Objective To evaluate the clinical effectiveness of the Invance sling in treating children incontinence caused by neurogenic sphincteric incompetence. Methods Two children were treated with Invance sling for their neurogenic sphincteric incompetent incontinence because of congenital myelodysplasia.Both were male,aged of 9 and 10,respectively. Results Two patients were followed up of 12 and 14 months.Both patients micturated once each 2～4 hours with 1～2 episode of incontinence by chance in the daytime and without urinary pad.The maximum bladder capacities were 163 ml and 223 ml pre-operatively and those were 164 ml and 230 ml post-operatively,the retrograde maximum urethral pressures or retrograde leak point pressures were 37 cmH_2O and 27 cmH_2O pre-operatively while those were 45 cmH_2O and 37 cmH_2O post-operatively,maximum urethral closing pressures were 37 cmH_2O and 26 cmH_2O pre-operatively while those were 40 cmH_2O and 37 cmH_2O post-operatively,the functional urethral lengths were 2.5 cm and 3.0 cm pre-operatively while those were 3.5 cm and 4.0 cm post-operatively,the post-voiding residual urine volumes were 40 ml and 30 ml pre-operatively while those were 6 ml and 25 ml post-operatively.Post-operative voiding cystourethrography demonstrated that it was pressed to narrow at the suspended in the bulbous urethra segment. Conclusions The sling in treating children neurogenic sphincteric incompetent incontinence is simple,mini-invasive.It can increase the urethral resistance and continence better.But it has specific indication and should be applied prudently.

Objective To estimate the clinical effect of fuzhenghuayu capsule in treatment of early hepatocirrhosis by liver instantaneous elastic imaging. Methods Eighty patients with early hepatocirrhosis were divided into experiment group and control group according to the treatment method with 40 cases each. All the patients in 2 groups were given the same antiviral treatment with entecavir dispersible tablets, and the patients in experiment group combined with fuzhenghuayu capsule. All treatment lasted for 6 months. The liver stiffness measurement (LSM) was measured before treatment and 1, 3 and 6 months after treatment by liver instantaneous elasticity imaging. The serum hyaluronic acid was measured, and the Child-Pugh score was evaluated at the same time. Results The LSM, hyaluronic acid and Child-Pugh scores 6 months after treatment in experiment group were significantly lower than those in control group:(19.3 ± 0.9) kPa vs. (29.6 ± 1.3) kPa, (215.6 ± 59.3)μg/L vs. (344.4 ± 39.6)μg/L and (2.1 ± 1.3) scores vs. (3.9 ± 0.9) scores, and there were statistical differences (P<0.05). No obvious adverse reactions related to the use of fuzhenghuayu capsule were found during the course of treatment. Conclusions Liver instantaneous elasticity imaging can be used to evaluate and monitor early hepatocirrhosis. Fuzhenghuayu capsule on patients with early hepatocirrhosis has a certain degree of curative effect.

BACKGROUND: The investigation of culturing, passaging and establishing human limbal stem cells can strengthen the recognition of the stem cells and provide the enough cellular reserve for the basic and clinical research of limbal stem cell transplantation.OBJECTIVE: To explore a method of pessaging and establishing cell line of human limbal stem cells cultured in vitro.DESIGN: Randomized controlled observation.SETTING: Gannan Medical College.MATERIALS: The experiment was performed at Scientific Center of Gannan Medical College and the National Key Laboratory of Ophthalmology Hospital Affiliated to Sun Yat-Sen University from June 2003 to April 2004. Fresh human limbus corneae were isolated from two healthy donors. Procedures were performed according to the informed consent of the donors. Main reagents contained RPMI-1640 (Sigma R8755, containing L-glutamine) and 200 g/L fetal calf serum (FCS) (Gibco 16140-071). DMEM medium, chondroitin sulfatase and human epidermal growth factor (hEGF) were purchased from Sigma Co. USA; HEPES and DMSO were bought from Gibco, USA; 100% glycerinum was purchased from Yunjia Huangpu Pharmaceutical Product Limited Company, PRC; glutaraldehyde was bought from E.Merk, Germany; Alcohol, chlorhydric acid, acetone and methyl aldehyde were purchased from Beijing Chemical Agent Company, PRC; 0.25% parenzyme was bought from Shanghai Xinhua Pharmaceutical Factory, PRC.Above-mentioned reagents were analytical pure grade.METHODS: After digestion, human limbal tissues in limbal basilar part with an abundant pigment were cultured in the culture flask containing RPMI-1640 and 200 g/L FCS and in culture dish containing amniotic extracellular matrix (AECM) as the cultural supporter. Primary and passage cells were observed under light microscope and scanning electron microscope (SEM). The revival ratio of stem cell refrigeration of every generation was calculated by the trypanblau exclusion experiment.MAIN OUTCOME MEASURES: ① Observational results of limbal stem cells during the primary culture and serial subcultivation in vitro, and ② revival ratio of stem cell refrigeration.RESULTS: ①Findings of primary culture: Most limbal stem cells in the culture flask had the adherence and were arrayed uniformly sparsely to form monolayer and adhered to the bottom of culture flask under the inverted phase contrast microscope after 1-day culture. ② Findings of serial subcultivation: After human epidermal growth factor (hEGF) was added into the second passage, cells were scattered into the monolayer and adhered to grow quickly.Morphological variability of all the cells increased obviously when passage the 30th generation. The cellular volume was obviously increasing, and the round or irregular round cells gathered together. The 33rd generation human limbal stem cells still could vigorously differentiate, proliferate and grow in ACEM. ③ The revival ratio of stem cell refrigeration was 82.2%.CONCLUSION: The human limbal stem cell lines were preliminarily established by culturing and freezing the cells of 33 generations in vitro. The human limbal stem cell lines preferred to grow in the culture dish containing AECM as the cultural supporter.

Objective:To observe the clinical efficacy of combined acupuncture and psychological desensitization therapy for anxiety in those with heroin addiction.Methods:All 90 cases were randomly allocated into a treatment group (45 cases) and a control group (45 cases).Cases in the treatment group received 30 min of combined acupuncture and psychological desensitization therapy for each treatment,twice a week and 8 weeks in total,whereas cases in the control group received no treatment.After that,the anxiety score and state were observed.In addition,the mental state prior to and after cue-elicited heroin craving was evaluated.Results:The total and standard scores of anxiety in the treatment group were significantly reduced compared to the control group (P＜0.05),coupled with a significant reduction of heroin craving (P＜0.01).Conclusion:Combined acupuncture and psychological desensitization can alleviate anxiety and inhibit the short-term heroin craving.

Objective To investigate the treatment effect of ginsenoside compound K (CK) on glucose and lipid metabolism in diabetic mellitus mice and the potential molecular mechanism.Methods A total of 36 mice were randomly divided into normal group,diabetic mellitus group,CK treatment groups (100 or 200 mg/kg body weight),dimethyldiguanide group and p38MAPK pathway agonist P79350 group,with 6 mice in each group.Diabetic mice were established by intraperitoneal injection of streptozotocin combined with high-fat diet,and CK with different doses was administrated by gastric lavage for consecutive 8 weeks.The levels of fasting blood-glucose,triglyceride (TG),total cholesterol (TC),high-density lipoprotein (HDL C),fasting serum insulin were measured,and the insulin sensitive index (ISI) was calculated in different treatment groups.Glucose tolerance was detected by oral glucose tolerance test.The protein levels of ASK1,p-ASK1 and p38,p-p38,was detected by Western blot.The mRNA expression of apoptosis signal regulating kinase-1 (ASK1) was detected by real-time quantitative PCR.Results The fasting blood-glucose,TG,TC,HDL C,fasting serum insulin and ISI were (28.31 ± 3.40),(1.90 ± 0.28),(5.00 ± 0.72),(0.50 ± 0.08),(9.01 ± 1.70) mmol/L and-6.42 ± 0.76 in diabetic mice,respectively.The corresponding values were (12.02± 1.81),(0.97 ±0.09),(2.90 ±0.49),(0.91 ±0.08),(15.12 ± 1.93)mmol/L and-4.33 ± 0.46 in 200 mg/kg CK treatment diabetic mice,and were (12.87 ± 2.61),(1.09 ± 0.11),(3.08 ± 0.27),(0.87 ±0.08),(14.97 ± 1.27) mmol/L and-4.42 ± 0.35 in dimethyldiguanide group.All of the fasting blood-glucose,TG and TC in CK treatment groups were significantly lower than those of diabetic mellitus group (P ＜0.05 or ＜0.01),but the fasting serum insulin and ISI in CK treatment groups were significantly higher than that of diabetic mellitus group (P ＜ 0.05 or ＜ 0.01).There were no significant difference between 200 mg/kg CK treatment group and dimethyldiguanide group.The mRNA levels of ASK1 in normal group,diabetic mellitus group and 200 mg/kg CK treatment group were 1.00 ± 0.07,2.52 ± 0.14 and 1.25 ± 0.08,respectively.The mRNA levels of ASK1 in diabetic mellitus group and 200 mg/kg CK treatment group were significantly up-regulated than that of normal group (P＜0.01),but there was no significant difference between 200 mg/kg CK treatment group and diabetic mellitus group in the mRNA levels of ASK1.There was no significant difference in the protein expression levels of ASK1 and p38 among normal group,diabetic mellitus group and 200 mg/kg CK treatment group,but the protein expression levels of p-ASK1 and p-p38 were significant higher in diabetic mellitus group than that in normal group (P＜0.05 or ＜0.01),and were significant lower in 200 mg/kg CK treatment group than that in diabetic mellitus group (P ＜ 0.05 or ＜ 0.01),and were no significant difference between 200 mg/kg CK treatment group and normal group.Conclusions Ginsenoside CK effectively attenuates diabetic mellitus in mouse model,possibly by inhibiting the phosphorylation of ASK1-p38MAPK signaling pathway.

With the widely development of psychiatric clinical researches,the ethical issue has been concerned gradually.Although the ethical review has strict rules on informed consent,there are many problems and challenges on informed consent implementation because of the special mental illness population.According to the relevant laws and regulations,combined with the characteristics of clinical psychiatric researches,this paper discussed the protection of subjects' fights and interests during the implementation of informed consent in psychiatric clinical researches,from the following aspects:providing a quiet,comfortable,and relatively independent environment for the participants to ensure informed consent,guaranteeing full informed consent time,choosing qualified researchers for informed consent,ensuring the effective process of informed consent,and guiding the subjects to correctly sign their names and the date.

Objective To observe and explore the effects of different tidal volume (VT) ventilation on right ventricular (RV) function in patients with critical respiratory failure.Methods Consecutive respiratory failure patients who were treated with invasive ventilator over 24 h in the Department of Critical Care Medicine at the Fourth Hospital of Hebei Medical University from June to December in 2015 were enrolled in this study.Clinical data including patients′ vital signs, ventilator parameters and RV echocardiography were collected within 6 h (D0), day1(D1), day2 (D2) and day3 (D3) after ventilation started.According to the VT, patients with acute respiratory distress syndrome (ARDS) were assigned to low VT group [S6, ≤6 ml/kg predicted body weight (PBW)] and high VT group (L6, >6 ml/kg PBW), while non-ARDS patients were also assigned to low VT group (S8, ≤8 ml/kg PBW) and high VT group (L8, >8 ml/kg PBW).Results A total of 84 patients were enrolled in this study.44.2% ARDS patients and 58.5% non-ARDS patients were in low VT groups.After ventilation, tricuspid annulus plane systolic excursion(TAPSE)decreased progressively in S6 [from 18.30(16.70,20.70) mm to 17.55(15.70,19.50) mm, P=0.001], L6 [from 19.50(17.00,21.00) mm to 16.30(15.00,18.00) mm P=0.001], S8[from 18.00(16.00,21.00) mm to 16.50(15.50,18.00) mm, P=0.001] and L8 [from 19.00(17.50,21.50) mm to 16.35(15.15,17.00) mm, P=0.001] groups.However, TAPSE decreased less in small VT groups (S6 and S8) than those of in large VT groups (S8 and L8) without significant differences.There were not statistical differences between different VT groups in terms of ventilation days, including right ventricle area/left ventricle area (RVarea/LVarea),TAPSE,peak mitral flow velocity of the early rapid filling wave (E),peak mitral flow velocity of the late rapid filling wave (A),early diastolic velocity of the tricuspid annulus (e′),pulmonary artery systolic pressure,inferior vena cava diameter (all P>0.05).Compared to L6 group, low VT (S6 group) resulted in decreased mortality at 28 days [1/19 vs 37.5%(9/24), P=0.014].There were not statistical differences between different VT groups in terms of ventilation days, length of intensive care unit stay, length of hospital stay (all P>0.05).Logistic regression analysis showed that VT could be the independent factor of TAPSE (OR=1.104,95%CI 0.100-1.003,P=0.049).Conclusions Positive pressure mechanical ventilation resulted in RV systolic dysfunction.Lower VT may have the protective effect on RV function.Trial registration Chinese Clinical Trial Registry,ChiCTR-POC-15007563.

This article describes a novel Multifunctional and Transparent Urinary System Model (MTUSM), which can be applied to anatomy teaching, operational training of clinical skills as well as simulated experiments in vitro. This model covers kidneys, ureters, bladder, prostate, male and female urethra, bracket and pedestal, etc. Based on human anatomy structure and parameters, MTUSM consists of two transparent layers i. e. transparent organic glass external layer, which constraints the internal layer and maintains shape of the model, and transparent silica gel internal layer, which possesses perfect elasticity and deformability. It is obvious that this model is preferable in simulating the structure of human urinary system by applying hierarchical fabrication. Meanwhile, the transparent design, which makes the inner structure, internal operations and experiments visual, facilitates teaching instruction and understanding. With the advantages of simple making, high-findelity, unique structure and multiple functions, this model will have a broad application prospect and great practical value.
Female ; Humans ; Kidney ; Male ; Models, Anatomic ; Models, Biological ; Prostate ; Ureter ; Urethra ; Urinary Bladder ; Urogenital System ; anatomy & histology

BACKGROUND:Articular chondrocytes with the ability of autocrine and paracrine can provide the growth factors and microenvironment for synovial mesenchymal stem cels differentiating into the chondrocyte. The
three-dimensional scaffold could provide space for cels adhesion, proliferation and differentiation.
OBJECTIVE: To study the ability of chondrogenesis by co-culturing synovial mesenchymal stem cels and chondrocytes under the three-dimensional condition.
METHODS:The synovial membrane and articular cartilage were harvested from rat knee joint. The synovial
mesenchymal stem cels and chondrocytes were obtained through the method of enzyme digestion. The passage 3 synovial mesenchymal stem cels and passage 2 chondrocytes were co-cultured in the chitosan/I colagen
composite scaffolds at the ratio of 1:2. Then, the cels/scaffold composite was harvested to be examined
morphologicaly, histologicaly and immunohistochemicaly after being cultured 21 days. The confocal laser was also employed to detect the cels distribution in the scaffold.
RESULTS AND CONCLUSION: After being cultured 72 hours, it could be observed from the cels/scaffold composite examined through the scanning electron microscope that the cels adhered on the surface of the
scaffold and extracelular matrix surrounding the cels was seen on the scaffold. After being cultured 21 days, it could be found through the confocal laser scanning that the cels were wel-distributed on the scaffold, and cels decreased gradualy. Type II colagen was positive in the extracelular matrix immunohistochamicaly. It
suggested from this study that the synovial mesenchymal stem cels could be co-cultured with chondrocytes in the chitosan/I colagen composite scaffolds and have the ability of chondrogenesis differentiation.

BACKGROUND:Synovial mesenchymal stem cells have the ability of multilineage differentiation in vitro, which are expected to be seed cells for the treatment of cartilage defects in cartilage tissue engineering. Appropriate growth factors are critical for the chondrocyte differentiation of synovial mesenchymal stem cells.
OBJECTIVE:To study the role of secreted factors by chondrocytes to induce chondrogenesis of synovial mesenchymal stem cells.
METHODS:The synovial mesenchymal stem cells and chondrocytes were harvested from rat knee joints and cultured through the digestion method. The supernatant was col ected from chondrocytes, and centrifuged, filtered and cryopreserved. The third passage synovial mesenchymal stem cells centrifuged as pel ets were cultured in the chondrocyte supernatant for 21 days. And the cells morphology was examined and the type II col agen and aggrecan were detected through immunohistochemistry and RT-PCR.
RESULTS AND CONCLUSION:The synovial mesenchymal stem cellpel ets cultured in the chondrocyte supernatant became cartilage-like tissue after 21 days. The type II col agen was detected positively in the matrix of synovial mesenchymal stem cellpel et immunohistochemical y. RT-PCR examination showed that the type II col agen and aggrecan expressed in the synovial mesenchymal stem cellpel et cultured in the chondrocyte supernatant. It suggested that synovial mesenchymal stem cellcould be induced to differentiate into chondrocytes depending on soluble factors secreted by chondrocytes.