Based on detailed analysis of the status of and problems in the use and management of implantable medical devices and equipment in clinical departments of hospital, we propose some clinically operable solving strategies and methods. It is important to further regulate the use and management of implantable medical devices for timely and safe use the devices in clinical departments.

Objective To construct an immortalized rat astrocyte strain expressing enkephalin which can be regulated by doxycycline.Methods pRevTet-On and recombinant plasmid pRevTRE/hPPE were transfected into packaging cell PT67 respectively by standard lipofectamine methods.The supernatant containing RevTet-On virus was used to infect immortalized rat astrocyte strain(IAST)and RevTRE/hPPE virus was used to infect the IAST/Tet-On cell.Immortalized rat astrocyte strain that stably expressed Tet-regulated enkephalin was established. hPPE gene expression level of IAST/Tet-On/hPPE cell strain was detected by real time-PCR,immuno- cytochemistry and radio-immunoassay.Results Real time-PCR,immuno-cytochemistry and radio-immunoassay confirmed the level of enkephalin expression was regulated by doxycycline in a dose-dependent manner.Conclusion An immortalized rat astrocyte strain which secrets enkephalin as controlled by doxycycline has been constructed successfully.

Objective To investigate the related risk factors,clinical features and prognosis of hospital-acquired acute kidney injury (AKI) in intensive care unit (ICU).Methods We retrospectively analyzed 48 patients with both acute kidney injury and multiple organ dysfunction syndrome (MODS),who received renal replacement therapy from October 2006 to February 2011 in our ICU.According to whether the occurrence time of AKI was 48 hours after admission,they were divided into hospital-acquired AKI (HA-AKI) group and community-acquired AKI (CA-AKI) group,with 13 and 35 cases respectively.We compared the differences between these two groups in gender,age,acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ),primary diseases,days of mechanical ventilation,times of renal replacement therapy,number and indicators of organ failure,prognosis,renal function recovery,length of stay in ICU and hospital.Results The mean age of HA-AKI group is ( 64.5 ± 21.4) years,which is older than that in CA-AKI group ( 50.2 ± 17.5 ) years (P=0.022).The top three primary diseases in CA-AKI group are severe infection(42.8％ ),chronic kidney disease (CKD) concurrency of AKI ( 11.4％ ) and multiple trauma without head injury ( 8.6％ ).However severe infection still occupies the first in HA-AKI group ( 30.8％ ),followed by stroke (23.1％,P=0.024),multiple trauma with head injury( 15.4％,P=0.018 ) and gastrointestinal bleeding( 15.4％ ) ;Patients in HA-AKI group with more than four organ failures account for 84.6％,significantly higher than 65.7％ in CA-AKI group (P=0.000).On the first day,the levels of serum sodium ( P =0.036 ) and bicarbonate ( P=0.001 ) in HA-AKI group are higher than that in CA-AKI group,and the urinary volume is more(P =0.046).In HA-AKI group,the level of urea nitrogen on the seven day increases so progressively that it becomes significantly higher than that on the first day(P=0.015),but in CA-AKI group,there is no significant change in the levels of serum creatinine and urea nitrogen after AKI,while the levels of seruum sodium ( P=0.023 ) and bicarbonate ( P=0.030) increase significantly;APACHE Ⅲ score in HA-AKI group after admission 24 hours is significandy lower than that in CA-AKI group(53.2 ±22.8) point vs (89.1±25.7) point,P=0.000),and the length of stay in ICU and hospital and days of mechanical ventilation in HA-AKI group are significantly longer than that in CA-AKI group,but there are no significant differences in times of RRT therapy,prognosis and recovery of renal function.Conclusion APACHE Ⅲ score after 24 hours of admission does not accurately reflect the prognosis of patients with MODS and HA-AKI.There are great differences in age,primary diseases,organ function changes and other aspects of HA-AKI when compared with CA-AKI.

Objective To investigate the clinical features of primary retroperitoneal fibrosis (RPF), and to find out better method for diagnosis and therapy. Methods Nine patients with primary RPF in Peking Union Medical College Hospital since 1990 to 2003 were analyzed retrospectively. Results All patients had abnormal findings in CT or MRI, and 8 of them had chronic non-specific inflammation of the retroperitoneum in pathology. Six patients had renal involvement and 2 of them had severe renal failure. Eight of the patients had received therapy with corticosteroid or tamoxifene. Conclusions RPF is an uncommon collagen vascular disease characterized by a chronic non-specific inflammation of the retroperitoneum.Because of the atypical manifestations of RPF, awareness of the disease is important.CT and (or) open biopsy remains the gold standard for diagnosis.Management typically includes surgery and drug treatment.Corticosteroid therapy or more recently,tamoxifen has been used successfully. The clinical and radiographic improvement with drug treatment has been seen in several patients and confirmed the diagnosis,thereby early diagnosis and treatment can bring the patient more excellent renal and general outcome.

Objective To investigate the osteogenesis capability of different frequency extracorporeal shock wave.Methods 39 rabbits received different frequency extracorporeal shock wave at the middle potion of tibia for 3 or 7 days,these rabbits were then sac rificed and the tibia bones were collected to process for HE and toluidine blue staining,the pathological changes were observed under the light microscope.Results After different frequency extracorporeal shock wave treatment,the typical periosteal reaction were observed,external periosteum bleeded and thickened but there was no reaction at internal periosteum,marrow cavity opened and fibrosed.the osteoblast-1iking cell proliferated,however,no cartilage cells were observed;The rabbits received 7 days shock wave treatment showed more severe reaction than those for 3 days.The shock wave at lower frequency showed more severe reaction than higher frequency.Conclusion shock wave induced osteogenesis through the periosteal reaction of external periosteum;the osteogenesis capability of different frequency extracorporeal shock wave were affected by the frequency.Higher frequency of shock wave was not the ideal way to promote osteogenesis.

Objective To construct the recombinant yeast expressing PreS2 120-146-hepatitis B surface antigen (HBsAg),and to evaluate the immune effects of whole yeast cells.Methods PreS2 120-146 and HBsAg gene sequence were optimized according to the yeast cell codon preference,and were recombined and cloned into pPIC3.5K yeast expression vector to construct pPIC3.5K/PreS2 120-146 plasmid.After digested and linearized by Bgk Ⅱ restriction enzyme,pPIC3.5K/PreS2 120-146-HBsAg recombinant plasmid was electrotransformed into GS115 strain to screen PreS2 120-146-HBsAg-recombinant Pichiapastoris .The expression of PreS2 120-146-HBsAg was identified by sodium doclecyl sulfate polyacrylamide gel electrophogesis (SDS-PAGE),Western blot and enzyme linked immunosorbent assay (ELISA)analysis. BALB/c mice were vaccinated by inactivated whole recombinant yeast cells expressing target protein. Specific antibodies to HBsAg were detected by ELISA.Cytotoxic T lymphocyte (CTL)response induced by interferon (IFN)-γ was detected by reverse transcription-polymerase chain reaction (RT-PCR)when immune spleen cells of mice were stimulated by CTL epitope on HBsAg.Independent sample t test was used. Results Data of PCR detection,restriction enzyme digestion and sequencing analysis showed that recombinant pPIC3.5K/PreS2 120-146-HBsAg plasmid was successfully constructed.SDS-PAGE,Western blot and ELISA verified the expression of PreS2 120-146-HBsAg in the lysate of the recombinant Pichiapastoris induced by methanol.Levels of specific anti-HBsAg IgG antibodies produced by inactivated yeast cells vaccinated mice were comparable to purified HBsAg immunization (t =0.946,P =0.381 ). Analysis of HBsAg-specific CTL responses revealed that the level of IFN-γwas significantly higher when the immune spleen cells of mice were stimulated by CTL epitope peptides on HBsAg (t =2.305 ,P =0.044).Conclusions PreS2 120-146-HBsAg target protein is successfully expressed by construction of recombinant Pichiapastoris . The specific humoral and cellular immune responses are induced by recombinant whole yeast cells vaccinated mice.

OBJECTIVETo compare the difference in the efficacy on thoracic facet joint disorder between the combined therapy of electroacupuncture and manual reduction and the simple manual reduction.

METHODSOne hundred and sixty patients were randomized into an electroacupuncture and manual manipulation group (group A) and a simple manual manipulation group (group B), 80 cases in each one. In the group A, Ashi points and three pairs of Jiaji (EX-B 2) bilateral to the painful sites were selected. The perpendicular puncture was used at Ashi points, the oblique puncture was used at Jiaji (EX-B 2) and connected with electric stimulation for 20 min, additionally, the corresponding manual reduction was adopted at the sites of facet joint disorder. In the group B, the simple manual reduction was applied to the affected sites. Acupuncture was given once every day, the manual reduction was applied once every 10 days. The treatment of 10 days made one session. The efficacy was analyzed statistically at the end of two sessions of treatment. Before and after treatment, McGill pain scale was adopted for the value statistical analysis. PRI score, VAS score and PPI score of patients were calculated before and after treatment and compared in the two groups. The efficacy was compared between the two groups.

RESULTSThe curative rate was 56.3% (45/80) in the group A, which was better than 18.8% (15/80) in the group B (P< 0.01). The total effective rate was 95.0% (76/80) in the group A, which was better than 76.3% (61/80) in the group B (P<0.01). The scores of PRI, VAS and PPI after treatment were all improved significantly in the two groups (all P<0.05), in which, the results in the group A were better than those in the group B (PRI: 4.00 +/- 0.97 vs 5.44 +/- 1.16, VAS: 3.29 +/- 0.72 vs 3.87 +/- 0.81, PPI: 1.07 +/- 0.74 vs 1.64 +/- 0.90, all P<0.05).

CONCLUSIONThe combined therapy of electroacupuncture and manual manipulation achieves the superior efficacy on thoracic facet joint disorder as compared with the simple manual manipulation. The combined therapy relieves the symptoms of thoracic facet joint disorder and reduces the severity of disorder.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Thoracic Diseases ; therapy

BACKGROUND:TiO2 nanotube array prepared by anodic oxidation is a nanomaterial having a perfect promising application at present.
OBJECTIVE:To review the research progress of TiO2 nanotube in clinic.
METHODS:The key words were TiO2 nanotubes, anodization, and biomaterials. We retrieved PubMed Database for articles concerning the clinical application of TiO2 nanotube published from January 2000 to June 2013. Repetitive and old studies were excluded, and 47 literatures were included for the review.
RESULTS AND CONCLUSION:The summarized results of the 47 literatures showed that TiO2 nanotube promoted the adhesion and proliferation of osteoblasts and mesenchymal stem cells including human. In vivo experiments verified that TiO2 nanotube could be used as a carrier to carry other drugs such as growth factor and antibiotics so as to promote the biocompatibility of the materials and to prevent bacterial adhesion. Results suggested that TiO2 nanotube contributed to the osseointegration of the material in vivo, and had a good biocompatibility.

BACKGROUND:Hydroxyapatite has excellent biocompatibility, but biocompatibility of nano-hydroxyapatite/TiO2 nanotube composites is rarely reported.
OBJECTIVE:To evaluate the biocompatibility of nano-hydroxyapatite/TiO2 nanotube composites.
METHODS:First, the TiO2 nanotubes were fabricated on the surface of the titanium by anodic oxidation
technique. Second, the nano-hydroxyapatite/TiO2 nanotube composites were fabricated by electrodeposition technique. The surface morphology of the composites was observed by scanning electron microscopy. Mouse osteoblasts MC-3T3-E1 were co-cultured with the nano-hydroxyapatite/TiO2 nanotube composites, TiO2 nanotubes and titanium, and commercial y pure titanium to observe the celladhesion, proliferation and necrosis on scaffolds.
RESULTS AND CONCLUSION:The morphology of the TiO2 nanotubes and nano-hydroxyapatite/TiO2 nanotube composites could be control ed by altering the conditions of the anodic oxidation and electrodeposition. Under the inverted microscope, after 3 days of co-culture with TiO2 nanotubes and nano-hydroxyapatite/TiO2 nanotube composites, MC-3T3-E1 cells proliferated wel with regular shape and arrangement that were superior to those on commercial y pure titanium. Under scanning electron microscope, the cellwere adhered and proliferated wel on the surface of the TiO2 nanotubes and nano-hydroxyapatite/TiO2 nanotube composites after 3 days. Apoptosis rate of the cells was significantly reduced on the surface of nano-hydroxyapatite/TiO2 nanotube composites (7.8%) compared with TiO2 nanotubes (9.4%) and commercial y pure titanium (13.5%), indicating nano-hydroxyapatite/TiO2 nanotube composites have good biocompatibility.

Water soluble extract (WSE) is an important index for the quality evaluation of Astragali Radix (AR). In this study, the WSE of the wild AR from Shanxi province (SX) and the cultivated AR from Gansu Province (GS) were compared. The WSEs of two types of AR were determined according to the appendix of Chinese pharmacopoeia. Then the WSEs were subjected to NMR analysis, and the obtained data were analyzed using HCA, PCA, OPLS-DA, microarray analysis, and Spearman rank analysis. In addition, the Pearson correlation of differential metabolites were also calculated. The results showed that the WSE content of GS-AR (37.80%) was higher than that of SX-AR (32.13%). The main constituent of WSE was sucrose, and other 18 compounds, including amino acids, organic acids, were also detected. Multivariate analysis revealed that SX-AR contained more choline, succinic acid, citric acid, glutamate, taurine and aspartate, while GS samples contained more sucrose, arginine and fumaric acid. In addition, the Pearson correlations between different metabolites of the two types of AR also showed apparent differences. The results suggested that the WSE of two types of AR differs not only in the content, but also in the chemical compositions. Thus, the cultivation way is important to the quality of AR. This study supplied a new method for the comparison of extract of herbal drugs.
Arginine ; analysis ; Aspartic Acid ; analysis ; Choline ; analysis ; Citric Acid ; analysis ; Drugs, Chinese Herbal ; analysis ; chemistry ; Fumarates ; analysis ; Glutamic Acid ; analysis ; Magnetic Resonance Spectroscopy ; Multivariate Analysis ; Phylogeography ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Succinic Acid ; analysis ; Sucrose ; analysis ; Taurine ; analysis