BACKGROUND:As mechanical load-bearing tissues, tendons have unique biomechanical characteristics. Mechanical loading is necessary in tendon development, and the tendon can alter its structure and biological behaviors in response to the various mechanical loading conditions. OBJECTIVE: To fuly understand the healing process and biomechanical properties of the damaged tendon so as to know the researching progress in the role of stress in the tendon healing process. METHODS: An electronic search of Chinese Biomedical Literature Database and PubMed databases was done for colection of reviews and papers addressing stress effects on tendon healing, and then we analyzed the role of stress in the healing process of tendon from the micro and macro levels. RESULTS AND CONCLUSION:Totaly 59 relevant articles were enroled. Tendon is sensitive to stress, and it can change its structure and biological reaction in response to different stress loadings. Proper stress stimulus to the tendon is necessary to the tendon development and healing. How to achieve a good balance between the lowest (resulting in alienation effect) and the highest stress loadings (resulting in minimaly invasive injury) during the clinical tendon healing is a chalenge. At present the treatment of tendon injuries is stil a huge chalenge to clinicians, and the vast majority of tendon injuries belong to tissue healing.

BACKGROUND:Tissue-engineered tendons have been used to repair the damaged tendon tissue. Use of tissue-engineered tendons for repair of tendon injury has become a hot spot in this research field. OBJECTIVE: To elaborate the types, advantages and disadvantages of seed cels, the design method, advantages and disadvantages of scaffold materials, and the factors that induced the formation of tendon, so as to promote the optimization of each joint, al of which benefit for mature construction of tissue-engineered tendons. METHODS: The related reviews and paper reports of tendon tissue engineering published from January 2000 to January 2015 were retrieved from Chinese Biomedical Literature Database (CBM), China Knowledge Resources Database (CNKI) series database, Chinese Citation Database and PubMed database. The key words were “tissue engineering; tendon; tendon defect”. The research progress of seed cels, scaffold material and induction factors were analyzed. RESULTS AND COMCLUSION:The recent research of tissue-engineered tendons for repair of tendon injury has been summarized. Seed cels, scaffold, induction factors were discussed. Tendon stem cels, as a kind of seed cels, are currently the first choice in the process of tissue engineering tendon research, because tendon stem cels have the homology of the homogenous or autologous tendons and possess strong differentiation and proliferation capacities. However, there have been no systematic schemes regarding acquisition and proliferation and culture of tendon stem cels. The currently designed tissue-engineered tendons cannot meet the clinical requirements because of poor mechanical properties of tendon tissue, poor integration with the host tissue, being susceptible to degradation in late period and functional disuse. Induction factors are the laft key factors for tissue-engineered tendons for repair of tendon injury. The selection and use of induction factors are prerequisites for the regulation of tendon tissue development. But the categories of induction factors and the association and interrelationship between induction factors have not been fuly clear and studies are needed to further investigate these uncertainties.

Objective To explore the clinical value of different transcatheter arterial embolization methods for renal carcino-ma before radical nephrectomy.Methods The related data of 43 patients with renal carcinoma who were confirmed by surgical pa-thology were retrospectively analyzed.Renal artery,renal capsular artery and adrenal artery of lesion side kidney were super-selec-tive embolized before surgery was set as group A,while Lesion side renal artery embolized was set as group B.Direct surgical radical nephrectomy was set as group C.The related data of operation time,ease or complexity of operation,intraoperative blood loss,suc-cess rate of lesion resection and postoperative survival rate were analyzed and compared in the three groups with statistical meth-ods.Results There were significant differences among the three groups in the average operation time,ease or complexity of opera-tion,intraoperative blood loss,success rate of lesion resection and postoperative survival rate (P < 0.01 ).There were significant differences between group A and B about all indexes except success rate of lesion resection(P <0.01).Conclusion The cases with additional transcatheter arterial embolization before radical nephrectomy improved obviously,especially in the cases who underwent completely embolization of lesion side renal artery and renal capsular artery.

Objective To discuss manifestations of neurogenic tumors on chest wall on CT imaging and pathology.Methods 7 patients with neurogenic tumors on chest wall confirmed surgically and pathologically were reviewed.To facilitate differential diagnosis,3 cases of malignant sarcoma were reviewed for their features on CT.Results 4 out of 5 cases of neurinoma were benign,with one case showing even density on plain CT scan,3 were poorly even,one case showed obvious evenness after enhancement,and 1 case was poorly evenly enhanced,2 benign cases had compression absorption of surrounding bone of scapula or ribs.One case of moderate malignancy was uneven in plain scan and slightly enhanced after enhancement procedure,and neighboring bone of scapula and rib were compressed and destroyed and absorbed,and neighboring muscular interspace and upper mediastinum were involved.One case showed single lesion of neurofibroma,displaying relatively even density on plain scan and moderate unevenness after enhancement procedure,as well as compression and absorption of neighboring ribs.One case of neurofibroma had multiple lesions,showing uneven density on plain scan.This case did not undergo enhanced scan.The remaining 3 cases were all sarcoma including 2 cases of fibrosarcoma and one case of synovial sarcoma.Conclusion Mass of soft tissues that are situated on chest wall or paravertebral area and with smooth edge are suggestive for benign neurogenic tumor.On the contrary,rough edge and coarse shape and infiltration into neighboring tissues are characteristic for malignant ones.

Objective To analyze the voice acoustic characteristics in Parkinson's disease(PD)patients,and to study the correlation between voice features and the severity of disease.Methods A total of 83 patients with PD were selected from the Dongguan Songshan Lake Central Hospital from January 2021 to January 2022 as the experi-mental group,and 87 healthy subjects were enrolled as the control group.All the PD patients were tested with Uni-fied Parkinson's Disease Rating Scale(UPDRS).The vioce samples of all subjects were collected and acoustic char-acteristic were analyzed using speech processing software.The acoustic parameters of two groups were compared ac-cording to sex,and the correlation between vioce features and the severity of disease was analyzed.Results A total of 3 720 speech samples were collected,including 1 895 for PD and 1 825 for the controls.The maximum fundamen-tal frequency,fundamental frequency range and fundamental frequency period change rate were lower than the con-trol group,and the amplitude disturbance was higher than the control group,the differences were statistically signif-icant(P＜0.05).There was a negative correlation between UPDRS-Ⅲ score and the rate of fundamental frequency period change in female patients with PD(r=-0.617,P＜0.05).Conclusion The changes in acoustic parameters are mainly manifested as the decrease in the maximum fundamental frequency,range of fundamental frequency and the change rate of fundamental frequency period,and the increase in the the amplitude disturbance.The rate of fun-damental frequency period change may be used as an indicator to evaluate the severity in female patients with PD.

Objective To retrospectively evaluate the safety ,technical success rate and long‐term efficacy of the hepatic mul‐tiple cavernous hemangioma with super selective arterial cheoembolization .Methods 6 cases multiple hepatic cavernous hemangio‐ma by clinical diagnosed between 2004-2011 years in our hospital ,Through arterial super selective and completely filling cheoem‐bolization by Pingyang mycin lipiodol emulsion(PYM‐Lip) ,To assess the long‐term efficacy .by multi slice spiral CT enhanced scan‐ning and carry on relevant statistics processing in postoperative 6 ,12 ,36months .Results 26 lesions were embolismed in 6 cases multiple hepatic cavernous hemangioma ,Among the number of successful embolization were 15 of 1 cases ,2 of 4 cases ,3 of 1 cases , respectively .26 lesions was decreased with different degrees ,which the diameter of lesions were reduced with embolismed by CT enhanced scanning in postoperative 6 ,12 ,36months and diameter reduced> 50% ,diameter reduced≤50% ,lesions disappear was 38% (10/26) ,54% (14/26) ,8% (2/26) ,62% (16/26) ,23% (6/26) ,15% (4/26) ,69% (18/26) ,12% (3/26) ,19% (5/26) .Technical operation success rate 100% ,not serious complications occurred .There are statistically significant differences in the size of lesions before and after operation(P<0 .01) .Conclusion The technique success rate was high ,minimally invasive ,the complications was less ,the curative efficacy was obvious by transcatheter arterial super selective cheoembolizaton with hepatic multiple cavernous he ‐mangioma .

Objective:To analyze the accuracy of diagnostic indicators for perioperative venous thromboembolism（VTE）in orthopedic patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 109 patients who underwent initial total hip arthroplasty（THA），total knee arthroplasty（TKA）or proximal femoral nail antirotation（PFNA）in Hechuan District People ’s Hospital of Chongqing from January 2015 to September 2019. There were 55 males and 54 females，with age range of 18-76 years［（46.3 ± 11.2）years］. Of all，54 patients underwent unilateral THA due to femoral head necrosis and femoral neck fracture，36 patients underwent unilateral TKA due to osteoarthritis and 19 patients underwent PFNA due to proximal femoral fracture. VTE was confirmed in 47 patients（VTE group），and did not occur in 62 patients（non-VTE group）. Venous blood was collected from all patients on admission and at postoperative 1，3，5，7 days to measure levels of plasma D-dimer，serum interleukin（IL）-18 and vascular endothelial growth factor（VEGF）. The accuracy of the above indicators in VTE diagnosis was analyzed by using receiver operating characteristic（ROC）curve. Results:In both groups，preoperative levels of D-dimer，IL-18 and VEGF were significantly lower than those postoperatively，and each indicator showed significant difference at each time points after operation（ P < 0.05 or 0.01）. Moreover，levels of D-dimer，IL-18 and VEGF in VTE group were significantly higher than those in non-VTE group at each time after operation（ P < 0.05 or 0.01）. Area under the ROC curve（AUC）for D-dimer was 0.839（95% CI 0.729-0.887），with the optimal cut-off of 5.5 μg/ml，sensitivity of 87.0%，specificity of 79.0% and Youden index of 0.67. AUC for IL-18 was 0.817（95% CI 0.719-0.857），with the optimal cut-off of 293.5 pg/ml，sensitivity of 67.0%，specificity of 87.1% and Youden index of 0.457. AUC for VEGF was 0.837（95% CI 0.784-0.918），with the optimal cut-off of 510.8 pg/ml，sensitivity of 81.0%，specificity of 79.0% and Youden index of 0.583. AUC for combined D-dimer，IL-18 and VEGF was 0.870（95% CI 0.747-0.992），with the sensitivity of 87.2%，specificity of 83.4% and Youden index of 0.606. Conclusions:For diagnosis of perioperative VTE in orthopedic patients，serum VEGF is relatively accurate，while serum IL-18 has a low accuracy. However，the diagnostic rate of VTE can be improved by combining indicators of D-dimer，IL-18 and VEGF.

Objective:To construct an adeno-associated vector expressing Snail "tough decoy" (TUD).Methods:The nucleotide sequence of Snail gene were obtained from GenBank,then 2 cDNAs were designed and synthesized coding expression of small hairpin RNAs for Snail genes.The pAAV-U6-shRNA-Snail-TUD-EGFP expression vector was constructed by molecular biological techniques.Then pAAV-U6-shRNA-Snail-TUD-EGFP was co-transfected with Helper Free adeno-associated virus system pAAV-RC and pAAV-Helper into AAV-293 cell line to form rAAY-U6-shRNA-Snail-TUD(shRNA-Snail).The silencing effect of shRNA-Snail in Tca8113 and Cal-27 cells was detected by RT-PCR.The titer of the virus was measured.The expression level of green fluorescent protein in AAV-293 cells was monitored by the fluorescent microscopy.Results:The result of gene sequencing showed that shRNA-Snail was successful constructed in pAAV-U6-shRNA-Snail-TUD-EGFP vector.The titer of the recombined virus was 4.4 × 1010/ml.The Snail mRNA and protein expression level was significantly reduced in Tca8113 and Cal-27 cells by rAAY-U6-shRNA-Snail-TUD-EGFP transfection.Conclusion:rAAY-U6-shRNA-Snail-TUD-EGFP may inhibite Snail gene expression in cells.

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.