0.05 ; and (2) in combined test, the combined OR= 3.2353 and its 95% confidence interval was in 2.21 - 4.74 (? 2= 36.2 ,P

Objective To summarize the clinical experience of operation treatment of Lisfranc fracture dislocation,and evaluate its clinical effect.Methods Thirty-nine patients with Lisfranc joint injuries (46 sides) were managed with open reduetlon as well as internal fixation with serews and Kirsehnerwlres.Results All the patients were followed up from12.0 to 42.0 months,the average was (21.1 ± 1.8) months.Evaluated the clinical effect according to the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score standard,there were 29 cases of excellent,8 cases of good,and 3 cases of aceeptable.Conclusion By Kirschner wire combining with screw fixation,open reduction and internal fixation may achieve satisfactory clinical results for the treatment of Lisfranc joint injurie.The operation is simple and fast,small trauma,less complications and can obtain good effects.

The basement membrane (BM) is crucial in regulating the physical and biological activities of esophageal epithelial cells which attach to the underlying BM. In order to simulate the natural construction of BM, we prepared the fibrous scaffolds using biodegradable polylactide (PLA) and silk fibroin (SF) as the materials via electrospinning technology. BM's proteins containing collagen (IV), laminin, entactin and proteoglycan were extracted from porcine esophagus and coated on the eletrospun fibers. Morphology, mechanical strength, biodegradability and cytocompatibility of the coated and uncoated scaffolds were tested and evaluated using scanning electron micrography, mechanical test system, immunofluorescence assay and western blotting with CK14 as the primary antibody. The fibrous scaffold PLA or PLA/SF, generated from the present protocol had good formation and mechanical and biodegradable properties. After coating with BM's proteins, the scaffold could enhance the growth and differentiation of esophageal epithelial cells, which would contribute to remodel and regenerate the tissue engineered epithelium and further contribute to engineer the whole esophagus in future.
Absorbable Implants ; Basement Membrane ; Biocompatible Materials ; chemistry ; Epithelium ; Esophagus ; physiology ; Fibroins ; chemistry ; Humans ; Nanostructures ; chemistry ; Polyesters ; chemistry ; Regeneration ; physiology ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

BACKGROUND:Polyurethane has good mechanical and physical characteristics and is extensively used in
clinical and experimental studies, but its hydrophobicity and histocompatibility are not ideal, which limits its use in tissue engineering as a biomaterial scaffold to some extents.
OBJECTIVE:To observe the hydrophilicity of polyurethane membrane grafted with silk fibroin and glutin and its compatibility with human hypopharyngeal cel s.
METHODS:The changes in hydrophilicity of polyurethane membrane grafted with silk fibroin and glutin were detected by contact angle measurements. Human hypopharyngeal fibroblasts were cultured in vitro on
polyurethane membrane, silk fibroin-polyurethane membrane, glutin-polyurethane membrane and tissue culture plate. Cel compatibility was compared using cytometry and cel morphology obsevation.
RESULTS AND CONCLUSION:Hydrophilicity of silk fibroin-or glutin-polyurethane membranes significantly increased (P<0.01). The hydrophilicity of silk fibroin-polyurethane membrane was higher than that of
glutin-polyurethane membrane (P<0.01). The number of cel s on the tissue culture plate was the most. The number of human hypopharyngeal fibroblasts on the silk fibroin-or glutin-polyurethane membrane was higher
than that on the polyurethane membrane, especial y on the silk fibroin-polyurethane membrane. These suggested that hydrophilicity and cel compatibility of silk fibroin-or glutin-polyurethane membrane were elevated.

Objective To evaluate the impact of hepatitis B e antigen (HBeAg) states and hepatitis B virus DNA loads on the prognosis of chronic severe hepatitis B.Methods A total of 406 hospitalized patients with chronic severe hepatitis B in Nanfang Hospital of Southern Medical University from January 2002 to December 2007 were retrospectively analyzed.The impact of HBeAg states and HBV DNA loads on the prognosis was evaluated.The measurement data were compared by t test and rates were compared by chi square test.Results Of all the 406 patients with chronic severe hepatitis B,208 (51.2%) patients were HBeAg-positive and the remaining 198 (48.8%) were HBeAgnegative.There was no significant difference of constituent ratio of male and female,average peak value of total bilirubin and average valley value of prothrombin activity between HBeAg-positive group and HBeAgnegative group.However,the average age of HBeAg-negative patients was (46.7±12.8) years old,which was significantly higher than that (38.3±13.5) years old in HBeAg-positive group (t = 6.43,P＜0.01 )the proportion of patients with liver cirrhosis in HBeAg-negative group (67.7%) was much higher than that in HBeAg-positive group (45.7%) (X2=19.97,P＜0.01);the improved rate in HBeAg-negative group (32.3%) was significant lower than that in HBcAg-positive group (44.7%) (X2=6.56,P＜0.05).Increasing HBV DNA levels was associated with lower improved rate in both 208 HBeAg-positive and 198 HBeAg-negative patients(X2=22.98,26.04,respectively,both P＜0.01 ).Conclusions HBeAg-negative patients with chronic severe hepatitis B has worse prognosis than HBeAg-positive patients;and the prognosis is getting worse with the increasing HBV DNA level regardless of the HBeAg status.

Objective To identify shortcomings in the current evaluation index system of medical quality. Methods The documentary analysis focused on the existing index system comprises the Hospital Management and Quality Evaluation Standards (2007) by China Hospital Association, Hospital Management Evaluation Guidelines (2005) by the Ministry of Health, and Implementation Rules of Hospital Management Evaluation Standards for Beijing (2007). JCI Accreditation Standards for Hospitals (edition 2) (2003), and New Hospital Accreditation Standards for Taiwan (2005, 2006) were referred to in the study. Results The shortcomings found include the weak operability of indexes, and the deficiency of evaluation indexes from the point of hospital visiting process by patients. Conclusion In view of the hospital visiting process of patients, add more indexes for patients' hospital visiting process,and quantize and highlight the operability of indexes, with summary and optimization of experiences in time by steps.

Objective · To explore the change of metabolomic profiling after erlotinib (anepithelial growth factor receptor tyrosine kinase inhibitor)resistance of lung adenocarcinoma cells (PC9-ER), and find the differential metabolome associated witherlotinib resistance. Methods · Metabolic profiling of PC9-ER cells and homologous parent PC9 cells was acquired by the ultraperformance liquid chromatography tandem quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS). The data were analyzed by multi-dimensional statistical methods, such as partial least squares projection to latent structures-discriminant analysis (PLS-DA), to select and identify differential metabolites associated with erlotinib resistance. Results · A total of 14 differential metabolites were identified in PC9-ER cells. Seven up-regulated metabolites included N-acetylspermidine, phosphatidylethanolamine, AMP, pantothenic acid,proline, glutamate, and histidine, while seven down-regulated metabolites included citrulline, phosphorylcholine, glutathione, cysteinylglycine, glutathione oxidized, NAD, and S-adenosylmethionine, mainly participating in glutathione metabolism, glutamate metabolism, ammonia recycling, and protein biosynthesis. Conclusion · Metabolic profiling of erlotinib-resistant lung adenocarcinoma cells was changed. The information of differential metabolites associated with erlotinib resistance could provide clues for new resistance mechanisms and potential metabolism-related drug targets.

BACKGROUND: Both biological and physical methods contribute to the repair of white meniscal tears, so the combined use will be better. OBJECTIVE: To study the influence of radiofrequency combined with platelet-rich plasma (PRP) on the repair of white meniscal tears. METHODS: Forty-eight adult New Zealand white rabbits were randomly divided into four groups, including simple suture, radiofrequency, PRP, and combination groups, and then the model of medial meniscus posterior root tears was established in all experimental animals. The simple suture group underwent interrupted mattress suture; the radiofrequency group was treated with radiofrequency (20 W, 45 ℃) after suture; the PRP group received the intra-articular injection of PRP after suture; the combination group was firstly treated with radiofrequency after suture, and then underwent the intra-articular injection of PRP. The gross and histological changes of the meniscus were observed, and the expression levels of transforming growth factor β1, vascular endothelial growth factor and platelet-derived growth factor were detected at 3 and 12 weeks postoperatively. RESULTS AND CONCLUSION: At 12 weeks after operation, the simple suture group showed no healing; the radiofrequency and PRP groups healed partially; and the combination group healed completely, and chondrocytes and collagen fibers arranged regularly. There was a significant difference in the healing rate between combination and simple suture groups (P=0.003). At 3 weeks postoperatively, the expression levels of vascular endothelial growth factor in the radiofrequency, PRP and combination groups were obviously higher than that in the simple suture group, which decreased markedly at the 12th week. At 3 weeks postoperatively, the expression level of platelet-derived growth factor was increased in all groups, especially in the PRP and combination groups. The PRP group showed the highest level of transforming growth factor β1 at 12 weeks postoperatively. These results manifest that the combination of radiofrequency and PRP promotes the repair of white meniscal tears by increasing the cell proliferation, cell mitosis and angiogenesis.

Objective To investigate the correlation between the prognosis and the early lactate clearance in patients with postcardiac surgery undergoing cardiopulmonary bypass.Methods The clinical data of 73 patients who underwent postcardiotomy undergoing cardiopulmonary bypass in SuBei Hospital of Jiangsu Provience,from March 2006 to February 2010,were prospectively collected and analyzed.The collection data including:( 1 ) Preoperative factors:including gender,age,diagnosis preoperative,NYHA grade,APACHE Ⅱ score and left ventricular end-diastolic diameter.(2) Operative factors:operation time,block aorta time.(3)Postoperation factors:hemorrhage volume,mechanical ventilation time,and factors of hemodynamics and oxygen metabolism at 6 hour postoperative:heart rate(HR),central venous pressure(CVP),pulmonary capilary wedged pressure( PCWP),cardiac output index( CI),arterial blood lactic acid,6 h lactate clearance,partial pressure of oxygen( PO2 ),mixed venous oxygen saturation ( SvO2 ),oxygen delivery index ( DO2I),oxygen consume index (VO2I),oxygen extraction ratio(O2ext).Patients were divided into survival group,control group,high level of lactate clearance group( lactate clearance rate ＞ 30％ ) and low level of lactate clearance group.Firstly,the data analyzed with process of single variable analysis and some parameters,which showed the significant difference,were sorted out from two groups.Then these parameters were put to the Logistic regression analysis.Consequently,the independent risk factors of death of postcardiac surgery could be found.Results The mortality in high lactate clearance group ( 4.55％ [ 2/44 ] ) was significantly less than the low lactate group (34.48％ [ 10/29] ) ( x2 =11.889,P ＜0.01 ).The single variable analysis had shown that there were significant difference on APACHE Ⅱ score ( [ 16.9 ± 2.9 ] vs [ 19.2 ± 2.6 ],t =2.537 ),left ventricular end-diastolic diameter( [ 53.9 ± 5.6 ] mm vs [ 63.8 ± 4.6 ] mm,t =5.847 ),block aorta time ( [ 101.2 ± 34.2 ] min vs [ 122.7 ±22.7 ] min,t =2.078 ),hemorrhage volume( [464.0 ± 158.8 ] ml vs [ 603.2 ± 159.5 ] ml,t =2.773 ),mechanical ventilation time( [ 22.6 ± 5.1 ] h vs [ 28.8 ± 5.2 ] h,t =3.857 ),arterial blood lactic acid ( [ 3.5 ±1.3 ] mmol/L vs [5.1 ± 1.5 ] mmol/L,t =3.912),lactate clearance ( [38.8 ± 17.4]％ vs [ 14.6 ±9.7]％,t =4.846),and SvO2( [69.1 ±4.2]％ vs [59.2 ±6.9]％,t =5.847) (P＜0.05 or P ＜0.001)between survival group and control group.Multiple regression analysis showed that lactate clearance and left ventricular enddiastolic diameter were the two independent risk factors of death,and the odds ratio(OR) were 7.773 (95％ CI 1.364-44.306,P ＜0.05) and 15.186(95％ CI 2.758-83.162,P ＜0.01).Conclusion Early lactate clearance rate can be used as an important indicator to evaluate the prognosis of patients with postcardiac surgery undergoing cardiopulmonary bypass.

BACKGROUND:We have found that oriented fibers can guide the alignment of smooth muscle cells in our previous experiments. Thus, we designed the experiment to prepare wel aligned polymeric fibers using electrospinning technology, aiming at guiding the growth of esophageal smooth muscle cells to maintain cellmorphology and biological function. OBJECTIVE:Using electrospinning technology, to fabricate isotropic and directed nano-fibrous scaffolds made of polycaprolacton, gelatin and silk fibroin. METHODS:Polycaprolacton/silk fibroin fibers at a ratio of 4:1 were prepared with proper parameters, including solution concentration, voltage and injection speed, under the self-made spinning system. The polycaprolacton/gelatin sheets with mass ratio of 2:1, 1:1 and 1:2, respectively, were also fabricated under suitable process parameters. Using the rol er col ector instead of the metal plate, polycaprolacton/gelatin nano-fibrous scaffold with good alignment of fibers was manufactured. RESULTS AND CONCLUSION:The isotropic polycaprolacton/silk fibroin scaffold with fiber diameter of (535.9±126.7) nm was prepared under conditions of solution concentration (0.08 g/mL), injection speed (1.6 mL/h) and voltage (22.5 kV), and these fibers were uniform with no beads. The isotropic polycaprolacton/gelatin scaffold with fiber diameter of (257.9±117.8) nm was prepared under conditions of solution concentration (0.10 g/mL), injection speed (0.8 mL/h) and voltage (22.5 kV). Using the rol er col ector instead of the previous metal plate, polycaprolacton/gelatin (w:w, 1:2) nano-fibrous scaffold with good alignment of fibers was manufactured. The process parameters were 3 000 r/min of rol ing speed, 0.8 mL/h of injection speed and 15 kV of voltage.