Research methods and progress of gradient multiphase scaffold materials promoting rotator cuff tenon-bone interface repair and regeneration / 中华骨科杂志

Regeneration of rotator cuff tendon-bone interface is crucial in rotator cuff repair. The tendon-bone interface consists of four continuous and gradual regions: the tendon region, the unmineralized fibrocartilage region, the mineralized fibrocartilage region, and the bone region. The development and regeneration of various regions in the tendon-bone interface is regulated by growth factors, inorganic ions, mechanical stimulation, and hypoxic environment. Inspired by factors affecting the development and regeneration of the tendon-bone interface, many researchers have designed gradient scaffold systems that promote regionalized regeneration of the tendon-bone interface. The gradient distribution of these scaffolds includes inorganic ion gradients and growth factor gradients. According to different gradients of the scaffold system, osteogenesis, chondrogenesis and tendon differentiation of cells at the tendon-bone interface are promoted, and the healing of the tendon-bone is synchronously completed to realize the repair and regeneration of the rotator cuff tendon-bone interface. Current studies indicated that gradient multiphase scaffolds had high academic research value and guided significance for future clinical applications in the reconstruction of the tendon-bone interface. In this paper, the factors affecting the development and regeneration of the tendon-bone interface are reviewed, and the effects of these factors on osteogenesis, chondrogenesis and tendon formation of various regions in promoting rotator cuff tendon-bone interface repair are summarized. The properties and effects of reported gradient multiphase scaffolds for rotator cuff injury are discussed, including gradient scaffolds containing inorganic ions and growth factors. Finally, the problems and future development opportunities of gradient multiphase support in rotator cuff repair are summarized.

Sexual orientation and characteristics of sexual behaviors among 200 HIV positive male college students in Beijing / 中国学校卫生

Objective@#To understand sexual orientation and characteristics of sexual behaviors related with HIV infection among HIV positive male college students in Beijing and to provide suggestions for development of sexual health education and HIV prevention strategy for student population.@*Methods@#HIV positive male college students diagnosed from 2016 to June 30, 2019 in Beijing were recruited. Questionnaire was used to retrospectively investigate sexual orientation and characteristics of sexual behaviors before HIV infection. Behaviors related to HIV infection were compared between absolutely homosexual and others sexual orientation.@*Results@#The average age of male students firstly identified to be HIV positive was (22.18±2.70) years old, 61.5%(123) of them were undergraduate, 69.5%(139) were not registered permanent residency in Beijing, 38.5%(77) of their interviewed sexual partners were from online chat and 83.0%(166) had homosexual behaviors. Sexual orientation score analysis showed that 50.0% of the participants self identified as exclusively homosexual. Compared with other sexual oriental group, exclusively homosexual group had lower mean age of their HIV infection firstly identified（ t =2.77， P =0.01）, higher rate of Rush use, firstly insertive sexual behavior with male, firstly insertive sexual behavior before 18 years old, sexual partners more than three persons, having regular partners, nonpersistent use of condom, being diagnosed of sexual transmitted disease and the frequency of homosexual behaviors more than 1 time per month （ χ 2=5.15,28.06,4.16,5.34,5.89,7.39,6.68, P <0.05）. Rush users had higher rate of STD diagnosis than non users in exclusively homosexual group ( χ 2=6.26， P =0.01).@*Conclusion@#Risky sexual behaviors associated with HIV infection were higher in exclusively homosexual group then other sexual orientation groups among HIV positive male college students. Family and school should concern with sexual health education byreinforcing health education via network media to improve college students’ awarenees on HIV/AIDS.

Observation of Short-term and Long-term Efficacy of Bronchoscopic Interventional Therapy in the Treatment of Typical Carcinoid / 中国肺癌杂志

BACKGROUND@#The curative potential of various bronchoscopic treatments such as electric snare, carbon dioxide freezing, argon plasma coagulation (APC), Neudymium-dopted Yttrium Aluminium Garnet (Nd:YAG) laser and photodynamic therapy (PDT) for the treatment of intraluminal tumor has been administered previously, but this regimen is not common in the treatment of typical carcinoid. The aim of this study is to investigate the curative effects both in short-term and long-term of interventional bronchoscopy in the treatment of typical carcinoid.@*METHODS@#We retrospectively reviewed the clinical data of typical carcinoid patients who were treated with interventional bronchoscopy for tumor suppression and they were hospitalized in the Emergency General Hospital from December 2010 to December 2020, and Wilcoxon rank sum test and chi-square test were used for analysis.@*RESULTS@#A total of 32 patients were included, including 18 cases of preoperative bronchial artery embolization (embolization rate 56%, 95%CI: 31%-79%). The grade score of dyspnea decreased from before treatment to after treatment, and the difference was statistically significant [(1.44±1.03) score vs (0.25±0.58) score, P=0.003]; The degree of bronchial stenosis decreased from pre-treatment to post-treatment, and the difference was statistically significant [(87.50%±13.90%) vs (17.50%±6.83%), P<0.001]; There was significant difference in bronchial diameter before and after treatment [(0.14±0.18) cm vs (0.84±0.29) cm, P<0.001].@*CONCLUSIONS@#Bronchoscopic interventional therapy has significant short-term and long-term effects in the treatment of typical carcinoid.

Study on mechanical ventilation pressure under continuous cuff pressure monitoring in critical patients / 中华危重病急救医学

Objective:To explore the effective pressure range under continuous cuff pressure monitoring in critical patients with mechanical ventilation, so as to achieve the goal of ensuring ventilation quality and reducing mucosal injury without increasing the incidence of endotracheal catheter displacement and aspiration.Methods:Ninety critically ill patients with non-pulmonary diseases admitted to the department of intensive care unit (ICU) of Airport Hospital of Tianjin Medical University from June 2017 to June 2019 were enrolled, and divided into three groups according to the random number table, with 30 patients in each group. For all patients in the three groups , the head of the bed was raised by 30°and the balloon was measured continuously. Cuff pressure in the three groups were maintained at 20, 25 and 30 cmH 2O (1 cmH 2O = 0.098 kPa) respectively. The patient's air leakage, oxygen saturation, tracheal tube displacement of each group were recorded every hour when the patients were calm. Fiberbronchoscope was used to aspirate sputum during extubation to check for mucosal damage. Chest X-ray examination was used to evaluate pulmonary infection and sputum bacteria culture examination was conducted at the same time. Results:There was no significant difference in gender, age and critical condition among the three groups. The number of patients with airway mucosal injury in the 30 cmH 2O group was significantly higher than that in the 20 cmH 2O group (cases: 8 vs. 4, P < 0.05). There was no significant difference in airway mucosal injury between Group 20 cmH 2O and Group 25, Group 25 cmH 2O and Group 30 cmH 2O. When the balloon pressure was 20, 25, and 30 cmH 2O, there was no significant difference in air bag leakage (cases: 14, 10, 12), trachea catheter displacement (cases: 18, 11, 16), ventilator-associated pneumonia (cases: 3, 4, 3), all P > 0.05, and there was no significant difference in mechanical ventilation time and the hospitalization time [mechanical ventilation time (hours): 77.07±65.34, 80.80±70.20, 77.60±65.23; the length of ICU stay (days): 5.70±3.74, 5.30±4.57, 6.23±3.51, all P > 0.05]. Conclusion:The cuff pressure of 20 cmH 2O will not increase the mechanical ventilation time and hospitalization time of patients, while 20 cmH 2O is much safer in airway mucosal injury.

Research progress in hydrogel and their role in nerve regeneration / 国际生物医学工程杂志

Hydrogel is a kind of three-dimensional matrix scaffold material with chemical or physical cross-linked structure, with high moisture retention and high water absorption, but insoluble in water. Because of its good biocompatibility and the ability to imitate the natural cytoplasmic matrix, hydrogel has broad practical significance and application prospects in the fields of tissue engineering and biomedicine. Nerve tissue engineering is a fast-growing field that is expected to address severe neurological diseases. Choosing the right matrix scaffold material to promote neural cell differentiation and axon growth is critical to the overall design of nerve tissue engineering. Hydrogels have been widely used to deliver neurotrophic factors, antagonists of nerve growth inhibitors and other neural growth-promoting agents to tissues to improve the difficult regeneration of the nervous system, and have proven to be excellent matrix scaffold materials for neural tissue engineering. In this review paper, a variety of hydrogel systems that have been applied to neuro-related research were classified and discussed, and their advantages and disadvantages were analyzed. The prospects and challenges of hydrogels in neural tissue engineering were also discussed.

Animal experimental study on the examination of upper digestive tract with medical disposable portable endoscopy / 中华消化杂志

Objective:To evaluate the safety, feasibility and operational performance of self-developed medical disposable portable endoscopy (YunSendo) for upper gastrointestinal endoscopy examination in Ba-Ma mini-pigs.Methods:A total of 10 Guangxi Ba-Ma mini-pigs were used in the experiment, and mucosal injury models were established in advance by biopsy forceps in esophagus, stomach, and duodenum. Each experimental animal underwent medical disposable portable endoscopy and Olympus endoscopy (GIF-Q260J) performed by two endoscopists separately. The time when the endoscope reached the duodenum, the number of detected mucosal injuries and endoscopic pictures of different parts with standard image acquisition were recorded. Endoscopic operational performance and endoscopic image quality were evaluated. Different endoscopists recorded experimental results with blind method. The procedures of the two endoscopic examinations were performed by coin-tossing method. The paired t test was used for statistical analysis. Results:There were no statistically significant differences in the insertion time and total operation time between medical disposable portable endoscopy and Olympus endoscopy ( (171.00±9.96) s vs. (164.00±17.84) s, (285.00±33.94) s vs. (273.40±23.46) s; t=1.289 and 1.281, P=0.230 and 0.232). There were no statistically significant differences in the percentage of time of clear visual field during endoscopy insertion and total operation between medical disposable portable endoscopy and Olympus endoscopy ((91.83±1.85)% vs. (91.52±1.51)%, (93.07±3.10)% vs. (92.06±2.57)%; t=0.401 and 0.689, P=0.698 and 0.508). Moreover, there were no statistically significant differences in the score of comprehensive operation performance, score of clear image number, score of image color recognition, score of image illumination, comprehensive score of image quality and number of detected mucosal injuries ((9.66±0.30) points vs. (9.86±0.15) points, (39.50±0.71) points vs. (39.30±1.06) points, (39.70±0.48) points vs. (39.40±0.70) points, (39.40±0.70) points vs. (39.50±0.71) points, (9.88±0.09) points vs. (9.85±0.20) points, 9.80±0.42 vs. 9.90±0.32; t=2.176, 1.000, 1.152, 0.317, 0.629 and 0.557, all P>0.05). There were no adverse events after operation in medical disposable portable endoscopy group and Olympus endoscopy group. Conclusions:The medical disposable portable endoscopy is safe and feasible for endoscopy examination in live animal models. Different parts of upper gastrointestinal tract and mucosal lesions can be clearly detected. The operational performance and the image quality are excellent, which is similar to Olympus endoscopy (GIF-Q260J).

Application of early goal-directed sedation with bispectral index in sedation management of severe patients in ICU / 中国医师杂志

Objective The bispectral index (BIS) was introduced into the sedation strategy of critical patients in intensive care unit (ICU) and replaced the Richmond agitation sedation scale (RASS).The ventilation time,ICU length of stay,and 90-day mortality were compared between the two groups of patients who performed early goal-directed sedation (EGDS) or standard traditional directed sedation (STDS) strategies.Methods A prospective controlled study of severe patients with mechanical ventilation ≥48 h in ICU (20 cases from April 2016 to May 2017,46 cases from June 2017 to April 2018) were randomly divided into EGDS or STDS group.There were no significant differences in age,gender,and acute physiology and chronic health evaluation score Ⅱ (APACHE Ⅱ) score between the two groups in the two periods.The correlation between RASS and BIS was analyzed in the first period.The BIS of the patients in a RASS range of (-2-1) was 73.65 ± 7.87 in the EGDS group,and that of RASS range of (-3--1) was 64.14 ± 7.25 in the STDS group.The above BIS was applied to the two sedation strategies in the second period respectively.The ventilation time,ICU length of stay,and 90-day mortality were recorded.Results There was no significant difference in the ventilation time between the two groups [(164.12 ± 137.96) h and (155.33 ±64.86)h,P =0.08].ICU length of stay of the EGDS group was longer than that of the STDS group.The 90-day mortality of the EGDS group was higher than that of the STDS group.Conclusions Correlations between RASS and BIS were found in this study,and BIS can be used for sedation assessment in ICU patients.Large sample study is still needed to compare EGDS and STDS with BIS.

Animal study on master-slave system controlled robot-assisted flexible endoscopy in gastricendoscopy examination / 中华消化杂志

Objective@#To evaluate the safety, feasibility and operational effectiveness of master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ in upper gastrointestinal endoscopy examination in living pigs. @*Methods@#Seven Guangxi BA-MA Mini-pigs underwent upper gastrointestinal endoscopy examination with master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ and Olympus GIF-Q260J gastroendoscope (Japan). The experiment divided into manual operation group and robot operation group. Nine gastroenterologists skilled with endoscopy operation handled the robot once in vitro to familiar with the mechanism and method of robot operation. And then performed manual operation and robot operation four times each. Endoscopy pictures and operation time were recorded. T test and one-way analysis of variance were performed for statistical analysis. @*Results@#Both manual operation and robot operation could successfully finish standard esophagus and stomach endoscopic examination. There were no complications such as hemorrhage, perforation, mistaken insertion into of trachea, injures of pharynx and larynx and inhalation pneumonia. Esophagus, gastric cardia, gastric fundus, gastric body, gastric angle, gastric antrum and gastric pylorus could be clearly observed in both groups. The manual operating time of nine gastroenterologists was (3.67±1.95) minutes, which was shorter than that of robot operating time ((7.60±2.00) minutes), and the difference was statistically significant (t=8.445, P<0.01). The time of first in vitro operation performed by nine gastroenterologist was (13.10±6.32) minutes. The operation times of each case of nine gastrienterologist were (8.49±0.90) minutes, (7.50±1.19) minutes, (7.30±1.33) minutes and (7.12±1.61) minutes. The difference was statistically significant (F=7.901, P<0.01). Operation time gradually shortened and operation proficiency significantly improved. @*Conclusion@#Master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ which provides a clear observation of esophagus and stomach is safe in endoscopic examination of living animal.

The robot-assisted system YunSRobot for soft endoscopy: a trial of remote manipulation on simulation models / 中华内科杂志

Objective To evaluate the feasibility and safety of the robot - assisted system YunSRobot for remote manipulation endoscopy. Methods When the master of YunSRobot was installed in the gastroenterology office in Chinese PLA General Hospital, the robot slave and upper gastrointestinal simulation model (Takahashi Lm103,Japan) were installed at the same time in the State Key Laboratory of Robotics, Shenyang Institute of Automation. Three physicians were trained to operate the master robotics and performed gastroscopy on the simulation model based on network cloud. Each physician performed 3 procedures of oesophagogastroduodenoscopy (EGD) by YunSRobot using traditional manual endoscopy, on-site operating mode, and remote manipulation mode, respectively. The operating time, lumenal anatomic exposure,man-machine interaction and other parameters were recorded. Results The number of standard pictures obtained by traditional manual endoscopy group, on-site operating group and remote manipulation group were 39.9±0.3, 39.8±0.4, 39.9±0.3, respectively. The images of all five lesions could be obtained by each operation. The operating time in the duodenum of remote group was longer than that of on-site group, with average time (78.2±16.0)s vs. (68.9±15.8)s (P=0.021) respectively. As to the operating time on other parts or total time, all three groups were comparable. Although there was a mean delay of (572.1±48.5) ms in remote operation group, the operation was still smooth. However, compared with on-site group, the percentage of clear view time in the duodenum was significantly shortened in remote group: [(77.8±8.2)% vs. (83.9 ± 6.4)% , P=0.024]. Statistically significant difference was detected in percentage of clear view time neither in other sites, nor was in the total operating time between two groups. The operating time in each part of remote group was obviously longer than that of manual group as followings, pharyngeal (27.3±4.2) s vs. (9.2±1.3)s (P<0.001), esophageal (29.7±6.4)s vs. (19.3±1.6)s (P=0.004), stomach (56.7±17.0)s vs. (40.3±7.0)s (P=0.003), pylorus (20.2±5.5)s vs. (9.3±1.3)s (P<0.001), duodenum (78.2±16.0)s vs. (29.3±5.6)s (P<0.001). Thus the total operating time was also longer in remote group as (559.0±87.2)s vs. (253.1±16.6)s (P<0.001). The respective time in pharynx, esophagus, stomach, pylorus, duodenum, or the overall time was all longer in remote group than that in manual group. Conclusions The soft endoscopy robot YunSRobot has satisfactory safety and stability. Remote upper gastrointestinal endoscopy can be completed based on common network and an endoscope simulation model with smooth operation. The inspection time by YunSRobot robot per part and the overall time are longer than those of manual operation on site, still, remote operating time meets the standard of upper gastrointestinal endoscopy.

The change of female progesterone level and blood calcium concentration in perimenopausal women with benign paroxysmal positional vertigo / 中华耳鼻咽喉头颈外科杂志

Objective@#The estrogen level and blood calcium concentration changes were studied on menopausal women with benign paroxysmal positional vertigo (BPPV).@*Methods@#Between January 2015 and January 2016, 70 menopause women with BPPV in outpatient clinics of Department of Otorhinolaryngology, Inner Mongolia Medical University Affiliated Hospital were included in this study as research group, while 30 menopause healthy women who came to hospital for check-up were included as control group. Serum levels of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (PRO), testosterone (T), serum prolactin (PRL) and the calcium concentration were analysed and comparied between research group and control group. SPSS17.0 statistical software was used to analyze the data. χ2 test was used to compare the percentage of decreased serum level of sex hormone, and t test was used to compare the serum level of sex hormone and calcium concentration of two groups.@*Results@#In research group, sex hormone decreased proportion of E2 (91%) and PRO (67%) were obviously higher than those in control group (χ2 value was 8.13, 10.28, respectively, all P<0.05). The E2 and PRO in research group were significantly lower than those in control group ((33.18±31.45) pmol/L vs (64.92 ±31.52) pmol/L, (0.64±0.48) nmol/L vs (1.02±0.60) nmol/L, t value was 6.238, 8.566, respectively, all P<0.05). There was no statistically significant difference of the level of LH, PRL, T, FSH and blood calcium concentration in research group compared with control group ((29.81±13.13) U/L vs (27.21±10.19) U/L, (0.49±0.20) nmol/L vs (0.49±0.15) nmol/L, (0.56±0.42) nmol/L vs (0.73±0.62) nmol/L, (64.25±31.44) U/L vs (60.38±29.97) U/L, (2.28±0.17) mmol/L vs (2.32±0.21) mmol/L, t value was 13.427, 14.876, 7.505, 12.090, 7.532, respectively, all P>0.05).@*Conclusion@#The level of E2 and PRO decrease obviously in postmenopausal women with BPPV, which can cause the inner ear microcirculation disorder , may be one of the risk factors of BPPV.

Effects of aspirin on the endometrium of patients with severe intrauterine adhesions after electrical resection / 中国生化药物杂志

Objective To investigate the effect of aspirin on the endometrium of patients with severe intrauterine adhesions after electrical resection.Methods 130 patients with severe intrauterine adhesions after electrical resection from August 2013 to August 2015 in our hospital were selected and randomly divided into the observation group and the control group ( 65 cases in each group ); The control group were given progestogen sequential therapy, while the observation group were given aspirin for treatment on basis of the control group; All the two groups were treated for three menstrual cycles; Before and after treatment indexes including uterine endometrial thickness, ovulation of the uterine artery blood flow index artery pulsatility index in ultrasound (PI), resistance index (RI), endometrial blood flow parameters[vascular index (VI), flow index (FI) and vascular blood flow index (VFI)] were recorded and compared, as well as menstruation and uterine cavity shape 3 menstrual cycles after treatment;All the two groups were followed up for one year, and one year pregnancy rates in the two groups were recorded.Results After treatment, the total efficiency in the observation group was 92.3% significantly higher than 69.2% in the control group ( P <0.05 ) .After treatment, in the two groups endometrial thickness, PI, RI, VI, FI and VFI were significantly improved compared with before treatment (P<0.05), but the observation group improved more obviously (P<0.05).Within one years in the observation group the pregnancy rate was 57.1%higher than that in the control group 26.5%(P<0.05) .Conlcusions Application of aspirin can significantly improve the endometrial thickness on the basis of estrogen and progesterone sequential therapy , increase the endometrial blood flow and improve the pregnancy rate, which mechanism may be related to promoting endometrial repair and improving blood perfusion of the uterus.

Diagnostic value of brainstem auditory evoked potential combining with Doppler ultrasound in ;elderly patients with vertigo / 中国医学装备

Objective: To explore the diagnostic value of brainstem auditory evoked potential (BAEP) combining with transcranial Doppler ultrasonography (TCD) in elderly patients with vertigo. Methods:54 cases of elder patients with confirmed in elderly patients with vertigo were selected as the observation group and 51 patients without vertigo and neurological signs were selected as the control group. Two groups of patients were underwent brainstem auditory evoked potential (BAEP) combining with Doppler ultrasonography, which were examined in carotid artery, internal carotid artery and other arteries by Doppler ultrasound. The peak latency and I, II and V wave amplitude were measured by brainstem auditory evoked potential, and the pulsation index and resistance index (RI) were compared between the two groups. Results: Patients in the observation group probability was significantly higher than the control group in the basilar artery stenosis, unilateral vertebral artery stenosis, bilateral vertebral artery stenosis and unilateral vertebral artery hypoplasia(x2=8.872, x2=8.523, x2=11.238, x2=12.351;P<0.01). There were differences between them. The comparison between V wave peak latencies and III~V wave peak latencies were significantly different (t=4.381, P<0.01). The total abnormal rate in the observation group (81.5%) was significantly higher than that of the control group(25.5%). The differences were statistically significant (x2=9.758, P<0.01). Conclusion: The diagnostic value was high for elderly patients with vertigo brainstem auditory evoked potential in combination with Doppler ultrasound.

Construction,package and identification of lentiviral vector for CXCR4 gene / 局解手术学杂志

Objective To construct and identify lentiviral vector pGC-FU-CXCR4 gene. Methods CXCR4 gene amplification was used by real-time polymerase chain reaction. The target gene fragments with the digested plasmids were exchange. Then the lentiviral vector pGC-FU-CXCR4 was constructed successfully. Use the constructed lentiviral vector to infect the competent escherichia coli cells. Polymerase chain reaction analysis was used to identify the cultural clones and DNA sequencing and comparative analysis were used to positive fragments. The successfully constructed plasmids had the same sequence with the target gene. Results Polymerase chain reaction tests showed that am-plified target genes were inserted in pGC-FU vectors. The electrophoresis results,digestion showed that the reconstructed plasmid was consist-ent with the theoretical fragment and the sequence result of the positive fragments were exactly the same with the target gene. Conclusion Lentiviral vectors of CXCR4 gene over-expression were successfully constructed.

Development and application of iris recognition system of patient management in human assisted reproductive centers / 军事医学

Objective To introduce iris recognition application in human assisted reproductive technology and set up an iris registration platform and an iris recognition platform for patients .Methods Every patient′s iris was used as the only code.The complicated verification of identity cards and birth permit was replaced by the digital service platform .We set up a database for basic information ,and electronic records of treatment and follow-up for centralized management .Results and Conclusion Compared to other authentication systems ,this iris digital system is easy and efficient .It can more effectively eliminate replacement and prevent medical disputes .The time taken to check the information of each patient is shortened to twenty seconds .

Effectiveness and safety of endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Endoscopic submucosal dissection of the esophagogastric junction is the most difficult gastric and esophageal dissection procedure. No reports of endoscopic submucosal dissection for Siewert type II carcinoma of the esophagogastric junction have compared the outcomes of endoscopic submucosal dissection for all three Siewert types of adenocarcinoma. This study aimed to evaluate the efficacy and safety of endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction.</p><p><b>METHODS</b>From October 2008 to June 2013, 73 patients underwent endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction. The patients were prospectively evaluated regarding the executability of the technique, short-term results of the procedure, en bloc resection rate, curative resection rate, complications and additional treatment after endoscopic submucosal dissection, and follow-up outcomes.</p><p><b>RESULTS</b>Sixty-eight of the 73 patients (93.2%) underwent en bloc resection; the mean maximum specimen diameter was 33.7 mm. Fifty-seven of 61 patients (93.4%) who underwent curative resection were successfully followed-up for 1.0 to 56.0 months (average, 24.1 months). Local recurrence developed in one patient with high-grade intraepithelial neoplasm. Twelve patients underwent noncurative resection, including lateral resection margin residues in three, vertical resection margin residues in one, signet ring cell carcinoma or undifferentiated adenocarcinoma in four, lymphatic or vessel invasion in one, vertical residual margin residues combined with signet ring cell carcinoma in one, and undifferentiated adenocarcinoma with lymphatic or vessel invasion in two. In the noncurative resection group, one patient was lost to follow-up, seven underwent additional surgery, and the remaining four were periodically followed up; none had local recurrence or distant metastases. The only complication was delayed bleeding in three patients, which was successfully controlled by conservative treatment or endoscopic therapy.</p><p><b>CONCLUSIONS</b>Endoscopic submucosal dissection is safe and effective for intraepithelial neoplasia of the esophagogastric junction. R0 en bloc resection is possible and can avoid the risk of local recurrence.</p>

Nursing care for patients with mid-stage hepatocellular carcinoma treated with 131I-chTNT combined with radiofrequency ablation / 介入放射学杂志

Objective To summarize the nursing points for patients with mid-stage hepatocellular carcinoma who are receiving radiofrequency ablation (RFA) combined with 131I-chTNT treatment. Methods The clinical data of 12 patients with mid-stage hepatocellular carcinoma, who were encountered at authors’ hospital during the period from Aug. 2009 to Sep. 2011, were retrospectively analyzed. RFA combined with 131I-chTNT was carried out in all patients. Preoperative prophylactic anti-allergy medication and protection measure for the thyroid were employed. After the operation strengthened radiation protection and close observation for complications were conducted. The results were analyzed. Results After active treatment and proper nursing, the tumor shrank in all patients. All the patients were followed up for 5 - 48 months with a median follow- up time of 31 months. The median overall survival time was 43 months. No serious complications such as bone marrow suppression or thyroid dysfunction occurred. Conclusion For the treatment of mid-stage hepatocellular carcinoma, 131I-chTNT combined with RFA has satisfactory therapeutic effect. Close observation for the occurrence of complications and careful nursing can improve the quality of life and prolong the survival time.

Concise Review: Differentiation of Human Adult Stem Cells Into Hepatocyte-like Cells In vitro

Adult stem cells (ASCs) are undifferentiated cells found throughout the body that divide to replenish dying cells and regenerate damaged tissues, which are the powerful sources for cell therapy and tissue engineering. Bone marrow-derived mesenchymal stem cells (BMSCs), adipose tissue-derived mesenchymal stem cells (ADSCs), and peripheral blood monocytes (PBMCs) are the common ASCs, and many studies indicated that ASCs isolated from various adult tissues could be induced to hepatocyte-like cells in vitro. However, the isolation, culture protocols, characterization of ASCs and hepatocyte-like cells are different. This review aims to describe the isolation and culture procedures for ASCs, to summarize the molecular characterization of ASCs, to characterize function of hepatocyte-like cells, and to discuss the future role of ASCs in cell therapy and tissue engineering.

The value of esophageal intrapapillary capillary loop visualized by magnifying narrow-band imaging endoscopy in diagnosing esophageal mucosal pathology / 中华内科杂志

Objective To investigate the diagnostic potential of magnifying narrow-band imaging endoscopy (NBI-ME) for different intrapapillary capillary loop (IPCL) for the diagnosis of esophageal lesion.Methods Patients with abnormal esophageal mucosa found by white light gastroscopy in digestive endoscopy center,Chinese PLA General Hospital during the period of November 2009 to November 2010 were enrolled in this study.IPCL was observed and divided into different types by NBI-ME.Histopathology of biopsy or endoscopic submucosal dissection (ESD) specimens was evaluated and used as the gold standard to evaluate the diagnostic value of NBI-ME for IPCL.Results A total of 146 lesions from 145 subjects with esophageal mucosa abnormal were collected. Among them, 88 were pathology-proven inflammation,5 were pathology-proven esophageal cancers,20 were pathology-proven low intraepithelial neoplasia (LIN) and 33 were pathology-proven high intraepithelial neoplasia (HIN) detected with NBI-ME.By a per-lesion analysis,the accuracy of inflammation and cancer were 100％ (88/88) and 7/7.For the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio of LIN and HIN were 7/10,69.8％ ( 30/43 ),69.8％ ( 37/53 ),35.0％ (7/20),90.9％ (30/33),12.5％ (70/559),2.3％ (30/1290) and 87.1％ (27/31),72.7％ ( 16/22),81.1％ ( 43/53 ),81.8％ ( 27/33 ),80.0％ ( 16/20 ),634.1％ ( 837/132 ) and 35.2％ ( 124/352 ),respectively.Conclusions NBI-ME can classify the different esophageal IPCL.Higher diagnostic accuracy of IPCL indicates the feasibility of NBI-ME for the efficacious diagnosis of esophageal inflammation and cancer.There is the higher diagnostic accuracy of HIN than LIN.

The role of endothelial cells on inflammatory cytokine release in septic shock / 中华微生物学和免疫学杂志

Objective To study the role of endothelial cells on the inflammatory cytokine release in septic shock through the septic shock serum stimulating human primary endothelial cells (HPAEC) and peripheral blood mononuclear cells(PBMC).Methods PBMC isolated from healthy people by density gradient centrifugation.HPAEC cell surface markers CD144 and von Willebrand factor(vWF) molecule expression by RT-PCR and Western blot.Serum levels of IL-6,TNF-α,MCP-1 from septic shock patients and healthy human detected by ELISA.HPAEC and PBMC were stimulated with the isolated serums and LPS,respectively.ELISA was used to detect the supernatant IL-6,TNF-α,MCP-1 levels.HPAEC membrane molecules ICAM-1 expression was detected by flow cytometry with serum shock and LPS stimulation.Supernatant levels of IL-6,TNF-α,MCP-1 of HPAEC with S1P1 receptor agonist CYM-5442 pretreatment was detected by ELISA after shock serum stimulation.Results Endothelial cell markers CD144 and vWF molecules could be detected in the HPAEC.Levels of inflammatory cytokines IL-6,TNF-α,MCP-1 in patients with septic shock serum were significantly higher than healthy people (P＜0.01).PBMC and HPAEC with LPS or shock serum treatment respectively,compared with normal group,levels of inflammatory cytokines in the culture supernatant were significantly higher(P＜0.01).For PBMC,the level of inflammatory cytokines between shock group and LPS group were not significantly different (P＞0.05).But for HPAEC,levels of inflammatory cytokines in the supernatant of the shock group compared to the LPS group was significantly higher (P＜0.01).Similarly,when two cells after LPS stimulation,IL-6,TNF-α levels of HPAEC's supernatant were significantly lower than PBMC' s (P＜0.01),MCP-1 levels was no difference (P＞ 0.05).But when the stimulation of shock serum,HPAEC of IL-6,TNF-α levels and PBMC no significant difference (P ＞0.05).MCP-1 was significantly increased (P＜0.01).Shock patients serum stimulation S1P1 receptorspecific agonist CYM-5442 pretreatment of HPAEC with pretreatment of S1P1 receptor specific agonist CYM-5442,the culture supernatant of inflammatory cytokines IL-6,TNF-α,MCP-1 levels were significantly lower (P＜0.01).Conclusion Endothelial cells may play a central role on the release of inflammatory cytokine during septic shock.

Layer-by-layer assembled selenium containing mimic artificial blood vessels with catalyzing NO generation / 国际生物医学工程杂志

ObjectiveA new style of artificial vessel scaffold was designed making the use of property of organoselenium catalyzing the releasing of Nitric oxide (NO). MethodsSelenium-containing catalyst organoselenium immobilized polyethyleneimine (SePEI) as polycation and polyglutamic acid (PGA) as polyanion were alternately coated onto the surface of polycaprolactone (PCL) nanofiber scaffolds obtained by electrospinning to form the blood vessel scaffold. Self-assembly was characterized by UV and atomic absorption qualitatively and quantitatively. Catalytic generation of NO from the NO donors- RSNOs was tested under the existence of reducing agent RSH. Biological properties were also evaluated. Results The NO release was relatively stable with no significant burst appeared, and still could be detected after 80 hours of catalyzing. The material was proved to show little cytotoxicity, and displayed significant effect in inhibiting of platelet aggregation through biological testing. Conclusion The new style of artificial vessel scaffold has good effect on improving the biological properties of materials.