Aim To examine the apoptosis and bFGF expression on the cochlea of guinea pig after administrated streptomycin(SM) and the antagonism of Salvia Miltiorrhiza Injection(DS) on SM ototoxity.Methods Forty guinea pigs were divided into four groups,and treated with DS and SM respectively.The apoptosis and bFGF expression were examined by TdT mediated biotin dUTP nickend labeling(TUNEL) techniques and SABC immunohistochemical staining with paraffin slide.The intensity of images were stored in a computer and analyzed by the image quantitative analysis technique.Auditory brainstem response(ABR) measurement was used to detect the ototoxicity before/after the examination.Results After 10 d treated by drugs,the ABR threshold of SM increased significantly,while the DS+SM reduced more(P

Background Retinal Müller cells are important gliocytcs and the source of retinal stem cells.Researching the biological behavior of Müller cells is of important significance to the study on retinal physiopathological process and stem cell therapy of retinal diseases.To establish a stable culture method of Müller cells is a solid basis of relative basic research.Objective This study was to establish a simple and stable method of isolation and culture of human retinal Müller cells and provide sufficient and high-quality Müller cell source.Methods Human retinal Müller cells were isolated from healthy human donor eyes.The mixture solution of hyaluronidase (100 U) and 0.25％ trypsin were used to digest chopped retinal tissue.The DMEM/F12 medium with 20％ fetal bovine serum (FBS) was added to stop the digestion process.RPMI1640 medium with 20％ FBS was used to culture the cell for 72 hours and then replaced the half medium.The cells were passaged by the RPMI1640 medium with 20％ FBS.The morphology of the cells were examied under the optical microscope,and the expressions of glial fibrillary acidic protein (GFAP),a marker of gliocytes,and glutamine synthetase (GS),a special marker of retinal Müller cells,were detected by immunochemistry and immunofluorescence technology.Results Human retinal Müller cells were successfully isolated by enzyme mixture solution of hyaluronidase (100 U) and O.25％ trypsin.The cells were adherent to walls 24 hours after primary culture and completely merged 9-10 days after culture.The cells showed oval in shape with abundant cytoplasm,and a part of cells presented with cone-shaped bulge bilaterally and ectasia in the posterior containing large nuclei.After cells passage,the cells were enlarged and grew toward polygonal shape.The positive expression of GFAP was observed in more than 95％ cells and strongly positive expression of GS was observed in more than 90％ cells by immunohistochemstry and immunofluorescent staining.Conclusions Human retinal Müller cells can be successfully isolated by hyaluronidase combined with trypsin digestion.Abundent and pure human retinal Müller cells can be obtained by successively using RPMI1640 medium with 20％ FBS and 10％ FBS.

Objective To evaluate the effects of iron dextran or iron sucrose on the stability of fat emulsion in total nutrient admixture (TNA) in pediatric settings.Methods TNA with different intravenous doses of iron sucrose or iron dextran (0.25,0.5,0.75,or 1.00 mg) were prepared,and each dose was prepared 10 bags.The TNAs were stored at 25 ℃ for 3 days,and the stability of fat emulsion was observed by electron scanning microscopy.Meanwhile,the pH and osmolality were also measured.Results The particle sizes of fat emulsions in TNA with different concentrations of iron sucrose or iron dextran at different time points were not significantly different (F =0.32,P =0.7836 ; F =1.73,P =0.1321,respectively).The mean particle size of the fat emulsion in each group was ＜ 0.5 μm within 72 hours.For TNA containing different concentrations of iron,the percentage of particles ＞ 0.5 μm,pH,and osmotic pressure showed no significant difference at different time points (percentage:F =1.47,P =0.3467 ; F =1.04,P =0.4758.pH:F =0.63,P =0.5942 ; F =0.46,P =0.6825.osmotic pressure:F =1.37,P =0.3648 ; F =0.65,P =0.6023).Conclusion The TNA addeded with iron sucrose or iron dextran with an concentrations of ＜ 1％ is stable.

Objective To investigate the complications of three-dimensional correction surgery for scoliosis and the corresponding prevention and treatment strategies.Methods From December 2004 to June 2011,727 cases of scoliosis were treated by three-dimensional correction system.There were 245 males and 482 females,aged from 3 to 62 years (average,18.2 years).Coronal Cobb angles ranged from 32° to 142° (average,87.6°),and sagittal Cobb angles ranged from-10° to 75° (average,45°).Results All patients were followed up for 12 to 90 months (average,62.5 months).All patients underwent surgery safely.The coronal correction rate ranged from 55％ to 98％ (average,85.2％),and the sagittal correction rate ranged from 35％ to 67％ (average,47.5％).There were no major complications such as death and nerve injury,but occurrences of other minor complications were 113 times in 102 cases.There were 26 cases of instrumentation-related complication,including 5 cases of pedicle screw loosening,5 cases of broken screw,8 cases of broken rod,3 cases of hook loosening,and 5 cases of pedicle fracture; 14 cases of them occurred early after correction surgery for adult scoliosis.There were 65 cases of correction-related complication,including 36 cases of junctional kyphosis (21 cases of proximal junctional kyphosis,11 cases of which were neuromuscular scoliosis; 15 cases of distal junctional kyphosis,including 4 cases of Marfan syndrome with scoliosis and 6 cases of neuromuscular scoliosis),22 cases of adding-on phenomenon,and 7 cases of flat back.Internal medicine complications included 6 cases of superior mesenteric artery syndrome and 7 cases of pulmonary complications.Operation-related complications included 4 cases of pressure sore and 5 cases of wound infection.Conclusion Accurate procedures of diagnosis and surgery for scoliosis are the key to decrease and prevent the complications.For adult scoliosis,enough instrumentation should be placed at the apical segments to decrease instrumentation-related complications.For neuromuscular scoliosis and Marfan syndrome with scoliosis,appropriate extension of fusion segment can effectively decrease junctional kyphosis.

ObjectiveTo evaluate the efficacy about the different wearing manner with Milwaukee and Boston for the treatment of adolescent idiopathic scoliosis (AIS).MethodsRetrospectively summarization and analysis was performed in 85 adolescent patients with idiopathic scoliosis who were treated from February 2004 to March 2009.The skeletal growth of them had not completed.There were 57 cases who received brace treatment.In them,28 were treated with (CTLSO) Milwaukee brace,and the rest were treated with (TLSO) Boston brace and orthopedic gymnastics.The 30 cases wear regularly used for 21 to 23hours per day,and 27 cases could consist on wearing only 6 to 15 hours per day.The other 28 cases of 85AIS cases were only treated with orthopedic gymnastics instead of orthosis treatment.All patients were periodically observed with lateral side (X)-ray photograph at standing position and photograph,and Cobb angle and Risser sign were measured every 3 to 6 months.Since 2008 all adolescent idiopathic scoliosis patients treated with orthosis were requested to fill with simplified Chinese SRS-22.Results73 cases adolescent idiopathic scoliosis patients were followed up for 2 ～5 years [ mean(26.3 ± 33.7)months ].Milwaukee orthosis group showed the regular wearing group had 91.67 ％ ( 11/12) effective rate and the intermittent wearing group had 56.25％ (9/16) effective rate and the group without wearing orthosis only had 20％ (4/20)effective rate.The group regularly wearing Milwaukee brace had superior effect than the other two groups (P ＜ 0.05 ).Boston orthosis group showed the regular wearing group had 88.89％ (16/18) effective rate and the intermittent wearing group had 54.55％ (6/11 ) effective rate and the group without wearing brace with 25％ (2/8) effective rate.The group regularly wearing Boston brace had better effect than the other two groups ( P ＜ 0.05 ).Due to the different choice of AIS patients and orthosis,the effective rate of the Milwaukee and Boston orthosis was not compared.ConclusionsThe adolescent idiopathic scoliosis patients should insist on regularly wearing brace regardless of the Milwaukee or Boston orthosis ( this article suggest that the wearing time should not less than 21 ～ 23 h/d).The group regularly wearing with the Milwaukee or Boston orthosis had better effect than the intermittent group or the group without wearing brace.It's a good treatment for the AIS patients who have with the indication of orthosis treatment.

Objective: To determine the clinical efficacy and feasibility of multiple special formed titanium mesh cages (TMCs) to treat lumbo-sacral spinal tuberculosis via posterior approach. Methods: From July, 2007 to June, 2013, 25 patients with lumbo-sacral spinal tuberculosis underwent one-stage posterior debridement, internal if xation, and interbody fusion using multiple special formed titanium meshes. We compared the parameters as follow: the pre- and post-operative American Spinal Injury Association (ASIA) score, lumbo-sacral angle, the height of intervertebral space, visual analogue scale (VAS), and erythrocyte sedimentation rate (ESR), and observedoperation time, intraoperative blood loss, and time of bone gratf fusion. Results: Operation time ranged from 90 to 180 min, (128±24) min in average. Blood loss in the operation ranged from 100 to 800 mL, (310±125) mL in average. hTe patients were followed up for 24 to 59 months, (43±7) months in average. One patient delayed healing of wound. ASIA score was improved in a certain degree in patients with neurological dysfunctions. hTe lumbo-sacral angle and the height of intervertebral space in the post-operation were signiifcantly higher than those in the pre-operation (P<0.001). VAS was reduced obviously atfer 2 weeks of operation. hTe ESR recovered to the normal level 6 months atfer operation in all the patients. Solid fusion was achieved within 4 to 8 months, 6 months in average. No sinus tract, cerebrospinal meningitis, tuberculosis recurrence and titanium mesh subsidence were found. Conclusion: For lumbo-sacral tuberculosis, multiple special formed titanium mesh cages via posterior approach is safe and effective, which is good to the stability in spine reconstruction.

Objective To develop a Chinese version of Frommelt Attitude Toward Care of the Dying scale (FATCOD) and evaluate its validity and reliability to provide a tool for the field of hospice care and death education used among nurses.Methods FATCOD scale was adopted according to Brislin's translation model for cross-cultural research and its reliability and validity of the new Chinese version was tested in 126 nurses.Factor analysis and correlation analysis were applied to establish the validity and reliability.Results The Chinese version of FATCOD scale consisted of 30 items.The Cronbach's α coefficient of the scale was 0.828; split-half coefficient of the whole scale was 0.807; the varimax rotation factor analysis of the scale identified twelve principal factors and explained for 69.5％ variances.Conclusions The Chinese version of FATCOD scale is valid and reliable in the sample of nurses,and can be used in the field of hospice care and death education.

BACKGROUND:There are few studies concerning estrogen receptorβgene, and its mechanism of regulating the bone metabolism is stil unclear now. OBJECTIVE:To analyze the effect of estrogen receptorβ(ERβ) silencing on the expressions of transforming growth factorβ1 (TGF-β1) and bone morphogenetic protein 2 (BMP-2) in human osteoblasts METHODS:There were three groups:blank control group (hFOB 1.19 uninfected with any retrovirus);negative control group (containing invalid interference fragment ERβ-shRNA-nc);optimal RNAi group (ERβ-shRNA-3). ERβ-shRNA retroviral vectors in the optimal RNAi group were used to transfect human osteoblasts fol owed by resistance screening and cel expansion. MTT assay was used to detect the proliferative activity of ERβ-silenced osteoblasts. Then under estrogen intervention, the stable inhibition rate of ERβwas determined using western blot assay, and the expressions of TGF-β1 and BMP-2 in human osteoblasts after ERβsilencing were detected by RT-PCR technology and western blot assay. RESULTS AND CONCLUSION:Human osteoblasts that were stably transfected by ERβ-shRNA-3 retroviral vector was selected successful y, and ERβsilencing had no significant influence on the cel proliferation (P>0.05). Under the interference of estrogen, the silencing efficiency of ERβprotein was (93.11±0.57)%(P<0.05), and after ERβsilencing, the expressions of TGF-β1 and BMP-2 were increased by (26.65±3.81)%and (16.62±1.71)%at mRNA level, and increased by (23.79±3.76)%and (18.08±3.20)%at protein level (both P<0.05). In conclusion, ERβmay play an important role in bone metabolism by regulating the expressions of TGF-β1 and BMP-2.

Objective:To evaluate the clinical efficacy and prognostic factors in patients with stage Ⅲb/c or Ⅳ inoperable advanced gastric cancer.Methods:The clinical data of 33 patients with unresectable locally advanced (stage Ⅲb/c) or unresectable stage Ⅳ gastric cancer were collected from May 2017 to may 2019 in the Department of Surgical Oncology, Anqing Hospital affiliated to Anhui Medical University, Among them, there were 25 males and 8 females with an average age of 65.48±9.00 years. According to the data of patients with conversion therapy efficacy and postoperative pathology and other factors for statistics, using univariate and multivariate analysis method to evaluate its correlation with the prognosis of patients.Results:Of 33 patients, 2 patients were complete remission, 18 patients were partial remission, the objective response rate(ORR) was 60.6%. 20 patients recevied surgical treatment, 17 patients achieved R0 resection. The median overall survival(mOS) of all 33 patients was (18.6±4.5) months. The mOS of patients who underwent surgical treatment was (25.7±10.99) months, which in patients without surgical treatment was (11.2±2.5) months( P=0.004). The mOS of stage Ⅲb/c patients Was (18.9±10.99) months, and of stage Ⅳ patients was (11.3±0.35) months( P=0.568). Univariate analysis showed that preoperative chemotherapy cycle ≥4 weeks had a better prognosis than patients with less than 4 cycles ( P=0.003), TRG score 1/2 patients had a better prognosis ( P=0.001), and positive lymph nodes ≥7 was risk factor. Multivariate analysis showed that positive lymph nodes ≥7 was the only independent prognostic factor ( P=0.013). Conclusion:For patients with stage Ⅲb/c or Ⅳ inoperable advanced gastric cancer, surgical resection after conversion therapy can improve patient survival, adequate preoperative chemotherapy can improve the prognosis of patients with at least 4 cycles of chemotherapy.

BACKGROUND:Transverse acetabular fracture often involves the damage of anterior and posterior columns of acetabulum. The most popular fixation of the anterior and posterior columns needs the combined anterior and posterior approach. Big trauma is not conducive to patient’s recovery after surgery. Limited incision or percutaneous minimaly invasive lag screw placement can reduce soft tissue injuries, but the strength of the fixation lacks of biomechanical verification. OBJECTIVE: To compare different types of fixations for transverse acetabular fracture, explore the appropriate fixation options that can achieve effective fixation and reduce tissue injury by combing with repair approach and the condition of soft tissue. METHODS: The fourth generation of synthetic semi-pelvic sawbones was set as a template to establish a model of acetabular transverse fracture using finite element analysis. Five different fixation options were used to fix the transverse acetabular fracture. The magnitudes of anterior and posterior displacement of transverse fracture were compared to assess the stability of different options under a simulated condition of incomplete weight bearing stand. RESULTS AND CONCLUSION:The motion at anterior column was minimal when fixed by anterior column locking plate + posterior column screw and the minimum displacement at posterior column was the fixation of anterior column screw + posterior column locking plate. Both of the motions of these two fixations were less than the reconstruction plate fixation respectively. The worst fixation was the anterior column and posterior column lag screw fixation with the largest displacement. The anterior column locking plate + posterior column screw, accomplished by single approach, could not only reduce surgical trauma, but also has a stronger stability. Moreover, this fixation option is effective method to place posterior column lag screw under direct vision and reduce the difficulty of screw implantation.