BACKGROUND:To construct tissue engineering cartilage would open up a novel way for the repair of cartilage damage in avoidance of the disadvantages of traditional therapeutic method.OBJECTIVE: To probe the techniques for the isolation of mesenchymal stem cells (MSCs) from bone marrow, as well as the in vitro differentiation into chondrocytic phenotype in a specific culture fluid.DESIGN:A complete randomized experimentSETTING:The Department of Traumatic Orthopedics and Hand Surgery of the First Affiliated Hospital of Guangxi Medical University, and Teaching and Research Faculty of Histology and Embryology of Guangxi Medical University.METHODS: The experiment was carried out at Guangxi Medical University between August 2002 and April 2003. Twenty SD neonatal weaning rats were selected. Bone marrow was aspirated from the bones of rat limbs and was isolated by gradient centrifugation in Percoll, and MSCs could be obtained in combination with adherent screening method, which were then cultured in DMEM-LG with 15% fatal bovine serum (FBS) in the incubator of 37℃ with 5% CO2 for 10-14 days. The passage cells were induced in DMEM-HG with 15% FBS (containing TGF-β1 10 μg/L, 10-7 mol/L dexamethasone, 50 mg/L VitC).MAIN OUTCOME MEASURES :The morphology, growth, as well as proliferation and specific expression of chondrogenic matrix of in vitro cultured MSCs due to specific induction.RESULTS: Totally 20 SD rats were observed and analyzed with no loss SCs grew in visible symmetric colonies, displaying a long-spindle shape,and the morphological characteristics of marrow-derived MSCs had no obvious changes during passage-culture, but its proliferation time was found from a shuttle fibroblastic appearance to polygonal shape, displaying posiHC staining of type Ⅱ collagen of cartilage specific matrix.bronectin adherent screening technique is a convenient, effective and practical method to separate and collect MSCs from rat bone marrows in chondrogenic phenotype when induced by a specific medium and can secrete cartilage specific matrix, and they can be the optimal seed cells for cartilage tissue engineering.

Objective To explore the influence of the length of time elapsed from ingestion of paraquat to hemoperfusion on prognosis in patients with acute paraquat poisoning.Methods The investigation was carried out with retrospective analysis.A total of 303 patients with acute paraquat poisoning were admitted to the Emergency Intensive Care Unit (EICU) of the First Affiliated Hospital of China Medical University from January 2009 to December 2012.According to the length of time between ingestion and hemoperfusion,patients were divided into three groups,Group A:the time interval between ingestion and hemoperfusion ＜ 4 h ; Group B:4h ≤ the time interval between ingestion and hemoperfusion ＜ 8 h; Group C:8 h≤the time interval between ingestion and hemoperfusion ＜ 12 h.Compared the extent of target organ injury,28-d mortality and the survival time of non-survivors among three groups for determining the influence of the length of time elapsed from ingestion to hemoperfusion on the prognosis of patients.Results Totally 303 patients with average age of 34.8 ± 10.8 years old (ranging from 15 to 72 years),and 117 male and 186 female.The median estimated amount of 20％ paraquat ingested was 50 mL (ranging from 10 to 270 mL,IQR:45 mL).The hemoperfusion was employed (3.6 ±1.2) times (ranging from 2 to 5 times) for every paitient within 24 h after ingestion.The overall mortality rate was 68.6％ (208/304)during a 28 days follow-up period,and only 95 of 303 patients survived.The median length of time between paraquat ingestion and hemoperfusion at the emergency department was 6.6 h (ranging from 1.4 to 11.5 h,IQR:3.5 h).However,it was 7.2 h (ranging from 3.1 to 11.5 h,IQR:2.4 h) in non-survivors and 4.9 h (ranging from 1.4 to 7.6 h,IQR:1.5 h) in survivors.The difference was statistically significant (U =2.014,P =0.043).The difference in 28-day mortality among three groups was statistically significant (x2 =9.27,P =0.009),and the difference in average survival time of non-survivors among three groups was statistically significant (F =3.31,P =0.038).The length of time between ingestion and hemoperfusion and the survival time of non-survivors was a negative correlation (r2 =0.421,P =0.045).The difference in ALTmax,SCrmax,AMYmax and PaO2 min,as the severity indicators of acute liver injury,acute kidney injury,acute pancreas injury and acute lung injury among the three groups were statistically significant (all P ＜ 0.05).Conclusions Employment of hemoperfusion within 4 h after ingestion can attenuate the degree of target organ injury,reducing 28 day mortality of patients with acute paraquat poisoning.

Metastasis is the essential character of biological behaviors in malignancies,which is also the main reason for the death of patients with tumor. So it is very important to research the metastasis for the pre-vention and treatment of carcinomas. Rectal cancer is one of the most common gastrointestinal cancer,and its prognosis is bad. lymphatic metastasis is one important factor in the determination of colon cancer' s progno-sis. More than 50% patients are found lymphatic metastasis when taking operation. The ralationship of lym-phatic metastasis and prognosis is more important than the original tumor's invasiving. So it is meaningful to study the mechanism of tumor metastasis, and to provide a scientific approach to the prediction of tumor me-tastasis, the precise assessment of prognosis and the treatment of tumor metastasis.

Objective:To investigate the clinical effect of liver transplantation from organ donors in elderly patients.Methods:The clinical data of 346 patients who underwent liver transplantation in the general surgery center of Beijing You′an Hospital Affiliated to Capital Medical University from January 2018 to November 2020 were retrospectively analyzed. After screening, they were divided into the elderly donor group (30 cases) aged 60-70 years and the non elderly donor group (60 cases) aged < 60 years. The observation indexes were operation time, anhepatic phase time and operation bleeding. The prognosis indexes were: postoperative ICU stay, length of hospital stay, primary graft nonfunction (PNF), delayed graft function recovery (DGF) and in-hospital mortality. The measurement data in accordance with normal distribution are expressed as ( Mean± SD). The comparison between the two groups was analyzed by t-test. The measurement data that did not conform to the normal distribution were expressed as median (range). Mann Whitney U test was used for comparison between the two groups. The counting data were collected by the computer χ2 test or Fisher′s exact test analysis. Results:The operation time, anhepatic period and blood loss in the elderly group were (444.33±72.44) min, 56.0 (30-170) min, 1 992.1(400-9 000) mL, respectively and the non elderly group were (460.88±91.32) min, 58.45 (35-140) min, 1 885.8(400-12 000) mL, respectively, there were no significant difference between the two groups ( P>0.05); Among the prognostic indicators, the length of stay in ICU, the length of stay in hospital and the in-hospital mortality of the elderly group were 4.9 (2-21) d, 20.4 (3-40) d and 10% respectively, while the length of stay in ICU, the length of stay in hospital and the in-hospital mortality of the non elderly group were 5.3(1-32) d, 22.1(3-61) d and 10% respectively, with no significant difference between the two groups ( P>0.05); No PNF occurred in the two groups, but the incidence rate of DGF in the elderly group was 13.33%(4/30), and the non elderly group was 1.67%(1/60). There was a significant difference between the two groups ( P<0.05). Conclusion:Under strict preoperative donor evaluation and accurate recipient selection, 60-70 years old donors can achieve similar short-term effect as non elderly donors, but the long-term effect needs further observation.

OBJECTIVETo investigate the factors which may influence the imatinib plasma concentration in Chinese patients with gastrointestinal stromal tumor(GIST), and to illuminate the significance of monitoring imatinib plasma concentration in adjuvant therapy for patients with GIST.

METHODSA cross-sectional study with 60 GIST patients who accepted the imatinib therapy after surgery was conducted. They were respectively administrated in 10 domestic hospitals from December 2014 to April 2016, including The First Affiliated Hospital of Nanjing Medical University(n=28), The Affiliated Hospital of Nantong University(n=9), The Affiliated Hospital of Xuzhou Medical College(n=6), Nanjing Drum Tower Hospital(n=5), The Second Affiliated Hospital of Nanjing Medical University (n=2), Jingling Hospital (n=2), The Second People's Hospital of Lianyungang(n=2), Shandong Provincial Hospital(n=2), Jiangsu Province Tumor Hospital(n=2), and The First Affiliated Hospital of Zhejiang University(n=2). Some specific time points for collecting blood sample before and after taking imatinib were determined, then liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used for monitoring imatinib plasma concentration in patients with GIST. Linear regression analysis was used for the correlation analysis of imatinib plasma concentration with dosage, clinicopathologic feature and side effect.

RESULTSPatients who could not tolerate 400 mg imatinib per day(n=3) received 300 mg per day. There was no significant difference in imatinib plasma concentration between patients with 300 mg and those with 400 mg imatinib(n=53)(P=0.527). However, the imatinib plasma concentration in patients with 600 mg imatinib per day (n=4) was significantly higher as compared to those with 400 mg(P=0.000). Linear regression analysis indicated a negative correlation between the imatinib plasma concentration in patients with 400mg imatinib per day for 90 days continuously and body surface area(R=0.074, P=0.035), but no significant correlations of with age, creatinine clearance and serum albumin concentration were observed (all P>0.05). The differences in imatinib plasma concentration were not statistically significant between patients of different gender and those taking proton-pump inhibitor (PPI) or not (both P>0.05). Difference in imatinib plasma concentration between patients with different surgery was significant (P=0.026). Compared to patients who underwent wedge resection, enterectomy and other surgeries, the imatinib plasma concentration of patients with subtotal gastrectomy or total gastrectomy decreased significantly (all P<0.05). After 90 days of taking imatinib continuously, linear regression analysis revealed a negative correlation between imatinib plasma concentration in patients with 400 mg imatinib per day and white blood cell count (R=0.103, P=0.013), and a positive correlation with serum alanine aminotransferase (ALT) concentration (R=0.076, P=0.033).

CONCLUSIONSThe imatinib plasma concentration in patients with larger body surface area, subtotal gastrectomy or total gastrectomy may be lower. For these patients, dosage of imatinib should be considered to increase in order to achieve effective plasma concentration. Excessive imatinib plasma concentration can result in some side effects, such as decrease of white blood cells and liver damage. Therefore, it is significant for receiving optimal clinical therapeutic efficacy to monitor imatinib plasma concentration, adjust imatinib dosage timely and keep imatinib plasma concentration in effective and safe range.

Adult ; Antineoplastic Agents ; administration & dosage ; pharmacokinetics ; Benzamides ; Combined Modality Therapy ; Cross-Sectional Studies ; Female ; Gastrectomy ; Gastrointestinal Stromal Tumors ; drug therapy ; surgery ; Humans ; Imatinib Mesylate ; administration & dosage ; pharmacokinetics ; Male ; Middle Aged ; Piperazines ; Pyrimidines ; Tandem Mass Spectrometry