Bone marrow mesenchymal stem cells(MSCs) are a sort of somatic stem cells deriving from the mesoderm.They are capable of self-renewing,differentiating into mesenchymal or non-mesenchymal tissues,anti-inflammatory,reducing oxidative stress and immunomodulatory.MSCs exert their protective effect on various tissues,especially the ischemia-reperfusion injured tissue.This review summarizes the repairative potential of MSCs on ischemia-reperfusion injury.

Objective To investigate the clinical efficacy of two types of duodenum-preserving pancreatic head resection (Beger procedure and Berne procedure) for chronic pancreatitis with mass in the head of the pancreas.Methods The clinical data of 46 patients with chronic pancreatitis and mass in the head of the pancreas who were admitted to the Affiliated Hospital of Guiyang Medical College from September 2008 to April 2012 were retrospectively analyzed.There were 24 patients received Beger procedure (Beger group),and 22 received Beme procedure (Berne group).The complications,life quality and pain after the operation were evaluated.Patients were followed up via phone call and out-patient examination till April 2013.The measurement data were analyzed using the Mann-Whitney U test,and the constituent ratios were compared using the chi-square test.Results The operation time and volume of blood loss were (377 ± 21) minutes and (746 ± 129) mL in the Beger group,and (323 ± 17) minutes and (577 ± 111)mL in the Berne group,with significant difference between the 2 groups (U=14.0,88.0,P ＜0.05).Four patients in the Beger group and 1 in the Berne group were complicated with pancreatic leakage,with no significant difference between the 2 groups (x2=0.714,P ＞ 0.05).The scores of life quality evaluation (physical condition,work capacity,cognitive ability,emotion,social competence and overall life quality) were 82 ± 14,74±24,90 ± 18,78±20,83 ± 18,73 ± 18 in the Beger group,and 79 ± 16,71 ±20,92 ±21,76 ± 18,80 ±21,70 ± 16 in the Berne group,with no significant difference between the 2 groups (U =177.5,183.5,187.5,178.0,189.5,192.0,P ＞ 0.05).The scores of symptom evaluation (fatigue,nausea and vomitting,pain,anorexia,dyspnea,sleep disorders,obstipation,diarrhea,financial worries) were 28 ± 16,24 ± 10,20±12,23 ± 14,4 ± 1,32 ± 12,6 ±2,18 ± 14,36± 18 in the Beger group,and 26 ± 18,26 ±20,22 ± 16,26 ± 16,3 ± 1,30 ± 10,5 ± 1,16 ± 12,38 ± 20 in the Berne group,with no significant difference between the 2 groups (U=194.5,215.5,182.5,180.5,213.0,199.0,195.0,184.5,181.5,P＞0.05).In the Beget group,19 patients did not have acute onset of pain,and 5 patients had acute onset of pain once a year; 6 patients were administered antalgesic occasionally.In the Berne group,20 patients did not have acute onset of pain,and 2 patients had acute onset of pain once a year; 4 patients were administered antalgesic occasionally,with no significant difference between the 2 groups (x2=0.485,0.041,P ＞ 0.05).All the patients were followed up,and the median time of follow-up was 36.3 months.No perforation of duodenum and steatorrhea was observed.No patient died perioperatively.Conclusion The clinical efficacy of the Berne procedure is similar to that of the Beger procedure,while the Berne procedure has advantages of easy manipulation and less operation time.

10 cmH 2O,and 2 cases were of severe grade with stress urethral pressure

Objective To evaluate the clinical efficacy and safety of low-volume TURP on patients with BPH. Methods A total of 76 high-risk patients with BPH were treated with either standard TURP (Group 1,n=39) or low-volume TURP(Group 2,n=37).The operative duration,blood loss,postoperative irrigation time,IPSS,Qmax,postvoid urine residual volume (PURV) were comparatively evaluated. Results In Groups 1 and 2,the operation durations were (67.5?18.2)min and (16.4?3.5)min (P= 0.011);blood loss,(158.4?47.3)ml and (54.7?25.2)ml (P=0.013);postoperative irrigation time (4.9?1.8)d and (1.3?0.5)d (P=0.029);IPSS change (19.3?7.6) and (15.3?9.7)(P=0.46);Qmax (13.4?8.8)ml/s and (11.7?9.1)ml/s (P=0.79);PURV (134.9?68.6)ml and (163.8? 94.5)ml (P=0.17) respectively.31 cases in Group 2 (low-volume TURP) were followed up for 2 to 18 months (mean,10 months) with satisfactory results. Conclusions The low-volume TURP is effective and characterized by shorter operative duration,minimal-invasion and better tolerance for the high-risk patients with BPH.

Objective To explore the nechanism of the interaction between K-opioid receptor and ? adrenal receptor. Method The effects of u50 488H on L-type calcium currents in the normal and hypoxic rat ventricular myocytes were studied by using whole-cell patch clamp technique. Results The basal as well as Isoproterenol-stimulated I_ Ca,L were inhibited by U50,488H in a dose-dependent manner in normal rat ventricular myocytes. In the hypoxic rat ventricular myocytes,the inhibitory effect of U50,488H was decreased. U50,488H had no significant effect on Forkolin-stimulated I_ Ca,L . Conclusion The results indicated that the negative modulation of ?-opioid receptor on ?-adrenoceptor was attenuated in the hypoxic ventricular myocytes,and the target of U50,488H on ?-adrenergic system might be situated between ?-adrenoceptor and adenylate cyclase.

Objective To investigate the possibility, effect and safety of intracoronary autologous moronuclear bone marrow cell (MBMC) transplantation in patients with ischemia heart failure (IHF). Methods 41 patients with IHF were enrolled in this prospective nonrandomized study. 14 patients were transplanted with autologous MBMC via a balloon catheter placed into the infarct-related artery during balloon dilatation by highpressure infusion, which was performed 6-8 times for 2 minutes each. 13 patients were transplanted via selective the infarct-related arteries by highpressure infusion. Results There were no major periprocedural complications. Two patients had limited premature ventricular contractions during cell infusion forseveral seconds. Two patients felt cold after 15-30 minutes infusing cell and got better several minutes later. There were no new onset of arrhythmias found on 48 h ECG monitoring. After 3 months of follow up, the symptoms and cardiac function were significantly improved in the transplantation group. FDG-PET analysis revealed a significant increase in myocardial metabolism (23.94?7.28)% (P=0.015). Plasma BNP lever decreased significatly at 3 days and 7 days after transplantation than before transplantation (P

BACKGROUND:Periprosthetic femoral fracture after total knee arthroplasty is related with the osteoporosis, bone defects, prosthesis, frail patients and high complication rate, so it is difficult to prevent and treat.
OBJECTIVE:To explore the risk factor, classification, treatment, rehabilitation and prophylaxis of periprosthetic femoral fracture after total knee arthroplasty based on the reviewed and summarized articles published in recent years.
METHODS:A computer-based online search was conducted in PubMed database from January 1, 1990 to December 31, 2011 and in SpringerLink database from 1980 to 2011 for the related articles with the key words of“periprosthetic fracture, knee”in English. A total of 626 articles were retrieved.
RESULTS AND CONCLUSION:According to inclusion and exclusion criteria, the articles were screened and 40 articles were included final y. The results showed that with the extensive development of total knee arthroplasty, the incidence of periprosthetic femoral fracture was increased gradual y;due to the poor prognosis, we should pay attention to the prevention. The risk factors of periprosthetic femoral fracture included patients’ internal factor that was hard to control, and some external factors such as the surgical techniques. Rorabeck classification was commonly applied for periprosthetic femoral fracture after total knee arthroplasty, but it was not perfect in clinical application. Kim classification wil be better for clinical guidance. The treatment of periprosthetic femoral fracture included nonoperative treatment, open reduction and internal fixation, retrograde intramedul ary nailing and revision arthroplasty. An appropriate treatment is chosen depending on fracture classification, local bone quality, patients’ medical and nutritional status. At present, however, there is not a perfect guideline for the selection of appropriate treatment method. But the early functional exercise is beneficial to prevent the related complications caused by longtime immobilization and the loss of joint function. Therefore, the indications must be under strict control in the treatment of periprosthetic femoral fracture after total knee arthroplasty. Except the firm fixation, early exercise for the patients should be encouraged at the same time.

Objective To investigate the effect of Naoxintong on nuclear transcription factor-κB ( NF-κB ) , matrix metalloproteinase-9(MMP-9)and TNF-αin the brain of ischemic rat models.Methods One hundred and ten healthy male SD rats were randomly divided into sham operated group ( n=30 ) , model control group ( n=40 ) and Naoxintong treatment group(n=40).Each group was further divided into five sub group by 0.5d, 1 d, 3 d, 5 d and 7 d after ischemia-reperfusion.The middle cerebral artery occlusion ischemia reperfusion rat models were prepared by Zea Longa method;meanwhile the MRI and the Bederson score were used to select the successful models .In order to observe the changing process of the ischemic brain tissue after given Naoxintong capsule , six rats in each group each timepoint were examined by MRI .The expression levels of protein and mRNA of NF-κB, MMP-9 and TNF-αwere detected respectively by western blot and real time PCR .Results Cerebral infarction volume of Naoxintong treatment group was significantly reduced compared with the model control group .The mRNA and protein levels of NF-κB, MMP-9 and TNF-αof the Naoxintong treatment group decreased significantly compared with the model control group (P <0.05).The mRNA and protein levels of NF-κB, MMP-9 and TNF-αhad no significant difference between the sham group and Naoxintong treatment group .Conclusion Naoxintong has a neuroprotection effect on cerebral ischemia via alleviating the inflammatory factors in the ischemic area .

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

Objective To investigate the efficiency of the modified posterolateral curved incision with double intermuscular approach in the treatment of posterolateral tibial plateau fractures.Methods From August 2009 to March 2013,15 men and 17 women aged 28 to 77 (mean,46.25) years with posterolateral spitting or collapse tibial plateau fractures were treated to undergo a modified posterolateral approach.All types of fractures were closed,without nerve or artery injury.The duration from injury to fixation was 3-18 (mean,7.13) days.The modified posterolateral approach was preformed to expose tibial anterolateral condyle and posterolateral condyle through intermuscular space of anterior tibial muscle,popliteus muscle and soleus muscle.After open reduction,anterolateral fractures and posterolateral fractures were fixed by the T-shaped plate and Golf shaped plate respectively.Results All of the 32 patients were followed up from 6 months to 36 months (in average of 15.3 months).Postoperative X-ray showed satisfied fractures without obvious collapse of the articular surface.At the last follow-up,the Rasmussen scores were range from 6 to 18 (in average of 14.06),namely 14 cases excellent,15 cases good,3 cases fair.The knee joint functions were evaluated according to HSS.The HSS results showed that there were 12 cases excellent,16 cases good,3 cases fair and 1 case bad.None of the cases suffered from injuries of crucial blood vessel or nerves.No incision necrosis,wound infection or fixation failure occurred during follow-up.Conclusion Open reduction and internal fixation via modified posterolateral approach can expose posterolateral and anterolateral tibial plateau fracture in one incision.Fibular head osteotomy can be avoided.The present approach could also reduce surgical injury,minimize the possibilities of incision necrosis or plate exposure.The modified posterolateral approach can be recommended in clinical practice.