Efforts have been directed at the development of efficient protocols for the differentiation of pluripotent stem cells into pancreatic β-cells.This review focuses on the mechanism of RA,BMP,FGFs,IDE1,IDE2,ALK-i 1 and ALKI-2 during the process in which pluripotent stem cells differentiate to pancreatie β-cells and the relationship between the differentiation and the expression of the surface markers including CD14,CD49e,CD238,CD24,EpCAM,SSEA3 and SSEA1 in the different stage of this process.

Objective:To explore the relationship between periodontitis and coronary heart disease (CHD)by meas-uring changes of serum inflammatory cytokine levels.Methods:A total of 197 patients from our hospital were en-rolled,including CHD + periodontitis group (123 cases),pure CHD group (CHD group,39 cases)and pure peri-odontitis group (periodontitis group,35 cases).Another 45 healthy subjects were enrolled as healthy control group. Concentrations of tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),serum amyloid-a (SAA),high sensitive C reactive protein (hsCRP)and plasma fibrinogen (Fg)were measured in all groups,and levels of above inflammatory cytokines were compared among four groups.Results:Compared with healthy control group,there were significant rise in levels of above inflammatory cytokines in CHD + periodontitis group (P<0.01 all),Com-pared with CHD group or periodontitis group,there were significant rise in levels of hsCRP [(6.52±2.03)mg/L, (4.34±1.76)mg/L vs.(9.21±2.65)mg/L],IL-6 [(65.32±21.01)ng/L,(65.12±12.34)ng/L vs.(85.76± 25.96)ng/L]and TNF-α[(9.75±3.74)ng/L,(9.34±4.55)ng/L vs.(13.46±8.12)ng/L],SAA [(2.25±1.2) pg/ml,(2.22 ±1.02)pg/ml vs. (2.85±1.45)pg/ml],P<0.05 all in CHD + periodontitis group;there were no significant difference in all serum inflammatory cytokine levels between CHD group and periodontitis group (P>0.05 all).Conclusion:Serum inflammatory cytokine levels significant rise in palients with periodontitis,it is related with coronary heart disease.

Objective To investigate the effect of bilateral uterine artery embolization in the prevention of postpartum hemorrhage.Methods Twenty-seven patients with risk factors of postpartum hemorrhage (prevention group) and 36 patients with postpartum hemorrhage refractory tendency(treatment group) were underwent bilateral uterine artery embolization.The clinical efficacy and side effects were observed.Results The patients in prevention group were given bilateral uterine artery embolization and conventional induction by ethacridine.All of them finished vaginal delivery,postpartum hemorrhage was 200-480 ml,average 385 ml,no case of postpartum hemorrhage.The patients in treatment group occurred intractable postpartum hemorrhage before bilateral uterine artery embolization,the amount of hemorrhage was 1 000-4 200 ml,average 2 050 ml.Among them,9 patients were given carbasus to stuff cavitary uteri,2 patients were given striped-back saturation.Effective in 35 patients,the successful rate was 97.2％ (35/36).One patient was performed with hysterectomy because of inefficient treatment.None occurred maternal deaths,inefficient and necrosis of lower limbs.All of patients had entire involution of uterus.Reviewed at clinic service after delivery,none occurred postpartum hemorrhage,puerperal infection,Sheehan's syndrome.The menstrual recovery time was 3-13 months for 53 patients who were followed up.Conclusions Bilateral uterine artery embolization have advantage such as safe,effective,less side effects,and is an effective method for the treatment of various causes of intractable postpartum hemorrhage.It is worthy of clinical application on the prevention of postpartum hemorrhage.

We conducted questionnaire for anonymous answers.The sample comprised 388 papers.The results obtained response to inquiry.Based on human dermatoglyphics development,its teaching reform,curriculum construction have been made in this paper.

Accidents, Occupational ; statistics & numerical data ; Humans ; Poisoning ; epidemiology

BACKGROUND:Treatment of complex tibial plateau fracture is a difficulty in orthopaedic trauma. Comprehensive assessment and appropriate surgical plan before surgery are the key points of surgery.
OBJECTIVE:To investigate the application value of three-dimensional reconstruction and virtual surgical techniques in assessing and surgical planning of complex tibial plateau fracture before surgery.
METHODS:The CT scan data of 30 patients with tibial plateau fracture were imported into the Mimics 13.0 software to establish the three-dimensional digital models of complex tibial plateau fracture, and three-dimensional measurements and reclassification was performed according to three-column classification were made. Virtual surgeries such as bone window operation, reduction of the fracture and bone grafting were made in these models.
RESULTS AND CONCLUSION:Reconstructed three-dimensional digital models of complex tibial plateau fracture could indicate the characteristics of fracture accurately, could be observed at any direction, and could help doctors to reclassify the fracture according to three-column classification. Virtual surgeries of bone window operation, reduction of the fracture and bone grafting made in computer by Mimics 13.0 were confirmed to be vividly simulate the clinical surgery, and helpful in estimating the amount of bone grafting. Three-dimensional reconstruction and virtual surgical techniques play an important role in assessing and surgical planning of complex tibial plateau fracture before surgery, which should be a conventional step in the management of complex tibial plateau fracture.

Objective To compare the pharmacokinetic profile of propofol administered by target-controlled infusion (TCI) during anesthesia in patients with and without obstructive jaundice. Methods Twenty-four ASAⅠorⅡpatients aged 40-65 yrs weighing 50-75 kg undergoing elective surgery under general anesthesia were divided into 3 groups (n = 8 each) : group A control (serum total bilirubin 171.1?mol?L-1) . Each group received propofol by TCI using Graseby 3500 infusion pump, based on pharmacokinetic parameter set published by Marsh. The target plasma concentration of propofol was set at 3?g?ml-1 . TCI of propofol was started from the induction of anesthesia and maintained until the end of the surgery. Arterial blood samples were taken at 0.5, 1, 2, 4, 6, 8 min after TCI of propofol was started and every 15 min during maintenance of anesthesia and at 2, 4, 6, 8, 10, 20, 30, 40, 50, 60, 90, 120, 180, 240 and 300 min after TCI was terminated. Plasma concentrations of propofol were determined by high-performance liquid chromatography (HPLC) with fluorescence detector. NONMEM was used to analyze the pharmacokinetic parameters. Results The 3 groups were comparable with respect to sex ratio, age and body weight. The pharmacokinetic profile of propofol given by TCI was best described by three-compartment open pharmacokinetic model in the majority of patients and by two-compartment open pharmacokinetic model in a few patients. There were no significant differences in the pharmacokinetic profile of propofol among the 3 groups. Conclusion Obstructive jaundice does not affect the pharmacokinetics of propofol.

Objective To review the experience of the bone traction treatment for displaced fracture of femur shaft in children.Methods All of the cases were treated with femur supercondylar traction,and they were fixed in a stable position with hip joint in 90? flexion and 30?~45? abduction and with knee in 90? flexion.Result The effects of 86 cases were satisfactory.Conclution This method is simple and effective.It reduces complications of skin traction and operation to patients.

Objective To evaluate the salvage surgery for papillary thyroid cancer patients with residual neck metastatic lymph nodes after thyroidectomy.Methods Clinical data of 97 patients undergoing salvage neck dissection between September 2007 to June 2010 were analyzed retrospectively.Results Among 97 patients,residual metastatic lymph nodes were found in 80 patients in lateroposterial neck,overall residual rate was 82.47％.Residual rate was 85.71％ in 56 patients who underwent initial lateroposterial neck dissection in other hospitals:100％ in 8 patients who underwent berry-picking; 93.33％ in 30 patients who underwent partial dissection; 66.67％ in 18 patients who underwent whole neck dissection.Residual rate was 78.05％ in 41 patients who did not undergo initial lateroposterial neck dissection.The number of dissected lymph nodes was 15-45,with an average of 23 nodes removed and 8.21 metastatic lymph nodes per case.Residual metastatic lymph nodes were found in 67 patients in central neck,overall residual rate was 82.47％,residual rate was 53.85％ in 13 patients who underwent initial central neck dissection,and 71.42％ in 84 patients who did not undergo initial central neck dissection.Conclusions Correct imaging diagnosis decreases cervical residual metastatic lymph nodes in patients with papillary thyroid cancer.Successful salvage operation lies in choosing correct mode of neck dissection and carrying out sufficient dissection.