Objective To analyse the clinical effect and mechanism of hirudin in the treatment of patients with lower limb venous thrombosis after fracture.Methods 56 patients who were diagnosed with lower limb venous thrombosis after fracture in our hospital were collected.All patients were randomly divided into experimental group (n:28) and control group (n:28).12h after fracture operation, patients in control group were treated with subcutaneous injection of low molecular weight heparin calcium, patients in experimental group were treated with Maixuekang capsule ( hirudin) orally on the basis of control group.Before and after the treatment, the plasma levels of thrombin antithrombin complex ( TAT) , thrombin activated fiber soluble inhibitor (TAFI), D-Dimer (D-D), fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and clinical effect were detected in all patients.Results After treatment, the total effective rate of experimental group ( 92.86%) was significantly higher than that of the control group ( 71.43%) ( P<0.05 );compared with control group, the plasma levels of TAT, TAFI were lower in the experimental group (P<0.05); the plasma levels of D-D, FIB were lower in the experimental group (P<0.05); the plasma levels of TT,PT,APTT were higher in the experimental group ( P<0.05 ) .Conclusion The hirudin could inhibit thrombin activation and coagulation function in fracture patients with lower limb venous thrombosis, decrease the plasma D-D and FIB levels for improving blood hypercoagulable state and preventing thrombosis,thus improve the clinical efficacy.

Haemophilia is caused by lack of coagulation factor VIII or IX in patients′blood with inadequate hemostasis.Currently recombinant coagulation factor VII(rFVII)produced in different cells is used against clini-cal bleeding of haemophilia patients.To enhance the production and activity of rFVII;some eukaryotic cells such as baby hamster kidney(BHK);Chinese hamster ovary(CHO);insect cell and fish embryo;were used to express rFVII.Meanwhile;the effect of functional gene on the activity of rFVII and the limitation of rFVII production caused by post-translational modification were investigated by different methods.The role of rFVII in hemostasis;synthesis of rFVII in different eukaryotic cells and impact on production of post-translational modification are reviewed in this article.

BACKGROUND:Compared with traditional hydrogels, intel igent hydrogels can appear to exhibit different responses to different stimuli such as temperature, pH value, light, and magnetic field, produce two-stage structure and alter chemical structure to generate the ordered supramolecular structure by self-assembling, and ultimately cause the formation of the gel with three-dimensional structure.
OBJECTIVE:To review the research status of intel igent hydrogels and its application in tissue engineering.
METHODS:A computer-based search of CNKI and PubMed databases was performed to retrieve articles addressing intel igent hydrogels in tissue engineering published before 2014. The keywords were“hydrogel, tissue engineering”in Chinese and English.
RESULTS AND CONCLUSION:Intel igent hydrogels are classified into temperature sensitivity, pH sensitivity, photosensitivity, magnetic susceptibility and temperature/pH dual responsive hydrogels. The change of the external environment can be automatical y detected and responded. Intel igent hydrogels exhibit a series of outstanding performances in drug delivery systems, drug delivery, repair and improvement of defected tissues, which are not possessed by traditional materials. In particular, the intel igent hydrogels show considerable superiorities in tissue engineering, including low immunogenicity that reducing inflammation and rejection, biodegradability, realizing the three-dimensional scale simulation of cel microenvironment that is conducive to cel adhesion, growth, migration and differentiation.

Objective To observe the levels of serum 25‐hydroxy(25OH) vitamin D and bone mineral density(BMD) in appar‐ently healthy middle‐aged and elderly people in Zhongshan area and investigate the correlation between each other .Methods The BMD of 200 participants was measured by ultrasound BMD detector ,the participants were divided into 3 groups according BMD re‐sults .Simultaneously ,their serum 25OH vitamin D levels were measured by ECLIA .Results Among 200 participants ,the preva‐lence of vitamin D severe deficiency ,deficiency ,insufficiency and sufficiency w ere 7 cases (3 .5% ) ,35 cases (17 .5% ) ,102 cases (51 .0% )and 56 cases(28 .0% ) ,respectively .There was no significant difference in the BMD values among subgroups of different vitamin D levels(P>0 .05) .The prevalence of low BMD and osteoporosis were 60 cases(30% ) and 10 cases(5% ) ,the levels of ser‐um 25OH vitamin D in normal BMD ,low BMD and osteoporosis group were (67 .31 ± 18 .28) ,(65 .62 ± 15 .41) and (64 .95 ± 19 .86)nmol/L ,respectively .There was no significant difference in the levels of serum 25OH vitamin D among BMD subgroups (P>0 .05) .Serum 25OH vitamin D levels were not directly correlated with BMD(P>0 .05) .Conclusion Vitamin D deficiency and insufficiency are quite serious problems in apparently healthy adults in Zhongshan area .There is no evidence that the status of ser‐um 25OH vitamin D is correlate with BMD ,for laboratory diagnosis of osteoporosis ,more sensitive laboratory markers are needed .

Objective To investigate the application value of procalcitonin (PCT ) ,C-reactive protein (CRP) ,prealbumi (PA ) and white blood cell count (WBC))in children with hand-foot-and-mouth disease (HFMD) .Methods A total of 209 children with HFMD were classified into ordinary group (171 patients) and severe group (38 patients) according to the condition of disease ,an-other 30 healthy children were selected as the control group .The levels of PCT ,CRP ,PA and WBC in the three groups were meas-ured and compared .Results The levels of PCT ,CRP ,PA and WBC of ordinary group were 0 .16(0 .08 - 0 .34)μg/L ,11 .7(5 .0 -19 .0)mg/L ,(142 .6 ± 38 .4)mg /L and (11 .3 ± 4 .6) × 129 /L respectively ,and those of severe group were 0 .26(0 .14 - 0 .92)μg /L , 18 .4(5 .3 - 41 .4) mg /L ,(125 .5 ± 32 .9)mg/L and (13 .0 ± 5 .6) × 129 /L respectively .The PCT ,CRP ,PA and WBC in ordinary group and severe group were significantly different with those in the control group (P < 0 .05) .The PCT ,CRP and PA in severe group had statistical differences compared with those in the ordinary group (P< 0 .05) .Conclusion PCT ,CRP ,PA and WBC could be used as reference indexes of inflammation in HFMD ,and could be used in the diagnosis of HFMD in children ,PCT and PA could be used to evaluate the severity of disease .

Objective To evaluate the terminal segment of the intracranial vertebral artery (tICVA) fine and atherosclerotic lesions using high-resolution MRI (HRMRI) in order to guide endovascular interventional therapy.Methods From October 2015 to October 2016,4 patients with bilateral tICVA diagnosed with digital subtraction angiography (DSA) and admitted to Xuanwu Hospital,Capital Medical University were analyzed retrospectively.At the same time,time of flight (TOF) and black blood imaging were used.The bilateral tICVA imaging features in 4 patients were analyzed.Congenital dysplasia of vertebral artery and atherosclerotic lesions were identified.Results DSA revealed that bilateral tICVA fine or occlusion.HRMRI evaluation of the vascular wall structure showed that vascular dysplasia in 4 cases were all located on the right sides,showing no obvious thickening of the wall thickness,and the diameter was less than 1/2 of the contralateral side.One patient had atherosclerotic stenosis on the left and 3 had occlusion,showing local wall thickening,plaque formation,and resulting in the narrowing of the corresponding lumen and even occlusion.Three of the patients were treated with endovascular intervention.Conclusion HRMRI is helpful to differentiate hypoplasia in terminal intracranial vertebral artery and atherosclerotic stenosis or occlusion,identifying the dominant side of the vertebral artery and providing image basis for endovascular treatment of vertebral artery.

Objective To study the effects of using the polysiloxane impression material in the repair of the precise attachment.Method Using the Rapid polysiloxane impression material to make 37 work impressions,29 un-work impressions were made by alginate impression material.Results All the work impressions were eligible while there were 4 un-work impressions not eligible at the first time. Conclusion The effects of using the polysiloxane impression material in the repair of the precise attachment is satisfactory.

Objective To investigate the feasibility and safety of endovascular recanalization of chronic occlusion of large intracranial artery.Methods From January 2009 to January 2017,the clinical and imaging data of 15 patients with chronic occlusion of large intracranial artery admitted to the Department of Interventional Neuroradiology,Xuanwu Hospital,Capital Medical University for endovascular recanalization were analyzed retrospectively.Twelve patients were V4 segment occlusion of vertebral artery and 3 were internal carotid artery occlusion.Preoperative whole brain digital subtraction angiography (DSA) was used to assess the occlusion length and location.High-resolution magnetic resonance imaging (MRI) was used to evaluate the nature of occlusion and the feasibility of recanalization.The intraoperative bilateral femoral artery sheath placement was conducted in 13 cases,one side was used for recanalization and stenting,and the other side was compensated by filling the distal occlusion of the artery through collateral circulation as the reference path map,and increased the feasibility of recanalization.According to the thrombolysis in cerebral infarction (TICI) grades after procedure,the forward flow after recanalization was systematically evaluated,and grade ≥2b was defined as the success of recanalization.Results The median time between the first onset of symptoms and recanalization was 50 (range,18-365) days.The occluded recanalization sites included intracranial segment of vertebral artery in 12 cases and intracranial segment of internal carotid artery in 3 cases.Recanalization was successful in 13 cases and recanalization failure of the intracranial segment of vertebral artery was in 2 cases.Recanalization was successful in 13 cases,and intracranial vertebral artery recanalization failed in 2 cases.Of the 13 patients of successful recanalization,the forward flow of angiography returned to grade TICI 3 in 12 cases after recanalization,and returned to TICI 2b in 1 case;the symptoms of 7 cases were improved,the symptoms of 4 cases did not have any change,and the symptoms of 2 patients aggravated after procedure and developed transient ischemic attack or stroke.After 11 patients were followed up for a median of 39 (3-89) months,the median mRS score was 1 (0-2).Conclusion For recanalization of chronic large intracranial artery occlusion,using preoperative high-resolution magnetic resonance imaging evaluation and intraoperative bilateral sheath placement technique may increase the patency rate and reduce the perioperative complications.

Objective To establish a rat model of tympanosclerosis(TS) by myringotomy and inoculation of streptococcus pneummoniae, and to observe the morphological change in the tympanic membrane (TM) and middle ear mucous.Methods Forty Sprague-Dawley rats were randomly divided into two groups (n=20/group) and then ten in each group were chosen to serve as the control and the other ten were set up for the TS model.Group A (myringotomy): myringotomy was performed on the bilateral TMs of all rats except the control group.Group B (bacterial inoculation): streptococcus pneumoniae was inoculated into the bilateral middle ear cavity of all rats except the control group.The condition of the TMs and the middle ears in the two groups were respectively examined at 2 weeks after myringotomy and at the five time points (1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks) after bacterial inoculation.Then the rats were decapitated and the morphological changes were observed by hematoxylin and eosin staining.Results One rat in group B died two weeks after the inoculation.In the two experimental groups, the calcifications were observed in 70%of the TMs (14/20) in group A and in 33.33%of the TMs (6/18) at 8 weeks in group B.At the same time, the inflammatory infiltration and hyaline degeneration markedly appeared in the tympanic membrane and middle ear mucous membrane.In the two control groups, neither morphological changes nor calcifications occurred.Conclusion The current study indicated that the animal model of TS was successfully accomplished by myringotomy and inoculation of streptococcus pneummoniae, and their morphological changes were basically consistent.However, the method of myringotomy is easier to use and can obtain a higher modeling rate in a relatively short time.

Objective To evaluate the imaging changes of the arterial wall and lumen at the site of intracranial large artery lesions with high-resolution magnetic resonance imaging (HR-MRI) before and after Wingspan stent implantation.Methods From December 2013 to December 2014,9 patients with symptomatic intracranial arterial stenosis (stenosis rate:70%-99%) admitted to the Department of Interventional Neuroradiology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively.The sites of the lesions included middle cerebral arteries,basilar artery,and intracranial segment of vertebral artery.Head 3D HR-MRI technique was used to analyze and compare the changes of the tube-wall enhancement areas in the lesion sites through image registration and matching.The consistency of stenosis rates measured by HR-MRI and DSA was compared through Pearson correlation analysis and Bland-Altman Plot.Results The success rate of technique was 100% without related complications.(1) After Wingspan stent implantation,the gadolinium enhancement in the vascular walls of the stenosis sites was decreased significantly compared with that before procedure.The area of enhancement decreased was 87±16% after stent implantation compared with before implantation,and the difference was statistically significant (t=2.325,P=0.049).(2) Before stent implantation,the mean stenosis rates of the HR-MRI and DSA measurements were 82±6% and 82±8% respectively,and the difference was not statistically significant (t=0.051,P=0.961);after procedure,the mean stenosis rates of HR-MRI and DSA measurements were 16±12% and 21±12% respectively,and the difference was not statistically significant (t=1.345,P=0.216).(3) The Pearson correlation coefficients of HR-MRI and DSA for stenosis rate measurement before and after stent implantation were 0.347 (P=0.361) and 0.545 (P=0.129) respectively.Bland-Altman statistical images showed that most of the data points were within the consistency limit (x-±1.96 s).Conclusions As an in vivo noninvasive imaging means,HR-MRI can be used to assess the changes of vascular walls of the lesion sites,the vascular lumen,and the original plaques after the intracranial stent release.It can also be used to evaluate the reconstruction of intracranial arterial walls.