BACKGROUND:Scholars are stil looking for ideal bone tissue-engineered scaffolds, and three-dimensional (3D) printing technology is a novel construction method. In the meanwhile, bone extracel ular matrix is becoming a hotspot in osteogenic induction. OBJECTIVE:To construct the polycaprolactone/bone extracel ular matrix scaffold using 3D printing technology and co-culture method, and to detect its osteogenic property. METHODS:216 3D-printed polycaprolactone scaffolds were divided into group A (96 pores, n=72) and group B(48 pores, n=144). Passage 5 bone marrow mesenchymal stem cel s from Sprague-Dawley rats were seeded onto the two kinds of polycaprolactone scaffolds, and the group A was used for alizarin red staining and Masson staining, while the group B for col agen and glycosaminoglycan detection at 1, 2 and 3 weeks of incubation. Afterwards, the scaffolds at 1, 2 and 3 weeks of culture were decel ularized and labeled as groups AE1, AE2, AE3, BE1, BE2 and BE3. Then passage 5 bone marrow mesenchymal stem cel s from Sprague-Dawley rats were seeded onto each scaffold again, and the former three groups underwent alizarin red staining, and the latter three were used for calcium, alkaline phosphatase activity and DNA quantitative analysis at 1, 2 and 3 weeks of culture. RESULTS AND CONCLUSION:Masson staining, glycosaminoglycan and hydroxyproline quantitative analysis showed that the extracel ular matrix on the composite scaffold increased with time. Alkaline phosphatase activity revealed that the composite scaffold had a significantly stronger osteogenic differentiation than the normal polycaprolactone scaffold (P<0.05). Alizarin red staining and calcium quantitative analysis showed that the mineralization of the composite scaffold was more obvious than that of the normal polycaprolactone scaffold (P<0.05), but the total DNA analysis did not differ significantly between scaffolds. These results suggest that the composite scaffold with extracel ular matrix is constructed successful y using the 3D technology and co-culture method and exhibits a better osteoinductivity.

Objective To observe the effect of Minocycline on RP process of retinal pigmentarydegeneration rd mice[C3H/HeN(Pde6brd-/rd-)]. Methods 40 rd mice were divided into ten groupsrandomly:5 experimental groups and 5 control groups,4 rd mice in each group.The experimental groupreceived intraperitoneal injection of minocycline 22.5mg/kg while the control group received saline 10ml/k2 every day from the posmatal day 1(P1).Mice were sacrificed at P1,P7,P14,P21 and P28respectively.Eyeballs were enucleated to carry out histology observation and apoptosis cell detection.Meanwhile,to statistically analyze the number of retinal photoreceptor cells,the thickness of outer nuclearlayer(ONL)and the number of apoptosis cells. Results (1)Photoreceptor cell began to apoptosis onP7,peaked on P14,and totally disappeared on P28.(2)No statistically significant differences were foundof the number of photoreceptor cells and the thickness of ONL on P7 between the experimental group andthe control group.(3)The number of photoreceptor cells and the thickness of ONL in the experimentalwere more than that in the control group at P14,P21,P28 respectively,the differences are statisticallysignificant(P＜0.05).(4)The apoptotic cells on ONL were less in the experimental group than that in thecontrol group on P7 and P14 respectively,the difference are statistically significant(P＜0.05).Conclusions Minocycline appears to protect photoreceptor cell from apoptosis in the early stage of theretinal degeneration mice,but it may not completely prevent RP from occurrence.

Objective To study the predictive value of heart-type fatty acid-binding protein (H-FABP) in the improvement of survival rate in patients with severe sepsis.Methods There was a prospective case-control study in 50 patients with severe sepsis from October 2014 to October 2015.According to the international guidelines for severe sepsis and septic shock set in 2012,all patients were divided into sepsis group (n =16),severe sepsis group (n =14) and septic shock group (n =20),and these patients were further divided into to survival group (n =22) and non-survival group (n =28) as per patients surviving within 28 days.Gender,age,ethnic,and Acute Physiology and Chronic Health Evaluation score (APACHE Ⅱ) were recorded.H-FABP,B-type natriuretic peptide (BNP),creatine kinase (CK),creatine kinase isoenzyme (CK-MB),and troponin-T (cTn-T) were determined within 6 hours after admission.The statistical software SPSS21.0 was used to do t test,test,and the receiver operating characteristic curve for comparison between groups.Results H-FABP in septic shock group was higher than severe sepsis group and sepsis group (P ＜ 0.01).The 28-day mortality of septic group (80％) and severe sepsis group (71.4％) were higher than sepsis group (12.5％) (P ＜ 0.01).Non-survival' s H-FABP,BNP,cTn-T,CK,CKMB was higher than survivals (P ＜ 0.05).Through the ROC of H-FABP (AUC=0.748,P=0.003,95％ C I:0.605-0.890) and BNP (AUC =0.714,P=0.010,95％ CI:0.573-0.856),it shows that H-FABP is better than BNP.when H-FABP take 9.902 ng/mL,the sensitivity of 82.1％,specificity of 63.6％.H-FABP,BNP has a certain value in 28-day mortality prediction.Conclusions Sepsis shock has significantly higher 28-day mortality than sepsis and severe sepsis.Compared with BNP,H-FABP has greater predictive value in sepsis patients,it will increase along with the aggravation of the disease;it can also predict 28-day mortality.

Objective Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of anterior and mid pelvic. Methods One hundred and seven female patients, aged 20 to 84 years ( average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results In all the 107 cases, 70 ( 65.4% ) presented rectocele on dynamic MRI; 28 ( 26. 2% ) presented anismus;60 (56. 1% ) presented cystocele; 59 presented vaginal or cervical prolapse(55. 1% ); and, 54 (50. 5% )presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic.

Objective To investigate the clinical efficacy of Asian proximal femur intramedullary nail antirotation (PFNA-Ⅱ) in the treatment of intertrochanteric fractures in elderly people.Methods From July 2009 to December 2011,127 elderly patients with intertrochanteric fracture were treated by PFNA-Ⅱ.They were 49 cases of male and 78 cases of female,with a mean age of (74.3±15) years.127 elderly patients were classified by modified Evans:type Ⅰ (n=37),typeⅡ (n=42),type Ⅲ (n=26),type Ⅳ (n=15),type V (n=7).We made the statistics on the intraoperative bleeding volume,operation time,incision length,X-light exposure times,and made evaluation of the efficacy of postoperative follow-up and complications by the Harris hip score.Results The average operation time was 42.5 min (35-90) min,the average intraoperative bleeding volume was 107.5 ml (65-410)ml,X-light exposure times were (2.5±1.4) times (2-4) times and the average total incision length was (6.5± 1.8) cm (5.5-11.0) cm.No serious complications or original complications were found during perioperative period.All patients received a 6 to 24 month follow-up (mean 12.5 months in average).The X ray examination showed that the average neck shaft angle was (134±13)° (120°-150°).The average fracture healing time was (14.0±2.5) weeks (11 to 19 weeks).The average hip Harris score was (86.5± 19.5) points (65-100 points).Among them,29 cases (22.83％) were excellent,76 cases (59.8％) were good,20 cases (15.7％) were moderate,2 cases (1.6％) were poor.Totally,excellent and good rate was 82.7％.No complications including hip varus deformity,screw cut-out and femoral shaft fractures were found.There were 14 patients (11.0％) with thigh pain and 5 patients (3.9％) with inner thigh pain.The heavier pain in 4 patients were improved by physical therapy.Conclusions Asian PFNA-Ⅱ has advantages including simple operation,fewer complications,and better clinical efficacy for the treatment of intertrochanteric fractures,but its longterm efficacy and complications still need a large sample and multi-center observation.

Objective To explore the consistency between preoperative clinical TNM stage and postoperative pathological TNM stage of gastric cancer and look for the underlying reason.Methods Sixty-four patients of gastric cancer with complete clinical data from December 2010 to December 2011 in Gansu Provincial Hospital were enrolled into this study.All cases were performed postoperative pathological TNM staging according to the TNM stage criteria of gastric cancer from JGCA(the 14th edition,2010),and the results were compared with preoperative TNM staging,then we studied the consistency of T staging,N staging and M staging using SPSS 18.0.Results The Kappa value from T staging of preoperative and postoperative was 0.729,showing a good consistency.The N stage' s consistency was lower,Kappa value being only 0.216.For M staging,Kappa value 0.743,having a good consistency.Conclusions According to the General Rules for Gastric Cancer Treatment,a accurate TNM staging and individual treatment plan can be made for gastric cancer patients in clinic.But the overestimate and underestimate still existed,especially in N staging.Therefore,making a accurate judgment for N staging according to all kinds of preoperative clinical data and images is the key to improvement of preoperative TNM staging accuracy and treatment.

Objective To analyze the causes of clinical misdiagnosis of solid pseudopapillary tumor of pancreas (SPTP),and recommend the countermeasures with a combination of pertinent literature.Methods The clinical data of 10 cases of SPTP with misdiagnosis were retrospectively analyzed.There were 9 women and 1 man,and the average age was 29.3 years old.The clinical symptoms were nonspecific.Results All patients received surgical treatment,and the correct diagnosis was made according to the pathology after surgery.All patients were followed up,and no recurrence or metastasis was found.Conclusions SPTP is a rare disease in clinic.Sufficient understanding in the clinical features and imaging characteristics can improve the rate of diagnosis before operation.

Objective To explore the selection of prostheses for the elderly patients with severe displaced fracture of the femoral neck through retrospective comparison of the long term clinical results between bipolar hemiarthroplasty and total hip replacement. Methods From January 1986 to December 2002, 101 cases of Garden Ⅲand Ⅳtypes of the femoral neck fracture were treated with either bipolar hemiarthroplasty (Group A: 55 cases) or total hip replacement (Group B: 46 cases). The age of the patients at the time of operation ranged from 55 to 94 years old (mean: 70.4 years old) in Group A, and from 57 to 75 years old (mean 69.5 years old) in Group B. The average period of follow up was 4.9 years (1 to 10 years) in Group A and 3.5 years (1.5 to 5 years) in Group B. The clinical results were evaluated according to Harris and Merle d'Aubigue criteria. The perioperative complications were compared. Results The excellent and good clinical results were 78.12 %in Groups A and 95.65 %in Group B respectively. The rate of groin and thigh pains was higher in Group A (36.36 %) than in Group B (6.52 %). The flexion of the hip in Group A was more limited (mean 85 degrees) than in Group B (mean 110 degrees). There were more cases of sunken femoral stem in Group A. The perioperative complications were similar in both groups. Conclusions The total hip arthroplasty is the first choice for the elderly patients with severe displaced femoral neck fracture if the conditions of the patient and the skills of the surgeon permit. The bipolar hemiarthroplasty is suitable for patients of more than 75 years old, or for those with severe diseases.

Objective To evaluate the efficacy of computed tomography guided radiofrequency(RF) ablation of non-small cell lung carcinoma with a clustered electrode.Methods 71 patients were allocated to 2 group:the group A(36 patients) were undergone RF tissue ablation 38 times and analysed image data,tumor size before and after the procedure were compared,the group B(35 patients) were treated with the combined chemotherapy of "FAP" or "CAP".Results The group A thirty-six cases at 10 days,twenty at 30 days,fifteen at 60 days after the ablation,all patients were repeatedly examined by CT scans,respectively.The tumor size was decreased by 20% at 10 days in 69% patients,decreased by 30% at 30 days in 75% patients,decreased by 50% at 60 days in 53% patients and disappeared in 13%,no operative death was noted,the effective rates were 66% in group A and 22 9% in group B respectively(P

The purifying operating room with tidiness, antisepsis and easy operation is widely used in more hospitals. The same time, depurative flow, manufacturing skill and technical standards of it are still developing. But filter maintenance and replacing as key component has major difference in different region and season. Through four-year exploration and practice, the methods of filter maintenance and replacing were explained, which carry out the questions of consumption and energy efficiency.