BACKGROUND:Bone tissue transplantation or osteogenic material fil ing is after used for bone defect repair. To remove autologous bone tissues can lead to additional damage and secondary deformity, therefore, it is extremely urgent to search for a new osteogenic material. OBJECTIVE:To construct the porousβ-tricalcium phosphate (β-TCP)/col agen scaffold modified with human bone morphogenetic protein 2 (hBMP2) gene, and to observe its effects on differentiation of MC3T3-E1 cel lines. METHODS:The porousβ-TCP/col agen scaffold modified with hBMP2 gene was prepared. Then in vitro culture system of MC3T3-E1 cel lines with composite scaffold was established. There were scaffold and plate groups, and each group was divided into two subgroups according to the different concentrations of plasmid. Samples were col ected and observed morphological y by scanning electron microscope and light microscope after complex culture. After 1, 3, 7 and 14 days of induction, calcium nodules were observed through alizarin red staining, the cel cycle was detected by real-time PCR, and expressions ofαI-chain col agen type I gene, Osterix and bone sialoprotein were observed. RESULTS AND CONCLUSION:The number of cel s adhered, differentated and distributed on the composite scaffold was significantly higher than that of the single scaffold (P<0.05). Alizarin red staining and real-time PCR detection showed that the osteogenesis ability of MC3T3-E1 cel lines in the scaffold group was stronger than that in the plate group. To conclude, the porousβ-TCP/col agen scaffold modified with hBMP2 gene is an appropriate candidate for bone defect repair.

Objective To fabricate a silk fibroin scaffold with biomimetic oriented microstructure using the directional crystallization technology, and to evaluate the possibility of application to the cartilage tissue engineering. Methods The silk fibroin scaffold with biomimetic oriented microstructure was made by the directional crystallization technology. The structure of scaffold was observed by the scanning electron microscope, and the pore size, porosity and mechanical properties were calculated. Adipose-derived stem cells were isolated from rabbit, and the passage 3 was seeded into the scaffold. The cell proliferation was detected by CCK8 method. The cell adhesion ability was observed by HE staining and scanning electron microscope. The cell viability was observed by LIVE/DEAD staining. Results The scanning electron microscopy showed that the parallel microtubule-like structure can be seen arranged in longitudinal section of the scaffold, which had a uniform directivity, and also the elliptical or circular pore structure in cross-section. The scaffold had a good pore interconnectivity with (112.43±12.65) μm pore diameter of the cross-section, (90.25±2.05)%porosity and (52.48±5.78) kPa the compression modulus. HE staining and scanning electron microscopy demonstrated that the cells uniformly adhered to the surface and inner pore, and which secreted lots extracellular matrix distributed in the oriented microstructure. Results of CCK8 showed that the good cell proliferation on the scaffold, and the LIVE/DEAD staining indicated that the cells were maintained good viability. Conclusion The silk fibroin scaffolds have a biomimetic oriented microstructure, and show good pore diameter, porosity, biocompatibility and biomechanical properties, which made it a suitable candidate as an alternative scaffold for cartilage tissue engineering.

Objective To explore the reconstructive methods of keeping cardiac function after resec- tion of cardiac carcinoma. Methods After anastomosis of esophageal mucosa and sub-mueosa with gastric counterparts, oblique invagination with gastric ehorion and visceral muscle were adopted in experimental group to keep cardiac anatomical and physiological function.Additionaly, tissues around pylorus were suffi- ciently dissociated to keep pylorie function.Contrastively,regular anastomosis with GF-1 26/28 after resection of cardiac carcinoma was adopted to reconstruct cardia,with thread marked 4 intervally used to reinforce anastomotic ostium in control group.The sphincter of pylorus was dilated to prevent pylorospasm and obstruc- tion.Results In experimental group,no anastomotic leakage,anastomotic stricture and gastroesophageal re- flux occurred.In control group,the incidence of anastomotic leakage and anastomotic stricture were 2.8 %(1/ 36)and 50 %(18/36)respectively,and pH≤4 at anastomotic ostium were found in 12 eases,accounting for 33.3 %, and pH≤6 in 29 cases, accounting for 80.6 %(29/36). Conclusion The reconstructive method of keeping cardiac and pyloric function in resection of cardiac carcinoma benefits recovery of post-operation pa- tients and improve their life quality.

Objective To discuss methods of decoration reconstruction for finger defect in emergency and to observe the elinical effects.Methods Of the 41 cases of finger injuries of different degrees,15 were repaired with part of the skin flaps of the big toenails or skin flaps of the second toenalis,8 were repaired with part of the skin flaps of the big toenails,7 were reeonstructed with the second tiptoes,11 were repaired with the abdominal skin flaps of the big toes or lateral flaps of the second toes.Results All the 41 fingers sur- vived.One skin flap of the big toe was somewhat swelling and a decorating operation was performed.The 4～18 months of follow-up visitation of the rest cases revealed good function and shapes.No obvious functional ab- norality was found in the donating feet.Conclusion Various kinds of decoration reeonstruetion for finger defects are available to recover the hand shape and function as much as possible.

In recent years, non-viral gene vectors have attracted great attention for efficient gene delivery due to the advantages, including low toxicity, low immunogenicity and simple preparation. Polyethylenimine (PEI) is one of the typical non-viral gene carriers that have been widely utilized for gene delivery owing to its superior capabilities in gene compression and buffering capacity. This article discusses the processes of gene delivery and the barriers of PEI-based carrier during the gene delivery, such as low biocompatibility, cytotoxicity, lack of specific targeting and insufficient gene release, etc. Therefore, we summarize the multiple approaches for the modifications of PEI in terms of improved biocompatibility, degradability, specific targeting and buffering capacity. Furthermore, we also review on the recent impressive progresses of smart stimuli-responsive PEI carriers, including endogenous stimuli (pH, reactive oxygen species, glutathione, biomolecular, etc), exogenous stimuli (light, temperature, magnetic field, etc) and dual-responsive strategies, which might provide guidance for the development of more efficient and safer non-viral gene vectors.

Objective To evaluate a rapid biochip system for the determination of muhidrugresistant tuberculosis (MDR-TB) in Mycobacterium tuberculosis isolates. MethodsA total of 1 186 clinical strains, including 800 rifampin (RFP) resistant isolates, 797 isoniozid (INH)resistant isolates, 791 MDR-TB and 380 susceptible strains, were selected from Beijing Chest Hospital, Shanghai Pulmonary Hospital and Guangzhou Chest Hospital respectively using stratified sampling method. Biochips were used to detect loci of rpoB 511 (T→C), 513 (A→C, C→A), 516 (G→T, A→T, A→G) , 526 (C→T, C→G, A→T, A→G), 531 (C→T, C→G), 533 (T→C), katG 315 ( G→C, G→A) and inhA -15 (C→T). Absolute concentration drug susceptibility test of RFP and INH were performed to serve as the gold standard to calculate susceptibility, specificity and overall concordance of biochip test. All polymerase chain reaction (PCR) products were sequenced to confirm the mutations. ResultsThe concordances between the biochip system and absolute concentration drug susceptibility test were 93.7％ ( 1 108/1 183 ) for RFP, 83. 8％(994/1 186) for INH and 82.4％ (975/1 183) for MDR-TB. Compared with absolute concentration drug susceptibility test, the biochip method displayed a sensitivity of 92. 0％ (733/797) and 77. 4％ (617/797)and a specificity of 97. 2％ (375/386) and 96. 9％ (377/389) for RIF and INH, respectively. For MDR-TB, the biochip system reached a sensitivity of 74. 6％ ( 588/788 ) and a specificity of 98.0％ ( 387/395 ).Among rpoB mutants, mutations were mostly detected at codon 531[64. 5％ (480/744)]. In stains with mutations in katG or inhA, 77.4％ ( 487/629 ) had mutation at codon 315 ( TCG ) of katG only. The sequencing results had a high concordance with that of the biochip method. There were slight differences in 5 strains, among which one strain was detected by biochip as katG 315(G→C) mutant, but was identified by sequencing as wild type, and mutation types other than those detected by the biochip were confirmed in the other 4 strains by sequencing. Conclusion This biochip system is adapted for extensive application in clinical diagnosis, as it allows fast and reliable detection of resistance to isoniazid and rifampin in tuberculosis clinical isolates.

Objective To observe the therapeutic effect of hoop circumference drug,Hongzhongxiao tincture,on the treatment of skin abscess in rats under the guidance of defended field theory.Methods Forty SpragueDawley (SD) rats were randomly divided into normal control group,model group,western medicine control group,Hongzhongxiao pretreatment group and Hongzhongxiao treatment group according to the computer generated random number.Subcutaneous abscesses models were reproduced by subcutaneous injection of 1 mL (3-5 × 109 cfu/mL) of staphylococcus aureus,and the normal control group was subcutaneously injected with the same amount of normal saline.After molding,the rats in the model group were treated with normal saline for change of dressing;the western medicine control group was treated with mupirocin ointment for external use;Hongzhongxiao pretreatment group was treated with 2 mL of Hongzhongxiao for dressing 4 hours after the modeling;in Hongzhongxiao treatment group,2 mL dressing was given after the emergence of hard swelling,and the Hongzhongxiao drug range applied was 1 cm over the swelling range.Each group was dressed once daily.The changes of mental state,body weight,skin temperature,range and time of abscess formation,wound ulceration and healing time,transcutaneous oxygen pressure (TcPO2) at the periphery of abscess were observed in each group.Results ① After modeling,the activity of the rats was decreased,the appetite became worse,and the food intake less.Except the normal control group,the rats in other groups had different degrees of mental listlessness.② After 3 days of treatment,the body weight gain of the model group was significantly lower than that of the normal control group (g:8.75 ± 9.85 vs.31.67 ± 7.92,P ＜ 0.01),and continued to 18 days after treatment (g:27.13± 11.70 vs.98.00 ± 8.94);after treatment for 18 days,the body weight gain in the western medicine control group,Hongzhongxiao pretreatment group and Hongzhongxiao treatment group was significantlyhigher than those of model group (g:53.28 ± 19.69,49.12 ± 7.23,44.71 ± 12.42 vs.27.13 ± 11.70,all P ＜ 0.05).③ After 3 days of treatment,the body temperature of the model group was obviously lower than that of the normal control group (℃:33.75 ± 0.68 vs.35.03 ± 0.41,P ＜ 0.01) and continued to 10 days (℃:34.30 ± 0.35 vs.35.03 ± 0.41,P ＜ 0.01).The body temperature of the rats in Hongzhongxiao pretreatment group was significantly lower than that in the normal control group,the model group and the western medicine control group on the 14th day after treatment (℃:33.97 ± 0.83 vs.35.10 ± 0.57,35.01 ± 0.68,35.25 ± 0.23,all P ＜ 0.05).The body temperature of Hongzhongxiao treatment group was significantly higher than that of the Hongzhongxiao pretreatment group (℃:34.87 ± 0.94 vs.33.97 ± 0.83,P ＜0.05).④ After treatment for 13,15,17 days,the contraction rates of swollen area in western medicine control group,hongzhongxiao pretreatment group and hongzhongxiao treatment group were greater than the rate in model group,and the change was most significant on the 17th day after treatment [(96.37 ± 5.09)％,(92.76 ± 13.56)％,(98.41 ± 3.85)％ vs.(77.46 ± 19.07)％,all P ＜ 0.05].⑤ Compared with the model group,the times of abscess localization in the western medicine control group,the Hongzhongxiao pretreatment group and the Hongzhongxiao treatment group was shorter than that in the model group (days:9.28 ± 1.38,7.33 ± 1.97,7.67 ± 1.63 vs.12.63 ± 1.99,all P ＜ 0.05);the time of wound healing in Hongzhongxiao pretreatment group aud Hongzhongxiao treatment group were significantly shorter than those of the model group (days:17.67 ± 1.03,16.83 ± 1.51 vs.19.92 ± 2.33,P ＜ 0.05).⑥ TcPO2 in the Hongzhongxiao pretreatment group was significantly higher than that in the model group on the 7th day after treatment [mmHg (1 mmHg =0.133 kPa):63.33 ± 9.77 vs.39.51 ± 8.42],and the Hongzhongxiao treatment group (44.25 ± 6.41) was significantly lower than that of the Hongzhongxiao pretreatment group,and the Hongzhongxiao treatment group was significantly higher than that of the model group (59.50 ± 7.34 vs.49.52 ± 10.17) on the 14th day after drug application,and the western medicine control group was significantly lower than that of the model group (37.71 ± 5.63 vs.54.33 ± 7.74),the Hongzhongxiao pretreatment group and Hongzhongxiao treatment group were significantly higher than those of the western medicine control group,the difference being statistically significant (all P ＜ 0.05).Conclusions The Hongzhongxiao tincture applied on top and circumferentially around the periphery of the abscess can reduce the local inflammatory response,improve the body weight and mental state,increase the blood supply around wound periphery for anti-infection and anti-inflammation in order to promote the formation of defending field of nursing.Although the early application of Hongzhongxiao tincture cannot reduce the local infectious symptoms and kill the Staphylococcus aureus,it can make skin abscess localization as soon as possible and shorten the wound healing time.

OBJECTIVETo explore a new procedure for aesthetic correction of the medial epicanthal fold aim at the etiopathogenesis.

METHODSThe new Z-epicanthoplasty devise the upper and inferior margin of angle of eye medial as one angle of the Z.

RESULTSFrom 2004 to 2006, 129 patients were treated by using the method. Follow-up 6 to 24 months, all patients were satisfied by eliminating the medial epicanthal fold without obvious scar.

CONCLUSIONSThe method is more effect than traditionally Z-plasty. Our technique is a simple, advanced procedure that can be performed widely.

Adolescent ; Adult ; Blepharoplasty ; methods ; Eyelids ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Young Adult

Objective To establish an animal model of annulus fibrosus (AF) partial defect for the repairing of interver?tebral disc (IVD) defect. Methods Image J 1.46r software was used to measure the T12/L1-L6/S1 intervertebral height in ovine lumbar spine X-ray films. AF thickness was measured by axial split disc. A 11 blade was used to make a trapezoid de?fect of upper bottom 3 mm, lower bottom 5 mm, height 5 mm and thickness 3 mm, whose lower bottom toward the nucleus pulposus (NP) in the left front of ovine lumbar IVD in vitro. The minimally invasive lateral approach was used to make the same type of trapezoid defect in the left front of the ovine lumbar IVD in vivo. The trapezoidal defect length of the axial divid?ing disc was measured, AF and a small amount of NP from trapezoidal defect in IVD were weighed, and the production of trapezoidal defect in IVD was evaluated. Results The lumbar intervertebral space height of ovine was (4.45 ± 0.28) mm. There were significant differences in the thickness of AF (4.08±0.50) mm , thickness (3 mm) and height (5 mm) of trapezoidal defect (P<0.05), respectively. There were no significant differences in trapezoidal defects in ovine lumbar IVD in vitro on the upper bottom (3.03 ± 0.09)mm, the lower bottom (5.03 ± 0.09) mm, the height (4.97 ± 0.10) mm, the thickness(3.02 ± 0.06) mm and the trapezoidal defect predetermined value on the upper bottom 3 mm, the lower bottom 5 mm, the height 5 mm and the thickness 3 mm (P>0. 05). The weights of the AF and NP taken out from ovine lumbar IVD in vitro and in vivo were (0.162 ± 0.011) g and (0.166 ± 0.014) g, and there was no significant difference between them (P > 0.05). Conclusion Through the operation of minimally invasive lateral approach, the method of making a trapezoidal defect in the experiments can establish animal model of AF partial defect, which meets the requirements for the repairing of IVD defect, and is simple, safe and reliable.

Objective To assess the prospect of integrated biphasic silk fibroin scaffold made by annulus fibrosus-nu?cleus pulposus tissue engineering in application as integrated intervertebral disc(IVD). Methods An integrated annulus fi brosus-nucleus pulposus(AF-NP)biphasic scaffold was made by silk fi broin using two different uncomplicated methods which were paraffin spheres-leaching method(outer AF phase)and phase separation method(inner NP phase). The scaf?fold was investigated by general observation, stereomicroscope and scanning electron microscopy(SEM). Its pore size, poros?ity, and compressive elastic modulus were determined. AF and NP cells were isolated from rabbit IVD and seeded into the corresponding phase of the scaffold respectively. The cell-scaffold complex was cultured for 48 hours. The biocompatibility of the scaffold was evaluated by SEM, live/dead staining while CCK-8 assay was used to assess cell proliferation. Results Stereomicroscope and SEM showed that AF phase and NP phase integrated perfectly without cross-linking. Both phases pos?sessed highly interconnected porous structure [pore size of AF and NP phase were(220.0±23.1)μm and(90.0±17.8)μm, re?spectively] and highly porosity(AF and NP phase were respectively 91%and 93%). In addition, this silk biphasic scaffold had impressive mechanical properties(150.7 ± 6.8)kPa. SEM revealed that disc cells attached to regions of pore walls, dis?tributed uniformly and secreted extracellular matrix. Live/Dead staining and cell count kit-8(CCK-8)analysis showed that the silk composite scaffold was non-cytotoxic to disc cells. Conclusion This silk biphasic AF-NP scaffold has satisfied pore size, porosity, biomechanical properties and biocompatibility, so it is ideal candidate for IVD tissue engineering.