BACKGROUND:Transforming growth factor beta-1(TGF-β1)is a cytokine having variously biological effects in repair and renew of tissue injuries; meanwhile, tendon sheath fibroblasts and collagen Ⅰ play important roles in healing and desmoplasia of tendon.OBJECIVE:To study the effects of TGF-β1 on the proliferation and collagen production of tendon sheath fibroblasts.epitenon tenocytes and endotenon tenocytes in the three cell types of rabbit fexor tendon.DESIGN:Contrast observation study.SETTING:Department of Trauma Surgery,Affiliated Hospital of Medical College,Qingdao University.MATERIALS:The experiment was carried out in the Animal Laboratory,Affiliated Hospital of Medical College,Qingdao University from July 2004 to September 2005.A total of 6 adult New Zealand rabbits,of either gender,weighing 3.5-4.5 kg,were selected from Qingdao Experimental Animal Center.Collagenase was provided by Sigma Company;collagen Ⅰ,Ⅱand Ⅲ antibody by Sigma Company;TGF-β1 by Wuhan Boster Biology Company.METHODS: Three cell lines of tendon sheath,epitenon and endotenon were isolated from rabbit flexor tendon and cultured in serum culture media and then in serum-free culture media.In addition,the cells in the experimental group were added with 5 μg/L TGF-β1 in each well,but they were not added with any additive in the control group.MAIN OUTCOME MEASURES:①Proliferation in the two groups was measured with cytometry at 1,2,3 and 4 days after culture.②Preduction of collagens Ⅰ,Ⅱ and Ⅲ was measured with immunohistochemical staining at 4 days after culture.③Collagen contents of the three types were measured with enzyme linked immunosorbent assay(ELISA)in the two groups;expressJon of collagen Ⅰ gene was detected with reverse transcription polymerase chain reaction(RT-PCR).④Contents of collagen Ⅰ induced by TGF-β1 in various dosages of 0,5.10,15 and 20 μg/L were detected with ELISA technique.RESULTS:①Proliferated rates were similar in the two groups at 1 day after culture;however,proliferated rate of tendon sheath fibroblasts was rapidly increased, and there was significant difference as compared with that of epitenontenocytes and endotenon tenocytes(P＜0.05).②Expressions of collagens Ⅰ, Ⅱ and Ⅲ:Immunocytochemical stain demonstrated that three kinds of cells could produce collagens Ⅰ, Ⅱ and Ⅲ;while ELISA indicated that the contents of collagens in three types produced by tendon sheath fibroblasts were the most;in addition,content of collage Ⅰ was higher in the experimental group than that in the control group(P＜0.05-0.01).③Expression of collage Ⅰ gene of tendon sheath fibroblasts was increased as 1.3 times in the experimental group as that in the control group and there was signiflcant difierence(P＜0.01);meanwhile,expressions in epitenon tenocytes and endotenon tenocytes were also higher in the experimental group than those in the control group(P＜0.05).④TGF-β1 in the dosage of 5-10 μg/L had obvious effects on increasing production of collagen;however,production of collagen was not obviously changed when it was affeCted by TGF-β1 in the dosage of 10-20 μg/L.CONCLUSION: TGF-β1 can increase the production of collagen in tendon sheath fibroblasts,epitenon tenocytes and endotenon tenocytes and the expression of collagen Ⅰ gene. In addition, it is important for regulating level of TGF-β1 after tendon injury to prevent adhesion of tendon.

Objective To observe the alteration of scavenger receptor class A types Ⅰand Ⅱ (SR-AⅠ/Ⅱ) gene knock-out on lipid metabolism in mice fed with high-fat diet, and explore the underlying mechanism. Method The SR-AⅠ/Ⅱgene knock-out and wild-type male mice were fed with normal and high-fat diet for 12 w. Thereafter, the level of lipid metabolism (such as the levels of lipids in blood and liver) was detected with enzyme method or oil red O staining, and the expression of scavenger receptor class B typeⅠ(SR-BⅠ) and CD36 in liver was analyzed by RT-PCR. Results Under high-fat diet condition, as compared with wild-type mice, the levels of TG, TC, LDL and HDL in SR-AⅠ/Ⅱgene knock-out mice were decreased at 3, 6, 12 w (P0.05). Conclusion The alteration of lipid metabolism induced by high-fat diet in SR-AⅠ/Ⅱgene knock-out mice might be relative with the up-regulated SR-BⅠmRNA expression and the counter transport of peripheral lipids to liver.

Disruption of blood supply to the femoral head and subsequent hypoxia are implicated in the pathogenesis of osteonecrosis of the femoral head(ONFH),which frequently leads to the progressive collapse of the femoral head,thus causing degenerative arthritis of the hip joint.But the pathophysiology of osteonecrosis of the femoral head has not been completely elucidated.It is accepted that steroids and alcohol intake are two most common causes of ONFH.Now many theories have been proposed to decipher the etiology and pathogenesis of ONFH,including abnormal lipid metabolism,elevated intraosseous pressure,intravascular coagulation,second collision theory,etc.The purpose of this review is to summarize the etiology and pathogenesis of osteonecrosis of the femoral head.

[Objective]To investgate the expression of vascular endothelial growth factor in osteonecrosis of the femoral head during the repairing with biodegradable strontium-doped calcium polyphosphate in glucocorticoid-induced rabbits.[Method]Twenty mg/kg methylprednisolone was injected into right gluteus medius muscle at intervals of 24 hours for three times in 21 adult male Japanese white rabbits.Three rabbits were killed randomly at 2 weeks after methylpednisolone injection,both the femora and humeri were histologically examined for the presence of osteonecrosis. The remaining 18 animals with a total of 36 cylindrical 2.5?5 mm femoral head defects were created following the trapdoor procedure. Eighteen animals with femoral head bone defects were randomly divided into three groups. Group A:the defects filled with strontium-doped calcium polyphosphat,Group B:the defects filled with calcium polyphosphate and Group C:the defects filled with autologous cancellous bone alone. Roentgenographic and histological examinations were performed postoperatively. Finally,immunohistochemical analysis using monoclonal antibodies anti-VEGF was performed.[Result]No hip joint dislocation occurred. In Group A,the results of VEGF expression had a significantly difference from those in the other groups 12 weeks after operation. Most of the biodegradable strontium-doped calcium polyphosphate was resorbed and was largely replaced by newly formed trabecular bone at 12 weeks. While in Group B,a major part of defect were repaired. New formed trabecular bone in the defect was very thin. In Group C,morsellized cancellous bone was completely surrounded by fibrous and newly formed trabecular bone. [Conclusion]VEGF expression in the defect of osteonecrosis of the femoral head during the repairing with biodegradable strontium-doped calcium polyphosphate may play a role in stimulating vascular invasion and granulation tissue formation.This may be an important step toward facilitating the resorption in the osteonecrosis,thus impooring the repairing proceduce of femoral head defect.

Objective To investigate the effect of remifentanil combined with dezocine or fentanyl on analgesia in patients with cholecystectomy. Methods A total of 98 patients with cholecystectomy from our hospital were collected, patients were randomly divided into the experimental group and control group with 49 cases in each group.Patients in the control group were treated by remifentanyl combined with fentanyl intravenous injection and patients in the experimental group were treated by remifentanyl combined with dezocine intravenous injection.The analgesia and sedation score and vital signs changes at recovery time (T1), after recovery 1h (T2), 2 h (T3), and the revival time, extubation time and adverse reactions were compared between two groups.Results The visual analogue scale score in experimental group at T1 , T2 , T3 and Ramsay sedation scale ( RSS) at T2 , T3 were lower than control group, the revival time and extubation time in experimental group were lower than control group, with significant difference (P<0.05). There was no significant difference at T0 ,T1 ,T2 and T3 between two groups.There was no respiratory depression happened in two groups, and there was no significant difference in adverse drug reaction between control group and experimental group (16.33% vs.10.20%).Conclusion The remifentanil combined with dezocine has a good inhibitory effect on postoperative hyperpathia with less adverse reactions.

[Objective]To probe the approach of supplementing Qi and nourishing Yin in the treatment of lung cancer. [Methods] With detailed research into Chinese medicine literature from recent years regarding its application in lung cancer, the basic pathogenesis of lung cancer, and relevant clinical effects and fundamental research of lung cancer are summarized.[Result]Numerous studies have shown that Qi and Yin deficiency is the basic pathogenesis of lung cancer, thus the approach of supplementing Qi and nourishing Yin can reduce the side effects and strengthen the clinical effects of radio-chemotherapy, stim-ulate immune function, improve life quality, and prolong the survival time of the patients.[Conclusion]It is significantly obvious that the approach of supple-menting Qi and nourishing Yin has shown great advantages in the treatment of lung cancer, however further clinical and basic research are expected.

Objective:To find out the problems still existing in the teaching reform through the investigation and research of eight-year program graduates of clinical medicine.Methods:In 2017, 118 questionnaires were issued to Batch 2005-2006 graduates of eight-year program in clinical medicine, and 103 valid questionnaires were retrieved. The questionnaire was based on that of the Fuyi Design of the Education Department in Zhongshan Hospital affiliated to Fudan University. The questionnaire was revised on the basis of the pre-survey and the statistical analysis was carried out on the data using Excel 2010.Results:We found that 60.2% of the graduates were satisfied with the training mode of eight-year program, 69.9% of the graduates gave a satisfactory evaluation on the teaching quality in the teaching hospital, and 63.1% of the graduates believed that the curriculum still need partial adjustment.Conclusion:Based on the finding, medical talent training mode is relatively mature in Batch 2005-2006 eight-year program of clinical medicine. The future medical education reform of the eight-year program should be more embodied in innovating the grafting mode of professional medical degree system, strengthening enrollment publicity, adopting diversified enrollment, strictly controlling procedure, carrying out integrated curriculum reform, enhancing clinical teaching design, at the same time further improving teachers' comprehensive quality, and speeding up the construction of clinical teaching staff.

Object To investigate the main risk factors of ICU sydrome,and establish Logistic regression model to evaluate the accuracy rating、sensitivity and specificity for predicting ICU sydrome.Methods Investigated all patients hospitalized in ICU from June to July of 2007.Data collected include age,gender,religion,family income,education degree,primary disease,character type,APACHE II score and et al.Case-control study Was used to retrospectively investigate the clinical data of ICU sydrome.Firstly,sillgle factor analysis was used in 21 clinical variables.Then,Multivariate Logestic regression analysis was used in selected variables.Results Twelve clinical variables,including age,gender,family income,health care cost wiping out degree,whether or not having family member'death,whether or not encountering other patients'death,length of stay in ICU,whether or not receiving ventilator theraphy,sleep quality,score of APACHE II,time with disease,character type.By Logestic regression analysis,it WSS revealed that there were 6 significant factors for ICU sydrome in diminishing sequence as whether or not receiving ventilator theraphy,length of stay in ICU,sleep quality,gender,time with disease and whether or not encountering other patientsMeath.Logestic regression equation was as following:P=1/[1+Exp∑(31.425+2.611X1+8.188X2-2.677X3+7.474X4+4.312X5+6.153X6)].The accuracy rating、sensitivity and specificity of the Logestic model was 82.37%.79.42% and 85.13% respectively.Conclusions Whether or not receiving ventilator theraphy,length of stay in ICU,sleep quality,gender,time with disease and whether or not encountering other patients'death were the main risk factors of ICU sydrome.The Logestic regression model based on these factors is reliable in predicting ICU sydrome.

Objective To evaluate the decreased level of serum inhibin B(INHB)treated by gunadotropin releasing hormone agonist(GNRH-a)in predicting ovarian response and pregnancy in in vitro fertilization-embryo transfer(IVF-ET).Methods The prospective study enrolled 124 women given by GnRH-a+recombine follicle stimulating hormone(rFSH)+human chorionic gonadotrophin(hCG)long term stimulation protocol undergone their first cycle of IVF-ET treatment.The following predictive factors were collected and analyzed,such as age,basal level of follicle stimulating hormone(FSH),the ratio of FSH/luteinizing hormone(LH),the concentration of INHB after down-regulation,total number of antral follicle count(AFC)and mean ovarian volume. Ovarian response was evaluated by the number of oecytes obtained.A multiple regression analysis and logistic regression model were used for all possible prognostic variables to evaluate the value of difierent hormones in predicting ovariall response and pregnancy after IVF-ET.Receiver operating characteristic(ROC) analysis was used to evaluate the level of INHB in predicting the number of oocytes obtained.The sensitivity and specificity were calculated at the discriminating cut-off point Results The concentration of INHB after down-regulation showed a highly significant positive correlations with the number of oocytes obtained(r=0.435,P<0.01).The multiple regression analyses showed INHB was the most significant predictor of the number of retrieved oocytes,but INHB was not associated with IVF-ET outcome significantly(P>0.05).ROC analyses showed INHB after down-regulation had the largest area under curve(AUC)0.933(95%CI:0.878-0.988).When a threshold of 15 ng/L of INHB was established,95.5%sensitivity and 50.0% specificity in ovarian response were observed.Conclusions The level of INHB Was the best factor in predicting ovarian response in IVF-ET.Decreased level of INHB Was the early sign of ovarian reserve function failure,however,useless in predicting IVF-ET outcome.

This study is to investigate the effect of hydroxyethylpuerarin on the expression of tumor necrosis factor-alpha (TNF-α) and activity of nuclear factor kappa B (NF-κB) after middle cerebral artery occlusion (MCAO) in rats. Rats were subjected to cerebral ischemia-reperfusion injury induced by MCAO. Hydroxyethylpuerarin (10, 20, 40 mg·kg-1, iv) was administered just 30 min before occlusion and immediately after reperfusion. After a 24 h reperfusion following 2 h of MCAO, the number of viable neurons in hippocampal CA1 region was counted by hematoxylin and eosin (HE) staining. TNF-α protein and its mRNA expression were examined with radioimmunoassay (RIA) and reverse transcriptase-polymerase chain reaction (RT-PCR) respectively. NF-κB activity was observed by electrophoretic mobility shift assay (EMSA), and inhibition of NF-κB α (IκBα) protein expression was evaluated by Western blotting analysis. Animals treated with hydroxyethylpuerarin had a significant increase in neuronal survival in comparison with vehicle-treated group. Hydroxyethylpuerarin significantly reduced the protein and mRNA expression of TNF-α following 2 h of ischemia with 24 h of reperfusion. NF-κB DNA binding activity and the degradation of IκBα in the cytoplasm also decreased by hydroxyethylpuerarin treatment. The protective effects of hydroxyethylpuerarin against ischemia-reperfusion injury may be mediated by decreasing the expression of TNF-α and the activity of NF-κB in rats.