Objective To explore the immunogenicity of a novel bionic scaffold of nucleus pulposus tissue engineering. Methods The biocompatibility of a subcutaneously implanted scaffold of nucleus pulposus tissue engineering was studied in SD rats by analyzing tissue reactions up to 3 months using histological and ultrastructural methods. The expression of IFN-?, IL-2, IL-4 and IL-10 mRNA was measured by RT-PCR, and the levels of serum antibodies to porcine type Ⅱ collagen were measured by ELISA. Results There was less inflammatory reaction in rats induced by subcutaneously implanted scaffold. By degrees, a granulation tissue had developed within the implant, which had disappeared by 3 months. The expression of IFN-?, IL-2 mRNA by RT-PCR was of no changes. But the expression of IL-4 and IL-10 mRNA increased, which meant the implant induced Th cell into Th2 cell and the induction inhibited the inflammatory reaction. No antibodies to porcine type Ⅱ collagen were found in the sera of implanted rats. Conclusion There was less immunogenicity in rats induced by implanted scaffold of nucleus pulposus tissue engineering.

Objective To assess the clinical diagnostic value of left atrial function index (LAFI) for heart failure with normal left ventricular ejection fraction (HFNEF).Methods One hundred and ten patients with HFNEF were divided into 3 groups by New York Heart Association (NYHA) cardiac functional grading:NYHA Ⅱ grade group (43 cases),NYHA Ⅲ grade group (40 cases) and NYHA Ⅳ grade group (27 cases),and another 33 healthy subjects were selected as control group.The 4 groups were examined by ultrasoundcardiogram,LAFI and E/E' were calculated,and the plasma brain natriuretic peptide (BNP)levels were determined.The relation between LAFI and NYHA cardiac functional grading and the correlation between LAFI and plasma BNP,E/E' were observed.Results The worse heart function,the higher plasma BNP and E/E',and the lower LAFI,and there were statistical differences [control group:(40.9 ± 26.1) ng/L,6.4 ± 2.0,0.73 ± 0.10,NYHA Ⅱ grade group:(230.1 ± 85.9) ng/L,10.0 ± 3.7,0.46 ± 0.30,NYHA Ⅲ grade group:(398.6 ±98.7) ng/L,16.9 ±4.0,0.26 ± 0.30,NYHA Ⅳ grade group:(680.3 ± 146.6) ng/L,23.8 ± 3.9,0.17 ± 0.20,P ＜ 0.05].The correlation analysis results showed that LAFI and plasma BNP,E/E' were negatively correlated in patients with HFNEF (r =-0.868,-0.873,P ＜ 0.01).Conclusions In HFNEF patients,there is significant correlation between LAFI and left ventricular diastolic dysfunction.LAFI can well diagnose diastolic heart failure early and evaluate the diastolic function of the left ventricle.

Recent original articles about investigation and application minimally invasive posterior pedicle screw fixation in thoracolumbar fracture were extensively reviewed.It can be divided into three parts,such as the improvement of navigated pedicle screw placement accuracy,the melioration of the internal fixation instruments and the advance of endoscopic decompression technique.With the development of minimally invasive spinal syrgery,the combination of percutenous pedicle screw fixation and the computer assist surgery have been widely applied in the treatment of spinal fractures.The combination of minimally invasive posterior pedicle screw fixation and the computer assist surgery accelerates the treatment of the thoracolumbar fractures,there will be more and more thoracolumbar fracture patients willing to be treated by the minimally invasive surgery.

[Objective]To investigate the diagnostic methods and clinical effects of the management of spondylolithesis with adjacent segment degeneration.[Method]Between October 2000 and October 2005,16 consecutive patients(3 males and 13 females) aging 42 to 76 years(mean 59.1 years) received instrumented lumbar interbody fusion procedure using traditional posterior approaches for spondylolithesis with adjacent segment degeneration.Lumbar functions were assessed using Prolo system.Preoperative and follow-up lateral lumbar radiographs were studied for reduction of spondylolithesis,disc heights,lumbar lordosis,fusion rates and complications.[Result]Fourteen patients were followed up,with an average duration of 28(16–53) months.Clinical outcomes in terms of Prolo system was 7 points in 3 patients,8 in 7 patients,9 in 2 patients,and 4 in 2 patients at 3 months after operation with 85.7% being graded as good or excellent.Seven points in 4 patients,8 in 6 patients,and 9 in 4 patients at last follow-up(graded as 100% good or excellent).Fusion rate was 66.7%(8/14)at 6 months and 92.9%(13/14)at 12 months after operation.Ten patients(71.4%) fully recovered from spondylolithesis,4 had partial reduction,and their reduction status was unchanged according to plain radiographs at 12 months and last follow-up.The operative wound healed without complications in all patients.The mean Lordosis was 26.64??6.67?,33.29??3.39?and 32.71??2.80?before and at 3-month,or last follow-up after operation.The mean of fused Lordosis was 15.64??6.21?,28.29??3.28?and 32.36??3.91?before at 6 months or at last time follow-up after operation.The disc heights were 6.54?1.13mm and 9.62?0.81mm before and after operation.Statistics showed significant difference(P

ObjectiveTo study the feasibility and effect of microendoscopic discectomy on the central type of enormous intervertebral disc herniation.MethodsFrom 2003 to 2006,23 patients(18 males,5 females) were diagnosed with enormous central type lumbar disc herniation and treated by microendoscopic discectomy.Their clinical data were restropectively analyzed,and postoperative outcomes in hip function were evaluated by Macnab scoring system.ResultsBeing followed up for 3-12 months,21(86.9%) patients were rated as good or excellent for their outcome,and the other two as fair.ConclusionMicroendoscopic discectomy through interlaminar approach achieves satisfied outcome for enormous central type lumbar disc herniation.

Objective To design and construct a new bionic scaffold of nucleus pulposus tissue engineering. Methods The collagen-hyaluronic acid (HyA) matrices were prepared, and mixed with Collagen type Ⅱ (pH 1-2) and lyophilized. 6-chondroitin sulfate (CS) was covalently attached to collagen using 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS). Afterwards the initial structure of bionic scaffolds was evaluated. Results The bionic scaffolds were porous structure, of which the pore size was 89-132 ?m, the porosity was 94.8%. Water-binding capacity of resulting matrices was 79.2%, and the denaturation temperature was 74.6 ℃. Glycosaminoglycan (GAG) content was 224 mg/g, and the elastic modulus was 0.673 MPa. Conclusion Composition and tissue structure between the scaffolds are similar to the extracellular matrices of nucleus pulposus. The bionic scaffold is an ideal scaffold material of nucleus pulposus tissue engineering in structure. Further experiment is required on the biocompatibility of the novel scaffolds.

Objective To summarize the technique and evaluate the effect of anesthesia for off-pump coronary artery bypass surgery (OPCAB). Methods From 1997 through March of 2005, five hundred and forty-three consecutive patients undergoing OPCAB were retrospectively studied. Anesthesia was induced with midazolam 0.05～0.12mg/kg, ketamine 0～0.5mg/kg and fentanyl 5～15?g/?kg. Anesthesia was maintained with isoflurane 0.3%～1.5% and oxygen, combined with propofol 1～3mg/(kg?h). Intraoperative hypotension resulting from either surgical procedure or anesthetics should be dealt with inotropes immediately. Results Intraoperative hemodynamics deviation was tolerated with the support of inotropics. The mean extubation time was 5.8?1.6h. The ICU stay was 0.5 to 2.0 day. The patients were discharged in 8.0?1.2 days. Two patients met sudden death in the second postoperative day. Conclusion Rational use of anesthetics and inotropics to stabilize hemodynamics during operation plays a key role in successful OPCAB.

Objective To review the preliminary experience on managing the patients suffering from lumbar disc herniation with lateral recess stenosis by microedoscopic discectomy.Methods A total of 79 patients affected with lumbar disc herniation with lateral recess stenosis were treated by MEDⅡ in our hospital from Jan 2002 to Sep 2004.Results All patients were discharged within 7 d postoperatively and no complications occurred.The average duration of follow-up was 12.3 months and the successful clinical outcome was 99%.Conclusion Microendoscopic discectomy is a minimum invasive procedure.The successful clinical outcome could be achieved in properly selected patients.The microendoscopic discectomy is an effective procedure in managing lumbar intervertebral disc herniation with lateral recess stenosis.

0.05). VAS and ODI were significantly improved in the 2 groups compared with those before operation (P

AIM:To investigate the influence and mechanisms of human pancreatic cancer tumor microenvironments on T-cell immunoglobulin mucin-3 (TIM-3) expression and function of dendritic cells (DCs).METHODS:Tumor-infiltrating dendritic cells (TIDC) and para-carcinoma tissue DCs were isolated by Ficoll-Hypaque density centrifugation from trypsinized pancreatic carcinoma tissues, and the peripheral blood mononuclear cells were isolated from pancre-atic cancer patients or healthy people.The expression of TIM-3 on DCs was detected by flow cytometry.DCs isolated from healthy people peripheral blood mononuclear cells were induced by rhGM-CSF and IL-4.The expression of TIM-3 in the DCs treated with the culture supernatants of Capan-2, SW1990 and Panc-1 pancreatic cancer cells or human skin fibroblast (Hs27) cells for 48 h, and in the DCs treated with supernatants of Capan-2 cells, anti-VEGF-R2, anti-IL-10 and EP2 re-ceptor blocking peptide were evaluated by flow cytometry.The releases of IFN-βand IL-12 in the culture supernatants of DCs pretreated with monoclonal antibody ( mAb) to TIM-3 or DNase+RNase, followed by stimulation with apoptotic Ca-pan-2 cells, were detected by ELISA.RESULTS:DCs in tumor microenvironments had higher expression of TIM-3 than the DCs from para-carcinoma tissues and pancreatic cancer patient or healthy people peripheral blood ( P<0.01 ) .TIM-3 expression in the DCs treated with the culture supernatants of Capan-2, SW1990 and Panc-1 pancreatic cancer cells for 48 h was much higher than that in Hs27 cells (P<0.05).Treatment with a combination of anti-VEGF-R2, anti-IL-10 and EP2 receptor blocking peptide largely diminished the upregulation of TIM-3 on the DCs mediated by Capan-2 cell superna-tants (P<0.05).The concentrations of IFN-βand IL-12 in the DCs with high expression level of TIM-3 were lower than those in the DCs with low TIM-3 expression level.Treatment with mAb to TIM-3 resulted in much more IFN-βand IL-12 releases (P<0.01), but DNase+RNase made this effect disappear.CONCLUSION:TIM-3 serves as a negative regula-tor of DCs innate immune responses in the pancreatic cancer microenvironments.The secretion of soluble factors to tumor microenvironment by pancreatic cancer cells, including IL-10, VEGF and PGE2 , may contribute to the regulation of TIM-3 expression.