BACKGROUND: A silk fibroin/chitosan scaffold has good biocompatibility, osteoinductivity and degradability.OBJECTIVE: To review the structure, performance and application of the silk fibroin/chitosan scaffold in bone,cartilage and soft tissue engineering regeneration.METHODS: PubMed, Wanfang, and CNKI databases were retrieved by computer for articles related to the structure, performance and application of the silk fibroin/chitosan scaffold in orthopedics published from 1998 to 2016. The keywords were chitosan, silk protein, bone tissue engineering in English and Chinese, respectively.RESULTS AND CONCLUSION: The silk fibroin/chitosan scaffold is characterized by good biocompatibility, bone inductivity and biodegradability that make cells grow well on the scaffold. The silk fibroin/chitosan scaffold has been widely used in bone tissue engineering, and has a prominent performance in bone defect repair and cartilage injury treatment. Meanwhile, the silk fibroin/chitosan scaffold exerts a crucial role in wound healing as well as in the treatment of spinal nerve injury and other soft tissue injuries. However, the silk fibroin/chitosan scaffold currently is less reported in the clinical use due to various reasons, and it will be the main research direction of future efforts. As is known to us, silk protein can be used to prepare the cruciate ligament and construct tissue-engineered nuclei; therefore, the silk fibroin/chitosan scaffold can be developed in the treatment of tendon ligament injury and intervertebral disc tissue engineering.

Objective To investigate the change and its clinical significance of the deceleration capacity (DC) of heart rate in elderly patients with coronary heart disease (CHD).Methods A total of 105 elderly CHD patients and 86 elderly non-CHD patients were selected.All patients underwent 24 h ambulatory electrocardiographic recording.DC,heart rate variability (HRV) time domain index,heart rate turbulence (HRT) parameters including turbulence onset (TO) and turbulence slope (TS),and the occurrence of ventricular arrhythmias were off-line calculated.Results The values of DC,HRV and HRT were decreased in elderly patients with CHD.DC had positive correlations with standard deviation of normal-to-normal intervals (SDNN),the square root of the mean squared successive differences between normal-to-normal RR intervals (rMSSD) and percentage of adjacent normal-to-normal intervals that differed more than 50 ms (pNN50) (r=0.60,0.51,0.49,0.41,respectively,all P ＜0.05) and had a negative correlation with the occurrence of ventricular arrhythmias (r=-0.34,P＜0.05).The value of DC was much decreased in elderly CHD patients with type 2 diabetic or acute myocardial infarction.Conclusions The decreased DC value is correlated with heart rate variability,turbulence slope and the occurrence of ventricular arrhythmias in elderly CHD patients.The deceleration capacity of heart rate is a better noninvasive method for screening and predicting sudden death in high-risk elderly patients with CHD.

BACKGROUND:Currently, there is a lack of effective hip preserving therapy in patients with alcohol-induced osteonecrosis of femoral head. Artificial hip replacement is the only choice for the patients whose function of the hip joint is affected by the colapse of the femoral head in the late stage. Therefore, to understand the pathogenesis of alcohol-induced osteonecrosis of femoral head is of great significance for the effective hip preserving therapy in patients.
OBJECTIVE: To review the research progress in apoptosis of bone cels in the pathogenesis of alcohol-induced osteonecrosis of femoral head both at home and abroad in recent years, so as to provide a theoretical basis for the study of the treatment of alcohol-induced osteonecrosis of femoral head.
METHODS:PubMed and Embase databases were retrieved by the first author using computer to search relevant articles addressing the effect of apoptosis of bone cells in the pathogenesis of alcohol-induced osteonecrosis of femoral head. The keywords were “osteonecrosis of femoral head and apoptosis”, “bone cell, apoptosis, gene, signal” or “osteonecrosis, alcohol”in the title and the full text. Repetitive and old literatures were excluded, and finally 40 foreign language articles were included in result analysis.
RESULTS AND CONCLUSION: In recent years, the theory of apoptosis of bone cells in the pathogenesis of alcohol-induced osteonecrosis of femoral head has been gradually recognized and has become the focus of research on the pathogenesis of alcohol-induced osteonecrosis of femoral head. Apoptosis of bone cells plays an important role in the pathogenesis of alcohol-induced osteonecrosis of femoral head. Various genes, such as p53, Bcl-2 family, tumor necrosis factor, Caspase, are crucial to control the apoptosis of bone cells. Although we have made some progresses at the gene level, there is still a lack of relevant studies on alcohol-induced osteonecrosis of femoral head due to the complexity of pathogenesis.

Objective To establish a molecular typing method (opa-typing) for Neisseria gonorrhoeae, and to evaluate its performance based on epidemiological data. Methods Twenty-six gonorrhea patients were recruited from March to April 2006 at two sites, including 17 cases from the STD Clinic of Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College and 9 cases from the STD Clinic of Shandong Provincial Institute of Dermatology. Of the 26 patients, 6 were from three known sexual links, while the remaining 20 patients did not have any sexual contact with each other. The opa gene was amplified by using PCR from Neisseria gonorrhoeae isolates from these patients followed by overnight digestion with restriction enzymes Taq Ⅰ and Hpa Ⅱ. The enzyme digestion band patterns were analyzed using the Cel-Compar program. Results The opa gene was successfully amplified from all the 26 Neisseria gonorrhoeae strains, and restrictedly digested by endonucleases Taq Ⅰ and Hpa Ⅱ . Identical band patterns were observed between patients with sexual links, but not among the remaining 20 patients. Conclusions The results of opatyping of Neisseria gonorrhoeae coincide with the information on sexual behaviour provided by patients. Opatyping may serve as a reliable tool in sexual network analysis.

Recent years have witnessed great development of TLA (Total Laboratory Automation) technology, however, its application hit the bottleneck of high cost and openess to other parties' instruments. Specifically speaking, the initial purchase of the medical devices requires large sum of money and the new system can hardly be compatible with existing equipment. This thesis proposes a new thought for system implementation that through incremental upgrade, the initial capital investment can be reduced and through open architecture and interfaces, the seamless connection of different devices can be achieved. This thesis elaborates on the standards that open architecture design should follow in aspect of mechanics, electro-communication and information interaction and the key technology points in system implementation.
Automation, Laboratory ; Computer Systems

BACKGROUND: Calcium phosphate cement (CPC) can strengthen the immediate and early fixation of screws by improving the quality of bone and the surface of screws. OBJECTIVE: To evaluate the biomechanical efficacy of CPC in augmentation of anterior cervical unicortical screw fixation. DESIGN: A study of controlled observation. SETTING: Department of Orthopaedics of First Xiangya Hospital of Xiangya Medical College of Central South University. MATERIALS: Experiments were performed at the Room of Electromechanical Tensile Property of College of Material Science and Engineering of Central South University from September 2003 to January 2004. Anterior cervical unicortical screw (pure titanium) was produced by Zhangjiagang Xinda Medical Equipment Co., Ltd. Injectable calcium phosphate cement was produced by Shanghai Ruibang Biomaterial Co., Ltd. Axial pull-out sleeve was produced by Machine Manufacture Center of Central South University. METHODS: ①Sixteen cervical vertebrae (C3-6) of four fresh young man cadavers with fine results in bone mineral density (BMD) test and sixteen cervical vertebrae (C3-6) of 4 fresh old man cadavers with poor results in BMD test were selected. Specimens were provided by Department of Anatomy of Xiangya Medical College of Central South University. Mortal remains of the deceased were donated according to the will of the dead. Informed consents were obtained from their family members. Twelve vertebrae were selected in each group for three tests. Six vertebrae were selected in pull-out test, and six vertebrae in cyclic bending test and shearing test. Screw holes, which were 8 mm apart from the midline and 5°inclined centrally, were made on both sides in the front part of the vertebra. Cortical bone was not penetrated. ②A screw was randomly inserted into one side hole, which was considered to be a control group. Pull-out test was performed on material testing machine at 5 mm/min. The screw hole was filled with CPC (0.10-0.15 mL) to repair the screw hole, and then the screw was implanted, which was considered to be a restoration group. The screw hole was injected with CPC, and then the screw was implanted, which was considered to be a augmentation group. 24 hours later, pull-out test was conducted again at 37 ℃. ③The screw was randomly implanted into one side hole (as a control group). The screw hole was injected with CPC, and then screw was implanted (as an augmentation group). Both groups received cyclic bending test and shearing test. MAIN OUTCOME MEASURES: ①The maximal axial pull-out strength of screws, ②displacement of screws after cycle bending test, ③the maximal shear strength after cycle bending test. RESULTS: ①The axial pull-out test: In normal vertebrae, axial pull-out strength was (313±64)N, (376±88)N and (446±121)N in the control group, the restoration group and the augmentation group respectively. In osteoporotic vertebrae, axial pull-out strength was (106±47)N, (154±67) N and (191±80)N in the control group, the restoration group and the augmentation group respectively. The axial pull-out strength in the restoration group and augmentation group was significantly bigger than in the control group (P < 0.05). ②The cyclic bending test: The displacement of the unicortical screw in the augmentation group was much smaller than in the control group (P < 0.05). ③ In normal vertebrae, the maximal shear strength was (301±79)N and (395±105)N in the control group and the augmentation group respectively. In the osteoporotic vertebrae, the maximal shear strength was (87±39)N and (149±63)N in the control group and the augmentation group respectively. The maximal shear strength was significantly bigger in the augmentation group than in the control group (P < 0.05).CONCLUSION:CPC can enhance the axial pull-out strength and shearing ability of the screw. The augmentation is more evident in osteoporosis patients.

Objective To explore the correlation between delirium and dementia in elderly patients undergoing hip fracture surgery.Methods A prospective study was conducted on 118 elderly patients with hip fracture who were free from prefracture dementia.Caregivers or the relatives described the patients' prefracture cognition by the Informant Questionnaire on Cognitive Decline in the Elderly-short form (IQCODE SF).Delirium was assessed by the Confusion Assessment Method (CAM).After 6 months,cognition was reassessed by using 5 cognitive tests,taking DSM-Ⅳ as the diagnostic criteria.Results Among 32 cases (27％) suffered from delirium in the acute phase,12 cases (38％) reached to the diagnostic criteria of dementia after 6 months follow up,while there were 6 cases (7％) reached to the diagnostic criteria of dementia after 6 months follow-up in the group without delirium in the acute phase (x2 =16.81,P＜0.001).IQCODE-SF score had no statistically significant difference in the prediction of dementia.Conclusions In elderly patients without the history of dementia,delirium after hip fracture surgery is the major predictor of dementia within half years.

Objective: To develop a quality of life instrument for hepatitis B patients(QOL-HBV) and examine it's reliability and validity.Methods:The item analysis, construct validity, content validity, criteria validity, reliability and discriminate were assessed by a survey on 134 HBV patients with QOL-HBV.Results:Item analysis showed that QOL-HBV had satisfactory item discrimination. Eight common factors were extracted by exploratory factor analysis and they can be reduced to three domains. The ?2/DF was 1.310, GFI was 0.972 and AGFI was 0.967 by the confirmatory factor analysis. The coefficients of Cronbach's ? of the instrument and all domains were above 0.80. In comparison with SF-36, there was good correlation among corresponding domains.Conclusion:QOL-HBV is a good scale in testing the quality of life, which has good reliability and validity.

Objective To understand the effects of chemoradiotherapy combined with radiotherapy on peripheral differential blood cell counts on tumor patients.Methods 40 patients receiving concurrent chemoradiotherapy were randomly selected in the radiotherapy department in our hospital.Peripheral blood WBC,PLT radiotherapy for 1-4 weeks were retrospective analysis.Results The first 1-4 week of radiotherapy,peripheral blood cells of WBC,PLT decreased.The difference was statistically significant (WBC:x2 =16.902,P =0.001,PLT:x2 =8.492,P =0.037),and obviously in the second week.Conclusion Tumor radiotherapy decreases blood cell counting and classification in the WBC,PLT,and obviously in the second week.

[Objective]To evaluate the biomechanical efficacy of calcium phosphate cement(CPC)in augmentation and restoration of anterior cervical unicortical screw fixation.[Method]Anterior cervical unicortical screw were fixed in the cervical vertebra(C_(3~6)),pull-out test and cyclic bending test was performed and anti-shear test after cyclic bending.[Result]The pull out strength(pos)of restoration group and augmentation group were significantly higher than that in the control group,the statistic difference was also significant(P