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COMPARATIVE STUDY ON HEALING BETWEEN THE FREE TENDON GRAFT AND TENDON TRANSFER IN THE RECONSTRUCTION OF FLEXOR TENDON IN ZONE Ⅱ

In order to understand the influence of the free tendon graft and the tendon transfer on their blood supply, histological and biochemical changes during healing following repair of the damaged tendon after the alteration of the nourishing environment, an experiment was carried on 36 New Zealand white rabbits. In the front paws of the rabbits, the free tendon graft was sutured in the tendon defect of flexor of the fourth toe and the flexor tendon of the third toe was transferred to the second toe to reconstr...

COMPARATIVE STUDY ON THE MAIN BIOLOGICAL CHARACTERISTICS OF MARROW-DERIVED STROMAL CELLS AND CHONDROCYTES IN VITRO CULTURE IN RABBITS

Objective To observe the main biological characteristics and chondrogenesis potency of bone marrow -derived stromal cells(MSCs) after cytokinesinduction or gene modification in vitro. Methods MSCs from an adult New Zealand white rabbit were isolated and cultivated, and then MSCs were divided into the common medium group(Group A, 15%FBS in DMEM), the induced group by cytokines (Group B), the transfected group(Group C)with adenovirus-hepatocyte growth factor transgene (adHGF). The medium of group B consisted of transforming growth factor-β1(TGF-β1,10 ng/ml), basic fibroblast growth factor(bFGF,25 ng/ml) addexamethasone (DEX,10-7mol/L) with 15%FBS in DMEM. Cartilage slices wereobtained from femoral condyles and patellar grove in the same rabbit. The minced cartilage was digested in Ⅱ collagenase (3 mg/ml) to obtain chondrocytes(Group D). The change of cell appearance, proliferation capacity, glycosaminoglycans(GAG), immunohistochemical staining for type Ⅰ, Ⅱ collagen were observed during the 5th passage MSCs and MSCs after induction or gene modification. Expression of mRNA for type Ⅰ and Ⅱ collagen was detected by RT-PCR. Results Primary MSCs proliferated as shortspindle shape, while the 5th MSCs showed longspindle shape. Positive stain of type Ⅰ collagen could be found in groups A, B and C, while positivestain of type Ⅱ collagen was shown in groups B and D. The content of GAG in group B was higher than that in group A, but there was no significant difference between them（Pgt;0.05）, and there was significant difference between groups A and D（Plt;0.05）. No significant difference was noted in groups A,B and C on proliferation by MTT（Pgt;0.05）,except that of at the fourth day after transfection between groups A and C（Plt;0.05）. RT-PCR demonstrated that MSCs always had higher levelsof mRNA type Ⅰ collagen in groups A, B and C. The expression of mRNA type Ⅱ collagen was identified in groups B and D, and only low levels of mRNA type Ⅱ collagen in group C. Conclusion The above results indicate MSCs have a natural tendency of osteogenic differentiation in vitro culture, and also demonstrate the chondrogenic potency with the technique of cytokines induction or gene modification after passage. MSCs can be transfected efficiently being seed cells in tissue engineered bone or cartilage to accept target genes such as adHGF, and have a higher levels of expression in vitro, which lasted 4 weeks at least.

两种腹膜后腔建立方法的比较

【摘要】 目的 比较气囊法组和直接法组建立腹膜后腔的临床价值。 方法 对2005年5月-2008年12月32例后腹腔镜手术建立腹膜后腔的临床资料进行比较，统计分析两种腹膜后腔建立方法在时间、空间大小、食指经穿刺孔能否触及肾脏、并发症发生率、出血量等的差别。 结果 两种方法均成功建立腹膜后腔。气囊法组建立腹膜后腔时间平均为（13.17±1.40） min，直接法组为（4.45±1.20） min。气囊法组腹膜后腔空间为（396.00±13.33） mL，直接法组为（85.50±6.05） mL。气囊法组食指经穿刺孔能触及肾脏6例（50%），直接法组无1例（0%）。组间比较，差异有统计学意义（Plt;0.01）。两组患者建立空间后经观察均为少量渗血，气囊法组发生气囊爆裂1例。 结论 直接法组在时间上明显优于气囊法组，与气囊法组比较并未增加相关并发症，但建立的空间较小；在熟练掌握了气囊法组后可以运用直接法组建立腹膜后腔。

几种颅骨成形材料的临床应用比较

A Comparative Study on Theories and Methods of Medical Expenditure Control between China and the US

Objective　The rising medical expenditure is an international problem. By comparing theories and methods of medical expenditure control between China and the US, this paper aims to find out the medical expenditure strategies fitting for our country and to help with the new round of medical and health system reform. Methods　This evidence-based research searched for literatures using the search strategy and screened literatures according to inclusion and excluding criteria. Useful information in the literatures was extracted through quantitative analysis of literature tables and descriptive statistical analysis. Results　We found that the US academia showed a sustainable and steady trend of increased concern on the medical expenditure control, while the Chinese academia showed a larger volatility on it. There were some obvious differences such as reasons for expenditure increase, the reasonableness of the medical expenditure increase, and the specific methods and strategies of the medical expenditure control between Chinese and American authors. Conclusion　On the one hand, the purpose of medical expenditure control is based on the different stages of development. On the other hand, the main interest group determines the main body who is responsible for the medical expenditure control. According to our national context, China should develop effective strategies and methods for medical expenditure control.

Review on the Research Progress of Mining of OMIM Data

Online Mendelian Inheritance in Man (OMIM) is a knowledge source and data base for human genetic diseases and related genes. Each OMIM entry includes clinical synopsis, linkage analysis for candidate genes, chromosomal localization and animal models, which has become an authoritative source of information for the study of the relationship between genes and diseases. As overlap of disease symptoms may reflect interactions at the molecular level, comparison of phenotypic similarity may indicate candidate genes and help to discover functional connections between genes and proteins. However, the OMIM has used free text to describe disease phenotypes, which does not suit computer analysis. Standardization of OMIM data therefore has important implications for large-scale comparison of disease phenotypes and prediction of phenotype-genotype correlations. Recently, standard medical language systems, term frequency-inverse document frequency and the law of cosines for document classification have been introduced for mining of OMIM data. Combined with Gene Ontology and various comparison methods, this has achieved substantial successes. In this article, we have reviewed various methods for standardization and similarity comparison of OMIM data. We also predicted the trend for research in this direction.

LATERAL RADIOGRAPHIC COMPARISON FOR VELAR MOVEMENT BETWEEN PALATOPLASTY WITH VELOPHARYNGEAL MUSCULAR RECONSTRUCTION AND MODIFIED VON LANGENBECK’S PROCEDURE

Objective To verify the effect of palatoplasty with or without velopharyngeal muscular reconstruction on the velar movement through the lateral radiography. Methods From October 1988 to October 2000, 62 patients with cleft palate and velopharyngeal insufficiency were treated. Of them, 32 were repaired by velopharyngeal muscular reconstruction (group A) and 30 by modified von Langenbeck’s procedure (group B). The lateral radiographs and cephalometric analysis were taken. The velopharyngeal closure, velar extensibility, the angle changes of velar elevation, the distance changes of velar levator eminence based on anatomy (LEA) to velopharyngeal closure line (VCL), the varieties in LEA, the comparison of LEA and velar levator eminence based on phonation (LEP), the distance comparison between posterior nasal spine (PNS) to LEA and LEP through soft palate line (SPL) were measured. Results During the phonation, group A was significantly greater than group B in the velopharyngeal closure rate(Plt;0.01)， the velar extensibility(Plt;0.05) and the location comparison between LEA and LEP(Plt;0.01); group B was significantly greater than group A in velar elevation angle (Plt;0.05), the varieties in LEA(Plt;0.05). In velar rest position, the distance of LEA to VCL was greater inB group than in A group(Plt;0.01). There was significant difference in thedistance comparison between LEA and LEP(Plt;0.05), difference between LEA and LEP(Plt;0.01) and the distance PNS-SPL-LEA and PNSSPL-LEP(Plt;0.05) within group B; contrary to the results within group A(P＞0.05). Conclusion The velopharyngeal muscular reconstruction in palatoplasty can result in a near normalizationof anatomic measurement of velar levator muscles and improve the velar functionand velopharyngeal competence. Repositioning of velar muscles in a more anatomic correct, transverse position is more important to improve the velar length andaccordant velar movement with velopharyngeal muscles in functional palatoplasty. The velar angle change and velar elevation during phonation are not determinative factors for velopharyngeal competence.

A COMPARISON OF OPEN REDUCTION AND CLOSED REDUCTION IN TREATING DISTAL RADIUS FRACTURES IN ELDERLY PATIENTS

Objective To discuss the relationship between recovery of anatomical integrity and functional outcome in elderly patients with distal radius fractures by comparing the effects of open reduction and closed reduction. Methods The cl inical data were retrospectively analyzed from 78 elderly patients with distal radius fractures treating with nonoperation andoperation from February 2005 to March 2009. Thirty-seven patients underwent closed reduction and spl intlet fixation or cast appl ication (non-operation group), and forty-one patients underwent open reduction and internal fixation (operation group). In non-operation group, there were 15 males and 22 females with an average age of 73 years (60-83 years). According to the AO classification system for fracture, there were 8 cases of type A2, 7 cases of type A3, 7 cases of type B1, 4 cases of type B2, 2 cases of type B3, 4 cases of type C1, 2 cases of type C2, and 3 cases of type C3. The time from injury to admission was between 30 minutes and 3 days with a mean time of 1 day. In operation group, there were 18 males and 23 females with an average age of 71 years (62-80 years). According to the AO classification system for fracture, there were 5 cases of type A2, 7 cases of type A3, 7 cases of type B1, 6 cases of type B2, 3 cases of type B3, 4 cases of type C1, 5 cases of type C2, and 4 cases of type C3. The time from injury to admission was between 30 minutes and 7 days with a mean time of 1 day. There were no significant differences (P gt; 0.05) in sex, age, disease course and fracture classification between two groups. Results All incisions obtained heal ing by first intention after operation in operation group. All patients were followed up for 9-36 months (20 months on average). Fracture heal ing was achieved within 8 to 15 weeks, with an average of 11 weeks. There were no significant differences (P gt; 0.05) in fracture heal ing time between non-operation group [(10.8 ± 2.0) weeks] and operation group [(11.7 ± 2.5) weeks]. At last follow-up, thepalmar tilt angle was (5.6 ± 2.0)° and (8.6 ± 3.0)°, the radial incl ination angle was (19.1 ± 4.9)° and (21.8 ± 2.0)°, and the radial length was (8.3 ± 1.3) mm and (10.4 ± 1.4) mm in non-operation group and operation group, respectively; showing significant differences (P lt; 0.05) between two groups. According to the Gartland-Werley score, the results were excellent in 9 cases, good in 21 cases, fair in 5 cases, and poor in 2 cases in non-operation group, the excellent and good rate was 81.1%; in operation group, the results were excellent in 13 cases, good in 25 cases, fair in 2 cases, and poor in 1 case, the excellent and good rate was 92.7%, showing no significant difference (P gt; 0.05) between two groups. There were no significant differences (P gt; 0.05) in flexion and extension activity of wrist, radioulnar partial activity, pronation-supination activity, grip and pinch strength between two groups. Conclusion Open reduction and closed reduction can achieve satisfactory functional outcomes, but closed reduction was inferior to open reduction in anatomic reduction for treating distal radius fractures in elderly patients.

不同厂商紫头真空采血管的血常规结果比对

目的：对不同厂商的紫头真空采血管进行评估，其血常规结果是否有差异。方法：同时使用美国BD公司和成都瑞琦公司生产的紫头真空采血管采集40份新鲜全血标本，分别在自动血液分析仪XE-2100进行检测，再进行白细胞(WBC)、红细胞(RBC)、血红蛋白(HGB)、血小板(PLT)等参数的相关性比较。结果：WBC、RBC、HGB和PLT等参数的差异百分率分别为：0.49%、0.05%、0.13%和1.01%；相关系数(r)分别是：0.9985、0.9964、0.9966和0.9932；t检验的P值分别是：0.9706、0.9020、0.9679、0.9061，均gt;0.05。结论：真空采血管普遍应用于临床标本的采集，由于真空度、抗凝剂的量、管壁的质量对血常规结果均有影响，不同厂商的真空采血管质量不完全相同，通过新鲜全血的结果比对，美国BD公司和成都瑞琦公司生产的紫头真空采血管的血常规结果相关性好，其相关系数均在0.99以上，P值均gt;0.05，无显著性差异，差异百分率小，均lt;±2.0%的可接受范围，表明可用于临床。

Comparative Study of Schoolaged Children Behavior Problems Between Yueyang City and Jining City

摘要:目的:探索区域文化、亚文化、经济水平、教育环境、家庭环境等因素对学龄儿童行为的影响。方法: 比较分析岳阳市与济宁市学龄儿童行为问题调查结果。结果:岳阳市与济宁市学龄儿童行为问题总体现患率分别为9.19%和10.7%(χ2=8.804, Plt;0.05),但与全国22个城市协作调查组报告结果(12.97±2.19)%基本相符;行为问题现患率和构成比存在性别与地区差异(Plt;0.05),男性儿童行为问题现患率高于女性儿童、男性儿童以“A行为”为主、女性儿童以“N行为”为主;行为问题现患率在8、9、12岁三个年龄段有地区差异(Plt;0.05)。结论:学龄儿童行为问题与区域文化、亚文化、经济水平、教育环境、家庭环境等因素有关联,与男女生物学特征的差异和不同环境的反应倾向及年龄等生物社会心理因素有关。Abstract: Objective: To explore the factors affect schoolaged children behavior by regional culture, subculture, economic level, educational environment, family environment and so on. Methods: Compared and analyzed the investigation results of schooleaged children behavior from Yueyang City and Jining City. Results: The prevalence rate of schoolaged children with behavior problems reflects respectively 9.19% and 10.7% (χ2 = 8.804, Plt;0.05), which is in collaboration with the National Investigation Unit report on the results (12.97 ± 2.19)%; the prevalence rate and composition exist gender and regional differences (Plt;0.05). The behavior problems prevalence rate of male child is higher than female children, male children in “A behavior” mainly, female children in “N behavior” mainly; The behavior problems prevalence rate at the age of 8,9,12 exist regional differences (Plt;0.05). Conclusion: Schoolaged children behavior problems are associated with regional culture, subculture, economic level, educational environment, family environment and other factors, and have something with biopsychosocial factor as the differences in male and female biological characteristics, different environments and age.