Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

OBJECTIVE:To provide reference for scientific and standardized management of temporary purchased drugs. METHODS:By using ABC analysis method,the data of non-antimicrobial temporary purchased drugs in a hospital in 2014 were analyzed statistically with ABC analysis in terms of quantity,the number of types and departments. Class A drugs were analyzed es-pecially. RESULTS:A total of 152 kinds of drugs were purchased temporarily,including 20 464 boxes,20 kinds of class A drugs, which accounted for 70.56%. Main types were antitumor drugs and nutraceuticals by pharmacology;26 departments temporarily purchased drug,mainly in tumor department and hematology department. CONCLUSIONS:The types of temporary purchased drugs meet the clinical demand in the hospital basically. The necessary type A drugs used frequently can be used as reference of tem-porary drug purchase;the temporary purchased drugs can be managed scientifically and normatively based on ABC analysis.

Objective To investigate the role and mechanism of sinomenine and sulfasalazine (SASP) in experimental colitis of mice.Methods Seventy SPF grade Kunming mice were evenly divided into seven groups.Except control group,all mice were treated with oxazolone to create experimental colitis model.After modeling,the model group,low dose sinomenine group,high dose sinomenine group,low dose sinomenine combined group,high dose sinomenine combined group and SASP group was gavaged once daily with 0.9％ NaC1 solution 1 mL,40 mg/kg sinomenine,120 mg/kg sinomenine,40 mg/kg sinomenine and 400 mg/kg SASP,120 mg/kg sinomenine and 400 mg/kg SASP and 400 mg/kg SASP alone for seven days.The mouse stool characters,changes in body weight and fecal occult blood were recorded and disease activity index (DAI) was scored.The next day after the end of the intervention,all mice were sacrificed and specimens of the colon were obtained aud injury was scored.The specimens of inflammation part and ulcer site of colon were taken for histological examination and injury scoring.The expression of mitogen-activated protein kinase kinase 5 (MKK5),extracellular signal-regulated kinase 5 (ERK5),mitogen-activated protein kinase kinase 7 (MKK7),Jun N-terminal kinase (JNK),nuclear factor κB (NF-κB) at mRNA level were detected by reverse transcription-polymerase chain reaction (RT-PCR).The t-test was performed for comparison between groups.Results The DAI of low dose sinomenine group,high dose sinomenine group,low dose sinomenine combined group,high dose sinomenine combined group and SASP group was 2.33±0.77,1.03±0.73,2.70±0.67,1.60±0.66 and 2.03±0.79,respectively,the score of injury was 5.50±1.43,4.00±1.49,6.80±1.75,4.80±1.32 and 5.40±1.58,respectively,all were lower than those of model group (3.40±0.66 and 11.40±1.71) and the differences were statistically significant (tDA1 =3.33,7.61,2.34,6.08 and 4.18,t score of injury =8.35,10.31,5.94,9.66 and 8.15 ; all P＜0.05).The score of injury of high dose sinomenine group,high dose sinomenine combined group and SASP group was 1.40 ±± 1.26,1.70 ± 1.06 and 1.80 ± 1.32,respectively,which were lower than that of model group (3.00 ± 1.05) and the differences were statistically significant (t ＝ 3.07,2.75 and 2.25,all P＜0.05).The expression of MKK5,ERKS,MKK7,JNK and NF-κB at mRNA level of SASP group was 24.29±3.40,34.74±3.05,21.34±3.74,18.71±4.12 and 21.68±2.96,respectively,all were lower than those of low dose sinomenine group (51.94±9.16,50.71±11.09,57.98±17.22,55.99±9.65 and 67.41±10.21) and low dose sinomenine combined group (72.03±17.44,119.91±47.26,74.09±21.24,71.83±16.91 and 86.51±18.61).However,those of SASP group were higher than those of high dose sinomenine group (6.53±0.85,17.87±2.74,13.52±2.56,10.41±2.62 and 13.79± 1.43) and high dose sinomenine combined group (16.80±7.15,21.09±3.92,15.81±1.35,14.11±3.10 and 16.62±3.15).All of low dose sinomenine group were higher than those of high dose sinomenine group,all of low dose sinomenine combined group were higher than those of high dose sinomenine combined group,all of low dose sinomenine combined group were higher than those of low dose sinomenine group and all of high dose sinomenine combined group were higher than those of high dose sinomenine group and the differences were statistically significant (tMKK5=8.95,8.49,16.01,2.99,15.61,9.26,3.22 and 4.51,tERK5=4.41,5.69,13.02,12.81,7.82,6.78,4.50 and 2.13,tMKK7 =6.58,7.73,5.80,4.40,8.11,6.32,1.86 and 2.94,tJNK=10.59,7.57,5.37,2.82,13.21,7.57,2.57 and 2.88,tNF-κB =13.60,10.88,7.60,3.70,16.44,11.71,2.85 and 2.59 ; all P＜0.05).Conclusions Sinomenine can efficiently improve the inflammatory reaction in the mouse model of colitis and the mechanism may be related with ERK5,JNK and NF-κB signaling pathways.The higher the dose,the more significant the efficacy.The antagonism may exist between sinomenine and SASP.

AIM:To investigate the effect of Haikun Shenxi Capsule(fucoidan)on disorder of lipid metabolism on the patients with chronic kidney disease(CKD).METHODS:98 patients with CKD 3、4 stage were divided into 2 groups at random:control group were given routine therapy and therapy group were given routine therapy plus Haikun Shenxi Capsule.The changes of the levels of TCH,TG,HDL-Ch,LDL-Ch,VLDL-Ch,ApoA-1,ApoB in 2 groups were observed.RESULTS:The level of TCH,TG decreased significantly(P 0.05).CONCLUSION:Haikun Shenxi Capsule has a positive effect on disorder of lipid metabolism on the patients with CKD.

Myelodysplastic syndromes(MDS) is a malignant disease of hematopoietic stem cell / progenitor cell clones. Therapies of MDS including immuno-suppressive drugs, chemotherapy, hemopoietic stem cell transplantation and drugs suppressing malignant clones have improved much in recent years. This review is about intervention therapy of MDS and the therapy effect.

Objective To detect the expression of T cell immunoglobulin mucin 3 (Tim-3) and its relationship with Th17/Treg cytokine isolated from peripheral blood mononuclear cells (PBMCs) and broncho-alveolar lavage fluids (BALF) cells in the asthmatic murine model and to investigate the role of Tim-3 in the occurrence and development of the asthmatic inflammation. Methods The asthmatic murine model was established by the method of ovalbumin (OVA) injection and inhalation. The mice were randomly divided into 2 groups: the normal control and the asthma group. PBMCs and BALF cells in each group were collected. Expression of Tim-3 mRNA was detected by the real-time PCR assay. Levels of CD4+IL-17+ and CD4+CD25+FoxP3+, reflecting expressions of Th17 and Treg respectively , were detected by flow cytometry. The correlationbetween Tim-3 and Th17/Treg level was analyzed. Results Contrast with the normal control group, the expression of Tim-3 mRNA in PBMCs and BALF cells in the asthma group increased significantly (P < 0.01). OVA sensitization and challenges resulted in the increased CD4+IL-17 production and the decreased CD4+CD25+Foxp3+in PBMCs and BALF cells compared with those in the normal control group (both P < 0.05). The ratio of Th17/Treg significantly increased in asthma group (P < 0.05). Tim-3 mRNA expression in PBMCs and BALF cells was positively correlated with CD4+IL-17+ level and Th17/Treg ratio , respectively , and was negatively correlated with CD4+CD25+Foxp3+ level. Conclusions Tim-3 mRNA level in PBMCs and BALF cells in the asthma group was increased , indicating that Tim-3 might take part in the occurrence and development of asthmatic inflammation and has a very close relationship with the Th17/Treg imbalance.

BACKGROUND:Granulocyte colony-stimulating factor (G-CSF) can strongly mobilize bone marrow hematopoietic stem cells (HSCs). It has been proved that G-CSF has the ability to mobilize both HSCs and mesenchymal stem cells (MSCs).OBJECTIVE:To investigate the therapeutic effect of G-CSF in mobilizing autologous bone marrow stem cells entering cerebral infarction zone on ischemic cerebral infarction in rats.DESIGN:A randomized grouping design, animal experiment.SETYING: Center for Stem Cell Biology and Tissue Engineering of Sun Yat-sen University.MATERIALS: This experiment was carried out at the Animal Experimental Department of Sun Yat-sen University (North District) and Center for Stem Cell Biology and Tissue Engineering of Sun Yat-sen University from September 2004 to January 2005. Totally 200 male Wistar rats were chosen and randomly divided into autologous bone marrow stem cells transplantation group and control group, with 100 rats in each group.METHODS:Rats of two groups were made cerebral infarction models by line occlusion. Transplantation group introduced intraperitoneal injection of 60 μg/kg G-CSF one hour after operation. The control group introduced intraperitoneal injection of saline of the same dosage at the same time. ①All rats were weighed before operation and 24 hours, 48 hours, one week after operation to evaluate body mass loss rate. They were also given neurological grading. Grading criteria: Grade 0 is normal. Grade Ⅰ is that the right forelimb bends. Grade Ⅱ is that the right forelimb grasped weakly when the tail is lifted. Grade Ⅲ is that the rat has no directivity in automatic action and circumrotates to right when the tail is lifted. Grade Ⅳ is that the rat circumrotates to right in automatic action. ②15 rats in each group were selected. 24 hours, 48 hours, one week after operation, we opened the skulls, took out the brain and used 2,3,5-Triphenyltetrazoluim Chloride (TTC) staining to measure infarction volume, hematoxylin-eosin(HE) staining to observe the pathological change , and immunohistochemistry to detect the infiltration of CD34+ cells.MAIN OUTCOME MEASURES:Body mass loss rate, neurological grade,infarction volume, pathological change and infiltration of CD34+ cells.RESULTS: Totally 180 of 200 rats were successfully made cerebral infarction model. 48 rats died in seven days after operation. As a result, 132 rat models were alive and 120 rats were randomly selected for data analysis. ①Measurement of body mass and neurological grading: There was no significant difference in body mass loss rate between two groups 24 hours and 48 hours after operation (P ＜ 0.05);one week after operation, body mass loss rate was significantly lower in transplantation group [(10.5±8.2)%]than in control group [(17.8±7.1)%] (P ＜ 0.05). There was no significant difference in neurology grade between two groups. ②Infarction volume:Infarction volume and the percent of infarction volume in the whole brain in control group were all higher than those in the transplantation group,with significant difference [ (251.69±52.77) mm3 vs(145.72±28.05)mm3,(17.00±2.69)% vs (9.90±1.62)% ,P ＜ 0.01]. ③Pathological change: 24 hours after operation, the brain tissue of two groups got classical pathological change of cerebral ischemia infarction. There were some mono-nucleus cells infiltrating in transplantation group while none in control group. 48 hours after operation, most nerve cells disappeared and the glial cells were degenerated. There were many mono-nucleus cells infiltrating in transplantation group while a few in control group. One week after operation, tissues in the infarction zone were liquescent with many monocaryons and lymphocytes infiltrating around them in control group. In transplantation group, part of the infarction zone was plerosised through proliferation of newly born capillaries and glial cells and inflammatory cells were not evident. ④Immunohistochemistry: CD34+ mono-nucleus cells were detected in the ischemic territory in transplantation group 24 hours after operation while none in the brain of other side and control group. There were CD34+ mono-nucleus cells and pyramidate cells with mutations in transplantation group 48 hours after operation while none in the brain of other side and control group.CONCLUSION:The stem cell transplantation in situ therapy, which employs self-marrow stem cells mobilized by G-CSF can relieve the ischemic degree and reduce the infarction volume.

Objective To explore the risk factors of prognosis for children with acute kidney injury (AKI). Methods Clinical data of 118 children with AKI, including the causes,clinical characteristics, laboratory features, renal pathological findings, treatment and outcome, were reviewed retrospectively. Association between risk factors and prognosis was analyzed. AKI was defined by the new classification criteria of the Acute Kidney Injury Network. Prognostic factors were determined by univariate methods and stepwise multiple logistic regression analysis. Results One hundred and eighteen patients (83 male, 35 female) were enrolled in the study, who admitted in our department between January 1, 2005 and May 31, 2008. Median age at the time of AKI children was 7.5 years (range 1 day-14 years), among whom 28.0% (33 cases) was less than 3.0years, 17.8% (21 cases) between 3.0 and 7.0 years and 54.2% (64 cases) more than 7.0 years.Patients' AKI was classified according to the staging system as follows: 52.5% stage 1, 32.2%stage 2 and 15.3% stage 3. The common causes of AKI children were infectious and autoimmune diseases (39.8%), renal vascular disease (27.1%) and circulatory disturbance (11.9%). Hospital mortality was 21.2%. Multivariate analysis showed that independent risk factors for death were need for mechanical ventilation (OR=51.75, P＜0.01＝, sepsis/septic shock (OR=14.76, P＜0.01＝, severe acidosis (OR=11.38, P＜0,01＝, and white blood cells (WBC) count more than 20.0×109/L (OR=8.51, P＜0.01＝. Conclusion Infectious and autoimmune diseases, renal vascular disease and circulatory disturbance are the common causes of AKI children. The important risk factors of death in AKI children are need for mechanical ventilation, sepsis/septic shock, severe acidosis, and WBC count more than 20.0×109/L.