Objective An investigation of the effectiveness of treatment of spinal cord injuries(SCI) from the point of view of the transforming factor. Methods Animal model of SCI was made by modified Allens method. Mixed grafts of Schwann cells(SCs) modified with nerve growth factor(NGF) and brain derived neurotrophic factor(BDNF) genes along with fetal spinal cord cell suspension(FSCS) were transplanted into SCI site after 1 month and 3 months. Immunocytochemical staining was conducted for neurofilament(NF), glial fibrillary acidic protein(GFAP), myelin basic protein(MBP), 5 hydroxytryptamine/serotonin(5 HT), NGF, BDNF and the results analyzed with image pattern analysis. Pathological changes of spinal cord tissues were observed with light and electronic microscopy. Results These findings demonstrate the advantages of using mixed grafts of NGF and BDNF genetically modified SCs with FSCS in SCI in the rat: 1) They can be well integrated with the host and survive, 2) FSCS plays the role of bridging and mesomerism, 3) SCs can act as canal tubes and guides for the axons, 4)NGF and BDNF may stimulate the growth of axons and salvage the injuried neruron. Conclusion Mixed grafts of SCs genetically modified with NGF and BDNF genes along with FSCS may be effective measures for the treatment of SCI.

Objective The investigation was to evaluate the efficiency of the frozen shoulder treated by hydraulic distention and manipulation under dynamic arthrography of shoulder joint ,and analyze the in-fluencing factors on the outcome.Methods One hundred patients with frozen shoulders were enrolled the prospective and controlled study,who were divided into two groups randomly.Fifty patients were treated by the hydraulic distention and manipulation under dynamic arthrography of shoulder joint (GroupⅠ),and fifty patients were treated by NSAIDs administration(GroupⅡ).The relationship of clinical results with the amounts of injected fluid during hydraulic distention and manipulation,the range of motion,the visualized rate of the vagina synovialis of long head of biceps brachii tendon and subacromial bursa,and releasing de-gree of joint adherence were observed.The patients consisting of forty-two males and58females aging from42to74years were assessed at two time-intervals.The short term follow-up period ranged from3to6months,and final follow-up from10to21months.Results The clinical results was significantly difference between GroupⅠand GroupⅡdepending on daily activity and range of motion(P

Objective To evaluate the clinical results of the anterior cruciate ligament (ACL) reconstruction by bone-patellar tendon-bone(BPB) transplantation and fixation with absorbable interface screws under arthroscopy. Methods From December 1999 to June 2003, 32 patients with ACL injuries underwent BPB transplantation. There were 22 males and 10 females, and the average age was 32.5 years (ranged from 20-45 years). The lesions were left knees in 18 and right knees in 14, including 8 acute and 24 chronic injuries. The BPB for reconstructing the ACL was harvested from the anterior approach mini-invasively; the implants were fixed with the absorbable interface screws under arthroscopy. The associated injuries were treated simultaneously. All the patients were encouraged to rehabilitate with the continuous passive motion (CPM) and other physical therapies earlier after operation. Results All the patients were available at follow-up; the average duration of follow-up was 32 months (ranged from 6-40 months). Before operation, anterior drawer test positive in 32, Lachman test positive in 20 and pivot shift test positive in 16, were changed into negative. The patients were evaluated according to Lysholm knee scoring scale and the modified Lysholm knee score, the functional results of knee joint were classified as excellent in 24, good in 7 and fair in 1, and the average knee score was 52.1?5.6 and 98.7?3.6 before and after operation respectively, the difference was of statistical significance(P

By analysis on existing problems of the classification, the suggestions were put forward to provide a reference for improving the classification of medical devices.
Equipment and Supplies ; classification

Objective To investigate the mechanism of mesenchymal stem cells in enhancing the effects of haploid matched bone marrow cells transplantation in mice with acute radiation syndrome(ARS).Methods The survival of mice infused with difierent levels of MSCs and bone marrow cells after 8 Gy TBl were examined.BALB/c female mice irradiated with 8 Gy of 60Co γ-rays were randomly divided into two groups,MSCs group,infused with MSCs of female CB6F1 mice labeled with cm-DiI and bone marrow monocytes of male CB6F1,Control group,only infused with bone marrow monocytes.Peripheral blood counts,T-lymphocyte subpopulation of peripheral blood cells,the sry-gene chimerism of bone marrow of the receiptors,the distribution of MSCs in the receiptors,the occurrence time of cGVHD,pathologic variety of medulla were observed.Resuits MSCs improved the survival of mice after 8 TBI,but 1.5×108/kg of MSCs increased the mortality of irradiated mice.In comparison with the control group,leukocytes and plastocytes recovered rapidly in MSCs group.Megacaryocytes in sternum marrows grew fastly in MSC group.The percent of CD3 and CD4 positive cells in the MSCs group were hisher than those in control post-transplantation.The sry-gene chimerism of bone marrow of the receiptors was higher in the MSCs group than that in the control at 30 d.The MSCs were distributed in intestine,thymus,bone marrow,liver,heart of the receiptors at 30 d.The cGVHD occurrence was 30 d later in MSCs group than that of the control.Conclusions MSCs could improve stem cell engraftment,enhance T-lymphocyte and plastocytes recevery,delay occurrence of cGVHD,repair injured organs and increase survivals.It is indicated that MSCs can enhance the treatment effects of haploid hematopoietic stem cells transplant for ARS.

Objective The patients with lethal irradiation after sucessful hematopoietic stem cells transplan-tation had blood recovery, but did not avoid to died of multiple organ failure(MOF). To overcome the block, the article investigated mechanisms of mesenchymal stem cells (MSCs) protecting lethal radiated mice from multiple organ failure after haploid bone marrow cells transplantation. Method BALB/c mice irradiated with 8Gy60COγ-rays were randomly divided into two groups: MSCs group, infused MSCs labeled with cm-DiI and bone marrow monocytes of CB6F1 mice; Control group, only infused bone marrow monocytes; normal group, mice were infused cm-DiI marked MSCs without irradiation. The distribution of MSCs and the serous densities of Il-2, Il-10 and TNF-α in the recipients were observed after transplantation. Results MSCs collected in the bone marrow and the intes-tine in normal group at 15 d,in MSCs group MSCs enriched the different organs at 3,15 and 30 d. MSCs regulated down the secretion of IL-2 and TNF-α,and up the IL-10 density. Conclusions MSCs protected mice from multiple organ failure through above effects and may be open a new treatment strategy on acute radiation syndrome by stem cells.

Objective To comparatively analyze the HIV disease progression and the death situa-tion between injecting drug users (IDUs) with HIV infection and those with HIV/HCV co-infection.Meth-ods The counts of CD4+T cells were collected through a retrospective study and the data about death situa-tion were collected with follow-up cards from 2006 to 2014 .A statistical analysis was conducted for the two groups .Results Among the 175 cases with HIV infection , the average value of primary CD 4+T cell counts was 370 cell/μl and 25.71%of them, primary CD4+T cell counts were less than 200 cell/μl.The average change rate of CD4+T cell counts was -1.50 cell/μl in month.The annual mortality rate was 18.18%. Among the 325 cases with HIV/HCV co-infection, the average value of primary CD4+T cell counts was 420 cell/μl and 20.45%of them, primary CD4+T cell counts were less than 200 cell/μl.The average change rate of CD4+T cell counts was -2.76 cell/μl in month.The annual mortality rate was 32.14%.The differ-ences between the groups were significant (P<0.05).Conclusion Compared with patients with HIV infec-tion, those with HIV/HCV co-infection showed significantly decreased CD 4+T cell counts , resulting in a faster disease progression and a faster death .It was urgent for the management department to work out HIV prevention and therapeutic measures .

OBJECTIVETo investigate the effect of two treating principles and formulas, which are named 'invigorating spleen to remove phlem and promoting blood circulation to remove meridian obstruction' (Jianpi) and 'invigorate the kidney and promoting blood circulation to remove meridian obstruction' (Bushen), on the expression of osteogenic factors in steroid-induced osteonecrosis of the femoral head (SONFH), such as bone morphogenetic protein 2 (BMP2) and transforming growth factor beta1 (TGFbeta1) and Smads, as well as to explore and compare their mechanisms of prevention and treatment of SONFH.

METHODAnimal model of SONFH was established by injection with methylprednisolone in chest muscle on chickens. 48 SONFH chickens were randomly assigned to model, Jianpi and Bushen group. Another 16 normal chickens served as control group. At the 8th and 16th week, the expression of BMP2, TGFbeta1, Smad4 and Smad7 of bilateral femoral heads were detected with immunohistochemistry.

RESULTThe expression of BMP2, TGFbeta1 and Smad4 decreased, and Smad7 increased significantly in model group compared with control group. The expression of BMP2, TGFbeta1, Smad4 increased and Smad7 decreased significantly in Jianpi group at the 8th week compared with model group, and the same changes in Bushen group at the 16th week.

CONCLUSIONBoth Jianpi and Bushen formulas exerted preventive and therapeutic activity on SONFH through regulating the expression of BMP2, TGFbeta1, Smad4 and Smad7 to promote bone repair. Notably Jianpi formula took effect earlier than Bushen formula

Animals ; Bone Morphogenetic Protein 2 ; metabolism ; Chickens ; Drugs, Chinese Herbal ; pharmacology ; Female ; Femur Head Necrosis ; chemically induced ; metabolism ; pathology ; Methylprednisolone ; Osteogenesis ; drug effects ; Random Allocation ; Smad4 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism

Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.

A detailed analysis on re-classification procedure of medical devices from Food and Drug Administration.The experience on classification procedures,the work-flow of risk reanalysis and regulatory categories reassessment of listed products,as well as launching a comprehensive evaluation and downgrading of listed high-risk products were explored in recent years.Based on the analysis on classification procedures and supervision of medical device products in the USA,and combined with the current situation of classification of medical devices in China,some suggestions were put forward on the current classification mode of medical devices so as to improve the quality and efficiency of classified management of medical devices in China.
China ; Equipment Safety ; Equipment and Supplies ; United States ; United States Food and Drug Administration