Objective: To compare the therapeutic effect of intervention transcatheter direct thrombolysis and vein thrombolysis and anti-coagulation drugs on lower extremity deep venous thrombosis (DVT). Methods: A total of 61 patients with lower extremity DVT accorded with inclusion standards were selected. They were randomly divided into intervention transcatheter direct thrombolysis group (n=30, intervention group) and vein thrombolysis and anti-coagulation group (n=31, thrombolysis + anti-coagulation group). Patients were treated for four weeks as a course. Results: Total effective rate of intervention group was significantly higher than that of thrombolysis + anti-coagulation group (93.33% vs. 64.52%), χ2=4.987, P=0.032. There were no significant differences in hemorheology indexes between two groups before treatment, P>0.05. Compared with before treatment, after treatment, there were significant reductions in high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity and fibrinogen level in intervention group, P<0.05 all; there were significant reductions in plasma viscosity and fibrinogen level in thrombolysis + anti-coagulation group, P<0.05 both. After treatment, compared with thrombolysis + anti-coagulation group, there were significant reductions in low shear whole blood viscosity [(12.10±2.13) mPa•s vs. (11.08±1.67) mPa•s] and plasma viscosity [(1.85±0.13) mPa•s vs. (1.31±0.09) mPa•s] in intervention group, P<0.05 both. After treatment, total effective rate of vessel open up in intervention group was significantly higher than that of thrombolysis + anti-coagulation group (90.00% vs. 61.29%), χ2=4.173, P=0.047. Conclusion: For patients with acute DVT and no operation contraindications, therapeutic effect of transcatheter direct thrombolysis is more significant. It can significantly improve hemorheology and vessel open up rate, it may be recommended as the preferred in clinic.

Objective To evaluate a minimally invasive procedure for intertrochanteric fracture treatment in elderly patients. Methods Total 46 elderly patients with intertrochanteric fracture were treated with a minimally invasive procedure from September 2008 to February 2010. The fractures were fixed with multiple K-wires combined with skeletal traction through supracondyle of femur. All procedures were undertaken under local anesthesia. Results All the patients were followed up for 8.8-months in average, and 42 patients recovered with independent walking, and the good rates was 91.3%, without severe complications in this group. Conclusions Minimally invasive procedure including fixation with multiple K-wires combined with traction through femoral supracondyle, is a safe and effective treatment for intertrochanteric fracture in elderly patients, avoiding high risks of intra-and post-operative complications.

Objective To compare the sedative efficacy with oral or rectal chloral hydrate in pediatric patients by using Meta-analysis method.Methods Ten randomized controlled trials about the sedative efficacy with oral or rectal chloral hydrate in pediatric patients were retrieved.Meta-analysis was carried out using the RevMan 5.0 software.Results The results showed that the sedative efficacy with rectal medication was better than that with oral way.Nausea and vomiting occurred in 95 children with oral chloral hydrate,bowel movement occurred in 57 children with rectal chloral hydrate.Conclusions The sedative efficacy with rectal chloral hydrate was better than that with oral way.The safety in pediatric sedation with chloral hydrate should be emphasized in order to avoid adverse reaction.

Objective To investigate the effect of H 2 S and its synthetase inhibitor propargylglycine ( PAG) on the autophagic function in caerulein-induced acute pancreatitis ( AP) mice.Methods A total of 60 male BALB/c mice were randomly divided into control , AP, NaHS and PAG group using random number method.AP was induced in mice via hourly intraperitoneal injection of caerulein (50 μg/kg) continuously for 6 hours.NaHS and PAG group received NaHS (10 mg/kg) or PAG (50 mg/kg) 1 h before the AP induction . A equal volume of normal saline solution was injected in control group and AP group .All the mice were killed at 12 h after the first caerulein injection and blood sample was collected for the detection of serum amylase and lipase content.Deproteinization spectrometry was used to detect serum H 2 S content, and pancreatic tissue was pathological examined and scored . Real-time PCR detected mRNA expression of CSE , and the protein expression of LC3-Ⅱ/LC3 Ⅰand p62 was measured using Western blot .Results Serum amylase, lipase, H2S, CSE mRNA, LC3Ⅱ/LC3Ⅰand p62 were (2 700 ±100)U/L, (70 ±20)U/L,(22.9 ±1.7)mmol/L, 1.0 ±0.1,0.419 ±0.080, 0.227 ±0.140 in control group; (17 290 ±500)U/L,(520 ±40)U/L, (31.3 ± 3.0)mmol/L, 5.4 ±0.4, 1.184 ±0.120, 1.985 ±0.210 in AP group; (27 784 ±1 200)U/L, (900 ± 80)U/L,(38.6 ±3.3)mmol/L, 6.9 ±0.9,1.600 ±0.210, 4.229 ±0.050 in NaHS group; (13 750 ± 2 000)U/L,(370 ±20)U/L, (24.5 ±2.1)mmol/L, 4.2 ±0.5, 0.745 ±0.130, 1.203 ±0.080 in PAG group.All those biomarkers detected above in AP group significantly increased compared with control group , which were much lower than those in NaHS group , but higher than those in PAG group , and the differences were statistically significant (all P<0.05).Pancreatic histological damage in NaHS group was more severe than that in AP group , which in PAG group was less severe than that in AP group .Conclusions PAG could greatly decrease serum amylase and lipase level , and reduce the damage on autophagy and the severity of AP .

Objective To investigate the relationship among Helicobacter pylori (Hp) infection, serum gastrin level and colorectal carcinoma. Methods Fasting serum samples from 47 consecutive patients with colorectal carcinoma and 30 demoographically matched colonoscopy-negative controls were detected for serum gastrin levels and IgG antibodies against Hp (Hp IgG) by enzyme linked immunosorbent assay. Some of them accepted 14C urease breath test and/or rapid urease test after undergoing endoscopy. Hp infection was affirmed when at least two of the three tests were positive. Results The Hp infection incidence was significantly higher in patients with eoloreetal carcinoma (61.7%, 29/47) as compared with controls (36.7%, 11/30) (P<0.05). The Hp infection incidence in distal distribution of carcinoma was higher than that in controls, and in female carcinoma was higher than that in female controls(P <0.05). Mean fasting serum gas-trin levels were significantly higher in patients with coloreetal carcinoma[(139.7±53.3 ) ng/L]than those in controls [(89.5±26.1 ) ng/L] (P < 0.01 ). There was a significant association between hypergastrinemia and distal distribution of carcinoma. Conclusion Increasing serum gastrin levels, higher Hp infection incidence has a positive relationship with colorectal carcinoma.

BACKGROUND:Continuing stress stimulation has been confirmed to promote repair of rotator cuff injury.This experiment attempts to fu rther quantify the intensity of stress stimulation in order to reach a better therapeutic effect in the entire process of rotator cuff injury repair.OBJECTIVE:To explore the biomechanical performance of stress stimulation with different intensities on repair of acute rotator cuffinjuryMETHODS:Sixteen male New Zealand rabbits were randomly divided into high intensity,low intensity and control groups,with 12 animals in each group.Rabbits were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus.At 1 week after operation,rabbits were treated by continuous passive motion(CPM)apparatus,which was-60°to 60° flexion-extension for the high intensity group,and-15° to 15° for the low intensity group.At 2 weeks after operation,the CPM was performed every other day,with 10 minutes per time;which was changed to daily training from week 3 with the same frequently,and 15 minutes per time at week 4.Rabbits in the control group were housed freely.Each 4 animals were sacrificed at weeks 2,3 and 4 after operation,and the largest tensile strength and severity at osteotendinous junction were compared.RESULTS AND CONCLUSION:The maximum tensile intensity and stiffness of the supraspinatus tendon in the low intensity group were greater than that of the control and high intensity group(P＜0.05),which was smallest in the high intensity group.All the breakage point existed at the intra-articular portion.The result demonstrated that low intensity stimulation exhibits superior repair effect in acute rotator cuff injury,while high intensity stimulation is harmful to the early repair of acute rotator cuff injury.

Objective To investigate the expression of inositol requiting enzyme1 α (IRE1 α) and tumor necrosis factor receptor-associated factor 2 (TRAF2) and its significance through establishing models of intestinal ischemia reperfusion injury (IIRI) in rats.Methods According to the random number table,50 male SD rats were randomly divided into 2 groups:sham operation group (n =10) and ischemia reperfusion (I/R) group (n =40).Sham group animals underwent laparotomy.I/R group rats were subjected to occlusion of the superior mesenteric artery for 30 min;then the blood flow was restored.I/R group animals were divided into 4 subgroups:2 h,6 h,12 h,24 h according to the time of reperfusion.Eight rats were examined based on the number of live rats in each subgroup.The HE staining pathological changes in intestinal samples were observed by the light microscope.The small intestinal epithelial cell apoptosis index (AI) was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL).The expression levels of intestinal tissues tumor necrosis factor α (TNF-α) and plasma intestinal fatty acid-binding protein (Ⅰ-FABP) were detected by ELISA tests.Situ end labeling method was used to detect intestinal cell AI.Western blot was applied to investigate the expression of endoplasmic reticulum stress(ERS) proteins IRE1α,phosphorylation IREIα (p-IRE1 α) and TRAF2 in all group rats intestinal tissues.Results (1)The pathological changes showed that the intestinal injury of I/R groups was more severe than that of sham group,especially at 6 h.(2) Compared with sham group,the expression levels of TNF-α [sham group (16.41 ± 4.44)ng/ L,2 h group:(79.71 ± 8.20) ng/L,6 h group:(131.70 ± 11.59) ng/L,12 h group:(94.23 ±7.66) ng/L,24 h group:(69.78 ± 9.58) ng/L],AI[sham group:(3.93 ±0.77)％,2 h group:(16.24 ± 1.97)％,6 h group:(42.19 ±2.40)％,12 h group:(37.79 ± 2.34)％,24 h goup:(10.38 ±1.46)％] and plasma Ⅰ-FABP [sham group:(0.65 ±0.10) × 103 ng/L,2 h group:(1.47 ±0.10) ×103 ng/L,6 h group:(2.36 ±0.17) ×103 ng/L,12 h group:(37.79 ±2.34) ×103 ng/L,24 group:(l.41 ±0.09) × 103 ng/L] were higher (F =231.462,149.032,162.491,all P ＜ 0.01).(3) The expression of TRAF-2 protein and p-IRE1 α/IRE1 α could be up-regulated after IIRI (F =40.473,59.59,P ＜ 0.01).The expression of these proteins was up-regulated 2 h after reperfusion,peaking at 6-12 h reperfusion,and then decreased at 24 h,and the variation tendencies of all groups were the same.Conclusions IIRI could induce ERS,activate IRE1 α and up-regulate TRAF2.IRE1α/TRAF2 mediating ERS might be involved in regulating the cell inflammation,apoptosis and increasing intestinal permeability after IIRI.

Objective To investigate effect of peripheral blood miR-21 expression on the clinicopathological features of gastric cancer before and after gastric surgery.Methods The peripheral blood was collected on the operative day and postoperative 7 d in 42 patients with primary gastric cancer surgery.The real-tine quantitative PCR was adopted to detect the relative expression of miR-21 in plasma with U6 as an internal reference gene.Results The plasma miR-21 expression level after gastric cancer operation was significantly down-regulated compared with before operation(P <0.01),the overall relative expression level was dropped by an average of 18.2 times;and it was found that the postoperative miR-21 expression in the patients with the tumor family history was up-regulated,the postoperative plasma miR-21 expression in the patients without the tumor family history was decreased by 22 times compared with before operation(P <0.05);the experimental results also fund that as the patient′s differentiation degree was changed from high to low,the lymph node metastasis rate was gradually increased,while postoperative average miR-21 expression was changed from low to high,showing the relative expression times of miR-21 were distributed in the four differentiated zones of high,middle,middle-low and low,which showed the correlation with the distribution of the lymph node metastasis rate in these four differentiation zones.Conclusion The peripheral blood MiR-21 detection has the clinical significance to early auxiliary diagnosis and the judgement of postoperative malignant degree.

Objective To study the anatomic features of surface vasa vasorum on longissimus in thoracolumbar segments,and its protection function during the internal fixation for thoracolumbar fracture via Wiltse approach.Methods From March 2010 to October 2012,a total of 97 patients with thoracolumbar fractures underwent posterior internal fixation with pedicle screw system.The trend and distribution of surface vasa vasorum on longissimus in thoracolumbar segments were observed in the operation,and the vessels were protected during the surgical procedures by using specific devices and techniques.Operative time and intra-operative blood loss were recorded.Visual analogue scale (VAS) values were evaluated after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation.MRI images of longissimus in thoracolumbar segments were compared after preoperative and postoperative 6 months.Results Surface vasa vasorum distribution on 194 longissimus and 402 inter-pedicle areas of 97 patients were observed.In 402 areas,94.3％ of surface vasa vasorum presented sarciniform,while only 5.7％ of surface vasa vasorum presented tube shape.In 379 areas of sarciniform distribution,9.8％ of blood vessel bundles were located in vertebral pedicle area;76.0％ of blood vessel bundles were located in the upper inter-pedicle areas;12.4％ of blood vessel bundles were located in middle inter-pedicle areas;1.8％ of blood vessel bundles were located in lower inter-pedicle areas.In 379 areas,87.3％ of blood vessel bundles could be completely retained;12.7％ of blood vessel bundles were treated by electro coagulation and burning.Intra-operative blood loss was 21±9.3 ml.VAS values after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation were 3.3± 1.6,2.1± 1.4,1.2±0.7 and 1.1±0.7.The longissimus treated with electro coagulation demonstrated pimelosis change on MRI after postoperative 6 months.Conclusion Surface vasa vasorum on longissimus in thoracolumbar segments are generally of sarciniform,and most of them are located in upper inter-pedicle areas.The protection of vasa vasorum can reduce the intra-operative lesion and postoperative pimelosis change of longissimus.

Objective To study the effect of precise locating technique of C?arm fluoroscopy in order to reduce the radia?tion exposure during the surgical procdure for thoracolumbar fracture. Methods From March 2010 to Octorber 2012, a total of 92 cases with thoracolumbar fracture underwent postierior internal fixation procdures with pedicle instrumentation. C?arm fluoros?copy was used in 44 cases with precise locating technique, while in 48 cases with traditional methods. In precise locating group,C?arm fluoroscopy was used after anesthesia. Once an ideal view was got, the position parameters of C?arm fluoroscopy machine were recorded. The machine was positioned according to the recording for the secondary fluoroscopy. Pre?operative and intra?operative number of times of exposure, length of exposure time, time for fluoroscopy and total operating time were recorded and compared be?tween two groups. Results Pre?operative number of times of exposure, exposure time, and time for fluoroscopy in precise locating group were (5.51±2.47), (2.26±1.05) s and (9.83±3.67) min,which were higher than those of (4.02±2.42), (1.78±0.98) s and (8.29± 3.52) min in traditional group. However, intra?operative number of times of exposure, exposure time, and time for fluoroscopy in precise locating group were (5.26±3.64), (2.24±1.24) s and (10.39±4.82) min,which were lower than those of (9.74±4.38), (4.21± 2.38) s and (24.69±6.35) min in traditional group,and total number of times of exposure, exposure time, time for fluoroscopy and total operating time in precise locating group were(10.77±4.16), (4.50±1.83) s, (20.22±5.03) min and(70.52±18.33)min,which were also lower than those of (13.76±5.31), (5.99±3.27) s , (32.98±7.83) min and(81.86±21.57)min in traditional group. Conclu?sion Precise locating technique of C?arm fluoroscopy reduces the radiation exposure during the surgical procdure for thoracolum?bar fracture.