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.

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 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.

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.

Objective To evaluate right ventricular (RV)systolic function in type-2 diabetes mellitus (T2DM)patients.Methods Fifty T2DM patients and fifty normal controls were included in the study and underwent echocardiographic examinations.The following parameters were measured:1 ) Right heart dimensions,pulmonary artery (PA)diameter,pulmonary acceleration time (AT)and PA systolic pressure (PASP);2)RV systolic function:RV fractional area change (RVFAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (S'),tricuspid annular plane systolic excursion (TAPSE),longitudinal strain of six RV segments by 2-dimensional speckle tracking imaging (2D-STI);3 )RV diastolic function:E,A ratio of the tricuspid inflow spectrum (E/A),E,E'(peak early diastolic velocity of the tricuspid annulus) ratio (E/E');4)RV Tei index.Results Statistic analysis showed that T2DM patients had thicker RV walls,wider PAs and shorter AT than the control group (P =0.000,0.001 and 0.000),while their right heart chamber sizes and PASP remained unchanged.Among systolic parameters,absolute values of RV longitudinal strain at the lateral wall-mid (lat-m),septum-mid (sep-m)and septum-basal (sep-b)segments were significantly lower in the diabetic group than the control group (P =0.001 ,0.000 and 0.005),whereas strain of the other three RV segments and RVFAC,TAPSE.S'were not significantly different.Moreover, E/A,E/E'and Tei index were all significantly different between the two groups (P = 0.000,0.000 and 0.006),indicating declined diastolic and general function of RV in the T2DM group.Conclusions RV myocardial strain by 2D-STI is more sensitive in detecting RV systolic dysfunction than TAPSE,S' and RVFAC.Among the six segments of RV walls,lat-m,sep-m and sep-b are better locations for 2D-STI than the other three.

Objective To evaluate the prognosis influencing factors of early non-small cell luny cancer (NSCLC) after radiotherapy.Methods 81 early NSCLC patients received definitive radiotherapy and were eligible.Among these patients,60 were diagnosed as squamous cell carcinoma,16 were adenocarcinoma and 5 were diagnosed through imaging instead of pathology.45 patients received conventional radiotherapy,36 patients received three dimensional conformal radiotherapy (3D-CRT),All of them received a total dose of 50-96 Gy with a median dose of 67.8 Gy. Kaplan-Meier survival curves and Cox regression model analysis were applied to evaluate the survival and prognostic factors. Results The median survival time was 34 months.The 1-,3- and 5-year survival rates (OS) were 88.7 ％,41.9 ％,21.8 ％,respectively.Karnofsky performance status≥80,Clinical stage, diameter≤4 cm and the therapeutic effect were associated with improving overall survival.Cox hazards model showed that Karnofsky performance status≥ 80 and diameter≤4 cm were likely to be independent positive prognostic factors. Conclusion Karnofsky performance status and tumor diamater can be used to evaluate the prognosis of early NSCLC after radiotherapy.

Objective To apply the binary Logistic regression model and evaluate the value of grey scale ultrasonography(US),ultrasond elastography(UE) and contrast-enhanced ultrasound(CEUS).Methods US,UE and CEUS were performed in 130 patients with 142 solid thyroid micronodules (the largest diameter less than 10 mm).Pathology was followed up as golden diagnosis criteria.A Logistic model on the basis of ultrasonographic features was obtained.A receiver operating characteristic(ROC) curve was used to assess the performance of Logistic model.Results Four ultrasonic indexes were finally entered into the Logistic regression model including microcalcification,acpect ratio,advanced CEUS mode and elasticity score.The percentage correction of prediction was 92.1％ (129/142),the area under the ROC curve was 0.944.Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid thyroid micronodules by ultrasonography,and select out the valuable indexes for differential diagnosis.

Objective To analyze the risk factors for delayed gastric emptying (DGE) after pancreaticoduodenectomy.Methods Clinical data of 213 patients who underwent pancreaticoduodenectomy at our hospital from January 1996 to December 2011 was retrospectively analyzed.Results The overall incidence of DGE was 40.8％ (87/213).The incidence of grade A,grade B and grade C DGE was 14.1％ (30/213),14.5 ％ (31/213) and 12.2％ (31/213) respectively.Median postoperative hospital stay was significantly prolonged in patients with DGE:30.5,32 and 61 days for grade A,B and C respectively versus 21 days in patients without DGE (x2 =66.171,P =0.000).Univariate analysis showed that operation time (≥420 min),intraoperative blood loss (≥ 1000 ml),Child alimentary reconstruction and pancreatic fistula were risk factors for postoperative DGE.Multivariate analysis using Logistic regression identified three variables as independent risk factors associated with postoperative DGE,namely,Child alimentary reconstruction (OR =2.098),intraoperative blood loss (≥ 1000 ml) (OR =2.525) and pancreatic fistula (OR =4.821).Grade C DGE was more frequently seen in patients suffering from postoperative pancreatic fistula.Conclusions The incidence of DGE after pancreaticoduodenectomy is still high.DGE prolongs the postoperative hospital stay significantly.The incidence of DGE could be reduced by Roux-en-Y reconstruction and reducing intraoperative blood loss.Postoperative pancreatic fistula is significantly associated with DGE,especially grade C DGE.