Objective To evaluate the possibility for the treatment of chondral defects on the femoral bearing surface with autologous osteochondral transplantation under arthroscopy. Methods There were 17 patients with cartilaginous surface defects, including 12 males and 5 females. The average age of patients was 29 years ranging from 18 to 45 years. The defects were located at 10 left knees and 7 right knees. The functional status of patients were evaluated according to the Brittberg-Peterson scoring scale system, the results were average 80.65?9.69 points ranging from 65 to 105. 3 patients had no an obvious history of trauma, but suffered from the rheumatoid disease; however, the other 14 patients had been injured at the knee joint with pain and followed with muscle atrophy on the thigh. 3 patients experienced interlocking, and 2 had snapping in their knee joints. All the 14 patients with traumatic history had only solitary lesion, the area of local cartilaginous defects at the bearing surface of the lateral femoral condyle was of 2.5-3.0 cm2; the local defects of the other 3 patients were located at the medial femoral condyle with defect area of 2.0-2.5 cm2, which was diagnosed either as chondomalacia or corruption. The procedures of the mosaicoplasty consisted of harvesting osteochondral cylinders from non-weight bearing surface of the knee and then implanting the grafts into the cartilaginous defects under arthroscopy. Results All the patients were followed up for 10 to 20 months (mean, 15 months). The joint mobility recovered to nearly normal. According to the Brittberg-Peterson system, 14 patients had score of 0, and 3 had scores of 2-3 because of mild pain. The follow-up MRI showed adequate cartilaginous coverage in the original lesions and excellent position of the cylindrical osteochondral grafts. Conclusion The autologous osteochondral mosaicplasty is proved to have good and reliable clinical results for the cartilaginous defects in the knee bearing surface.

ObjectiveA comparison between intragate and ECG-respiration triggered techniques was performed to determine their differences in measuring the structure and function of the heart at 7.0 T.MethodsTen normal ICR mice aged five to six weeks were examined on a 7.0 T MR scanner.A central slice with papillary muscle included at the short-axis view was scanned with a FLASH-cine bright blood sequence,FLASH-cine black blood sequence,IG-FLASH-sat-cine black blood sequence,and IG-FLASH-cine bright blood sequence.The area of the left ventricle of the end systole and end diastole ( including and excluding the myocardium) was measured with manually outlined ROIs.The increased area of the left ventricle and the myocardium from the end systolic to end diastolic phases was calculated.The signal intensity was measured from 8 ROIs which were evenly located at the myocardium of the end systole,and the mean and standard deviation were then determined.The coefficient of variation ( CV ) was derived by dividing the mean into the standard deviation.ResultsThere was no significant difference ( the increased area of the myocardium t =0,P =1,the increased area of the left ventricle t =2.12,P =0.06) in the function index between the ECG-triggered black blood sequences [the increased area of the myocardium (0.100 ±0.018) cm2,the increased area of the left ventricle (0.060 ± 0.024) cm2] and intragate black blood sequences[the increased area of the myocardium (0.090 ± 0.014) cm2,the increased area of the left ventricle (0.060 ±0.012) cm2].No significant difference(the increased area of the myocardium t =1.56,P =0.15,the increased area of the left ventricle t =2.08,P =0.07 ) in the function index was observed between the ECG-triggered bright blood sequences [the increased area of the myocardium ( 0.100 ±0.018) cm2,the increased area of the left ventricle(0.060 ±0.014) cm2]and intragate bright blood sequences [the increased area of the myocardium (0.090 ±0.019) cm2,the increased area of the left ventricle (0.050 ±0.015) cm2].Furthermore,there was no significant difference(t =1,P =0.34) in the CV of the myocardium signal intensity of bright blood sequences between the ECG-triggering ( 0.050 ± 0.013 ) and intragate (0.040 ± 0.015 ),but significant difference ( t =4.51,P =0.001 ) in the CV of the myocardium signal intensity of black blood sequences between the ECG-triggering ( 0.070 ± 0.033 ) and intragate ( 0.160 ± 0.046 ) was obtained.ConclusionsThe intragate sequences could take the place of the ECG gate sequences in functional analysis of the heart( including bright blood and black blood sequences).The bright blood intragate sequences also could replace the bright blood ECG-triggered sequences in analyzing the signal of the myocardium.

Objective To explore the effects of 7.5% hypertonic saline (HS) and pentoxifylline (PTX) on the pulmonary inflammation in rats with hemorrhagic shock. Method Controlled hemorrhagic shock in rats was induced to 40 mmHg MAP by blood withdrawal and maintained for 60 min. Animals were randomly (random number) divided into 3 groups. In sham shock group ( n = 8), rats underwent cannulation without exsanquination or resuscitation and served as negative controls. In RL-resuscitated animals group ( n = 8), rats received 32 mL/kg RL (Ringers'lactate solution). In HSPTX group, rats received 4 mL/kg of 7.5% NaCl + 25 mg/kg of PTX.PaO2,pH,PaCO2, lung wet/dry weight ratio (W/D) and lung penetrating index were determined, and the percentages of neutrophil in bronchoalveolar lavage fluid (BALF) were detected. The levels of malondialdehyde (MDA) and superoxide dismutase(SOD)were measured. The tumor necrosis factor-α(TNF-α) and interleukin 1β(IL-1β) in BALF supernatant were determined by using ELISA method. Results Compared with RL group, PaO2 and pH of arterial blood more increased and PaCO2 of arterial blood more decreased in HSPTX group ( P ＜ 0. 01).The wet/dry lung weight ratio and the percertages of neutrophil in BALF were reduced in HSPTX group. The level of tumor necrosis factor-αand interleukin 1β in HSPTX group were both more significantly decreased than those in RL group ( P ＜0.01). Conclusions Compared with RL group, the more attenuation of pulmonary inflammation in HSPTX group after shock is associated with less neutrophil activation and decrease in production of the irlammatory cytokines.

BACKGROUND: Gentamicin bead chain is an effective drug delivery system for treatment of osteomyelitis, but it cannot be degraded, need to be removed by second operation, and can breed pathogens. As a result, biodegradable drug delivery systems become a hotspot. Nano-hydroxyapatite/poly(β-hydroxybutyrate-co-β-hydroxyvalerate)-polyethylene glycol-gentamicin (nano-HA/PHBV-PEG-GM-DDS) is considered to be a good choice for the current predicament. OBJECTIVE: To evaluate the acute or chronic toxic reactions of the whole body and local tissues, intracutaneous stimulation, cytotoxicity and hemolytic reactions after bone remodeling and implantation of nano-HA/PHBV-PEG-GM-DDS, thus providing a new kind of material for treating osteomyelitis. METHODS: Plastic nano-HA/PHBV-PEG-GM-DDS was prepared using plastic fibrin glue as microsphere scaffold and nano-HA as the core carrier of GM that was coated with PHBV and PEG. The acute, subacute/chronic toxicity, implantation, hemolysis, cytotoxicity and intracutaneous stimulation tests were performed according to the evaluated criteria of medical implanted materials as wel as biological and animal trials recommended in GB/T16886.1-1997. RESULTS AND CONCLUSION: The plastic nano-HA/PHBV-PEG-GM-DDS was nontoxic and caused no apparent changes in liver and kidney function and serum biochemical indexes. Pathological examination showed that the implanted material was covered with tissues, and inflammation changes accorded with the general regularity of inflammatory outcomes. After implantation, the nano-HA/PHBV-PEG-GM-DDS was biodegraded and replaced by osseous tissues. The hemolytic rate of the material extract to the composite diffusion solution was 1.2%, which was below the standard criteria (5%). Human bone marrow cells cultured in vitro with the plastic nano-HA/PHBV-PEG-GM-DDS grew normally with good morphology. There was no stimulation reaction according to the criteria after the diffusion solution was subcutaneously injected into the back of the animal. These findings indicate that the plastic nano-HA/PHBV-PEG-GM-DDS for treating osteomyelitis possesses excel ent biocompatibility and security.

Objective This paper aimes to analyze the scientific research development trend,research emphasis and cooperation situation of Chinese Center for Disease Control and Prevention since its establishment,to provide the suggestions for policy making of scientific management and related decisions.Methods Based on GoPubMed,Literature quantitative analysis was used to analyze the publication time and journal distribution,research topics and core authors of the scientific papers from 2002 to 2015.Results A total number of 4 501 research papers had been published in 576 different kinds of periodicals.Research topics were based on population health with special focus on the epidemiological,microbiological and etiological studies of infectious disease.Chronic non-communicable disease and health research were paying more and more attention to.Core author group and the core research team have been formed.Conclusions The capability to conduct scientific research was increased and the international influence was increasing year by year,the ability of infectious disease control was strengthened,and the scientific research team worked together more closely.Thus,the Chinese Center for Disease Control and Prevention should reinforce scientific management,develop advanced disciplines,as well as improve the quality of scientific research in the future.

From 2006 to 2010,381 national or provincial projects were granted to Chinese Center for Disease Control and Prevention (Chinese CDC).According to the development plan of key dsciplines made by Chinese CDC, this study stratified the granted projects and analyzed their distribution in the four units (including 37 subunits),namely,infection disease,health,chronic disease and general technology platform. The results indicated that most of the important topics proposed by our center received financial support from the government,and the supported projects were mostly in the field of infectious disease and health.The results also revealed that the key projects proposed by Chinese CDC meet the practical requirements of disease control,and those projects covered the key scientific topics and key technologies.Meanwhile,the result reflected that Chinese CDC is very competitive as far as scientific research is concerned,but the research structure is not balanced among the 4 units.

Objective To evaluate the safety and efficacy of self-expanding metallic stents (SEMS) in one-stage surgery for patients with left-sided malignant colorectal obstruction. Methods The clinical data of 97 patients with left-sided colorectal cancer who had been admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University from May 2005 to September 2008 were retrospectively analyzed. Forty-six patients with left-sided malignant colorectal obstruction were in the test group, after the placement of SEMS, they received one-stage resection and anastomosis; 51 patients with left-sided colorectal cancer (without obstruction) were in the control group, and they received one-stage surgery. The defecation and anal exhaust time, hospital stay and incidence of postoperative complications between the 2 groups were analyzed. All data were analyzed via t test or chi-square test. Results One patient in test group had acute diffuse peritonitis which was induced by intestinal perforation at postoperative day 4, and was treated with radical resection for sigmoid cancer. One-stage surgery was successfully performed on 45 patients, and they were discharged at postoperative day 11-16. One patient died of respiratory infection and heart failure at postoperative day 10. All patients were followed up for 4-48 months. There was no significant difference in defecation and anal exhaust time, hospital stay, incidence of perioperative complications, recurrence, metastasis and survival within follow-up interval between the 2 groups (t=0.164, 1.358, χ~2 = 0.252, 1.200, 0.580, P >0.05). Conclusion SEMS is effective and safe in the treatment of left-sided malignant colorectal obstruction.

To explore the differentiation of gastrointestinal stromal tumor(GIST) with synchronous carcinoma clinical and pathological features,diagnosis and differential diagnosis.Methods Clinical characteristics,pathological morphology and immunohistochemical staining were observed in 9 cases of GIST with synchronous carcinoma,with review of the relevant literature.Results Microscopically,in 4 cases GIST with esophageal carcinoma,most of tumor cells in central focus were squamous cells and keratin pearls which were well differentiated and the rest of tumor cells are basal like cells on the edge.In the other 5 cases (4 of them with gastric carcinoma and 1 with rectal cancer).Microscopically,the tumors were composed of dysplastic glands which presented as adenoid structures and poorly differentiated.The majority of gastric GIST were spindle cell tumors,which resembled smooth muscle tumors histologically and showed a variety of histological pattern,such as lace like pattern,palisading pattern,antique coins like pattern and eddy pattern.And a perinuclear vacuolization pattern was common.Immunohistochemistry showed that the tumor cells were positive for CK5/6,CK14 and p53,but negative for S-100,CK7 of the 4 cases GIST with esophageal carcinoma.In the other 5 cases (4 of them with gastric carcinoma and 1 with colorectal cancer),showed that CK7,CK20,CEA and HER-2 were positive and negative for S-100.In all the 9 case of GIST,the tumor cells were positive for CD34,CD117 (+),DOG1 and SMA,but negative for S-100,desmin,etc.Conclusion There are no special clinical symptoms in most of GIST with synchronous carcinoma,because these GISTs are generally incidental findings.The proliferative index of GIST with synchronous carcinoma is observably lower than that of GIST without synchronous carcinoma.Most GISTs with synchronous carcinoma can be treated by the standard treatment for the accompanying carcinoma,and do not need specific additional treatments.

This study aimed to investigate whether β-elemene could improve the dysfunction of vascular endothelial cells induced by low shear force (LSS), and the proliferation and migration of vascular smooth muscle cells induced by oxidized low-density lipoprotein (ox-LDL). Parallel plate flow chambers and ox-LDL were used to establish vascular endothelial cells (ECs) dysfunction model and vascular smooth muscle cell (VSMCs) proliferation and migration model, respectively, and the effects of β-elemene on ECs dysfunction and VSMCs proliferation and migration were examined. The activity of ROS in ECs was measured by DHE and the activity of NO in ECs was tested by DAF-FM DA. The protein phosphorylation of Akt and ERK in ECs were detected by Western blot. The proliferation of VSMCs was measured by MTT. The migration of VSMCs was examined by cell scratch test and Transwell assay. The gene expression of MMP-2 and MMP-9 in VSMCs was measured by RT-qPCR. In ECs, β-elemene could significantly reduce the LSS-induced increase in ROS, significantly increase the LSS-induced decrease in NO, decrease the phosphorylation of ERK, and increase the phosphorylation of Akt. In VSMCs, β-elemene could significantly reduce the proliferation and migration of VSMCs induced by ox-LDL, and reduce the gene expression of MMP-2 and MMP-9. To conclude, β-elemene can improve the LSS-induced ECs dysfunction and ox-LDL-induced VSMCs proliferation and migration.

We performed a simultaneous pancreas-kidney transplantation (SPK) for type 2 diabetes complicated with end-staged renal disease (ESRD) in March, 2007. The recipient was a 65-year old male, who suffered type 2 diabetes for 15 years and renal dysfunction for 5 years and other diabetic complications such as retinopathy and peripheral neuropathy. SPK was performed successfully for him, in which the kidney was placed in the left iliac fossa, while the pancreas in the right iliac fossa, with an entedc drainage for pancreas exocrine and a systemic drainage for endocrine. Serum C-peptide, creatinine and blood urea nitrogen reached normal levels on day 1,4 and 11 post-transplant, respectively. Blood glucose became stabilized gradually to normal level and therefore the injected insulin was stopped on day 16 post-transplant. Oral glucose tolerance test (OGTT) showed the function of grafted pancreas was normal after 3 weeks of transplant, and no transplant-related complications occurred. With the recipient followed up for 20 months, both his blood glucose level and renal function maintained normal without using insulin.