To achieve continuously physiological monitoring on hospital inpatients, a ubiquitous and wearable physiological monitoring system SensEcho was developed. The whole system consists of three parts: a wearable physiological monitoring unit, a wireless network and communication unit and a central monitoring system. The wearable physiological monitoring unit is an elastic shirt with respiratory inductive plethysmography sensor and textile electrocardiogram (ECG) electrodes embedded in, to collect physiological signals of ECG, respiration and posture/activity continuously and ubiquitously. The wireless network and communication unit is based on WiFi networking technology to transmit data from each physiological monitoring unit to the central monitoring system. A protocol of multiple data re-transmission and data integrity verification was implemented to reduce packet dropouts during the wireless communication. The central monitoring system displays data collected by the wearable system from each inpatient and monitors the status of each patient. An architecture of data server and algorithm server was established, supporting further data mining and analysis for big medical data. The performance of the whole system was validated. Three kinds of tests were conducted: validation of physiological monitoring algorithms, reliability of the monitoring system on volunteers, and reliability of data transmission. The results show that the whole system can achieve good performance in both physiological monitoring and wireless data transmission. The application of this system in clinical settings has the potential to establish a new model for individualized hospital inpatients monitoring, and provide more precision medicine to the patients with information derived from the continuously collected physiological parameters.

OBJECTIVETo explore the role of platelet-activating factor receptor (PAFR) in adhesion and invasion of phospho- rylcholine (PC)-positive Aggregatibacter actinomycetemcomitans in cultured human umbilical vein endothelial cells (HUVEC).

METHDOSCultured HUVECs were pretreated with the PAFR antagonist CV3988 or anti-human PAFR monoclonal antibody for 30 min before infection with PC-positive or -negative A. actinomycetemcomitans strains. The bacterial adhesion and invasion and cytotoxicity in the cells were examined using MTT assay.

RESULTSPretreatment with PAFR antagonists at 100, 200 and 500 nmol/L significantly reduced the adhesion rate (36.29∓3.52)%, (19.04∓3.35)% and (7.69∓3.19%), respectively] and invasion rate [(12.12∓1.58)%, (7.08∓0.29)% and (2.60∓2.26)%, respectively] of PC-positive A.actinomycetemcomitans in HUVECs. Similarly, pretreatment with anti-PAFR antibody also significantly reduced A.actinomycetemcomitans adhesion and invasion in HUVECs [(50.05∓5.28)% and (39.09∓6.50)%, respectively]. Pretreatment with PAFR antagonist (200 and 500 nmol/L) and anti-PAFR antibody (25 µg/mL) significantly increased the viability of HUVECs incubated with PC-positive A.actinomycetemcomitans from (25.39∓9.33)% to (91.12∓3.14)%, (94.12∓2.15)% and (65.5∓1.87)%, respectively, but such pretreatments did not increase the viability of cells incubated with PC-negative A.actinomycetemcomitans.

CONCLUSIONSPAFR plays an important role in the adhesion, invasion, and cytotoxicity of PC-positive A.actinomycetemcomitans in cultured HUVECs.

Aggregatibacter actinomycetemcomitans ; pathogenicity ; Bacterial Adhesion ; Cells, Cultured ; Human Umbilical Vein Endothelial Cells ; microbiology ; Humans ; Platelet Membrane Glycoproteins ; metabolism ; Receptors, G-Protein-Coupled ; metabolism

Objective To explore the efficacy of Chen's cholangiojejunostojmy for tumors around biliary-intestinal anastomosis.Methods The clinical data on 11 patients operated from Jan 2012 to Dec 2014 were retrospectively analyzed.Results All these 11 patients underwent Chen's cholangiojejunostomy.The postoperative liver function significantly improved,and the symptoms of jaundice completely disappeared after operation [ALT (182.0 ±110.6) U/L vs (68.3±33.3) U/L,TBil (316.9 ±153.9) μmol/L vs (60.3 ± 25.8) μmol/L,DBil (184.1 ± 89.6) μmol/L vs (28.6 ± 12.4) μmol/L,P ＜ 0.01;AST (195.5 ± 206.9) U/L vs (48.6 ± 21.2) U/L,GT (806.7 ± 480.0) U/L vs (204.0 ± 99.1) U/L,ALP (612.8 ±424.6) U/L vs (277.5 ± 68.7) U/L,P ＜ 0.05].The level of CA19-9 also significantly decreased [(1 369.75 ± 1 812.18) kU/L vs (71.0 ± 46.5) kU/L,P ＜ 0.05].There were no significant differences in the CA125,CA15-3,CEA levels [CA125 (35.3 ± 26.0) kU/L vs (29.4 ± 23.5) kU/L,CA15-3 (19.4±12.3) kU/L vs (17.9±10.7) kU/L,CEA (8.4 ±7.7) μg/L vs (7.8 ±6.6) μg/L,P ＞ 0.05].There was no perioperative death.All the patients had a smooth perioperative recovery,except in 1 patient who developed bile leakage and another patient who had episodic attacks of cholangitis.There were no recurrent or metastatic tumors detected on follow-up.Conclusion Chen's cholangiojejunostomy was effective in the treatment of bile duct obstruction caused by tumors around biliary-intestinal anastomosis.

Objective To compare the clinical effect of the primary total hip replacement (THR)and the secondary THR after failed internal fixation in elderly patients with displaced femoral neck fracture,so as to investigate the optimal treatment for displaced femoral neck fractures in elderly patients.Methods From January 2006 to December 2012,22 patients treated with a secondary THR after failed internal fixation were chosen as the observation group and 30 patients treated with a primary THR were chosen as the control group,the operation time,blood loss,postoperative Harris scores for hip joint and health-related quality of life (~ index score) were observed and analyzed in two groups.Results Both of the groups were followed up successfully and each of the groups had 1 patient died.There were no joint infection,re-operations and any other complications in both groups.The operation time in observation group was longer than that in control group [(114.82 ±32.13) min vs.(90.63 ± 16.24) min],blood loss was more than that in control group [(551.73 ± 241.62) ml vs.(314.46:± 156.72) ml],there was significant difference (P ＜ 0.05).But the Harris score and KPS index score between two groups had no significant differences (P ＞ 0.05).Conclusion The primary THR in elderly patients with displaced femoral neck fracture has lower risk in operation tocompare with the secondary THR after failed internal fixation,but the two ways are similar in the hip joint function recovery and improve patients quality of life.

BACKGROUND:Studies have shown that bone loss can lead to a series of diseases, such as osteoporotic fractures, thus seeking to increase bone mass has become a goal of the majority of researchers.
OBJECTIVE:To summarize the current studies of improving bone mass by using stem cel transplantation, hoping to the extensive application of stem cel transplantation in the clinical treatment of osteoporosis as early as possible.
METHODS:A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles relevant to stem cel therapy for osteoporosis published from January 1997 to October 2014. The keywords were“to improve bone mass, regenerative medicine, bone marrow mesenchymal stem cel transplantation, stem cel therapy”in Chinese and English, respectively, which appeared in the title, abstract or keywords. Articles published recently or in authoritative journals were preferred, and final y 28 articles were included in result analysis.
RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s which are isolated and cultured easily can proliferate rapidly and have multi-lineage differentiation potential. Studies have shown that the osteogenic differentiation of bone marrow mesenchymal stem cel s can real y improve bone mass, and obtain more achievements in the treatment of orthopedic disorders. This new cel therapy can help to accelerate bone healing and reduce treatment time, offering a new therapeutic choice for orthopedic surgery, plastic surgery, oral and maxil ofacial surgery, and therefore, it has broad application prospects.

BACKGROUND: It is difficult to conduct the operation of ossification of ligamentum flavum (OLF) in thoracic spine, and the operation needs complecated operative skill, and unmerited disposal tends to worsen neurological dysfunction.OBJECTIVE: To analyze the operative method for OLF of thoracic spineand functional restoration.DESIGN: Case analysis.SETTING: Department of Orthopaedics, Changzheng Hospital, SecondMilitary Medical University of Chinese PLA.PARTICIPANTS: Totally 56 patients with OLF of thoracic spine, whowere treated at the Department of Orthopaedics, Changzheng Hospital fromAugust 1996 to August 2003.METHODS: The operative therapy was performed in all the patients, and the method was determined by the results of MRI and CT examination: ①The 19 patients, whose OLF in thoracic spine was focal type, and range of lesion did not exceed two segments, were treated with simple resection and decompres sion in posterior wall of vertebral canal. ②Fenestration and sledging-allocating manipulation in the whole piece unilateral lamina of vertebra were carried out in 29 cases involving more than 2 segments. ③If coplanar OLF in thoracic spine combined with protrusion of thoracic spine disc or ossification of posterior longitudinal ligament, decompression of posterior midline approach+posterior lateral approach was performed, totally 8 cases.MAIN OUTCOME MEASURES: Post-operation functional restoration was evaluated with Epstein standard, excellent: recovery of sensation and exercise was near to normal; good: spinal cord function was improved significantly, and permitted to walk with brace; fair: small partial restoration of sensory and motor function, unable to walk; bad: Inefficiency or becoming severe.RESULTS: A total of 55 cases were followed up for more than one year and 1 case only for two months after operation. ①Functional restoration: excellent: 39 cases; good: 8 cases; fair: 5 cases; bad: 4 cases. ②Symptom recovery after operation was confirmed by disappearance of tight sensation, reduction of muscular tension, relieving of numbness in order. ③The recovery was rapid for 3 to 6 months after operation. Part of patients' condition was still ameliorating during one year after operation, and rare advancement 2 years later. The recovery of complete paraplegics was bad, so was the severe paraplegia with long history. CONCLUSION: Compressive myelopathy caused by OLF in thoracic spine should be treated in an earlier period by operation. Resection and decompression of posterior wall of thoracic spine and decompression of posterior approach could be choosed according to different condition.

BACKGROUND: Occurrence and development of the glioma are not only related to regulative gene of cell cycle, but also dealt with adjustive genes of cell invasion, cell metastasis and apoptosis.OBJECTIVE: To identify the differentially expressed genes related to cell proliferation and apoptosis in glioma cell of different differentiating degree with cDNA microarray, and provide basic data for further research of mechanisms of cell proliferation and apoptosis in human gliomas.DESIGN: Opening-up experiment.SETTING: Institute of Pathology, Southwest Hospital and Department of Neurobiology, Basic Medicine Faculty as well as Department of Pharmacy,Xinqiao Hospital, Third Military Medical University of Chinese PLA.MATERIALS: Human malignant glioma cell line CHG-5 ( Ⅱ grading according to the WHO standard) was constructed, kept and cultured in this experiment. SHG-44 (Ⅳ grade according to the WHO standard) was provided by Institute of Brain Tumor, Second Hospital Affiliated to Suzhou Medical College. Serum of calf was produced and provided by Hangzhou Sijiqing Biomaterial Institute. In experiment RPMI-1640 medium (Gibco),Trizol test kit (Gibco-BRL), RNAsecureTM solutions (Ambion, Austin,Texas), biophotometer (Eppendorf, Hamburg, Germany) were also applied.Gene chip contained 9 984 human cDNA segment, which was prepared and provided by City University of Hongkong (UniGEMV2 cloneset known gene and ESTs were purchased from Incyte Company), Superscript Ⅱ reverse transcriptase was provided by Gibco-BRL Company. Fluorochrome Cy3 & Cy5 was the products of Amersham Pharmacia Company.METHODS: The experiment was performed at Chongqing Third Military Medical University of Chinese PLA and City University of Hongkong between 2001 and 2003. Total RNA was extracted from Trizol test kit. Reverse transcription polymerase chain reaction (RT-PCR) was conducted in Superscript Ⅱ reverse transcriptase, and cDNA product was marked with fluorochrome Cy3 & CyS. Followed by chip hybridizationto detect the difference of gene expressions between human glioma cell line CHG-5 and SHG-44 tumor cell, especially the difference of related genic expression between cell proliferation and apoptosis, and the chip result was verified with Northern blot hybridization.MAIN OUTCOME MEASURES: The difference of gene expression of human glioma cell in different differentiating degree; Comparison of result between Northern blot and related gene chip.RESULTS: ①Compared with CHG-5, 120 gene expressions were detected obvious up-regulation and 22 gene expressions were significant down regulation in SHG-44 cells, and the variety of these differentially expressed genes was many, in which apoptosis related genes were 6, including 3 up-regulation genes and 3 down-regulation genes; Cell cycle and proliferating related genes were 12, including 5 up-regulation genes and 7 down-regulation genes. ②Chip result was supported by Northern blot result further.CONCLUSION: The differentially expressed genes of glioma are revealed primarily, especially the differentially expressed genes related with cell proliferation and apoptosis.