BACKGROUND:Al ogeneic bone has anatomical appearance and biological features similar to autogenous bone, which is an excel ent biological scaffold material. Mesenchymal stem cel s originating from autogenous bone marrow have mutli-lineage differentiation potential, can differentiate into osteoblasts and chondrocyte, and thus can accelerate the formation of bone tissue and cartilage tissue. OBJECTIVE:To establish the osteogenic ability of al ogeneic bone with autogenous bone marrow mesenchymal stem cel s for repairing major mandibular defects. METHODS:The left mandibular teeth of 24 beagles were extracted, and at 2 months after wound healing, mandibular defects were made artificial y. The beagles were divided into two groups:control group treated with lyophilized al ogeneic bone, and experimental group with autogenous bone marrow mesenchymal stem cel s and lyophilized al ogeneic bone. Densitometry with CT and Micro-CT was conducted 4, 12, and 24 weeks after surgery. RESULTS AND CONCLUSION:Compared with the control group, the bone density of the mandible was significantly higher in the experimental group at 12 weeks after transplantation (P<0.05). Over time, the bone densities in the two groups were both increased, but the bone density in the experimental group was always higher than that in the control group. Bone structure parameters were progressively increased or decreased in the two groups, especial y in the experimental group. At 24 weeks after surgery, the degree of trabecular separation in regions of interest was higher in the experimental group than the control group (P<0.05), but the bone volume fraction, number of trabecular bone, and bone trabecular thickness were significantly lower in the experimental group than the control group (P<0.05). These findings indicate that bone marrow mesenchymal stem cel s are capable of accelerating the reconstruction of al ogeneic bones.

BACKGROUND:The favorable structure and biological characteristics of al ogeneic temporomandibular joint become an effective solution for condylar defect, but immunologic rejection and slow ossification are the main problem for the presence of bone al ograft. OBJECTIVE:To meet the requirements of rebuilding mandible defect by lyophilizing canine mandible. METHODS:The periosteum, soft tissue, and cartilage of 12 canine mandibles were removed. 1 mm diameter hole was dril ed with 1 to 2 cm intervals in their cortical bones with a fissure bur. After washing, they were placed into a-4 ℃ refrigerator for 12 hours, and then stored at-80℃gradual y for 1 week. The mandibles were put in a drier. When the moisture content of osseous tissue decreased to 5%, the bones were packed in aseptic environment, radio pasteurized, and stored in vacuum container at atmosphere temperature. A biomechanical test was conducted after the lyophilization. RESULTS AND CONCLUSION:The maximum shifts of lyophilized mandibles in compression and bending tests were slight according to the steep load-shift curve. The plastic zone was insignificant and fractures appeared immediately when the pressure exceeded the plastic zone. The maximum load, maximum shift, and rigidity in the compression test were (5 163.10±730.16) N, (0.78±0.19) mm and (11 069.17±1 758.12) N/mm, respectively. The data in bending test were (486.67±134.12) N, (0.67±0.15) mm and (1 151.67±256.46) N/mm, respectively. It is concluded that the dehydrated and lyophilized canine mandibles have good shape and support ability and can meet the mechanical requirements in repairing and reconstructing mandibular defect.

Objective Albumin is well known to decrease in response to sepsis, However, the.degradation and distribution in patients with severe sepsis to explore the mechanism of hypoalbuminemia in sepsis. Methods 10 volunteers and 10 patients with severe sepsis. 125I labeled albumin was administered intravenously to 10 healthy volunteers and 10 patients with severe sepsis. Each subject had frequent blood samples taken at 0,1,2,4,8,12,24 hours and on day 2, 3, 4, 5, 6, 7, 9, 11, 13, 15, 18, 22, 25 to measure 125I concentration and draw the curve of concentration over time. Plasma was regarded as the central pool and body fluid as side pool, The curve of albumin concentration vs time was expected to follow two compartment model. Results Radioactivity of blood samples was counted and the results were graphically expressed. The half-life time(t1/2), apparent volume of distribution(Vd) and transportation rate(K12) of albumin from the central pool to the side pool were calculated. The half-life time in sepsis was obviously shorter than that in control group (8.2 1.4 vs 12.5 1.7days, P<0.001). The transportation rate in sepsis group was quicklier than that in control group [(4.4±1.9)× 10-2/h vs (2.4±0.6)×10-2/h, P<0.005]. There was no significant difference in apparent volume of distribution between two groups. Conclusions In patients with severe sepsis, the distribution rate of albumin from plasma to body fluid was obviously elevated and the decomposition rate of albumin was markedly increased.

Objective To explore the correlation of ABO blood group and serum cystatin C level and decompensated hepatitis B cirrhosis.Methods Retrospectively analysed the clinical data of 472 patients with decompensated hepatitis B cirrhosis,and compared with 681 healthy control volunteers.All the informations such as gender,age,family history of liver disease,hepatitis B virus infection,hepatic function classification,complications of portal hypertension and the distribution of ABO blood group were observed.Results The highest incidence of decompensated hepatitis B cirrhosis was found in A blood group.There was no significant difference in the distribution of ABO blood group for patients with different age (P ＞ 0.05).Significant correlations were observed between AB blood group and family history of hepatitis B patients,expansion of the portal veines ＞ 1.5 cm,esophageal varices,cirrhosis complications,hepatic function classification (P ＜ 0.01).C ystatin C expression was increased with hepatic function classification (P ＜ 0.05).Conclusions The risk of liver cirrhosis is increased in patients with A blood group.Compare with other blood group,patients with AB blood group has a serious progression.The level of nitrogen,creatinine,cystatin C in decompensated cirrhosis are significantly higher than healthy controls.The level of cystatin C expression is increased with hepatic function classification.Cystatin C may be a potential marker in the classification of hepatic function.

OBJECTIVETo investigate the effect of segmental defects reconstruction of canine mandible with allogenenic bone marrow mesenchymal stem cells (BMSC) combined with lyophilized bone.

METHODSA 30 mm segmental defect was created on the left mandibles of beagles. Beagles were randomly divided into three groups. Allogeneic bone marrow mesenchymal stem cells with lyophilized bone were used for segmental defects reconstruction in group A. Autologous bone marrow mesenchymal stem cells with freeze- dried bone were used for segmental defects reconstruction in group B. The defects of group C were repaired with lyophilized bone only. Every three beagles were sacrificed 4, 12, 24, and 48 weeks after surgery respectively. The reconstruction effect was evaluated by CT and histopathological examination.

RESULTSCT examination showed that new bones formed in group A and group B 12 weeks after surgery, but not in group C. The form of the reconstructed mandibles in the three groups recovered in 48 weeks. The small pores on the bone graft were filled with new bones in group A and group B. In group C, the pores were still evident. Histopathological examination showed that bone trabecula between allogeneic bone and autogenous bone was completely joined in group A and group B. A large number of fibrous tissue appeared around the implanted bone and new bones were formed. In group C, the lyophilized bone resorption was still not obvious, the new bone formation was significantly slower than the other two groups. There was no difference between group A and group B.

CONCLUSIONSBoth allogeneic bone marrow mesenchymal stem cells and autologous mesenchymal stem cells could accelerate the bone formation.

Allografts ; Animals ; Bone Transplantation ; Dogs ; Mandibular Reconstruction ; methods ; Mesenchymal Stem Cell Transplantation ; Osteogenesis ; Time Factors ; Tissue Engineering ; methods

OBJECTIVETo conduct a systematic review of the safety and efficacy of enhanced recovery after surgery(ERAS) program in perioperative management of pancreaticoduodenectomy.

METHODSA computerized search was performed in databases including PubMed, Embase, Medline, Web of Science, Cochrane Library, CNKI, Wanfang and VIP for randomized controlled trials (RCTs) or clinical controlled trials (CCTs) describing an ERAS program in patients undergoing pancreaticoduodenectomy published between January 1966 and May 2014. After assessment of methodological quality and data extraction, meta-analysis was performed using RevMan 5.2.0 software.

RESULTSSix RCTs and 8 CCTs including 2565 patients were selected for this study, including the study group(n=1366) and the control group (n=1199). Compared with the control group, the study group had a shorter length of hospital stay(WMD=-3.67, 95% CI:-5.66--1.68, P<0.05), lower postoperative complication rate(OR=0.73, 95% CI:0.56-0.95, P<0.05) and lower mortality(OR=0.63, 95% CI:0.44-0.91, P<0.05). However, no significant differences existed in mortality, readmission rate and re-operation rate between the two groups.

CONCLUSIONSEnhanced recovery after surgery programme in perioperative management of pancreaticoduodenectomy is safe and effective. But due to the medium quality of the literature. This still need more rigorously designed RCTs to prove the safety and efficiency of ERAS programme for the patients undergoing pancreaticoduodenectomy.

Humans ; Length of Stay ; Pancreaticoduodenectomy ; Postoperative Complications

Objective Breast cancer is one of the deadliest malignancies in the world. ebracteolatain A (EA) is a kind of acetylphloroglucinol extracted from ebracteolatain. To explore the specific mechanism of EA inhibiting the proliferation of breast cancer cell MCF-7, so as to provide a new approach for the clinical treatment of breast cancer. Methods EA with different concentrations were added to breast cancer cell MCF-7 to detect changes in PKD1 protein expression. The plasmid with overexpressed PKD1 was constructed and transfected into cells, and the mRNA and protein expression levels of PKD1 were detected by real-time fluorescence quantitative PCR and Western Blot assay. CCK-8 assay was used to detect changes in cell proliferation capacity. Western Blot assay was used to detect the expression level of PKD1 and its related signaling pathways. Results EA inhibited the expression of PKD1 protein in breast cancer cells with a dose-dependent manner (P< 0.05). When transfected with the overexpressed plasmid, PKD1 was significantly increased in mRNA and protein levels (P<0.001). At the same time, PKD1 overexpression significantly reversed inhibition of EA on MCF-7 proliferation (P<0.001). It was confirmed by signaling pathway analysis that EA might affect the proliferation ability of breast cancer cells by inhibiting PKD1-mediated MEK/ERK and PI3K/AKT signaling activity (P<0.05). Conclusion EA could inhibit the proliferation of breast cancer cells by regulating PKD1-mediated MEK/ERK and PI3K/AKT signaling pathways.