Objective To explore effects of breath training and psychological induction to heart rate before coronary angiography with 64-slice spiral CT. Methods 100 cases are involved. All of them are divided into 2 groups randomizedly. Heart rate is counted before examination. Breath training and psychological induction are performed in one group. Results Heart rate decreases significantly in the group accepting training and induction. Conclusion It is effective to decrease heart rate and stablize heart rhythm for patients to accept breath training, psychological induction, and other relaxing training. Also, breath training makes patients to coordinate examination properly.

Objective To look for an ideal substance to repair large gap of nerve defect after injuries by culture,population of Schwann cells(Scs)and preparation of acellular allogenous nerve grafts with chemical extraction. Method The double adhesion culture and Arab c to prohibit the fibroblast growth were used to achieve high purified Scs;detergents:Triton X 100 and sodium deoxycholate were used to achieve acellural nerve grafts (ANG);and finally the Scs were micro injected into the acellural nerve grafts and the consequence studied Result By the way above,high purified Scs and the ANG was acquired,which can integrated each other well Scs can survived and transformed to aline in vitro Conclusion ANG populated isogenous Scs may be an ideal substance to repair the large gap of nerve defect after injuries

Objective Investigate the degradation process of polyactic acid (PLA) filaments within peripheral nerves and its adverse effects on peripheral nerve. Method Bilateral sciatic nerves of 20 SD rats were exposed, and PLA filaments were implanted among the fascicles at one side, while Vicryl filaments were implanted into the contralateral nerve as control. The filaments and nerves were harvested at 1,4,8 and 12 weeks postoperatively, and inspected by macroscopy, light microscope and transmission electron microscope. Results The degradation occurred not only on the surface but also inside the PLA filaments after they were implanted into the sciatic nerve. PLA fragments still could be found at the end of this study. During the degradation of PLA filaments, macrophages invaded into the filaments and exhibited active phagocytosis. There were mild degree infiltration of lymphocytes and fibroblast around the filaments during their degradation. However, the structure of peripheral nerve didnt change significantly. Conclusion It takes more than 12 weeks that PLA filaments degrade in peripheral nerve completely. Mild nonspecific inflammation develops following the implantation of PLA filaments into peripheral nerve, but it has no adverse effects on nerve.

The upper limbs of 23 adult cadavers were dissected and the internal structures of the median nerve were studied for microsurgery of the nerve.Under operative micros- cope(24X),the median nerves of 20 cadavers treated with 10% acetic acid were dissec- ted.The median nerves of the remaining three were cross-sectioned,inch by inch,and stained with Sudan Ⅲ for microscopic observation.Microscopic ptotographs were taken to visualize the intra-neural topography of motor bundles or bundle groups. 1.The morphology,topographic relationships,size and number of bundles of the median nerves were observed under microscope and were recorded. 2.At the level of the arm and forearm,the nerve trunk and its internal bundles appear to twist to a certain degree in the way of external rotation from the distal to proximal. 3.The motor bundles of the thenar muscles emerge at the level about 40.1mm below the styloid process of radius.They enter the nerve trunk anteriorly on the radial side,and run upward at the Rower part of the forearm,and continue postero-laterally and appear as a admixture of sensory and motor nerves.At the mid-portion of the fore- arm,they are situated posteriorly,while at the level of antecubital fossa and above, they occupy the central position and finally most of the bundles join the medial head of the median nerve. 4.The motor bundles that supply the flexor muscles of the forearm are located anteriorly and posteriorly in separate portions after entering the nerve trunk.At the level of the arm,these two portions of median nerve are mixed bundles but motor nerve fibers predominate. 5.The fundamental method of funicular suture were discussed in relation to the intra-neural topography of the median nerve.

Purpose To construct expression vector of Fas extracellular region gene(eFas) ,to express and purify recombination protein and to prepare polyclonal antibody, which have laid a foundation of studying its function. Methods The eFas gene encoding sequence was acquired through overlapping PCR, and pET-22b ( + )/eFas expression vector was constructed. Then this vector was transformed into E. coli Rosetta-gami. Re-combinant protein was expression being induced by IPTG,and was purified using Ni-NTA matrix of affinity chromatograph. The purity of recombination protein was identified by SDS-PAGE. Hereafter, the purified eFas recombinant protein was immunized to New Zealand white rabbit in order to prepare polyclonal antibody. The titer of polyclonal antibody was determined by ELISA. Results The encoding sequence and expression vector of eFas was obtained while the interest protein was mainly expressed in the inclusion body. The eFas fusion protein's expression quantity accounts for more than 30% proportion of total E. coli protein. The eFas protein we obtained was provided with the purity of at least 95 % . Conclusion The successful constrution, expression and purification of FasL fusion protein and preparation of polyclonal antibody will provide some material for further studies of Fas.

Objective To compare the clinical effectiveness of ozone (O_3) nucleus pulposus ablation only with that of 03 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome in treating lumbar disk herniation accompanied with intervertebral facet arthritis. Methods Eighty patients with lumbar disk herniation and intervertebral facet arthritis were equally and randomly divided into two groups. Under CT guidance, O_3 nucleus pulposus ablation was performed in patients of group A(n = 40), while O_3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome (0.5 ～ 1 ml) was carried out in patients of group B (n = 40). Using double blind method the therapeutic effectiveness was evaluated before and 1 week, 3, 6-months after the procedure by an Oswestry Low Back Pain Disability Questionnaire. Results One week after the procedure the effective rate of group A and group B was 65% and 82.5% respectively. Three and six months after the treatment, the effective rate was 75% and 70% respectively for group A, while it was 90% and 92.5% respectively for group B. The difference between two groups was significant (P < 0.05). Conclusion lntradiscal injection of O_3 combined with intervertebral facet joint injection of compound Betamethasome is an effective and safe treatment for lumbar disk herniation accompanied with intervertebral facet arthritis. It is worth popularizing this technique in clinical practice.

BACKGROUND: Schwann cell derived neurotrophic factor, which is isolated and purified from the kytoplasm of Schwann cell with the relative molecular mass of 58000, is a kind of neurotrophic substance possessing obvious neurotrophic activity. It can be against neurovirulent substance of nitrogen monoxidum.OBJECTIVE:To create root avulsion animal models and observe the protective effects of Schwann cell derived neurotrophic factor (SDNF) on motoneurons of spinal anterior horn from spinal root avulsion induced cell death.DESIGN: Repeated observation and measure.SETTING: Third Department of Orthopaedics, Second People's Hospital of Shenzhen; Department of Micro-surgery , First Hospital Affiliated to Sun Yat-sen University.MATERIALS: This experiment was conducted at the Experimental Animal Center of Medical College of Sun Yat-sen University from March to May 2003. Twenty Sprague-Dawley rats with the age of 3-4 months, of clean degree, were selected and divided randomly into experimental group of Schwann cell derived neurotrophic factor and control group of normal saline with 10 rats in each group. The right side was injured, and the left side was intact served as normal control side.METHODS : ①A rat model of C6,7 spinal root avulsion induced motoneuron degeneration was established. ② A small piece of gelfoam presoaked in 40 μL SDNF solutions (1 g/L) was placed in contact with the injured spinal cord in the animals of the experimental group. Normal saline was added as the same way as above in the animals of the control group. ③ A silica pipe was put on the surface of gleform, one end of the silica was sutured to the glefoam , and the other end wasfixed subcutaneously with vaselinum. Local intramuscular injection of penicillinum was performed on the wound following closing the incision. All rats received an injection (20 μL) of either SDNF or normal saline solution at the lesion site through the silica pipe sutured to the glefoam once a week after the surgery. All the animals were killed by the end of the third weeks. ④The spinal region of C6,7 level was dissected out for observing survival rate and morphological change of motoneurons of spinal anterior horn as well as the expression of nitricoxide synthase(NOS).MAIN OUTCOME MEASURES: ① Survival and morphological change of spinal motor neurons. ②Change of nitricoxide synthase expression of spinal motor neurons.RESULTS: Totally 20 rats were enrolled in the experiment, and all of them entered the stage of result analysis. ① Survival and morphological changeof spinal motor neurons: 68.6% motoneurons of injured side of the control group died at 3 weeks after surgery. The survival rate was 31.4%,which was significantly lower than that of the intact side (P ＜ 0.01), and the survived neurons was shrinked significantly; the death rate of spinal motor neurons of injured side of experimental group was decreased by 35%as compared with control group (P＞ 0.05). The survival rate was 66.4%,and the survived neuron body was increased, similar to the intact side (P ＞ 0.05). ② Change of nitricoxide synthase expression of spinal motor neurons: In normal spinal cord, NOS positive neurons were shown in dorsal horn, surrounding the central canal and in the intermediolateral column.NOS was not seen in the anterior horn motonurons. At the end of the third week after C6,7 spinal root avulsion, increased NOS expression was not found at the injured side in the Schwann cell derived neurotrophic factor group and the intact side in the control side, while the significantly increased NOS expression of spinal motoneurons was found at the injured side of the control group.CONCLUSION: Degeneration of spinal motoneuron and increased expression of NOS can be induced by spinal root avulsion. SDNF has a significant effect in protecting spinal motoneurons from spinal root avulsion induced cell death and inhibiting the expression of NOS. These results suggest that the effects .of SDNF on motoneuron survival may be achieved by modifying the expression of certain cellular molecule such as NOS.

BACKGROUND: Schwann cell-derived neurotrophic factor is a bioactive protein isolated and purified from the kytoplasm of Schwann cell. It can obviously maintain the survival of spinal cord anterior horn motor neuron and promote the regeneration of peripheral nerve.OBJECTIVE: To observe the protective effect of Schwann cell-derived neurotrophic factor on the high injury of peripheral nerve-induced apoptosis of sensory neurons in spinal dorsal root ganglia.DESIGN: Randomized and controlled animal experiment.SETTING: Shenzhen Second People's Hospital.MATERIALS: Totally 30 3-week-old SD infant rats, of clean grade and either gender, were used in this experiment. They were randomly divided into neurotrophic factor group and control group with 15 rats in each one.Left sides of the animals in both two groups were set as normal sides and right sides as injured sides.METHODS: This experiment was carried out at the Experimental Animal Center, Medical College of Sun Yat-sen University from May 2003 to July 2003. ① L4.5 nerve root high-mutilation animal models were developed on the rats in two groups. Proximal nerve stump was connected with silicone tube. According to grouping, 60 mg/L Schwann cell-derived neurotrophic factors and 20 μL normal saline were injected into the silicone tubes respectively. Two ends of silicone tube were enveloped with vaseline.② Sample collecting was conducted at postoperative 4 weeks, survival rate and morphological change of sensory neurons in dorsal root ganglia of injured nerve was observed.MAIN OUTCOME MEASURES: ① Gross observation of sciatic nerve regeneration at injured side of the rats in two groups ② Survival of sensory neurons in dorsal root ganglia ③ Morphological change of sensory neurons in dorsal root ganglia.RESULTS: All the 30 rats entered the stage of result analysis. ① Gross observation of sciatic nerve regeneration: In the neurotrophic factor group,nerve new born axon grew along silicone tube, with 1cm in length; there were few and thin newborn axons in control group with 0.8 cm in length.② Survival of neuron in dorsal root ganglia of the rats in two groups: There was little fibrous tissue proliferation in the dorsal root ganglion in neurotrophic factor group. The loss of neurons was not obvious and the survival rate was 91.8%. Obvious fibrous tissue proliferation appeared in the dorsal root ganglia in control group, and a great many neurons were lost with the survival rate of 58.6%. Survival rate of neurons was 33.2% higher in neurotrophic factor group than in control group (P ＜ 0.01 ). ③ Morphological change of neurons in dorsal root ganglia: The diameter and area of neurons in dorsal root ganglia were significantly lower in control group than in neu rotrophic factor group and normal side [(21.8±1.4) μm,(373.1±50.9) μm2 vs (24.8±1.1) μm, (482.8±42.2) μm2 and (24.5±1.3) μm, (471.5±51.4) μm2,P ＜ 0.01], while there were no significant difference in diameter and area of neurons between neurotrophic factor group and normal side(P ＞ 0.05).CONCLUSION: Schwann cell-derived neurotrophic factors have obvious neurotrophic bioactivity for sensory neurons in the injured dorsal root ganglia.

ObjectiveTo adopt a new suture technique the core long-distance buried for repair of flexor tendon rupture which was designed by author and could lessen adhesion.Methods60 human cadaver flexor digitorum tendons were divided into 3 groups and sewed by core long-distance buried suture, Kessler's technique and Bunnell's technique respectively. Instron-testing machine was used to test gap formation force, 2 mm gap formation force and maximum load. 30 hen second and third toe flexor profundus tendons were divided into 2 groups, each group of tendons were transected and repaired by core long-distance buired suture and Kessler's technique respectively. Information of tendon healing and tendon adhesion was observed in the 3rd, 4th and 6th weeks after operation.ResultsIn the group of using core long-distance buried suture technique, the gap formation, 2 mm gap formation and maximum load in were higher than that using Kessler's technique and Bunnell's technique, the effects of lessening adhesion and promoting tendon healing were better than that in the Kessler's technique group.ConclusionCore long-distance buried suture can offer great tensile strength needed by clinic, and allow early motion and lessen adhesion after operation.

Objective To validate the effect of anti-infective reconstituted bone xenograft (ARBX) in treating posttraumatic osteomyelitis by one-stage grafting in the adults.Methods With clinical application approval of Medical Command,Logistics Ministry of PLA,ARBX was used to treat 27 adult patients (29 lesions) with posttraumatic osteomyelitis by one-stage grafting after debridement since September 2001.The study analyzed 27 patients (29 grafts) who were followed up for average 26 months (12-63 months).Results The follow-up for average 26 months (12-63 months) in 27 patients showed that infection of 22 patients (24 lesions) was controlled and cured,except for three with failure to control the infection or with recurrence of infection,two with controlled infection but with postoperative nonunion.The infection control rate was 89.7% (26/29) and the cure rate was 82.8% (24/29) ,which were better than the results of traditional therapy.Conclusions ARBX has high osteoinductive activity and enhanced anti-infective capability,which enables it to be used as one-stage grafting to treat posttraumatic osteomyelitis in the adults.