BACKGROUND: At present, there has been no definite experiment systemically evaluating adherent separation and density gradient centrifugation to isolate bone marrow mesenchymal stem cells (BMSCs). Whether the two methods produce different influences on BMSC induction and differentiation remains unclear.OBJECTIVE: This study was designed to verify difference of these two isolation methods in chondrogenic differentiation of BMSCs.DESIGN, TIME AND SETTING: A controlled observation was performed at the Shengjing Hospital Affiliated to China Medical University from March to September 2005. MATERIALS: Twenty Japanese big-ear rabbits, aged 2-3 months, weighing 1.2-2.0 kg, were included for this study. METHODS: BMSCs were isolated by adherent separation and density gradient centrifugation. Two groups of BMSCs were taken from the same passage and induced towards chondrogenic differentiation with transforming growth factor beta 1. MAIN OUTCOME MEASURES: Growth of BMSCs was observed under an inverted microscope to draw growth curves; Type II collagen expression was detected by immunohistochemistry. Type II collagen mRNA expression was determined by in situ hybridization. RESULTS: The growth curves demonstrated that cellular growth velocity of the two groups tended to be the same. Immunohistochemistry results showed that the efficiency of adherent separation and density gradient centrifugation for promoting chondrogenic differentiation of BMSCs was 76.1% and 77.7%, respectively, and in situ hybridization results showed that the efficiency was 70.3% and 71.0%, respectively. No significant difference in differentiation efficiency existed between the adherent separation and the density gradient centrifugation. CONCLUSION: Adherent separation and density gradient centrifugation had no different influences on BMSC growth and chondrogenic differentiation.

Objective To establish the model of hyperlipidemie acute pancreatitis(AP)to explore the mechanism of hyperlipidemia in aggravating AP.Methods Sprague-Dawley rats were divided into four groups at radmon:1)control group(C);2)hyperlipidemic group(TG);3)acute pancreatitis group(AP);4)hyperlipidemic acute pancreatitis group(HAP).After 8 weeks,blood,pancreas and peripancreas tissue were collected from each rats for determination of various parameters.Results The levels of hyperilidemic index were elevated in HAP group compared with those of other groups.The ADP/ATP ratio was obviously increased in HAP group.Caspase-3 and caspase-8 of HAP group presented in zymogen forms,while in AP group they were in activity forms.After the pancreas issue were stained bv HE and further analyzed through TUNEL assay,we found that there were more pancreatic acinar cells undergoing necrosis in HAP group.Conclusion Hyperilidemia may promote the course of apoptosis to necrosis of pancreatic acinar cells,which may be the mechanism of deterioration in hyperlipidemic acute pancreatitis.

Objective To investigate the level of nurses′preparedness and influencing factors of nurses with low seniority in Anhui province. Methods Totally 295 nurses with low seniority were recruited by convenience sampling method. They were investigated by a self-designed demographic data questionnaire and the Disaster Preparedness Evaluation Tool. Results The score of the disaster nursing ability of the nursing managers was 163.85 ± 32.41, the mean score was 3.64 ± 0.72. Regression analysis showed that the gender, the experience of disaster rescue,disaster training were the influencing factors of disaster preparedness. Conclusions The capacity of disaster preparedness for nurses is not ideal. There is still room for improvement among nurses in Anhui province to enhance disaster preparedness, and improved disaster nursing training system is needed to achieve this.

Objective To investigate the preventive effect of continuous quality improvement(CQI) on malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly patients undergoing peritoneal dialysis.Methods A single-center prospective self-controlled study was performed.32 stable elderly patients to undergo continuous ambulatory peritoneal dialysis (CAPD) were included.The continuous quality improvement program was conducted by using the 4-step problem-solving framework called the PDCA cycle (plan,do,check and act).The dialysis adequacy,nutritional status,inflammation and cardiovascular events were analyzed before and after PDCA.Results Compared with before PDCA,the proportion of patients with Kt/V≥1.7 and urea kinetics (Kt/V) level were increased after PDCA [71.8％ vs.93.75％,(1.97±0.36) vs.(2.08±0.33),both P＜ 0.05].Serum levels of albumin (ALB),prealbumin (PAB) and serum carbon dioxide combining power (CO2 CP) were increased after PDCA (all P＜0.05).The proportion of patients with ALB≥40 g/L was increased after PDCA as compared with before PDCA (9.4％ vs.31.3％,P＜0.05).The nutritional variables including mid-arm circumference (MAC),triceps skinfold thickness (TSF),mid arm muscle circumference (MAMC),and lean body mass (LBM),lean body mass percentage (LBM％),normalized protein equivalent of total nitrogen appearance (nPNA),handgrip strength were improved after PDCA (P＜ 0.05).High sensitivity C-reactive protein (hs-CRP) level and the proportion of patients with hs-CRP＞3 mg/L were decreased after PDCA as compared with before PDCA [(8.65±6.22) mg/L vs.(5.37±4.33) mg/L,53.1％ vs.25％,both P＜0.05].The incidence of peritoneal dialysis related peritonitis was reduced obviously from 1 case every 25.4 months to 1 case every 78.1 months after PDCA (P ＜ 0.05).The hospitalization rate due to cardiovascular events was decreased after PDCA as compared with before PDCA (25％ vs.3.13％,P＜0.05).Conclusions CQI may significantly improve the malnutrition,inflammation and dialysis adequacy,and reduce the hospitalization rate due to cardiovascular events in elderly patients undergoing peritoneal dialysis.

Objective To establish the pyrogen removing effect of activated carbon in the technics of traditional Chinese medicine (TCM) injections. Methods The content of bacterial endotoxin concentration was detected by kinetic turdimetric assay to evaluate the effect of removing pyrogen before and after using activated carbon in concentrated solution of TCM injection. Results The activated carbon adsorption rate of Shuanghuanglian concentrated solution≥70%and the activated carbon adsorption rate of Danshen concentrated solution>95%. Conclusion Pyrogen manufacturing process is scientific and rational by adding activated carbon adsorption in powder injection of TCM. The bacterial endotoxin of large doses can't be removed fully by activated carbon adsorption.

ObjectiveTo evaluate the value of the measurement with a scale in arthroscopic anatomic anterior cruciate ligament (ACL) reconstruction.Methods Thirty-six patients with unilateral ACL-deficient knees were divided into single bundle group and double bundle group based on the length of the major axis of the native ACL footprint measured with a scale.Consistent with the International Knee Documentation Committee (IKDC) scoring systems,Lysholm knee scoring scale and Tegner activity rating were used to evaluate the clinical results,and data from 23 to 26 months follow-up were gathered and analyzed statistically.ResultsIn terms of IKDC evaluation,19 patients( 90.4％ ) in the double band group and 13 patients( 86.7％ )in the single band group were graded as normal or nearly normal ( Z =7.82,6.33 ; P ＜ 0.05 ).The mean Lysholm scores were 93.8 ± 9.9 and 94.2 ± 9.6 and the mean Tegner scores were 6.6 ± 1.9 and 6.5 ± 1.7 for the double and single band groups,respectively( t =2.31,5.60,3.55,7.09 ;P ＜0.05 ).ConclusionArthroscopic measurement with a scale combined with other traditional methods to determine the tunnel location is easy to conduct and intuitional to understand.It could be useful in anatomic ACL reconstruction.

Objective To elucidate the mutations of NPHS1 gene in children with sporadic steroid-resistant nephrotic syndrome (SRNS) in Southern Chinese Han ethnic group.Methods Peripheral blood samples were collected for genetic analysis from 40 patients with sporadic SRNS and 50 healthy volunteers as control.Genomic DNA was isolated from peripheral blood leucocytes.Twenty-nine exons and exon-intron boundaries of the NPHS1 gene were amplified by polymerase chain reaction.Mutational analysis was performed by DNA sequencing directly.Results Seven variants,928G＞A(D310N),2677A＞G (T893A),2869G＞C (V957L),IVS8+30C＞T,IVS21+14G＞A,IVS25-23C＞T and *142T＞C,of NPHS1 gene were found in 6 of 40 children with sporadic SRNS,whereas they were not found in 50 healthy controls.2677A ＞G,IVS8 +30C ＞T,IVS21 +14G＞A,IVS25-23C ＞T and *142T＞C were novel.Moreover,thirteen already reported NPHS1 polymorphisms,294C＞T,349G＞A,IVS3+15C＞T,IVS3+61A＞G,803G＞A,IVS8+68A＞G,1339G ＞A,1802G ＞C,2223C ＞T,2289C ＞T,IVS24 +36C ＞T,3315G＞A and IVS27 +45C ＞T,were detected in some patients and controls. Conclusions NPHS1 mutations in 6 of 40 children with sporadic SRNS in Southern Chinese Han ethnic group (15％) are detected.NPHS1 mutations are existed in Southern Chinese children,so it is necessary to perform the mutation analysis of NPHS1 gene in those children patients.

ObjectiveTo investigate fecal diversion in the management of pelvic fractures associated with perineal injuries.MethodsThis retrospective study involved 27 patients of pelvic fractures associated with perineal injuries during April 2005 to April 2011.There were 23 males and 4 females,and the mean age was 32.9 years old (range,16-62 years old).Fractures type according to Tile classification:4 cases were type A,10 cases were type B,and 13 cases were type C.The pelvic external fixator and fecal diversion were selectively used.Results Of the 27 patients of pelvic fractures associated with perineal injuries,24survived.The overall mortality of pelvic fractures associated with perineal injuries in the present study was 11％.The survived 24 patients were totally reviewed clinically.The mean follow-up time of these patients was 10.9 months (range,4-42 months).Of those patients who underwent early fecal diversion (＜ 48 h),none experienced infectious completions.However,of those underwent non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion),four patients experienced infectious completions.Fisher's exact test was used to compare the infection rate of these two groups.And the result of Fisher's exact test demonstrated that those patients who underwent early (＜ 48 h) fecal diversion and non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion).ConclusionStabilization of hemodynamic; selective fecal diversion; early stabilization of pelvic fracture are necessary for the emergency management of pelvic fractures associated with perineal injuries.Rectal injury and severe perineal injury without involvement of rectum should undergo fecal diversion.Early fecal diversion (＜ 48 h) could reduce the infection rate of pelvic fractures associated with perineal injuries.

ObjectiveTo detect mRNA and protein expression of steroidogenic factor-1 ( SF-1 ) and DAX-1 in human adrenocortical tumors and normal adrenal cortex,and to investigate the effect of SF-1 and DAX-1 on the steroidogenesis and development of adrenocortical tumors.Methods Total RNA and protein was extracted from angiotensin Ⅱ unresponsive aldoterone-producing adenomas ( A Ⅱ -U-APA,n =12 ),angiotensin Ⅱ responsive aldoterone-producing adenomas ( AⅡ -R-APA,n =5 ),cortisol-producing adenomas ( CPA,n =10 ),adrenal nonfunctional adenomas ( NFA,n =10 ),aldosterone-producing carcinoma ( APC,n =2 ) and normal adrenal cortex ( NAC,n =8).To analyze gene expression of SF-1,DAX-1,ACTH receptor(ACTHR),and β-actin by real-time quantitative PCR in different tissues.The protein expression of SF-1,DAX-1,and β-actin in the same tissues by Western blot.To study the relationship of ACTHR,SF-1,and DAX-1 with clinical data in adrenocortical tumors.ResultsThe expression of SF-1,DAX-1 mRNA and protein was different in NAC,AⅡ -U-APA,A Ⅱ -R- APA,APC,CPA,and NFA tissues [ relative expression of SF-1 mRNA:24.58±2.45,23.89±3.17,21.59±3.00,(38.75,44.16),14.17±2.80,and 36.38±3.50; DAX-1 mRNA:0.57±0.06,0.37±0.05,0.43±0.05,( 1.52,1.21 ),0.39 ±0.04,and 0.83 ±0.08 ; SF-1 protein:0.76 ±0.11,0.76 ±0.10,0.73 ±0.07,(1.24,1.40),0.55±0.04,and0.98±0.10; DAX-1 protein:0.65±0.14,0.39±0.13,0.43±0.14,(1.18,1.02),0.56±0.04,and 1.03±0.13 ; all P＜0.05 or P＜0.01 ].There was negative correlation by higher SF-1/DAX-1 ratio and tumor size in AⅡ -U-APA tissues.The mRNA and protein expression of SF-1 was lower in CPA and there was the positive correlation with tumor size.Conclusion SF-1 and DAX-1 might play a key role in the development of the adrenocortical tumorigenesis and steroidogenic tissues.

This study compared two techniques of artery anastomoses,renal artery to the ex- ternal iliac artery (ESA) and to the internal iliacartery (EEA) in renal transplantation.The operation time and the incidence of anastomotic stenosis was cut down significantely in ESA group.The blood flow in grafts has no difference in two groups with normal renal function.The utilization rate of grafts with multiple arteries was higher (94.4%) in ESA group.Back bench surgery for artery repain,cold ischemia time and renal damage were reduced in ESA group.