BACKGROUND:Three-dimensional (3D) nanofiber scaffolds are aimed to mimic the physical and chemical signals of stem celsin vivo. 3D nanofiber scaffolds, which are capable to maintain the activity of stem cels, are promising in tissue regeneration and stem celltherapy. OBJECTIVE:To review the synthesis methods for 3D nanofiber scaffolds, and the interactions of stem cels and 3D scaffolds as wel as the current progress of 3D nanofiber scaffolds in tissue engineering. METHODS:Web of Science was searched with key words of “tissue engineering, nanofiber scaffold, stem cellfate” in English for articles relevant to stem celltissue engineering and 3D nanofiber scaffolds. RESULTS AND CONCLUSION:3D nanofiber scaffolds can mimic the physical architecture ofin vivo microenvironment due to its nano-scale topology. Chemical modification of scaffolds endows chemical cues to stem cels. Therefore, 3D nanofiber scaffold can be a promising delivery vehicle of stem cels in tissue engineering. Nanofiber scaffolds can be synthesized through self-assembly, sol-gel phase separation, and electric spinning. 3D nanofiber scaffolds have been shown to improve thein vitro proliferation of hematopoietic stem cels, embryonic stem cels, mesenchymal stem cels, and neural stem cels. 3D nanofiber scaffolds with specific topology/chemical properties can induce the differentiation of stem cels into bone, cartilage, nerve, or muscle. 3D nanofiber scaffold which provides a satisfactory microenvironment for stem cellenhance the performance of stem celltherapy.

Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Child ; Conjunctivitis ; therapy ; Female ; Humans ; Male ; Young Adult

Objective To study clinicopathologic features of ALK-positive large B-cell lymphoma.Methods The clinical data,histopathological characteristics,immunophenotype and fluorescence in situ hybridization (FISH) result of a patient with ALK-positive large B-cell lymphoma were analyzed and discussed combined with related literatures.Results A 30-years-old male patients with the left neck lymphadenectasis was studied.Histological evaluation revealed the tumor grew in sheets in the nodal,with round nuclei,dispersed chromatin,a single prominent central nucleolus and moderate amounts of eosinophilic to amphophilic cytoplasm.The neoplastic cells exhibited immunoblastic/plasmablastic morphology.Immunohistochemistry measurement showed that the tumor cells were marked positively by CD138,ALK-1,CD45RO,CD4,Perforin,CD117 and Kappa proteins,while negatively by CD3,CD8,CD20,CD30,CD38,CD57,CD79a,Pax-5,EMA and AE1/AE3 proteins.FISH test demonstrated the presence of ALK gene translocation.The patient was given 4 cycles of CHOP chemotherapy after surgery.However,the conditions deteriorated after 4 months.Now the patient continued to receive treatment.Conclusion ALK-positive large B-cell lymphoma represents a distinct variant of diffuse large B-cell lymphoma,and the tumor has special histological features along with a distinct immunophenotype and ALK gene rearrangement.

Objective To evaluate the value of MRI in diagnosing the bucket handle tear (BHT) of the knee meniscus.Methods Eighty four knees which underwent both MRI and arthroscopy (AS) examinations were analyzed. Results of AS were used as golden standard to evaluate the results of MRI. The evaluating criteria included primary reports, central displaced fragments of meniscus (CDFM), double posterior cruciate ligament sign (DPCLS) and the absent bow tie sign (ABTS). Results For MRI diagnosing BHT, the sensitivity and specificity of primary reports were 43% and 87%, respectively; the sensitivity and specificity of CDFM were 72% and 87%, respectively; the sensitivity and specificity of the DPCLF were 31% and 97%, respectively; and the sensitivity and specificity of the ABTS were 71% and 69%, respectively.Conclusions When MRI was applied to diagnose BHT, the CDFM had higher sensitivity and specificity, while the ABTS had higher sensitivity and lower specificity. The DPCLF had the highest specificity and the lowest sensitivity.

5 mm. Oblique coronal MR of secrum could show the full length of sacral never. There were some primiral espression of MR of sacral neurological dam-age -- the variation of sacral never canal, the fatty disappearance of peri-never, the route alteration of never. 14 patients were followed up from 6 to 12 months with an average of 7.1 months. According to the BMRC score system the excellent result was obtained in 9 cases, good in 1 case, no change in 1 case. Con-clusion Clinic history and neurological examination associated with X-ray, CT and MRI was the important of the diagnosis of sacral neurological damage, the new surgical approach may be a ideal approach to treat sacral neurological damage in the sacral nerve canal region.

Objective:To assess capacity of cardiovascular disease diagnosis and treatment service in primary health care (PHC) in Beijing-Tianjin-Hebei region.Methods:From September to December 2016, document acquisition and abstraction and in-person interviews were conducted on 327 PHC institutions and their medical staff from 43 districts/counties in the Beijing-Tianjin-Hebei region to comprehensively assess their infrastructure and services, human resources, health information system and drug availability related to cardiovascular disease diagnosis and treatment.Results:⑴ Infrastructure and services: 30.0% Community Health Center (CHC) and 100.0% Township healthcare center (THC) provided inpatient services, 20.5%, 98.1% village clinic (VC) could not provide blood glucose tests and lipid tests, respectively; ⑵ Human resources: in CHC, THC or CHS, 19.6% doctors' educational levels were below the requirement for a licensed assistant doctor, and in VC, 32.4% doctors' educational levels were below the requirement for village doctors. 56.3%CHC、THC and CHS, 99.5% VC could not provide government-funded " four insurances and one allowance" for non-registered staff, and 30.0% village doctors had exceeded 60 years old; ⑶ Health information system: 40.0% CHC, 41.7% THC, and 0 VC had electronic medical record (EMR), respectively; ⑷ Drug availability: 71.9% PHC institutions stored all four types of antihypertensive drugs [angiotensin-converting enzyme inhibitors/angiotensin receptor blockors (ACEIs/ARBs), β-blockers, calcium channel blockers (CCBS), diuretics], and 2.1% did not have any.Conclusions:The capacity of cardiovascular disease diagnosis and treatment services in PHC institutions in Beijing-Tianjin-Hebei region are fair in general, but efforts should still be made to enhance the infrastructure construction, improve the remuneration packages of PHC doctors, promote the comprehensive ability of PHC doctors, optimize the layout of urban and rural health resources, strengthen the information construction, and improve the joint development of medical system in the three cities and provinces.

Purpose To investigate the mutation status of KRAS and PIK3CA gene in colorectal cancer (CRC) primary lesions and corresponding liver metastasis and its clinical significance.Methods The gene mutations of KRAS and PIK3CA were detected in 58 cases of primary lesions of CRC and corresponding liver metastasis tissue by real-time PCR.Results The mutation rates of KRAS were 31.03％ (18/58) and 25.86％ (15/58) in primary lesions of CRC and corresponding liver metastasis tissue,respectively,in which G12D was most commonly detected.The mutation rates of PIK3CA were 8.62％ (5/58) and 10.34％ (6/58) respectively,in which the most common mutation site was E545K.Only one case carried simultaneously both mutations of KRAS (G12D) and PIK3CA (E545K).The mutation of KRAS and PIK3CA had a good consistency between primary lesions and liver metastasis.Univariate analysis showed that the mutation of KRAS was related to the primary lesion of tumor location,the quantity of metastasis and the types of tumor (P ＜ O.05),PIK3 CA mutation was associated with the synchronous/metachronous liver metastasis and the quantity of metastasis (P ＜ 0.05).Multivariate Cox regression analysis showed that synchronous/metachronous liver metastasis and the mutation of KRAS were influencing factors for prognosis of CRC.The overall survival of patients with CRC who had simultaneous liver metastases was longer than those with heterotopic liver metastases;the overall survival of KRAS wild-type mutant patients was longer than those of mutant patients (P ＜ 0.05).Conclusion The G12D site of KRAS gene has the highest mutation frequency in CRC,KRAS/PIK3CA mutation has a good consistency of the primary lesions of CRC and corresponding liver metastasis.Primary lesions can be as the source of molecular detection.To achieve individualized treatment,we need to reassess the genetic status of metastasis based on the choice of targeted therapy for precision medicine.

Objective To study the serum iaminin (LN) and fibronectin (FN) changes in acute coronary syndromes (ACS), and explore the role of them in assessing the severity of ACS. Methods This study included 46 ACS patients [25 with acute myocardial infarction (AMI) and 21 with unstable angina (UA)], 51 stable angina (SA) patients and 47 people without CHD as controls. Serum levels of LN, FN, fibrinogen and blood fat were assessed. Coronary angiography were performed on 49 of them. Results The serum concentration of LN was lower in ACS patients [(85.20±27. 57)ng/mL], higher in SA patients [(116. 80 ± 28. 80)ng/mL] as compared to that in the control group [(100.06±29.96)ng/mL], with significant difference among the groups (P<0.05). No difference was found in FN among the three groups. However, the subgroup analysis in the group with ACS showed that the serum concentration of FN was significantly higher in UA patients [(229.60±121.39)μg/mL ], and lower in AMI patients [(108.31±47.12) μg/mL ]. The serum LN and FN concentration could respectively enter the logistic regression equations of ACS patients and US patients. Neither LN nor FN concentration was correlated with narrowing of coronary artery of angiography. Conclusion Serum LN and FN level may be a useful indicator for stability of atherosclerosis plaque in coronary arterial disease patients, but could not predict the extent of narrowing in coronary angiography.

Objective: To assess trends of β-blocker use within 24h of admission in ideal candidates with acute myocardial infarction (AMI) in eastern urban China from 2001 to 2011. Method: A 2-stage random sampling design was performed. In the first stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select cases from the participating hospitals. Data was obtained by central medical record abstraction. 10-year trend and predictors of early β-blocker application were assessed with weighted calculation for each year to represent the overall situation of eastern urban China. Results: 35 hospitals were sampled and 32 of them were finally participated. With necessary exclusion, 1399 ideal candidates were included in this analysis. The early weighted β-blocker application rates in 2001, 2006 and 2011 were 64.7%, 69.7%, and 60.9% respectively, P=0.0447 for trend. Patients with chest pain at admission (OR=2.22, 95% CI 1.19-4.13), higher systolic blood pressure (OR=1.40, 95% CI 1.11-1.77) or faster heart rate (OR=2.01, 95% CI 1.58-2.55) were more likely to use β-blocker; in contrast, compared with NSTEMI patients, STEMI patients seemed less likely to receive such treatment (OR=0.55, 95% CI 0.37-0.81). Conclusion: The early β-blocker therapy in eastern urban China is suboptimal for ideal AMI patients who could benefit from it. The application pattern has not been changed from 2001 to 2011 which might be related to physicians' misunderstanding of relevant evidence or guidelines. Our study may help to create an important target to improve the quality of AMI care.

Objective To investigate the value of drug intervention for difficult weaning from mechanical ventilation. Methods A prospective single-blind randomized controlled trial was conducted. 120 patients with difficult weaning from mechanical ventilation encountered in Department of Critical Care Medicine of Peking University Third Hospital from January 2008 to December 2013 were included,and the patients were divided into treatment group and control group according to random number table,with 60 cases in each group. Patients received furosemide therapy in the treatment group 3 days before weaning up to 48 hours after weaning in order to control negative liquid balance. Enema was given the day before weaning to reduce abdominal pressure. On the weaning day,all of the patients received nitroglycerin and beta blocker or cedilanid to prevent or control elevation of blood pressure and heart rate in the process of weaning. All patients in treatment group received anisodamine in small dosage 2 hours before extubation.The patients in control group received conventional treatment without drug intervention. Baseline indexes of two groups were compared,including the heart rate,respiration rate(RR),mean arterial pressure(MAP),pulse blood oxygen saturation(SpO2),blood gas,hemoglobin(HG),albumin(ALB)and creatinine(Cr). The main reasons of difficulty in weaning,sedative and analgesic drug selection,presence of abdominal discomfort before weaning,interval between sputum suction before extubation,liquid balance at the beginning of the investigation and at time of weaning,24 hours and 48 hours after weaning,failures of spontaneous breathing test(SBT),length of mechanical ventilation,length of ICU stay,and total length of mechanical ventilation and total length of ICU stay during hospitalization. Results There was no statistically significant difference in the heart rate,RR,MAP,SpO2,blood gas,HG,ALB,Cr at the beginning of the investigation between the two groups. The main reasons for difficult weaning in both groups of patients were respiratory dysfunction,cardiac insufficiency,and central nervous system dysfunction. The use of propofol combined dexmedetomidine in the treatment group was more frequent than the control group〔16.7%(10/60)vs. 1.7%(1/60),χ2=8.107,P=0.004〕,and there was no statistically significant difference in the use of other combinations of sedative drugs between the two groups. Abdominal discomfort before weaning was milder in treatment group as compared with control group〔10.0%(6/60)vs. 25.0%(15/60),χ2=4.675,P=0.031〕. The interval between sputum suction before extubation in the treatment group was significantly longer than that of the control group〔hours:1(1,2)vs. 1(1,1),Z=-2.209,P= 0.027〕. SBT failure was less frequent in treatment group compared with control group〔times:0(0,1)vs. 1(1,2),Z=-6.561,P=0.000〕. Liquid balance was better in the treatment group than the control group at time of weaning,24 hours and 48 hours after weaning〔at time of weaning:-567.71 (-755.95,-226.41)vs. 1 256.76(472.48,1 796.63),Z=-9.038,P=0.000;24 hours after weaning:-5.03 (-530.28,245.09)vs. 342.28(125.36,613.25),Z=-4.711,P=0.000;48 hours after weaning:115.50(-450.26, 485.00)vs. 330.00(16.25,575.25),Z=-1.932,P=0.053〕. Compared with control group,length of mechanical ventilation〔days:1.0(1.0,2.0)vs. 2.0(2.0,3.0),Z=-6.545,P=0.000〕,ICU stay time〔days:3.0(3.0,4.0) vs. 4.0(4.0,5.0),Z=-6.545,P=0.000〕,and total length of mechanical ventilation〔days:8.0(6.0,12.0)vs. 11.0(8.0,15.0),Z=-4.091,P=0.000〕and total length of ICU stay during hospitalization〔days:12.5(9.2,19.0) vs. 17.0(12.0,29.5),Z=-2.722,P=0.000〕were all significantly shorter in the treatment group. Conclusions Adjuvant drugs therapy is helpful in patients weaning from the mechanical ventilation,and can shorten length of mechanical ventilation and ICU stay time. Propofol,combined dexmedetomidine,is helpful for weaning.