Locking compression plate(LCP)functions as an internal fixator in orthopedic surgery.It is a new screw-plate system developed by combining the traditional plating techniques with the principles of AO internal fixator.Compared with them,LCP omits pre-bending,avoids large-area exposure of fracture site,minimizes the damage to soft tissue,significantly reduces implant failure and decreases the incidence of infection and bone non-union.In addition,LCP can function as internal fixator with multiple anchor points to improve stability.All these properties of LCP accord with BO internal fixation principles and expand the application in the treatment of complex fracture.However,it is still not uncertain about the appropriate application of LCP including plate length,appearance,and type,and principles of screw application such as the number,type,sequence and position of screws.

Objective To investigate the expression and clinical significance of RegⅣand EGFR,PI3K proteins in gastric adenocarcinoma .Methods S-P immunohistochemistry was used to detect the expression of RegⅣand EGFR,PI3K proteins in pathological tissues of 73 cases with gastric adenocarcinoma and tumor -adja-cent normal gastric tissues .Results The positive expression rates of RegⅣand EGFR,PI3K proteins in 73 cases with gastric adenocarcinoma tissue were 50.7%(37/73),56.2%(41/73) and 69.9%(51/73) respectively, which were significantly different from the positive expression rates of tumor -adjacent normal gastric tissues ,be-ing 20.5%(15/73),19.2%(14/73),and 21.9%(16/73),respectively(P<0.05).The expression of RegⅣprotein was significantly correlated to differentiation degree ( P<0.05 ) and the expression of EGFR protein was significantly correlated to infiltrative depth,TNM stage,and lymph node metastasis(P<0.05).The expression of PI3K protein was significantly correlated to differentiation degree ,infiltrative depth,TNM stage and lymph node metastasis(P<0.05).There was positive correlation between the expressions of RegⅣ/EGFR,RegⅣ/PI3K and EGFR/PI3K proteins in gastric adenocarcinoma and the values of Spearman coefficient correlation were 0.325, 0.403 and 0.384,respectively(P<0.05).Conclusion RegⅣmay play an important role in gastric adenocarci-noma genesis and progression by activating EGFR /PI3K/Akt signaling pathway .

Objective To explore the effect of dexmedetomidine for the dosage of drug of pain pump of the patients postoperative.Methods From April 2013 to July 2015,86 patients with intestinal obstructionwhich come to our hospital for surgical treatment were divided into observation group and control group according to the lottery method,each had 43 cases.The patients of control group were given pain pump for pain treatment ; and the patients of observation group were given dexmedetomidine on the base of control group for treatment.The heart rate,systolic arterial pressure(SAP),arterial oxygen pressure(PaO2),analgesia satisfaction,visual analogue scale/score(VAS)pain score,sleep quality score,sufentanil dosage,the number of self-administration,adverse reactions,postoperative anal exhaust time.Results 36h and 72h,SAP,PaO2 in the observation group were significantly better than those in the control group after treatment(P<0.05); The total satisfaction of analgesia was significantly higher than that of control group(P<0.05); VAS pain score was significantly lower than the control group(P<0.05); The sleep quality score was significantly higher than that of the control group(P<0.05); The dosage of sufentanil and the times of administration were significantly lower than those of the control group(P<0.05); Anal exhaust time was significantly shorter than the control group(P<0.05); The incidence of adverse reactions was significantly lower than that of the control group(P<0.05).Conclusion By using dexmedetomidine on the base of pain pump can improve the analgesic effect postoperative,reduce the dosage of pain pump medication and the adverse reactions.

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

Objective To study the differential expression of cell adhesion molecule(CAM) genes in the pathegenesis of AAA. Methods Microarray technique was applied to screen for the differential expression of CAM genes between AAA and normal aortic tissues. Results Three differentially expressed CAM genes were found in AAAs by microarray technique and molecular biology investigation, including VCAM 1, PECAM 1, TSP,with up regulating ratio of 5 683,3 601,57 406,respectively.Conclusion These abnormally up regulated CAM genes found in AAA might participate in the development of abdominal aortic aneurysms.

Objective To analyze the risk factors of restenosis after renal artery endovascular treatment in patients with Takayasu arteritis.Methods In this study,39 patients with Takayasu arteritis underwent endovascular therapy from January 2003 to March 2014.Univariate and multivariate logistic regression analysis were used to analyze the risk factors relating to restenosis.Results There were 13 males and 26 females.The mean age was (27 ± 11) years.Seventeen unilateral and 22 bilateral renal artery stenosis were treated.A total of 54 endovascular procedures were successfully performed including 23 cases of unilateral percutaneous transluminal angioplasty (PTA),14 cases of unilateral stent implantation,12 cases of bilateral PTA,and 5 cases of bilateral stent implantation.The mean follow-up was (48 ±34) months,the restenosis rate was 38.9％ (21.54) and the mean time of restenosis was (11.5 ± 2.3) months.Elevated erythrocyte sedimentation rate (ESR) (OR =6.624,95 ％ CI:1.222-35.902) was independent risk factors for restenosis.Antiplatelet therapy (OR =0.158,95％ CI:0.028-0.887) and glucocorticoids or i mmunosuppressive therapy (OR =0.035,95 ％ CI:0.003-0.349) were protection factors against renal artery restenosis.Conclusion The elevated ESR increases the risk of restenosis after endovascular treatment in Takayasu arteritis associated renal artery stenosis.Antiplatelet therapy and glucocorticoids or immunosuppressive therapy were protection factors for renal artery restenosis.

Objective To investigate the distribution of anxiety and depression disorders in patients of carotid artery stenosis (CAS),and the relationship between symptoms of cerebral infarction and the severity of anxiety and depression.Methods We used Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale(SDS) created by William W.K.Zung to evaluate the anxiety and depression disorders associated with CAS in 93 patients hospitalized at the Department of Vascular Surgery,and 146 hospitalized varicose veins patients as acontrols.Results The scales of CAS are significantly higher than the control group(SAS:32 ± 8 vs 29 ± 7,P ＜ 0.001 ; SDS:42 ± 14 vs 35 ± 11,P ＜ 0.001),within-group analysis of CAS shows that there is no statistical difference between symptomatic group and non-symptomatic group (SAS:32 ±8 vs 32 ± 7,P =0.780; SDS:41 ± 14 vs 42 ± 14,P =0.830),or between infarction group and non-infaction group (SAS:31 ± 8 vs 33 ± 8,P =0.147; SDS:39 ± 14 vs 43 ± 13,P =0.241).Conclusions CAS can cause anxiety and depression disorders,and the disorders are not related to symptoms of cerebral ischemia and cerebral infarction.

Objective To explore the characteristics of ventilatory efficiency and exercise capacity during cardiopulmonary exercise testing in patients with idiopathic pulmonary fibrosis (IPF).Methods Pulmonary function test,arterial blood gas analysis and cardiopulmonary exercise testing were performed in 28 IPF patients (IPF group) from April 2012 to April 2013 and 28 healthy volunteers (control group).And the relevant parameters were measured and compared.Results No significant differences existed in age [(57.8 ±9.8) vs.(59.2 ±5.5) years],gender or body mass index (BMI) [(23.8 ±2.7) vs.(25.0 ± 2.8) kg/m2,P ＞ 0.05].The paramneters of pulmonary function test,such as forced vital capacity ％ predicted (74.8 ± 14.6 vs.101.8 ± 10.8),forced expiratory volume in 1 second ％ predicted (73.8 ± 14.6 vs.97.0 ± 10.1),maximum voluntary ventilation ％ predicted (77.5 ± 14.9 vs.95.4 ±24.5),total lung capacity ％ predicted (75.6 ± 12.4 vs.99.8 ± 5.4),residual volume ％ predicted (80.7 ± 15.4 vs.95.8 ± 11.3),diffusing capacity of lung for carbon monoxide ％ predicted (66.2 ± 13.7 vs.103.2 ± 17.3) in the IPF group,were significantly lower than those of the control group (P ＜ 0.01).The parameters of arterial blood gas analysis,such as PaO2 [(72.7 ± 7.3) vs.(92.6 ± 3.8) mmHg] and SaO2 (94.3 ± 2.1 vs.98.3 ± 0.7),were lower than those of the control group (P ＜ 0.01).Thus P(A-a) O2 in the IPF group was higher than that in the control group (33.3 ± 5.7 vs.17.8 ± 1.9,P ＜0.01).These results strongly suggested that IPF group had restrictive ventilatory dysfunction and impaired gas exchange.The IPF patients had higher VE/VCO2-slope (37.4 ± 5.3 vs.25.7 ± 2.5,P ＜ 0.01) and lowest VE/VCO2 (39.2 ±6.7 vs.30.6 ± 2.7,P ＜ 0.01) than the controls; VE/VCO2 and VD/VT during every period were significantly higher in the IPF group than those in the control group (P ＜ 0.01) ; during peak exercise,peakLoad％pred (70.4 ±±29.9 vs.104.8 ±29.7,P ＜0.01) and peakVO2％pred (68.7 ±29.8 vs.98.7 ±36.4,P =0.001) were significantly lower in the IPF group than those in the control group.In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with DLCO％pred (r=-0.589,P ＜0.01; r=-0.481,P＜0.05; r=-0.527,P＜0.05).In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with peakVO2％ pred (r =-0.548,P ＜ 0.05 ; r =-0.539,P ＜ 0.05 ; r =-0.564,P ＜ 0.05).So the exercise tolerance and ventilation efficiency of the IPF group decreased significantly.Conclusion Cardiopulmonary exercise testing reveals that the ventilation efficiency of IPF patients decreases significantly so as to seriously affect their exercise tolerance

Objective To determine the effect of ulinastatin on improving gastric mucosal perfusion during orthotopic liver transplantation. Methods Thirty patients undergoing orthotopic liver transplantation were randomly divided into control group (group C,n=15) and ulinastatin group (group U,n=15). In ulinastatin group,patients were intravenously administrated 4000U/kg ulinastatin immediately after entering the operating room and then the administration was continued with an injection pump with a dose of ulinastatin of 2000U/(kg?h) till the end of operation. Normal saline in the same volume and infusion rate was given to patients in control group. Blood pressure (BP),heart rate (HR),cardiac output (CO) and introgastric pH value (i-pH) plus Pg-aCO2 were measured before the operation (T0),20min of preanhepatic phase (T1),5 min of anhepatic phase (T2),30min of anhepatic phase (T3),5min of new hepatic phase (T4),30min of new hepatic phase (T5) and the end of operation (T6),respectively. Results Compared with the measurement at the time point of T0,mean artery pressure (MAP),central venous pressure (CVP) and CO were significantly decreased and complicated with a marked increase of HR at the time point of T2 in all patients of two groups (P

Objective To research the influences of massive hemorrhage on spatial learning and memory ability in elderly SD rats .Methods Fifty six aged SD rats were randomly divided into 3 groups:blank group (B group ,n=8) ,control group (C group , n=24) ,and hemorrhage group (H group ,n=24) .B group was not given any intervention .C group received femoral artery ligation and was sutured under general anesthesia .H group underwent femoral artery puncture phlebotomy ,and then the rats were sutured . Morris water maze was used to test the spatial working ability .Results The escape latency of H group on postoperative day 1 ,3 and 7 were(29 .93 ± 7 .93)s ,(34 .56 ± 6 .74)s and (15 .47 ± 6 .42)s respectively .Compared with B group(12 .56 ± 3 .08)s ,these re‐sults indicated the spatial learning and memory of H group was destroyed after surgery 1 d and 3 d (P<0 .05) ,but no significant difference between H group and B group on postoperative day 7 (P>0 .05) .The escape latent periods to platform observed in C group rats on day1 ,3 and 7 after operation were(15 .74 ± 5 .86)s ,(15 .61 ± 2 .56)s and (13 .56 ± 4 .61)s .Compared with B group [(12 .56 ± 3 .08)s] ,these results indicated that there was no significant difference 7 (P>0 .05) .Conclusion The findings of this study indicate that massive hemorrhage of old rats may destroy the spatial learning and memory .