Objective To explore the influences of different inductive methods on cartilage repair by tissue engineered cartilage with the seed cell of mesenchymal stem cells.Methods Rabbit mesenchymal stem cells were divided into dexamethasone-inducing group and TGF-?_1-dexamethasone co-inducing group.The cartilage defects were repaired by autologous tissue engineered cartilage constructs.The defects of control group were filled with scaffold without cells.Specimens were harvested 6 and 12 weeks postoperatively and assessed by histological grading and in situ detection of apoptosis.Results The repair tissue formed perpendicular column structure resembling that of normal cartilage in TGF-?_1-dexamethasone co-inducing group.The histological score 12 weeks postoperatively was higher in co-inducing group(20.26?1.35) than those in dexamethasone-inducing group(14.52?1.46) and control group(4.12?1.13).But the formation of tidemark was not observed in the repair tissue.Cells of repair cartilage at the bone-cartilage interface showed apoptosis.The ratios of apoptosis in dexamethasone-inducing group were(21.4?4.5) six weeks postoperatively and(7.3?2.2) twelve weeks postoperatively.The ratios of apoptosis in TGF-?_1-dexamethasone co-inducing group were(19.8?4.7) six weeks postoperatively and(6.9?2.0) twelve weeks postoperatively.The ratios of apoptosis at 6 th week were higher than those at 12 th week postoperatively with statistical significance(P

This paper has reported the effect of preservation myceh'al fungus by the methods of slant and rubber plug. The mycelial fungus preserved include 29 genera, 69 species, 128 strains. The preservation time is from 2 years to 17 years. By slant inoculation, their survival conditions are still good keep their original charaters. The result shows that it is simple and effective preserving some mycelial fungus by the methods of slant and rubber plug.

Objective:To observe the clinical effects of dexmedetomidine(DDM)under monitored anesthesia care(MAC)in oral and maxillofacial patients undergoing percutaneous dilatational tracheostomy(PDT).Methods:38 patients with oral and maxillofa-cial tumor undergoing PDT before surgery were randomly assigned into 2 groups(n =19).Patients in group D received a single-dose DDMof 0.5 μg/kg infused for 10 min;those in group Mreceived 2 mg of midazolam and 1 μg/kg of fentanil.Then all patients were given local anesthesia followed by PDT.MAP,HR and SpO2 were monitored before (T0 )and after drug administration (T1 ),at T2 (skin incision)and T3 (insert dilation catheter).Ramsay scorce,bucking,respiration depression and adverse cardiovascular reaction were recorded.All patients were followed up 24 h postoperatively for the observation of adverse recall of PDT.Results:Compared with T0 ,at T1 ,T2 MAP and HR in group D were lower,but MAP and HR at T3 in group Mwere higher(P <0.05).At T1 ,T2 and T3 ,MAP and HR in group D were significantly lower than those in group M(P <0.05).During operation,the incidence of bucking and respiration depression in group D was lower than that in group M(P <0.05).Conclusion:During PDT operation under MAC,a single-dose dexmedetomidine is effective in stablizing hemodynamics,reducing bucking and respiration depression.

Objective To discuss the value of glucocorticoid steroids (GCs) in the treatment of patients with severe community-acquired pneumonia (SCAP) complicated with septic shock.Methods A prospectively controlled randomized trial was conducted.Fifty-eight SCAP patients complicated with septic shock admitted to emergency intensive care unit (ICU) of China-Japan Friendship Hospital from May 2014 to February 2016 were enrolled.The patients were randomly divided into conventional treatment group (n =29) and GCs group (n =29).Fluid resuscitation,vasopressors,mechanical ventilation if needed,antibiotics and other general treatment including symptomatic treatment and eliminating phlegm were given to patients in both groups.Beside the treatment mentioned above,80 mg methylprednisolone once a day for 7 days was added to patients in GCs group.The changes in oxygenation index (PaO2/FiO2) and C-reactive protein (CRP) at 1,4,8 days after treatment as well as the imaging improvement in both groups were observed.Discharge or death was set as a cut-off point,the average time of temperature controlling,duration of mechanical ventilation,time of vasopressors usage and 28-day mortality were observed.The incidence of hyperglycemia,infection and hemorrhage of digestive tract were observed.Results There were no statistically differences in gender,age and body mass between the two groups,indicating that baseline data for the two groups were balanced.PaO2/FiO2 after treatment in the two groups was gradually increased,and it was significantly higher at 8 days after treatment in GCs group than that of conventional treatment group [mmHg (1 mmHg =0.133 kPa):426.46 ± 86.97 vs.363.00 ± 83.96,P ＜ 0.05].CRP after treatment in the two groups was gradually decreased,and it was significantly lower at 4 days and 8 days after treatment in GCs group than that of conventional treatment group (mg/L:95.78 ± 47.38 vs.124.72 ± 51.01,57.60 ± 47.44 vs.88.85 ± 48.18,both P ＜ 0.05).Radiographic imaging improved rate at 4 days and 8 days after treatment in GCs group was significantly higher than that of conventional treatment group (55.2％ vs.27.6％,75.9％ vs.51.7％,both P ＜ 0.05),and average time of temperature controlling (days:3.94 ± 2.39 vs.7.22 ± 3.11),time of vasopressors usage (hours:13.64 ± 6.47 vs.28.34 ± 12.56),and the average hospitalization days (days:28.50 ± 8.61 vs.36.21 ± 15.26)in GCs group were significantly shorter than those of conventional treatment group (all P ＜ 0.01).There was no significant difference in duration of mechanical ventilation between GCs group and conventional treatment group (days:13.39 ± 2.62 vs.16.16 ± 5.85,P ＞ 0.05).28-day mortality of the two groups was 10.3％ equally (P ＞ 0.05).No significant differences in the incidences of hyperglycemia (10.3％ vs.6.9％),infection (51.7％ vs.55.2％) and gastrointestinal bleeding (3.4％ vs.0) were found between GCs group and conventional treatment group (all P ＞ 0.05),indicating that glucocorticoid steroids could not increase the common side effects.Conclusion GCs is an important adjuvant treatment of patients with SCAP complicated with septic shock.

OBJECTIVE To apply 3M standardized chemical indicator(CI) process challenge device(PCD) to the practice of batch monitoring to guarantee sterility assurance.METHODS The standardized CI PCD and biological indicator(BI) PCD to two different sterilizers were applied with the test parameters of 132 ℃,3.5min and 8min,and 134 ℃,3.5min and 8min,respectively.RESULTS A total of 310 trials of CI PCD were obtained as negative results,with the ink moved into the accept area of the moving-front style indicator,and 240 trials of BI PCD were obtained as negative results.CONCLUSIONS Standardized CI PCD can provide further sterility assurance with more accurate monitoring and batch release capabilities.

OBJECTIVE To study the medical instruments,packs,and textile goods disinfected and sterilized in a hospital. METHODS Totally 432 of surgical instruments were randomly divided into 4 groups.They were washing by hands and machines and detected their blood residue. RESULTS Using the multi-enzyme detergent was more effective than unused.It was helpful for the contaminated medical instruments clean by multi-enzyme detergent for(2 min). CONCLUSIONS It is important for assure the quality of the disinfection and sterilization to proper cleaning and the care of the medical instruments.

Objective To discuss some problems about current learning objectives for the speciality of clinical medicine in China,including the concepts,the decision-making systems and value-orientation,and to provide the reference for stipulating the learning objectives in future. Methods The objectives of some Chinese medical universities were collected from their websites.Some medical educators were consulted about their feelings about these learning objectives,and also were asked to identify their own objectives. Results Medical educators failed to distinguish their own objectives,and there were four main problems in current learning objectives: generalization,similarity and lack of individuality,difficulty in guide the curricula and teaching,and setting up too high object. Conclusion The learning objectives in clinical medicine should reflect both specialty characteristic and university individuality,so they should be drawn up by teachers,students and educatirnal administrators,moreover their value orientation should be eligible standard,not excellence.

OBJECTIVE: To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease. METHOD: Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases. RESULT: There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment. CONCLUSION Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.
Abscess ; etiology ; surgery ; Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Drainage ; Esophageal Perforation ; etiology ; surgery ; Esophagus ; Female ; Foreign Bodies ; complications ; surgery ; Humans ; Male ; Middle Aged ; Neck ; pathology ; Young Adult

OBJECTIVE: To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction. METHOD: Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms. RESULT: PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident. CONCLUSION Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.
Adult ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Nasal Obstruction ; complications ; pathology ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; etiology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the feasibility and efficacy of endoscopic sinus surgery for sinonasal malignancy. METHOD: Clinical data of 40 cases of sinonasal malignancy treated in our hospital from January 2007 to December 2011 were retrospectively analyzed. The pathological types encountered were: 5 cases of malignant transformation of sinonasal inverted papilloma, 2 cases of maxillary sinus carcinoma, 3 cases of ethmoid sinus carcinoma, 11 cases of mucosal melanoma, 7 cases of olfactory neuroblastoma, 2 cases of neuroendocrine carcinoma, 4 cases of myoepithelial carcinoma, 3 cases of adenoid cystic carcinoma, 1 case of malignant hemangiopericytoma. These patients were operated on either by an exclusive endoscopic surgery or endoscopic surgery with a complementary external approach. Thirty-two patients received adjuvant radiotherapy and/or chemotherapy. RESULT: All the patients were followed up for a period of 1 to 5 years after operation, of which 18 cases survived for more than three years. Four cases recurred after six months to two years, but the result was satisfactory after revision endoscopic sinus surgery. Three cases occurred cervical lymph node metastasis, of which 2 cases received neck dissection and 1 case received chemotherapy and radiotherapy due to no surgical indications. Four cases occurred distant metastasis. Eight cases died of tumor until the last follow-up. The other 21 cases occurred no recurrence and metastasis during follow-up period. CONCLUSION Endoscopic sinus surgery is an effective method for sinonasal malignancy. Appropriate indication must be carefully selected for malignant tumor. Combined treatment based on surgery should be adopted to it.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Nose Neoplasms ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Retrospective Studies ; Young Adult