BACKGROUND:The clinical study on the mechanical properties of biomaterials for cruciate ligament reconstruction is of great importance, which can provide a theoretical basis for the clinical development of materials with good structure, biomechanics and compatibility. OBJECTIVE:To analyze the mechanical properties of vascularized patelar tendon graft. METHODS:The anterior cruciate ligaments of the left foreleg from 42 New Zealand white rabbits were cut off. Then, these rabbits were randomly and evenly divided into two groups: experimental group and control group. Rabbits in the experimental group were implanted vascularized patelar tendon graft for anterior cruciate ligament repair. Rabbits in the control group were implanted with autologous non-vascularized patelar tendon graft for anterior cruciate ligament repair. At the 8th, 12th and 16th weeks after implantation, biomechanical properties of specimens from these two groups were detected. RESULTS AND CONCLUSION: There was no significant difference on the fracture location at different time points between these two groups; at the 12th and 16th weeks after transplantation, the knee laxity in the experimental group was higher than that in the control group (P < 0.05). At the 8th week after transplantation, there was no significant difference in the knee laxity between these two groups. At the 8th, 12thand 16th weeks after transplantation, the maximum load in the experimental group was higher than that in the control group (P < 0.05). At the 8th, 12th and 16th weeks after transplantation, the stiffness in the experimental group was higher than that in the control group (P < 0.05). There was no significant difference in the maximum tensile elongation between these two groups at different time points after transplantation. These results demonstrate that vascularized patelar tendon graft has good mechanical properties.

[Objective] To explore the clinical effects of three methods in the treatment of cesarean scar pregnancy.[Method]All the patients with cesarean scar pregnancy accepted treatment at 2 affiliated hospitals of Sun Yat-Sen University from May 2006 to September 2016 were retrospectively analyzed.According to their different therapies,186 of them were divided into three groups:surgery group (undergone transvaginal removal of ectopic pregnancy tissue and repair of uterine defect,73 cases),medical treatment group (treated with medical and combined with curettage,51 cases),UAE group (treated with UAE and combined with suction curettage,62 cases).The success rate,hospitalization time,hospitalization expenses and treatment side effects of the three groups were compared.[Result] The success rates of the three groups were 98.6％,54.9％,and 80.6％;The hospitalization days of the three groups were (7.3 ± 3.3) days,(16.2 ± 11.2) days,(12.6 ± 10.4) d.The hospitalization expenses of the three groups were (7 967 ±1 987) yuan,(5 499-± 1 965) yuan,(15 863 ± 5 941) yuan.The treatment side effects of the three groups were 15.1％,23.5％,and 37.1％.The success rate,hospitalization days,hospitalization expenses and treatment side effects of the three groups were statistically different (P ＜ 0.05).The surgery group has a highest success rate,shortest hospitalization time,lower hospitalization expenses,and less complication.[Conclusions] Transvaginal removal of ectopic pregnancy tissue and repair of uterine defect is a reliable treatment for CSP.

Objective:To investigate the clinical effect of botulinumtoxin type A (Botox-A) combined with electromyographic biofeedback therapy on the upper limb muscle spasm after stroke.Methods:86 cases of patients with upper limb muscle spasm after stroke in our hospital from January 2016 to January 2017 were selected and divided into the observation group and the control group,with 43 cases in each group.Patients in the control group were treated with electromyographic biofeedback therapy,and the observation group was treated with Botox-A based on the basis of control group.The improvement of upper limb muscle spasm,Upper limb movement function,the active range of wrist joint and life skills before and after treatment were compared between two groups.Results:After treatment,the total effective rate of improvement of upper limb muscle spasm of observation group were significantly higher than that of the control group (P＜0.05);At 2 weeks and 4 weeks after treatment,the Fugl-Meyer scores,Wrist joint activities,modified Barthel index (MBI) of two groups were significantly higher than those before treatment (P＜0.05),which were significantly higher in the observation group than those of the control group (P＜0.05).Conclusion:Botox-Acombined with electromyographic biofeedback therapy had remarkable clinical effect on the upper limb muscle spasm after stroke,which could effectively reduce the upper limb spasticity,improve the arm and wrist movement ability and the ability of daily life.

Objective To know the contamination status of Giardia lamblia and Cryptosporidium in drinking water of Jiangsu Province,so as to provide the evidence for producing hygiene and safety drinking water. Methods A total of 28 water plants of 13 cities in Jiangsu Province were selected,and the source water(10 L),chlorinated water(100 L)and tap water(100 L) were collected separately in each site. The water samples were then treated by filtration,washing,centrifuging concentration, immune magnetic separation,and immunofluorescent assay,to detect the numbers of Giardia cysts and Cryptosporidium oocysts. Results Totally 84 samples from 13 cities were collected,including 28 source water,28 chlorinated water and 28 tap water samples. Among the chlorinated water and tap water samples,no Giardia cysts and Cryptosporidium oocysts were found. Howev-er,Giardia cysts were detected in 3(10.71％,3/28)source water samples(Yancheng,Lianyungang,Changzhou cities),with the density of 1 cyst/10 L of all. Cryptosporidium oocysts were also detected in 3(10.71％,3/28)source water samples(Nan-jing,Zhenjiang,Yangzhou cities),with the density of 1 oocyst/10 L of all. Conclusions The source water in partial areas of Ji-angsu Province has been contaminated by Giardia and Cryptosporidium. To ensure the safety of drinking,the regulation of source water and surveillance of drinking water should be strengthened.

Objective The aim of this study was to evaluate whether PRDM16 gene polymorphisms were associated with dyslipidemia. Methods The polymorphisms of rs2651899, rs2236518, rs870171, and rs2282198 in PRDM16 gene in 528 participants were genotyped by the method of snapshot or ligase detection reaction. The genotype differences and the allele differences between the case group and the control group were analyzed. Linkage disequilibrium analysis was performed with SHE-sis online software. The interaction between rs2651899, rs2236518, rs870171, rs2282198 and gender, age, BMI were analyzed by MDR software. Results The frequency of allele A in rs2651899 locus was significantly higher in low HDL-C group compared with that in control group[OR(95%CI)=1.32(1.02-1.71), P=0.033]. The frequency of A/C genotype in rs870171 was significantly different between LDL-C abnormal group and control group[OR(95% CI)=1.97(1.01-3.86), P=0.037]. There may be interaction between rs2236518 and sex, which is a risk factor for low HDL-C[Model Ⅱ: OR(95% CI)=1.958(1.366-2.809), P<0.01]. There may be interactions among rs2651899, rs2236518, rs870171, and rs2282198, which seemed to be risk factors for lower HDL-C[Model Ⅳ: OR(95% CI)=3.991(2.707-5.884), P<0.01]. rs870171, rs2282198 may have interaction with age, which is a risk factor for high LDL-C [Model Ⅶ: OR(95%CI)=3.991(2.707-5.884), P<0.01]. Conclusion Allele A of rs2651899 may be a risk factor to low HDL-C. Under the codominant inheritance patterns, genotype A/C of rs870171 may be a risk factor to high LDL-C. In addition, there may be interaction between SNPs with gender and age.

Rho/Rho-kinase signaling pathway is a ubiquitous one in vivo and plays a role of "molecular switch" by regulating the polymeric state of intracellular actin cytoskeleton and participates in the regulation of various cellular functions.As research continues,some of them have provided evidence of Rho kinase signal pathway function at the occurrence and development of inflammatory bowel disease.This review aims to summarize the relationship between Rho kinase signal pathway and inflammatory bowel disease.

Objective To investigate the efficacy and feasibility of preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) matching for beta-thalassemia. Methods A total of 43 referred beta-thalassemia couples, with at least on child in need of hematopoietic stem cell transplantation (HSCT), underwent PGD for HLA matching at the First Affiliated Hospital of Sun Yat-sen University from 2010 to 2015. PGD cycles of these couples were retrospectively analyzed, and 15 infants born from PGD-HLA were followed up. Results A total of 84 oocyte retrieval cycles were performed, providing 14±7 oocytes per cycle. Fifty nine embryos biopsied cycles were done, including 24 cleavage stage and 35 blastocyst stage biopsy cycles. In cleavage stage, 259 embryos were biopsied, 93.4% (242/259) of them with conclusive molecular diagnosis, and the percentage of unaffected embryos (normo-homozygote and heterozygote) was 71.4%(185/259). The percentage of HLA matched unaffected embryos was 9.3%(24/259). In blastocyst stage, 306 embryos were biopsied, while 93.8% (287/306) of them were conclusive, and the percentage of unaffected embryos was 70.6% (216/306). The percentage of HLA matched unaffected embryos in blastocyst stage biopsy was 14.4%(44/306), which was higher than in cleavage stage biopsy (P<0.05). Forty three female carriers underwent 48 embryo transfer cycles including 3 fresh and 45 frozen-thawed embryo transfer cycles. Three fresh embryo transfer cycles were done after cleavage stage biopsy, resulted in a birth of healthy twins born at 36 weeks′gestation. All the embryos were frozen after blastocyst biopsied. Totally, 54 frozen-thawed embryos that were transferred in 45 frozen-thawed embryo transfer cycles included 25 embryo from cleavage stage biopsy and 29 embryo from blastocyst stage biopsy, and 42 of them were HLA matched. Clinical pregnancy rate and implantation rate per cycle in frozen-thawed embryo transfer were 38%(17/45) and 37%(20/54) respectively. A total of 15 infants were born, 2 were from a fresh embryo transfer cycle, and 13 were from frozen-thawed embryo transfer cycles. Results of prenatal diagnosis from delivered cases were matched to that of PGD. Four sick children have been cured by HSCT from these HLA matched born siblings. Conclusion PGD with HLA matching is an established method for conceiving a child who may donate hematopoietic stem cells to save an ill sibling.

Objective:To investigate the status of clinical nurses′ professional identity, structural empowerment and psychological empowerment, analyze the correlation between professional identity and structural empowerment and psychological empowerment, and establish a multiple stepwise regression model to discuss the dependence between professional identity and structural empowerment and psychological empowerment in clinical nurses.Methods:A total of 1 008 clinical nurses from Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University were selected as the subject by using the convenience sampling method. The General Information Questionnaire, Professional Identity Scale, Conditions of Work Effectiveness Scale, and Psychological Empowerment Scale were used to questionnaire.Results:The professional identity of nurses was at medium level (104.49±19.54), the total scores of structural and psychological empowerment of nurses were 60.09±13.49 and 42.59±7.31. Correlation analysis showed that the total score of professional identity of clinical nurses was positively correlated with the total score of structural empowerment, psychological empowerment and theirs dimensions ( r values were 0.436-0.715, P<0.01). Multivariate stepwise regression results showed that the nurse working years, health status self-assessment, formal empowerment, informal empowerment, work meaning, self-efficacy, work influence was the main influencing factors of nurses professional identity, which explained 60.5% of the total variation. Conclusions:Nursing managers should focus on the professional identity of clinical nurses, by optimizing the management organizational structure and pay attention to the perception of empowerment behavior to improve the comprehensive empowerment level, so as to enhance the professional identity of nurses.

Objective:To explore the incidence and degree of compassion fatigue in clinical nurses, and the effects of psychological empowerment on nurses' compassion fatigue level.Methods:A total of 1 005 clinical nurses were investigated with the general information, Chinese version of Professional Quality of Life Scale, Psychological Empowerment Scale. And the relationship between different degrees of compassion fatigue and psychological empowerment were analyzed by ordinal regression analysis.Results:The incidence of sympathetic fatigue was 93.0%,(935/1 005), mild was 53.8%(541/1 005), medium was 22.7%(228/1 005), severe was 16.5%(166/1 005). The score of Chinese version of Professional Quality of Life Scale three dimensions: compassion satisfaction, burnout, and secondary traumatic stress of clinical nurses were 34.15±5.53, 23.96±5.10, 23.73±5.92. The degree of compassion fatigue was negatively correlated with psychological empowerment score and score of each dimension( r values were 0.094-0.468, all P<0.05). The ordinal regression analysis indicated that job impact(odds ratio(OR) value was 1.095, 95% credible interval( CI) 0.094-0.236, P<0.01), self-efficacy( OR value was 0.920, 95% CI 0.250-0.054 , P<0.01) and job meaning( OR value was 0.820, 95% CI 0.431-0.240, P<0.01) were the independent risk factor of compassion fatigue level. Conclusions:The nurses mainly showed mild compassion fatigue, and main manifestation is secondary traumatic stress. The nurses who had more higher job impact scores were more likely to report higher levels of empathy fatigue, while nurses who had higher job meaning and self-efficacy scores were more likely to have low levels of empathy fatigue. Therefore, it is suggested that nursing managers should carry out timely intervention and management in accordance with the different level of compassion fatigue:improve nurses' perception of work meaning and self-efficacy, and avoid increasing workload while paying attention to the influence of work on perception level.

Objective To understand the characteristics and distribution of injury related deaths in residents aged ≥60 years in Jing'an district of Shanghai and provide evidence for the prevention of injury and effective intervention in this population.Methods According to the data from diseases surveillance and death-reporting system in Jing'an during 1975-2014,the causes of 5 199 injury related deaths were analyzed.Results The average injury related mortality in the elderly aged ≥60 years in Jing'an was 159.37/100 000 during this period.The injury related mortality increased with age.Fall was the first cause of injury related death,accounting for 53.30％.The characteristics and distribution of injury related deaths varied with age and gender.Conclusion Injury has become an important cause affecting the health of the elderly.It is necessary to conducted targeted injury prevention and control in the elderly in communities.