BACKGROUND: Pathological changes of form and structure are induced in some tissues during repairing albuginea penis trauma, while structure and component of collagen fiber will be correspondingly changed necessarily.OBJECTIVE: To find a convenient, shortcut, and sensitive method to observe the dynamic change of type and distribution of collagen fiber during albuginea penis healing. DESIGN, TIME AND SETTING: A contrast study was performed at the Laboratory of Tissue Engineering, Guiyang Medical College between June 2005 and October 2007. MATERIALS: Fifteen male New Zealand rabbits were used in this study. METHODS: All rabbits underwent an excision of albuginea sizing 5 mm×5 mm at dorsal penis to establish models of albuginea penis trauma, and then the excision was sutured in situ. Thereafter, albuginea penis was obtained from five rabbits once after 2, 6, and 12 weeks. The samples were treated with picric-sirius red staining and observed under polarizing microscope. MAIN OUTCOME MEASURES: Dynamic changes of area of collagen fiber during albuginea penis healing.RESULTS: There were significant differences in content of the same collagen fiber at different time points (P<0.05). At 2 weeks post-trauma, both type Ⅰ and type Ⅲ collagen fibers were observed, and the ratio was equal, but the arrangement was confused and disorder. At 6 weeks post-trauma, red and yellow type Ⅰ collagen fiber was apparently increased, but type Ⅲ collagen fiber was decreased, and the arrangement was still disorder. At 12 weeks post-trauma, thick, bright red and yellow type Ⅰ collagen fiber was rapidly increased, but thin and green type Ⅲ collagen fiber was rapidly decreased.CONCLUSION: Picric-sirius red polarized light method can not only differentiate types of collagen fiber, but also clearly display the distribution, form and proportion of type Ⅰ and type Ⅲ collagen fiber, characterizing by simple, convenient, specific, and highly sensitive.

Objective To investigate the effects of serum leptin and tumor necrosis factor-?(TNF-?) on nutrition states in patients with chronic obstructive pulmonary disease (COPD). Methods The serum leptin and TNF-? levels were examined. Body mass index (BMI) and percent age of normal body weight(NW%) were measured. The correlation between leptin and other parameters was analysed. Results Serum leptin and TNF-? levels in acute exacerbation of COPD were significantly higher than those in the stable patients with COPD and control (P

BACKGROUND: It is indicated in the study of recent years that gingko biloba extract (EGB) is a kind of natural cleaner of free radical and it protects the body from the damage induced by free radical and improves cerebral circulatory disturbance and neuronal function. But the experimental or clinical study on the effects of EGB on high neural functional activity, like cognition, is relatively lagged.OBJECTIVE: To probe into the function of EGB on high functional activity in central neural system so as to provide the experimental evidence on clinical application of EGB in treatment of cognitive disturbance.DESIGN: Randomized controlled experiment was designed.SETTING: Department of Geriatrics of Psychiatric Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology,Department of Pathophysiology in Tongji Medical College of Huazhong University of Science and Technology and Department of Neurology in Union Hospital affiliated to Jinan Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Basic Department of Tongji Medical College of Huazhong University of Science and Technology in June 2002. Forty Wistar rats were employed and randomized into 5groups, named as normal control of aged rats (normal group), model group,EGB 75 mg/kg group, EGB 150 mg/kg group and EGB 500 mg/kg group, 8 rats in each one.METHODS: Scopolamine was used to induce disturbance of learning and memory in aged rats to simulate the model of senile dementia animals. In normal and model groups, physiological saline of same volume was used for gastric perfusion and in every EGB group, EGB of 75, 150 and 500 mg/kg was used for gastric perfusion successively, 50-400 g/time, continuously for 5 days. On the 6th day, water maze and evading-dark-room tests were performed. During the testing, the medical perfusion stopped. The assay methods of behavioral training of learning and memory, such as experiment with water maze and evading-dark-room test, and biochemical assay were used to observe the changes in learning and memory and in acetylcholine (Ach) and protein contents in cerebral hippocampus before and after medication.MAIN OUTCOME MEASURES: ① Time required in maze test of rats in each group. ② Mistakes in maze test of rats in each group. ③ Time required and mistakes in evading-dark-room test of rats in each group. ④Contents of Ach and protein in cerebral hippocampus of rats in each group.RFSULTS: Except that 1 rat was died without definite reason in EGB 150 mg/kg group and 1 rat was escaped in either EGB 75 mg/kg or 500 mg/kg group during gastric perfusion, terminally, 37 rats entered result analysis.① The time required and mistakes in maze test in every EGB group were less remarkably than model group (P＜0.05 or P＜0.01). The time required and mistakes in maze test in model group were higher remarkably than normal group (P＜0.01). ② In learning of passive escaping in evading-darkroom test, the duration of learning for the rats in EGB 500, 150, 75 mg/kg groups was shorter remarkably than that in model group [(156.78±25.97),(172.66±13.56), (198.54±17.12), (208.34±28.56) s, P ＜ 0.05 or P＜0.01].The mistakes of electric shock in EGB 500, 150, 75 mg/kg groups were less remarkably than model group [(3.41±0.26), (6.97±0.35), (7.23±0.62),(8.38±0.92) times, P＜0.01]. The times of electric shock in EGB 500 mg/kg group was less significantly than 150 mg/kg group (P＜0.01) and that in 150 mg/kg was less remarkably than 75 mg/kg group (P＜0.05). ③ Hippocampal Ach content in modeled rats in EGB 500, 150, 75 mg/kg groups was higher than that in model group [(421.89±36.32), (387.45±32.76),(380.17±41.25), (365.28±11.42) μg/g, P＜0.05 or P＜0.01]. Hippocampal Ach content in 500 mg/kg group was higher significantly than 150 and 75 mg/kg groups (P＜0.01). In addition, compared with normal group,protein content in hippocampus in rats with disturbance of learning and memory induced by scopolamine in model group was reduced significantly [(41.75±3.82), (95.13±6.34) mg/kg, P ＜ 0.01]. After administrated with EGB,even though the protein content in hippocampus was increased in experimental rats after modeling, the difference was not significant (P＞0.05).CONCLUSION: EGB improves significantly learning and memory in experimental animal in dose-dependence and increases significantly Ach content in hippocampus.

Objective To explore the mechanism of cytokines for the scars,and to study the effect of platelet derived growth factor(PDGF)on the biological behavior of fibroblasts in scars.Methods Fibroblasts of scars and normal skins were cultured in vitro.The results were observed and analyzed by light inverted microscopy(LM),and 3-(4,5-dimethyl-thiazol-2-yl)-2,5 ciphenyl tetrazolium bromide (MTT)assay.The effects of PDGF on the biological behaviors of fibroblasts of scars were also determined. Results In vitro study,using LM,FCM and MTT assay,showed that proliferation of fibroblasts were inereased significantly when PDGF was added to the cultures,as compared to the control groups.Conclusions PDGF can increase fibroblast proliferation.These results demonstrate that PDGF is beneficial for wound healing at early stage.

BACKGROUND: Nerve growth factor is secreted and synthetized by a variety of cells, such as inflammatory calls and repairing calls, its biological effects are diverse and closely related to the process of wound repair, but its mechanism is not yet clear.OBJECTIVE: To observe the influence of nerve growth factor on the biological characteristics of scar fibroblasts.METHODS: Eight clinical surgical resection specimens, including 5 face and neck hyperplastic scar or keloid specimens, did not receive any treatment; three were prepuce specimens following circumcision (normal tissue). By use of tissue block method, the scar and normal skin fibroblasts were cultured, followed by digestion passage. The scar tissue and normal tissue flbroblasts at 3-6passages in the logarithmic phase were seeded in 96-well plate and divided into the experimental group (scar flbroblest group) and the control group (normal skin fibroblasts group), with two parallel holes in each group were added with 3,33, 0.33 mg/L nerve growth factor, 50 μL. Inverted microscope was used to observe fibroblast morphology. At 24, 48, 72 hours after culture, the absorbanca value was measured using MTT. Fibroblast DNA content and cell apoptosis were determined by flow cytometry.RESULTS AND CONCLUSION: The fibroblasts were adherent cells, the scar and normal skin tissues were shown to cell free out of tissue block and gradual expansion at 4-6 days after incubation. Compared with normal skin fibroblasts, the pathological scar fibroblasts became larger, irregular shape and arrangement. MTT results showed that nerve growth factor could promote the normal and hypertrophic scar fibroblasts growth, which becomes more apparent. Flow cytometry results showed that by adding nerve growth factor, the percentage of scar fibroblasts at proliferating S-G_2-M phase was higher than that in the control;group; with a Iower level of apoptosis. It is indicated that nerve growth factor plays an obviously promoting role on normal and scar skin fibroblasts growth and proliferation, especially on the scar skin.

Objective To investigate the expression of HIF-1α and P-gp protein in pancreatic carcinoma and determine their clinicopathological significance and the correlation between the expression of HIF-1α, P-gp and the clinical prognosis. Method In samples from 74 cases of pancreatic carcinoma and 10 healthy individuals, the expression of HIF-1α and P-gp were detected by immunohistochemical method. Results The positive expression rate of HIF-1α and P-gp was 75.7% and 86.5%,respectively, which were remarkably higher than that in normal pancreatic tissue (P＜0.05). There was a positive correlation between the expression of HIF-1α and that of P-gp. The aberrant expression of HIF-1α and P-gp was associated with lymph node metastasis but not the location, size, clinical stages and nerve invasion of the tumor. Patients with high intensity of HIF-1α and P-gp expression showed a significantly lower median survival time than those with low intensity expression.Conclusions The expression of HIF-1α and P-gp is up-regulated in pancreatic carcinoma and there is a positive correlation between them. The expression of HIF-1α and P-gp might be related to the lymph node metastasis and poor prognosis.

Objective To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse (POP).Methods Between March 2007 and December 2009,65 patients with stage Ⅲ POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study.Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly.Clinical parameter associated with perioperation,objective and subjective successful rate and complication were recorded.Results The mean operating time was (71 ±22) min and the mean blood loss was (93 ±40) ml.No intraoperative blood transfusion and viscera injury cases were observed.All patients were able to recover spontaneous micturition.Two cases experienced pelvic hematoma with diameter of 7 cm,after conservative treatment,they all recovered later.The objective success rate was 100％ at 6 weeks follow-up by POP-Q scoring.And 46.2％ (30/65) were followed up at range of 1 -3 years,recurrence rate were 10％ (3/30),and however,no operation were needed.At median of 20 months,all patients were followed up by telephone,the subjective successful rate was 95.4％ (62/65).At 6 weeks after operation,6.2％ (4/65) patients suffered from lower back pain and right thigh pain,visual analogue scale of pain was at range of 3 to 5,which relieved gradually after treatment and disappeared totally within 2 years.The rate of suture exposure was 10％ (3/30),the new urinary incontinence 4.6％ (3/65),and the new dyspareunia 12.5％ (3/24).Conclusions Ischiospinous ligament fixation is a safe and efficacious management.

ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

Objective To evaluate clinical and sexual outcomes in women with severe uterine prolapsed at child-bearing period undergoing laparoscopic high uterosacral ligament suspension combined with cervical amputation.Methods From November 2007 to March 2010,34 patients (≤50 years old) with severe uterine prolapse (prolapse group) who had already given birth and underwent laparoscopic high uterosacral ligament suspension combined with cervical amputation in Peking Union Medical College Hospital were enrolled in this retrospective study.All patients were defined as Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ.Follow-up was performed at 1,6,and 12 months,and then annually.Anatomic failure was defined as ≥ 1 pelvic compartment classified as POP-Q ≥ stage Ⅱ.Sexual outcomes were assessed at baseline and 3-year follow-up according to validated Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).Thirty one age-matched women who underwent health examinations during the same time period were selected as a healthy control group.Results Mean age of women at prolapse group were (39 ±5) years and average surgery time were (51 ±8) minutes.No severe intraoperative complications occurred,including urethral twist,bladder and rectum injury,pelvic hemotoma.All patients were followed up for more than 3 years,the mean following up period was 40 months (36-64 months).Based on stage Ⅱ of POP-Q as recurrence criteria,the anatomical success and patient satisfaction rates were both 100％ (34/34).POP-Q point C and D measurements were significantly higher after surgery then those at preoperative values [C:(-5.4±0.6) cm versus (2.2 ±0.7) cm,D:(-6.7 ±0.4) cm versus (-4.0 ±0.7) cm; P ＜0.01 for all].Three years postoperatively,33 patients were sexually active.Among the 94％ (31/33) patients who answered the PISQ-12 questionnaire,there was significant improvement in post-and preoperative total PISQ-12 scores (38 versus 26,P ＜ 0.01) and in all three subscale PISQ-12 domains (P ＜ 0.01 for all).The postoperative PISQ-12 score was similar to that of the control group (38 ± 6 versus 37 ± 3,P ＞ 0.05).Conclusion Laparoscopic high uterosacral ligament suspension combined with cervical amputation conferred satisfying long-term anatomic and sexual function outcomes in women at child-bearing age.

Clinical practice is the critical stage of training medical students in basic clinical quality.For the current major issues,such as lack of clinical case resources,lack of teaching conditions,and less chances of practice for students,cases library combined with medical human patient simulator is used in extern's teaching.Through this teaching,the students can touch numerous and comprehensive clinical cases,grasp clinical techniques proficiently,predominate diagnosis and treatment of common diseases in Orthopaedics efficiently by using medical human patient simulator.The effect of clinical practice teaching is improved greatly.The practice of related teaching means and methods provides a new way for the reform of the practice teaching.