Bone marrow-derived mesenchymal stem cells(BMSCs)exist in and can be isolated from the bone marrow of adult human being and animals and can be induced to differentiate into different cells.They are easy to be isolated,cultivated,and amplified.They are also less immunogenic in the body and can avoid ethical dispute when applied in transplantation.Studies have shown that BMSCs can be induced to differentiate into neural cells under certain conditions in vitro.This article reviewed the recent development in the research on the induction protocols for neural differentiation of BMSCs and the possible mechanisms.

To evaluate whether different doses of X ray irradiation can induce apoptosis of rat C6 glioma cells. A rat C6 glioma cell was irradiated with X ray in different doses in vitro. Apoptosis was identified by the classical “ladder” pattern (oligonucleosome sized fragments) in DNA agarose gel electrophoresis. Results: The results showed that significant apoptosis was found in 15, 20 or 30 Gy groups at 4 hours and 1 day after X ray irradiation compared with control, whereas this phenomenon could only be seen vaguely in the 40 Gy group. The latter group showed more necrosis than apoptosis. It suggested that the apoptotic mode of cell death and necrosis may represent the response in this X ray irradiated rat C6 glioma cells in vitro.

Objective To evaluate the short-term outcomes of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking compression plate(LCP) in the treatment of distal tibial fractures.Methods From June 2004 to March 2006,16 patients with distal tibial fractures were treated using MIPPO combined with LCP in our department.According to the AO classification,there were 7 cases of type 43A1,5 type 43A3,2 type 43B1 and 2 type 43C3.After reduction of tibial fracture with three methods,LCP was inserted and fixed with locking screw.All the cases were followed up periodically after the operation.Results All the cases were followed up for 5 to 20 months(mean,11.5 months).Primary wound healing was achieved in 16 patients.No complications,such as non-union,abnormal union and breakage of the plate,occurred in the cases.Callus formation was seen on X-rays at 7.6 weeks(4 to 12 weeks) after the surgery,when the patients began part weight-bearing exercises.The bone union was detected at 16 weeks(8 to 20 weeks),when the patients began full weight bearing.3 patients felt uncomfortable at the distal tibia around the implant.According to the AOFAS Ankle-Hindfoot Scale,14 cases(87.5%) were excellent and 2(12.5%) were good.Conclusions MIPPO combined with LCP technique is an effective treatment for the fractures of the distal tibia.This minimally invasive method can achieve stable fixation,promote bone healing,and permit early functional rehabilitation.

Objective:To establish a HPLC for determination of Gracillin in Rhizoma Paridis and Yunnan white on the bases of determining anti tumor cytotoxic bioactivities of more than 20 varieties of chinese medical materials and traditional Chinese patent medicines.Methods: The determination was carried out by HPLC on KR 100-5C18 column, with acetoitrile water (43∶5) as a mobile phase. The detection wavelength was 210nm. and the flow rate was 0.8ml/min.Results: The recoveries are 99.8% (RSD in 2.6%, n=6) and 98.8% (RSD is 1.5%, n=6), respechrely. The within day and between day accuracies are 1.4% of RSD(n=6) and 1.8% of RSD (n=4), respectively.Conclusion: The results showed that water, methanol and alcohol extracts of Rhizoma Paridis and Yunnan white had strong inhibition on 6 kinds of neoplasm cells of human body and their component Grarillin also had the inhibition on tumor cells.

Objective To evaluate the long- term results of intracystic corticosteroid injection for the treatment of simple bone cysts. Methods Seventy- six children with simple bone cysts treated by intracystic injection of corticosteroid from 1985 to 1995 were followed- up for an average of 8.2 years（ 5－ 13 years） . Forty- one of the cysts were situated at the proximal end of the humerus, 20 at the proximal end of the femur and 15 at other sites. The mean injection times were 4.2(2－ 13 times). Results Forty- two(55.3％ ) cysts were healed up completely, 16(21.1％ ) basically healed up, 9(11.8％ ) healed up partially and 9(11.8％ ) failures. Satisfactory and effective rate was 76.4％ and 88.2％ respectively. Conclusion Intracystic corticosteroid injection appears to be the initial choice of treatment for simple bone cysts, because it is an effective, and non－ invasive method which can be carried out easily.

Objective To investigate the mechanism of platelet inhibitor from Agkistrodon halys venom (AHV-PI) on platelet aggregation. Methods Protein kinase Akt phosphorylation levels in platelet were measured by Western blot. XS-1000I blood cell counter was used for platelet count. The plasma content of 5'-NT and platelet membrane GPIb were determined by Enzyme-Linked Immunosorbnent Assay (ELISA). The effect of AHV-PI on binding rate between the fluorescence labeled monoclonal antibody CD61 (FITC-CD61) and platelet membrae glycoprotein Ⅱb/Ⅲa (GPⅡb/Ⅲa) was observed by flow cytometry (FCM). Results AHV-PI can reduce the level of Akt-phosphorylation level and the number of platelet. AHV-PI can increase the content of 5'-NT in plasma, reduce the expression of platelet GPIb. Flow cytometry displayed AHV-PI can not affect the rate of combination between platelet GPⅡb/Ⅲa and FITC-CD61. Conclusion The mechanism of inhibition of platelet aggregation may be inhibit protein kinase Akt phosphorylation to block the signal transduction pathway of Akt. Limit cell grouth and reduce platelet number, also it may be related to its 5'-NT activity, it can degradate ADP to prevent the formation of platelet thrombus.

OBJECTIVE:To improve rational drug use and reduce potentially inappropriate medication (PIM). METHODS:PIM of 700 elderly inpatients in internal medicine department of our hospital was evaluated by Beers criteria(2012 edition)and STOPP/START criteria. RESULTS:700 inpatients whose mean ages were (76.3 ± 7.2) years old took (12.1 ± 4.9) kinds of drugs per patient. 144 cases involved PIM(20.6%). The number of PIM was 220 in total,among which there were 117 cases/times relat-ed to drugs and 22 cases/times related to disease in according to Beers criteria,9 cases/times of STOPP and 72 cases/times of START. Drug with most frequency of PIM in accordance with Beers was benzodiazepines and most frequency in STOPP was thia-zides that used by patients with gout histonry. The most omission frequency of START prescription were absence of metformin thera-py for type 2 diabetes and absence of antiplatelet therapy for diabetes complicated with cardiovascular risk. CONCLUSIONS:A high prevalence of PIM in elderly inpatients in our hospital requires various measures to prevent its occurrence.

Objective To evaluate the role of spinal Toll-like receptor 4 (TLR4) signaling pathway in the development of inflammatory pain in rats.Methods Thirty-six adult male Sprague-Dawley rats were divided into 3 groups (n=12 each) using a random number table:control group,inflammatory pain group and TLR4 signaling pathway inhibitor epigallocatechin gallate (EGCG) group (EGCG group).Inflammatory pain was induced by injecting 50 μl of complete Freund's adjuvant (CFA) into the ankle joint cavity of the left hindpaw of rats anesthetized with isoflurane.At 1-3 days after injection of CFA,EGCG 30 μg was intrathecally injected once a day in group EGCG.At 1,3 (30 min after intrathecal injection),5and 7 days after injection of CFA,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.The ipsilateral L4.5 segments of the spinal cord were removed at 3 days after CFA injcction for determination of TLR4 expression (by Western blot) and contents of tumor necrosis factor-alpha (TNF-oα),interleukin-6 (IL-6) and IL-1β in the spinal dorsal horn (by enzymelinked immunosorbent assay).Results Compared with control group,the MWT was significantly decreased and the TWL was shortened at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was up-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were increased in inflammatory pain group (P＜ 0.05),and no significant change was found in the parameters mentioned above in EGCG group (P＞0.05).Compared with inflammatory pain group,the MWT was significantly increased and the TWL was prolonged at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was down-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were decreased in EGCG group (P＜0.05).Conclusion Spinal TLR4 signaling pathway is involved in the development of inflammatory pain in rats.

Objective To discuss the indications, surgical techniques and outcome of less invasive stabilization system (LISS) in treatment of special proximal femoral fractures. Methods Twenty-eight patients with special proximal femoral fractures were treated with LISS from June 2005 to December 2007. All fractures could not be reduced by close reduction with traction table. There were eight patients with in-tertrochanterie fractures ( including type 31-A2.2 fractures in three, type 31-A2.3 in two, type 31-A3.1 in three and type 31-A3.3 in two according to AO classification), 19 with subtrochanteric fractures (including type ⅡA fractures in three, type ⅢB in one and type Ⅴ in 15 according to Seinsheimer classification) and one with peripheral fractures ( type Vancouver B1 fracture) of the femoral prosthesis. The data about opera-tion duration, intraoperative blood loss, postoperative complications, fracture healing time and postoperative hip function score were recorded. Results The operation lasted for mean 88 minutes (45-120 minutes), with intra-operative blood loss of average 320 ml (50 -700 ml). There occurred deep vein thrombosis of lower limb in two patients, myocardial infarction in one and lower digestive tract bleeding in one after oper-ation, with no incision complications. One patient with breast cancer was died of brain metastasis after op-eration and three lost follow-up. Other 24 patients were followed up for mean 18 months (6-33 months), which showed that 23 patients got fracture healing 2-5 months ( average 3 months) postoperatively but that one patient with type Seinsheimer V fracture had breakage of proximal locking screws six months postopera-tively because of nonunion of subtrochanteric fracture. The Harris score of the hip was 70-99 points ( aver-age 84 points). Conclusions Reverse femoral LISS has advantages of minimal invasion, easy opera-tion, stable fixation, high degree of safety and minor complications for treatment of special proximal femoral fractures. Skillful reduction, correct positioning of guide wire into hole A and avoidance of immediate weight bearing are key to success of the operation.

OBJECTIVETo investigate the occurrence and associated factors for posttraumatic stress disorder (PTSD) in rescuers and firefighters.

METHODSThe PTSD of 264 rescuers and firefighters who had participated in rescue was evaluated using the self-designed fireman general situation questionnaire and PTSD Checklist-Civilian Version (PCL-C). The factors associated with the occurrence of PTSD were also analyzed.

RESULTSThe incidence rate of PTSD in the subjects was 8.3%. The PTSD rate of special service corps (12%) was significantly higher than that of other subjects (P<0.05). The incidence of PTSD was highest in the rescuers and firefighters above the third rank, but without significant differences (P>0.05). The PTSD rate of married rescuers and firefighters was significantly higher than that of unmarried subjects (P<0.05). The PTSD rate of subjects addicted to drinking was significantly higher than that of non-drinking subjects (P<0.05). Subjects with more frequent attendance were more susceptible to PTSD compared with those with less attendance.

CONCLUSIONThe incidence rate of PTSD is high in rescuers and firefighters who have attended rescues. It is necessary to implement both short-term and long-term counseling programs for stress management and intervention in order to reduce the psychological trauma after rescue and improve the mental health of rescuers and firefighters.