Objective To compare the effects of rib internal fixation and thoracic external fixation in treatment of traumatic flail chest. Methods Eighty six cases of traumatic flail chest with multiple injuries,admitted to hospital from January 2006 to June 2009 ,were recruited into the study and divided into rib internal fixation and thoracic external fixation groups randomly. The clinical data were analyzed retrospectively. Rib internal fixations with Ti-Ni shape memory alloy embracing connector were performed in internal-fixation group(n = 45) and thoracic external fixations were performed in external-fixation group(n = 41). The outcomes were compared between the two groups. Results No patient in internal-fixation group developed chest wall deformity,while 19 patients in external-fixation group had chest wall deformity left. The mean times of hospital stay([ 15. 1 ± 1.8]d vs [22. 9 ±2. 8]d,t = - 15. 724,P ＜0. 01) ,ICU stay([5.7 ± 1.5]d vs [ 14. 4 ±2. 9]d,t =- 17.711, P ＜ 0. 01), and mechanical ventilation([ 3.9 ± 1.5 ] d vs [ 1 1.6 ± 2. 3 ] d, t = - 17. 256, P ＜ 0. 01),in internal-fixation group were significantly shorter than those in external-fixation group. The occurrence rate of respiratory complications (including pulmonary inflammation and (or) atelectasis and (or) respiratory failure)in internal-fixation group was significantly lower than those in external-fixation group(35.6% vs. 70. 7% ,x2 =10.641,P ＜ 0.01). Followed-up data of three months after discharge showed that the pulmonary function parameters, such as total lung capacity([ 89. 5 ± 3. 1 ] % vs. [ 79. 1 ± 5. 1 ] %, t = 11. 705, P ＜ 0. 01), forced vital capacity([ 80. 2 ± 2. 8 ] % vs. [ 69. 8 ± 3. 8 ] % ,t = 14. 241 ,P ＜0. 01) ,forced expiratory volume in the 1st second ([74.8 ±4.4]% vs. [71.9 ±3.6]% ,t =3.201,P ＜0.01),peak expiratory flow ([82.8 ±4.4]%vs. [79. 8 ±4. 9]% ,t =2. 885,P ＜0. 01) and forced expiratory flows at 75% of the vital capacity( [68.2 ±2. 2] % vs. [61.9 ± 2. 9 ]%, t = 11. 286; P ＜ 0. 01) were significantly higher in internal-fixation group than those in external-fixation group. Conclusion Rib internal fixation for traumatic flail chest can quickly correct chest wall deformity, stabilize thoracis and eliminate paradoxical chest wall movement. Patients accepted this treatment have a shorter therapy process during the intensive care unit and hospital stay, less pulmonary complications. They also show less long-term restrictive pulmonary functions impairment, when compared to the patients in the thoracic external fixation group. Rib internal fixation with Ti-Ni shape memory alloy embracing connector is a simple and effective therapy.

Objective To study the relationship of Helicobacter pylori(Hp)infection degree with serum pepsinogen(PG)and the tumor markers related with gastric cancer .Methods Totally 342 cases of health physical check‐up in our hospital from January to June 2015 were selected .13 C‐UBT was performed to evaluate the Hp infection and infection severitys .The level of serum PG was detected by ELSIA and the levels of tumor markers were detected by luminescence immunoassay .Then the results were statistically analyzed with the SPSS statistical software .Results The positive rate of Hp in 342 research subjects was 49 .42% ,and there was no difference between the male and the female groups(P>0 .05) .The level of serum pepsinogen Ⅰ (PGⅠ )and pepsinogen Ⅱ (PGⅡ)in the Hp(+ + )and Hp(+ + + )groups was significantly higher than that in the Hp negative group ,while the PGⅠ /PGⅡ lev‐el was significantly lower than that in the negative group (P<0 .05) .The level of carbohydrate antigen 724(CA724)and carcino‐em‐bryonic antigen(CEA)had the statistical difference between the Hp(+ + + ) group and the Hp negative group(P= 0 .040 ,P=0 .010) .The Pearson correlation analysis displayed that Hp infection was related with PG Ⅰ ,PGⅡ ,PGⅠ /PGⅡ ,CA724 and CEA . There was a positive correlation between PG Ⅱ and CA50)(r=0 .116 ,P=0 .032);there was a negative correlation between PG Ⅰ /PGⅡ and CA50(r= -0 .193 ,P=0 .000) .Conclusion The combined detection of Hp ,PG and tumor markers could be used as one of methods for screening benign and malignant gastric diseases in the healthy physical check‐up population ,which has an important value for the prevention and intervention of related disease occurrence and development .

A large-scale population survey has been made to clarify the degree of harm and feature of distribution of cerebrovascular disease (CVD) in China. The sample investigated was 5814851 from about a billion people in 29 provinces, municipal cities and autonomous regions except Taiwan in China. The incidence, prevalence and mortality rates have been standardized by the direct method using the world standard population. It has been found that the incidence rate of CVD in China was 109.95 per 100 000 people in 1986 and its 95%CI (confidence interval) was 107. 25 ~ 112. 65 per 100000. The age-standardized incidence rate was 115.87/100000. The point prevalence rate of CVD in China was 245.49 per 100000 people on December 31, 1986 and its 95%CI was 241.57-249.61 per 100000, with an age-standardized prevalence rate of 259.86 per 100000. The mortality rate of CVD was 76.78 per 100000 in 1986 and its 95%CI 74.52~79.04 per 100000, with an age-standardized mortality rate of 80.94 per 100000. It has also been found that there was a tendency for the rates to increase gradually from south to north and to decrease progressively from east to west. The models of linear regression have been established between latitude and rates as well as between longitude and rates, respectively. The incidence, prevalence and mortality rates of CVD differ significantly in various topographic areas. They were much higher in cities than in rural areas, and much higher in men than in women. The incidence, prevalence and mortality rates increased with the age, and their relationships were fitted with logistic curve, respectively.

Point prevalence rate of complete stroke on December 31, 1986 in China was investigated using a retrospecive section study for 5 814 851 people of 29 provinces and cities (excluding Taiwan province), and 14275 stroke cases were found. Point prevalence rate was 245.49 per 100000 people with 95% CI (confidence interval) 241.57-249.61 per 100000 people. The rate standardized by the constituent ratio of population between city and rural area of China in 1986 was 247.66 per 100000 people. The rate age-standardized by the population of China in 1982 accounted for 191.92 per 100000 and the rate agestandardized by the world standard population was 259.86 per 100000 people.It has also been found that there was a tendency for the prevalence rates to increase gradually from south to north and to decrease progressively from east to west. The linear regression models have been fitted between the point prevalence rates and latitude or longitude respectively. The results were Y= 12.3819?-1107.38 (tb = 4.65 df = 5 P = 0.0056) for longitudes and Y = 12.6279?-146.6266 (tb = 11.7517 df = 4 P = 0.0003) for latitudes. There was a difference statistically among various topographic areas. The prevalence rate was much higher in urban areas than rural areas and much higher in men than in women. The prevalence rate increased with age and their relationships have been fitted well with the logistic curve.

Aim To establish in vitro blood-brain barrier (BBB) model with characteristics of simulation of in vivo BBB by primi-tive co-culture of brain-microvessel endothelial cells (BMECs) with brain-microvessel pericytes (BMPC)and astrocytes (AS). Methods BMECs,BMPC and AS from SD rats were primitively isolated,purified and cultured,and then primitive culture cells were identified by cellular morphological and immunocytochemi-cal staining methods.Five types of in vitro BBB models were es-tablished by using Millicell culture insert (pore diameter 0.4μm)and their barrier functions were evaluated by detection of transendothelial electrical resistance (TEER),permeability of sodium fluorescent (Na-FLU ),expression of alkaline phospha-tase (AKP)and γ-glutamyl transpeptidase (γ-GT1 ),and simi-larity of permeation amount for positive drugs in vitro and in vivo BBB conditions.Results Primitive culture of BMECs presented typical pebbles-like structure,BMPC presented larger soma with branching property,AS presented slender synapse and shallower cytoplasm.Moreover,immunocytochemical staining results iden-tified primitive cells were targeted cells.TEER value for co-cul-ture of BMECs,BMPC and AS reached (478 ±25 )Ω· cm2 , permeability coefficients (Papp )value of Na-FLU was [(8.23 ± 0.78) ×10 -6 ]cm·s-1 ,expression of AKP and γ-GT1 were (6.90 ±0.27 )King unit · g-1 Pro and (4.39 ±0.32 )μg · g-1 Pro respectively.Moreover,good correlation could be found in Papp for positive controls in vitro and in vivo BBB models (R2=0.92).Conclusion The established in vitro BBB model by using primitive co-culture of BMECs with BMPC and AS posses-ses in vivo BBB properties in cell morphology,structures and barrier functions,and can be used as a powerful tool for studying physiology,pathology of BBB and screening candidate com-pounds.

ObjectiveTo investigate the molecular mechanism of prostaglandins E2 ( PGE2 ) in promoting bone formation by detecting the changes of gene expression profiles of MC3T3-E1 osteoblasts treated with PGE2. MethodsThe genes with differential expression in MC3T3-E1 osteoblasts treated with 10 μmol/L PGE2 for 30 minutes were performed by gene chip technology. Several major genes during bone regeneration were selected for Western blot analysis. ResultsAfter co-culture of MC3T3-E1 cells with PGE2 at concentration of 10 μmol/L for 30 min, 276 genes were up-regulated, including bone regeneration related MMD (monocyte to macrophage differentiation associated), NR4A2 (nuclear receptor subfamily 4, group A, member 2), BMP-7 ( bone morphogenetic protein-7), POSTN ( periostin, osteoblast specific factor) and catenin (cadherin-associated protein) genes; and 168 genes were down-regulated,including bone regeneration related Idl ,2,3 ( inhibitor of DNA binding 1,2,3 ) genes. Western blot analysis indicated that the expressions of nuclear factor (NF)-κB p65 and BMP-7 protein in the osteoblasts treated with 10 μmol/l PGE2 were apparently higher ( P ＜ 0. Ol ) than that of the controls, whereas the ld2 expression decreased (P ＜0. O1 ) under the same conditions, which was almost the same as the results of gene chip technology. ConclusionsWith the results of gene chip and Western blot, it can be speculated that the PGE 2 firstly activates the nuclear receptor NR4A2 and then the nuclear transcription factor NF-κB, induces the changes of the downstream gene BMP-7 and Id2 expression and finally results in the differentiation of the osteoblasts and promote the bone regeneration.

OBJECTIVE: To investigate the clinical outcomes of artificial bone (hydroxyapatite) and bone cement implantation in treating young patients with avascular necrosis of the femoral head caused by different reasons. METHODS: A total of 18 patients (23 hips) with Ficat stage Ⅲ and Ⅱ avascular necrosis of the femoral head were treated with dead bone debridement, artificial bone and cement implantation in Department of Orthopedics, Third Affiliated Hospital of Guangxi Traditional Chinese Medical College from October 2003 to July 2008. The patients were followed up for 24.6 months (ranging 3 months to 5 years). The affected hip function was evaluated by modified Merled'Aubigne Scores and X-ray. RESULTS: Mean hip scores improved significantly from 11.65 to 15.09 after surgery. Postoperative radiographs demonstrated the improved collapse and restoration of femoral head sphericity. The femoral heads of most patients remained the appearance after surgery, and the necrosis range did not enlarge. The patients were satisfactory to the treatment results. CONCLUSION: Artificial bone and cement implantation could restore head sphericity and prevent further collapse. The method can be used as an alternative for treatment of avascular necrosis of femoral head at Ficat stage Ⅱ and Ⅲ, especially for young patients.

AIM: To explore the histocompatibility of pinealocyte microencapsules in vivo. METHODS: The pineal glands of neonatal rats were removed under operating microscope and pinealocytes were isolated through collagenase and trypsin digestion. Pinealocytes were cultured for one week in vitro and collected immediately after digesting was encapsulated in APA microencapsules. The cells and empty capsules were transplanted into abdominal cavity or intermuscular space respectively and retrieved at the 15th or 30th day after operation. Morphological observation, HE staining, cell counting, and HPLC technique were used to analyze the shape, proliferation and function, the degree of inflammation fibrosis of retrieved microencapsules. RESULTS: The retrieve rate of cell capsule from abdominal cavity was about 85 % . The retrieved capsules had integrated profile mostly although some were damaged. The amount of macrophages attached to capsule wall and the thickness of wall increased gradually following the period of transplantation. However, the retrieve rate, wall thickness had no difference between retrieved cell and empty capsules at the same time. Secretion ability of pinealocytes in capsule retrieved at 15th day after operation decreased rapidly and those retrieved at 30th day after operation lossed secretion function. CONCLUSION: APA microencapsules had histocompatibility relatively in vivo and protected pinealocytes in capsule from immunologic rejection of the host. The survival time was about 20 days. During this period cells in capsule maintained activity and MT secretion ability.

A series of adefovir mono-L-amino acid esters, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs with more potent anti-HBV activity and lower nephrotoxicity were designed and synthesized. Adefovir bis (L-amino acid) ester was used as lead compound, according to pathological and pharmacological findings that non-steroidal anti-inflammatory drugs can effectively inhibit the organic anion transporter 1 (hOAT1)-mediated adefovir phosphonic acid pairs of anion transport across tubular basement membrane thereby reducing the nephrotoxicity of adefovir. Flatten design principle was used to introducing non-steroidal anti-inflammatory drugs structural fragments to design and synthesize target adefovir mixture ester prodrugs. HepG2 2.2.15 cell line was used as in vitro anti-HBV activity evaluation model. Five compounds exhibited antiviral activity, and compound 18 showed the most potent anti-HBV activity and relatively high selective index (EC50 3.92 micromol L(-1), SI 9.97). HK-2 cell line was used as in vitro model to evaluate nephrotoxicity. Results suggested the target compounds have lower cytotoxicity than the positive control. Moreover, by analyzing the primary structure and activity relationship of these compounds, it could suggest that mono-L-amino acid ester, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs strategy has significant potential in the acyclic nucleoside phosphonates prodrug design.

Objective To study the role of mesenchymal stem cells (MSC) in an animal model combining ischemia-reperfusion with 85％ liver resection.Methods Eight-week-old male SD rats received BM-MSC by tail vein and then underwent 30-min ischemia followed by 85％ liver resection.The survival rate was monitored for 7 days after surgery.Liver regeneration was assessed on day 2 after hepatectomy.Liver damage,liver cell apoptosis,and cytokine expression in the first 24 h after hepatectomy were also assessed.Results BM-MSC mostly homed to the spleen.Transplantation significantly inhibited myeloperoxidase [(19.9 ± 6.0) mg/g vs.(41.4 ± 10.2) mg/g] and downregulated proinflammatory cytokines.BM-MSC significantly reduced the ALT and AST levels [AST (1 475 ± 275) IU/L vs.(2 550 ± 441) IU/L,P ＜ 0.05;ALT (738 ± 101) IU/L vs.(1 113 ± 268) IU/L,P ＜ 0.05].The attenuation of liver injury was also verified histologically 24 h after surgery.Liver cell apoptosis was markedly reduced.Moreover,BM-MSC infusion significantly promoted remnant liver regeneration.As a result,the survival rate was improved by BM-MSC treatment in this model (95％ vs 70％,P ＜ 0.05).Conclusion In an animal model combining ischemia-reperfusion with 85％ liver resection,BM-MSC infusion attenuated liver injury and promoted hepatocyte regeneration,resulting in improved survival rate.