In vitro construction technology is a key approach to industrialization and clinic application of engineered cartilage. However, it is very difficult to acquire a functional engineered cartilage with the present technology. Bioreactors can simulate the cartilage microenvironment in vivo and are expected to make up the shortcoming of the present technology. Current bioreactors in use are designed according to fluid shear pressure, hydrostatic pressure and/or direct compression, all of which can promote the development and mature of cartilage in vivo. Due to the failure to achieve ideal results by a single-purpose bioreactor, it will become a development direction in future to design and produce a compound bioreactor. This article reviewed the advances in the bioreactor for cartilage tissue engineering.

It is the new aims and requests in the education of rehabilitation therapeutics,paying more attention to be attached importance of spirit innovation and improving application capacity.The authors discussed the new requires and methods applied in Jiamusi University including training the teachers,course offered,teaching methods and education substances and practical teaching,according to analyze the current situation of education in rehabilitation therapeutics in China.

ObjectiveTo study change of aminoacid content in the brain of newborn rabbits with bilirubin encephalopathy. MethodsNewborn rabbits (3-5 days after birth) with bilirubin encephalopathy were induced by administration intra peritoneally with bilirubin (200mg/kg). Aminoacid content in brain were analysed by Hitachi 835 50 type aminoacid analysis instrument.ResultsThe content of glutamate and aspartate in brain tissue with bilirubin encephopathy decrease; GABA, alanine, tyrosine, valine and pheny lalanine increase. ConclusionsThe change of content of neurotransmitters in brain indicates that excitotoxicity of EAAs may contribute to the bilirubin encephalopathy. The increase of non neurotransmitters level proves that bilirubin may inhibit the biologic composition of protein in brain.

Objective To explore the effects of core stability training on gross motor function and walking ability of children with spasticcerebral palsy. Methods 60 children with spastic cerebral palsy were divided into 2 groups. The control group (n=30) received routine rehabilitation.The experimental group (n=30) received core stability training for 15~20 minutes during exercise therapy training in routine rehabilitation.Before and 3 months after training, they were assessed with D and E domains of Gross Motor Function Measure (GMFM) andfootprints analysis. Results The scores of D and E domains of GMFM, the step length, the step width and the velocity were better after training(P<0.05), especially in experimental group (P<0.05). Conclusion Core stability training combined with routine rehabilitation is effectiveon improving gross motor function and walking ability of children with spastic cerebral palsy.

ObjectiveTo observe the effects of wrist hand orthoses on cerebral palsy children with adduction of thumb. MethodsChildren with spastic hemiplegia were divided into experimental group （14 cases) and control group （15 cases）. Children in the both groups received routine rehabilitation for 3 months. Children in experimental group wore wrist hand orthoses 4～8 h/d in addition. ResultsThe passive range of motion (PROM) and scores of Fine Motor Function Measure Scale (FMFM) significantly increased in both groups after treatment. The PROM and FMFM scores in experimental groups increased more than those in the control group after treatment （P＜0.05).ConclusionWrist hand orthoses can improve the passive adduction angle of carpometacarpal joints of thumb and the fine motor function in spastic hemiplegia children after cerebral palsy.

Objective To investigate the regulation on extracellular signal regulated kinase (ERK )1/2 and p38 signaling pathways and immune expression by moist exposed burn therapy/moist exposed burn ointment(MEBT/MEBO)in diabetic foot and their relationship ,to explore the repair mechanism of MEBT/MEBO on diabetic foot ulcers .Methods Totally 40 diabetic foot pa‐tients were treated by MEBT/MEBO ,to take wound tissue before and after treatment and detect the expression of ERK 1/2 ,p38 , MAPKK6 ,c‐myc ,Akt ,ATF2 ,IgA ,IgM ,IgG ,C3c and C4c by immunohistochemistry ,to investigate their relationship .Results Af‐ter treatment with MEBT/MEBO ,the area of foot wounds in 39 patients was reduced in different degree .Only one patient had no obvious change .14 patients(35 .00% ) were markedly effective ,25 patients(62 .50% ) and 1 patient(2 .50% ) were ineffective .Before andaftertreatment,allpositiveexpression,positiveimmunoreactivity(anyindex)andpositiveexpression(specificindex)ofsignal pathway molecules were statistically significant (P<0 .05) .While the positive rate of molecular expression in wound pathway in‐creased ,the positive expression rate of immune factor increased .Before treatment ,a small amount of immune factors were found in the wound tissue .After treatment ,the immune factors IgA ,IgM ,IgG ,C3c ,C4c were distributed widely and diffusely .Before treat‐ment ,the wound tissue showed a very small number of signal molecules .After treatment ,the signal pathway molecules MEBT/MEBO and p38 ,MAPKK6 ,c‐myc ,Akt ,ATF2 showed broad and diffuse distribution .Conclusion MEBT/MEBO may promote the expression of ERK1/2 and p38 signaling molecules and immune in diabetic foot ,p38 and ERK1/2 signaling pathway may promote the healing of diabetic foot wound by increasing the expression of immune .

Objective To investigate the use of parenteral nutrition preparations in Jiangsu Province,and to provide reference for the standardized management of parenteral nutrition preparations.Methods 720 cases using parenteral nutrition preparations from January 2017 to June 2017 in the department of general surgery of 12 hospitals in Jiangsu province were selected.The rate of nutritional risk screening,the indications of parenteral nutrition,the way of infusion,the rationality and economy of the prescriptions were retrospectively evaluated.The calorie,amino acid content,non-protein calorie/nitrogen ratio,glycolipid ratio and cation concentration of the patients received total parenteral nutrition were calculated.Results The total costs of parenteral nutrition preparations of 720 cases were 1.614 1 millions,and 346 cases did not have the indications for parenteral nutrition.The results of prescription comment showed that only 16 patients were screened for nutritional risk by Nutritional Risk Screening 2002 tool at admission.544 cases were intravenous dripped with amino acid and fat emulsion from peripheral vein.In the 176 total parenteral nutrition prescriptions,there were 39 non-protein calorie/nitrogen ratio cases,15 glycolipid ratio cases,69 cation concentration cases,61 calorie cases and 32 amino acid content cases failing to comply with the recommendation of the guidelines.Only 31 total parenteral nutrition prescriptions were completely reasonable.Conclusion The costs of parenteral nutrition preparations used in hospitals of Jiangsu are high but the rate of rationality is low.Nutrition support team should be established to regulate the use of parenteral nutrition preparations and save medical resources.

Objective:To investigate the influence of water tank on endotoxin(ET)content in hemodialysis fluid.Methods:Specimens of hemodialysis fluid were collected from 36 hemodialysis centers in Shanghai from Nov 2010 to Oct 2012,and the ET content in hemodialysis fluid were detected by chromogenic substrate method.Results:A total of 2694 samples have been obtained from 36 hemodialysis centers during the 2 years’period.The contents of ET below 0.1 EU/mL were detected in 2348 (87.16%)samples,between 0.1 EU/mL and 0.5 EU/mL in 260(9.65%)samples,and above 0.5 EU/mL in 86(3.19%) samples.Water tanks were used in 19 of the 36 hemodialysis centers.ET contents of hemodialysis fluid in the hemodialysis cen-ters which used water tanks were higher than those didn’t use water tanks,and the difference showed statistical significance (P <0.05).Conclusion:The usage of water tank could significantly increase the ET content in hemodialysis fluid.Monitoring of water storage equipment should be strengthened.

OBJECTIVE: To compare the effects of robotic and laparoscopic-assisted radical total gastrectomy on lymph node dissection and short-term outcomes in patients with Siewert type II adenocarcinoma of esophagogastric junction (AEG). METHODS: Inclusion criteria: the tumor center was located between 2 cm above and below the esophagogastric junction and was confirmed as adenocarcinoma by endoscopic biopsy. EXCLUSION CRITERIA: tumor with local invasion of the liver,spleen, pancreas or other organs; intraoperative finding of tumor dissemination or distant metastasis; patients undergoing palliative surgical treatment or preoperative neoadjuvant chemotherapy; patients with serious heart diseases, lung diseases, liver diseases, kidney diseases and other comorbidities; patients with multiple primary cancers;patients receiving emergency surgery. According to the above criteria, 82 patients with Siewert type II AEG who underwent gastrointestinal surgery at the Affiliated Hospital of Qingdao University from October 2014 to October 2018 were enrolled in the study. They were randomly divided into robotic surgery groups (41 cases) and laparoscopic group (41 cases) according to a computer-generated randomized allocation table. Both groups underwent radical total gastrectomy plus D2 lymph node dissection through the transabdominal esophageal hiatus approach. The intraoperative conditions and postoperative short-term outcomes were compared between two groups, including surgery time, intraoperative blood loss, length of esophagectomy, postoperative complications, postoperative gastrointestinal recovery time, length of hospital stay, postoperative unplanned reoperation rate and rehospitalization rate. Mean±SD is used for the measurement data that conforms to the normal distribution, and two independent sample t-tests are used to compare the two groups; the comparison of the count data is performed by the χ² test. RESULTS: There were 35 males (85.4%) with age of (62.3±10.0) years and body mass index of (24.4±3.2) kg/m² in the robotic surgery group. There were 37 males (90.2%) with age of (62.5±10.0) years and body mass index of (23.8±2.6) kg/m² in the laparoscopic group. No significant differences in the baseline data between two groups were found (all P>0.05). All the patients of both groups completed R0 resection successfully without conversion to laparotomy or perioperative death. Compared with the laparoscopic group, the robotic group had less intraoperative blood loss [(70.7±39.9) ml vs. (110.2±70.6) ml, t=3.118, P=0.003], longer resected esophagus [(3.0±0.7) cm vs. (1.9±0.5) cm, t=8.759, P<0.001], but longer setup time [(56.5±7.4) minutes vs. (36.0±6.6) minutes, t=4.241, P<0.001], and higher hospitalization costs [(122 317.31±57 789.33) yuan vs. (99 401.56±39 349.53) yuan, t=2.099, P=0.039], whose differences were statistically significant (all P<0.05). The total number of harvested lymph node in the robotic surgery group was 39.2±15.3,which was significantly higher than that in the laparoscopic group (33.0±12.1) (t=0.733, P=0.047). In the robotic group and the laparoscopic group, the mediastinal lymph node No.110 and No.111 were 3.6±1.2 vs. 1.5±1.0 and 3.7±2.0 vs. 1.8±1.1, respectively, with significant difference (t=10.138, P<0.001, t=8.227, P<0.001); axillary lymph node No.19 and No.20 were 2.3±1.2 vs. 1.1±0.9 and 2.0±1.0 vs. 1.0±0.1, respectively, with significant difference (t=7.082, P<0.001,t=8.672,P<0.001). There were no significant differences in the total number of abdominal lymph node and the number of lymph node in abdominal stations between two group (all P>0.05). The highest lymph node metastasis rate was approximately 20% and observed in No.1, No.2, No.3, and No.7, followed by No.8a, No.9, No.11p, and No.110 with around 5%. The lymph node metastasis rate in other stations (No.4sa, No.4sb, No.4d, No.5, No.6, No.11d, No.12a, No.19, No.20 and No.111) was less than 5%.There were no significant differences in postoperative complication rate, postoperative fever time, postoperative exhaust and defecation time, fluid diet time, and postoperative hospital stay (all P>0.05). There were 2 patients(4.9%) with unplanned reoperation and 1 patient (2.4%) with unplanned re-admission in the laparoscopic group,while 3 patients (7.3%)with unplanned reoperation and 2 patients (4.9%)with unplanned re-admission in the robotic surgery group, whose differences were also not statistically significant (χ²=0.240,P=0.675;χ²=0.346,P=1.000). CONCLUSION Robot-assisted radical total gastrectomy for Siewert II AEG is safe and feasible, which is characterized by more sophisticated operation, less blood loss and higher quality of lymph node dissection, especially for subphrenic and inferior mediastinal lymph nodes.
Adenocarcinoma ; classification ; pathology ; surgery ; Aged ; Esophageal Neoplasms ; classification ; pathology ; surgery ; Esophagectomy ; Esophagogastric Junction ; pathology ; surgery ; Female ; Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Retrospective Studies ; Robotic Surgical Procedures ; Stomach Neoplasms ; classification ; pathology ; surgery ; Treatment Outcome