Objective To study the biocompatibility of human hair keratin artificial tendon(HHKAT) material in vitro. Methods Human embryonic tendon cell (HETC) was incubated with various concentrations (100%,50%,10%) of extracted liquid of HHKAT material for 1,3,5 and 7 days, respectively. Collagen I expression in HETC was detected by immunocytochemistry. The effects of HHKAT material on the proliferation and ultrastructure of HETC were observed. Results Various concentrations of extracted liquid of HHKAT had no effect on the morphologic, collagen I expression and ultrastructure of HETC. HETC could adhere, grow and proliferate on the surface of HHKAT material. Conclusion HHKAT is a medical biomaterial with good biocompatibility in vitro.

Objective To summarize the experience of microsurgical repair of soft tissue defects in 136 cases with firearm wound,to probe into repairing defect methods in different parts and to improve repairing results Methods According to the location,area of soft tissue defects or special needs,dorsalis pedis flap,latissimus dorsi flap,thoracoumbilical flap,forearm flap,lateral leg flap,tensor fascia lata flap or compound tissue flap were used to repair 136 cases with soft tissue defects in the firearm wound Results All 136 cases with soft tissue defects were repaired successfully Conclusions Microsurgical technique is a good method to repair soft tissue defects and reconstruct function in the firearm wound

Objective To investigate the successful rate and the therapeutic effect of loosening posterior tubercle of cervical transverse process with CT-guided insertion or blind insertion of small needle knife for cervical spondylotic radiculopathy. Methods Ninety patients with cervical spondylotic radiculopathy were divided into CT-guided insertion group and blind insertion group in the admission order using the random number table method, 45 cases in each group. CT-guided insertion group adopted the insertion of small needle knife following by the guide of CT, and the blind insertion group adopted the insertion of small needle knife following by cervical bony landmarks and muscles. After insertion, the position of the small needle knife in patients of the two groups was located by CT scan. If the needle knife did not arrive to the foci, it will be inserted again following by the guide of CT till successful insertion and location. The successful rate for the two times of insertion was calculated, and the pain scores were evaluated by visual analogue scale(VAS). Results(1) The successful rate for the first insertion of CT-guided insertion group was 73.3％, and that of the blind insertion group was 47.8％, the difference being significant(P < 0.01). The successful rate for the second insertion of CT-guided insertion group was 92.2％, and that of the blind insertion group was 80.0％, the difference being significant (P<0.01). (2) After treatment for one week, pain VAS scores of the two group were decreased (P < 0.01 compared with those before treatment) , and the decrease in the CT-guided insertion group was more obvious than the blind insertion group (P < 0.05). Conclusion CT-guided insertion makes the small needle knife therapy be more accurate and safer, ensures much better therapeutic effect, and brings less pain in the patients.

A simple, fast and sensitive analytical method for the simultaneous separation and detection of 18alpha-glycyrrhizinic acid, 18beta-glycyrrhizinic acid, related substance A and related substance B by RP-HPLC and drug quality standard was established. The structures of principal component isomer and related substances of raw material drug of ammonium glycyrrhizinate have been confirmed. Reference European Pharmacopoeia EP7.0 version, British Pharmacopoeia 2012 version, National Drug Standards of China (WS 1-XG-2002), domestic and international interrelated literature were referred to select the composition of mobile phase. The experimental parameters including salt concentration, pH, addition quantities of organic solvent, column temperature and flow rate were optimized. Finally, the assay was conducted on a Durashell-C18 column (250 mm x 4.6 mm, 5 microm) with 0.01 mol x mL(-1) ammonium perchlorate (add ammonia to adjust the pH value to 8.2) -methanol (48 : 52) as mobile phase at the flow rate of 0.8 mL x min(-1), and the detection wavelength was set at 254 nm. The column temperature was 50 degrees C and the injection volume was 10 microL. The MS, NMR, UV and RP-HPLC were used to confirm the structures of principal component isomer and related substances of raw material drug of ammonium glycyrrhizinate. Under the optimized separation conditions, the calibration curves of 18 alpha-glycyrrhizinic acid, 18beta-glycyrrhizinic acid, related substance A and related substance B showed good linearity within the concentration of 0.50-100 microg x mL(-1) (r = 0.999 9). The detection limits for 18alpha-glycyrrhizinic acid, 18beta-glycyrrhizinic acid, related substance A and related substance B were 0.15, 0.10, 0.10, 0.15 microg x mL(-1) respectively. The method is sensitive, reproducible and the results are accurate and reliable. It can be used for chiral resolution of 18alpha-glycyrrhizinic acid, 18Pbeta-glycyrrhizinic acid, and detection content of principal component and related substances of raw material drug of ammonium glycyrrhizinate. It is concluded that the separation of principal component isomer of raw material drug of ammonium glycyrrhizinate and the validity of the substance's structure assignments of retention time being 1.2 in the European pharmacopoeia EP7.0 version, British pharmacopoeia 2012 version remains open to question. It may be of practical value for the quality control of raw material drug, preparation, and Chinese herbal medicine of ammonium glycyrrhizinate.

BACKGROUND:Whether long time exposure to the lead concentration which is withinthe state allowed range will cause any bad effects on people's health?OBJECTIVE: To investigate the nerve conducting velocity (NCV) and other biological indices of workers who are exposed to low concentration lead.DESIGN: It was an investigation and the subjects were workers exposed to low concentration lead.SETTING: Occupational Disease Department and Electrophysiological Department of Xinhua Affiliated Hospital of the Shanghai Second Medical University.PARTICIPANTS: In lead contact group were 66 heat treatment workers who were exposed to lead and received physical examination from September 2000 to October 2002. In control group were 40 office workers that worked at the same factory but were not exposed to lead.METHODS: Questionnaire and laboratory examination were adopted for measurement of NCV and other biological indices like blood lead, blood zinc protoaetioporphyrin (ZPP), blood free protoporphyrin (FPP) and hemoglobin content in the two groups. And the relative risk analysis was conducted.biological indices in both groups.RESULTS: All the 106 subjects entered analysis stage. In lead contact group there were 34 workers of more than 10 working years and the other ulnar nerve in those of over 10 working years were faster than those in control group [(50.11 ±4.76) m/s, (63.11±2.58) m/s vs (47.59±4.86)m/s,those of over 10 working years was higher than those of less than 10years [(0.568±0.28), (0.425±0.31) μmol/ L, P ＜ 0.05]. So was the FPP level [(2.24±0.32), (2.09±0.27) μmol/L, P ＜ 0.05] and urine lead level [(0.087±0.008), (0.083±0.007) μmg/L, P ＜ 0.05]. The ZPP level of those of over 10 working years was also higher than those less than 10 years [(1.42±0.33) μmol/L vs (1.25±0.35) μmol/L, P ＜ 0.05] and control [(1.42±0.33) μmol/L vs (1.22±0.44) μmol/L, P＜ 0.05]. The hemoglobin of those of over 10 working years was lower than those of less than 10 years [(12.26±4.5) g/L vs (14.55±4.81) μmol/L, P ＜ 0.05] and control [(12.26±4.5) g/L years presented abnormality in conducting sensory signals and the abnormality rate was 3% (1/32). Whereas four cases in those with more than 10working years did so and the abnormality rate was 12% (4/34). As for biological indices, one case in those less than 10 working years was beyond normal values (abnormality rate 3%) and five did so in those of over 10working years (abnormality rate 15%). It could be seen that changes in both NCV and biological indices of those of over 10 working years were more serious than those les than 10 years exposure with the relative risks of 4.1 and 5.3 respectively.CONCLUSION: Persistent exposure to lead not only alters biological indices but also damages nervous system in different degrees. Sensory verve of lower extremities and motor nerves of upper extremities are usually damaged first. Peripheral nerve injury is common in workers of over 10 working years. Because the regeneration of nervous system is poor, so the nerve injury is usually irreversible. Therefore the neuroelectrophysiological changes always predict early nerve injury and so neuroelectrophysiological monitoring can be adopted for prevention of nerve injury.

Objective To investigate the effect of artemisinin on the proliferation of human hepatoma cell line HepG‐2 .Methods The inhibition effect of cell proliferation in human hepatocelluar carcinoma cell line HepG2 of artemisinin was detected by MTT test ,and the cell cycle and apoptosis were detected by Flow cytometry .Results Artemisinin at 80 umol/L could effectively inhibi‐ted the proliferation of HepG‐2 cell in a dose‐and time‐dependent manner;the drugs could block cells at G0/S phase ,and induct the HepG‐2 cell apoptosis .Conclusion Artemisinin could effectively inhibit the proliferation of HepG‐2 cell .

AIM:To investigate the regulatory effects of phosphatylinositol 3-kinase/protein kinase B (PI3K/PKB) signaling pathway on the expression of osteopontin ( OPN) in transforming growth factor-β1 ( TGF-β1 )-induced hu-man hepatic stellate cells .METHODS:Human hepatic stellate cell line LX-2 was cultured in DMEM and stimulated by TGF-β1 at the final concentration of 2.5, 5, 10 and 20 μg/L for 24 h or at final concentration of 10 μg/L for 12 h, 24 h and 48 h.LX-2 cells were pretreated with wortmannin , a specific inhibitor of PI3K/PKB signaling pathway , at final con-centration of 0.1 μmol/L for 1 h, followed by incubation with TGF-β1 at final concentration of 10μg/L for 24 h.The cells were collected.The expression of OPN was detected by real-time PCR and Western blotting .RESULTS: In LX-2 cells, the expression of OPN was apparently elevated when incubated with TGF-β1 .With the increase in TGF-β1 concentration or the extension of incubation hours , the expression of OPN was increased gradually in a dose-and time-dependent manner with certain limits.LX-2 cells pretreated with wortmannin and incubated with TGF-β1 had a significant decrease in the OPN expression as compared with control group (P<0.01).CONCLUSION:The expression of OPN in TGF-β1-induced LX-2 cells is regulated by the PI3K/PKB signaling pathway.

OBJECTIVEThe aim of this study was to survey the influence of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) repression to receptor activator of nuclear factor-kappaB ligand (RANKL) expression of human periodontal ligament fibroblasts (HPDLFs) under the stimulation of lipopolysaccharide (LPS).

METHODSThe level of RANKL in HPDLFs stimulated by 100 ng x mL(-1), 1 microg x mL(-1) and 10 microg x mL(-1) Escherichia coli (E. coli) LPS after 6, 12, 24 and 48 h was detected by enzyme linked immunosorbent assay (ELISA). The level of RANKL in HPDLFs stimulated by 1 microg x mL(-1) E. coli LPS after pretreatment with different titre anti-TLR2+anti-TLR4, anti-TLR2 and anti-TLR4 antibody were observed respectively.

RESULTSRANKL was detected at 6 h after stimulation with LPS, and the levels of these cytokine were highest at 24 h, and then gradually decreased. The regularity of each LPS concentration was approximately similar. After pretreatment with anti-TLR2+anti-TLR4, anti-TLR2 and anti-TLR4 antibody, the level of RANKL was significantly decreased under the stimulation of 1 microg x mL(-1) LPS (P<0.05). In the three groups, the expression of RANKL was significantly different (P<0.05). The level of RANKL in anti-TLR2+anti-TLR4 antibody pretreatment group was the lowest, the level in anti-TLR4 antibody pretreatment group was higher, and the level in anti-TLR2 antibody pretreatment group was the highest.

CONCLUSIONTLR2 and TLR4 participate in the process of RANKL expres-in HPDLFs induced by LPS. Anti-TLR4 antibody has better inhibition effect to RANKL expression of HPDLFs stimulated by LPS than anti-TLR2.

Objective To discuss experiences in reconstruction of severe tibial shaft fractures by using different flaps and external fixations.Methods The study involved 190 patients with type GustiloⅢB Ⅲ C (160 patients) and GustiloⅢC (30 patients) tibial shaft fractures treated from 1990 to 2007.There were 169 males and 21 females,at average age of 42.5 years.The injury causes included traffic accidents in 132 patients,machine accidents in 32 and stone smashing in 26.The management procedure consisted of administration of antibiotics,serial debridement and different flap grafting (including free thoracoumbilical flaps in 20 patients,sural neurocutaneous vascular flaps in 108,saphenous neurocutane ous vascular flaps in 12,superficial peroneal neurocutaneous flap in two,fasciocutaneous flaps in 26 and gastrocnemius muscular flaps in 22) and different external fixators (half-ring fixators in 84 patients,unilateral axial dynamic fixators in 12,AO fixators in 10,Weifang fixators in 42 and hybrid fixators in 40).The average follow-up was 7.3 years.Results All flaps survived.Of all,186 patients obtained fracture healing,with mean fracture healing time varying in different patients treated with different external fixators:7.5 months for 84 patients treated with half-ring fixators,11.2 months for eight with unilateral axial dynamic fixators,8.5 months for 12 with AO fixators ,8.1 months for 42 with Weifang fixators and 7.8 months for 40 with assembly fixators.Except for half-ring fixation,the other fixators needed necessary bone graft.Four patients treated with unilateral axial dynamic fixators resulted in nonunion due to osteo myelitis.The latest follow up showed that the function of the ankle and knee was normal,with no pain.Conclusion Combination of half-ring external fixators with various flaps provides good method for treatment of Gustilo ⅢB and ⅢC tibial shaft fractures.