The conformity between bone implant and bone tissue plays an important role in osseointegration.Protein molecules such as extracellular matrix proteins,cytoskeletal proteins,and attachment proteins,which produced by osteoblasts,promote the attachment of osteoblasts to bone implant and the surrounding ceils.In vitro studies show that nano-plated implant material bears excellent biocompatibility and superior physical and chemical features.Nano-scale material has the advantage of high surface roughness,wettability and electrochemistry features which erdaance the adherence and interaction of extracellular matrix proteins and promotes the attachmerit,proliferation and differentiation of osteoblasts.The expression of cytokines,such as prostaglandin E2(PGE2)and transforming growth factor-β(TGF-β)are also increased in nano-structured bone implants which in turn promote the new bone formation.Further studies need to be done to explain the mechanism of the effect of nano-tructured bone implant on osteoblasts.

Objective To study the 2-4 years intermediate-term clinical effects of bone-patellar tendon-bone (B-PT-B) autograft plus interface screw method and quadruple semitendinosus tendon autograft plus endobutton plate fixation method in anterior cruciate ligament (ACL) reconstruction after ACL injury and to estimate the correlation of various implants and fixation techniques with clinical effect. Methods A retrospective analysis was done on 104 cases with ACL injury as well as detailed clinical data from October 1998 to October 2000. ACL reconstruction with bone-patellar tendon-bone autograft (PT group) and kurosaka interface screw fixation were performed in 55 cases and quadruple semitendinosus tendon autograft and endobutton plate fixation (ST group) in 49 cases. The average follow up was 38.5 months in the PT group and 35.7 months in the ST group. We compared the intermediate myodynamic recovery, ROM, lachman test, pivot shift test, IKDC score, lysholm score, Werner score and X-ray view of tunnul enlargement between two groups. Results In the PT group, the circumference of thigh was (1.097?0.079) cm, shorter than that of normal side, and (0.896?0.126) cm in the ST group. The cases accounting for 82% (45/55) in the PT group and 88% (43/49) in the ST group had extension limitation less than 3?. Knee flexion limitation of 0?-5? accounted for 87% (48/55) in the PT group and 86% (42/49) in the ST group. Bilateral comparison of Lachman test less than 5 mm accounted for 93% (51/55) in the PT group and 96% (47/49) in the ST group. Negative rate of pivot shift test was 89% (47/55) in the PT group and 92% (45/49) in ST group. Bilateral comparison of AP knee laxity with 20Ib KT-1000 in laxity with less than 3 mm accounted for 53% (29/55) in the PT group and 57% (28/49) in the ST group. Lyoholm score in the PT group was increased from preoperative 69.2?6.4 to postoperative 86.7?4.3 and that in the ST group from 68.3?7.5 to 88.4?8.6. Knee motion standard of IKDC score in the PT group was 78%(43/55), which was found normal or nearly normal, and 82%(40/49) in the ST group. Patellar femoral pain Werner score was 43.0 ?6.1 in the PT group while 45.0?6.3 in the ST group. The X-ray showed that tunnel enlargement phenomena was 53% (29/55) in the PT group while 43% (21/49) in the ST group. Conclusions From 2-4 years intermediate-term follow up, there is no significant difference in ACL reconstruction using patellar tendon autograft plus interface screw method and quadruple semitendinosus tendon plus endobutton plate fixation method. Bone grafting in the donor site can reduce the incidence of anterior knee pain. Twisting technique is beneficial to overcome of the postoperative laxity caused by viscular elasticity of quadruple semitendinosus.

Aim To investigate the effect of resveratrol (Res)on septic mice and LPS-insulted H9c2 cells,as well as its involved mechanisms.Methods By use of a mouse cecal ligation and puncture-induced septic model (CLP),the survival of septic mice was evalua-ted after resveratrol treatments.H9c2 cells were insul-ted by LPS and then treated with resveratrol,the mR-NA expressions of TNF-α,SIRT1 and other class III HDAC members were detected using RT-PCR and real-time PCR,Finally,the protein levels of nuclear p65, an important subunit of NF-κB,were measured in H9c2 cells using Western blot assay,to reveal the effect of resveratrol on LPS-induced nuclear transloca-tion of NF-κB.Results Compared with the control septic animals,intraperitoneal injection of resveratrol (1 or 5 mg·kg -1 ·d -1 )significantly increased the survival of septic mice.Furthermore,resveratrol signif-icantly increased mRNA expressions of SIRT1,SIRT2, SIRT6 and SIRT7 in LPS-insulted H9c2 cells.Res-veratrol also remarkably inhibited LPS-induced nuclear translocation of NF-κB.Conclusion An appropriate dose of resveratrol protects septic mouse hearts from the injury induced by LPS through the activation of SIRT family members and the inhibition of NF-κB pathway.

OBJECTIVETo investigate the expression of nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) in monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood flow occlusion.

METHODSThe monkeys were immediately removed brain after death in operation of group A (identical temperature perfusion group) and group B (ultraprofound hypothermia perfusion group). Immunohistochemical technique was used to determine frontal cellular expression of NGF and GDNF. Statistics were analyzed by ANOVA analyses with significance level at P < 0.05.

RESULTSThe expressions of NGF and GDNF in the group B were significantly higher than those in the group A (P < 0.05).

CONCLUSIONNGF and GDNF increased significantly in the monkeys of resuscitation after selective cerebral ultraprofound hypothermia and blood flow occlusion. It may be a protective mechanism for neuron survival and neural function recovery.

Animals ; Brain ; metabolism ; Cell Survival ; physiology ; Cerebrovascular Circulation ; physiology ; Cerebrovascular Disorders ; metabolism ; physiopathology ; Cytoprotection ; physiology ; Glial Cell Line-Derived Neurotrophic Factor ; metabolism ; Hypothermia, Induced ; Hypoxia-Ischemia, Brain ; metabolism ; physiopathology ; prevention & control ; Macaca mulatta ; Nerve Growth Factor ; metabolism ; Neurons ; metabolism ; Recovery of Function ; physiology ; Reperfusion Injury ; metabolism ; physiopathology ; prevention & control ; Resuscitation ; Up-Regulation ; physiology

Accidents, Traffic ; Brain Injuries, Traumatic ; therapy ; Humans ; Neurosurgeons ; Randomized Controlled Trials as Topic

Objective To investigate the effects of Rho GTPase expression,actin cytoskeleton re- organization and cell migration in hepatic stellate cells after transform growth factor(TGF)?_1 stimulated. Methods Primary rat hepatic stellate cells were isolated and cultured.A Transwell Chamber system was used to observe the changes of serum starved HSCs haptotactic migration (direct stimulation) and chem- otactie migration(indirect stimulation) after different concentration of TGF?_1 treatment.Changes in ac- tin cytoskeletal organization were visualized by fluorescence staining using FITC labeled phalloidin and fluorescence images were recorded using confocal microscopy.The activation of GTP-loaded GTPases were evaluated by GST pull-down assays with GST-fusion proteins of GTPase hinging domains of differ- ent effectors for Rho GTPases.Results TGF?_1 treatment of hepatic stellate cells resulted in the en- hancement of migration in response to haptotactic and chemotactic stimuli,especially after 5ng/ml TGF?_1 stimulation(haptotactic migration cells :130.90?7.64 vs 102.93?1.01,P＜0.05;chemotactie migration cells:205.17?10.78 vs 102.93?1.01,P＜0.05).Serum-starved,untreated cells had a rounded-up morphology.Stimulation of hepatic stellate cells with 5 ng/ml TGF?_1 induced a rapid mor- phological change concomitant with a robust reorganization of actin cytoskeleton.Five minutes after TGF?_1 stimulation,the cells flattened out and the formation of lamellipodia occurred.Five minutes after TGF?_1 was added,stress fibers became visible,and after 15-30 minutes,the cells became well spread with fully developed stress fibers.TGF?_1 stimulation did not alter the amount of GTP-bound Racl.In contrast,Cdc42 and RhoA GTPase activity was significantly augmented after more than 5ng/ml TGF?_1 stimulation(GTP-Cdc42:0.273?0.024 vs 0.176?0.001,P＜0.05;GTP-RhoA:0.176?0.005 vs 0.096?0.004,P＜0.05).Conclusion The stimulation of TGF?_1 can induce the actin cytoskeleton re- organization,which appears to be mediated through the activity of the Rho GTPases signaling pathway. The ability of TGF?_1 to trigger activation of Cdc42 and RhoA GTPase along with actin cytoskeleton reor- ganization might well play a crucial role in hepatic stellate cells migration.

Objective To investigate neuroprotective effect of AM-36 on secondary brain injury following traumatic brain injury(TBI)in rats.Methods A total of 38 male Sprague-Dawley rats were divided into an experimental group,a control group and a sham operation group,then sustained to moder- ate TBI.AM-36(0.1 ml/100 g)was administered intraperitoneally in the experimental group and isoton- ic saline solution was administered intraperitoneally in the control and the sham operation groups at 30 mi- nutes,24 and 48 hours after TBI,respectively.The brain water content was determined at 24 hours after TBI.Rats were sacrificed by decapitation at 24 hours or one week after TBI for observing histological changes in peripheral cortex,thalamus and hippocampus by means of Hematoxylin and Eosin staining and Fluoro-Jade(F-J)staining.Results The brain water content of bilateral hemispheres 24 hours after TBI in the experimental group was significantly decreased,compared to that of the control group.Histo- logical examination revealed less degenerating neurons(F-J positive neurons)in the cortex,thalamus, CAI and CA3 of the hippocampus in AM-36 treated rats 24 hours and one week after injury(P＜0.05). Conclusion Systemic administration of AM-36 at the early stage after TBI can decrease brain water content and exert neuroprotective effect on TBI.F-J staining can be used for histopathologic quantitation of neuronal damage,for it can accurately exhibit pathologic changes following TBI induced by fluid per- cussion.

Objective To identify the types of pulmonary complications after pancreaticoduodenectomy,and to discuss the prevention and management of these complications.Methods Clinical data of 165 cases of pancreaticoduodenectomy in our hospital were retrospectively analyzed.Pulmonary complications were identified,therapeutic effects were observed.Results The incidence rate of pulmonary complications was 19.4％ ( 32/165),case-fatality rate was 6.25％ (2/32),two patients died from pneumonia,respiratory failure and ARDS.Complications mainly included pneumonia 13.9％ (23/165),pleural effusion 4.2％ (7/165),atelectasis 3.6％ (6/165),pneumothorax 1.8％ ( 3/165 ),respiratory failure 2.4％ (4/165) and ARDS 1.2％ (2/165).Conclusion Pulmonary complications after pancreaticoduodenectomy are not rare,especially for pulmonary infection and most are hospital acquired pneumonia.To understand rules and particularity of respiratory physiopathological changes after pancreaticoduodenectomy is very important for patients to safely pass over the perioperative period.

BACKGROUND: Research shows that genetic factors are an important component of the congenital dislocation of the hip(CDH) . However, no susceptibility genes have been identified by now. The homebox-containing (HOX) genes that regulate the embryogenesis and vertebrate limb development may play a role in the pathogenesis of CDH.OBJECTIVE: To investigate whether a correlation exists between CDH and the Hox genes.DESIGN: Controlled study associated with family.SETTING: Department of aevelopmental pediatrics, genetic laboratory, department of pediatric orthopaedics in an affiliated hospital of a university.PARTICIPANTS: All the 101 CDH patients and their parents (altogether 303 members) were the in-patients from the Department of Pediatric Orthopaedics of the Second Clinical College of China Medical University; from December 1999 to January 2001. All the patients presented typical clinical manifestations and were diagnosed by X rays and operations for confirmation.METHODS: Four microsatellite markers D7S1808, D17S1820, D12S1686 and Hox4EP were selected in the chromosome regions of7p14 - 15, 17q21, 12q13and 2q31 where Hox A, Hox B, Hox C and Hox D genes which regulate the embryonic limb development reside respectively. Genotypes of 303 members in 101CDH families were analyzed by the techniques of polymerase chain reaction (PCR) and denaturing polyacrylamide gel electrophoresis. Then transmission disequilibrium test(TDT) was performed to analyze the data of genotypes.MAIN OUTCOME MEASURES: The genotypes of four microsatellite markers D7S1808, D17S1820, D12S1686 and Hox4EP in every CDH family including one child and parents; transmission disequilibrium test between transmission alleles and non-transmission alleles.RESULTS: Transmission disequilibrium was found between CDH and allele 7 of D7S1808(X2 = 6. 045, P = 0. 014) among a total of 10 alleles detected, between CDH and allele 4 of D17S1820(X2 =6. 025, P =0. 014) among a total of 12 alleles detected, between CDH and allele 4 of Hox4Ep (X2 = 6. 461, P =0.011) among a total of 16 alleles detected. But no transmission disequilibrium was found between CDH and D12S1686(X2 = 6. 171,P =0. 965) with 16 alleles detected.CONCLUSION: CDH may be related to Hox A, Hox B, Hox D genes, and Hox A, Hox B, Hox D genes may be susceptibility genes in CDH.

Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of pancreatic gastrointestinal stromal tumor (GIST). Methods We reported a case and reviewed the medical literature on pancreatic malignant GIST. We searched the Pubmed and main domestic database. The clinical data of the reported cases were studied, and their predictive factors for postoperative recurrence and metastasis were analyzed. Results Between January 1980 and July 2010, 16 cases of pancreatic GIST were reported. There were 7 males and 9 females, with a median age pf 56.5 (31-72)years. The clinical symptoms were nonspecific. The main presentation was upper abdominal pain or discomfort. A preoperative diagnosis was suspected on radiological examination. The tumor mainly appeared as a well-defined solid-cystic mass. Irregular enhancement appeared in the circumferential and solid portion of the tumor on enhanced CT scan sequences. The pancreatic and biliary ducts were rarely dilated. Endoscopic ultrasound guided fine needle aspiration cytology (EUS-FNA) was helpful in preoperative diagnosis. Of the 15 surgical patients, 14 underwent complete resection, while the remaining received cyst-jejunostomy. A correct diagnosis was made on histopathology and immunohisto-chemistry. On a mean follow up of 21 months (range, 1-60) in 14 patients, all patients were alive.Recurrence or metastasis occurred in 4 patients with tumors of high malignant potential. On univariate analysis, the only significant predictor for adverse outcome was mitoses≥10/50 HPF. Conclusions Pancreatic GIST is a rare tumor of relatively low malignant potential. It has a better prognosis than ductal adenocarcinoma. It is important to arrive at a correct diagnosis and treat the tumor with radical resection. Aggressive surgical resection is potentially curative. Imatinib is recommended in the treatment of patients with tumors with high malignant potential.