Objective To investigate the immune and pathological mechanism of the effect of monocyte chemotaxis protein -1 on the development of spinal tuberculosis.Methods A total of 1002 patients were enrolled in Tianjin Haihe Hospital from January 2011 to January 2016, which were included in the diagnostic criteria and exclusion criteria.Divided into 332 cases of spinal tuberculosis group(new spine tuberculosis subjects), 334 cases of pulmonary tuberculosis group( new pulmonary tuberculosis subjects), 336 cases of healthy group(healthy subjects), the serum concentration of monocyte chemotactic protein-1 ( MCP-1 ) was detected by enzyme-linked immunosorbent assay ( ELISA ) .To investigate the factors influencing the expression of MCP-1 and to analyze the correlation between serum MCP-1 concentration and spinal tuberculosis.Results Serum MCP-1 concentration in the body with the tuberculosis pathogenicity and sowing was gradually increasing.The concentration of MCP-1 in the spine tuberculosis group was significantly higher than that in thepulmonary tuberculosis group and the healthy group, the difference was statistically significant (P<0.05).There was no significant difference in serum MCP-1 concentrations between male and female patients in spine tuberculosis group , pulmonary tuberculosis group and healthy group.There was no significant difference in serum MCP-1 concentration between children and adults patients in spine tuberculosis group, pulmonary tuberculosis group and healthy group.Conclusion The serum concentration of MCP-1 in Spinal tuberculosis group is higher than pulmonary tuberculosis group and health group, and it shows an upward trend with the spread of tuberculosis.

Aiming at the problems faced by the medical postgraduate students in the cooperative medical education and the classified training mode,combined with the characteristics of the cultivation of medical postgraduates,the article constructed the quality guarantee system of graduate education based on project management.From the three dimensions of time dimension,corpus dimension and objective dimension,the article established a model of training quality guarantee system and analyzed the four work modules:construction of project organization,standardization of whole life cycle process,control of project quality and integration of project information.In addition,the article introduced the practice of this quality guarantee system in Binzhou Medical University.

Objective To study expression of extracellular signal-regualated kinase in intraepithelial neoplasia,prostatic cancer and BPH tissue. Methods Expression of extracellular signal-regualated kinase (ERK) was determined in 12 prostatic intraepithelial neoplasia (PIN),11 prostate cancer and 16 benign prostatic hyperplasia specimens.ERK expression was determined by immunohistochemistry. Results ERK expression was positive in all the 12 PIN specimens,6 of which being overexpressed.In the 11 prostate cancer specimens,overexpression was observed in only one while the other 10 under expressed.Overexpreassion was not observed in all the BPH specimens whereas 12 of the 16 showed underexpression. Conclusions ERK expression is obviously higher in PIN tissue (P

ObjectiveTo investigate value of minimally invasive surgical approach in patients with hypertensive intracerebral hemorrhage in primary hospital.MethodsAccording to the operation procedure,93 cases with basal ganglia hemorrhage were divided into three groups:1.minimally invasive surgery group A (n =37 ),2.ventricular puncture and drainage,lumbar cistern drainage group B(n=10),3.usual operation group C( n =46).Estimated operation effect with computed tomography in 24 hours after operation.Case fatality rate and complication incidence were analyzed after three months of operation according to the Glasgow Outcome Scale (GOS).ResultsMinimally invasive surgery group A had the highest hematoma clearance rate (82.7 ± 8.1 ) ％,group B (78.6±6.5 ％ ),group C (50 ±10％ ).The incidence rate of rebleeding was 8.1％ in group A( n =3 ),10％ in group B ( n =1 ),34.8％ in group C (n =16).The grade Ⅳ of the GOS and the grade Ⅲ of the GOS was respectively 93.8％ and 6.5％,case fatality rate was zero.Conclusion The minimally invasive surgical operation not only lead to less tissue damage and decrease rebleeding,but also improve neurological functional recovery.

BACKGROUND: During conventional treatment for bone tuberculosis, there is a low effective concentration of anti-tuberculosis drugs, and the therapeutic effect is poor. OBJECTIVE:To develop a new biomaterial as a slow-release artificial carrier that can be directly implanted into the surrounding tissue of bone tuberculosis, maintain a certain anti-tuberculosis drug concentration for a long time, thereby playing an effective therapeutic action. METHODS:Rifampicin/polylactic acid/glycolic acid microspheres and isoniazid/polylactic acid/glycolic acid microspheres were prepared using the emulsion-solvent evaporation method. Usingα-cyanoacrylate, a biological adhesive, two kinds of microspheres were processed into a long-term slow-release bicomponent drug carrier. Then, in vitro release characteristics of the dual-drug sustained-release carrier were observed. After that, the dual-drug sustained-release carrier was implanted into rabbit intertrochanteric femur bone defects for observing drug release concentrations, histocompatibility and bone defect healing at different time points after drug delivery carrier implantation. RESULTS AND CONCLUSION:For rifampicin/polylactic acid/glycolic acid microspheres, the mean particle size was (240±13)μm, and the drug loading load rate was (26±1.5)%. For isoniazid/polylactic acid/glycolic acid microspheres, the mean particle size was (250±10)μm, and drug loading rate was (28±1.8)%. The in vitro cumulative release rate could reach 80%for rifampicin and 90%for isoniazid at day 90. The in vivo released concentration of rifampicin and isoniazid within 90 days was (0.5±0.4) and (0.6±0.3)μg/g, respectively. There were a smal amount of infiltrated neutrophils between the fascia and muscle fibers after the drug delivery carrier was implanted, and the amount of neutrophils in the muscle were reduced significantly at day 59. X-ray plain film showed that bone defects decreased obviously in size. These findings indicate that this dual-drug sustained-release carrier can maintain a certain anti-tuberculosis drug concentration in the surrounding tissues of bone tuberculosis, which is expected to provide a new type of dual-drug delivery carrier in the surgical treatment of bone tuberculosis.

Objective To transfect a recombinant pcDNA3.1-DCN into HepG2 cells and detect the expressions of decorin(DCN) and p21WAF1/CIP1 so as to investigate the mechanism of tumor suppression of DCN.Methods HepG2 cells were divided into pcDNA3.1-dec-HepG2 group(transfected group) and pcDNA3.1-HepG2 group(control group).After the recombinant pcDNA3.1-DCN and pcDNA3.1 were transfected into HepG2 hepatoma cells by liposome,the stably transfected cell lines were established using G418 screening.RT-PCR method was used to detect the expressions of DCN and p21WAF1/ CIP1 mRNA;Western blotting method was used to detect the expressions of DCN and p21WAF1/CIP1 protein;immunohistochemistry was performed to detect the expression of DCN protein.Results Compared with control group,the expressions of DCN and p21WAF1/CIP1 mRNA were significantly increased in transfected group by RT-PCR(P

The development of clinical pathways must "start and end up with education" as put by the authors. The article discussed the objectives, significance and contents, as well as approaches in the education of clinical pathways. It recommended a tiered education for hospital leaders, medical care workers, office staff, patients and their family members, and different target groups and contents in the education for clinical pathways application.

BACKGROUND:Elderly patients with hip surgery in the department of orthopedics are often associated with a variety of diseases, and easily suffer from complications after implantation.
OBJECTIVE:To analyze the characteristics and the factors of complications and mortality of the elderly patients with hip disease by different orthopedic implants.
METHODS:249 patients accepted total hip arthroplasty, femoral head replacement, proximal femoral nail, Gamma nail, and holow screw fixation. We analyzed patients’ age, sex, hip disease type, anesthesia risk assessment, psychological and psychiatric factors, admission hemoglobin, preoperative albumin, Charlson comorbidity index, ways of anesthesia, orthopedic implants, operation time, intraoperative bleeding, length of stay, postoperative complications, mortality and survival.
RESULTS AND CONCLUSION:Hip disease in the elderly was repaired with five kinds of implants. (1) There were significant differences in age, anesthesia risk assessment, hemoglobin on admission and preoperative albumin, length of stay, duration and intraoperative bleeding. No significant difference in complications and death was found. (2) The most significant indicators affecting complications were length of stay and albumin on admission and preoperative Charlson comorbidity index. The most significant
indicators affecting death were age and hemoglobin on admission and preoperative Charlson comorbidity index. (3) Significance of comprehensive assessment of patients before placement: during hip operation, implants were not the factors that affected the complications and mortality after placement, patients with artificial joint replacement could get out of bed early, and complications and mortality could be reduced. Elderly patients with anemia, hypoalbuminemia and Charlson comorbidity index≥3 should be given a high degree of attention. We should assess Charlson comorbidity index as early as possible, positively treat complications, correct anemia and hypoproteinemia, prevent the occurrence of complications, shorten the length of hospital stay, and reduce the mortality after placement.

Objective To study the clinical and electrophysiological features of the patients with hereditary neuropathy with liability to pressure palsy ( HNPP) diagnosed by gene analysis.Methods Seven patients from two HNPP families were assessed on medical history, physical examination, electrophysiology findings and gene analysis.Results A clinical manifestation of acute, painless, recurrent peripheral nerve palsies was typical for HNPP.Median, ulnar and peroneal nerves were usually affected.Electrophysiology study revealed that prolonged distal motor latency and slowing nerve conduction velocity were prominent.Gene studies exhibited a deletion of the peripheral myelination protein 22 gene in all the seven patients.Conclusions HNPP usually affects areas where nerves are subject to entrapment, and many episodes are preceded by minor compression on the affected nerve.As a reliable screening tool in detecting HNPP, the electrophysiological study shows that segmental demyelination is most commonly seen at common nerve entrapment sites.

BACKGROUND:Polylactic acid-glycolic acid polymer is a sustained-release material with relatively large drug loading and long-term release abilities that can degrade with cel growth in the body. However, its poor hydrophily easily leads to aseptic inflammation that is detrimental to the body’s recovery. OBJECTIVE:To study the release and distribution of anti-tuberculosis drug delivery materials local y oriented within the rabbit radius. METHODS:After modeling, 20 New Zealand white rabbits with distal radius bone defect were randomly divided into a control group and an experimental group, which were respectively given implantation of isoniazid-rifampicin polylactic acid-glycolic acid polymer/β-tricalcium phosphate material and isoniazid-rifampicin polylactic acid-glycolic acid polymer into the defect. Then, X-ray examination of the defect region was conducted at weeks 4, 8, 12 post implantation. Histological observation and detection of peripheral blood or local blood concentration were performed at week 12. RESULTS AND CONCLUSION:After implantation, Lane-Sandhu X-ray scores were significantly higher in the experimental group than the control group (P<0.05). The defect in the experimental group was healed completely with less release residual among newborn bone trabeculae and osteocytes were markedly visible on the material surface, while in the control group, new bone tissues were interconnected with the surrounding bone tissues at the defect site, and less release residual was found. Both peripheral blood and local blood concentrations in the experimental group were significantly higher than those in the control group after implantation (P<0.05). To conclude, the anti-tuberculosis drug delivery material, isoniazid-rifampicin polylactic acid-glycolic acid polymer/β-tricalcium phosphate, has ideal release effect that can stably deliver anti-tuberculosis drugs for a long term at a high bactericidal concentration.