Objective: to observe the effect of Roux-en-Y Gastric Bypass (RYGB)on STZ induced type 2 diabetic rat model, and to clarify its initial mechanism. Methods: 42 type 2 diabeticrats were randomly allocated into operation group(group O 12 rats); sham group(group S 10 rats); diet control group(group F 10 rats); control group(group C 10 rats). Fasting glucose, Insulin Growth Factor-1 ( IGF1), fasting plasma insulin levels, weight and food intake were measured before and 1st , 2nd, 3 rd ,4th, 8th and 16 th week after operation. Results: 16 weeks after operation in the Group O, fasting glucose fell to (8.8?4.9)mmol/L, IGF1 increase to (148.6?7.3)ng/L ,fasting plasma increase to (74.7?9.2)mIU/L and weight decline to (212.6?15.1)g ,there was statistical significance compared with the levels of preoperation (P

0.05).On the day 3,7 postoperatively,IL-6 and CRP significantly increased as compared to those preoperatively in two groups(P

Objective To clarify mechanism of Roux-en-Y gastric bypass (RYGB) and gastric banding on diabetes induced by STZ injection. Methods 40 rats with STZ induced diabetes were randomly allocated into Roux-en-Y gastric bypass (RYGB) group (group RYGB, n=10), gastric banding group (group GB, n=10 ), diet control group (group F, n=10), control group (group C,n= 10). The fasting blood glucose, the fasting insulin IGF-1, the fasting Plasma leptin, the fasting plasma insulin level, the weight and the food-intake, the operation time, the death rate were measured and recored before and after operation on 1st , 2nd, 3 rd ,4th, 8th and 16 th week postoperatively. Results The fasting blood glucose of the group of gastric banding(GB) descended to (12.6±3.7) mmol/L, the fasting plasma insulin rose to (58.7±9.2) mIU/L, the fasting plasma leptin descended to (14.6±3.3) pg/ml, the weight was (212.6±15.1) g.There were significant differences between before and after operation on 16 th week(P<0.01). The fasting blood glucose of the group of Roux-en-Y (RYBG) descended to 8.8±4.9 mmol/L in the sixteenth week, the fasting insulin IGF-1 rose to (148.6±7.3) ng/L, the fasting plasma insulin rose to (14.1±3.5) pg/ml, the fasting plasma leptin descended to 14.1±3.5 pg/ml, the weight was (200±15.1) g. There were significant differences between before and after operation 16 th week (P<0.01). There were significant differences of the fasting plasma insulin and the the fasting plasma leptin between group F and group C during the 3 rd to 4th week after operation (P<0.05). Compared the weight of the group F and the group C on the third week of operation, there were significant differences (P<0.05), and there were no significant differences in other time. The fasting blood glucose of the group F and the group C had no sig-nificant differences between before and after operation.(P<0.05). Conclusions The fasting blood glucose and the fasting insulin level of the group F improve more than of the group GB at the same time. The plasma insulin and the plasma leptin of the two groups all work in glucose control. The diet control and the modification of the plasma insulin and the plasma leptin all play a major role in the gastric banding mechanism, and the IGF-1 may work in the descending the blood glucose after the operation of Roux-en-Y. In the operation time and die rate, the group of F surpass the group of GB.

BACKGROUND:Bone marrow derived mesenchymal stem cells (BMMSCs) have multi-differentiation potentials, possessing a repairing capability for the sectional bone defects if combined with degradable porous β-tricalcium phosphate china. This provides a new idea in clinical repair of various bone defects.OBJECTIVE: To explore in radiology the curative effect of implanting porous β-tricalcium phosphate and autogenous BMMSCs compound to treat bone defects.DESIGN: A randomized controlled study with callus growth at various healing periods as subjects for observation. SETTING: Department of Orthopaedics, Renmin Hospital, Wuhan University; Tissue Engineering Center, Research Institute of Basic Medicine,Academy of Military Medical Sciences of Chinese PLAMATERIALS: This experiment was carried out at the Tissue Engineering Center, Research Institute of Basic Medicine, Academy of Military Medical Sciences of Chinese PLA between March and September 2002. Twenty China healthy adult sheep were randomized into the groups of blank control group (4 sheep), simple implantation group (8 sheep) and complex implantation group (8 sheep).METHODS: Under general anesthesia and aseptic condition, 10-15 mL of sheep marrow was extracted; MSCs were separated and cultured before combined with porous β-tricalcium phosphate china for tissue engineering bone construction. Rats in each group were cut off 21mm long metatarsus in the middle section of metatarsus bonestem. Β-tricalcium phosphate china and autogenous MSC compound was implanted into the sheep of the complex implantation group; β-tricalcium phosphate china was implanted into the simple implantation group; and the bone defects in the blank control group remained untouched. Then the incision was sutured.X-ray filming was carried out right after the operation, as well as 1, 3,and 6 months after the operation for radiological appraisal (scored for1 if bone union formed in one surface of bone defect, but scored 0 if no boneunion formed in any surface of bone defect, and scored 4 if bone union formed in front, back, lateral surfaces and the center of bone defect), Xray radiation-resisting density was analyzed to compare the results of bone defect repair.MAIN OUTCOME MEASURES: The postoperative general condition and general observation, as well as the results of the radiological analysis of the bone defects of all sheep.RESULTS: Totally 20 sheep were brought into this xperiment and all entered the stage of result analysis. ① The postoperative general condition:Sheep regained consciousness 2-6 hours after the operation without incision infection and loosing of internal fixation. Their spirit gradually was back to normal 1 week after the operation, at which time the injured legs could touch ground but were incapable of bearing load, and the affected legs could bear load 2 weeks after the operation, walked slightly lamely 3 weeks after the operation, and even moved freely without limp 4 weeks after the operation. ②The general condition 6 months after the operation: In pure implantation group, the surface white hyaline cartilage-like tissues were gradually calcified, with both ends connected with the host bone by bone bridge, but china granules could still be easily observed; while no implantation substance could be observed in compound implantation group,with the boundary between implantation substance and host bone vanished,and bone defect became basically the same as host bone. However there was no bone tissue formed in bone defect at various postoperative time points in the blank control group. ③ Radiological analysis of the bone defects at various postoperative time points: The radiological rating score was obviously higher in complex implantation group at the time poin ts of 3, 6 months after the operation compared with the pure implantation group [(2.3±0.3), (1.8±0.5); (3.3±0.5), (2.6±0.6), P ＜ 0.05]. ④ Radiological analysis of bone callus thickness and the relative value of radiation-resisting density at various postoperative time points: The bone callus thickness in the complex implantation group was obviously lower than that of the pure implantation group at the postoperative time point of 6 months (4.62 vs 7.64, P ＜ 0.05), with relative value of radiation-resisting density obviously higher than that of the pure implantation group (70.4±1.5 vs 61.18±1.2, P ＜ 0.05).CONCLUSION: Radiological appraisal and bone defect density measurement can well reflect the dynamical repairing process of bone defects; the implantation of porous β-tricalcium phosphate china and autogenous BMMSCs compound into sheep can enhance the repair of large sectional bone defect.

BACKGROUND:Sirius red is a strong acid anionic dye. Being not-easyto-fade and specific, sirius red becomes the best dye for collagen staining.Collagen is a major component of extracellular matrix and has some specific physiological functions. Through synthesis and reconstruction of collagen, bone fracture repair will be accomplished.OBJECTIVE: Picric acid-Sirius red stained slides were observed under a polarized light microscopy for evaluation the dynamic changes in the ratio of different collagen types and their distributions in bone fracture healing.DESIGN: It was a controlled observation.SETTING: It was conducted in the Department of Orthopedics, Renmin Hospital, Wuhan University; Department of Traumatic Orthopaedics, Tianjin Hospital; Department of Traumatic Orthopaedics, Jishuitan Hospital,Medical Department, Peking University; Tissue Engineering Center of Institute of Basic Medical Sciences, Academy of Military Medical Sciences of Chinese PLAMATERIALS: It was conducted at Tissue Engineering Center of Institute of Basic Medical Sciences, Academy of Military Medical Sciences of Chinese PLA from March 2002 to September 2003. Three healthy adult Chinese sheep, male and in weight from 25 to 35 g, were selected.METHODS: All the animals were anesthesized and sterilized; a transverse osteotomy of the trunk of metatarsus was performed; and the end of fracture was fixed with a six-hole Medoff sliding plate. At the post-operative month 1, 3 and 6, samples were taken from bone fractures. After decalcification with EDTA, they were stained with Picric acid-sirius red, and the types and distribution of collagens were observed under a polarized light microscopy.MAIN OUTCOME MEASURES: Types and distributions of collagens in bone lesion in different period of bone healing were investigated.RESULTS: Three sheep used in this study entered the statistical analysis.①Morphological features of various collagens under a polarized light microscopy postoperatively: Type Ⅰ collagen packed tightly, with a strong refraction and yellow, orange or red thick fibres. Type Ⅱ collagen formed a loose reticulation with fibres exhibiting different colour and a weak refraction. Thin fibres of type Ⅲ collagen with weak refraction and green colour formed a loose reticulation. ②Quantitative studies on various collagens under a polarized light microscopy postoperatively: At postoperative month 1,red or orange fibres (type Ⅰ collagen) were rarely seen in bone fracture,while green fibres (typical of type Ⅲ collagen) were dominant with a disorder pack. At postoperative month 3, red or orange fibres increased significantly and the ratio of type Ⅲ collagen reduced. The collagen fibres assembled regularly. At postoperative month 6, thick yellow-red collagen became dominant and thin green type Ⅲ collagen decreased dramatically and arranged in an obvious oblique, spiral and crossed orientations.CONCLUSION: Picric acid-sirius red stain combined with polarized light microscopy technique is not only capable of identifing type Ⅰ and type Ⅲ collagens in bone fraction, but also can reflect the morphological features,distribution and the ratio of these two type collagens. This approach has the virtues of easiness in operation, strong specificity and high sensitivity.

Objective To review the experience in the management of gastric cancer with liver cirrhosis and portal hypertension.Method A retrospective analysis was made in 35 gastric cancer cases with liver cirrhosis and portal hypertension admitted into our hospital from January 2000 through June 2009.Result There were no intraoperative death in this group.Postoperative ascites occurred in 19 patients,anastomotic leakage in one case,anastomotic bleeding in 2 cases,wound bleeding in 2 cases,intraabdominal infection in 17 cases (of which combined fungal infection in 4 patients),incision infection in one patient and chylous leakage in one case.The morbidity rate was 71%.Four patients died during hospitalization including multiple organ dysfunction syndrome in 2 cases,with mortality rate of 11%. Conclusion In order to reduce the incidence of mortality and complications,we should complete preoperative evaluation,correct perioperative management,guide surgery with damage control concept,follow individualized principles and emphasize on preventive devascularization.

Objective: To investigate the feasibility of chitin as bone substitute material and carrier of rhBMP2.Methods: Porous chitin and chitin/rhBMP2/collagen complex were implanted into calvarial defects in 8 rabbits. Bone repairing ability was assessed by radiographic and histological observation. 2 rabbits without implantation were served as controls. Results: Chitin had certain bone conductive ability. When combined with rhBMP2,a complex possessing both bone conductive activity and bone inductive activity was produced. The complex had greater bone repairing ability than chitin alone. Conclusion: Chitin may be used as a bone substitute material and carrier of BMP. But its mechanical strength and surface activity should be improved.

Objective To evaluate the feasibility of reconstruction of artificial bladder tissue using the expanded bladder cells seeded onto both sides of a synthetic PLGA polymer and cultured in the nude mice by tissue engineering technique. Methods The urothelial cells and smooth muscle cells were obtained from young rabbits by mechanical isolation and enzyme digestion method. In vitro cultured and expanded smooth muscle cells and urothelial cells were seeded onto the outer and inner surfaces of each polymer. Then, the constructs were implanted into the subcutaneous pockets of athymic mice. At 4 and 8 weeks after implantation, the specimens were harvested and examined macroscopically, histologically, and immunohistochemically. Results The polymer was covered with urothelial cells inside and smooth muscle cells outside. As polymer degradation was in progress, the urothelial cells and the smooth muscle cells kept proliferation and converged. Conclusion Artificial bladder tissue reconstructed by tissue engineering technique has the similar properties to those of the normal bladder wall. This study has laid solid foundation for further studies of tissue engineering bladder.

Objective To evaluate gastrobiliary duct drainage in the treatment for iatrogenic distal common bile duct injury found during the operation.Methods We analyzed clinical data of 17 cases with application of gastrobiliary duct drainage in immediate treatment for the injury of distal common bile duct found during the operation from June 2010 to June 2016.Postoperative bile drainage,postoperative gastrointestinal function recovery,time for removal of the gastrobiliary duct and hospitalization time were recorded.Postoperative bile leakage,intestinal fistula and pancreatic leakage were observed.Patients were followed up until June 2016.Results The mean volume of bile drainage on the third postoperative day were (310 ± 112)ml,the mean time of postoperative gastrointestinal function recovery were (3.0 ± 1.5) days,time for removal of the gastrobiliary stent were (7.5 ± 1.0) days and hospitalization time were (9.5 ± 1.5) days.There was no postoperative bile leakage,intestinal fistula and pancreatic leakage.All patients were followed up for a median time of 12 months (range,1-45 months).Meanwhile,we found no significant biliary strictures and cholangitis patients.Conclusion Gastrobiliary duct drainage is a simple,rational and effective treatment for iatrogenic injury of distal common bile duct during common bile duct exploration.

Rice stripe virus (RSV) infects rice and is transmitted in a propagative manner by the small brown planthopper.How RSV enters an insect cell to initiate the infection cycle is poorly understood.Sequence analysis revealed that the RSV NSvc2 protein was similar to the membrane glycoproteins of several members in the family Bunyaviridae and might induce cell membrane fusion.To conveniently study the membrane fusion activity of NSvc2,we constructed cell surface display vectors for expressing Nsvc2 on the insect cell surface as the membrane glycoproteins of the enveloped viruses.Our results showed that NSvc2 was successfully expressed and displayed on the surface of insect Sf9 cells.When induced by low pH,the membrane fusion was not observed in the cells that expressed NSvc2.Additionally,the membrane fusion was also not detected when co-expressing Nsvc2 and the viral capsid protein on insect cell surface.Thus,RSV NSvc2 is probably different from the phlebovirus counterparts,which could suggest different functions.RSV might enter insect cells other than by fusion with plasma or endosome membrane.