BACKGROUND: Bone metabolism disorder happens in diabetic environment, bone defects in which are difficult to repair. Study addressing osteogenic property of adipose-derived stroma cells (ADSCs) in diabetic environment provides theoretical basis for its application in certain environment.OBJECTIVE: To explore the effects of high glucose (HG) and advanced glycation end-products (AGEs) on osteogenic capacity of human ADSCs. METHODS: 100 mg/L AGEs and 27.5 mmol/L HG were used to simulate in vitro diabetic environment and intervened ADSCs osteogenic differentiation. The cells were divided into 4 groups, with 6 samples in each group. The expression of type Ⅰ collagen was examined by fluorescent immunofluorescence at 21 days after osteogenic induction. The number of calcification nodes was counted under contrast phase microscopy at 14, 21 and 28 days. RESULTS AND CONCLUSION: Fluorescent quantitation scan showed that the type Ⅰ collagen amount of the AGEs+HG treated group was 2.76 times lower than that of the control group. AGEs+HG reduced the number of ADSCs calcification nodes compared with the control, HG, and AGEs groups, the differences were statistical significant (P < 0.01). AGEs and HG exposure inhibit the cognate osteogenic differentiation of ADSCs, which suggest that AGEs and HG are unfavorable factors that reduce ADSCs osteogenic ability.

BACKGROUND: Adult acetabular dysplasia in advanced stage combined with hip joint osteoarthritis should undergo total hip replacement. The severity of acetabular lesion is various in different patients, which leads to significantly increased difficulty in reestablishing acetabulum. Acetabular medial wall displacement osteotomy can solve the component of acetabular prosthesis, but the displacement range of the acetabular medial wall following osteotomy is controversial.OBJECTIVE: To look for a suitable displacement range of acetabular medial wall following osteotomy by computer-aided design finite element analysis.METHODS: SolidWorks 2008 software was used to establish three-dimensional models of acetabular dysplasia pelvis. Acetabular medial wall displacement osteotomy was simulated to make acetabular medial wall bone displace from 2 mm bone contact to 7 mm bone contact in the pelvic cavity. One experimental group was set at 1 mm intervals, totally 10 experimental groups. The acetabulum in each group was split into four quadrants. The prosthesis acetabulum-bone interface in each group was analyzed by computer simulation contrast mechanics experiment. The Mises stress and shear stress values were measured between acetabular prosthesis and bone interface.RESULTS AND CONCLUSION: In groups 1, 5, 6, 9 and 10, the Mises stress was unevenly distributed in posterior inferior, anterior superior and anterior inferior quadrants. In groups 2, 3, 4, 7 and 8, the Mises stress was evenly distributed in posterior inferior,anterior superior and anterior inferior quadrants. Of them, the stress was most even in the group 4. In groups 2, 3, 4, 7 and 8, the shear stress was evenly distributed in the above-mentioned three quadrants. The shear stress was lowest in the groups 7 and 8.These indicate that joint force in the acetabulum mainly focused in the posterior superior quadrant. With the displacement of acetabular cup, the contact area of acetabular cup and bone would gradually increase, which finally increased the Mises stress in the contact surface. However, shear stress decreased with displacement of acetabular medial wall. Therefore, the suitable displacement range of acetabular medial wall osteotomy is 1 mm away from the pelvic cavity and 1 mm complete embolism in the pelvic cavity. The optimal position was 1 mm complete embolism in the pelvic cavity.

OBJECTIVEBy means of observing the clinical development of asymptomatic chronic HBsAg carriers (AsC) to explore the clinical rule of development of chronic hepatitis B (CHB) to liver cirrhosis (LC) to hepatocellular carcinoma (HCC) and to seek effective method for blocking the procedure.

METHODSAsCs were selected from health examination according to the diagnostic standard from the National Program for Prevention and Treatment of Viral Hepatitis, by periodical or non-periodical conventional examination of liver diseases, mixed infection of HCV was excluded. A 16-year systematic observation on clinical process of HBV infection series was completed.

RESULTSIn the 217 AsCs observed, 21 cases (9.68%) with the HBsAg negatively converted, the average year negative conversion rate being 0.58%, among them, 13/21 cases (61.9%) had production of anti-HBs antigen; 20 cases were clinically cured; 1 case transferred to HCC; 124 cases (57.14%) remained asymptomatic carriers; 73 transferred to chronic liver disease, showing a tendency of gradually developing from CHB to LC to HCC, the year transferring rate from AsC to LC and HCC being 1.04% and 0.40%, respectively. Fifteen patients died of liver diseases, in which one died of severe CHB, 3 of LC and 11 of HCC.

CONCLUSIONDifferent clinical end-results may reveal in AsCs according to their age and regulation on immune response to HBV. Few of the HCC and LC patients were HBeAg (e+) positive, they often reveal HBeAg (e-) negative or anti-HBe positive. HCC always develops on the basis of liver fibrosis or cirrhosis, which are the prophase of HCC, and patients with liver fibrosis or cirrhosis are the high risk group of developing HCC. HCC is not only the terminal pathologic stage of hepatopathy, but also one of the most important factors that causes death of chronic hepatopathy. From the viewpoint of integrative medicine in typing hepatopathy to observe the clinical speciality of AsC developing to CHB, LC and HCC, it is considered that the degree of blood stasis is in accordance with the development of hepatopathy.

Carcinoma, Hepatocellular ; virology ; Carrier State ; virology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; virology ; Liver Neoplasms ; virology ; Male ; Medicine, Chinese Traditional

Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.

Pancreaticoduodenectomy (PD) is the mainstay of treatment for periampullary space-occupying disease. The occurrence of pancreatic fistula after PD is still an unsolved clinical problem, which seriously affects the safety of surgery. Various methods have been reported in clinical practice to reduce the incidence of pancreatic fistula, such as improving pancreaticoenteric anastomosis, using biological sealants, applying somatostatin analogs, and continuous peritoneal irrigation, etc., but the incidence of pancreatic fistula remains at 5%-30%. There are many risk factors related to pancreatic fistula after PD, in which reasonable selection of suture materials is an important factor and also an important factor affecting the curative effect of surgery. The authors analyze the characteristics and shortcomings of various sutures used in PD, in order to provide help to improve the safety of surgery and reduce the incidence of pancreatic fistula after PD.

Synovial sarcoma is a soft tissue malignancy of unknown origin which usually occurs around the joints of the extremities, but rarely detected in the kidneys. A case of primary synovial sarcoma of the kidney was reported, which was preoperatively diagnosed as a malignant tumor of the right kidney for intermittent gross hematuria. After the laparoscopic radical nephrectomy, primary renal synovial sarcoma was confirmed by pathological examination. The patient refused further treatment, and there was no recurrence or metastasis during the 13 months of follow-up.