Objective To investigate the practicality and stability of self -made bedside angle instrument in clinic .Methods 81 cases of mechanical ventilation were randomly divided into the experimental group (n=42) and the control group(n=39) .The bed head in the control group was elevated according to the experience and sensation .However the bed head in the experimental group was elevated by the self-made bedside angle instrument .The bed head elevation angle in the two groups was measured at the differ-ent timepoints .Results The accuracy of bed head elevation was 100% in the experimental group and 57 .69% in the control group , the difference between the two groups had statistical significance (P<0 .05) .Conclusion The bedside angle instrument has good practicality and stability ,effectively ensures the accuracy of the bed head elevation and contributes to conduct the body posture nursing on the patients with mechanical ventilation .

Objective To investigate the effects of Shuxuetong Injection (SXT ) on expressions of cell apoptosis and TLR4 a-round ischemic area after focal cerebral infarction in rats and to discuss its neuroprotective mechanism on ischemia-induced brain in-jury .Methods The SD rats were subjected to establish the model of middle cerebral artery occlusion (MCAO)by nylon monofila-ment suture ,then were randomly divided into the sham-operated group ,the model group and the SXT treatment group ;the cell ap-optosis and the expressions of TLR4 mRNA and protein around ischemic area at 12 ,24 ,48 ,72 h after cerebral ischemia were detec-ted respectively by TUNEL test mediated with DNA ,RT-PCR and immunohistochemistry .Results In the model group ,the number of TUNEL positive cells ,the expressions of TLR4 mRNA and protein were gradually increased at 12 h ,reached the peak at 24 h , then decreased and were still higher than those in the sham-operated group(P<0 .01);in the SXT treatment group ,these expres-sions after 24 h were lower than those in the model group (P<0 .05)and declined as the treatment time increase(P<0 .05) .Conclu-sion In subacute stage of cerebral ischemia injury ,apoptosis is related with the expression of TLR4 ,SXT may inhibit apoptosis , down-regulate the expression of TLR4 around ischemic area ,this may be one of the mechanisms of neuroprotection .

Objective To observe the expression of angiotensin Ⅱ type 2 receptor (AT2R) and coronary arterial remodeling in ischemia-reperfusion(I-R) injury rat after the renin -angiotensin blocker valsartan pretreatment .Methods 123 rats were random-ly divided into 3 groups :sham -operation group(sham) ,control group and valsartan group(ARB) .The control group and the sham group received the gavage of normal saline and the ARB group received valsartan gavage 10 mg/(kg · d) for 4 weeks before surger-y .The I-R injury rat model was established by thoracotomy for ligating the left anterior descending (LAD) coronary artery and re-moving the ligation after 30 min .The sham group was performed the thoracotomy without ligation .At the 4 timepoints of postoper-ative 3 ,7 ,14 ,28 d ,the left ventricular diastolic and systolic pressures were measured ,then the rats were killed for collecting the rat heart sample .The section was stained by sirius red .The collagen deposition in coronary arterial remodeling and coronary arterial pe-ripheral area ,and the dynamic change of location and expression of AT2R in the coronary artery were observed by the immunohisto-chemical streptavidinbiotin peroxidase complex (SABC) .Results The immunohistochemical analysis revealed that AT 2R was local-ized in the adventitia of coronary arteries with the radial distribution ,showing the higher density especially in large coronary arterial peripheral area ,the partial expression existed in the coronary arterai intima .The expression of AT2R was transient ,which on 7 d af-ter I-R operation in the control group reached the peak value ,while the expression peak value of AT2R in the valsartan group was higher and earlier than that in the control group .The heart diastolic function on 3 d after I-R operation was impaired ;the left ven-tricular end diastolic presure (LVEDP) in the valsartan group was significantly lower than that in the control group .The collagen deposition of coronary peripheral mesenchyma on postoperative 28 d in the valsartan group was significantly lower than that in the control group;the coronary peripheral collagen deposition in the control group was gradually increased with the time progression , which on postoperative 14 ,28 d was significantly higher than that in the sham group .Conclusion Valsartan could inhibit the coronary arterial remodeling for protecting the heart function possible by the transient high AT 2R expression after myocardial I-R injury .

Objective To study the interventional effects of Candesartan Cilexetil on vascular endothelial function and expres-sions of ERK/CREB signaling pathway in rats with acute myocardial infarction.Methods 30 rats were randomized into CAN group,AMI group and Sham group.Two weeks after the treatment rats were sacrificed and blood pressure,levels of blood AngⅡ, NO and NOS,endothelial vasomotor effects of isolated thoracic aorta strips,myocardial infarctual area and the expressions of ERK mRNA and CREB mRNA in infarctual myocardium were explored.Results Blood AngⅡ levels were distinctly higher in AMI group when compared with the Sham group,while the NO and NOS level were much lower.accompanied with EDDs decreased seri-ously,and higher mRNA expressions of ERK1 and CREB in infarctual myocardium.All of the above differences were significant. After the treatment of Candesartan Cilexetil,levels of serum NO and activities of NOS were obviously higher and almost reached the similar levels to those in Sham group,additionally endothelium-dependent diastole in isolated aortic strips improved greatly.Mean-while Candesartan Cilexetil can not only increase the plasma AngⅡ,but also decrease the size of myocardial infarction and the mR-NA expressions of ERK1 and CREB in infarctual myocardium significantly.However,blood pressure in all groups was not affected. Conclusion Candesartan Cilexetil can greatly improve the disordered endothelial function developing post-AMI,decrease the size of myocardial infarction and down-regulate the mRNA expressions of ERK and CREB in myocardium of infarctual zone.And all of the above protective effects of Candesartan Cilexetil were independent on blood pressure lowering.

Objective To evaluate the Biological properties of thermoplastic starch(TPS).Methods According the standard of the government,operate three biological evaluation(acute toxicity,haemocompatibility and short-time toxicity)compound with SPSS analyse.Results The rate of haemocompatibility was 2.06%,no more different weight between trail and control in acute toxicity or short-time toxicity in any key period time.Conclusion TPS is acceptable biology materials.

Objective To explore the prognostic determinants and clinical treatment strategy in 142 patients with severe trauma brain injury(STBI).Methods Retrospective analysis of clinical data of 142 patients with STBI in our department from April 2006 to April 2012.All the patients were divided into good prognosis group(Ⅲ~V grade)and poor prognosis group(I~Ⅱgrade)ac-cording to the GOS classification standard.Age,gender,GCS,encephalocele,morphotogy of the basal cisterns on CT scanning,asso-ciated inj ury,shock,hyoxemia,underlying disease and hyperglycemia were chosen as the observation index.Statistical analysis was performed with Pearson Chi-square Test.Results 52.11% of patients with good prognosis,47.89% of patients with poor progno-sis and 3 1 .6 9% of patients were dead.Age,GCS,encephalocele,morphotogy of the basal cisterns on CT scanning,associated inj ury, shock,underlying disease were the prognostic determinants of STBI(all results P<0.05).Conclusion Age,GCS,encephalocele, morphotogy of the basal cisterns on CT scanning,associated inj ury,shock,underlying disease can determine the prognosis of STBI. Multidisciplinary cooperation treatment depending on the patient′s conditions is the key of improving the outcomes of STBI.

Objective To evaluate the short-term results of ARCH plate in cerical expansive open-door laminoplasty(ELAP)for OPLL.Methods From June 2010 to September 2011,a total of 12 cases with OPLL underwent open-door ELAP by ARCH plate fixation and were followed up in our hospital.8 cases were males and 4 cases were female.The average age was 60.5 years.The neurological effect was evaluated by use Japanese Orthopedic Association(JOA)scoring criteria for cervical myelopathy.The ana-tomical effect was analyzed by compare roentgenogram and CT before and after surgery.Results The JOA scores were improved for 39% after the operation,while the saggital diameters of the cervical spinal canaldural after operation was enlarged for 82%(P<0.05).X-ray films and CT scan after operation that there was no occurrence of re-close of door,there was no occurrence of anchor loosing.Conclusion For OPLL,ELAP using ARCH plate fixation bring less occurrence of re-close of door,slight postoperative neck AS,and satisfactory clinical outcomes.

Objective To evaluate the surgical techniques and clinical efficacy of retroperitoneoscopic ligation of renal lymphatic vessels outside adipose capsule and inside adipose capsule for comparison in the treatment of chyluria.Methods Retrospective anal-ysis of the retroperitoneal laparoscopic adipose capsule of kidney pedicle lymphatic duct ligation(group Ⅰ)and adipose capsule pathways in the kidney totally or subtotally free renal pedicle lymphatic ligation(group Ⅱ)and 1 1 1 patients with chyluria clinical data,compared two groups of operation time,bleeding volume,the rate of analgesia,postoperative gastrointestinal function recovery time,drainage time,postoperative recovery time,postoperative hospital stay and postoperative complications and other index differ-ence.Results Retroperitoneal laparoscopic operation group of adipose capsule in operation time,bleeding volume,postoperative an-algesia,postoperative gastrointestinal function recovery time,drainage time,postoperative recovery time,postoperative hospital stay and postoperative complications were better than the adipose capsule of kidney totally or subtotally free operation group,the differ-ence was statistically significant(P<0.05).Conclusion Retroperitoneal laparoscopic renal adipose capsule of kidney pedicle lym-phatic disconnection for the treatment of chyluria effect,and adipose capsule operation ways,the method less trauma,quicker recov-ery,can completely replace the renal adipose capsule total or Sub-total of free kidney pedicle lymphatic disconnection operation,wor-thy of clinical application.

Objective To establish a method to isolate,culture and identify cardiomyocytes from neonatal mouse,estimate the cardiomyocytes survival rate,and identify the purity of cardiomyocytes.Methods Neonatal C5 7 mouse heart(within 3 days)was di-gested using trypsin and collagenase.Cardiomyocytes survival rate was estimated by trypan blue staining,and cardiomyocytes purity was identified byα-actin immunofluorescence staining.Results Mouse cardiomyocytes could be successfully isolated and cultured using neonatal mouse within 3 days.Trypan blue staining showed cardiomyocytes survival rate was>95%,and cardiomyocytes pu-rity was more than 95% demonstrated byα-actin immunofluorescence staining.Conclusion Under the strict experimental condi-tions,mouse cardiomyocytes can be successfully isolated and cultured with high survival rate and high purity.

Objective To evaluate how functional endoscopic sinus surgery(FESS)modifies patients symptom profiles and the quality of life and analyze the influential factors.Methods During 2010 to 2012,90 cases were investigated to evaluate the quality of life of different age groups to use SNOT-20.Results The quality of life after the surgery of different age groups were significantly higher than it before the surgery(P<0.05).The juvenile group:first dimension(nasal congestion,70%),the second dimension (memory,30%),the third dimension(worried about the condition,30%)and the fourth dimension(social influence,40%).The young aged group:first dimension(nasal congestion,73.3%),the fourth dimension(social influence,43.3%),second dimension (quality of sleep,20.0%)and the third dimension(irritability,16.7%).The middle and old aged group:first dimension(nasal con-gestion,66.7%),the third dimension(trepidation,20%),the second dimension(quality of sleep,20.0%)and the fourth dimension (financial burden,40.0%).Preoperative QOL related factors:complications,age,gender,disease duration and urban-rural;Postop-erative QOL related factors:complications,disease duration,age,perioperative management,gender and urban-rural.Conclusion The quality of life of different ages after FESS is improved in different aspects.To increase the level of perioperative compliance can improve the quality of life.