Culture-Expanded Autologous Adipose-Derived Mesenchymal Stem Cell Treatment for Osteonecrosis of the Femoral Head

BackgroudOutcomes of traditional treatment for osteonecrosis of the femoral head (ONFH) are not always satisfactory. Hence, cell-supplementation therapy has been attempted to facilitate necrotic-tissue regeneration. Adipose-derived mesenchymal stem cell (ADMSC) transplantation is potentially advantageous over bone marrow-derived MSC implantation, but its outcomes for ONFH remain unclear. The aim of this study was to determine 2-year radiological and clinical outcomes of culture-expanded autologous ADMSC implantation for ONFH.MethodsEighteen hips with necrotic lesions involving ≥ 30% of the femoral head were included. ADMSCs were harvested by liposuction and culture expanded for 3 passages over 3 weeks. With a 6-mm single drilling, ADMSCs were implanted into the necrotic zone. All patients underwent magnetic resonance imaging (MRI), single-photon emission computed tomography/computed tomography (SPECT/CT) at screening and 6 months, 12 months, and 24 months postoperatively. The primary outcome was the change in the size of necrotic area on MRI. Secondary outcomes were changes in clinical scores and radioisotope uptake on SPECT/CT. Conversion total hip arthroplasty (THA) was defined as the endpoint.ResultsPreoperatively, the necrotic lesion extent was 63.0% (38.4%–96.7%) of the femoral head. The mean Harris hip score was 89.2, the University of California at Los Angeles (UCLA) score was 5.6, and Western Ontario and McMaster Universities Arthritis index (WOMAC) was 79.4. Three patients underwent THA and 1 patient died in an accident. Finally, 11 patients (14 hips) were available for ≥ 2-year follow-up. At the last follow-up, no surgery-related complications occurred, and 14 of 17 hips (82%) were able to perform daily activities without THA requirement. There was no significant decrease in lesion size between any 2 intervals on MRI. However, widening of high signal intensity bands on T2-weighted images inside the necrotic lesion was observed in 9 of 14 hips (64%); 11 of 14 hips (79%) showed increased vascularity on SPECT/CT at 2 years postoperatively. No significant differences were observed between preoperative and 24-month mean Harris hip score (89.2 vs. 88.6), WOMAC (79.4 vs. 75.7), and UCLA score (5.6 vs. 6.2).ConclusionsOur outcomes suggest that culture-expanded ADMSC implantation is a viable option for ONFH treatment without adverse events.     

Akt/PKB activation in gastric carcinomas correlates with clinicopathologic variables and prognosis

Akt/protein kinase B (PKB) plays an important role in cell survival. However, the role of Akt in the biology of gastric cancer has not been well studied. We sought to investigate the expression of Akt or phosphorylated Akt (pAkt) in human gastric carcinomas and to analyze the relationship between Akt or pAkt and the clinicopathologic parameters. The expressions of Akt and pAkt were evaluated immunohistochemically in 311 gastric carcinomas using the tissue array method. Akt expression was detected in 74% of the tumors and pAkt expression in 78%. pAkt was highly expressed in the early stage of pTNM (p=0.011). We also found an inverse association between pAkt and lymphatic invasion (p=0.01) or lymph node metastasis (p=0.008). pAkt expression was significantly correlated with a higher survival in patients with stage I carcinomas (p=0.0003). Interestingly, combined evaluation revealed that the group with pAkt-positive and lymph node-negative carcinomas showed a better prognosis than the other groups (p<0.0001). In addition, pAkt was shown to correlate positively with APC (p=0.002) and Smad4 (p<0.0001) expression. These findings suggest that pAkt expression may help to predict the clinical outcome of gastric cancer patients.     

等容血液稀释对大鼠局灶性脑缺血作用的研究

以血液稀释治疗血栓栓塞性脑缺血为目的,采用大脑皮层局部血流量(rCBF)、脑组织含水总量以及脂质过氧化物含量(LPO)为重要指标,共71只大鼠的实验研究,结果表明:大脑局灶性缺血24小时后经血液稀释治疗2小时,血细胞压积由49.4±3.5%降至39.3±3.77%,rCBF增加19.95%(n=16,P<0.005),脑组织含水量及LPO含量,对照组与稀释组分别为81.39±1.56%(n=12),79.00±1.08%(n=13,P<0.001);645.57±106.72nmol/100mgpro(n=11),360.47±117.46nmol/100mgpro,(n=14,P<0.001)。提出血液稀释可增加rCBF,减轻脑水肿,降低LPO。     

Facilitating visuospatial attention for the contralateral hemifield by repetitive TMS on the posterior parietal cortex

Previous studies have demonstrated that repetitive transcranial magnetic stimulation (rTMS) could modulate the visuospatial functions. In this study, we investigated the effect of off-line high frequency subthreshold rTMS, when applied over the right or left posterior parietal cortex (PPC), on the visuospatial attention of the bilateral hemispaces. The subjects underwent visuospatial tasks before and immediately after receiving 1000 pulses of 10 Hz rTMS for a period of 20 min, and their responses were recorded. Our results demonstrated that the high frequency rTMS applied over the PPC produced facilitative effects on the visuospatial attention to the contralateral hemispace. The inhibitory effect to the ipsilateral hemispace was noticeable only in the left PPC.     

膝骨关节病的关节镜诊断治疗

目的 通过对79例84膝骨关节病的关节镜诊断治疗回顾性总结,探讨高效率、创伤小、疗效佳的方法。方法 采用关节镜微创技术,结合术前检查对膝骨关节病分为：软骨破坏型,滑膜类型,游离体型及半月板型,依此施行有针对性,局限化手术治疗。结果 69膝得到6mo-3a的随访,按膝关节综合评分表评分,优20％,良59％,可和差21％。结论 该方法具有创伤小、康复快、并发症少等优点,在病损严重的病例,全膝置换或截骨术是进一步提高总体疗效的适宜选择。     

人巨细胞病毒感染与宫颈癌关系的研究

采用聚合酶链反应 (PCR)检测 30例宫颈癌、 30例宫颈炎、 8例正常宫颈组织标本中 HCMV早期 (IE)、晚期 (L)基因片段、 HCMV79- aa ORF癌基因及 HPV16、 18、 32、 5 2 b、 5 8型 DNA。结果表明 :除 HCMV L 基因外 ,以上各基因在宫颈癌组之检出率均显著高于宫颈炎组 ,且宫颈癌组 IE和 L 基因、HPV高危型和 HCMV同时感染的比值比 (OR)分别高于 IE或 L 基因、HPV高危型或 HCMV单独感染的 OR值之和。提示人巨细胞病毒与宫颈癌的发生有关 ,可通过其 IE基因启动、激活 HPV的致癌作用 ,HCMV79- aa ORF癌基因的整合也可能是致宫颈癌的一个不可忽视的重要因素     

医院物资管理与计算机网络

本文通过对医院物资管理特点的分析,总结出适用于医院的"三级分层体系"物资管理模式及办法,并对本院应用该模式建立的物资管理系统的工作原理、实现细节及特点作了较详尽的论述.     

降纤酶治疗青年人短暂性脑缺血发作的临床研究

目的 探讨降纤酶对青年人短暂性脑缺血（ＴＩＡ）发作的治疗效果。方法 将７２例患者随机分为两组。治疗组３７例,给予降纤酶静滴至ＴＩＡ发作终止或治疗达１周;对照组３５例,给予阿司匹林、尼莫地平、低分子右旋糖酐、脉络宁治疗２周。两组于治疗前、后分别采静脉血检测血浆纤维蛋白原、红细胞压积、全血粘度和血浆粘度的变化。结果 总有效率治疗组为９１．６６％,对照组为７７．１４％,２组间有显著性差异（Ｐ〈０．０１）