OBJECTIVE: Autologous bone transplantation has been extensively used clinically, but the scant bone source eligible for transplantation cannot meet the demand in large bone defect repair. Tissue engineering seems to provide a way out, by inducing bone regeneration for repairing bone defect. In this article, the authors review the development in bone tissue engineering achieved in recent years.DATA SOURCES: A literature review was conducted with Google and Medline-based search for reports published in Chinese on bone tissue engineering in the last 3 years, as well as for worldwide literature published from January 1964 to December 2002, using the key words for retrieval of bone tissue engineering, scaffold, hydroxyapatite composites.STUDY SELECTION: Fifty-six articles were selected, which documented in vtiro bone culture, non-crystal medical biomaterials, development of bone tissue engineering, experimental and clinical trials of bone tissue engineering and clinical application of the results of bone tissue engineering.DATA EXTRACTION:From the 56 articles, 14 were excluded for repetition of contents. The remaining 42 were classified for reviewing and 21 of these were enrolled as references here.DATA SYSTHESIS: Autologous bone grafting is the usual choice for bone defect repair. The grafts include allografts and xenograft of spongy bone and compact bone, joints, decalcified bone matrix, marrow, ceramics and ceramics composites. But the effect of repair or reconstruction of large bone defect as left by excision of large bone tumors is not satisfactory. Tissue-engineering studies on composites for repair of the damaged nerve, tendon and skin are still in their infancy, while studies of bone scaffold materials has made great progress.CONCLUSION: Great breakthroughs have been made in tissue engineering and relevant studies of tissue defect and function impairment is fast developing. As the structure of motor system and skeletal system are relatively simple,and the bone or cartilage defects clinically common, bone tissue engineering might first enter clinical use in the field of orthopedics.

Objective Hemangioma had been recognized as one of the most common tumors; however, intramauscular hemangioma (IMH) was a kind of uncommon benign tumor in skeletal muscle. A large number of orthopaedic surgeons knew little about it's specific clinic features. This paper was to report the diagnosis and therapy of 110 IMH cases, and to review tbe causes for misdiagnosis as well. Methods From oct. 1962 to Dec. 1998, 110 patients underwent surgical therapy with the definitive histological diagnosis; the clinical feature, gender, age, value of X-ray imaging, computed tomography(CT), single photon emission computed tomography (SPECT)?magnetic resonance imaging (MRI) and ultrasonography of IMH were analysed. Surgical technique, pathological classification, postoperation effects, prognosis and recurrence reason were discussed. Measures for cmplication and recurrence prevention, differential diagnosis were put forward. Results Anatomical distribution was 11.82% in the neck, 10.91% in the trunk, 16.36% in the upper limb and 60.91% in the lower limb. The disease was characterized by localized pain within soft tissue, local mass, deep tenderness, muscular soreness and mass expansion after exercise. According to Allen's classification, three types were defined: 1) capillary type; 2) cavernous type; 3) mixed type, combination of both, which included miscellaneous types of deep soft tissue(venous,arteriovenous,epithelioid and granulation tissue type). There were capillary type (38.18%), cavernous (33.64%) and mixed type(28.18%). Forty-nine of 110 cases were followed up for an average of six years and two months, the result of 48.98% patients was excellent, 22.45% was good, and 20.41% was unsatisfactory. Only four of 49 cases had local recurrence which was susceptible to infection. Conclusion Intra muscular hemangioma is easy to be mis or under diagnosed, especialy when it is deep or small localized, and it can rarely be diagnosed radiologically unless calcified phlebolithes occurs. Usually, peripheral nerve is not invaded, but could be compressed by the tumor. MRI is most helpful to define the diagnosis, and SPECT can also provide helpful diagnostic information. Although it can be treated by various methods, surgical excision provides the best result. Recurrence can always attribute to incomplete excision. Wide excision of the lesion is the treatment of choice. Preoperative embolization of IMH can reduce intraoperative blood shedding. Embolization combined with surgery forms a new modern approach to treat IMH.

OBJECTIVE To study clinical distribution of Serratia and learn the antimicrobial susceptibility to S.marcescens in vitro in order to offer the reference to optimally selecting antibiotic.METHODS It was analyzed that the 222 Serratia strains were distributed in and the was deteted 164 S.marcescens strains were isolated from our hospital from 2001 to 2006.Their VITEK-2 of French Bio-M?rieux Company was adopted to proceed the identification of bacteria and antimicrobial susceptibility test.Data were analyzed by WHONET 5.4.RESULTS Serratia were mainly isolated from sputum,urine,blood,secretion,bile,cerebrospinal fluid,abdominal fluid,et al.Infection of both in-and out-patients could be caused by Serratia and most were in surgery ward.S.marcescens had higher drug resistance rates to piperacillin,cefazolin,cefuroxime,gentamicin and tobramycin which were all above 60%.They were all susceptible to imipenem(minimum inhibitory concentration only 1 ?g/ml) and their susceptible rates to piperacillin/tazobactam,ceftazidime,cefepime,and levofloxacin were all higher than 80%.CONCLUSIONS Serratia are less isolated from clinics,but have much higher antimicrobial resistance to the 1st and 2nd generation cephalosporin and show diversely drug resistance to 3rd cephalosporin,so physicians should pay attention to the infection caused by them.

Objective To label human VEGF targeted bevacizumab (avastin) with 111In and to evaluate the application of 111 In?DTPA?avastin SPECT imaging for tumor diagnosis. Methods DTPA?avastin was prepared by coupling with a bifunctional chelating agent, and then labeled with 111 In to obtain 111 In?DTPA?avastin. The stability and molecular integrity of the labeled radiotracer were studied. Human hepatoma cell ( BEL7404) bearing nude mice tumor model was employed for tumor targeting evaluation. Gamma imaging was acquired after intravenous injection of 18.5 MBq probe. At the end of the observation, animals were sac?rificed for bio?distribution study. Results 111 In?DTPA?avastin tracer was synthesized and purified to a?chieve a radiochemical purity yield above 98% and specific activity up to 185 GBq/nmol. Its stability in 5%BSA was optimal, and the radiochemical purity after incubation for 96 h was over 90%. Gamma imaging re?sults showed that the tracer possessed definite tumor targeting property. Its biodistribution was consistent with that of normal in vivo antibody metabolism while possessing a good tumor?targeting property with a relatively high uptake of (3.8±0.8) %ID/g in tumor tissues 96 h after injection. Conclusions 111 In?DTPA?avastin tracer has good physicochemical properties, in vivo stability and good VEGF targeted binding. 111 In?DTPA?avastin has potential to be a new molecular probe for SPECT imaging.

ObjectiveTo investigate the value of urinary BNP for diagnosis of chronic heart failure (CHF). MethodsThe levels of Urinary BNP and plasma BNP were measured by microparticle enzyme immunoassay (MEIA) in 83 patients with CHF and 30 control subjects. The heart function was classified according totheNYHAcriteria. Leftventricularejectionfractions(LVEF)weremeasuredby echocardiology. ResultsThe level of urinary BNP in patients with CHF was[90. 0(38. 3 -209. 5 )]ng/L and the level of plasma BNP was[680. 0 ( 289. 7 - 1543.5)]ng/L, both of them were much higher than those in healthy subjects,[17. 0 ( 13.0 - 33. 0)]ng/L and[84. 5 ( 56. 0 - 158.0 )]ng/L, respectively (P＜0. 01 ). The concentrations of urinary BNP increased gradually with more severe symptoms ( NYHA cl ass Ⅰ -ⅣV ). The level of urinary BNP was positively correlated with NYHA class ( r = 0. 742, P ＜ 0. 01 )and the level of plasma BNP (r =0. 842,P ＜0. 01 ) while negatively related with LVEF (r = -0. 801 ,P ＜0. 01 ). The level of urinary BNP in patients with LVEF ＜ 40％ was[143.0 ( 85. 0 - 258.0)]ng/L , which was much higher than that in patients with LVEF≥40％ ,[31.5( 17.3 -38. 8)]ng/L, (P ＜0. 01 ). At a decision threshold of 36. 5 ng/L, the urine BNP assay demonstrated a clinical sensitivity and specificity of 84％ and 80％ ,respectively. In this study,the area under the curve(AUC) was 0. 905. ConclusionUrinary BNP is a new candidate marker for the diagnosis of CHF,it provides a similar accuracy with plasma BNP.

Objective To investigate the effects of injecting allogeneic mesenchymal stem cells(MSCs) on the cellular immunity in rat in vivo.Methods Bone marrow-derived MSCs were isolated from Wistar rats.The purity of MSCs was identified by morphological examination with microphotography,and the phenotypes were identified with flow cytometry.Twenty SD rats were randomly divided into 4 groups.Different concentrations of MSCs(5?106/ml for group A,5?105/ml for group B,and 5?104/ml for group C,respectively) and PBS(for group D) were given to allogeneic SD rats via intravenous infusions.The suppressive effect of MSCs on lymphocytes proliferation in recipient rat was analyzed using mixed lymphocyte cultures(MLR) 10 days after cultivation.At the same time,proportions of CD4+,CD8+ and CD4+CD25+/CD4+ T-lymphocytes in peripheral blood and spleen were analyzed with flow cytometry.Results Proliferation rate of splenic lymphocytes in group A(5?106/ml MSCs,8.58%?0.27%) was markedly lowered compared with that in group D(PBS,24.40%?5.21%,P

OBJECTIVE To learn the profile of Gram-negative bacilli in ICU ward during the eight years and analyze the drug resistant rates in order to provide the basis for empirical treatment of infection.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted Kirby-Bauer method.Data were analyzed by WHONET5.4 software.RESULTS Totally 1492 strains of Gram-negative bacilli were isolated from ICU ward,which included 1146 strains of non-fermentaters,accounted for 76.8% and 346 strains of Enterobacteriaceae,accounted for 23.2%.The first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Escherichia coli by turns.The drug resistant rates were higher and had the tendency of increase by years.CONCLUSIONS Non-fermentaters are the main organisms in ICU ward.The species of bacteria are diversified and the drug resistant rates of them are serious,which should be monitored not only because helping clinical therapy but also discovering the prevalence of drug resistant strains.

OBJECTIVE To learn the epidemiology of respiratory infection in ICU and non-ICU wards,and analyze the difference of drug resistance of Gram-negative bacilli between those two wards in order to provide the basis of empirical therapy for the respiratory infection from the different wards.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted by K-B method.Data were analyzed by WHONET 5.3 software.RESULTS Totally 2184 strains of Gram-negative bacilli were isolated all from the respiratory tract,among which 655 strains were isolated from ICU ward and 1529 strains were from non-ICU ward.In ICU ward,the first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Chryseobacterium meningosepticum,and Stenotrophomonas maltophilia.It showed that non-fermentatives were the main pathogenic bacteria in ICU.In non-ICU ward,the first five bacteria were P.aeruginosa,Klebsiella pneumoniae,A.baumannii,B.cepacia,and S.maltophilia.Drug resistant rate of strain from ICU ward was generally higher than that from non-ICU ward,while levofloxacin in ICU ward showed the better activity than in non-ICU ward.CONCLUSIONS The respiratory infection is one of the hazards in nosocomial infection,drug resistant rate of Gram-negative bacilli from respiratory specimen in ICU is generally higher than that in non-ICU,and the main strains are the mlti-resistant non-fermentatives,which should attract the clinician′s more attention.

OBJECTIVE To offer the clinical physician the basis of optimal application of antibiotic,we have investigated the variation of antibiotic resistance and the bacterial spectra in the blood culture.METHODS Blood was cultured in BACTEC9120 of BD.The clinical isolates were identified by API and VITEK-2 of Bio-Merieux of France.Antibiotic susceptive test was done by Kirby-Bauer method and the result which was analyzed by WHONET5.3 and SPSS11.5 software was determined by the NCCLS standard of 2005′s edition.RESULTS Organisms were isolated from the blood specimen of 1468 patients,and there were 743 strains of Gram-positive cocci accounted for 50.7%,565 strains of Gram-negative bacilli accounted for 38.5%.Ninety three strains of fungi accounted for 6.3%.We analyzed the drug-susceptive result of Staphylococcus,Escherichia coli,and Klebsiella pneumoniae during five years,and found that all the antibacterial drug lost efficacy in some degree,except that the sensitivity of the staphylococci to vancomycin was 100%.CONCLUSIONS Gram-positive cocci are the main bacteria in blood culture,the species from which are diversified,and the rate of the drug resistance of some bacteria is high.It indicated that doctors should take more blood culture and monitor the bacteria drug resistant for the data of etiology,so that they can utilize antibiotic more reasonably.

Objective To establish a novel direct radio-labeling method for 99Tcm-IgG and evaluate the biologic distribution of 99Tcm-IgG.Methods IgG protein was modified with 2-mercaptoethanol.Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE),UV-vis spectrophotometer,matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) were used to identify the concentration,integrity of the modified protein.Then radiolabeled IgG-SH with 99TcmO4-was analyzed with radio-HPLC.The product was prepared as frozen kits.The distribution and metabolic process of 99Tcm-IgG were observed in New Zealand white rabbits.Results The relative molecular mass of IgG-SH and IgG measured by SDA-PAGE were similar.The relative molecular mass measured by MALDI-TOF was 1.47× 105.The radiolabeling yield was over 95％,the specific activity was 1.7× 105 GBq/mmol.All the radioactive conjugates of 99Tcm-IgG showed excellent stability in vitro.And more than 95％ conjugates retained their original structures for 6 h in 5％ BAS.Gamma imaging in New Zealand white rabbits showed blood retention in first 4 h after injection,and prominent uptake of radiotracers in the liver,kidneys,and urinary bladder at 24 h after injection,which indicated that 99Tcm-IgG was excreted mainly through the renal route.99Tcm-IgG kept its original biological activity after the modification.Conclusions Direct radio-labeling of 99Tcm-IgG was successfully established.The methods may be useful for radio-modification of monoclonal antibody.