BACKGROUND: Chitin and its derivatives possess many biological activities such as immune modulation and promoting wound healing and hemostasis. As one of the derivatives of chitin, the effect of N-acetylglu cosamine on fracture healing has not yet been acknowledged.OBJECTIVE: To observe the changes in osteoblastic activity and the expression of bone morphogenetic protein (BMP) in response to the intervention with N-acetylglucosamine during the fracture healing. DESIGN: A randomized controlled experiment SETTING: Department of Anatomy, Medical College of Qingdao University.MATERIALS: This experiment was carried out in the Laboratory of Neuroanatomy, Medical Colloge of Qingdao University from March to August 2002. Seventy healthy New Zealand rabbits were randomized into four groups, namely saline group (n=23), Jiegupian group (n=23) and N-acetyl glucosamine group (n=24).METHODS: The rabbits were subjected to operations to induce 3-mm bone defect in the middle segment of the right radius with subsequent treatments with saline (1.00 mL/kg), Jiegupian (1.00 mL/kg) and N-acetyl glucosamine (0.28 g/kg) via intragastric administration on a daily basis till the time of tissue sampling at postoperative days 9, 17, 30 and 42, respectively. X-ray examination and HE staining were performed to observe the healing process, and the expression of BMP was assessed immunohistochemically.MAIN OUTCOME MEASURES :① General condition of the rabbits after operation; ② Fracture healing process revealed by X-ray at the specified time points; ③ Expression of BMP between the fracture ends at each time point; ④ Results of histological observation.RESULTS: According to intent-to-treat analysis, 70 rabbits entered the data analysis. X-ray revealed better fracture healing in N-acetylglucosamine group than in the ither two groups at postoperative days 9, 17, 30 and 42(P ＜ 0.05). Compared with saline group, the expression of BMP protein in Jiegupian group and N-acetylglucosamine group was increasing at postoperative 9 and 17 days, particularly in the latter group (P ＜ 0.05), but decreased at postoperative 30 and 42 days. Histologically, the gap between the fracture ends reduced in N-acetylglucosamine group at postoperative 9 days with the appearance of ()bmogenous bone trabecula an orderly arrangement of osteoblasts; in saline group, the gap was greater and contained less or even no bone trabecula, with much less, if any, osteoblasts.On postoperative day 30, the bone defect were completely filled by bone trabecula in N-acetylglucosamine group, with the bone trabecula almost communicating with the bone marrow cavity, and the osteoblasts surrounding the bone trabecula were arranged orderly with osteoclasts seldom observed; in saline group, the defect was substituted mostly by bone trabecula with breaches, and the chondrocytes could be observed scarcely. On postoperative day 42, the bone plate woven bone formed primarily at the fracture ends in N-acetylglucosamine group, with completely communicating marrow cavity and numerous active osteoclasts, and osseous lacuna can be observed; in saline group, the defect was filled with bone trabecula but clear fusion lines were not seen, and communication of the bone marrow cavity was nearly achieved with orderly arranged osteoblasts and presence of the osteoclasts.CONCLUSION: N-acetylglucosamine can accelerate fracture healing possibly by promoting the osteoblastic activity and increase the expression of BMP during the early period of fracture healing.

To advocate cadaver donation is to advocate the spirit of devotion and scientific research.It has been proved in the development of modern medicine that many problems of medical education and stubborn diseases were solved by necrospy.However,currently the cadavers donated cannot satisfy practical need,mainly because that few people would voluntarily register to donate their bodies,and those among the registered who actually donated are even fewer.This paper analyzes three factors that contribute to the bottleneck in the cadaver donation.And on the basis of present situation,countermeasures are presented to solve the problems.

Objective:T explore the longitudinal mediation of emotional labor and emotion regulation between occupational stress and job burnout in cinema employees.Methods:This study was a two-point longitudinal study (Interval of 2 months) with the 1067 employees from 44 city cinemas across the country as the sample,using the Emotional Labor Questionnaire (ELQ) to measure the degree of emotional labor,Emotion Regulation Questionnaire (ERQ) to measure the degree of emotion regulation,Occupational Stress Indicator-2(OSI-2) to measure the degree of occupational stress,Maslach Burnout Inventory(MBI) to measure the degree of job burnout and Job Satisfaction Scale to measure the degree of job satisfaction.A series of structural equation model analyses was conducted for data analyses.Results:The scores of expression suppression were negatively correlated with scores of occupational stress (r =-0.16,P ＜0.01),and positively correlated with the scores of job satisfaction (r =0.17,P ＜0.01).The structural equation model which include the scores of occupational stress as the predictive variable,the scores of emotional labor and emotion regulation as the mediator,the scores of job burnout and job satisfaction as the outcome variable fit well.Emotional labor (surface acting and deep acting) acted as a mediator between occupational stress and job burnout(95 ％ CI:0.03-0.05;0.02-0.05).Emotion regulation (cognitive reappraisal) acted as a mediator between occupational stress and job bumout(95％ CI:0.01-0.03).Conclusion:Emotional labor and emotion regulation acted as a mediator between occupational stress and occupational outcomes.Expression suppression has positive effect in Chinese culture.People who well in using cognitive reappraisal can lead to positive work effect througgh more deep acting and less surface acting.

BACKGROUND:Using three dimensional (3D) reconstruction techniques,any part of body is accessible to visual observation.However,reports concerning 3D reconstruction of craniofacial vascularity based on PC are few in China.OBJECTIVE:To explore the method and the application values of reconstructing a digital 3D model of craniofacial vascularity based on the data of CT strengthening scanning.METHODS:CT strengthening scan images from a healthy volunteer in DICOM format were imported into Mimics 10.01 software and craniofacial blood vessels were reconstructed with the technique of thresholding,editing and 3D region growing.RESULTS AND CONCLUSION:The 3D digital model of craniofacial blood vessels was obtained.This model could be zoomed and rotated randomly and displayed the spatial positions and adjacent relationships of different anatomical structures,also the reconstructed structures could be measured in 3D space.The 3D digital model of craniofacial blood vessels can be reconstructed conveniently and quickly with Mimics software on PC,and also it can bring morphological reference to human anatomy teaching,clinical neurosurgery,oral and maxillofacial surgery,as well as image diagnosis,and will be helpful to generate a virtual plateform in craniofacial surgery.

Objective To observe the efficacy and safety of trimetazidine/coenzyme Q10 combination in the treatment of the elderly patients with chronic heart failure(CHF).Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group.Patients in control group received optimal conventional CHF therapy according to the guideline for CHF,while patients in intervention group received trimetazidine of 20 mg,3 times per day,coenzyme Q10 20 mg,3 times per day,additionally for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),plasma brain natriuretic peptide (BNP),6 min walking distance (6MWT) and NYHA cardiac function classification of two groups before and after treatment were observed.Results Before treatmen,the NYHA function class of patients in intervention and control groups were 2.8±0.7,2.7±0.7 respectively,after treatment were 2.1± 0.6,2.4 ± 0.7 respectively,the differences were significant before and after treatment (t=6.808,2.249;P＜0.01,P＜0.05).Before treatment,BNP of intervention and control groups were (540±351)ng/L,(483 ± 351) ng/L respectively,after treatment were (219± 172) ng/L,(316 ± 202) ng/L respectively,the differences were significant before and after treatment (Z =-4.927,-4.042;P ＜ 0.01).Moreover,after treatment,NYHA function class and plasma BNP in intervention group were significantly better than those in control group (t =-2.109,P ＜ 0.05;Z =-2.219,P ＜ 0.05).Before treatment,LVEF,LVEDD and 6MWT of intervention group were (44.3 ± 3.1) ％,(54.0 ± 4.7) mm and (217.0 ± 60.9) m respectively,after treatment were (46.8±3.9) ％,(53.2±4.3) mm and (267.0±91.1) m respectively,the differences were significant before and after treatment(t=-8.313,2.254,-4.561;P＜0.01 or P＜0.05).Moreover,after treatment,LVEF and 6MWT in intervention group were significantly better than those in control group ((44.9± 3.5)％,(213.2 ±78.1) m;t =2.000,2.186;P ＜ 0.05).No significant adverse events were detected in the intervention group.Conclusion Combination of trimetazidine and coenzyme Q10 on the basis of the conventional treatment in the elderly with CHF,can further improve cardiac dysfunction and have a good safety.

Objective To assess the clinical and histopathological features as well as treatment of Wells syndrome.Methods The clinical and pathological findings from 7 patients with Wells syndrome were retrospectively reviewed.Results Lesions were located on both lower extremities in 4 patients,on the back in 1 patient,on the face and trunk in 1 patient,and on the buttocks in 1 patient.Clinical manifestations included cellulitis (n =3),urticaria (n =1 ),annular plaques (n =1 ) and papulonodules (n =2).Histopathological examination of skin biopsies showed an infiltrate of numerous eosinophils with occasional flame figures in the dermis of all the patients.Leucocytoclastic vasculitis was found in 3 cases.No triggering factors were found in any of the 7 cases.The lesions nearly subsided in 3 patients after 2-week treatment with oral small-dosage prednisone and tripterygium glycosides.Conclusions Wells syndrome shows a wide diversity of clinical manifestations with distinct histological features.Systemic glucocorticoids and tripterygium glycosides are effective for the control of this condition.

Anatomic structure in craniofacial region is very complicated and orthognathic surgery is difficultly performed.Therefore,it is necessary to generate virtual surgical model from CT scan data before operation on personal computer in order to make surgery more accurate.This technique has been increasingly interested in the field of orthognathic surgery both at home and abroad.The sample was scanned with thin-layer CT.CT image data (336 layer,1.0 mm slice thickness) were analyzed with the Mimics software.Simultaneously,three-dimensional model and virtual surgery of the facial cranium were established.The digitized virtual surgical platform of facial cranium was preliminarily created,and three common surgical methods in maxillofacial surgery,i.e.,LeFort Ⅰ osteotomy,mandibular angle osteotomy,and genioplasty,for maxillofacial surgery were simulated.The results showed that the digitized virtual surgical platform of facial cranium could be generated with the Mimics software on personal computer,which provides convenient and quick methods for research,teaching,and clinical surgery.More importantly,it creates theoretical basis for virtual surgical platform which can be widely used on personal computer.

Purpose To explore the expression of monocarboxylate transporters 4 (MCT4) and its clinicopathologic significance in cer-vical squamous cell carcinoma. Methods The expression level of MCT4 in 72 cervical squamous cell carcinoma tissues and 48 cervi-cal normal tissues were detected by immunohistochemistry assay, and its relationship with clinical pathological features was analyzed. Results The positive rate of MCT4 was 81. 9% (59/72) in cervical squamous cell carcinoma tissues and 35. 4% (17/48) in normal cervical tissues. The positive rate of MCT4 in cervical squamous cell carcinoma was significantly higher than that in cervical normal tis-sues (χ2 =26. 848, P<0. 001). In addition, the expression of MCT4 protein was correlated with clinical stage (χ2 =5. 389, P=0. 020) and lymph node metastasis (χ2 =4. 706, P=0. 030). However, it did not correlated with age (χ2 =1. 238, P=0. 266), tumor differentiation (χ2 =0. 530, P=0. 467) or infiltration degree (χ2 =1. 300, P=0. 254) in patients with cervical squamous cell carcinoma. Conclusion The expression of MCT4 is up-regulated in cervical squamous cell carcinoma and correlate with clinical stage and lymph node metastasis of cervical squamous cell carcinoma. MCT4 may be a biomarker for evaluating the biological behavior of cer-vical squamous cell carcinoma.

Objective To retrospectively analyze the effect of two kinds of biological agents in volume -re-duced bullae .Methods 11 patients who suffered from bullae were operated under large C-arm locating ,and infused two kinds of biological agents through micro catheter of fibreoptic bronchoscopy .All of them were randomly divided into the two groups .The biological agents in group A were fibrinogen and diluent thrombin , and that of group B was Porcine Fibrin Sealant Kit .In group A,the micro catheter with diameter of micro thread less than 1.2mm was placed in bullae through fibreoptic bronchoscope ,and then the 2mL lidocaine,5 ml fibrinogen,and double of 500u diluent thrombin were inproperorder injected through micro catheter .In group B,the Porcine Fibrin Sealant Kit was injected at the same method,and then the suspension fluid was exacted .The operation time was recorded ,and then the clinical efficacy and incidence rate of complications were compared .Results The operation time of group A was 5-15 minutes, and that of group B was 6-20 minutes.For all the patients ,4 cases were totally effective ,2 cases were significantly effective,and 2 cases were totally non-effective.The total effective rate was 81.82%(9/11).The incidence rates of common complications in group A and B were 52.38%(22/42),58.33%(14/24),respectively,the difference was not significant (χ2 =0.22,P>0.05).Moreover,there were no serious complications in all cases .Conclusion The security and effect of two kinds of biological agents might be well enough ,but in view of less cases ,they were worth to further popularized and applied in clinical practice .

Objective To explore the security and its influencing factors on benign airway stenosis treated with interventional of high pressure balloon expansion catheter.Methods Clinial data of 39 cases of inpatients suffered from benign airway stenosis were chosen.17 cases were male,and 22 cases were female.The ages of them ranged from 15 to 83 years old.According to the clinical symptoms,HRCT 3D reconstruction,and the results of bron-choscope,all patients were treated with balloon expansion catheter at different criterions.The balloon catheter with size that slightly smaller than the targeted normal bronchial tube was chosen,expansion for average 1 -4 times,single balloon expansion time ranged from 0.5 to 4 min,the pressures were kept at 3 -6 atmosphere,and the highest pres-sure did not exceed 8 atmospheric pressure.The efficacy and complications were retrospectively analyzed.Results 19 cases were completely effective,14 cases were basically effective,6 cases were completely ineffective,and the total effective rate was 84.6% (33 /39 ),the incidence of complications was 35.8% (14 /39 ),moreover,no deaths occurred.Conclusion High pressure balloon catheter expansion is one of commonly used technology in breathing interventional treatment;it has the characteristics of easy operation,and immediate curative effect,and so on.But if the improper operation,incorrect selection of the case,or inaccurate evaluation of the stenosis during operation,serious complications and unnecessary iatrogenic injury can be occurred.Therefore,it is worthy of attention and further summarizing by breathing interventional physicians.