Background and Objectives: The search for a suitable alternative for urethral defect is a challenge in the field of urethral tissue engineering. Induced pluripotent stem cells (iPSCs) possess multipotential for differentiation. The in vitro derivation of urothelial cells from mouse-iPSCs (miPSCs) has thus far not been reported. The purpose of this study was to establish an efficient and robust differentiation protocol for the differentiation of miPSCs into urothelial cells. Methods: and Results: Our protocol made the visualization of differentiation processes of a 2-step approach possible. We firstly induced miPSCs into posterior definitive endoderm (DE) with glycogen synthase kinase-3β (GSK3β) inhibitor and Activin A. We investigated the optimal conditions for DE differentiation with GSK3β inhibitor treatment by varying the treatment time and concentration. Differentiation into urothelial cells, was directed with all-trans retinoic acid (ATRA) and recombinant mouse fibroblast growth factor-10 (FGF-10). Specific markers expressed at each stage of differentiation were validated by flow cytometry, quantitative real-time polymerase chain reaction (qRT-PCR) assay, immunofluorescence staining, and western blotting Assay. The miPSC-derived urothelial cells were successfully in expressed urothelial cell marker genes, proteins, and normal microscopic architecture. Conclusions We built a model of directed differentiation of miPSCs into urothelial cells, which may provide the evi-dence for a regenerative potential of miPSCs in preclinical animal studies.

Objective The three-dimensional finite element model of the normal ankle joint was established to simulate the changes of stress and displacement under stress from different directions and of different magnitudes so as to provide a theoretical basis for the biomechanical mechanism of the ankle joint injury.Methods Spiral CT scan was performed on the left ankle of a 30 year old healthy male volunteer to obtain the original CT image data.The three-dimensional digital model of ankle joint generated by Mimics and Geomagic softwares was imported into the software Ansys.The three-dimensional finite element model of ankle joint with complete anatomical structure was obtained after the main steps of meshing,central node,element linking and module loading using finite element method.Stress from different directions and of different magnitudes were loaded unto the model.The stress changes were measured by foot stress distribution measurement system.The stress changes,displacement change distribution,the stress peak value of heel are,metatarsal stress,and plantar contact stress area as well as the maximum,minimum,and contact are of the tibial articular surface contact stress were compared between the finite element model and the volunteer himself to verify the consistency.Results For the finite element model of normal ankle joint,the plantar peak stress was [(0.33 ± 0.10) MPa],the metatarsal stress was [(0.13 ± 0.21)MPa],the foot contact stress area was [(78.60 ±0.32)mm2],the tibial articular surface maximum contact stress was [(2.72 ± 0.10) MPa],the minimum contact stress was [(1.35 ±0.12)MPa],and the contact stress area was [(79.1 ± 0.14)mm2].For the volunteer,double foot plantar peak stress was [(0.35 ± 0.12)MPa],the metatarsal stress [(0.13 ±0.16)MPa],the foot contact stress area was [(77.3 ± 0.42)mm2],the tibial articular surface maximum contact stress was [(2.79 ± 0.23) MPa],the minimum contact stress was [(1.37 ± 0.20) MPa],and the contact stress area was [(79.10 ±0.14)mm2] (P ＜0.05).Therefore,the three finite element model of ankle joint was basically consistent with the real human ankle joint because of the similiar distribution,trend,and values.Conclusion The three-dimensional finite element model of normal ankle joint can objectively reflect the anatomical structure and biomechanical characteristics of the joint,which is of great value to understand the changes of the internal mechanics and ankle joint injury.

Objective To design an anatomic locking plate for the posterior malleolus using 3D reconstruction CT of the ankle joint and software Mimics.Methods The CT data of 20 normal ankles were imported into software Mimics in.dicom format for 3D reconstruction of the ankle joint.The angles of posteromedial and posterolateral varus,the twist height on the sagittal plane and the height of safe screw placement zone,the width of the posterior malleolus were measured for the posterior malleolus.After the anatomic locking plate was designed using the anatomic data measured and software Ungraphics NX5.0,it was 3D printed in a proportion of 1:1.Next,the model plate was tested and evaluated in 15 fresh cadaveric specimens of the ankle all the soft tissues of which were removed to fully expose the bony structure of the posterior malleolus.Results The anatomic measurements showed that the angles of postemmedial and posterolateral varus increased gradually towards the medial and lateral sides along the central axis of the posterior malleolus while the twist height reduced from the lateral to the medial side,and that the width of the posterior malleolus increased gradually from the superior to the inferior.It was found that after placement in the 15 fresh cadaveric specimens the anatomic model plate fit the posterior malleolus very well,fulfilling all the designed requirements for the anatomic locking plate for the posterior malleolus.Conclusion A novel anatomic locking plate for the posterior malleolu has been successfully designed and manufactured using 3D reconstruction CT of the ankle joint,software Mimics and 3D printing.

Objective To discuss the safety and feasibility of single-incision laparoscopic appendectomy ( SILA ) . Methods A retrospective analysis was made on clinical data of patients diagnosed as having appendicitis by clinical manifestations , ultrasound or computer tomography at our department from June 2009 to December 2014.There were 189 cases of transumbilical SILA ( transumbilical group ) and 123 cases of traditional three-port laparoscopic appendectomy ( three-port group ) .Patients with incomplete records, combination with other surgery , pregnancy appendicitis , acute appendicitis over 72 hours were excluded .Intraoperative and postoperative data of two groups were compared . Results No conversion to open surgery was required in both groups .The operation time, postoperative exhaust time , and postoperative hospital stay had no significant differences between the transumbilical group and the three-port group [(45.5 ±12.7) min vs.(46.3 ±17.8) min, t=-0.461, P=0.650; (1.4 ±0.5) d vs.(1.5 ±0.6) d, t=-1.588, P=0.112;(3.8 ±1.6) d vs.(4.1 ±1.9) d, t=-1.554, P=0.121].The cosmetic scores at 3 months after surgery was higher in the transumbilical group than that in the three-port group [(4.5 ±0.6) points vs.(4.2 ±0.5) points, t=4.585, P=0.000].No significant differences were identified in the incidence of complications and pathological types between the two groups . Conclusion SILA is technically feasible and safe with better cosmetic effects .

DNA polymerase iota (Polt),as well as Revl,Polκ and Polη,are all Y family DNA polymerases,which are able to replicate damaged DNA via translesion synthesis pathway.However,Pol(t) has the lowest fidelity among all DNA polymerases in both correct and inaccurate DNA templates.Also Pol(t) can bypass certain DNA damages and accumulate mutations.Recent studies show that the aberrant expression of Pol(t) is observed in human uveal melanoma,breast cancer,bladder cancer,lung cancer and esophageal cancer,which may contribute to the tumorigenesis and progression of tumor.The special role of Pol(t) in replicating damaged DNA may contribute to the resistance in oncotherapy.

Objective To investigate the effect of heme oxygenase-1 ( HO-1 ) on the acute radiation-induced skin injury by gene transfer.Methods Thirty-three male SD rats were randomly divided into three groups as PBS-injected group,Ad-EGFP-injeeted group and Ad-HO-1-injected group ( n =11 ).In each group,three rats were used for determining the expression of target gene and the other rats were irradiated on the buttock skin with 40 Gy electron beam generated by a linear accelerator.Immediately after irradiation,rats were administered with a subcutaneous injection of PBS,Ad-EGFP or Ad-HO-1,respectively.Subsequently,the skin reactions were measured twice a week using the semi-quantitative skin injury scale.Results The strong positive expression of HO-1 was observed in subcutaneous dermal tissue after injection of Ad-HO-1.Compared to the PBS-injected group or the Ad-EGFP-injected group,a significant mitigation of skin injury was observed in Ad-HO-1-injected mice 14 d after irradiation (q =0.000-0.030,P ＜ 0.05 ).Conclusions HO-1 could significantly mitigate radiation-induced acute skin injury and Ad-HO-1 could be used to treat radiation-induced skin injury.

OBJECTIVE: To introduce a kind of method for skull base reconstruction after resecting anterior skull base tumors involving paranasal sinuses. METHOD: A retrospective analysis was carried out on 13 patients who underwent anterior skull base reconstruction. Pericranial flap were detached with integrity from the frontal bone during craniotomy, after the tumor had been resected partitionedly, the cribriform plate of ethmoid bone which was involved by tumor was resected. Using the fat tissue to fill the skull-base defects and sutured the pedicled pericranial flap with surrounding normal dura mater. Then reinforced at the junction of pericranial flap and dura mater with biogel. RESULT: The pathogenic diagnosis of all cases were meningioma. I grade resection was acquired in 12 cases and II grade in 1 case according to Simpson grading standard of meningioma resection. The postoperative complications were 3 cases aseptic meningitis, 3 cases frontal syndrome. No CSF leakage, intracranial infection, nor death occurred. An average of 3. 4-year follow-up was achieved in all the cases from 9 months to 8 years, no tumor relapse. CONCLUSION CSF leakage can be effectively prevented by filling the skull-base defects with the fat tissue, suturing the pedicled pericranial flap with surrounding normal dura mater, and reinforcing at the junction of pericranial flap and dura mater with biogel.
Adult ; Aged ; Cerebrospinal Fluid Rhinorrhea ; prevention & control ; Female ; Humans ; Male ; Meningeal Neoplasms ; prevention & control ; surgery ; Meningioma ; pathology ; surgery ; Middle Aged ; Postoperative Complications ; prevention & control ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skull Base ; surgery ; Skull Base Neoplasms ; pathology ; surgery

OBJECTIVE: To study the clinical characteristics and operative effect of hippocampus lesions. METHODS: We retrospectively analyzed the clinical characteristics and operative outcome of 44 patients with hippocampus lesions between August 2005 and April 2010. RESULTS: Seizure attack was the initial symptom among 40 of the 44 patients. Pathological examinations revealed 18 gliomas, 9 cavernous malformations, 12 hippocampus sclerosis, 2 focal cortical dysplasia, 1 atypical hyperplasia, 1 injury glial scar, and 1 encephalomalacia. Thirteen patients received anterior medial temporal lobectomy and the other 31 received lesionectomy or selective amygdalohippocampectomy via transsylvian approach. An average of 15.7 month follow-up was accomplished in 37 patients. Postoperative epileptic outcomes were evaluated according to Engel classification: Grade I 73.0%(27/37), Grade II 13.5%(5/37), Grade III 10.8%(4/37) and Grade IV 2.7%(1/37). No perioperative death occurred. One patient experienced hemiplegia but recovered 8 months after the operation. Noticeable postoperative visual field deficit was left in 2 patients. Two patients with glioma died of remote tumor recurrence during follow-up. CONCLUSION Seizure attack is a major complaint of hippocampus lesions. Satisfactory seizure and tumor control may be achieved through anterior medial temporal lobectomy or selective amygdalohippocampectomy with lesionectomy.
Adolescent ; Adult ; Brain Neoplasms ; surgery ; Child ; Child, Preschool ; Epilepsy ; surgery ; Female ; Glioma ; surgery ; Hippocampus ; pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sclerosis ; surgery ; Temporal Lobe ; surgery ; Treatment Outcome ; Young Adult

Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.

Aim To investigate the protective effects of high concentration fentanyl on the brain slice injury induced by oxygen glucose deprivation(OGD).Methods Rat brain slices were made and randomly assigned to four groups:control(n=10),OGD(n=10),fentanyl 50 ?g?L~(-1)(F_(50),n=10) and fentanyl 500 ?g?L~(-1)(F_(500),n=10).Changes of the neuron injury and apoptosis were observed with TTC staining,LDH releases,TUNEL staining,immunohistochemistry and electromicroscope.In addition,changes of intracellular calcium were measured with confocal laser-scanning microscopy.Results F_(50) and F_(500) attenuated the decrease of TTC staining and the increase of LDH release induced by OGD in brain slices.Neuronal apoptosis and changes of neuronal ultrastructures were attenuated by F_(50) and F_(500).Bcl-2 and Bax protein expressions were increased after OGD.Bax protein expression was decreased by F_(50) and F_(500),while Bcl-2 protein expression was increased by F_(50)and F_(500).Intracellular calcium concentration was increased by OGD and then it was lowered by F_(50) and F_(500).The protective effects of F_(50) were more obvious than that of F_(500).Conclusions High concentrations of fentanyl have neuron protective effects against OGD injury in rat brain slices,and fentanyl 50 ?g?L~(-1) has more obvious protective effects than fentanyl 500 ?g?L~(-1).