Objective To evaluate the effects of different degrees of acute normovolemic hemodilution (ANH) on intrapulmonary shunting, oxygen delivery and consumption during one-lung ventilation(OLV) in dogs. Methods Twelve healthy mongrel dogs weighing 18-22 kg were anesthetized with Ⅳ pentobarbital sodium 20mg.kg-1, scopolamine 0.3 mg and pancuronium 0.2 mg. kg-1 and intubated with a left-sided Carlen' s tube. Correct positioning of the tube was verified by auscultation and by visual inspection after thoracotomy at the end of the experiment. The dogs were mechanically ventilated with 100% oxygen. PET CO2 was maintained between 4.67-6.00 kPa. ECG and rectal temperature were continuously monitored. An intravenous line was established for infusion of Lacted Ringer solution. SwanGanz catheter was inserted via femoral vein on one side for sampling of mixed venous blood and measurement of cardiac output (CO) by hemodilution technique and pulmonary artery pressure (PAP).Femoral artery on the other side was cannulated for measurement of mean arterial pressure(MAP) and arterial blood sampling. The body temperature was maintained between 35℃-39℃ during the experiment.Four degrees of ANH were achieved by blood withdrawal and replacement with an equal volume of gelofusin step by step: HD1 (Hct 35%), HD2 (Hct 25%), HD3 (15%) and HD4(7%-8%). The volume of blood to be removed was based upon the patients' estimated blood volume [EBV = body weight (kg) ×7% ], the beginning Hct(Hct0) and the target Hct (Hctt) V = EBV × (Hct0-Hctt)/Hctav. During each degree of hemodilution(HD) two lungs were ventilated(TLV) first followed by one-lung ventilation(OLV)Each ventilation condition was maintained for at least 15 min, then hemodynamics was measured and blood gas analysis including blood concentration of lactate of both arterial blood and mixed venous blood was performed, then Qs/Qt, oxygen delivery (DO2) and oxygen consumption(VO2) were calculated. Results With increasing hemodilution, MAP, pulmonary vaseular resistance(PVR), mean pulmonary arterialpressure(MPAP), PO2 and DO2 had a tendency to decrease, While oxygen extraction ratio(ERO2 ), blood lactate and Qs/Qt tended to increase. There were DO2-dependent VO2 and anaerobic metabolism during HD3 and HD4. PVR and MPAP increased significantly when one lung was being ventilated before HD and during HD1 and HD2 . During HD3 and HD4 there was little difference in PVR and MPAP between OLV and TLV. Qs/Qt increased by 74% (HD2), 164% (HD3) and 177% (HD4) during OLV. Conclusions The results show that both ANH and OLV can affect Qs/Qt and oxygenation. The degree of ANH should be limited to Hct 25 % during OLV.consumpation

Objective To evaluate the skill and outcome of arthroscopic reconstruction of posterior cruciate ligament (PCL) with retention of PCL remnant. Methods From April 2004 to June 2006, 38 patients (38 knees) with PCL deficiency were verified by clinical and arthroscopic examinations. Of them, there were 9 knees combined with disruption of the posterolateral comer, 6 with rupture of the posteromedial corner, 8 with lateral meniscus tear and 4 with medial meniscus tear. With reservation of PCL remnant and synovium, all the impaired PCLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy. Interference screws were used for direct anatomic fixation of the reconstructed ligament. Results No severe comphcations occurred at early stage after operation in all 38 patients who were followed up for 12-37 months (average 20.79 months). Lysholm score was improved significandy from 40-70 points (mean 51.32 pints) before operation to 70-100 pints (mean 92.37 points) at the latest follow up (t=-30.14, P<0.01). According to International Knee Documentation Committee (IKDC) score, there was a remarkable improvement from 16 abnormal knees (grade C) and 22 severely abnormal knees (grade D) preoperatively to 18 normal knees ( grade A), 18 nearly normal knees (grade B) and 2 abnormal knees at the latest follow up (Z=-6.00, P <0.01). Of 38 patients, 36 returned to normal sports level but 2 degraded level of sports. Conclusions Arthroscopic PCL reconstruction with retention of PCL remnants is a feasible technique, with satisfactory outcome. Preservation of PCL remnants and synovium may be beneficial to biological incorporation and reinnervation of the reconstructed ligament.

Objective To assess the accuracy of mixed venous oxygen saturation ( S(-v)O2 ) in reflecting the change in CO during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty-five NYHA Ⅰ -Ⅲ patients of both sexes, aged 50-75 yr, weighing 55-85 kg, undergoing OPCABG, were studied. Anesthesia was induced with midazolam, fentanyl, etomidate and pipecuronium and maintained with propofol infusion and intermittent iv boluses of fentanyl and pipecuronium supplemented with isoflurane if necessary. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 8-10 bpm, I:E 1:2). PETCO2 was maintained at 35-45 mm Hg.Radial artery was cannulated and pulmonary catheter was placed. CI, S(-v)O2 and Hb were monitored and recorded before skin incision, during anastomosis with left anterior descending artery (LAD), right coronary artery (RCA)and left circumflex coronary artery (LCX), when the chest was closed, when the patients' body position was changed and the heart was manipulated. S(-v)O2 and CI were scaled immediately after the pulmonary artery catheter was placed and before anastomosing LAD. Results The CO change in S(-v)O2 was real-time and accurate in reflecting the body positioning and elevation of hearts. There was no simultaneous significant change in CI.Conclusion The CO change in S(-v)O2 is real-time and accurate in reflecting the body positioning and elevation of hearts during OPCABG.

Objective To analyze the change in qualification rate of comprehensive assessment , and to provide an effective theoretical basis for future selection and recruitment of military flying cadets .Methods Group A consisted of 400 cadets who were randomly chosen from the final selection with the physical examination conclusions of disqualifiedandqualified by comprehensive assessmentin a certain year via the cross-sectional investigation method , and group B was composed of 400 cadets who were chosen from the following year with the same method as group A .A questionnaire con-cerning demographic features was conducted among all cadets .A database was established with Epidata 3.02 software, and SPSS 16.0 software was used to analyze diseases which were qualified by comprehensive assessment.Results The qualification rate of comprehensive assessment in group A was higher than group B (45.00%vs 34.75%, P<0.01),there were differences between the two groups in overweight ( underweight ) ,deflection of nasal septum , gallbladder polyp , spinal malformation and undertall(P<0.05 or P<0.01).Conclusion The expert consensus which is made by the air force ex-perts through their work experience and the foreign air force standards has a positive application effect in the practical work . It is an efficient supplement to the physical examination standards and has an important effect on military aviator selection .

Objective To evaluate the medical indexes for student pilots from different areas , to discover the major different indexes between different areas ,and to establish the space distribution model of military pilots .Methods A cross-section survey was conducted among student pilots , and 290 student pilots sampled as respondents were interviewed with questionnaires and subjected to a physical examination , involving distant vision , heart function , and pulmonary function , before a database was established , cleaned and analyzed by EpiData 3.02, SAS 9.13 with double checking .Results There was no difference between the medical indexes of student pilots from 7 areas, but the psychological selection performance record and the entrance examination record were different .Student pilots from area E had the highest psychological selection performance record while those from area D had the highest entrance examination record .Conclusion Student pilots have area difference ,so we should pay close attention to their birth place during recruitment of student pilots .

Objective To compare the standards for recruitment of cadet pilots between PLA Air Force and the US Air Force,so as to offer reference for revising PLAAF medical standards for recruiting cadet pilots.Methods Literature from medical bibliographic databases and foreign military official websites was retrieved, four published reports and network information were cited and PLAAF medical standards were compared with those in China.Results The American medical standards include Department of Defense Instruction, Air Force Medical Examination and Standards, Air Force Medical Standards Directory, and Air Force Waiver Guide,which are independent and aimed directly at different examinations so that medical requirements have been gradually broadened.Compared to our standards, the American medical selection is more dependent on clinic consultations, and more detailed in specifications of diseases, more focused on body functions than on body shape, and the psychological screening is more subtle.Conclusion The standards adopted by US Air Force are more evidence-based.We are to rectify our medical standards accordingly, which should be efficacious, safe and effective for improving the overall quality of our military pilots.

Objective To analyze the spectrum of anus disease during the medical selection of flying cadets and com-pare the medical standard between US Air Force and Chinese Air Force in order to improve the system of medical selection. Methods The data on flying cadets of Chinese Air Force medical selection from 2012 to 2015 were retrospectively analyzed and these data were re-analyzed by medical standards for US Air Force flying cadets.Results Ninety students were elimi-nated because of anal disease,including 65 hemorrhoids,14 fistula and 11 fissure.The rate of disqualification from 2012 to 2015 was 48.28%, 33.33%, 31.37%, 39.69%and there was no significant statistical difference between each two years (x2 =2.6154,P=0.4548).There was statistically significant difference(P=0<0.05)in hemorrhoids standards between CAF and USAF,and significant difference in fistula and fissure standards.Conclusion Compared with Chinese medical se-lection standards,the US Air Force standards focus on whether the symptoms of disease have effect on air safety and effi-ciency.To improve our medical selection standards,we need to learn from foreign air forces and take our own conditions into account.

Pinch-3 protein is an important constituent of cell membranes, which directly affects the cell morphology and mechanical properties. We observed and compared the change of morphology and cell traction force of glomerular podocytes before and after Pinch-3 gene inhibition by gene interference technology in this experiment. We found that a number of pores appeared on the cell surface, and the cell projected area were increased at the same time, with an approximate average about an increase of 40% after Pinch-3 gene inhibition. The results showed that the cell traction force of glomerular podocytes was significantly reduced, with an approximate average decrease of 40%, the maximum value of the cell traction force was reduced and the distribution of cell traction force became dispersive. All this suggested that after Pinch-3 gene inhibition, some pores created on the cell surface influenced the physical properties of glomerular podocytes and then affected the cell projected area and influenced the formation and distribution of cell traction force of the glomerular podocytes as well.
Adaptor Proteins, Signal Transducing ; genetics ; physiology ; Biomechanical Phenomena ; Cell Movement ; Genetic Engineering ; Humans ; Kidney Glomerulus ; cytology ; LIM Domain Proteins ; genetics ; physiology ; Mechanotransduction, Cellular ; physiology ; Membrane Proteins ; genetics ; physiology ; Podocytes ; cytology ; physiology ; Stress, Mechanical

OBJECTIVETo compare the expression of DKKL1 in ejaculated spermatozoa of normal fertile men and men with asthenospermia and investigate the role of DKKL1 in the pathogenesis of asthenospermia.

METHODSThe characteristics of semen samples collected from normal fertile men and men with asthenospermia were analyzed using computer-assisted sperm analysis according to WHO criteria. The ejaculated sperms were isolated by Percoll discontinuous density gradients to detect the expression of DKKL1 mRNA and protein using real-time PCR and Western blotting.

RESULTSThe expression of DKKL1 mRNA was significantly down-regulated by 11.1 times in asthenospermic men as compared with that in normal fertile men (P<0.01). Western blotting showed that the expression of DKKL1 protein was down-regulated by 2.4 times in asthenospermic men compared to normal fertile men.

CONCLUSIONThe expression of DKKL1, which may play an important role in sperm motility,is significantly decreased in ejaculated spermatozoa of men with asthenospermia.

Objective:To report a case with frontotemporal dementia (FTD) characterized by involuntary laughter.Methods:The clinical manifestations and imaging characteristics of a patient diagnosed as FTD was analyzed. Then the results of cerebrospinal fluid, positron emission tomography-computed tomography (PET-CT) and single-photon emission computed tomography examinations were collected. Blood samples were tested for related genes of FTD.Results:The patient is a 66 years old woman with insidious onset and progressing symptoms and she was mainly manifested as laughing out loud involuntarily when looking at others, childishness, stubbornness, loss of interest, irritability and other personal changes. Mild motor and language disorders were also manifested as moving slowly and speaking unclearly. The magnetic resonance imaging showed the atrophy of bilateral frontal, temporal lobe and bilateral hippocampal while the image of PET-CT showed the metabolism was reduced in different degrees. Eventually, behavioural variant of FTD was diagnosed. The result of ANXA11 gene sequencing revealed the mutation of c.107C>G(p.P36R).Conclusions:This is the first case in which a heterozygous mutation of ANXA11 gene, which is related to amyotrophic lateral sclerosis (ALS), is found in simple FTD patient, suggesting that ANXA11 gene may play an important role in the pathogenesis of FTD. This further supports the theory that ALS and FTD are spectrum disorders.