The effects of interferon-? (IFN-?) on chronic myelogenous leukemia cells were studied in vitro by long-term bone marrow culture(LTBMC). There were no inhibition of cellularity from non-adherent layers and formation of adherent layers, however, CFU-GM from non-adherent layers was inhibited at IFN-? 103U/ml and 104 U/ml groups, when IFN-?was added only at initiation of culture. If IFN-? was continuously added weekly, the cellularity and CFU-GM of non-adherent layers were significantly inhibited, and the formation of adherent layers was inversely associated with the increasing concentration of IFN-?. in addition, Ph(+) cells in non-adherent layers were disappeared early and the percentage of Ph(-) population was increased with the combination of IFN-? and LTBMC. It is concluded that IFN-?selectively inhibits the later CFU-GM of CML cells and the development of stromal cells, the combination of IFN-?and LTBMC might exert a synergically purging effect on Ph(+) CML cells

Objective:To investigate the effect of different ventilation time in the prone position on patients with endogenous/exogenous ARDS.Methods:30 endogenous/30 exogenous ARDS patients were randomly devided into 4 groups,ventilation in the prone position for 2 h and 4 h.Recording the score of APCHEII,oxygenation index,the absorption situation in X-ray,HR,MAP,extubation time,the time out of ICU.Results:The APCHEII scores HR and MAP in four groups have no significant statistics (P＞0.05);4h ventilation for endogenous ARDS patients has a better indicators than 2 h in oxygenation index,the absorption situation in X-ray,extubation time and the time out of ICU (P＜0.05);2 h and 4 h ventilation for exogenous ARDS patients can improve indicators above,two groups have no significant statistics (P＞0.05),the results of exogenous groups are precede than endogenous group (P＜0.05).Conclusion:Ventilation in the prone position can improve the situation of ARDS patients,both endogenous patients and exogenous patients.Exogenous ARDS patients have a better treatment effect after the ventilation of 2h,however,endogenous patients need longer time and have a non-ideal prognosis.

Objective To evaluate the long-term clinical outcomes and survivorship of fixed bearing total knee arthroplasty (TKA) and the risk factor for failure.Methods Between June 1993 and April 2002,285 Chinese patients accepted TKA with cemented fixed bearing platform in our center,and 226 patients (246 knees) were successfully followed up.The age was (62.2±9.4) years at index operation.The survivorship of TKA and the related impact factor were analyzed.The hospital for special surgery (HSS) knee score,range of motion (ROM) and radiological results were studied at the final follow-up.Results One hundred and sixty patients (177 knees) were followed up longer than 10 years.Survival rate was 93.6％±1.7％ at 10years,92.8％±1.8％ at 15 years,with reoperation of the implant as the endpoint.Main reasons for failure were infection and aseptic loosening.There were no statistically difference in survival rate between posterior cruciate ligament retaining and posterior stabilizing group,patellar resurfacing and non-resurfacing,rheumatic arthritis (RA) and osteoarthritis (OA) patients.Meanwhile,RA patients had lower longterm survivorship compared with OA patients.HSS knee score of 96 of the knees increased from 56.58±11.05 preoperatively to 92.29±10.95 postoperatively,and ROM increased from 84.8°±24.0° preoperatively to 99.7°±17.6° postoperatively.Totally,15 knees underwent revision surgery with the relating reason of infection for 10 knees,aseptic loosening for 3,and stiffness for 1 knee.Conclusion Fixed bearing TKA can fulfill satisfactory long-term clinical results,with more than 90％ of 10-year survival rate.The strategy for posterior cruciate ligament,patellar and preoperative diagnosis has no statistically impact on the long-term survivorship.

Objective To evaluate the effects of butorphanol pretreatment on myocardial damage induced by limb ischemia/reperfusion (I/R) in rats.Methods One hundred and eight male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 3 groups (n =36 each) using a random number table:sham operation group (group S),I/R group and butorphanol pretreatment group (group B).Limb ischemia was induced by occlusion of bilateral hind limbs for 2 h followed by reperfusion in I/R and B groups.At 10 min before ischemia,butorphanol 0.2 mg/kg was injected via the right jugular vein in group B,while the equal volume of normal saline was injected in group I/R.Six rats were chosen randomly before ischemia (baseline,T0) and at 2,6,12,24 and 48 h after reperfusion (T1-5) and blood samples were taken from the abdominal aorta for determination of the serum creatine kinase isoenzyme-MB (CK-MB) activity and cardiac troponin Ⅰ (cTnI) concentration.The animals were then sacrificed and myocardial specimens were obtained for determination of myocardial apoptosis (using TUNEL) and the expression of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated protein kinase (ERK) (using Western blot analysis).Apoptosis index was calculated.Results Compared with group S,the serum CK-MB and cTnI levels were significantly increased at T1-5,and the apoptosis index and expression of JNK and ERK were increased at T2-5 in group I/R (P ＜ 0.05).Compared with group I/R,the pathological changes of myocardium were significantly reduced at T4,the serum CK-MB and cTnI levels were decreased at T2-5,the apoptosis index was decreased at T4,5,the expression of ERK was up-regulated at T2-5,and the expression of JNK was down-regulated at T2-4 (P ＜ 0.05).Conclusion Butorphanol pretreatment can reduce apoptosis in myocardial cells through activating MAPK signal transduction pathway,up-regulating ERK expression and down-regulating JNK expression,thus attenuating myocardial damage induced by limb I/R in rats.

In 2013, Shanghai Medical College of Fudan University restarted the enrollment of the undergraduate students in directional pediatrics. To cultivate medical talents in pediatrics, a serious of educational innovations and practices have been carried out guided by competency training, including training a team of teachers with simulated teaching skills and establishing a teaching platform for simulation teaching. Medical students can practice medicine and gain experience through the risk-free simulated scenarios, that is helpful to enhance their confidence in clinical skills and communications and decrease medical errors in their future careers.

BACKGROUNDThe long term outcome of patellar resurfacing in Chinese has not been well described. This study evaluated more than 10-year clinical outcomes and survivorship of patellar resurfacing or nonresurfacing in total knee arthroplasty.

METHODSFrom January 1993 to December 2002, 265 patients accepted total knee arthroplasty in Department of Orthopaedic Surgery, Peking Union Medical College Hospital. Among them, 226 patients (246 knees) were successfully followed up, with 176 knees for patellar resurfacing and 70 knees for nonresurfacing. The survivorship of total knee arthroplasty between two groups and the hospital for special surgery knee score (HSS), patellar score, patellar related complication and radiological results were studied at the latest follow-up.

RESULTSThe HSS knee score increased from 55.9±12.2 preoperatively to 92.0±10.9 postoperatively for patellar resurfacing group and from 56.6±9.9 to 94.2±11.4 for nonresurfacing group after average 11.4-year follow-up. Patellar score increased from 13.93±2.42 preoperatively to 28.33±2.20 for resurfacing group and from 13.55±2.73 to 27.8±2.37 for nonresurfacing group. There was no statistically significant difference for both HSS score, patellar score between the two groups with higher rate of anterior knee pain for nonresurfacing group. Patellar nonresurfacing had higher lateral subluxation than resurfacing group according to radiological evaluation. Patients with rheumatoid arthritis had 5.5 fold patellar related complication than patients with osteoarthritis. The 10-year survival rate was not statistically significant different between the two groups (P = 0.12).

CONCLUSIONSThere was no significant difference of long-term clinical outcome and survivorship between patellar resurfacing and nonresurfacing. Patellar nonresurfacing can be advisable during primary total knee arthroplasty especially in Chinese patients with osteoarthritis. Selective patellar resurfacing for patients with rheumatoid arthritis can achieve lower patella related complication.

Aged ; Arthroplasty, Replacement, Knee ; Asian Continental Ancestry Group ; Female ; Humans ; Male ; Middle Aged ; Patella ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo determine the postoperative complications of primary total knee arthroplasty (TKA) within 30 postoperative days, and the different causes for revision surgery during follow-up.

METHODSBetween January 2001 and December 2012, a total of 1 920 patients underwent 2 779 primary TKA with fixed bearing platform in Peking Union Medical College Hospital, with 323 for male and 1 607 for female. The revision surgery at index time and the hemophiliac arthropathy were excluded for this study. The average age was (66 ± 9) years (from 25 to 86 years).Osteoarthritis accounted for 1 720 cases (89.58%), rheumatoid arthritis for 168 cases (8.75%), ankylosing spondylitis for 12 cases (0.63%), secondary arthritis for 20 cases (1.04%). The postoperative complications with 30 postoperative days and revision surgery during follow-up were recorded.

RESULTSFollow-up was concluded at December 2013. Totally, 1 854 patients (2 693 knees) were successfully followed-up.Forty-one patients experienced systemic complication within 30 postoperative days, with the rate of 2.21%. The most common reasons of systemic complication were the respiratory complication and cardiovascular complication in origin, with the rate of 0.49% (9/1 854) and 0.38% (7/1 854) respectively. The average rate of deep venous thrombosis in this group was 3.02% (56/1 854). The local complication rate within 30 days was 1.29% in this group. Totally 59 knees experienced the revision surgeries during average 67 months follow-up. The most common causes for revision surgery in relative values were septic loosening, with the rate of 1.19% (32 in 2 693 knees), followed by postoperative stiffness, with the rate of 0.37% (10 in 2 693 knees).

CONCLUSIONSThe most common reasons of systemic complication with 30 postoperative days after primary TKA procedure are the respiratory complication and cardiovascular complication in origin. The most common reason for revision surgery during mid-term follow-up for primary TKA is septic loosening.

Aged ; Aged, 80 and over ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Knee ; Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis ; Postoperative Complications ; Postoperative Period ; Reoperation ; Spondylitis, Ankylosing

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care