Objective To investigate the effect of vagina reconstruction using tissue-engineering biological material (acellular dermal matrix) in an animal model.Methods Vagina excision and vagina reconstruction with tissue-engineering biological material were performed in 12 Chinese experimental miniature pigs.The control group was matched with two of normal vagina specimens resected.At week 1,2,4,6,8,12 after surgery,the animals were sacrificed,respectively,and the neovaginas were prepared for immunohistochemical and Van Gieson (VG) staining to evaluate the status of various layer growth of vagina.Epithelial broad spectrum of monoclonal antibodies of AE1/AE3 and α-actin were used to test the existence of epithelial and smooth muscle tissue by immunohistochemical staining.The ultrastructure of neovagina was studied by transmission electron microscope at week 1 and 12 after surgery.Contractile function of isolated smooth muscle of neovagina was evaluated by chemical and electronic stimulation after 12 weeks' reconstruction.Results (1) Epithelization of 2/3 neovaginal mucosa was observed within 1 week.Only 1-2 layer epitheliums were observed under the light microscopy and epithelial cells with characteristics of loose and disarrangement were shown with the electron microscopy.Within 4-6 weeks,epithelization in mucosa of neovaginal canal was intensified to 4-5 layers.After 12 weeks,the differences between the neovagina and the native vagina were harldy noted either in the gross or microscopically.(2) After 4 weeks,a few smooth muscle cells were observed with VG and immunohistochemical staining,and homogeneous muscle bundle was formed.(3) After 12 weeks,similar contractile responses between neovagina and native vagina were observed when KCI and electrical stimulation with different frequency and voltage were given [(2.96±0.29)g vs.(3.14±0.30)g,(3.43±0.34)g vs.(4.65±0.73)g,(4.92±0.38)g vs.(4.89±0.44)g].Conclusion The tissue-engineering biological material might be an ideal graft used in the reconstruction of vagina.

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

Objective To explore the timing of wound closure and the choice of methods in Gustilo Ⅲtype tibiofibula open fractures after emergency debridement.Methods 42 patients with Gustilo Ⅲ type tibiofibula open fractures from January 2014 to January 2015 were selected as the observation group.All patients were performed emergency fracture fixation after debridement and wound secretion culture immediately after debridement, if the training result was positive,the debridement,again until the training results for negative when square in 48 hours after closing a wound.Selected 38 patients with GustiloⅢtype tibiofibula open fractures,the prompt debridement 38 cases were fracture fixed routine treatment after closing the wound,they were set as the control group.Compared two groups of patients with wound infection and fracture healing.Results The fractures wound infection rate of the observation group was 4.76%,which was significantly lower than 15.79% of the control group,the difference was statistically significant(χ2 =10.739,P=0.000).The wound healing time and fracture healing time of the observation group were significantly better than those of the control group,there were statistically significant differences( t=9.684,7.324,all P<0.05).Conclusion GustiloⅢtype emergency open tibiofibula fracture after debridement of the wound closure time should according to the results of wound secretion culture,cultivate the results can be achieved when the negative for wound closure,according to the degree of injury of soft tissue,to choose the right means of wound closure.

BACKGROUND:Neural stem cells(NSCs)are characterized by widely resources,convenient harvesting,easy culture and prone to import and express exogenous genes,which can be served as carriers of gene therapy for neural system disease.OBJECTIVE:To review the application of NSCs in spinal cord injury.METHODS:Databases of PubMed(http://www.ncbi.nlm.nih.gov/PubMed)and Wanfang(http://www.wanfangdata.com.cn)were searched by the correspondence author using key words of "neural stem cells,spinal cord injury,cellular transplantation" both in English and Chinese to retrieve papers concerning isolation,identification,differentiation of NSCs as well as its application in repairing spinal cord injury.A total of 82 documents were initial obtained by computer,after repetitive studies were excluded,23 papers were included in the final analysis.RESULTS AND CONCLUSION:The NSCs transplantation has been widely used in animal experiments.Currently,the applications of NSCs in repairing spinal cord injury are concentrated on the following aspects:Firstly,cellular replacement therapy,namely,direct transplanting NSCs or activating in vivo NSCs to differentiate into neurons and glial cells,and then integrating transplanted cells with the existed neural cellular structure to cure the disease.Secondly,NSCs were utilized as gene carriers,which carrying target gene to body and reach the aims of cellular replacement and gene therapy.Thirdly,autologous NSCs were induced differentiation for self neural repair via studying growth factors and cytokines.

Insertion of foreign genes into the genome map of Chinese herb always produces the intended beneficial effects, but also the unintended effects. Analysis of genomic function and metabolic end products based on the principle of substantial can reveal the influence on the quality of herbs, which is able to provide valuable refer-ence for the following evaluation on pharmacology and toxicology.

Objective To study the clinical presentation and pathological features of rare nonepithelial vulvar tumors. Methods The clinical data of 42 patients with nonepithelial vulvar tumors who were operated on during 1986 to 2007 in Peking Union Medical College Hospital were analyzed. Results The average age of 42 patients was 44. 1 years. There were 32 eases (76%) with a vulvar mass. Twenty one of these 42 patients (50%) complained of associated symptoms of itch and pain Surgical treatment was the chief treatment of nonepithelial vulvar tumors, which included local excision (40, 95%), simple vulvectomy ( 1,2% ) and radical vulveetomy ( 1,2% ). Among the pathological diagnoses after operation,the most common benign histological subtypes were hidradenoma and haemangioma, while the must common malignant histological subtypes were leiomyosarcoma and aggressive angiomyxoma. Conclusions Most of the nonepithelial vulvar tumors are mesenehymal tumors. The clinical presentation has no special characteristics. Diagnosis of nonepithelial vulvar tumors can be made based on histological inspection.Surgical treatment is the treatment of choice.

Objective: To study influence of glycosylated hemoglobin A1c (HbA1c) on major adverse cardiovascular events (MACE) in patients with diabetes mellitus (DM) complicated coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Methods: A total of 100 DM+CHD patients after PCI were selected from our hospital.According to HbA1c level, they were divided into HbA1c<6.5% group (n=48) and HbA1c≥6.5% group (n=52).Levels of C reactive protein (CRP), tumor necrosis factor α (TNF-α), erythrocyte sedimentation rate (ESR) and interleukin (IL)-6 before PCI, incidence rate of MACE on six and 24 months after PCI were compared between two groups.Results: Compared with HbA1c<6.5% group before PCI, there were significant rise in serum levels of CRP[(18.5±6.2) mg/L vs.(25.8±4.2) mg/L]and TNF-α[(32.4±12.3) ng/L vs.(48.3±11.8) ng/L]in HbA1c≥6.5% group, P<0.01 both.On six months after PCI, incidence rate of myocardial infarction in HbA1c≥6.5% group was significantly higher than that of HbA1c<6.5% group (9.62% vs.0, P=0.028);24 months after PCI, compared with HbA1c<6.5% group, there were significant rise in incidence rates of myocardial infarction (2.08% vs.15.38%) and diseased vessel restenosis (12.50% vs.32.69%) in HbA1c≥6.5% group (P<0.05 all).Conclusion: In DM+CHD patients after PCI, those with lower HbA1c level possess better prognosis.

Objective To evaluate whether there is a correlation among plasma levels of procalcitonin (PCT),N-terminal pro-brain natriuretic peptide (NT-pro-BNP)and cardiac troponin T (cTnT)in patients with sepsis,as well as significance to prognosis of patients.Methods 48 patients with sepsis who were admitted to the intensive care unit of a hospital between September 2014 and March 2015 were chosen for study,patients were divided into severe and mild sepsis groups according to the disease condition,plasma levels of PCT,NT-pro-BNP,and cTnT were de-tected,mortality of patients were analyzed statistically,relation between plasma levels of PCT,NT-pro-BNP,cT-nT and patients’death were compared.Results The plasma levels of PCT,NT-pro-BNP and cTnT in severe sepsis group were significantly higher than those in mild sepsis group (all P <0.05);mortality of mild sepsis group was significantly lower than that of severe sepsis group (10.53% vs 41.38%,P <0.05);Levels of PCT,NT-pro-BNP and cTnT levels in died patients were all higher than surviving patients (all P <0.05);levels of PCT and NT-pro-BNP,NT-pro-BNP and cTnT were positively correlated respectively (rs = 0.337,P <0.05;rs =0.456,P =0.001, respectively ),while PCT was not significantly correlated with cTnT.Plasma levels of PCT,NT-pro-BNP,and cTnT were all correlated with the prognosis of patients (P <0.05),and is helpful for judging the prognosis of pa-tients,combination of three indexes had better prognostic value for the prognosis.Conclusion Combination detec-tion of plasmid levels of PCT,NP-pro-BNP,and cTnT can assess the severity of infection in patients with sepsis, and preliminarily judge the prognosis of patients with sepsis.

Objective To analyze the epidemic characteristics of mushroom poisoning incident in order to find the regularity of outbreak and provide the fundamental guidelines of prophylaxis,control,diagnosis and treatment.Methods According to the reported information from the Management Information System of Public Health Emergency in China mainland,the area-time distribution of mushroom poisoning incidents from 2004 to 2014 was analyzed,and the descriptive analysis of mushrooms poisoning incidents including causes,places,occupation of victims and incidents identification were made from 2010 to 2014.Results In China (excluding Hong Kong,Macao and Taiwan),the top five provinces of mushroom poisoning incidents were Yunnan,Guizhou,Sichuan,Guangxi and Hunan.The epidemic peak was reached in summer-autumn season.The major and significant incidents accounted for 76.56％ of overall mushroom poisoning incidents,and the fatality rate of 3 701 patients accounted for 21.24％ (786 deaths).The causes were mistaking poisonous mushrooms as edible mushrooms or purchasing poisonous mushrooms in the market by accident.About 87.50％ incidents happened at home.Farmers,workers,children and students were easily subjected to mushroom poisoning because of their large range of activities,strong curiosity and lacking related ability for distinguishing edible mushroom from poisonous mushrooms.No identification was done in 200 mushroom poisoning incidents from 2010 to 2014,which accounted for 92.59％ of mushroom poisoning incidents in the corresponding period.Standard species identification was carried out only in two poisonous mushroom incidents.Conclusions Mushroom poisoning incident was one of the most important causes of death in per-oral poisoning incidents.It should to cope with surveillance and meticulous management during high prevalence season and in high-risk provinces.At the same time,it should be strengthened to train doctors and health professionals with the knowledge of identification of mushroom poisoning in key areas as well as to develop the health promotion of mushrooms poisoning prevention.

Objective: To develop a way of high-quality real-time three dimension surface reconstruction for high-resolution volume data.Method 3D surface point sets of single organ were using a method of binding the threshold and morphological operations.The normal vector of every surface point was calculated.According to the gray gradients of volume data,the triangle face was replaced by surface points to describe the organ surface,and the surface was displayed with OpenGL interface of display card after defining the color and transparent of the organ surface.Result Based on hardware platform of personal computer,the reconstruction of skeleton and skin for the digitized virtual Chinese man No.1(VCH-M1) from CT database was constructed,the rendering speed was faster than 25 F/s.Conclusion The algorithm is capable of realizing a real-time rendering for 512?512?1720 high resolution volume data.