BACKGROUND:Compared with smooth titanium, titania nanotubes cannot only induce mesenchymal stem cels osteogenic differentiation and promote bone integration, but also be used as drug nanocarriers. OBJECTIVE:To prepare dexamethasone-loaded titania nanotube system and to test its drug release characteristics. METHODS:Titania nanotubes were prepared by electrochemical anodic oxidation, and dexamethasone was dripped onto the prepared titania nanotubes. Subsequently layer by layer self-assembly technology was employed to fabricate gelatin/chitosan multilayered structure on the prepared samples. Scanning electron microscope and contact angle test were carried out during the process of building the gelatin/chitosan multilayered structure. The drug release was measured by a ultraviolet spectrophotometer. RESULTS AND CONCLUSION:Under the scanning electron microscopy, the fabricated titania nanotubes had integral structure with even tube size of about 70 nm and arranged regularly, and the nanotubes were completely covered and sealed by the gelatin/chitosan multilayered membrane. Contact angle test results showed that ever since the fifth layer, contact angles changed alternately and displayed a zigzag profile. Ultraviolet spectrophotometer test results showed that when cultured for 3 hours, the cumulative drug release was about 32.7% and demonstrated an initial burst folowed by sustained release. When cultured for 24 hours, the cumulative drug release about 52.3%. However, after cultured for 7 days, little drug release was detected. And there was about 8.0%-10.0% dexamethasone of initial loading preserved in nanotubes.

OBJECTIVE:To provide reference for avoiding the recurrence of medical safety(adverse)events or inducing more severe medical accident. METHODS:The medical safety(adverse)events reported by a class A grade 3 hospital from July 2013 to March 2016 were studied retrospectively,and excluded purely adverse drug reactions and transfusion reactions to analyze the rea-son and characteristics. RESULTS:Of 747 events,there were 578 medical,nursing and drug-related medical safety (adverse) events,accounting for 77.38%;among 175 medical related medical safety(adverse)events,top 3 reasons were basic skills defi-ciencies,defects in the system processes,inadequate communication and education, accounting for 32.00%,24.00%,19.43%. The occurrence of medical safety (adverse) events were closely related to working life and qualifications;among 578 medical, nursing and drug-related medical safety (adverse) events,the incidence of adverse events was 71.11% in 5-year working life group,and that was 73.18% in junior titles group. CONCLUSIONS:Various professionals should strictly implement procedure and regulations,strengthen communication and education in daily work,and improve professional knowledge and skills so as to prevent the occurrence of adverse event completely.

Objective To analyze the relationship between the radiation doses to mediastinal lymph nodes regions and the regional failure patterns when involved field radiation therapy (IFRT) was used for limited-stage small cell lung cancer (SCLC).Methods The mediastinal lymph node regions (group 1 to 10) of the iimited-stage SCLC patients received definitive radiotherapy were contoured in treatment planning system.The intentional or incidental radiation doses to each lymph node regions were recorded.In-field recurrence,marginal recurrence and out-of-field recurrence were respectively defined as the volume of failed lymph nodes located within the 80％ iso-dose lines,in the 80％-20％ iso-dose lines and beyond the 20％ iso-dose lines of prescribed doses.Results A total of 1 216 lymph node regions in 76 patients were contoured.The median follow-up time was 17.4 months.At diagnosis,lymph node regions with metastatic rates ＞50％ were 4R (68.7％),4L (57.9％),10R (57.9％),2R (56.6％) and 7 (51.3％).The positive lymph node regions were all subjected to prescribed doses.The lymph node regions that received incidental radiation doses of more than 3 000 cGy were:3P,4L,7,6,4R,5,2L.The median lymph node failure-free time was 9.8 months.In this study,only 1 patient developed out-of-field mediastinal lymph nodes failure.The rest of out-of-field recurrences and marginal recurrences were developed in the supraclavicular regions or contralateral hila.Conclusions When IFRT is used to treat mediastinal lymph node regions for patients with SCLC,negative mediastinal regions can be subjected to considerable incidental radiation doses.Out-of-field recurrences of the mediastinal lymph node regions are rare.This is contributed by the incidental radiation dose to these regions.

OBJECTIVE:To investigate the regularity and characteristics of adverse drug reaction (ADR) in our hospital,to reduce the incidence of ADR,and to provide reference for clinical rational drug use. METHODS:1 731 ADR cases reported by our hospital during Jan. 2002 to Jul. 2015 to national ADR monitoring center through the network system were selected and analyzed statistically in respects of gender,age,related drugs,route of administration,causal relationship evaluation,reporting personnel status,ADR results and drug dosage form organs or systems involved in ADR and manifestation. RESULTS:There were a total of 1 731 ADR patients,among which 640 cases were male,and 1 091 cases were female;patients aged 41-60,≥61 were 676,568 cases;there were 86 cases of severe ADR and 1 645 cases of general ADR,249 cases of new ADR,include 19 cases of severe ADR;causal relationship evaluation of ADR was“impossible”(572 cases) and“very likely”(859 cases) as the vast majority of staff reporting;the most of reporters were doctors (1 290 cases,74.52%),followed by pharmacists (323 cases, 18.66%) and nurses (118 cases, 6.82%);ADR of most patients were improved and recovered. There were 16 routes of administration in ADR cases,among which intravenous infusion and oral administration were the main route of administration, accounting for 92.95%;ADR reports involved 32 kinds of dosage form,which mainly were injection,tablets and capsules, accounting for 86.76%. CONCLUSIONS:Great importance should be attached to ADR monitoring and reporting. We also should reduce the use of intravenous drugs,pay attention to the safety of drug use in elderly patients,promote clinical rational drug use, and ensure the safety of patients.

Objective To observe enhancing effect of nerve regeneration on peripheral nerve defect models bridged by VPA/PRGD conduit combined with adipose derived mesenchymal stem cells (ADSCs).Methods From February,2013 to August,2014,the hollow nerve scaffolds were constructed by PRGD and VPA.The activity of AD SCs proliferation was tested through the method of CCK-8.Moreover,the effect of VPA/PRGD conduit combined with ADSCs on peripheral nerve regeneration was evaluated,as well as recovery of motor function following sciatic nerve resection in rats.A 10 mm sciatic nerve deficit was created in a rat model and bridged by VPA/PRGD conduit combined with ADSCs (group A),VPAfPRGD conduit (group B) and autograft (group C) respectively.The results was analyzed by the method of group t-test of SPSS 19.0.Results At 3 d,6 d,9 d,CCK-8 test showed that the OD value of groups VPA/PRGD and control has no significance(P ＞ 0.05).At 12 weeks after surgery,the numbers of regenerated nerve proximal to the tube of group A (268±7.48),group B (269±6.86) and group C (271±7.55),had no significant difference between two groups(P ＞ 0.05).The numbers of regenerated nerve in the tube of group A (257±6.19) and group C (260±5.60) were significantly higher than those of group B (229±5.08) (P ＜ 0.05).There was no significant between groups A and C (P ＞ 0.05).The numbers of regenerated nerve distal to the tube of group A (246±5.89) and group C (247±5.02) were significantly higher than those of group B (214±7.55) (P ＜ 0.05).There was no significant between groups A and C (P ＞ 0.05).Conclusion These promising results illustrate that this novel VPA/PRGD combined with ADSCs conduit can obviously facilitate the regeneration of injured nerve in rats.

Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

OBJECTIVETo investigate the intra-vaginal ejaculation latency time (IELT) of varicocele patients, the influence of spermatic vein ligation on IELT, and the relationship of Visual Analogue Score (VAS) with IELT.

METHODSWe selected 112 males who had regular sexual life after spermatic vein ligation and conducted follow-up visits for 6 months. According to preoperative IELT, we divided the patients into an IELT < or = 2 min group and an IELT > 2 min group, and compared their IELT, VAS and Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores before and 6 months after operation.

RESULTSFollow-up was accomplished in 81 of the patients, 18 in the IELT < or = 2 min group and 63 in the IELT >2 min group. Compared with the baseline, IELT was significantly prolonged postoperatively in both the IELT < or = 2 min group ([1.26 +/- 0.37] vs [4.53 +/- 1.69] min, P < 0.01) and the IELT >2 min group ([5.14 +/- 2.03] vs [7.69 +/- 4.51] min, P < 0.05); the postoperative CIPE-5 scores were remarkably improved in the former (11.27 +/- 3.52 vs 15.64 +/- 2.37, P < 0.05) but insignificantly in the latter group (20.42 +/- 4.65 vs 21.83 +/- 5.49, P > 0.05); the postoperative grades of the CIPE-5 scores showed significant differences in both groups (chi2 = 6.353, P = 0.042 and chi2 = 3.910, P = 0.048); the postoperative VAS was markedly increased (3.18 +/- 0.92 vs 1.56 +/- 0.83 and 3.24 +/- 0.95 vs 1.74 +/- 0.79, P < 0.05), with significant differences in the grades of VAS in both groups (chi2 = 4.433, P = 0.035 and chi2 = 10.088, P = 0.001). The variation of VAS was negatively correlated with that of IELT in both groups (r = -0.572, P < 0.01 and r = -0.465, P < 0.05).

CONCLUSIONVaricocele may be one of the causes of premature ejaculation, and some of the varicocele patients with IELT < or = 2 min may benefit from spermatic vein ligation. Improved VAS is negatively correlated with prolonged IELT. The relationship between varicocele and premature ejaculation deserves further studies.

Adult ; Ejaculation ; physiology ; Follow-Up Studies ; Humans ; Ligation ; Male ; Retrospective Studies ; Varicocele ; surgery ; Young Adult

OBJECTIVETo investigate the changing laws of serum high mobility group box 1 protein (HMGB1) in septic rats and intervention effect of Xuebijing on it.

METHODSLipopolysaccharide (LPS) (5 mg/kg BW) was intravenously injected into the tail vein of healthy male Wistar rats to prepare the sepsis rat model. In Experiment 1: 50 Wistar rats were randomly divided into three groups, i.e., the normal group (A, n=10); the LPS model group (B, n=10), the LPS +Xuebijing treatment group (C, n=30). Rats in the C group were further divided into three subgroups, i.e., 2 h before LPS injection (group C1), 2 h after LPS injection (group C2), and 8 h after LPS injection (group C3), 10 in each group. Blood samples were collected from the caudal vein to detect serum HMGB1 levels by Western blot at 4, 12, 24, 48, and 72 h after LPS injection. Experiment 2: 30 Wistar rats were equally divided into the LPS model group (D) and the LPS + Xuebijing treatment group (E), 15 in each group. They were treated as rats in the B group and the C1 group respectively. Five rats were sacrificed at 12, 24, and 48 h after LPS injection in the two groups. Blood as well as the tissue samples were harvested to measure such indices as ALT, AST, Cr, and BUN, as well as pathological changes of liver, lung, and kidney.

RESULTS(1) Compared with the A group, serum HMGB1 levels were higher at various time points in the B group (P < 0.05). Compared with the B group, serum HMGB1 levels at 12,24,48, and 72 h decreased in the C1, C2, and C3 groups. Besides, the decrease was more obvious at 24 h and 48 h.The decrement in the C3 group was less than that in the C1 and C2 groups (P < 0.05). (2) In the D group, ALT, AST, Cr, and BUN were significantly higher than those in the A group and reached the peak at 24 h (P < 0.05). Compared with the E group, AST, Cr, and BUN at 24 and 48 h, and ALT at each time point decreased significantly in the E group (P < 0.05). (3)The results of pathological section of liver, lung, and kidney showed local congestion and hemorrhage, cell edema/necrosis/degeneration, infiltration of inflammatory cells, damage of characteristic structures and so on; particularly serious lesion occurred at 24 and 48 h in the D group. The microscopic lesion was obviously alleviated in the E group than in the D group at corresponding time points.

CONCLUSIONSThe serum HMGB1 levels increased in septic rats, with late occurrence of peak value and longer duration of the high value. HMGB1 played an important role in excessive inflammatory response and multiple organ dysfunction. Xuebijing could reduce the serum levels of HMGB1, improve biochemical parameters, and attenuate severe inflammatory response of liver, lung, and kidney tissues in septic rats. Besides, the earlier use, the better effect obtained.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; HMGB1 Protein ; blood ; Male ; Rats ; Rats, Wistar ; Sepsis ; blood ; drug therapy

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Lamivudine ; therapeutic use ; Male ; Th1 Cells ; immunology ; Th2 Cells ; immunology

OBJECTIVETo study therapeutic effects of retrograde locked intramedullary nail for the treatment of middle or distal fractures of humeral shaft.

METHODSFrom October 2002 to February 2005, 21 patients with middle or distal fractures of humeral shaft were treated with AO retrograde locked intramedullary nail. Among the patients, 13 patients were male and 8 patients were female, ranging in age from 23 to 56 years, with an average of 34.5 years. Nineteen patients were fresh fractures, and 2 patients were old fractures. Eleven patients had middle fractures of humeral shaft, and other 10 patients had distal fractures of humeral shaft. Two patients with old fractures were non-union and treated with autoallergic bone grafting; 5 patients combined with radial nerve injury underwent exploration. The therapeutic effects were evaluated according to Constant-Murley shoulder score and Mayo elbow score.

RESULTSAll the patients were followed up, ranging from 18 to 24 months, with an average of 20.8 months. The fractures were healed except 1 patient with old fracture and 1 patient with extremely distal acute fracture. The shoulders and elbows had satisfactory recovery except 1 patient with old fracture. The mean Constant-Murley score was (83.6 +/- 13.4) points (50-97), 12 patients got an excellent result, 5 good, 4 fair and no bad; the mean Mayo elbow score was (88.6 +/- 9.8) points (65-95), 13 patients got an excellent result, 5 good, 3 fair and no bad.

CONCLUSIONThe retrograde locked intramedullary nail offers an ideal treatment method for middle and distal fractures of humeral shaft. Strict operative indication, precise surgical techniques and stable locking are the keys to a successful treatment results.

Adult ; Bone Nails ; Elbow Joint ; physiopathology ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged