[Objective]To evaluate the effectiveness of recombinant human bone morphogenetic protein-2 in the repair of rabbit rotator cuff injury.[Method]Forty-eight male New Zealand rabbits,aged 8 months,received an rotator cuff acute injury and reconstruction of the insertion of supraspinatus tendon on greater tuberosity of humerus.The rabbits were randomly divided into 3 groups postoperatively:(1) rhBMP-2 group:fibrin sealant(FS) containing rhBMP-2 was applied to the interface between the bone-tendon interface; (2)FS control group:only FS was applied;(3)blank control group:untreated after the surgery.Harvested 36 specimens underwent biomechanical analysis at the 2nd,4th,8th postoperative weeks respectively.Harvested 12 specimens underwent histological analysis at the 8th postoperative week.[Result]Histological examination showed that Sharpey's fibers were found in the interface with the formation of four-layer indirect insertion in the rhBMP-2 group at the 8th postoperative week.In the FS control group and blank group,the tendon-bone interface was filled with granulation tissue and part of Sharpey's fibers and the newly generated bone tissue.Biomechanical analysis displayed that the tensile strength and stiffness of bone-tendon interface increased time-dependently in all groups,and it in the rhBMP-2 group was significantly higher than those in the other two groups at any time-points (both P

BACKGROUND: Supraspinatus tendon injury is common in rotator cuff injury, the repair difficulty of which is reconstructing the bone-tendon interface. Currently, there are no effective therapeutics and suitable experimental animal models.OBJECTIVE: To establish rabbit rotator cuff injury prosthetic experimental animal model and to observe the effect of continuous passive motion (CPM) on early healing of rabbit rotator cuff bone-tendon interface by MRI, which can provide guidance for preparing an optimal rehabilitation strategy after rotator cuff injury.METHODS: Sixteen male New Zealand rabbits, aged 8 months, were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus. The rabbits were randomly divided into cage activity group (n=4) and CPM group (n=12). At 2 days after operation, rabbits were treated by rabbit shoulder joint continuous passive motion apparatus of 75°～75° flexion-extension with various CPM speeds[2 (°)/s, 4 (°)/s, and 10 (°)/s)]. General state and MRI changes of rabbit rotator cuff bone-tendon interface was observed prior to and at weeks 1,2, and 4 after operation.RESULTS AND CONCLUSION: Gross observation showed that the incisions healed very well at 2 weeks after operation. There was no infection, haematoma or disruption after removing the suture. Compared to the cage activity group, the tendon-bone interface of CPM group heeled better at weeks 1, 2 and 4, especially at the speed of 4°/s with 75°-75° flexion-extension. Results demonstrated that this animal model can be satisfied to experimental study. From the following day after operation, various CPM speeds can accelerate the healing of tendon-bone interface, and the optimal speed of CPM was 4 (°)/s.

Objective To compare the sedative efficacy with oral or rectal chloral hydrate in pediatric patients by using Meta-analysis method.Methods Ten randomized controlled trials about the sedative efficacy with oral or rectal chloral hydrate in pediatric patients were retrieved.Meta-analysis was carried out using the RevMan 5.0 software.Results The results showed that the sedative efficacy with rectal medication was better than that with oral way.Nausea and vomiting occurred in 95 children with oral chloral hydrate,bowel movement occurred in 57 children with rectal chloral hydrate.Conclusions The sedative efficacy with rectal chloral hydrate was better than that with oral way.The safety in pediatric sedation with chloral hydrate should be emphasized in order to avoid adverse reaction.

BACKGROUND:Continuing stress stimulation has been confirmed to promote repair of rotator cuff injury.This experiment attempts to fu rther quantify the intensity of stress stimulation in order to reach a better therapeutic effect in the entire process of rotator cuff injury repair.OBJECTIVE:To explore the biomechanical performance of stress stimulation with different intensities on repair of acute rotator cuffinjuryMETHODS:Sixteen male New Zealand rabbits were randomly divided into high intensity,low intensity and control groups,with 12 animals in each group.Rabbits were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus.At 1 week after operation,rabbits were treated by continuous passive motion(CPM)apparatus,which was-60°to 60° flexion-extension for the high intensity group,and-15° to 15° for the low intensity group.At 2 weeks after operation,the CPM was performed every other day,with 10 minutes per time;which was changed to daily training from week 3 with the same frequently,and 15 minutes per time at week 4.Rabbits in the control group were housed freely.Each 4 animals were sacrificed at weeks 2,3 and 4 after operation,and the largest tensile strength and severity at osteotendinous junction were compared.RESULTS AND CONCLUSION:The maximum tensile intensity and stiffness of the supraspinatus tendon in the low intensity group were greater than that of the control and high intensity group(P＜0.05),which was smallest in the high intensity group.All the breakage point existed at the intra-articular portion.The result demonstrated that low intensity stimulation exhibits superior repair effect in acute rotator cuff injury,while high intensity stimulation is harmful to the early repair of acute rotator cuff injury.

Objective To investigate the expression of inositol requiting enzyme1 α (IRE1 α) and tumor necrosis factor receptor-associated factor 2 (TRAF2) and its significance through establishing models of intestinal ischemia reperfusion injury (IIRI) in rats.Methods According to the random number table,50 male SD rats were randomly divided into 2 groups:sham operation group (n =10) and ischemia reperfusion (I/R) group (n =40).Sham group animals underwent laparotomy.I/R group rats were subjected to occlusion of the superior mesenteric artery for 30 min;then the blood flow was restored.I/R group animals were divided into 4 subgroups:2 h,6 h,12 h,24 h according to the time of reperfusion.Eight rats were examined based on the number of live rats in each subgroup.The HE staining pathological changes in intestinal samples were observed by the light microscope.The small intestinal epithelial cell apoptosis index (AI) was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL).The expression levels of intestinal tissues tumor necrosis factor α (TNF-α) and plasma intestinal fatty acid-binding protein (Ⅰ-FABP) were detected by ELISA tests.Situ end labeling method was used to detect intestinal cell AI.Western blot was applied to investigate the expression of endoplasmic reticulum stress(ERS) proteins IRE1α,phosphorylation IREIα (p-IRE1 α) and TRAF2 in all group rats intestinal tissues.Results (1)The pathological changes showed that the intestinal injury of I/R groups was more severe than that of sham group,especially at 6 h.(2) Compared with sham group,the expression levels of TNF-α [sham group (16.41 ± 4.44)ng/ L,2 h group:(79.71 ± 8.20) ng/L,6 h group:(131.70 ± 11.59) ng/L,12 h group:(94.23 ±7.66) ng/L,24 h group:(69.78 ± 9.58) ng/L],AI[sham group:(3.93 ±0.77)％,2 h group:(16.24 ± 1.97)％,6 h group:(42.19 ±2.40)％,12 h group:(37.79 ± 2.34)％,24 h goup:(10.38 ±1.46)％] and plasma Ⅰ-FABP [sham group:(0.65 ±0.10) × 103 ng/L,2 h group:(1.47 ±0.10) ×103 ng/L,6 h group:(2.36 ±0.17) ×103 ng/L,12 h group:(37.79 ±2.34) ×103 ng/L,24 group:(l.41 ±0.09) × 103 ng/L] were higher (F =231.462,149.032,162.491,all P ＜ 0.01).(3) The expression of TRAF-2 protein and p-IRE1 α/IRE1 α could be up-regulated after IIRI (F =40.473,59.59,P ＜ 0.01).The expression of these proteins was up-regulated 2 h after reperfusion,peaking at 6-12 h reperfusion,and then decreased at 24 h,and the variation tendencies of all groups were the same.Conclusions IIRI could induce ERS,activate IRE1 α and up-regulate TRAF2.IRE1α/TRAF2 mediating ERS might be involved in regulating the cell inflammation,apoptosis and increasing intestinal permeability after IIRI.

Objective: To establish a method for simultaneous determination of calceolarioside B and chlorogenic acid in Caulis Stauntoniae Chinensis tablets by HPLC.
Methods: The analysis was performed on a Thermo BDS HYPERSIL C₁₈ column (4.6 mm×250 mm,5 μm) maintained at 35 ℃. The mobile phase was consisted of methanol and 0.1% phosphoric acid solution, and gradient eluted with a flow rate of 1.0 mL·min^-1. The detection wavelength was 327 nm, and the injection volume was 10 μL.
Results: The linear ranges of calceolarioside B and chlorogenic acid were 0.51-20.60 μg·mL^-1 (r=1.000) and 0.52-20.63 μg·mL^-1 (r=1.000), respectively. The average recoveries were 100.3% with RSD as 1.1% and 105.9% with RSD as 1.4%, respectively. The content results of 5 batches of Caulis Stauntoniae Chinensis tablets were 0.083-1.115 mg·g^-1 for calceolarioside B and 0.161-1.204 mg·g^-1 for chlorogenic acid.
Conclusion: The method can be used for improving the quality evaluation standard of Caulis Stauntoniae Chinensis tablets.

Objective:To investigate the clinicopathological features, treatment and prognosis of neuroendocrine carcinoma of the breast.Methods:Clinical data of 26 patients with neuroendocrine carcinoma of the breast admitted to the Northern Jiangsu People's Hospital from July 2013 to Mar 2021 were analyzed.Results:All 26 cases were female, the average aged of (62.81±11.95) years, the first clinical manifestations were painless breast masses, the average size being of (23.34±9.47) mm. At the time of diagnosis, regional lymph node metastasis was found in 4 cases, 1 case developed distant metastasis. Most patients' were on stage Ⅱ by TNM staging, molecular typing was Luminal A, and invasive mammary carcinoma with neuroendocrine differentiation was most common, with positive rates of ER and PR of 96%, the positive rate of CgA and Syn were 69% and 100%, and there was not positive expression of HER2. All patients received surgical treatment, 25 patients underwent postoperative adjuvant therapy. Twenty-five patients were followed up for a median follow-up time of 39.50 months. During the follow-up, 3 cases developed distant metastasis, 1 case died, the mean survival time was (40.81±26.90) months, there was ao satistically significant difference compared with invasive mammary carcinoma ( t=1.291, P=0.209). The mean disease free interval is (39.96±27.58) months. The overall survival and disease free survival at 1, 2 and 5 years are 100%, 100% and 87%, respectively. Conclusions:Neuroendocrine carcinoma of the breast occurs more frequently in elderly women, often with large tumor size, low rate of regional lymph node and distant metastasis, moderate histological grade, early clinical stage, and the molecular typing is mostly Luminal A.The overall prognosis is fair.

Objective:To investigate the effects of hydrogen rich-saline (HRS) on intestinal mucosal barrier in rat with intestinal ischemia/reperfusion injury (IIRI).Methods:Twenty-four healthy male Sprague-Dawley rats, aged 8 weeks, were randomly divided into 3 groups (8 in each group) by random number table method: sham group, model group and HRS group.Rats in HRS group were intraperitoneally injected with HRS (10 mL/kg) at 30 min of ischemia, and the same amount of normal saline was intraperitoneally injected in model group.After 45 min of ischemia and 6 h of reperfusion, rats were sacrificed.Serum and ileum were collected for further detection.Tumor necrosis factor alpha (TNF-α), interleukin (IL)- 1β and IL-17A expression levels in serum were detected by conducting enzyme-linked immunosorbent assay (ELISA). The localization expressions of tight junction protein Occludin was detected by immunohistochemical staining (IHC), while the localization expression of tight junction protein zonula occluden-1 (ZO-1) were detected by immunofluorescence staining (IF). The protein expression of Occludin, ZO-1, and Lysozyme were detected by performing Western blot.The mRNA expression of Lysozyme and α-defensin were detected by real-time PCR (qPCR).Results:ELISA results proved that the levels of serum TNF-α and IL-1β in HRS group rats were significantly lower than those in model group [(62.02±29.97) ng/L vs.(113.40±44.58) ng/L, (21.68±0.35) ng/L vs.(28.29±3.49) ng/L], while the level of IL-17A increased [(28.18±5.28) ng/L vs. (15.10±3.60) ng/L] (all P<0.05). IHC staining: compared with model group, the expression of Occludin in HRS group was uniform and continuous, and the staining was darker.IF results: compared with model group, the fluorescence signal intensity of ZO-1 in HRS group rats significantly increased, and the distribution was clear and continuous.Wes-tern blot results: compared with model group, the expression levels of Occludin and ZO-1 proteins in HRS group rats remarkably increased (0.79±0.06 vs. 0.54±0.04, 0.91±0.11 vs. 0.51±0.13), while Lysozyme protein decreased (1.50±0.40 vs. 2.99±0.80) (all P<0.05). qPCR results revealed that the expression level of Lysozyme mRNA in HRS group rats was lower than that in model group (1.64±0.33 vs. 2.20±0.40), while α-defensin mRNA obviously increased (0.82±0.19 vs. 0.47±0.13) (all P<0.01). Conclusions:HRS protects intestinal mucosal barrier by inhibiting the expression of tight junctions and the secretion of antimicrobial peptides in rat suffering from IIRI.

Objective To study the clinical events and risk factors of in stent restenosis (ISR) during the ＞1 year follow-up period after vertebral artery stenting.Methods Forty-six patients with 48 stents implanted from the Shaoxing No.2 Hospital between January 2010 and October 2016were divided into ISR group (n=8) and ISR-free group (n=38) or clinical events group (n=8)and clinical events-free group (n=38).The influencing factors for their long-term clinical outcome were analyzed after vertebral artery stenting.Results The mean stenosis length was (7.7 ± 4.6mm,the stenosis severity was 80.7％±14.2％,and the residual stenosis was 3.0％±8.4％ before stenting.The mean angiographic follow-up time was 31.6±20.8 months,during which ISR occurred in 8 patients (17.4％).The mean clinical follow-up time was 53.8±27.0 months,during which clinical events occurred in 8 patients (17.4％).Survival analysis showed that ISR usually occurred in the first 20 months and no clinical events occurred in 23 patiemts (50.0％) after vertebral artery stenting.The stenosis was significantly longer in ISR group than in ISR-free group (6.00±2.00 mm vs 2.76±4.14 mm,P=0.003).The diameter of stents was significantly shorter in clinical events group than in clinical events-free group (3.53±0.93 mm vs 4.18±0.67 mm,P=0.024).Conclusion The long-term clinical follow-up outcome is associated with the length and diameter of stents in patients after vertebral artery stenting.

Objective To evaluate the clinical characteristics and the clinical outcomes of perianal abscess (PA) in neonates.Methods A retrospective review was performed on the collected data of 185 patients of PA in neonates prospectively admitted to Binzhou Medical University Hospital from January 2008 to December 2015.Patients were divided into 2 groups on the parents' intention:nonsurgical treatment and surgical treatment,the standard surgical treatment for PA was incision and drainage with the use of packing.The standard surgical treatment for PA was surgical incision drainage of lower abscess under local anesthesia by the use of filling tamponade iodoform gauze,while the patients receiving conservative treatment took hip bath perianally with topical 1 ∶ 5 000 potassium permanganate,besmearing erythromycin eye ointment outside locally.Incision-thread-drawing procedure was recommended in fistula-in-ano (FIA) after 6 months.Antibiotics were administered in all patients in the early days.The clinical data of age,gender,accompanying diseases,abscess amount and location,treatment approach,healing time and recurrence rates were analyzed with statistical method.Results All patients were boys,time of visiting hospital was 1-25 day,the average time 7.5 days;60 cases (32.4％)had neonatal diarrhea,45 cases (24.3％)had neonatal jaundice,but no patients had severe fever.A single skin lesion was present in 145 patients (78.4％),2 lesions in 30 patients (16.2％),and 10 patients had 3 lesions (5.4％).The most commonly affected sites were at 9 o'clock clockwise direction with 115 (62.2％)lesions on lithotomy position,followed by 3 o'clock clockwise direction with 65(35.1％) lesions by 1 o'clock clockwise direction with 3 (1.6％) lesions and 6 o'clock clockwise direction with 2 (1.1％) lesions.Bacteria cultures were obtained from 123 patients (90.4％,123/136 cases) of surgical treatment and 35 patients (71.4％,35/49 cases) of nonsurgical treatment obtained the results of bacteria culture.The average healing time was (21 ±2) days (10-60 days) in the surgical treatment group,and (36 ± 3) days (9-90 days) in the nonsurgical treatment group,7 out of 136(5.1％) patients had a recurrence with surgical treatment,incision drainage was performed again with the use of packing,and FIA was not found,10 out of 49 (20.4％) patients had a recurrence with nonsurgical treatment group,and 6 out of 49 (12.2％) were spontaneously resolves within the first year of life,4 out of 49 (8.1％) developed into FIA,incision-thread-drawing procedure was performed after 6 months.The significant difference was observed between and nonsurgical treatment and surgical treatment in healing time (t =-6.707,P =0.000),recurrence (x2 =11.347,P =0.001) and FIA formation rate (x2 =10.054,P=0.002).Conclusions PA is an entity in neonates.Incision and drainage of PA is an effective and safe therapy in the early days.Surgery for PA may result in low recurrence rates,a low rate of evolution toward FIA,and a short healing time,which should be considered as the primary treatment.The key procedure is to keep the drainage unobstructed by the use of filling gauze drainage to prevent crissum abscess recurrence.Postoperative care with antibiotics is effective to shorten hospital stays.