BACKGROUND:Core decompression with bone implantation in treatment of early avascular necrosis of femoral head may provide insufficient support for subchondral bone and increase the risk of fracture and col apse. Tantalum rod implantation can not only provide good biological support, but also promote the revascularization at necrotic regions, thus repairing the necrosis of femoral head.
OBJECTIVE:To evaluate the efficacy of core decompression, core decompression with bone implantation and core decompression with tantalum rod implantation in treating early-stage avascular necrosis of femoral head. METHODS:A total of 24 cases (28 hips) who suffered from ARCO I/II avascular necrosis of femoral head were treated with core decompression with bone implantation, and 25 cases (29 hips) who suffered from ARCO I/II avascular necrosis of femoral head were treated with core decompression with tantalum rod implantation. Al the subjects were fol owed up for 24 months. The efficacy of two different surgical methods was evaluated before and after treatment by observing the changes in Harris scores.
RESULTS AND CONCLUSION:Al involved patients were fol owed up. Harris score of core decompression with bone implantation group were increased 4.93 points at 6 months after surgery;Harris score of core decompression with tantalum rod implantation group were increased 6.89 points at 6 months after surgery. There were significant differences between two groups before and after surgery (P<0.05). After 12 months, Harris scores in the two groups were both significantly increased and the scores of core decompression with tantalum rod implantation group was higher than that of core decompression with bone implantation group (P<0.05). The overal fine/excellent rate of core decompression with tantalum rod implantation group was 83%, which was better than core decompression with bone implantation group (75%). After 24 months, X-ray score of core decompression with tantalum rod implantation group was significantly higher than core decompression with bone implantation group (P<0.05). Comparing with core decompression with bone implantation, core decompression with tantalum rod implantation can better prevent femoral head col apse, improve hip function and delay the process of osteonecrosis of the femoral head.

BACKGROUND:Local injection with simvastatin can induce osteogenesis, significantly increase the bone mineral density and mechanical strength of femoral neck and femoral condyle of rats with osteoporosis and analyze effects of local injection of simvastatin on trabecular bone of the femoral condyle.
OBJECTIVE:To explore the effects of local injection of simvastatin on trabecular bone of the femoral condyle of osteoporotic rats and provide experimental basis for the application of simvastatin in clinical topical treatment of osteoporosis.
METHODS:Eighteen female Sprague-Dawley rats received bilateral ovariotomy at 3 months, and were used to produce rat models of osteoporosis. They were assigned into three groups. Experimental rats received 5 and 10 mg simvastatin by single injection into right femoral cavity. Control rats received blank vector. The rat models were sacrificed at 1 month after injection and specimens were col ected. Right femoral condyles were taken out for bone histomorphometric analysis by Micro-CT.
RESULTS AND CONCLUSION:One month post-injection, Micro-CT scanning results revealed that cortical bone thickness, trabecular bone density and connection rate were significantly better in the simvastatin group than those in the control group. Results indicated that single injection of smal-dose simvastatin obviously promoted rebuilding of trabecular bone of condyles of femur, improved microstructure of skeleton, strengthened local skeleton, prevented and treated osteoporosis, and provided a further basis for the prevention and treatment of osteoporosis, especial y for osteoporotic fractures.

Objective To explore the learning curve of transbronchial needle aspiration by evaluating the procedure time and the positive rate for respiratory physicians who have already mastered the bronchoscopy. Methods Clinical data of 60 patients who received TBNA procedure from May 2013 to August 2014 were retrospectively analyzed. The patients were divided into four groups (A, B, C, D) according to the time sequence of receiving the TBNA procedure, 15 patients in each group were set as a learning stage. The patients were received TBNA by the same doctor. The average time in each stage of puncture, positive rate, and puncture complications were compared among each groups. Results There did not show any significant differences in gender, age, etc. (P > 0.05) among the four groups. Puncture time in group A (15.2 ± 2.0) min and in group B (14.7 ± 2.2) min were significantly longer than that in group C (8.3 ± 1.6) min and in group D (7.6 ± 1.3) min (P < 0.05). In terms of the positive rate after the puncture, group A (26.7%) and group B (33.3%) were significantly lower than group C (80.0%) and group D (80.0%) (P < 0.05). There were no significantly different between group A and group B, and group C and group D in terms of puncture time and positive rate. Complications in each group was similar to intravascular puncture, after-puncture bleeding, pneumothorax, mediastinal hematoma, mediastinal bleeding and mediastinal infection did not show significant differences. Conclusion The learning curve of transbronchial needle aspiration for respiratory physicians who havemastered the bronchoscopy is around 30 cases.

Aim To investigate the feasibility of using arnnion allograftcombined with nerve growth factor to bridge peripheral nerve deficit.Methods 48 SD rats as models of sciatic nerve deficit were randomlyassigned into one of the following groups: autograft (Group A), allograftwith Cyclosporine A (CSA) 5 mg/(kg @ d) for 5 weeks (Group B), deficitbridged by amnion allograft combined with nerve growth factor (Group C) ,and allograft with no immune treatment (Group D) . 6 Wistar rats weresacrificed as the donors of the sciatic nerve allograft. Observation wascarried under light microscope and electron microscope examination at 12weeks post-operatively for morphological studying; The latency, ampli-tude, conduct velocity and negative area under the curve were recordedas electrophysiologic index; Maximum contractility of gastrocnemiusmuscle and thickness of myelin of the regenenative nerve were measured;Axons counting were also performed to evaluate the quality of regenera-tion. Results At 12 weeks, group A, B and C recovered better (Indexessuch as latency, amplitude, conduct velocity , negative area under thecurve, maximum contractility of gastrocnemius muscle, thickness of myelinand axons counting were compared by ANOVA test, F= 12.87, P ＜0.05; F=19.54, P ＜0.05; F=35.21, P ＜0.01; F=56.33, P ＜0.01. F=75.26, P ＜0.05; F=14.83, P ＜0.05; F=96.11, P ＜0.01), and no significant difference was found among these groups ( P ＞0.05). Conclusion For long distance peripheral nerve deficit, usingamnion allograft combined with nerve growth factor to bridge the deficit canfacilitate the regeneration of nerve and the recovery of function.

BACKGROUND: A better understanding of medical students' attitude towards living liver donation in China would be of importance significance in the development of organ transplantation. OBJECTIVE: To investigate the medical students' attitude toward living liver donation in China and to analyze the factors that affect such an attitude.METHODS: A random sample of 250 medical students was taken and stratified by grades with 50 students in each grade. The attitude was evaluated by a modified psychosocial questionnaire from Spain. The questionnaire was completed anonymously and was self-administered. A bivariate analysis including the Student's t test and the Chi-square test was performed using SPSS software. RESULTS AND CONCLUSION: The questionnaire completion rate was 97.2% (n=243) for the medical students. Among the respondents, only 13.2% (n=32) of them were in favor of unrelated living liver donation. Another 66.3% (n=161) were only in favor if the donation was for a relative. Of the rest, 6.6% (n=16) did not agree with living liver donation, and the remaining 14.0% (n=34) were undecided. The factors related to this attitude were the decision of donating the organs of a family member (P=0.002), attitude toward deceased donation (P=0.000), a willingness to receive a donated living liver organ if one were needed (P=0.000), attitude toward living kidney donation (P=0.000). The medical students have a favorable attitude toward living liver donation in China. The students' attitude toward other types of organ donation and the willingness to accept living donated liver influence their attitude toward living liver donation. There is a great lack of education about the organ donation and transplantation for the medical students in China and more education programs should be incorporated into their traditional curriculum.

Objective To explore the clinical effents of bevacizumab on the recrudescence of the limbal corneal epithelial cell auto-graft transplantation in treating patients with pterygium.Methods The clinical data of 75 cases(99 eyes) with pterygium were retraspectively reviewed,and they were divided into 3 groups by different conservative treatment.A group:the limbal corneal epithelial cell auto-graft transplantation combined with bevacizumab.B group:the limbal corneal epithelial cell auto-graft transplantation combined with MMC.C group:the limbal corneal epithelial cell auto-graft transplantation.After follow-up for 3 months,the curative effect and recurrence were compared between the two groups.Results The recurrence of three groups was significantly different( x2 =12.267,P ＜ 0.05 ).The reccurrence rate of A,B,C group were 12.1％,15.2％,45.5％.The recurrence rate of A group and B group wasn't significantly different(x2 =2.117,P ＞0.05).The recurrence rate of B group and C group wasn't statistically different( x2 --3.930,P ＜ 0.05 ).The recurrence rate of A group and C group was significantly different( x2 =4.155,P ＜ 0.05 ).After 1 week,all patients had different degrees of eye pain,photophobia or tearing,and disappeared after 1 week;2 patients in group B found that limbal shallow scleral necrosis,superficial punctate keratitis.The average time of removal of stitches in group A was 5.9d,group B was 7.0d and group C was 7.5d.Conclusion Bevacizumab could obviously reduce the recrudescence of the limbal corneal epithelial cell auto-graft transplantation in treating patients with pterygium.It was safe with less complications and good prognosis.It was worthy for being widely used in treatment of pterygium.

Objective:To compare the difference on the positive detection rate of the main aeroallergens and food allergens specific IgE measured with the systems between fluorescence enzyme immunoassay(FEIA, referred to as ImmunoCAP system)and western blot(referred to as Allergy Screen system), in order to provide a basis for the rational application of methods and interpretation of the test results.Methods:The clinical information and sIgE test results data were collected from a total of 458 cases of allergic diseases from October 2017 to April 2019 in the outpatient clinic of Allergy Department in Beijing Children′s Hospital.All of the 458 cases were detected for a panel of common aeroallergens and food allergens sIgE level in their serum with the Allergy Screen system.Simultaneously, the above 141 cases were detected main aeroallergen and food allergen sIgE with ImmunoCAP system, while 303 cases only for aeroallergens and 14 cases only for food allergens.All of the cases were divided into three different phenotype groups according to the main target organ and diagnosis such as airway allergic disease group( N=293), skin allergic disease group( N=14)and multi-system allergic disease group( N=151). Meanwhile, three different age groups were referred to as <3 years old group( N=97), 3 to 6 years old group(3 years and 6 years included)( N=186)and >6 years old group( N=175). The same kinds of the allergens included in the two systems were house dust mite(HDM), cat dander, dog dander, egg white, milk, crab, shrimp, therefore data of sIgE to those seven allergens were compared. Results:In all the enrolled cases, the positive detection rate of HDM, egg white and milk sIgE detected by ImmunoCAP system were significantly higher than those by Allergy Screen system(30.6%, 36.1% and 43.2% vs 21.2%, 21.3% and 21.3%). Among the disease groups, the positive detection rate of HDM sIgE detected by ImmunoCAP system was significantly higher in the airway allergic disease group and multi-system allergic disease group than those by Allergy Screen system, respectively(33.7% and 24.6% vs 23.4% and 16.2%). The positive detection rate of egg white and milk sIgE detected by ImmunoCAP system in the multi-system allergic disease group was significantly higher than those by Allergy Screen system, respectively(47.6% and 47.6% vs 26.2% and 25.2%). There was no significant difference in the positive detection rate of cat dander, dog dander, crab and shrimp sIgE among the disease groups.The positive detection rate of HDM sIgE detected by ImmunoCAP system in all of the age groups were significantly higher than those by Allergy Screen system, respectively(14.9%, 26.9% and 42.3% vs 5.7%, 17.6% and 32.6%). The positive detection rate of cat dander sIgE detected by ImmunoCAP system in <3 years old group was significantly lower than that by Allergy Screen system(6.9% vs 16.1%). The positive detection rate of egg white sIgE detected by ImmunoCAP system in the <3 years old group and the 3 to 6 years old group were higher than those by Allergy Screen system, respectively(47.1% and 33.3% vs 32.4% and 15.0%). The difference in the positive detection rate of milk sIgE detected by these two methods in the <3 years old group and the 3 to 6 years old group was similar to the egg white.Conclusion:According to the analysis of seven kinds of major aeroallergen and food allergen sIgE results, there are differences between the two methods to detect HDM, cat dander, egg white and milk sIgE.It depends on the type of allergic disease and age.The positive detection rates of dog dander, crab, and shrimp sIgE detected by the two methods are consistent.In clinical application, comprehensive analysis should be made, testing methods should be selected rationally, and the results should be interpreted scientifically.

Objective:Through histological analysis, immunofluorescence staining, electrophysiological detection and Sensory and motor function evaluation to investigate the effects of 3D printed hydrogel scaffold combined with bone marrow mesenchymal stem cells (BMSCs) in promoting functional recovery of spinal cord injury.Methods:10% GelMA hydrogel and 10 6 U stem cell suspension were prepared into bioink of appropriate concentration to construct the biomimetic spinal cord scaffold through 3D printing platform. The scaffold was placed in the medium and cultured in an environment of 37 ℃ CO 2 incubator. The microstructure of the scaffolds and the distribution of BMSC in the scaffolds was observed by scanning electron microscope. CAM/PI staining and confocal microscopy were used to observe the survival of stem cells in the scaffolds and determine the biocompatibility of the scaffolds. The scaffolds were implanted into the subcutaneous tissues of the back of rats, and the subcutaneous tissues were determined by HE staining to detect the immunogenicity of the scaffolds. After the rat model of hemicytoma defect was made, stents were transplanted for treatment, and confocal microscopy was used to evaluate the regeneration of neurons and axons in local area of spinal cord injury. At the same time, BBB score was used to evaluate motor function, mechanical pain score was used to evaluate sensory function, and surface electrode detection method was used to evaluate electrophysiological recovery weekly. Results:The long spindle shaped BSMC were uniformly distributed in the scaffold with a loose reticular structure. The scaffolds had good biocompatibility, and the cell survival rate of the prepared scaffolds reached 96% after 24 hours of printing. After 28 days of subcutaneous transplantation, the immune rejection was mild and immunogenicity was low. It was shown that the regenerated spinal cord tissue in the treatment group was significantly increased compared with the control group, which was widely distributed with cells after 28 days by HE staining. It was confirmed that part of the regenerated spinal cord tissue was neurons by immunohistochemical staining.Compared with the injured group, the regeneration of neurons and axons in the treatment group were significantly increased by immunofluorescence staining and confocal microscopy. In the treatment group, the BBB score recovered to 10 points, while the control group only recovered to about 1 point in the first week, which was statistically significant. And it recovered to 17 in the fourth week, while the control group only recovered to about 4 point in the four week, which was statistically significant. The Angle of inclined plate support of the treatment group was restored to 40 degrees, while it was only restored to 22 degrees in the control group. The pain threshold of the treatment group decreased to 18.5 points, which was not statistically different from that of the control group. The latent recovery effect of electrophysiology in the treatment group was the same as that in the sham operation group and better than that in the control group.Conclusion:3D printing hydrogel scaffold with loose network structure is suitable for cell proliferation. It has well biological survival, low cytotoxicity and low immunogenicity, which promoted neurons and axons to recovery and extend so as to effectively promote the recovery of motor function, sensory function and neural signal transmission rate after spinal cord injury.

Fifty-six patients diagnosed as early stage lung cancer by spiral CT scan,underwent CTguided percutaneous transthoracic biopsy with a successful rate of 100%.Forty nice cases were confirmed pathologically including adenocarcinoma in 30 cases,squamous carcinoma in 14,alveolar cell carcinoma in 2 and small cell lung cancer in 3.Three cases were diagnosed as chronic inflammatory lesion,2 cases as tuberculosis and the diagnosis was not confirmed in 2 cases.The results suggest that CT-guided percutaneous transthoracic biopsy is an effective diagnostic measure for patients with stage Ⅰ-Ⅱ lung cancer.

BACKGROUND: Islet transplantation is an effective therapy for type I diabetic patients sensitive to insulin.OBJECTIVE: To investigate and evaluate the status and obstacles of islet transplantation in type I diabetes in China.METHODS: Published articles reported from January 1980 to December 2008 on Chinese Medical Current Contents database,the national funds from 2002 to 2008 in the database of National Natural Science Foundation of China on islet transplantation were searched to analyze the status of islet transplant research and clinical practice in China.RESULTS AND CONCLUSION: 340 articles were reported from 1980 to 2008 related to islet transplantation in China, including 165 (48.5%) basic research, 45 (13.2%) clinical research and 130 (38.2%) reviews. Most of researches were conducted in the developed regions in the east of China. The Edmonton protocol had a great impact on the islet transplant research in China, and many projects of islet transplant have been supported by the National Natural Science Foundation. However, there remains obstacles in this field, such as organ and capital shortage and incomplete organ donation system.