Experimental incised wounds 8 mm in diameter were made on the right side of the back of 48 rats under anesthesia using aseptic technique. All animals were randomly divided into 12 groups according to the time of wound biopsies which were taken immediately after skin cutting, lh,12h,24h,2,3,4,5,6,7,8,9 and 10 days after wounding.One rat of each group was given colchicine before animal sacrifice in order to observe cell mitosis. Skin specimens were fixed in 10% formalin,embeded in paraffin and sectioned for HE stain,Gorden and Sweet stain for reticular fiber,Weigert stain for elastic fiber,PTAH stain for fibrin and Van Gieson stain.Macroscopically, wounds were getting smaller daily,and reduced in size markedly on the 6～7th day. The histologic changes were as follows:Acute inflammation on the wall of wounds occurred 1h after skin cutting;profuse fibrin exudation at the top of the base and on the wall of wounds at 24h;new capillary formation and regeneration of the epidermis on the 2nd day;granulation tissue formation and collagen fiber deposition on the 3rd day;small artery formation in the granulation tissue on the 4～5th day;granulation tissue maturation and the regenerating tissue covering the whole wound area on thd 6～7th day;the scar formation and contraction on the 8～9th day;further sear contration on the 10th day.The epidermis regenerated from the proliferation of the epidermis at the edge of the wound with the speed of 1.23mm/day. The regeneration of the epithelium proceeded under the necrotic tissue on both the wall and at the base of wounds. The mechanism of the wound contraction was discussed.

Stem cells research has generated markedly increasing interest and liver stem cells have enormous potential for clinical applications.Based on the development of modern cell biology,molecular biology and genetics,the fundamental study and clinical application of liver stem cells have been greatly progressed.This paper reviews current development of liver stem cells for clinical application.

Objective To explore expression of IL -33 and IL -33 mRNA in peripheral blood of patients with ankylosing spondylitis,and analyze the clinical significance,so as to provide scientific reference for the treatment and prognosis of the disease.Methods From February 201 4 to May 201 6,32 patients with ankylosing spondylitis were included as study group,30 healthy persons were selected as control group.Real -time quantitative PCR and enzyme -linked immunosorbent assay were used to detect IL -33 mRNA level in peripheral blood and IL -33 level in plasma of subjects.Results Compared with the control group (1 .23 ±0.58),IL -33 mRNA in peripheral blood of patients in the study group was higher(1 .74 ±0.75),and the difference was statistically significant (t =2.981 , P =0.004).ELISA results showed that IL -33 level in plasma of the study group was higher (227.30 ±45.67)pg/mL than the the control group (1 1 4.70 ±39.58)pg/mL,the difference was statistically significant (t =1 0.344,P <0.01 ).Compared with the control group,the ESR,CRP and PLT of the study group were significantly higher[(47.80 ± 4.73)mm/h,(42.60 ±3.38)mg/L,(329.60 ±48.39)×1 09 /L](t =42.542,54.722,1 4.040,all P <0.01 ).IL -33 in plasma and IL -33 mRNA in peripheral blood of ankylosing spondylitis patients were positively correlated with BASDAI(r =0.472,0.457,all P <0.05),CRP(r =0.71 3,0.687,all P <0.05).Conclusion IL -33 and IL -33 mRNA in patients with ankylosing spondylitis significantly increase,indicates that they should play important role in the occurrence and development of ankylosing spondylitis.

[Summary] Rare diseases are one of the major challenges we face today in the era of precision medicine, because of the low incidence and prevalence, difficulty in diagnosis, lack of sufficient therapeutic methods, as well as their significant impacts on affected individuals, families and the society. Integration of clinical phenotypic and biological omics data and the further analysis are providing a way to illustrate the mechanisms of rare diseases, discovering novel diagnostic and prognostic biomarkers, developing orphan drugs and other therapeutics, and improving clinical outcomes and quality of life for the patients. A nation-wide registry system and the cohorts studies based on the registry are vital to the research of rare diseases. National Rare Diseases Registry System ( NRDRS) of China will provide this essential platform to promote the rare diseases research in China. With the collaboration of 20 leading medical institutes and innovation in medical informatics technologies, this system will, for the first time in China, collect the epidemiological, clinical, socio-economical, genomics and metabolomics data of more than 50 rare diseases and not less than 50 000 cases. As a national strategy for enhancing the development of medical sciences and the improvement of population health in China, NRDRS and its cohort studies will provide the pivotal support to policy making, clinical care, novel drug discovery, patient advocacy, and finally scientific progress in the field of rare diseases.

Objective To investigate the expression of T help cell 1(Th1),T help cell 2(Th2)and related cytokines interleukin 12 (IL -12)and interleukin 4 (IL -4)in the lumbar disc herniation and their clinical significance. Methods 30 postoperative patients with lumbar disc herniation were included as observation group.The control group included 10 patients with lumbar fracture.Flow cytometry was used to distinguish the Th1 and Th2 cells.ELISA was used to measure the expression of interferon γ(IFN -γ),IL -12(the cytokines secreted by Th1 cells)and IL -4 (the cytokine secreted by Th2 cells).RT -PCR was used to detect the mRNA levels of STAT4 and STAT6.Results The distribution of Th1 /Th2 cells was higher in patients with lumbar disc herniation compared to the control group [(6.24 ±2.89)vs (25.12 ±3.20),t =16.26,P <0.05;(2.68 ±0.58)vs (8.16 ±1.20),t =3.84,P <0.05]. The levels of IFN -γand IL -12 in the study group were significantly higher than the control group,the differences were statistically significant[(23.47 ±5.61)vs (7.65 ±3.21),t =8.422,P <0.05;(1.52 ±0.87)vs (5.34 ± 1.39),t =8.135,P <0.05].The level of IL -4 was undetectable in the control group,however,IL -4 expressed in the study group.The expressions of IL -12,IFN -γand IL -4 in the study group were negatively correlated by Spearman correlation analysis (r =-0.57,P <0.05;r =-0.23,P <0.05).In addition,the mRNA level of STAT4 was higher in patients with lumbar disc herniation compared to the control group[(3.21 ±0.49)vs (1.12 ±0.24), t =13.15,P <0.05].Conclusion The expressions of Th1 cells,Th2 cells and related cytokines were participated in the pathogenesis of lumbar disc herniation.

Objective To discuss the clinical therapeutic effect of tibia fracture treated by intramedullary nail using limited incision or close reduction.Methods We treated 54 tibia transverse fracture cases,93 oblique fracture cases, 7 1 fragmental fracture cases by intramedullary nail using open with limited incision or close reduction.We then compared operation time,X-ray time,hospital stay duration,infection rate,nonunion rate, and postoperative function restoration between patients with different fractures.Results There was no different operation time in transverse fracture group,but longer for close reduction in oblique fracture group and for open reduction in fragmental fracture group.X-ray time did not differ for open or close reduction in transverse fracture group.Long X-ray time was used in close reduction in oblique and fragmental fracture groups.There was no significant difference in nonunion rate for open and close reduction in both transverse and fragmental fracture groups.The oblique fracture nonuinon rate was higher in close reduction group than in open reduction group.No difference was found in infection rate or function recovery whether for open or close reduction in all types of fractures.Conclusion Different therapy methods should be determined by different fracture types.Open reduction with minimal incision should be used for oblique fracture cases and fragmental fracture cases with reduction difficulty.

Objective To evaluate the clinical characteristics,efficacy and toxicity of three dimensional conformal radiotherapy(3D-CRT)for elderly patients suffering from advanced stage of non-small cell lung cancer(NSCLC).Methods From September 1999 to October 2006,with the use of Leibinger planning system,the authors performed 3-dimensional conformal radiotherapy(3D-CRT)for 108 elderly patients suffering from advanced stage of non-small cell lung cancer who had not received operation because of medical contraindications such as cardiac insufficiency,impaired pulmonary function,etc.For the patients with positive lymph metastasis,the primary tumor was treated with high dosages.Conventional radiotherapy was delivered,and the tumor site and draining lymphatic areas received 40~45Gy of radiation,followed by 3D-CRT.Results All patients received whole course of radiotherapy,and the total survival rate for 1,2,3 years was 65%,33% and 28%,respectively.Meanwhile,the radioreaction did not exceed grade 2 in all 108 cases.Conclusions 3-dimensional conformal radiotherapy was relatively an effective treatment for non-small cell lung cancer in elderly patients who could not withstand operations because of medical contraindications or other problems.The treatment was proved to improve total survival rate and life quality,relieve complications such as radiation pneumonia and radiation esophagitis.Therefore,3-dimensional conformal radiotherapy was recommended for elderly patients with advanced stage of lnon-small cell lung cancer.

Objective To evaluate the therapeutic effects of three-dimensional conformal radiotherapy(3D-CRT) for malignant tumors.Methods From July 1999 to October 2006,830 patients with malignant tumors received non-coplanarity multifield 3D-CRT by using Leibinger three-dimensional stereotactic conformal radiotherapy machine,Varian 600C/D 6MeV X liner accelerator and multileaf collimator.Single dose was 4-8Gy per fraction,once every two days and total dose was 50-82Gy.Results All 830 cases underwent 3D-CRT.According to the WHO evaluation standard for therapeutic effects,CT results showed that complete response(CR),partial response(PR),no change(NC),and progression(PD) rates were 20.7%(172/830),68.7%(570/830),10.2%(85/830),and 0.3%(3/830),respectively.Overall response rate(CR+PR) was 89.4%(742/830).No patients suffered from serious adverse effects.The incidence of radiation penumonia was 9%.Conclusions For patients with malignant tumors who could not endure operations due to existing contraindications or other conditions,3D-RCT was a relatively effective treatment because the method could deliver an increased therapeutic dose to tumors,enhance survival rate,improve life quality,decrease injuries to adjacent normal tissue,and reduce the incidence of complications.

Objective To analyze clinical characteristics of patients with gastrointestinal bleeding (GIB)and the death-related risk factors.Methods A retrospective analysis Was conducted in 414 patients hospitalized for GIB during a 16-year period of 1994 to 2009.Logistic regression analysis identified predictors of mortality.Results The mean age of the 414 patients is 83.5 years old,ranging from 65 to 96years old.The main causes of GIB were peptic ulcer(33.1%,137/414),gastroduodenal mucosal erosion (28.5%,118/414)and tumor(21.0%,87/414).The main symptom was melena(71.0%,294/414).Drugs that induced GIB were mainly non-steroidal anti-inflammatory drugs,including aspirin(11.1%,46/414),acetaminophen(8.9%,37/414)and indomethacin(1.9%,8/414).14%of patients(58/414) died of GIB in 30 days.The proportion of drug-induced GIB and gastroduodenal mucosal erosion caused GIB had increased significantly during the period of 2004 to 2009(P<0.05).Analysis of 30-day mortality risk showed advanced age,low diastolic blood pressure,high heart rate,low hemoglobin levels at presentation and hemorrhage volume in dead GIB elderly patients were significantly different compared with GIB elderly patients alive.Presence of severe comorbidity(heart failure and renal failure)and caused by cirrhosis and portal hypertension in GIB elderly patients were the only independent predictors of 30-day mortality (P<0.001).Conclusion Death of GIB patients occurred predominantly in elderly patients with severe comorbidities and systemic conditions at presentation.

Objective To explore the influence of intravesical chemotherapy combined with hyperthmia on levels of insulin growth factor( IGF) and tumor necrosis factor( TNF) in bladder cancer after operation. Methods 64 cases of transitional cell carcinoma of bladder accepted TURBt were randomly divided into two groups: intravesical chemotherapy combined with hyperthmia group and intravesical chemotherapy group. Levels of ICF and TNF in two weeks before therapy 、two weeks after therapy, four weeks after therapy were tested. Results The IGF levels were (65.97±5.25)μg/L,(49.93±1.98)μg/L,(36.82±1.89)μg/L in intravesical chemotherapy combined with hyperthmia group and(61.87 ±5.41)μg/L, (57.86 ±2. 18) μg/L, (48. 68 ±2. 26) μg/L in intravesical chemotherapy group. The TNF levels were(2.32 ±0. 36)μg/L, (3. 84 ±0. 31) μg/L, (8. 79 ±0. 46)μg/L in intravesical chemotherapy combined with hyperthmia group and(2. 21 ±0. 19)μg/L,(2. 89 ±0.47) μg/L, (3. 87 ±0.61)μg/L in intravesical chemotherapy group. The influence of intravesical chemotherapy with hyperthmia on levels of IGF and TNF were significant than intravesical chemotherap, and the influence degree showed in time-dependent manner (all P ＜ 0. 05 ). Conclusion Intravesical chemotherapy combined with hyperthmia had curative effect in inhibiting the recurrence of tumor after operation.