Objective To investigate the clinical application of forearm arteriovenous fistula in uremia patients, and find out the cause of fistula dysfunction. Methods Three hundred and forty-five chronic uremia patients were collected. Forearm arteriovenous fistula were set up as vascular access. Recorded the relationship betwe the using condition. Results Chronic nephritis was the most, and diabetic nephropathy was lowest in the using fistula time exceeding 2 years, the internal fistula losing function occurred 103 cases in 1 year after intenal fistula establishment, the highest rate was diabetic nephropathy, then hypertension innocence renal arteriolar sclerosis. There were significant difference beween diabetic nephropathy, hypertension innocence renal arteriolar sclerosis and chronic nephritis (P<0.05). Conclusion In diabetic nephropathy and hypertension patients, the using time of fistula is short and the accidence of fistula dysfunction is high.

Objective To discuss the relationship age and pathologic type, tumor size (≥4 cm) and pelvic lymph metastasis in cervical cancer, and the relative factors of cervical cancer with metastasis of pelvic lymphaden and the possibility of ovarian conservation. Methods 166 cases of cervical cancer accepted radical hysterectomy and pelvic lymphadenectomy in our hospital from June 2002 to June 2007, and were analyzed retrospectively. 166 cases of cervical cancer were divided into two groups, the age in group A was less than 35, while in group B was more than 35. Results The possibility of adenocarcinoma, the tumor size (≥4 cm) and the metastasis of pelvic lymphaden were higher in group A than in group B. The higher the clinical stage, the higher the pathological type and grade were. The greater the tumor size were ,the higher the rate of pelvic lymphatic metastasis (P <0.01). The more tissue infiltrate were, the higher the rate of pelvic lymphatic metastasis (P <0.01). Conclusion The possibility of adenocarcinoma carcinoma, the tumor size (≥ 4 cm) and the metastasis of pelvic were more higher in young women. The rate of pelvic metastasis is closely related to clinical stage, pathological type and grade, tumor size, and tissue infitration.

Objective To investigate the changes of collagen types Ⅰ and Ⅲ, the effects of Oleum Curcumae Aromaticae oil injection on injuried rat arteries and collagen types Ⅰ and Ⅲ after balloon angioplasty Methods The left common carotid artery in rats was denuded with a balloon catheter The rats were killed 14 days after injury Cross sections stained with picrosirius red from the injuried segments were processed for distribution, arrangememt, amount, proportion of collagen type Ⅰ and type Ⅲ by polarizing microscope, and those stained with hematoxylin eosin for histological and morphological changes studied by computer assisted picture analysis system Results Fourteen days after balloon injury, collagen type Ⅰ and type Ⅲ of the model group were found mainly in adventitia, much more, thicker, brighter and more disordered than those of the sham operation group Compared with the model group, collagen type Ⅰ and type Ⅲ of the E Zhu You group were found mainly in adventitia, less, thinner, dimmer and more orderly Lumen area, EEL perimeter, IEL perimeter of the model group were decreased and the areas of collagen types Ⅰ and Ⅲ increased more significantly than those of the sham operation group Compared with the model group, maximal intimal thickness, neointima area, the areas of collagen type Ⅰ and Ⅲ of the E Zhu You group were decreased significantly which was not different from those of the sham operation group Lumen area, EEL perimeter and IEL perimeter were increased markedly up to those of the sham operation group The ratio of collagen subtypes Ⅰ/Ⅲ was not significantly different between the two of the three groups Conclusion The accumulation and derangement of collagen types Ⅰ and Ⅲ may be more important in restenosis than the ratio of collagen subtypes Ⅰ/Ⅲ We concluded that Oleum Curcumae Aromaticae oil injection inhibits neointimal formation and vascular remodeling after arterial injury by mechanisms involving collagen types Ⅰ and Ⅲ production and their arrangement

BACKGROUND:As bone marrow mesenchymal stem cel s can be differentiated into osteoblasts under certain induction conditions, autologous bone marrow mesenchymal stem cel s can be implanted into the bone nonunion site of bone fracture. This new technology garners increasing attention of orthopedic clinicians.
OBJECTIVE:To summarize the clinical efficacy of transplantation of bone marrow mesenchymal stem cel s in the treatment of bone nonunion of limb fractures.
METHODS:A computer-based search of Foreign Medical Journal Ful-Text Service and CNKI databases was performed for articles related to bone marrow mesenchymal stem cel s for treatment of bone nonunion of limb fractures published from 1998 to 2014 using the keywords of“bone marrow stem cel s (BMSCs), stem cel transplantation (SCT), nonunions, tissue engineering”in English and Chinese, respectively. Literatures with repetitive content and lack of originality were excluded. A total of 36 literatures were obtained for further analysis. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s are transplanted into the end of bone nonunion, and then can be induced to differentiate into osteoblasts to repair bone nonunion and bone defects,
laying a theoretical basis for clinical application. Bone marrow mesenchymal stem cel s can repair bone defects, which provides an effective method and material to promote fracture healing. Transplantation of bone marrow mesenchymal stem cel s is safe and effective for treatment of bone nonunion of limb fracture.

Analyze the problems of medical insurance real-time settlement in outpatient department.Explore the situation of stringent management of health medical insurance agencies,accuracy of the information,significant increasing costs that medical insurance agencies refused to pay and severe environment to doctors.And management strategy such as regulating doctors' behavior strictly,upgrading hospital information systems,increasing hospital staff to excavate the hospital potential and publicizing the new policy of medical insurance comprehensively.

BACKGROUND:Drug treatment is the main method for the treatment of diabetes currently, but the development of the disease and occurrence of related complications are the chal enges to the effect of drugs. OBJECTIVE:To investigate the effect and feasibility of co-transplantation of bone marrow mesenchymal stem cells and islet cells for the treatment of diabetes. METHODS:The rat bone marrow mesenchymal stem cells were separated and purified, and cultured in vitro to establish the diabetes models. The rat diabetes models were injected with bone marrow mesenchymal stem cells, co-cultured mixture of bone marrow mesenchymal stem cells and islet cells, and normal saline or phosphate buffer (control). The effect of transplantation was evaluated through observing the blood glucose levels, insulin secretion, and pathological changes of pancreatic tissue in the rat diabetes models. RESUTLS AND CONCLUSION:In the diabetes rats treated with bone marrow mesenchymal stem cel transplantation, the C-peptide levels were significantly increased after transplantation, while the blood glucose levels were significantly decreased, but not lower than the normal level, and the blood glucose levels were increased again with the time prolonging. In the diabetes rats treated with co-transplantation of bone marrow mesenchymal stem cells and islet cells, the blood glucose levels were decreased significantly and lower than the normal level which was maintained in a certain time, and the decreasing degree was larger than that in the rats treated with simple bone marrow mesenchymal stem cel transplantation. Co-transplantation of bone marrow mesenchymal stem cells and islet cells is feasible for the treatment of diabetes with a certain effect.

Objective To study the relationship between parathyroid hormone(PTH)level and central arterial stiffness in patients with high risk of coronary artery disease(CAD) and preserved renal function.Methods Seventy-seven patients with at least one risk factor of coronary artery disease (CAD) were divided into increased arterial stiffness group(n=35) and control group(n=42),based on whether the noninvasive pulse wave analysis index of the central pulse pressure(CPP) was higher than 40mmHg or not.Coronary artery angiography was performed in all cases.Serum intact PTH,calcium,phosphor,and highly sensitive C reactive protein (hsCRP) was assessed by radioimmunoassay.Coronary angiography was also performed.Results The patients in increased arterial stiffness group were elder and had higher serum uric acid compared with those in the control group.Forty-four patients were confirmed to have CAD; CAD patients in the stiffness group (n=23) had significantly higher serum iPTH level compared with those in the control group(n=21) (P40 mmHg)after adjustment for age,BMI,hs-CRP,and male gender.Conclusion CAD patients with increased central arterial stiffness and preserved renal function have higher serum PTH level.The serum PTH level is positively correlated with central arterial stiffness,and is the independent risk factor for increased arterial stiffness.

BACKGROUND:Rabbit bone marrow mesenchymal stem cels as a kind of adult stem cels with strong proliferation and multilineage differentiation potential exhibit a tremendous application potential in tissue engineering and biological therapy.
OBJECTIVE:To in vitro culture, proliferate and identify rabbit bone marrow mesenchymal stem cels and to observe cel biological characteristics.
MEHTODS:Bone marrow of rabbits was extracted under sterile conditions to separate bone marrow mesenchymal stem cels using the whole bone marrow adherence method and Percol density gradient centrifugation method. Afterwards, the cels were purified and proliferated using differential adherence method. Morphology and growth pattern of cels were observed under microscope, and expression of cel surface antigen markers was detected by flow cytometry.
RESULTS AND CONCLUSION:Rabbit bone marrow mesenchymal stem cels presented with short adherent time and fast growth. After passage and purification, impurities cel counts were decreased. Primary cels presented with triangular, fusiform and spindly shapes. Passage 5 cels with single shape showed the typical polar swirling growth, and could not express CD34 and CD45, but expressed CD29 and CD44. These findings indicate that the cels cultured using the whole bone marrow adherence method and Percol density gradient centrifugation method possess stem cel characteristics in morphology, surface markers and multilineage differentiation, which have been identified as bone marrow mesenchymal stem cels by flow cytometry.

Objective To establish osteochondral scaffolds with remained calcified cartilage zone for finding an ideal scaffold for tissue engineered repair of osteochondral defect.Methods Cartilage zone was harvested from fresh adult porcine knee to fabricate type Ⅱ collagen hydrogel.Bone blocks measuring 8 mm in diameter with calcified cartilage zone were prepared by trephine and acellular treatment was performed.Histological staining was used to identify complete removal of cells.To fabricate the osteochondral models containing calcified cartilage zone,type Ⅱ collagen was seeded onto the acellular bone blocks with calcified cartilage zone,lyophilized,and cross-linked with 10 g/L of genipin ethanol solution.Then cell seeding and scanning electron microscope were performed after the models were established.Results HE staining,toluidine blue staining,solid green staining,safranin O staining,and DAPI staining showed cells were completely removed from bone blocks by decellularized process.Porosity of type Ⅱ collagen sponge was (91.1 ±3.8) ％ and pore size was (79.7 ± 17.1) μm.Porosity of acellular bone blocks was (73.5 ±2.6)％ and pore size was (470.2 ± 158.8) μm.Cells seeded onto osteochondral scaffolds grew well by scanning electron microscope.Conclusion Osteochondral scaffolds with calcified cartilage zone provide good biocompatibility and suitable pore size and porosity and may be an ideal material for repairing osteochondral defect in tissue engineering.

Objective To systematically assess the incidence of needlestick injury in Chinese nursing interns.Methods Research articles published on China Academic Journal Electronic Retrieval Database (CNKI),Chinese Scientific Journals Full-text Database (VIP),Wanfang DATA,ISI Web of Knowledge,PUBMED,OVID,Springer and other databases before 2013 were searched,which were relevant to needlestick injury in Chinese nursing interns.Using STATA 12.0 software,pooled estimates were summarized by Meta-analysis.Results 61 articles were included in this study,which covered a total of 15 451 nursing interns.Meta-analysis showed that the pooled incidence of needlestick injury in nursing interns was 65％,95％CI=60％～71％.Although the incidence declined year by year in recent decade,it was still higher than 55％.However,the injury reporting rate was 22％,95％ CI=16％～29％.Conclusions Needlestick injury showed a high incidence in Chinese nursing interns,but declined slightly year by year.However,the injury reporting rate was still very low.