Adult ; Bronchoalveolar Lavage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Alveolar Proteinosis ; therapy ; Treatment Outcome

BACKGROUND:Under co-culture conditions, mesenchymal stem cel s could regulate osteogenic differentiation and osteogenesis of osteoblasts. OBJECTIVE:To observe the osteogenic efficiency of osteoblastic precursor cel s co-cultured with undifferentiated bone marrow-derived mesenchymal stem cel s, umbilical cord-derived mesenchymal stem cel s, or placenta-derived mesenchymal stem cel s in mineralization medium. METHODS:Adipose-derived stem cel s were induced in osteogenic differentiation medium for 7 days before being indirectly co-cultured with undifferentiated mesenchymal stem cel s isolated from different tissues (bone marrow group, umbilical cord group and placenta group) in Transwel plates. Induced adipose-derived stem cel s cultured alone served as control group. At different experimental intervals, quantitative analysis of alkaline phosphatase activity and calcified matrix was preformed to observe the effects of mesenchymal stem cel s from different sources on the osteogenic efficiency of induced adipose-derived stem cel s. RESULTS AND CONCLUSION:Expression of alkaline phosphatase was significantly higher in different experimental groups than the control group (P<0.05), and it was also higher in the bone marrow group than the umbilical cord and placenta groups (P<0.05). Quantitative analysis of calcified matrix revealed that the experimental groups were significantly higher than the control group (P<0.05);and in experimental groups, the umbilical cord group was higher than bone marrow group and placenta group (P<0.05). These findings indicate that the osteogenic efficiency of induced adipose-derived stem cel s is improved dramatical y under co-culture conditions.

Objective To study role of MDC/CCI22-CCR4 axis in mouse milky spots with peritoneal carcinomatosis of gastric cancer. Methods We examined the expression of CCR4 in 615 Mouse gastric cancer cell (MFC) lines by RT-PCR and Western-blot; Peritoneal metastasis model on the 615mouse was established by intraperitoneal injection of 0.2 ml MFC cells(1×104 cells). Dil fluorescence was used to observe the transfer process and section of MFC. Immunohistochemistry was conducted to detect the expression of CCR4 and CCL22 in omental milky spot; the structure of Milky spot was observed by scanning electron microscopy. Mice were randomly divided into 2 groups, namely, the saline control group (received saline) and MFC group. The concentration of CCL22 in ascitic fluid was measured in the 615 mice injected MFC after 6,8,10 days and in the saline group. Results MFC first metastasizes to the milky spot on the omentum, the expression of CCR4 and CCL22 were observered in the milky spot. The surface layer cells in milky spot consisted of discontinuous mesothelial cells and mainly macrophages and lymphocytes. The average value of CCL22 was 43 pg/ml and 364 pg/ml respectively in saline control group and MFC group.Conclusions MDC/CCL22-CCR4 axis plays an important role in the development of peritoneal carcinomatosis in mouse gastric cancer.

Objective:To meet the demand of medical system for talents, the training of medical students' competency has become a new direction of medical education. This study aims to evaluate the effectiveness of training quality in medical graduates through the competency scale.Methods:Taking "attitude", "skill" and "knowledge" as the evaluation dimensions, the competency development was divided into four levels of "state", "explain", "apply" and "transfer", and we proposed the competence concept of "A.S.K.-SEAT" and formulated an evaluation scale. Questionnaires and behavior event interviews (BEI) were conducted in medical graduates of Shantou University in 2018. Reliability and validity of the questionnaire were evaluated and current situation of different competency items were analyzed.Results:A total of 155 questionnaires were collected with good reliability and validity, and 15 graduates participated in BEI. A total of 21 A.S.K. competency items (including five basic competency items and two discriminating competency items) and SEAT textual descriptions were finally established.Conclusion:A.S.K.-SEAT scale can provide valid references for the competency evaluation of medical graduates.

Objective To explore the role of the improved computer aided design of the digital three -dimensional titanium mesh in the repair of skull,to reduce the incidence of postoperative epidural hematoma and epidural fluid.Methods Retrospective analysis of 93 cases of skull repair using the three -dimensional titanium mesh was conducted.49 cases in the conventional group used the conventional three -dimensional titanium mesh. 44 cases in the observation group were given the improved three -dimensional titanium mesh.The clinical effect of the two groups was observed.Results In the conventional group,postoperative epidural hematoma occurred in 4 cases, 1 case of epidural fluid.All patients were fine in the observation group.The improved three -dimensional titanium mesh could reduce the incidence of epidural hematoma and effusion(χ2 =4.745,P =0.029).The conventional group and the observation group both had one case of infection after operation,there was no significant difference between the two groups(χ2 =0.001,P =1.000).Conclusion The improved three -dimensional titanium mesh can effective-ly reduce the incidence of postoperative complications and improve the curative effect of the operation.

Objective:To analyse the relationship of ultrastructural changes of glomerular basement membrane (GBM) and glomerular distributions of laminin α1 and laminin α5 in patients with Alport' s syndrome. Methods: Twenty patients with Alport' s syndrome were recruited. The thickness of GBM and the extension of thickening and splitting GBM were measured under transmission electron microscope. Normal renal tissues from 6 nephrectomies of renal carcinoma were taken as controls. Paraffin embedded sections of formalin-fixed renal tissue were processed for immunohistochemistry with monoclonal antibodies to laminin α1 and laminin α5. Their distributions in GBM were evaluated by a semiquantitative scale of positive extension; absent, 0≤25% , 1; 25%-50% , 2; 50%-75% , 3;≥75% , 4. Results: There were a variety of degrees of thickening or splitting GBM in patients with Alport' s syndrome. Laminin al was positive in glomerular mesangial area and absolutely negative in GBM and laminin α5 was evenly positive in GBM in normal tissue. In Alport' s syndrome, laminin α1 was much weaker in glomerular mesangial area, but strongly positive in GBM; laminin α5 in GBM was prominently reduced. There was a high negative correlation of semiquantitative scores between laminin al and laminin α5 (r =-0. 83, P＜0. 001). The extension of thickening or splitting GBM was positively correlated with scores of laminin al in GBM ( r = 0. 76, P＜0.001; r = 0. 56, P=0. 015 ) , and was negatively correlated with scores of laminin α5 in GBM ( r =-0. 59, P =0. 010; r=-0. 53, P =0.025). Conclusion: Abnormal distribution of laminin al and laminin α5 in GBM is correlated with GBM thickening and splitting in human Alport' s syndrome.

Objective To evaluate the osteogenesis of a novel borosilicate glass materials combined with platelet-rich plasma in repairing segmental bone defects. Methods 36 New Zealand white rabbits which bilateral radius were resected into l.5cm bone defect, were divided into 4 groups averagely depending on implanted materials: group A (one side: D-Alk- 1B, another side: D-Alk- 1B +PRP), group B (one side:D-Alk- 1B +PRP, another side: β-TCP); group C (one side: β-TCP, another side: experimental bone defect),and group D(one side:D-Alk-1 B,another side :experimental bone defect). The specimens were examined after 4, 8,12 weeks; the osteogenesis was evaluated through gross observation, X-ray radiograph,histological examination,scanning electron microscope and Micro-CT. Results There were similar results about gross observation,X-ray radiograph ,histological examination. After 4, 8, 12 weeks ,D-Alk-1B materials, β-TCP and D-Alk-1 B + PRP group had better osteogenesis ability than the experimental control group (P ＜0.05); D-Alk-lB + PRP had the best performance, better than D-Alk-1B and β-TCP (P＜0.05); D-Alk-1B were similar to β-TCP (P＞0.05). D-Alk-1 B materials degradated faster than β-TCP materials, and the porous structure of the materials disappeared after degradation. D-Alk-1B materials intergrated with host's bone was better than β-TCP materials. Conclusion D-Alk-1B material have good biological activity, histocompatibility and biodegradation and simiar presence of bone formation compared withβ-TCP in the aspect of repairing the segmental bone defect, the combination of PRP and D-Alk-1 B strengthened osteogenesis in vivo.

The inundation of Cordyceps sinensis counterfeits in the market makes it difficult to identify. In this study, 21 batches of wild C. sinensis from 3 different regions, 30 batches of naturally cultured C. sinensis and 4 kinds of counterfeits extracted by methanol and water were analyzed using NMR technology. 9 characteristic peaks were defined as quantitative criterion after comparison, and NMR fingerprints of C. sinensis were established. According to the result it is highly similar between naturally cultured C. sinensis and wild ones by comparing their NMR fingerprints. However, NMR spectra of four kinds of adulterants showed differences with C. sinensis. The result also showed that NMR fingerprint of C. sinensis are highly characteristic and specific. The NMR characteristic fingerprint of wild C. sinensis was consistent with the naturally cultured C. sinensis, and it indicated that the chemical constituents of wild C. sinensis and naturally cultured C. sinensis are nearly the same.

Objective To analyze effects of thoracoscopy in the diagnosis and treatment of suspected diaphragmatic injury after thoracoabdominal stab wound.Methods Sixty-eight patients who received thoracoscopic diagnosis and management of diaphragmatic injuries due to thoracoabdominal stab wounds from April 2000 to October 2011 were retrospectively analyzed.Results Occult diaphragmatic injuries were found in 11 patients.Seven patients underwent thoracoscopic suture,of which five had synchronous laparotomy for inspected abdominal organ injuries.Pulmonary parenchymal lacerations occurred in 15 patients who received thoracoscopic repair or resection.Coagulated hemothorax in 13 patients were removed.Postoperative complications included pleural effusion in one patient,pneumonia in two and pulmonary atelectasis in one.Hospital stay was(7.9±13.5)days,without ICU stay.The length of drainage,operation time and intraoperative blood loss were(3.3±1.5)days,(45.6±78.1)minutes and(57.8±24.3)ml respectively.There was no conversion to thoracotomy.Thoracic CT scan was performed six months postoperatively,without hernias.The accuracy of thoracoscopy in diagnosing diaphragmatic injury was 100％.Conclusion Thoracoscopy should be performed for the thoracoabdominal stab wounds with stable hemodynamics,with definite significance especially for the diagnosis and treatment of wounds at the 7-9th intercostal spaces.

Objective To introduce and evaluate a new surgical technique about concealed penis.Methods The incision was chosen on the outer lamina of the bilateral sides of penis.The excision of fibrous cord of penis dartos and suprapubic fat pad and skin fixation on the penis root were done to the patients.For the severe patients,the superficial layer of the suspensory ligament of penis must be excised.Thirty-nine cases were treated with this new technique,22 cases with Devine technique,and 23 cases with modified Shiraki technique and clinical comparative research was carried out.Results Penis of 39 cases were found 2 to 3 centimeters pro-pubic projection.Within 3 to 36 months of follow-up,no obvious reduction of penis was found and the erection function was normal.By new evaluat standard of surgical efficacy,the clinical efficacy of new technique,Devine′s and modified Shiraki′s technique were 92.31%(36/39 cases),77.27%(17/22 cases) and 78.26%(18/23 cases),respectively and the efficacy rate in new technigue was significcmthy higher than that of Devines and modified Shirak′s groups(Pa