Analysis on the evaluation indicators of medical quality in TCM hospitals - taking Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine as an example / 国际中医中药杂志

To improve the evaluation indicators of medical quality in TCM hospitals; To realize objective, fair, and accurate evaluation of the quality of TCM. Based on relevant literature on medical quality in traditional Chinese medicine hospitals research and thematic group discussions, 21 evaluation indicators for TCM characteristics were formed. A questionnaire survey was conducted among 40 experts, and 37 were effectively collected, with a positive coefficient of 92.50%. After two rounds of expert consultation, the evaluation indicators were determined to be: the intensity of outpatient use of TCM decoction pieces (utilization rate of TCM decoction pieces, prescription number of TCM decoction pieces, dosage of TCM decoction pieces, and service price of TCM decoction pieces), the intensity of the use of TCM technology (proportion of TCM technology, number of TCM projects, cost of TCM technology, and course of treatment). Case studies were conducted on relevant data from 10 departments using the operational decision support system (BI) platform of Yueyang Integrated Traditional Chinese and Western Medicine Hospital affiliated with Shanghai University of Traditional Chinese Medicine to verify the rationality of indicators. The 10 departments were analyzed and evaluated, and the results obtained were basically consistent with the actual medical quality situation of the hospital. The indicators used in this study can reflect the actual medical quality situation, and have a certain degree of scientificity, feasibility, and applicability, providing reference for improving the medical quality evaluation indicators of TCM hospitals.

Clinical efficacy and safety of unilateral biportal endoscopy versus microendoscopic discectomy in treatment of lumbar spinal stenosis: a Meta-analysis / 中华创伤骨科杂志

Objective:To compare the efficacy and safety of unilateral biportal endoscopy (UBE) and microendoscopic discectomy (MED) in the treatment of lumbar spinal stenosis by Meta-analysis.Methods:PubMed, Web of Science, CNKI and Wanfang Data were searched from their establishment to January 2021 for all the studies on UBE and MED in the treatment of lumbar spinal stenosis. The data extracted were authors, year of publication, study design, subject characteristics, sample size, surgical protocol, age, sex ratio, duration of surgery, length of hospital stay, complications, visual analogue scale (VAS), and Oswestry Disability Index (ODI). The Meta-analysis was conducted with software Revman 5.3 to analyze the operation time, hospital stay, complication rate, waist and lower extremity VAS scores and ODI scores at preoperation, early postoperation and the last follow-up. The quality of the case-control studies included was evaluated using the Newcastle Ottawa Scale (NOS) while the methodological quality and risk of bias of the randomized controlled studies (RCT) included were evaluated using the Cochrane Bias Risk Assessment Tool.Results:Finally, 7 studies were included, 6 in English and one in Chinese. There were 2 RCTs and 5 case-control studies. There were 251 patients in the UBE group and 224 patients in the MED group. Compared with the MED group, the UBE group had a significantly shorter hospital stay ( MD=-2.28, 95% CI: -3.42 to -1.14, P<0.001), and a significantly lower VAS score for early postoperative low back pain ( MD=-0.80, 95% CI:-1.44 to -0.16, P=0.01). There were no significant differences between the 2 groups in operation time, complication rate, waist VAS scores at preoperation or the last follow-up, lower extremity VAS or ODI scores at preoperation, early postoperation or the last follow-up, or dural dilatation area ( P>0.05). Conclusions:In the treatment of lumbar spinal stenosis, compared with MED, UBE is superior in early relief of low back pain and hospital stay after operation, but shows no significant difference in long-term efficacy or safety.

Preoperative Nomogram prediction model for lymph node metastasis in patients with renal cell carcinoma / 中华泌尿外科杂志

Objective:To identify preoperative clinical predictors of positive lymph nodes in patients with renal cell carcinoma (RCC)and provide a preoperative predictive model.Methods:The data of 173 RCC patients who underwent either retroperitoneal lymph node dissection or biopsy at a single institution from January 2016 to December 2020 were retrospectively analyzed. There were 109 males and 64 females, with an average age of (53.29±13.58) years, median tumor diameter of 70 (23-150) mm, 68 patients with local symptoms, 24 patients with systemic symptoms, and 56 patients with ECOG score ≥1. There were 96 patients with tumor pseudocapsule, 23 patients with renal vein or inferior vena cava tumor thrombus, 114 patients in stage T 1-2, 59 patients in stage T 3-4, 22 patients with distant metastasis and 88 patients with lymph node metastasis by preoperative imaging examination. Univariate analysis was performed by Mann-Whitney U test or Chi-square test, and multivariate logistic regression analysis was used to determine preoperative predictors of pathologic lymph node positivity. The significant variables were then included in a novel Nomogram to predict the probability of lymph node invasion.C-index and Bootstrap self-sampling methods were used to evaluate the discrimination and consistency of the model. Results:Of the 173 patients, 49(28.32%)and 124(71.68%)had pN 1 and pN 0 disease, respectively. Among 88 patients with suspected lymph node involvement (cN 1) assessed by preoperative imaging, only 47.73%(42/88) were confirmed to be pathologically positive. However, 8.24% (7/85) of the 85 patients with negative lymph nodes (cN 0) assessed by preoperative imaging were pathologically positive. Age, ECOG score, symptoms at presentation, tumor pseudocapsule, metastasis at diagnosis, clinical tumor stage, clinical nodal status, clinical nodal size, D-dimer, lactate dehydrogenase, microscopic hematuria were significant in the univariate analysis ( P<0.05). On multivariable analyses, the most informative independent predictors were age, clinical tumor stage, clinical nodal status, clinical nodal size and microscopic hematuria ( P<0.05). A Nomogram with good performance was developed to predict the probability of lymph node metastasis. The C-index of the model was 0.954, the calibration curve of forecasting curve with the ideal curve fit was good, indicating that the model has a good consistency. Conclusions:Younger age, microscopic hematuria, suspected lymph node involvement in imaging, larger lymph node diameter and higher T stage were independent risk factors for renal cell carcinoma with lymph node metastasis. The Nomogram based on the above factors has good identification and calibration ability, which can help predict the probability of lymph node metastasis of renal cell carcinoma before surgery.

Application of reperfusion-expanding-thrombectomy-stenting technique in carotid tandem lesions / 中华神经科杂志

Objective:To analyze the feasibility and clinical efficacy of reperfusion-expanding-thrombectomy-stenting (RETS) technique in the endovascular treatment of acute carotid artery tandem lesion.Methods:The general clinical data of 88 patients with carotid artery tandem lesion who received emergency endovascular treatment from January 2018 to December 2020 in Department of Neurology, Linyi People′s Hospital were reviewed, the Modified Rankin Scale (mRS) was used as the evaluation standard for the prognosis of patients at 90 days after endovascular treatment, and the clinical data were analyzed, including the recanalization (modified thrombolysis in cerebral infarction ≥2b), perioperative complications and 90-day prognosis, and good prognosis was defined as a mRS score of 0-2.Results:A total of 88 patients with tandem carotid artery disease were included,48 of whom were treated with RETS technique, 40 were treated with anterograde approach. Compared with antegrade recanalization, RETS technique had significant differences in the time from puncture to recanalization [(72.06±17.29) min vs (98.88±26.09) min, t=-5.56, P<0.001] and the primary recanalization rate [35/48(73.0%) vs 21/40(52.5%),χ2=3.93 ,P=0.047], with statistically significant difference. There was no significant difference in clinical prognosis and surgical complications between the two methods (all P>0.05). Conclusions:RETS technique can shorten the operation time and increase the primary recanalization rate. RETS technique is safe and feasible for the treatment of carotid tandem lesions.

Efficacy and Safety of Long-acting GLP- 1 Receptor Agonist Semaglutide for Type 2 Diabetes：A Systematic Review / 中国药房

OBJECTIVE： To systematically evaluate therapeutic efficacy and safety of long-acting glucagon like peptide-1 （GLP-1） receptor agonist Semaglutide vs. placebo or other glucose-lowering drugs in the treatment of type 2 diabetes mellitus （T2DM）， and to provide evidence-based reference for T2DM in clinic. METHODS： Retrieved from PubMed， Embase， Medline， Cochrane library， randomized controlled trials （RCT） about Semaglutide （trial group） vs. placebo or other glucose-lowering drugs （control group） in the treatment of T2DM were selected during the establishment of database to Sept. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed for HbA1c level and compliance rate， fasting plasma glucose （FPG） level， systolic blood pressure （SBP）， diastolic blood pressure （DBP）， body mass index （BMI）， body weight pulse frequency level， the incidence of hypoglycemia and gastrointestinal reaction by using Rev Man 5.3 software.  RESULTS： A total of 12 RCTs involving 9 966 patients were included. The results of Meta-analysis showed that compared with control group， trial group could effectively decrease the levels of HbA1c [MD＝－1.03， 95％CI（－1.22，－0.85）， P＜0.001] and FPG [MD＝－1.14， 95％CI（－1.53，－0.76）， P＜0.001]， increase compliance rate of HbA1c [RD＝0.40， 95％CI（0.31，0.49）， P＜0.001]， reduce SBP [MD＝－2.61， 95％CI （－3.23， －1.98）， P＜0.001] and DBP [MD＝－0.56， 95％CI     （－0.96， －0.16）， P＝0.006]， decrease BMI [MD＝－1.25， 95％CI （－1.51， －0.99）， P＜0.001] and body weight [MD＝     －3.60， 95％CI（－4.24， －2.96）， P＜0.001]， increase pulse frequency [MD＝2.16， 95％CI （1.51， 2.81）， P＜0.001]. The major adverse drug reactions were gastrointestinal reaction； the incidence of gastrointestinal reaction was higher than control group [RD＝0.20， 95％CI（0.15，0.26）， P＜0.001]， but there was no statistical significance in the incidence of hypoglycemia events between 2 groups [RD＝0.00， 95％CI（－0.01，0.02）， P＝0.44]. CONCLUSIONS： Semaglutide can significantly decrease HbA1c， FPG， body weight， blood pressure and increase pulse frequency in T2DM patients， and increase the compliance rate of HbA1c. Although the incidence of gastrointestinal reaction is higher than control group， but the risk of hypoglycemia is not higher， indicating Semaglutide is well tolerated and safe.

Clinical and radiologic features of cerebral venous sinus thrombosis associated with iron deficiency anemia / 中华神经医学杂志

Objective To investigate the clinical and imaging features of patients with cerebral venous sinus thrombosis (CVST) associated with iron deficiency anemia (IDA) and to analyze its possible pathogenesis. Methods Eighteen patients with CVST associated with IDA, consecutively admitted to our hospital from January 2006 to June 2018, were chosen in our study. Their clinical presentations, laboratory and neuroimaging features, treatments and prognoses were retrospectively analyzed. Results (1) Mean hemoglobin concentration was (81.6±16.0) g/L (53 g/L-112 g/L), with mild anemia in 5 patients (27.8％), moderate anemia in 11 patients (61.1％) and severe anemia in 2 patients (11.1％); mean platelet count was (371.9±202.5)×109/L ([64-825]×109/L). (2) The clinical symptoms were highly variable: all the 18 patients had headache (5 with isolated headache); 14 patients were combined with other neurological symptoms, including focal neurological deficits (n=11, 61.1％), disturbance of consciousness (n=5, 27.8％), and epilepsy (n=2, 11.1％). (3) MR imaging showed that 14 patients (77.8％) were with venous infarction, in which 10 (55.6％) had hemorrhagic transformation; MR venography showed that 16 patients (88.9％ ) were with more than one cerebral venous thrombosis, and the most common sites were transverse sinus (n=16, 88.9％), followed by sigmoid sinus (n=13, 72.2％), and superior sagittal sinus (n=9, 50.0％). (4) All 18 patients accepted anticoagulant therapy; one died at the acute phase, and 17 were with good prognosis after 3-6 months of follow-up. Conclusion CVST associated with IDA is common in young and middle-aged women with moderate and severe anemia; the common symptoms include headache and focal neurological deficits; the common imaging features include multiple venous sinus involvement with venous infarction and hemorrhagic transformation; good prognosis can be obtained after anticoagulant therapy.

Automated radiolabeling and in vivo evaluation of 18F-FDOPA / 中华核医学与分子影像杂志

Objective To synthesize 18F-fluoro-L-3,4-dihydroxyphenylalanine (18 F-FDOPA) and evaluate its biodistribution and kinetics in mice,in order to explore its feasibility for insulinoma detection.Methods 18F-FDOPA was synthesized by a three-step nucleophilic reaction.Radiolabeling yield,radiochemical purity and stability in vitro were analyzed.Normal mice were scarified at 2,5,15,30,60 and 120 min postinjection to measure radioactive counts in main organs.Biodistribution and kinetics were evaluated by dynamic microPET in normal mice.The insulinoma tumor (INS-1) model was established and dynamic microPET was performed immediately after intravenous injection and stopped at 60 min.Region of interest (ROI) was drawn to access time-activity curve (TAC) in main organs and insulinoma.Results 18F-FDOPA was prepared with radiochemical yield of (11.0±0.4) ％,radiochemical purity of (99.3±0.2)％.The radiochemical purity was still ＞99％ after being stored for 120 min at room temperature.Predominant uptake of 18F-FDOPA was in the kidneys,and was cleared rapidly in blood.Pancreas showed stable uptake from 20 to 50 min,which was (5.98±0.71) percentage activity of injection dose per gram of tissue (％ ID/g) at 20 min and (4.62±0.47) ％ID/g at 50 min postinjection,respectively.18 F-FDOPA showed high affinity to tumor tissue of insulinoma ((11.42±0.70) ％ID/g) at 2 min.Conclusions 18F-FDOPA could be easily synthesized in short total reaction time with high radiochemical purity and stability.Early phase imaging of 18F-FDOPA may be helpful for insulinoma detection.

Study on Chemical Compounds and in vitro Antibacterial and Antioxidant Activities of Monoraphidium dy-bowskii / 中国药房

OBJECTIVE:To study chemical compounds of Monoraphidium dybowskii,and to investigate the in vitro antibacte-rial and antioxidant activities of isolated compounds. METHODS:The ethanol extract of M. dybowskii were extracted with aether petrolei,ethyl acetate and n-butyl alcohol. The ethyl acetate extract was separated from M. dybowskii and chemical components were analyzed by sillica gel column chromatogram,HPLC and GC-MS. Their structures were identified according to physicochemi-cal properties and NMR. MIC of 4 isolated compounds to Pseudomonas aeruginosa,Candida albicans,Bacillus subtilis and Esche-richia coli were determined by resazurin disc test. Free radical scavenging rate(concluated by IC50)and reducing capacity were mea-sured by 1,1-diphenyl-2-picryl-diazanyl (DPPH) and ferric reducing antioxidant power (FRAP) assay. RESULTS:Compounds 1-6 were obtained from E4 and E5 segments of ethyl acetate extract of M. dybowskii,and their structures were identified as stigmas-terol,diisonoyladipate,indole-3-carboxylic acid,(+)-epiloliolide,(-)-loliolide,5-hydroxy-3,4-dimethy-5-pentyl-2(5H)-furanone. MIC of compounds 3-6 were 10-500 μg/mL,and IC50 ranged 22.02-71.01 μg/mL;FRAP ranged (62.04 ± 5.36)-(281.22 ± 8.3) μmol/L. CONCLUSIONS:M. dybowskii contains multiple lipid and alkanoic acid,and possesses certain in vitro antibacterial and antioxidant activities.

Biological characteristics of human olfactory mucosa mesenchymal stem cells / 中南大学学报(医学版)

OBJECTIVE@#To observe the biological characteristics of the human olfactory mucosa mesenchymal stem cells (hOM-MSCs).@*METHODS@#The hOM-MSCs were isolated, cultured and identified in vitro. Scanning electron microscope and transmission electron microscope were used to observe the ultrastructure of hOMMSCs. Th e cells were induced towards adipocyte, osteocyte, neural stem cells, neural-like-cells in vitro.@*RESULTS@#The hOM-MSCs were mainly in spindle shape, arranged with radial colony. The hOMMSCs expressed CD73 and CD90 but no CD34 and CD45. Th e short and thick microvilli processes were seen at the surface of hOM-MSCs by scanning electron microscope, and 2 different cellular morphology of hOM-MSCs were seen under transmission electron microscope. Moreover, the hOMMSCs could be differentiated into adipocyte, osteocyte, neural stem cells and neural cells.@*CONCLUSION@#The hOM-MSCs possess general biological characteristics of MSCs and display multiple differentiation functions. They can be served as ideal seed cells in tissue-engineering for injury repair.

DNA sequencing of HEV ORF3 cDNA and expression in HepG2 cell / 重庆医学

Objective To analysis the DNA sequence of HEV ORF3 cDNA and express in HepG2 cell .Methods Recombinant vector carrying HEV ORF3 cDNA was constructed and identified by DNA sequencing .Expression of recombinant vector in HepG2 cell was determined by immunofluorescence technique .Results The recombinant vector was constructed and expressed in HepG2 cell successfully .Conclusion The research laid experimental foundation for exploring the biological function of ORF3 protein in the pathogenesis of viral hepatitis E .

Clinical and radiologic features of posterior reversible encephalopathy syndrome associated with preeclampsia-eclampsia / 中华神经科杂志

Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome (PRES) associated with preeclampsia-eclampsia.Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features.Results The most common clinical presentations were seizures( 18 cases ),headache (16 cases),altered mentation (15 cases) and vision change (12 cases). Vasogenic edema lesions distributed in the parietal or occipital lobe (20 cases),the frontal lobes (14 cases),temporal lobes ( 11 cases), and basal ganglia (11 cases). The splenium involvement occurred in 4 cases,cerebellar hemispheres and brain stem involvement was prcscnted in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital (7 cases),the holohemispheric watershed (7 cases),and superior frontal sulcal (6 cases).Partial and asymmetric expression of PRES only occurred in 1 case.Conclusions The clinical features of PRES associated with preeclampsia-eclampsia are typical.Except the parietal or occipital lobe,involvement of the frontal lobe,temporal lobe and basal ganglia is common,followed by the occasional presence of the splenium,cerebellar hemispheres and brain stem.Three primary PRES patterns are noted,occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES ncurotoxicity morc accurately when PRES present.

Plasma level of adiponectin in coronary heart disease patients combined with abnormal glucose metabolism / 中南大学学报(医学版)

OBJECTIVE@#To examine the plasma adiponectin concentration in coronary heart disease (CHD) patients combined with abnormal glucose metabolism, and to explore the clinical significance of adiponectin.@*METHODS@#Eighty-seven hospitalized CHD patients confirmed by coronary angiography from August 2009 to April 2010 at Xiangya Hospital were enrolled and divided into 3 groups according to their glucose metabolic state: 31 patients were selected as a simple CHD group, 28 were selected as a CHD combined with impaired glucose tolerance group (CHD+IGT group), and the other 28 as a CHD combined with diabetes mellitus group (CHD+DM group). The 31 healthy subjects who got health checkup at the same time were enrolled as a normal control group (NC group). Plasma adiponectin was measured by enzyme linked immunosorbent assay. The height, weight,waistline and blood pressure of all the subjects were checked, and the fasting blood glucose (FBG), insulin, lipids, high-sensitivity C-reactive protein (hs-CRP), free fatty acids (FFA), the liver function and the renal function were checked as well. The body mass index and the homeostasis model were assessed for insulin resistance.@*RESULTS@#1) Plasma adiponectin in the CHD group, the CHD+IGT group, and the CHD+DM group was all lower than that in the NC group (P<0.05); 2) Compared with the CHD group, the plasma adiponectin in the CHD+DM group was the lowest, followed by the CHD+IGT group, and there was significant difference in the 3 groups (P<0.05); 3) Plasma adiponectin level was positively related with the high density lipoprotein cholesterol-C (HDL-C) (r=0.483, P<0.01), while it was negatively related with the hs-CRP and Gensini score (r=-0.489, P<0.05;r=-0.252, P<0.05).@*CONCLUSION@#Plasma adiponectin concentration is reduced in the CHD patients, and significantly reduced in CHD patients combined with abnormal glucose metabolism. Plasma adiponectin concentration decreases significantly with the severity of abnormal glucose metabolism. CHD and the abnormal glucose metabolism are important influence factors for plasma adiponectin. That plasma adiponectin level significantly decreases may be the superimposed results of CHD and abnormal glucose metabolism. Plasma adiponectin combined with HDL-C, hs-CRP and Gensini score may provide the reference in the judgement of the severity of CHD patients with abnormal glucose metabolism.

Plasma level of RBP4 in patients with coronary heart disease and the effect of hyperinsulinemia / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the change of plasma level of retinol binding protein 4 (RBP4) in patients with coronary heart disease, and to explore the effect of hyperinsulinemia.@*METHODS@#This study was carried out at Xiangya Hospital of Central South University, China, from September 2009 to May 2010. Thirty patients with coronary artery disease (the CAD group) were confirmed by coronary angiography, 29 patients with CAD plus hyperinsulinemia (the CAD+HIns group), and 30 healthy subjects were enrolled as controls (the control group). The peripheral blood sample from the anticubital vein was collected aseptically in all the subjects to measure the RBP4 by enzyme linked immunosorbent-assay (ELISA). The height, weight, body mass index (BMI) the waist-to-hip ratio (WHR), the blood pressure, the fasting plasma glucose (FPG), the fasting insulin (Fins), the 2-hour postprandial inslulin (2hPIns), and the homeostasis model assessment-insulin resistance index (HOMA-IR) was measured. The lipids, high sensitivity C reactive protein (hsCRP), uric acid(UA), free fatty acids (FFA) were all examined.@*RESULTS@#The level of plasma RBP4 in the CAD+HIns group was higher than that in the CAD group and the control group (both P0.05). Correlation analysis showed that the plasma RBP4 level was significantly correlated with BMI, FPG, FIns, 2hPIns, HOMA-IR, TG, HDL-C, UA, and hsCRP (r=0.259, 0.331, 0.582, 0.452, 0.600, 0.236, -0.290, 0.243, 0.231, respectively; all P>0.05). Multiple regression analysis showed that BMI, 2hPIns, and HOMA-IR were the independent factors related to RBP4.@*CONCLUSION@#The plasma level of RBP4 does not increase in the CAD group, but it is high in the CAD +HIns group. RBP4 level is related to BMI, lipids, UA, and other cardiovascular risk factors. BMI, 2hPIns, and HOMA-IR are the independent factors associated with RBP4.

Effects of rh-endostar in combination with radiotherapy on rats with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>Radiation sensitivity is closely related to tissue oxygen, and rh-endostatin can induce the high level of oxygen content in tumor by "normalizing" tumor angiogenesis which is associated with radiotherapy sensitivity. The aim of this study is to observe the effect of combination of radiotherapy with rh-endostatin in the rats with lung cancer.</p><p><b>METHODS</b>Immediate lewis cancerous ascetic injection method was used to make rats tumors bearing model, then the rats was divided into four groups randomly: group A was treated with saline; group B was treated with rh-endostatin; group C was treated with irradiation and group D was treated with rh-endostatin and irradiation. After all rats were treated, inhibition rates and the tumor growth curve were calculated. Immunohistochemisty was adopted to check the expressions of vascular endothelial growth factor (VEGF) and microvessel density (MVD).</p><p><b>RESULTS</b>Compared with group A, the growth rates of the tumors in the other group were obviously slower, and the tumor weights were significantly different form group A (P < 0.05). Compared with the other groups, the tumor weights of group D were obviously reduced (P < 0.05). Compared with group A, VEGF and MVD of other three groups were reduced (P < 0.05), and group D were significantly cut down.</p><p><b>CONCLUSION</b>Combination with radiotherapy and rh-endostatin could inhibit the lung cancer significantly in rats. The possible mechanisms are to decrease the expression ofVEGF and inhibit the production of angiogenesis.</p>

Traumatic Segmental Defects of Tibia Treated by Internal Bone Transport Using Adjustable Mono-lateral External Fixation / 中国康复理论与实践

@#ObjectiveTo evaluate the clinical and functional outcome of traumatic segmental defects of the tibia treated by internal bone transport using the the adjustable mono-lateral external fixation.Methods12 patients who underwent internal bone transport using the the adjustable mono-lateral external fixation for traumatic segmental defects in the tibia were reviewed, the length of bone defect was 6～10 cm.ResultsMean follow-up was 14 months. All the cases got primary bone union. The length of time in healing was 9～14 months.ConclusionTraumatic segmental defects of the tibia treated by internal bone transport using the adjustable mono-lateral external fixation is a simple, less traumatic, non-bone graft and effective way.

Construction of Completely Biological Tissue-Engineered Small-Diameter Blood Vessel Based on a Biological Hybrid Scaffold / 中国康复理论与实践

@#Objective To prepare completely biological tissue-engineered small-diameter blood vessel based on a biological hybrid scaffold.MethodsEndothelial cells and smooth muscle cells were isolated from the porcine aorta and expanded in vitro. Mixture of smooth muscle cells and porcine fibrin was prayed coating on the decellularized canine carotid artery. Then, the inner surface of the decellularized artery was seeded with the endothelial cells to construction of completely biological tissue-engineered small-diameter blood vessel. The tissue-engineered blood vessel was evaluated with Hematoxylin and Eosin (H&E) staining and scanning electron microscopy.ResultsHistology examination revealed that the completely biological tissue-engineered small-diameter had intact media and intima. Scanning electron microscopy examination confirmed that the inner surface of tissue-engineered blood vessel was covered with intact monolayer endothelial cells and the external surface was covered with multilayer smooth muscle cells.ConclusionThe completely biological tissue-engineered small-diameter with intact media and intima was prepared using mixture of blood vessel cells and porcine fibrin on the decellularized canine carotid artery.

Effect of combining endostatin and radiation on growth inhibiting and apoptosis of A549 cell line / 肿瘤研究与临床

Objective To investigate antiproliferative activity of endostatin(ES), the combining effect of Endostar and radiation on VEGF and apoptosis of the A549 human lung adenoearcinoma cell line.Methods The cell of exponential phase of growth were divided into the control, radiation alone, ES alone,radiation after ES(ES→RT), ES after radiation(RT→ES), radiation and ES at equal paee (RT+ES), γ-ray radiation at a dose of 2 Gy, single fracination irradiation, YH-16 10 μg/ml in the cell culture bottle. The combining effect was quantified by the survival curve. ELISA was used to observe the VEGF of radiation with ES on A549 cell lines. Apoptosis was observed by Hoeehst staining. Results There showed that both of ES and combining treatment had the function of antiproliferative. But the union treatment's function was more obvious (P＜0.05). The expression of VEGF in ES and the combining treatment group was more lower than others (P＜0.05). On apoptosis, the rate of apoptosis in ES, RT, combining treatment group was higher than others (P＜0.05). Conclusion On antiproliferative activity and rate of apoptosis, the combining of ES and radiation is better than to use them alone. To reduce VEGF of the A549 human lung adenocareinoraa cell line by ES could enhance radioresponse. There is no evidences to show that the expression of VEGF is concerned with the different choronological order of radiation and ES.

Comparative study of the effect of deep-frozen meniscus and meniscal acellular matrix for allograft transplantation / 中国组织工程研究

BACKGROUND: Three kinds of donor meniscus are commonly used at present, namely cryopreserved, fresh and deep-frozen meniscus, which,however, almost invariably give rise to degenerative changes of various degrees after transplantation.OBJECTIVE: To compare the outcome of transplantation of allograft deep-frozen meniscus and meniscal acellular matrix to determine the most preferable means of allograft meniscus preservation.DESIGN: Randomized controlled experiment with rabbits.SETTING: Department of Orthopedics, Second Hospital Affiliated to Harbin Medical University.MATERIALS: Sixty-four male Japanese white rabbits with body mass of 3.0 - 3.5 kg.METHODS: This experiment was carried out in the Animal Experimental Center, Second Hospital Affiliated to Harbin Medical University between September 2002 and September 2003. Totally 64 adult rabbits were assigned into 32 pairs according to the body weight to served as the donor and the recipient animals, respectively. The medial menisci was obtained from the bilateral knees of the donor animals with the right one cryopreserved at -80 ℃ and the left prepared into acellular matrix for deep-frozen preservation. The donor menisci were respectively transplanted into the corresponding knee joints of the recipient animal's hindlimbs, with the left side taken as the experimental side and right as control. Gross observation,X-ray examination, and histological examination of the tissues were carried out at postoperative 4, 8, 12 and 16 weeks, respectively.MAIN OUTCOME MEASURES: Findings in X-ray, gross observation and histological observation of the grafted meniscus with meniscal measurement and findings in abdominal aorta perfusion.RFSULTS: All the 64 rabbits were observed for result analysis. X-ray examination of the grafted meniscus revealed no obvious changes in either the experimental and control side at 4 and 8 weeks postoperatively, but mild changes occurred on the control side at 12 weeks, which became obvious at 16 weeks, presented by joint space narrowing, hyperostosis and osteosclerosis below the cartilage of varied severities (with scores of 1.3 and 0.6, respectively, P ＜ 0.05). By gross observation, meniscal atrophy on the experimental side was milder and slower than the control side, with al so lower atrophy rate [(15.14±4.62) % vs (20.97±4.72) % at week 4, P ＜ 0.001, and (19.23±11.27) % vs (32.74±10.43) % at week 16, P ＜ 0.05].Perfusion of the abdominal aorta revealed no revascularization in the surrounding tissues of the meniscus by gross observation in either groups, but histologically, the experimental side showed more favorable structure than the control side at postoperative weeks 4, 8, 12 and 16.CONCLUSION: Meniscal acellular matrix may produce better outcome than deep-frozen meniscus after transplantation and can be a more practical means for preservation of the meniscus.