Objective To explore the biological characteristics and karyotype of bone marrow-derived mesenchymal stem cells(MSCs)in patients with systemic lupus erythematosus(SLE)and hematopoietic sup- port of MSCs.Methods MSCs were isolated from bone marrow of 11 SLE patients and 6 healthy controls by density centrifugation and adhesive culture in vitro.The surface markers were detected by flow cytometry (FCM).The morphological changes of MSCs were observed in primary and passage cultures.The growth curves were assayed.The karyotype of MSCs was detected by blocking cellular mitosis with colchicines.The MSCs from SLE patients and healthy controls were infused to ICR mice after high-dose chemotherapy.The changes of peripheral blood counts of the mice were recorded.Results Approximately(6～9)?10~9 MSCs from SLE were obtained after 5 passages and their growth was slower than normal controls(P＜0.01).Both groups were positive for CD29,CD44 and CD105,and negative for CD14,CD34,CD45 and HLA-DR.MSCs from SLE had a normal karyotype.MSCs infusions of the two groups were accompanied by no adverse event and the recovery of white blood cell,hemoglobin and platelet count was quicker when compared with the controls(P＜0.05).Conclusion MSCs from SLE have demonstrated abnormalities in expansion in vitro.MSCs from SLE have a normal karyotype.Ex vivo MSCs infusion from SLE patients can support hematopoiesis as normal MSCs.

Objective To evaluate the effect of convalescent training on patients after special prosthesis replacement in treatment of giant cell tumors. Methods 20 patients with giant cell tumors were treated with convalescent trainings postoperatively,including trainings of muscle strength,joint movement, balance, noumenal sense and gait and were emphasized for earlier training of active muscle contraction. Results According to Enneking score system of bone and muscle postoperation, the lowest for extremitas superior postoperation score of 5 patiens was 20,the highest was 28, the average was 26.6. 4 patiens score was higher than 24, the good rate was 80.0 %.15 patiens extremitas inferior score was from 14 to 27, the average was 21.5, the good rate was 86.7 %. Conclusion Earlier staged joint functional rehabilitation exercise after special prosthesis replacement in treatment of giant cell tumors could prevent ankylosis,improve adhering of capsule,ligament and other soft tissue,and recover the joint function to maximum.

AIM: To observe the efficacy and safety of small incision manual nuncleofragmentation technology in hard-nucleus cataract.METHODS: Fifty-four patients (54 eyes) were performed with small incision manual nucleofragmentation and intraocular lens implantation.Uncorrected-visual acuity,corrected-visual acuity and astigmatism were measured before and after surgery.Anterior segment of eye,retina,surgical complications were observed.RESULTS: Preoperative uncorrected vision(LogMAR) was 1.095±0.171,corrected vision (LogMAR) was 0.994±0.158.Postoperative uncorrected vision(LogMAR) was 0.321±0.214 and corrected vision(LogMAR) was 0.276±0.179 at 1wk after operation.Both had statistical significance compared with uncorrected vision(LogMAR) (t=27.052,P<0.01) and corrected vision (LogMAR)(t=29.211,P<0.01) after cataract operation.Average preoprative corneal astigmatism was 0.93±0.34D,average postoprative astigmatism was 0.95±0.29D at 3mo,there was no statistical significance of astigmatism before and after surgery(t=1.048,P>0.05).No severe complications occurred in all cases.CONCLUSION: The technology of small incision manual nuncleofragmentation in hard-nucleus cataract is proved to be safe and effective.

To evaluate the clinical effect of small incision cataract extraction with a manual nucleus division technique combined with intraocular lens implantation in cataract operation of large quantities.
●METHODS: Totally 105 patients (105 eyes) underwent small incision cataract extraction surgery. Visual acuity was observed, eye condition, fundus and intraocular pressure were examined by slit lamp at postoperative 1wk; 1mo.
●RESULTS: The visual acuity improved significantly at postoperative 1mo, 89 cases (89 eyes) with better than 0. 3( 85%), 101 cases ( 101 eyes) with 0. 1 and above (96%). lt had short operation time, fewer complications and good anesthetic effect.
● CONCLUSlON: This operation is suitable for primary hospitals, which visual acuity improved obviously, without serious complications, and economic and feasible.

Objective To assess the safety and efficacy of domestic sirolimus-eluting stent(SES)compared with bare metal stent(BMS)in the primary percutaneous coronary intervention(PCI)for patients with ST-segment elevation AMI in a real-world scenario.Method From January 2005 to March 2006,a total of 143 patient with ST-segment elevation AMI were enrolled in this study,and all of them underwent primary percutaneous coronary intervention(PCI).Among the 143 patients,74 were treated with domestic SESs(Firebird stent)and 69 with BMSs.The incidence of major adverse cardiovascular events(MACE:death,reinfarction,and target vessel revascularization[TVR])was evaluated at 30 days and 180 days.Continuous variables were compared using Student's unpaired t test.Categorical variables were compared using Fisher's test.Cox proportional hazard survival models were used to assess risk reduction of adverse events.P value

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

Mean hemoglobin (Hb) concentration of about 3 500 subjects derived from 17 studies of Himalayan highlanders (Tibetans, Sherpas, and Ladakhis) was compared with lowlanders (Chinese Han, Indian Tamils) lived in the Himalayas, and European climbers during Everest expeditions as well as Andean natives. The results found that Hb concentration in Himalayan highlanders was systemically lower than those reported for Andean natives and lowland immigrants. These comparative data demonstrated that a healthy native population may successfully reside at high altitude without a significant elevation in Hb, and the lower Hb levels of Himalayan highlanders than those of migrated lowlanders and Andean natives are an example of favourable adaptation over the generations. In addition, excessive polycythemia has frequently been used as a marker of chronic mountain sickness (CMS). Altitude populations who have a higher Hb concentration also have a higher incidence of CMS. The low Hb in Himalayans suggested as showing adaptation over many generations in Tibetan stock. Recent work in Tibet, suggested that Tibetans there may have adapted to high altitude as a result of evolutionary pressure selecting for genes which give an advantage at altitude. All of the population genomic and statistical analysis indicated that EPAS1 and EGLN1 are mostly likely responsible for high altitude adaptation and closely related to low Hb concentration in Tibetans. These data supported the hypothesis that Himalayan highlanders have evolved a genetically different erythropoietic response to chronic hypoxia by virtue of their much longer exposure to high altitude.
Adaptation, Physiological ; Altitude ; Asian Continental Ancestry Group ; genetics ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Evolution, Molecular ; Hemoglobins ; genetics ; Humans ; Hypoxia-Inducible Factor-Proline Dioxygenases ; genetics ; Tibet

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To screen the mimotopes ofpemphigus vulgaris (PV) antigen, desmoglein3 (Dsg3) with a phage-displayed random nonapeptide library, so as to update the knowledge on the patho-genesis of PV. Methods Recombinant fusion protein of extracellular domain 1-2 (EC1-2) of Dsg3 and glutathione transferase was expressed by E.coli BL21, and used to purify polyclonal autoantibody binding to recombinant EC 1-2 from the sera of patients with PV. Then, selected autoantibody was applied as a ligand for biopanning of a phage-displayed linear random nonapeptide library and circular random nonapeptide library. Monoclonal phages were selected by immunoscreening and tested with ELISA and competitive ELISA. Results After two rounds ofbiopanning, a population ofpeptide-displaying phages binding to autoan- tidody were highly enriched. Sixty individual phage clones selected by immunosereening were further sub-jected to screening with ELISA and competitive ELISA. Finally, three positive phage clones were obtained. As shown by ELISA and competitive ELISA, they reacted with serum from patients with PV but not with that from normal human controls, and blocked the interaction between patients' sera and recombinant fusion protein of EC1-2. Conclusion Three mimotopes closely associated with PV antigen were successfully selected from a phage-displayed random nonapeptide library.

OBJECTIVE: To investigate feasibility and effectiveness of pedicle screw bi-cortical fixation in lumbar spondylolisthesis or destabilization of aged people. METHODS: The statistical significance of the distance between the anterior edge of vertebral body and the anterior major blood vessels at the level of pediculus arcus vertebrae by CT scan at random were measured and analyzed. 82 cases of lumbar spondylolisthesis or destabilization, aged 65 years (range 51 to 75 years), including 35 males and 47 females, were treated pedicle screw bi-cortical fixation, with the anterior edge of the vertebral body penetrated by one screw thread. The function was evaluated by Macnab backleg pain scale standards. RESULTS: There was significant difference in the distance of the anterior edge and the major vessels between the old and the young (P< 0.05). All the 82 cases were operated successfully, and the mean time was 145 minutes and the mean amount of bleeding was 530 mL. The 43 cases including 15 males and 28 females were followed up for 18 months (range 3 to 53 months). There was one case of rupture of the spinal dura mater with no sequela after the suture. There were 3 cases of transient paralysis and pain of lower limbs, which were alleviated after 2 months' treatment. No complications of nerve root or vessel injuries were found. All incisions healed well at the primary stage. The lumbocrural pain of all 43 cases was alleviated to a certain content. There were 31 cases of excellent, 10 of good, and 2 of fair; the excellent and good rate was 97%. CONCLUSION: It is feasible and safe to treat the lumbar spondylolisthesis or destabilization in the old with the pedicle screw bi-cortical fixation.