Objective To improve the level of diagnosis and treatment of uterine scar pregnancy after cesarean section,and has a very important relationship with the quality of life of the patients.At present,the purpose of reducing the rate of cesarean section and improving the level of diagnosis and treatment is to improve the quality of life of patients.Methodsthe drug contact ultrasound,analysis of surgical instrument for gynaecology and obstetrics usage of cesarean section to the hospital,and the diagnosis and treatment of uterine incision scar pregnancy patients were selected from 12 patients were investigated.Drugs containing methotrexate combined with mifepristone and mifepristone combined with trichosanthin etc.The diagnosis and treatment process,given daily doses of methotrexate intramuscular injection depth,mifepristone 50mg,two times a day,and then a B-knowledge,in the monitoring,found after a drug combined with gynaecology and obstetric operation type-B ultrasonic monitoring instrument in diagnosis and treatment of cesarean scar pregnancy after mass occurred in the bain line,and the surrounding the blood supply appeared to reduce and disappear.Blood B-HCG levels decreased.The operation of the instrument and the monitoring of the Qing Dynasty under ultrasound monitoring,after abdominal and vaginal B ultrasound monitoring,to avoid the abortion operation of obstetric and gynecological surgical guide device complications,reduce the occurrence of medical disputes.It also realizes the real-time digital recording and storage of the image during the diagnosis and treatment process.Resultsthe drug treatment and application,strengthen the guidance and application of ultrasound in obstetrics and gynecology surgical instrument,reduce the bleeding of uterine scar after cesarean section pregnancy,reduced complications.Conclusionthrough the follow-up of patient records,and proved that this method to reduce the risk,improve the patients quality of life etc.on the safe and effective.

Objective To study the value of serum intestinal fatty acid binding protein(I-FABP) and calcium levels for evaluating the effect of emergency surgical on the treatment of severe acute pancreatitis(SAP). Methods A total of 68 firstly diagnosed as SAP from June 2014 to October 2016 were collected into this study. The arrest time was less than 72 h and they were underwent emergency endoscopic or laparoscopic surgery. The serum I-FABP and calcium levels were detected 12 hours after surgery and analyze the values of serum I-FABP and calcium levels in evaluating the clinical effects by receiver operating characteristic curve(ROC). Results There were 33 cases with excellence, 21 cases with availability and other 14 cases with no-effect, the total efficacy rate was 79.4%. The gender, age, arrest time, APACHE Ⅱ score, derum amylase, blood glucose and total cholesterol levels were no statistical differences in effective group and no-effect group.The serum I-FABP levels 12 hours after surgery in effective group were lower and calcium levels were higher than no-effect group(P<0.05).The evaluating accuracy was 0.856, sensibility was 86.5%,specificity was 92.2%,cut-off value was 368 ng/mL of serum I-FABP by ROC analysis. And they were 0.844,83.5%,86.7% and 1.96 mmol/L of serum calcium level by ROC analysis. Conclusion Serum I-FABP combined with calcium can be used for evaluating the effects of emergency surgical on the treatment of the patients with SAP.

Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy.Methods One patient was hospitalized due to headache and twitch.Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy.During the treatment,the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy,assessed drug interaction between omeprazole-escitalopram and mannitoldexamethasone,monitored the adverse drug reaction of valproate,and provided medication education to the patient.Results Physician adopted clinical pharmacist's suggestion.The patient discharged with stable condition.Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.

BACKGROUND: Rapid development of tissue engineering is the new hope of repairing bone defect so as to obtain complete bone regeneration,and rapid proliferation of seed cells is one of the important factors in it.OBJECTIVE: To evaluate the proliferation and osteogenic differentiation of human mesenchymal stem cells (MSCs) plated at different cell density during subculturing period.DESIGN: Repetitive measurement.PARTICIPANTS: The experiment was conducted in the Trauma, Burn and Combined Injury Laboratory of the Third Military Medical University of Chinese PLA between January 2003 and March 2004. MSCs were obtained from iliac bone bone marrow of the 5 healthy male volunteers by separation and proliferation.METHODS: The MSCs of second generation were inoculated at 8×103/cm2,3×103/cm2, and 8×102/cm2, respectively, and then the growth curve was drawn and analyzed. After 18 days of proliferation and culture, the increased amount of MSCs was recorded to analyze the post-proliferation growth curve and osteogenic ability.MAIN OUTCOME MEASURES: ①Growth curve of cells plated at different cell density; ②Results of alkaline phosphatase(ALP) staining and immunohistochemical staining of osteocalcin.RESULTS: Human MSCs from bone marrow were CD34 negative and expressed low level of ALP. Population doubling time was 40 hours after MSCs were plated at 8×103/cm2 and the number of the cells was expanded (51±13) times after 18 days. MSCs were expanded (28±6) times 18 days after plated at 3×103/cm2. While plated at 8×102/cm2, the number of the cells was only expanded (5±3) times. Proliferative ability of cells cultured at a low density was stronger that that at a high density. MSCs could be induced to differentiate into the osteocytic lineages after plated at not only 8×103/cm2 but also 8×102/cm2.CONCLUSION: Cell density plays an evident role in the proliferation of MSCs. Cell density of 8×103/cm2 is proper to the rapid proliferation of MSCs as seed cells in bone tissue engineering.

Objective To observe the biological behavior of chondrocytes in chitosan based hydrogel in vitro and to evaluate the possibility of chitosan and glycerophosphate mixed gel using as injectable scaffolds in tissue engineering.Methods A novel injectable thermosetting gel was made of chitosan and glycerophosphate mixture.Chondrocytes isolated by enzymic digestion from the articular cartilage of the young rabbits aged 3-4 weeks were cultured in monolayer system.After primary culture and subculturing,the cells were seeded in chitosan based gel in concentration of 5?10~7/ml in vitro.Characteristics of chondrocytes during 4-week culture were observed with invert microscope.MTT was used to detect the seed growth after one-week culture.In 4th week,after haematoxylin eosine and toluidine blue staining,the artifical cartilage was performed type Ⅱ collagen immunohistochemistry and observed by scanning electron microscope.Results Chondrocytes retained their round morphology,multiplied,and produced matrix in chitosan and glycerophosphate mixture gels.The results of immunohistochemistry were strongly positive.Conclusion That most chondrocytes appeared to occupy large areas of rough chitosan based gels,guarantees a suitable environment where chondrocytes secrete matrix macromolecules and preserve their round morphology in vitro.Chitosan and glycerophosphate mixture gel may be a vehicle for injectable tissue-engineered cartilage.

OBJECTIVE To investigate the antimicrobial-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA).METHODS Forty strains of MRSA were clinically isolated.Nine kinds of antimicrobial-resistant genes were analyzed by polymerase chain reaction(PCR).RESULTS The positive rates of mecA,aac(6′)/aph(2′)and tetM were all 100.0%.The positive rates of ermA/B/C,aph(3′)-Ⅲ,qacA/B,PVL and ant(4′,4″) were 82.5%,67.5%,45.0%,10.0% and 2.5%,respectively.CONCLUSIONS There are higher positive percentages of relevant resistance genes in MRSA isolates clinically.MRSA can induce clone transmition in hospital which should pay,and attention to the disinfection and isolation.

Objective To investigate the clinical characters and therapy of primitive neuroectodermal tumor(PNET).Methods A retrospective analysis was conducted.A 36-year-old female patient was showed pain and numbness of the right upper limb and back for 6 months.The cervical spine MRI showed a spindleshaped intradural mass right ventrolateral of spinal cord at C5-7 with in homogeneously enhancing.Surgery and pathologic examination confirmed that was PNET.Combiled with a series of literatures to analyse the clinical characters Results Surgery was performed to remove the tumor and decompression combined with radiotherapy.The pathologic examination and immunohistochemical analysis revealed that it was PNET.MRI identified local recurrence in spinal canal at 3 month later after surgery.Conclusion Spinal PNET is an uncommon intraspinal tumor with poor prognosis.Histopathology is the evidence of diagnosis.Optimal therapy has not yet been found.Surgical resection with the combination of chemo-radiotherapy or radiotherapy might get the better outcomes.Multidisciplinary treatment should be further clinical required.

BACKGROUND: Proliferation and differentiation of mesenchymal stem cells (MSCs) is associated with platelet concentration in platelet-rich plasma (PRP). Low enrich multiple cannot reach proper effects, but high level had inhibitory effects on osteoanagenesis.OBJECTIVE: To observe the effect of different volume fraction of PRP on dog BMSC proliferation.DESIGN: A cytological in vitro study.MATERIALS: Healthy 12-month male Beagle dogs were supplied by the Experimental Animal Center, Xiangya Medical College,Central South University.METHODS: Dog BMSCs of 5 passage were adjusted to 3×10~8/L, and incubated in a 96-well plate at 200 μL per well. Following 24 hours of routine culture, primary medium and non-adherent cells were discarded. Prepared PRP gel was mixed with serum-free low-glucose DMEM containing penicillin and streptomycin, and then diluted into 5%, 6.25%, 7.5%, 8.75%, 10% volume fraction. 200 μL above-described liquid was added into the 96-well plate, which was subsequently placed in a incubator.We set up a blank control.MAIN OUTCOME MEASURES: MTT was used to investigate effect of different volume fraction of PRP on dog BMSC proliferation.RESULTS: Compared with the blank control group, various volume fraction of PLP could promote dog BMSC proliferation in early stage. With prolonged time, proliferation speed began to increase at day 6 in the 8.75% and 10% PRP groups, entering platform stage. BMSC number was increased rapidly in the 5% and 6.25% PRP groups, especially in the 6.25% PRP group.CONCLUSION: PRP gel could promote BMSC proliferation markedly and proliferation strength of BMSCs was correlated to the density of PRP. BMSC proliferation would be accelerated by the low density of PRP.

BACKGROUND: Platelet-rich plasma (PRP) contains abundant growth factors that were needed for osteanagenesis. Moreover,the proportion of each growth factor formed by an organism, with good synergism.OBJECTIVE: To explore the influence of PRP on osteogenetic activity of canine bone marrow mesenchymal stem cells (BMSCs) after induction in vitro.DESIGN, TIME AND SETTING: The in vitro cytological experiment was performed at the Central Laboratory of Xiangya Hospital of Central South University from June 2007 to February 2008.MATERIALS: Healthy 12-month male Beagle dogs were supplied by the Experimental Animal Center, Xiangya Medical College,Central South University.METHODS: The 3~(rd) generation BMSCs were collected and divided into 4 groups. BMSCs in the control group were incubated in standard medium. BMSCs in the osteogenetic induction medium group were incubated in high-glucose DMEM containing fetal calf serum, dexamethasone, beta-sodium glycerophosphate and vitamin C. BMSCs in the PRP group were incubated in low-glucose DMEM containing 6.25% PRP. BMSCs in the combination group were incubated in high-glucose DMEM containing 6.25% PRP, dexamethasone, beta-sodium glycerophosphate, and vitamin C.MAIN OUTCOME MEASURES: Alkaline phosphatase activities were measured. Expression of collagen type I was examined by immunocytochemical staining. Calcium tuberoses were labeled using modified Von Kossa staining. Expression of osteocalcin mRNA was examined by RT-PCR.RESULTS: Levels of alkaline phosphates of all groups became increased along with time. The alkaline phosphates level of combination group was strongest (P < 0.05). Following 7 and 14 days of induction, type I collagen expressed positively in the osteogenetic induction medium and combination groups, but negatively in the PRP and control groups. Following 14 days,formation of calcium nodules were found in the osteogenetic induction medium and combination groups. Following 7 and 14 days,expression of osteocalcin mRNA were similar between the control and PRP groups (P > 0.05), which was significantly lower than the osteogenetic induction medium and combination groups (P < 0.05). Expression of osteocalcin mRNA was significantly lower in the osteogenetic induction medium group compared with the combination group (P < 0.05).CONCLUSION: PRP gel can effectively promote osteoblastic effect of BMSCs after induction in vitro following induction in osteogenetic medium.

BACKGROUND: Chitosan-disodium β-glycerol phosphate (C/GP) gel has been shown to be compatible with the entrapment of viable chondrocytes, and bone marrow mesenchymal stem cells (BMSCs) are considered to be the potential cells used in tissue engineering. This experiment is aimed to observe the cytocompatibility of BMSCs with C/GP gel.OBJECTIVE: To study the effect of C/GP gel on the growth, proliferation and chondrogenic differentiation in vitro cultured BMSCs and explore a new carrier for the application of cartilage tissue engineering.DESIGN: Completely randomized controlled experiment.SETTING: Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical College; Center Laboratory of Southwest Hospital Affiliated to the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was performed in Center Laboratory of Southwest Hospital Affiliated to the Third Military Medical University of Chinese PLA between October 2005 and April 2006, Six adult female mini-pigss were employed. C/GP gel is prepared by mixture the HCI solution of chitosan with salt solution of β-glycerol phosphate, allowed gel at 37 ℃ in incubator for about 5 to 10 minutes.METHODS: ① BMSCs culture: 4-6 mL of bone marrow harvested from the posterior superior lilac crest were plated at 20 ×10<'6>/100 mm dish and then grown for 14 days in complete media, consisting of DMEM/F-12 supplemented with 10% fetal ovine serum. Cells were harvested and re-seeded for subculture. ② BMSCs differentiation assays: Osteogenic differentiation was assessed by histologic detection of alkaline phosphatase activity and calcium in cultures under osteogenic conditions. Chondrogenic differentiation was evaluated by histology for toluidine blue and immunohistochemistry for type Ⅱ collagen in cultures under chondrogenic conditions. ③ In vitro assays, expanded BMSCs were suspended in C/GP solution and allowed gel at 37 ℃ in incubator for about 5 to 10 minutes, then cultured under chondrogenic conditions for 3 weeks. Cells attached to and viability in C/GP gel was monitored with the aid of an inverted light microscope. Chondrogenic differentiation of cell in C/GP gel were assessed by histological and immunohistocbemistry. The cell proliferated was monitored by MTT after 2, 5, 8 days seeding.MAIN OUTCOME MEASURES: ① Characterization of mini-pigs' BMSCs; ② BMSCs attached to and viability in C/GP gel; ③ Chondrogenic differentiation of BMSCs in C/GP gel; ④ BMSCs proliferated in C/GP gel.RESULTS: ① Characterization of mini-pigs' BMSCs: Cultured BMSCs showed fibroblastic morphology and were able to differentiate to chondrocytes or osteogenic cells under chondrgenic or osteogenic cultured condition respectively. ②BMSCs attached to and viability in C/GP gel: BMSCs attached to and remained > 90% viable in C/GP gels immediately post-casting, and throughout the 21 days, using MTT staining. ③ Chondrogenic differentiation of BMSCs in C/GP gel: During 21 days culture period in vitro, chondrogenic induced BMSCs produced amounts of de novo cartilage matrix in the chitosan, as assessed by histological and biochemical criteria. ④ BMSCs proliferated in C/GP gel: Chondrogenic induced BMSCs cultured in C/GP gels continued to proliferate. There was a significant difference among the values of optical density in the cells-gel constructs compared to the controls without cells after 2, 5, and 8 days of culture (P<0.05).CONCLUSION: It is confirmed that C/GP gel shows good cytocompatibility with BMSCs and contributes to the growth, proliferation and chondrogenic differentiation for BMSCs in vitro culture. C/GP gel can be a potential cell-carrier for tissue engineering of articular cartilage.