Objective To observe the levels of matrix metalloproteinases-9 (MMP-9) and tissue factor (TF) as well as blood lipid in patients with acute coronary syndrome (ACS) ,and to study the effect of Fluvastatin on levels of serum MMP- 9 and plasma TF. Methods 40 patients with ACS were selected (including 20 patients with AMI and 20 patients with UAP) ,20 stable angina patients (SAP) and 13 patients without coronary heart dis-ease as control group. 40 patients with ACS were randomly assigned to the Fluvastatin group (n = 20) and the rou-tine group (n = 20) in this study. The MMP - 9 and TF were detected on admission and after 2 weeks treatment. Re-suits The levels of MMP-9 and TF were significantly higher in ACS group than that of SAP and control group (P < 0.001 ,P < 0.05) ,which were elevated in AMI group compared with that of UAP group (P < 0.05). The levels of cholesterol (TC) ,low density Lipoprotein (LDL - C) ,MMP- 9,TF decreased significantly at two weeks after treat-ment in fluvastatin group (P < 0.05), but no significant changes were observed in the routine group (P > 0.05). The change of MMP 9, TF and blood lipid was not related in fluvastatin group (P > 0.05). Conclusion Serum MMP-9 and plasma TF in ACS patients are significantly elevated and fluvastatin decreases the levels of MMP-9 and TF after two weeks treatment,so it may be benefit to atheroaclerotic plaque stabilization and prohihit thrombosis for-marion, and this is not related to regulation of blood lipid.

Objective:To investigate the changes of ultrastructure of myocardial cells and the expression levels of tumor necrosis factor α(TNF-α) in myocardium tissue of the diabetic rabbits during early myocardial ischemia and their mechanisms,and to provide the theoretical basis for studying the pathogenesis of diabetic myocardial ischemia injury.Methods:A total of 42 healthy male New Zealand white rabbits were chosen.The method of intravenous injection of alloxan in ear vein was used to establish the diabetic models in 26 rabbits among 42 rabbits;the method of partial ligation of left anterior descending coronary artery by thoracotomy was used to establish the diabetic myocardial ischemia models in 22 model rabbits with diabetes.A total of 16 (modeling succesfully) were divided into diabetic myocardial ischemia 7 d group and 28 d group;other 16 rabbits were used as sham operation groups at the relevant time points(7 and 28 d),and there were 8 rabbits in each group.The ultrastructure of myocardial cells was observed by transmission electron microscope;the apoptosis index (AI) of myocardial cells in ischemic myocardium tissue of the rabbits was detected by TUNEL method;the expression levels of TNF-α in ischemic myocardium tissue of the rabbits were detected by real-time RT-PCR method.Results:In sham operation groups,the nuclei of myocardial cells was bigger,the nuclear chromatin was in uniform distribution,the myofibril ordered arrangement,the sarcomere was neat;the mitochondria between myofibril were rich,and their structures were clear.For the rabbits in diabetic myocardial ischemia group,their early-stage cardiocyte nuclei were irregular in shape,myofibrils was loose in structure,the part of myofibril was broken,and the mitochondrial hyperplasia between the myocardial cells was obvious.Compared with sham operation groups,the AI of myocardial cells and the expression levels of TNF-α in the ischemic myocardial cells of the rabbits in diabetic myocardial ischemia 7 d and 28 d groups were significantly increased(P<0.05),and the indexes mentioned above in diabetic myocardial ischemia 7 d group was higher than those in diabetic myocardial ischemia 28 d group(P<0.05).Conclusion:The destruction of ultrasturctue and obvious apoptosis of the myocardial cells of the rabbits occur in the early stage of diabetic myocardial ischemia.The increasing of expression level of TNF-α may involve in the myocardial ischemic injury.

Objetive:To analyze the fixation methods and sites in treatment of zygomatic complex fractures of 152 patients. Methods:The clinical data of 152 patients from 1990 to 2004 were investigated and analyzed, which focused on the changing trend of etiology and treatment methods. Results:Traffic accident was the primary reason for zygomatic complex fractures in China.152 patients received primary, timely reduction and fixation; Scalp coronal incision in combination with other incisions or alone was applied in 108 patients, the rest were treated by single local incisions. Rigid internal fixation was applied in 123 cases, and the single application of transosseous wire fixation was performed in 22 patients. 328 Ti plates were used. As to the fixation sites, 96 were applied at the zygomatic-frontal suture, 45 plates at zygomatic-maxillary suture and zygomatic crest, 92 plates at zygomatic-temporal suture, and 95 plates across the fracture line. Conclusion:Scalp coronal incision in combination with other incisions or alone can provide satisfactory outcome. Early, timely reduction and rigid internal fixation may result in better treatment results. The sites are focused at zygomatic-frontal suture, zygomatic-maxillary suture and zygomatic crest, zygomatic-temporal suture and the fracture line which restore the horizontal and vertical force route.

Chest contusion is the soft-tissue injury disorders that the external violence directly destroys the chest wall and the soft tissues, causing chest pain, fullness, and symptoms aggravate when the chest moves. Chinese medicine showed many treatments with clinical efficacy. Therefore, Chinese medicine has been widely used in clinics. This paper was to review the research progress of Chinese medicine treatment for chest contusion.

Objective To evaluate the effects of thrombus aspiration on postoperative clinical prognosis of acute ST-segment elevation myocardial infarction (STEMI) patients with emergency percutaneous coronary intervention(PCI).Methods From September 2009 to January 2012,a total of 239 patients with STEMI undergoing emergency PCI (thrombus aspiration + PCI (n =118) and PCI (n =121)) were enrolled in this study.The angiographic and clinical results were retrospectively analyzed and compared between the two groups of patients.Results There were significant differences between the thrombns aspiration group and the PCI group on instant blood flow TIMI3 grade (106 (89.8％) vs.96 (79.3％) ; x2 =5.026,P ＜ 0.05),ST-segment depression rate at two hours after surgery (101 (85.6％) vs.90 (75.2％) ; x2 =5.500,P ＜ 0.05),ejection fraction within one week after surgery (68 (57.6％) vs.52 (43.0％) ; x2 =5.130,P ＜ 0.05),incidence of reinfarction during hospitalization (0 (0) vs.5 (4.1％) ; x2 =4.980,P ＜ 0.05).There were no significant statistical difference between the two groups on the average length of stay ((10.05 ± 5.40) d vs.(10.40 ± 5.03) d; t =-0.525,P ＞ 0.05),incidence of ventricular fibrillation during surgery (4 (3.4％) vs.3 (2.5 ％ ; x2 =0.174,P ＞ 0.05),heart failure during hospitalization (15 (12.7％) vs.18 (14.9％) ; x2 =0.235,P ＞0.05),Malignant arrhythmias (12 (10.2％) vs.15 (12.4％) ; x2 =0.296,P ＞ 0.05),and mortality rate (2 (1.7％) vs.5(4.1％);x2 =1.248,P ＞0.05).Conclusion Application of thrombus aspiration,which is a safe and effective way,may improve the clinical outcomes in acute ST-segment elevation myocardial infarction patients with emergency PCI.

Objective To observe the effect of Chinese herbal fumigation combined with CPM promote the function recovery after Postoperative Patellar Fracture. Methods Eighty patients with patellar fracture were randomly divided into treatment group (40 cases) and control group (40 cases). The control group was treated with CPM. The treatment group was treated with Chinese Herbal Fumigation and CPM. After 8th weeks, the clinical curative effect, knee range of motion and KSS knee score were observed and compared. Results The effect rate of the treatment group was 87.5% (35/40), and the control group was 65.0% (26/40). The difference was statistically significant (χ2=5.591, P<0.01). After treatment, the range of motion of knee joint (138.38°± 7.82°vs. 0.29°± 7.83°, t=10.338), KSS knee function score (88.38 ± 9.52 vs. 3.46 ± 9.36, t=2.330) of the treatment group were higher than those in the control group (P<0.01 or P<0.05). Conclusions The Chinese medicine fumigation combined with CPM functional exercise could accelerate the recovery of knee function and reduce the complications of fracture after patellar fracture.

Objective Evaluation of the effect of manual reduction with small external fixation on the treatment of elderly Barton fractures.Methods A total of 244 elderly patients with Barton fractures were divided into conservative group (n=126) and operation group (n=118) according to random number table. The conservative group was treated by with manual reduction with small external fixation, and the operation group was treated with open reduction and internal fixation. The complications of the patients, the time of fracture healing, hospitalization time and treatment cost were recorded.The wrist function was evaluated by PRWE wrist score system and Wrightington wrist function score system.The clinical efficacy was evaluated by Gartland-Werley Colles fracture evaluation method.Results The excellent and good effect rate was 91.3% (115/126) in the conservative group and 97.5% (115/118) in the operation group. There was no significant difference between the two groups(χ2=0.857,P=0.354). One year, 6 months, 3 months and 6 weeks after treatment, in the conservative group, the PRWE score (10.4 ± 7.9, 19.1 ± 8.0, 40.5 ± 7.8, 55.7 ± 8.1vs. 80.8 ± 8.2,F=113.665), wrightington score (8.2 ± 3.7, 13.2 ± 4.0, 21.4 ± 3.9, 26.3 ± 4.2vs. 30.1 ± 4.2,F=121.348) were significantly lower than those before treatment (P<0.01). And in the operation group, the PRWE score (10.2 ± 7.8, 15.0 ± 8.0, 26.5 ± 8.0, 44.7 ± 8.2vs. 79.6 ± 8.6,F=81.411), Wrightington score (8.1 ± 3.8, 12.1 ± 4.0, 16.5 ± 4.0, 20.6 ± 4.3vs. 29.8 ± 4.6,F=69.113) were significantly lower than those before treatment (P<0.01). But there was no significant difference in PRWE score and Wrightington scores between the two groups after treatment (t=0.149, 0.104,P=0.881, 0.917, respectively). In the conservative group, the hospitalization time (5.28 ± 2.10 dvs. 12.8 ± 2.21d,t=25.260) was significantly shorter than that of the control group (P<0.01), and the treatment cost (3.26 ± 0.93 thousandvs. 28.66 ± 1.04 thousand,t=200.369) was significantly lower than that in the control group (P<0.01). The overall incidence of complication was 8.7% (11/126) in the conservative group and 17.8% in the surgery group (21/118). There was significant difference between the two groups(χ2=4.396,P=0.036).Conclusions The manual reduction with small splint external fixation was simple, low cost, small trauma, short hospitalization time, and less complications.

BACKGROUND:During fracture healing, in addition to the need for appropriate biomechanical environment, the role of cytokines is also increasingly attracted attention.
OBJECTIVE:To study the effect of nerve growth factor and alpha-lipoic acid on fracture healing in rat models of femoral fracture.
METHODS:Sprague-Dawley rat models of femoral fracture were established. Seventy-two rats were randomly divided into three groups. In the control group, rats were intramuscularly injected with physiological saline. In the nerve growth factor group, rats were intramuscularly injected with nerve growth factor 200 ng/kg, once a day. In the combined therapy group, rats were intramuscularly injected with nerve growth factor 200 ng/kg and oral y taken alpha-lipoic acid 25 mg/kg, once a day. At 1, 2 and 3 weeks after administration, bony cal us volume was measured. Enzyme linked immunosorbent assay was used to measure serum bone morphogenetic protein-2 levels. Western blot assay was utilized to detect bone morphogenetic protein-2 protein expression at the broken end of fracture. Semi-quantitative RT-PCR was applied to examine vascular endothelial growth factor mRNA expression.
RESULTS AND CONCLUSION:(1) At 1 week after administration, no significant difference in bony cal us volume was detected among the three groups. Serum bone morphogenetic protein-2 level, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA expression were significantly higher in the nerve growth factor group and combined therapy group compared with the control group (P<0.05), but no significant difference was found between the two groups. (2) At 2 weeks after administration, the amount of cal us, serum bone morphogenetic protein-2 levels, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA levels were significantly higher in the nerve growth factor group and combined therapy group compared with the control group (P<0.05). Above expression levels were higher in the combined therapy group than in the nerve growth factor group (P<0.05). (3) At 3 weeks after administration, serum bone morphogenetic protein-2 levels, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA levels were significantly decreased in the nerve growth factor group. However, above expression levels were stil high in the combined therapy group, and significantly higher than in the nerve growth factor group (P<0.05). (4) These results indicate that nerve growth factor combined with alpha-lipoic acid had better effects on the fracture healing compared with the nerve growth factor alone.

Objective To observe the clinical efficacy of multiple radiofrequency ablation therapy of trigeminal neuralgia. Methods 60 patients diagnoised as trigeminal neuralgia in our hospital were included from January 2014 to september 2014. The patients were randomly divided into two groups , 30 patients in treatment group and 30 patients in control group. Patients in treatment group were treated by multiple radiofrequency ablation therapy while patients in control group were treated by radiofrequency thermal coagulation therapy for trigeminal ganglion.Then comparing the curative effect of the two groups after the treatment. Results The VAS score showed insignificant difference between the two groups (P > 0.05). Conclusion The multiple radiofrequency ablation in the treatment of trigeminal neuralgia is effective clinically as fewer complications and shows higher security.

AIM To investigate the preventive effects of Shangke Huangshui Gauze (Scutellariae Radix,Coptidis Rhizoma,Phellodendri chinensis Cortex,etc.) on vascular crisis after digital replantation.METHODS Sixty-eight cases of patients with amputated digits meeting the inclusion criteria were randomly divided into observation group (36 cases with 57 fingers) and control group (32 cases with 54 fingers),the former was wet-dressed with Shangke Huangshui Gauze,the latter was bandaged with sterile dry gauze.The observation and comparison were made between the two groups on four coagulation indexes,visual analog scores (VAS),improvement of swelling degrees,the occurrence rates and survival rates of vascular crisis after operation,together with the evaluation of efficacy and adverse reaction.RESULTS In the observation group,the 7th day after operation,the prothrombin time,activated partial thromboplastin time,international normalized ratio,thrombin time and swelling improvement rate were higher than those in the control group;but the fibrinogen and postoperative 4 days' VAS pain score were lower than those in the control group.The incidence rates of vascular crisis and adverse reaction in the observation group were lower than those in the control group,and the survival rate of replanted fingers was higher than that in the control group.CONCLUSION Shangke Huangshui Gauze can prevent the occurrence of vascular crisis after digital replantation to a certain extent without obvious adverse reaction.