BACKGROUND:Many studies have demonstrated that in order to achieve the endothelialization of the polymer materials, surface loading of bioactive factors is an important means and the introduction of human endothelial cells on the surface of the polymer materials wil contribute to increase the biocompatibility of materials. OBJECTIVE:To synthesize the polyethylene glycol hydrogel packaging vascular endothelial growth factor, basic fibroblast growth factor and endothelial progenitor cells, and to observe the sustained release of growth factors and culture status of endothelial progenitor cells. METHODS:The polyethylene glycol-modified hydrogel containing arginine-glycine-aspartic acid peptide was synthesized, and then, rat endothelial progenitor cells, basic fibroblast growth factor, vascular endothelial growth factor, matrix metal oproteinases were successively added. The hydrogel were immersed in PBS, and ELISA was used to test the levels of growth factors in supernatants every 12 hours. Matrix metal oproteinases-2 (100, 1 000 ng) and matrix metal oproteinases-9 (100, 1 000 ng) at different mass were added into the PBS containing hydrogel after 72 hours. ELISA was also used to test the levels of growth factors in supernatants every 12 hours. The hydrogel encapsulating endothelial progenitor cells was cultured in a culture medium for 5 days, and the number of survival cells was counted by a flow cytometer after digestion. RESULTS AND CONCLUSION:Within 12-72 hours, the release percentage of basic fibroblast growth factor and vascular endothelial growth factor remained at about 41%. After 72 hours, the release percentage of both growth factors was found to grow steadily when matrix metal oproteinases-2 (100, 1000 ng) and matrix metal oproteinases-9 (100, 1 000 ng) at different mass were added, which reached 95%. The release percentage was increased with the increasing mass of matrix metal oproteinases. After 5 days of culture, 88.17%cells stil survived in the hydrogel. These findings indicate that sel-assembly polyethylene glycol-modified hydrogel can realize the control ed release of basic fibroblast growth factor and vascular endothelial growth factor, and it can also support the proliferative growth of endothelial progenitor cells.

BACKGROUND:Iron overload as a new etiological factor participate in the pathogenesis of senile osteoporosis, but its mechanism remains unclear. But the mechanism of iron overload cause senile osteoporosis pathogenesis remains unclear. Osteogenic/adipogenic differentiation homeostasis of bone marrow mesenchymal stem cel s (BMSCs) plays an important role in the maintenance of normal human bone mass, and its imbalance can lead to senile osteoporosis. Iron effects on the osteogenic/adipogenic differentiation of BMSCs remain unclear. Therefore, we clarify the role of iron overload in the pathogenesis of senile osteoporosis by studying the effect of iron overload on BMSCs osteogenic/adipogenic differentiation. OBJECTIVE:To explore the effect of iron overload on the osteogenesis and adipogenesis of human BMSCs (hBMSCs) in vitro and to explicit the role of iron overload in the pathogenesis of senile osteoporosis. METHODS:hBMSCs were isolated by using density gradient centrifugation method. Isolated cel s were treated with normal saline as normal control group, treated with 10, 20, 30μmol/L ferrous citrate to mimic iron overload conditions, or treated with 30μmol/L ferrous citrate fol owed by 0.5 mmol/L N-acetylcysteine as an antioxidant. RESULTS AND CONCLUSION:Iron overload did not remarkably inhibit the proliferation of hBMSCs, but it could promote the generation of reactive oxygen in hBMSCs. After treatment with ferrous citrate, the expression of c-Maf and Runx2 decreased, and the expression of peroxisome proliferator-activated receptorγincreased;moreover, formation of calcium nodules decreased, but lipid droplets were produced. N-acetylcysteine could inhibit the production of reactive oxygen and increase the expression of c-Maf induced by iron overload. These findings indicate that iron overload inhibits osteogenesis and promotes adipogenesis in hBMSCs through the generation of reactive oxygen. Meanwhile, c-Maf plays an essential role in the iron-overload induced differetiation imbalance.

Objective To compare the efficacy of different dose esomeprazole-based triplen therapies for Helicobacter pylori (Hp)eradication. Methods Two hundred and forty Hp-infected patients were randomly assigned to undergo high-dose (40 mg) or low-dose (20 mg) esomeprasole combined with clarithromycin (500 mg) and amoxicillin (1g) twice a day for one week. Hp eradication test was performed at 4 weeks after the end of treatment to evaluate the response to therapy. Results One hundred and fourteen patients were followed up in high-dose patients, and 104 were Hp eradication. One hundred and thirteen patients were followed up in low-dose patients, and 101 were Hp eradication. There was no significant difference in eradication rate of intention-to treat analysis and per protocol analysis between high-dose and low-dose patients [86.7%(104/120) vs 84.2% (101/120) and 91.2% (104/114) vs 89.4% (101/113), P>0.05]. There was no significant difference in the rate of adverse effect between high-dose and low-dose patients (8.3%(10/120)vs 6.7%(8/120), P>0.05). Conclusion It demonstrates that low-dose esomeprazole-based triple therapy has a similar Hp eradication rate compared with high-dose esomeprazole-based therapy in China.

BACKGROUND: Previous studies have shown that the complex of polyethylene glycol diacrylate and chitosan is biodegradable, has the anti-inflammation effect and can promote wound healing, with good biocompatibility.However, the composite material is brittle, and thus, it is necessary to develop a mechanical support material due to the anatomy of the nasal cavity.OBJECTIVE: To study the cytocompatibility of a novel degradable absorbable nasal packing material made of polyethylene glycol diacrylate composite hydrogel.METHODS: In our experiment, the composite hydrogel was formed by the combination of different ratios of polyethyleneglycol diacrylate, chitosan and polyvinyl alcohol using photo-crosslinking method. According to the international standard of medical devices, we used direct and indirect international standard experimental methods to evaluate the cytotoxicity of the materials. (1) Direct contact method: the polyethylene glycol acrylate composite hydrogel and mouse fibroblasts L929 were co-cultured for 24 hours to observe the morphological changes of cells. (2) Indirect extraction: mouse fibroblasts L929 were cultured in polyethylene glycol diacrylate composite hydrogel extracts (100, 50 μL) and RPMI1640 medium (100 μL), respectively, for 3 days to observe the proliferation and cytotoxicity by cell counting kit-8 assay.RESULTS AND CONCLUSION: (1) Direct contact method: the cells around the material formed a flat structure with fusiform or stellated protrudes. The material was confirmed to have good biocompatibility depending upon the presence of adherent cell growth, full and strong refraction, and the overall growth trend. (2) Indirect extraction method: with the increase of time, the number of cells in the hydrogel extract group increased, the relative proliferation rate of cells increased gradually, and the cytotoxicity was 0 to 1. To conclude, these experimental findings indicate that the polyethylene glycol acrylate composite hydrogel material has good cytocompatibility.

Objective To explore the dynamic changes of serum S100B and glial fibrillary acidic protein (GFAP) levels and their clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods By means of enzyme-linked immunno-sorbent assay (ELISA),the serum S100B and GFAP levels from 33 DEACMP patients were assayed,and the condition changes were analyzed with three types of scale:the activity of daily living scale ( ADL),information-memory-concentration test (IMCT) and Hasegawa' s dementia scale(HDS).The comparison with 32 patients of acute carbon monoxide poisoning without DEACMP was also conducted.Results (1) The serum S100B( (0.60 ±0.21)ng/ml) and GFAP( (226.58 ±90.05 )ng/ml) in DEACMP group at acute stage were significantly higher than those in acute-CO-poisoning group ( (0.50 ± 0.20) ng/ml,( 183.04 ± 73.01 ) ng/ml) and those in DEACMP group at convalescent stage ( (0.51 ±0.16) ng/ml,(183.25 ±81.76)ng/ml) (all P values ＜0.05).(2)In DEACMP group,the serum S100B and GFAP at acute and convalescent stages were significantly correlated (at acute stage:r=0.466,P=0.006; at convalescent stage:r=0.365,P=0.037 ).(3)The S100B and GFAP in ineffective DEACMP patients at acute stage were significantly higher than those in the other groups ( all P values ＜ 0.05 ).(4) In DEACMP group,the ADL,HDS and IMCT scores( (45.21 ± 9.69),(8.26 ± 6.31 ),(9.91 ± 7.52) ) at acute stage were significantly different from those at convalescent stages( (33.67 ± 13.62),( 15.91 ± 10.83),( 19.06 ± 10.37 ) ) ( all P values ＜0.01 ).Conclusion There is secondary brain insult (SBI) in DEACMP; glial activation may play an important role.The S100B and GFAP levels may be associated with the prognosis of DEACMP.

Objective To evaluate the intervention effect of atorvastatin on the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease. Methods One hundred and eighteen patients who undertook intracavitary therapy (including Balloon dilation, Stent implantation and endarterectomy, Stent implantation and thrombectomy) in our hospital from January 2008 to January 2010 were divided into two groups randomly,60 cases into the control group,and 58 cases into the atorvastatin group whom were orally medicated with Atorvastatin 20 mg once daily. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower limb artery of two groups were observed and recorded before treatment and at 4 weeks, 12 weeks, 24 weeks after treatment. Results Success rates of intracavitary therapy were 98. 33% (59/60) and 100. 00% (58/58) in the control and atorvastatin group respectively. The patency rate decreased in different degree with time in both groups,which decreased more significantly in the control group but remained relatively stable in the atorvastatin group. By follow up we found that the patency rate in the control group was significantly lower than that of in the Atorvastatin group(77. 96% vs 94. 82% ,P ＜ 0. 01 )at 24 weeks. Blood lipid, C-reactive protein, Intima-media thickness and the patency rate of lower extremity artery of control group increased in different degrees, but with no statistical significance (P＞ 0. 05 ), while these indices began to decrease in atorvastatin group after 4 weeks of medication and were significantly lower than the control group ( P ＜ 0.01 ). Conclusions Atorvastatin has effect on preventing the arterial restenosis after intracavitary therapy of the lower extremity atherosclerotic occlusive disease.

Objective To analyze the related factors of femoral head necrosis after internal fixation operation of femoral neck fracture.Methods Clinical data of 524 patients with femoral neck fracture who underwent internal fixation surgery between January 2012 and January 2015 were retrospectively analyzed.Taking the femoral head necrosis as an observable indicator,the clinical data of postoperative femoral head necrosis and those other patients who were treated at the same period were compared.Whether the clinical factors (gender,age,surgical reduction type,fracture type,quality of reduction,post-injury operation time,loading time after operation,and whether to withdraw internal fixation) were in correlation with postoperative femoral head necrosis was analyzed by univariate analysis.Then the statistically significant indicators were integrated into logistic regression analysis to determine the related factors of femoral head necrosis.Results According to inclusion and exclusion criteria,the study group consisted of 212 cases,including 94 males and 118 females;the follow-up time was 2-5 years,and the average follow-up time was 3.6±1.6 years.There were 46 cases with femoral head necrosis and 166 cases without femoral head necrosis after operation.The rate of femoral head necrosis was 21.7％ (46/212).The femoral head necrosis group included 46 cases with 21 males and 25 females;20 cases below 60 years old and 26 cases above 60 years old;17 cases using open reduction and 29 cases using closed reduction;6 cases belong to type Ⅰ/Ⅱ and 40 cases belong to type Ⅲ/Ⅳ according to Garden classification;16 cases got satisfactory reduction while 30 cases with unsatisfactory reduction;30 cases below 48 h and 16 cases above 48 h on post-injury operation time;17 cases below 3 months and 29 cases above 3 months on post-operation loading time;22 cases with internal fixation removal and 24 cases without internal fixation removal.The femoral head without necrosis group included 166 cases with 73 males and 93 females;84 cases below 60 years old and 82 cases above 60 years old;69 cases using open reduction and 98 cases using closed reduction;120 cases belong to type Ⅰ/Ⅱ and 46 cases belong to type Ⅲ/Ⅳ according to Garden classification;160 cases got satisfactory reduction while 6 cases with unsatisfactory reduction;119 cases below 48 h and 47 cases above 48 h on post-injury operation time;70 cases below 3 months and 96 cases above 3 months on post-operation loading time;74 cases with internal fixation removal and 92 cases without internal fixation removal.Univariate x2 analysis suggested that fracture type and quality of reduction were associated with postoperative femoral head necrosis.Other clinical factors (gender,age,surgical reduction type,post-injury operation time,loading time after operation and whether to remove internal fixation or not) were not associated with postoperative femoral head necrosis.The multivariate Logistic regression analysis showed fracture type and quality of reduction were significantly related to postoperative femoral head necrosis.Conclusion Femoral head necrosis after internal fixation operation of femoral neck fracture is affected by many factors.The fracture type and quality of reduction are important factors affecting femoral head necrosis after internal fixation operation of femoral neck fracture.

ObjectiveTo explore the state of misdiagnosis, missed diagnosis and excesseive diagnosis related to cerebral palsy(CP).Methods389 cases were retrospectively analyzed who were misdiagnosed, missed or escessively diagnosed related to CP as the first diagnosis in the inpatient and outpatient department from July 1999 to March 2010.ResultsAmong 389 cases, 156 cases were missed or misdiagnosed as nutritional disease, and 118 cases of other diseases were misdiagnosed as CP, while 115 cases who were normal children was excessively diagnosed as CP. The false diagnosis had relativity with children's age: doctors are more prone to make misdiagonsis when the children's age are smaller, while 293 cases were misdiagnosed before 12 months old (75.3%); 102 cases (65.4%) were misdiagnosed or missed as other diseases before September, 2004, while 87 cases (75.7%) were excessively diagnosed as CP after September, 2004. Frequency of misdiagnosis as CP reduced from 2004, and the proportion dropped from 55.9% to 44.1%.ConclusionIt is very important to master the diagnostic standard of CP. Both sides of the question are important, one side is to make early diagnosis and early treatment in order to achieve the best effect of rehabilitation, and the other side is to prevent misdiagnosis and excessive diagnosis which woud delay illness, or waste medical resources, increase the financial and psychological burden.

Objective To investigate the effect of the number of sentinel lymph node (SLN) dissection on prediction of non-sentinel lymph node (nSLN) metastasis in SLN biopsy in patients with early-stage breast cancer. Methods A retrospective analysis of clinical and pathological data of 82 patients with early-stage breast cancer who underwent SLN biopsy and axillary lymph node dissection in the Affiliated Cancer Hospital of Shanxi Medical University from January 2015 to December 2016 was conducted, and the univariate analysis and logistic multivariate regression analysis were performed to analyze the influencing factors of nSLN metastasis. Results Univariate analysis showed that nSLN metastasis was associated with histological grade (χ2 = 10.114, P= 0.006), vascular invasion (χ2 = 12.381, P< 0.01), and the number of positive SLN ≥2 (χ2=13.734, P<0.01), however, it was not related to patient's age, tumor size, SLN metastasis rate, molecular subtype and pathological type (all P>0.05). Multivariate analysis showed that the number of positive SLN≥2 was an independent influencing factor of nSLN metastasis (OR= 4.145, P= 0.015). Conclusions Surgeons need to ensure that the number of SLN dissection is > 2 when the SLN biopsy is performed in patients with breast cancer. When the number of positive SLN is≥2, the risk of nSLN metastasis increases.

Objective:To analyze the expression of MXD1 and Ki-67 in breast invasive ductal carcinoma (IDC) and their relationship with clinicopathologic features.Methods:Clinical data of 68 patients with breast invasive ductal carcinoma admitted to Shanxi Maternal and Child Health Hospital and Shanxi Cancer Hospital from Mar. 2022 to Mar. 2023 were retrospectively analyzed,and the expressions of MXD1 and Ki67 in cancer tissues and adjacent normal tissues of patients with breast invasive ductal carcinoma were measured. The expressions of MXD1 and Ki67 in cancer tissues of patients with different clinicopathological characteristics were analyzed. The relationship between the expression of MXD1 and Ki67 and clinicopathological features; Follow-up until March 2024 was conducted to analyze the survival of different expressions of MXD1 and Ki67.Results:The high expression of MXD1 and positive Ki67 in cancer tissues of 68 patients were 63.24% and 69.12%, respectively, which were significantly higher than 8.82% and 11.76% in normal tissues ( χ2=43.67, 46.43, P<0.05). The proportion of high expression of MXD1 and Ki67 positive in histological grade Ⅲ, low differentiation, TNM stage Ⅲ or Ⅳ was significantly higher than that in histological grade Ⅰ or Ⅱ, middle and high differentiation, TNM stage Ⅰ or Ⅱ ( χ2=4.05, 5.87, 6.00, 4.00, 5.78, 5.39, P<0.05). The expressions of MXD1 and Ki67 were positively correlated with histological grade and TNM stage, and inversely correlated with differentiation degree ( r=0.34, 0.39, 0.39, 0.38, -0.39, -0.34, P<0.05). The survival curves of different expressions of MXD1 and Ki67 were statistically significant (Log-Rank χ2=10.13,10.72, P<0.05). At the end of follow-up,the median survival time of low and high expression of MXD1 was 17 months (95% CI: 15.059-18.941) and 14 months (95% CI: 12.452-15.548), respectively, and the median survival time of negative and positive expression of Ki67 was 19 months (95% CI: 13.335-24.665), 14 months (95% CI: 12.432-15.568) . Conclusion:MXD1 is highly expressed and Ki67 positiverate is higher in patients with breast invasive ductal carcinoma, which is related to histological grade, TNM stage, differentiation degree and survival time.