Biologic scaffold materials derived from decellularized tissues and organs have been successfully used in tissue engineering and regeneration medicine.Decellularization methodology varies according to the differences of the origin,tissue density,composition,geometric and biologic properties of the tissue.Optimal decellularization method should be developed on the basis of complete cell content removal with the preservation of extracellular matrix (ECM) integrity and bioactivity.In this article,an overview of decellularization methods and their effect upon acellular bracket structure and composition are presented.

Objective To compare the efficacy of supraclavicular approach and infraclavicular approach in ultrasound-guided brachial plexus block(BPB).Methods One hundred and twenty patients,ASA Ⅰ-Ⅲ,aged 18-80 yr,scheduled for upper extremity surgeries of both gender,were randomized into two groups(n =60):supraclavicular group(group SCB)and infraclavicular group(group ICB).The anesthetic mixture consisted of ropivacaine 0.375％ and lidocaine 1％ in equal volumes with epinephrine 1∶200 000,the total dose was 0.5 ml/kg.The block performance time,duration of anesthesia and success of anesthesia(surgery was accomplished without supplementary block)were recorded.A blinded observer assessed pinprick sensory block in the seven distal nerve territories(axillary,radial,musculocutaneous,median,ulnar,medial antebrachial and medial brachial cutaneous nerves)every 5 min up to 30 min after injection.Success of nerve block,side effects and complications were recorded during and after operalion.Results Group ICB was superior in success rate of anesthesia and nerve block of ulnar,medial antebrachial and medial brachial cutaneous nerves,the rate of parasthesia was lower and the block performance time was longer compared with group SCB(P ＜ 0.05).No major complications occurred in both groups.Conclusion Under ultrasound guidance,infraclavicular BPB is superior to supraclavicular approach.

BACKGROUND:Acel ular tracheal matrix is similar to the native trachea with structure and biological performance preserved after decel ularization, and it is an important aim in tissue engineering to find an effective method of decel ularization.
OBJECTIVE:To select the optimal decel ularization method through comparing chemical extraction method with detergent-enzymatic method for preparing rabbit tissue engineering trachea matrix.
METHODS:Thirty tracheas from New Zealand white rabbits were randomly divide into three groups. Twenty of rabbit tracheas were subjected to decel ularization using 2%TritonX-100 combined with deoxyribonuclease I and ribonuclease (chemical extraction method group), and sodium deoxycholate combined with deoxyribonuclease I (detergent-enzymatic group), respectively. The other ten were given no intervention as controls. Samples were col ected and observed by hematoxylin-eosin staining, Masson-trichrome staining, safranin O staining, DAPI staining and scanning electronic microscope.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining demonstrated that compared with the control group, almost al cel ular components of the mucosal epithelium were removed in the detergent-enzymatic and chemical extraction groups, and there were few remnant chondrocytes. Masson-trichrome staining indicated that compared with the control group, components of the mucosal layer chondrocytes in the chemical extraction and detergent-enzymatic groups were completely removed, with only part of remained chondrocytes in the cartilage zone. Glycosaminoglycan was slightly decreased both in the chemical extraction and detergent-enzymatic groups shown by Safranin O staining, but more reduction was found in the chemical extraction group. DAPI staining reveled that only a smal amount of cartilage cel s remained in the dense layer of cartilage and lacuna both in this two methods. Scanning electronic microscope showed that using the detergent-enzymatic method there were the hierarchical structures of native trachea, but slight disruption using the chemical extraction method. In conclusion, decel ularized rabbit trachea matrix obtained by detergent-enzymatic method is better, with little disruption to the matrix.

AIM:To investigate the effects of peroxiredoxin 4 ( Prdx4) protein expression levels on the migra-tion and invasion of human cervical cancer HeLa cells.METHODS:The plasmid pcDNA3.0-HA-Prdx4 was transfected into HeLa cells.The HeLa cells were infected with LV-Prdx4 RNAi vector to establish stable Prdx4 shRNA HeLa cells. The change in the expression of Prdx4 protein was validated by Western blotting.The wound-healing assay, and Transwell migration and invasion assays were performed to detect the migration and invasion of HeLa cells, respectively.RESULTS:The expression of Prdx4 protein was up-regulated in the HeLa cells after transfection with pcDNA3.0-HA-Prdx4 plasmid ( P<0.05), whereas it was down-regulated in the Prdx4 shRNA HeLa cells (P<0.05).The abilities of migration and inva-sion were significantly increased in Prdx4-overexpressing HeLa cells compared with non-transfected and mock plasmid trans-fected control groups ( P<0.01) .When Prdx4 was knocked down by shRNA, the migration and invasion of the HeLa cells were remarkably repressed compared with blank control group and negative control group ( P<0.01 ) .CONCLUSION:The up-regulation of Prdx4 expression facilitates the migration and invasion of HeLa cells, and the down-regulation of Prdx4 expression inhibits the migration and invasion of HeLa cells, indicating that Prdx4 may be a potential molecular target for cervical cancer therapy.

Objective To determine the changes in serum and urine vitamin D binding protein ( VDBP) concentrations in type 2 diabetes, and to explore the clinical significance. Methods The serum and urine VDBP concentrations in 102 healthy individuals and 106 type 2 diabetic patients were determined by ELISA. For analysis and comparison, 106 type 2 diabetic patients were divided into imperfect glycemic control subgroup and perfect glycemic control subgroup, microalbuminuria subgroup and normal albuminuria subgroup. Results The cut-off point of serum VDBP concentrations was 60. 6 μg/ ml and the cut-off point of the urine ratio of VDBP and creatinine was 7. 76 mg/ g, and both were determined according to the upper limit of 97. 5 % credit intervals in 110 healthy individuals. Serum VDBP concentration and the urine ratio of VDBP to creatinine in type 2 diabetic patients were significantly higher than those in the healthy individuals ( P < 0. 01 ), the imperfect glycemic control subgroup had higher serum VDBP concentrations and the urine ratio of VDBP to creatinine than those in the perfect glycemic control subgroup ( P <0. 05). The microalbuminuria subgroup had higher urine ratio of VDBP to creatinine than that in the normal albuminuria subgroup ( P<0. 01). Urine ratio of VDBP to creatinine in diagnosing early diabetic nephropathy had sensitivity of 96. 4 % , specificity of 68 % , and concordance of 83% . Conclusion Detection of serum VDBP levels has some reference value in understanding the state of diabetes. Combined determinations of urine ratio of VDBP to creatinine and ratio of albumin to creatinine have significant clinical value in the early diagnosis of diabetic nephropathy.

Objective To evaluate the effect ofcytochrome P450 isoenzyme subfamily 2C19 (CYP2C19)gene polymorphism on the clopidogrel antiplatelet therapy in cirrhosis patients after receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods The clinical data of 171 cirrhosis patients,who were treated with TIPS during the period from January 2013 to December 2014,were retrospectively analyzed.During operation both the portal vein and the elbow vein blood samples were collected and sent for CYP2C19 gene testing.After TIPS,clinical follow-up checkup was made once every 3 months.The gene detection results and clinical follow-up findings were comparatively analyzed.Results A total of 110 patients,who had not received blood transfusion before TIPS and who had regularly taken clopidogrel antiplatelet therapy after TIPS were enrolled in the study.The mean time to take clopidogrel was 192.4 days (31-517 days),and the gene detection results of portal vein and elbow vein were quite consistent.CYP2C19 genotype of *1/*1 was found in 49 patients (44.5％),CYP2C19 genotype of *1/*2 in 27 patients (24.6％),CYP2C19 genotype of *1/*3 in 18patients (16.4％),CYP2C19 genotype of *2/*2 in 11 patients (10.0％),CYP2C19 genotype of *2/*3 in 3patients (2.7％),and CYP2C 19 genotype of *3/*3 in 2 patients (1.8％).Following-up examinations showed that the incidence of shunt dysfunction in patients carrying slow metabolic gene was 87.5％ (14/16),which was significantly higher than that in patients carrying moderate metabolic gene (20.0％,9/45;x2=22.9,P=0.006)as well as in patients carrying fast metabolic gene (8.2％,4/49;x2=37.91,P=O.O00 1).Multivariate analysis of Cox regression model indicated that CYP2C19 slow metabolic gene variation was an important predictive factor for shunt dysfunction (95％CI:1.80-9.03,P=O.O00 7).Conclusion CYP2C19 slow metabolic gene variation,including genotype of *2/*2,*2/*3 and *3/*3,is an important factor that can influence the efficacy of clopidogrel treatment after TIPS.Preoperative CYP2C19 gene detection results can provide useful information,which is very helpful in making an effective and reliable anti-platelet treatment plan for patients after TIPS.

Objective To investigate the distribution,drug resistance of bile pathogenic bacteria,and the risk factors for biliary infection.Methods Clinical and laboratory data of patients hospitalized from January 2008 to October 2015 were reviewed for pathogenic bacteria and drug resistance,and the factors related to biliary tract infection were studied.Results Among all 320 cases,there were 249 cases of pathogenic bacteria in bile specimens,the positive rate was 77.81％.There were 356 strains of pathogenic bacteria of 40 species,including 244 strains of gram negative bacteria (68.54％),93 strains of gram positive bacteria (26.12％) and 19 strains of fungi (5.34％).Top three bacteria were Escherichia coli (84 strains,23.60％),Klebsiella pneumonia (60 strains,16.85％),and Enterococcus faecium (40 strains,11.24％).The Escherichia coli and Klebsiella pneumoniae had the highest drug resistance to cefazolin,and they had a lower drug resistance to cefoxitin and amikacin.The multivariate analysis showed that age ≥ 60 years (AOR =2.311,95％ CI:1.292-4.135) and the history of ERCP operation (AOR =3.475,95％ CI:1.587-7.607) were independent risk factors for biliary tract infection.Conclusion Bacteria are mainly gram negative bacteria in the bile of patients with biliary tract infection,suggesting antibiotics with low resistant rate of gram-negative is the first choice.The age ≥ 60 years and history of ERCP surgery are independent risk factors for patients with biliary tract disease.Measures to prevent biliary infections in high-risk patients should be taken.

Objective To provide reference for clinical pharmacists participating in pharmacotherapy of low molecular weight heparin calium-induced thrombocytopenia.Methods Clinical pharmacists carried out pharmaceutical care for a patient with chronic cor pulmonale with acute exacerbation of chronic asthmatic bronchitis in the use of low molecular weight heparin calium,who developed progressive thrombocytopenia,and helped clinicians to manage adverse reaction and select subsequent treatment drug.Results The suggestions were adopted by clinicians.The platelets of patients gradually recovercd without thrombosis events.Condusion Participation of clinical pharmacists in the treatment of low molecular weight heparin calium induced-thrombocytopenia can effectively improve the prognosis of patients and ensure the safety in drug use.

Objective To investigate and analyze the experience of planting and maintaining implantable venous access ports(IVAP) in management of post-operative breast cancer patients. Methods Breast cancer pa-tients receiving IVAP after surgery from Mar. 2011 to Jun. 2014 were retrospectively analyzed. The relative com-plications were documented and summarized during implanting operation. Results 468 patients received IVAP, among whom 451 patients underwent piercing implantation via right internal jugular vein, 15 patients underwent piercing implantation via right subclavian vein, and 2 patients underwent piercing implantation via left internal jugular vein. The mean cathe tering leng th was 12.8 cm for patients receiving IVAP via right internal jugular vein, ranging from 12 to 15 cm. Thereinto, 30(6.4%) patients experienced shot-term complications including 16 cases of puncture difficulty, 5 cases of accidental arterial puncture, 2 cases of extravasation, 2 cases of blood aspiration dif-ficulty and 5 cases of arrhythmia. Three cases had long-term complications as the following:one case of catheter-re-lated infection, one case of catheter lost, and one case of incision rupture. Conclusions IVAP is a safe and effec-tive intravenous infusion device. It is crucial to choose individualized implanting access and length by professional surgical team.

Objective To study the hemostnsis effects of compression cords oppressing after femoral artery puncture and encheiresis. Methods Self-made compression cords were used to stop bleeding of femoral artery puncture sites in 2164 patients underwent 3046 cases of arteriopuncture encheiresis. The total eases were divided into group A (1482 eases) and group B (1564 cases) according to different treatment of oppression and breaking duration which were 8-10 hours for group A and 5-6 hours for group B, the hemostasis effects, discomfortableness and related complications within two groups were evaluated. Results The proportion of patients who got good hemostasis effects were 99.2% in group A, 99.0% in group B. There was no difference in hemostasis effects between two groups (P> 0.05). While the rate of discomfortableness in group A (63.8%) was higher than that in group B(42.9%) (P<0.05). The related serious complications were 2 patients in group A, but no occurred in group B. Conclusion Self-made compression cords op- pressing and 5-6 hours breaking time course can achieve both finer hemostasis effect and lower frequency of complications after femoral artery puncture and encheiresis.