Objective To investigate the retainage rate,distribution,and emigration of the bone marrow mesenchymal stem cell(BMMSC) after transcoronary infusion and to further evaluate the feasibility of injecting BMMSCs into coronary artery.Methods BMMSCs were isolated,purified,expanded,and labelled with CM-DiI.The infarcted SD rat hearts were removed and perfused with Langendorff apparatus.The cells were injected into the aortic root and the fluid returning from the coronary system was collected and the labelled cells in the coronary effluent were quantitated with flowcytometry.At the same time,left ventricle function was recorded to evaluate the safety of this approach.In vivo study,the cells were then injected into clamped ascending aorta through a catheter inserted through the left ventricle into the aortic root.The hearts were harvested at different time points after cell transplantation to obtain the direct evidence of distribution and emigration of the implanted cells.Results Only 3%～5% of transplanted cells returned into the right ventricle and more than 90% cells retained in the heart after beinginjected into aortic root of Langendorff model of infarcted hearts of SD rats.Left ventricle function did not deteriorate after cell transplantation.The labelled cells were entrapped within the coronary capillary immediately after cell infusion,mainly in the normal area.After 24 hours some cells migrated through the capillary wall into interstitium of the heart.One week later we found that most survival cells located at the infarcted area and the border zone.Conclusion The majority of BMMSCs delivered by transcoronary infusion retained in the heart.BMMSCs can penetrate the vessel wall and home back to the interstitial compartment and the injured area in a few hours.

Objective Establish rabbit VX2 soft tissue tumor model,and treat it with percutaneous ethanol injection(PEI)under the guidance of magnetic resonance imaging.Make ready for the therapeutic evaluation with functional magnetic resonance imaging. Methods Fifteen healthy New Zealand white rabbits were included in this study.0.2 mL tumor tissue suspensions were injected into the rabbits’posterior limb.14 days later,all rabbits were underwent conventional MRI examination.PET were performed to all the tumors under the guidance of MRI in the next day of the examination.T2 WI was used as guidance and monitoring means.MR com-patible puncture needle with lateral hole was stabed into the lesion center,and inj ected anhydrous ethanol according to the volume of tumors’diameter (1 mL/cm )slowly.the tumors signal characteristics,morphological feature and pathological feature were ob-served pre and post-operation.Results All of the 1 5 rabbits were established soft tissue tumor model successfully;the success rate is 100%.The tumors were oval or round,3-4 cm in diam.MRI scanning showed low signal on T1 WI and high signal on T2 WI be-fore PEI.PEI was performed to all the tumors under the guidance of MR successfully with 3.5 mL ethanol injected into the tumors in average.T2 WI could monitor the ethanol in dispersion and distribution within the tumors clearly.Histologically,tumors were composed of large,uniform,oval/round cells arranged in solid nests which was intensive in the periphery of tumors.Necrosis tissue was apparent in the center of the tumors.10 days after operation,most tissue in the periphery of tumors was coagulative necrosis , only a few tumor cells left.Ranges of necrosis in the tumors center were obviously increased compared with pre-operation.Conclusion Rabbit VX2 tumor of soft tissue model is suitable for the therapeutic evaluation of tumor .It is an animal model which has the characteristic of simple to operate and high rate of suc-cessful.MR T2 WI can monitor the ethanol in dispersion and distribution within the tumors clearly.It is a good guidance and monitoring imaging method of tumor ablation.

Objective To better characterize the clinical and histopathological manifestations, diagnosis and differential diagnosis of epithelioid sarcoma (ES).Methods Clinical data were collected from nine patients with ES diagnosed and treated at the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from 2000 to 2014.The clinical and histopathological manifestations, immunophenotype, treatment and prognosis of ES were reviewed retrospectively.Results The median age at onset of ES was 34.5 years in these patients, and the average disease duration was 8.3 years.Lesions began on the extremities in 8 patients, and manifested as nodules,ulceration and lymphedema.Histopathological examination showed that tumor cells mainly consisted of spindle cells and epithelioid cells, some of which were in a palisade arrangement with central necrosis.Cytokeratin, epithelial membrane antigen (EMA) and vimentin were coexpressed by tumor cells.Recurrence was observed at the original site in 6 patients after lesion resection, and pulmonary metastasis occurred in 4 patients.Five patients were followed up and two of them died of pulmonary metastasis.Conclusions Local recurrence is frequent in patients with ES after lesion removal.Lymph node and pulmonary metastases of ES are common, and pulmonary metastasis is usually associated with a poor prognosis.

Objective To explore the utility of ADC histogram analysisin differentiation of clear cell renal cell carcinoma(ccRCC)and non-clear cell renal cell carcinoma(non-ccRCC)with r-Fov DWI. Methods Sixty-six renal tumors(46 patients with 47 ccRCCs and 18 patients with 19 non-ccRCCs)in 64 patients, who underwent preoperative routine renal MRI sequences and r-FOV DWI, were retrospectively evaluated. The whole-lesion ADC values derived from histogram anlysis(including ADC mean, ADC median, ADC_5th, ADC_25th, ADC_75th, ADC_95th, skew and kurtosis)were measured for each patient. All parameters between ccRCC and non-ccRCC were compared by using the Student's t test or Mann-Whitney U test. ROC analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the two groups. Results The postive skewness of ADC histograms were mostly seen in the non-ccRCC group, while the negtative skewness were present in the majority of ccRCCs. The skewness was significantly higher in non-ccRCCs than those of ccRCCs(P<0.05). Mean ADC, median ADC, 5th percentile ADC, 25th percentile ADC, 75th percentile ADC and 95th percentile ADC(all P<0.05)were significantly lower in non-ccRCC . There was no significant difference of Kurtosis between two groups(P>0.05). 75th percentile ADC achieved the highest AUC(0.987)in differentiating ccRCC and non-ccRCC, whena cutoff value was 1.81× 10-3 mm2/s. The sensitivity and specificity were 100.0％and 94.7％. Conclusion ADC histograms of r-FOV DWI may be helpful to differentiate ccRCC from non-ccRCC, and the diagnostic accuracy of 75th percentile ADC is highest.

BACKGROUND: Recently, a few studies have reported the correlation between transforming growth factor-α (TGF-α) and graft-versus-host disease (GVHD); however, the combination of TGF-α with other cytokines in patients with chronic or acute GVHD requires further study.OBJECTIVE: To analyze the changes of serum tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and transforming growth factor-α (TGF-α) in leukemic patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and investigate the effects of these cytokines on different grades of GVHD.DESIGN: Case control study.SETTING: Department of Hematology, Organ Transplantation Center, the Second Affiliated Hospital, General Hospital of Chinese PLA; Department of Nuclear Medicine, the Second Affiliated Hospital, General Hospital of Chinese PLA.PARTICIPANTS: Forty-two leukemic patients (23 males and 19 females, 16-68 years old, mean age of 35 years) who underwent Allo-HSCT for the first time were selected from the Department of Hematology, Organ Transplantation Center, the Second Affiliated Hospital, General Hospital of Chinese PLA and Department of Transplantation, the 307 Hospital of Chinese PLA from June 2005 to June 2007. Twelve patients had acute granulocytic leukemia (AGL), fifteen patients had acute lymphocytic leukemia (ALL), and fifteen patients had chronic granulocytic leukemia (CGL). Among the 42 patients, 37 underwent peripheral blood transplantation and five received bone marrow transplantation. Twenty-one patients had acute GVHD (18 cases in grades Ⅰ-Ⅱ and three cases in grades Ⅲ-Ⅳ) after Allo-HSCT, but the other 21 patients did not. Fourteen patients had chronic GVHD (five cases of limited type and nine cases of extensive type), but the other 28 patients did not. An additional 30 healthy subjects (18 males and 12 females, 20-70 years old, mean age of 44 years) were collected as a normal control group. All patients provided confirmed consent, and the study was approved by the local ethics committee.METHODS: Levels of serum TNF-α, IL-4, and TGF-α in leukemic patients with Allo-HSCT and normal subjects were measured by radio-immuno-assay, the cytokines levels of the patients with/without acute GVHD, of those with/without chronic GVHD and of different grades of GVHD were compared.MAIN OUTCOME MEASURES: Comparisons of serum TNF-α, IL-4, and TGF-α among the groups.RESULTS: All 42 leukemic patients and 30 healthy subjects were included in the final analysis. Levels of TNF-α, IL-4, and TGF-α in patients with acute or chronic GVHD were significantly higher than those in the normal subjects (P<0.05-0.01). Levels of TNF-α and IL-4 in patients without acute GVHD were significantly higher than those in the normal subjects (P<0.01,0.05). Levels of TNF-α, IL-4, and TGF-α in patients with acute GVHD were significantly higher than those in patients without acute GVHD (P<0.05). Levels of TNF-α, IL-4, and TGF-α in patients with chronic GVHD were significantly higher than those in patients without chronic GVHD (P<0.05). Levels of serum TNF-α and TGF-α in patients with acute GVHD of grades Ⅲ-Ⅳ or chronic GVHD of extensive type were significantly higher than those in patients with acute GVHD of grades Ⅰ-Ⅱ or chronic GVHD of limited type (P<0.05-0.01).CONCLUSION: After Allo-HSCT, dynamically monitoring changes of levels of TNF-α, IL-4, and TGF-α may serve as a possible means of predicting the onset of acute or chronic GVHD and may contribute considerably to deciding clinical severity of GVHD.

Combining with advances in optogenetics and feedback control of physiological function, we have utilized self-made PPDP (preview, presentation, demonstration, promotion) teaching method to clarify how various physiological functions are regulated by the nervous system and carried out physiological innovation experiment activities. The innovative experiments aim to cultivate students' self-study capability, broaden their vision, enhance their interest in physiology, and finally promote the effect of physiological theory teaching. We herein summarize our practice of closed-loop control of innovative experimental teaching in optogenetics from the following four facets: education concept, students and teacher resources, teaching design, and teaching experience. This summary is trying to explore new experiences of promoting students' participation in teaching activities and improving the teaching quality of physiology.

Objective·To investigate the effects of a novel chitosan-silver nitrate gel (CSNG) dressing on anti-septic in wound healing.Methods·By using the ion membrane,the release rate of the new composite materials of silver ion was tested in vitro.Meanwhile,the anti-septic effects of CSNG on methicillin resistant Staphylococcus aureus (MRSA),Escherichia coli and Candida albicans were tested by colony counting.The rat wound healing model was used to detect the ability of new material to kill MRSA in vivo.Results·Compared with control group,the release of silver ions of CSNG was much slower.Sterilization experiment showed that CSNG killed the MRSA,Escherichia coli and Candida albicans much more efficiently,compared to that in the other treatments.Animal experiments also showed that CSNG promoted the rats of wound healing.Conclusion·Combining chitosan with silver nitrate and supplementary material could develop a novel chitosan-silver nitrate gel material,which not only has the obvious effects on antibacterial,but also on promoting wound healing.

BACKGROUND: Currently, most of the clinical trials of cell transplantation for ischemic heart disease is the transplantation of bone marrow mononuclear cells through the bypass graft artery in patients with acute myocardial infarction, but reports in combination with cell transplantation for old myocardial infarction are few. OBJECTIVE: To investigate the safety and feasibility of intracoronary artery injection of bone marrow mononuclear cells through the bypass graft artery during coronary artery bypass grafting (CABG). DESIGN: Self-control and case analysis. PARTICIPANTS: A total of 10 patients who had old myocardial infarction, left ventricular ejection fraction (LVEF)≤40%, were selected from Cardiovascular Institute and Fuwai Hospital from November 2004 to June 2005. METHODS: The bone marrow mononuclear cells were harvested from the bone marrow by Ficoll density gradient centrifugation method before the CABG was carried. And the patients received CABG and 10 mL mononuclear cell suspension through the grafts into anterior descending branch. In addition, 10 mL mononuclear cell suspension was injected into the circumflex branch and right coronary artery through the proximal heart. MAIN OUTCOME MEASURES: The heart function was evaluated with transthoracic echocardiography (TEE) and cardiac MRI after the operation. RESULTS: All patients recovered. A total of 45-60 mL bone marrow was harvested from iliac crest, and 4.1 ×10~7 mononuclear cells were isolated and identified by trypan blue test (cell activity >95%). TEE showed that the LVEF at 1 week and 1, 3 months postoperatively was significantly improved compared with before operation; creatase arid troponin T were not increased, and no myocardial infarction changes were found. MRI showed that the LVEF was significantly increased following operation (P < 0.01); left ventricular end-diastolic and systolic diameters were significantly decreased (P < 0.05). There was no complication associating with bone marrow harvest, or cell transplantation. CONCLUSION: Bone marrow mononuclear cells transplantation through bypass graft, as an adjunctive therapy, is safe and feasible.

Objective To explore clinical application of single utility port or single port video-assisted thoracoscopic lobectomy.Methods Conducting a prospective study to 191 patients with lung disease who underwent complete video-assisted thoracoscopic surgery (VATS) lobectomy in Department of Thoracic Surgery of The People's Hospital of Wuhan University from June 2013 to Dec 2014.Results Of the 191 patients, 35 underwent left upper lobectomy, 42 underwent left lower lobectomy, 43 underwent right upper lobectomy, 11 underwent right middle lobectomy, 47 underwent right lower lobectomy, and 13 underwent bilobectomy.Operations were successful in all patients with 3 patients transferred for open thoracotomy for severe adhesion or bleeding.A total of 7 of 78 upper lobectomy and 8 of 113 middle or lower lobectomy was done with adding another incision for severe adhesion.The mean operative time was 50 ～ 190 (80.3 ±43.2) min.The mean blood losing was 90 ～ 350 (145.4 ± 56.2) ml.Thirty nine patients underwent upper lobectomy, who were placed two chest tubes, respectively.The upper chest drainage duration was (1.5 ±0.8) d, and the lower chest drainage duration was (4.2 ± 1.3) d.Forty eight patients underwent lower lobectomy, middle lobectomy, or bilobectomy, who were placed one chest tube, respectively.The chest drainage duration was(4.0 ± 1.7)d.The mean recovery time after operation was (6.1 ± 2.5) d.Seventy six patients were diagnosed with lung cancer, and the average number of dissected lymph nodes from each patient was (14.7 ±6.9).The lung cancer was classified as tumor node metastasis (TNM) stage Ⅰ A, Ⅰ B,ⅡA, ⅡB and ⅢA in 67, 61, 34, 22 and 7 cases, respectively.No serious complications, such as bronchopleural fistula or death, occurred in perioperation.Conclusions In consideration of placing two chest tubes after upper lobectomy and placing one chest tube after lower lobectomy, middle lobectomy, or middle and lower lobectomy, we think single utility port-VATS (2-port) for upper lobectomy and single port-VATS lobectomy for lower lobectomy, middle lobectomy, or middle and lower lobectomy are technically safe and have the advantages of drainage, lessening pain, rapid postoperative recovery, and have no significant difference in operation time, the incidence of complications and the number of removed lymph nodes, compared to traditional 3-port-VATS.

OBJECTIVE: To explore the application of mixed reality technique for the surgery of oral and maxillofacial tumors. METHODS: In this study, patients with a diagnosis of an oral and maxillofacial tumor who were referred to Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2018 to January 2020 were selected. The preoperative contrast-enhanced computed tomography data of the patients were imported into StarAtlas Holographic Medical Imaging System (Visual 3D Corp., Beijing, China). Three-dimensional (3D) model of tumor and key structures, such as skeleton and vessels were reconstructed to three-dimensionally present the spatial relationship between them, followed with the key structures delineation and preoperative virtual surgical planning. By using mixed reality technique, the real-time 3D model was displayed stereotactically in the surgical site. While keeping sterile during operation, the surgeon could use simple gestures to adjust the 3D model, and observed the location, range, and size of tumor and the key structures adjacent to the tumor. Mixed reality technique was used to assist the operation: 3D model registration was performed for guidance before tumor excision; intraoperative real-time verification was performed during tumor exposure and after excision of the tumor. The Likert scale was used to evaluate the application of mixed reality technique after the operation. RESULTS: Eight patients underwent mixed reality assisted tumor resection, and all of them successfully completed the operation. The average time of the 3D model registration was 12.0 minutes. In all the cases, the surgeon could intuitively and three-dimensionally observe the 3D model of the tumor and the surrounding anatomical structures, and could adjust the model during the operation. The results of the Likert scale showed that mixed reality technique got high scores in terms of perceptual accuracy, helping to locate the anatomical parts, the role of model guidance during surgery, and the potential for improving surgical safety (4.22, 4.19, 4.16, and 4.28 points respectively). Eight patients healed well without perioperative complications. CONCLUSION By providing real-time stereotactic visualization of anatomy of surgical site and guiding the operation process through 3D model, mixed reality technique could improve the accuracy and safety of the excision of oral and maxillofacial tumors.
Augmented Reality ; China ; Humans ; Imaging, Three-Dimensional ; Neoplasms ; Retrospective Studies ; Surgery, Computer-Assisted