Objective To explore the improvement effect of rehabilitation nursing on joint swelling and pain after total knee arthroplasty.Methods According to the digital table,100 patients with total knee arthroplasty were randomly divided into observation group and control group,50 cases in each group.The control group after operation used routine nursing care,the observation group was given targeted rehabilitation nursing.They were compared with visual analogue scale (VAS),American Knee Society Score (AKSS),range of motion (ROM),length of hospital stay,joint swelling degree.Results Mter treatment,the VAS score of the observation group was lower than the control group[(2.43 ±0.51) points vs.(4.58 ± 0.81) points,t =15.882,P ＜ 0.05],AKSS scores and ROM were higher than those in the control group[(69.94 ± 14.23)points vs.(53.23± 12.91)points,(103.47 ± 14.84)° vs.(91.23 ±12.53) °,t =6.149,4.456,all P ＜ 0.05].The hospitalization time of the observation group was shorter than that of the control group[(14.23± 3.81)d vs.(17.82 ± 4.03) d,t =4.577,P ＜0.05].At 3d and 7d after operation,the swelling degree of the observation group was lower than those of the control group[(1.23 ±0.26)mm vs.(1.97 ±0.38)mm,(0.62 ± 0.21) mm vs.(1.38 ± 0.35) mm,t =11.364,13.166,all P ＜ 0.05].Conclusion The application of rehabilitation nursing after total knee joint surgery can effectively relieve joint swelling and pain,and it is worth to be popularized.

Objective To investigate the relationship between concentration of plasma homocysteine(Hcy) and recurrence of ischemical cerebral stroke(ICS).Methods Plasma Hcy concentration were measured using fluorescence polarization immunoassay(FPLA) in 303 primary and 97 recurrent ICS patients [173 cases of atherosclerotic thrombotic cerebral infarction(thrombotic group),170 cases of lacunar cerebral infarction(lacunar group) and 57 cases of cardiogenic embolism] and 200 non-cerebrovascular disease patients(control group).Multifactorial regression analysis was conducted on recurrent factors contributing to ICS.Results(1) Plasma Hcy concentration in patients with ICS [thrombotic group(16.17?10.83) ?mol/L,lacunar group(14.64?7.71) ?mol/L,cardiogenic embolism group(15.75?6.8) ?mol/L] were significantly higher than that in the control group [(9.61?4.22) ?mol/L](all P

Objective To determine the lumbar anatomical structure parameters of the lumbar spine posterior column and its sample data of three-dimensional conformation,and based on these data to design the lumber laminar screw dynamic fixation system.Methods 20 human L3 ～ S1 bone specimens,the thickness of the lumber laminar region were measured to obtain the normal anatomical parameters of the lumbar laminar.And 20 healthy lumbar vertebrae L3-S1 for three-dimensional reconstruction were detected by CT scan,which could obtain the structure data of the normal lumbar posterior three-dimensional conformation,and to obtain conformational sample data of three-dimensional space of the posterior structure.Results Lumbar lamina medial 1/3 could serve as a spine laminar screw setting area by anatomical observations and measurements.Lamina thickness of L3-4 on average (6.6 ±0.9) mm,L5 ～ S1average (6.0 ± 0.6) mm.Lumber laminar screw length 6.5 ～ 8.0mm could meet the requirements of bilateral cortical fixation.Conclusion Lower lumbar spinal lamina area can serve as the region to fix the bilateral cortical bone screw,and the optimal length of the laminar screw is 6.5 ～ 8.0rmm.

Objective To investigate the effect factors for language and memory dominance testing in propofol Wada test in refractory epilepsy patients.Methods From January 2010 to August 2013,total of 23 patients underwent propofol Wada tests for language and memory dominance evaluation.According the performance in language test and memory test,the patients were divided into two groups,respectively:succeed with test or failed in test.The relevant factors including age,duration of epilepsy,handedness,FIQ (full scale of intelligence quotient),lateralization of lesions,language dominance,dose of propofol and the adverse effects of propofol were recorded as independent variables.Logistic regression was adopted to screen the effect factors for memory dominance evaluation.All statistical analyses were processed with SPSS software.Results All 23 patients succeeded with language test,but only 13 patients succeed with memory test.The difference of success ratios between language test and memory test was significant (P=0.001).For memory test,the difference of duration of epilepsy and FIQ in success group and failed group was significantly different (duration of epilepsy:(10.57±4.68) vs (18.30±9.30),P=0.032,FIQ:(81 ±25.33) vs (64.2±10.86),P=0.046).More grade Ⅱ adverse effects of propofol occured in the patients who failed in memory test (P=0.011).Logistic regression results indicated the grade Ⅱ adverse effects of propofol were the main risk factor for memory test failure (OR=28.0,P＜0.01).Conclusions Propofol Wada test is an effective method for language dominance evaluation.However,the effect factors for memory dominance evaluation are much more than language evaluation,such as duration of epilepsy,FIQ and grade Ⅱ adverse effects of propofol,and grade Ⅱ adverse effects of propofol may be the most significant risk factor.

Abstract:Aim To study the effect of rotenone on α-synuclein in rat midbrain of Parkinson's disease(PD).Methods Rats were subcutaneouly injected with chronic low dose rotenone(1.0 mg·kg~(-1)·d~(-1)).Movements within 5 minutes were evaluated in open field test.Tyrosine hydroxylase(TH)-positive neuronsin the midbrain were measured with immunofluorescence staining.α-SYN protein level in the midbrain was demonstrated with immunohistochemical staining and Western blot.Results Compared to the control group,latency time,crossing,rearing and rearing time were changed significantly(P<0.05,0.01)in the rotenone group,TH-positive neurons were reduced(P<0.05)and α-SYN protein level in the midbrain was increased(P<0.05).Conclusion Injection with rotenone can induce PD symptom,which may be correlated to α-SYN protein level in the midbrain.

Objective To evaluate the efficacy and toxicity of gefitinib on the treatment of advanced NSCLC with brain metastases.Methods 17 cases received gefitinib 250 mg/m2/d,30 days a cycle.Results Objective response rate of 35.3% was achieved,and DCR was 70.6% ,the toxic reactions could be controlled with relative therapy.Conclusion Gefitinib is effective and well tolerable for advanced NSCLC with brain metastases.It is worth to be used.

Aim To study the effect of activating Sonic hedgehog( Shh) pathway on the function of endothelial progenitor cells ( EPCs ) in type 1 diabetic mice. Methods EPCs were isolated and cultured by density gradient method from diabetic mice. The effects of Shh N-terminal peptide and agonist SAG on EPCs prolifera-tion were evaluated by using the MTT colorimetric as-say. EPCs migration was measured by Transwell meth-od. EPCs tube formation ability was estimated by Matrigel . EPCs senescence activity was determined by β-galactosidase staining. Results Compared with control mice, the function of EPCs in type 1 diabetic mice was impaired. The proliferation, migration and tube formation of diabetic EPCs could be promoted by Shh peptide and agonist SAG. The senescence of dia-betic EPCs could be decreased by Shh peptide and ag-onist SAG. Conclusion Activating Shh signaling pathway can improve the impared function of diabetic EPCs in type 1 diabetic mice.

BACKGROUND:Neurotrophin-3 is found in the repair of spinal cord injury in the role of the strongest neurotrophic factor.It can effectively promote axonal regeneration through the glial scar tissue in repairing spinal cord injury.OBJECTIVE:To construct recombinant lentiviral vectors for gene delivery of homo sapiens neurotrophin-3(hNT3),and to investigate the expression of hNT3 gene in Schwann cells after transfection.DESIGN,TIME AND SETTING:Observational experiment was performed from June 2007 to March 2008 at the Central Laboratory of Changhai Hospital.MATERIALS:Bilateral sciatic nerves were harvested from 3-day-old Sprague Dawley rats for culture and identification of Schwann cells.Three-plasmid lentivirus systems:pGC-E1-EGFP,pHelper 1.0 and pHelper 2.0 were gained from Shanghai Chemical Technology Co.,Ltd.METHODS:pGC-E1-hNT3-EGFP plasmid was constructed by double restriction enzyme digestion and ligation,and then the plasmid was transformed into E.coli DH5?.Purified pGC-E1-hNT3-EGFP plasmids from the positive clones was confirmed by PCR and sequencing.293T cells were cotransfected with lentiviral vector pGC-E1-hNT3-EGFP,pHelper 1.0 and pHelper 2.0 by Lipofectamine 2000 to produce lentivirus.2 mL recombinant virus complete culture solution was added according to multiplicity of infection=1,4,8,10,12.The titer of virus was tested according to the expression level of enhanced green fluorescent protein.The control groups were Schwann cells and Schwann cells transfected by no-loaded lentivirus.MAIN OUTCOME MEASURES:The lentiviruses were transduced to Schwann cells,and the transfection efficiency was examined by flow cytometry,the overexpression of hNT3 was determined by Real-time PCR and Western blotting.RESULTS:The exogenous gene sequence of the recombinant hNT3 was completely in accordance with that of its open reading frame in GeneBank.The titer of concentrated virus was 5?107 TU/L.After recombinant LV-hNT3 infection,Schwann cells gave off strikingly bright green fluorescence,and the transfection efficiency amounted to 85%(multiplicity of infection=10).Real-time RCR test showed that the hNT3 mRNA were highly expressed in hNT3-Schwann cells,while did not express in the control group.Western blotting showed the hNT3 expression in Schwann cells.CONCLUSION:Construction of hNT3 gene lentiviral vector can transfect Schwann cells leading to an efficient overexpression of hNT3.

Objective To discuss the effect of H2 on osteoclast differentiation of RAW264.7 cells induced by RANKL and RANKL/TNF-α.MethodsRAW264.7 cells were treated with H2 in the presence of RANKL and RANKL/TNF-α.RAW264.7 cells viability was assessed by CCK-8.Test the Oxidative Stress of the induced RAW264.7.The number of TRAP-positive cells were counted under light microscopy.The levels of cathepsin K (CTK) and matrix metalloprotein-9(MMP-9) mRNA were analyzed by real-time PCR.ResultsH2 can not influence the RAW264.7 cell viability but can lower oxidative stress.The significant difference(P<0.05) indicated that H2 could significantly decrease the number of TRAP-positive MNCs.The significant difference among the 4 groups in CTK and MMP-9 genes (P<0.05) indicated that H2 could down-regulate their mRNA expression.ConclusionH2 can reduce the oxidative stress and inhibit differentiation of RAW264.7 cells into osteoclasts.

This study is to investigate the amelioration effect of glucocorticoid receptor (GR) antagonist mifepristone on the changes of learning and memory abilities in rat model of depression. In the present study, a 35-day rat chronic unpredictable stress (CUS) model was used to observe both depression-like behaviors with sucrose preference test and open-field test and learning and memory-associated behaviors with Morris water maze test. A total of 45 male adult Sprague-Dawley rats were randomly assigned to three groups of equal size: control group (CON); CUS group (CUS); CUS + mifepristone group (CM). Animals in CM group were first exposed to CUS for 14 days, and then were administered with 50 mg x kg(-1) x d(-1) of mifepristone with continued CUS procedure. Corticosterone EIA Kit was used to detect the concentration of plasma corticosterone (CORT). Nissl staining was used to observe the structure of hippocampus. The results demonstrated that CUS exposure induced both depressive-like and learning and memory-associated behaviors and these deficits were reversed by mifepristone. Compared to CON group, the concentration of plasma CORT increased significantly in CUS group. CUS exposure damaged the structure of hippocampus, whereas mifepristone had an amelioration effect. Together, the structural deficits of hippocampus resulting from long-term stress exposure, which could contribute to the impairment of learning and memory in depression, are reversed by the GR receptor antagonist mifepristone.