Objective To observe the value of flexible bronchoscopy (fiberoptic bronchoscopy/electronic bron choscopy, abbreviation bronchoscopy) in the diagnosis and treatment of patients with decannulation dififcult after tracheotomy. Methods 17 cases with decannulation difficult after tracheotomy which were diagnosed and treated by lfexible bronchoscopy were reviewed and evaluated. Result Among the 17 patients with decannulation dififcult, except one failure in decannulation because of upper airway scar contracture with atresia after brain injury, the rest was successful, and decannulation rate was 94.1%. Except one patient with displacement of metal stents, and one patient with breathing dififculty after the decannulation, there was no other adverse reactions and deadly complications. Conclusion Flexible bronchoscope plays an important part in the diagnosis and treatment of the patients with decannulation dififcult after tracheotomy. It is safe and reliable, so it is worthy of clinical promotion.

Biological Clocks ; Genetic Therapy ; Heart Diseases ; therapy ; Humans ; Stem Cell Transplantation

BACKGROUND: Under wear particles stimulation, mononuclear macrophages, fibroblasts, and osteoblasts can produce a large amount of inflammatory factors, leading to periprosthetic osteolysis. But the precise mechanisms remain unclear. OBJECTIVE: To analyze the molecular biological mechanism underlying osteolysis induced by titanium wear particles . RESULTS AND CONCLUSION: Cleaned titanium particles stimulation induced an unbalanced ratio of RANK mRNA to OPG mRNA. Over-expressed RANK bound to RANK ligand and promoted osteolysis. No RANK mRNA expression was detected in the LPS group, but OPG mRNA expression was transiently increased at 4 hours. NF-κB/inflammatory cytokine, rather than RANK/OPG, is the main signal pathway for LPS to induce osteolysis. After LPS binding to titanium particles, these two signal mechanisms, RANK/OPG and NF-κB/inflammatory cytokine, have synergistic effects during artificial joint loosening.

Objective To investigate the clinical characteristics,treatment and prognosis of spine and spinal cord stab injury with foreign bodies retained in wound.MethodIn a group of 128 cases of spine and spinal cord stab injury that admitted to our department from January 1995 to November 2005,19 had foreign bodies retained in wound.The result of 19 cases were analyzed retrospectively.ResultOperations such as scrutinization of the spinal canal,clean-up of the hematoma,extraction of foreign bodies were performed according to different conditions for 19 cases of spine and spinal cord stab injury with foreign bodies retained in wound of 19 patients,one(5.3%) died,two happened cerebrospinal fluid leakage,one meningomyelitis and wound infection was observed.Of 14 cases with neurological injury,scores of ASIA scales of 13 patients increased after comprehensive rehabilitation treatment(P

Objective To investigate the clinical effect of acellular allogenic dermis combined with split-thickness autogenous skin graft for coverage of wound in extremity joint. Methods After contraction scar, giant pigmented nevus and capillary hemangioma being removed, acellular allogenic dermis with split-thickness autogenous skin graft was used to repair 25 cases of wounds of elbow, ankle, knee and wrist joints. The area of wounds was from 7cm?11cm to 12cm?19cm. Out of 25 wounds, there were 4 in wrist, 8 in elbow, 7 in ankle and 6 in knee joints. The survival rate of graft skin and improvement degree of joint function were observed. Results All grafts survived and had the smooth surface without obvious pigmentation and wound contraction. The function of joint was significantly improved after operation. Conclusion Tissue-engineered dermis with autogenous epithelium is an ideal graft for coverage of various wounds in extremity joint.

?Objective:To investigate the behavior of absorbable coral hydroxyapatite (Interpore 500R) as bone tissue engineering scaffold. Methods: Marrow stromal stem cells harvested from legally aborted human fetus were cultured in DMEM containing 100 ml/L fetal boving serum and induced to differentiate towards osteoblasts.Then the cells were seeded onto absorbable coral hydroxyapatite , then the composite was implanted subcultaneously into the back of nude mice .Cell materia attachement was observed with scanning electron microscope,type I collegen secretion was studied with laser confocal microscope and new bone formation was studied histologicaley. Results: The cells could adhere to absorbable coral hydroxyapatite and secrete collagen I.Mature bone tissue was found in the implanted composite 40 day after transplantation. Conclusion: Absorbable coral hydroxyapatite Interpore 500R is a favorable bone tissue engineering scaffold.

Objective To explore the experience in scalp operation of craniopagus and repairing of scalp and dura defect after separating Methods Analysis the cause and management of the complication after skin expander implantation Discuss the characteristic of repairing skull soft tissue defect by expanded scalp flap and fiber capsule Results Dural and scalp defect could be repaired satisfactory with expanded scalp at one stage Conclusion It's necessary and important for successful separation in D type craniopagus with preoperation care, an elabarate operative management, careful postoperative observation and timely treatment for complication

Regulatory T cells (Tregs) possess the function of immune suppression and achieve immunosuppression by the approach of expressing cytotoxic T lymphocyte-associated antigen,perforin-particle enzyme mediated cytotoxic effect,and secretion of cytokines such as IL-10,TGF-β,et al.The antibodies,vaccines and chemical drugs can be applied for targeting FOXP3 + CD25 + CD4 + Tregs,depleting Tregs in peripheral blood and tumor tissues of patients of various forms of cancers.The function of immune suppression can be decreased and antitumor curative effects by immunotherapy can be enhanced.

Objective To develop a highly sensitive and accurate time-resolved immunofluorometric assay (TR-IFMA) for measurement of Dickkopf-1(DKK-1),as a novel serologic biomarker for lung cancer. Methods The study constructed a two-manoclonal-antibody "sandwich"-type assay and the sensitivity, within run CV and between run CV and accuracy were evaluated. Serum DKK-1 concentrations were measured by TR-IFMA in 120 healthy controls, in 72 benign lung disease patients, and in 212 lung cancer patients before surgery. The association between serum DKK-1 levels and clinicopathological features were evaluated. Results A standard curve for DKK-1 TR-IFMA had been developed with good sensitivity (0.08 μg/L). Both within run CV and between run CV were less than 6.5%. Accuracy studies, parallelism and precision data were determined and all found to be satisfactory. The validity of DKK-1 assay was confirmed by the good correlation between the results obtained by TR-IFMA and commercial ELISA (r=0.972, P=0.01). The serum levels of DKK-1 were higher in lung cancer patients 31.93(79.47-18.03) μg/L than in benign lung diseases 15.25(18.41-11.49) μg/L and in healthy controls 13. 90( 16. 91-11.02) μg/L DKK-1 levels were significant associated with the presence of distant metastases, as well as lymph node metastases and TNM stage, but not with patients' age, gender and tumor histology. At the cutoff of 22.63 μg/L, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the TR-IFMA for lung carcinoma were 68.4%, 92.2%, 82.1% ,90.6% and 72.5%. Diagnostic sensitivity and accuracy were higher for small cell carcinoma than for non-small cell carcinoma (70.7% vs 69.5% and 85.6% vs 80.7%, respectively). Conclusions A highly sensitive and reliable TR-IFMA for DKK-1 has been developed. The determination of serum DKK-1 levels may be useful for diagnosis and tumor staging of lung cancer.