BACKGROUND: Matrix material for cartilage tissue engineering exhibits too fast or too slow chondrocytes degradation in vivo, affecting tissue regeneration and shaping reconstruction, which has troubled scholars.OBJECTIVE: To amply bone marrow stromal cells (BMSCs) and induce them to chondrocytes in vitro, so as to study the feasibility of repairing articular cartilage defects in rabbits using poly(lactic-co-glycolic acid) (PLGA) loaded with BMSC-derived chondrocytes.DESIGN, TIME AND SETTING: Comparative experiment was performed at the Institute of Orthopaedics in the Fourth Military Medical University of Chinese PLA and the Center Laboratory of the Airforce General Hospital of Chinese PLA between June 2002 and June 2008.MATERIALS: A total of 36 two-month-old New Zealand white rabbits were used, and 4-6 mL bone marrow was aspirated from bilateral femoral trochanters in each animal. Primary culture and subcultures were done. In subcultures, the medium contained bone morphogenetic protein-2 (100 μg/L.), and high polymer hyaluronic acid was spread on bottom of the culture flasks in advance.In this way, the BMSCs were induced into chondrocytes and the third passage of cells at the adjusted density of 2.0×10~(10)/L wereco-cultured with PLGA for 24 hours, then PLGA-cell composites were prepared.METHODS: A defect of 4-mm in diameter and reaching medullary cavity were created in femoral condyles of 36 rabbits, and 36 right knees were treated with PLGA-cell composites, serving as experimental group, while 18 left knees with PLGA only as material group, and the other 18 knees remained untreated, as blank control group.MAIN OUTCOME MEASURES: At 4,8,12, 24 weeks after operation, the animals were euthanized and the newly formed tissues were observed macroscopically and microscopically, graded histologically, and analyzed statistically.RESULTS: Material group and blank control group shared identical outcomes of gross and histological observation, thus assigning into a control group. In the experimental group at 24 weeks, the defects were filled with white translucent cartilage tissue which appeared smooth and tenacious. The color and the luster were similar to that of normal cartilage, and was ill-demarcated from the surrounding normal cartilage. The cells on the surface paralleled to joint surface. Though the cells in the deep layer arranged disorderly, they tended to align vertically. The matrix was extensively stained. The subchondral bone formed.The tide mark basically recovered, and the new cartilage integrated with normal cartilage finely. In the control group, chondrocytes proliferated in the border, but in the bottom, there were mainly fibrous tissues. The histological grade of 12 and 24 weeks was different significantly from that of 4 and 8 weeks (P < 0.01). There were also significant differences between experimental group and control group at each time intervals after operation (P < 0.01).CONCLUSION: BMSCs were successfully induced into chondroncytes by use of bone morphogenetic protein-2 and high polymer hyaluronic acid. PLGA can be degraded and absorbed gradually while new cartilage tissues form. It can be used as a suitable scaffold material for repairing articular cartilage defects in tissue engineering.

Objective To analyze the incidence,clinical feature and the risk factors of invasive fungal infection in pediatric intensive care unit (PICU). Methods We retrospectively summaried the invasive fungal infection in our PICU from Jan 2007 to Dec 2009 in order to analyze the incidence, clinical feature and the risk factors of invasive fungal infection in PICU. Multiple clinical data were collected such as pediatric critical illness score, mechanical ventilation, urinary drainage tube, indwelling gastric canal and continuous blood purification. Results ( 1 ) The incidence rate of invasive fungal infection was 1.65 % ( 35/2 116 ). The morbidity was 20. 00% ( 7/35 ). ( 2 ) Mean infected day was ( 10. 4 ±- 8. 3 ) d after admission. The clinical manifestations included fungal pneumonia( 60. 0% ), peritonitis ( 14. 3% ), urinary tract infection ( 11.4% ),intestinal tract infection(8. 6% ) ,sepsis(2. 9% ) and meningitis(2. 9% ). All of the patients had used broad spectrum antibiotic. (3) The risk factors of invasive fungal infection included lower pediatric critical illness score, mechanical ventilation, indwelling gastric tube, urinary drainage tube and continuous blood purification.(4) Candia albicans was the predominant pathogen in invasive fungal infection. Conclusion Invasive fungal infection has become one of the main nosocomial infection in PICU. Lung is most commonly involved and candida albicans is the major pathogen. Using antibiotics appropriately, decreasing unnecessary invasive performance,and rationally using antifungal agent mi.ght be effective strategy for invasive fungal infection in PICU.

Objective To analyze current situation and problems of health manager training in the pilot training areas. Method With the recommendations of health administration deputies in the plot areas of Shanghai, Chongqing and Urumqi, 2 centers for community health services (CHSs) were selected in each area, 9 relative persons were interviewed, 3 focus group discussions (FGDs) involved 18 persons were held totally. The FGDs focused on such questions as“the general information of the training students”“the objectives and purposes of the training in each area”, and so on. Field investigation and qualitative analysis were used to investigate the status quo and main problems of the training of health manager in the pilot areas. Result The problems of the training of health manager existing in the pilot areas mainly are:part of teachers were not fully competent to the training of health manager, training of operant skill was insufficient, training course was not unified, the assessment mechanism was not perfect. Conclusion Optimizing the construction of teachers team, standardizing the training content, increasing the time of operating skills training, establishing a unified and standardized assessment mechanism are essential.

Objectives To observe and quantify the intraepidermal and papillary dermal nerve fibers,and the contact between intraepidermal nerve fibers and Langerhans cells in the lesional skin of pso-riasis vulgaris.Methods The nerve fibers and Langerhans cells were analyzed with immunohistochemical LAB-SA method,double-labelled immunofluorescence and confocal laser scanning microscopy in28biopsies of lesional skin taken from psoriatic patients and17normal controls.Results The length of nerve fibers was significantly longer in psoriatic lesions than that in normal controls(t =4.09,P

In order to promote the integration between disciplines, the convergence between basic course and clinical teaching, increasing students ability including the active learning and life-long learning ability, finding problem and solving problem ability, teamwork spirit and so on. After nearly 3 years preparation, Hebei Medical University successfully carried out the PBL teaching in Seven-year Clinical Medicine Science. Combining with the teaching activities, formative assessment was carried out, and PBL teaching website was established. The reform has already achieved initial results, got good responds from teachers and students. Through the study, it has been confirmed that the PBL teaching method in Hebei Medical University is effective and worthy to reference.

Objective To explore the therapeutic efficacy of endovascular embolization for the treatment of tiny intracranial aneurysms (≤3.0 mm) and to discuss its technical skill. Methods During the period from Dec. 2010 to July 2013, a total of 12 patients with tiny intracranial aneurysms (≤3.0 mm) were admitted to authors’ hospital to receive endovascular embolization therapy. Of the 12 patients, narrow-necked aneurysm (neck-to-body ratio ≤0.5) was seen in 7 and embolization with coils only was carried out, while wide-necked aneurysm (neck-to-body ratio > 0.5) was seen in 5 and stent-assisted coils embolization was adopted. Based on Raymond grading standard, the immediate therapeutic results were evaluated, and the procedure-related complications were recorded. Thirty days after the treatment , GOS grade was used to assess the results. Follow-up evaluation with angiography or through call was conducted. Results Successful embolization of the aneurysm was obtained in all the 12 aneurysms , with a success rate of 100%. Angiography performed immediately after the treatment showed that complete embolization was achieved in 8 aneurysms (66.7%) and residual aneurysm cavity was seen in 4 aneurysms (33.3%). GOS grading indicated that 12 cases belonged to grade V. The 12 patients were followed up for 1 - 12 months through telephone , and no re-bleeding occurred. Conclusion For the treatment of tiny intracranial aneurysms (≤ 3.0 mm), endovascular embolization is feasible although its safety and efficacy need to be further observed.

Objective : To learn the effects of cassia seed extract,ginkgo biloba leaf extract,salvia miltiorrhiza extract and red yeast rice compounds on blood lipid level of rats with hyperlipidemia. Methods : The model of hyperlipidemia in SD rats was established. The rats in the low,moderate and high dose groups were given 0.267 g/kg body weight,0.533 g/kg body weight and 1.600 g/kg body weight of cassia seed,red yeast rice,ginkgo biloba leaf and salvia miltiorrhiza compounds by gavage for 30 days. A blank control group and a model control group were also set. The levels of serum total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）and low-density lipoprotein cholesterol（LDL-C）in the five groups were measured before and after the intragastric administration. Results : One week after the model was founded,the levels of serum TC,TG and LDL-C in the model control group were higher than those in the blank control group（P<0.05）. Before the intragastric administration,there were no significant differences in the levels of serum TC,TG,HDL-C and LDL-C between the model control group and each dosage group（P>0.05）. After the intragastric administration,there were no significant differences in the levels of serum HDL-C and LDL-C between the model control group and each dosage group（P>0.05）. The levels of serum TC and TG in the high dose group were significantly lower than those in the model control group（P<0.05）;There was no significant differences in the levels of serum TC and TG between the moderate dose,low dose group and the model control group（P>0.05）. Conclusion The compounds of cassia seed extract,red yeast rice,ginkgo biloba extract and salvia miltiorrhiza extract with a dosage of 1.600 g/kg body weight can reduce serum TC and TG levels in rats with hyperlipidemia.

Objective To evaluate the clinical effect of reduced glutathione in protecting the liver function for patients with hepatocellular carcinoma (HCC) after receiving international therapy.Methods The clinical data of 110 HCC patients,who were admitted to authors' hospital during the period from January 2010 to June 2013,were retrospectively analyzed.According to the random number table method the patients were divided into the control group (n=50) and the treatment group (n=60),and transcatheter arterial chemoembolzation (TACE) and transcatheter arterial infusion (TAI) were carried out in all patients.After the treatment,intravenous infusion of 2.0 g vitamin C,0.2 g vitamin B6,2.0 g inosine,and 250 ml branched chain amino acid was employed per day for one week for the patients of both groups,and additional intravenous dripping of 1.8 g reduced glutathione (added in 250 ml of 5％ glucose solution) was adopted for the patients of the treatment group.Various liver function indexes were tested before and one week after the treatment,the results were compared between the two groups.Results Before the treatment,no obvious differences in the hepatic functions and in the clinical condition existed between the two groups.One week after the treatment,in both groups the aminotransferase (ALT and AST) and total bilirubin (TBIL) were significantly increased when compared with the preoperative data (P＜0.05),while the serum pre-albumin (PA) was remarkably decreased when compared with the preoperative data (P＜0.05);these changes of various indexes in the treatment group were apparently better than those in the control group (P＜0.05).Conclusion The use of reduced glutathione can effectively relieve the liver function damage caused by interventional therapy in HCC patients,therefore,reduced glutathione has a very good clinical application value.

Objective To evaluate the efficacy of interventional therapy for various types of acute iliofemoraldeep venous thrombosis (IF-VT) through jugular vein. Method Thirty-eight patients with acute IF-VT from theAffiliated Hospital of Xuzhou Medical Collge underwent catheter-directed urokinase thrombolysis through jugularvein. Results Left IF-VT or with extension of thrombus into inferior vena cava was diagnosed in 16 patients,leftIF- VT with left common iliac vein occlusion in 17 ,left IF-VT with extersion of thrombus into inferior vena cava andleft common iliac vein stenosis or occlusion in 3,and both IF-VT with left common iliac vein stenosis or occlusion in2. Complete thrombolysis and partial thrombolysis was carried out in 33 (86.8%) and 5 (13.2%) patients, re-spectively. During a period of 2 - 18 months following-up in 20 patients, reoccurrence was found in 2 patients.Conclusions Interventional therapy for various types of acute lower extremity DVT through jugular vein is a safeand effective method.

Objective To evaluate the efficacy of interventional therapy for hepatocellular carcinoma complicated by Budd-Chiari syndrome. Methods Clinical data and imaging studies of 17 patients with hepatocellular carcinoma complicated by Budd-Chiari syndrome were retrospectively analyzed. Budd-Chiari syndrome was diagnosed by color Doppler ultrasound and confirmed by cavography in 17 patients. Hepatocellular carcinoma was diagnosed by fine-needle aspiration cytology in 5 patients,and by color Doppler ultrasound, computed tomography and /or MRI, and elevated level of alpha-fetoprotein in 12 patients. Both percutaneous transluminal angioplasty for treatment of obstruction of the inferior vena cava and transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma were performed in all patients. During follow-up, the tumor size, liver function, serum alpha-fetoprotein level and the recanalized inferior vena cava were evaluated by liver ultrasound, CT and laboratory examination. t test was used to compare the pressure. Results Thirty-nine interventional procedures were performed in 17 patients and all operations were successful without complications. Over the follow-up period of 2 to 90 months after percutaneous transluminal angioplasty in 17 patients, re-occlusion of inferior vena cava occurred in only one patient, which was redilated successfully. Following TACE, all 17 patients survived at two months followup, 13 patients survived at 6 months follow-up, 10 patients survived at 1 year follow-up, 5 patients survived at 2 years follow-up. The pressure of vena cava was (20.5±2.1) cm H2O (1cm H2O=0.098 kPa) before the interventional theraphy, while it was (3.6±1.0) cm H2O after it (t=30.32, P＜0.05). Conclusion Interventional therapy can be effectively performed for treatment of hepatocellular carcinoma complicated by Budd-Chiari syndrome.