Objective:To conduct reliability and validity test of Chinese versions of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire so as to evaluate whether they are applicable to the current situation of medical teamwork in China.Methods:From January to April 2019, the Chinese versions of TeamSTEPPS teamwork perceptions questionnaire and TeamSTEPPS teamwork attitudes questionnaire were used to evaluate 900 emergency department workers in 9 ClassⅢGrade A hospitals in Shanghai by cluster sampling, and reliability and validity of the questionnaires were analyzed and evaluated. In this study, a total of 900 questionnaires were issued, 870 were recovered and 861 were valid, with an effective recovery rate of 96%.Results:The exploratory factor analysis of the Chinese versions of Chinese versions of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire was carried out to extract the five dimensions of team structure, leadership, situation monitoring, mutual assistance and communication. The cumulative variance contribution rates were respectively 71.248% and 71.010%. In addition, a confirmatory factor analysis was performed on the questionnaires. The Chi-square degrees of freedom ratio (χ 2/ df) values were 2.870 and 2.214, normed fitting index ( NFI) values were 0.861 and 0.906, Tucker-Lewis index values were 0.896 and 0.940, incremental fit index ( IFI) values were 0.905 and 0.946, comparative fit index (CFI) values were 0.904 and 0.946, and root mean square error of approximation ( RMSEA) values were 0.066 and 0.053. The fitting values all reached the judgment standard, and the structural validity of the two questionnaires was good. The content validity indexes were good and they were respectively 0.94 and 0.95. The overall Cronbach's α coefficients of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire were respectively 0.949 and 0.938, the split-half reliability was respectively 0.848 and 0.959, and the test retest reliability were respectively 0.959 and 0.964. Conclusions:The Chinese versions of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire have good reliability and validity and high applicability, which can be used to measure the attitude and perceptions of medical teamwork in China.

Objective:To investigate the clinical effect of bridging fixation with locking plate for the Seinsheimer type V subtrochanteric femoral fracture. Methods:From March 2009 to September 2014,18 cases of Seinsheimer type V sub-trochanteric femoral fracture were treated by open reduction and bridging fixation with locking plate through proximal and distal approach including 16 males and 2 females with an average age of 41 years old ranging from 22 to 67 years old. Among them , 12 cases caused by traffic accident,5 cases by falling,1 case by heavy aboving. All cases were fresh and closed fractures. Time between injury and operation was from 4 to 9 days with an average of 6.2 days. Of them ,11 cases were fixed with reverse LISS and the other 7 cases were fixed with anatomical locking plates of proximal femur. Results:The mean time of operation was 110 min (ranged from 90 to 155 min). The mean blood loss during operation was 425 ml (ranged from 350 to 650 ml) and 16 cases got blood transfusion which was meanly 300 ml. The mean hospital time was 14 days (ranged from 12 to 18 days). The mean duration of followed up was 11.8 months (ranged from 8 to 22 months). The mean time of bone union was 6.6 months (ranged from 5 to 8 months). There was not any complication such as infection,implant failure,hip varus,external rotation deformity of low limb or fat embolism. The Sanders hip scores were 53.22±6.48,the result was excellent in 12 cases and good in 6 cases at the last follow up. Conclusion:Under the principle of biological osteosynthesis ,treatment of Seinsheimer type V sub-trochanteric femoral fracture with bridging locking plate fixation has such advantages as high mechanism ,less interference of blood supply,stable fixation and little complication. It is a safe and idea way for the treatment of the Seinsheimer type V sub-trochanteric femoral fracture.

OBJECTIVETo investigate the role of human Wnt7b gene in rat chondrocyte degeneration.

METHODSWnt7b gene obtained by PCR was cloned to PCDH-GFP. 293ft cell line was transfected with PCDH-GFP and PCDH-Wnt7b, and the supernatant and transfected cells were collected. The expression level of Wnt7b in 293ft cells was detected by Western blotting. The first passage of chondrocytes were isolated from articular cartilages of newborn born (within 24 h) SD rats were cultured in the supernatants from the transfected cells (at 10- and 50-fold dilutions). The cell morphology of the rat chondrocytes was observed under inverted microscope, and the protein expressions of MMP13, MMP3 and type II collagen and mRNA expressions of A-can, ADAMTS5, Col X and Sox9 were examined by Western blotting or real-time PCR.

RESULTSHuman Wnt7b gene cloned to PCDH-GFP was expressed efficiently in 293ft cell line. Rat chndrocytes cultured for 24 h in the supernatants from PCDH-Wnt7b-transfected 293ft cells underwent changes from a polygonal to a spindle-shaped morphology. The protein expression levels of MMP13 and MMP3 increased while type II collagen decreased significantly, and the mRNA levels of A-can and Sox9 were down-regulated while Col X and ADMATS5 up-regulated in ratchondrocytes after incubation in supernatants from PCDH-Wnt7b-transfected 293ft cells.

CONCLUSIONHuman Wnt7b gene can be expressed efficiently in 293ft cell line and can induce rat chondrocyte degeneration in vitro.

Animals ; Cartilage, Articular ; cytology ; Cell Line ; Chondrocytes ; pathology ; Humans ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Transfection ; Wnt Proteins ; genetics

Objective To investigate the role of human Wnt7b gene in rat chondrocyte degeneration. Methods Wnt7b gene obtained by PCR was cloned to PCDH-GFP. 293ft cell line was transfected with PCDH-GFP and PCDH-Wnt7b, and the supernatant and transfected cells were collected. The expression level of Wnt7b in 293ft cells was detected by Western blotting. The first passage of chondrocytes were isolated from articular cartilages of newborn born (within 24 h) SD rats were cultured in the supernatants from the transfected cells (at 10-and 50-fold dilutions). The cell morphology of the rat chondrocytes was observed under inverted microscope, and the protein expressions of MMP13, MMP3 and type II collagen and mRNA expressions of A-can, ADAMTS5, Col X and Sox9 were examined by Western blotting or real-time PCR. Results Human Wnt7b gene cloned to PCDH-GFP was expressed efficiently in 293ft cell line. Rat chndrocytes cultured for 24 h in the supernatants from PCDH-Wnt7b-transfected 293ft cells underwent changes from a polygonal to a spindle-shaped morphology. The protein expression levels of MMP13 and MMP3 increased while type II collagen decreased significantly, and the mRNA levels of A-can and Sox9 were down-regulated while Col X and ADMATS5 up-regulated in ratchondrocytes after incubation in supernatants from PCDH-Wnt7b-transfected 293ft cells. Conclusion Human Wnt7b gene can be expressed efficiently in 293ft cell line and can induce rat chondrocyte degeneration in vitro.

Objective To investigate the role of human Wnt7b gene in rat chondrocyte degeneration. Methods Wnt7b gene obtained by PCR was cloned to PCDH-GFP. 293ft cell line was transfected with PCDH-GFP and PCDH-Wnt7b, and the supernatant and transfected cells were collected. The expression level of Wnt7b in 293ft cells was detected by Western blotting. The first passage of chondrocytes were isolated from articular cartilages of newborn born (within 24 h) SD rats were cultured in the supernatants from the transfected cells (at 10-and 50-fold dilutions). The cell morphology of the rat chondrocytes was observed under inverted microscope, and the protein expressions of MMP13, MMP3 and type II collagen and mRNA expressions of A-can, ADAMTS5, Col X and Sox9 were examined by Western blotting or real-time PCR. Results Human Wnt7b gene cloned to PCDH-GFP was expressed efficiently in 293ft cell line. Rat chndrocytes cultured for 24 h in the supernatants from PCDH-Wnt7b-transfected 293ft cells underwent changes from a polygonal to a spindle-shaped morphology. The protein expression levels of MMP13 and MMP3 increased while type II collagen decreased significantly, and the mRNA levels of A-can and Sox9 were down-regulated while Col X and ADMATS5 up-regulated in ratchondrocytes after incubation in supernatants from PCDH-Wnt7b-transfected 293ft cells. Conclusion Human Wnt7b gene can be expressed efficiently in 293ft cell line and can induce rat chondrocyte degeneration in vitro.

A comprehensive, geometrically accurate, nonlinear C0-T1 three-dimensional finite element (FE) model was developed for the biomechanical study of human cervical spine and related disorders. The model was developed with anatomic detail from the computed tomography (CT) images of a 46-year-old female healthy volunteer, and applied the finite element model processing softwares such as MIMICS13.1, Hypermesh11.0, Abaqus 6.12-1, etc., for developing, preprocessing, calculating and analysing sequentially. The stress concentration region and the range of motion (ROM) of each vertebral level under axial rotation, flexion, extension, and lateral bending under physiologic static loadings were observed and recorded. The model was proven reliable, which was validated with the range of motion in previous published literatures. The model predicted the front and side parts of the foramen magnum and contralateral pedicle and facet was the stress concentration region under physiological loads of the upper spine and the lower spine, respectively. The development of this comprehensive, geometrically accurate, nonlinear cervical spine FE model could provide an ideal platform for theoretical biomechanical study of human cervical spine and related disorders.
Biomechanical Phenomena ; Cervical Vertebrae ; Female ; Finite Element Analysis ; Humans ; Middle Aged ; Models, Biological ; Range of Motion, Articular ; Rotation

BACKGROUND:Bisphosphonates that can increase bone density and inhibit bone resorption have been clinical y confirmed, but the structure of the bone matrix has been less studied.
OBJECTIVE:To observe the effects of alendronate on bone structure and bone matrix metabolism, and then to investigate the control ing mechanism by which alendronate improves bone mass and increase bone intensity.
METHODS:An ovariectomized rat model was prepared and intervened with alendronate as treatment group. Model and sham-surgery groups were set as controls. Alendronate effects on bone mineral density, bone metabolism, bone biomechanics, and bone structure were observed in bone loss rats using bone imaging, bone tissue pathology and biomechanical test and enzyme-linked immunosorbent assay.
RESULTS AND CONCLUSION:Alendronate intervention could fight against bone loss as compared with model group at weeks 4, 8, and 12 after treatment (P<0.05). Compared with the model group, the expression of urinary deoxypyridinoline and serum carboxyterminal propeptide of type Ⅰ procol agen was decreased significantly after alendronate intervention (P<0.05);the maximal load, maximal pressure and modelus on the lumbar vertebrae and femur were increased as wel as ratio of urinary pyridinoline/deoxypyridinoline of type Ⅰ procol agen (P<0.05). These findings suggest that alendronate intervention can inhibit bone loss in rats induced by estrogen deficiency, increase biomechanical properties, improve bone matrix structure, and meanwhile, recover the Ⅰ col agen crosslinking component due to ovariectomy.

Objective To study the levels of Matrix Metalloproteinase-3 (MMP-3) and interleukin (IL-1) in the synovial fluid and plasma of C57 black mice with osteoarthritis (OA) and their relationships with the severity of pathological changes so as to investigate their effects and correlation with OA. Methods The C57 black mice with OA were enrolled for this study. Different levels of exercise were appicated based on their age. Knee joint pathological changes were examined for pathological severity of OA. ELISA sandwich method was used to measure the levels of MMP-3 and IL-1 in serum and synovial fluid. Correlation analysis was performed to demonstrate the relationship between the levels of MMP-3 and IL-1 in the serum and synovial fluid, and the pathological severity of OA. Results ①Morphological observations: C57 black mice were characterized by spontaneously developing OA and the incidence and the severity of osteoarthritis gradually increased with age and exercising burdens. ② The level of MMP-3 and IL-1 in the synovial fluid of exercising mice MMP-3 (84±6) ng/ml, IL-1 (48±3) ng/ml was higher than that in the aged ones [MMP-3 (84±6) ng/ml, IL-1 (71±5) ng/ml J, the difference was significant (P<0.01). The level of MMP-3 and IL-1 level in the serum had a linear correlation with that of the synovial fluid. At the same time, they also had linear correlation with the pathological severity of OA (All r>0.67, and all P<0.01). Conclusion The levels of MMP-3 and IL-1 in serum and synovial fluid can help to make early diagnosis of OA, especially elevated MMP-3 level.

Objective To compare the effect of glucosamine (Virtral-s) on the cartilage oligomeric matrix protein (COMP) secretion of chondrocytes and synoviocytes in vitro.Methods Chondrocytes and synoviocytes isolated from knee cartilage of osteoarthritic patients were cultured by phased enzymatic digestion.Sera containing Virtral-s of the experimental animals were obtained after orally administrated Virtral-s at the dosages that equal to human.Cells were cultured in the medium with Virtral-s containing sera.Super-natant COMP level was tested by enzyme-linked immunoabsorbent assays (ELISA).Results COMP conceu-tration of synoviocytes cultured in vitro was significantly higher than that of chondrocytes (P＜0.05).Virtral-s could significantly increase COMP secretion in cultured chondrocytes in vitro (P＜0.05),however,it had a weaker role on synoviocytes,ie,it could only mildly reduce COMP secretion of synoviocytes.Conclusion Glucosamine (Virtral-s)-containing serum can promote COMP secretion of chondrocytes in vitro,and it has no significant effect on synoviocytes in vitro.

Objective To observe the expression of core-binding factor ?1 (Cbf?1) in aging osteoblast, and try to provide new mechanisms of Chinese medicine on bone formation. Methods Rat osteoblast from different age donors (6 months and 16 months) were isolated and cultured by the tissue-fragment-migrating-growth method. The biological characteristic was observed by phase-contrast microscope and identified with mineralizing nodule staining. The expression of Cbf?1 was examined by RT-PCR and immunohistochemistry. Results RT-PCR and immunohistochemistry showed that the expression of Cbf?1 was upregulated by Gubenzhuanggu and Jinkuishenqi, and downregulated by Zhibaidihuang in aging osteoblast, but the effect was different on the Cbf?1 expression in Bushenyijing. Conclusion Buyang Chinese medicine among Bushen Chinese medicine promoted bone formation.