BACKGROUND: The core of bone tissue engineering is to construct a scaffold that is similar to human bone tissue structure and features.OBJECTIVE: To compare pathochemical and mechanical characteristics between pig and human bone scaffold materials.DESIGN, TIME AND SETTING: Contrast study was performed at Clinical Anatomy Institute, South Medical University; Guangdong Province Key Laboratory of Tissue Construction and Detection from March to December 2006.MATERIALS: Four fresh health adult human cadavers were provided by South Medical University, Guangzhou Red Cross Society, and the relatives knew the fact. Ultra low temperature freezing 6-month iliac bones of 6 adult swines were also used in this study.METHODS: Pig iliac and healthy adults iliac bones were obtained to remove soft tissue, curettage periosteum and bone marrow. Bone sawing machine was used to cut cancellous bone into smaller bone sections around 5 mm×5 mm×40 mm, which underwent ultrasonic cleaning, H2O2 and alcohol soaking, freeze drying and radiation treatment; finally, xenogeneic bone scaffold and allogeneic bone scaffold were obtained.MAIN OUTCOME MEASURES: Xenogeneic bone scaffold material and human allograft bone scaffold were observed with scanning electron microscopy to compare porosity, contents of protein content, calcium and phosphorus, and mechanical properties.RESULTS: Xenogeneic bone scaffold and allogeneic bone scaffold both had intrinsical bone trabecula, trabecular spaces and bone cavity system. Both of them had unabridged natural three dimensional network structure. The 3D supporting frames of them were complete. The xenogeneic bone scaffold had more spaces than allogeneic bone scaffold. The size of both scaffolds was approximation, about 400 μm. The interval porosity of xenogeneic bone scaffold was higher than the allogeneic bone scaffold (P<0.05). And the protein of xenogeneic bone scaffold was not as many as it of allogeneic bone scaffold (P<0.05). The contents of Ca and P were similar (P>0.05), and there was no significant difference in Young's modulus of xenogeneic bone scaffold and allogeneic bone scaffold (P>0.05).CONCLUSION: Xenogeneic bone scaffold may completely meet the clinical demands for bone grafting or be the scaffold of bone tissue engineering in mechanical chemical properties.

The aim of this study is to investigate the critical factor affecting the properties of PLGA microspheres fabricated by a solid-in-oil-in-water (S/O/W) emulsion technique with BSA as a model protein. Prior to encapsulation, the BSA microparticles were fabricated by a modified freezing-induced phase separation method. The microparticles were subsequently encapsulated into PLGA microspheres by S/O/W emulsion method, then Motic BA200 biological microscope, confocal laser scanning microscope, scanning electron microscope were used to observe the structure of S/O/W emulsion and PLGA microspheres. The protein content extracted or released from BSA microspheres was measured by Bradford protein assay method. It was found that NaCl added in the outer aqueous phase effectively suppressed material exchange between the inner and outer phase of S/O/W emulsion. Then, the structure and permeability of obtained microspheres were influenced. As a result, with the increase of NaCl concentration in the outer aqueous phase, the encapsulation efficiency of microspheres significantly increased from 60% to more than 85%, the burst release of microspheres reduced from 70% to 20%, and the particle size decreased from 103 microm to 62 microm. Furthermore, the rehydration of encapsulated protein was also retarded and then integrity of BSA was successfully protected during encapsulation process. In vitro release test showed that BSA released from PLGA microspheres in a sustained manner for more than 30 days.

ObjectiveTo understand condition about cost and economic burden of outpatients in countries and townships medical institutions in Xinjiang.MethodsThirty-one medical institution were selected and the cost and income of one-day outpatients were investigated,then the cost of different diseases,age groups and payment methods and the later disease cost burden were analyzed.ResultsOut-patient expenses of top ten common diseases was pneumonia100.12 yuan,injury 85.18 yuan,hypertension and coronary heart disease(CHD) 69.13 yuan,examination and diseases related to pregnancy 49.60 yuan,disease of the genitourinary system 41.71 yuan,enterogastrtis 34.80 yuan,bronchitis 30.72yuan,osteoarthrosis 24.60 yuan,upper respiratory infection ( URI ) 23.63 yuan,scytitis 21.14yuan;The outpatient expenses of those taking part in Neotype Countryside Cooperative Medical Care Insurance,whose family-month-income was less than 250 yuan,was 18.07 yuan,which disease cost burden was 25.56％.ConclusionThe expenses of infectious diseases in country and township hospitals was in the top ten.The cost of chronic non-communicable diseases was rising significantly;For those participating Neotype Countryside Cooperative Medical Care Insurance,the outpatient expenses was low and the disease economic burden was higher.

Objective To investigate the expression of serum soluble cytotoxic T lymphocyte associated antigen 4 (sCTLA4), the association of sCTLA4 level with erythrocyte sedimentation rate (ESR) and C reactive protein (CRP), as well as its role in patients with Crohn's disease (CD). The relationship-1661A/G and -1722T/C polymorphisms of CTLA4 gene and between disease susceptibility and phenotype of CD was analyzed. Methods A total of 126 CD patients and 300 healthy controls were enrolled in the study. Serum sCTLA4 level was determined by enzyme-linked immunosorbent assay. The concentrations of ESR and CRP were analyzed by automatic ESR Analyzer SRS 100/Ⅱ and rate nephelometry, respectively. The polymorphisms of CTLA4-1661A/G and -1722 T/C were genotyped by DNA sequencing. Results Serum sCTLA4 level was higher in CD patients than in healthy controls [(18. 70±3. 72) ng/ml vs (1.72±0. 32) ng/ml, P＜0. 01)]. Among CD patients, sCTLA4 level was higher in patients with active disease when compared to those with inactive disease [(19.83±4.35) ng/ml vs (18. 02±3.14) ng/ml, P=0. 015)]. sCTLA4 level was positively correlated with ESR and CRP levels (r=0. 267, P=0. 003; r=0. 524 P ＜0.01, respectively). In CD patients, serum sCTLA4 level was significantly higher in those with stricturing disease behavior than that in those without stricturing and penetrating or with penetrating disease behavior (P= 0.021; P=0. 015, respectively). Detection of CTLA4 -1661A/G and -1722T/C polymorphisms showed no significant difference between CD patients and healthy controls. Conclusions The high level of serum sCTLA4 in CD patients is correlated with disease activity, CRP levels and disease behavior. It suggests that sCTLA4 may play an important role in pathogenesis of CD.

Objective To evaluate the effect of open reduction and internal fixation in treatment of calcaneal fractures in aged patients. Methods Between January 1997 and June 2007,37 patients (41 fractures)at a mean age of68.3 years(60-78 years)with calcaneal fractures underwent surgical operations.According to Sanders classification based on CT scanning.14 fractures were rated as typeⅡ,18 as type Ⅲ and 9 as type Ⅳ.Of all,5 fractures were treated with reconstruction plate,18 with shapeable titanic plate,4 with Y-shaped plate,12 Depuy titanic plate and 2 with AO locking titanic plate plus open reduction and internal fixation.The foot function was evaluated by X-ray,American Orthopedic Foot and Ankle Society(AOFAS)Score and Maryland Foot Score. Results A total of 27 patients (60.9%)with 31 fractures were followed up for 12-48 months(average 27.6 months),which showed that all fractures were healed,with morphous improvement of the calcanus determined by 8 parameters measured in X-ray films.The average active range of motion was 36°of plantar flexion,12°of dorsiflexion,15°of inversion,and 10°of eversion.According to Maryland Foot Score,functional foot score was excellent(90-100 points)in 16 fractures,good(75-89 points)in 13 and fair(50-74 points)in 2,with excellence rate of 94%(29/31). Conclusion Open reduction and intemal fixation can gain good clinical result in severe calcaneal fractures in aged patients with obvious dislocation of posterior articular facet.

Objective To investigate the function of major histocompatibility complex (MHC)class Ⅰ-related gene (MIC) in ulcerative colitis (UC) pathogenesis. Methods The difference of MICA, M ICB and their ligand NKG2D genes expression in colonic mucosa tissue of 34 UC patients and 12 healthy people were determined by fluorescent real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and the expression location of M ICA in colonic mucosa tissue was obtained by laser scanning confocal microscope. Results The mRNA level of MICA, MICB and NKG2D expression in UC groups (3. 5408±2. 6658, 8. 9879±3. 2893 and 2. 4395±0. 8147 accordingly) was significantly higher than that in the healthy controls ( 1. 0477 ± 0. 7201, 4. 6293 ± 1. 2616 and 1. 1624±0. 3954 accordingly) (P = 0.0053, 0.0039 and 0. 0078 accordingly). It suggested that MICA was expressed in colonic epithelia cell membranes by laser scanning confocal microscopy.Conclusion The mRNA level of MICA, M ICB, and their ligand, NKG2D expression were all up regulated in the colonic mucosa of UC patients, which indicated MIC gene might perform important local function in UC.

Objective To discuss the value of intrapartum operation in management of birth defects and the prognosis. Methods From August 2008 to November 2009, 11 fetuses were identified with birth defects through 3D color Doppler ultrasound and confirmed by MRI and fetal karyotype in the Maternal Fetal Medicine Center, Affiliated Shengjing Hospital, China Medical University including three lymphangiomas,two congenital diaphragmatic hernias (CDH), one sacrococcygeal teratoma, three omphalocele and two gastroschisi. All the above identified birth defects were indications for surgery. All fetuses were born abdominally and received intrapartum operations, including three intrapartum fetal operations with placental infusion (two repairs of CDH, one sacrococcygeal teratoma resection), six ex-utero intrapartum treatment (EXIT; two repairs of omphalocele, two repairs of gastroschisi, two lymphangioma resection) and two surgeries in house (one omphalocele repair and one lymphangioma resection). Both the mothers and fetuses were regularly followed up. Results ( 1 ) Operations: the average operating time for the three intrapartum fetal operations was 89 minites, 5.5 minites for the six EXIT, during which EXIT was performed first,followed by blocking the umbilical circulation and neonatal surgery, and 37 minites for the two surgeries in house. All neonates survived except for one death from severe CDH at 3.5 hours after the operation. The average blood loss for cesarean section and fetal operation was 275 ml. All mothers recovered soon without fever or infection and were discharged three to five days after the operation. (2) Follow-ups: the ten survived neonates were followed up at 1 - 18 mouths at the pediatric clinics and all were growing and developing normally except for one baby with gastroschisi suffered from enteral torsion and feeding intolerance showed lower weight than babies at the same age, but catched up to normal at four months old after posture therapy. One baby with mild CDH developed pulmonary infection at two months after operation with 1/4 pneumothorax on chest X-ray, and were hospitalized for two weeks. At six months old, patent ductus arteriosus was diagnosed in the same baby and chest X-ray was normal. The baby with omphalocele was complicated with ventricular septal defect before operation and the cardiac function was normal during followups for one year. The baby with sacrococcygeal teratoma was reported to have no automatic micturition, but recovered to normal at one month of age. Conclusion Babies with certain birth defects can be managed through intrapartum operation with better outcomes.

Objective To understand the relationship between the infants′iron-deficiency anemia and the dependents′KAP (knowledge,attitude,practice)of iron nutrition,and to provide a theoretical support for the prevention and cure of the infants′iron-eficiency anemia.Methods A total of 960 infants,aging from 6 months to 36 months,were randomly chosen as samples at the child care clinics in Wuhan while they were doing their routine health check-up there.Their hemoglobin was examined.Their dependents were asked to fill in questionnaires about KAP of iron nutrition.Results The ratio of anemia in infants in Wuhan is 26.6%.The ra-tio difference of different age groups has statistical significance(P <0.05).The dependents′KAP of iron nutrition is in direct pro-portion to their educational level and family income.The ratio of anemia in infants is in inverse proportion to their dependents′edu-cational level and family income.The dependents′knowledge,attitude and practice of iron-intake were positively related.The aver-age score of guardian nutrition knowledge(K)was (11.96±3.77)points,the average score of attitude(A)was (7.09±2.80)points while the average score of feeding practice(P)was (18.05±3.60)points.Conclusion Much publicity should be given to the knowl-edge of iron nutrition and it should be conducted from various perspectives,in order to improve the cognitive level of the depend-ents′knowledge of iron nutrition and to lower the ratio of anemia in infants.

Objective To determine the ED50 of dexmedetomidine for suppressing cardiovascular responses to placement of laryngeal mask airway (LMA) in patients undergoing gynecological laparoscopic surgery with induction of propofol. Methods ASA I or II Patients aged 18 to 55 undergoing elective gynecological laparoscopic surgery were enrolled. After an bolus dose of dexmedetomidine over 10 min , anaesthesia was induced with target-controled propofol, and then bolus of vecuronium of 0.1 mg/kg was injected when the BIS was between 45 and 55. LM palcement was performed 3 minutes after vecuronium injection. The modified Dixon ’ s up-and-down method was used to determine the bolus dose of dexmedetomidine , starting from 1.0 μg/kg (step size:0.1 μg/kg). Cardiovascular response was defined as an increase in SBP and/or HR by 15% of baseline within 2 min after placement of LMA. The test ended after at least 7 crossovers ( successive ‘response’ or ‘non-response’) were obtained. Probit analysis was used to calculate ED50, ED95 and 95% confidence interval (CI). Results The ED50 and ED95 (95% confidence interval) of dexmedetomidine for suppressing cardiovascular responses to placement of LMA was 0.65 μg/kg (0.44-0.80) μg/kg and 0.94 μg/kg (0.79-2.47) μg/kg. Conclusion Under induction of target-controled propofol , the ED50 of dexmedetomidine is 0.65 μg/kg for suppressing cardiovascular responses to placement of LMA in female patients.

Objective:To explore influence of nasal continuous positive airway pressure (nCPAP)on maximal oxygen uptake (V · O2 max )etc.in patients with chronic congestive heart failure (CHF)complicated moderate-to-severe ob-structive sleep apnea-hypopnea syndrome (OSAHS)and explore its significance.Methods:A total of 83 CHF com-plicated moderate-to-severe OSAHS patients were selected and randomly divided into routine treatment group (n=40)and nCPAP group (n = 43).Both groups were treated for six months.Left ventricular ejection fraction (LVEF),apnea hyponea index (AHI)and V · O2 max were measured and compared between two groups before and af-ter treatment.Results:Compared with routine treatment group after six-month treatment,there was significant re-duction in AHI [(27.5±6.2)vs.(6.8±1.2)],and significant rise in LVEF [(0.45±0.07)vs.(0.48±0.05)]and · V O2 max [(16.5±3.5)ml·kg-1 ·min-1 vs.(19.2±3.4)ml·kg-1 ·min-1 ]in nCPAP group,P <0.05 all.Con-· clusion:The nCPAP can improve ventilation function,heart function and V O2 max in patients with CHF complicated moderate-to-severe OSAHS,who have received basic medication.