The structure of collagen fibers in the loose and dense connective tissues, from various sources (central tendon of dog diaphragm, tentorium cerebelli of hen, pericardium of adult man, etc.) were investigated with light microscope (LM), transmitting electron microscope (TEM) with ultra thin sections cut after reembedding with epoxy resin following orientation under LM, and ultrathin section under TEM coordinated with the semithin section under LM. It was observed that: (1) The logitudinal striated structure within the so called collagen fibers and the collagen fiber without the logitudinal striated structure under LM are all the closely arranged collagen fibril bundle in which the space between the fibrils is narrower than 0.2?m under TEM. So that both must belong to the same grade. (2) The collagen fibrils in vivo may be singlely dispersed, or in double, or in bundles formed from 3 to hundreds of fibrils; the space between fibrils varied closely to several ?m. (3) The diameter of collagen fibrils is genera ly 20—200 nm, but there are also thicker or thiner fibrils. According to these and other previous works, we suggest the following points on the nomenclature: (1) The collagen fibril is the collagen structure which has generally the diameter of 20—200nm and the cross striations of 64—70nm along its longitudinal axis under EM It should no longer be Called the collagen microfibril. (2) The collagen fiber is the bundle which is composed of three or more closely arranging collagen fibrils bound by a small amount of cement substance. Under EM, the space between the bundles is larger than 0.2?m but the space between the fibrils within the bundle is narrower than 0.2?m. Under LM, the collagen fiber is the structure without the visible subunit filament and may branch and anastomose- each other. (3) The collection of collagen fibers should be called collagen fiber bundle. It includes the so called "collagen fibers" (old routine nomenclature) with the visible subunit filaments under LM. This nomenclature should remove the confusion on the structural grading of collagen fibers and unify the concept of collagen fiber under LM with that under EM.

41 biopsies of rami cutaneous dorsalis of nerve peronaeus superficalis in neuro-pathies(12 inherited,8 dysglobulinemia,8 infective,3 vascular,3 other,7 unknown)and 9 biopsies from normal man were observed under electron microscope.It wasfound that 10 oud of the 4 biopsies(24%)oud 4 of the 9 biopsies(44%)had theperineurial canalicular system.The perineurial canalicular system can be divided into 2gradations.(1)The perineurial microcanaliculus consists of 1-2 layers of the perineurialcells,the lumen was irregular;(2)The perineurial canaliculus consists of 1-3 layers ofthe perineurial cells,the lumen was more regular.The luminal surface of the perineu-rial cells had no basal lamina but the external surface of them had basal lamina.The density in the luminal contents obviously lower than that of outside and glyc-ogen-like granules and myelin-like substance could be seen within the lumen.Pino-cytotic vesicles in the perineurial cells of the canalicular wall opened into the lum-inal surface.These canaliculi extraordinarily twisted between the perineurial cells ofvarious layers and the diameter of the lumen was generally 0.1-2.7?m.The originof the canaliculi situated in the inner layer of perineurium was separated from thesubperineurial space with complete basal lamina and intercellular space that contain-ed basal lamina-like substance between perineurial cells.Their termination was notknown yet.The role and function of the perineurial canalicular system were discuss-ed.

OBJECTIVE:To observe clinical efficacy and safety of flupirtine maleate for pain caused by acute lumbar sprain. METHODS:60 patients with acute lumbar sprain were selected and divided into trial group and control group according to even and odd-numbered admission order. Trial group received flupirtine maleate capsule,1 piece/time,3 times/d;control group was giv-en codeine sustained-release tablet,2 tablets/time,2 times/d. The VAS score,clinical efficacy and ADR were compared between 2 groups. RESULTS:The VAS score of treatment group after treatment was significantly lower than that of control group,with statis-tical significance(t=2.375,P=0.013). The clinical efficacy of trial group was significantly higher than that of control group,with statistical significance (u=9.431,P=0.024). The ADR of trial group was mild,and there was no significant difference between two groups(χ2=0.131,P=0.717). CONCLUSIONS:Flupirtine maleate has a good clinical efficacy and safety in the treatment of pain caused by acute lumbar sprain.

The perineurial cells of the small nerve branch of the normal human abdominal wall are observed with electron microscope. The fibrous long-spacing bodies (FLS) are found within the interstitial substance of the endoneurium. 1. 2-5 layers of the perineurial cells surround the nerve fasciculus. The perineurial cells are squamous in shape and the cytoplasm contains microfilaments and pinocytotic vesicles. Each perineurial cell has an obvious basement membrane on its basal surface but the fibroblasts, whatever situated in the endoneurium or on the outer surface of the perineurium, has no basement membrane. Numerous desmosome and some gap junctions between the close attached perineurial cells are demostrated. The collagen fibrils between perineurial cells can be often shown. FLS bodies and collagen fibrils about 45 nm in diameter in the interstitial substance of endoneurium inside perineurial cells are demonstrated. In the connective tissue surrounding the outside of perineurial cells, the collagen fibrils of 80 nm in diameter can be seen, but no FLS bodies present there. 2. FLS bodies in the endoneurial matrix can be demostrated. Most of them closely associated with the basement membrane of the Schwann cells surrounding the unmyelinated nerves but no FLS bodies are found associate with those of the myelinated nerves. A few FLS bodies do not relate to basement membrane and they are invested only with the collagen fibrils. In the longitudinal sections, most of FLS bodies are in spindle shape of various sizes, their longitudinal axes parallel to that of the adjoining collagen fibrils. Sometimes the FLS bodies continue with the collagen fibrils are found. Occasionally, FLS body like a bridge locate between two Schwann cells and its dark bands continue to the basement membrane of the Schwann cells. Two or three FLS bodies may fuse together but their cross bands do not registered at the same level. In the oblique sections, FLS bodies are nearly rectangular in shape, with the cross bands shown, and their appearance do not show greaty difference from those in longitudinal sections. The periodicity of FLS bodies is about 133nm in length; the dark band in it is about 53 nm, which is made of the dense granular substance; the light band is about 80 nm, which is made of a network with approximated parallel microfilaments. There are no further crossstriated structures within the periods. Some problems, such as the role of the perineurial cells, the relationship of FLS bodies with basement membrane, are briefly discussed.

BACKGROUND: Autologous bone marrow is the only tissue that contains abundant osteoinductive osteogenitor cells and is the first-choice transplantation materials for treatment of bone nonunion. Artificial bone with osteoinductive capacity can provide a supporting effect for the in-growth of osteocytes. Iliac periosteum can be used for treatment of bone nonunion due to the advantages including abundant blood circulation, easy harvesting, and able to improve local arterial blood supply. BJECTIVE: To treat refractory bone nonunion in limbs using artificial bone with autologous bone marrow combined with iliac periosteum transplantation, and to compare the therapeutic efficacy to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation. METHOD: Thirty-nine refractory bone nonunion limbs from 36 patients were assigned to three groups: artificial bone with autologous bone marrow combined with iliac periosteum transplantation (combination group, n = 19), artificial bone with autologous bone marrow (bone marrow group, n = 9), and autologous iliac periosteum (iliac periosteum group, n = 11). The time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score were evaluated. RESULTS AND CONCLUSION: All initial 39 limbs acquired bone union and were followed up for an average period of 18.5 months. The combination group yielded better therapeutic effects than the bone marrow group and the iliac periosteum group in terms of the time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score (P < 0.05). These findings indicate that artificial bone with autologous bone marrow combined with iliac periosteum transplantation exhibits better clinical therapeutic effects in treatment of refractory bone nonunion in limbs.

OBJECTIVETo observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE).

METHODSA total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients.

RESULTSThe IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P < 0.01), even longer in group C than in A and B (P < 0.01). The PEDT scores of the three groups were 5.1 ± 1.8, 4.9 ± 1.7, and 3.8 ± 1.2 after treatment and 8.2 ± 2.4, 8.1 ± 2.4, and 6.5 ± 2.1 at 1 month after drug withdrawal, significantly improved in comparison with 13.2 ± 3.2, 12.8 ± 3.1, and 13.1 ± 3.4 before treatment (P < 0.01), even more significantly in group C than in A and B (P < 0.01).

CONCLUSIONQilin Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

Adult ; Drug Therapy, Combination ; methods ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; drug effects ; physiology ; Humans ; Male ; Premature Ejaculation ; drug therapy ; Qi ; Sertraline ; therapeutic use

Objective To establish a system in which mouse embryonic stem cells (mESCs) differentiate into insulin-secreting cells in vitro. Methods mESCs were cultured to form embryoid bodies(EBs). EBs were cultured in serum-free medium to obtain nestin-positive cells. The selected nestin-positive cells were expanded,then added nicotinamide into the medium to induce the differentiation of nestin-positive cells. Immunochemistry staining and flow cytometry analysis were made on 15th day after induction.Results Flow cytometry analysis revealed that the percentage of nestin-positive cells were different from EBs. The percentage of nestin-positive cells from EBs were higher than those of other diameters. Nestin-positive cells induced by nicotinamide formed islet-like cell clusters. Percentage of insulin-positive cell induced by 10 mmol/L nicotinamide was higher than those induced by 0 mmol/L or 5 mmol/L nicotinamide(P

Objective To evaluate the optimal management of cardiac surgery during pregnancy,in the second or third trimester,and the maternal and fetal outcomes in pregnant patients after surgery.Methods Six pregnant women with heart diseases were identified,who underwent cardiac surgery with cardiopulmonary bypass.Surgery was performed using cardiopulmonary bypass at mild hypothermia/normothermia,with pulsatile perfusion.Natural progesterone(20 mg)was added in priming solution,monitoring uterine contractions and heart rate changes.The mode of surgeries included mitral valve replacement+tricuspid valve plastic in three cases,aortic and mitral valve replacement+tricuspid valve plastic in one,left ventricular myxomatomy in one,left ventricular septal myectomy+artificial aortic valvular vegetations dissection+tricuspid valve plastic in one.Results The cardiopulmonary bypass and cross clamp time averaged 169 minutes(range,96~419 minutes)and 113 minutes(range,56~296 minutes),respectively.Five patients were alive.One maternal and fetal death occurred 6 h after surgery caused by heart failure and pulmonary edema.The other 5 patients terminated pregnancies after heart surgeries,one underwent with cesarean section 3 d after surgery in second trimester,two of whom with induction of labor,and two full-term labor(one with cesarean section,one with normal delivery).Two newborns were alive with no malformation.Conclusion Cardiopulmonary bypass can be used safely with satisfactory maternal and fetal outcomes in pregnant patients with heart disease undergoing cardiac surgery.

Objective To explore the polymorphism distribution of the hormone-sensitive lipase (HSL) gene i6 in Zunyi region. Methods HSL i6 in the Zunyi population was examined with ploymerase chain reaction-single strand conformation polymorphism (PCR-SSCP),and analyzed for its distribution. Results Six different alleles and 11 different genotypes were found in the HSL i6. The PIC is more than 0.7,in which allele 6 and allele 7 were most widely distributed.Conclusion The polymorphism of HSL i6 was identified and the result suggests in Zunyi HSL as a candidate gene of glucose and lipid metabolism.