BACKGROUND: The rudiment of tissue engineering is to obtain tissue from patients. The cells are expanded into a population through cellular culture, and seeded into scaffolds, which can accommodate and guide the growth and proliferation of new cells in the three-dimensional scaffolds. At last, the constructed tissue is transplanted in vivo to repair or replace damaged or diseased tissues. Afterward neovascularization of the graft, the scaffolds are absorbed gradually. Finally, the new tissue replaces completely the damaged or diseased tissuesOBJECTIVE: To evaluate the feasibility of designing and fabricating customized anatomical-shaped bone tissue-engineering scaffolds with reverse engineering and rapid prototyping (RP) techniques. To avoid the disadvantage of the conventional fabricated methods of the scaffolds.DESIGN: The method of fabricating customized anatomical-shaped bone tissue engineering scaffolds.SETTING: Computer-aided design (CAD) of the scaffold was conducted in CAD training center, Guangdong Machinery Research Institute. Rapid prototyping fabrication of the scaffold was conducted in Guangdong Longchuangyu Limited Cooperation. The scaffold was fabricated by sterophotocureable technology and was made of photosensitized resin.METHODS: This experiment was carried out at the Center of Department of Traumatic Orthopedics, General Hospital of Guangzhou Military Area Command of Chinese PLA from October 2004 and January 2005. According to reverse engineering, layered image information of skeleton of the patients was scanned with CT/MRI. Anatomical models of region of interesting were created by means of CT or MRI three-dimensional reconstruction and surface reconstruction. The internal construction of the scaffolds was designed with CAD software in the outline of the anatomical models to develop computer-aided model. The prototypes of the scaffolds were fabricated by RP process.MAIN OUTCOME MEASURES: ①CT/MRI scanning, three-dimensional reconstruction, anatomical modeling; ② computer-aided design of customized bone tissue engineering scaffolds; ③rapid prototyping fabrication of customized bone tissue engineering scaffold.RESULTS: ①Anatomical models of bone joint were established through CT/MRI three-dimensional reconstruction. ② The internal structure of the scaffold was designed to establish the entity model of bone tissue engineering scaffold successfully with computer-aided design software. ③ CAD model of bone tissue engineering scaffold guided prototypes to develop the customized anatomical-shaped bone tissue engineering scaffolds. The internal structure of bone tissue engineering scaffold was fine and had high degree of porosity-and pore interconnectivity.CONCLUSION: Customized anatomical-shaped bone tissue engineering scaffolds can be fabricated with reverse engineering and RP technology. Among all RP processes, stereophotocureable technology (SLA) is the best one with good precision, smooth surface and good shaping.

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on non-fluent aphasia in patients after stroke.Methods Forty stroke patients displaying non-fluent aphasia were randomly assigned to an rTMS group and a control group using a random number table.Both groups were treated with conventional language therapy,while the rTMS group was additionally given 0.5 Hz rTMS over the Broca's homologues of the unaffected hemisphere 5 days a week for 3 weeks.The patients were stimulated at 90％ of the motor threshold (MT),with 16 second trains and intervals of 3 seconds 48 times (384 pulses) in a session.Before and after the 3 weeks of treatment,the Western Aphasia Battery (WAB) and the Communicative Abilities in Daily Living (CADL) test were conducted in both groups to evaluate their language function and communication ability.Results Only spontaneous speech improved significantly (P＜0.05) in the control group after 3 weeks of treatment.In the rTMS group,the spontaneous speech,auditory comprehension,repetition,naming and aphasia quotient (AQ) had all improved significantly (P＜0.05).Moreover,after the treatment,the average score of the auditory comprehension (153.90± 31.79),repetition (82.65± 15.14),naming(81.28±22.12) and AQ (63.66± 13.64) of the rTMS group were significantly higher than those of the control group (P＜0.05).Conclusion rTMS applied to the Broca's homologues of the unaffected hemisphere can significantly improve language function in those exhibiting non-fluent aphasia after stroke.

Objective Observe the efficacy and safety of glucocorticoid deescalation combined antiviral therapy on severe hepati‐tis B .Methods Forty‐nine patients with early severe hepatitis were selected and divided them into observation group(n=24) and control group (n=25) randomly .Control group were given the conventional synthetic therapy while observation group were given conventional synthetic therapy combined glucocorticoid deescalation therapy .Then compare the differences of TBIL ,ALT ,PTA be‐fore and after treatment ,and the improvement time of syndrome and death rate between two groups .Results The death rate in ob‐servation group and control group were 16 .7% and 32 .0% respectively(P<0 .05) ,the improvement time of syndrome in observa‐tion group were shorten than control group(P<0 .05) ,and there was no statistical difference in bleeding and infection rate between two groups(P>0 .05) .After the treatment ,the TBIL ,ALT ,PT were improved in both two groups(P<0 .05) .But the observation group had better improvement than control group ,the difference had statistical significance(P<0 .05) .After treatment ,the changes of HBV DNA between two groups showed no significant difference(P> 0 .05) .Conclusion Glucocorticoid deescalation therapy could decrease the death rate ,shorten the syndrome lasting time in treating severe hepatitis B .It was an effective and safety meth‐od .

Objective:To investigate the expression of MEK/ERK signaling pathways in renal cell car-cinoma with bone metastasis,and to analyze the differences of expressions of VEGFR-2,MEK,ERK on the primary and metastasis tissue and its mechanism.Methods:The tissue samples were obtained from 7 renal cell carcinoma patients kindly provided by Department of Urology,Peking University People’s Hos-pital from January 1,2009 to January 1,2010.The expression of MEK/ERK signaling pathways was de-tected in the 7 renal cell carcinoma patients`primary and matched metastatic tissues with ICH,The anti-body concentrations were 1 ∶200,1 ∶25,and 1 ∶250,respectively.The mutation of the twentieth exon of the PDGFRA gene,the second exon of the K-ras gene,the fifteenth exon of the Brafgene and the se-cond exon of the MEK1 gene were detected with PCR.Results:The expression intensities of VEGFR-2, MEK,and ERK were measured by H-score [intensity (1,2,3,or 4)multiplied by the distribution (%)].VEGFR-2,MEK,and ERK expressions were divided into 3 groups according to the positive dis-tribution of the tumor cells:1,0 -5%;2,6% -50%;and 3,>50%,To assess intratumor heteroge-neity,three distinct microscopic fields (×200)from each specimen were used to evaluate the expres-sions,Subsequently,the scores were averaged to obtain a single concatenated score for each tissue. VEGFR-2,MEK,and ERK expressions were assessed by 2 independent pathologists who were blinded to the clinicopathological data.The data were expressed as the mean value of the triplicate experiments.The expressions of MEK,and ERK were higher in the metastatic tissues than in the matched RCC tissues (6.10 ±4.10 vs.1.33 ±0.51,P =0.015;9.10 ±2.24 vs.4.43 ±2.84,P =0.021 )while the ex-pression of VEGFR-2 was not different between the primary and metastatic tissues (P =0.901).No mu-tation was detected on the twentieth exon of the PDGFRA gene,the second exon of the K-ras gene,the fifteenth exon of the Brafgene and the second exon of the MEK1 gene.Conclusion:MEK/ERK signa-ling pathways may play an important role in the metastasis and the resistance of sunitinib in RCC patients with bone metastasis.

Objective Leucine-rich repeat transmembrane neuronal protein 2 (LRRTM2) localizes to excitatory glutamatergic synapses,and triggers the formation of excitatory synapses.This study aims to investigate the expression of LRRTM2 protein in the temporal lobe tissue of SD rats induced by lithiumpilocarpine,and explore its roles in epilepsy.Methods Fifty-six Sprague-Dawley (SD) rats were induced by lithium-pilocarpine and randomly divided into 6h,24h,72h,7d,14d,30d and 60d subgroups.Eight SD rats were treated with normal saline instead of pilocarpine as controls. Expression of LRRTM2 protein was accessed by immunohistochemistry,immunofluorcscence and Western blot analysis. Results LRRTM2 protein mainly expressed in neurons of temporal lobe,gradually decreased in acute phase,and then up-regulated in latent and chronic periods.The immunohistochemistry A values in model rats from 6 h,24h,72h,7d,14d,30d and 60d subgroups were 0.286 ±0.012,0.227 ± 0.008,0.425 ± 0.015,0.509 ±0.019,0.579 ± 0.018,0.488 ± 0.018 and 0.566 ± 0.014,respectively,compared to 0.330 ±0.016 in control group ( t =3.965,11.987,9.131,14.121,20.452,12.929 and 22.786,all P＜0.05). Gray value ratios of LRRTM2/β-actin in different groups of model rats were 0.0354 ± 0.0043,0.0174 ± 0.0026,0.0685 ± 0.0064,0.0957 ± 0.0125,0.1044 ± 0.0103,0.0910 ± 0.0108,and 0.1012 ±0.0063,respectively,which were significant differences from control group (0.0471 ± 0.0033,t=4.354,14.191,5.989,7.541,10.565,7.730and15.316,allP＜0.05).Conclusions LRRTM2 protein gradually increases in the neurons of temporal lobe of SD rats treated by lithium-pilocarpine in silence and chronic phases,which indicates that it may play an important role in cpileptogenesis.

Chronic heart failure(CHF)is the performance of end-stage cardiovascular disease and the leading cause of death in recent years.With the rapid development of medical care,the mortality rate of heart failure is still high.This is one in the two major challenges in the cardiovascular field in the 21st century.The new drug LCZ696 is a dual inhibitors of angiotensin receptor blockers(ARB)and neprilysin(NEP),which may lead to new hope for patients with heart failure.In order to determine the efficacy and safety of LCZ696 in the treatment of heart failure,foreign countries have carried out some large-scale trials,such as PARAMOUT, PARADIGM,TITRATION and so on.The results of these studies reflected the superiority of LCZ696 compared with enalapril,valsartan and other drugs in the treatment of chronic heart failure.ARB/antiotensin converting enzyme inhibitors(ACEI)targets the angiotensin receptor to dilate blood vessels and inhibits the sympathetic nerve,but their effects on sodium withdrawal and diuresis are weak.The sacubitril in LCZ696 prevents natriuretic peptide from degrading,strengthens the natriuretic diuretic and further expansion of blood vessels.Thereby it improves water and sodium retention and cardiac function.It can play a better synergistic role combined with valsartan.

Objective To evaluate the health-related quality of life (HRQOL) for prostate cancer patients receiving androgen deprivation therapy (ADT).Methods We studied 200 patients with prostate cancer who were treated with primary ADT in Peking University People's Hospital from June 2014 to June 2015.The patients'average age was 73.9 years.The mean PSA level was 21.57 ng/ml when they were diagnosed with prostate cancer.Of these 200 patients,79％ (158/200) were localized and seclected ADT therapy due to age,body condition,basic diseases or individual will.21％ (42/200) were locally advanced or metastasic,which accord with the indication of ADT therapy.The scales,including the MOS item short from health survey (SF-36),Functional Assessment of Cancer Therapy-General module (FACT-G),Functional Assessment of Cancer Therapy-Prostate instrument (FACT-P),Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were used to evaluate their HRQOL.Results According to results of SF36,the physical health component score and mental health component score was 67.41 ± 16.39 and 64.81 ± 17.51,respectively.They indicated that the overall quality of life of these patients was at an acceptable level.And the average score of all domains exceeded 60 except general health domain,which the score was only 40.03 ± 21.89.When it comes to FACT-P,the sum score,emotional well-being score and prostate cancer component score were 8.15 ± 3.72,12.30 ± 4.04 and 77.41 ± 9.95,respectively,which were less than half of their respective top score.However the physical well-being score was 20.41 ±4.29,which was a relatively satisfactory value.In addition,61％ (121/200) patient selected not at all in item I am able to have and keep an erection.The score of SDS and SAS was 46.76 ± 8.29 and 43.25 ±9.69,respectively.And there were 23.0％ (46/200) and 21.5％ (43/200) patiens exhibited depression and anxiety,respectively.Conclusion In the present study,the prostate cancer patients receiving ADT showed acceptable HRQOL,but some patients sufferd from depression,anxiety and erectile dysfunction.

Objective To evaluate the CT enterography(CTE)of Crohn's disease (CD)in active state and catabatic state by using the Logistic regression analysis.Methods 6 2 patients with CD diagnosed by clinic,imaging,endoscopy,surgery or pathology were analyzed retrospectively.The CTE features of CD in active state and catabatic state were recorded and compared by using single factor and multiple stepwise Logistic regression analysis,and the Logistic regression model was established.Results There were 62 patients with CD, including 40 in active state and 22 in catabatic state.There were significant differences between the bowel wall thickness,the CT value in arterial phase as well as in portal venous phase,the type of enhancement pattern,pseudodiverticulum of free margin,increased mesenteric fat density,comb sign,enlarged abdominal lymph nodes and cellulitis in active state and those in catabatic state of CD by using single factor analysis (P<0.05).The bowel wall thickness (OR=4.589,95%CI:1.689-11.822),bowel wall uniformity enhancement (OR=0.006, 95%CI:0.001-0.067 )and comb sign(OR=23.112,95%CI:1.707-312.997)were significant features by using Logistic regression analysis. Conclusion The bowel wall thickness,bowel wall uniformity enhancement and comb sign are the independent characteristic CTE features to predict the CD in active state or in catabatic state.The Logistic regression model is helpful in demonstrating the state of CD.

Objective To analyze the relationship between blood glucose,blood lipid and body mass index (BMI) in elderly patients with hypertension.Methods Form January 2016 to December 2017,376 hypertensive patients over 65 year old in Jinan city were enrolled in this study.The sex,age,BMI,fasting blood glucose and blood lipid were investigated and tested.The prevalence of coronary heart disease and diabetes mellitus in hypertensive patients were investigated,and the relationship between BMI and blood glucose,blood lipid and liver function index were explored.Results Of 376 hypertensive patients,the detection rate of diabetes mellitus was 21.01％ (79/376),221 cases were diagnosed with coronary heart disease,with the detection rate of 58.78％.With the rise of BMI,fasting blood glucose showed an upward trend.Person correlation analysis showed that there was a significant positive correlation between BMI and fasting blood glucose(r =0.167,P =0.003).The difference between TG and TC in different BMI groups was statistically significant(FTG =12.48,P ＜ 0.001;Frc =4.83,P ＜ 0.001).The content of alanine transaminase in the overweight group and obese group was significantly higher than that in the normal body weight group,the difference was statistically significant(F =5.24,P =0.005).Conclusion For elderly hypertensive patients,it is urgent to test blood glucose and coronary heart disease screening.For people over the age of 65,obesity is still an important risk factor for hyperlipidemia and hyperglycemia.Therefore,body weight control is needed in elderly patients with hypertensive.

Objective To study the neurobehavioral manifestations of pilocarpine-induced temporal lobe epilepsy (TLE) rats in different kinds of learning and memory ability tests at chronic stage.Methods Thirty SD rats were randomized into TLE group (n=20) and control group (n=10).Intraperitoneal injection of lithium-pilocarpine (LIP) was performed in rats of the TLE group,and saline was given to the control group.Six weeks after modeling,rats were investigated in spatial,object,time and space combined episodic memory tests,and received 7.0 T MR imaging for structural images.Results Immediately after LIP treatment,13 rats in the TLE group exhibited status epilepticus.Six weeks later,11 of the 13 rats in the TLE group were observed spontaneous seizures.T2 images from MR imaging implied gray matter damage in the hippocampus in the TLE group and intact structure in the control group.The ranges of motion in the spatial memory,object memory and episodic memory in the control group were (90.56±19.9) m/min,(92.58±14.83) m/min and (94.20±30.99) m/min,respectively;those in the TLE group were (95.09±21.51) m/min,(117.10±44.38) m/min and (104.90±35.22) m/min;no significant differences were noted between the two groups (P＞0.05).In the control group,more exploration time on novel location in the spatial test,novel object in the object test,familiar location-familiar object and novel location-novel object in the episodic test were showed than that on the other objects,with significant difference (P＜0.05).In all the tests,there were no significant differences in the exploration times between/among the objects in the TLE group (P＞0.05).Conclusion All spatial,object and episodic memory are impaired in chronic LIP-TLE rats.