Objective To prepare an internal quality control substance of free hemoglobin (FHb),and evaluate its perform-ance.Methods ① 5 normal whole human blood samples with known hemoglobin (Hb)concentration was selected and dilu-ted with distilled water in the ratio of 1∶500,1∶1 000,1∶2 000,1∶4 000 respectively.After 20 FHb solutions was fully mixed,the concentration of FHb solutions was tested and compared with its theoretical data.②One of the highest value and the lowest value solutions were chosen as qualitye control substance,packed and stored in -20℃ fridge.Each group was an-alyzed 20 days continuously in the routine conditions,where average (-x )of the groups,standards deviation (s )and coeffi-cients of variation (CV)were calculated and Levey-Jennings control chart was conducted.Then,the test was repeated every week,and the data on the chart was updated accordingly until (CV)of the reagents were changed.The average (-x)of the-groups,standards deviation (s)and coefficients of variation uality control material was calculated during the whole test peri-od.Results ①The theoretical value (-x ±s)of the concentration of free hemoglobin was 125.44±93.04 mg/L,and the actu-al value was 125.22±93.08 mg/L,there was no statistic significance (t value was 0.706,P >0.05).② During 20 continu-ously daystest,the detected values (-x ±s)of the highest quality control material was 303.55±3.70 mg/L;the values of the lowest quality control material was 69.29 ± 1.88 mg/L.The coefficients were 1.22% and 2.68% respectively.Both the highest and the lowest quality control material were under control during the whole detecting period.The (-x ±s )values of the highest was 302.56±3.99 mg/L,the CV value of it was 1.32%;The (-x ±s)values of the lowest was 69.04±1.88 mg/L,the CV value of it was 2.71%.Conclusion The preparation method of internal quality control substance of free hemoglo-bin is convenient and stable,and was applicable in blood station’s and clinical laboratory.

BACKGROUND: The clinical application of one-level osteotomy and multilevel osteotomy has been well documented, but currently few studies were reported to compare their biomechanical characteristics.OBJECTIVE: To investigate the biomechanical characteristics of one-level osteotomy with Dick screw fixation and multilevel osteotomy with Luque instrumentation in the treatment of kyphosis.DESIGN: Randomized comparative experiment.SETTING: Laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University.MATERIALS: Fresh specimens of thoracic and lumbar spinal segments obtained from 12 3 or 4-year-old calves.METHODS: The experiment was conducted in the laboratory of the Department of Orthopedics, Renmin Hospital of Wuhan University between September 2002 and September 2003. Fresh spinal segments T8-L5 from 12 calves were randomized into an intact group, Dick screw group with one-level osteotomy with Dick screw fixation and Luque group with multilevel osteotomy with Luque instrumentation, with 4 spesimens in each group. Lateral bending test of the specimens was performed to examine the physiological overload using an Instron 5 500 universal material testing machine at the constant speed of 10 mm/minute until fracture or dislocation was induced. Changes in the loading were recorded and the induced injuries observed to obtain the load-displacement curve of the injury test.MAIN OUTCOME MEASURES: The load-displacement curve of the destructive right bending test in each group.RESULTS:All the data of 12 canines were involved in the result analysis.The spinal segments of the intact group yielded to the force of 3 600 N with a flat and smooth load-displacement curve, and those of Dick screw group yielded to a load of 2 800 N with also a relatively flat curve, while in Luque group, the segments did not yield until a load of 7 160 N, followed by drastic decrease of the resistance to less than 4 000 N, generating a flat and smooth curve afterwards.CONCLUSION: Luque instrumentation is a little more preferable than Dick screw in terms of the maximum resistance, but this difference does not justify the clinical decision of their superiority. Both techniques benefit postoperative recovery of spinal function with strong stability.

BACKGROUND:Studies have shown that extracorporeal shock wave therapy is an effective, safe, and non-invasive treatment for ischemic heart disease, which can improve angiogenesis in the ischemic myocardium. OBJECTIVE:To summarize the research advances in promotion of angiogenesis for ischemic myocardium by extracorporeal shock wave therapy. METHODS:A computer-based online search of PubMed database and CNKI database was performed for relevant articles published between 1998 and 2014 with key words of “shock wave, ischemic heart disease, angiogenesis, cytokine, stem cel” in English and Chinese, respectively. Articles related to the promotion of angiogenesis for ischemic cardiovascular disease by extracorporeal shock wave were selected. Repetitive articles were excluded. According to inclusion criteria, 51 literatures were selected in result analysis. RESULTS AND CONCLUSION: Extracorporeal shock wave therapy can improve angiogenesis in the ischemic myocardium by mobilizing proliferation and differentiation of stem cels into vascular endothelial cels, and by enhancing the expression of growth factors such as vascular endothelial growth factor and basic fibroblast growth factor. Moreover, the extracorporeal shock wave therapy can create a local favorable microenvironment for angiogenesis by inhibiting inflammation, oxidative stress and apoptosis and by regulating components of the extracelular matrix. Extracorporeal shock wave therapy plays an important role in the angiogenesis of ischemic myocardium and displays a good clinical prospect in the treatment of ischemic heart disease. However, the specific mechanism requires further studies.

BACKGROUND:Through a ful investigation of biodegradable scaffolds, we propose a new self-expanding degradable poly-L-lactide coated endotracheal stent based on the design, production, experimental and clinical applications of nickel titanium memory alloy stent. OBJECTIVE:To design a kind of biodegradable endotracheal stent with poly-L-lactide and hydroxyapatite, and to test its mechanical properties, biocompatibility and biodegradation capacity. METHODS:With the technology of computer aided design, the stents were prepared with poly-L-lactide (Mr RESULTS AND CONCLUSION:The average radial supporting force of the tracheal stent was 7.8 kPa, the percentage of stent surface coverage was less than 20%, the stent expansion rate was≥4%, and the stent longitudinal shortening rate was≤9%, which reached the mechanical requirements for degradable endotracheal stents. After 4-16 weeks, there was no significant inflammatory response. The decline in molecular weight changes and weight loss ratio was higher for in vivo degradation than in vitro degradation at different time (P<0.05). These findings indicate that poly-L-lactide/hydroxyapatite composite stents have good mechanical properties, biocompatibility and biodegradability. 150 000) and hydroxyapatite materials, 20 mm to 26 mm in diameter. The mechanical properties were tested using a universal testing machine. These poly-L-lactide/hydroxyapatite stents were implanted into dog models of tracheal stenosis at an appropriate size. The histopathological changes of the tracheas were observed, and biodegradation property was studied via molecular weight changes and weight loss ratio after 4, 8, 12, 16 weeks.

Objective To observe the treatment effects of trimetazidine on myocardial bridge. Methods A total of 76 patients with clinical symptoms, such as different degrees of chest tightness, palpitation, breath shortness, chest pain, were diagnosed as coronary myocardial bridge by coronary angiography, and were divided into two groups randomly. While control group (n=40) was given beta-blocker or (and) calcium antagonist as routine treatment. The treatment group (n=36) was given routine treatment and trimetazidine, 20 mg, three times daily. The mean follow-up period was 12 weeks. The episodes of chest pain per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24 h and walking distance in 6 min were observed in two groups of patients. Results The parameters of chest pain times per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24 h and walking distance in 6min were improved in treatment group compared with control group, and the symptoms were effectively relieved, the life quality of patients were improved. Conclusion The conventional treatment combined with trimetazidine is safe and effective, which can further improve myocardial energy metabolism and exercise tolerance, and enhance the clinical effect and the life quality of patients.

Objective: To observe the effect of extracorporeal shock wave therapy (ESWT) on proliferation, cell cycle and intercellular adhesion molecule-1 (ICAM-1) expression in human umbilical vein endothelial cells (HUVECs). Methods: HUVECs were culturedin vitro at the concentration of (1×105/ml) and the cells were divided into 2 sets of groups:CSWT group, the cells were treated by different energy of (0.03, 0.09, 0.18, 0.24) mJ/mm2 respectively and corresponding Control group, in which the cells had no CSWT. HUVEC proliferation was detected by CCK colorimetric method, cell cycle was measured by lfow cytometry, mRNA and protein expressions of ICAM-1 were examined by RT-PCR and Western blot analysis respectively. Results: Compared with Control group, (0.09 mJ/mm2) CSWT group had promoted HUVECs proliferation,P<0.05 and the other CSWT groups were similar to corresponding Control groups,P>0.05; (0.09 mJ/mm2) CSWT group showed decreased proportion of G0/G1 stage and increased S and G2/M stages, allP<0.05; while (0.03 mJ/mm2) CSWT group only increased the proportion of G2/M stage,P<0.05 and the other CSWT groups were similar to corresponding Control group,P>0.05. Compared with Control group, (0.09 mJ/mm2 ) and (0.03mJ/mm2) CSWT groups showed increased mRNA expression of ICAM-1 (9.27±0.95) vs (1.02±0.27),P<0.001 and (7.08±0.60) vs (1.02±0.27),P<0.01; (0.09 mJ /mm2) CSWT group had elevated protein expression of ICAM-1,P<0.05. Conclusion: ESWT especially at (0.09 mJ/mm2) may accelerate cell cycle transition from G0/G1 stage to S and G2/M stages, promote HUVECs proliferation and increase ICAM-1 expression which may play important roles in ESWT facilitated angiogenesis in vitro.

Objective To compare inhibitory effects among extract of Radix tripterygii wilfordii (RTW),dexamethasone and diclofenac sodium on nitric oxide (NO) production and inducible isoform of nitric oxide synthase (iNOS) activity in chondrocytes of patient with rheumatoid arthritis,and to explore cartilage protection of three kinds of medicines in the treatment of rheumatoid arthritis (RA).Methods Chondrocytes from the resected knee joint cartilage of patients with RA were isolated and cultured.The chondrocytes were stimulated by IL 1,and at the same time the cells were treated with RTW,dexamethasone and diclofenac sodium in different concentration overnight.Supernatants were collected to detect the content of NO with Griess reagent.Chondrocytes were collected to examine the iNOS activity by detecting the conversion of L 14 C arginine into L 14 C citruline.The total RNA of chondrocytes was extracted and the iNOS mRNA was examined by Northern blot.Results RTW inhibited NO production and iNOS activity in different concentration (2,4,8 and 16 mg/L).The maximal inhibitory rates were 81 1% and 84 3% respectively.Such inhibitory effects were dosage dependent.Corresponding to NO and iNOS,RTW inhibited the expression of iNOS mRNA induced by IL 1 in chondrocytes.Dexamethasone inhibited NO production,iNOS activity and iNOS mRNA expression significantly,the maximal inhibitory rate around 50%,but not dosage dependent.Diclofenac sodium only had 12 9% inhibitory effect.Conclusion RTW and dexamethasone both inhibited NO production by chondrocytes,but inhibitory effect of dexamethasone was limited.Diclofenac sodium only had weak inhibitory effect.

Objective To investigate the long-term results of gastrocnemius fascial turn-down flaps and suture anchors in reconstruction of chronic Achilles tendon rupture.Methods From September 2007 to February 2010,20 patients with chronic Achilles tendon rupture were reconstructed with gastrocnemius fascial turn-down flaps plus suture anchors.There were 13 males and 7 females at mean age of 36 years (range,23-50 years).Unilateral tendon rupture was observed in 19 patients and bilateral in 1 patient.Tendon defect gap was 5-9 cm (mean 6.7 cm).Braces were used to immobilize the lower limber,and early exercise was encouraged.The outcomes were assessed using Arner-Lindhohm scoring system and Leppilahti scoring system.Results Postoperative recovery was uneventful.No patients experienced cut infection or other complications.After a mean 38-month follow-up (range,30-42 months),all patients could stand on the injured toes.Muscular strength of the affected lower limber was restored to 89％ of the unaffected side.According to the Arner-Lindhohm score,10 patients were rated as excellent and ten good.Mean Leppilahti score was 85 points (range,60-100 points),with excellent results in nine patients,good results in 10 and fair result in one.Conclusion For patients with chronic Achilles tendon rupture,the reconstructing using gastrocnemius fascial turn-down flaps combined with suture anchors can attain rigid fixation,early functional exercise,effective prevention of tendon adhesion,and good function recovery.

Objective:To systematically review the relationship between PTGER 4 genetic polymorphisms and the risk of inflam-matory bowel disease (IBD).Methods:All eligible case-control studies which published up to February 29,2016 were searched by PubMed,Embase,Web of Science.The studies in accordance with high quality were included in this study .We synthesized pooled odds ratio ( OR) and its 95%confidence interval ( CI) using STATA12.0.The sensitivity analysis was used to determine the stability of re-sults in meta-analysis.The Egger′s analysis was performed to evaluate the publication bias .Results:Twenty original publications invol-ving 44 case-control studies were included in this study ,in which 25179 patients with Crohn′s disease (CD),5261 patients with ulcer-ative colitis ( UC) and 44652 control subjects were detected .The allelic frequency ,additive model ,dominant model and recessive mod-el were used to analyze the association of rs 4613763 T/C polymorphism and CD ,and the pooled OR and 95%CI were as followings:1.24 (1.06-1.45),1.32 (1.06-1.64),1.25 (1.06-1.48),1.28 (1.03-1.59).For rs17234657T/G polymorphism and CD,the pooled OR (95%CI) of four genetic models were 1.35 (1.28-1.47),2.12 (1.70-2.63),1.46 (1.36-1.57) and 1.90 (1.54-2.35),re-spectively.For rs4495224A/C polymorphism and CD,the pooled OR(95%CI) were 1.05 (0.79-1.41),1.08 (0.62-1.88),1.12 (0.75-1.65) and 1.00 (0.67-1.49).And the pooled OR (95%CI) were 0.77 (0.67-0.88),0.59 (0.51-0.69),0.73 (0.61-0.87),0.68 (0.59-0.79) for rs9292777G/T polymorphism and CD.For rs1373692T/G polymorphism and CD,the pooled OR (95%CI) were 1.23 (0.96-1.57),1.39 (0.74-2.59),1.26 (0.74-2.13),1.31 (1.00-1.72).The pooled OR (95%CI) of allelic fre-quency , additive model , dominant model and recessive model for the association of rs 4613763 T/C polymorphism with UC were 1.30 (1.17-1.44 ), 1.73 ( 1.16-2.59 ), 1.32 ( 1.17-1.48 ), 1.64 ( 1.10-2.45 ), respectively.Conclusion: Polymorphisms of rs17234657T/G,rs4613763T/C and rs9292777G/T are associated with CD.Polymorphism of rs4613763T/C is associated with UC sus-ceptibility.

To treat large facial defect (more than 6 cm x 4 cm in diameter) or a wound with bone exposure to atmosphere by less-traumatic, easier-healing reconstruction method, a pedicle flap including facial, neck, posterior auricle and occipital skin flap was designed and transferred, one by one, to repair facial defect as well as other flap donor sites, but occipital skin flap was only used to cover posterior auricle area. After 2-3 years follow-up, well-healed skin flaps with good color, elasticity and sensation were observed in all 16 patients. It is concluded that this method is effective and practical.
Carcinoma, Basal Cell/surgery ; Cicatrix/*surgery ; Face ; Neck ; Orbital Neoplasms/*surgery ; Parotid Neoplasms/*surgery ; Reconstructive Surgical Procedures/methods ; Scalp ; *Surgical Flaps