In vitro differentiation of human adipose-derived adult stromal cells into neuron-like cells in hippocampal astrocyte conditioned medium

BACKGROUND: At present, researches on differentiating from human adipose-derived adult stromal cells (hADASC) to neuron-like cells are focus on inducing by artificial-synthetic compound solution; however, hippocampal astrocyte conditioned medium (HCAM) can induce in vitro differentiation from hADASC to neuron-like cells is still unclear. OBJECTIVE: To observe whether HCAM can induce in vitro differentiation from hADASC to neuron-like cells. DESIGN: Randomized control study. SETTING: Department of Neurology, Taixing People's Hospital; Central Laboratory, North China Coal Medical College. MATERIALS: Donor of adipose tissue was donated by female volunteers suffering from caesarean section in the department of obstetrics & gynecology in our hospital and aged 20-35 years. Adipose tissue was collected from subcutaneous tissue of abdomen during the operation. In addition, 8 male newborn Wistar rats within 24 hours with average body mass of 20 g were provided by Animal Institute of Chinese Academy of Medical Sciences. Rabbit-anti-human Nestin polyclonal antibody, rabbit-anti-human glial fibriliary acidic protein (GFAP) polyclonal antibody, rabbit-anti-human neuro-specific enolase polyclonal antibody and mouse-anti-human microtubal associated protein 2 (MAP-2) polyclonal antibody were provided by Wuhan Boster Company. METHODS: The experiment was carried out in the Central Laboratory of North China Coal Medical College from October 2004 to June 2005. hADASC was cultured with HCAM and its growth and morphological changes were observed under inverted phase contrast microscope. Immunocytochemistry, immunofluorescence and Western blotting were used to evaluate the expressions of Nestin, which was a specific sign of nerve precursor, neuro-specific enolase and MAP-2, which was a specific sign of nerve cell, and GFAP, which was a specific sign of neuroglial cells. MAIN OUTCOME MEASURES: Nestin, which was a specific sign of nerve precursor, neuro-specific enolase and MAP-2, which was a specific sign of nerve cell, and GFAP, which was a specific sign of neuroglial cells. RESULTS: On the 3rd day of culture, partial hADASC started deformation from slender shuttle-shape cells to neuron-like cells. It suggested that cells stretched out apophysis, which were mainly double-pole or multiple-pole cells. Five days later, immunohistochemical detection suggested that expression of Nestin (10.5±0.037) was found out in cells; meanwhile, expressions of GFAP (38.4±0.052) and neuro-specific enolase (NSE) (15.7±0.023) were also found out in cells; however, expression of MAP-2 was not observed. Western blot indicated that, 5 days after effect of HCAM, Nestin was found out in hADASC; meanwhile, expressions of GFAP and neuro-specific enolase were also found out; however, expression of MAP-2 was not observed. CONCLUSION: HCAM can induce the differentiation from hADASC to neuron-like cells in vitro.

The dynamics of adult neurogenesis in human hippocampus

The phenomenon of adult neurogenesis is now an accepted occurrence in mammals and also in humans.At least two discrete places house stem cells for generation of neurons in adult brain. These are olfactory system and the hippocampus. In animals, newly generated neurons have been directly or indirectly demonstrated to generate a significant amount of new neurons to have a functional role. However, the data in humans on the extent of this process is still scanty and such as difficult to comprehend its functional role in humans. This paper explores the available data on as extent of adult hippocampal neurogenesis in humans and makes comparison to animal data.

Human adult pluripotency: Facts and questions

Cellular reprogramming and induced pluripotent stem cell(IPSC) technology demonstrated the plasticity of adult cell fate, opening a new era of cellular modelling and introducing a versatile therapeutic tool for regenerative medicine.While IPSCs are already involved in clinical trials for various regenerative purposes, critical questions concerning their medium-and long-term genetic and epigenetic stability still need to be answered. Pluripotent stem cells have been described in the last decades in various mammalian and human tissues(such as bone marrow, blood and adipose tissue). We briefly describe the characteristics of human-derived adult stem cells displaying in vitro and/or in vivo pluripotency while highlighting that the common denominators of their isolation or occurrence within tissue are represented by extreme cellular stress. Spontaneous cellular reprogramming as a survival mechanism favoured by senescence and cellular scarcity could represent an adaptative mechanism. Reprogrammed cells could initiate tissue regeneration or tumour formation dependent on the microenvironment characteristics. Systems biology approaches and lineage tracing within living tissues can be used to clarify the origin of adult pluripotent stem cells and their significance for regeneration and disease.

艾曲泊帕联合不同用药方案治疗成人原发免疫性血小板减少症的疗效与安全性比较

目的 评估艾曲泊帕联合不同用药方案治疗成人原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)的疗效及安全性。方法 根据入排标准,选取2018年1月—2022年12月本院血液内科收治的73例ITP患者作为研究对象进行回顾性分析,其中接受艾曲泊帕的患者为对照组19例,接受艾曲泊帕联合地塞米松治疗的患者39例,接受艾曲泊帕联合重组人血小板生成素(recombinant human thrombopoietin,rhTPO)治疗的患者15例。比较各组患者治疗前后的凝血功能、临床疗效和不良反应事件发生情况。结果 与本组治疗前相比,各组治疗后的血小板显著升高,而凝血酶原时间和活化部分凝血活酶时间均显著降低(P<0.05);艾曲泊帕联合地塞米松组和艾曲泊帕联合rhTPO组的PLT显著高于对照组,而PT和APTT水平均显著低于对照组(P<0.05);对照组总有效率为47.4%(9/19),艾曲泊帕联合地塞米松组总有效率为89.7%(35/39),艾曲泊帕联合rhTPO组总有效率为73.3%(11/15)。联合治疗组有效率均显著高于对照组;艾曲泊帕联合地塞米松组的总有效率显著高于艾曲泊帕联合rhTPO组(P<0.05);各组总不良反应事件发生率的差异无统计学意义(P>0.05)。结论 与单药相比较,艾曲泊帕联合用药的有效性显著提高,安全性没有显著差异,其中艾曲泊帕联合地塞米松有效率显著高于联合rhTOP。

5-Bromo-2'-deoxyuridine labeling:historical perspectives,factors infiuencing the detection,toxicity,and its implications in the neurogenesis

The halopyrimidine 5-bromo-2′-deoxyuridine(BrdU)is an exogenous marker of DNA synthesis.Since the introduction of monoclonal antibodies against BrdU,an increasing number of methodologies have been used for the immunodetection of this synthesized bromine-tagged base analogue into replicating DNA.BrdU labeling is widely used for identifying neuron precursors and following their fate during the embryonic,perinatal,and adult neurogenesis in a variety of vertebrate species including birds,reptiles,and mammals.Due to BrdU toxicity,its incorporation into replicating DNA presents adverse consequences on the generation,survival,and settled patterns of cells.This may lead to false results and misinterpretation in the identification of proliferative neuroblasts.In this review,I will indicate the detrimental effects of this nucleoside during the development of the central nervous system,as well as the reliability of BrdU labeling to detect proliferating neuroblasts.Moreover,it will show factors influencing BrdU immunodetection and the contribution of this nucleoside to the study of prenatal,perinatal,and adult neurogenesis.Human adult neurogenesis will also be discussed.It is my hope that this review serves as a reference for those researchers who focused on detecting cells that are in the synthetic phase of the cell cycle.

人机交互领域中面向老年群体的对话智能体研究现状综述

对话智能技术以更加便捷、友好、包容的技术优势,被认为是老年人共享数字红利的重要技术手段。然而,老年群体对其接受和使用程度依旧面临着诸多挑战,需要更加全面、系统化地理解和分析。为此,研究旨在综合分析当前面向老年群体的对话智能体设计和研究现状,为之后面向老年群体的对话智能体技术设计和发展提供理论支撑,开展了针对近15年来人机交互领域中面向老年群体的对话智能体文献综述研究,并基于此给出设计建议。

Comparison of phenotypic markers and neural differentiation potential of multipotent adult progenitor cells and mesenchymal stem cells

AIM: To compare the phenotypic and neural differentiation potential of human bone marrow derived multipotent adult progenitor cells (MAPC) and mesenchymal stem cells (MSC). METHODS: Cultures of MAPC and MSC were established in parallel from same samples of human bone marrow (n = 5). Both stem cell types were evaluated for expression of pluripotency markers including Oct-4 and Nanog by immunocytochemistry and reversetranscription polymerase chain reaction (RT-PCR) and expression of standard mesenchymal markers including CD14, CD34, CD44, CD45, CD73, CD90, CD105 andhuman leukocyte antigen (HLA)-ABC by flow cytometry. After treatment with neural induction medium both MAPC and MSC were evaluated for expression of neural proteins [neuronal filament-200 (NF-200) and glial fibrillar acidic protein (GFAP)] by immunocytochemistry and Western blotting and neural genes [NF-200, GFAP, Tau, microtubule-associated protein (MAP)-1B, MAP-2, neuron-specific enolase (NSE) and oligodendrocyte-1 (Olig-1)] by quantitative real-time-PCR. RESULTS: MAPC had small trigonal shaped while MSC had elongated spindle-shaped morphology. The MAPC expressed Oct-4 and Nanog both at gene and protein levels, whereas MSC were negative for these pluripotent markers. MAPC were negative for HLA-ABC while MSC had high expression of HLA-ABC. In addition, MAPC as compared to MSC had significantly lower expression of CD44 (36.56% ± 1.92% vs 98.23% ± 0.51%), CD73 (15.11% ± 2.24% vs 98.53% ± 2.22%) and CD105 (13.81% ± 3.82%vs 95.12% ± 5.65%) (P < 0.001, for all) MAPC cultures compared to MSC cultures treated with neural induction medium had significantly higher fold change expression of NF-200 (0.64), GFAP (0.52), Tau (0.59), MAP-2 (0.72), Olig-1 (0.18) and NSE (0.29) proteins (P < 0.01 for Olig-1 and P < 0.001 for rest) as well as higher fold change expression of genes of NF-200 (1.34),GFAP (1.12),Tau (1.08),MAP-1B (0.92), MAP-2 (1.14) andNSE (0.4) (P < 0.001 for all). CONCLUSION: MAPC can be differentially characterized from MSC as Oct-4 and Nanog positive stem cells with no expression of HLA-ABC and low expression of mesenchymal markers CD44, CD73 and CD105 and when compared to MSC they possess greater predilection for differentiation into neuro-ectodermal lineage.

Effects of hepatitis B virus infection on human sperm chromosomes

AIM: To evaluate the level of sperm chromosome aberrations in male patients with hepatitis B, and to directly detect whether there are HBV DNA integrations in sperm chromosomes of hepatitis B patients.METHODS: Sperm chromosomes of 14 tested subjects (5healthy controls, 9 patients with HBV infection, including 1with acute hepatitis B, 2 with chronic active hepatitis B, 4with chronic persistent hepatitis B, 2 chronic HBsAg carriers with no clinical symptoms) were prepared using interspecific in vitro fertilization between zona-free golden hamster ova and human spermatozoa, and the frequencies of aberration spermatozoa were compared between subjects of HBV infection and controls. Fluorescence in situ hybridization (FISH) to sperm chromosome spreads was carried out with biotin-labeled full length HBV DNA probe to detect the specific HBV DNA sequences in the sperm chromosomes.RESULTS: The total frequency of sperm chromosome aberrations in HBV infection group (14.8%, 33/223) was significantly higher than that in the control group (4.3%,5/116). Moreover, the sperm chromosomes in HBV infection patients commonly presented stickiness, clumping, failure to staining, etc, which would affect the analysis of sperm chromosomes. Specific fluorescent signal spots for HBV DNA were seen in sperm chromosomes of one patient with chronic persistent hepatitis. In 9 (9/42) sperm chromosome complements containing fluorescent signal spots, one presented 5 obvious FISH spots, others presented 2 to 4signals. There was significant difference of fluorescence intensity among the signal spots. The distribution of signal sites among chromosomes was random.CONCLUSION: HBV infection can bring about mutagenic effects on sperm chromosomes. Integrations of viral DNA into sperm chromosomes which are multisites and nonspecific, can further increase the instability of sperm chromosomes. This study suggested that HBV infection can create extensively hereditary effects by alteration genetic constituent and/or induction chromosome aberrations, as well as the possibility of vertical transmission of HBV via the germ line to the next generation.

单用促性腺激素释放激素类似物及联合重组人生长激素治疗对月经初潮后特发性中枢性性早熟女童身高的影响

目的探讨促性腺激素释放激素类似物(GnRHa)联合重组人生长激素(rhGH),单用GnRHa治疗对有月经初潮的特发性中枢性性早熟(ICPP)女童身高的影响。方法回顾性分析2014年1月至2020年12月于徐州医科大学附属徐州儿童医院儿童生长发育门诊就诊76例有月经初潮的ICPP女童为研究对象,根据治疗方案分为治疗对照组(n=22),单用GnRHa治疗组(n=22)和GnRHa联合rhGH治疗组(n=32),随访观察至接近成年终身高(near final adult height,NFAH),比较三组病儿NFAH、身高净生长(ΔHt)、遗传增高(NFAH-遗传身高)。结果对照组、GnRHa组、联合用药组三组就诊基线身高、体质量、身体质量指数(BMI)、骨龄、遗传靶身高差异无统计学意义(P>0.05),随访NFAH分别(158.27±3.63)cm、(159.61±3.91)cm、(162.61±3.34)cm,ΔHt分别(12.66±3.54)cm、(13.49±3.06)cm、(16.79±3.17)cm,遗传增高分别(−2.32±3.82)cm、(0.16±3.46)cm、(3.52±4.62)cm,三组间均差异有统计学意义(P<0.05),其中联合用药组与GnRHa组、对照组比较均差异有统计学意义(P<0.05);GnRHa组和对照组在遗传增高方面差异有统计学意义(P<0.05),在NFAH、ΔHt方面比较均差异无统计学意义(P>0.05)。结论对已有月经初潮的ICPP女孩,GnRHa联合rhGH治疗,可改善NFAH,但需权衡治疗成本及身高获益,临床应谨慎推荐,单用GnRHa治疗不改善NFAH,可改善遗传增高。

非接触共培养体系下抑制ARPE-19中CAMKⅡ表达对HUVECs迁移和侵袭及管腔形成的影响

目的:探讨非接触共培养体系下抑制人视网膜色素上皮细胞(ARPE)中Ca2+/钙调蛋白依赖性蛋白激酶Ⅱ(CAMKⅡ)表达对人脐静脉内皮细胞(HUVECs)迁移、侵袭、管腔形成的影响。方法:将过表达CAMKⅡ-δ的ARPE-19样本进行RNA测序,应用生物信息学分析差异基因参与的功能。使用transwell小室构建ARPE-19和HUVECs非接触共培养体系,根据实验干预措施分为:空白组:仅接种未共培养的HUVECs,无ARPE-19细胞;对照组:ARPE-19和HUVECs细胞均使用完全培养基进行共培养;AIP组(CAMKⅡ抑制组):ARPE-19使用含有AIP(160 nmol/L)的完全培养基,HUVECs使用完全培养基,进行共培养。检测HUVECs迁移、侵袭和管腔形成能力的变化,并通过Western blotting检测CAMKⅡ/AMPK/mTOR/VEGFA蛋白表达水平。结果:生信分析发现差异基因参与细胞生长与死亡和细胞运动等生物学过程。划痕和transwell迁移实验均表明AIP组的HUVECs相对迁移率均明显低于对照组(均P<0.05)。而侵袭和小管形成实验表明,AIP组的相对侵袭率和相对管腔形成率较对照组无明显改变(均P>0.05)。Western blotting结果表明AIP组CAMKⅡ、P-mTOR、VEGFA蛋白表达较对照组均明显下调,而P-AMPK蛋白表达较明显上调(均P<0.05)。结论:在非接触共培养体系下抑制ARPE-19细胞中CAMKⅡ表达可以显著降低HUVECs迁移能力,但不能改变侵袭和管腔形成能力,这可能是通过AMPK/mTOR/VEGFA信号通路实现的。

Eye Blink Responses to the Four Basic Taste Stimuli in Healthy Young Humans

Taste stimuli can elicit facial responses, and the facial responses may be useful indexes of taste sensations. In this study, we propose that eye blinking is also elicited by taste stimuli and we examined eye blink responses in six healthy young adults. Low and high concentration solutions of the four basic taste qualities (sweetness, saltiness, sourness, and bitterness) and distilled water were delivered via a silicone tube. Facial responses were recorded by a video camera and eye blink responses were identified. The number of eye blinks in the 5 s following stimulation, and the latency and duration of the first eye blink, were quantified. High concentrations of sour and bitter solutions increased the number of eye blinks (195% and 227%, respectively;P P

Immunohistochemical study of hepatic oval cells in human chronic viral hepatitis

AIM To detect immunohistochemically the presence of oval cells in chronic viral hepatitis with antibody against c-kit.METHODS We detected oval cells in paraffin-embedded liver sections of 3 normal controls and 26 liver samples from patients with chronic viral hepatitis, using immunohistochemistry with antibodies against c-kit, π-class glutathione Stransferase ( Tr-GST ) and cytokeratins 19(CK19).RESULTS Oval cells were not observed in normal livers. In chronic viral hepatitis, hepatic oval cells were located predominantly in the periportal . region and fibrosis septa,characterized by an ovoid nucleus, small size,and scant cytoplasm. Antibody against stem cell factor receptor, c-kit, had higher sensitivity and specificity than π-GST and CK19. About 50% -70% of c-kit positive oval cells were stained positively for either π-GST or CK19.CONCLUSION Oval cells are frequently detected in human livers with chronic viral hepatitis, suggesting that oval cell proliferation is associated with the liver regeneration in this condition.

Protection of the Human Rights of Those Under Guardianship in the General Provisions of the Civil Law

Based on the guardianship system in the General Principles of the Civil Law, the General Provisions of the Civil Law establish the three concepts of respecting the true will of the ward, benefiting the ward to the greatest extent, and moderate intervention of public power in guardianship. The three concepts are embodied in the specific provisions of the guardianship system, highlighting respect for and protection of human rights under the spirit of the Constitution as well as the human rights concept of protecting the interests of this vulnerable group, improving the scope of protecting the human rights of minors, the disabled and the elderly in the Chinese guardianship system. The General Provisions of the Civil Law expand the functions and types of the guardianship system, enrich and perfect the guardianship system for minors, and clearly stipulate the conditions and means for disqualifying guardians, and arranging temporary custody and state custody. They expand the scope of guardianship for minors, respond to the reality of increasing guardianship needs and the aging of Chinese society, dovetail with the international community’s concept of respecting and safeguarding the rights of the elderly and adults with disabilities, and reflect the law moving with the times. The Specific Provisions on Marriage and Family under the General Provisions of the Civil Law now being compiled should refine and enrich the guardianship system under the framework of the guardianship system in the General Provisions, so that they become the rules of conduct that is practically feasible and enforceable in judgments.

Adult T-cell leukemia/lymphoma presenting multiple lymphomatous polyposis

Multiple lymphomatous polyposis (MLP) is an unusual form of non-Hodgkin's lymphoma characterized by polyps throughout the gastrointestinal tract. It has been reported that most MLP are observed in cases with mantle cell lymphoma of B-cell type. We herein present a case of a 66-year-old man with adult T-cell leukemia/lymphoma (ATLL). Colonoscopy revealed MLP throughout the colon and histopathological findings of ATLL cell infiltration. The patient died despite combination of chemotherapy. The literature of manifestations of colonic involvement of ATLL isreviewed and the importance of endoscopic evaluation to differentiate ATLL intestinal lesions from opportunistic infectious enterocolitis is discussed.

EFFECTS OF DIFFERENT MANIPULATIONS OF ACUPUNCTURE ON ELECTRICAL ACTIVITY OF STOMACH IN HUMANS

The author observed effects of 4 different acupuncture manipulations (lifting-thrusting, twisting-twirling, uniform reinforcing-reducing, and needling with sensation propagating along channels) on electrical activity of the stomach, using amplitude and frequency of human electrogastrogram (EGG) as the indexes. The experiment proved that both the twisting-twirling and the uniform reinforcing-reducing methods inhibited electrical activity of the stomach to reduce the frequency of EGG (P【 0.05), and at the same time the uniform reinforcing-reducing method decreased the amplitude (P【 0.001); while both the lifting-thrusting method and the manipulation for needling sensation propagating along channels excited electrical activity of the stomach to raise the amplitude of EGG (P【 0.01), and the lifting-thrusting method increased the frequency (P【 0.001). Accordingly, the lifting-thrusting method or the manipulation for needling sensation propagating along channels is suitable for chronic superficial gastritis, chronic atrophic gastritis, carcinoma of stomach with lower frequency and amplitude of EGG; whereas the uniform reinforcing-reducing or twisting-twirling method is good for patients with gastric and duodenal ulcer and hyperhydrochloria with higher frequence and amplitude of EGG.

Human cyclosporiosis in Turkey

Six patients infected with Cyclospora cayetanensis who sought medical care at three different hospitals in Turkey are herein presented. Four patients were male and the others were female and their ages ranged from 7 to 62 years. The first patient was HIV-positive and presented with watery diarrhea with a frequency of up to 18 times a day for more than ten months and diagnosed as cyclosporiosis in Kayseri, 1996. The second patient was also HIV positive and diagnosed as cyclosporiosis in Kayseri, 2000. The third patient was an acute myeloblastic leukemia (AML) patient and diagnosed in Istanbul, 2000. The fourth patient was idiopathic hepatic cirrhosis complaining of diarrhea and weakness and diagnosed in Kayseri, 2001. The fifth and sixth patients were immunocompetent patients complaining of diarrhea and diagnosed in Izmir and Kayseri, 2002. Diarrhea occurring from one to ten times a day continued for 7 to 70 d in the last 5 patients. Treatment with a trimethoprim/sulfamethoxazole compound was done for all patients. Both symptomatic and parasitologic improvements were quickly observed. In summary, C. cayetanensis infection is rare in Turkey and most patients infected with this pathogen tend to be immunosuppressive individuals at present.

Transition to adulthood: A critical role for exercise in building overall well-being

A growing number of multidisciplinary studies have reported the beneficial effects of physical activities towards the development of overall well-being and the reduction of chronic illnesses. Physical inactivity is a serious worldwide problem and is considered the key lifestyle factor that negatively influences health and function of individuals. Here we propose that growth kinetics of body and mind and associated disproportionate physical activity may have considerable effects on the increased physical and mental illnesses and premature death rates currently observed in mid to late adulthood people. Children and young adults, being in exponential growth phase and self-motivated to engage in physical activity, possess more cognition, resilience, and mind-body-emotion-spirit integration. In contrast, as our body transitions into adulthood, there is a decline in the growth of body and mind. Furthermore, in this period, adults experience the increased stressors of career and financial demands, time pressure, and family responsibilities. The decline in growth combined with prolonged stress appears to result in reduced cognition, resilience, and mind-body-emotion-spirit integration, leading to sedentary and other faulty lifestyles, which could further lead to a predisposition to maladaptive behaviours and various chronic diseases at a later stage. In agreement with this, currently more than two thirds of the adult population across the world are physically inactive and are failing to perform the daily recommended guidelines of moderate to vigorous exercise. As negative changes and faulty lifestyles begin to occur during and after adulthood transition, creating awareness in people between 29 to 35 years of age about mindful exercise should be considered a national priority. This would allow adults to achieve overall well-being, and increased productivity and life expectancy, reducing health care-associated economic burden placed on the nation.

Crohn's disease in adults: Observations in a multiracial Asian population

瞄准：决定人口统计学和 CD 并且第二的临床的表示在一张多种族的亚洲人口在在不同的种族组之间的流行决定任何差别。方法：在马来亚医学中心(UMMC ) 的大学里在 2001-2003 被看见的有 CD 的病人在这研究被注册。疾病的流行作为分母每种族组与医院录取总体上并且由种族为这个组被计算。结果：34 个病人被诊断有 CD。病人的基本人口统计的数据；male:female 17:17；意味着年龄 29.1 年(+/-13.5 年) ；种族组：马来语 5 (14.7%) ，汉语 12 (35.3%) 并且印第安人 17 (50%) 。(76.5%) 26 不到 40 和 8 岁被诊断(23.5%) 超过 40 岁被诊断。疾病的地点作为 follows:ileocolonic 13 (38.2%) ，终端回肠仅仅 9 (26.5%) ，结肠仅仅 8 (23.5%) ，并且上面胃肠 4 (11.8%) 。(47.1%) 十六让了渗透疾病，(26.5%) 9 有 stricturing 疾病，(26.5%) 9 有非渗透、苛评得非的疾病。CD 的医院承认流行总的来说是 26.0，印第安人 52.6，汉语 6.9，并且马来语 9.3 每 10 (5 ) 录取每种族组。印第安人和马来语之间的差别：[或 5.67 (1.97， 17.53 ) P【0.001 ] 是统计上重要的然而并非在印第安人和汉语之间[或 1.95 (0.89， 4.35 ) P=0.700 ] 汉语之间的 .The 差别和马来语也不是统计上重要的。[或 2.90 (0.95， 9.42 ) P=0.063 ] 。结论：CD 的临床的演讲类似于西方的经验。尽管全面流行是低的，看起来是在印第安人之中的清楚的种族优势。

Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy

Background: Adult acquired flatfoot deformity is generally mediated with an Evans procedure where a wedge of bone is placed into the calcaneus to better align the foot and decrease the deformity. The purpose of this study was to assess the efficacy and safety of human amniotic allograft applied to allogeneic tri-cortical grafts in Evans calcaneal osteotomy. Methods: The medical records of patients who had Evans calcaneal osteotomy with implantation of tri-cortical iliac crest bone graft with human anmiotic allograft for surgical management of adult acquired flatfoot deformity with 2 years follow-up data were reviewed. Results: A total of 63 patients (mean age: 33.3 yr, range: 18 - 66 yr) were enrolled with adult acquired flatfoot deformity. Median time to weight-bearing was 6 weeks. Time to wearing normal shoes was 10 weeks, and time to radiographic healing was 16 weeks. Conclusions: The use of human amniotic allograft did not diminish the long term outcome of procedure or the short term benchmarks for healing after surgery. There were no nonunion, wound dehiscence, infection, or allergic or immune reaction reported. This retrospective study demonstrated that tri-cortical iliac crest bone graft and HAA could be safely used in Evans calcaneal osteotomy with favorable results.