Bone morphogenetic proteins (BMPs) play a pivotal role in the formation,induction and repair of the bone; BMPs have been confirmed to induce bone formation.Transforming growth factor-beta,insulin-like growth factor-Ⅰ and basic fibroblast growth factor also contribute to bone formation; combination of the factors with BMPs can promote the healing of fracture and non-union,which may have a bright future in orthopedics.

Objective To investigate the influencing factors of surgical treatment of patients with laryngeal cancer.It could provide the better way to treat laryngeal cancer.Methods A total of 80 patients with laryngeal cancer from May 2003 to May 2008 in our hospital were studied.All patients were treated by surgery.The effect of surgery would be observed.The influencing factors and the effect of surgery were analyzed by Logistic.Results A total of 80 patients in the 5-year survival rates were 98.75％ (79/80),76.25％ (61/80),and 51.25％ (41/80).Univariate results showed that age,primary site of the tumor,lymph node metastasis,tumor size,tumor node metastasis(TNM) stage,and treatment modality significantly impacted on the prognosis of patients (P ＜0.01).Multivariate Logistic regression analysis showed that the primary site of the tumor,lymph node metastasis,TNM staging and therapy were independent prognostic risk factors with a statistically significant difference(P ＜ 0.05).Conclusions The prognosis of laryngeal cancer is affected by many factors,the primary sites of tumor,TNM staging,lymph node metastasis,and treatment methods were independent prognostic factors.Laryngeal function preservation surgery is an ideal method in the treatment of laryngeal cancer.

OBJECTIVE:To establish a pharmacy online to offline (O2O) platform service quality evaluation model,and to provide reference for platform operators to improve the service quality. METHODS:Using SERVQUAL scale,combining the situa-tion of pharmacy O2O platform development in China,the reliability,safety and aspects of O2O platform were analyzed to sum up primary evaluation index of pharmacy O2O platform service quality. Based on this,the expert interviews questionnaire was de-signed. According to the questionnaire results,indicators were modified and empowered to construct the pharmacy O2O platform service quality evaluation model;the reliability and validity of model were validated. RESULTS & CONCLUSIONS:According to the connotations of each dimension analysis in the SERVQUAL scale and expert interview results of pharmacy O2O platform ser-vice quality,pharmacy O2O platform service quality evaluation model is constructed,including five indicators as“reliability”“se-curity”,and 18 secondary indexes as the“number of platform pharmacy”“pharmacy qualification show”“pharmacy type”. The re-sults of model index reliability and validity verification show that model construction is reasonable and can provide reference for platform operators improving service quality. Follow-up research should give full consideration to the Chinese consumer behavior habits,personal preferences and other factors to build more suitable pharmacy O2O platform service quality evaluation model in China.

Objective To explore the clinical efficacy of three dimensional (3D) laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity combined with type 2 diabetes mellitus.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Qinghai Red Cross Hospital between January 2013 and April 2016 were collected.All the patients underwent 3D LSG.Observation indicators:(1) surgical and postoperative recovery situations;(2) follow-up and metabolic indexes changes.Follow-up using outpatient examination and telephone interview was performed to detect complications of patients after discharge and usages of antidiabetic drugs or insulin up to February 2017.Body mass,body mass index (BMI),hemoglobin (Hb),albumin (Alb),fasting serum C-peptide,fasting blood sugar,2-hours postprandial blood glucose (2HPBG) and glycosylated hemoglobin (GHb) were detected at month 1,3,6 and 12 postoperatively.Measurement data with normal distribution were represented as (x)±s.Repeated measurement data were analyzed by the repeated measures ANOVA.Count data were evaluated by the proportion.Results (1) Surgical and postoperative recovery situations:28 patients underwent successful 3D LSG,without conversion to open surgery.Operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery and time of postoperative drainage tube removal were (133 ± 20) minutes,(45 ± 22) mL,(2.5 ± 1.2) days and (3.4 ± 0.9) days,respectively.There were no postoperative complications and perioperative death.Duration of hospital stay was (7.1 ± 1.5) days.(2) Follow-up and metabolic indexes changes:28 patients were followed up for 6-12 months,with a median time of 8 months.During the follow-up,there was no death or severe complications.Body mass,BMI,Hb,Alb,fasting serum C-peptide,fasting blood sugar,2HPBG and GHb from pre-operation to month 1,3,6 and 12 post-operatively were decreased from (113±26) kg to (78± 14) kg,from (44±6) kg/m2 to (35±5) kg/m2,from (157±19) g/L to (140±13) g/L,from (43±5)g/L to (40±4)g/L,from (2.50±0.37) μg/L to (1.20±0.33) μg/L,from (10.5±2.0)mmol/L to (5.6±0.5)mmol/L,from (16.3±3.1)mmol/L to (7.9±0.9) mmol/L,from 9.2％± 0.9％ to 6.8％ ±0.6％ with statistically significant differences between preoperative and postoperative indicators (F=396.47,328.20,111.10,21.28,161.06,127.80,243.40,234.64,P＜0.05),and showing a downward trend.Of 28 patients,25 had complete remission of type 2 diabetes mellitus at 12 months postoperatively and 3 had partial remission,with an effective rate of 100.0％ (28/28).The excess weight loss was 63％± 16％.Conclusion 3D LSG is safe and effective in the treatment of obesity combined with type 2 diabetes mellitus,with a good shortterm outcome.

BACKGROUND:The incidence of open fracture of the elbow joint is increased rapidly with an increased number of accidents. Fractures are often accompanied by severe soft tissue injuries. At present, a combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation for the treatment of open fractures has been widely reported. OBJECTIVE:To investigate the characteristics of the combined therapy of autologous skin grafting, vacuum sealing drainage, and external fixation for repair of complex and severe open fracture of the elbow joint. METHODS:A total of 41 patients with complex and severe open fracture of the elbow joint who received the combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation during January 2009 to December 2013 in General Hospital of Tianjin Medical University, China were selected. Al patients were treated with routine debridement, external fixation and vacuum sealing drainage to cover wound during the first period. During the second period, autologous skin grafting or flap transfer was used to repair wound when the fresh granulation tissue covered the wound. RESULTS AND CONCLUSION:The postoperative folow-up period of these 41 patients was 8-22 months, with an average period of 13 months. External fixation period was 8-13 months with an average period of 9.8 months. The open wounds were completely healed after autologous skin grafting or skin flaps transfer. Fractures were healed in 31 patients during the first period. There were 7 cases of delayed union, 3 cases of nonunion. Al fractures were completely healed during 8-12 months after iliac bone grafting. The excelent and good rate of limb function recovery was 73.1% among 41 patients with severe open fracture of the elbow joint. The limb function of Gustilo II patients better recovered. These results suggest that the clinical effect of the combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation for the treatment of complex and severe open fractures of the elbow joint is satisfactory.

Objective To evaluate the feasibilty of modified osteogenic culturing of goat adipose derived stromal cells(ADSCs).Methods From March,2013 to September,2014,platelet-rich plasma(PRP) was made from goat autogenous vein blood,and abodimoneal fat was aspirated,following aspetic procedure,primary and series passage of ADSCs was established.Osteoinduced ADSCs was carried out according to following group:combinative osteoinduction group(PRP+rhBMP-2 +ADSCs),growth factor group(rhBMP-2+ADSCs),conventional inductive group(dexamathasone+ascorbic acid + ADSCs) and noninductive group(blank group).Converted microscope was used to observe cellular pattern,cell activity,osteocalcin and collagen type Ⅰ level were detected at 1,3,5,7,9,13,17,21 days.Red Alazarin and Von Kossa staining were also assayed at different interval.Results Under observation of converted microscopy,remarkable cell proliferation with abundant ECM was noticed in combinative osteoinduction group,compared with other groups,level of cell activity,osteocalcin,collagen type Ⅰ [(0.82 ± 2.19)AU,(79.82 ± 1.36)U/L at,(78.51 ± 4.32)μ g/ml at]were significantly higher than other groups (P ＜0.05),and remarkable ALP expression and calcifed nodules were also seen.Conclusion PRP can enhance the inductive effect of rhBMP-2,and combinative osteoinduction procedure acts as a satisfactory culturing method.

Objective To investigate the prognostic relevant factors of hepatocellular carcinoma (HCC) in recipients following liver transplantation (LT).Methods The clinical data of 147 cases of HCC undergoing LT between Aug. 2004 and Feb. 2011 in Nanfang Hospital were studied retrospectively.Those of significance in 14 relevant factors involving gender,age,blood-type,CTP,model of end-stage liver disease (MELD),alpha-fetoprotein (AFP),tumor number,cumulative diameter of tumor,tumor occupying proportion of the liver,bilobar involvement,envelope invasion,macrovascular invasion,and microvascular invasion (MVI),HCC histology differentiation,which were based on univariate analysis with Log-Rank,were analyzed by means of Multivariate Cox proportional hazard regression model to screen out independently relevant ones.Results 143 cases were followed up.The follow-up duration ranged from 6 to 84 months.The 1- and 3-year cumulative survival rate was 75.2％ and 54.7％ respectively.The tumor free 1- and 3-year cumulative survival rate was 70％ and 59％ respectively.Univariate ananlysis revealed that age,AFP,tumor number,cumulative diameter of tumor,tumor occupying proportion of the liver,bilobar involvement,envelope invasion,macrovascular invasion,and MVI had significant difference, In a Cox model,MVI,macrovascular invasion and AFP≥ 400 μg/L were independent prognostic factors.Conclusion MVI,macrovascular invasion and AFP are the main prognostic risk fators.Intervention and non-tumor technique should be performed preoperatively and intraoperatively,respectively.

Objective To investigate the clinical efficacy of ziprasidone in the treatment of first-episode schizophrenia.Methodsfrom January 2014 to June 2016to receive the treatment of patients with first-episode schizophrenia in 156 cases as the research object in the psychiatric hospital, which were randomly divided into two groups, the control group were given risperidone treatment, the observation group was treated with ziprasidone treatment, compared two groups of clinical curative effect of the treatment of patients after.ResultsThe patients in the observation group the total effective rate was 97.4%, the control group total effective rate was 89.7%;group after treatment in patients with negative symptoms score were significantly lower than the control group, with statistical significance between the two groups (P<0.05).ConclusionThe application of ziprasidone in the treatment of first-episode schizophrenia has achieved good clinical efficacy, the total effective rate of treatment is higher, and the negative symptoms are effectively controlled.

Cardiovascular Diseases ; Cell Proliferation ; Humans ; MicroRNAs ; Muscle, Smooth, Vascular

Objective To discuss the feasibility, safety and validity of the use of ViabahnTM self-expanding covered stent in endovascular repair of peripheral traumatic pseudoaneurysm (TPA). Methods During the period from June 2012 to April 2014, a total of 8 patients with peripheral TPA were admitted to the Department of Vascular and Endovascular Surgery of Shanghai Changzheng Hospital . The clinical data were retrospective analyzed. The lesions were located at the common carotid artery (n=4), vertebral artery (n=1), subclavian artery (n=1) and superficial femoral artery (n=2). On the basis of acute and chronic TPA classification and different therapeutic principles, endovascular repair with ViabahnTM self-expanding covered stent was employed in 8 patients. Intraoperative angiographic findings, the size and number of the implanted stent, and the immediate angiographic results after stent implantation were recorded. All the patients were followed up to evaluate the improvement of the symptoms, the effectiveness of the repair of TPA cavity, and the occurrence of endoleak or restenosis. Results Successful implantation of ViabahnTM self-expanding covered stent was accomplished in all 8 patients, with a technical success rate of 100%. Angiography performed immediately after stent implantation showed that complete repair of TPA cavity was obtained in all patients, the distal segment of the parent artery was patent, and no endoleak was observed. The sizes of the stent used in the patients were 8×50 mm (n=2) and 9×50 mm (n=2) in common carotid artery, 6×50 mm (n=1) in vertebral artery, 11×100 mm (n=1) in subclavian artery, and 8×100 mm (n=2) in superficial femoral artery. The patients were followed up for 6-30 months (mean of 14.3 months), and the clinical symptoms disappeared in all patients. CT angiography indicated that there was no endoleak or restenosis. Conclusion Based on the different therapeutic principles, the use of ViabahnTM self-expanding covered stent in endovascular repair of peripheral TPA is technically simple and micro-invasive, and clinically feasible with reliable effect and safety. Therefore, this technique can be employed as a first-line therapy option for peripheral TPA.