BACKGROUND:Peripheral nerve defect due to limb dysfunction has always been the difficulty faced by the medical profession. Ideal materials and processing technology for constructing a tissue engineering scaffold targeting peripheral nerve repair are stil in research stage. OBJECTIVE:To review the research progress in peripheral nerve repair using col agen/silk fibroin nerve conduits. METHODS:In this paper, the first author retrieved the PubMed and CNKI from 2003 to 2016 to search articles regarding methods of constructing artificial nerve scaffolds and selection of raw materials. Data from these articles were col ected, summarized and analyzed. RESULTS AND CONCLUSION:Forty-six articles were included for final analysis. Col agen and its degradation products trigger no inflammatory response in the host because of high biocompatibility and biodegradability. However, its use is largely limited by its rapid degradation and poor physical performance. Silk fibroin has a high flexibility and biocompatibility, and exhibits a slow degradation in vivo. As a rapid prototyping technique, three-dimensional printing can print various forms of scaffolds within a short time, characterized as high-quality pore structure and large-scale production. Given these, the col agen/silk fibroin nerve conduit prepared using the three-dimensional printing technology can maintain the biocompatibility and even improve the mechanical properties of the raw materials. Until now, more investigations on nerve repair using col agen or silk fibroin have been done, and we have never stopped improving the production process of these scaffolds. Therefore, the col agen/silk fibroin scaffold prepared using the three-dimensional printing technology is expected to become the main candidate for the repair of peripheral nerve defects.

Objective To research the clinical rehabilitative effect of repeated transcranial magnetic stimulation (rTMS) for the non-motor symptoms of Parkinson's disease.Methods Fifty-five PD patients were randomly divided into an rTMS treatment group (n =29) and a sham stimulation group (n =26).The treatment group received a course of 0.5 Hz rTMS treatment,while the sham stimulation group had the same treatment but with no energy output.Both groups were evaluated using a non-motor symptoms questionnaire (NMSQuest),the Hamilton depression scale (HAMD),the Pediatric Daytime Sleepiness Scale (PDSS),the mini-mental state examination (MMSE) and the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT) before treatment,immediately after,and a month after treatment.Results Compared with before treatment,the average NMSQuest score of the treatment group declined significantly,though 1 month after treatment the improvement was no longer significant.After treatment and 1 month later the average NMSQuest score of the sham stimulation group increased gradually.The effect in the treatment group was therefore significantly better than in the sham stimulation group.After treatment and 1 month later the average HAMD score of the treatment group was significantly lower than before treatment while the average HAMD score of the sham stimulation group had increased gradually.The improvement in depression in the treatment group was therefore significantly better than in the sham stimulation group.After treatment,sleep disorders in the treatment group had been significantly alleviated,but one month later the improvement was no longer significant compared with before treatment.PDSS scores in the sham stimulation group declined gradually,but the improvement in sleep disorders among the treatment group was significantly better than among the sham stimulation group.Cognition improved significantly among the treatment group right after treatment,but 1 month later it had worsened while the MMSE scores of the sham stimulation group decreased gradually.The difference between the two groups was statistically significant.The average SCOPA-AUT scores of the two groups were not significantly different from each other or from the scores before treatment.Conclusion Repeated TMS can improve most non-motor symptoms of PD.The improvement in depression is the most significant.A short course of rTMS has no obvious rehabilitative effect on the autonomic function disorders of PD patients.

Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17％,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.

cholesterol 7α-hydroxylase gene ( CYP7A 1 ) plays a key role in the catabolism of cholesterol into bile acids. To investigate whether the A-204C polymorphism in CYP7A1 gene affects the gene expression,using luciferase as the reporter gene, four recombinants were constructed by inserting forward or reverse sequence with A or C allele at the polymorphism site into the promoter-less vector pGL3-basic. The constructs were then transfected into four cell lines and the luciferase activity of each expression vector was examined by dual luciferase reporter gene assay system. The results showed that activities of the forward sequence of both genotypes were higher than that of reverse sequence. Promoter activity of the recombinants with A allele was about one third lower than that with C allele. According to the analysis with TRANSFAC database, there may exist a Zic3 binding site when there is the C allele at -204. Our study indicates that the A-204 C polymorphism in CYP7A1 promoter region decreases its promoter activity and thus represses the gene expression, possibly due to the lack of a potential Zic3 binding site.

Objective　To study the effect and safety of radiofrequency ablation (RFA) in the treatment of liver cancer.Methods　The clinical data of prospectively and non-randomly selected 102 liver cancer patients were analysed. Results　102 patients with a total of 216 tumors were found in this series, the size of hepatomas were 1.5 to 14*!cm in diameter (average 4.9*!cm in diameter). In 67 of primary liver hepatocellular carcinoma, the tumors' size were smaller than 5*!cm in diameter in 21 cases; 35 with secondary liver tumors. RFA were performed under the guidance of ultrasonography in 43 cases, under CT in 50, under laparoscopy in 3, and 6 were performed during open surgery. All patients received ultrasonography and CT scanning of liver one month after the ablaton. The echoes of the tumors were stronger, and the area of the echo reached was larger than pre-ablation; blood flow in the tumor obviously reduced and even disappeared in sonography; CT showed that the shadow density in the tumor was diminished. Of the 102 patients, 14 underwent 18-FDG-PET imaging 30 days after the ablation, of them, 11 showed defect of radiation in the tumor, 3 showed residual locus in the tumor. 2 of the 3 cases underwent RFA again and the residual was disappeared completely, the another subject to ethanol injection because of advanced age. All the patients were followed up for 3-18 months. Except 6 patients with late metastastic liver cancer died within 1 year after RFA, the other 96 cases remained alive now, the 1-year survival rate was 94.1%. Conclusions　RFA is a new ideal therapy for liver cancer. It is safe, effective, and good tolerance with little trauma.

Objective To analyze the data of influenza A(H1N1) viruses surveillance and genetic characteristics from Taian City during 2005-2008,so a scientific basis can be provided for the prevention and treatment of influenza.Methods The specimens from Influenza-Like Illness(ILI) were collected.The viruses were isolated with MDCK cell and identified with HAI and RT-PCR.The product of PCR were sequenced.Then the sequences were analyzed through biometric software.Results A total of 121 influenza strains were obtained from 615 specimens,and 4 of them were identified as A(H1N1) subtype.There were 3 strains mutated on several sites.Compared with strains isolated in 2005,there were 5 and 8 mutations in the amino acid sequences of virus strains isolated in 2007 and 2008 respectively.And there were a total of 22 amino acid mutations compared with A/Brisbane/59/2007(H1N1).Conclusions Influenza type A(H1N1) are detected in Taian City.There are several mutations in the amino acid sequences of virus strains isolated in Taian. The antigenic drift of virus strains is due to accumulation of amino acid substitutions

Objective To compare biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) with intraductal papillary mucinous neoplasm of the pancreas (P-IPMN).Methods From January 2008 to December 2013,eleven (6.0％) cases of BT-IPMNs were retrospectively identified from a total of 182 biliary tract tumors resected in our institution,while 50 cases underwent surgery for P-IPMN.The mean age of the 11 BT-IPMN cases was 57.3 years (range 40 to 74 years).There were 8 men (73.0％).The mean age of the 50 P-IPMN cases was 57.4 years (range 33 to 85 years).There were 34 men (68.0％).The clinical features,radiologic findings,pathology,surgical strategies,and long-term follow up outcomes between the 2 groups of patients were analyzed.Results There was no significant difference between BT-IPMN and P-IPMN in the following aspects:mean age,sex ratios and clinical presentation [including the most common presenting symptom abdominal pain (73.0％ vs.68.0％),and elevated tumor markers (CEA and CA19-9)].The mean tumor size of BT-IPMN was significantly smaller than P-IPMN (1.7 vs.4.1 cm,P ＜ 0.05).Macroscopically visible mucin was detected in all the 11 patients basing on the original surgical reports.The most common abnormal preoperative imaging findings for BT-IPMN were bile duct dilatation (100％) and intraluminal masses (55.0％).Most cases (82.0％) involved the intrahepatic bile duct and hilum.For tumor clearance,we conducted left hepatectomy in most cases (64.0％).Only one patient underwent biopsy and choledochojejunostomy for multiple tumors involving the extrahepatic,right and left bile ducts.BT-IPMN was likely to have a higher risk of malignancy (55.0％ vs.44.0％) and poorer prognosis (median survival,57 vs.63 months),although there was no significant difference (P ＞ 0.05).The patient without tumor resection died of liver failure 22 months after palliative surgery.Conclusions BT-IPMNs are very rare and they had some similarity with P-IPMN.Complete resection of BT-IPMN is associated with good survival.

Objective To determine any relationship among detrusor wall thickness (DWT),bladder capacity (BC) and neurogenic lower urinary tract dysfunction (NLUTD),and to study the clinical implications of using DWT to predict the risk of renal injury after spinal cord injury (SCI).Methods Forty-eight adults with NLUTD due to SCI were recruited for the SCI group,and another 41 healthy adults formed a control group.Both groups underwent urodynamic evaluation and maximum bladder capacity (MBC) detection.The DWT of all subjects was measured by ultrasound imaging of the anterior bladder wall.Thereafter,the SCI group was divided into low and high risk subgroups based on the results of the urodynamic tests.Patients with detrusor leak point pressure ＜40 cmH2O were classified as low risk.Results At MBC,the average DWT in the SCI group was (0.97 ± 0.31)mm and (0.59 ± 0.08)mm in the control group,demonstrating a significant difference in DWT between patients with NLUTD and normal adults.The average DWT among the patients with type A detrusor sphincter dyssynergia was (1.10 ± 0.34)mm,which was significantly higher than among the patients with external urethral sphincter contraction without detrusor contraction (type C).DWT was significantly correlated with detrusor leak point pressure.A DWT of 0.87 mm (sensitivity 89.5％,specificity 58.6％) could be used as a critical point for predicting risk of renal injury in patients with NLUTD.Conclusions DWT is significantly greater among SCI patients with NLUTD and it correlates positively with detrusor leak point pressure.DWT could be used as a risk predictor for renal injury in patients with NLUTD due to SCI.

Objective To evaluate surgical therapies for chronic pancreatitis.Method The clinical data of 229 patients admitted for chronic pancreatitis during March 2009 to November 2013 in our hospital was retrospectively analyzed,different operation method and their clinical outcome were compared.Results Drainage operations or resection operations were made to all these 229 patients according to different types.57 patients underwent longitudinal pancreaticojejunostomy (LPJ procedure).118 patients received local resection of the head of pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure in 105 cases,Berne procedure in 6 cases,Beger procedure in 7 cases).7 patients received pancreaticoduodenectomy,21 patients received distal pancreas resection,26 patients received other procedures.Post-operative pain relief rate was 89.3％,overall morbidity was 19.6％.Conclusions In cases of chronic pancreatitis,different surgical types are adopted according to their individual indications.Operation in accordance with pathological types guarantees clinical outcome.

Objective To investigate the effect of radiofrequency ablation(RFA) in the treatment of small liver cancer.Methods In recent 6 years,130 patients with primary or secondary liver cancer(≤5cm in diameter)were treated by RFA,among which 86 cases were primary,and 44 cases were secondary liver cancer.Among the 130 cases,18 received RFA plus TAEC,and 20 had RFA combined with PEI.Results Overall 1-and 3-year survival rate was 91.3% and 77.7% respectively.Complications occurred in 7 cases,including biliary fistula,intestinal fistula,and slight burn of skin.There was no death in this series.Conclusions RFA is an effective and safe therapeutic approach for small liver cancer ≤5cm in diameter.Its effect may be similar to that of surgical resection.