Objective The treatment of limb bone fracture in combination with main vessel injury wasanalyzed retrospectively.Methods Twenty ccsese were respectively conducted by interlocking intramedullary pin fixation,plate and screw fixation,plate and screw fixation orextemal brace fixation according to the injury conditions of the fractures.Then,vascahr injaries were flexibly dwelt with direct repair,end-to-end anastomosis or blood vessel grafting.Results The-limb save rate in this study is 70%.and the reaoons which csllsed the amputation included:Long ischemia time and serious tissue damage.Conclusion Fractures of the extremities with major vascular injuries should be diagnosed promptly to be conducted properly.In this way,better outcome would be obtained.

Objective To investigate the relationship between aquaporin-4 (AQP4) expression level inbrain and dynamic change of brain edema in rats after cardiopulmonary resuscitation (CPR), and to evaluate the in-tervention effects of Edaravone. Method Totally 72 Sprague-Dawley male rats were randomly divided into fourgroups:normal group (n = 6, group A) ,shame-operated group ( n = 6, group B), CPR group including 1 hour,6 hours, 12 hours, 24 hours, and 72 hours after ROSC (5 sub-groups, n = 6for each,group C) ,edaravone-treat-ed group with the same time points as CPR groups(5 sub-groups, n = 6for each,group D). Asphyxia cardiac ar-rest with CPR model was used in group C and group D. Edaravone at a dose of 3.0 mg/kg was given intravenouslyand the same dose of edaravone was administered subcutaneously to the rats of group D after CPR. Anaesthosia,vascular cannulation and endotracheal intubation were pedormed in rats without asphyxia and CPR in group B. Ateach interval, the brain water content was calculated. The AQP4 expression level in brain tissue was determinedusing immunohistocbemical staining. Neurodeficit scores were assessed and pathological change was observed, Re-sults The brain water content in rats of group C increased obviously along with the prolongation of time followingROSC,and reached its peak at ROSC 24h,which was much higher than that of group B (P<0.01). Meanwhile,AQP4 expression in brain had a trend towards increasing and the integral optical density(iOD) and coloratian arearatio(△S) in group C were significantly increased compared with group B ( P<0.01). The trend of changes wasnearly the same as that of the brain water content. The correlation analysis demonstrated that AQP4 expression levelsuch as iOD (r=0.858, P < 0.01 ) and △S ( r = 0.870, P < 0.01 ) were correlated with the brain watercontents apparently. Compared with group C, the brain water content was decreased obviously (P<0.05), iODand △S was down-regulated at the same lime (P<0.01) in group D. The neurodeficit scores increased (P <0.05) and pathological damage was dramatieaUy ameliorated. Conclusions AQP4 expression increased greatly inbrain after CPR and the relationship between AQP4 and brain edema was positively correlated. AQP4 may play arole in the formation of brain edema following CPR. Edaravone could attenuated brain edema after CPR in rats byway of inhibiting the expression of AQP4. It had neuroprotective effect.

Objective 　Determination of Wilson disease gene mRNA expression in human fibroblast cell strain (Me32aT22/2L) by reverse transcription-polymerase chain reaction (RT-PCR). Methods　Using lipofection reagent, the plasmid vector carrying the Wilson disease gene (pRc/CMV-WD) was transferred into Me32aT22/2L cultured in serum free complement medium. RT-PCR was used to determine WD mRNA expression in Me32aT22/2L. Results　 Wilson disease gene expression was detected in Me32aT22/2L, while no specific signals were detected in untransfected fibroblast. Conclusions　It demonstrated that Me32aT22/2L strain could express the Wilson disease gene, suggesting that Wilson disease gene transfer might develop a new approach to study Wilson disease.

Objective:To investigate the relationship between caspase recruitment domain protein 9 (CARD9) level and inflammatory response in cerebral tissue of ischemic brain injury mice.Methods:Totally 24 SPF BALB/c male mice were randomly(random number) divided into 4 groups: sham operated group, ischemia 3 h group, ischemia 6 h group, and ischemia 12 h group, 6 mice in each group. The permanant middle cerebral artery occlusion (pMCAO) model in the ischemia groups was established by using line embolism to block blood flow. Mice in each group were sacrificed at the predetermined time point after operation. CARD9 and p-p65NF-κB levels were detected by Western blot, and the inflammatory factors mRNA and protein including TNF-ɑ, IL-lβ and IL-6 were detected by RT-PCR and ELISA, respectively. The data were analyzed by SPSS 21.0 software, the comparison of measurement data between each two groups was analyzed by independent sample t test, and the correlations between CARD9 and inflammatory factors were analyzed by Pearson analysis. Results:Compared with the sham operated group, the CARD9 levels in the ischemia 3 h, 6 h and 12 h groups were increased significantly [(0.325±0.011) vs. (0.462±0.019), P=0.036; (0.735±0.036), P=0.003; (0.903±0.024), P=0.001], the p-p65NF-κB levels in the ischemia 3 h, 6 h and 12 h groups were increased significantly [(0.227±0.016) vs. (0.316±0.017), P=0.041; (0.445±0.021), P=0.016; (0.671±0.039), P=0.008], the TNF-ɑ levels in the ischemia 3 h, 6 h and 12 h groups were significantly increased [(0.53±0.06) vs. (1.06±0.10), P=0.009; (1.47±0.15), P=0.004; (2.78±0.18), P=0.001], the IL-lβ levels in the ischemia 3 h, 6 h and 12 h groups were significantly increased [(0.55±0.07) vs. (1.01±0.11), P=0.009; (2.13±0.16), P=0.003; (3.09±0.18), P=0.001], and the IL-6 levels in the ischemia 3 h, 6 h and 12 h groups were significantly increased [(1.99±0.18) vs. (4.10±0.41), P=0.006; (8.54±0.84), P=0.002; (11.56±0.96), P=0.001]. Pearson analysis showed that CARD9 was positively correlated with the p-p65NF-κB and TNF-ɑ, IL-lβ, IL-6 ( r=0.894, P=0.001; r=0.747, P=0.008; r=0.810, P=0.001; r=0.773, P=0.007). Conclusions:A positive correlation exists between CARD9 and inflammatory responses in the early stage of ischemic brain injury in mice

Objective To explore the effects of H2S on cerebral injury after cardiopulmonary resuscitation (CPR) and its mechanism.Methods Forty-five healthy Sprague-Dawley (SD) rats were randomly (random number) divided into shame-operated group ( group A,n =5 ),resuscitation group ( group B,further divided into four subgroups as per rats sacrificed 6 h,12 h,24 h,and 72 h after resuscitation,n =5),and NaHS pretreatment group ( group C,further divided into 4 subgroups as done in group B).The ratio of water content in brain tissue was calculated.The content of H2S in cerebral cortex of rats in all groups was determined by using universal microplate reader. Immunohistochemistry method was used to count the Nestin-positive cells. Results The content of H2S in hippocampus area of brain showed dramatic changes from rising up at first and then to lowering down to the minimum and finally returning to the original level in 72 h in B group.Compare to group B,brain water content was lesser ( P ＜0.05 or P ＜ 0.01 ) and the levels of Nestin in hippocampus increased in group C(P＜0.05 or P ＜0.01).The neurological deficit score (NDS) was improved (P ＜0.05 or P ＜0.01) and pathological changes in hippocampus of rat brain detected by using hemotoxylin - eosin staining were slighter in group C in comparison with group B.Conclusions Endogenous H2S may involve in the course of formation and progress of cerebral injury after CPR and small dose of NaHS (exogenous H2S) can improve NDS by decreasing cerebral edema and up-regulating Nestin level in hippocampus of brain,playing a protection role in cerebral injury after CPR.

Objective:To observe the effect of horse-riding squat exercise plus Governor Vessel-regulating Tuina(Chinese therapeutic massage)therapy on static balance function in patients with stroke.Methods:A total of 176 stroke patients were enrolled as the study subjects and divided into four groups by the random number table method,namely horse-riding squat+Tuina group,horse-riding squat group,Tuina group,and control group,with 44 cases in each group.The control group was treated with rehabilitation balance training.The horse-riding squat+Tuina group,horse-riding squat group,and Tuina group were treated with additional horse-riding squat exercise plus Tuina,horse-riding squat exercise,and Tuina treatment,respectively.Four weeks of treatment was regarded as one treatment course.After 1 treatment course,the balance function of the four groups was compared.Results:After treatment,the ellipse area of motion and the length of motion in all four groups were reduced,and the intra-group differences were all statistically significant(P＜0.05).The difference in the ellipse area of motion before and after treatment in the horse-riding squat+Tuina group and the horse-riding squat group was larger than that in the control group,and the differences were statistically significant(P＜0.05).The difference in the ellipse area of motion before and after treatment in the horse-riding squat+Tuina group was larger than that in the Tuina group,and the difference was statistically significant(P＜0.05).The difference in the length of motion before and after treatment in the horse-riding squat+Tuina group,the horse-riding squat group,and the Tuina group was greater than that in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the pairwise comparison between the horse-riding squat+Tuina group,the horse-riding squat group,and the Tuina group(P＞0.05).Conclusion:Horse-riding squat exercise plus Governor Vessel-regulating Tuina therapy can effectively improve the static balance function in patients with stroke.Training the affected lower limb weight-bearing exercise,adjusting the center of gravity distribution,and promoting the mutual balance and coordination between muscle groups may be the mechanism of improving the static balance function.

Objective: To investigate the community promotion feasibility of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint. Methods:A total of 180 cases (duration <1.5 years) with post-stroke motion impairment of the shoulder joint were recruited from three community health centers in Changning District, 60 from each community. They were randomly allocated into an observation group (n=90) and a control group (n=90). Patients in both groups received standard internal and rehabilitation care. Patients in the observation group received additional superficial needling plus club swing. The visual analogue scale (VAS) was conducted before and 60 d after the treatment to evaluate the severity of shoulder pain. The active movement of the shoulder joint and activities of daily living (ADL) were also observed. Results:There were no between-group statistical differences before the treatment (allP>0.05). After a 60-day treatment, the shoulder pain severity, active range of motion of the shoulder joint and ADL in the observation group were significantly improved than those in the control group (allP<0.01). In addition, no adverse events were reported by participants in the observation group. Conclusion:Superficial needling plus club swing plays a positive role in improving post-stroke motion impairment of the shoulder joint. This safe, reliable and economical therapy has good patient compliance and is suitable for community promotion.

Objective:To observe the clinical effect of electroacupuncture(EA)combined with exercise therapy on balance function in patients with knee osteoarthritis(KOA). Methods:Seventy patients with KOA were randomly divided into a treatment group and a control group,with 35 cases in each group.The treatment group was treated with EA combined with exercise therapy.EA was applied to Dubi(ST35),Neixiyan(EX-LE4),Xuehai(SP10),Liangqiu(ST34),Yanglingquan(GB34),and Zusanli(ST 36).Exercise therapy(muscle strength training and knee mobility training)was applied after EA.The control group only received the same exercise therapy as the treatment group.The two groups were treated with the same course of treatment,3 times a week for 4 consecutive weeks,12 times in total,and followed up for 1 month.The Pro-Kin254P balance test system was used to measure the balance function parameters at 4 time points,including before treatment,after 1 session of treatment,after 12 sessions of treatment,and at 1-month follow-up after treatment.The visual analog scale(VAS)and the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores were recorded. Results:The markedly effective rate and total effective rate in the treatment group were higher than those in the control group(P<0.01).The Romberg area,Romberg length,and VAS scores of the two groups decreased significantly after 1 session of treatment,12 sessions of treatment,and 1 month after treatment,and the differences between different time points in the same group were statistically significant(P<0.01).There were significant differences between the two groups at the same time point(P<0.05).The total WOMAC scores of the two groups after 1 session of treatment,12 sessions of treatment,and 1 month after treatment decreased significantly,and there were significant differences between different time points in the same group(P<0.05),but there was no significant difference between the two groups at the same time point(P>0.05). Conclusion:EA combined with exercise therapy or exercise therapy alone can enhance the balance function,relieve joint pain,and improve joint function in patients with KOA.EA combined with exercise therapy is superior to exercise therapy alone in improving balance function and pain,but the two treatment protocols have similar effects in improving joint function.

Objective To Btudy effect of standardized acupuncture combined with rehabilitation therapy (function training)on improvement of comprehensive function among patients with stroke in communities,Changning District of Shanghai.Methods One hundred and seventy-six stroke patients were divided into rehabilitation therapy group(88 cases)and control group(88 cages)with block randomization.Patients in rehabilitation therapy group were treated with standardized acupuncture combined with function training in addition to regular medical treatment,and patients in control group regular medical treatment only.All the patients were evaluated with functional comprehensive assessment(FCA)scale by the end of 2-and 5-month of treatment,respectively.Results By the end of 5-month of treatment,scores of FCA in both groups increased significantly (P＜0.01),as compared to those before treatment,more in rehabilitation therapy group than that in control group(P＜0.05).Conclusions Effect of standardized acupuncture combined with rehabilitation therapy Can obviously improve their comprehensive function among stroke patients in communities.