Ligaments are dense fibrous connective tissue that maintains joint stability through bone-to-bone connections. Ligament tears that due to sports injury or tissue aging usually require surgical intervention, and transplanting autologous, allogeneic, or artificial ligaments for reconstruction is the gold standard for treating such diseases in spite of many drawbacks. With the development of materialogy and manufacturing technology, engineered ligament tissue based on bioscaffold is expected to become a new substitute, which can lead to tissue regeneration by simulating the structure, composition, and biomechanical properties of natural tissue. This paper reviewed some recently published in vitro and animal researches focusing on ligament tissue engineering, then evaluated the properties and the effects on tissue repair and reconstruction of fiber structure scaffolds, multi-phase interface scaffolds and bio-derived scaffolds designed by bionic principle and made of different materials, manufacturing techniques and biological factors. Finally, summarization followed by the prospection for future development direction of biological scaffolds in ligament tissue engineering research is given.
Objective To observe the effects of nitric oxide ( NO) inhalation on lung inflammation of acute lung injury ( ALI) in rats. Methods Twenty-four SD rats were randomly divided into four groups, ie. a normal control group, an ALI group, a 20 ppm NO inhalation group, and a 100 ppm NO inhalation group. ALI model was established by LPS instillation intratracheally and the control group was instilled with normal saline. Then they were ventilated with normal air or NO at different levels, and sacrificed 6 hours later. Pathological changes were evaluated by HE staining. The expression of TLR4 in lung tissues was detected by immunohistochemistry. IL-6 level in lung homogenate was measured by ELISA. Results In the ALI group, the inflammation in bronchus and bronchioles was more apparently, and the expressions of TLR4and IL-6 were elevated significantly compared with the control group. 20 ppm NO inhalation significantly decreased the expression of TLR4 and IL-6, and alleviated the inflammation of ALI. However, 100 ppm NO inhalation did not change TLR4 expression and lung inflammation significantly, and increased IL-6 level.Conclusions Inhalation low level of NO( 20 ppm) can alleviate lung inflammation possibly by reducing theexpression of TLR4 and IL-6.
Objective Isoflurane has an acute preconditioning effectiveness against ischemia in kidney, but this beneficial effectiveness can only last for 2-3 hours. To investigate whether isoflurane produces delayed preconditioningagainst renal ischemia/reperfusion (I/R) injury, and whether this process is mediated by hypoxia inducible factor 1α(HIF- 1α). Methods A total of 52 male C57BL/6 mice were randomly assigned to 4 groups (n=13 in each group): the controlgroup (group A), PBS/isoflurane treated group (group B), scrambled small interference RNA (siRNA)/isoflurane treated group (group C), and HIF-1α siRNA/isoflurane treated group (group D). In groups C and D, 1 mL RNase-free PBS containing 50 μg scrambled siRNA or HIF-1α siRNA was administered via tail vein 24 hours before gas exposure, respectively. Equivalent RNasefree PBS was given in groups A and B. Then the mice in groups B, C, and D were exposed to 1.5% isoflurne and 25%O2 for 2 hours; while the mice in group A received 25%O2 for 2 hours. After 24 hours, 5 mice in each group were sacrificed to assesse the expressions of HIF-1α and erythropoietin (EPO) in renal cortex by Western blot. Renal I/R injury was induced with bilateral renal pedicle occlusion for 25 minutes followed by 24 hours reperfusion on the other 8 mice. At the end of reperfusion, the serum creatinine (SCr), the blood urea nitrogen (BUN), and the histological grading were measured. Results The expressions of HIF-1α and EPO in groups B and C were significantly higher than those in group A (P lt; 0.01). The concentrations of SCr and BUN in groups B and C were significantly lower than those in group A, as well as the scores of tubules (P lt; 0.01), and the injury of kidney was amel iorated noticeably in groups B and C. The expressions of HIF-1α and the concentrations of SCr and BUN in group D were significantly lower than those in group A (P lt; 0.01). Compared with groups B and C, the expression of HIF- 1α and EPO in group D decreased markedly (P lt; 0.01), the concentrations of SCr and BUN were increased obviously, as well asthe scores of tubules (P lt; 0.01), and the renal injury was aggratived significantly. Conclusion Isoflurane produces delayed preconditioning against renal I/R injury, and this beneficial effectiveness may be mediated by HIF-1α.
ObjectiveTo observe the effects of Tianjiang Niuhuang Powder on cognition, seizure and hippocampal formation in epileptic model of pilocarpine rats.MethodsFouty SD rats were selected in this study. They were randomly divided into four groups (each group n=10), including a blank control group (group A) and three pilocarpine epilepsy model groups. The model groups were divided into Tianjiang Niuhuang Powder treatment Group (group B), Sodium valproate (group C) and model control group (group D) according to the different processing methods. The seizures number of discharges in the EEG monitor, cognitive ability were observed on the 7th, 14th and 21st day, The pathological sections of the brain and the neuronal damage in the hippocampal CA1 area were observed after the rats were sacrificed.ResultsThere was no significant difference in the number of spontaneous episodes, duration, and average number of discharges per minute between group B and group C (P>0.05). Compared with groups B and C, group D increased the number of episodes and increased duration. The number of discharges increased, the difference was statistically significant (P<0.05). Group A had no seizures. There were no significant differences in cognitive ability between groups A, B and C (P>0.05). Compared with group A, B and C, group D had poor cognitive ability (P<0.05). The number of surviving cells in the hippocampus CA1 region was significantly improved compared with the D group (P<0.05). Compared with the A group, the viable cells in the hippocampal CA1 region of the three experimental groups were significantly lower (P<0.05).ConclusionsTianjiang Niuhuang Powder can reduce seizures, improve cognition and effectively alleviate neuronal damage in hippocampal CA1 neurons in rats with epilepsy.
Objective To understand the attitude of xinjiang medical workers towards national essential drugs and the requirements and suggestions about training, so as to provide necessary baseline information for spreading the application of Essential Medicine List (EML) in Xinjiang. Methods A questionnaire designed by Chinese Evidence-Based Medical Center was distributed for a face-to-face survey. The data were double-input by EpiData 3.1 with double checks, and statistically analyzed by EXCEL with constituent ratio as the statistical index. Results A total of 80 questionnaires were distributed and then retrieved with 100% recovery rate. Respondents employed in six public hospitals at or above the county level and in six community health service centers as well. a) The accuracy of 80 respondents about the basic concepts of essential drugs, serviceable range of EML, and the relationship between EML and basic medicare drug list were 72.6%, 89.5% and 17.8%, respectively; b) 33.8% (27) of the respondents always firstly considered using the essential medicine in their prescription, and 22.5% (18) of the respondents considered using essential drugs in most cases; c) EML were welcome loy 35% (28) of the respondents; d) The problems of practicing EML issued by respondents were the following in order: doctors’ awareness of essential drugs and prescribing habit of doctors, the safety and effectiveness of essential drugs, lower income, patients’ awareness of essential drugs and preference to medication, and the applicability of the essential medicine list; e) The main approaches to getting information about essential drugs were academic seminars (37 person-time, 46.2%), professional journals (27 person-time, 33.8%) and documents (25 person-time, 31.2%); f) There were 46 respondents who had participated in EML training once or twice; g) The total EML training or learning time of 34 respondents (42.5%) was less than one week; and h) Respondents suggested that, the training objects should be medical personnel, pharmacists and administrators; the training contents should be rational drug use, formularies and the use of essential drugs, drug policy, and the effectiveness of integration of the traditional Chinese medicine and western medicine; the training methods should be theoretical teaching and online learning; and the training place should be hospitals, homes or offices. Conclusion It is extremely urgent to improve doctors’ awareness of EML and strengthen the training of usage, and to conduct the research on EML applicability and effectiveness evaluation, financial subsidies, medical staff income, purchase and reimbursement problems.
Objective To explore the effects of lecture-based learning (LBL), problem-based learning (PBL) or combination of both on the cardiovascular system anatomy teaching. Methods Nine classes majoring in clinical medicine of Grade 2009 were randomly divided into the LBL class, the PBL class and the PBL combined with LBL class. The examination scores and questionnaire were used to evaluate the teaching effect. Results The students of LBL class did well in the objective questions test, but badly in case analysis. On the contrary, the students of PBL class did well in case analysis, but were weak in objective questions test. However, the students of PBL combined with LBL class could get good grades in both of them. Questionnaire showed that the PBL teaching method, PBL and LBL combined method could improve their communicative ability, learning motivation, comprehensive analysis ability, language skills and so on. Conclusion Combination of PBL and LBL not only enhances students’ memories about the anatomic knowledge, but also helps students practice efficiently what they learned to analyze clinical cases. Furthermore, the method of PBL combined with LBL improves, to a certain extent, students’ comprehensive quality.
ObjectiveTo assess the use of 18-Fluorine-labelled 2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the diagnosis of uveal melanoma. MethodsTwenty-three patients with uveal melanoma confirmed by histopathologic examination or imaging examination were enrolled. There were 16 male, 7 female, and the mean age was (49.8±12.3) years. All the lesions were unilateral, with 11 cases in OD, 12 cases in OS. Diagnosis was confirmed by histopathological examination of enucleated eyeballs in 15 cases, by ophthalmoscope, fundus fluorescein angiography, ocular B-mode ultrasound and magnetic resonance imaging and other imaging technology in 8 cases. 15 patients diagnosed by histopathologic examination of enucleated eyeballs were divided into three types including mixed (7 patients), spindle cell (6 patients) and epithelioid cell (2 patients) types. The mixed cell type and epithelioid cell type are considered as high-risk; spindle cell type is low-risk. All the patients were evaluated by whole body PET/CT. The location, size, shape, boundary of the lesions, and the relationship with adjacent structures were observed in CT images. 18F-FDG uptake was quantitative expression by standardized uptake value (SUV) in PET image; positive diagnosis should be made when the maximum standardized uptake value (SUVmax) was not less than 2.5. The correlation between SUVmax and maximum diameter of tumor base, tumor height was analyzed by Spearman rank correlation test. The detection rate of high-risk and low-risk patients between 18F-FDG PET and CT methods was comparative analyzed. ResultsAll the CT images showed abnormal high density ocular lesions. The shape of the lesions included 8 patients of semi sphere-like, 7 patients of flat-like, 4 patients of mushroom-like, 3 patients of round-like and 1 patient of diffuse lesions. The tumors were located in the posterior pole (9 patients), temporal equator (5 patients), nasal equator (4 patients), superior equator (1 patient), temporal ciliary body (1 patient), inferior ciliary body (1 patient), temporal iris (1 patient), and nasal iris and ciliary body (1 patient). SUVmax≥2.5 were found in 9 patients (39.13%), the largest basal diameter and height were (17.53±3.48), (11.37±3.85) mm respectively. SUVmax < 2.5 were found in 14 patients (60.87%), the largest basal diameter and height were (10.66±3.25), (5.33±2.23) mm respectively. The former's largest basal diameter and height were greater than the latter's and the difference was statistically significant (t=4.815, 4.786; P < 0.01). SUVmax was positively correlated with the largest basal diameter and height respectively (r=0.881, 0.809; P < 0.01). 15 patients (39.13%) were diagnosed by histopathological diagnosis after enucleation, of which SUVmax≥2.5 were found in 8 patients which included 6 patients of mixed type, 1 patient of epithelioid cell type, and 1 patient of spindle cell type. The detection rate of high-risk type (77.78%, 7/9) was higher than that of low-risk type (16.67%, 1/6), the difference was statistically significant (χ2=5.402, P < 0.05). Conclusions18F-FDG PET-CT examination can show large uveal melanoma tumor from cell metabolism, and may help to evaluate the prognosis of the preoperative patients. But, for small tumor, it has little value. We don't recommend 18F-FDG PET-CT is used as a routine examination for uveal melanoma.
ObjectiveTo analyze the accessibility of primary care in Sichuan Province from both the perspective of doctors, patients, and field workers, and then make some policy recommendations.MethodsBased on the Quality and Costs of Primary Care in Europe primary care questionnaire, we surveyed 48 primary care facilities from six cities / states in Sichuan by multi-stage stratified random sampling method, taking in account of the regional development level from November 2017 to December 2018. Then integrated accessibility score for primary care was calculated based on the question items for both doctors and patients.ResultsThis study effectively surveyed 319 primary care doctors and 641 patients. In general, the integrated accessibility score for primary care for these areas was 0.25. The accessibility of primary care was worst in less-developed regions (0.23), while it was much better in medium-developed area (0.30) and developed area (0.28).ConclusionsWe can do lots of things to improve accessibility of primary care. Evidence based policies are needed to promote this goal that everyone will have access to basic medical and health services.