BACKGROUND:Tissue-engineered bone has been considered to be a promising candidate for the repair and reconstruction of load-bearing large segmental bone defects. Currently, the studies on the application of tissue-engineered bone mainly focus on cel-scaffold or cytokine-scaffold constructs, which haveshed light upon the repair of large segmental bone defects. OBJECTIVE:Toestablish simple and convenient tissue engineering of anatomicaly shaped tibial bone defect models using three-dimensional rapid prototyping technology to manufacture rabbit tibia biomimetic artificial bone scaffolds. METHODS:Three-dimensional electronic models were constructed using Mimic software. Hydroxyapatite/polycaprolactonescaffolds were manufactured by fused deposition modeling equipment. Fifty rabbits aged 6 months were randomly divided into three groups: blank control(n=3), control(n=6) and experimental groups(n=6), respectively. Tibial defects ranged 1.2 cmweremade in al groups. No treatment was given in blank control group. The bone defects in control and experimental groups were repaired with autogenous osteotomized bone and anatomicaltissue-engineered bone, respectively, and fixed with plates and screws. RESULTS AND CONCLUSION:(1) Rabbit tibial bone measurements:tibiallengthwas (93.77±0.59)mm, tibiofibular transverse diameter(8.36±0.13)mm, sagittal diameter(5.97±0.12)mm, average thickness of bone cortex(1.20±0.10)mm, average diameter of the medulary cavity(4.30±0.06)mm. Anglebetween the connection line of the midpoints of superior and inferior articular surfaces at the side of tibial bone models and the connection lineof the midpoints of superior and inferior intersecting surfaces at the side of osteotomized bone modelswasα=(5.97±0.13)°.(2) X-ray in bone defects: at postoperative 4 and 12 weeks, no obvious displacement and angulated deformity were found in bone grafts, suggesting the good bone defect repair.(3) Histological examination: at postoperative 4 weeks, bone scaffolds were filed with new bone in the experimental group. Furthermore, considerably increased new bone formation and mineralization were observed at postoperative 12 weeks.(4) General observation: no obvious displacement and angulated deformity occurredin bone defect grafts at postoperative 4 and 12 weeks. These findings suggest that rabbit anatomical models of large segmental tibial bone defects with good stability were constructed using three-dimensional prototyping technology, which may simulate the structure and function of bone tissue and be used for guiding the new bone regeneration.

Laparo-endoscopic single site (LESS) surgery is in line with the development trend of minimally invasive surgery.Resolving the problems caused by the tiny single trocar is very important for the popularizing of LESS surgery.From February to September in 2012,34 patients with cholecystolithiasis or polypoid lesions of the gallbladder received gasless singleincision laparoscopic cholecystectomy at the Xuanwu Hospital.All the operations were successfully done,with no conversion to conventional laparoscopic surgery or open surgery.The mean operation time,intraoperative blood loss and duration of postoperative hospital stay were 70 minutes (range,45-135 minutes),18 ml (range,5-40 ml) and 3.4 days (range,3-4 days).There was no complication within the follow-up of 3 weeks,and all patients recovered well with satisfied cosmetic effect.Combination of gasless single-incision laparoscopic techniques could decrease the difficulty of LESS surgery and help to popularize LESS surgery.

Sixty barrows (Duroc × Labdrace × Yorkshine) were randomly assigned to two groups by weight of 33 kg,each of which was replicated three times with ten pigs. Half of the pigs were fed with diets containing 10 mg/kg lead and 0.5% particulate montmorillonite,the other half pigs were fed only with diets supplemented 10 mg/kg lead as control groups for 100 days.The results showed that the addition of particulate montmorillonite to the diet significantly decreased lead concentration in tissues such as blood,brain,liver,bone,kidney and hair and enhanced the erythropoiesis as measured by increasing numbers of RBC,hemoglobin and hematocrit values ,and elevated ALA-D activity in liver. The damage of lead to the liver was evident in the increases in hepatic concentration of malondialdehyde (+ 17.08% );decreases in the antioxidant enzymes catalase(-85.73 % ),superoxide dismutase ( - 52.17% ) and glutathione peroxidase ( - 47.56% ). Concomitant use of particulate montmorillonite in the diets completely ameliorated the lead-induced oxidative damage. It indicated that particulate montmorillonite is possessed of the potential therapeutic activity against lead poison.

Objective To develop a radiology algorithm and test its the accuracy in distinguish pacing in the septum from the other parts. Methods One hundred patients were implanted with double-chamber pacemakers. Sites of the leads were verified by two-dimensional echocardiography, and the patients were divided into 4 groups according to the echocar?diography:septal right ventricular outflow tract group(RVOT), RVOT anterior free wall group, mid septum group, and anteri?or septum group (near to the anterior free wall ). An algorithm was developed according to radiological characteristics in the 45° left anterior oblique (LAO45° ) view and the 30° right anterior oblique (RAO30° ) view. Then its sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were tested . Results The algorithm has high sensitivi?ty and specificity, which were 90%and 97%respectively. The positive predictive value and negative predictive value were 90% and 97% respectively. Conclusion The radiology algorithm we developed have a high sensitivity and specificity in identifying the site of the leads.

[Objective]To study the mechanism of posterior longitudinal ligament in cervical spine through measuring the collagen and Proteoglycan and Calcium changes.[Method]Fifteen specimens of cervical longitudinal ligament from cervical spondylotic myelopathy(CSM)and ten control specimens from corpses without cervical spondylosis were obtained.The content of the collagen was measured by Weossner method.Collagen type Ⅰ and Ⅱ were measured by Enzyme-Linked Immunosorbentassay(ELISA)method.Phloroglucinol spectrophotometer to determine the change of amount of Proteoglycan.The Calcium by Methyl-Thymes-Blue(MTB)Colorimetric Method.The specimens were treated hy Hematoxylin and Eosin(HE)stain method and by Masson stain method,the pathological changes of two groups were observed through microscopy.[Result]In CSM,as compared to the control groups,there showed a decrease in the contents of the total Collagen,Collagen type Ⅰ and Proteoglycan,and increase in the content of collagen type Ⅱ.The rate of type Ⅰ/Ⅱ in CSM was lower than that in control groups.An increase in the content of the Calcium.All of which have statistic significance(P

To discuss the clinical situation and treatment of cervical intramedullary spinal teratoma, two cases of it in our department were presented, and the related literatures were reviewed. A concomitant anomaly of the cervical vertebral canal was found to be accompanied by cervical intramedullary spinal teratoma. MRI showed the tumors with mixed signal intensity. During operation the tumor was found to have both cysts and hard bony nodules. It was very difficult to remove the total tumor. It is concluded that the plain film of cervical vertebra and cervical spine MRI are sensitive to differentiate teratomas from other tumors. Surgery should be the first choice for treatment.

[Objective] To explore the effect of the method of activating spleen to solidify superficial on intestinal microecology of children recurrent respiratory tract infection.[Method] Select 60 cases aged 1~12 of Qi deficiency type of lung and spleen in recurrent respiratory tract infection,randomly divide them into treatment group 30 cases and control 30;the treatment one takes TCM Fugangning formula orally for activating spleen to solidify superficial;the other takes orally BIFICO,for 12 w;compare their Bifidobacteria(B) and Escherichia coli(E) changes and B/E value after treatment,compare it to the control one's.[Result] After treatment,in the dejecta samples,the B content was higher than that in control one(P0.05);the B and E content and B/E were lower than normal group(P0.05),while control group was more than the normal group(P

Objective: To study the treatment of complicated and giant carotid body tumor. Methods: A giant carotid body tumor was dissected 2 years ago. The external carotid artery was embolized by means of catheterization before surgical intervention, and techniques of internal shunting and autogenous blood transfusion was used during the operation. Results: The tumor was resected completely without cerebral vessel disorders and major cephalic nerve injuries. Conclusion: The application of radial intervention of external carotid artery, shunting of internal carotid artery and autogenous blood transfusion are helpful to the treatment of giant and re operative carotid body tumor.

Objective To investigate the clinical and pathological characteristics of bacterial infectious diarrhea.Methods The clinical and pathological characteristics of 2380 cases of bacterial infectious diarrhea in Jinshan Hospital,Fudan University from 1998 to 2007 were analyzed retrospectively.Enumeration data were analyzed by X~2 test.Results Among the 20 169 patients who went to hospital because of diarrhea in 10 years,2380 cases fecal bacterial culture were positive,including Vibrio parahaemolyticus(2247 cases,94.4%),Shigella(99 cases,4.2%),Salmonella (29 cases,1.2%),Vibrio alginolyticus(3 cases),pathogenic Escherichia coli(2 cases).Patients with diarrhea were common from June to 0ctober in each year.The main manifestations of Vibrio parahaemolyticus infection were abdominal pain,diarrhea,nausea,vomit or dehydration.The main manifestations of Shigella infection were fever,abdominal pain and diarrhea.Conclusions The bacterial culture positive rate of stool samples from patients with bacterial infectious diarrhea is not high in Jinshan district.Shanghai.The major pathogens are Wbrio parahaemolyticus and Shigella.

Objective To investigate acquired carbapenemases and prevalence of carbapenem- resistant gram-negative bacill.Methods The antimicrobial susceptibility was determined by agar dilution method.Metallo-B-lactamase(MBLs)were screened by EDTA-disk synergy tesL The encoding genes of MBLs were amplified by PCR followed by sequencing.Strain homology Was investigated by pulsed-field gel electronphoresis(PFGE).Results In 141 carbapenem-resistant Pseudomonas aeruginosa(P.aeruginosa), there were three resistant patterns which were imipenem(IMP)-resistant+meropenem(MEM)-resistant (66.7%),IMP-resistant+MEM-sensitive(32.6%),and IMP-resistant+MEM-sensitive(0.7%).AⅡthe carbapenem-resistan Acinetobacter baumannii(A.baumannii),Acinetobacter lwoffi(A.lwoffi),Citrobactor freundii(C.freundii),Klebsielta pneumoniac(K.pneumoniac)and Serratia were resistant to imipenem and meropenem.Four strains of 141 P.aeruginosa were positive by EDTA-disk synergy test,and they produced VIM-2-type Metallo-B-1actamase.Of 34 carbapenem-resistan A.baumannii,30 strains produced OXA-tllrpe.Among them, OXA23, OXA24 and OXA66 accounted for 79.4%,38.2% and 67.6%,respectively.And 22 of 34 strains(64.7%)produced multiple OXA-carbapenemases.All 7 strains A.lwoffi produced OXA-23-type carbapenemases.A11 11 strains C.freundii,5 strains k pneumoniac and 1 strains Serratia produced KPC-2-type carbapencmases.And 6 of 11 strains C.freundii produced new subtype IMP-8.Of 15 PFGE type in 34 strains A.baumannii,14 strains belonged to A-type,7 strains belonged to B-type.Seven A.lwoffi strains distilbuted in difierent PFGE type.Four strains of P.aeruginosa producing VIM-2.type Metallo-8-lactamase did not have the same PFGE type.Eleven C.freundii strains had the same PFGE type.Five k pneumoniae strains had the sanle PFGE type.Conclusions Drug resistance to 12 common antibiotics in carbapenem-resistant gram-negative bacill was higher than non-carbapenem-resistant gram-negative.The former produced many kinds of carbaponemases and the strains prducing carbapenemases were prevalent in the C.freundii, A.baumanii, and k pneumoniae.