Comparative study with the effect of stromal cell derived factor-1 on osteogenic differentiation of human healthy and inflammatory periodontal ligament stem cells / 华西口腔医学杂志

OBJECTIVE@#This study aims to compare the osteogenic differentiation capability of stem cells derived from human inflammatory periodontal ligament tissues (iPDLSCs) with those of stem cells derived from healthy periodontal ligament tissues (hPDLSCs). Both types of tissues were induced by stromal cell derived factor (SDF-1) in vitro.@*METHODS@#iPDLSCs and hPDLSCs were primarily cultured by tissue digestion method and purified by limited dilution cloning. The cells were passaged and identified by stem cell surface marker expression through flow cytometry. Then, we used thiazolyl blue tetrazolium bromide to detect and compare the proliferation capabilities of the iPDLSCs and hPDLSCs. Express of bone volumes were detected by alizarin red staining after SDF-1 was added to the cells. Using alkaline phosphatase, we evaluated the osteogenic differentiation capability of the cells induced by SDF-1. The expression levels of the osteogenesis-related genes of the cells induced by SDF-1 were determined by reverse transcription-polymerase chain reaction.@*RESULTS@#After purification, both iPDLSCs and hPDLSCs expressed stem cell markers. hPDLCSs had a higher proliferation capability than iPDLSCs. Osteogenesis-related genes had higher expression levels in the cells induced by SDF-1 than in those without induction (P<0.05). SDF-1 at 50 and 200 ng·mL⁻¹ concentration greatly affected the differen-tiation capabilities of iPDLSCs and hPDLSCs respectively.@*CONCLUSIONS@#iPDLSCs and hPDLSCs had osteogenic differentia-tion capability. The level of osteogenic differentiation in normal and inflamed periodontal ligament stem cells increases after SDF-1 induction.

Analysis of risk factors for spontaneous rupture of hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the risk factors for spontaneous rupture of hepatocellular carcinoma (SRHC).</p><p><b>METHODS</b>A retrospective analysis of 34 consecutive patients with SRHC treated by emergency interventional embolization in our hospital from July 2003 to July 2011 was conducted. General condition, laboratory examination and imaging data were analyzed, and compared with the data of 34 patients with primary hepatocellular carcinoma but without rupture, randomly selected from 215 concurrent patients. The patients with SRHC were selected for risk factor analysis, and the non-SRHC patients were taken as control group.</p><p><b>RESULTS</b>No significant difference between the SRHC group and control group was found in age, sex, Child-Turcotte-Pugh (CTP) grade, Barcelona clinic liver cancer (BCLC) stage, HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), glucose (GLU), cirrhosis, portal tumor thrombus, the maximum diameter of tumor, location, and cholecystitis or cholelithiasis. The univariate analysis showed that activated partial thromboplastin time (APTT), lower or normal plasma fibrinogen (FIB) level, alpha fetoprotein (AFP), tumor protrusion > 1 cm above the liver surface were all associated with increased risk of SRHC (P < 0.05). Multivariate analysis only showed that lower or normal level of FIB (P = 0.033) and tumor protrusion > 1 cm above the liver surface (P = 0.041) were significant independent risk factors for SRHC.</p><p><b>CONCLUSION</b>Lower or normal level of FIB and tumor protrusion > 1 cm above the liver surface are significant independent risk factors for spontaneous rupture of hepatocellular carcinoma.</p>

Multi-center clinical study on the treatment of the low-middle frequency sudden hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate and compare the short-term outcome of patients with low-middle frequency sudden deafness treated with alone or combination treatment.</p><p><b>METHODS</b>From August 2007 to October 2011, 205 patients with the diagnosis of low-middle frequency sudden deafness who were from 33 different clinical centers were recruited. All patients were followed up for four weeks from the initial examination. Patients were treated with steroid , Ginaton, batroxobin respectively, or Ginaton and steroid combination treatment.</p><p><b>RESULTS</b>The total effective rate was 90.73%. In Ginaton group, the total effective rate was 87.27%, 89.19% in steroid group, 87.80% in batroxobin group, and 95.83% in Ginaton and steroid group. Considering the total effective rate, there was no statistical difference between four groups (χ(2) = 7.98, P = 0.54). The clinical cure rate for steroid alone was 81.01%, Ginaton alone 76.36%, batroxobin alone 68.29%, and Ginaton and steroid combination treatment 80.56%. There were no clinically significant differences between the different treatments (P > 0.05).</p><p><b>CONCLUSIONS</b>The low-middle frequency sudden deafness tends to have a relatively favorable prognosis. The steroid played a good effect in the treatment. But different treatments either improving the microcirculation of inner ear or alleviating edema blood has undifferentiated results. Therefore the combination therapy may be more effective.</p>

Controlled clinical trials on different surgical methods for the treatment of acromioclavicular dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical effects of clavicular hook plate fixation, coracoid transplantation, and clavicular hook plate fixation combined with modified dynamic muscle transfer for the treatment of the complete acromioclavicular dislocation.</p><p><b>METHODS</b>From January 2006 to November 2009, 65 patients with sustained complete acrominoclavicular dislocation were treated with clavicular hook plate fixation, coracoid transplantation,and clavicular hook plate fixation combined with modified dynamic muscle transfer. All the patients were divided into three groups: 22 patients in group A were treated with clavicular hook plate fixation, including 17 males and 5 females, with an average age of (31.0 +/- 10.0) years; 21 patient in group B were treated with coracoid transplantation, including 16 males and 5 females,with an average age of (33.0 +/- 6.4) years; 22 patients in group C were treated with clavicular hook plate fixation combined with modified dynamic muscle transfer,including 18 males and 4 females, with an average age of (30.0 +/- 5.3) years. Postoperative functional recovery was evaluated by Karlsson criteria.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from half to three years (averaged 1.5 years). In group A, 8 patients got half re-dislocation, 2 patients got complete re-dislocation and arthritis of acromioclavicular joint after internal fixations removal, 1 patient had clavicular hook plate broken after operation. In group B, 7 patients got half re-dislocation, 1 patient got complete re-dislocation,and 5 patients had arthritis of acromioclavicular joint with acute pain and limited shoulder function after internal fixations removal. In group C,2 patients got half re-dislocation, no complete re-dislocation and arthritis of acromioclavicular joint occurred after internal fixations removal. According to Karlsson evaluation, in group A, 12 patients obtained an excellent result, 8 good and 2 poor; in group B, the data were 9, 7 and 5 respectively; in group C, they were 20, 2 and 0 respectively. There were remarkable differences of therapeutic effects between the clavicular hook plate fixation combined with modified dynamic muscle transfer and that with either of the former two treatment methods (P < 0.05).</p><p><b>CONCLUSION</b>Clavicular hook plate combined with modified dynamic muscle transfer is a reliable and good treatment for the complete acrominoclavicular dislocation, with advantages such as easy to handle,stable fixation and early exercise.</p>

Otoendoscopic treatment of hidden lesions in otomastoiditis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Surgical treatments for chronic suppurative and cholesteatoma otitis media have been discussed for several decades, but recurrences still occur because of the complex dissection required and hidden lesions associated with otomastoiditis. This study investigated the technology and strategy behind the use of otoendoscopic-assisted otosurgery.</p><p><b>METHODS</b>We reported on hidden lesions in 32 ears of patients with otomastoiditis between November 2006 and January 2009. All the patients were treated with the aid of an otoendoscope. The advantages of otoendoscopy, including multi-angle light scattering, aperture illumination, and magnification of the local operative field, were utilized in otologic microsurgery, and otoendoscopic operative techniques were introduced for operative sites such as the epitympanum, aditus of the antrum, facial recess, sinus tympani and the mastoid tip.</p><p><b>RESULTS</b>All patients were followed up from 3 months to 2 years after surgery. All patients recovered well within 3 months following surgery, except for one case of epithelialization of the mastoid cavity occurring 6 months after surgery for cholesteatoma on the cerebellar surface and another case with Bezold's abscess, hyperplastic granulation tissue developed at the antrum.</p><p><b>CONCLUSIONS</b>Otoendoscopy can overcome the technical deficiency of rectilinearity of the visual axis associated with otomicroscopic illumination, which presents a problem when dealing with otomastoiditis lesions in hidden areas. This technique allows such lesions within the complex three-dimensional structure to be visualized and cleaned. Otoendoscopy thus has significant potential for improving the quality of surgery and reducing the risk of postoperative recurrence.</p>

Application of facial recess approach in intact-bridge tympanomastoidectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To introduce and evaluate the application of facial recess approach in modified intact-bridge tympanomastoidectomy (IBM) procedures for cholesteatoma otitis media and improve the surgery results and living quality of patients following the operation of tympanomastoidectomy.</p><p><b>METHODS</b>Sixty-five cases of tympanomastoidectomy for cholesteatoma otitis media followed for more than 3 years between 2000 - 2003 were retrospective analyzed. The long-term results of recurrence and hearing level of IBM were discussed.</p><p><b>RESULTS</b>In total sixty-five ears received modified IBM, there were sixty ears improved hearing level (threshold improved > 10 dB), and the pure-tone average threshold improved by (18.5 +/- 7.3) dB after operation and the dry ear was obtained in 60 cases (95%).</p><p><b>CONCLUSIONS</b>With the modified IBM technique, cholesteatoma could be completely and safely removed from the middle ear, and a durable reconstruction of the middle ear with reasonable hearing could be achieved. Therefore, the modified IBM technique was a reasonable choice for the surgical treatment of cholesteatoma otitis media.</p>

Surgical strategy for treatment of cholesteatoma otitis media / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the otologic surgical procedures for cholesteatoma otitis media and improve the surgery results and living quality of patients following the operation of tympanomastoidectomy.</p><p><b>METHODS</b>Two hundreds and sixty-six cases (269 ears) of tympanomastoidectomy for cholesteatoma otitis media followed up for more than 3 years between 1994 to 2003 were analyzed retrospectively. The long-term results of recurrence and hearing level was discussed on the procedure of canal wall up (CWU), canal wall down (CWD) and modified intact-bridge tympanomastoidectomy (IBM).</p><p><b>RESULTS</b>On the contrast of improved hearing level, there were not significant difference between CWU group and CWD group (F = 3.686, P>0.05), but the results of IBM group was significantly better than others (F = 125.167 and 59.438, P <0.05). On the contrast of duration of getting dry ear, IBM and CWU groups [(5.0 +/- 1.9) weeks and (6.0 +/- 1.6) weeks respectively] were significantly shorter than CWD group [(9.0 +/- 2.8) weeks; F = 56.32 and 30.639, P <0.05]. As the recurrence rate, IBM group and CWD group were significantly lower than CWU group (CWU: 24.6%; CWD: 6.0%; IBM: 7.0%) chi2 = 6.162 and 6.007, P < 0.05).</p><p><b>CONCLUSIONS</b>With the modified IBM technique, cholesteatoma could be removed completely and safely from the middle ear and a reasonable reconstruction of middle ear with approved hearing level could be achieved. The surgical procedure usually began with CWU and should be change according to the pathological founding of middle ear during operation. Modified IBM was a valuable choice for the surgical treatment of cholesteatoma otitis media.</p>