ObjectiveTo analyze the effectiveness and problems existing in implementing acquired immune deficiency syndrome (AIDS) control and prevention in community health service centers, and to provide scientific evidence for promoting AIDS control and prevention. MethodsRelated information on AIDS control and prevention in community health service centers in a community in the whole year of 2013 was acquired. The effectiveness and problems existing in case management, laboratory testing and highly active antiretroviral therapy (HAART) based on the current community health service system were analyzed. ResultsBy the end of 2013, the rate of AIDS case management was from zero to 100%, the rate of CD4 T detection was from 76.60% (360/470) to 88.35% (508/575), and the rate of receiving highly active antiretroviral therapy among AIDS patients was from 81.40% (175/215) to 84.41% (287/340). But in the actual work on AIDS in community health service centers, there were still some common problems needing to be solved. ConclusionThe community level management mode of AIDS can promote the accuracy of AIDS patients' information, improve the rate of case management, the rate of CD4 T detection and HAART. It is suggested that the community level management mode of AIDS should be promoted in the cities where AIDS patients are concentrated.
ObjectiveTo investigate the efficacy of sulfasalazine combined with thalidomide in the treatment of spondyloarthropathy (SpA), and to probe whether the treatment can reach and maintain clinical remission for the patients. MethodBetween January 2011 and June 2013, we used a prospective, non-intervention and regular follow-up study to observe and assess 70 SpA patients on their Bath ankylosing spondylitis disease activity index, visual analogue scale score, peripheral arthritis, blood sedimentation, and C-reactive protein. All the patients had taken sulfasalazine, thalidomide and non-steroidal anti-inflammatory drugs for 24 weeks. Multivariate analysis of factors affecting the efficacy of the program was our object of this study. ResultsAfter 24 weeks, the total clinical remission rate of these patients was 72.9%. Clinical remission rate of 40 patients with short duration of SpA was 90.0%, while it was 50.0% for the other 30 patients with a non-short duration of SpA. Observation indexes before and after treatment in both groups of patients had significant differences (P<0.05). For patients with non-short duration SpA, the curative effect for female was obviously better than male, but the difference between male and female patients with short-duration SpA was not so obvious. Clinical remission rate for youth was similar with that for non-youth patients. Binary logistic regression analysis showed that whether the disease had a short duration[OR=3.408, 95%CI (1.637, 7.437), P=0.001] and whether the patients were urban residents[OR=4.163, 95%CI (2.011, 8.761), P=0.001] were statistically significant (P<0.05). ConclusionsClinical remission of spondyloarthropathy can be maintain by sulfasalazine combined with thalidomide. Clinical remission rate of the scheme is affected by duration of disease and residency except age and gender of the patients. Short duration and urban residency are independent factors for reaching clinical remission after treatment.
Cardiac enlargement is an important symptom of vascular and heart disease. The cardiothoracic ratio (CTR) is an important index used to measure the size of heart. The aim of this study was to assess the relationship between aging and cardiothoracic ratio. This paper also presents an improved C-V level set method to segment lung tissue based on X-ray image, which used to automatically compute CTR. In the investigation carried out in our school, we got more than 3 120 chest radiographs from medical examination of the working population in Beijing, and we systematically studied the effects of age and gender on the CTR to obtain reference values for each group. The reference values established in this study can be useful for recording and quantifying the cardiac enlargement, so that it may be useful for calling attention to the cardiovascular diseases and the heart diseases.
Objective To construct recombinant adenovirus vector co-expressing human interleukin (hIL)-10 and green fluorescent protein (GFP) for study of the expression of genes of interest in vascular smooth muscle cells （VSMCs）. Methods hIL-10 cDNA was amplified from pUCm-T/hIL-10 cDNA using polymerase chain reaction (PCR), and cloned into shuttle plasmid pShuttle-IRES-hrGFP-1. Kanamycin resistance screeninged for recombinant plasmids, which were linealized with PmeⅠand transformed into BJ5183-AD-1 containing pAdEasy-1 by electroporation after determining the insert’s sequence correct by NotⅠ and XholⅠdigestion， sequencing and basic local alignment search tool (BLAST). Prepared recombinant adenovirus plasmids were transformed into XL10-Gold cells. Amplified plasmids were transfected to AD-293 cells for packaging after being linearized with PacⅠ. PCR was used to determine target gene; The titer of the recombinant adenovirus was measured. VSMCs were transfected by recombinant adenovirus and viewed under fluorescence microscope. hIL-10 concentration in transfected VSMCs supernant was measured by enzyme linked immune sorbent assay (ELISA). Results Recombinant shuttle plasmids contained interest gene. Recombinant adenovirus had 30 kb and 3 kb fragments after digestion with PacⅠ. PCR indicated that the recombinant adenovirus contained interest gene. The titer of recombinant adenovirus was 3×10１0 efu/ml. Transfected VSMCs had GFP expression and hIL-10 concentration in supernatant was 25 ng/106 cells. Conclusion The recombinant adenovirus co-expressing hIL-10 and GFP is successfully constructed and could effectively express in VSMCs, this lays the foundation for the gene therapy of vascular intimal hyperplasia.
ObjectiveTo investigate the clinical characteristics of pancreatitis, panniculitis, and polyarthritis syndrome (PPP syndrome). MethodsA patient with PPP syndrome in July 2013 was reported. The clinical features of 33 cases of PPP syndrome at home and abroad were reviewed. ResultsOur patient with panniculitis and arthritis as the first manifestation had few abdominal symptoms despite high serum levels of pancreatic enzymes. In the 34 PPP cases, 70.6% (24/34) had absent or mild abdominal symptoms, easily leading to misdiagnosis. Multi-joint involvement was more common, and in almost 1/3 of the patients, joint symptoms with poor NSAIDs and/or hormonal responses predated the identification of pancreatic disease. Panniculitis biopsy found characteristic "ghost cells". Ten patients died of complications of pancreatic disease (including 2 cases of cancer), and the mortality rate was as high as 29.4% (10/34). ConclusionPPP syndrome with mild abdominal symptoms and high mortality should be taken for the treatment of pancreatic disease, to prevent misdiagnosis and mistreatment.
ObjectiveTo investigate the effect of transforming growth factorβ1 (TGF-β1) and basic fibroblast growth factor 1 (bFGF-1) on the cellular activities, prol iferation, and expressions of ligament-specific mRNA and proteins in bone marrow mesenchymal stem cells (BMSCs) and ligament fibroblasts (LFs) after directly co-cultured. MethodsBMSCs from 3-month-old Sprague Dawley rats were isolated and cultured using intensity gradient centrifugation. LFs were isolated using collagenase. The cells at passage 3 were divided into 6 groups: non-induced BMSCs group (group A), non-induced LFs group (group B), non-induced co-cultured BMSCs and LFs group (group C), induced BMSCs group (group D), induced LFs group (group E), and induced co-cultured BMSCs and LFs group (group F). The cellular activities and prol iferation were examined by inverted contrast microscope and MTT; the concentrations of collagen type Ⅰ and type Ⅲ were determined by ELISA; and mRNA expressions of collagen types I andⅢ, fibronectin, tenascin C, and matrix metalloproteinase 2 (MMP-2) were measured by real-time fluorescent quantitative PCR. ResultsA single cell layer formed in the co-cultured cells under inverted contrast microscope. Group F had fastest cell fusion ( > 90%). The MTT result indicated that group F showed the highest absorbance (A) value, followed by group D, and group B showed the lowest A value at 9 days after culture, showing significant difference (P < 0.05). Moreover, the result of ELISA showed that group F had the highest concentration of collagen type Ⅰ and type Ⅲ (P < 0.05); the concentration of collagen type Ⅲ in group E was significantly higher than that in group D (P < 0.05), but no significant difference was found in the concentration of collagen type Ⅰ between 2 groups (P > 0.05). The ratios of collagen type Ⅰ to type Ⅲ were 1.17, 1.19, 1.10, 1.25, 1.17, and 1.18 in groups A-F; group D was higher than the other groups. The real-time fluorescent quantitative PCR results revealed that the mRNA expressions of collagen type Ⅰ and type Ⅲ and fibronectin were highest in group F; the expression of tenascin C was highest in group D; the expression of MMP-2 was highest in group E; and all differencs were significant (P < 0.05). ConclusionDirectly co-cultured BMSCs and LFs induced by TGF-β1 and bFGF-1 have higher cellular activities, proliferation, and expressions of ligament-specific mRNA and protein, which can be used as a potential source for ligament tissue engineering.
ObjectiveTo summarize the clinical experience of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma. MethodWe retrospectively analyzed the clinical data of 38 patients with esophageal carcinoma undergoing thoracoscopic and laparoscopic esophagectomy in Central Hospital of Chongqing Three Gorges between March 2011 and March 2013. There were 25 males and 13 females aged 64.25±7.68 years (ranged 45-79 years). The esophagus was freed and the lymph nodes were cleaned under the thoracoscope in the left lateral position. Then the stomach was freed under laparoscope and lifted up to anastomose with the esophagus through the passageway behind the sternal bone. ResultsAll surgical process progressed successfully without intraoperative death or major hemorrhage. The total operating time ranged from 250 to 340 minutes. The intraoperative hemorrhage ranged from 80 to 350 ml. The number of lymph nodes cleaned ranged from 7 to 15 (10.24±2.04) and a total of 8 patients were found of tumor metastasis. Postoperative stage grading indicated 8 patients of T1N0M0, 16 patients of T2N0M0, 5 patients of T2N1M0, 6 patients of T3N0M0 and 3 patients of T3N1M0. Postoperative complications included chylothorax in 1 patient, pulmonary infection in 4 patients, and cervical anastomotic leakage in 4 patients. All 38 patients were followed up for 3 to 12 (6.31±2.18) months, and 1 patient was lost. Two patients died from cervical anastomotic leakage resulting in chest infection. The other all achieved recoveries without metastatic or recurrence of tumor. ConclusionThe intraoperative and postoperative complications of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma are less frequently than traditional surgery, so it's worthy of promotion in large regional general hospitals.
ObjectiveTo systematically evaluate the efficacy and safety of intra-articular injection of hyaluronic acid for knee osteoarthritis. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), WanFang Data, CBM, and CNKI were searched to collect randomized controlled trials (RCTs) about intra-articular injection of hyaluronic acid for knee osteoarthritis from inception to February 2016. The meta-analysis was conducted using RevMan 5.3 software. ResultsA total of 17 RCTs involving 4 070 patients were included. The results of metaanalysis showed that: there were no significant differences in WOMAC pain scores (7 weeks: MD=-0.01, 95%CI -0.46 to 0.44, P=0.98; 13 weeks: MD=-0.01, 95%CI -0.46to 0.43, P=0.95; 26 weeks: MD=0.32, 95%CI -0.04 to 0.67, P=0.08), stiffness scores (7 weeks: MD=0.10, 95%CI -0.26 to 0.45, P=0.59; 13 weeks: MD=0.24, 95%CI -0.11 to 0.60, P=0.17; 26 weeks: MD=0.06, 95%CI -0.09 to 0.22, P=0.42), and life function scores (7 weeks: MD=-0.20, 95%CI -0.75to 0.36, P=0.49; 13 weeks: MD=-0.02, 95%CI -0.57 to 0.52, P=0.93; 26 weeks: MD=0.30, 95%CI -0.07 to 0.67, P=0.11) between the hyaluronic acid group and the control group in 7-, 13- and 26 weeks. However, the hyaluronic acid group was superior to the control group in 50-step test (MD=-0.49，95%CI -7.36 to -3.61，P<0.000 01). ConclusionCurrent evidence suggests that intra-articular injection of hyaluronic acid has better effect than control treatment for pain at movement. However, due to the limited quantity of the included studies, the above conclusion still need to be verified by more high quality studies．
ObjectiveTo systematically evaluate the effectiveness of arthroscopic debridement versus non-operative treatment for degenerative meniscal tear. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 7, 2015), WanFang Data, CBM, and CNKI were searched to collect randomized controlled trials (RCTs) about arthroscopic debridement versus non-operative treatment for degenerative meniscal tear from inception to July 2015. The meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine RCTs involving 1 023 patients were included. The results of meta-analysis showed that:there were no significant differences between two groups at different follow-up time points in knee scoring scale (less than 6 months:SMD=0.12, 95%CI -0.11 to 0.35, P=0.30; 1 year:SMD=-0.03, 95%CI -0.18 to 0.11, P=0.65; 2 years:SMD=-0.07, 95%CI -0.32 to 0.19, P=0.61) and pain score (less than 6 months:MD=0.30, 95%CI -0.10 to 0.70, P=0.14; 1 year:MD=0.10, 95%CI -0.40 to 0.60, P=0.70; 2 years:MD=0.02, 95%CI -0.52 to 0.92, P=0.90). ConclusionCurrent evidence suggests that arthroscopic debridement hasn't better effective than non-operative treatment for degenerative meniscal tear, however, due to the limited quantity of the included studies, the above conclusion still need more high quality research to be verified.
ObjectiveTo discuss whether human amniotic mesenchymal stem cells (hAMSCs) possesses the characteristic of mesenchymal stem cells, and could differentiate into ligament cells in vitro after induction. MethodsThe hAMSCs were separated through enzyme digestion, and the phenotypic characteristics of hAMSCs were tested through flow cytometry. The cells at passage 3 were cultured with L-DMEM/F12 medium containing transforming growth factor β1 (TGF-β1)+basic fibroblast growth factor (bFGF) (group A), containing hyaluronic acid (HA) (group B), containing TGF-β1+bFGF+HA (group C), and simple L-DMEM/F12 medium (group D) as control group. The morphology changes of cells in each group were observed by inverted phase contrast microscope at 21 days after induction; the cellular activities and proliferation were examined by sulforhodamine (SRB) colorimetric method; and specific mRNA and protein expressions of ligament including collagen type I, collagen type III, and tenascin C (TNC) were measured by real-time fluorescence quantitative PCR and immunohistochemical staining. ResultsThe flow cytometry result indicated that hAMSCs expressed mesenchymal stem cell phenotype. After 21 days of induction, the cells in groups A, B, and C grew like spindle-shaped fibroblasts under inverted phase contrast microscope, and cells showed single shape, obvious directivity, and compact arrangement in group C. The SRB result indicated that the cells in each group reached the peak of growth curve at 6 days; the cellular activities of groups A, B, and C were significantly higher than that of group D at 6 days after induction. Also, the immunohistochemical staining results showed that no expressions of TNC were detected in 4 groups at 7 days; expressions of collagen type I in groups A, B, and C were significantly higher than that in group D at 7, 14, and 21 days (P<0.001); the expressions of collagen type III in groups A, B, and C were significantly higher than that in group D at 14 and 21 days (P<0.001). There was an increasing tendency with time in collagen type I of group B, in collagen type III and TNC of groups A and C, showing significant difference among different time points (P<0.001). The real-time fluorescence quantitative PCR results revealed that the mRNA expressions of collagen type I and TNC in group C were significantly higher than those in groups A and B (P<0.05), and the mRNA expression of collagen type III in group B were significantly higher than that in groups A and C at 21 days (P<0.05). The mRNA expressions of collagen type I and TNC in groups A and C and mRNA expression of collagen type III in group C had an increasing tendency with time, showing significant difference among different time points (P<0.001). ConclusionThe hAMSCs possesses the characteristics of mesenchymal stem cells and excellent proliferation capacity. After in vitro induction, the expressions of ligament specific genes can be up-regulated and the synthesis of ligament specific proteins can be also strengthened. As a result, it can be used as one of ligament tissue engineering seed cell sources.