BACKGROUND: Tissue engineering has a promising prospect in corneal transplantation. Scaffolds are always restricting the development of tissue-engineered cornea. OBJECTIVE: To analyze application of different seed cells and scaffolds, and to summarize the progress of tissue-engineered cornea in recent years.METHODS: First author searched literature from CNKI (2000/2010-10) and PubMed database (2000/2010-10). The key words are tissue engineering, corneal transplantation in Chinese or English. A total of 223 literatures were seized by computers, according to the inclusion criteria, papers concerning the advance, application and reconstruction of tissue-engineered cornea were analyzed. Finally, 33 papers were included for further analysis. The present study was to analyze the seed cells, scaffolds, organ building and clinical applications of tissue-engineered cornea and investigate the development direction in the future. RESULTS AND CONCLUSION: The results show that seed cells and scaffolds are the focus of the studies now. Corneal transplantation has a high success rate in organ transplantation since the immune privilege of eye and avascular cornea, and it will be able to be a tissue engineering organ that can be largely built, easy to transplant. Reconstruction of cornea has reached first base, but every kind of scaffold has certain drawbacks, so the next goal is to find an ideal scaffold material.

BACKGROUND; As the bridge vessel, radial artery is easy to occur spasm and injury of endometrium, and the abnormal proliferation of endometrium, re-vasospasm, etc. appear at early period postoperatively, which can affect the operative outcomes.OBJECTIVE: To compare the effects of nitroglycenn (NTG), verapamil (VP), paraverine (PA), and the mixture of NTG and VP on relaxing spasm of radial artery in human being.DESIGN: A randomized controlled trial.SETTING: Department of Cardiosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA.PARTICIPANTS: Thirty patients who underwent coronary artery bypass graft (CABG) with autologous radial artery, were selected from the Department of Cardiosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA from September to November in 2006, including 18 males and 12 females, 48-74 years of age. Informed consents were obtained from all the patients or their relatives preoperatively.METHODS:① The samples of human radial artery in CABG were collected, and totally 95 vascular rings were used in this study. The rings were divided into five groups: NTG group, VP group, PA group, VP+NTG group and control group.There two parts of the experiment, vasospasm relaxation test and vasospasm prevention test. The vascular rings in the control group were only immersed in the Krebs- Ringer solution without any drug. ② Drugs: NTG was purchased from Solo Pak Laboratories (Franklin Park, IL), PA from Eli Lilly & Co., (Indianapolis, IN), VP and others from Sigma (St.Louis, MO). ③ Thirty vascular rings were used in the vasospasm relaxation test, and the method of bath chamber was applied. Deoxyepinephrine (terminal concentration of 1 ×10-3 mol/L) was added to stimulate the contraction and spasm of the vascular rings, then four vasodilatators were added, the concentrations of VP and NTG were 30 μmol/L, and that of PA was 0.1%. Relaxation rate=(resting tension after stimulation-initial resting tension)/initial resting tension× 100%. ④ The other 60 vascular rings were used in the vasospasm prevention test. Firstly, the rings were immersed in the four solutions of vasodilatators of corresponding concentrations and Krebs- Ringer solution respectively for 30 minutes. After pretreatment, the vascular rings were randomly divided intc normothermia group (n =30) and cryopreservation group (n =30). In the cryopreservation group, the vascular rings were put into the Krebs-Ringer buffer solution at 4 ℃, and kept in refrigerator at 4 ℃ for 24 hours. The spasms of radial artery were observed.MAIN OUTCOME MEASURES: Changes of resting tension (degree of contraction and relaxation rate of dilatation) of vascular rings before and after administration.RESULTS: ① Effect on the dilatation of spastic radial artery: The radial artery was completely within 11 minutes in all the VP+NTG group, VP group, NTG group and PA group. But in the first 3 minutes, the dilating effects of VP+NTG and NTG were obviously better than the other two groups. The dilatation curves showed that the dilating ability in order was VP+NTG ＞ NTG ＞ VP ＞ PA. ② Effect of pretreatment of radial artery on antispasm: In the normothermia group, the contractility of the vascular ring produced by 1 ×10-3 mol/L deoxyepinephrine was close between the VP+NTG group and VP group [(0.47±0.06), (0.49±0.08) g, P ＞ 0.05], which were obviously different from those in the NTG group and PA group [(0.81±0.22), (0.87±0.26) g, P ＜ 0.05]. After cryopreservation for 24 hours, the contractility in the VP+NTG group was not obviously different from that in the VP group [(0.86±0.11), (0.90±0.13) g, P ＞ 0.05], and obviously lower than those in the NTG group, PA group and control group [(4.82±0.87), (5.00±0.53), (5.10±0.67) g, P ＜ 0.01], whereas those in the NTG group and PA group were close to that in the control group (P ＞ 0.05).CONCLUSION: The drugs can prevent and relax the spasm of radial artery to different extents, whereas considering from preventing spasm and the time-effect of treatment, the mixture of VP and NTG seems to be more proper as the preparation solution for the treatment of radial artery in CABG.

Objective To evaluate the medium and long term safety and efficacy of sacrospinous ligament fixation (SSLF) performed with conventional instruments in treating stage Ⅲ-Ⅳ pelvic organ prolapse (POP).Methods A prospective cohort analysis was conducted in the Peking Union Medical College Hospital,between May 2007 and June 2015,enrolling 55 women with stage Ⅲ-Ⅳ POP who intended to receive SSLF.Primary end points were objective success rates using pelvic organ prolapse quantitation system (POP-Q) and subjective satisfaction rates with questionnaires after surgery according to vaginal examination and related questionnaires for all patients who received SSLF eventually.Exploratory outcomes included perioperative parameters and complications.Results Of these 55 POP patients enrolled,52 (95％,52/55) received SSLF using conventional surgical instruments,the other 3 cases converted to ischial spinous fascia fixation due to difficulty exposing.Medium blood loss during operation was 100 ml (20-300 ml) and operative time 60 minutes (20-165 minutes).Pelvic hematoma with diameters of 5 cm and 7 cm were observed in two patients,both recovered fully with conservative methods.All patients were able to micturate spontaneously after catheter withdrawal.One patient reported right thigh pain after operation which remained till 3-month follow-up and relieved after physiotherapy.The objective success rate was 100％ (52/52) at 3 months.With a medium follow-up time of 23.7 months,the objective success rate was 98％ (51/52),the recurrence rate was 2％ (1/52) and the satisfactory rate was 94％ (49/52).De novo urinary incontinence occurred in 6％ (3/52) of patients.Conclusion Most POP could be corrected with SSLF using conventional instruments which is a feasible,economic and effective procedure for Asian patients with medium compartment prolapse.

Objective:To explore a new method of the cultivation of adoptive immunotherapy cells.Methods: Mononuclear cells was isoplated by density gradient centrifugation and then proliferated by using CD 40-agonist monoclonal antibody 5C11、cytokine of IFN-αand IL-7(CD40 group)in vitro.During the culturing procedure ,the cell morphology was obersved by optical microscope.The percentage of T-lymphocytes, NK-T cells, Treg cells and the cell proliferation, which were compared with CIK group CD3mAb activated,was detected on the 9th day.Results:There was no significant difference of CD 4+/CD8+T cells percentage between the two groups.But the Treg cells percentage of CIK group was far higher than that of CD 40 group,while the percentage of CD3+CD56+NK-T cells was lower than that of CD 40 group.And a group of Mo-NK-DC cells were observed in the CD 40 group.Conclusion: The new method of adoptive immunity therapy has been established in this study could increase the percentage of NK -T cells which had the ability to kill tumor cells.Simultaneously ,it is reduced the amount of Treg cells significantly.

Objective To investigate the effects of reducing the auditory organ dose by limitation of sub regional auditory organ in IMRT plan. Methods Total 223 cases of nasopharyngeal carcinoma patients were divided into group A and group B. In group A, the IMRT plans of 114 patients were designed by limiting overall auditory organ dose. In group B, the IMRT plans of 109 patients were designed by limiting sub regional auditory organ dose. According to the Clinical prescription, the IMRT plans were designed. Paried t?test was difference between groups. Results By comparing the two groups of auditory organ dose, in all stages, the tympanic cavity Dmean average in group B decreased by T1 vs. 17?? 7%,T2 vs. 22?? 4%,T3 vs. 15?? 7% and T4 vs. 14?? 2% ( P= 0?? 000,0?? 000,0?? 000,0?? 000);cochlea Dmean average decreased by T1 vs. 11?? 0%, T2 vs. 20?? 1%, T3 vs. 10?? 0% and T4 vs. 9?? 0%(P= 0?? 004,0?? 000,0?? 007,0?? 036);vestibule Dmean average decreased by T1 vs. 22?? 6%, T2 vs. 31?? 8%, T3 vs. 20?? 6% and T4 vs. 21?? 4%, significantly less than in group A (P= 0?? 000,0?? 000,0?? 000,0?? 000). The bony portion of eustachian tube Dmean average in group B decreased were not significantly less than in group A (decreased by 3?? 4%,6?? 8%,3?? 6%,0?? 1%;P= 0?? 291, 0?? 006,0?? 155,0?? 963). Conclusions In IMRT plan, optimization on dose limitation of sub regional auditory organs were used to reduce the auditory organ dose and decrease the radiation damage to auditory organ.

OBJECTIVE:To systematically evaluate the efficacy and safety of glutathione (GSH) in preventing oxaliplatin-in-duced peripheral neurotoxicity(OIPN),and to provide evidence-based reference in the clinic. METHODS:Randomized controlled trials (RCTs) about therapeutic efficacy of GSH vs. placebo/no any measures (called placbo group) or other drug in preventing OIPN were retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database and VIP. Meta-analysis was performed with Rev Man 5.3 statistical software after data extraction and quality evaluation with Jadad scale. RESULTS:18 RCTs were in-cluded,involving 1200 patients. The results of Meta-analysis showed that:total incidence of oxaliplatin-induced chronic peripheral neurotoxicity (OICPN)[RR=0.71,95%CI(0.59,0.87),P<0.001] and the incidence of severe OICPN [RR=0.50,95%CI(0.42, 0.60),P<0.001] in GSH group were significantly lower than placebo group,with statistical significance;there was statistical signif-icance in the incidence of oxaliplatin-induced acute peripheral neurotoxicity(OIAPN)[RR=0.89,95%CI(0.72,1.09),P=0.25]. The incidence of severe OICPN in GSH group was significantly higher than mecobalamine group,with statistical significance [RR=2.06,95%CI(1.07,3.99),P=0.03]. There was no statistical significance in the incidence of OICPN[RR=1.38,95%CI(0.83,2.31), P=0.21] and severe OICPN [RR=1.91,95%CI(0.85,4.30),P=0.12] between GSH group and Ca+Mg mixture group. CONCLU-SIONS:GSH can effectively prevent the occurrence of OICPN,however,its therapeutic efficacy is equivalent to Ca+Mg mixture and inferior to mecobalamine in preventing severe OICPN.

Objective:To investigate the effect and prognostic factors of rituximab-containing chemotherapy regimen in treatment of patients with mantle cell lymphoma (MCL).Methods:The clinical data of 56 patients aged ≤65 years in the First Affiliated Hospital of Soochow University from June 2007 to November 2018 were retrospectively analyzed. Rituximab-containing chemotherapy regimen was used, and the effects of clinical features, treatment regimen and biological indexes on overall survival (OS) and progression-free survival (PFS) were observed.Results:The median age of 56 patients was 57 years old, including 43 males and 13 females. Among these cases, 24 patients received R-CHOP chemotherapy regimen; 29 patients received cytarabine-containing chemotherapy regimen, including R-hyper CVAD/R-MA regimen used in 15 patients and R-CHOP alternating with R-DAHP regimen used in 14 patients; and 3 patients received other treatment regimens. Among 56 patients, 19 patients received autologous hematopoietic stem cell transplantation (ASCT) consolidation therapy. The median OS time was 74 months, 2-year OS rate was 83.8%, 3-year OS rate was 70.9%, 2-year PFS rate was 72.0% and 3-year PFS rate was 49.7%. International prognostic index (IPI) high-risk and receiving ASCT or not during the treatment were independent influencing factors of OS and PFS in MCL patients. The overall response rate (ORR) in cytarabine-containing regimen group was higher compared with that in R-CHOP regimen group (93.1% vs. 83.3%), and there was no statistically significant difference ( χ2=0.465, P=0.495). In addition, there were no significant differences between two groups in both OS ( χ2=0.291, P=0.590) and PFS ( χ2=0.912, P=0.339). ASCT consolidation prolonged the median OS time (72 months vs.124 months, χ2=3.973, P=0.040) and the median PFS time (34 months vs. 90 months, χ2=3.984, P=0.046) in MCL patients achieving remission after induction therapy. Among patients in simplified MCL IPI (sMIPI) score middle-high risk group, compared with those not receiving ASCT, patients receiving ASCT therapy could obtain better OS and PFS (OS: χ2=5.037, P=0.025; PFS: χ2=6.787, P=0.009); among patients of sMIPI score low risk, there were no statistically significant differences in OS and PFS between the group receiving ASCT and not (all P > 0.05). Conclusions:Cytarabine-containing chemotherapy regimen has no predicatively satisfactory value in improving the prognosis and survival for MCL patients. For MCL patients who have achieved remission after reduction therapy and those in sMIPI score middle-high risk group, ASCT consolidation therapy can improve the prognosis and can be taken as the first-line consolidation treatment in young patients.

Objective:To investigate the effects and mechanisms of curcumin on insulin resistance in streptozocin-induced diabetic rats.Methods:Diabetic rats were induced by intraperitoneal injection of STZ, then all the rats were randomly divided into diabetes (DM), diabetes+ curcumin (DM+ Cur), and diabetes + buffer control (DM+ NC) groups. Normal SD rats were used as control group (NC). The DM+ Cur group was treated with curcumin, while the DM+ NC group was treated with equal-volume buffer. The test lasted 12 weeks. The blood glucose was detected, and hyperinsulinemic-euglycemic clamp test was performed to estimate peripheral insulin resistance. At the end of the experiments, rats were killed and the total protein and cell membrane protein were extracted from skeletal muscle. The levels of phosphorylated PI3K, phosphorylated AKT, total PI3K, and total AKT were measured by Western blot. The levels of total GLUT4 and GLUT4 of cell membrane were also detected by Western blot, GLUT4 levels in skeletal muscle cell membranes were detected by immunofluorescence.Results:Blood glucose levels of DM+ Cur group were lower than those of DM group [(18.67±1.99 vs 24.38±2.88) mmol/L, P<0.05], and insulin resistance was also improved[the average GIR(14.69±0.29 vs 10.25±0.30) mg·kg -1·min -1, P<0.01]. The phosphorylation levels of PI3K and AKT were increased, and GLUT4 translocation to the cell membrane was increased. Conclusion:By activating the PI3K/AKT pathway, curcumin promotes GLUT4 translocation, increases skeletal muscle glucose uptake, and finally improves insulin resistance.

Objective To evaluate the correlation between seram interleukin-10 (IL-10) and testosterone with coronary heart disease (CHD). Methods 387 patients were divided into CHD group (n = 239) and control group ( n = 148 ) according to the results of coronary angiography. CHD patients were divided into subgroups accord-ing to the numbers, Gensini score of lesions in the coronary arteries and clinical severity ( statue of stable coronary artery disease, unstable angina or acute myocardial infarction). Serum IL-10 and testosterone levels were measured by ELASA. Logistic regression and partial correlation were used to evaluate the correlation of serum IL-10 and testoster-one with CHD. Results IL-10 was significantly lower in the CHD group than in the control group[ (39.08 ± 14.22) ng/L vs (49.27 ± 24.67)ng/L, P < 0. 001 ]. The partial correlation analysis results in subgroups showed that the correlation coefficient of IL-10 with number of lesions,gensini score and clinical severity of CHD was - 0.25, P < 0.001, -0.25 ,P <0.05 and -0.25 ,P <0.001 ,respectively. Serum testosterone had no difference in control group and CHD group (P >0.05 ). Logistic regression analysis found that only smoking (OR = 3.79,95% CI 2.09～ 6.84,P<0.01) ,diabetes mellitus (OR =2.48,95% CI 1.05 ～5.88,P <0. 05) ,apoB ( OR = 14.3,95% CI 4.29～46.61 ,P <0.01 ) and IL-10 ( OR =0.74,95%, CI 0.57～0.89 ,P <0.01 ) entered the model. Conclusions Serum IL-10 is not only significantly correlated with CHD but also with its severity. IL-10 is an independent pro-tective factor for CHD.

Objective To explore the psychological experience of ICU nurses who had worked follow different work patterns, and find the most appropriate staffing model. Methods A phenomenological approach of qualitative research was conducted in 5 ICU nurses by intensive interview,then the data collected were read, analyzed, reflected,finally the theme was got. Results In the work pattern of shifted every 12 hours, with low work frequency and strong feeling of fatigue. In the work pattern of shifted every 8 hours, with high work frequency and the disadvantage of nurse- patient relationship. In the short-time continuous APN work pattern, with continuous management of patients' condition, promotion of nurse-patient relationship, improvement of doctor-nurse relationship, comparatively stable biological clock. Conclusions The short-time continuous APN work pattern can concentrate nurses' work and rest time, relieve the press that caused by the shifted work, at the same time, promote the patients',patients' family and doctors' satisfaction degree with nursing work, increase nurses' effect in the ICU team, guarantee the quality of care, eventually ensure the patients' safety.