BACKGROUND: It is a gold standard to repair and construct bladder via intestinal tract. However, intestinal tract existing in urinary system may cause metabolic disorder, infection, lithogenesis, or even a series of severe complications.OBJECTIVE: To summarize the performance of tissue engineering during reconstruction of urinary bladder, and to search a reasonable replacement of urinary bladder.METHODS: A computer-based online search was conducted with the key words of "tissue engineering, bladder, mesenchymal stem cells" in both Chinese and English from January 1993 to October 2009. Inclusion criteria: Articles about correlation among seed cells, tissue-engineered bladder, and bio-scaffold materials were included. Exclusion criteria: Duplicated researches or Meta analysis was excluded. Among 29 articles, the following five points were mainly analyzed: how to stably and rapidly obtain sufficient and viable cell source; how to choose bio-scaffold materials of bladder; how to repair and reconstruct bladder tissue; how to solve the ethics problem; how to accumulate vascularization of the in vitro constructed bladder tissue after transplantation. RESULTS AND CONCLUSION: Autoallergic bone marrow mesenchymal stem cells (BMSCs) which were chosen for bladder tissue engineering characterized by convenient collection and low immunogenicity; additionally, BMSCs could differentiate into transitional epithelial cells, smooth muscle cells, vascular endothelial cells, and neurocytes so as to improve blood supply and neural function of regenerated tissue. Furthermore, BMSCs could help grafts avoid from fibration-contracture; therefore, BMSCs have a perspective application. However, the efficacy of tissue-engineered bladder needs to be further evaluated for clinical application. For example, the healing, structure, functional reconstruction, and vascularization of tissue-engineered bladder and autoallergic bladder tissue, innervated establishment, and ethical difficulty will be further studied in the future.

The American College of Rheumatology (ACR) published treatment recommendations for juvenile idiopathic arthritis (JIA) in 2011.The recommendations meant as a guide to health care providers caring for JIA children with dividing JIA into 5 distinct subtypes.The ACR updated the 2011 recommendations in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtybe is developed to 3 phenotypes.And the conception was firstly addressed that systemic JIA with features concerning for macrophage activation syndrome(MAS).Different treatment options was applied for clinical manifestations score,and these recommendations offered guidance for providers caring for children with the most common phenotypes associated with systemic JIA,rather than exceptional cases with unusual disease manifestations or refractory disease.

BACKGROUND:Mesenchymal stem cells from transgenic animals carry green fluorescent protein that can be stably expressed in viable cells and can be used to rapidly screen modified cells in comparison with traditional virus and plasmids. OBJECTIVE:To study the biological features of bone marrow derived stromal cells from transgenic rats with green fluorescent protein gene. METHODS:Bone marrows were isolated from the bilateral long bones of 2-week-old transgenic rats with green fluorescent protein gene, and cultivated in conditioned culture medium to obtain bone marrow mesenchymal stem cells with green fluorescent protein gene. The passage 5 bone marrow mesenchymal stem cells with green fluorescent protein gene were analyzed by flow cytometry to detect cellsurface molecules, and were induced in calcium or adipogenic induction medium. After calcium induction, the alizarin red staining was performed to test the formation of calcium concentration. After adipogenic induction, bone marrow mesenchymal stem cells were detected with oil red O staining. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells, stably expressing green fluorescent protein gene, were obtained successful y from the transgenic rat with green fluorescent protein gene. The cells expressed CD90, CD105 strongly, but did not express or weakly expressed CD14 andCD45. After 3 weeks of calcium induction, jacinth calcium salts could be detected in the cells by alizarin red staining. At 3 weeks of adipogenic induction, the cells showed positive oil red O staining. The green fluorescent protein gene, as report gene, exerts no effect on the cellsurface molecules and multilineage potential of bone marrow mesenchymal stem cells, which can be used as an efficient tracer.

The American College of Rheumatology (ACR) updated the 2011 recommendations for juvenile idiopathic arthritis (JIA) in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtype is developed to 3 phenotypes:(1) phenotype of systemic JIA with active systemic features and yarying degrees of synovitis; (2) phenotype of systemic JIA without active systemic features and with varying degrees of active synovitis ; (3) phenotype of systemic JIA with features concerning for macrophage activation syndrome (MAS).The treatment recommendation was made according each phenotype,including initial therapeutic options and therapeutic options for continued disease activity.And uncertain or inappropriate options for continued disease were listed alphabetically.Development of treatment recommendations for children with SOJIA and features of MAS is particularly challenging.However,it is anticipated that in the near future,with research of the disease process,the better recommendation may be made.

BACKGROUND:Chemokine receptor 4 (CXCR4) is the main homing regulating factor for mesenchymal stem cells in vivo. How to improve the self-expression of CXCR4 is crucial for regulating the homing ability of stem cells in vivo targeting organs. OBJECTIVE:To construct lentiviral vectors carrying CXCR4 or green fluorescent protein (GFP) gene, and to observe their effects on growth and secrete function of bone marrow mesenchymal stem cells. METHODS:Lentiviral vectors were used to over-express CXCR4 in rat bone marrow mesenchymal stem cells. GFP gene was transfected as a control. Transfection efficiency was analyzed using fluorescence microscopy, RT-PCR and western blot assay for detecting the expression of CXCR4 or GFP in cells at both the mRNA and protein levels. Effects of CXCR4 expression modified on the cellular proliferation of bone marrow mesenchymal stem cells were assayed with flow cytometry. Effect of CXCR4 regulation on secretion function of bone marrow mesenchymal stem cells was determined by protein analysis from cellsupernatant. RESULTS AND CONCLUSION:CXCR4 gene or GFP gene could be transfected into bone marrow mesenchymal stem cells safely and effectively with lentivirus transfection system. Analysis of CXCR4 expression at the mRNA and protein levels confirmed the transfection efficiency. Effects of CXCR4 over-expression on the cellular proliferation of bone marrow mesenchymal stem cells and effects of CXCR4 regulation on secretion of protective factors from bone marrow mesenchymal stem cells were improved. The proliferation ability of bone marrow mesenchymal stem cells with CXCR4 over-expression was improved, which was approved with flow cytometry (P<0.05). And it was helpful for bone marrow mesenchymal stem cells to secrete some protective factors. Many protein and soluble factors were at higher levels, and those were good at cells proliferation and immunoloregulation in bone marrow mesenchymal stem cells (P<0.05). The method of lentiviral transfection is a safe and effective way to modify bone marrow mesenchymal stem cells. We can improve the ability of bone marrow mesenchymal stem cells in the survival and emiocytosis ability through genetic engineering.

Objective To explore the methods for treating no-functioning renal graft.Methods The management of 240 cases of non-functioning renal graft between 1978 and December 2003 was retrospectively analyzed.Results Twenty-nine recipients with renal failure one month after renal transplantation were subjected to removal of the renal graft. One year after renal transplantation, the recipients with renal failure received resection of the renal graft, 4 were treated with renal artery embolism, and 114 did not receive special treatment.Conclusion The non-functioning renal graft required removal at early stage of renal transplantation. At later stage, no symptomatic cases of post-transplanted renal failure required no management after stopping immunosuppressant. The appropriate management is reserved for the symptomatic cases.

As an important member of the adisintegrin and metalloproteinase (ADAM) superfamily,ADAM17 can mediate a variety of membrane molecular hydrolysis off,such as adhesion molecules,cytokines,growth factors,etc,and play an important role in regulating tumor cell adhesion,apoptosis,metastasis and proliferation through the EGFR-PI3K-Akt pathway,Notch signaling pathway and other signaling pathways.The research of ADAM17 targeted drugs provides a new direction for cancer therapy.

Objective To investigate the value of video-assisted thoracoscopy in the diagnosis and treatment of pleural effusion with unknown causes.Methods Video-assisted thoracoscopic biopsy or pleurodesis was performed in 45 cases of pleural effusion unexplained by routine examinations from March 2002 to March 2005.Results The diagnosis was clarified in all the 45 cases.There were 3 cases of malignant effusion,38 cases of tuberculous pleurisy,3 cases of nonspecific effusion,and 1 case of idiopathic pleural effusion.No severe surgical complications occurred.Follow-up checkups for 2~36 months found no recurrence.Conclusions Video-assisted thoracoscopy is a safe,effective,and micro-traumatic approach for the diagnosis and treatment of pleural effusion.

Objective To explore the distribution of Acinetobacter baumannii and its drug resistance to 17 antimicro-bial agents to provide basis for clinical treatment.Methods The data of 689 strains of A.baumannii from Jan.2010 to Dec. 2012 were collected and reviewed for bacterial identification and drug sensitive test and then analyzed using WHONET 5.4. Results 689 strains of A.baumannii isolates were broadly distributed in sputum (75.5%), most primarily isolated from the ICU (36.9%).The antimicrobial susceptibility testing showed that the drug resistance rate of Ab was the highest to Bactrim (36.3%), followed by gentamicin (29.0%), and the lowest to cefperazone-sulbactam (8.0%).The drug resistance rate of Ab to cefperazone-sulbactam was the lowest (8.5%) in 2012.In the three years, the drug resistance rate of Ab to imipenem was the biggest rise (14.5%);while to gatifloxacin and levofloxacin declined.The drug resistance rate of Ab to gatifloxacin dropped by 13.1%, which was bigger than that to levofloxacin (9.5%).The drug resistance rates of Ab to the rest antimi-crobial agents fluctuated insignificantly, but were all in an increasing trend.Conclusion Acinetobacter baummannii mainly distribute in sputum of patients in the ICU and department of respiratory diseases, and its detection rate and drug resistance rate are increasing year by year.

Objective To explore the applied value of static and dynamic of virtual defecography technology in the etiological diagnosis of constipation.Methods 50 patients with constipation were included.Conventional cleaning enema was performed firstly.Then they were injected the virtual defecography agentwith lateral position,filling the rectum,sigmoid and descending colon.Thirdly,siting on the qualities commode,adjusting height coincides with the left and right femur,displaying the pubic symphysis and coccyx dynamic acquisition image acquisition with the speed of 4/s,the dynamic changes of the rectum and anal canal were analyzed and measured.Results Among 50 patients,32 cases with rectocele,1 case with rectal bend,2 cases with anal canal stenosis,7 cases with rectal prolapse,4 cases pelvic floor spasm syndrome,and 4 cases with no cause.Conclusion Static and dynamic virtualdefecography was an important method in the etiological diagnosis of patients with constipation.