Objective To explore the nursing after free great toe fibular flap transplant to repair finger pulp defects. Methods 12 cases with finger pulp defect accepted the free great toe fibular flap were reviewed. Results All flaps survived and no vascular crisis occurred. The flap shaped well, and the skin sweated and the two point discrimination was 4-6 mm. Conclusion Close monitoring and appropriate is important after free great toe fibular flap transplant to repair finger pulp defects.

BACKGROUND: Demineralized bone matrix (DBM) has natural mesh pores, good plasticity and biocompatibility. However, the decalcification time in preparation of DBM remains controversial.OBJECTIVE: To compare effects of varying degrees of decalcification with DBM on the proliferation of bone marrow stromal stem cells (BMSCs) so as to provide the best DBM scaffold for cartilage tissue engineeringMETHODS: Rabbit iliac bones were prepared into strips, defatted, followed by 6,12 and 24 hours of decalcification and 2 days of soaking in alcohol to prepare DBM. DBMs were placed in 24-well plates. The third passage of BMSCs at a density of 5×10~9/L were incubated on 24-well plate with DBMs. The DBM porosity and pore size were observed by scanning electron microscopy;BMSCs proliferation on the DBM was determined by MTT, and cell attachment on DBM was observed by scanning electron microscopy.RESULTS AND CONCLUSION: DBM displayed natural high-density porous grid structure, in the presence of bone trabecula,trabecular space and bone luminal system. The porosity and pore size of DBM decalcified for 6,12 and 24 hours were similar (P > 0.05). Compared with decalcified for 12 and 24 hours, BMSCs attached to DBM decalcified for 6 hours more closely and the DBM showed better compatibility. SEM observation showed the BMSCs on DBMs decalcified for 6 hours proliferated stably after 8 days and applicable for transplantation. Moreover, the number of cells were significantly more than DBMs decalcified for 12 and24 hours (P< 0.01).

BACKGROUND: Demineralized bone matrix (DBM) having a great biocompatibility is a common material to repair bone defect in clinic Bone marrow stromal cells (BMSCs) which can differentiate into bone and cartilage cells are ideal for repairing cartilage defect. OBJECTIVE: To observe the effects of allograft DBM combined with autograft BMSCs on repairing the articular cartilage of rabbits. METHODS: Bone and cartilage defect was induced in 27 rabbits and the models were randomly divided into combined group (DBM combined with 8-day-curtured autograft BMSCs), DBM group (DBM implantation alone), and control group. The reparative tissue samples were evaluated grossly, histologically, and immunohistochemically. The repairing effect was evaluated by Wakitani's score system.RESULTS AND CONCLUSION: The repaired tissues were hyaline cartilage-shaped, smooth and glossy, and well combined with peripheral cartilage and subchondral tissues at 12 weeks after implantation in the combined group; some tissues were cartilage-likely repaired in the DBM group; a few of tissues were fiber-like repaired in the control group. Immunohistochemical staining showed that type Ⅱ collagen was positive in both combined and DBM groups. Repaired cells which could express type Ⅱ collagen were cartilage cells. However, the expression of type Ⅱ collagen was negative in the control group. At 4,8, and 12 weeks after implantation, the scores in the combined group were significantly higher than in the DBM and control groups (P < 0.01), suggesting that DBM/BMSCs complex could be an efficient graft to repair the articular cartilage defects.

Objective To explore the repair result of full-thickness cartilage defects in diannan small-ear pig by bone mesenchymal stem cells (BMSCs) transferred with both transforming growth factor-β3(TGF-β3) and bone morphogenetic protein-2(BMP-2) gene mediated by adenovirus vector and combined with deminerized bone matrix (DBM). Methods 32 full-thickness defects from 16 knees of 8 pigs were randomly divided into 4 groups in the experiments. In group A, the animals′ lateral femoral condyle of right knee joint was repaired with DBM and BMSC infected with both Ad-TGF-β3 and Ad-BMP-2. In group B, the medial femoral condyle of right knee joint was repaired with DBM and BMSC without infection. In group C, the lateral femoral condyle of left knee joint was repaired with DBM. And the group D is control group. Morphology and histology were observed 2, 4, 8 and 12 weeks after operation. Results 12 weeks after operation, the whole defects were repaired in group A, HE staining showed typical cartilaginous structure in the repaired area. In group D, defects were not repaired but filled with fibrous tissue. The O′driscoll scores were 15.65 ± 0.11 (group A), 11.33 ± 0.22 (group B), 6.13 ± 0.15 (group C) and 5.08 ± 0.15 (group D). There was significant difference among the groups (P < 0.05). Conclusions The new type of tissue engineering scaffold that DBM combined with BMSCs transfected with both Ad-BMP-2 and Ad-TGF-β3 could induce cartilage regeneration and repair the defects.

Objective This study was performed to investigate the levels of HSP70 in tissue in pemphigus as a possible new theoretical basis for further elucidate the pathogenesis of pemphigus.Methods The expression of HSP70 in 62 patients with pemphigus was determined by immunohistochemistry,and the normal skin was taken as control.Results The results showed that the positive cells of HSP70＞75 ％ in the blisters of pemphigus vulgaris and the positive cells of HSP70＞50％ in the inflammatory cells near the blisters,and the expression of HSP70 was significantly higher than that in normal skin,which was statistically significant(Z=5.42,4.73,P＜0.01).Conclusion The abnormal expression of HSP70 in inflammatory cells and psoriasis of pemphigus patients showed that HSP70 is involved in the pemphigus.

Objective: To investigate the changes of the intestinal mucosa-associated microbiota in the patients with ulcerative colitis (UC), and to explore their correlation with the clinical manifestations. Methods: From June to October 2016, at Gastrointestinal Endoscopy Center, the Second Affiliated Hospital of Xi′an Jiaotong University, 28 patients with UC and 16 healthy individuals who underwent colonoscopy examination were enrolled. The mucosa specimens of them were collected for fluorescent in situ hybridization (FISH). The bacterial flora were observed and counted, the correlation between the bacterial flora and the clinical manifestations were analyzed. Kruskal-Wallis test and Spearman rank correlation analysis were performed for statistical analysis. Results: Among 28 patients with UC, 16 were at active phase and 12 at remission phase. The number of total bacteria flora, Escherichia coli, Clostridium and Bacteroides of the active UC group and remission UC group were all more than those of healthy control group; however the number of Lactobacillus and Bifidobacteria were less than those of healthy control group, and the differences were statistically significant (χ²=23.34, 19.94; 23.40, 12.96; 23.39, 19.16; 23.32, 10.46; 23.19, 4.25; 18.94, 12.33; all P<0.05). The number of total bacteria flora, Escherichia coli and Bacteroides of the active UC group were more than those of the remission UC group, however the number of Lactobacillus and Bifidobacteria were less than those of the remission UC group, and the differences were statistically significant (χ²=7.32, 5.63, 5.62, 20.38 and 4.82; all P<0.05). In the patients with UC, the defecation frequency was positively correlated with the count of Bacteroides (r=0.459, P=0.014) and was negatively correlated with the count of Lactobacillus (r=-0.634, P<0.01). In UC patients, bloody stool, endoscopic appearance and total Mayo score were positively correlated with the counts of universal bacteria, Escherichia coli and Bacteroides (r=0.469, 0.403, 0.376; 0.604, 0.562, 0.475; 0.551, 0.463, 0.461; all P <0.05); and which were negatively correlated with Lactobacillus and Bifidobacteria (r=-0.570, -0.413; -0.899, -0.458; -0.862, -0.480; all P<0.05). The evaluation by the doctors was positively correlated with the counts of Escherichia coli (r=0.415, P=0.028), however was negatively correlated with Lactobacillus and Bifidobacteri (r=-0.841, -0.529; both P<0.01). Conclusion The intestinal microbiota have sigificantly changed in patients with UC which are correlated with some clinical manifestations of UC.

OBJECTIVETo formulate a novel histological typing and grading-rated system for colorectal cancer (CRC) for evaluating the biological behavior of CRC and prognosis.

METHODSAccording to the highly heterogeneous histological features, WHO classification and histological differentiation criteria, and other biological behavior parameters of CRC, a novel histological typing and grading-scale system for CRC was designed. The histological typing and corresponding grading-scale of CRC was defined as the following: (1) No mucin-producing adenocarcinoma, including tubular adenocarcinoma, sieve-like acne adenocarcinoma, medullary carcinoma, serrated adenocarcinoma and micropapillary carcinoma, etc. (1-3 points); (2) Mucin-producing adenocarcinoma, including mucinous adenocarcinoma and signet ring cell carcinoma (3-4 points); (3) Squamous cell carcinoma (1-3 points); (4) Neuroendocrine tumors, including neuroendocrine tumors, neuroendocrine carcinoma (1-4 points); (5) The special type of CRC, including clear cell carcinoma, spindle cell carcinoma, etc. (4-points); (6) Undifferentiated carcinoma (5 points). The pathology report form was formatted based on the major histological type with the secondary histological type. The final total score of CRC was defined as the sum of the corresponding grading scores for different histological types. The total score of a single-structure CRC was defined as the corresponding grading score multiplied by 2. A total of 666 patients with advanced CRC were pathologically reviewed and analyzed to assess the correlation of the histological typing and grading scores with TNM staging and lymph node metastasis.

RESULTSThe results showed a significant correlation of the histological grading-scale and TNM staging and lymph node metastasis (P<0.05). The scores of CRC histological grading-scale increased synchronously with the TNM staging and lymph node metastasis rate.

CONCLUSIONThe novel histological grading system allows objective evaluation of the biological behaviors and prognosis of CRC for determining individualized postoperative treatment. This system still needs further revision and updates based on evidence from prospective, multi-centered, large-scale trials.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; methods ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Young Adult

OBJECTIVETo investigate the expression of TMEM16A in gastric carcinoma and its clinical implications.

METHODSA total of 72 surgical specimens of gastric carcinoma were collected for examination of TMEM16A expression with immunohistochemical staining.

RESULTSTMEM16A expression was detected in the cytoplasm and cell membrane of the tumor cells. Of the 72 specimens of the tumor tissues, the total positivity rate of TMEM16A expression was 80.56% (58/72), significantly higher than the rate in the adjacent tissues (4.17%, 3/72, P<0.005).

CONCLUSIONAberrant expression of TMEM16A occurs in the majority of gastric carcinoma cases. TMEM16A can be used as a new candidate target for diagnosis and treatment of gastric carcinoma.

Adult ; Aged ; Anoctamin-1 ; Carcinoma ; metabolism ; pathology ; Chloride Channels ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology