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Objective This study aimed to explore the effect of peripheral blood mesenchymal stem cells combined with porous absorbable gelatin sponge/self assembling peptide composite scaffolds on SD rat femoral con-dyle bone defect reconstruction and provide a new strategy for the repair of bone defects. Methods 30 female SD rats,8W age,were randomly divided into 3 groups,10 every group.The group A was blank control group,group B was porous absorbable gelatin sponge/self assembling peptide composite scaffold group,and group C was periph-eral blood mesenchymal stem cells combined with porous absorbable gelatin sponge/self assembling peptide compos-ite scaffold group. The effect of osteogenesis was observed by paraffin section,hematoxylin eosin staining,X-ray examination,and Micro-CT scanning in 3 dimensional reconstruction of femoral condyle defect. Results Imaging examination showed that the experimental group had better osteogenesis effect. Histological examination showed that a lot of new bone tissue was found in group C,while only a small amount of new bone was found in the group of A and B. Conclusions The experiment shows that peripheral blood mesenchymal stem cells as the seed cells for tissue engineering,combined with porous absorbable gelatin sponge-self assembling peptide has better ability to repair bone defects,and has good application prospect,which is worthy of further research.
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Objective To learn the comments on the practice of "Management Regulations of Medical Institutions(Regulations below)" by those related to such Regulations. And to identify problems found in the application. Methods A questionnaire was designed by means of literature review and expert brainstorming, to learn the awareness of the respondents on the Regulations, and their comments on regional planning of medical institutions, setup approval authority, classification of medical institutions, and regulators of these institutions. A total of 1 000 questionnaires were delivered to medical institutions, health administrative authorities and patients at large 854 valid questionnaires were recovered, with the data analyzed in descriptive statistics. Results 90.7% of the respondents supported the revision of the main contents of the Regulations. 54.3% of them held that not all types of medical institutions need to be limited by regional planning; 69.1% of them held that the regulatory powers of different rankings on the business approval need to be revised; 56.9% of them held that the Regulations should clarify the legal status of other regulatory authorizes over medical institutions. The respondents also named 11 articles of the Regulations to be added. Conclusions A number of articles of the Regulations need to be revised, such as those on setup approval and classified administration, to meet administrative needs and medical institutions' development needs. In the meantime, interest relationship of health administrators, medical institutions and patients should be taken care of as well.
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Objective To explore the clinical characteristics of multidrug-resistant organisms (MDROS) and analyze the risk factors for MDROS recurrent infections in orthopedic in-patients.Methods A retrospective study was conducted of the clinical data of 296 in-patients with MDROS infection from June 2011 to August 2017.They were 216 males and 80 females with an average age of 49.9 years.Their average hospital stay was 37.2 days.Univariate analysis was conducted for items like age,hospital stay,bedridden time,concomitant internal disease (chronic obstructive pulmonary disease,chronic cardiovascular disease and diabetes),open or closed fracture,uninary catheter,use of hormone,stay in ICU,implantation material,incision grade,albumin level,hemoglobin level,reoperation,type of antibiotics and duration of antibiotics use.Multivariate logistic regression analysis was performed using SPSS 20.0 for items with significant differences.Results A total of 352 strains of pathogens were isolated,including methicillin-resistant staphylococcus aureus (26.7％),extended-spectrum β-lactamase-producing Escherichia coli (24.4％) and multidrug-resistant acinetobacter baumannii (24.1％).The pathogens were observed mostly at surgical sites (34.1％) and open wounds (23.0％).Forty-two patients reinfected the same strain after treatment.The multivariate logistic regression analysis revealed the following as the independent risk factors for MDROS recurrent infections in the orthopedic in-patients:hospital stay [OR =4.918,95％ CI (1.642,14.731),P =0.004],long bedridden time [OR=3.583,95％ CI (1.081,11.876),P=0.037],open injury [OR=2.375,95％CI (1.291,4.368),P=0.005],diabetes [OR=6.360,95％ CI (2.112,19.149),P=0.001],and chronic obstructive pulmonary disease [OR=4.170,95％ CI (1.419,12.251),P=0.009].Conclusions To prevent recurrent MDROS infections in orthopedic patients,surgeons should shorten unnecessary hospital stay,encourage ambulation as early as possible,effectively control blood sugar and actively treat concomitant internal diseases in addition to regular use of antibiotics.
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Although medical damage risks really exist, an effective medical risk sharing system is still not available in China right now. By analyzing the status quo of Chinese medical damage risks sharing system, the authors put forward the following suggestions to improve the current system: Upgrading the preventive strategy for medical disputes, establishing multi-level and multi-channel comprehensive medical damage risks sharing system, promoting the effective cooperation between insurance relief systems and mediation system for medical disputes, and constructing highly effective pathways to resolve the medical disputes.