A case of the Sick Sinus Syndrome which was based on the diagnosis ofautopsy is reported in this paper.It was found that a decreased number ofpacemaker cells with fibrosis,fatty infiltration and the thick endothelium ofcenter arteriole in sinus-atrial node.Otherwise the vacuolar degenerationcould be seen in the bundle of his.There were no fetal pathological changesto be seen in other organs.

There have been many methods to prepare fluoroquinolones-loaded sustained-release chitosan microspheres, including precipitation, emulsion crosslinking, spray-drying, and ionic gelation. Each of them has its own merits and disadvantages, but the mechanisms underlying drug delivery are basically similar. The prepared drug microspheres can enhance the capacity of anti-fluoroquinolones-resistant bacteria and are primarily used in the anti-inflammation and anti-infection. This paper introduces the preparation methods and sustained drug delivery mechanisms of fluoroquinolones-loaded sustained-release chitosan microspheres and investigates drug delivery characteristics and applications by analyzing, sorting, and summarizing related manuscripts published recently. Fluoroquinolones-loaded sustained-release chitosan microspheres show satisfactory sustained-release and anti-bacterial properties. Therefore, it is of important scientific research and clinical application significance to develop fluoroquinolones-loaded sustained-release nanometer-sized chitosan microspheres.

Chitosan microsphere containing fluoroquinolones is a kind of novel sustained-released antibacterial agent that possesses the antibacterial and bacteriostatic property of chitosan as well as bactericidal properties of fluoroquinolones. Loading fluoroquinolones in the chitosan microsphere can greatly enhance its antibacterial, bactericidal, anti-inflammation and anti-infection characteristics. This paper reviewes the recent study on different preparation methods of chitosan mierosphere containing fluoroqninolones and discusses its applications.

Objective To systematically assess the relationship between oral administration of aspirin and survival benefit for patients with colorec?tal cancer(CRC)by meta?analysis. Methods Relevant studies were identified through searching PubMed and EMBASE. Random?effects model was derived to composite the pooled hazard ratio for overall mortality and CRC?specific mortality. The subgroup analysis was conducted for included data,and the bias analysis was reported. Results Thirteen studies on aspirin therapy were finally included in this meta?analysis. The overall surviv?al benefit associated with oral administration of aspirin represented an HR of 0.83(95%CI:0.71?0.96). Oral administration of aspirin was also asso?ciated with CRC?specific survival(HR=0.77,95%CI:0.64?0.93). No evidence was observed of an association between prediagnostic aspirin use and CRC overall survival(HR=1.00,95%CI:0.85?1.18)or CRC?specific survival(HR=0.97,95%CI:0.83?1.13). Conclusion These findings provide further indication that post?diagnostic aspirin therapy can improve CRC prognosis.

Objective To observe the preemptive analgesia effects of katamine and elonidine, and to find out the influence of preemptive on stress responses. Methods 36 patients with hysteromyoma undergone hysteromyomec-tomy were randomly assigned to three groups (n = 12 each group) :group Ⅰ , control group, without preemptive analge-sia,the patients in control group were given continous epidural analgesia with 2% lidoeaine 12 - 14ml. Group Ⅱ ,the patients were injected 0. 6mg/kg katamine into epidural analgesia 30 minutes before operation. Group Ⅲ,the patients were injected 0. 6mg/kg katamine and 1.5μg/kg clonidine into epidural analgesia 30 minutes before operation. The patients in three groups were recorded VAS score on 2h ,4h ,6h, 12h ,24h after operation, also recorded the change of epinephrine(E) and norepinephrine(NE) and sensation and movement recovery time after operation. The side effects such as dizziness nausea,vomit,and exited talking were observed during the operation. Results The VAS score were significantly different between group Ⅰ ,Ⅱ and Ⅲ. The levels of E and NE in plasma in group Ⅰ were increased more than group Ⅱ and Ⅲ within 24 hours after operation, also there is significant difference in group Ⅱ compared with group Ⅲ in T1 ,T2 ,T3. The time of sensation and movement recovery were remarkably longer in group Ⅲ com-pared with group Ⅰ and Ⅱ, showing significant difference. There were no significant difference in side effects after operation in three groups. Conclusion The preemptive analgesia of kutamine and colnidine can relieve the pain of lower abdominal surgery and stress response after operation,and it do not increase the side effects.

[Objective]To investigate the outcomes of cementless metasul metal-on-metal total hip arthroplasty.[Method]Metasul metal-on-metal total hip arthroplasty of 30 hips in 25 patients was performed from August 2003 to December 2005.There were 11 males and 14 females with an average age of 47 years(28-72 years).Harris hip scores were determined before surgery and at the last follow-up examination.Standardized radiographs were obtained to evaluate component conditions.Blood samples were taken to determine serum chromium levels with use of atomic absorption spectrometry.[Result]Twenty-three patients(28 hips)were followed up with a mean period of 3.6 years(2.5-4.8 years).The mean Harris hip score improved from 49.5(17-78)points preoperatively to 93.4(55-99)points at the time of final follow-up.Twenty-two hips(85%)had an excellent result.Radiolucent lines were found in 3 hips.Focal femoral osteolysis was seen only in one patient.Sciatic nerve was injured in one case,which showed rehabilitation after 2.5 years.One hip had periprothetic infection because of diabetes 4 years after operation.There was no measurable wear by X-rays.No dislocation or fracture was found.The median serum chromium concentration was 0.082 ?g/mL(0.020～0.140 ?g/mL).No patient was diagnosed with renal insufficiency or hematologic malignancy during the study period.[Conclusion]The outcomes of Metasul metal-on-metal total hip arthroplasty are satisfactory.However,additional follow-up is necessary to determine any possible long-term deleterious effects.

[Objective]To discuss the cementless revision for postoperative infection after hip arthroplasty.[Methods]From November 1997 to December 2006,7 patients(7 hips) with infection after hip arthroplasty were treated,including 3 males and 4 females,with a mean age of 58 years(36～73 years).In the 7 hips,4 hips underwent a revision of total hip arthroplasty,2 hips only received new acetabular components and 1 hip underwent stem revision.One-stage revision was performed in 4 cases,two-stage revision was performed in 3 cases.Consecutive radiographs were compared to evaluate component conditions.Harris hip scores were determined before surgery and at the final follow-up examination.The erythrocyte sedimentation rate and C-reactive protein were detected.[Results]All patients were followed up with a mean period of 3.6 years(1.5～10.6 years).The mean Harris hip score improved from 35(18-63) points preoperatively to 89(60～99) points at the time of final follow-up.No re-infection was found.Femoral component exsertion was found in 1 patient but without any symptom.Pain of hip joint disappeared in 5 cases,and 2 patients had mild pain when walking long distance.At the time of final follow-up,5 patients still had slight limp.Heterotopic ossification developed in 1 hip.The mean polyethylene liner wear was 0.08 mm per year at final follow-up.Deep vein phlebothrombosis and nerve injury were not found.[Conclusion]It is possible to have satisfactory clinical outcome by one-stage or two-stage revision using cementless prothesis for postoperative infection after total hip arthroplasty.Whether the original prothesis can be saved when fixed tightly with femur or acetabular bone needs more experiences to confirm.

[Objective]To evaluate the clinical and radiographic results of revision hip arthroplasty with cementless prothesis.[Method]Revision hip arthroplasty of 41 hips in 36 patients was performed from November 1997 to August 2007 using cementless prothesis.In the 41 hips,29 hips underwent a revision total hip arthroplasty,8 hips underwent new acetabular components,and 4 hips underwent stem revision.Consecutive radiographs were compared to evaluate component conditions.The value of AAOS and Paprosky classification was used.Harris hip scores(HHSs)were determined before surgery and at the most recent follow-up examination.The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Result]Twenty-two patients(26 hips)were available for complete clinical and radiographic analysis.The mean follow-up period was 4.6 years(range,1-11 years).The mean preoperative Harris hip score of 38(range,11-76)points improved to 88(range,60-99)points at the time of final follow-up.The pain and function socre improved from 16.9 and 17.3 points to 40.4 and 39.9 points,respectively.All patients had moderate to severe limp before revision.At the time of final follow-up,8 patients still had slight limp and 4 patients had moderate limp.Twenty-one hips(75%)had an excellent result.A 1mm width radiolucent line was found in 1 femoral component without any symptom.Osteolysis and migration were seen in 4 hips(3 in acetabular and 1 in femoral component),which needed re-revision(12.5% failure).Heterotopic ossification developed in 8 hips(31%).The mean polyethylene liner wear was 0.27 mm(range,0.02-0.87 mm)in all and 0.08 mm(range,0-0.25 mm)per year.The wear rate was only correlated with changes of abduction angle of the acetabulum.The coincidence of bone defect classification in AAOS is better than Paprosky.Kaplan-Meier survivorship at 4.6 years was 89% with repeat revision for any reason as the end point and 81% with repeat revision or radiographic loosening as the end point.[Conclusion]Cementless prothesis appears to be a good alternative to other revision systems in revision total hip arthroplasty.Careful intraoperative evaluation of bone deficiency are needed to choose an appropriate prothesis in order to obtain a good outcome.

[Objective]To evaluate the midterm clinical and radiographic results of revision hip arthroplasty by acetabular reinforcement ring (ARR) with impaction bone grafting. [Methods]Revision hip arthroplasty by ARR with impaction bone grafting of 8 hips was performed from May 2001 to December 2006. There were 5 males and 3 females with an average age of 53 years (range, 36~70 years).The mean BMI was 20 (range, 15~28). The mean interval between the primary arthroplasty and revision was 5 to 20 years (mean 6.7 years). The causes for revision were infective loosing in 2 and aseptic loosening in 6. In the 8 hips, 6 hips underwent a revision total hip arthroplasty, 2 hips received replacement of the acetabular component. Consecutive radiographs were compared to evaluate component conditions and the influence of bone deficiency to fix the prothesis was analyzed. Harris hip scores (HHSs) were determined before surgery and at the most recent follow-up examination. The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Results]Seven hips were available for complete clinical and radiographic analysis. One patient died for myocardial infarction. The mean follow-up period was 4.5 years (range, 1.5~7.1 years).The mean preoperative Harris hip score of 30(range, 20~64) points improved to 88 (range, 74~94) points at the time of final follow-up, the pain and function socre improved from 13.8 and 11.5 to 40.3 and 39.9 respectively. All patients had severe limp before revision. At the time of final follow-up, 5 patients still had slight limp and 1 patients had moderate limp.Five hips had an excellent result. Infective osteolysis and migration were seen in 2 hips, which need re-revision. Heterotopic ossification developed in 2 hips . Kaplan-Meier survivorship at 4.5 years was 63% with repeat revision or radiographic loosening.[Conclusion]ARR with impaction bone grafting is an effective approach to treat massive acetabular bone defect in revision hip arthroplasty, the midterm result is acceptable, but any possible reason for infection must be monitored.

Purpose:To study the feasibility of 1 H-magnetic resonance spectroscopy ( 1 H-MRS) in the chemical induced rat hepatocellular carcinoma(HCC) model by a new 1.5T MR set and endeavor to have an initial understanding of the characteristics of its cancer development. Methods:Diethylnitrosamine (DEN) induced rat HCC models(n=30) were established. At different intervals rats were randomly scanned before being killed on the following day. Their livers were dissected for histopathologic study. Results:Three rats died unexpectedly. 27 rats (90%) developed liver lesions and were investigated according to the plan. T 1 WI is good for demonstration of anatomic structure and T 2 WI at showing the lesions in detail. The scanning methods have been improved gradually. 1 H-MRS results were satisfactory for 64% of the single-voxel and 50% of the multi-voxel respectively. Conclusions:DEN induced rat HCC model is suitable for the Medical Imaging studies and liver 1 H-MRS scan is practical with this new 1.5T unit.