Monocyte chemotactic protein 1 increases homing of mesenchymal stem cell to injured myocardium and neovascularization following myocardial infarction

Objective：To investigate the effect of MCP-1 on mesenchymal stem cells（MSCs） homing to injured myocardium in a rat myocardial infarction（MI） model. Methods：Rat myocardial infarction model was established by permanent left anterior descending branch ligation. Mesenchymal stem cells from donor rats were cultured in IMDM and labeled with BrdU. The Rats were divided into two groups. Monocyte chemotactic protein I（MCP-1） expression were measured by in situ hybridization and immunohistochemistry in the sham operated or infarcted hearts at 1, 2, 4, 7, 14 and 28 days post operation in MCP-1 detection group. The rats were injected with MCP-1, anti-MCP-1 antibody or saline 4 days after myocardial infarction in intervention group. Then, a total of 5 × 10^6 cells in 2.5 ml of PBS were injected through the tail vein. The number of the labeled MSCs in the infarcted hearts was counted 3 days post injection. Cardiac function and blood vessel density were assessed 28 days post injection. Results：Self-generating MCP-1 expression was increased at the first day, peaked at the 7^th day and decreased thereafter post MI and remained unchanged in sham operated hearts. The MSCs enrichment in the host hearts were more abundant in the MI groups than that in the non-MI group（P= 0.000）, the MSCs enrichment in the host hearts were more abundant in the MCP-1 injected group than that in the anti-MCP-1 antibody and saline injected groups （P = 0.000）. Cardiac function was improved more in MCP-1 injected group than anti-MCP-1 antibody and saline injected groups（P= 0.000）. Neovascularization in MCP-1 injected group significantly increased compared with that of other groups（P = 0.000）. Conclusion： Myocardial MCP-1 expression was increased only in the early phase post MI. MCP-1 may enhance MSCs homing to the injured heart and improve cardiac function by promoting neovascularization.     

胸椎黄韧带骨化症临床研究

目的 探讨胸椎黄韧带骨化症的诊断特点及改良手术的疗效。方法 总结我院从1995～2005年收治的28例胸椎黄韧带骨化症的患者并对其手术疗效加以分析。结果28例患者全部获得随访，随访时间6～36个月，平均23个月。术后JOA评分为6～11分，平均9．3分，恢复率为73．6％，优良率为84．5％。结论临床表现结合CT及MRI检查是诊断胸椎黄韧带骨化症的有效手段，改良的外科手术方式安全可靠，手术疗效佳。     

经内镜胆管放置改良胆道支架的临床应用

目的 通过研究ERCP放置胆管内支架和改良后胆管内支架解决梗阻性黄疸,判断改良后支架临床实用价值.方法 对20例梗阻性黄疸患者进行常规ERCP,经FRCP将导丝插入胆管并超过梗阻部位,用推送导管将合适的常规支架或改良后支架,或用鼻胆管自制支架置于胆管适当位置,对比病变前后1周胆红素情况,观察术后3个月支架移位,堵塞情况,对比两种支架引流的效果.结果 20例梗阻患者均成功置入塑料支架,成功率100.0%.患者血清总胆红素从(137.8±15.6)μmol/L,术后1周下降到(30.8±5.2)μmol/L,显效16例(80.0%),有效3例(15.0%),总有效率95.0%,1例无效(5.0%).常规支架中显效8例,有效2例,改良支架中显效9例,无效1例.3个月后改良支架未发生移位.常规支架中,2例移位,其中1例致肠壁损伤,1例支架脱落.结论 改良胆管支架(自行对支架进行塑型、打孔、增加侧翼)更容易成功放置,引流更加通畅,并且不易发生移位.     

Opsite Flexifix: An effective adjunct in the management of pain and hypersensitivity in the hand

Hand trauma commonly results in pain, swelling and stiffness. These sequelae of injury usually resolve uneventfully. In a small number of patients, however, pain will persist long after the initial trauma. Persisting pain has a significant impact on the patient's ability to participate in the hand therapy programme; this, in turn, hinders restoration of hand function. Pain management strategies are numerous and draw from a wide variety of disciplines, including hand therapy (occupational therapy and physiotherapy), psychology, pharmacology and, occasionally, surgery. Opsite film has been used for a number of years in the management of pain associated with diabetic neuropathy. The types of symptoms experienced by patients with neuropathy are very similar to those described by some patients with hand injuries. For the past 12 months the authors have trialled Opsite Flexifix (Smith and Nephew) on 42 patients with varying diagnoses. Patient response to this pain-relieving strategy has been very positive and the authors believe that inclusion of Opsite Flexifix in a pain management programme is indicated.     

Surgical access to the oral cavity

The treatment goals for surgical management of oral cancers are local control, improved survival, reduced complications and recurrence and to maintain form and function.     

DNA酸解后甲基绿——派洛宁改良染色法在胃癌,食管癌诊断中的应用

目的 对ＤＮＡ酸解后甲基酸－－派洛宁染色进行改良并用于肿瘤诊断。方法 收集已明确诊断的常规外检标本胃癌及食管癌共１２６例，应用改良染色法对ＤＮＡ酸解后组织进行染色观察。结果 被染组织色彩艳丽可清楚显示肿瘤细胞的染色强度及染色数量，清楚显示肥大细胞的形态特点，也显示其他多种组织成分。结论 ＤＮＡ酸解后甲基绿－－派洛宁改良染色法可用于判定肿瘤的增殖活性及分化程度，用于区别良、恶性病变，也适用于其他病理外检的诊断及组织形态学研究。     

Continuing professional development – global perspectives: synopsis of a workshop held during the International Association of Dental Research meeting in Gothenburg, Sweden, 2003. Part 2: regulatory and accreditation systems and evidence for improving the performance of the dental team

This paper is the second in a series of two that report on continuing professional development (CPD). Details of the informants and the methodologies used were reported in the first paper. This paper reports the data and information presented on the topics of regulatory and accreditation systems for CPD and evidence that CPD improves the performance of the oral health team. By June 2003, participation in CPD was mandatory in most of the states of the USA, all Canadian Provinces, the UK and Latvia and was likely to become mandatory in a number of other countries in the near future. A variety of accreditation systems were reported including collecting CPD points, which in some countries were weighted depending on the type of CPD activity, and re‐certification examinations. Very few studies for the effectiveness of dental CPD were identified. However, in general it was concluded that there is little evidence for the effectiveness of CPD for the oral health team. The main recommendation from this study is that a systematic review of the effectiveness of CPD in improving the performance of the oral health team and patient based outcomes be undertaken. A range of other research questions was also identified including: how can CPD be best matched to clinicians’ needs rather than demands?     

High-dose chemoradiotherapy with syngeneic bone marrow transplantation for multiple myeloma: a case report and literature review

We had the opportunity to treat a patient with progressive heavily pretreated multiple myeloma with high-dose chemoradiotherapy with hematopoietic rescue by syngeneic bone marrow transplantation. The patient was a 53-year-old male who had previously received melphalan, prednisone, 1,3-bis (2-chloroethyl)-l-nitrosourea (BCNU), vincristine, and standard radiation therapy. At the time of bone marrow transplantation, he had increasing bone pain, increasing M-protein (IgG kappa), and a bone marrow diagnostic of myeloma. The transplant regimen consisted of cyclophosphamide, 60 mg/kg intravenously for 2 days, and total body irradiation--1,200 rads given as 200-rad fractions, twice daily for three days. The transplant course was complicated by confusion, herpes simplex mucositis, fever, and two episodes of idiopathic diffuse interstitial pneumonia. Over the next 2 years the patient did well and was in immunologic and bone marrow complete remission. Unfortunately, 3 years after treatment, the myeloma relapsed with detectable M-protein. Three and one-half years after transplant, clinical relapse occurred with bone pain and lytic lesions necessitating additional radiation and chemotherapy. Salvage therapy has produced clinical improvement and the patient is alive almost 4 years from transplant and almost 7 years from diagnosis. Although intense chemoradiotherapy did not cure this patient, substantial control of a refractory tumor was observed. This case, together with other cases of intense therapy for myeloma which are reviewed in this paper, support the concept of high-dose therapy and should foster further investigation of high-dose therapy.     

改良斜轴位磁共振成像扫描在距腓前韧带损伤中的应用价值

目的  评估改良斜轴位磁共振成像（MRI）检查对慢性踝关节不稳患者距腓前韧带损伤诊断的可靠性及有效性。方法  选取2013年1月-2015年11月从该院预行踝关节镜检查的住院患者中招募研究对象。所有研究对象行踝关节常规轴位及改良斜轴位MRI检查，利用MRI图像评估距腓前韧带损伤，对比上述检查对韧带全长的显示效果，利用ICC指数评估观察者间一致性，以踝关节镜检查结果作为金标准，评估上述检查的敏感性、特异性、阴性预测值，阳性预测值、准确性。结果  招募91例研究对象。其中，男性49例，女性42例,平均（34.6±13.2）岁。常规轴位MRI显示，效果与改良斜轴位MRI的差异有统计学意义（观察者A：Z =-4.987，P =0.000；观察者B：Z =-4.084，P =0.000），斜轴位MRI检查观察者间ICC指数为0.943，95%CI：0.902，0.987。共有60例患者经关节镜检查确诊为距腓前韧带损伤。改良斜轴位MRI检查的敏感性、特异性、阴性预测值、阳性预测值及准确度：观察者A分别为92%、97%、86%、98%和95%；观察者B分别为95%、94%、91%、97%和95%。结论  对于诊断距腓前韧带损伤，改良斜轴位MRI检查具有很好的观察者间一致性以及突出的诊断价值，可以较好地显示韧带全长，值得在临床推广应用。

     

Early life growth patterns persist for 12 years and impact pulmonary outcomes in cystic fibrosis

Background

In children with cystic fibrosis (CF), recovery from growth faltering within 2?years of diagnosis (Responders) is associated with better growth and less lung disease at age 6?years. This study examined whether these benefits are sustained through 12?years of age.