Absrtact: Osteoarthritis (OA) is a most common form of degenerative joint disease, primarily characterized by the degradation of articular cartilage, subchondral sclerosis and inflammation of the synovial membrane. Mesenchymal stem cells (MSCs), a multipotent adult stem cell population, can be isolated from many connective tissue lineages, including those of the diarthrodial joint. Joint-resident MSCs or MSC-like progenitor cells contribute to the maintenance of healthy microenvironment or to the response to trauma. The onset of degenerative changes in the joint related to abnormal condition or depletion of these endogenous MSCs and native host hyaline cartilage cells, leading to limited self-repair potential of the joint and advance of the degradation. To date, no acknowledged medical treatment strategies, including non-operative and classical surgical techniques, are efficient in restoring normal anatomy and function of hyaline cartilage in OA. This highlights an urgent need for better celled-based therapeutic strategies that supplement these functional cells exogenously to recover the tissue homeostasis and repair in joint cavity via chondrogenic and anti- in fl ammatory functions. In this review we focus on the role of native MSCs in healthy or OA joint and recent progress in cell-based researches utilizing culture-expanded chondrocytes, pluripotent stem cells, or MSCs from different sources for treating OA.

Objective:To analyze the job preference of doctors at township health center ( THC) and provide references for formulating effective policy. Methods:238 cases of doctors were sampled from Shandong, Anhui and Shaanxi provinces. Using a discrete choice experiment, we analyzed the data with a conditional logit model. Results:The most important job attribution was salary, followed by education for children, permanent post, work location, training opportunity, and years before promotion. The OR value of the monthly income of 8 000 yuan is 7. 0 compared to 2 000 yuan. Doctors will pay 3 857 yuan and 3 294 yuan respectively for better education for children and perma-nent posts. Monthly income increasing to 8 000 yuan will reduce the quitting rate from 35% to 8%, and providing better education for children and permanent posts will reduce 5%. The permanent posts at township health center and non-permanent posts in county hospital have the same appeal to the doctor. Conclusion:When choosing a job, doc-tors at THCs valued salary the most. Improving the education level for children can be beneficial for attracting and re-taining doctors at THCs. A permanent post is more attractive to doctors than non-permanent posts at THCs.

Acute paraplegia is a rare presentation for a spinal cord ependymoma. Subarachnoid hemorrhage (SAH) due to spinal ependymoma is also very rare. We report a 32-year-old woman who presented with acute paraplegia and typical clinical signs of SAH with normal cerebral angiography, and further diagnostic work-up revealed an spinal cord ependymoma as the source of the hemorrhage. There is evidence that some spinal cord ependymomas have intratumoral hemorrhage, but most of these bleedings occur without symptoms. We discuss the clinical and neuroradiological findings of this rare case and review the literature related to this unusual presentation.431

Acquired Immunodeficiency Syndrome ; immunology ; Adolescent ; Chemokines ; immunology ; Child ; Child, Preschool ; Female ; Humans ; Male

Objective To investigate whether an innovative intake duct driven from nasobiliary tube via nose improved the success rate of oronasal conversion and shorten the operation time.Methods 118 patients with routine nose bile duct drainage under ERCP examination were randomly divided into magnetic group and thread group. Patients in magnetic group were using a self-made nasal biliary drainage tube derived via nasal catheter traction and nasal catheter, one end of the magnet will be equipped with high performance through mouth to mouth pharynx, smooth delivery nose bile duct. While patients in thread group adopts godet from pharynx posterior wall drawing pulled stomach tube or catheter again, then ifx the nose bile duct.Results The success rate was signiifcantly higher in magnetic group than thread group, with less stimulation of pharynx, and less complications.Conclusion Self-made intake duct derived magnetic catheter was simple and less stimulation, avoid oral mucosa damage, reduced the suffering of patients, shortened operation time and improved the operation efifciency with high success rate.

Objective To analyze the prognostic factors associated with three-year survival outcome in patients with serous ovarian adenocarcinoma by classification tree.Methods Retrospectively we analyzed 81 cases with serous ovarian adenocarcinoma who had 3-year clinical outcomes and were hospitalized in People's Hospital from Jan 1991 to Dec 2003 by classification and regression trees(CART)software.Establish the classification tree.Results Among the factors that were associated with the 3-year survival rate,age was the most important factor,other factors in turn were International Federation of Gynecology and Obstetrics(FIGO)stage,lymphoid metastasis,residual size after operation,chemotherapy and pathologic grade.By substitution variable analysis,it was demonstrated that there was cross interaction between age and residual size as well as age and chemotherapy.Conclusion Age,FIGO stage,lymphoid metastasis,residual size after operation,chemotherapy and pathologic grade are important prognostic factors related with three-year survival probability of serous ovarian adenocarcinoma patients.

Objective To explore the changes of neutrophil elastase (NE) and surfactant protein A (SP-A) in acute lung injury(ALI) rats,and the effect of antioxidant. Methods Sixty healthy mature Wister rats were divided into 2 groups, the control group and treatment group. The rats in two groups all received peritoneal injection of E. coli to establish the ALI animal model. 30 minutes after injection of E. coli,the rats in treatment group were injected reduced glutathione from vena caudalis. The levels of NE in blood and expressions of SP-A in lung tissue were detected at 3,6 and 12 hours after injection of E. coli. Results ALI symptom appeared 3 hours after injection of E. coli in the control group, obvious after 6 hours, the rats vomi-ted pink secretion after 12 hours. Lung edema and bleeding were found by pathologic examination. No obvious symptom was found in treatment group after 3 hours, slight tachypnea after 6 hours, slight edema in pulmonary tissue after 12 hours. After administration of reduced glutathione,levels of NE at 3,6 and 12 hours in the treatment group were lower than those in the control group,and indicated statistical significance in 6 and 12 hours(P <0. 05) ;Levels of SP-A in 3,6 and 12 hours in the treatment group were higher than those in the control group, and indicated statistical significance in 3,6 and 12 hours (P < 0. 05). Conclusion Dysfunction of pulmonary surfactant is secondary in ALI, degradation of SP-A is the one of reasons, the application of reduced glutathione as antioxidant, could effectively suppress NE to decompose basosexine elastin of cells and destroy surface active protein, has protective effect on ALI.

Objective To explore the specific ultrasonic manifestation features of intracranial foreign bodies after firearm injury,and to evaluate the value of ultrasonography in detecting intracranial foreign bodies.Methods ① The specific ultrasonic manifestation features of intracranial foreign bodies were summarized by making ultrasonic scanning over known foreign bodies of different types inserted before hand in around the injury tracts.②With the summary,ultrasonic scanning was made to the foreign bodies with unknown size and types,the result was confirmed with the fetched-out foreign bodies,and the coincidence of ultrasonography in scanning the intracranial foreign bodies after firearm injury was evaluated.Results Ultrasonography could distinguish intracranial foreign bodies from brain parenchyma,intraeranial foreign bodies of different types had different ultrasonic manifestation features.The size and the materials of the foreign bodies had certain affection on the result of ultrasonic scanning.The accuracy of qualitative judgement in scanning the intracranial foreign bodies was 71.52％,and the accuracy in scanning the foreign bodies with diameter ＞ 0.5 cm was higher than that with the diameter ＜ 0.5 cm.The coincidence in qualitative judgement of the foreign bodies of different materials ranged as follows:bullet (97 ％ )＞ steel ball (81.13％),bone pieces (78％) and glasses (72％) ＞gauze (54.67％) and wood pieces (54.67％).Conclusions The intracranial foreign bodies of different materials have specific ultrasonic manifestation features and ultrasonography can scan out their locations.The coincidence of qualitative judgement in scanning the bodies with diameter over 0.5 cm is high.Ultrasonography may be of important significance in guiding the fetch-out of intracranial foreign bodies on the spot and in raising the rescuing level of firearm injury.

Objective To investigate the effect of pretreatment with electroacupuncture at point Neiguan(PC6) on CK and myocardial cell activity in rabbit myocardial ischemia-reperfusion injury and provide an experimental basis for a relatively specific relationship between pericardium meridian points and the heart. Methods Forty New Zealand big ear rabbits were randomly allocated to groups A, B, C, D and E, eight rabbits each. Group A was a sham operation group. Group B was an ischemia-reperfusion model group, in which the left anterior descending coronary artery was occlude for 30 min and reperfused for 60 min. In groups C, D and E, points Neiguan(PC6), Lieque(LU7) and Hegu(LI4) were separately given electroacupuncture stimulation, 20 min every day, at seven days before model making. Creatine kinase (CK) and myocardial formazan contents were compared between the groups. Results There were statistically significant differences in serum CK and myocardial formazan contents between group B, C, D or E and group A (P＜0.01, P＜0.05). There was a statistically significant differences in serum CK content between group C, D or E and group B (P＜0.01). There was a statistically significant differences in myocardial formazan content between groups C and B (P＜0.05). There were statistically significant differences in serum CK and myocardial formazan contents between group D or E and group C (P＜0.01, P＜0.05). Conclusion Electroacupuncture at point Neiguan(PC6) can reduce myocardial ischemia-reperfusion induced injury to myocardial cells to produce a protective effect on the heart.

Objective To explore the effect of team-based individualized health management on health literacy and health status among hypertensive patients in community. Method This study was a self-controlled quasi-experimental design. A two-stage cluster random sampling method was used. Two neighborhood committees among 23 neighborhood committees in Desheng community were randomly sampled. The name list of hypertensive patients were obtained from the 2 sampled neighborhood committees, getting one from each five, 470 in total before intervention and 444 in total after. The two groups of patients before and after intervention had comparability in the social demographic characteristics as the age (67.16± 9.84, 66.47 ± 10.50 years), the gender (the male accounted for 47.00%and 44.10%), the ethnicity (the Han accounted for 93.80%and 92.30%) and the marital status(the married accounted for 91.30%, 88.90%)(t=1.447 χ2 =0.774, 1.595, 2.555, P>0.05). Since July 2013, Desheng community health service center intervened the hypertensive patients by team-based individualized health management. After one year, we compared the change of their health literacy and health status. Result After health management, the proportion of hypertensive patients with adequate health literacy increased from 38.50% to 53.40%, The average rate of health knowledge awareness among them increased from 65.30% to 75.30%. The average accuracy of health services utilization skills of them increased from 49.10%to 70.90%, lifestyle behaviors in dietary and in exercise the average increase was from 35.55, 17.07 to 37.05, 21.28 respectively, after the intervention the patients did better work in self management behavior, such as self-test of blood pressure, medication compliance and control of salt intake (74.40%, 87.60%, 80.00%) were obviously better than before intervention (61.30%, 68.30%, 62.20%), and the differences were statistically significant (χ2 =16.813, 48.295, 52.058, P<0.05). After health management, the self-report health was better among hypertensive patients. The proportion of them with normalized blood pressure increased from 72.90% to 79.50%, and the difference was statistically significant (P<0.05). Conclusion Team-based individualized health management could increase health literacy of hypertensive patients in community and improve their health status obviously.