Objective To study surface heparinization of small intestinal submucosa(SIS)and an- tithrombegenicity of beparinized SIS films with plasma initiation technique for the engineering vascular scaffolds. Methods The SIS films were grafted with heparin by hypothermia plasma initiation technique.The blood com- patibility of the modified SIS films was assessed by observing blood coagulation time in vitro and the long term pa- tency of hepafinized SIS vascular scaffolds directly under the circulation of blood.Results The hypothermia plasma initiation method could attach heparin onto the SIS surface,The water contact angle of SIS films modified with heparin was decreased while the surface free energy and hydrophilicity increased.The prothrombin time(PT),ac- tivated partial thromboplastin time(APTT)and thrombin clotting Time(TT)of the SIS films modified with heparin were prolonged obviously.Small caliber engineering vascular scaffold made of heparinized SIS films kept the patency for six weeks.Conclusion Heparin can be attached to SIS films by hypothermia plasma initiation technique.The modified surfaces provide good and persistent antithrombogenicity,and possess potent blood compatibility,

Objective:To study the feasibility of using the bionic technology to construct small-caliber vascular prostheses with modified SIS.Methods: The vascular endothelial cells and smooth muscle cells were separated from canine saphenous artery,the cells blended with collagen gel,which were planted respectively on the SIS films,these films were rolled into the biologic three-layer prostheses around a 3mm diameter polyethylene tube;one-layer prostheses without these cells and collagen gel served as control.These 2 types of prostheses were implanted into the defect of bilateral canine femoral by anastomosis in 15 dogs.doppler colour ultrasonic,histology detection and electron microscope examination were done postoperatively.Results: By 12 weeks postoperatively,14 biologic vascular prostheses had kept well patency,the patency rate being 93.3%,the biologic structure like blood vessels had formed,the inner surface of the vessels had been covered with full endothelial cells,a lot of smooth muscle cells had been found in the media of vascular walls in regular line;the patency rate in control group was 60.0%,the endothelial cell coverage was incomplete.Conclusions: The bionic vascular prostheses showed potent blood compatibility,which could keep long-term patency in vivo.Curative effect of repairing the small-caliber vessel defect was well satisfactory.

Objective To explore the application and clinical outcome of intracapsular reduction for comminuted distal radial fractures.Methods From January 2003 to October 2005,37 cases of comminuted fractures of distal radius were treated in our hospital.They were categorized according to the AO classification,and underwent open intracapsular reduction,internal fixation with either locking com- pressing plate(LCP)or external fixator according to the types of fractures.The results of treatment were evaluated by functions and X-ray examination of involved wrists.Results All the 37 patients were fol- lowed up regularly.Satisfied synostosis by X-ray had been acquired.The wrist functions were evaluated by the Gartland and Werley system to find excellent result in 26 cases,good in eight,fair in two,and poor in one,with the excellent and good rate of 92%.Conclusion For the treatment of comminuted distal radial fractures,open intracapsular reduction can obtain fast fracture healing and recovery of wrist joint function.

Objective To explore the diagnostic value of multislice spiral CT (MSCT) for breast carcinoma.Methods One hundred and twenty consecutive suspicious cases of breast carcinoma diagnosed clinically and/or by imaging modalities were studied with MSCT prospectively. The dynamic contrast-enhanced serial scanning was done as follows:Scanning was triggered 35 s (early arterial phase) after beginning of contrast agent infusion at a speed of 3 mL/s by high pressure automatic injector, and would be repeated at the time point of 60 s and 150 s. Eventually, the CT diagnostic results were compared with the pathological consequences to calculate the diagnostic accuracy of MSCT for breast carcinoma. Results Eighty-nine patients with 100 foci of breast cancer from 120 suspicious cases were confirmed pathologically and their imaging data were analyzed. Among the 89 cases, 61 cases were invasive ductal carcinomas,12 ductal carcinomas in situ, 8 invasive lobular carcinomas, 6 medullary carcinomas and 2 inflammatory carcinomas. According to lesion morphologic appearance, lesion enhancement mode, time-density curve of lesion, and combination of all the above three parameters, the diagnostic accuracies were 78%, 82%, 84% and 92%, respectively. Conclusion MSCT has a great clinical value in diagnosing breast carcinoma.

Aspirin is a kind of anti-inflammatory drug and may be used to reverse hyperglycemia, hyperinsulinemia, and dyslipidemia by improving insulin resistance. We hypothesized that aspirin improves insulin resistance in type 2 diabetes by inhibiting hepatic nuclear factor kappa-beta (NF-kappaB) activation and serum tumor necrosis factor-alpha (TNF-alpha). Adult male Wistar rats were randomly divided into four groups: control, untreated diabetic, diabetic treated with metformin (100 mg/kg/day), and diabetic treated with aspirin (120 mg/kg/day). Diabetes was induced by high-fat feeding and a low dose of streptozotocin (30 mg/kg). After treatment, plasma glucose, insulin, lipids, free fatty acids (FFAs) concentrations and serum TNF-alpha were determined. The expression of NF-kappaB in hepatocytes was analyzed by immunohistochemistry and western blot. The results showed administration of aspirin caused no significant lowering in fasting glucose level but significant reduction of hepatic NF-kappaB expression and serum TNF-alpha level with improved insulin resistance compared to the diabetic group. The relevant analysis showed positive correlation between the expression of homeostasis model assessment-insulin resistance (HOMA-IR) and NF-kappaB (r = 0.799, P < 0.01); HOMA-IR and serum TNF-alpha (r = 0.790, P < 0.01). It is concluded that aspirin improves insulin resistance by inhibiting hepatic NF-kappaB activation and TNF-alpha level in streptozotocin-induced type 2 diabetic rats.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/*pharmacology ; Aspirin/*pharmacology ; Blood Glucose/analysis ; Diabetes Mellitus, Experimental/blood/chemically induced/*metabolism ; Fatty Acids, Nonesterified/blood ; Hypoglycemic Agents/*pharmacology ; Insulin/blood ; Insulin Resistance ; Liver/metabolism ; Male ; Metformin/therapeutic use ; NF-kappa B/*metabolism ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha/*blood

OBJECTIVETo study the clinical effect of tractive reduction with external fixator and arthroscopically assisted treatment for tibial plateau fractures.

METHODSFrom February 2003 to January 2005, a total of 26 cases with tibial plateau fractures were reviewed. There were 4 cases of type I fracture, 5 type II, 4 type III, 6 type IV, 5 type V and 2 type VI based on Schatzker criteria. Before operation, X-ray examination and CT scanning were done. During operation, the dissociative fragments were reconstructed by tractive reduction with external fixator arthroscopically and fixated with screws or plates.

RESULTSAll the fractures were healed within 1.5 - 4 months, with no severe complications such as poor wound healing, infection or osteofascial compartment syndrome. All patients that were followed up for 7 - 21 months (mean, 16 months) showed no traumatic osteoarthritis, inversion or eversion of the knee. According to the Rasmussen scoring system, the outcome was excellent in 11 cases, good in 13 and fair in 2, with total score of 27 +/- 2.

CONCLUSIONSAs for Schatzker type I - VI tibial plateau fractures, tractive reduction with external fixator and arthroscopically assisted treatment is characterized by minimal invasion, fast fracture healing. It broadens operative interspace of articular cavity, improves accuracy of reduction, is beneficial for knee joint function to recover.

Adult ; Arthroscopy ; methods ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Traction ; instrumentation ; methods ; Treatment Outcome

Objective To investigate the change of the basic fibroblast growth factor(bFGF) leve in human detrusor muscle(DM)in bladder outlet obstruction(BOO)due to benign prostatic hyperplasia(BPH)and its implication.Methods Fifty-four patients with BPH were divided into two groups:the obstructive DM stability and instability groups;and 15 men with bladder tumor who underwent operation in the same period were enrolled in the control group.The bFGF mRNA level in DM was measured by reverse transcription and polymerase chain reaction(RT-PCR)and the bFGF protein level was measured by immunohistochemical staining method.Results The bFGF-mRNA expression level of bladder smooth muscle cells was significantly lower in the control group than that in the obstructive DM stability and instability groups(all P＜0.05),but there was no significant difference between the obstructive DM stability and instability groups(P＞0.05). Conclusions The expression level of bFGF mRNA in bladder DM is elevated in BOO due to BPH,but there is little or no correlation between the increased expression of bFGF mRNA and detrusor muscle instability.

BACKGROUND AND OBJECTIVERadiotherapy is effective in treating nasopharyngeal carcinoma (NPC). This study evaluated the treatment efficacy, toxicity, and prognostic factors of intensity-modulated radiotherapy (IMRT) in the treatment NPC.

METHODSBetween September 2003 and September 2006, 305 patients with NPC were treated with IMRT in Fujian Provincial Cancer Hospital. IMRT was delivered as follows: gross tumor volume (GTV) received 66.0-69.8 Gy in 30-33 fractions, high-risk clinical target volume (CTV-1) received 60.0-66.65 Gy, low-risk clinical target volume (CTV-2) and clinical target volume of cervical lymph node regions (CTV-N) received 54.0-55.8 Gy. Patients with stages III or IV disease also received cisplatin-based chemotherapy. All patients were assessed for local-regional control, survival, and toxicity.

RESULTSWith a median follow-up of 35 months (range, 5-61 months), there were 16, 8, and 39 patients who had developed local, regional, and distant recurrence, respectively. The 3-year rates of local control, regional control, metastasis-free survival, disease-free survival, and overall survival were 94.3%, 97.7%, 86.1%, 80.3%, and 89.1%, respectively. Multivariate analyses revealed that T-classification had no predictive value for local control and survival, whereas N-classification was a significant prognostic factor for overall survival (P < 0.001), metastasis-free survival (P < 0.001), and disease-free survival (P = 0.003). For stages III-IV disease, concurrent and adjuvant chemotherapy did not influence prognosis. The most severe acute toxicities included Grade III mucositis in 14 patients (4.6%), Grade III skin desquamation in 90 (29.5%), and Grades III-IV leucocytopenia in 20 (6.5%). There were 7% patients with Grade II xerostomia after 2 years of IMRT, no Grades 3 or 4 xerostomia was detected.

CONCLUSIONSIMRT provided favorable locoregional control and survival rates for patients with NPC, even in those with locally advanced disease. The acute and late toxicities were acceptable. N-classification was the main factor of prognosis. Further study is needed on chemotherapy for patients with NPC.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; etiology ; Lymphatic Metastasis ; Male ; Middle Aged ; Mucositis ; etiology ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; adverse effects ; methods ; Retrospective Studies ; Survival Rate ; Xerostomia ; etiology ; Young Adult

With the continuous expansion of the domestic population flow,the medical and health services is-sues of migrant population are becoming more and more serious. Based on the three aspects of the demand,supply, and utilization of health services,this article explores and analyzes the utilization of health services for migrant popu-lation in Beijing in 2015 on the basis of behavioral models. The results showed that the prevalence of chronic diseases and the frequency of disease in migrant population are relatively low. The migrant population has low efficiency and overall evaluation of public health services. From the point of view of convenience and diversity of services,the sup-ply of public health services needs to be further improved. In terms of the active utilization of medical and health services,the proportion of respondents who did not participate in any medical insurance still have a large proportion, while the proportion of regular physical examination was lower. In terms of passive utilization,both outpatient and in-patients service use are low. Family income and medical insurance have influenced patients'choice of medical institu-tions to some extent. The health promotion strategy is proposed from the perspective of supply side and utilization.

Background and Objective:Radiotherapy is effective in treating nasopharyngeal carcinoma (NPC). This study evaluated the treatment efficacy,toxicity,and prognostic factors of intensity-modulated radiotherapy (IMRT) in the treatment of NPC. Methods: Between September 2003 and September 2006, 305 patients with NPC were treated with IMRT in Fujian ProvinciaI Cancer Hospital.IMRT was delivered as follows:gross tumor volume (GTV) received 66.0-69.8 Gy in 30-33 fractions.high-risk clinical target volume(CTV-1)received 60.0-66.65 Gy,low-risk clinical target volume(CTV/-21 and clinical target volume of cervical lymph node regions(CTV-N)received 54.0-55.8 Gy.Patients with stages Ⅲ or Ⅳ disease also received cisplatinbased chemotherapy.All patients were assessed for local-regional control,survival,and toxicity.Results:With a median follow-up of 35 months (range,5-61 months),there were 16,8,and 39 patients who had developed Iocal,regional, and distant recurrence, respectively.The 3-year rates of local controI.regional controI.metastasis--free survival,disease-free survival,and overall survival were 94.3%,97.7%,86.1%,80.3%,and 89.1%,respectively.Multivariate analyses revealed that T-classification had no predictive value for local control and survival,whereas N-classification was a significant prognostic factor for overall survival(P<0.001),metastasis-free survival(P<0.001),and disease.free survival(P=0.003).For stages Ⅲ-Ⅳ disease,concurrent and adjuvant chemotherapy did not influence prognosis.The most severe acute toxicities included Grade Ⅲ mucositis in 14 patients (4.6%),Grade Ⅲ skin desquamation in 90(29.5%),and Grades Ⅲ-Ⅳ leucocytopenia in 20(6.5%).There were 7% patients with Grade Ⅱ xerostomia after 2 years of IMRT, no Grades 3 or 4 xerostomia was detected.Conclusions:IMRT provided favorable locoregional control and survivaI rates for patients with NPC.even in those with locally advanced disease.The acute and late toxicities were acceptable. Nclassification was the main factor of prognosis. Further study is needed on chemotherapy for patients with NPC.