Objective:To approach the prediction value of alpha-fetoprotein(AFP) and ?-L-fucosidase(AFU) during the hepatoma recurrence post of liver transplantation.Methods:Thirty-five patients with hepatoma recurrence underwent transplantation of liver were followed up and observed.The changes of AFP and AFU in blood serum during the hepatoma recurrence post-transplantation of liver were analyzed.Results:It was followed up 2 to 12 months,10 patients were lost.The average time was(5.75?2.46) months.The rest 25 patients were all suffered hepatoma recurrence.There were 12 in liver recurrence(48%) ,13 recurrence outside(lung 36%,bone 4%,portal vein cancer blot 4%,crinosity transfusion 8%) .Conclusion:The sensitivity and specificity of AFU is better than AFP in the hepatoma recurrence,AFU is a better blood serum index in following up the hepatoma recurrence post liver transplantation.

Objective To compare the outcome of proximal femoral nail anti-rotation (PFNA)versus anatomical locking plate (ALP) in treatment of unstable intertrochanteric fracture.Methods The study included 89 patients who had received PFNA fixation (PFNA group,n =45) or ALP fixation (ALP group,n =44) for unstable intertrochanteric fracture between February 2008 and September 2009.Operation time,amount of bleeding,drainage volume,postoperative complications,fracture healing time and hip joint score after fracture healing were compared between two groups.Results Mean operation time in PFNA group was obviously shorter than that in ALP group (61.4 minutes vs 114.8 minutes,P ＜0.01).Mean amount of bleeding and drainage volume were significantly lower in PFNA group than in ALPgroup (119.3 mlvs 136.8ml,P＜0.01; 74.9mlvs80.3 ml,P＜0.01).While,PFNA group was not significantly different from ALP group with regard to average fracture healing time and Harris hip joint score after fracture healing (4 months vs 4.1 months,P ＞ 0.05; 91.2 points vs 89.8 points,P ＞0.05).Two patients had poor fracture reduction in PFNA group,but all patients had good fracture reduction in ALP group.No obvious adverse postoperative complications occurred in PFNA group,but one patient had fracture nonunion in ALP group.Conclusions PFNA and ALP fixation of unstable intertrochanteric fracture present insignificant differences in fracture healing time,postoperative complications and hip joint function after fracture healing.Whereas,PFNA is more suitable for the elder patients on account of shorter operation time and less intraoperative bleeding.

Objective To investigate the medium-term efficacy of total hip replacement with CFP handle prosthesis.Methods Thirty-two patients (34 hips) undergoing total hip replacement with CFP handle prosthesis were selected.The preoperative diagnosis was:femoral neck fracture in 6 cases,femoral head necrosis in 12 cases,osteoarthritis in 10 cases,ankylosing spondylitis in 3 cases,and pigmentation villi nodular synovitis in 1 case.Ten days,1 month,6 months,and 1 year (a year later) after surgery,the hip joint function and X ray film performance were followed up.Results There was no complication such as infect and injury of blood vessel and nerve.Postoperative X ray film showed the femoral handle prosthesis position was good.The average Harris hip score was 32.6 (20-53) scores before surgery,and back to 95.3(90-100) scores after surgery,no patients needed revision surgery.Postoperative Engh score was above 10 scores after half a year.Conclusion The medium-term efficacy of total hip replacement with CFP handle prosthesis is good,and can be used as one of the choice of primary total hip replacement.

Objective To investigate the risk factors of postoperative delirium in elderly patients with intertrochanteric facture.Methods This retrospective analysis was conducted on 256 patients aged over 65 years treated with internal fixation of intertrochanteric facture between January 2012 and December 2013.Incidence and risk factors of postoperative delirium were documented.Results Incidence of postoperative delirium was 14.8％ (38/256).Risk factors of postoperative delirium included body mass index (BMI) less than 20 kg/m2 (P ＜ 0.05),preoperative hemoglobin (Hb) less than 100 g/L (P ＜ 0.05),atrial fibrillation (P ＜ 0.05),low sodium (P ＜ 0.05),preoperative total protein less than 60 g/L (P ＜ 0.05),preoperative waiting time more than 4 days (P ＜ 0.05),preoperative cognitive impairment (P ＜ 0.05),operation time more than 2.5 hours (P ＜ 0.05),perioperation blood loss more than 1,000 ml (P ＜ 0.05),and more than two kinds of medical conditions (P ＜ 0.05).Logistic regression identified three independent factors for postoperative delirium:preoperative waiting time more than 4 days (P ＜ 0.05,OR =2.74),BMI less than 20 kg/m2 (P ＜ 0.05,OR =13.27),preoperative cognitive impairment (P ＜ 0.05,OR =4.47),and operation time more than 2.5 hours (P ＜ 0.05,OR =4.56).Conclusions Risk factors of postoperative delirium in elder patients with femoral intertrochanteric fracture are complicated.Therefore,overall situation should be taken into consideration and comprehensive and effective treatment should be formulated to prevent the occurrence of postoperative delirium.

ObjectiveTo explore the value of CT virtual endoscopy in the treatment strategies in low rectal cancer surgery.MethodsFifty- seven cases of rectal cancer in Jining First Hospital were collected,preoperative rectum CT virtual endoscopy,detailed records of patients with rectal invasion and the circumstances surrounding lymph nodes were investigated.Differences were compared in patients after routine pathological examination.And the distance of the tumor from the anal margin was compared with the preoperative rectum on rectal examination and rectal CT virtual endoscopy.ResultsPreoperative rectum CT virtual endoscopy had no significant difference in evaluation of metastases of the surrounding lymph nodes.Compared with postoperative pathological examination( x2 =2.5,P ＞ 0.05 ),while had significant difference in evaluation in perirectal infiltration( x2 =4.44,P ＜ 0.05 ).Rectal examination and rectum CT virtual endoscopy had no significant difference judgement of the tumor from the anal margin ( P ＞ 0.05 ).ConclusionsCT virtual endoscopy has a great significance in the preoperative evaluation of rectal cancer surgical treatment strategies,which should be further studied.

BACKGROUND: Demineralized bone matrix (DBM) has natural mesh pores, good plasticity and biocompatibility. However, the decalcification time in preparation of DBM remains controversial.OBJECTIVE: To compare effects of varying degrees of decalcification with DBM on the proliferation of bone marrow stromal stem cells (BMSCs) so as to provide the best DBM scaffold for cartilage tissue engineeringMETHODS: Rabbit iliac bones were prepared into strips, defatted, followed by 6,12 and 24 hours of decalcification and 2 days of soaking in alcohol to prepare DBM. DBMs were placed in 24-well plates. The third passage of BMSCs at a density of 5×10~9/L were incubated on 24-well plate with DBMs. The DBM porosity and pore size were observed by scanning electron microscopy;BMSCs proliferation on the DBM was determined by MTT, and cell attachment on DBM was observed by scanning electron microscopy.RESULTS AND CONCLUSION: DBM displayed natural high-density porous grid structure, in the presence of bone trabecula,trabecular space and bone luminal system. The porosity and pore size of DBM decalcified for 6,12 and 24 hours were similar (P > 0.05). Compared with decalcified for 12 and 24 hours, BMSCs attached to DBM decalcified for 6 hours more closely and the DBM showed better compatibility. SEM observation showed the BMSCs on DBMs decalcified for 6 hours proliferated stably after 8 days and applicable for transplantation. Moreover, the number of cells were significantly more than DBMs decalcified for 12 and24 hours (P< 0.01).

BACKGROUND: Demineralized bone matrix (DBM) having a great biocompatibility is a common material to repair bone defect in clinic Bone marrow stromal cells (BMSCs) which can differentiate into bone and cartilage cells are ideal for repairing cartilage defect. OBJECTIVE: To observe the effects of allograft DBM combined with autograft BMSCs on repairing the articular cartilage of rabbits. METHODS: Bone and cartilage defect was induced in 27 rabbits and the models were randomly divided into combined group (DBM combined with 8-day-curtured autograft BMSCs), DBM group (DBM implantation alone), and control group. The reparative tissue samples were evaluated grossly, histologically, and immunohistochemically. The repairing effect was evaluated by Wakitani's score system.RESULTS AND CONCLUSION: The repaired tissues were hyaline cartilage-shaped, smooth and glossy, and well combined with peripheral cartilage and subchondral tissues at 12 weeks after implantation in the combined group; some tissues were cartilage-likely repaired in the DBM group; a few of tissues were fiber-like repaired in the control group. Immunohistochemical staining showed that type Ⅱ collagen was positive in both combined and DBM groups. Repaired cells which could express type Ⅱ collagen were cartilage cells. However, the expression of type Ⅱ collagen was negative in the control group. At 4,8, and 12 weeks after implantation, the scores in the combined group were significantly higher than in the DBM and control groups (P < 0.01), suggesting that DBM/BMSCs complex could be an efficient graft to repair the articular cartilage defects.

Objective To investigate the role of transient receptor potential vanilloid tpye 1 (TRPV1) in the pathological process of detrusor overactivity (DO) induced by partial bladder outlet obstruction (BOO).Methods Between June 2014 and December 2014,40 female Wistar rats received partial urethral ligation and urodynamic analysis 6 weeks after.Urinary bladder and dorsal root ganglion (DRG) were removed and RT-PCR,Western Blot and IHC were performed to investigate the expression and location of TRPV1 in control and DO rats.Effect of different concentrations of TRPV1 agonist,as well as TRPV1 antagonist,was also evaluated with isolated detrusor strips.Results 40 female Wistar rats received BOO surgery and 26 of them developed DO.Immunohistochemistry observed linear TRPV1-reactive staining mainly in sub-urothelial and muscular layer.Expression of TRPV1 mRNA and protein in urinary bladder [(0.18±0.02) vs.(0.36 ±0.03),P＜0.05] and dorsal root ganglia (DRG) [(0.41 ±0.05) vs.(0.66 ±0.04),P ＜ 0.05] significantly increased in BOO induced OAB rats.In isolated detrusor strips studies,the amplitude [(0.26 ±0.05)g vs.(0.69 ±0.11)g,P ＜0.05] and frequency [(5.91 ±0.59) Hz vs.(8.75 ± 0.54) Hz,P ＜ 0.05] of contractions of DO tissues were significantly higher than that of control ones.Capsaicin significantly increased the amplitude but not frequency of detrusor intrinsic contractility and this effect was enhanced in OAB conditions.All changes induced by capsaicin were blocked by capsazepine pre-incubated.Conclusions In BOO induced DO rats,over-expressed TRPV1 was involved in DO pathological process by directly sensitizing bladder afferent fibers or indirectly enhancing detrusor intrinsic properties.

Objective To explore the repair result of full-thickness cartilage defects in diannan small-ear pig by bone mesenchymal stem cells (BMSCs) transferred with both transforming growth factor-β3(TGF-β3) and bone morphogenetic protein-2(BMP-2) gene mediated by adenovirus vector and combined with deminerized bone matrix (DBM). Methods 32 full-thickness defects from 16 knees of 8 pigs were randomly divided into 4 groups in the experiments. In group A, the animals′ lateral femoral condyle of right knee joint was repaired with DBM and BMSC infected with both Ad-TGF-β3 and Ad-BMP-2. In group B, the medial femoral condyle of right knee joint was repaired with DBM and BMSC without infection. In group C, the lateral femoral condyle of left knee joint was repaired with DBM. And the group D is control group. Morphology and histology were observed 2, 4, 8 and 12 weeks after operation. Results 12 weeks after operation, the whole defects were repaired in group A, HE staining showed typical cartilaginous structure in the repaired area. In group D, defects were not repaired but filled with fibrous tissue. The O′driscoll scores were 15.65 ± 0.11 (group A), 11.33 ± 0.22 (group B), 6.13 ± 0.15 (group C) and 5.08 ± 0.15 (group D). There was significant difference among the groups (P < 0.05). Conclusions The new type of tissue engineering scaffold that DBM combined with BMSCs transfected with both Ad-BMP-2 and Ad-TGF-β3 could induce cartilage regeneration and repair the defects.

Objective This study was performed to investigate the levels of HSP70 in tissue in pemphigus as a possible new theoretical basis for further elucidate the pathogenesis of pemphigus.Methods The expression of HSP70 in 62 patients with pemphigus was determined by immunohistochemistry,and the normal skin was taken as control.Results The results showed that the positive cells of HSP70＞75 ％ in the blisters of pemphigus vulgaris and the positive cells of HSP70＞50％ in the inflammatory cells near the blisters,and the expression of HSP70 was significantly higher than that in normal skin,which was statistically significant(Z=5.42,4.73,P＜0.01).Conclusion The abnormal expression of HSP70 in inflammatory cells and psoriasis of pemphigus patients showed that HSP70 is involved in the pemphigus.