Objective To explore the biocompatibility of nano-hydroxyapatite/polyamide 66 (nHA/PA66) with human bone mesenchymal stem cells (hBMSCs) after osteogenic induction.Methods After hBMSCs were isolated and cultured in vitro,the experiment was conducted in 3 groups.Group A were hBMSCs subjected to no osteogenic induction,group B hBMSCs subjected to osteogenic induction,and group C was the composite of nHA/PA66 with hBMSCs subjected to osteogenic induction.Adhesion of the cells onto the nHA/PA66 in group C was observed by electron microscope scanning.Growth and proliferation of the cells in groups B and C were detected by MTI test at 1,2 and 3 weeks.The ability of osteogenic differentiation of hBMSCs in vitro was analyzed by alkaline phosphatase (ALP) activity and alizarin red staining.The ability of osteogenic differentiation of hBMSCs on nHA/PA66 was tested by ALP activity.Results Electron microscope scanning showed that the cells spread and attached well on the surface of the composite scaffold in group C;the proliferation of the cells in groups B and C showed no significant difference (P ＞ O.05).These suggested that the proliferation of hBMSCs was not affected by nHA/PA66.The number of mineralized nodules in group B was significantly larger than in group A (P ＜ O.05);the ALP activity of the cells in group A was significantly lower than in group B at 6 and 12 days (P ＜ 0.05);no significant differences were observed between groups B and C (P ＞ 0.05).These indicated that the hBMSCs were capable of osteogenic differentiation which was not affected by nHA/PA66.In groups B and C,the ALP activity of the cells at 12 days was significantly higher than at 6 days,indicating the ALP activity increased with increased induction time (P ＜ 0.05).Conclusion nHA/PA66 can be used as a carrier of hBMSCs in bone tissue engineering because hBMSCs can well adhere to,proliferate,and differentiate into bone on nHA/PA66 scaffolds.

Objective To assess the safety and efficacy of abdominal radical nephrectomy and systematic lymph node dissection for treatment of renal carcinoma. Methods A total of 136 patients underwent radical nephrectomy and regional clearance of lymph nodes from July 2004 to June 2008.There were 92 males and 44 females in the study group.Ages ranged from 23 to 81 years,with a mean age of 54 years.The mean tumor diameter was 55 mm (range,15-170 mm).The tumor size detected by CT and MRI was consistent with that detected by B-ultrasound,98 were stage Ⅰ,13stage Ⅱ,12 stage Ⅲ,and 2 stage Ⅳ. Results All 136 cases underwent radical nephrectomy with retroperitoneal lymphadenectomy.All operations were successful without any major complication.The operative time was 90 to 180 min,with an average of 120 min,and blood loss was 20-400 ml,with an average of 50 ml.The pathological diagnoses were as follows: renal cell carcinoma 123 cases (90%), papillary renal cell carcinoma six cases(4%),chromophobic two cases(1.4%),oncocytoma two cases(1.4%),collecting duct two(1.4%),and others three cases(2.2%).Eight cases reported positive lymph nodes.Of the 136 cases,92 cases were T1 N0 M0,11 were T2 N0 M0,10 were T3 N0 M0,eight were T3 N1 M0 and two were T1 N0 M1.Ninety-five cases (70%) were followed-up at six to 40 months (mean,20 months).The one year and three year survival rates were 96% (91/95) and 86% (82/95),respectively.Conclusions Radical nephrectomy with systematic lymph dissection has advantages of accurate staging,effective resecting of renal tumors and preventing recurrence.Radical nephrectomy is an effective method for the treatment of renal carcinoma.

Objective To investigate the efficacy and toxicity of sorafenib in the treatment of advanced renal cell carcinoma. Methods From May 2007 to JUN 2009, 33 patients with advanced renal cell carcinoma were given oral sorafenib 400-600 mg twice daily. There were 23 males and 10 females in the study group. The pathological diagnosis of the primary tumors was clear cell carcinoma in 29 patients, papillary renal cell carcinoma in 2 patients, chromophobe renal cell carcinoma in 1 patient and chromophobe renal cell carcinoma mixed with clear renal cell carcinoma in 1 patient. Fifteen patients had multiple organ metastases and 18 patients had single organ metastasis. The median follow-up time was 29 weeks. Results Four (12%) patients achieved partial remission, 2 (6%) patients achieved progression disease, the remaining 27 (82%) patients achieved stable disease. Complete remission was not observed in the group. Two of the partial remission patients benefited on bone metastases. Common toxicities were skin reaction (85%), diarrhea (46%), erythra (42%), alopecia (36%), oral ulcer (18%) and hypertension (9%). Conclusions Sorafenib could be effective in controlling tumor growth. The overall effectiveness was 12%, the disease control proportion was 94% in this group and its toxicity was relatively minor and well tolerated.

Purpose To explore the application of contrast-enhanced ultrasound in evaluating the local muscle microcirculation before and after acupuncture at Zusanli point in normal people.Materials and Methods A total of 72 healthy volunteers who visited the Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University from September 2018 to May 2020 were prospectively collected,all subjects performed ultrasound contrast before acupuncture,acupuncture with strongest deqi,and two hours after acupuncture to observe the blood flow perfusion of the microvessels in the tibialis anterior muscle.The pre-selected areas of interest the small arteries,muscle tissues and venules in the middle were analyzed to obtain the time-intensity curve and contrast transit time(CTTs)perfusion parameters.Needle sensation was evaluated using objective scoring criteria for acupuncture combined with moxibustion recipients.Gastrin,plasma gastrin,cholecystokinin,and secretin were measured in all subjects before acupuncture,when acupuncture had the strongest deqi,and two hours after acupuncture.Results ①CTTs of arterial-muscle,muscle-venous and arterial-venous of the tibialis anterior muscle at acupuncture with strongest deqi were significantly shorter than those at before acupuncture and two hours after acupuncture(all P<0.001),and there was no significant difference in CTTs before and after acupuncture and moxibustion(P>0.05);②when acupuncture deqi was strongest,serum gastrin,plasma prokinetics,cholecystokinin,and secretin were significantly increased compared with those before acupuncture and two hours after acupuncture,with statistically significant difference(all P<0.001),while there was no significant difference in these parameters between before acupuncture and two hours after acupuncture(P>0.05);③when acupuncture had the strongest deqi,there were positive correlations between gastrin,plasma prokinetic hormone,cholecystokinin,and secretin values and CTTs of arterial-muscle,muscle-venous,and arterial-venous(r=0.360-0.702,P<0.001).Conclusion Acupuncture of the Zusanli,when it gains the strongest deqi,can cause changes in the microcirculation around the skeletal muscle,leading to a significant shortening of CTTs,and also promotes the secretory function of the gastrointestinal tract.

Objective:To analyze the correlation between the muscle thickness (MT) and echo intensity (EI) of the medial head of gastrocnemius and muscle mass, strength and functional parameters, and to evaluate the diagnostic efficacy of MT and EI for decreased muscle mass.Methods:Fifty-two subjects who visited the Department of Ultrasound Medicine of the Second Affiliated Hospital of Fujian Medical University from March to December 2021 were collected.MT of the medial head of gastrocnemius was measured by two-dimensional ultrasound, and EI values in the region of interest were analyzed using Image J software. Twenty of the subjects were selected to assess the intra-observer and inter-observer agreements in measuring MT and EI values using the intraclass correlation coefficient (ICC) and Altman-Bland analysis was performed. The subjects were divided into healthy control group (30 cases) and decreased muscle mass group (22 cases) according to 2019 Asian Sarcopenia Working Group (AWGS) diagnostic criteria, the differences in MT and EI values between the two groups were compared, and the correlation between MT, EI values and muscle mass, strength, function were analyzed using Pearson correlation analysis. The diagnostic cutoff values of MT and EI values for decreased muscle mass were obtained using ROC curves, and the diagnostic efficacy was compared.Results:①The ICC of MT and EI in medial head of gastrocnemius detected by the same physician and different physicians were greater than 0.97, and the retest reliability was good. ②Compared with the healthy control group, the MT value in medial head of gastrocnemius decreased and the EI value increased in the decreased muscle mass group ( t=4.759, -3.789; all P<0.001). ③The MT value in medial head of gastrocnemius was positively correlated with appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), lower limb skeletal muscle mass (LLSM), grip strength, and gait speed ( r=0.579, 0.568, 0.585, 0.495, 0.415; all P<0.001), of which, the correlation with LLSM was the best; ④EI in medial head of gastrocnemius was negatively correlated with ASM and ASMI, LLSM, grip strength, and gait speed, ( r=-0.583, -0.591, -0.590, -0.537, -0.455; all P<0.001), and among which the correlation with ASMI was the best. ⑤The medial head of gastrocnemius MT and EI were 14.33 mm and 58.85 for predicting decreased muscle mass, respectively, and there was no significant difference in the diagnostic performance of the two for decreased muscle mass ( Z=0.734 3, P>0.05). Conclusions:The MT and EI values of the medial head of gastrocnemius can accurately assess muscle mass and can be used in the evaluation of patients with decreased muscle mass.

Sepsis is a severe and life-threatening symptom that poses a significant risk to human health.Treatment mainly involves supportive care,but research on new drugs is ongoing.Advancements have been achieved in the management of immune function,inflammatory pathway,blood coagulation,and vascular endothelial homeostasis in sepsis.The advances in the treatment of sepsis in recent years were these reviewed in this article.

Objective To observe the effects of ultrasound-guided serratus anterior plane block(SAPB)for pain relief in the acute phase of rib fractures and its impact on early rehabilitation.Methods This study included 160 patients from Taizhou Central Hospital with unilateral rib fractures undergoing conservative treatment.The patients were randomly divided into two groups,with 80 patients in each group.Group A received flurbiprofen alone for pain relief,while Group B received ultrasound-guided SAPB combined with flurbiprofen.Numerical rating scale(NRS)before treatment and at 1h,6h,12h,24h,and 48h after treatment,additional analgesic use,adverse reactions,functional recovery parameters(including vital capacity,peak expiratory flow,and walking distance),and hospital stay duration were recorded and compared between the two groups.Results The pain scores in Group B were significantly lower than those in Group A at 1h,6h,and 12h after treatment(P＜0.01),with no significant differences at 24h and 48h(P＞0.05).The use of additional analgesics and adverse reactions were significantly less in Group B compared to Group A(P＜0.01).Group B patients had significantly higher vital capacity,peak expiratory flow,and walking distance(P＜0.01).Additionally,the average hospital stay in Group B was significantly shorter than that in Group A(P＜0.01).Conclusion Ultrasound-guided SAPB combined with flurbiprofen is significantly more effective than flurbiprofen alone for treating rib fracture patients.SAPB provides more effective pain control,faster functional recovery,and has a high safety profile.

Central precocious puberty (CPP) is an endocrine disease of children due to the early onset of hypothalamic-pituitary-gonadal axis function. This leads to increased secretion of gonadotropin release impulse, causing the development of internal and external genitalia and the presentation of secondary sex characteristics. Studies have found that the onset of CPP in children may be related to vitamin D deficiency. Vitamin D, affected by sunlight duration, acts on neurons and neurotransmitters in the hypothalamic-pituitary-gonadal axis, promotes obesity and affects the expression level of insulin-like growth factor-1, which are four factors involved in the occurrence and development of CPP. The overall effect of vitamin D combined with gonadotropin-releasing hormone analogues on CPP is significant. This article reviews the correlation between vitamin D deficiency and CPP, as well as the possible mechanism of action, in order to provide some theoretical basis for researchers.

Objective:To compare the clinical effects of hip arthroplasty through direct anterior approach (DAA) in lateral decubitus in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia.Methods:The prospective study method was used to select the patients who needed hip arthroplasty in the Fourth Department of Orthopedics, the Second Affiliated Hospital of Harbin Medical University from January 2015 to December 2019. All of them were operated with lateral decubitus DAA. According to the inclusion criteria, they were divided into Kacshin-Beck disease hip osteoarthritis group (group A) and congenital acetabular dysplasia hip osteoarthritis group (group B). Hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, visual analogue scale (VAS) score were conducted, and hip abduction angle and flexion angle were measured before surgery, 3, 14 days and 1, 3, and 12 months after surgery.Results:Nineteen and twenty-two patients were included in group A and group B, respectively. All patients successfully completed the surgery. There was no significant difference in Harris score between the two groups before surgery, 3, 14 days, and 1, 12 months after surgery ( P > 0.05). There were no significant differences in WOMAC score, VAS score, hip abduction angle and hip flexion angle between the two groups before surgery and each time point after surgery ( P > 0.05). In the same group, there were significant differences in Harris score, WOMAC score, VAS score, hip abduction angle and hip flexion angle at different time points ( P < 0.001). All postoperative indicators were significantly improved compared with those before surgery. Conclusions:There is no significant difference in the clinical effects of hip arthroplasty through lateral decubitus DAA in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia. This surgical method has good therapeutic effect on both types of hip osteoarthritis.

ObjectiveTo determine the epidemiological characteristics of COVID-19 in Shaanxi Province. MethodsEpidemiological analysis was conducted on the confirmed cases of COVID-19 （n=245） from January 23rd， 2020 through February 21st， 2020 based on the official data announced by Shaanxi Province. The effects of local population migration， prevention and control measures on the epidemic were explored. ResultsAs of February 21st， 2020， a total of 245 COVID-19 cases had been notified in Shaanxi Province， with a cumulative incidence rate of 0.63 per 100 000， of which imported cases accounted for 47.34%. The high incidence was observed between January 31st and February 5th. Xi’an had the largest number of COVID-19 cases， followed by Ankang， Hanzhong and Xianyang， totally accounting for 81.20% of the cases in the province. In terms of social factors， daily morbidity was positively correlated with Baidu migration scale index 14 days before. On January 25th， the provincial health emergency response was launched， and on January 31st， it was further upgraded for quarantine. On February 20th， the provincial prevention and control system was implemented by classified areas. There were no emerging local cases after February 21st and no confirmed cases for 28th consecutive days as of March 19th. Local cases and close contacts were cleared to zero on March 27th. ConclusionThe COVID-19 epidemic in Shaanxi Province is mainly concentrated in Guanzhong area and southern Shaanxi， with a widespread pattern in all cities. The prevention and control measures have effectively contained the epidemic， with a declining incidence. However， quarantine of suspected cases and close contacts remains crucial for routine prevention and control strategy.