Objective To investigate the biological effect of GM-CSF on splenic dentritic cells (DCs)when used to treat severe sepsis and the influence on the prognosis.Methods All 160 male Kunming mice were randomly(random number)divided into four groups:control group(n =50),the mice didnt receive special treatment; CLP group(n =42),the mice underwent cecal ligation and puncture;conventional treatment group(n =34),the mice received intraperitoneal injection of 5 mg/kg ceftriaxone at 12,24,36,48,60,72 and 84 h after surgery; GM-CSF treatment group(n =34),the mice received hypodermic injection of 20 μg/kg GM-CSF besides ceftriaxone at 12,36,60,and 84 h after surgery.The mice were sacrificed at 0,12,24,48 and 72 h after CLP by cervical dislocation.The amount of splenic DCs and apoptosis rate were measured by flow cytometry,and the serum concentrations of IL-12 were detected by ELISA in each group.Meanwhile the survival prognosis was observed at 96 h.Results At every time point,the apoptosis of splenic DCs increased and the amount markedly reduced in severe sepsis(P ＜0.05),the serum concentration of IL-12 increased on an one-way curve type(P ＜0.05).The treatment of cephalosporin exacerbated the loss of DCs(P ＜ 0.05),while hadnt any effect on IL-12(P ＞ 0.05).GMCSF treatment increased the amount of DCs(P ＜ 0.05),and decreased IL-12 concentrations(P ＜ 0.05).The OR of GM-CSF was 0.079 computed by Logist regression analysis.Conclusions GM-CSF treatment severe sepsis can increase the amount of splenic DCs,decrease serum levels of IL-12,and improve prognosis.

Objective Study the changes of bFGF, COX2 after human severe brain injury and find an effective method for estimating time interval after brain injury.Method 35 brain tissue samples of severe brain injury were examined using immunohistochemical staining and image analysis technique to evaluate the expression of bFGF and COX2.Results Maximal bFGF expression was found at 0h after brain contusion. The intensity of bFGF staining decreased remarkably 12h after brain contusion and descended gradually to the minimum on the 11th day. Expression of COX2 positive cells increased significantly 12h after brain contusion and reached the maximum level one day after brain contusion. Then the expression decreased gradually from the 2nd day to almost aero on the 11th day.Conclusion The changes of bFGF and COX2 were regular along with various survival time after brain contusion so that bFGF and COX2 immunohistochemical staining can be used as a referential data for estimating time interval after human brain contusion.

The paper conducts a case study of Yangzhou No.1 People′s Hospital, introduces the practice of outpatient process opti-mization based on informatization support platform, analyzes the operation status of self-service outpatient service platform and existing problems.Based on the M/M/s model in queuing theory, the queuing model of payment for outpatient service in the hospital is construc-ted, the characteristics of queuing payment problems for outpatient service are revealed, the relationship between the sharing rate of self-service terminals and the average length of the queue in service windows, the average waiting time of patients.

Objective To analyze the clinical outcomes after different treatments for the Monteggia's fracture in children. Methods From January 1991 to December 2001, a total of 128 children with Monteggia's fracture were reviewed, there were 91 males and 37 females, the average age was 7.4 years (range, 2-14 years). According to the Bado classification system: 73 of typeⅠ( extension type) accounted for 57.0%; 20 of type Ⅱ (flexion type), 15.6%; 33 of type Ⅲ (adduction type), 25.8%; 2 of type Ⅳ, 1.6%. 50 patients received conservative treatment, all belonged to the fresh fractures (within 1 week after injury); the other 78 patients were operated, including 30 fresh fractures after failure of closed reduction and 48 old fractures. The conservative patients received manipulation and plaster immobilization. In the operative group, 45 patients (16 fresh and 29 old fractures) were fixed with single Kirschner wire after reduction of the radiohumeral joints, and the ulnas were free of fixation; 33 children (14 fresh and 19 old fractures) were fixed with double wire both for the radiohumeral joints and fractured ulnas. In the fresh Monteggia's fractures, the annular ligament was repaired simply without reconstruction, but in the old fractures, neither reparation nor reconstruction was needed. The plaster was kept for 4-6 weeks postoperatively. Results All patients were available at the final follow up with a mean of 5.6 years (range, 1-10 years). According to the Lihan Ming's scoring system for the motion function in children: the conservative patients were classified as 42 excellent, 4 good, 2 fair and 2 poor, the excellent and good rate was 92%; and in the single wire group, there were 31 excellent, 5 good, 2 fair and 1 poor, the excellent and good rate was 93.3%; finally in the double wire group, 22 excellent, 7 good, 2 fair and 2 poor, the excellent and good rate was 87.9%. Conclusion The closed reduction should be selected first for the fresh Monteggia's fracture in children, the operation is only indicated for the special fresh or old fractures, in which neither the anatomic reduction was satisfactory nor the reduction can be kept without internal fixation. The operative technique, including the open reduction of the radiohumeral joint and fixation both with Kirschner wire and plaster,is reliable to improve the clinical results.

retina. Degeneration was found in the epithelial cells of lens at day 30 after radiation. During day 90 to 360 after radiation, lens capsule was thickened, degeneration of epithelial cells, and edema on the posterior surface were found, and cataract ensued. The injurious effect was dose-related. Conclusion High power EMP may cause posterior capsular opacity and subsequent cataract, and the injurious effect was dose-related.

retina. Posterior capsular edema and vacuoles were found. The main complication of lens injury was cataract. Conclusions High power EMP may cause serious injuries to optical system. Lens is the most sensitive organ to EMP injury, and may lead to cataract

[Objective]To discuss the tissue engineering method of treating bone defects through rabbit bone marrow mesenchymal stem cells(MSCs)'culture in vitro and make composite grafts with anti-extracted bovine cancellous bone(BCB).The composite grafts were implanted into segmental radial defects in rabbits was compared on the curative effect of repairing segmental bone defects in rabbits with the composite grafts.[Method]The purified,culture-expanded MSCs were combined with BCB in vitro according to condition of cell culture.The composite grafts were tested by scanning electron microscope.An bone defect(15mm in length) was created at two radii in each rabbit.The composite grafts were implanted into segmental radial defects in rabbits through open operation.The curative effect was evaluated by radiographic examination,histologic analysis,biomechanical test after surgery in experimental groups and control's and blank's.[Result]Roentgenographically,the bone defects that had been treated with grafts exhibited new bone formation increased with time.But the result of experimental groups were apparently superior to that of the control groups′s at 2、4、8、12、16 week after operation(P

Objective To compare the ExacTrac X-ray and CBCT image guide system for the head and neck cancer patients in radiotherapy. Methods Twenty head and neck cancer patients were randomly chosen and divided two Group. In group A ( 10 patients) ,the cross X-ray radiation photos were matched with the DRR after positioning with the infrared markers. Obtain the setup errors on three directions and rotation errors. Then adjustment of error with 6D treatment bed,record time set-up and registration. In group B ( 10 patients) ,the CBCTimages were matched with reference CT data after manual positioning. Obtain the setup errors on three directions and around the vertical axis direction errors. Then adjustment of error,record the time of set-up and registration. Groups were compared using the paired t-test. Results For group A and B group,the translation errors were (0.59±0. 25) mm,(0.62±0. 25) mm,(1.56±0. 28) mm,and (0.52± 0. 31) mm,(0.74±0. 17) mm,(1.58±0. 34) mm on horizontal,vertical,up-down directions,respectively (P=0.43,0.21,0.90).For group A,the rotation errors were (0.54±0.17)°,(0.72±0.27)°,(0.44± 0. 22)°,respectively;with (1.26±0. 33)°on vertical directions on B group (P=0. 01).The time of set-up registration on group A was significantly less than group B ( 108. 0 s vs . 165. 8 s , P= 0. 00 ) . Conclusions For the head and neck cancer patients in raditherapy,the image guide systems is feasible. The rotation errors of ExacTrac X-ray slightly less than CBCT.The time of set-up and registration of ExacTrac X-ray significantly less than CBCT,but the image resolution of ExacTrac X-ray inferior for CBCT.

BACKGROUND:There are numerous studies on bone marrow mesenchymal stem cells(BMSCs)from small animals such as rats and rabbits,but no few reports addressing BMSCs from big animals.OBJECTIVE:To observe in vitro cultured goat BMSCs,and to understand its biological properties.METHODS:A healthy Chinese goat aged ten months was obtained to extract 5 mL fresh bone marrow from the posterior superior iliac spine by puncture following anesthesia.Using the whole bone marrow method,the samples were incubated in a sterile plastic culture flask and added with DMEM/F12 containing 10% fetal bovine serum.Following 80% 90% confluence,cells were digested by trypsin.Cells at passage 3 in logarithmic phase were collected and frozen,and then recovered.Changes in cell morphology were observed using an inverted microscope.Cell growth curve was measured using MTT assay.The potential of osteogenic differentiation was examined utilizing Von Kossa's staining.RESULTS AND CONCLUSION:The primary cultured BMSCs were cultured with adherent growth.The cells were spindle form.Cell morphology following passage 3 was similar,showing long spindle shape.Following freezing and recovery,cell adherence was slower compared with subculture cells,and no significant difference was detected in cell morphology and viability compared with subculture cells.Growth cycle was similar in passage 3-passage 5 cells.BMSCs entered lag phase at days 2 and 3,logarithmic phase at day 3,and platform phase at days 6 and 7,and then growth speed was slow.Goat BMSCs were positive for Von Kossa's stain at 3 weeks following osteogenic induction.Results verified that cultured goat BMSCs showed strong genetic stability and proliferation ability,and differentiated into osteoblasts.