L; (0.93±0.25), (0.91 ±0.37) mmol/L, respectively. There was no significant difference between the blood pyruvate before the exercise and under the lactate threshold intensity in both human body and animals (P ＞ 0.05).CONCLUSION: There is no hypoxia at the transition from aerobic to anaerobic metabolism. Oxygen inhaling supplementary has no influence on the mechanism transition; It is not easy for the pyruvate to pass the myocyte membrane, but the lactate can. The result demonstrates that the pyruvate can transform to lactate directly, which can also prevent the accumulation of pyruvate in kytoplasm.

Objective To explore the iodine status of pregnant women after 17 years of salt iodization in rural areas of Shijiazhuang City.Methods Probability proportionate to size sampling was employed in which 30 towns were selected from the 211 towns in the rural areas of Shijiazhuang City.In each town selected,40 pregnant women were randomly selected to collect their spot urine samples,edible salt samples and drinking water samples from their households to measure iodine content.The iodine content of salt was determined quantitatively using a titration method (GB/F 13025.7-2012).The urinary iodine content was determined using the method of ammonium persulfate digestion arsenic cerium catalytic spectrophotometry (WS/T 107-2006).The iodine content in drinking water was determined by the method of standard test for drinking water.Results A total of 1 200 salt samples was collected from the pregnant women's households in 30 towns,with the overall median iodine content being 27.2 mg/kg.The median salt iodine content in 30 towns varied from 23.4 to 32.6 mg/kg.A total of 478 water samples were collected,with a median of 5.3 μg/L.The median urinary iodine content (UIC) of 1 200 pregnant women in 30 towns was 146.4 μg/L.The median UIC in the first (≤ 13 weeks),second (14 ～ 26 weeks) and third (≥27 weeks) trimesters was 166.3,145.1 and 133.5 μg/L,respectively.The median UIC in the first trimester was significantly higher than that in the third trimester (Mann-Whitney Test,U =18 265,P ＜ 0.05).Except for the 9-20 and 37-40 weeks period of pregnancy,the median UIC was lower than the WHO criteria (150 μg/L).Tested by linear correlation,the pregnant women's median UIC did not correlate with median salt iodine (r =0.725,P ＞ 0.05).Conclusion Under the current universal salt iodization,the pregnant women's iodine intake could almost meet their requirement in the rural areas of Shijiazhuang City,however,mild iodine deficiency has existed in the third trimester.Alternative measures of iodine supplement could be implemented.

The levels of IgG2b monoclonal antibodies against LD H-C4 in sera of mice bearing hybridoma backpack tumors secreting anti-LDH-C4-IgG2b were detected by quantitative ELISA． The accuracy between batches is 7.04%～l3.30 %, the intra-assay variation is 3.6l%～l0.20%． Standard curveof monoclonal lgG2b was well correlated (r=0.962　　884～0.996　　795)． The sensitivit y of the assay reach e dup to0.0l?mg/L． The present modified ELISA offers a reproducible, se nsitive, specific method in determination of antigen-specific IgG2b antibody in sera．

Objective To analyze the prevention and treatment of postoperative hemorrhage after pancreaticoduodenectomy. Methods The clinical data of 142 patients undergoing pancreaticoduedenectomy from Jan 1995 to Dec 2008 were retrospectively analyzed. Results The incidence of postoperative hemorrhage was 14.1% (20/142), the mortality caused by this complication was 35% (7/20). Among these patients, intra-abdominal hemorrhage occurred in seven cases, and gastrointestinal hemorrhage occurred in 14 cases, with one case suffering both. There were three and four cases of early and delayed intra-abdominal hemorrhage respectively. Early and delayed gastrointestinal hemorrhage occurred in three and eleven cases respectively. Univariate analysis showed that operative blood loss, blood transfusion, infection and pancreatic fistula were significantly associated with postoperative hemorrhage. Multivariate analysis using Logistic regression identified two variables as independent factors associated with postoperative hemorrhage, namely, infection(OR=6.918) and pancreatic fistula(OR=3.948). Conclusions The incidence and mortality of hemorrhage after pancreaticoduodenectomy is still high. Skillful operation and prevention of pancreatic fistula, infection and stress ulcer are the key paints for reducing postoperative hemorrhage. Proper treatments should be used according to the site, onset and severity of hemorrhage.

Objective To investigate the way to accurately delineate gross tumor volume (GTV) of high grade gliomas(HGG) for intensity modulated radiation therapy (IMRT) by using computed tomography (CT) and magnetic resonance imaging (MRI) image fusion technique. Methods CT and MRI images were fused from 19 patients. The GTV of each patient were independently delineated by one chief doctor and one resident doctor on CT and MRI image. The GTV contoured on CT (GTVCT), MRI (GTVMRI) were measured, and composite volumes (GTVCT+MRI) were the sum of CT-defined GTV and MRI-defined GTV. The differences of these volumes were compared. Results Whether chief or resident doctors delineated, all were GTVMRI ＞GTVCT(P ＜0.050). The percentages of GTVMRI on GTVCT+MRI were (98.57±7.00)% by chief doctors, and (97.84±10.00)% by resident doctors. Compared the difference between GTVCT and GTVMRI in postoperative patients and preoperative patients, P =0.046, and the difference between chief doctors and resident doctors was statistically significant for GTV defined by CT (P =0.020), but not by MRI and composite image (P ＞0.050).Conclusion The GTV of HGG patients must be delineated on both CT image and MRI image, including using CT and MRI image fusion. But the composite volumes(GTVCT+MRI) should be the sum of CT-defined GTV and MRI-defined GTV. Especially for the postoperative patients,delineating GTV should be taken more attention. And the GTV should be delineated by doctors with full experiences.

Objective To analyze the risk factors for pancreatic fistula after pancreaticoduodenectomy.Methods Clinical data of 351 patients who underwent pancreaticoduodenectomy in our hospital from Jan 2001 to Dec 2015 were retrospectively analyzed.Results The overall incidence of pancreatic fistula was 20.2％ (71/351),with grade A in 34 (9.7％) patients,grade B in 25 (7.1％),and grade C in 12 (3.4％).Postoperative hospital stay was significantly prolonged in patients with grade B and C pancreatic fistula.Multivariate analysis using Logistic regression identified three variables as independent factors associated with pancreatic fistula,namely,BMI (OR =2.281),preoperative total bilirubin level (OR =2.180) and soft pancreatic texture (OR =3.653).Preoperative total bilirubin level (OR =2.684),soft pancreatic texture (OR =5.128) and postoperative hemorrhage (OR =9.030) were independent risk factors of grade B and C pancreatic fistula after pancreaticoduodenectomy.Conclusions The incidence of pancreatic fistula after pancreaticoduodenectomy is still high.Pancreatic fistula prolongs the postoperative hospital stay significantly.The incidence of grade B and C pancreatic fistula could be reduced by avoiding postoperative hemorrhage.