Objective:To evaluate the diagnostic values of serum fibrinogen and D-dimer for periprosthetic joint infection (PJI).Methods:The medical records were retrospectively analyzed of the 175 patients who had undergone hip or knee revisions at Department of Joint Surgery, Affiliated Hospital to Qingdao University from August 2013 to June 2019. Of them, 59 were diagnosed as PJI (31 knees and 28 hips), including 33 males and 26 females with an age of (67.4±11.7) years and a body mass index (BMI) of (26.1±3.6) kg/m 2 while 116 as aseptic loosening (AL) (19 knees and 97 hips), including 67 males and 49 females with an age of (70.3±8.9) years and a BMI of (25.0±3.6) kg/m 2. The plasma levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen and D-dimer in the 2 groups were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to calculate the sensitivity and specificity of each indicator; the diagnostic value for each indicator was calculated according to the area under the curve (AUC). Results:There was no significant difference between the PJI and AL groups in gender, age or BMI ( P>0.05), but there was a significant difference in the joint type ( P<0.05). Compared with the AL group, the PJI group had significantly higher levels of CRP, ESR, fibrinogen and D-dimer ( P<0.05). The AUCs for CRP, ESR, fibrinogen and D-dimer were 0.830, 0.850, 0.848 and 0.664, respectively. By the Youden index, the optimal predictive cutoffs for CRP, ESR, fibrinogen and D-dimer were 8.06 mg/L, 17.60 mm/h, 3.73 g/L and 685.00 ng/mL, giving sensitivities of 79.2%, 85.4%, 81.3% and 64.6% and specificities of 85.7%, 76.2%, 79.8% and 61.9%. Conclusions:The diagnostic value of serum fibrinogen may be high for PJI, similar to that of CRP or ESR. However, D-dimer may be of limited value for diagnosis of PJI.

Objective:To discuss the new idea of on-the-spot recompression treatment and multidisciplinary treatment (MDT) for patients with unstable vital signs of type II decompression sickness. To provide reference for the nearby treatment of patients with critical decompression sickness.Methods:The clinical data of a case of a multi-disciplinary collaborative treatment of type II decompression sickness complicated with multiple organ dysfunction syndrome (MODS) admitted to a third-class A hospital in January 2020 were analyzed and summarized.Results:The patient suffered from consciousness disturbance and shock after 3 min of diver's blow-up out of the water. CT examination showed gas accumulation in the systemic multi-organ venous system, and laboratory examination suggested MODS. The oxygen inhalation regimen was given in the session of recompression treatmen by 0.12-0.18 MPa. Intravenous fluid was the total of 8900 ml in the session, and the total recompression treatment time was 9 h 45 min. The patient was still in unconscious when he finished the session. CT re-examination confirmed the elimination of venous bubbles, and laboratory examination indicated multiple organ failure (MOF) . The patient was given comprehensive supporting treatment by mechanical assisted breathing and following by continuons renal replacement therapy (CRRT) and extrocorporeal membrane oxygenation (ECMO) in the intensive care unit, and was discharged after 32 d of hospitalization.Conclusion:Critical decompression sickness patients with unstable vital signs are taken to a local general hospital with hyperbaric oxygen chamber and intensive care unit. The successful treatment can be achieved by organizing diving medicine, hyperbaric oxygen medicine and critical medical personnel for MDT.

Objective:To discuss the new idea of on-the-spot recompression treatment and multidisciplinary treatment (MDT) for patients with unstable vital signs of type II decompression sickness. To provide reference for the nearby treatment of patients with critical decompression sickness.Methods:The clinical data of a case of a multi-disciplinary collaborative treatment of type II decompression sickness complicated with multiple organ dysfunction syndrome (MODS) admitted to a third-class A hospital in January 2020 were analyzed and summarized.Results:The patient suffered from consciousness disturbance and shock after 3 min of diver's blow-up out of the water. CT examination showed gas accumulation in the systemic multi-organ venous system, and laboratory examination suggested MODS. The oxygen inhalation regimen was given in the session of recompression treatmen by 0.12-0.18 MPa. Intravenous fluid was the total of 8900 ml in the session, and the total recompression treatment time was 9 h 45 min. The patient was still in unconscious when he finished the session. CT re-examination confirmed the elimination of venous bubbles, and laboratory examination indicated multiple organ failure (MOF) . The patient was given comprehensive supporting treatment by mechanical assisted breathing and following by continuons renal replacement therapy (CRRT) and extrocorporeal membrane oxygenation (ECMO) in the intensive care unit, and was discharged after 32 d of hospitalization.Conclusion:Critical decompression sickness patients with unstable vital signs are taken to a local general hospital with hyperbaric oxygen chamber and intensive care unit. The successful treatment can be achieved by organizing diving medicine, hyperbaric oxygen medicine and critical medical personnel for MDT.

? Concept analysis of expectation regarding aging (ERA) is carried out by Walker and Avant's strategy. Four defining attributes of ERA were identified including self-definition and social attributes, aging perception, degree of positive willingness to participate in the life process, confidence in adapting to the decline with aging. ERA mainly affects the health outcomes of the elderly through health promotion behaviors, activities of daily living, physical examination behaviors, the path of new-established support system,expectation regarding aging and attitudes towards aging of stakeholders.

Objective:To study the alveolar bone morphology in the anterior teeth area of the skeletal Class Ⅱ malocclusion subjects with different vertical skeletal types.Methods:64 patients with skeletal Class Ⅱ malocclusion and 15 subjects with normal occlusion were included.The alveolar bone structure of the anterior teeth were observed using CBCT.Results:The labial and lingual alveolar bone height and the alveolar bone thickness of the incisors of the patients were much lower than those of the normal controls.The height of labial and lingual alveolar bone and the alveolar bone thickness of anterior teeth in high-angle subgroup were lower than those in low-angle subgroup.Conclusion:The thickness of the anterior teeth alveolar bone of skeletal Class Ⅱ malocclusion is low,espe-cially in the high-angle group.

Objective:To investigate the craniofacial features in patients with cleidocranial dysplasia (CCD).Methods:The facial features,cervical vertebral bone age and skeletal abnormalities of 8 patients with CCD were studied by analyzing facial photos,cephalo-metric and panoramic radiographs.Results:4 patients were in the early growth stage and the other 4 in the late period of development. The bossing forehead and inclined eye fissure were observed in all patients,but underdevelopment of midfaces were not obviously pres-ented in younger patients.Morphological abnormalities of craniofacial bones,such as ascending ramus,coronoid process,nasal bones and disappearence of gonial angle were observed in all patients.Conclusion:Some craniofacial malformations in patients with CCD may be presented earlier than underdeveloped midface,which can be helpful for early diagnosis of CCD.

BACKGROUND:Extracellular matrix can simulate microenvironment and make the stem cells proliferate maintaining the characteristics of stem cells wel in vitro. OBJECTIVE:To prepare the extracellular matrix from human bone marrow cells and to analyze its microstructure and composition preliminarily. METHODS:Human bone marrow cells of passage 4 were cultured for 14 days, and the induction medium was used during the last 8 days. After decellularization, cells were removed to prepare human bone marrow cells-derived extracellular matrix. The surface morphology of human bone marrow cells-derived extracellular matrix was observed by inverted microscope and scanning electron microscope. Changes of col agen I and biglycan before and after decellularization were observed by immunofluorescence staining. Human periodontal ligament stem cells were seeded onto human bone marrow cells-derived extracellular matrix, fibronectin coated 6-wel plate and normal culture plate to compare the influence of different matrix on cellmorphology and adhesion. RESULTS AND CONCLUSION:We obtained intact human bone marrow cells-derived extracellular matrix by chemical combined with physical decellularization. The structure and amount of col agen I and biglycan had not been compromised dramatical y after decellularization. Human periodontal ligament stem cells growing on the human bone marrow cells-derived extracellular matrix developed in accordance with the orbit of the extracellular matrix, differing from the original cellmorphology. There were more human periodontal ligament stem cells adhering to the extracellular matrix during the same time. These findings indicate that effective decellularization can produce intact the extracellular matrix membrane without destroying its microstructure. Extracellular matrix protein is not compromised due to decellularization. The extracellular matrix affects cellmorphology and promotes celladhesion. We can use the extracellular matrix model to simulate stem cellmicroenvironment and thereafter, acquire a large number of adult stem cells with high quality in vitro.

BACKGROUND:Human bone marrow cells-derived extracellular matrix can promote proliferation of human periodontal ligament stem cells and maintain stem cellproperties.
OBJECTIVE:To preliminarily investigate the effect of human bone marrow cells-derived extracellular matrix on the proliferation of human periodontal ligament stem cells.
METHODS:Human periodontal ligament stem cells and bone marrow cells were separately derived from human periodontal tissue and jaw bone marrow, and human bone marrow cells-derived extracellular matrix was prepared. Human periodontal ligament stem cells were cultured and purified using limited dilution cloning method, and transmission electron microscope was used for ultrastructure observation. Human periodontal ligament stem cells at passage 2 were cultured with human bone marrow cells-derived extracellular matrix and normal culture medium (control group). The cellcounting kit-8 and flow cytometry were used to determine the proliferation potential of human periodontal ligament stem cells cultured on human bone marrow cells-derived extracellular matrix.
RESULTS AND CONCLUSION:Compared with the control group, human periodontal ligament stem cells cultured on human bone marrow cells-derived extracellular matrix had a superior capacity of proliferation (P<0.05), and the cells met their morphological and biological characteristics, and grew in good conditions. Human bone marrow cells-derived extracellular matrix is a promising matrix for large-scale expanding human periodontal ligament stem cells for future use in stem cel-based therapy.

BACKGROUND:Many studies have showed that enough blood supply is an essential condition of bone repair and regeneration. OBJECTIVE:To construct the endothelial progenitor cells/bone marrow mesenchymal stem cells (EPCs/BMSCs) composite sheet. METHODS:After isolation and culture, EPCs and BMSCs were co-cultured directly to form EPCs/BMSCs sheet by cellsheet-inducing medium. After 10 days of induction, the sheet was investigated by gross observation, inverted microscope and hematoxylin-eosin staining. The distribution and communication of EPCs and BMSCs during the process of cellsheet induction were observed after the fluorescence labeling separately. Alkaline phosphatase assay and alizarin red staining were applied to examine the ability of osteogenic differentiation of EPCs/BMSCs sheet.
RESULTS AND CONCLUSION:EPCs/BMSCs sheet was harvested after 10-day induction. Cel-cellcontact between EPCs and BMSCs could be observed during the process of the cellsheet preparation. The harvested sheet was composed of multiple layers of cells and cel-produced extracellular matrix. Alkaline phosphatase assay and alizarin red staining both demonstrated that EPCs/BMSCs sheet had good osteogenic differentiation ability. These results suggested that EPCs/BMSCs sheet can be constructed successful y, and the sheet has strong osteogenic differentiation capability in vitro, providing the foundation for the repair of bone defects.

Objective To investigate the application of neurophysiological monitoring and microsurgi-eal technique in acoustic neurinoma resection, exploring the significance of neurophysiological monitoring in facial and auditory nerve reservation of acoustic neuronma microsurgery. Methods Accompanied with EMG and BAEP nerve monitoring, 113 patients harboring acoustic neuroma were treated surgically by the subocipi-tal retrosigmoid approach for reserving facial and auditory nerve. The facial nerve was stimulated to evaluate its function during late-operation. Postoperative facial and auditory nerve function were valuated in all the postop-erative following up. Results All of them were treated microsurgically via the suboccipitai retrosigmoid ap-proach. Total tumors resection was achieved in 102 cases (90.3%), subtotal resection in 6 cases(5.3%) and partial resection in 5 case (4.4%). The facial nerve was preserved anatomically in 98 cases (86.7%), the functional valuation of facial nerve according to the House-Brakman (H-B) postoperatively: 86 cases (76.1%) in class Ⅰ -Ⅱ , 12 cases(lO.6%) in class Ⅲ-Ⅳ and 15 cases (13.3%) in class Ⅴ-Ⅵ. The acoustic nerve was preserved anatomically in 40 cases (35.4%). It denoted the good function of facial nerve responsing sensi-tively to electrostimulation ≤ 4mA at the end of operation. Conclusion Assisted with the intraoperative electrophysiological monitoring techniques, it would be greatly facilitate the preservation of facial and auditory nerve in acoustic neuroma resection. Simultaneously, it would valuate the functional convalescence by late-op-erative electrostimulation in the postoperation.