At present,reports at home and abroad suggest a low probability of successful preservation of ovarian endocrine function after ovarian shift radiotherapy.After radiotherapy for cervical carcinoma,the ovarian function is associated with various factors,such as radiotherapy dose and method,patient's age,shift position,and concurrent chemotherapy drugs.Therefore,as for each patient,the dose to the ovarian tissue should be controlled within the individual dose limit to effectively preserve the ovarian function.

BACKGROUND: How to effectively harvest bone marrow mesenchymal stem cells with homogeneity is crucial for cartilage tissue engineering research. OBJECTIVE: To isolate and culture rat bone marrow mesenchymal stem cells and to observe biological characteristics of the cells. METHODS: Bone marrow mesenchymal stem cells were isolated from the femur and tibia of 30 Sprague-Dawley rats using the whole bone marrow adhesion method. Cell surface markers were identified using flow cytometry, cell proliferation ability was observed through cell counting, and cell survival rate was determined by MTT assay. RESULTS AND CONCLUSION: The harvested cells were mostly round and oval, which partially showed a triangular shape. Cell fusion appeared after 12-15 days of inoculation. The proliferation of passaged cells was accelerated. Two hours after passage, the cells evenly covered the bottom of the culture dish. With the increasing of cell generations, the cell proliferation ability was gradually decreased. The survival rates of cells at passages 1-5 were over 95%, significantly higher than those at passages 6 and 7 (P < 0.05). The harvested cells were negative for CD34, but positive for CD44. To conclude, the whole bone marrow adhesion method is effective to isolate rat bone marrow mesenchymal stem cells with stable growth and strong proliferation ability. Passage 5 cells can be selected as seed cells for cartilage tissue engineering.

Objective To perform a mechanical test of fresh cadaver specimens and compare the biomechanical properties of the novel minimal invasion dynamic hip plate (MIDHP) and the dynamic condylar screw (DCS) in treatment of subtrochanteric fractures of the femur.Methods All specimens were firstly used to simulate models of Seinsheimer type ⅡA subtrochanteric fractures of the femur,which were later divided into DCS group and MIDHP group.Based on experimental requirements,the femoral head and distal femur were embedded using seff-freezing type dental base acrylic resin powder.Torsion strength test was given in the first place,succeeded by compression strength test.Finally,destructive test was made to record the limit load.All experimental data were analyzed statistically.Results Torsion strength test showed that specimens of both groups were basically stable as the reverse was within 3°.Torque for specimens in DCS and MIDHP groups was (3.16 ± 0.13) N · m and (3.31 ± 0.27) N · m respectively as the reverse was 1.5°.Both torque and torsion stiffness had no statistical significance between the two groups,and the anti-rotation features of the two internal fixations were similar.Compression strength test showed that compression stiffness of specimens in DCS group was (532.27 ±61.02) N/mm and (581.98 ±77.56) N/mm in MIDHP group at a load of 800 N,with evidently higher compression displacement and stiffness in MIDHP group (P ＜ 0.05).Destructive test showed the maximum load of specimens in DCS and MIDHP groups was (2 994.38 ±244.81) N and (3 322.13 ± 141.21) N respectively,far higher in MIDHP group (P ＜ 0.01).Conclusions MIDHP is characterized by reasonable design,strong anti-rotation property and anti-compression property over DCS.In comparison with DCS,MIDHP has biomechanical advantage in treatment of femoral subtrochanteric fractures,for it can be performed minimally invasive and is worthy of further application.

Objective To investigate radiological characteristics of the posterior tibial plateau fracture and operative treatments for the fracture.Methods Thirty-one cases of posterior tibial plateau fracture treated between February 2009 and February 2014 were enrolled.There were 19 men and 12 women aged 24-72 years (mean,42.5 years).Injury arose from traffic accidents (13 cases),falls from a height (9 cases),fall on the ground (5 cases),and crash (4 cases).Type Ⅴ in 15 cases and type Ⅵ in 15 cases were classified by the Schatzker classification.Meanwhile,all fractures were identified as three-column pattern.According to the X-ray and CT manifestations of fracture displacement,the cases with minor displacement were grouped as Group A (22 cases) and the cases with major displacement group as Group B (9 cases).Depending on the radiographic characteristics of fracture size and angle off fracture line,anterior approach for reduction and fixation was performed in Group A and combined anterolateral and posteromedial approaches in Group B.Radiographic and functional outcomes were evaluated using the Rasmussen score.Results All cases underwent one-stage surgery uneventfully.Operation time was 80-120 minutes (mean,98 minutes) in group A and was 110-165 minutes (mean,110 minutes) in Group B.Mean total operation time was 105 minutes.Period of follow-up was 6-48 months (mean,21.5 months).Rasmussen radiographic results showed total excellent to good rate of 84％ with 86％ in Group A and 78％ in Group B respectively.Rasmussen functional results showed total excellent to good rate of 87％ with 91％ in Group A and 78％ in Group B respectively.Conclusions Anterior approach or anterolateral approach combined with posteromedial approach for reduction and internal fixation is developed according the radiographic findings and degree of fracture displacement.Clinical outcome is good and associated intraarticular soft tissue injury can be managed concurrently.

ObjectiveTo analyze the clinicopathologic features of hereditary cutaneomucosal venous malformation (VMCM) in a Chinese family.MethodsFamily history was investigated in a family with VMCM,and tissue specimens were obtained from the lesions of the proband and subjected to histopathological analysis.ResultsAmong 65 members from 5 generations of the family,19 were affected by VMCM,hinting an autosomal dominant inheritance.None of the family members experienced gastrointestinal bleeding,central nervous system disorders,or cardiac defects.Affected individuals usually presented with multiple irregularly sized,blue-violet,elevated and slightly indurated masses located in the oral mucosa and subcutaneous tissue of the extremities.Pathological analysis showed malformed veins with abnormally dilated cavities and irregularly thickened walls.Although small veins were abnormally proliferating and clustered,there was no endothelial discontinuity.The smooth muscle layer was thickned in a varying degree or absent.ConclusionA diagnosis of VMCM is made according to the inheritance manner,clinical manifestation and pathological findings.

Objective To observe the expression of MicroRNA-21(miRNA-21)in kidney tissue of unilateral ureteral obstruc-tion (UUO)rats and explore mechanisms of miRNA-21 involved in TGF-β1/Smad3 signaling pathway in renal interstitial fibrosis (RIF).Methods Totally 20 adult male SD rats were divided into UUO group and Sham operation group.The left ureter of rats in UUO group were ligated,and the rats in sham group were dissociated left ureter only,but not to be obstructed.The left kidney tis-sue was collected at the 3rd、7th days after surgery.Real-time quantitative PCR analysed the expression of miRNA-21.Masson stai-ning,HE staining and immunohislochemistry staining were used to evaluate the degree of RIF.The expression of transforming growth factor-β1(TGF-β1)、Smad3,α-smooth muscle actin (α-SMA)、and collagenⅠ(Col-Ⅰ)were examined by immunohislochemis-try staining.Results The expression of miRNA-21 in kidney tissue was higher at 3rd、7th days after surgery in UUO groups than that in Sham group(P <0.01).The expression in UUO group at 7th day was higher than 3rd day after surgery(P <0.01).The fi-brosis score,positive TGF-β1、Smad3、Col-Ⅰ、α-SMA area in UUO group were significantly higher than those of Sham group at 3rd、7th days (P <0.01),Which at 7th day were higher than 3rd day in UUO group(P <0.01).The expressions of miRNA-21 in kidney tissue was positive correlations with the fibrosis score(r=0.888,P <0.01).The expressions of miRNA-21 in kidney tissue was positive correlations with TGF-β1、Smad3、Col-Ⅰ、α-SMA(r=0.799,0.849,0.882,0.896,P <0.01).Conclusion The expres-sion of miRNA-21 was upregulated in UUO kidney tissue after model establishment.The RIF degree might be positive correlations with miRNA-21 expression,and TGF-β1/Smad3 signaling pathway positively regulate miRNA-21 to mediate rats RIF.

Objective:To explore the prevalence of irritable bowel syndrome (IBS) based on a community population of Shanghai and the treatment of IBS by acupuncture therapy.Methods:A population of 1 685 subjects aged between 18-80 years were randomly selected by clustered sampling from the inhabitants in Changqiao Community of Shanghai to receive a questionnaire,for understanding the symptomatology and prevalence of IBS according to modified Manning and Rome II criteria,and the voluntary IBS patients were treated by acupuncture therapy.Results:The community- based prevalence of IBS was 11.45 % and 5.04% respectively according to modified Manning criteria and Rome II criteria.The ratio of male and female was 0.77:1 in IBS patients and the proportion was 10.62% and 12.19% respectively.But there were no significant difference in prevalence between different age groups (P＞0.05) .IBS is more common in subjects aged between 45-65 years (38.86%).Regarding the 62 IBS patients treated by electroacupuncture (EA),the total effective rate in Tianshu (ST 25) group (n=32) was 84.38%,and it was 56.67% in Daheng (SP 15) group (n=30),which showed a significant difference.(P＜0.05).Conclusion:IBS is a commonly encountered disorder in Changqiao Community of Shanghai and should be taken into consideration for human welfare,disease prevention and further epidemical investigation.Acupuncture treatment is recommended for treating IBS due to its satisfactory therapeutic effect.

Objective To explore the curative effect of fibular flap with limbs composite soft-tissue.Methods From February,2013 to February,2016,13 cases with body severe trauma patients were treated,which including 5 cases of upper limbs and 8 cases of lower limbs,and all existed bone defect,soft tissue defect and trunk vessel defect.Three cases with limbs distal non blood supply were emergency treated with debridment and flow-through fibular flap transplantation renovation,peroneal artery repairing defective blood vesscls to rcstorc limbs distal blood supply,fibular flap repairing bone defect,skin flap repairing soft tissue defect.The limb blood supply for other 10 cases were in good condition,but one case with main artery defect did the second phase of fibular flap transplantation and repaired defective blood vessels,bone and skin soft tissue synchronously according to wound condition.According to the postoperative observation for flap survival and appearance,X-ray films to observe fracture healing after 6 weeks,three months and 6 months of operation as well as evaluating limb function recovery,then analyzed the results.Results Flaps survived successfully for 11 cases,and flaps for the other 2 cases were partial necrosis.One Case was edge flap necrosis,heal scabby after dressing,and the other case was necrosis for 1/3 of the area,but the deep fascia survival,and the skin graft healing after dressing.One case with forearm rolling was in vascular crisis after operation,but tbe crisis was relieved after detection,and fingers blood supply was recovered.All the patients were followed up for 6 to 36 months(mean,14 months).All flaps were survived,fractures healed well and limbs distal blood supply was good.Bone healing time was 8 to 24 weeks,and patients with lower limbs injury could bear load after 3 to 8 months.Lower limbs restored walking function.Upper limbs and hands restored rotation function.Transplant flapshad good elasticity and satisfactory appearance.Conclusion Using fibular flap to repair defective blood vessels,bone and soft tissue synchronously,not only can rescue the limbs on the verge of amputation,but also can repair defective composite tissue and get a good prognosis.It is an effective method for open injuries severely treatment in clinic.

Objective To construct a continuous diagnosis and treatment mode for children with dental caries, so as to improve the prevention and treatment effect of dental caries in children. Methods The continuous treatment group was set up to screen 262 cases of eligible patients and record the decyed, missing, filled teeth. All the patients were randomly divided into experimental group and control group by stage sampling method. The patients in both groups were given routine treatment, and the experimental group also received continuous treatment. The patients of both groups were investigated with children's dental caries prevention knowledge questionnaire and plaque test 3 months after the first visit, and 12 months after the first visit, the patients were checked for new caries and new caries incidence. Results Parents dental caries of the observation group was better than that of the control group, and the difference was statistically significant (Z=-9.816,P< 0.001). In the plaque test, the debris index (DI) of the observation group was better than that of the control group, and the difference was statistically significant (Z=-7.594,P< 0.001). The number of new caries of the experimental group was (1.33±1.16), which was lower than that of the control group (4.02±1.87), and the difference was statistically significant (Z=-10.763,P<0.001). There were 87 cases of new caries (67.97%) in the experimental group and 118 cases (91.47%) in the control group, and the difference was statistically significant (χ2=21.992,P< 0.001). Conclusions The continuous diagnosis and treatment mode of dental caries in children has been successfully constructed. The diagnosis and treatment mode has been transformed from a simple hospital-based treatment to a hospital-based treatment combined with active prevention at home, which effectively reduces the risk of caries in children and adapts to the development needs in the new situation.

Objective:To evaluate the efficacy and safety of intensity modulated radiotherapy (IMRT) and programmed death-1 (PD-1) immunotherapy combined with single-agent chemotherapy for patients with local failure of esophageal cancer after initial radical chemoradiotherapy.Methods:Clinical data of 80 patients with local failure of esophageal cancer after initial radical chemoradiotherapy treated with IMRT or PD-1 immunotherapy combined with single-agent chemotherapy in People's Hospital of Xinghua between June 2014 and June 2023 were retrospectively analyzed. IMRT was delivered at 1.8-2.0 Gy per fraction, 5 fractions per week, with a total dose of 45.0-60.0 Gy in 40 patients (IMRT group). The other 40 patients received PD-1 immunotherapy combined with single-agent chemotherapy (PD-1 immunotherapy combined with single-agent chemotherapy group). Kaplan-Meier method was used for univariate analysis and the cumulative survival probability. Log-rank test was used for survival significance test. Cox proportional hazards model was used for multivariate analysis of related factors affecting overall survival (OS), progression-free survival (PFS) and local control (LC).Results:By December 2023, the follow-up rate was 100%. The 1- and 2-year OS rates in the IMRT group were 66.1% and 18.9%, with a median OS time of 10.1 months. In the PD-1 immunotherapy combined with single-agent chemotherapy group, the 1- and 2-year OS rates were 72.3% and 36.9%, with a median OS time of 12.4 months. There was a significant difference in OS rates between two groups ( χ2=3.89, P=0.049). The 1- and 2-year PFS rates in the IMRT group were 47.4% and 31.6%, with a median PFS time of 8.5 months. In the PD-1 immunotherapy combined with single-agent chemotherapy group, the 1- and 2-year PFS rates were 70.0% and 64.2%, with a median PFS time of 11.9 months. There was no significant difference in the PFS rates between two groups ( χ2=2.66, P=0.103). The 1- and 2-year LC rates in the IMRT group were 68.6% and 62.3%, with a median LC time of 8.9 months. In the PD-1 immunotherapy combined with single-agent chemotherapy group, the 1- and 2-year LC rates were 72.8% and 66.7%, with a median LC time of 12.0 months. There was no significant difference in LC rates between two groups ( χ2=0.18, P=0.672). Grade 2 radiation esophagitis and radiation pneumonitis developed in 82.5% (33/40) and 32.5% (13/40) in the IMRT group, respectively. The incidence of grade 1-2 peripheral blood leukopenia was 40.0% (16/40), 50.0% (20/40) for grade 1-2 peripheral blood thrombocytopenia, 27.5% (11/40) for moderate to severe anemia, and 20.0% (8/40) for grade 1-2 thyroid dysfunction in the PD-1 immunotherapy combined with single-agent chemotherapy, respectively. Single- and multi-factor analysis showed that the failure site ( χ2=9.01, P=0.011) and short-term efficacy ( χ2=7.78, P=0.005) were the independent prognostic factors affecting OS. The short-term efficacy was the independent prognostic factor for PFS ( χ2=31.63, P<0.001). The short-term efficacy was the independent prognostic factors affecting LCS ( χ2=17.64, P=0.001) too. Conclusion:For the patients with local failure of esophageal cancer after initial radical chemoradiotherapy, the combination of PD-1 immunotherapy with single-agent chemotherapy yields better survival prognosis than re-irradiation alone, but it is still necessary to pay attention to the related drug toxicities.