Objective To explore the effects of Gantaikang on porcine serum-induced liver fibrosis in rats. Methods Hepatic fibrosis was induced in rats by intraperitoneal injection of 0.5ml porcine serum twice a week. Gantaikang was simultaneously administered intragastrically to rats in the intervention group at dose of 0.27g/kg?bw for 7 weeks. Then blood was collected, and serum levels of hyaluronic acid(HA), laminin(LN) and precollagen III(PCIII) were measured. Liver tissues was removed, and the pathologic changes of liver were observed by routine, Masson and James staining. The semi-quantitive analysis of collagen and reticulin in the liver tissues were performed. Results Gantaikang could effectively counteract the increase of HA, LN and PCIII level in serum, and attenuate hepatic collagen and reticulin proliferation induced by porcine serum in rats. Conclusion The results suggested that Gantaikang could, to a certain extent, prevent and attenuate immunologic hepatic fibrosis induced by porcine serum in rats.

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.

Henan is a large agricultural population province of China.It has relative scarcity of the primary health personnel and the health technology,together with farmers lacking understanding of prevention and treatment of cardiovascular diseases.which result in the diseases becoming the major effect on local residents'health.In the new situation of social change,the feasible medical technique extension for the rural health prevention and treatment of cardiovascular diseases faces on the new opportunities and challenges.The technical strategy was taken as following:choosing representative demonstration counties,focusing on actual demand for cardiovascular disease prevention and treatment and on technical problems of diseases with heavier burden and lack of appropriate technology.From the baseline survey.selecting a number of safe,effective and economic the feasible cardiovascular technology for the extension application in large area.The models of appropriate technology applications and operating mechanisms were studied systematically on different economic conditions and different regions.Some existing problems were found in the extension application.Meanwhile,the measures of prevention and treatment of cardiovascular rural grags-roots promotion of appropriate technology mode was put forward.This study would improve cardiovascular health services in rural areas.decrease the disease burden of farmers and raise their overall health level.

OBJECTIVE: To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors. METHOD: This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications. RESULT: Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient. CONCLUSION CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.
Adenoma, Pleomorphic ; complications ; Carcinoma, Adenoid Cystic ; complications ; Diagnosis, Differential ; Facial Paralysis ; complications ; Horner Syndrome ; complications ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; diagnosis ; therapy ; Pharynx ; pathology ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Salivary Gland Neoplasms ; complications ; Tomography, X-Ray Computed

The wheelchair is one of the main assistive appliance for patients with spinal cord injury. With the improvement of material and technique, it is more complicated to select the wheelchair and wheelchair seat equipment. The researches in recent years involved application of wheelchair for patients with spinal cord injury, including the cushions and other structures, which were reviewed in this article.

Community associated methicillin-resistant Staphylococcus aureus is a human pathogen.It can cause a series of infections cause morbidity and mortality,including bacteremia,pneumonia and soft tissue infections.USA300 clone is highly toxic and contagious.Its prevalence in the United States continues to rise,and has begun to spread to the rest of the world.This article briefly reviews the recent research on relevant aspects of molecular epidemiological characteristics,grug resistance mechanisms and treatment of USA300 clone.

To investigate the clinical efficacy of distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg for the treatment of traumatic chronic osteomyelitis of lower leg. A total of 25 patients with traumatic chronic osteomyelitis of lower legs were from Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2002 to June 2008. All the patients were treated with distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg after thoroughly debridement. Among them, 6 patients were treated with myocutaneous flap with nutrient vessel of saphenous nerve, and 19 patients were treated with myocutaneous flap with nutrient vessel of sural nerve. The sizes of the flaps were 5 cm×3 cm-18 cm× 12 cm, with attached muscles were 3 cm×3 cm-8 cm×5 cm. The lengths of the pedicles were 5-12 cm. All transplanted myocutaneous flaps survived well. A 6-24 months follow-up of all patients was obtained. The shape and texture of the myocutaneous flaps were good. And there was no recurrence of osteomyelitis. Results suggested that the distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg had reliable blood supply and satisfied efficacy, which was a good method for repairing traumatic chronic osteomyelitis of lower leg.

ObjectiveTo evaluate the clinical effects of surgery using scar flap in situ combined with radiotherapy in 24 hours in the restorative treatment of keloids on the auricula and the preventive effects of the therapy in the recurrence of the keloids.MethodsThe scar flap in situ was designed,its size was large enough for covering the wound of the keloid on the auricula.The keloids along the designed lines were excised using local anesthesia,the flap was clipped into the one with even thickness and suitable size which covered the wound tensionlessly to ensure that the scar flap in situ survived well,and then the wound was bandaged with pressure and drained when necessary.18-24 hours after the surgery the wound was perpendicularly irradiated by the 5 MeV high energy electron beam (beta particle) of the Siemens Primus linear accelerator.After the dressing change was performed and the drain was removed; the wound was exposed to the irradiation,3-4 Gy segmentation dose per time,and the wound was then bandaged with pressure.The radiation was performed every two days and four times altogether with a total irradiation dose of 12-16 Gy.Stitches were removed 8-10 days after the surgery.ResultsThere were no avascular necrosis in the 25 scar flaps in situ and the wounds were all primary healing with normal color and fine appearance.All the patients were satisfied with the surgery.There was no recurrence of the 23 patients during the 8 to 42 months' follow-up,but there was a tendency to recur in 2 patients after 4-6 months,and the recurrence was controlled after the beta methasone was locally injected for 2-4 times.ConclusionsIt is not necessary to harvest the flaps on the other sites applying the sear flap in situ in the restorative treatment of keloids on the auricula,and therefore it prevents the formation of the keloids on the donor sites.Furthermore,the surgery is simple and the appearance of the auricula is fine,and it presents satisfactory clinical effects to irradiate the wound in 24 hours after the surgery.

Objective To estimate the clinic features of severe multiple trauma with secondary thrombocytosis as a factor influencing the prognosis.Methods A retrospective single-center study was carried out in 680 patients with severe multiple trauma survived longer than 72 hours in Chongqing Emergency Medical Center from March 2010 through March 2013.The variables including age,gender,ISS (injury severity score),APACHE Ⅱ score,splenectomy and the usages of vasopressors,blood products transfusion,hematopoietic medicines and anticoagulant were analyzed.The prognosis indices including total in-hospital mortality after 72 hours,length of hospital stay and morbidity of thrombo-embolism were explored.The clinic characteristics and prognosis of severe multiple trauma with secondary thrombocytosis (platelet count more than 450 × 109 L-1) were evaluated.T test or rank sum test was used for comparison between measurement data and Chi-square test or Fisher' s exact test was used for comparison between enumeration data.Results Thrombocytosis was identified in 99 (14.56％) patients and it occurred one week after injury with median time of 27 days (ranged from 8 days to 304 days),and maintained for (18.62±4.38) d.The median of platelet count was 584 × 109 L-1 (lowest 478 × 109 L-1,highest 1 072 × 109 L-1) in severe multiple trauma patients with thrombocytosis.The proportions of splenectomy,prolonged use of vasopressors and employment of hematopoietic medicines or anticoagulant were significantly higher in patients with thrombocytosis than those in patients without thrombocytosis (14.14％ vs.7.06％,P=0.03;62.63％ vs.39.07％,P＜0.01; 28.28％ vs.6.71％,P＜0.01; 90.91％ vs.19.45％,P＜ 0.01).The highest D-Dimer level presenting in patients with thrombocytosis during the time of platelet increasing was significantly more common than that in patients of non-thrombocytosis group 7 days after trauma [(11.68 ± 11.90) vs.(5.05 ± 5.11),P =0.004].However,the mortality,length of hospital stay and morbidity of thrombo-embolism were not significantly increased in patients with thrombocytosis compared with patients without thrombocytosis [8.08％ vs.8.78％,P=0.82; 34 d (28.5,54.5) d vs.45 d (23,67) d,P =0.41; 10.10％ vs.10.50％,P =0.91].Conclusion There was a higher rate of secondary thrombocytosis in severe multiple trauma patients.The factors such as splenectomy,vasopressors,hematopoietic medicines and so on might induce the reactive thrombocytosis in trauma patients.Thrombocytosis might increase the incidence of thromboembolism in severe multiple trauma patients without appropriate prophylactic anticoagulation.For the sake of prophylaxis,employment of anti-platelet agent might be the appropriately therapeutic strategy for patients suffering from severe multiple trauma with secondary thrombocytosis accompanying risk factors of arterial thrombo-embolism.

Objective To evaluate diagnostic value and clinical significance of procalcitonin (PCT)in infection in intensive care unit (ICU)patients.Methods 96 ICU patients in a hospital between September 2011 and March 2012 were selected for study,levels of patients’PCT,high-sensitivity C-reactive protein (HsCRP)and white blood cell (WBC)count were detected,statistical analysis were conducted.Results Compared with non-bacteria infected patients,serum PCT and HsCRP levels in all bacteria infected patients increased,the difference were significant (Z=-6.102;-3.918,both P <0.05 );WBC count was not significantly different(Z =0.212.P >0.05).PCT sensi-tivity,specificity,positive predictive value,and negative predictive value for diagnosing infection was 82.35%, 67.86%,86.15%,and 61 .29% respectively;receiver operating characteristic (ROC)curve of PCT,HsCRP,and WBC was 0.898,0.755,and 0.581 respectively.Conclusion There are higher sensitivity and specificity of PCT to predict infection,which is helpful for early detection of infection in critically ill patients.