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The dura mater is a double-layer tough membrane tissue located between the surface of the brain and the inner surface of the skull that supports and protects the brain tissue. The phenomenon of dural defects caused by tumor resection, inflammation destruction, and craniotomies is becoming more common clinically. Therefore, the development of effective dural repair materials can not only reduce the leakage of cerebrospinal fluid and the occurrence of epilepsy complications but also promote the recovery of the dural defect to its normal physiological structure. With the continuous development of modern medicine, many biomaterials have been developed for dural defect repair. At present, the most promising and most researched biomaterials are synthetic polymer materials and natural polymer materials. Synthetic polymer materials have been extensively studied by domestic and foreign scholars due to their stable performance, low foreign body infection, and easy mass production advantages. Natural polymer materials are the most promising biomaterials because of their extensive sources, excellent biocompatibility, and biodegradability advantages. This article summarizes the research progress based on synthetic polymer materials and natural polymer materials in dural repair materials. In this review paper, the application progress of synthetic polymer materials and natural polymer materials in dural membrane repair was reviewed.
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Objective To investigate the value of interferon-γ release assays(IGRAs)in early diagnosis of pneumoconiosis complicated with tuberculosis.Methods The retrospective study analyzed the results of IGRAs of 498 patients with pneumoconiosis at our hospital from January 2016 to December 2017.The results were compared with those of 1176 non-pneumoconiosis patients.Results The rate of positive IGRAs in patients with pneumoconiosis who had symptoms of respiratory infection was 33.73%,significantly higher than that in non-pneumoconiosis patients (23.64%)(x2 =18.24,P<0.0001).In pneumoconiosis patients with tuberculosis,the rate of positive IGRAs was 95.35 %,and in pneumoconiosis patients without tuberculosis,the rate was 89.13 % (x2=0.48,P=0.49).The rates of positive IGRAs in patients with stage Ⅱ and stage Ⅲ pneumoconiosis were significantly higher than those in the patients with stage Ⅰ pneumoconiosis,and they increased with the progression of pneumoconiosis (x2 =2.21,P =0.023).Conclusions IGRAs offer added diagnostic value in early diagnosis of pneumoconiosis complicated with tuberculosis.
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Objective To investigate the effects of CBL in teaching human embryology for medical students.Methods After having seminar with clinical case, scoring rate of questions discussed and not discussed in final exam were compared in recent 3 years.Embryological knowledge were evaluated in 1, 2, 3 years after embryology class by online test.Results There is no difference of total scoring rate among 3 grades in final exam, while the score of questions discussion was significantly higher than that of non-dissaution course(P<0.01).Scoring rate of objective questions discussed was significantly higher.Scoring rate of online test decreased with years after embryology class, while questions discussed were better than not discussed.Conclusions Seminar with clinical case as CBL could improve the learning outcomes of embryology in short and long term memory.
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Objective In view of the trend of networking development in modern high education and the characteristics of students' strong self-learning ability, Peking Union Medical College established a multimedia morphological teaching website from 2013 including human anatomy, neuroanatomy, histology and embryology.Methods According to the teaching demand, the use of the ASP script, combined with Mysql database completed the website development, from the interface design to the curriculum, the syllabus, presentations and laboratory videos uploading.Results Through the questionnaire survey, 45% of the students use website more than 3 times a week, and course content column has the highest use frequency (79%).An independent learning platform effect has been achieved.Conclusions After nearly 4 years exploration and practice, multimedia website has become an important part of morphological courses, as a kind of new teaching mode, not only popular for college teachers and students, but also widely used in clinical teaching.
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Objective To investigate the appropriate timing of B-lynch suture in the treatment of atonic postpartum hemorrhage during cesarean section.Methods A total of 90 patients with atonic postpartum hemorrhage during cesarean section from January 2012 to December 2014 in our hospital were included in the study.They were divided into two groups, early suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 500 ml, n=66 cases) and late suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 1000 ml, n=24 cases).The hemostatic effect, amount of bleeding, blood transfusion rate, incidence of DIC, duration of hospitalization, and the puerperal morbidity were compared between the two groups.Results All the 90 patients were successfully treated and were discharged after comprehensive treatment.The amount of postpartum hemorrhage of the early suture group was (656±118) ml, which was significantly less than that of the late suture group [(1550±432) ml, t=-10.003, P=0.001].The rate of blood transfusion of the early suture group was 3.0% (2/66), which was significantly lower than that of the late suture group [(50.0%, 12/24), x2=26.092, P=0.000].There was no case of DIC in the early suture group, and the incidence of DIC in the late suture group was 16.7% (4/24), with the difference statistically significant (Fisher''s exact test, P=0.004).The puerperal morbidity in the early suture group was 3.0% (2/66) and that of the late suture group was 25.0% (6/24), with statistically significant difference (x2=7.952, P=0.005).There was no statistically significant difference in the hospitalization stay between the two groups (P>0.05).Conclusions B-Lynch suture is an effective method in the treatment of atonic postpartum hemorrhage during cesarean section, and early use of it can get better curative effect, such as less bleeding amount and lower rates of blood transfusion, DIC and complications like puerperal morbidity.In case the bleeding volume reaches 500 ml and the general conservative hemostatic methods are ineffective, B-Lynch suture is recommended immediately.
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Objective@#To isolate the cariogenic Streptococcus mutans (Sm) strains and study the therapeutical effect of egg yolk antibody (IgY) of the Sm on dental caries development.@*Methods@#Sm strains were isolated from the children's dental plaque samples. Morphological, biochemical and molecular biological methods were applied to identify the serotype, acid producing and adhesion abilities of isolated Sm strains. After inactivation one of the Sm strains was used as antigen to immune laying hens to collect and extract the specific anti-Sm IgY. The rats were infected with Sm (serotype e). After 16 weeks of infection, all the rats were found developing dental caries. The rats were then randomly divided into two groups. The rats in experimental group were supplied with diet containing anti-Sm IgY while the rats in control group with normal IgY. All rats were sacrificed after another 8 weeks' observation. The degree of caries for each rat was assessed using Keyes' method.@*Results@#We isolated 7 Sm strains from the children's dental plaque samples in the present study. The numbers of serotype c, e, f, k were 3, 2, 0 and 2, respectively. All strains showed similar morphological and biochemical characters as standard UA159 Sm strain, and possessed strong capabilities of acid production and adherence. Interestingly, even the same serotypec strains, such as No.3 and No.7 strains, demonstrated significant difference on acid producing and adherence capabilities. After 16 weeks infection with serotype e strain, the rats' mandibular teeth were apparently decayed, and treatment with specific anti-Sm IgY obviously attenuated the development of caries in the experiment group rats (16.4±2.0) compared with that in the control group rats (30.2±9.3) (P<0.05) determined by Keyes' method.@*Conclusions@#Seven cariogenic Sm strains of different serotypes were isolated, which possesses similar morphology and biochemical characters. Although belonging to the same serotype strains they always show significant difference in acid-producing and adherencec apabilities. Further experiment provides evidences that the serotype e strain could obviously induce caries independently, and employment of specific anti-Sm IgY as passive immunotherapy additive might effectively inhibit the further development of dental caries.
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Objective To investigate the effect of preoperative carbohydrate fluid intake on postoperative insulin resistance and immune function.Methods Sixty elective gastroenteric tumor resection patients were randomly divided into test (n =30) and control (n =30) groups.Control group were fasted before surgery,while test group were given oral carbohydrate before surgery.The blood samples were collected to measure the levels of fasting blood glucose (FBG),fasting insulin (FINS),and cellular immunity (CD3 +,CD4 +,CD8 +,and CD4 +/CD8 +) before operation and 1,3,7 day postoperation,respectively.Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance.Results Compared to preoperation,the levels of CD4 +,CD4 + / CD8 +,and HOMA-IR at 1 day postoperation in both control and test groups were significantly higher (P < 0.05).Compared to test group,the levels of CD4 +,CD4 +/CD8 +,and HOMA-IR at 1,3 day postoperation in control group were significantly higher (P < 0.05).At the seventh day after surgery,HOMA-IR levels in the test group were returned to the preoperative level (P > 0.05),while the control group was still higher than before surgery (P < 0.05).There were no differences in CD4 + and CD4+/CD8 + at seventh days after surgery between two groups (P > 0.05).Conclusions Preoperative carbohydrate administration may shorten the insulin resistance duration after gastrointestinal cancer surgery,reduce the intensity of insulin resistance,and improve immune function.Thus contributes to the rehabilitation of patients.
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Objective To evaluate the safety of myomectomy by extrusion in cesarean section , in comparison with routine cesarean delivery. Methods From January 2008 to December 2010, a total of 128 operations of myomectomy by extrusion in cesarean section were performed (Myoma Group), while another group of 128 cases undergoing caesarean section , which respectively followed every cases of the Myoma Group but had no hysteromyoma , was selected as the control group .The amount and rate of postpartum hemorrhage , the level of postpartum fever , and postoperative hospital stay between the two groups were compared , respectively. Results In the two groups:the amount of postpartum hemorrhage was (233.6 ±58.9) ml vs.(228.5 ±90.9) ml (t=0.530, P=0.597); the rate of postpartum hemorrhage was 0% (0/128) vs.0.8% (1/128) (P=1.000); the decrease of haemoglobin was (6.17 ±2.83) g/L vs.(6.89 ±3.09) g/L (t=-1.944, P=0.053); the decrease of hematocrit was 2.22%± 0.98%vs.2.27%±1.02% (t=-0.400, P=0.690); the rate of postpartum fever was 2.3% (3/128) vs.5.5% (7/128) (χ2 =1.665, P=0.197);the length of postoperative hospital stay was (4.2 ±0.8) d vs.(4.1 ±1.2) d (t=0.706, P=0.481). There were no significant differences between the two groups in the abovementioned parameters . Conclusions The myomectomy by extrusion in cesarean section does not increase the level of postpartum hemorrhage and the rate of postpartum infections .It is a simple, minimally invasive , safe and feasible surgical method , being worthy of clinical application .
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Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection.Methods Sixty elective gastroenteric tumor resection patients were divided into observation group and control group by random number table method,with 30 cases in each.Observation group was given carbohydrate administration before surgery,that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose;control group was treated according to the traditional methods,preoperative fasting 12 h,6 h forbidden to drink.The blood samples were collected to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) at 3 h before operation and 1,3,7 d postoperation respectively.Homeostasis model assessment (HOMA) was applied to calculate the insulin resistance index.Results The levels of FBG,FINS,HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [observation group:(10.65 ± 1.78),(7.32 ± 1.48) mmol/L vs.(5.09 ±0.43) mmol/L,(25.78 ± 12.43),(16.23 ±7.56) mU/L vs.(10.48 ± 1.57) mU/L,11.67 ±6.32,5.12 ± 2.11 vs.2.35 ± 0.54;control group:(11.18 ± 1.25),(8.04 ± 1.53) mmol/L vs.(5.12 ± 0.39) mmol/L,(39.67 ± 10.37),(24.34 ± 6.78) mU/L vs.(9.98 ± 2.04) mU/L,19.07 ± 5.49,8.56 ± 2.87 vs.2.28 ± 0.39](P < 0.05).The levels of FINS,HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group (P < 0.05).The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative (P > 0.05),while the levels in control group [(16.32 ± 4.56) mU/L,3.87 ± 1.12] was still higher than those at 3 h preoperation (P <0.05).Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection,and reduce the intensity of insulin resistance,thus contributing to the rehabilitation of patients.
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To develop standard in vitro chondrosarcoma models, we synthesized three hydrogels (i. e., PDMAAm, PNaAMPS and PMETAC) and investigated the influence of Young's modulus, swelling ratio and electric charges on the behavior of chondrosarcoma cells seeded on the hydrogels, including morphology, adhesion and aggregation. Results showed that the morphology of chondrosarcoma cells at 6h was dependent on the charges of hydrogels; cells present spindle-shaped and round-shaped morphology on negative charged and neutral hydrogel, respectively, while no cells spreaded on positive charged hydrogel. Chondrosarcoma cells formed aggregates on neutral PDMAAm after further culture. The hydrogels can be synthesized easily and has the characteristics of ease at use with defined components, which holds great potential for developing standard chondrosarcoma models in vitro.
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Humanos , Neoplasias Ósseas , Patologia , Linhagem Celular Tumoral , Proliferação de Células , Condrossarcoma , Patologia , Hidrogéis , Química , Farmacologia , Metacrilatos , Farmacologia , Nylons , Farmacologia , Eletricidade EstáticaRESUMO
Objective To study the clinical effective durations of a medical injected collagenous products, a high-purity medical injectable collagen filling agents extracted from bovine leather (Fumeida Produced by Changchun Botai Pharmaceutical Biotechnology Co, Ltd). Methods 30 subjects (60 sides) with moderate to severe nasolabial fold wrinkles were selected to perform a clinical observation, in which 49 sides with moderate and 11 sides with severe labial fold wrinkles, and the average age of subjects were (41. 80 ± 8. 03) years. 1 ml of medical collagen was injected into the subjects wrinkle on each side by surgeons. The follow-up was made immediately, 7, 30, 90, 150 and 360 days after injection. The photograph was taken, and the image data and the validity were analyzed. Results The follow-up rate of immediate to 150 days after injection was 100 %, and 93. 3 % after 350 days. At the each follow-up points, the total effective rates were as follows: 100. 0 %, 100. 0 % , 96. 7 %, 90. 0 %, 83. 3 % and 44. 6 % .respectively. There were dry lips with herpes simplex in two cases of subjects at 7 d and 90 d after injection, no redness, induration, exudate, ulceration or other abnormal performance on collagen injection zone in the other subjects at each follow-up time point. Conclusion In this study, there is the longer clinical effective duration of injected collagen used in filling wrinkles with satisfactory results.
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Objective To investigate health status of primary or middle school teachers. Methods A total of 4482 physical examination results of the teachers from Qiaokou District of Wuhan in 2008 were compared with 5526 data obtained in 2006. The rate of healthy to unhealthy participants was evaluated. The overall and age-specific disease incidence, including overweight, hypertension, hyperlipidmia, hyperglycemia,liver dysfunction, abnormal EGG, concrement, adiposis hepatica, and HBV infection, was recorded. X2 test was used for statistical analysis. Results Abnormal examination results were more common in 2008 when compared with those in 2006( X2 = 28. 35, P < 0. 05 ). The incidence of hypertension was descended ( X2 =4. 51 ,P < 0. 05 ), although the rates of hyperlipidimia, hyperglycemia, liver dysfunction, abnormal ECG,concrement, and adiposis hepatica were increased in 2008 ( P < 0. 05 ). The incidence of hyperlipidimia, liver dysfunction, abnormal ECG, and adiposis hepatica increased in all age groups ( P < 0. 05 ). The incidence of hyperglycemia and concrement increased in those > 35 years old ( P < 0. 05 ). Conclusion Except for hypertension and HBV infection, the incidence of common diseases has been increased in the young and middle-aged teachers during the last 2 years. Thus the health management for the primary or middle school teacher should be improved in the future.
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Objective To investigate low density lipoprotein receptor (LDLR)gene mutation in familial hypercholesterolemia (FH) patients. Methods The proband was given clinical diagnosis of homozygous FH based on marked features and blood lipid tests results. After apoB100R3500Q mutation was excluded, the promoter region and all of the 18 exons of LDLR gene were amplified by touch-downpolymerase chain reaction (PCR). The PCR products were analyzed by single-strand conformationalpolymorphism (SSCP). The PCR products with abnormal single strands were sequenced directly. Thesecondary structures of the mutational and wild type proteins were analyzed and compared byANTHEPROT5.0, and then the tertiary structures of the mutant and wild type LDLR were predicted atSWISS MODEL homepage online. Results A homozygous mutation A606T at exon 13 of the patients wasfound by SSCP and confirmed by DNA sequencing. GOR Ⅰ method in ANTHEPROT5.0 indicates that therandom coils and turns would replace some helixes at the mutation site. The online prediction from theSWISS MODEL homepage indicates the backbone structure of the mutant LDLR has no difference from thewild type one. Conclusion The results suggest the A606T mutation of LDLR gene is the cause of the FH inthis pedigree.
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Objective To examine the effect of labor analgesia with ropivacaine on maternal serum prolactin, time of first eolostrum production and the rate of abundant lactation. Methods A total of 124 women of vaginal delivery were randomly divided into labor analgesia group (n = 75 ) and control group (n =49). Labor analgesia group received ropivacaine by patient-controlled epidural analgesia. Three ml ropivacaine (0.125% ) was injected through an epidural catheter and another 12 ml ropivacaine was injected 5 min later if there were no total spinal anesthesia. The block level of analgesia was controlled to be below T10 level. Then 5 ml (0.104 mg/min) ropivacaine per hour was continuously pumped till full dilation of ostium of the uterus. The control group consisted of women of normal spontaneous delivery with no pain relieving measure. The prolactin levels of antepartum, postpartum 0 h, 2 h, 6 h, 12 h and 24 h were determined by microparticle chemoluminescence. Starting time of lactation, the feeding times in 24 hours,the rate of abundant lactation, and neonatal weight 24 hours after delivery were recorded. Results ( 1 ) The serum prolactin of both groups increased instantly after delivery, reached a peak 2 hours after delivery and kept high levels 24 hours after delivery. (2)The prolactin levels of labor analgesia group [(19. 5±8.4)nmol/L and ( 14. 5 ± 5.6 ) nmol/L] were lower than those of control group [( 22.6±7. 2 ) nmol/L and ( 16. 9 ± 5.7 ) nmol/L] 2 and 24 hours after delivery ( P < 0. 05 ). ( 3 ) In labor analgesia group the starting time of lactation was within 24 hours after delivery in 73 cases (97%), lactation amount was abundant within 48 hours in 55 cases (73%) and newborn weight reduction in the first day after delivery was(57 ±42)g. In control group the starting time of lactation was within 24 hours after delivery in 45 cases (92%),lactation amount was abundant within 48 hours in 28 cases (57%) and newborn weight reduction in the first day after delivery was( 62±40)g. There were no differences between the two groups in the starting time of lactation, the rate of abundant lactation, and newborn weight reduction ( P > 0. 05 ). Conclusions ( 1 )Epidural anesthesia with ropivacaine might affect the secretion of prolactin, while the starting time and amount of lactation may be affected by other factors. (2) Prolactin increases after delivery, reaches a peak 2 hours after delivery and maintains high levels 2.4 hours after delivery, which contented necessary for lactation.