AIM: Granulocyte colony-stimulating factor and stem cell factor are the important cell factor in the hematopoiesis. According to changes in the cell information conduction and obstruction of the expression of the stem cell adhesion molecule, they can increase the quantities of stem cells, restrain the apoptosis and alter the function of bone marrow mesenchymal stem cells. The experiment was to discover how to isolate and culture the granulocyte colony-stimulating factor and stem cell factor mobilized peripheral blood derived mesenchymal stem cells, and to explore the induction to the cartilage cells in the monolayer culture. METHODS: Experiments were performed at the Hebei Provincical Key Laboratory, Research Center, Fourth Hospital of Hebei Medical University from January 2005 to March 2006. ①The 4-6 weeks male BALB/c mice weighting 15-20 g were provided by Animal Experimental Center of Hebei Medical University. The lab procedure met the animal ethical standard. ②The density gradient centrifugation combined with the adherence method were adopted to isolate the mesenchymal stem cells from peripheral blood of BALB/C mice after granulocyte colony-stimulating factor and stem cell factor mobilization. Detections of colony forming unit-forming ability were preformed on grow well cells. Mesenchymal stem cells were identified by flow cytometry and immunohistochemical method. The 3rd passage mesenchymal stem cells were induced to differentiate into chondrocytes in high glucose DMEM medium containing transforming growth factor beta 1. The expression of type Ⅱ collagen was detected by immunohistochemical method. RESULTS: ①The peripheral blood derived mesenchymal stem cells possessed the similar phenotypes with bone marrow derived mesenchymal stem cells and could differentiate into chondrocytes. Flow cytometry showed that CD29 and CD44 were positive, while CD34 and CD45 of them were negative. ②The passage 3 mesenchymal stem cells did not express type Ⅱ collagen and laminin, expressed vimentin in immunohistochemical method. The differentiated mesenchymal stem cells expressed type Ⅱcollagen ③The passage 1,3,5 mesenchymal stem cells showed different ratios of colony forming unit. Pairwise comparison showed that with the passage increasing, the ratio of colony forming unit degraded gradually (21.32%,16.13%,9.63%,P

[Objective]To evaluate the clinical value of surgical treatment of multiple thoracolumbar spinal fractures by pedicle screw/rod Instrumentation system.[Method]Ninteen cases of male 14 and femal 5 of multiple injuries involving thoracic and lumbar spine were surgically treated through anterior approach by open reduction,selective vertebral canal decompression,internal fixation with pedicle screw/Rod spine instrumentation,and followed by anterior lateral bone graft fusion according to complex classification system 19 cases,Ba.m1T_(11) 1 cases,Ba.m.p2T_(11) 2 cases,Ba.m1T_(12) 1 cases,Ba.m.p2T_(12) 1cases,Ba.m.p3T_(12) 1cases,Ba.m1_L 4 cases,Ba.m.p2L_1 3cases,Fa.m.p3(T_(12),L_1) 2cases,Sa.m.p3L_2 1cases,Ba.m.p1L_2 1 cases.[Result]All cases were followed up form 6 to 15 months averageing 10.5 months.No implant failure and late kyphosis deformity was observed.The average vertebra height was improved from preoperative 48.14% to postoperative 92.14%.The postoperative neurological function in two cases of complete spina lcord injuries and 11 incomplete spina lcord injuries were improved according to JOA criterion.Astable bone fusion according to radiological criteria was achieved in call cases postoperatively,and progressive compression did not occur.[Conclusion]Pedicle screw/rod instrumentation system can achieve effective reduction for the fractured vertebrae and simultaneously restore spine stability on the basis of adequate vertebral canal decompression.Posterior spine instrumentation is an ideal choice for surgical treatment of thoracolumbar unstable fractures with or without spinal cord dysfunction.

Versican comes from fibroblasts and belongs to chondroitin sulfate proteoglycan.It distributes in various tissues.The versican have functions including regulate cell growth and differentiation,promote cell proliferation,invasion and metastasis,and stimulate angiogenesis.Experiments have confirmed that the expression of versican is involved in various cancers.Here,the author do an overview of versican in the occurrence and development of breast cancer,liver cancer and chondrosarcoma aimed to further explore the pathogenesis of tumors.

Objective Donor derived naive T cells initiated GVHD by contacting with,mesenchymal stem cells(MSC)have been used to prevent or treat graft-versus-host disease(GVHD).although we stiff puzzle about its mechanisms.Observe the effect of MSC on phenotypes of Naive T cell to study the mechanism of MSC immunomodulation. Methods After 3 passages, MSC Was incubated with Naive T cell differentiated from COrd blood CD+34 cells in vitro.Then the variances of naive T cell phenotypes were analyzed by flow cytometric.Results CD+8 T cells were relatively increased after 7 days co-culture with allogenic MSC when compared to control:(35.9±6.3)%VS(18.4±4.5)%.CD+8 CD+3 cells also showed the same trend (27.6±2.8)%vs(15.2±3.1)%.Conclusion MSC may partly reduce the incidence of GVHD by increase of CD+8 naive T cell.The result may provide new clue to explain immunoregulatory mechanism of MSC.

Sarcomas collectively represent over 100 different subtypes of bone and soft tissue tumors.They are not sensitive to chemotherapy,which requires the development of tissue-specific or pathway-specific therapies.As our understanding of the molecular mechanisms driving sarcomas is rapidly advancing,the number of targeted therapies is also increasing.Recently identified novel druggable targets including the MDM2 amplifications in welldifferentiated and dedifferentiated liposarcomas,the fusion NAB2:STAT6 of solitary fibrous tumor,the SDH mutations in gastrointestinal stro mal tumors,the suppression of Mcl1 in synovial sarcomas,CDK4 in alveolar rhabdomyosarcoma.They will play an important role in the treatment of sarcoma.Here,the author do an overview of these factors.

Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.

OBJECTIVE: To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction. METHOD: Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms. RESULT: PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident. CONCLUSION Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.
Adult ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Nasal Obstruction ; complications ; pathology ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; etiology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To evaluate the efficacy of endoscopic minitrephination combined with endoscopic frontal sinusotomy in the management of complex chronic frontal sinusitis. METHOD: Twenty-six patients suffering from chronic frontal sinusitis with complex frontal drainage approach were analyzed. Eleven patients (13 sides) received endoscopic minitrephination combined with endoscopic frontal sinusotomy, while the other 15 patients (18 sides) received endoscopic frontal sinusotomy only. Postoperatively all cases were followed up to evaluate the efficacy. RESULT: The ostia of frontal sinus were successfully opened in the group of patients received endoscopic minitrephination combined with endoscopic frontal sinusotomy without any complications. In the endoscopic frontal sinusotomy only group, three cases of complications were observed, one with the injury of anterior ethmoidal artery and the other two with the injury of papyraceous lamina. After 10 to 24 months of follow up postoperatively, the symptoms were relieved in all cases without recurrence. The combined surgery group with endoscopic minitrephination showed an endoscopic frontal sinus patency rate of 85%, and the endoscopic frontal sinusotomy only group exhibited an endoscopic frontal sinus patency rate of 83%. CONCLUSION Endoscopic minitrephination combined with endoscopic frontal sinusotomy is a simple, convenient, safe and effective method for management of complex chronic frontal sinusitis.
Adult ; Endoscopy ; Female ; Follow-Up Studies ; Frontal Sinus ; surgery ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Retrospective Studies ; Trephining ; methods ; Young Adult

Objective To investigate the dose response of S100A4 gene expression in the irradiated lymphoblastoid cells AHH-1 at different time points post irradiation.Methods AHH-1 cells was exposed to different doses(0,1,3,5,8,10,15 and 18 Gy)of 60Co γ-rays,and its mRNA levels of S100A4 was detected by reverse transcription PCR and real-time PCR at 4,8,12,24,48 and 72 h after irradiation.Results Within the range of applied doses,the level of S100A4 gene expression was upregulated with a good dose-response (R2 =0.79-0.93,P ＜ 0.05) and had obvious difference at different time points (F =8.91,P ＜ 0.01).Conclusion S100A4 gene expression at transcriptional level could be detected easily and had optimum dose-responses at certain time points after irradiation,and hence is applicable as a dosimeter.

BACKGROUND:Vertebral metastatic tumor often occurs in the thoracolumbar segment, and it is difficult for internal fixation due to the complex anatomical position. OBJECTIVE:To evaluate the stability of lumbar vertebra in the patients with single thoracolumbar vertebral metastases after treated with artificial vertebral placement and internal fixation. METHODS:Sixteen patients (9 male and 7 female) with single thoracolumbar vertebral metastases treated in the Department of Orthopedics, the Fourth Hospital of Hebei Medical University from January 2006 to January 2009 were selected, and the age ranged 40-74 years, averaged 52 years. Before treatment, al the patients were evaluated according to Frankel classification:A grade in two cases, B grade in three cases, C grade in three cases, D grade in five cases, and E grade in three cases. And the vertebral state of patients was detected with X-ray plain film examination, systemic radionuclide bone scanning, CT and MRI. The T11 vertebral metastases were treated with chest approach artificial vertebral placement and internal fixation, and T12-L2 vertebral metastases were treated with artificial vertebral placement and internal fixation via extrapleural and extraperitoneal space approach. RESULTS AND CONCLUSION:Al the 16 patients were fol owed up for 4-32 months, and the average survival time after treatment was 12 months. After treatment, Frankel classification was C grade in three cases, D grade in five cases and E grade in eight cases. The visual analog scale score was decreased from (6.22±1.31) before treatment to (3.25±0.94) after treatment, and there was significant difference between two groups (P<0.05). The artificial vertebral placement and internal fixation can restore the stability of lumbar vertebra in the patients with spinal metastases, and thus improving the symptoms and quality of life.