Objective To explore the therapeutic effects of Ni-Ti memory alloy embracing fixator on the multiple fracture of ribs and flail chest. Method From January 2006 to December 2009, the effects of operation and long-term follow-up after internal fixation operation with memory alloy embracing fixator in patients with multiple fracture of ribs and flail chest were observed. Results The hospital stay of patients treated with memory alloy embracing fixator was 10.31 ± 3.14 days and pain was significantly reheved after treatment ( P= 0.02) .The rate of post-operative complications was 17.65% such as atelectasis, pulmonary infection, etc. There were fewer longterm complications and less influence to daily activity of life. Conclusions It is a advanced and practical method for patients with the multiple fracture of ribs by using Ni-Ti memory alloy embracing fixator with slighter trauma,simple, safe, reliable, good histocompatibility and fewer post-operative complications.

OBJECTIVE:To study the chemical constituents of Sedum lineare. METHODS:Silica gel column chromatogra-phy,TLC and crystallization were adopted to isolate the chemical constituents of S. lineare. And chemical structures were analyzed and identified based on physicochemical properties and spectral data of compounds. RESULTS:A total of 6 sterols and 2 triterpe-noids were isolated from petroleum ether fraction of S. lineare,which were identified as stigmaster-5-ene-3β-ol-7-one(1),stigmas-ter-5-ene-3β,7α-diol(2),daucosterol(3),daucosterol palmitate(4),β-sitosterol(5),stigmaster-7-ene-3β-ol(6),δ-amyrin(7),andδ-amyrone(8)respectively. CONCLUSIONS:Compounds 3,4 and 7 are isolated from S. lineare for the first time,and compound 4 is isolated from genus S.lineare for the first time. The study has laid certain foundation for the quality evaluation of S. lineare.

Objective To explore the survival/proliferation,apoptotic and death effects of keratinocyte growth factor (KGF) in alveolar epithelial type Ⅱ cells (AT Ⅱ Cs) exposed to hyperoxia.Methods Primary culture of AT Ⅱ Cs from the Sprague-Dawley rat fetuses was studied under room air condition (210 mL/L O2) and hyperoxic condition (950 mL/L O2) for 0.5-12.0 h.Various concentrations of KGF (15 μg/L,25 μg/L,50 μg/L,75 μg/L,100 μg/L)were added into the cell cultures.Cells were randomly divided into room-air group,room-air-KGF group,hyperoxic-exposure group and hyperoxic-exposure-KGF group.The levels of intracellular reactive oxygen species (ROS),cleaved cysteinyl aspartate specific proteinase-3 (Caspase-3),cell death and proliferation of AT Ⅱ Cs were measured by flow cytometer,Western Blot,release of lactate dehydrogenase assays (LDH assays) and 3-(4,5-Dimethyhhiazol-2-yl)-2,5-diphenyhetrazolium bromide assays (MTT assays),respectively.Results Under room air condition,KGF could significantly increase AT Ⅱ Cs proliferation with 15-100 μg/L in a dose-dependent manner and significantly decrease LDH production at concentrations of 25-100 μg/L.Exposure to hyperoxia resulted in a significant increase in intracellular ROS production in AT Ⅱ Cs in a time-dependent manner compared with that of the room air group.Cell viability decreased and LDH release increased significantly in a time-dependent manner when AT Ⅱ Cs were exposed to 950 mL/L O2 for more than 4 h.After exposure to hyperoxia for 0.5 h and 1 h,KGF could significantly increase AT Ⅱ Cs proliferation in 15-75 μ g/L and significantly decrease LDH production at concentrations of 25-75 μg/L.After exposure to hyperoxia up to 4 h,higher viability was observed in 15 μg/L and 25 μg/L KGF group,and lower death rate presented in 25-100 μg/L KGF group.Further,prolnged hyperoxic exposure for 8 h,high viabilitv was shown only in 50 μg/L KGF group,and less death rate was observed only in 75 μg/L KGF group.In addition,no significant difference in viability and mortality was found between hyperoxic group and hyperoxic-KGF group after hyperoxic exposure for 12 h.Expression of cleaved Caspase-3 was significant higher after 4 h and 8 h hyperoxic exposure than that in room-air group ;at the same time,by adding 25 μg/L and 75.μg/L KGF led to decreased expression of Caspase-3 was detected,compared to hyperoxic group.Conclusions KGF may promote survival/proliferation,inhibited apoptosis and death of rat fetal AT Ⅱ Cs in room air condition or under temporary exposure to hyperoxia in vitro.However,prolonged exposure to hyperoxia may decrease the sensitivity of AEC Ⅱ Cs to KGF and limit its protective effects on lung injury.

BACKGROUND: The proper placement of the prosthesis during total knee arthroplasty(TKA) is a key factor that will affect the restored function of the knee.OBJECTIVE: To probe into the position and axial alignment of the tibial prosthesis in order to improve knee function and stability after TKA.DESIGN: A self-control study.SETTING: Orthopaedic department in the affiliated hospital of a university.PARTICIPANTS: A total of 12 patients(4 males and 8 females) received TKA due to severe osteoarthropathy or rheumatic arthritis in the Orthopaedic Departnent of the Affiliated Hospital, Xuzhou Medical College, from May 1999 to September 2004. One received bilateral TKA and 11 received unilateral TKA(4 in the left knee and 9 in the right knee).METHODS: TKA was performed in standard procedure and special attention was paid to the proper placement of the tibial prosthesis. Evaluation on lateral genual stability and HSS knee function was made before and after operation.MAIN OUTCOME MEASURES: ① Lateral genual stability before and after TKA. ② Genual function scale ( concerning pain, function, range of motion, muscle strength, flexion deformity and stability).③X-ray observation.RESULTS: Knee-Society-Scores were evaluated in the 12 patients. Before TKA, 3 knees had mild lateral instability, 7 moderates and 2 severe instabilitys. After TKA, only one knee was mildly unstable and no knee had moderate or severe instability. The mean scores of HSS scale increased from 41 before operation to 89 after operation with the effective rate of 91.7% (11/12).CONCLUSION: The precise placement of tibial prosthesis can increase stability of the knee and relieve pain as well as improve knee function and motion.

Objective To observe the effects of hyperoxia on Notch 1 receptor of alveolar epithelial type Ⅱ cells (AEC Ⅱ), in a hetcrocellular culture of alveolar epithelial type Ⅱ cells and lung flbroblasts(LF), in order to explore Notch signaling in hyperoxic induced lung injury and thus make theoretical basis for prevention and treatment of a acute/chronie neonatal lung injury. Method Twelve Spragne Dawkey female rats with 200～220 g and 3 Spragne Dawkey male rats with 220～250 g were offered from experimental animal centre of Tongji Medical Colleege, Huazhong University of Science and Technology. The AEC Ⅱ/ LF co-culture system was established successfully. AEC H s from premature rats were randomly assigned to 2 groups: air control group and hyperoxia group. Air control group was kept in room air 50% ml/L CO2 enviromnent at 37°C, while hyperoxia group was exposed to 950 ml/L O2 + 250 ml/L CO2. Immuno-histochemistry was taken to detect Notch 1. Fluorescent quantitafive PCR was used to quantify the Notch 1 mRNA. MTT method was taken to assess cen proliferation viability.Flow eytometry double label method was used to detect cell percentages. Results In hyperoxia group:Notch 1 activation was inhibited, and Notch 1 mRNA decreased to 0.43,0.29,0.11,0.03 fold of control (95% confidence limit). AEC Ⅱ percentage descended predominantly[ 24 h hyperoxia group vs. control group: (68.92±6.88)%vs. (90.35±4.01)%, P =0.006;48 h hyperoxia group vs. control group: (38.03±3.27) vs. (61.47±4.81)%, P =0.000;72 h hyperoxia group vs. control group:(20.13±4.45)% vs. (52.05±3.35)%, P =0.000;96 h hyperoxia group vs. control group:(8.17±1.99)% vs. (52.59±2.93)%, P =0.0001 while that d AECI rised[24 h hyperoxia group vs. contrd group:(0.11±0.03)% vs. (0.01±0.01)%, P=0.006;48h hyperoxia group vs. control gnmp:(49.73±3.45)% vs. (16.13±2.13)%, P =0.000;72 h hyperoxia group vs. control group: (52.43±3.14) % vs. (5.98±0.95) %, P = 0.000;96h hyperorxia group vs. control group:(19.85±3.26)% vs. (29.03±3.16)%, P =0.007]. Comclusions Hyperoxia may inhibit Notch signaling pathway, which can weaken proliferation and disdifferentiation of AEC Ⅱ s. Investigations on how to control Notch signaling will provide fresh thoughts for alveolar epithelium repairing.

BACKGROUND:Currently, literatures about autologous vein transplantation are few, and the research on the effect of different parts of autologous vein transplantation are not found yet. OBJECTIVE:To summarize the experiences of establishing the fistula using autologous vein transplantation so as to investigate the method of improving the success rate of surgery. METHODS:We analyzed retrospectively the data of 40 cases of establishing the fistula using autologous vein transplantation, and then compared the successful rate of autologous vein transplantation fistula, blood flow and operating time, thereby analyzing the influence of diabetes melitus on the successful rate of autologous vein transplantation fistula. RESULTS AND CONCLUSION:The successful rates of autologous vein transplantation fistula at different parts ranging from high to low were as folows: the cephalic vein, great saphenous vein, basilic vein and smal saphenous vein. Blood flow of the upper limb for vein transplantation fistula was obviously higher than that of the lower limb (P < 0.05). The operating time of autologous vein transplantation fistula was longer in the upper limbs than in the lower limbs (P < 0.01). For patients with diabetes melitus, the successful rate of autologous vein transplantation was markedly lower than those with no diabetes melitus (P < 0.01). For the hemodialysis patients with poor upper limb superficial vein, autologous vein transplantation is a better way of establishing the vascular access. Vein transplantation of the upper limbs is better than that of the lower limbs in success rate and operating time. Autologous vein transplantation fistula is not suitable for the patients with diabetes melitus.

Objective To investigate the changes and potential roles of the expression of apoptosis signal-regulating kinase 1(ASK1),thioredoxin(Trx)and thioredoxin reductase(TrxR)in the pathogenesis of lung injury of premature newborn rats exposed to hyperoxia. Methods In the first day after delivery,preterm SD rats were randomly divided into air group and hyperoxia group with 64 rats in each.The rats were respectively sacrificed at 1,4,7,10 and 14 days after air or hyperoxia exposure.Sections of 1ungs were stained with HE to observe the histologic changes.Trx and TrxR mRNA were detected by reverse transcription-polymerase chain reaction(RT-PCR).Immunohistochemistry was used to detect the expression and distribution of ASK1.Western blot was used to detect the expression of ASK1 protein. Results Rats in hyperoxia group showed typical lung injury,which was characterized by alveolitis and delayed of lung development.Immunohistochemistry detected that ASK1 expressed generally in the cytoplasm of both alveolar epithelial cells and vascular endothelial cells:ASK1 protein expression in hyperoxia group at 1th and 4th day were 0.4382±0.0227 and 0.5270±0.0432,higher than in the air group(0.3458±0.0263 and 0.3760±0.0058)(P<0.01),and it was until 7th day that the expression became weaker(0.4343±0.0254),but still higher compared with the air group(0.3473±0.0220)(P<0.01).Compared with the air group,Trx and TrxR mRNA of the hyperoxia group increased significantly and peaked at lOth day(0.6860±0.0811)and 7th day(2.0351±0.1600),respectively(P<0.05).ASK1 protein expressions resulting

Objective To explore the effects of expression of thioredoxin-2(Trx-2) suppressed by small interference RNA(SiRNA) in A549 cells exposed to hyperoxia on expression of nicotinamide adenine dinucleotide(NADH) dehydrogenase subunit 1(ND1)and cytochrome C oxidase Ⅰ(COX Ⅰ). Methods A549 cells were gained by serial subcultivation in vitro and transfered with synthetic Trx-2 sequence-specific SiRNA and then were randomly divided into air group without interference,hyperoxia group without interference,air group after interference,and hyperoxia group after interference.After exposure to oxygen or room air for 12,24 and 48 h,expressions of Trx-2,ND1 and COX Ⅰ mRNA of these cells were detected by reverse transcription-polymerase chain reaction (RT-PCR),and Trx-2 protein was detected by Western blot. Results (1)Sequence-specific SiRNAtargeting Trx-2 could significantly down-regulate its expression in A549 cells.(2)Trx-2 mRNA levds inhyperoxia group without interference at 24 h was higher than those in air group without interference(0.7799±0.1249 VS 0.4424±Ⅰ.1140,P<0.05).Th-2 mRNA levels in hyperoxia group after ireedcrence at 24 hand 48 h were 0.2774±0.0174 and 0.2587±0.0069,lower than those in air group after interference andhyperoxia group without interference (P<0.05).(3)ND1 mRNA levels in hyperoxia group without interference at 24 h was 0.6609±0.0368,lower than those in air group without interference(0.8898±0.1049)(P<0.05).ND1 mRNA levels in hyperoxia group after interference at 12 h was 0.8848±0.0135,higher than those in air group after imederence(P<0.05).ND1 mRNA levels in hypemxia group afterinterference at 48 h was 0.3808±0.0937,lower than those in air group after imerference and hyperoxiagroup without interference(P<0.05).(4)COXI mRNA levels in hypemxia group without inteference at 12,24 and 48 h were 1.7313±0.4331,2.1929±0.6722 and 2.0754±0.2584,higher than those in air group witheUt interference,respectively (P<0.05). Conclusions ND1 and COXⅠ participate in thedevelopment of hyperoxia indUCed lung.injury,and Trx-2 is likely to have protective effect on mitochondria ofA549 cells in hyperoxia lung injury.

Objective To investigate the incidence and risk factors of surgical site infection(SSI)in neurosurgical patients in a tertiary first-class hospital,and provide reference for the prevention and control of SSI.Methods 47 neurological patients with SSI (49 patients developed SSI,2 were excluded from study due to the lack of appropriate control subject)from December 31 ,2011 to December 31 ,2012 were as infected group,and 94 patients without SSI (1 ∶2 matching)were as non-infected group,risk factors for SSI were analyzed retrospectively.Results There was no significant difference in general condition of two groups of patients (all P >0.05 );among 3 708 patients,49 (1 .32%)developed SSI;intracranial infection was the main type of SSI (89.80%);27 patients were performed ce-rebrospinal fluid (CSF)bacteriological detection,6 (22.22%)of whom were positive for CSF bacteriological detec-tion.Univariate conditional logistic regression analysis showed that risk factors for SSI in neurosurgical patients were operational risk assessment score (OR =2.04),frequency of preoperative antimicrobial use(OR =3.15 ),fre-quency of intraoperative antimicrobial use(OR=2.58),duration of operation(OR=2.70),surgical blood loss(OR=1 .72),indwelling drainage tube(OR=4.30),duration of indwelling drainage tube after operation(OR=2.06),and time for initial dressing change(OR=1 .66);Multivariate conditional logistic regression analysis showed that the in-dependent risk factors for SSI were frequency of preoperative antimicrobial use(P =0.03,OR =4.86),duration of operation(P =0.05,OR = 2.89 ),and time for initial dressing change after operation (P = 0.01 ,OR = 1 .92 ). Conclusion Risk factors for SSI in department of neurosurgery are multiple,duration of operation,duration of in-dwelling drainage tube after operation,and time for initial dressing change after operation are major risk factors.

Objective To explore the 5-aminolevulinic acid (5-ALA) mediated photodynamic therapy (PDT) for proliferation and apoptosis of gastric cancer cell line MKN-45.Methods The human gastric cancer cell line MKN-45 was cultured in vitro.The MTT method was used to detect fixed lighting processing (laser radiation dose fixed for 25.00 J/cm2,5-ALA photosensitizer concentrations were 0 mmol/L,0.25 mmol/L,0.50 mmol/L,1.00 mmol/L,2.00 mmol/L),fixed photosensitizer concentration treatment (5-ALA photosensitizer concentrations fixed to 1.00 mmol/L,laser radiation dose were 0 J/cm2,6.25 J/cm2,12.50 J/cm2,25.00 J/cm2,50.00 J/cm2,100.00 J/cm2) of the cell apoptosis rate,and then fixed 5-ALA photosensitizer 1 mmol/L and selected the control group,5-ALA group,pure illumination group and PDT group.The promoting effect on cell apoptosis was determined by MTT,electron microscope and flow cytometry.The activity of human gastric cancer cells MKN-45 apoptosis related proteins p65 and the downstream gene regulatory protein bcl-2,bax,caspase-3 and caspase-9 were detected by using Western blot method.Results When laser radiation dose was fixed,5-ALA photosensitizer concentrations in promoting gastric cancer cell apoptosis was positively related to the dominant (P ＜ 0.01).When 5-ALA photosensitizer concentration was fixed,laser radiation dose effect had no longer dominant after 25.00 J/cm2 positive correlation (P =0.613).When 5-ALA photosensitizer concentration was fixed in 1 mmol/L,compared to control group,5-ALA group and pure illumination group,the inhibition of the MKN-45 cell proliferation in PDT group was more apparently,apoptosis rate increased obviously,signal pathways in cell apoptosis protein involved in the NF-kappa B p65 expression was reduced,the downstream gene regulation of target protein bcl-2,caspase-3 and caspase-9 expression were reduced,and bax protein expression was increased.Conclusions 5-ALA mediated photodynamic has a strong inhibitory effect on the growth of gastric cancer cell line MKN-45 in vitro.It can significantly increase the apoptosis rate of gastric cancer cells,and the effect may be carried out by activating the NF-kappa B pathway.