Objective To introduce a method using hydroxyapatite methylmethacylate cement implanted in the femoral head for the treatment of patients suffering from avascular necrosis of the femoral head due to different causes and to review the medium term follow up results. Methods From January 1990 to December 1995, eight hips in seven patients(male 4, female 3) with femoral head necrosis at Ficat stage Ⅲ were treated with the hydroxyapatite methylmethacylate cement implantation in the involved femoral head. Four osteonecrosis were secondary to femoral neck fracture, two were due to corticosteroid intake and one had alcohol abuse history. All patients complained pain and limited joint activity. The operation consisted of the removal of necrotic bone under weight loading cartilage with curet and the implantation of the hydroxyapatite methylmethacylate cement. The function of hip joint were well evaluated and X ray films were taken pre and postoperatively. The average postoperative follow up was 7.9 years, ranging from 5.1 to 11 years. Results Merle d Aubign? method was used to assess and compare the pre and post operative function of hip joint. The average score for unilateral cases increased from 8.66 to 15.5 at final examination. On radiography, the improvement of the contours of the femoral head was seen in all patients and most of them could preserve their initial postoperative contours during the follow up. No sign of expansion of the bone necrosis appeared in most of the patients, although certain patients presented various joint degeneration such as narrowing of joint space,sclerosis and osteophyte. Subjective evaluation was satisfactory except two suffering from painless limited activity of hip joint. Conclusion This method is relatively simple with less invasion and rapid postoperative recovery. It may be a choice of surgery for the treatment of certain femoral head necrosis at Ficat stage Ⅲ, especially for young patients.

Objective To investigate hemostatic effect of uterine tamponade in dealing with postpartum hem -orrhage due to uterine inertia during caesarean section .Methods 72 patients treated with conservative treatment due to bleeding uterine contraction weakness during cesarean section were chosen ,who were dealed with sterile gauze close packing of uterine bleeding ( uterine packing group ) .43 patients underwent conservative therapy of uterine contraction weakness resulted in postpartum hemorrhage were selected to carry out B -Lynch suture hemostasis ( B-Lynch suture group).Bleeding volume,operation time,bleeding efficiency of two groups were calculated .Results The uterine packing group had shorter operation time ,less bleeding,immediate hemostasis rate.The B-Lynch suture group had a tad longer operation time , bleeding more , immediate hemostasis rate low , low efficiency .Immediate hemostasis rate (95%VS 82%)between two groups had statistically significant (χ2 =4.02,P<0.05),and no significant difference in the operation time(t=0.73,P>0.05).Conclusion Uterine packing for postpartum hemorrhage due to uterine inertia during caesarean section has simple operation ,rapid,hemostatic effect,postoperative body without foreign body removal.

BACKGROUND: Minimally invasive percutaneous pedicle screw fixation possesses the advantages of less blood loss, less muscle and soft tissue dissection, and rapid recovery; however, accuracy of the screw positioning is the key to be successful.OBJECTIVE: To explore the application value of self-designed spinal localizer in the screw positioning for minimally invasive percutaneous pedicle screw fixation.METHODS: 428 patients with thoracolumber disorders were subjected to minimally invasive percutaneous pedicle screw fixation at the First Affiliated Hospital of University of South China, from March 2009 to March 2015, and randomly underwent the preoperative screw positioning by self-designed spinal localizer or one of traditional localizing methods (iliac crest, ribs, symptomatic vertebral appearance, skin marker, Kirscher wire, puncture needle localizations). The location accuracy, positioning time and radiographic times were compared among methods.RESULTS AND CONCLUSION: (1) Compared with the traditional localization methods, the self-designed spinal localizer was superior in accurate rate (P < 0.05), cost less positioning time (P < 0.05) and received less radiation (P < 0.05). (2) To conclude, the self-designed localizer exhibits a certain application value, which is an ideal method in preoperative localization for minimally invasive percutaneous pedicle screw fixation.

Objective:To investigate the distribution of precancerous conditions and lesions of high-risk population in the high-in-cidence area of esophageal cancer in Ci County, Hebei Province. Methods:Esophageal cancer was detected early in 40 to 69 year old patients in Ci Xian through endoscopic screening data and endoscopic screening using iodine staining and indicative biopsy. The pa-tients were classified according to gender, age group, statistical esophageal precancerous condition, and lesion detection rate. Results:The analysis included 11 423 cases by screening queue, and the esophageal biopsy rate was 66.90%. The detection rates of squamous epithelium with mild, moderate, and severe dysplasia were 11.84%, 2.66%, and 1.04%, respectively. DCIS detection rate was 0.40%in patients with squamous cell carcinoma. The detection rate of the patients had been infiltrated by the squamous cell carcinoma was 0.04%.The rate of the squamous cell carcinoma within the mucosa was 0.37%.The rate of the infiltration squamous cell carcinoma was 0.17%. The detection rate of the hyperplasia above average severe dysplasia and cancer was 2.01%. Conclusion: High incidence of esophageal precancerous lesions was found in the Ci County aged 40 to 69. A large number of asymptomatic patients with cancer were detected. Age and sex are closely related to detection rate.

: ObjectiveTo compare the clinical significance of motor unit number estimates (MUNE) and conventional electromyogram (EMG) in the evaluation of neuromuscular disorders. MethodsUnder the model of MUNE or quantity of motor unit potential (QMUP), 53 patients with various neurogenic disorders were tested with EMG at extensor digitorum brevis, thenar, or hypothenar eminence. ResultsFor 8 patients with amyotrophic lateralizing sclerosis, large and long-duration polyphasic potentials were detected in needle electrode EMG tests, and the motor unit numbers reduced. For 45 patients with peripheral neuropathies, few distinctive features could not be detected by needle electrode EMG, but motor unit numbers reduced in 2 patients; spontaneous activities were the only abnormality in the other 2 patients, and there were no obviously abnormal changes in the configuration and size of motor unit potentials and in motor unit numbers; EMG tests revealed neurogenic features and motor unit numbers significantly reduced in the remaining 41 patients. ConclusionConventional EMG and MUNE can work for the diagnosis of neuromuscular disorders, and do better in combination.

Objective To study the relationship between graft-versus-host disease (GVHD) and endothelium injury following hematopoietic stem cells transplantation in mice. Methods C57BL/6 mice as donors and Balb/c mice as recipients were randomly divided into 4 groups: control group, bone marrow transplantation group, GVHD group, GVHD mitigation group. The clinical manifestations,circulating endothelial cells and tissue pathological changes were observed at different time points after transplantation. Results No manifestations of GVHD were found in each group at the day 5, while those were found in GVHD group at the day 9 and all died within 15 days. The counts of endothelial cells in peripheral blood showed no significant difference at the day 5 between GVHD group (7. 34 ±1.26 cells/μl) and bone marrow transplantation group (11.51 ± 7. 40 cells/μl) or GVHD mitigation group (7. 36 ± 0. 16 cells/μl), while among three groups there was statistically significant difference at the day 9 (GVHD group: 153. 64 ± 35. 35 cells/μl vs bone marrow transplantation group: 10. 49 ±5. 61 cells/μl and GVHD mitigation group: 47. 82 ± 4. 69 cells/μl). The scores of pathological aGVHD had no significant difference at the day 5 between GVHD group (4. 33± 1. 53) and bone marrow transplantation group (3. 33 ± 0. 58) or GVHD mitigation group (4. 00 ± 1.73), while among three groups there was statistically significant difference at the day 9 (GVHD group: 10. 0 vs bone marrow transplantation group: 3. 33 ± 1.15 or GVHD mitigation group: 4. 33 ± 0. 58) and at the day 14 (GVHD group: 10. 33 ± 2. 58 vs bone marrow transplantation group: 2. 33 ± 1.25 or GVHD mitigation group 3. 33 ± 1.15). Conclusion Occurrence of GVHD causes endothelial damage again and injured endothelium worsens the GVHD.

Objective To (e)xplore inhibition of endothelial progenitor cells (EPCs) against hepatic vein thrombosis after allogeneic bone marrow transplantation (BMT).Methods Balb/c mice were randomly divided into three groups: (1) BMT group [Balb/c mice were injected intravenously with 5 × 106 bone marrow cells after total body irradiation (TBI)]; (2) EPCs co-transfusion with bone marrow cells group: 5 × 105 EPCs were infused into recipient mice simultaneously; (3) Normal control group.Liver index was detected on the day 0,5,10,15 and 20 after transplantation.Hepatic vein thrombosis,hepatic cells and vascular endothelial damage were observed under the light microscopy after H&E staining.The injury of liver cells,liver veins,hepatic sinusoidal endothelial cells (SECs)and platelet adhesion conditions were observed under a transmission electron microscope (TEM).The proportion of activated platelets and TNF-α concentration in peripheral blood were detected by using flow cytometry.Results On the day 0,5,10,15 and 20 after transplantation,the proportion of activated platelets,liver index and TNF-α concentrations in BMT group and EPCs co-transfusion group showed an upward trend,peaked on the 15th day,and then decreased.However,they were still significantly higher than those in normal control group (P＜0.05).The above parameters in EPCs co-transfusion group at each time point were significantly lower than those in BMT group (P＜0.05).As compared with BMT group,platelet adhesion decreased,hepatic vein thromboses were reduced,hepatocyte swelling and necrosis were alleviated,and liver damage repaired rapidly in EPCs co-transfusion group.Conclusion EPCs co-transfusion with bone marrow cells could inhibit the hepatic veins thrombosis and ameliorate liver damage significantly.

Objective To study the repair function of united endothelial progenitor cells (EPC)transplantation on injured liver endothelium by bone marrow transplantation (BMT) conditioning.Methods C57BL/6 mice were divided into four groups randomly: normal control group, without any treatment; irradiation alone group, administered a total body irradiation(TBI) pretreatment, without BMT; (3) BMT alone group: C57BL/6 mice were infused with bone marrow mononuclearcells (MNC) 5 × 106/only through caudal vein not more than 4 h after the same TBI pretreatment as the irradiation alone group; united transplantation group: receiving the same way as the BMT alone group, but C57BL/6 mice were infused with EPC 5 × 105/only at the same time. Two, 4, 7, 14, and 21 days after the TBI, the changes of the liver weight were observed regularly. The histopathological examination of liver was done at the 4th, 7th, 14th, and 21st day after the TBI. Results In irradiation alone group, BMT alone group and united transplantation group the liver weight began to increase significantly on the day 2 and peaked at 14th day after the TBI, and the peaks were respectively (1.65±0. 15) times (P＜0. 05), (1.61 ±0.06) times (P＜0.05), and (1.11 ±0.40)times (P＜0. 05) of those in normal control group. At the day 14, the liver weight in irradiation alone group, BMT alone group and united transplantation group began to decrease, and on the day 21 the liver weight in united transplantation group had been completely restored to normal level, however the liver weight in irradiation alone group and BMT alone group were still significantly heavier than that in normal control group (P＜0. 05). Liver histopathological examination revealed that there were obvious sinusoidal endothelial cells (SEC) injury, hepatocyte edema and severe inflammatory cell infiltration in irradiation alone group, and on the day 7 the hepatocyte edema and necrosis were significantly worse than before, and almost no alive SEC were found. On the day 14 the injury of SEC in BMT alone group was lighter than before, but on the day 21 the injury had not returned to normal. On the day 7 the injury of SEC, hepatocyte edema and necrosis were alleviated in united transplantation group as compared with irradiation alone group and BMT alone group, and on the day 14 the injury had returned to normal basically. Conclusion The transplantation conditioning could damage recipient liver endothelium and the injury would persist, and united EPC infusion could repair the injured SEC following BMT.

BACKGROUND: Our former studies have shown that bone marrow mesenchymal stem cells (BMMSCs) can be induced differentiation to vascular smooth muscle-like cells (VSMLCs) and vascular endothelium-like cells (VELCs), which are compatible with collagen-embedded polyglycolic acid scaffolds. OBJECTIVE: To investigate the possibility of constructing small diameter tissue-engineered blood vessels via subcutaneous implantation. METHODS: The cells-scaffold complex was produced by separately seeding VSMLCs and VELCs derived from BMMSCs on polyglycolic acid collagen scaffolds. The two layers were separated by ECMgel. The cells-scaffold complex was subcutaneous implanted into small diameter tissue-engineered blood vessels.RESULTS AND CONCLUSION: Histological analysis of the small diameter tissue-engineered blood vessel walls revealed a typical artery structure, which was similar to natural vessels. The tissue-engineered blood vessels were not broken down under a force of 26.6 kPa. Eight weeks after implantation, the Brdu-labeled seed cells were found in the three layers of the vessel walls. The results revealed that the subcutaneous tissue was a good bioreactor to construct small diameter tissue-engineered blood vessels.

Objective To determine the conditioning regimen suitable for mice allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Twelve BALB/c mice were randomly divided into 2 equal groups to undergo X-ray irradiation by linear accelerator at the dose of 7.0 Gy (pure X-ray group) or 60Co source irradiation at the dose of 7.0 Gy (pure γ-ray group).Thirty mice were randomly divided into 2 equal groups to undergo X-ray irradiation and then infusion of bone marrow from donor mice via caudal vein (X-ray + transplantation group) or γ-ray and then infusion of bone marrow via caudal vein (γ-ray + transplahtation group).3,5,7,10,15,20,and 30 d later peripheral blood samples were collected to calculate the number of white blood cells (WBCs) and detect the chimeric rates of lymphocytes by flow cytometry.5,10,and 20 d after irradiation 15 mice were killed with their lung,liver,small intestine,spleen,and femurs taken out to undergo pathological examination.Results The survival rates during the period 5-15 days of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group.The pathological changes of organs of the X-ray +transplantation group were all more severe than those of the γ-ray + transplantation group.Since the fifth day after transplantation cells originating from the donor began to appear in the peripheral blood.The chimeric rate of the γ-ray + transplantation group 10 days after transplantation was (95.53± 2.57) %.The chimeric rates 5,10,and 20 days after transplantation of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group (t = 15.263,3.256,P < 0.05).The WBC count of both irradiation groups decreased to the lowest level 5 d later and began to increase 10 days after transplantation and the WBC counts of the γ-ray + transplantation group 10 and 20 days aftertransplantation were both significantly higher than those of the X-ray + transplantation group (t = 3.624,6.695 ,P < 0.05).The chimeric rats of the peripheral lymphocytes 10 and 20 days after transplantation of the γ-ray + transplantation group were both significantly higher than those of the X-ray + transplantation group (t = 12.317,8.295,P < 0.05).The homogeneity rate of transplantation of the γ-ray +transplantation group was better than that of the X-ray + transplantation group.Conclusions As a conditioning regimen in allogeneic hematopoietic stem cell transplantation γ-ray irradiation causes milder injury and accelerated reconstitution of hematopoiesis and immunity,in comparison with X-ray irradiation.