Under the impact of medical and health system reform and focal events in China, the medical vio-lence policy change is characterized by partial discontinuous equilibrium. It gradually evolves from policymaker-based discontinuity to participatory one, from single decision-making field to the collaborative one, and from the ex-cessive protection of unilateral interest to the maintenance of public interest as a core. In the future, if we want to re-alize the effective minimization of medical violence by public policy, the participation of all parties in the policy deci-sion should be strengthened, the focal events should be analyzed as policy issues, and the policy should be clear in order to overcome the negative influence of the inactivity of old policies.

Objective To investigate the impact of human adipose-derived stem cells(hASCs) -plastelet-rich plasma(PRP) composite on the wound healing of radiation skin injury of nude mice.Methods ASCs were isolated from healthy adults after liposuction, conducted primary culture and subculture.PRP was prepared by two-step ultracentrifugation.The ASCs-PRP composite was prepared with ASCs (1 ×107cells/ml) at passage 6 and PRP.Twenty-four nude mice were randomly divided into 4 groups (n=6).A round shaped full-thickness skin defect (D=1cm) was made on the mice back after 20Gy (60Co) round shaped exposure (D=2cm).Right after radiation, wounds were treated as follows,in group A,there was ASCs+PRP, in group B, PRP,in group C, ASCs,in group D, sham group.The wounds were observed at postoperative 7 and 14 days.HE and CD31 stain were observed at 14th days after surgery.Results The wound healing of group A healed completely at 14th days.In group D,the wound healing were slowest and still filled with granulation tissue at 14th days.The wound healing of group B and group C were faster than that of group D, but they haven′t healed completely at 14th days.The inflammatory cells were significantly lower and the blood vessel density positive rate were significantly higher in ACSs+PRP group than in ACSs group,PRP group and sham group (P<0.05).Conclusion ASCs-PRP Composite can accelerate the wound healing of radiation skin injury by promoting wound angiogenesis.

BACKGROUND: Previous studies have found that nerve growth factors play an important role in the process of wound healing, but there is less research for the low-affinity nerve growth factor receptor p75 and sortilin in fibroblasts, and no reports on whether there are differences in expression of p75 and sortilin in the scar fibroblasts and normal skin fibroblasts. OBJECTIVE: To study the expression of low-affility nerve growth factor receptor p75 and sortilin in the normal human skin fibroblasts and the human keloid fibroblasts. METHODS: The keloid fibroblasts and normal hunman skin fibroblasts were cultured in vitro, and the immortalized epithelial cells HaCaT were used as the positive control. The real-time PCR was used to detect the mRNA expression of the p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts, and western blot and immunocytochemical staining were used to detect the protein expression of p75 and sortilin. RESULTS AND CONCLUSION: The real-time PCR and western blot results showed that in the protein and mRNA levels, p75 and sortilin showed positive expression in the keloid fibroblasts and normal human skin fibroblasts, and there was no significant difference in the expression of p75 between keloid fibroblasts and normal human skin fibroblasts, and the expressions of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were significantly lower than those in HaCaT. There was no significant difference of p75 expression between keloid fibroblasts and normal human skin fibroblasts, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts (P < 0.05). Immunocytochemical staining result showed that the expression of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were distributed in the membrane and cytoplasm. Precursor nerve growth factor combined with high-affinity p75 receptor could promote the apoptosis of the cells with the help of sortilin, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts, which may associated with the high proliferation of the keloid fibroblasts. The results provide a new target for the prevention and treatment of pathological scars.

Objective To evaluate the expression of MMP-2 and MMP-9 and their relation with tumor invasion and metastasis in transitional cell carcinoma of bladder (TCCB). Methods Immunohistochemistry of EliVision were respectively used to determine the MMP-2 and MMP-9 expression in tumor tissues of 46 patients with TCCB and 14 cases of control group which were screened quantitatively (3-5 cm of surrounding tumor) between August 2006 and August 2008. Results Expression of MMP-2 and MMP-9 in TCCB are obviously higher than the normal control group (P <0.01), expressions of MMP-2 and MMP-9 in level Ⅱ,Ⅲ are obviously higher than in level Ⅰ (P <0.01), but there was no significant relationship between high stage or level Ⅲ and low stage or level Ⅱ (P >0.05). Conclusion The positive expressions of MMP-2 and MMP-9 in tumor tissues correlated with the malignant degree, invasion and metastasis of TCCB, MMP-2, MMP-9 could be useful indicators for the assessment of prognosis of TCCB.

Mesaconitine was incubated with rat liver microsomes in vitro. The metabolites of mesaconitine in rat liver microsomes were identified by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method with high resolution power. A typical reaction mixture of 100 mol L-1 Tris-HCI buffer (pH 7.4) containing 0.5 gL-1 microsomal protein and 50 micro molL-1 mesaconitine was prepared. The above reaction mixture was divided into six groups, and the volume of each group was 200 micro L. The incubation mixture was pre-incubated at 37 degrees C for 2 min and the reactions were initiated by adding NADPH generating system. After 90 min incubation at 37 degrees C, 200 micro L of acetonitrile was added to each group to stop the reaction. The metabolites of mesaconitine were investigated by UPLC-MS/MS method. Mesaconitine and 6 metabolites M1-M6 were found in the incubation system. The structures were characterized according to the data from MS/MS spectra and literatures. The metabolic reactions of mesaconitine in rat liver microsomes included the demethylation, deacetylation, dehydrogenation and hydroxylation. The major metabolic pathways of mesaconitine in rat liver microsomes were determined by UPLC-MS/MS on multiple reaction monitoring (MRM) mode combined with specific inhibitors of cytochrome P450 (CYP) isoforms, including alpha-naphthoflavone (CYP1A2), quinine (CYP2D), diethyldithiocarbamate (CYP2E1), ketoconazole (CYP3A) and sulfaphenazole (CYP2C), separately. Mesaconitine was mainly metabolized by CYP3A. CYP2C and CYP2D were also more important CYP isoforms for the metabolism reactions of mesaconitine, but CYP1A2 and CYP2E1 haven't any contribution to MA metabolism in rat liver microsomes.
Aconitine ; analogs & derivatives ; metabolism ; Animals ; Chromatography, High Pressure Liquid ; Cytochrome P-450 CYP3A ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; Cytochrome P-450 Enzyme Inhibitors ; Cytochrome P-450 Enzyme System ; metabolism ; Enzyme Inhibitors ; pharmacology ; Ketoconazole ; pharmacology ; Male ; Metabolic Networks and Pathways ; Microsomes, Liver ; enzymology ; metabolism ; Quinine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Sulfaphenazole ; pharmacology ; Tandem Mass Spectrometry

Objective To observe the therapeutical effect of posterior vertebral column resection on chronic thoracolumbar tuberculosis with secondary paraplegia and to provide a safe and effective method for the treatment of chronic thoracolumbar tuberculosis with secondary paraplegia.MethodsFrom Aug.2007 to Mar.2010,12 cases with chronic thoracolumbar tuberculosis and secondary paraplegia were surgically treated by posterior vertebral column resection and Titanium net support for bone graft and internal fixation operation treatment.Cobb angle was measured,and conditions of internal fixation were observed before and after the operation by X-ray films.Neurological status were evaluated by Frankel grades.ResultsThe follow-up periods was 6- 18 months( on average 11 months).Operations eased all patients' back and chest pain.Frankel grade increased from C preoperatively to grade D or E postoperatively in 6 cases,from grade D to E in 4 cases and from grade B to C in 1 case.No obvious improvement of Frankel grade was observed in the other patient of grade B.The average Cobb angles were(76.0 ± 23.4) ° before surgery,( 15.5 ± 6.3 ) ° at one week after surgery and ( 16.0 ± 8.2) °at the last follow-up.The difference in the Cobb angle before and at one week after treatment was significant( t =3.41,P ＜ 0.01 ).No difference was found in the Cobb angle between at one week after treatment and at the last follow-up (t =1.58,P ＞ 0.05 ).All patients got bony fusion with Titanium net.No complications occurred with internal fixation.Conclusion Posterior vertebral column resection is a feasible method for the treatment of chronic thoracolumbar tuberculosis with secondary paraplegia.It achieves neurological decompression with high correction rate and minor injury,and no anterior surgery is needed.

This study reported the analysis of plasma phospholipid metabolism of the rats and the pathological biomarkers between the type 2 diabetes model control group (MC) and the normal control group (NC). SD rats were randomly divided into 2 groups: NC and MC. To investigate state of plasma metabolite profiling in normal body, type 2 diabetes mellitus (T2DM) model group using UPLC-Q-TOF/MS which was used as analysis tool in this research. The compounds were identified by UPLC-Q-TOF/MS based on MS/MS fragment ions information, element composition in MassLynx 4.1 and the Lipid Maps database. The sign of two groups of samples in specific markers for screening was through a software package in R software (BioMark software). The results show that the pathological markers were mainly phosphatidylcholine (PC) and triglycerides (TG); the 2-acyl PC in the MC group was less more obviously than that in the NC group; high carbon number and high degree of unsaturation of the TG was reduced under the condition of type 2 diabetes. In the state of type 2 diabetes, metabolic changes occurred in rat plasma phospholipids obviously, which had a close relationship with the occurrence and development of T2DM.

Objective To investigate the clinical features and treatment ofBrucellosis disease in children in recent years.Methods The clinical data of 24 children withBrucellosis disease admitted during January 2011 to December 2015 were retrospectively analyzed.Results In 24 children, 18 was male and 6 was female and average age was 9.8±3.13 years (4-14 years). Twenty-four children were diagnosed withBrucellosis disease by positive tiger red plate agglutination tests and their antibody titer was 1:800-1:100. The children lived mainly in the pastoral areas; four cases (16.67%) had sick family members and cattle and sheep; three cases (12.5%) had histoty of contact only with sick family members; 12 cases (50.00%) had cattle and sheep exposure history; 3 cases (12.5%) had raised cattle or sheep at home in the past 2 years; 2 cases (8.33%) had not have clear transmission route. The onset of the disease occurred year round, with the highest incidence in June and July. The common clinical symptoms were fever, arthralgia, weak, sweat, and anorexia, combined with hepatomegaly and splenomegaly. Patients younger than 8 years old were treated with rifampin and sulfamethoxazole. Patients equal to or older than 8 years old were treated with doxycycline and rifampin. Twenty-three children had been cured after treatment. Only one child stopped taking the drugs 3 weeks after discharge, which resulted in recurrence.Conclusion For children living in pasturing area suffered with unexplained recurrent fever, brucellosis disease should be considered and ruled out.

Objective Toinvestigatethevalueofimagingdiagnosisofthe lymphangioleiomyomatosis( LAM ).MethodsFifteen patients with LAM confirmed by pathological assessment were analyzed retrospectively for radiologic findings.They had chest radiograph, chest highresolution CT (HRCT),abdominal CT, direct lymphangiography(DLG), chest CT and abdominal CT after DLG.Results Chest radiograph findings included normal (1),increasing of lung markings (3),disseminated honeycomb or reticular pattern ( 11 ), pneumothorax ( 2 ), and pleural effusion ( 14 ). Chest conventional CT and HRCT showed typical imaging manifestation of PLAM in all cases, including sporadic or disseminated cysts in bilateral lungs. According to the grading standard of pulmonary disease made by Avila et at, there were 3 cases in grade Ⅰ , 5 cases in grade Ⅱ and 7 cases in grade Ⅲ . Fourteen of 15 patients with LAM had positive abdominal CT findings in retroperitoneum and pelvic cavity. Common abdominal CT findings included cystic lymphangioma in 9 of 14 patients, lymphangiomyoma in 13 and both coexisting in 7.One of the14patients alsohadhepaticlipomaandangiomyolipomas.Onepatienthadrenal angiomyolipomas; and one patient had hysteromyoma. All 15 cases underwent DLG, 1 cases had lymphatic obstruction in the lumbar 3 level, the remaining 14 cases had varying degrees of thoracic duct stenosis, or obstruction. Neck trunk, subclavian trunk and bronchial trunk showed lymphatic reflux. On post-DLG CT,thoracic duet outlet obstruction was not demonstrated in 3 cases, the remaining 12 cases showed thoracic outlet obstruction, consistent with the DLG findings.Conclusion HRCT is a useful diagnostic method showing characteristic findings of PLAM. MSCT can help to detect abdominal LAM. DLG and MSCT after DLG have value in displaying obstruction site of thoracic duct or lymphatic trunks and provide guidance for operative treatment.

Objective To investigate the effect of dexamethasone addition in block anesthesia before surgery on postoperative quality of life after extraction of impacted mandibular wisdom teeth. Methods Using a random number table, 120 cases of patients were divided into experimental and control groups, each group contains 60 cases whose mandibular wis?dom tooth will be extracted. Before the surgery, the experimental group patients perform local block anesthetic injection with 3 mL out of 5 mL mixture of 2%lidocaine 4 mL+dexamethasone 1 mL (5 mg) to block nerve. The control group was given block anesthesia of inferior alveolar nerve with 3 mL of 2%lidocaine block anesthesia alone. Improved postoperative symp?toms severity scale (PoSSe) was used to evaluate patients’quality of life after tooth extraction comprehensively and quantita?tively by analysis and comparison of the two sets of scores. Results The experimental group’s PoSSe scores were 18.059 1 ± 13.210 9, which was lower compared with control group (27.819 3 ± 15.716 9). In experimental group, diet, language, swelling, pain and daily points were lower than the control group (P<0.05). Conclusion Topical application of dexamethasone in mandibular wisdom tooth extraction reduces postoperative adverse reactions in a certain degree and im?prove postoperative quality of life.