Objective In cartilage tissue engineering,it was a difficult problem to keep chongdro-cytes phenotype for long time.The aim was made to investigate the dedifferentiation of human articular chon-drocytes,and to verify the inhibition to dedifferentiation by transfection with recombinant pcDNA3.1(+)/TGF-? 2 in vitro.Methods Free chondrocytes were isolated from healthy articular cartilage harvested from6adult patients underwent operation because of other condition.The recombinant pcDNA3.1(+)/TGF-? 2 con-structed in advance was transferred by liposome mediated transfection to monolayer cultured articular chon-drocytes.The first,sixth and ninth generation chondrocytes being transfected and non-transfected were as-sayed by histological examination of HE and Safranine-O staining to observe their morphological changes.RT-PCR,ELISA,immunohistochemistry analysis and prime hybridization were performed to these cells to i-dentify the expression and biosynthesis of TGF-? 2 and cartilage-associated genes and proteins.Results The non-transfected articular chondrocytes in monolayer culture demonstrated the tendency of dedifferentia-tion,and lost the characteristics of their phenotype progressively in subculture.The expression of TGF-? 2 ,collagen typeⅡand proteoglycan in non-transfected cells were decreased,but expression of collagen typeⅠincreased gradually with time going on.On the contrary,as for the transfected chondrocytes,the trans-ferred gene was expressed in cells of all examined generations,and the expression levels were higher than that of non-transfected cell of same generations.The transfected chondrocytes maintained their phenotype and characteristics of articular cartilage.They expressed and produced collagen typeⅡand proteoglycan in a higher level,and collagen typeⅠin a lower level than that of non-transfected cells.Conclusion Human articular chondrocytes in monolayer culture have the tendency of dedifferentiation.The results suggested that chondrocytes tranfected by pcDNA3.1(+)/TGF-? 2 could produce endogenous TGF-? 2 .Transfection of pcD-NA3.1(+)/TGF-? 2 is able to provide transient and long lasting expression of TGF-? 2 in chondrocytes,and may be a feasible method to inhibit dedifferentiation of articular chondrocytes in vitro.

BACKGROUND: Bone marrow mesenchymal stem cells(MSCs) have been investigated initially. Because both fat tissue and bone marrow are tissues originated from mesoderm, so whether MSCs could be obtained from fat tissue as well, which also have multi-lineage differentiation potential?OBJECTIVE:To investigate the basic biological characteristics of adipose MSC and its differentiation into osteoblast under given culture condition for the exploration of its feasibility as seed cell in bone tissue engineering.DESIGN: A randomized and controlled study based on cells.SETTING: Department of Orthopaedics of an Affiliated Hospital of a university.MATERIALS: The study was conducted in the Department of Orthopaedics of the Third Hospital of Peking University. Adipose MSC extracted from the fat tissue of Lewis rats was used as subject.METHODS: Adipose MSCs were obtained from inguinal fat pads of Lewis rat after digestion, which were induced into adipocytes and osteoblasts with adipose and osteogenesis induced culture mediums. The differentiations were examined with cytochemical staining, immuncytochemical staining and Western blotting.MAIN OUTCOME MEASURES: Morphological and biological characteristic of adipose MSCs, and the specific mark of osteoblast after induction.RESULTS: Adipose MSCs were obtained from rat adipose tissue culture,which appeared fibroblast-likely in the culture in vitro, and could stably proliferate and passage in vitro. Primary adipose MSCs could differentiate into adipocytes spontaneously, and passaged cells could form fat drop under the reaction of insulin and dexamethasone, and then differentiate towards adipocytes after the expression of peroxidase proliferation activated receptor ?(PPAR-?) enhanced. There was significant difference between induction group and control group in alkaline phosphatase(ALP) activity detection under the induction of dexamethasone, ascorbic acid, and ?-sodium glycerophosphate(P ＜ 0.01) . Calcium node appeared in yon Kossa staining. Result of osteopontin (OPN) immunocytochemcial staining was positive,and OPN expression was detected by Western blotting after induction.CONCLUSION: MSCs with multi-lineage potential can be obtained from rat adipose tissue, and differentiate into adipocytes and osteoblasts after inductions. Therefore, adipose MSCs can possibly be served as one of optimal seed cells for bone tissue engineering.

OBJECTIVE To investigate the epidemiology of bacterial infections isolated from liver disease patients with septic shock and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy. METHODS A retrospective survey was conducted in 83 liver disease patients with septic shock of our hospital from Jan 2005 to Aug 2006. Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System. RESULTS The infection was frequently identified in intra-abdominal cavity (73.5%),blood stream (24.1%) or respiratory tract (13.3%). The top 3 pathogens were Escherichia coli (36.6%),Klebsiella pneumoniae (15.9%) and Staphylococcus aureus (6.1%). Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to imipenem,levofloxacin or piperacillin-tazobactam. Extended-spectrum ?-lactamases (ESBLs) positive rates of E. coli and K. pneumoniae were 53.3% and 7.7%. Asprergillus and Candida glabrata were the predominant pathogens from fungal infections,and they were mostly resistant to fluconazole. CONCLUSIONS Pathogens of liver disease patients with septic shock are mostly multi-drug resistant. The microbiological surveillance is important for guiding clinical therapy.

The teaching for medical advanced students is a routine and important task in teaching hospital.To increase the teaching quality,we should emphasize professional theory learning,increase clinical skill training,strengthen medical records writing training and enhance emotional exchange.

Objective To observe the degree of joint flexion and extension of elbow and knee joints of moderate skeletal fluorosis patients before and after treatment and to assess the effects of Gun's MaQian decoction in treating moderate skeletal fluorosis. Methods 54 moderate skeletal fluorosis patients were randomly recruited into a treatment group and a control group. The treatment group was treated with Gun's MaQian decoction initially, and changed to be treated with GuKangNing capsule after 8 weeks' treatment. The control group was treated with placebo at first, and also changed to be treated with GuKangNing capsule after 8 weeks. Results Joint flexion and extension of elbow was improved greatly in both groups after the treatment, while the treatment group showing better effects than the control group (P<0.05). The improvement of joint flexion and extension of knee had not showed a statistical significance after the treatment. A 24 weeks follow-up to the joint flexion and extension of both elbow and knee revealed obvious improvement and the difference between the two groups were significance (P<0.05). Conclusion Gun's MaQian decoction can improve the flexion and extension of elbow and knee in moderate skeletal fluorosis patients.

Objective:To determine the correlations of single nucleotide polymorphisms (SNPs) with atrial fibrillation (AF) in the Chinese Han population from the central plains.Methods:A total of 168 hospitalized patients,including 56 AF and 112 controls,were recruited in this case-control study.The clinical data were obtained from the medical records.All 5 SNPs,rs337711 in KCNN2,rs11264280 near KCNN3,rs17042171 near PITX2,rs6771157 and rs6795970 in SCN10A,were genotyped using amplification refractory mutation system-polymerase chain reaction or direct sequencing.The x2 test was used to compare categorical variables and preliminarily examine correlations between the genotype frequencies and AF.Subsequently,a logistic regression model was constructed to determine the associations between the SNPs and AF based on the above screened results.Odds ratios (ORs) and 95％ confidence interval (CI) were calculated to assess the strength of the correlations.Moreover,we downloaded the genotype data from the HapMap Project for linkage disequilibrium analysis ofrs17042171.Results:AF patients were likely to be of older age and longer left atrial diameter and had more coronary artery disease and higher hypertension compared with the control group (P＜0.05).Among the 5 SNPs,the frequency distribution of genotype AA for rs17042171 was significantly different between the AF and control groups (P＜0.05).After adjusting for several covariates,there was still a high risk ratio in patients with the AA genotype compared with the AC+CC genotype (OR:5.591,95％CI 2.176 to 14.365,P-B＜0.008).Similarly,stratification analysis on the AA genotype demonstrated significant differences between rs17042171 and persistent AF.However,there were not significant correlations between AF and the control groups for the other 4 SNPs (P＜0.05).Conclusion:Rs17042171,near PITX2 on chromosome 4q25,is associated with AF susceptibility in the Chinese Han population from the central plains,suggesting that this SNP can provide a new strategy for clinical diagnosis in AF patients.

OBJECTIVE: To present the experience of nasal reconstruction with forehead flap. METHOD: nasal reconstruction with forehead flap were applied in eight nasal carcinoma cases after operation and 5 nasal trauma cases with defects. RESULT: These forehead flaps were alive in all patients, all incision healed in I stage, no post operative complications were found. The shapes of nose were satisfactory, there were no recurrence of tumor during 1 to 17 year follow up. CONCLUSION The method can be clinically applied for its simple procedure, reliable flap's blood supply, high survival rate and satisfied result.
Adolescent ; Adult ; Aged ; Female ; Forehead ; surgery ; Humans ; Male ; Middle Aged ; Nose ; injuries ; surgery ; Rhinoplasty ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult

Objective To understand the epidemiological characteristics and current situation of pertussis in Hubei Province from 2016 to 2021. Methods Data on the incidence of pertussis and immunization history of cases in Hubei Province from 2016 to 2021 were collected and descriptive epidemiological analysis was conducted. Results From 2016 to 2021, a total of 1 236 pertussis cases were reported in Hubei Province, with an average annual reported incidence rate of 0.35/100 000. The average annual reported incidence of pertussis in the age group ≤ 5 years old was 6.22/100 000, and the age group <1 year old reported the highest annual incidence rate (21.51/100 000). The proportion of pertussis among preschool children and students had increased significantly since 2020. Among the 1 111 cases with a known immunization history, 17.55% were under the age of vaccination , 41.85% were not vaccinated, and 17.46% had completed the whole course of vaccination. Conclusion Since 2016, the incidence of pertussis in Hubei Province has been on the rise. The risk of pertussis is higher in infants and young children who have not reached the age of vaccination and who have not been vaccinated in time according to the immunization program after reaching the age of vaccination. The timeliness and vaccination rate of DTP vaccine should be improved to reduce the risk of pertussis in infants and young children. In addition, more attention should be paid to the prevalence of pertussis among preschool children and students.

Objective To analyze the epidemic characteristics and causes of post-exposure immunization failure of rabies in Hubei Province from 2015 to 2021, and to provide evidence for the prevention and control of rabies in Hubei Province. Methods The investigation data of rabies cases in Hubei Province from 2015 to 2021 were collected, and descriptive epidemiological methods were used for data analysis. Results A total of 127 cases of rabies were reported in Hubei Province from 2015 to 2021, with an average annual incidence of 0.31/million, showing a downward trend. The male to female ratio was 1.70:1. Farmers accounted for 82.67% of the total cases, and the 50-79 years old group accounted for 75.59%. The incidence was mainly concentrated in Xiangyang, Shiyan, Yichang and Jingmen, accounting for 77.17%. Most of the cases were concentrated in summer and autumn. Exposure of grade Ⅱand Ⅲ accounted for 24.79% and 75.21%, respectively. Hands, lower limbs below knee, head, arms and lower limbs above knee accounted for 46.15%, 25.21%, 9.40%, 8.55% and 7.69% of the exposed parts, respectively. Dogs, cats and wild animals accounted for 95.73%, 3.42% and 0.85% of the exposed animals, respectively. Stray animals, domesticated animals, neighbors' animals and wild animals accounted for 41.88%, 37.61%, 19.66% and 0.85% of animal sources, respectively. Neither the neighbors’ animals nor domesticated animals were vaccinated against veterinary rabies virus. After exposure, 8.55% of patients went to medical institutions for standard treatment of wounds, 9.40% were vaccinated with human rabies vaccine, and 4.55% of patients with grade III exposure were injected with rabies virus immunoglobulin. The incubation period within 6 months, from 6 months to 1 year, and over 1 year accounted for 72.22%, 14.74%, and 12.04%, respectively. The exposure degree (Z=-1.98, P < 0.05), exposure site (χ²=10.91, P < 0.05) and wound treatment (χ²=15.73, P < 0.05) had statistically significant effects on the incubation period. Among the 11 cases of post-exposure immunization failure, all were grade Ⅲ exposure, 63.63% were exposed to the head and face, 81.81% were not fully vaccinated with human rabies virus vaccine, 63.63% were not immunized with immunoglobulin, and 27.27% were inappropriate wound treatment. Conclusion The key to rabies prevention and control is to standardize dog management, strengthen rabies education, standardize post-exposure wound treatment, timely vaccinate against rabies virus, and inject rabies virus immunoglobulin when necessary.

Objective To understand the epidemiological characteristics of the novel coronavirus diseases 2019 (COVID-19), and to scientifically guide the prevention and control of COVID-19 in Hubei Province. Methods All COVID-19 cases reported online in Hubei Province as of March 31, 2020 were extracted from Hubei^'s Infectious Disease Information System. The epidemic curve, age and sex characteristics, and spatiotemporal distribution characteristics of the COVID-19 cases were analyzed. Results As of March 31, 2020, a total of 70 764 cases were reported in Hubei Province, including 49 195 confirmed cases. A total of 4 579 deaths occurred among the confirmed cases, and the reported case fatality rate was 6.47%. The peak of the onset of symptoms occurred from January 20 to February 14, 2020. The sex ratio of male to female of the confirmed cases was 0.99: 1, and most were 30-69 years old. The cases diagnosed before January 5 were mainly reported by Wuhan City. From January 6 to January 31, all counties and districts in the province reported that the incidence of confirmed COVID-19 cases began to rise, and about 50% counties reported that the morbidity rate of confirmed COVID-19 cases was over 10 cases per 100 000. The morbidity rate of COVID-19 cases rose rapidly between February 1-15, and then gradually reached its peak after February 16. Conclusion Wuhan City of Hubei Province first discovered and reported the COVID-19 outbreak. The onset of symptoms peaked in January 20 to February 14, and the 30-69 years old group was the key population. Many measures such as restricting personnel movement, reducing contact, and strengthening health education played an important role in controlling the outbreak of COVID-19 in Hubei.