The irregular anatomic morphology of proximal femoral medullary cavity does not match the current regular prosthetic stem,which is a primary cause of prosthesis loosening post-surgery. The newly designed artificial furcal interior locking joint features irregular prosthetic stem, which adapts to the irregular medullary cavity in the proximal femur. The artificial furcal interior locking joint is anchored in a multi-plane and multi-point manner. Together it can prevent prothetic early peristalsis and late loosening in the medullary cavity post-surgery. Therefore, artificial furcal interior locking joint is promising for prosthetic replacement.

Objective The proliferation and differentiation of neural stem cells in the subventricular zone(SVZ) and subgranular zone(SGZ) have been observed in normal old rats or treated by middle cerebral artery occluded(MCAO) and sham operation respectively. Methods Old rats were used to make models of middle cerebral artery occluded(MCAO).By BrdU pulse labeling and immunohistochemical single staining,the change of the number of BrdU positive cells was observed in SVZ and SGZ of normal rats or cerebral ischemia rats after MCAO 3d,7d,14d,21d,28d and sham operation respectively.By BrdU accumulating label and immunohistochemical double staining,BrdU/NeuN and BrdU/GFAP positive cells were determined in SVZ and SGZ of aged rats after MCAO 14d. Results BrdU positive cells were found in bilateral SVZ and SGZ of all groups above mentioned.Compared with normal and sham groups,BrdU positive cells of SVZ and SGZ in cerebral ischemia rats were strikingly increased.BrdU positive cells reached the peaks in SVZ at 7d and in SGZ at 14d after MCAO.At 14d after MCAO,BrdU/NeuN(0.98%) or BrdU/GFAP(12.56%) double labled cells were observed in SVZ,but no double labled cell was observed in SGZ.Conclusion The focal cerebral ischemia markedly stimulated proliferation of neural stem cells in SVZ and SGZ in old rats,and some proliferative cells in SVZ can differentiate into neurons or glial cells.

Objective To evaluate the diagnostic value of serum retinol binding protein (RBP) on the early stage of type 2 diabet‐ic nephropathy by receiver operating characteristic(ROC)curve .Methods According to urinary albumin(mAlb)/urinary creatinine (UCr) ratio ,155 patients with type 2 diabetes were divided into simple diabetic mellitus group ,early stage of diabetic nephropathy group ,and clinical stage of diabetic nephropathy group ,while healthy people were recruited randomly during the same period as con‐trol group .RBP test were performed by using immunoturbidimetry .The diagnostic value of RBP on in the early stage of type 2 dia‐betic nephropathy were evaluated by analyzing the ROC curve .Results The concentration of serum RBP in the early stage of dia‐betic nephropathy was significantly higher than that in the group of simple diabetic mellitus and control group (P<0 .05) ,the area under the ROC curve of RBP in serum was 0 .770 ,and the cutoff value was 40 .95 mmol/L ,while the sensitivity and the specificity were 81 .0% and 95 .2% .Conclusion RBP was a good marker in detecting early renal damage .

Three problems of treatment based on syndrome differentiation, TBSD are discussed here. Firstly, in allusion to the diversity of the concept of TBSD, the due medical concept of it are discussed and analyzed. Hence, the actual difference and sameness, the due relationship as well as the principle of management between syndrome differentiation and disease differentiation are fully compared. Finally, the concrete operation procedure of syndrome differentiation and disease differentiation are expounded. The author detailedly introduced particular cognition to standardized operation of TBSD attained from Yao Hesheng, a famous physician in Jiangxi Province.

Objective To evaluate development of postoperative complications of calcanens fracture by employing Evidence-based medicine method so as to provide basis for clinical treatment strategy. Methods Eligible literatures on surgical treatment of calcalneus fractures from 1989 to 2008 were retrieved through Medline, Cochrane Database, Embase Database and Science Direct. The retrieved literatures were organized and analyzed by using SPSS14.0 and RevMan5 software. Results A total of 1823 literatures on calcaneus fractures were originally obtained based on preset retrieval conditions. With screening and evaluation, 29 clinical reports involving 2 661 patients (2 800 feet) met the criteria of meta-analysis. The results of recta-analysis indicated that the incidence rates (IR) and confidence interval (CI) of the complications that included infection (IC =8.6%, 95% CI =7.53-9.61), wound-edge necrosis (IC =2.6%, 95% CI =2.05-3.24), subtalar arthritis (IC =2.0%, 95% CI = 1.42-2.44), peroneal tendinitis (IC = 1.3% , 95% CI = 0.84-1.66), vascular or nerve damage (IC = 1.2%, 95% CI 0.81-1.62), osteotitis of calcaneus (IC = 1.0% ,95% CI 0. 60-1.33), non-union (IC =0.2%, 95% CI = 0. 04-0. 39) , malreduetion (IC = 0. 1%) and painful implants (IC = 0.7% , 95% CI = 0.4-1.03) respectively. Conclusion The postoperative complications of calcaneus fracture are common clinical problems, to which professional care without delay can attain satisfactory outcome.

Objective To review the treatment effect of limited disease small cell lung cancer (LD-SCLC) and to evaluate the prognosis factors for SCLC. Methods From Aug. 2002 to Feb. 2006, 212 patients of SCLC confirmed with pathology and cytology were. Treated by combined modality. All patients were treated with chemotherapy 2-6 cycles, 59 patients of which were treated with only chemotherapy, 108 patients of which were treated with chemotherapy plus radiotherapy, 45 patients of which were treated with surgery plus chemotherapy with or without radiotherapy. The patients of radiotherapy were exposed to 6 or 10 MV X-ray with a total dose of 40-66 Gy in 4-7 weeks. Results The overall median survival time was 15 months. The 1-,2- and 3-year overall survival rate were 58.0%, 33.2% and 22.1%, respectively. Univariate analysis indicated that weight loss, age, LDH, ECOG performance status, operation, response to radio-chemotherapy, cycles for chemotherapy, radiotherapy irflueoced survival significantly in LD-SCLC. Multivariate analysis suggested that ECOG performance status, response to therapy, cycles for chemotherapy were the independent prognostic factors for LD-SCLC. Conclusions For LD-SCLC patients, ECOG performance ≤ 1, good response to radio-chemotherapy, and ≥ 4 cycles chemotherapy show encouraging survival rate, Distance metastasis is still the mainstay of treatment failure.

BACKGROUND:Infrapatelar fat pad is often partialy resected in the knee surgery, which can be used as an important source of adipose-derived mesenchymal stem cels. OBJECTIVE: To explore the strategies of isolation, culture, and identification of adipose-derived mesenchymal stem cels from the infrapatelar fat pad and to detect the expression of cel surface markers of human adipose-derived stem cels. METHODS: Infrapatelar fat pad was obtained from patients undergoing knee arthroscopy surgery, and attached cels were obtained from adipose tissue by using colagenase I. Cels were cultured in 10% low-sugar DMEM. Stem cels proliferation was detected by means of MTT and then, cel growth curve was made. The obtained cels were induced and differentiated into adipocytes and osteocytes. Expressions of cel surface markers CD29 and CD44 were detected. RESULTS AND CONCLUSION:A few of attached cels were observed after cultured 24 hours. Cels proliferated faster and exhibited spindle shape after 1 week. Cel adherence and proliferation were speeded up after subculture. Growth curve of cels exhibited that the passages 5 and 2 cels had higher reproductive activity than passage 8 cels. The obtained cels can be induced and differentiated into adipocytes and osteocytes. Results from flow cytometry showed that 96.8% passage 5 cels expressed CD29 and 97.6% expressed CD44. These findings indicate that high-purity adipose-derived mesenchymal stem cels with high reproductive ability are easy to be isolated from the infrapatelar fat pad, which may be a kind of ideal seed cels for cartilage tissue engineering.

BACKGROUND:Because insulin-like growth factor I has the ability to induce mesenchymal stem cells into chondrocytes, we hypothesized that the chondrogenic diferentiation of adipose-derived stem cels can be improvedvia insulin-like growth factor I transfection. OBJECTIVE:To investigate the influence of insulin-like growth factor I transfection on chondrogenic potential of adipose-derived stem cels in vitroand tumor necrosis factor-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible 14 (Fn14) signaling pathway. METHODS:Recombinant lentivirus plasmid pLVX-IGF-I-IRES-ZsGreenl was constructed and transferred into passage 3 adipose-derived stem cels, and then these stem cels were induced to diferentiate into chondrocytes (experimental group 1). Meanwhile, the cels transfected with pLVX-IRES-ZsGreenl were taken as green fluorescent protein/adipose mesenchymal stem cel group (experimental group 2), and those with no transfection acted as control group. RESULTS AND CONCLUSION:The mRNA expression of TWEAK was reduced in the experimental group 1 as compared with the other two groups, but the mRNA expressions of insulin-like growth factor I, Col2a1 and Sox9 were up-regulated in the experimental group 1. At the same time, the protein expression of matrix metaloproteinase-3 and TWEAK were down-regulated, while the protein expression of Col2a1 was increased in the insulin-like growth factor I-transfected cels in contrast to the cels modified with pLVX-IRES-ZsGreenl or with no transfection. These findings indicate that pLVX-IGF-I-IRES-ZsGreenl transfection of adipose-derived stem cels results in a higher expression of insulin-like growth factor I, and down-regulates the expression of TWEAK mRNA and protein, which improves the diferentiation of adipose-derived mesenchymal stem cels into chondrocytes.

ObjectiveTo investigate the association between R405Q polymorphism of GLI1 gene and tetralogy of fallot(TOF).Methods In the case-control study,the R405Q polymorphism of GLI1 gene in 112 children with TOF and 200 healthy controls were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The distribution of genotype and allele frequency at R405Q polymorphism site were analyzed and to investigate its relationship with the risk of TOF.ResultsThe distribution of genotype frequency at R405Q polymorphism site was not different between TOF group and the healthy control group(x2 =5.317 ,P = 0.07) .However, the distribution of allele frequency at R405Q polymorphism site was significantly different between TOF group and the healthy control group (x2 = 6.790, P = 0.009) , and the relative risk for TOF in A allele carriers was higher than that in G allele carriers (OR = 1.561,95％ CI 1.116 ～ 2.185) Conclusion The R405Q polymorphism of GLI1 gene is associated with TOF and people with A allele have higher risk with TOF.GLI1 gene might be the genetic susceptibility gene of TOF.

Objective To study the protein fingerprinting of carbapenems resistant and susceptible Acinetobacter baumannii (Ab) strains ,investigate the clinical value of affinity distance in carbapenems resistant strains .Methods A total of 22 carbapenems resistant Ab strains and 18 carbapenems susceptible Ab strains were collected ,and bacterial protein fingerprinting was detected by surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) ,differentially expressed proteins was analyzed by Biomarker Wizard 3 .1 .Cluster analysis of differential expressed proteins was conducted on SPSS 19 .0 .Results The protein expression pattern of carbapenems resistant and sensitive Ab strains had significant difference (P< 0 .05) .Cluster anal-ysis showed carbapenems resistance Ab was given priority to with type A ,followed by type B .Conclusion The results of cluster a-nalysis carbapenems resistance of Ab protein fingerprinting could determine the distance of affinity relationship of Ab .It could pro-vide a theoretical basis for the infection and clinical epidemiology of Ab .