The rutile structure titanium oxide (Ti-O) film was prepared on the pure titanium material TA2 (99.999%) surface by the magnetic filter high vacuum arc deposition sputtering source. The method can not only maintain the material mechanical properties, but also improve the surface properties for better biocompatibility to accommodate the physiological environment. The preparation process of the Ti-O film was as follows. Firstly, argon ions sputtered to the TA2 substrate surface to remove the excess impurities. Secondly, a metal ion source generated Ti ions and oxygen ions by the RF discharge. Meanwhile a certain negative bias was imposed on the sample. There a certain composition of Ti-O film was obtained under a certain pressure of oxygen in the vacuum chamber. Finally, X-ray diffraction was used to research the structure and composition of the film. The results showed that the Ti-O film of the rutile crystal structure was formed under the 0.18 Pa oxygen partial pressure. A Nano scratch experiment was used to test the coating adhesion property, which demonstrated that the film was stable and durable. The contact angle experiment and the platelet clotting experiment proved that the modified surface method had improved platelet adhesion performance, and, therefore, the material possessed better biocompatibility. On the whole, the evaluations proved the modified material had excellent performance.
Heart Valves ; Heart, Artificial ; Ions ; Materials Testing ; Oxygen ; Surface Properties ; Titanium ; X-Ray Diffraction

Objective To establish a method for simulataneous determination of 18 free amino acids in snake venom. Methods Preparation of free amino acid samples by membrane. HPLC analysis was performed after derivatization by using phenyl isothiocyanate (PITC) as a derivative reagent, samples were analyzed on Ultimate LP-C18 column with gradient elution column of 0.05 mol/L sodium acetate buffer and methanol-acetonitrile- water (40:40:20), and current speed was1.0 mL/min, and the column temperature was set at 35℃, and detection wavelength was 254nm. Results The 18 kinds of amino acids showed a good linearity with the correlation coefficients ≥0.99. The recovery rate was 74.59%~110.62%. Snake venom contained 17 kinds of amino acids, the total content of amino acids was 0.2%. Conclusion The method was accurate, reproducible and reliable, and can be used for the determination of amino acids in snake venom and related products.

Objective: To study the current situation and distribution characteristics of pesticide poisoning in Ji'nan area, and to provide the basis for formulating the policy of scientific prevention and control of pesticide poisoning. Methods: The cases of pesticide poisoning from 2012 to 2016 were collected from medical institutions in Ji'nan, and the data was subjected to statistical analysis. Results: From 2012 to 2016 in Ji'nan reported a total of 2 237 cases of pesticide poisoning, non productive pesticide poisoning cases (72.78%, 2 149/2 237) and mortality (17.73%, 381/2 149) was significantly higher than that of productive pesticide poisoning. The average age is 46.78±18.57. The highest mortality rate of pesticide poisoning is more than 70 age group of the non productive pesticide poisoning. Organophosphorus pesticides (67.68%, 1 514/2 237) are the main pesticides causing poisoning, followed by herbicide (23.74%, 531/2 237). The highest mortality rate of pesticide was Paraquat (36.45%, 160/439), the second is the dichlorvos (19.19%, 170/886). Conclusion Pesticide poisoning is a public health problem and social problem which is harmful to the health of the residents in Ji'nan. It is necessary to strengthen the control and management of high toxic pesticides. Pay attention to the psychological intervention of elderly people to reduce the incidence of pesticide poisoning.

Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.

Objective To estimate the influence of the ambient PM10 and PM2.5 pollution on the hospital outpatient department visit due to respiratory diseases in local residents in Jinan quantitatively.Methods Time serial analysis using generalized addictive model (GAM) was conducted.After controlling the confotmding factors,such as long term trend,weekly pattern and meteorological factors,considering lag effect and the influence of other air pollutants,the excess relative risks of daily hospital visits associated with increased ambient PM10 and PM2.5 levels were estimated by fitting a Poisson regression model.Results A 10 μtg/m3 increase of PM10 and PM2.5 levels was associated with an increase of 0.36％ (95％ CI:0.30％-0.43％) and 0.50％ (95％ CI:0.30％-0.70％) respectively for hospital visits due to respiratory diseases.Lag effect of 6 days was strongest,the excess relative risks were 0.65％ (95％ CI:0.58％-0.71％) and 0.54％ (95％ CI:0.42％-0.67％) respectively.When NO2 concentration was introduced,the daily hospital visits due to respiratory disease increased by 0.83％ as a 10 μg/m3 increase of PM10 concentration (95％CI:0.76％-0.91％).Conclusion The ambient PM10 and PM2.5 pollution was positively associated with daily hospital visits due to respiratory disease in Jinan,and ambient NO2 concentration would have the synergistic effect.

Objective: To study the epidemiological characters and risk factors of primary intussusception among children who were ≤2 years old in Jinan city. Methods: A retrospective study was also applied to collect the disease information of inpatient cases through hospital information system of inpatient during 2011 and 2015. The attack rate (AR) was calculated in total and each year, respectively. 1∶₁ matched pared case-control study was conducted to explore the risk factors of primary intussusception. A total of new confirmed 93 residential cases were enrolled with ≤2 years old, diagnosed as primary intussusception or diseases coded as K56.1 according to the International Classification of Diseases, tenth version (ICD-10), and without any other reason for organic lesions. The 93 patients without primary intussusception inpatients were selected from the same hospital and departments as the controls, and matched with the cases as the same gender, ±3 months old, and disease onset within 7 days, visiting the hospital during January 1, 2016 and June 30, 2016. Clinical and epidemiological information was collected both from cases and controls. The difference of AR among different years was compared by Trend Chi-squiare test, and difference between gender, month old and regions was compared by Chi-squiare test, respectively. Multiple-variables factor analysis was applied to analysis the risk factors of cases compared with controls by conditional logistic regression model. Results: A total of 574 cases were found and the overall AR was 86.3 per 100 000. A significant decreasing trend (χ^2trend=23.43, P<0.001) of AR was showed between 2011 and 2015, with the highest AR in 2011 (117.6 per 100 000), and the lower AR in 2014 (66.0 per 100 000). The lowest AR was also observed in male (106.9 per 100 000) compared with the female (63.2 per 100 000) (χ²=13.76, P<0.001), and in ≤12 months old (102.1 per 100 000) compared with the >12 months old (70.4 per 100 000) (χ²=19.46, P<0.001). The higher proportion of 57.1% (328/574) was found in 4-12 months old cases. The cases with an overweight before illness (OR=4.98, 95%CI: 1.27-19.50), with mixed feeding of breast-milk and milk-powder (OR=16.90, 95%CI: 5.25-54.20), and with instruction of solid food before 6 months old (OR=16.50, 95%CI: 1.91-143.10) could increase the risk of illness compared with keeping a healthy weight, breast feeding, and instruction of solid food after 6 months old, separately. Conclusion A higher attack rate of primary intussusception in children with a ≤2 years old in Jinan was observed. Male and 4-12 months group had a higher risk. Body weight, breast feeding, and the instruction of solid food before and after 6 months old were related to the risk of primary intussusception among children who were ≤2 years old.

Objective: To explore the effects of Bmi1 on proliferation of mouse cranial suture mesenchymal cells. Methods: Primary posterior frontal and sagittal suture derived cells were isolated from the 2-5 d old C57BL/6 suckling mice (n=6) of the same brood and cultured. Flow cytometry and multilineage differentiation assay were performed to identify the mesenchymal stem cells (MSCs) characteristics of the 2 kinds of cranial suture-derived cells. The mRNA expression of stem cell related genes, Bmi1, Twist1, Gli1 and Axin2 were detected by real-time quantitative polymerase chain reaction (RT-PCR). Then, the proliferation and downstream protein expression were analyzed after down-regulation of Bmi1 in the sagittal suture derived MSCs by transfecting Bmi1 siRNA. The t test was used to compare the mean between two groups. Statistical significance was set at P<0.05. Results: The mouse cranial suture derived cells were successfully cultured in vitro. These cells expressed typical MSCs markers, CD44, CD90, CD73, except for CD34. These cells had osteogenic, adipogenic and chondrogenic differentiation potency. RT-PCR results showed that the mRNA expressions of Bmi1 (0.006 30±0.000 58 vs 0.002 60±0.000 34, t=5.430, P=0.005 6), Twist1(0.000 31±0.000 04 vs 0.000 15±0.000 02, t=3.343, P=0.028 8), Axin2(0.000 33±0.000 03 vs 0.000 17±0.000 05, t=3.067, P=0.037 4) and Gli1 (0.001 10±0.000 13 vs 0.000 60±0.000 33, t=3.956, P=0.016 7) were significantly decreased in the posterior frontal suture MSCs compared with those in sagittal suture derived cells. Among them, Bmi1 has the largest decline. After down-regulation of Bmi1 in sagittal suture MSCs, the protein expression level of Ink4a was significantly up-regulated compared with the control group, and the cell proliferation ability was significantly decreased. Conclusions Inhibition of Bmi1 expression can up-regulate the expression of Ink4a protein and decrease the proliferation ability of suture MSCs, which may lead to craniosynostosis.

Objective:To prospectively evaluate the development of palate and hyoid bone in infants with Pierre Robin sequence patients.Methods:A retrospective study was performed on 168 patients younger than 3 months ago who underwent bilateral mandibular distraction osteogenesis in the Department of Burn and Plastic Surgery, Children’s Hospital of Nanjing Medical University from January 2017 to December 2018. Using three dimensional-computed tomography (3D-CT) scan to reconstruct and survey the pattern of palate and hyoid bones. According to the palate morphology, the patients were divided into cleft palate group (CP group) and high palate arch group (HAP group). And according to the severity, they were divided into normal group, mild group and severe group based on the morphology of hyoid bone. Data were analyzed including the preoperative age, gender, body weight, respiratory (endotracheal intubation) and feeding support (nasal feeding) before and after distractors placement, and nutrition (serum albumin level) before and 3 months after the operation (before the distractors removal). Normal distribution datais represented by Mean±SD, and non-normal distribution data is represented to M ( P25, P75). Independent sample t-test was used to compare the age, body weight and serum albumin level. Kruskal-Wallis rank sum test was used to compare the postoperative intubation and nasal feeding time in each group. Paired sample t-test was used to compare the serum albumin before and after the operation. The preoperative gender, tracheal intubation, and nasal feeding of the children between each group were analyzed by Fisher’s precise test. P<0.05 considered the difference to be statistically significant. Results:168 infants (79 boys and 89 girls) with Pierre Robin sequence were included. The age was (36±22) d, the body weight at admission was (3.6±0.5) kg, and the preoperative intubation rate was 18.5% (31/168), the preoperative nasal feeding rate was 33.3% (56/168). 122 (72.6%) have cleft palate, and 46 (27.4%) have highly arched palate. There was no significant difference in admission age, gender, preoperative respiratory support or serum albumin between the two groups( P>0.05). In terms of feeding support, the HAP group (45.7%, 21/46) had a higher preoperative nasal feeding rate than the CP group (28.7%, 35/122) ( P=0.044), and had significantly longer postoperative nasal feeding time than CP group ( H=11.565, P=0.001), the differences were statistically significant. However, there was no significant difference in the time of endotracheal intubation between the two groups ( P>0.05). The breathing and feeding difficulties of the two groups of children were significantly improved three months after operation, and there was no need for endotracheal intubation and nasal feeding after the operation, and the serum albumin was significantly increased compared with those before the operation ( P<0.001). Further observation of hyoid bone morphology showed that normal hyoid bone morphological development in 76 cases (45.2%, normal group), complete hyoid body or hyoid ramus structure with smaller shape than normal in 57 cases (33.9%, mild group), and partial or complete hyoid bone structure absence in 35 cases (20.8%, severe group). There was no significant difference in the age of admission and preoperative serum albumin between the normal and mild group ( P>0.05); the age of the severe group was significantly younger than the normal and mild group, and the preoperative serum albumin level was also lower than the other two groups, and the difference was statistically significant ( P<0.05). In terms of preoperative respiratory support, the endotracheal intubation rate was higher in the severe group (34.3%) compared with the normal group (14.5%) or the mild group (14.0%), the difference was statistically significant ( P<0.05). There was no statistically significant difference between the normal group and the mild group ( P>0.05). In terms of preoperative nasal feeding, the difference in nasal feeding rate between the mild group (40.4%), the severe group (45.7%) and the normal group (22.4%) was statistically significant ( P<0.05), while there was no statistically significant difference between the mild and severe group ( P>0.05). Compared with the normal and mild group, the severe group had significantly longer postoperative endotracheal intubation time and nasal feeding time, and the difference was statistically significant ( P<0.05), while the mild group and the normal group had no significant difference Significance ( P>0.05). Serum albumin level of the three groups increased significantly at 3 months after operation, and the differences were statistically significant compared with those before operation ( P<0.001). Conclusions:Infants with Pierre Robin sequence exist different degrees of abnormal morphology of the upper palate and hyoid bone. Patients with HAP have more severe swallowing and feeding problems, and babies with severe hyoid bone deformities are more serious, with severe respiratory and feeding problem. Therefore, early evaluation of the morphology of the palate and hyoid bone may conduce to assess postoperative prognosis, respiratory and feeding monitoring, and related prevention and treatment as soon as possible.

Objective:To prospectively evaluate the development of palate and hyoid bone in infants with Pierre Robin sequence patients.Methods:A retrospective study was performed on 168 patients younger than 3 months ago who underwent bilateral mandibular distraction osteogenesis in the Department of Burn and Plastic Surgery, Children’s Hospital of Nanjing Medical University from January 2017 to December 2018. Using three dimensional-computed tomography (3D-CT) scan to reconstruct and survey the pattern of palate and hyoid bones. According to the palate morphology, the patients were divided into cleft palate group (CP group) and high palate arch group (HAP group). And according to the severity, they were divided into normal group, mild group and severe group based on the morphology of hyoid bone. Data were analyzed including the preoperative age, gender, body weight, respiratory (endotracheal intubation) and feeding support (nasal feeding) before and after distractors placement, and nutrition (serum albumin level) before and 3 months after the operation (before the distractors removal). Normal distribution datais represented by Mean±SD, and non-normal distribution data is represented to M ( P25, P75). Independent sample t-test was used to compare the age, body weight and serum albumin level. Kruskal-Wallis rank sum test was used to compare the postoperative intubation and nasal feeding time in each group. Paired sample t-test was used to compare the serum albumin before and after the operation. The preoperative gender, tracheal intubation, and nasal feeding of the children between each group were analyzed by Fisher’s precise test. P<0.05 considered the difference to be statistically significant. Results:168 infants (79 boys and 89 girls) with Pierre Robin sequence were included. The age was (36±22) d, the body weight at admission was (3.6±0.5) kg, and the preoperative intubation rate was 18.5% (31/168), the preoperative nasal feeding rate was 33.3% (56/168). 122 (72.6%) have cleft palate, and 46 (27.4%) have highly arched palate. There was no significant difference in admission age, gender, preoperative respiratory support or serum albumin between the two groups( P>0.05). In terms of feeding support, the HAP group (45.7%, 21/46) had a higher preoperative nasal feeding rate than the CP group (28.7%, 35/122) ( P=0.044), and had significantly longer postoperative nasal feeding time than CP group ( H=11.565, P=0.001), the differences were statistically significant. However, there was no significant difference in the time of endotracheal intubation between the two groups ( P>0.05). The breathing and feeding difficulties of the two groups of children were significantly improved three months after operation, and there was no need for endotracheal intubation and nasal feeding after the operation, and the serum albumin was significantly increased compared with those before the operation ( P<0.001). Further observation of hyoid bone morphology showed that normal hyoid bone morphological development in 76 cases (45.2%, normal group), complete hyoid body or hyoid ramus structure with smaller shape than normal in 57 cases (33.9%, mild group), and partial or complete hyoid bone structure absence in 35 cases (20.8%, severe group). There was no significant difference in the age of admission and preoperative serum albumin between the normal and mild group ( P>0.05); the age of the severe group was significantly younger than the normal and mild group, and the preoperative serum albumin level was also lower than the other two groups, and the difference was statistically significant ( P<0.05). In terms of preoperative respiratory support, the endotracheal intubation rate was higher in the severe group (34.3%) compared with the normal group (14.5%) or the mild group (14.0%), the difference was statistically significant ( P<0.05). There was no statistically significant difference between the normal group and the mild group ( P>0.05). In terms of preoperative nasal feeding, the difference in nasal feeding rate between the mild group (40.4%), the severe group (45.7%) and the normal group (22.4%) was statistically significant ( P<0.05), while there was no statistically significant difference between the mild and severe group ( P>0.05). Compared with the normal and mild group, the severe group had significantly longer postoperative endotracheal intubation time and nasal feeding time, and the difference was statistically significant ( P<0.05), while the mild group and the normal group had no significant difference Significance ( P>0.05). Serum albumin level of the three groups increased significantly at 3 months after operation, and the differences were statistically significant compared with those before operation ( P<0.001). Conclusions:Infants with Pierre Robin sequence exist different degrees of abnormal morphology of the upper palate and hyoid bone. Patients with HAP have more severe swallowing and feeding problems, and babies with severe hyoid bone deformities are more serious, with severe respiratory and feeding problem. Therefore, early evaluation of the morphology of the palate and hyoid bone may conduce to assess postoperative prognosis, respiratory and feeding monitoring, and related prevention and treatment as soon as possible.

Background and Objectives: Cranial sutures play a critical role in adjustment of skull development and brain growth. Premature fusion of cranial sutures leads to craniosynostosis. The aim of the current study was to culture and characterize human cranial suture mesenchymal cells in vitro. Methods: The residual skull tissues, containing synostosed or contralateral suture from three boys with right coronal suture synostosis, were used to isolate the suture mesenchymal cells. Then, flow cytometry and multilineage differentiation were performed to identify the typical mesenchymal stem cell (MSC) properties. Finally, we used quantitative real-time polymerase chain reaction (RT-PCR) to detect the mRNA expression of osteogenesis and stemness related genes. Results: After 3 to 5 days in culture, the cells migrated from the tissue explants and proliferated parallelly or spirally. These cells expressed typical MSC markers, CD73, CD90, CD105, and could give rises to osteocytes, adipocytes and chondrocytes. RT-PCR showed relatively higher levels of Runx2, osteocalcin and FGF2 in the fused suture MSCs than in the normal cells. However, BMP3, the only protein of BMP family that inhibits osteogenesis, reduced in synostosed suture derived cells. The expression of effector genes remaining cell stemness, including Bmi1, Gli1 and Axin2, decreased in the cells migrated from the affected cranial sutures. Conclusions The MSCs from prematurely occlusive sutures overexpressed osteogenic related genes and down-regulated stemness-related genes, which may further accelerate the osteogenic differentiation and suppress the self-renewal of stem cells leading to craniosynostosis.