Prosthesis for femoral head surface replacement was designed. Between January 2002 and December 2005,28 patients underwent femoral head surface replacement in Anyang People's Hospital. The diameter of the normal femoral head was determined by CT,and the prosthesis was selected according to the measured value ±1 mm. With the muscle gap approach,the center of the femoral head was determined according to the measured distance between the femoral head center and the culminated point of the round ligament fossa based on the mark of the culminated point of the round ligament pit. Additionally,the diameter of the femoral head was measured again to ensure the precise match of the prosthesis and acetabulum. X-ray films at 24-48 months show no loosening or dislocation of the prosthesis,which was well matched with acetabulum. Furthermore,the joint space did not remarkably change. The mean score was 63 before operation and 91.5 after operation respectively according to Harris sore. The successful rate is 92.86% (excellent in 23cases,good in 3,and improved in 2). The results show that femoral head surface replacement is an effective method for young patients with avascular necrosis of the femoral head at the stage of ARCO HI.

Objective To investigate the probability of assessment of hepatic fibrosis for liver transplantation using model for end-stage liver disease(MELD) by comparing the correlation of MELD score with Ishak pathological grading method. Methods Fifty-eight patients who underwent liver transplantation because of end-stage liver disease from February 2006 to September 2006 were performed quantitative hepatic fibrosis evaluation using computer-assisted digital image analysis. Pathological diagnosis according to the Ishak modified score was also performed. MELD scores were calculated using the original formula based on the clinical examination data collected on the admission days. The correlations among the image analysis method, Ishak grading and MELD scoring method were analyzed using the Spearman's rank correlation analysis. The linear relationship between the MELD scores and the degree of hepatic fibrosis shown from linear regression analysis was used to define the reference criterion. Results The hepatic fibrosis area ratios of the 58 patients were between 23.2 % and 88.4 % with average of 56.7% by computer-assisted digital image analysis. The MELD scores on the admission clays were between 11 and 38 with average of 22.85±9.32. The semi-quantitative Ishak classification showed that there were 0, 2, 7, 12, 18, 12, and 7 cases in each of the 7 grades respectively, the higher the grade the higher the hepatic fibrosis area ratio and the higher the MELD scores. Spearman rank correlation test indicated that there was significant correlation among these three methods(P ＜ 0.01). Linear regression analysis showed that there was a linear relationship between the MELD scores and the degree of hepatic fibrosis. Conclusions Computer-assisted digital image analysis can evaluate objectively the hepatic fibrosis degree and it is significantly correlated to the MELD system. Hepatic fibrosis degree can be evaluated by MELD scores.

AIM:To study the effects and mechanisms of ethanol on chloride channels in poorly differentiated nasopharyngeal carcinoma CNE-2Z cells.METHODS:The effect of ethanol on the cell growth was analyzed by MTT as-say.The technique of whole-cell patch-clamp was used to detect the chloride current .The characteristics of the chloride current were analyzed by using the chloride channel blockers .The siRNA technique was used to analyze the molecular basis of the ethanol-sensitive chloride channels .RESULTS: Under isotonic conditions , the background current was weak and stable.Ethanol at concentrations of 0.17~170 mmol/L activated a chloride current in a concentration-dependent manner (an inverted U-shape), with a maximum effect at the concentration of 17 mmol/L.The currents showed obviously outward rectification and were susceptible to extracellular hypertonicity and the chloride channel blocker , 5-nitro-2-(3-phenylpropyl-amino) benzoic acid ( NPPB) .ClC-3 siRNA obviously decreased the currents activated by ethanol .CONCLUSION:Ex-tracellular ethanol induces chloride currents through activating the ClC-3 chloride channels .

Objective:To explore the clinical value of arterial partial pressure of carbon dioxide (PaCO 2) combined with Wells score in predicting acute pulmonary embolism (PE). Methods:Patients with suspected acute PE admitted to Emergency Department of Beijing Chaoyang Hospital, Capital Medical University from January 1, 2016 to August 31, 2021 were screened. Patients with positive computed tomography pulmonary angiography (CTPA) results were classified as the PE group, and those with negative CTPA results were classified as the non-PE group. Demographic characteristics, symptoms, vital signs, underlying diseases, risk factors for venous thrombosis, arterial blood gas analysis and Wells scores were statistically analyzed and compared between the two groups, and the clinical efficacy of PaCO 2 combined with Wells score in predicting acute PE was evaluated. Results:A total of 1 869 patients with suspected acute PE were screened, and 1 492 patients were finally selected. There were 537 cases in the PE group and 955 cases in the non-PE group. The frequency of chest pain, dyspnea, unilateral lower limb edema, history of PE or deep venous thrombosis, history of surgery or immobilization within 3 months, history of fracture within 3 months, active malignant tumor, elevated Wells score and reduced PaCO 2 in the PE group was significantly higher than that in the non-PE group (all P< 0.05). The area under receiver operating characteristic (ROC) curve (AUC) of Wells score was 0.784 (95% CI: 0.758-0.810), and the sensitivity and specificity of predicting acute pulmonary embolism were 61.64% and 88.48%, respectively. The AUC of reduced PaCO 2 was 0.679 (95% CI: 0.651-0.707), and the sensitivity and specificity of predicting acute pulmonary embolism were 79.89% and 55.92%, respectively. The AUC of reduced PaCO 2 combined with Wells score was 0.837 (95% CI: 0.816-0.858), and the sensitivity and specificity of predicting acute pulmonary embolism were 74.12% and 77.07%, respectively. The AUC of reduced PaCO 2 combined with Wells score was significantly greater than the AUC of Wells score ( P<0.001) and the AUC of reduced PaCO 2 ( P<0.001). Conclusions:The efficacy of PaCO 2 reduction combined with Wells score in predicting acute PE was superior to that of either of them alone. This was a beneficial supplement to the screening of patients with acute PE, and would also help reduce the abuse of CTPA in the emergency department.

Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy

Overexpression of exogenous lineage-determining factors succeeds in directly reprogramming fibroblasts to various cell types. Several studies have reported reprogramming of fibroblasts into induced cardiac progenitor cells (iCPCs). CRISPR/Cas9-mediated gene activation is a potential approach for cellular reprogramming due to its high precision and multiplexing capacity. Here we show lineage reprogramming to iCPCs through a dead Cas9 (dCas9)-based transcription activation system. Targeted and robust activation of endogenous cardiac factors, including GATA4, HAND2, MEF2C and TBX5 (G, H, M and T; GHMT), can reprogram human fibroblasts toward iCPCs. The iCPCs show potentials to differentiate into cardiomyocytes, smooth muscle cells and endothelial cells . Addition of MEIS1 to GHMT induces cell cycle arrest in G2/M and facilitates cardiac reprogramming. Lineage reprogramming of human fibroblasts into iCPCs provides a promising cellular resource for disease modeling, drug discovery and individualized cardiac cell therapy.