Objective To investigate the cerebral protection of dexmedetomidine in patients with heart valve replacement under CPB.Methods Totally 80 cases of patients with heart valve replacement under CPB in Seventh people's hospital of Zhengzhou city from January 2015 to December 2015 were selected and divided into observation group and control group,40 cases in each group.Patients in observation group were treated with dexmedetomidine before anesthetic induction and during the operation,and patients in control group were treated with same dose of saline solution.The arterio-venous oxygen content difference (Da-jvO2),jugular venous oxygen saturation (SjvO2),cerebral oxygen extraction rate (CERO2),serum myelin basic protein (MBP),serum neuron-specific enolase (NSE),and S1003 protein content before anesthetic induction (T0) and when the ascending aorta open (T1),After 10 min of CPB (T2) and postoperative 6 h (T3) were compared between two groups,and occurring rates of MMSE and POCD were also compared.Results SjvO2 values of two groups at T1 were significant higher than T0 (P ＜ 0.05),Da-jvO2,and CERO2 were significant lower than T0 (P ＜ 0.05),SjvO2 values of observation group at T1 and T2 were significant higher than those of control group and Da-jvO2 and CERO2 were significant lower than those of control group (P ＜ 0.05);At T2 and T3,MBP levels of observation group and control group were significant higher than T0 (P ＜ 0.05),and those in observation group were significant lower than control group (P ＜ 0.05);At T1,T2,and T3 of observation group and control group were significant higher than T0 (P ＜0.05),and NSE levels of observation group at T1,T2,T3 were significant lower than those of control group (P ＜ 0.05),S-100β levels of observation group at T2 and T3 were significant lower than those of control group (P ＜ 0.05).After 7 d,MMSE score of observation group was significant higher than that of control group and POCD occurring rate was lower (P ＜ 0.05).Conclusion Dexmedetornidine can improve cerebral ischemia hypoxia state and reduce brain damage in patients with heart valve replacement under CPB.

Objective To evaluate the effect of TGF-β3 on rabbit nucleus pulposus( NP) cells cultured in three-dimensional polylactic-co-glycolic acid (PLGA)scaffold in vitro.Methods PLGA scaffolds were fabricated by particulate leaching method and soaked in rabbit NP cells suspension(1 × 106/scaffold).PLGA-seeded NP cells were devided into 4 groups: 100 ng/mL TGF-β3/PLGA,500 ng/mL TGF-β3/PLGA,1 μg/mL TGF-β3/PLGA, PLGA control group.Cell proliferation activity was measured using MTT assay.The glycosaminoglycan ( GAG ) analysis were performed by 1, 9-dimethylmethylene blue(DMMB) assay.mRNA expression was measured by quantitive PCR at each time point.Histological observation was performed to elucidate the morphological changes of NP cells in PLGA effected by TGF-β3.Results Higher cellular proliferation activity, GAG production,Collagen type II, Aggrean expression were observed in TGF-β3 /PLGA-seeded NP cells compared with PLGA control group on day-7,day-14,day-21(P<0.05). Higher dose of TGF-β3 exhibited intense cellular proliferation activity and peri-cellular matrix by increasing trend(P<0.05).Histological observation showed TGF-β3/PLGA developed more significant disc cells cluster than PLGA groups on day-21.Conclusion The 3D porous PLGA scaffold-seeded cells using TGF-β3 can promotes cell proliferation, and prompt extracellular matrix(ECM) production.It is a potential biotherapy for the treatment of disc degeneration.

Objective To evaluate the clinical outcomes of minimally invasive internal fixation for femoral intertrochanteric fracture in osteoporotic elderly patients. Methods A retrospective study was conducted in 112 patients using interan nail (IN) or trochanteric antegrade nail (TAN) for the management of intertrochanteric femoral fracture from January 2009 to September 2015 in our hospital. According to AO classification, there were 34 cases of type 31-A.1, and 61 cases of type 31-A.2, 17 cases of type 31-A.3. Clinical and radiological follow-up were available. Surgical and fluoroscopic time, length of hospital stay, blood loss, complications and hip functions were compared between two groups. Results A total of 78 patients meeting the criteria were evaluated at a mean follow-up of 15 months (range, 3-27 months). The IN was used in 41 patients and the TAN in 37 patients. Operative time, fluoroscopy time and blood loss showed significant difference between the IN group and TAN group (respectively, 58.9±6.9 vs. 75.6±5.9min; 2.70±0.47 vs. 4.40±0.47min; 107.6±6.7 vs. 127.8±6.8ml, P<0.05), suggesting that patients treated with the IN experienced shorter operative and fluoroscopy times, less blood loss and better hip function (73%) than those with TAN (65%, P<0.05). Rate of postoperative complications was lower in the IN group (4.9%) than in the TAN group (10.8%, P<0.05). There was no difference in hospital stay and fracture healing time between the two groups (P>0.05). Conclusions For minimally invasive treatment of unstable femoral intertrochanteric fractures, use of either the IN or TAN is clinically effective. However, IN presents more advantages (e.g., easy operation, reliable fixation, less bleeding, better clinical outcomes, and less complications). The use of IN is a suitable option for the treatment of unstable intertrochanteric fractures in osteoporotic elderly patients.