[Objective] To explore the causing and prevention factors of peroneal nerve injury after total knee arthroplasty(TKA).[Method] Nine postoperative peroneal-nerve injury in 9 patients were documented in a retrospective review of 2000 consecutive total knee arthroplasties performed at one institution from Jan.1996 to Jun.2007.Six fresh cadaver knees were executed TKA to observe the causing factors of peroneal nerve injury in operation.[Result]The causing factors of the 9(0.45%)patients were not clear.Cadaver knees TKA suggested the dangerous handlings by turns include the belows:①lifting distal femur by encircle dragging may enhance lesion probability of common peroneal nerve.②risk for common peroneal nerve to set Hoffman crook not paralleling longitudinal axis of tibia or posterior the lateral collateral ligament.③excessive straightening knee joint after the prosthesis had been fixed.[Conclusion]Lifting distal femur by encircle dragging should be avoided while peeling posterolateral joint caps and caput laterale musculi gastrocnemii.The location,inserting orientation and depth of Hoffman crook should be taken care of.Hyperextension of the knee should be avoided.

ObjectiveCardiopulmonary bypass (CPB) and its related ischemia reperfusion injury may cause endothelial cell injury.To study the protective effects of sodium ferulate in vascular endothelial function during CPB by testing the changes of vascular endothelial cell( CEC),nitric oxide( NO) and endothelin-1 ( ET-1 ) in children with congenital heart disease.MethodsSixty patients with congenital heart disease,including 28 males and 32 females were studied.The mean age was (19.7 ±10.4) months and body weight (10.5 ±6.1) kg.There were 37 VSD,8 ASD,7 TOF,5 TAPVC and 3 CAVC,among them 26 patients had pulmonary hypertension.They were randomly divided in to two groups:sodium ferulate group ( group S,n = 30),and control group ( group C,n =30) .Sodium ferulate (8 mg/kg) was given intravenously before CPB.Blood samples were taken from the arterial line at following time points:before CPB (TO),bypass 30 min(Tl ),the termination of CPB (T2 ),2h after operation ( T3 ) and 6h after operation ( T4 ),respectively for determination the concentration of vascular endothelial cell (CEC) in the blood,the concentration of nitric oxide (NO) and endothelin-1 ( ET-1) in the plasma.ResultsThere were no significant difference for the two groups regarding above parameters at TO ( P > 0.05).The level of CEC was significantly elevated after CPB in both groups ( P < 0.05 ) .CEC were lower at T2 in group S than in group C ( P < 0.05 ) .NO was decreased in both groups,but was higher in group S at T2,T3 and T4 ( P < 0.05 ) .The concentration of plasma ET-1 was not significantly different before CPB,but there was a slight decrease at T1,and then it was significantly increased in both groups (P<0.05).But it was lower in group S than in group C at T1,T2,T3 and T4(P<0.05 orP<0.01).ConclusionThere was severe endothelial cell damage during CPB.Sodium Ferulate can effectively antagonize the secretion of ET-1 to promote the formation of NO.Therefore,it reduces CPB-induced endothelial cell damage and protects vascular endothelial function during CPB.

Objective To screen out the effective constituents with estrogenic action in Fructus psoraleae. Methods Fructus psoraleae was separated by using systemic solvent distillation method, and the effective fraction was screened out by the experiment of increasing the uterine weight in mice. Then the petroleum fraction was separated by sil; ca gel chromatrography and the effective constituent was screened by the experiment of increasing the uterine weight in mice. Results High-dose(5g/kg) of the petroleum fraction showed obvious estrogenic action (P

AIM　The effect of bifico on experimental hepatic encephalopathy (HE) induced by thioacetamide(TAA) and the possible mechanism of its protective effect were studied. METHODS　Experimental hepatic encephalopathy was induced by ig thioacetamide 250 mg*kg-1 successively for two days; bifico was administraed ig once per day for one week before HE induction. RESULTS　Compared with control HE rat, Bifico improved rat neuro-reflexes score and hepatic injury grade(P<0.05); thus decreased rat serum ammonium and LPS concentrations, respectively (P<0.05,P<0.01). The preparation slightly increased the ratio of chain amino acid to aromatic amino acid as well as reduced the degree of liver necrosis. CONCLUSION　At the dosage of 840 mg*kg-1 ig for one week before liver intoxication, Bifico significantly protects rats from hepatic encephalopathy induced by TAA.

Objective: To study the expression of hepatocyte growth factor(HGF) in acute pulmonary embolism, and the diagnostic value of HGF thereof. Methods: The acute autoblood pulmonary thromboembolism was used to establish rat pulmonary embolism model. There were blood plasma HGF detection group,organization HGF mRNA detection group and control group respectively. The expressions of plasma HGF and organization HGF were observed during the different periods of acute pulmonary embolism. Results:The expression of HGF was much higher in blood plasma HGF detection group than that of control group at different time points(P ＜ 0.01). The expression of HGF mRNA increased in organization HGF detection group compared with that of control group at 12 h after pulmonary embolism(P ＜ 0.01). Conclusion: The expression of HGF increased in acute pulmonary embolism, which can be used as a diagnosis indicator in acute pulmonary embolism.

Objective To explore the factors related to vasovagal syncope (VVS) in children. Methods The clinical data of 125 children with conifrmed VVS were collected. According to the frequency of syncope during the ifve years from ifrst episode to the time of head-up tilt test, the children with 2 or 3 episodes of syncope were assigned into the low episode group, and the children with 4 or more episodes of syncope were assigned into the high episode group. The two groups were analyzed and compared. Results Among the 125 children, 84 children (67.2%) were in the low episode group and 41 children (32.8%) were in the high episode group. The single factor analysis showed that the age at head-up tilt test, onset of syncopal, causes of syncope, history of carsickness, and positive family history were associated with high attack frequency. The results of non-conditional logistic regression analysis showed that causes of syncope (OR?=?3.723, 95%CI:1.163-11.918, P?=?0.027), history of carsickness (OR?=?5.929, 95%CI:2.066-17.015, P?=?0.001), and positive family history (OR?=?6.794, 95%CI:2.006-23.013, P?=?0.002) were the independent risk factors of high attack frequency. Conclusions The causes of syncope (excluding persistent standing), history of carsickness, and positive family history have important clinical signiifcance in predicting high attack frequency of VVS in children.

Objective:To investigate the role of epidermal growth factor receptor (EGFR)in the regulation of B[a]P-induced silent information regulator 1 (SIRT1 ) activation in the human bronchial epithelial cells (BEAS-2B),and to clarify the relationship between EGFR/SIRT1 signal transduction pathway and the occurrence and development lung cancer.Methods:The prediction analysis of transcriptional factor binding sites of SIRT1 was performed by MOTIF SearchTM software.The primary cultivated BEAS-2B cells were divided into control group (without B[a]P exposure)and B[a]P groups (the cells were exposed to B[a]P for 6,12,24,48 h).RT-PCR and Western blotting method were carried out to detect the EGFR mRNA and protein expression levels.The BEAS-2B cells transfected with SIRT1 promotor luciferase reporter gene plasmid were treated with human epidermal growth factor (hEGF)and Genistein (tyrosine protein kinase inhibitor)for 24 h,the morphology of BEAS-2B cells was observed by inverted microscope, and luciferase reporter assay was used to test the SIRT1 transcriptional activity.The human lung tissue biopsies were acquired and the immunohistochemical analysis was used to determine the EGFR protein expression level.Results:The transcriptional factor binding sites of SIRT1 contained EGF, 2Fe-2S and vWF.Compared with control group,the expression levels of EGFR mRNA in B [a]P groups were increased in a time-dependent manner,and reached the peak at 12 h (P < 0.05);the EGFR protein expression levels were also increased (P <0.05).The SIRT1 luciferase activity in hEGF group was increased compared with control group (P <0.05);when hEGF and B[a]P worked together,the SIRT1 luciferase activity was increased even further (P <0.001). The cells showed arrangement and morphologic changes gradually when the B[a]P concentration was above 30 μmol · L-1. Genistein (30 μmol · L-1 )inhibited the increase of SIRT1 luciferase activity induced by B [a]P ,and there was significant difference compared with control group (P <0.05).The immunohistochemistry results showed that EGFR expression level in lung cancer tissue was higher than that in normal lung tissue (P < 0.001).Conclusion:EGFR can regulate the B [a]P-induced SIRT1 expression in BEAS-2B cells,and to cause lung chronic inflammation;EGFR/SIRT1 signal transduction pathway may play a role in the occurrence and development of lung cancer.

Ohjective To investigate the associations between the Arg389Gly polymorphism of the β_1-adrenergiecreceptor gene (ADRB1) and vasovagal syncope (VVS) in Chinese children. Methods Genotype of ADRB1 was determined by polymerase chain reaction-restriction fragment length pelymorphism analysis. Case-control studies and quantitative trait analysis were carried out by comparing between carriers (one or two copies of the Gly389 allele) and non-carriers (Arg389 genotype) of the ADRBI in 54 patients with unexplained syncope and in 54 healthy control subjects. Patients were subdivided into two groups according to head up tilt test (HUTT) : positive HUTT, known as VVS group and negative HUTT group. Distribution of Arg389Gly genetype in VVS group and the relationship to three clinical patterns were also analyzed. Results An allele frequency of Arg389 was 73.15% and Gly389 was 26.85% in healthy subjects. Higher Gly389 allele frequency was found in VVS group (n = 30) than that in negative HUTT group (33.33% vs. 14.58%, P < 0.05). In VVS group, the frequencies of the Gly389 allele in cardioinhibitory pattern (n = 6), mixed pattern (n = 9) and vasodepressor pattern (n = 15) was 66.67%, 33.3% and 23.33%, respectively, which had significant differences between the cardioinhibitory pattern from any of the other two patterns (both P < 0.05). Conclusions An association of positive HUTT with a single nucleotide pelymorphism of Gly to Arg switch at position 389 of the ADRB1 was found. This polymorphism may contribute to susceptibility to VVS.

Objective To investigate the safety of rituximab combination chemotherapy in the treatment of B-cell non-Hodgkin' s lymphoma (B-NHL) complicated with hepatitis B virus (HBV) infection,and assess the incidence of HBV reactivation reduced by prophylactic lamivudine.Methods A retrospective study of HBV-related markers,HBV-DNA and liver function was performed before and after rituximabcontaining treatment in B-NHL patients.Thirty nine B-NHL patients with HBcAb(+)/HBsAb(-) were divided into prophylactic group (14 cases) and control group (25 cases).The incidences of HBV reactivation,functional damage of liver were measured.Results Among the 108 B-NHL patients who received rituximab combinatio nchemotherapy,15 (13.89 ％) were HBsAg (+) and 39 (36.11％) HBsAg (-) / HBcAb (+).Of the 15 HBsAg (+)patients,2 (13.3 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 7.7 ％(1/13) in patients who received prophylactic antiviral treatment and 50 ％ (1/2) in those who did not receivelamivudine.Among the 39 HBsAg (-) / HBcAb (+) patients,3 cases (7.7 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 0 in patients who receivcd prophylactic lamivudine treatment and 12 ％ (3/25) in those who did not receive this antiviral drug.Conclusion Prophylactic lamivudine before rituximab combination chemotherapy can reduce HBV reactivation obviously.

Objective To analysis long-term effects and safety of arsenic trioxide (ATO)-based induction and maintenance therapy in newly diagnosed acute promyelocytic leukemia (APL). Methods Retrospective analysis induction remission and post-remission treatment of 62 newly diagnosed APL patients was performed. These cases were followed up for 5 and 7 years. Results The complete remission (CR) rate was similar in ATO/all-trans retinoic acid (ATRA) induction group and ATRA/chemotherapy induction group.However, the former group has the shorter time to CR. The negative rate of PML-RARα fusion gene after induction without ATO was less than that of ATO group (86.2 % vs 56.3 %, P ＜0.05). After CR, the 5-year overall survival (OS) between ATO-base rotation maintenance group and chemotherapy-base rotation maintenance group showed that the former was (94.4±5.4) %, the latter is (45.5±10.2) %; 7-year OS was (52.5±23.7) % and (27.3±9.3) %; 5-year disease free survivals (DFS) was (94.7±5,5) % and (41.3±10.1) %; 7-year DFS was (52.6±23.7) % and (27.5±9.4) %. There was significant different in 5-year or 7-year OS and DFS between two groups (P ＜0.05). The relapse rates of the two groups in post-remission treatment were 14.7 % and 37.0 % (P ＜0.05). Conclusion ATO combined ATRA induction therapy increased the negative rate of PML-RARα fusion gene. ATO-base rotation maintenance improved long-term outcome and decreased the rate of relapse. Furthermore, ATO appeared to be generally safe and well tolerated.