BACKGROUND:Membrane guided bone regeneration technology has become an important method in repairing bone defects. With the deepening of the research, related concept and the mechanism of membrane guided bone regeneration have been gradual y confirmed, but there are stil some unresolved issues.
OBJECTIVE: To review the classification of membrane tubes, performance, disadvantages and advantages in membrane guided bone regeneration, as wel as some unresolved issues in application and research.
METHODS:The first author searched PubMed and CNKI databases to retrieve articles about the discovery of membrane guided bone regeneration and the concepts, classification of membrane tubes, performance, disadvantages and advantages during bone defect treatment, which were published from 1963 to 2013. The key words were“guided bone regeneration, guided tissue regeneration, bone defect treatment”in English and Chinese, respectively.
RESULTS AND CONCLUSION:Membrane guided bone regeneration technique is a most promising treatment for bone defects, but for the treatment of long tubular bone defects, it is stil in the experimental stage. Currently, there is no membrane tube for long-segment bone defects. According to the material sources, the membrane tubes can be divided into:non-biological material, such as polytetrafluoroethylene, polylactic acid, silica gel, titanium film;biological materials, such as col agen membrane, chitin membrane, polyhydroxybutyrate. The membrane tubes can also be classified into nondegradable materials and biodegradable materials. Biodegradable materials have good histocompatibility and no cytotoxicity, which can degrade in a certain period after implantation;part of the membrane can also al ow free exchange of tissue fluid and nutritional substances. But there are stil some shortcomings that the degradation time is difficult to control and the volume is difficultly maintained under the membrane tube. New bone formation in non-biodegradable materials is complete. In the process of osteogenesis, the membrane tube cannot be absorbed and has to be removed secondarily, though it has good histocompatibility and better therapeutic outcomes. In the future, we should further improve membrane performance, so that the membrane tube can play a dual role, fixation and guided bone regeneration;a series of animal studies should be conducted to study the effect of stress on the membrane tube and osseointegration within the membrane tube, to master the law of osseointegration of membrane tubes, thereby providing evidence for repair of long tubular bone defects.

PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.
Clinical Trials as Topic ; Equipment and Supplies ; standards ; Humans ; Research Design

PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.
Clinical Trials as Topic ; standards ; Equipment and Supplies ; standards ; Humans ; Research Design ; standards

Objective To investigate ultrasound diagnosis different types of placenta previa (PP)during the late pregnancy and its relationship with the perinatal outcome.Methods The clinical data of 170 pregnant women with PP and 170 healthy pregnant women who underwent ultrasound were retrospectively analyzed.PP-related risk factors were analyzed,the perinatal outcome of different types of PP were compared.Results Among PP pregnant women,complete PP was in 82 cases,partial PP was in 36 cases,marginal PP was in 32 cases,low-lying placenta was in 20 cases.The rate of age ＞ 30 years old,parity,gravidity,the number of abortion and the number of cesarean section in PP pregnant women were significantly higher than those in healthy pregnant women [59.4％(101/170) vs.40.0％(68/170),(1.5 ± 0.6) times vs.(1.3 ± 0.4) times,(2.4 ± 0.5) times vs.(1.7 ± 0.1) times,(1.7 ± 0.1) times vs.(1.1 ± 0.3) times,(1.3 ±0.3) times vs.(1.0 ± 0.1) times,P ＜ 0.01].Parity,gravidity,the number of abortion,the number of cesarean section,age,and the incidence rate of cesarean section,postpartum hemorrhage,placental adherence,premature delivery,neonatal weight ＜ 2.5 kg,5 min Apgar score ＜ 7 scores in complete PP pregnant women were significantly higher than those in partial PP,marginal PP and low-lying placenta pregnant women (P＜0.01).Conclusions Ultrasound can dynamically observe the development process of the PP.There is a certain correlation with the severity of risk factors of PP,early intervention can improve the prognosis.

The change of gravity causes a series of physiological dysfunctions,such as redistribution of blood,destruction of skeleton,reduction of hemopoietic tissue and so on.Since the success of mission to the moon and construction of space station,the study on change of human physiological functions under microgravity has been underway.With the machine of microgravity developing maturely,associated researches have made big steps forward.However,intensive study on the changes of human hemostasis and thrombosis under the microgravity are still needed,especially in the area of high incidences of bleeding and thrombotic diseases.The result will help to prevent hemostasis and thrombosis on astronaut and promote the development of our national aerospace industry.

Objective To observe the impacts of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variability (BPV) in elderly hypertensive patients.Methods Eighty elderly patients with hypertension were randomized into valsartan and amlodipine (the amlodipine group, n=38) or valsartan and hydrochlorothiazide (the hydro-chlorothiazide group,n=37) group.The 24-hour dynamic blood pressure was monitored at baseline, 6-week and 12-week after treatment for the blood pressure and blood pressure variability. The control rate of blood pressure was calculated at 6-week after treatment, and side effects were observed during the treatment.Results Values of 24 h systolic blood pressure (SBP), daytime SBP, nighttime SBP, morning SBP and 24 h systolic blood pressure variability (SBPV) were significantly low-er at 6-week and 12-week than those of baseline in both two groups(P<0.05). There was an interaction between the group-ing factors and time on 24 h SBP, daytime SBP, nighttime SBP, 24 h SBPV and daytime SBPV (P<0.05). At the 6 and 12-week treatment, 24 h SBP, daytime SBP, nighttime SBP and daytime SBPV were significantly lower in amlodipine group than those in hydrochlorothiazide group (P<0.05). At 12-week treatment, 24 h SBPV was significantly lower in amlodipine group than tjat in hydrochlorothiazide group (P<0.01). There were no significant differences in control rate of blood pressure and side effects between two groups. Conclusion Valsartan in combination with amlodipine or hydrochlorothiazide can both ef-fectively control BPV in elderly hypertensive patients, and valsartan conbined with amlodipine has better effects on lowering blood pressure and BPV.

Objective:To discuss the therapeutic effect of pharmaceutical care for old patients with chronic obstructive pulmonary disease ( COPD) . Methods:Totally 192 patients diagnosed as COPD were randomly divided into 2 groups according to a random num-ber table, 100 cases in the experimental group and 92 cases in the control group. The control group was treated with the conditional therapy, and the experimental group was treated with pharmaceutical care additionally. The studieds on COPD assessment test ( CAT) , modified British medical research council ( mMRC) and the value of pulmonary function index ( FEV1% index) were carried out and compared between the two groups. Results:There was no statistically significant difference in the CAT score, mMRC classification and FEV1% index between the two groups on admission (P>0. 05), however, after the treatment, the CAT score and mMRC classifica-tion were decreased and FEV1% index was increased in the two groups, and there was statistical significance between them ( P <0. 05). The CAT score and mMRC classification in the experimental group were lower and FEV1% index was higher than that in the control group(P<0.05). Compared with the medication errors(n=13, 14.13%) and incidence of adverse drug reactions(n=5, 5. 43%) in the control group, the medication errors(n=2, 2. 0%) and incidence of adverse drug reactions (0%) in the experimental group were significantly decreased. Conclusion:Clinical pharmacists provide effectively pharmaceutical care, which can significantly improve the clinical therapeutic efficacy in old patients with COPD.

Objective To explore the role of endotoxin during hepatic ischemia reperfusion (HIR) in rats. Methods Wister rats were randomly divided into endotoxin, HIR and HIR plus endotoxin (HIRE) groups. In the HIR group, hepatic reperfusion was performed after 60 minutes of ischemia by interruption of the arterial and portal venous blood supply to the left lobes and middle lobes of the rat liver. In the HIRE group, LPS(1.0mg/kg) was injected via the dorsum vein of rat penis after ischemia and reperfusion. In the endotoxin group, LPS (1.0mg/kg) was injected via the dorsum vein of penis in the rats without ischemia and reperfusion. The NF-?B activities in the liver tissue of the rats were determined with EMSA. TNF-? expression levels in the liver tissue of the were measured with immunohistochemical staining. Serum ALT levels of the rats were also measured. Results NF-?B activity increased after reperfusion and remained high 12h after reperfusion in HIRE group compared with endotoxin group and HIR group. Both TNF-? expression levels and serum ALT levels increased markedly after reperfusion in HIRE group. Conclusion Endotoxin during HIR could induce hepatic injury. Endotoxin induced liver injury possibly by activating NF-?B followed by the subsequent expression of proinflammatory mediators in the liver tissue.

OBJECTIVE:To compare pharmacokinetic parameters of the common tablets and sustained-release melatonin tablets in beagle dogs in vivo.METHODS:The blood concentration of melatonin of6Beagle dogs was determined by HPLC and the pharmacokinetic parameters were calculated with3p97software after administered random crossover with single dose of sustained-release melatonin tablets6mg or the common tablets3mg.RESULTS:The concentration-time curves of both the common tablets and sustained-release melatonin tablets were in conformity with two-compartment model,C max of common tablets and sustained-release tablets were(11.27?3.77)ng/ml and(8.31?5.11)ng/ml respectively,t max of which were(0.50?0.18)h and(1.00?0.37)h respectively,t 1/2ke of which were(1.21?0.52)h and(3.27?0.89)h,AUC 0～t of which were(25.23?7.71)(ng?h)/ml and(38.03?16.45)(ng?h)/ml respectively.CONCLUSION:Compared with the common tablets,the sustained-release tablets showed slower absorption,longer peak time,lower peak concentration,slower elimination and longer duration.

Objective To compare the lateral decubitus and supine position in the treatment of femoral intertrochanteric fractures with femoral proximal nail antirotation (PFNA).Methods A retrospective analysis was performed of the 85 patients with intertrochanteric fracture who had been treated at our hospital between September 2013 and September 2014.They were 24 men and 61 women,28 to 99 years of age (average,78.5 years).By Evans-Jensen classification,one case was type Ⅰ,15 cases were type Ⅱ,40 type Ⅲ,23 type Ⅳ,and 6 type Ⅴ.All the patients were treated with internal fixation with PFNA.Lateral decubitus position was adopted in 45 cases and supine position in 40.The 2 groups were compared in terms of operation time,intraoperative bleeding volume,difference between preoperative and postoperative hemoglobin values,tip-apex distance (TAD),calcar tip-apex distance (Cal-TAD),fracture healing time,and Harris score of the hip joint.Results The 85 patients were followed up for 9 to 21 months (average,13.6 months).Both 2 groups obtained fracture healing,with no screw cut-out.The lateral decubitus group had significantly less operation time (60.3 ± 17.5 min) and intraoperative bleeding volume (70.8 ± 37.8 mL) than the supine position group (72.7 ± 19.7 min and 90.3 ± 20.9 mL,respectively) (P ＜ 0.05).The former also had a significantly smaller difference between preoperative and postoperative hemoglobin values (24.1 ± 5.7 g/L) than the latter (28.2 ± 8.5 g/L) (P ＜ 0.05).There were no significant differences between the 2 groups in TAD,Cal-TAD,fracture healing time (3.7 ± 0.9 months versus 3.7 ± 1.0 months),or Harris hip score (73.4 ± 10.7 versus 75.5 ± 9.5) (P ＞ 0.05).Conclusion In the treatment of femoral intertrochanteric fractures with PFNA,lateral decubitus position may be associated with shorter operation time and less intraoperative blood loss compared with supine position.