[Objective]To investigate the methods of preparing acellular cartilaginous matrix(ACM) and constructing the tissue engineered cartilage with adipose-derived stem cells(ADSCs)-seeded acellular cartilaginous matrix in vitro.[Method]The ADSCs were isolated from adult New Zealand albino rabbits by collagenase,cultured and amplified in vitro.Fresh cartilage isolated from adult New Zealand albino rabbits were freeze-dried for twelve hours and then treated with Triton X-100,Dnase and RNase so as to obtain the ACM.After sterilized with ultra-violet,the ADSCs were seeded in the acellular cartilaginous matrix at a final density of 2?107/L and cultured in chondrogenic differentiation medium for two weeks in order to construct tissue engineered cartilage.Histology,immunohistochemistry and transmission electron microscope(TEM) were applied to examine the fresh ACM and tissue engineered cartilage.[Result]The test of hematoxylin-eosin(HE) staining and TEM showed no cellular structure in the ACM with only recesses left by removed cells.The ACM had suitable interval porosity and aperture size.After integrated with ADSCs,cells migrated into the ACM and adhered to the surface of material and grew well.After cultured in chondrogenic differentiation medium for two weeks,immunohistochemical staining of type Ⅱ collagen showed part of the cells in the material had enhanced expression of type Ⅱ collagen.[Conclusion]ACM can be used as scaffold material in cartilage tissue engineering.If it was seeded with ADSCs and cultured in chondrogenic differentiation medium,ACM can be used to construct cartilage tissue successfully.

Objective To investigate the clinical efficacy of Ilizarov bone transport combined with dressing change in the treatment of acute tibial osteomyditis accompanied with massive soft tissue defection.Methods From July 2009 to september 2012, 14 patients with acute tibial osteomyelitis associsted with large-area soft tissue necrosis and defection were treated in Traumatic Orthopaedics Department of the Central Hospital of Binzhou.All cases were Gustillu Ⅲ type open fracture, and Ⅲ C type injury in 11 casas accompanied with vascular injure.Associated with contralateral lower limb in 4 casas.They were 10 male and 4 female,aged from 21 to 45 years old(average age of 35 years old).The duration from injury to surgery ranged from 12-24 days,averaging of 19 days.All cases were treated first with excision of the infected or necrosis bone segment and soft tissue.The wound keep opening, followed by llizarov bone transport combined with dressing change to repair the bone and soft tissue defection.The clinical efficacy was assessed using the Paley's evaluation system at the last follow-up.Results All the patients were followed up for 24 to 36 months (average of 27 months).The bone defection rapaired was from 5 to 1 3 cm(average of 7 cm).The mean duration of distraction was 4 months, range from 2 to 6 months.All cases' gain s.ufficient soft tissue coverage the later period of Ilizarov bone transport.All the fracture and bone defection were cured.Infection were cured in 13 cases, and 1 case converted to chronicle osteomyelitis, and the cure rate was 93％.According to the Paley' s system, the bone union was excellent in 11 cases, good in 2 cases, and fair in 1 Cases, with a good-to-excellent rate was 93％.The functional outcome was excellent in 10 cases,good in 2 cases,and fair in 2 cases,with a good-to-excellent rate of 86％.Conclusion Ilizarov bone transport and dressing change is one reliable and effective treatment of tibial acute infected and soft tissue defection.

Objective To discuss the value of Valsalva experiment combined with improved MRI tilt tomography applying on the pharyngeal ostium of eustachian tube opening function of patients with nasopharyngeal carcinoma.Methods 1 7 cases with patholog-ically proved NPC underwent conventional MRI plain and enhanced scan.In the eustachian tube area oblique transection T2 WI and T1 WI scanning was done before and after the Valsalva experiment.The invasion of eustachian tube and its surrounding structures was analyzed and the eustachian tube function was evaluated.Results Valsalva experiments combined with improved MRI trans-verse oblique scan could clearly display the whole structure of the eustachian tube and surrounding tissue invasion compared with conventional scanning MR scan.And it could better evaluate the eustachian tube opening function for patients suffered nasopharynge-al carcinoma.Conclusion Valsalva experiments with improved MRI oblique transverse imaging could achieve individualized scan of the eustachian tube,and could be used for evaluating the pharyngeal opening function of eustachian tube in patients with nasopharyn-geal carcinoma.

Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke.Methods Ninety-eight cases of severe acute stroke were divided into nutrition supported group(50 cases) and control group(48 cases) randomly.All patients were treated by conventional therapy.Nutrition supported group received high energy nutrition diet and control group received common liquid diet by nasal feeding.The levels of hemoglobin,serum albumin,neurologic impairment score (NIHSS)and the incidence rates of complications were assessed at the 1st,10 th and 21st day after admission.Results Hemoglobin was (122.5 ± 2.4),(106.4 ± 2.8) g/L and serum albumin was (36.5 ± 4.7),(34.2 ± 5.1) g/L at the 21st day after admission in nutrition supported group and control group,and there was significant difference between two groups (P < 0.05).The complication rate in control group was higher than that in nutrition supported group (P< 0.05).NIHSS score was(8.45 ± 3.02) scores in nutrition supported group and (10.24 ± 2.57)scores in control group at the 21st day after admission,and there was significant difference between two groups (P <0.05).Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of complications in patients with severe acute stroke,and it is helpful for clinical prognosis.

BACKGROUND: Hepatitis B virus (HBV) recurrence following liver transplantation has been difficultly treated, and antiviral therapy following HBV recurrence has been less reported yet.OBJECTIVE: To investigate the antiviral therapy using Adefovir + Lamivudine + anti-hepatis B immunoglobulin on liver functional improvement following liver transplantation.METHODS: A total of 208 cases with hepatitis B-related end-stage liver disease following liver transplantation were selected from Liver Transplantation Center of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January 2005 to October 2008. All patients were treated with Lamivudine + anti-hepatis B immunoglobulin so as to prevent from HBV recurrence. At 6-43 months after following up, HBV recurrence was found in 19 cases, including 13 with positive HBeAg and 8 with YMDD mutation. The 19 patients were treated with Adefovir based on the application of Lamivudine + anti-hepatis B immunoglobulin.RESULTS AND CONCLUSION: At 12, 24, and 48 weeks after treatment, DNA and glutamic-pyruvic transaminase of 19 cases were significantly decreased (P < 0.01). After 48-week treatment, recovery rate of glutamic-pyruvic transaminase, negativity rate of HBeAg, and negativity rate of HBV DNA were 84.1 %, 76.92%, and 78.9%, respectively. The results demonstrated that the application of Adefovir + Lamivudine + anti-hepatis B immunoglobulin effectively inhibited viral replication and prevented HBV recurrence following liver transplantation.

Objective To compare the efficacy between arthroscopic assisted reduction and traditional opera-tion approach for the treatment of tibial plateau fractures.Methods 75 patients with tibial plateau fracture(SchatzkerⅠ -Ⅳ type)were recruited,which were randomly divided into the arthroscopic and traditional operation group according to different treatment methods.The clinical efficacy and value of arthroscopically assisted reduction was ana-lyzed and compared according to the incidence of postoperative complications,the operative time,incision length,blood loss,hospital stay,and clinical efficacy between the two groups.Results Compared with the data in the traditional operation group,the incidence of postoperative complications (2.70% vs.21.3%)was significantly lower(χ2 =5.980,P =0.014).The operative time[(88.1 ±15.2)min vs.(103.8 ±22.1)min]was significantly shorter(t =3.575,P =0.001).And the incision length[(6.7 ±2.3)cm vs.(10.8 ±2.7)cm)]declined greatly(t =5.745,P =0.000).The hospital stay time and blood loss were significantly lower than that of the traditional operation group[(4.5 ± 2.3)d vs.(6.5 ±3.1)d;(145.2 ±43.0)mL vs.(294.4 ±90.2)mL,respectively],and the differences were statisti-cally significant(t =3.166,P =0.003;t =7.829,P =0.000,respectively).The excellent rate of clinical features in arthroscopic group(86.49%)was higher than that of traditional operation group(71.05%),and the difference was statistically significant(χ2 =3.723,P =0.039).Conclusion Arthroscopic -assisted reduction has many features for the tibial plateau fractures (SchatzkerⅠ -Ⅳ type),such as lower incidence of postoperative complications,less trau-ma,shorter operative time,and better postoperative knee function and so on,so it is worthy of clinical application.

This study aims to explore the clinical value of the computer-aided diagnosis (CAD) system for early detection of the pulmonary nodules on digital chest X-ray. A total of 100 cases of digital chest radiographs with pulmonary nodules of 5-20 mm diameter were selected from Pictures Archiving and Communication System (PACS) database in West China Hospital of Sichuan University were enrolled into trial group, and other 200 chest radiographs without pulmonary nodules as control group. All cases were confirmed by CT examination. Firstly, these cases were diagnosed by 5 different-seniority doctors without CAD, and after three months, these cases were re-diagnosed by the 5 doctors with CAD. Subsequently, the diagnostic results were analyzed by using SPSS statistical methods. The results showed that the sensitivity and specificity for detecting pulmonary nodules tended to be improved by using the CAD system, especially for specificity, but there was no significant difference before and after using CAD system.
China ; Diagnosis, Computer-Assisted ; Early Diagnosis ; Humans ; Lung ; pathology ; Radiographic Image Enhancement ; Radiography, Thoracic ; Thorax

Objectives To analyse the etiology and clinical characteristics of syncope in children. Methods The clinical data of 128 children with syncope were retrospectively analyzed. Results According to the definition of syncope and supporting test results, 20 cases of non-syncopal conditions were excluded. In 108 cases of syncope, there were 70 cases (64.81%) of neurally mediated syncope, 8 cases (7.41%) of cardiogenic syncope, and 24 cases (22.22%) of unexplained syncope. Eighty-five cases (78.71%) had incentives before the onsets. Twenty-one cases (19.44%) had the family histories of syncope. One case (0.93%) had the family history of sudden death. The neurally mediated syncope and cardiogenic syncope had the feature of recurrent attacks. The VVS were preceded by limbs weakness, pale complexion, darkness in front of eyes, hearing loss, nausea and chest pain, the POTS by palpitation, chest pain and weakness, the OH by darkness in front of eyes, pale complexion and hearing loss, and the car-diogenic syncope by precordial discomfort, pain and chest pain. Conclusions The VVS is one of the most common cause of syn-cope in children. The onsets of the various types of syncope often have incentives and are preceded by some symptoms. Most of them have the feature of recurrent attacks.

OBJECTIVETo analyze p-coumaril acid, trans-6-O-p-coumaroyl scandoside methyl ester and its metabolites in rat plasma after intragastric administration of exocarpium Diffusa effective extracts.

METHODRat blood samples were collected 1.0 h after oral administration of 0.4 g x kg(-1) exocarpium Diffusa effective extracts, and then were analyzed by using HPLC-Q-TOF-MS.

RESULTIn rat plasma, only one metabolite was detected. The structure was identified by reference substance to be p-coumaril acid.

CONCLUSIONThe methyl glucoside metabolite in rat from the main component parts of trans-6-O-p-coumaroyl scandoside methyl ester droppings of vines in Diffusa effective extracts is p-coumaril acid. This experiment provides a theortical basis for studying chemical compositions and pharmacodynamic action of Diffusa.

Animals ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; metabolism ; Hedyotis ; chemistry ; Male ; Mass Spectrometry ; methods ; Rats ; Rats, Sprague-Dawley

Objective:To evaluate immune response of murine peritoneal macrophage challenging by methicillin-resistant S.aureus(MRSA)after pretreatment with Pam3Csk4(TLR2 agonist).Methods: Murine peritoneal macrophage was pretreated with Pam3Csk4(1 μg/ml).Following pretreatment 12 h later,heat-killed MRSA( HK-MRSA) was added and incubated for another 2 or 6 hours.The protein and mRNA level of TNF-α, IL-6 and IL-1 were determined by ELISA and Q-PCR, respectively.To estimate phagocytosis of macrophage,HK-MRSA/MSSA labeled with FITC( FITC-HK-MRSA/MSSA) were added to well and incubated for 30 min.After washing 5 times with PBS,intracellular FITC-HK-MRSA was detected by flow cytometry.To estimate antimicrobal activity of macrophage,live MRSA and MSSA were added to well and incubated at indication time,the CFU of s.aureus was estimated via a 10-fold serial dilution on agar media.cDNA was further quantitative assessed using primers for mouse FCR-Ⅰ,FCR-Ⅲ,CR-1,CR-3,iNOS and LL37 by Q-PCR .Results: Compared with saline-pretreated cell, the protein and mRNA level of TNF-α, IL-6 and IL-1 were markely reduced, respectively.However, both the phagocytosis and antimicrobal activity to S.aureus were significantly increased in macrophages pretreated with Pam3Csk4.Further study found that the macrophages had higher FCR-Ⅰ,FCR-Ⅲ,CR-1,CR-3,iNOS and LL37 expression at 6 h and 12 h post-stimulation Pam3Csk4.Conclusion: The results suggest that Pam3Csk4 could activate murine antimicrobal activity of peritoneal macrophage challenging by methicillin-resistant Saureus via increasing opsonophagocytosis in depended antibodies, complements manners.The results suggest Pam3Csk4 probably be a novel immunotherapy candidate against MRSA.