Objective To analyze the load-bearing mechanism and stress relaxation properties of the articular cartilage (AC) through finite element simulation and experimental validation. Methods By comprehensively considering the solid phase of the matrix, the liquid phase of the pore and the reinforced phase of the collagen fibrils in AC, as well as the dilatation dependent permeability of AC, a fibril reinforced poroelastic (FRPE) model was built including changes of void ratio with subsurface depth of the AC. Based on the proposed model, and by utilizing ABAQUS software and FORTRAN language, the finite element analysis (FEA) on unconfined ramp compression of AC was conducted. The equilibrium modulus of porcine cartilage tissues under unconfined compression was measured by a self-designed biomechanical property measuring system, and the results between the FEA and the unconfined ramp compression test of the AC were compared. Results The liquid pore pressurization could last about 80 seconds and contributed up to 90 % of the total stress at the middle point of the test specimen when it was compressed at a strain rate of 0.45%/s. Conclusions The FEA on the unconfined ramp compression of AC based on the FRPE model can quantitatively evaluate the load bearing capacity of the solid and liquid phase, respectively, changed with different strain and loading time. Simulation analysis combined with the unconfined ramp compression test results facilitates the evaluation on mechanics properties of the cartilage with more accuracy.

Objective To study the expressions and significance of MRP and LRP in HCC. Methods The expressions of two genes were examined in three tissues (54 cases of HCC, 24 para cancer and 12 posthepatitis cirrhosis tissues) by SP immunohistochemical and PCR techniques. Results MRP and LRP were expressed in three tissues, with significantly higher rates in HCC than others (P

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Cephalosporins ; administration & dosage ; Enterobacter cloacae ; Enterobacteriaceae Infections ; drug therapy ; Female ; Gentamicins ; adverse effects ; Humans ; Imipenem ; adverse effects ; Isosorbide Dinitrate ; adverse effects ; analogs & derivatives ; Male ; Ofloxacin ; adverse effects ; Software

OBJECTIVETo study the effect of ex vivo expansion on the migration ability and the CXCR4 expression of umbilical cord blood (CB) hematopoietic stem/progenitor cells (HSPC).

METHODSCD(34)(+) cells isolated from fresh CB samples were cultured in a serum-free and stroma-free culture system. On day 7, 10 and 14, CD(34)(+) cells were re-selected from the expanded cells, and the expression of CXCR4 and the transmigration ability of these CD(34)(+) cells were evaluated respectively and compared with those of the precultured fresh CD(34)(+) cells.

RESULTS(1) SDF-1 induced a higher migration percentage of fresh or expanded CB CD(34)(+) cells than that of uninduced ones. (2) Both of the uninduced and SDF-1-induced migrations were slightly reduced in the first week and then much more reduced in the second week expansion (P < 0.05). (3) The number of the CD(34)(+)CXCR4(+) cells were significantly increased during the culture period, but there was a downtrend of CXCR4 expression on CD(34)(+) subset; the expression levels on day 10 and 14 were lower than that on day 0.

CONCLUSIONSThe expanded HSPC would sustain the chemotactic activity during one-week-culture, but with further extended culture time their intrinsic homing potential would be partly impaired.

Antigens, CD34 ; genetics ; metabolism ; Cell Culture Techniques ; Cell Movement ; Cells, Cultured ; Female ; Fetal Blood ; cytology ; metabolism ; Hematopoietic Stem Cells ; cytology ; metabolism ; Humans ; Male ; Pregnancy

OBJECTIVETo investigate the effects of platelet factor 4 (PF4) on the adherence, and the expressions of adherent molecules CD(49d) and CXCR4 and the receptor of SDF-1 of fresh and expanded cord blood CD(34)(+) cells.

METHODSCD(34)(+) cells were isolated from cord blood using MACS immune magnetic beads. The adherent ability was assayed by using crystal violet staining and the expression of adherent molecule CD(49d) and CXCR4 by FACS.

RESULTS(1) PF4 could increase the adherent ability of the fresh cord blood CD(34)(+) cells, the effect being positively correlated with the dose of PF4. (2) SDF-1 at concentration of 100 ng/ml increased the adherent ability of the fresh cord blood CD(34)(+) cells. (3) The spontaneous and the SDF-1 induced adherent ability of the cord blood CD(34)(+) cells began to decrease after being cultured for 10 days without PF4, while in the presence of PF4 at 100 ng/ml, the ability of the cord blood CD(34)(+) cell adhering to the stroma layer still remained at higher level. At day 14, the adherent ability was (262.04 +/- 64.81)% and (64.35 +/- 8.29)% in PF4 group and control group, respectively, if it was defined as 100% at day 0. SDF-1 at concentration of 100 ng/ml induced adherent ability was (138.31 +/- 32.39)% and (67.66 +/- 12.44)% in PF4 group and control group, respectively. (4) The expression of CD(49d) and CXCR4 increased 13.02% and 17.33%, respectively, when incubated with PF4.

CONCLUSIONSPF4 could increase the adherent ability and promote the expression of CD(49d) and CXCR4 of the cord blood CD(34)(+) cells, suggesting that PF4 promote the circulating stem cells homing to the marrow in the process of stem cells transplantation.

Antigens, CD34 ; blood ; Cell Adhesion ; drug effects ; Fetal Blood ; cytology ; Flow Cytometry ; Hematopoietic Stem Cells ; cytology ; drug effects ; Humans ; Integrin alpha4 ; blood ; Platelet Factor 4 ; pharmacology ; Receptors, CXCR4 ; blood

Objective:To prepare the synaptophysin and chromogranin A monoclonal antibodies with clinical evalua -tion.Methods:The fuse gene (Syn and CgA) was designed and it was constructed on the expression vector pET-28a.Then ,the fusion protein was purified.After protein immunization , cell fusion and screening , the target antibodies were selected .Specificity study and correlation coefficient of Syn and CgA was evaluated by clinical sample comparison validation .Results:By screening,two antibodies 3D9 and 4A12,respectively,for Syn and CgA,were obtained.19 kinds of wax block organization were detected by 3D9,4A12 and control antibody(Leica).The statistical results were analyzed ,the results were in good agreement ,and the correlation coefficients were r=0.9892 and r =0.9939, respectively.Conclusion: This method is prepared to obtain the synaptophysin and chromogranin A antibodies successfully and both can be used for immunohistochemistry .This method can also provide some reference for the study of antibody .

OBJECTIVETo evaluate the efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treatment of leukemia relapsed after first allo-HSCT.

METHODSNine patients with relapsed acute leukemia (5 AML, 4 ALL) and one with chronic myelogenous leukemia (CML) who showed cytogenetic relapse after first allo-HSCT received second allo-HSCT. The median relapse time from the first allo-HSCT was 141 days. Conditioning regimens for second allo-HSCT were combination chemotherapy based on moderate-dose Ara-C (n = 5), Bu (n = 3), conventional-dose Ara-C (n = 1) and Flud/Mel (n = 1). Prophylaxis for acute graft-versus-host disease (aGVHD) were CsA alone (n = 2), CsA/MTX (n = 1), FK506 (n = 1), and no prophylaxis in 6. The median number of peripheral blood mononuclear cells transfused was 6.1 x 10(8)/kg.

RESULTSEight cases were evaluable. All of them were engrafted and 7 developed aGVHD (grade I 4, grade II 3). The median time for absolute neutrophil count (ANC) > 0.5 x 10(9)/L and platelets > 20 x 10(9)/L were 11 and 12 days, respectively. Five cases developed localized chronic GVHD. Of all the 10 cases received second allo-HSCT, 8 died from interstitial pneumonia (n = 2), multiple-organ failure (n = 1), sepsis (n = 1), fungous pneumonia (n = 1), and leukemia relapse (n = 3), and 2 survived without leukemia for +986 and +1913 days, respectively. The leukemia free survival, transplantation related mortality and relapse rate at 2 year were 20%, 50% and 30%, respectively.

CONCLUSIONSecond allo-HSCT is a therapeutic alternative for selected patients with relapsed leukemia after first allo-HSCT.

Adult ; Disease-Free Survival ; Female ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; pathology ; surgery ; Male ; Neoplasm Recurrence, Local ; Retrospective Studies ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo compare the enhanced recovery program after surgery (ERAS) with conventional perioperative management in patients undergoing radical resection for colorectal cancer.

METHODSThe ERAS protocol included a combination of evidence-based and consensus methodology. A total of 597 consecutive patients undergoing elective colorectal resection were randomized to either the ERAS(n=299) or the control group(n=298). Outcomes related to nutrition and metabolism index, stress index, and recovery index were measured and recorded.

RESULTSDemographics and operative parameters were similar between the two groups(P>0.05). The nutritional status of patients in the ERAS group was improved after surgery compared with that of the control group. On postoperative day (POD) 1, the HOMA-IR in the ERAS group was significantly lower than that in the control group(P<0.01). The cortisol level in the control group was elevated on both POD 1(P<0.01) and POD 5(P<0.01) compared to the preoperative level. However, the cortisol level was not increased until POD 5(P<0.01) in the ERAS group. The levels of TNF-α, IL-1β, IL-6, and IFN-γ were reduced in the ERAS group, indicating less postoperative stress responses compared with the control group. In addition, ERAS group was associated with accelerated recovery of gastrointestinal function. The postoperative length of stay [(5.7±1.6) d vs. (6.6±2.4) d, P<0.01] and expense[(15 998±2655) RMB vs. (17 763±3059) RMB, P<0.01] were reduced in the ERAS group. Twenty-eight patients(9.4%) in the control group and 29(9.7%) in the ERAS group developed complications, while the difference was not statistically significant(P>0.05).

CONCLUSIONERAS protocol alleviates surgical stress response and accelerates postoperative recovery without compromising patient safety.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; methods ; Prospective Studies ; Young Adult

BACKGROUNDElevated fibrinogen (Fg) level is a known risk factor for ischemic stroke. There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention. We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention.

METHODSThis is a multicenter, randomized, parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for 12 months. Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules. The NIH Stroke Scale scores (NIHSSs) and plasma Fg level were recorded. The carotid artery intima-media thickness (IMT) and status of plaques were examined through carotid ultrasound examination. Primary outcomes included all-cause mortality, any event of recurrent ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, myocardial infarction and angina, and other noncerebral ischemia or hemorrhage. Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups. Comparison of median values between two groups was done by the Student t test, one-way analysis of variance (ANOVA), or non-parametric rank sum test.

RESULTSA total of 310 patients were enrolled, 192 patients in the treatment group and 118 patients in the control group. Compared to the control group, the treatment group showed favorable outcomes in the Fg level, carotid IMT, the detection rate of vulnerable plaques, the volume of carotid plaques, NIHSS scores, and incidence of total vascular (6.78% and 2.08%, respectively) and cerebral vascular events (5.93% and 1.04%, respectively) (P < 0.05). In the treatment group, the volume of carotid plaques was significantly related to the carotid IMT, the plaque diameter, width and number (P = 0.000, 0.000, 0.000, 0.022; F = 13.51, 2.52, 11.33, -3.29, but there was a weak correlation with the Fg level (P = 0.056). After 1-year therapy, the incidence of overall vascular end points was reduced by 4.7%.

CONCLUSIONLong-term oral fibrinogen-depleting therapy may be beneficial for secondary ischemic stroke prevention.

Administration, Oral ; Aged ; Carotid Intima-Media Thickness ; Endopeptidases ; administration & dosage ; therapeutic use ; Female ; Fibrinogen ; metabolism ; Humans ; Male ; Middle Aged ; Secondary Prevention ; Stroke ; prevention & control

BACKGROUNDAlthough the first leading cause of death in China was malignant neoplasms (mortality, 374.1 per 100,000 person-years), the full impact of primary brain tumors (PBT) on the healthcare system is not completely described because there are a few well documented reports about the epidemiologic features of brain tumors. This study aimed to report a comprehensive assessment on the prevalence of PBT.

METHODSA multicenter cross-sectional study on brain tumor (MCSBT) in China was initiated in five regional centers: Daqing (northeast), Puyang (north of China), Shiyan (center of China), Ma'anshan (center of China) and Shanghai (southeast). Prevalence rate was calculated by counting the number of people living with a PBT between October 1, 2005 and September 30, 2006 and dividing by the total population of the five communities at January 1, 2006. Estimates of prevalence were expressed as percentages and grouped according to gender and to age in fifteen-year categories. Within these strata, the rates were estimated with 95% confidence intervals (CI) using the accurate calculation of CI for Poisson distribution. A chi-square test was used to compare the various frequencies with α < 0.05. Age-standardized prevalence with the direct method was calculated with the ten-year age-specific prevalence and the age distribution of the Chinese population in 2010, obtained from World population prospects: the 2008 revision.

RESULTSWe estimated that the overall prevalence of PBT was 24.56 per 100,000 (95%CI, 14.85 to 34.27), and the overall prevalence of PBT in female population (30.57 per 100,000 and its 95%CI ranged from 19.73 to 41.41) was higher than that in male population (18.84 per 100,000 and its 95%CI ranged from 10.33 to 27.35). However, the discrepancy between genders was not statistically significant because the 95%CI overlapped. Of 272 cases of newly diagnosed PBT, the proportion of histological subtypes by age groups, gender was statistically different (χ(2) = 52.6510, P < 0.0001). More than half of all reported tumors (52.57%) were either gliomas or meningiomas. For the youngest (aged from 0 - 19) strata of the population, glioma appeared to occur more than other subtypes, accounting for 55.56% of all of cases. The majority of brain tumors presented in those aged from 20 to 59 years was pituitary adenomas (45.12%) and gliomas (31.10%). Opposed to brain tumors in adults and teenage, gliomas only accounted for 22.22%. Meanwhile, the median ages at diagnosis of the patients with PBT were similar between males and females except for pituitary adenomas (male: 59 years old; female: 45 years old).

CONCLUSIONSAge standardized prevalence of PBT is 22.52 per 100,000 (95%CI, 13.22 to 31.82) for all populations, 17.64 per 100,000 (95%CI, 9.41 to 25.87) for men, and 27.94 per 100,000 (95%CI, 17.58 to 38.30) for women. Age standardization to China's 2010 population yielded an estimated population of 304 954 cases with PBT. Our prevalence estimates provide a conservative basis on which to plan health care services and to develop programmatic strategies for surviving. In the future, it would be helpful to have long-term observed survival rates that would make the assumptions and the resulting imprecision in the current estimates unnecessary.

Adolescent ; Adult ; Age Distribution ; Aged ; Brain Neoplasms ; diagnosis ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Young Adult