Objective To study the variation of serum IL-6,IL-8,TNF-α and CRP in perioperative patients with pancreatitis. Methods 39 caaes in perioperative patients with pancreatitis in our hospital from January 2008 to 2010 April were selected as observation group,and 39 healthy people were selected as control group,and the serum IL-6,IL-8,TNF-α and CRP of the observation group before the treatment and after the treatment at 4h,at the first day, at the second day and the seventh day and the control group were detected, and the results were analyzed and compared. Results The serum IL-6,IL-8 ,TNF-α and CRP of the observation group before the treatment were higher than those of the control group( all P ＜ 0. 01 ) there were significant differences, and the levels of the observation group at 4h,at the first day,and at the second day showed decreasing,the levels compared to those of the control group( all P ＜ 0. 05 ) there were significant differences, the levels of the observation group at seventh day were compared to those of the control group(all P＞0. 05) there were no significant differences. Conclusion It was regulation of the variation of serum IL-6, IL-8 ,TNF-α and CRP in perioperative patients with pancreatitis, and tit could provide evidence for the treatment.

Objectives To explore the clinical effect of coupling meglumine cyclic adenylate (MCA)and the human granulocyte colony-ostimulating factor (G-CSF)on rat with diastolic heart failure(DHF).Methods Totally 60 rats of DHF model were evenly divided into 4 groups according to random number:Control group(n=15,control),Model group(n=15,DHF model),MCA group(n =15,treated with MCA)and MCA+GCSF group(n=15,treated with MCA plus G-CSF).MCA group were administered by intragastric injection of MCA 30 mg/kg/d for 15 d,MCA+G-CSF group were administered by intragastric injection of MCA 30 mg/kg/d and plus G-CSF 100 μg/kg/d for 15 d,while Control group and Model group were given same volume of saline solution.BIOPAC SYSTEM was used to analyze the model establishment.The mRNA levels of GATA-4 and Cx43 were measured by RT-PCR.The protein expressions of GATA-4,Cx43,cTNI and c-kit were measured with western blotting.ELISA and flow cytometry were used to detect cAMP and differentiation rate of bone marrow mesenchymal stem cells (BMSCs),respectively.Results Compared with MCA group,the denaturation degree of myocardial tissues in DHF rat was significantly improved than in MCA+G-CSF group.Moreover,the level of GATA-4 (1.62 ± 0.09),Cx43 (1.02 ± 0.07),cTNI (1.42 ± 0.12),c-kit (0.65±0.02),cAMP(283.67± 18.09)nmol/L and BMSCs cell differentiation rate(38.62 ± 1.52)％ in MCA + GCSF group were significantly promoted (all P＜ 0.05)than in MCA group,GATA-4 (0.82±0.07),Cx43 (0.52±0.05),cTNI(0.86 ± 0.13),c-kit (0.48 ± 0.03),cAMP(198.83 ± 16.03) nmol/L and BMSCs cell differentiation rate (19.82 ± 0.89)％.Conclusions The combination of MCA with G-CSF is significantly improved DHF than single MAC treatment,which may regulate BMSCs differentiation though cAMP/PKA signaling pathways.

Objective To study the impact of depression disorder in patients after coronary stent implantation on incidence rate of in-stent restenosis (ISR) in the coronary heart disease( CHD ), and its possible pathophysiological mechanisms. Methods According to the Hamilton Depression Scale (HAMD-24) and Self-rating Depression Scale(SDS) score,95 patients with unstable angina received coronary drug-eluting stent implantation combined with depression disorder were serve as the study group; randomly selecte 246 cases without depression due to unstable angina pectoris after coronary stent implantation as the control group in the same period. The incidence rate of ISR in these two group were observed, and serum aldosterone ( ALD), high-sensitivity C-reactive protein (hs-CRP) ,Leptin levels in two groups were compared. Results The incidence rate of ISR in study group were significantly higher than that of the control group (28/95 vs 46/246, P＜0. 05). Following with the aggravation of depression disorder,the incidence rate of ISR were elevated( χ2 =8. 148, P=0.017). Serum ALD,hs-CRP and Leptin levels of study group were significantly higher than the control group 7 days later after drug-eluting stent implantation ( ALD:277.4 ± 35.9 vs 258.9 ± 60.9, t= 3. 459, P= 0. 001; hs-CRP: 12.03 ± 3.06 vs 11.10 ±2. 806, t = 2.573, P = 0.008; Leptin:5.27 t 1.07 vs 4.98 ± 0.99, t= 2.323, P= 0.021 ). Pearson correlation analysis showed that its HAMA-24 score was positively correlated with serum ALD ,hs-CRP and Leptin( r=0.291,P=0.026; r=0.350, P=0.014; r=0. 312, P=0.023) ,and SDS score was positively correlated with hs-CRP( r=0. 302, P= 0. 020). Conclusion Serum ALD, hs-CRP and Leptin levels are higher in patients after coronary stent implantation combined with depression in patients, and the incidence rate of ISR is also higher in these patients, and the rates are elevated according to the aggravation of depression disorder.

Objective To investigate the expression and significance of S100A4 protein and Ecadherin in coloreetal carcinoma. Methods S-P immunohistochemical method was used to detect the expression of S100A4 and E-cadherin in 87cases with colorectal carcinoma and 87 cases with adjacent colorectal tissue, and the expression of S100A4 and E--cadherin were analyzed with relation to clinicopathologic factors and post-operative five-year survival. Results There was no expression for S100A4 protein in glandular epithelium of adjacent colorectal tissues. The positive expression rate of S100A4 was 64.4 %(56/87) in colorectal carcinoma. There was a significant difference between eolorectal carcinoma and adjacent group(P ＜0.01). The expression of S100A4 was positively correlated with the clinical stages, lymph node metastasis and five-year survival (P ＜0.05), but not with other clinicopathalagic factors (P ＞0.05). There was 100 % expression for E-cadherin in adjacent colorectal tissues. The positive expression rate of Ecadherin was 62.1%(54187) in colorectal carcinoma. There was a significant difference between colorectal carcinoma and adjacent group (P ＜0.01). The expression of E-cadherin was positively correlated with the clinical stages, lymph node metastasis, tumor site and five-year survival (P ＜0.05), hut not with other clinicopathologic factors (P ＞0.05). The expression of S100A4 was negatively correlated to E-cadherin in colorectal carcinoma without statistical meaning(r =-0.087, P ＞0.05). Conclusion S100A4 and E-cadherin are closely related with colorectal cancer invasion, metastasis and prognosis; S100A4 might be an important predictor of the clinicopathologic features and prognosis of eolorectal carcinoma.

Objective To evaluate the accuracy of methods in echocardiographic measurements of right ventricular (RV) volume.Methods Forty-six healthy volunteers were examined by two dimensional echocardiography (2-DE),real time three-dimensional echocardiography (RT-3DE) and cardiac magnetic resonance imaging (cMRI) within 24 hours.2 DE adopts three methods to measure RV volume,the first is Simpson,the second is the half ellipsoid method,and the last is biplane area-length method.In RT 3DE,RV volume were calculated respectively by tri-plane method and TomTec 4D RV-function CAP software.In cMRI,RV volume was calculated by Argus software.Right ventricular end diastolic and end-systolic volume (RVEDV,RVESV) were measured respectively.Then the echo measurement were compared to cMRI.Consistency of two methods was evaluated by Bland-Altman analysis.Results ①As compared to cMRI,Simpson,the half ellipsoid method and tri-plane method underestimated RV volume,with statistical significance(P ＜0.05).Biplane area-length method and TomTec 4D RV-Function CAP had no significant statistical difference (P ＞ 0.05).② The result of correlation analysis was as follows:RV volumes from Simpson and tri-plane method had bad correlation with those from cMRI (r =0.3-0.4).RV volumes from TomTec,half ellipsoid method and biplane area length method correlated highly with those from cMRI(r =0.7-0.8).③The Bland-Altman analysis of echo methods with cMRI showed that each measurement by TomTec and biplane area-length method had a smaller limit of the agreement and a smaller difference average.Conclusions Tom-Tec 4D RV-Function CAP in RT-3DE and biplane area length method in 2-DE can measure RV volumes accurately.

Objective To discuss the risk factors of free wall rupture (FWR) in acute ST-segment elevation myocardial infarction (STEMI) patients. Methods We retrospectively reviewed all patients (n=1247) with STEMI hospitalized in CCU from January 2005 to July 2010. Results FWR occurred in 29 patients(2.3%). Of these 1247 patients, 128 (10.2%) patients received thrombolytic therapy, 623 (50.0%) patients underwent primary PCI. Compared to No-FWR group, FWR group has signiifcant differences in age (62.4±6.4 y vs. 66.6±8.3 y, P<0.05), hypertenion (29.7%vs. 21.8%, P>0.05), diabetes mellitu (55.2%vs. 23.5%, P=0.022), presence of heart failure on admission (Killip≥Ⅱ) ( 16.4%vs. 34.0%, P<0.05), Peak value of hCRP[20.33 (15.02, 81.25) vs. 43.35 (16.56, 126.78)], no-history of pervious MI (10.3%vs. 18.4%, P=0.018). Multivariate logistic regression showed that age (≥70 years old), Killip≥Ⅱ, hCRP ( > 100 mg/L) and thrombolytic therapy were independent risk factors of FWR. Conclusions STEMI patients with advanced age, Killip≥Ⅱ, hCRP and thrombolytic therapy were more vulnerable of FWR.

BACKGROUND: The bone marrow stem cell (MSC) transplant treatment have the obvious superiority to tradition graft treatment for bone nonunion, but how to obtain the concentrated and highly effective bone marrow mesenchymal stem cell, as well as the dose-effect relations to fracture healing need further discussions. OBJECTIVE: To observe the curative effect of bone nonunion by using autologous MSC transplant treatment, and to compare with autologous iliac bone graft.DESIGN, TIME AND SETTING: Randomized controlled analysis was performed from January 1999 to June 2005 in the Affiliated Second Hospital of Hebei Northern College.PARTICIPANTS: The admitting 140 patients with humerus and tibia fracture were divided into 2 groups at random, autologous iliac bone graft group and autologous MSC transplant group, with 70 patients in each group. METHODS: Under aseptic condition, autologous MSC transplant group received puncture through posterior superior iliac spine, extracting bone marrow 10-20 mL from different spots, separating MSC using the density gradient centrifugation method, and counting as 4×10~9 nucleated cells/mL under the microscope for later use. In the autologous iliac bone graft group, bone fracture end was implanted with the suitable amount of iliac bone, while autologous MSC transplant group with the mixture of decalcified bone matrix and MSC, followed by suture. After the transplantation, external fixation may assist for 4-6 weeks according to the fixed degree of internal fixation.MAIN OUTCOME MEASURES: ① Bone callus formation and pain conditions in 2 groups at different time points after transplantation. ② Comparison of bone healing time between 2 groups. ③ Adverse events and side effects.RESULTS: According to intention-treatment analysis, experimental adopted 140 patients of humerus and tibia fractures, who all entered the final analysis. ① Bone callus formation and pain at different time points post-surgery: At 1 month after transplantation, bone callus formation in the fracture end was not obvious in autogenous iliac bone graft group, and could be seen in autologous MSC transplant group, both groups of fractures exhibited tenderness. At 2 months after transplantation, bone callus formation was observed in autogenous iliac bone graft group, fracture tenderness was relieved compared with the previous condition; in autologous MSC transplant group, a large number of bone callus formed, fracture tenderness was not obvious. At 3 months after transplantation, there were a large number of bone callus formations in autogenous iliac bone graft group, with slight fracture tenderness; in the autologous MSC transplant group, continuous bone callus formation appeared, without fracture tenderness. ② Bone healing time: The average healing time of autologous MSC transplant group was significantly shorter than autogenous iliac bone graft group [(5.5±1.5), (8.0±2.0) months, P < 0.05]. ③ Adverse events and side effects: Except 4 patients had iliac bone pain, all patients during the treatment had no infection and other complications, there were no re-fracture occurred at the follow-up of 8 months.CONCLUSION: The autologous MSC transplant treatment of exhibits a short duration and good effect for bone non-union, has obvious advantages over traditional bone graft.

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/ At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.
Bone Screws ; Bone Transplantation/*instrumentation ; Bone Transplantation/*methods ; Kyphosis/etiology ; Kyphosis/*surgery ; Lumbar Vertebrae/pathology ; Lumbar Vertebrae/surgery ; Nervous System Diseases/etiology ; Postoperative Complications ; Spinal Fractures/*surgery ; Spinal Fusion

BACKGROUND:At present, the methods of treating unstable comminuted radial head fractures contain open reduction and internal fixation and metal prosthesis replacement. There were success cases treated by the two methods, but some shortcomings simultaneously existed.
OBJECTIVE:To compare the clinical therapeutic effects of replacement of the radial head with metal prosthesis with open reduction and internal fixation for the treatment of unstable comminuted radial head fractures.
METHODS:A prospective randomized control ed analysis was performed in 45 cases of unstable comminuted radial head fractures. These cases received open reduction and internal fixation and metal prosthesis replacement. This study compared the Broberg and Morrey elbow joint function score and the incidence of complications after fixation, and performed statistical analysis.
RESULTS AND CONCLUSION:The subjects were fol owed up for 1-5 years, averagely 2.8 years. According to Broberg and Morrey scores, the average score was 90.1 and the incidence of complications was 13.6%in the prosthesis replacement group. The average score was 76.8 and the incidence of complications was 47.9%in the open reduction. Significant differences were visible between the two groups (P<0.01). Compared with the open reduction group, prosthesis replacement for unstable comminuted radial head fractures obtained better joint function and lower incidence of complications.

Psychiatric professional talents is specially needed in China.Our university was ratified by ministry of education of people's republic of China in 2011 to cultivate professional master degree postgraduates majoring in mental health and psychiatry.According to the social needs and requirements of ministry of education,we carried out comprehensive reform and exploration in cultivation direction and objective,time management and course offering,cultivating model,examination and evaluation system.Cultivation direction included clinical psychiatry,forensic psychiatry,community psychiatry,behavioral medicine and clinical psychology,which were closely related with social needs.The objective was to cultivate high-grade psychiatric special talents with higher political diathesis,competent clinical skills,certain teaching and research abilities and grasping one foreign language.The total time for cultivating clinical skills should no less than two years and a half.Course offering included degree course and non - degree course,clinical skills,academic activities,teaching practice,medical record arrangement or case analysis essay writing.We developed the cultivating model combining ‘ medicine,study and research' and developed multilevel and comprehensive examination and evaluation system.