Objective To investigate whether insulin glargine can increase compliance and improve hyperglycemia or not in solitary senile patients with type 2 diabetes.Methods Thirty-two solitary senile patients with type 2 diabetes were given insulin glargine once daily besides the previous oral hypoglycaemic agents.Results FBG decreased(2.6? 1.5)mmol/L and(0.3?0.1)mmol/L in observing and control group respectively(t=1.691,P

Objective To investigate the functional states of stroke patients using the International Classification of Functioning, Disability and Health (ICF) core sets for stroke. Methods Fifty in-patients with stroke participated in this study. Twenty-five patients less than one month after a stroke were assigned to the acute group, and another 25 patients with more than one month since their stroke were assigned to the sub-acute and chronic group. All the patients were assessed using the Glasgow coma scale, Rankin grading and the Barthel index. The ICF core set for stroke assessment was also used with both groups. The data was analyzed by using a Chi squared frequency test. Results Rankin grades and Barthel indices were significantly different between the two groups, and the functional states in the acute group were better than those in the sub-acute and chronic group. Some of the items, such as consciousness state, functions of structures adjoining the eyes, hearing, substitutive sound, accessory respiration, temperature regulation and protection function of the skin had no significant difference between the groups. The number of patients suffering from disorders of joint motion, joint stability, muscle endurance and control of voluntary movement was significantly greater in the sub-acute and chronic group than in the acute group. Both groups were influenced to different degrees by most of the environmental factors. Conclusion The ICF core sets correctly indicated joint motion, joint stability, muscle endurance and control of voluntary movement difficulties of stroke patients.

[Objective]To investigate Y-shaped osteotomy and the internal fixation with geese-head steel plates for treatment of congenital coxa vara.[Method]Lesser subtrochanteric and greater laterotrochanteric osteotomy were performed for 7 cases(9 hips)of congenital coxa vara with the Y-shaped osteotomy line.The distal femoral section met the lateral greater trochanteric section,fixed with geese-head steel plates.[Result]The cases were followed up for 1~5 years(averaged 3.6 years).According to Shi Yingqi's evaluation,4 hips were excellent,4 good and 1 fair.[Conclusion]The Y-shaped osteotomy and internal fixation with geese-head steel plates can improve the abnormal structure of upper femur,increase the real length of the affected limb.Therefore,it is an ideal effective method for treatment of congenital coxa vara.

ObjectiveTo explore the clinical characteristics and diagnosis of primary small intestinal tumor (PSIT). MethodsRetrospective analysis of the clinical and pathological data of the 112 PSIT cases was made. ResultsDuodenum was the most common site for PSIT (62 5%). Leiomyomas were most common benign tumors which were most likely found in ileum and jejunum. Adenocarcinoma was the most frequently seen malignant PSIT followed by lymphoma and leiomyosacroma. The chief method of diagnosis is barium meal X ray examination especially with the hypotonic contrast X ray examination. Endoscopy can increase the diagnostic rate. Superior mesenteric arteriography sometimes helps in determing the site of gastrointestinal haemorrhage. CT scan can be helpful in establishing diagnosis, preoperative classification and postoperative recurrences. Conclusion Duodenal adenocarcinoma is most common PSIT, followed by malignant lymphoma, liomyoma and leiomyosarcoma. Hypotonic contrast X ray examination is most effective in diagnosis, and locating of small bowel tumors. Superior mesenteric artery angiography and CT scanning are also helpful.

Hematopoietic Stem Cell Transplantation ; Humans ; Transplantation, Homologous ; Treatment Outcome

Acute Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; prevention & control ; therapy ; Postoperative Period ; Secondary Prevention

Objective To develop new methods to cultivate, retrieve and purify mouse mesenchymal stem cells (mMSCs). Methods Bone marrow was collected from 2-month-old Kunming mice by flushing femurs and tibias with complete medium of DMEM-LG. Cells were plated in a Petri dish. After 24 hours, non-adherent cells were removed by two to three washes with PBS, adherent cells were further cultured in complete medium and retrieved by trypsinisation with 0.25% trypsin for 5 min at 37 ℃. The treated adherent cells were cultivated with 3?dilution for further generations. CD11b-negative cells were retrieved from the collected adherent cells of 3rd generation by using immunomagnetic microbeads, and continued to be cultured in complete medium. After the cultured cells were retrieved, their morphology and their ability of osteoblastic differentiation and adipocytic differentiation were examined. Results Most of mMSCs from 1st generation were of shuttle shape, some of irregular shape. After treatment with magnetic microbeads and several generations, mMSCs were of spindle, star and irregular shape. These cells were of rich cytoplasma, clear nucleolus, and grew in parallel or vortex. The cultured adherent cells from the first and subsequent generations had plenty of CD11b-positive blooding-making cells. After 20-day osteoblastic induction, mMSCs differentiated into bone cells, which showed orange phosphate in extracellular matrix by Alizarin red S staining. mMSCs could differentiate into lipocytes. The size of cells increased along with fat-developing induction period. These cells showed many orange fatty follicles with O Red Oil dyeing. Conclusion Pure mMSCs can not be retrieved by either adhering method or generation cultivation method separately. The combined methods of adhering, immunomagnetic microbeads, and serial subcultivation is effective in vitro in retrieve mMSCs.

BACKGROUND:The majority of published article on cardiopulmonary resuscitation (CPR) used healthy animals. In fact, patients commonly have severe heart diseases before CPR, leading to ventricular fibrillation. OBJECTIVE: To investigate outcome of myocardial function and cardiopulmonary resuscitation in myocardial infarction rats treated with bone marrow mesenchymal stem cells (MSCs) transplantation.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the University of Southern California and Second Hospital of Sun Yat-sen University from April to August 2007.MATERIALS: A total of 18 adult male SD rats were randomly divided into model control and cell transplantation groups with 9 animals in each group. In addition, 1 SD rat aged 1 month was used to prepare bone marrow MSCs.METHODS: Myocardial ischemia was induced by ligation of the left anterior descending artery (LAD). Animals respectively received 5×106 MSCs (0.1 mL) marked with PKH26 in phosphate buffer solution (PBS) or PBS alone 4 weeks after LAD ligation. Ventricular fibrillation and CPR were performed 4 weeks after MSCs or PBS injection.MAIN OUTCOME MEASURES: Heart function was evaluated by ultrasound cardiography 2, 4 weeks after transplantation; hemodynamics was measured before and 4 hours following CPR. Myocardial tissues were harvested 72 hours after CPR for pathological exanimation.RESULTS: Compared with model control group, ejection fraction of transplantation group was significantly increased 2 and 4 weeks after transplantation (P<0.01), and cardiac index, dp/dt40, and -dp/dt were significantly improved before and within 4 hours after CPR (P<0.01, P<0.05). Moreover, the rats survived longer in transplantation group (72 hours) after CPR compared with control group (P<0.05). Pathological section results showed a large number of PKH26-1abeled MSCs in the rnyocardium.CONCLUSION: Myocardial function, hemodynamics and survival time after CPR were significantly improved in animals treated with MSCs transplantation.

Objective To explore the effects of adrenomedullin(AM) on human umbilical vein endothelial cells (HUVECs) and possible mechanisms involved. Methods The HUVECs were selected to be a model and the following aspects were studied: (1) Effects of high glucose (30 mmol/L) on the endothelial dysfunction induced. (2) The role of protein kinase C (PKC)? and PKC? in the endothelial dysfunction induced by high glucose and the effects of AM. The translocation of PKC? or PKC? in a single HUVEC was observed by laser-scanning confocal microscope and the expressions analysis was conducted quantificationally by Western blotting. HUVECs were cultured and divided into 3 groups: (1) Matched control group; (2) High glucose group (30 mmol/L glucose); (3) AM (10~(-9), 10~(-8), 10~(-7) mol/L) + highglucosegroupHUVECswereincubated with AM for 48 h. Results (1) High glucose could induce HUVECs dysfunction: increased apoptosis, decreased NO concentration and increased sICAM level of HUVECs. AM reversed the above changes of HUVECs induced by high glucose. (2) It was observed that AM inhibited the translocation of PKC? from plasma to nucleus in HUVECs induced by high glucose and the translocation of PKC? from nucleus to plasma and membrane in HUVECs. (3) AM inhibited the increasing expressions of PKC? in HUVECs induced by high glucose. The expressions of PKC? in high glucose group were not different from that of the control. Conclusion AM appears to correct the endothelial cell dysfunctions induced by high glucose. The inhibition of PKC? and PKC? seems to play some roles during the process.

Objective To study the clinical features,differential diagnosis and treatment of caesarean scar pregnancy (CSP) with sonographic mass.Methods A retrospective analysis was performed on 39 patients of CSP with sonographic mass undergoing treatment in Peking Union Medical College Hospital from 2005 to 2012.14 cases with misdiagnosis of gestational trophoblastic neoplasm,among 4 cases were administered by chemotherapy with methotrexate (MTX),cisplatin,fluorouracil (5-FU) and dactinomycin.According to treatment methods,39 cases were divided into five groups: 3 cases in methotrexate,16 cases in dilation and curettage,15 cases in excision of CSP lesion via laparoscopy,6 cases in excision of CSP lesion via laparotomy,and 4 cases in transabdominal hysterectomy (TAH).Results (1)Clinical characteristics: the mean age was (33 ± 5) years old.Five patients had undergone two prior caesarean sections.The median interval from the last caesarean delivery to CSP was 4 years.Thirty-five cases presented vaginal bleeding or abnormal serum β-hCG level from 5 cases with medical abortion,9 cases with artificial abortion and 21 cases with dilation and curettage.The sonography showed cystic-solid or solid mass with mixed echoes in the lower segment of anterior uterine wall,surrounded by peritrophoblastic vasculature.(2) Treatment outcome: diagnosis of gestational trophoblastic neoplasm was suspected or made in 20 patients,four of whom were even treated by chemotherapy.MTX therapy was given to 3 patients,2 of whom were cured.Dilation and curettages were given to 16 patients,11 of whom were cured.8 patients underwent curettage with sonographic guidance after uterine artery embolism,and 8 patients with laparoscopic or hysteroscopic guidance.All of 15 patients underwent excision of CSP lesion via laparoscopy were cured.4 patients were treated by TAH.(3) Time of in hospital and operation:in laparoscopy group,the average hospitalization days were (3.5 ± 1.6) days,the average operation duration was (54 ± 16)minutes.In laparotomy group,the average hospitalization days were (9.7 ± 5.8) days,and the average surgical duration was (87 ± 15) minutes.It reached significant difference (P ＜ 0.05).Conclusions CSP with sonographic mass was the consequence of continued growth of residual pregnancy mass after incomplete abortion or curettage of CSP with gestation sac.The similar sonographic image might lead to misdiagnosis.Individual therapy was recommended.Excision of CSP lesion via laparoscopy might be the primary option for its advantages in differential diagnosis,caesarean scar defect repair and successful ratio.