BACKGROUND: Olfactory ensheathing cells (OECs) and bone marrow mesenchymal stem cells (BMSCs) repair the function of injured spine cord. Whether their combination can have better repair effect is unclear. OBJECTIVE: To investigate effects of OEC and BMSC transplantation for treating injured spine cord.DESIGN, TIME AND SETTING: The randomized control animal experiment was performed at the Linyi People’ s Hospital and Kunming Medical College from June 2006 to October 2007. MATERIALS: Healthy clean adult female Sprague Dawley rats with the body mass of 220-280 g were enrolled and divided into a normal control group (n=5), a OEC group (n=10), a BMSC group (n=10), a co-transplantation group (n=10) and a operation control group (n=10). METHODS: OECs and BMSCs were harvested from the olfactory bulb and femoral bone. Animal models of complete spinal cord injury were established by cutting rat spinal cord. Rats in the normal control group only received vertebral plate unfolding, but no spinal cord transaction. Rats in the OEC group, BMSC group and co-transplantation group were respectively injected with OECs, BMSCs and their combination at the broken ends and proximal and distal ends. Using three points injection, the injection depth was separately 0.5 mm, 1.0 mm and 1.5 mm. Rats in the operation control group only received medium following spinal cord transaction. MAIN OUTCOME MEASURES: OECs and MSCs were co-cultured after being digested. Cells were identified by P75 and BrdU immunofluorenscence. Spinal cord functional recovery was assessed, and pathological changes and cell survival were observed after transplantation. RESULTS: One proportion of co-cultured cells wove into net with their processes linking. The other proportion grew like strip-shaped. OECs were identified on the cell membrane (green fluorescence) and on the cell core (red fluorescence), whereas BMSCs were identified on the cell core (red fluorescence) without cell membrane (green fluorescence). Spinal cord function was improved in rats treated with OECs and BMSCs. Four weeks later, the spinal cord function was better in the co-transplantation group compared to the OEC and BMSC groups. Pathology observation showed that spinal cord structure was severely destroyed in the operation control group, showing a mass of cavitates and pericaryon atrophy, surrounded by many cavitates and tissue fluids; cell number became small; nerve fibers arranged disordered. Following OEC and BMSC transplantation, spinal cord structure was still severely damaged, but cavitas area was small, with many cells; nerve cells arranged orderly. Under a fluorescent microscope, many cell nuclei stained red at the injured spinal cord, and many positive cells were seen at the proximal and distal ends of the injured spinal cord. OECs and BMSCs were both found in the co-transplantation group, but cells were disordered, no significant arrangement or significant movement. CONCLUSION: OECs and BMSCs are co-cultured well in vitro for repairing spinal cord injury. Their combination obtains a better outcome compared to OECs or BMSCs alone.

Objective To explore causes and preventive measures of recurrent laryngeal nerve injury during endoscopic thyroidectomy.Methods Clinical data of 3 cases of recurrent laryngeal nerve injury from 101 cases of endoscopic thyroidectomy in this hospital from January 2002 to July 2006 were retrospectively analyzed and summarized.Results There were 3 cases of hoarseness occurred at 24 h after operation.Under indirect laryngoscopy,the unilateral vocal cord was found immobile.The reasons leading to the injury included thermal burn by ultrasound knife in 2 cases and edema compression in 1 case.The injury was transient recurrent laryngeal nerve paralysis.The symptoms subsided spontaneously 3 months after operation in 2 cases and 20 days after operation in 1 case,respectively.Conclusions The recurrent laryngeal nerve injury is usually correlated with unskillful use of ultrasound knife.The improvement of surgeon's technique is crucial to reduce the incidence of this complication.

Objective To explore the causes and managements of peritoneal laceration in the laparoscopic totally extraperitoneal (TEP) hernia repair during learning curve.Methods The retrospective cross-sectional study was conducted.The clinical data of 120 patients with inguinal hernia who underwent laparoscopic TEP hernia repair in the Third Affiliated Hospital of Anhui Medical University (98 patients) and Anhui Provincial Hospital (22 patients) during surgeons' learning curve between February 2012 and January 2017 were collected.Patients underwent laparoscopic TEP hernia repair,meshes were intraoperatively placed and then fixed by medical glue.Observation indicators:(1) intraoperative situations:surgical procedure,operation time,using of mesh,intraoperative peritoneal laceration;(2) postoperative situations:time to anal exsufflation,time for fluid diet intake,occurrence of complications,duration of hospital stay;(3) follow-up:number of patients receiving follow-up,follow-up time,recurrence of hernia during follow-up,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain,incisional infection.Follow-up using outpatient examination and telephone interview within 10 days postoperatively and using telephone interview at 10 days postoperatively was performed to detect the recurrence of inguinal hernia,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain and incisional infection up to May 2017.Measurement data with normal distribution were represented as （x）±s.Results (1) Intraoperative situations:of 120 patients,112 underwent laparoscopic TEP hernia repair,5 converted to laparoscopic transabdominal preperitoneal hernia repair and 3 converted to open surgery due to adhesion between hernial sac and surrounding tissues induced bleeding of separation.Total operation time of 120 patients was (71 ± 13) minutes,including (63± 7) minutes in 106 patients with unilateral hernia and (79 ± 11)minutes in 14 patients with bilateral hernia.All the patients used intraoperatively meshes of 10.0 cm×15.0 cm and 16.0 cm× 10.8 cm.Forty-eight patients had intraoperative peritoneal laceration,peritoneal laceration occurred for reconstruction of preperitoneal space in 10 patients,separation of anterolateral preperitoneal space in 11 patients and improperly operating equipment or hernial sac in 27 patients.Of 48 patients with peritoneal laceration,40 continued to finish operation through acupuncturing into the abdominal cavity for exsufflation and then received peritoneal suture and repair,including 5 with recurrence of indirect inguinal hernia (receiving tissue repair) undergoing peritoneal repair through opening hernial sac,and 8 intraoperatively converted to other or open surgery.(2) Postoperative situations:time to anal exsufflation and time for fluid diet intake in 120 patients were (18± 4) hours and (15±6) hours.Of 120 patients,14 had postoperative complications,scrotal emphysema of 6 patients disappeared in 24 hours anti inguinal and scrotal seroma of 8 patients disappeared after puncture treatment.All the patients were discharged from hospital in 2 days postoperatively.(3) Follow-up:112 of 120 patients were followed up for 3-65 months,with a median time of 31 months.During follow-up,there was no occurrence of recurrence of hernia,pain in inguinal region,intestinal adhesion and obstruction induced abdominal pain and incisional infection.Conclusion During surgeons' learning curve,identifying anatomy of the groin clearly,a right way to treat the hernia sac and broken peritoneum in the operation can ensure the smooth completion of the laparoscopic TEP hernia repair.

Type Ⅰ congenital biliary dilatation is a congenital biliary duct defect disease.It is also called congenital choledochocele cyst (CCC).Endoscopic ultrasonography (EUS),magnetic resonance cholangiopacreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are very important for the diagnosis.Operation is generally regaded as the best choose.It is recommended that cholecystectomy + choledochal cyst excision + hepatic duct jejunum Roux-Y anastomosis is the chief therapeutic method.This article reviews the pathogenesis,classifications,diagnosis and treatment of the disease.

Objective To investigate the related factors affecting prognosis of patients with colorectal cancer undergoing palliative resection.Methods The clinical data of 345 patients with colorectal cancer who underwent palliative resection at the First Affiliated Hospital of Guangxi Medical University between January 2007 and December 2011 were retrospectively analyzed.Patients selected the emergent operations or restrictive operation based on the conditions of patients,and then received chemotherapy,radiotherapy and biotherapy.Chemotherapy regimens included FOLFOX4 (5-FU/CF + oxaliplatin) regimen,XELOX (capecitabine + oxaliplatin) regimen and FOLFIRI (5-FU + CF + irinotecan) regimen.Biotherapy regimens included molecular targeted therapies using bevacizumab and cetuximab.The follow-up was applied to patients by outpatient examination,telephone interview and correspondence once every 3 months up to March 1,2014.The survival curve was drawn by the Kaplan-Meier method.The survival rate was analyzed using the Log rank test.The multivariate analysis was done using the COX regression model.Results Of the 1 930 patients,345 patients received palliative resection with a percentage rate of 17.876％.Among the 345 patients,104 patients received emergent operations and others received restrictive operations.After operation,178 patients received adjuvant treatment,FOLFOX4 regimens were done on 85 patients,XELOX regimens on 32 patients,FOLFIRI regimens on 20 patients,radiotherapy on 17 patients and molecular targeted therapies on 24 patients.Seven patients died in the perioperative period and other patients were followed up for 3.0-82.0 months with a median time of 14.0 months.The 1-,3-and 5-year survival rates and the mean survival time were 49.57％,11.88％,6.38％ and 22.6 months,respectively.The results of univariate analysis showed that the CEA levels,bowel obstruction,primary tumor resection,peritoneal implantation,distal metastasis,lymph node metastasis,tumor differentiation,postoperative adjuvant therapy were related factors affecting the prognosis of patients undergoing palliative resection (x2=3.742,18.795,37.641,13.470,4.228,5.835,4.108,6.875,P ＜0.05).The results of multivariate analysis showed that the bowel obstruction,without primary tumor resection,peritoneal implantation,low-differentiation of tumor and without postoperative adjuvant therapy were the independent risk factors affecting the prognosis of patients undergoing palliative resection (RR =1.674,2.273,1.947,1.582,1.342,95％ confidence interval:1.193-2.485,1.646-4.376,1.497-3.587,1.184-2.382,1.032-2.074,P ＜ 0.05).Conclusion The low-differentiation of tumor,peritoneal implantation,bowel obstruction,without primary tumor resection and without postoperative adjuvant therapy are the independent risk factors affecting the prognosis of patients with colorectal cancer undergoing palliative resection.

OBJECTIVE To investigate the relationship among hepatitis B virus(HBV) basic core promoter(BCP) mutation,serum HBV DNA contents and HBV markers as well as liver function of chronic hepatitis B patients.METHODS The A to T mutation at nucleotide 1762 and G to A mutation at nucleotide 1764 were determined by the method of polymerase chain reaction(PCR) microplate hybridization ELISA in 176 patients with chronic hepatitis B virus infection.RESULTS The rate of HBV BCP mutants in negative and positive groups of HBeAg was 49.4% and 33.3%,respectively(P

Objective:To assess the safety and efficacy of induction chemotherapy with cisplatin and docetaxel followed by radia-tion concurrent with weekly cisplatin for unresectable, locally advanced esophageal cancer. Methods: Thirty-three patients with T3N0M0 to T4N2M0 thoracic esophageal squamous cell carcinoma without celiac lymph node metastasis were included in the study. They were treated with cisplatin (75 mg/m2 d1, d22) and docetaxel (75 mg/m2 d1, d22) neoadjuvant chemotherapy followed by three-dimensional conformal radiotherapy (60Gy/30F/6w) concurrent with cisplatin (30 mg/m2 d1, 8, 15, 22, 29, 36 from the beginning of radiation). Results:Grade 4 hematological toxicities were observed in 13.33%(4/33) of the patients after the neoadjuvant chemother-apy. No grade 3 or above hepatic or renal toxicities were found. During concurrent chemoradiation, the highest grade 3 hematological toxicities were observed in the erythrocyte, granulocyte, and macrophage at 21.21%(7/33), 15.15%(5/33), and 3.01%(1/33), respec-tively. No grade 2 or above hepatic or renal toxicities were observed. Grade 3 radiation esophagitis was observed in 9.1%(3/33) of the patients, whereas grade 3 and above radiation esophagitis or grade 1 and above acute radiation pneumonitis did not occur. The evalua-tion results after treatment completion were 84.85%(28/33), 12.12%(4/33), and 3.03%(1/33) for CR+PR, SD, and PD , respectively. Two months after treatment completion, the results changed to 75.76%(25/33), 9.10%(3/33), and 15.15%(5/33), respectively. Overall, 15 patients died. The one-year survival rate was 66.4%. Local failure was approximately 46.67%(7/15), whereas the local+distant fail-ure was approximately 26.67%(4/15). Therefore, local failure is the main pattern of failure in esophageal cancer. Conclusion:The re-sults indicate that neoadjuvant chemotherapy with cisplatin and docetaxel followed by radiotherapy concurrent with weekly cisplatin for locally advanced esophageal cancer is safe. Local failure remains the main pattern of failure in esophageal cancer.

Aim To study the effect of naftopidil(Naf) on noradrenalin(NA)-induced proliferation of rats vascular smooth muscle cells (VSMCs),and explore its mechanisms. Methods The cultured VSMCs was induced to proliferate by NA,and effects of Naf on the VSMCs proliferation was tested by MTT assay and cell counting method respectively. The intra-cellular calcium concentration is investigated by fluorimetry,and the expressions of c-myc,c-fos and hypertension related gene-1(HRG-1) mRNA were tested by Real-Time RT-PCR. Results The proliferation of VSMCs induced by NA was inhibited by Naf(10-7~10-6mol?L-1),which diminished clearly VSMCs [Ca2+]i and decreased mRNA expressions of c-myc,c-fos and increased the expression of HRG-1 mRNA. Conclusions Proliferation of VSMCs induced by NA can be inhibited clearly by Naf. The mechanisms may be related to diminishing [Ca2+]i,antagonizing the up-regulation of c-myc and c-fos mRNA expressions by NA and antagonizing the down-regulation of HRG-1 mRNA expression.

AIM: To determine the effects of recombinant human interleukin-10(rhIL-10) on proliferation of vascular smooth muscle cells(VSMC) by TNF-? and PDGF-BB and neointimal hyperplasia after rat carotid arterial injury.METHODS: Rat aortic VSMC was cultured and treated with rhIL-10 with or without tumor necrosis factor-?(TNF-?) and platelet-derived growth factor-BB (PDGF-BB), respectively.Proliferation of VSMC was quantified by colormetric assay.Cell cycle analysis was performed by flow cytomertry.SD rats were treated with recombinant human IL-10(rhIL-10) for 3 days after carotid arteries injury.Neointima to media area ratio at the site of arterial injury was measured at 28 days after balloon injury.RESULTS: Compared to control,both TNF-? and PDGF-BB stimulated VSMC proliferation. rhIL-10 alone had no effect on VSMC growth.With TNF-? or PDGF-BB stimulation,rhIL-10,at dose as low as 10 ?g/L,inhibited VSMC growth( P

Objective:To evaluate the clinical significance of our self-designed three-column scoring system for postoperative X-ray stability of intertrochanteric fracture after intramedullary nailing.Methods:A retrospective study was conducted of the 378 patients with intertrochanteric fracture who had been treated between January 2015 and June 2019 at Department of Orthopaedics, Linyi People's Hospital by internal fixation with proximal femoral nail antirotation (PFNA). They were 161 males and 217 females, aged from 60 to 97 years (average, 72.5 years). By the AO classification, there were 109 cases of type 31-A1, 188 cases of type 31-A2 and 81 cases of type 31-A3. Anteroposterior and lateral X-ray examinations of the hip were performed immediately after internal fixation to evaluate the fracture stability using our self-designed three-column scoring system by which the medial column is given 4 points, middle column 2 points and lateral column 2 points. A single column scoring full points is rated as stable, 3-column stability as excellent, 2-column stability as good, one-column stability as fair, and 3-column unstability as poor. Rehabilitation programs were carried out according to the results of stability evaluation: full weight bearing at an early stage was indicated for excellent patients, partial weight bearing at an early stage for good patients and weight bearing at an early stage contraindicated for fair or poor patients. Fracture union time and failure of internal fixation were recorded. The relationship between internal fixation failure and our three-column scoring system was calculated.Results:The 378 patients were followed up for 6 to 24 months (mean, 10.4 months). Of them, 365 obtained fracture union after an average time of 4.3 months (from 3 to 7 months). Internal fixation failure occurred in 13 patients, giving a failure rate of 3.4%(13/378).Of the 129 excellent patients by our three-column scoring system for post-operative X-ray stability of intertrochanteric fracture, none failed in internal fixation; of the 193 good patients, 4 failed; of the 56 fair patients, 9 failed. Internal fixation failure was closely related to our three-column scoring system for postoperative X-ray stability of intertrochanteric fracture ( r=-0.986, P=0.006), as well as to the column stability ( r=-1.000, P=0.033). Conclusion:Our self-designed three-column scoring system for postoperative X-ray stability of intertrochanteric fracture after intramedullary nailing can accurately reflect the fracture stability so that it can be used to guide rehabilitation programs for the patients and judge their prognosis.