Composite Tissue Allotransplantation (CTA) offers an alternative reconstructive strategy for complicated musculoskeletal injuries incurred during modern warfare where functional outcomes after multipe conventional reconstructions are suboptimal. Broader clinical application of CTA, however, continues to be hampered by requirement for long-term multi-drug immunosuppression to prevent graft rejection. Furthermore, unlike in solid organs, clinical success is dictated not only by graft acceptance, but also by functional outcome. Our study proposes a novel cell-based therapy utilizing mesenchymal stem cells (MSC) that can augment nerve regeneration while minimizing the need for immunosuppression. After transition from University of Pittsburgh to Johns Hopkins University, we optimized our isolation and culture protocol for MSCs. Immunophenotypic and functional characterization of cultured cells demonstrated potent immunomodulatory effects of MSCs in vitro. Preliminary functional outcome analysis using Catwalk showed convergent data with similar loss and return of function among groups. Similarly, compound muscle action potentials at early time points showed small non-significant increases in amplitude in experimental groups. In contrast, normalized gastrocnemius weights showed increased muscle weight in only the systemic injection group. Overall, we continue to monitor both functional and histological outcomes. Consistent with existing literature on nerve regeneration, we expect to observe more evident differences among groups with increased data over the longer term.

关键词：医药；治疗技术；复合组织异体移植术；神经再生

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Insomnia is a common complaint in the general population. Hypnotics are the most common treatment for insomnia, despite some unwanted effects such as tolerance and dependence. Cognitive Behavioral Therapy for Insomnia (CBT-I) was shown to be effective in the treatment of chronic insomnia. Recent studies comparing CBT-I treatment with hypnotics further demonstrated that the CBT-I treatment was at least as effective as hypnotics during acute treatment, and may be more effective than medication during long-term follow-ups. This chapter describes the role of neurophysiological and psychological factors in the regulation and dysregulation of sleep. Further, the rationales and procedures of CBT-I are introduced. Lastly, the application of CBT-I with modern information technologies is discussed.

关键词：医药；治疗技术；认知行为治疗；睡眠障碍

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Raman spectroscopy is an analytical technique recognised for its structural and conformational specificity. The efficient discrimination of molecular species by Raman is particularly potent for multidimensional microscopic imaging of complex biological environment, as demonstrated in the present book. The commonly admitted problem of Raman, low sensitivity, can often be circumvented due to high output instruments and via approaches like RRS (resonance Raman scattering), SERS (surface-enhanced Raman scattering), TERS (tip-enhanced Raman scattering) or CARS (coherent anti-Stokes Raman scattering). In contrast to the latter, RRS and SERS are realizable with less sophisticated set-up based on common Raman systems. Although more invasive than RRS, SERS provides better sensitivity and quenching of fluorescence. SERRS (surface-enhanced resonance Raman scattering) spectroscopy can be used in coupling with fluorescence and competes in selectivity and sensitivity with spectrofluorimetry. In the chapter below, we use recent applications made in our group to illustrate the use of Raman and SERRS spectral imaging for characterization of biological samples (animal subcutaneous tissue, human cancer cells) and pharmaceutical samples (microparticles for drug delivery, fibres for wound dressing). After a brief description of experimental details on spectral imaging, the chapter will focus on results concerning (i) biocompatible pharmaceutical materials made of alginates and (ii) anticancer drugs in pharmaceutical forms and in biological systems.

关键词：医药；药品；拉曼成像；化学成分

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Therapeutic options for patients suffering from end-stage renal disease have improved tremendously over the last decades and can be divided into three categories: hemodialysis, peritoneal dialysis and kidney transplantation. Transplantation remains the treatment of choice, however, lack of donor organs results in the necessity of performing -temporary-dialysis therapies of which hemodialysis is carried out in the majority of patients. To facilitate adequate hemodialysis therapy a reliable vascular access is mandatory and can be provided by either surgically connecting an artery with a vein (arteriovenous fistula), surgically connecting an artery with a vein using an interposition of prosthetic graft material (arterioven-ous graft) or a central venous catheter. This chapter shortly reviews the condition of end-stage renal disease after which history of vascular access, different options to create a vascular access, pre-operative work-up, surgical procedure, monitoring and usage, post-operative complications and the role of hemodynamics will be discussed. Finally, some future directions for vascular access creation and management will be identified.

关键词：医药；治疗技术；血液透析；血管穿刺

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In our research, in accordance with the traditional sand therapy practice usually held in Turpan areas, we built an indoor sand therapy laboratory in Xinjiang University. After heating the sand with a heater for one week, we obtained similar temperature in every layer of the sand to that in the sand therapy. Male rabbits were treated with the sand therapy and medication and compared with normal control. The blood, joint fluid and mechanical properties of the bones were compared. The comparison of the mechanical properties of the bone, as well as our clinical experience with the sand therapy shows the effectiveness of such a treatment.

关键词：医药；治疗技术；股骨治疗；维吾尔族砂疗法

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The traditional control of the dialysis session comes about by means of an open-loop system. At the beginning of the session some parameters are set, such as the kind of dialyzer, the blood flow, the ultrafiltration rate, the dialysate conductivity and the dialysate temperature. Generally speaking, these parameters are not modified unless there occur complications in the patient that call for adjustments to be made. The biofeedback concept, which is synonymous with a closed-loop control of biological variables, presupposes, on the other hand: the continuous measurement of a variable thanks to a specific sensor its evaluation by a sort of expert system - the so-called controller and a series of means - the actuators - that allow the behavior of the variable to be directly or indirectly influenced. In clinical practice, different biofeedback systems are emerging, addressed to the control of blood volume, body temperature, and blood pressure. Each one of these systems has been successfully utilized, especially in the management of "difficult" patients unstable from the hemodynamic point of view. However, the future will be an integrated system that sees a complex adaptive, multi-input, multi-output controller which, with a great simplicity of use and low costs, will allow renal replacement therapy to be increasingly physiological and more efficient.

关键词：医药；治疗技术；生物反馈；血液透析

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The circadian system in humans encompasses all organs, tissues and cells. Coordination of central and peripheral clocks and synchronization of cellular clocks within the brain regulate daily phases, neurophysiology and behavior. The mechanism of action of the circadian system is complex, but is centered on the paired structure of the suprachiasmatic nuclei (SCN) that serves as a pacemaker in humans. Light adjusts the phase of the SCN oscillator to the environmental light-dark cycle. Light therapy has been developed for clinical use and many apparatus and parameters have been extensively studied. Bright light therapy is the treatment of choice for seasonal affective disorder and circadian rhythm sleep disorders. Cumulative studies support the efficacy of light therapy for some clinical conditions which are characterized by seasonality or disrupted circadian rhythms. The benefit of light therapy is significant and warrants further clinical studies to optimize the treatment effect.

关键词：医药；治疗技术；光线疗法；睡眠障碍

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关键词：肿瘤乙肝；生物制药；单抗；药物金矿

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A major impediment to effective prostate cancer treatment involves the acquired resistance to cytotoxic therapies. Components of the tissue microenvironment are increasingly recognized to profoundly influence tumor cell phenotypes that include susceptibilities to toxic insults. Using a genome-wide analysis of transcriptional responses to genotoxic stress induced by cancer therapeutics, we have identified a spectrum of secreted proteins derived from the tumor microenvironment (TME) that have the potential to modify tumor growth and enhance resistance to DNA-damaging cancer therapeutics. These results suggest a mechanism by which genotoxic therapies given in a cyclical fashion can enhance subsequent treatment resistance through cell non-autonomous effects contributed by the TME. To date, the contributions of individual members of this DNA Damage-associated Secretory Program (DDSP) have not been defined, nor have the signaling mechanisms responsible for propagating the DNA-damage signal(s) been determined. Our objective during this grant period is to test whether treatment-associated DNA damage responses in cells comprising the prostate TME promote tumor growth and subsequent therapy resistance. During this funding period we have: (1) Generated a prostate fibroblast cell line stably expressing SPINK1; (2) Evaluated the impact which SPINK1 activation has upon the growth characteristics of prostate cancer cells lines; (3) Examined how SPINK1 secretion from the microenvironment modulates the response of prostate cancer cells to chemotherapeutics: (4) Begun the evaluation of SPINK1 regulatory pathway.

关键词：治疗技术；治疗抵抗；损伤反应

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Although the combination of radiation therapy and androgen deprivation therapy (ADT) is initially effective in many patients, biochemical failure rates of 20at 5-years to 50at 10-years have been reported, highlighting the need for improved treatments, particularly for men with high- risk prostate cancer. ADT in the neo-adjuvant setting is used to reduce tumor volume and improve the response to radiation. Additionally, ADT causes infiltration of lymphocytes into the prostate. B cell infiltrates may promote prostate cancer progression and development of castration resistant prostate cancer by the production of inflammatory cytokines and skewing CD4+ T cell responses towards Th2. We hypothesized that depletion of B cells at the time of castration would improve tumor control. Our results demonstrate that the depletion of B cells at the time of castration improves tumor latency.

关键词：治疗技术；前列腺癌；免疫反应

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