Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05).(2)The rate of the carotid artery thickness increased with systolic blood pressure variability increasing( P = 0. 001). There were no significant correlations between rate of the carotid artery thickness and diastolic blood pressure variability,24 h mean diastolic blood pressure(P = 0. 435, 0. 126). The IMT thickening rate was higher when the average systolic blood pressure was greater(P = 0. 013). (3)Regression analysis indicated that carotid artery IMT was positively related with systolic blood pressure variability,high-sensitivity C-reactive protein,24 h mean systolic blood pressure,2-hour postprandial blood glouse. Conclusion Carotid artery IMT is independently associated with variation of blood pressure,especially with systolic blood pressure variability in prehypertension patients.

Objective To discuss parallel fibular osteoseptocutaneous flap apply in heel defect reconstruction Methods From February,2006 to December,2011,parallel fibular osteoseptocutaneous flap were used to repair calcaneus and skin defects in 4 cases.The causes included road accident in 2 cases and strangulation in 2 cases.The defect locations were at the back of the calcaneus (1/2 of calcaneus in 2 cases and 2/3 in 2 cases,respectively).Results Followed up 24-72 months,all cases achieved bone union in allograft and had no complications of absorption,infection and repulsion.The flaps survived completely in 4 cases ; the distal flaps necrosed partly in 1 case and healed by dressing.According to USA foot-malleolus scores of AOFAS,1 case was excellent,2 good,and 1 fair.Conclusion Parallel fibular osteoseptocutaneous flap reconstruction heel defect can recover patients visage and heel function,improve their life quality.

Objective To observe the sedative effect of dexmedetomidine in senile cataract surgery with retrobulbar nerve block.Methods Ninety-three senile cataract patients,ASA Ⅱ or Ⅲ grades,aged from 65 to 82 years old,scheduled for cataract surgery with retrobulbar nerve block were equally randomized into three groups by systematic sampling.The patients in three groups were given bolus infusion dexmedetomidine 0.5 μ g/kg before operation and group A was maintained by 0.2 μ g/ (kg· h),group B was maintained by 0.4 μ g/(kg· h) and group C was maintained by 0.6 μ g/(kg· h).Ramsay score,mean arterial blood pressure (MAP),heart rate (HR),respiratory rate,pulse oxygen saturation (SpO2) were recorded before anesthesia (T0),after retrobulbar nerve block (T1),and after sedative administration for 10 (T2),20 (T3),30 (T4),60 min (T5).Results The operation in three groups was successful.The scores of Ramsay at T2-T5 in three groups was significantly higher than that at T0 [group A:(2.6 ± 0.7),(2.5 ±0.2),(2.4 ±0.8),(2.4 ± 0.3) scores vs.(2.0 ± 0.0) scores;group B:(3.0 ± 0.7),(3.8 ± 0.7),(4.2 ± 0.2),(4.5 ± 0.2)scores vs.(2.0 ± 0.0) scores;group C:(3.8 ± 0.6),(4.7 ± 0.4),(5.2 ± 0.8),(5.6 ± 0.6) scores vs.(2.0 ± 0.0) scores].The scores of Ramsay at T3-T5 in group C was significantly higher than that in group A and group B,the scores of Ramsay in group B was significantly higher than that in group A,there was significant difference (P ＜ 0.05).The HR at T3-T5 in three groups was significantly lower than that at T0 [group A:(77 ± 5),(76 ± 7),(74 ± 12) times/min vs.(88 ± 12) times/min; group B:(72 ± 9),(70 ± 8),(70 ± 11)times/min vs.(90 ± 10) times/min;group C:(64 ±7),(55 ±7),(54 ±6) times/min vs.(88 ±9)times/min],the HR at T3-T5 in group C was significantly lower than that in group A and group B,there was significant difference (P ＜ 0.05).The level of MAP,respiratory rate in three groups and interclass had no significant difference (P＞ 0.05).There was no respiratory depression,nausea,vomiting and dizzy occurred.Conclusion Bolus infusion dexmedetomidine 0.5 μ g/kg followed by intravenous infusion at 0.2-0.4 μ g/(kg·h) is suitable for sedation of elderly patients with cataract surgery.

Objective To investigate the feasibility of hip replacement through a minimal incision via modified Hardinge approach.Methods Hip replacement was performed in 21 cases(22 hip joints) from July 2005 to March 2006.The operation was completed through a minimal incision via modified Hardinge approach,with the greater trochanter as the center.There were 12 cases of total hip replacement(13 hip joints) and 9 cases of bipolar femoral head replacement.A biological prosthesis was used in all the cases. Results The mean length of incision was 7.6 cm(range,6.0~9.0 cm),the mean operation time was 76 min(range,(45~)150 min),and the mean blood loss,370 ml(range,190~580 ml).No severe complications occurred.All the cases were followed for a mean of 38 weeks(range,22~53 weeks).Evaluation with the Harris hip score system showed excellent outcomes in 18 cases(19 hips) and good in 3 cases,with a rate of excellent or good results of 100%.Conclusions Minimal incision hip replacement through the modified Hardinge approach has advantages of minimal trauma,little blood loss,low complication rate,and quick recovery.

BACKGROUND:There are less studies on static magnetic field, and its biological effects are stil unclear. OBJECTIVE:To investigate the static magnetic field effect on the secretion of nerve growth factor from Schwann cel s. METHODS:Schwann cel s were randomly assigned into three groups:0.05 mT sciatic magnetic field group, 0.1 mT sciatic magnetic field group and control group. At 2 days of inoculation, the cel s were exposed to the sciatic magnetic field, 12 hours per day. Cel s in the control group were not exposed to the sciatic magnetic field. After 6 days of exposure, RT-PCR method was used to detect nerve growth factor mRNA expression in Schwann cel s, and ELISA was adopted to detect the level of nerve growth factor secreted from Schwann cel s. RESULTS AND CONCLUSION:The mRNA expression and secreted level of nerve growth factors in the culture supernatant were significantly higher in the two sciatic magnetic field groups than the control group (P<0.05), especial y in the 0.1 mT group. However, there was no difference between the 0.05 mT and 0.1 mT groups (P>0.05). These findings indicate that the static magnetic field with certain intensity can promote the secretion of nerve growth factors from Schwann cel s.

Objective To investigate the cytotoxic activities of γδT cells against methotrexate (MTX)-resistant osteosarcoma (OS) cells.Methods The MTX-resistant U2OS cell line (U2OS/MTX) was established by in vitro exposing the parental cells to MTX at stepwise-increasing concentrations.Periph-eral blood mononuclear cells ( PBMCs) were isolated from healthy subjects and stimulated with zoledronate ( ZOL) in combination with IL-2 to induce the proliferation ofγδT cells.The cytotoxicity ofγδT cells against U2OS/MTX cells was analyzed by using a standard lactate dehydrogenase release assay (LDH).Flow cy-tometry analysis and ELISA were performed to detect the expression of CD69 and IFN-γby γδT cells, re-spectively.Results The γδT cells derived from healthy subjects showed cytotoxicity against the U2OS/MTX cells.Moreover, stronger cytotoxic activities of γδT cells were detected after pretreatment of U2OS/MTX cells with ZOL (1 μmol/L) for 24 hours (P<0.01).Stimulation with U2OS or U2OS/MTX cells in-creased the expression of CD69 onγδT cells and enhanced the secretion of IFN-γbyγδT cells (P<0.05). Increased expression of CD69 and enhanced secretion of IFN-γwere induced in γδT cells in response to stimulation with ZOL-pretreated U2OS/MTX cells (P<0.01).Conclusion TheγδT cells showed cytotox-icity against U2OS/MTX cells.Pretreatment of U2OS/MTX cells with ZOL could enhance the cytotoxic ac-tivity of γδT cells.

Objective:To investigate the effect of typeⅠIFN on the cytotoxic activity ofγδT cells from peripheral blood mono-nuclear cells ( PBMCs) of healthy donors and osteosarcoma patients stimulated by zoledronate ( Zol) and IL-2 against OS.Methods:PBMCs from healthy donors and osteosarcoma patients were stimulated with Zol+IL-2 or Zol+IL-2+typeⅠIFN,respectively.After 14 days of culture,ex vivo expandedγδT cells were assessed by flow cytometry.γδT cell cytotoxicity against target cells was analyzed using a standard lactate dehydrogenase release assay.IFN-γsecreted fromγδT cells was determined by ELISA kits.Results:γδT cells from PBMCs of healthy donors and patients with OS were selectively expanded by Zol+IL-2 or Zol+IL-2+typeⅠIFN in vitro,respectively, and showed cytotoxicity against OS.In addition,γδT cells pre-treated by TypeⅠIFN showed significantly higher cytotoxicity against OS cells.Conclusion:Type I IFN can enhance humanγδT cells’ cytotoxic activity against OS.

Objective To investigate the relationship of plasminogen activator inhibitor type 1(PAI-1) and ultrasensitive C-reative protein(hsCRP) in patient with metabolic syndrome and coronary heart disease.Methods Between June 2006 and December 2007,87 patients with metabolic syndrome were divded into two groups:simple MS group which consisted of 45 patients and MS with CHD group which consisted of 42 patients.30 health people at the same stage,whose age and sex were similar with those in MS group served as normal control group.The levels of body mass index(BMI),waist circumference(WC),systolic blood presser(SBP),diastolic blood presser(DBP),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),PAI-1 and hsCRP were measared.Results BMI,WC,FPG,SBP,DBP,TG,PAI-1 and hsCRP in both MS groups were higher than those in normal control group(P

[Objective]To explore the results of the treatment of the ischemic necrosis of femoral head using titanium alloy cage in animal models.[Method]The ischemic necrosis of femur head was made with the liquid nitrogen in 15 hybrid adult dogs.The titanium alloy cage of threaded central empty cylinder with multi-hole periphery was driven into the full depth of the center decompression canal to the subchondral bone.The dogs were divided into 3 groups,5 dogs in each groups were sacrificed respectively at 3,6,12 weeks after operation.Radiograph and histologic examination were used to evaluate the results.[Result]No collapse of femoral head was observed postoperation.The position of the cages was located wall in X-ray films.Under microscope,the cancellous bone of necrotic femoral head rebuilted up gradually.The cancellous bone grew into cage.After 12-week creeping substitution,the cancellous bone filled up the hollow and the peripheral holes of the cages.[Conclusion]The titanium alloy cage can provide structural support to the subchondral bone and prevent collapse.The cancellous bone grows into the cages through the peripheral holes.The necrotic femoral heads are restoration.The titanium alloy cage could be recommended for the treatment of the ischemic necrosis of femoral head.

[Objective]To study the biomechanics of the femoral neck on the treatment of ischemic of the femoral head in dogs using titanium alloy cage,single core decompression and normal.[Method]Twenty-one couples of fresh moist dogs ' femur specimens were divided randomly into 3 groups.In 2 groups,biomechanical test of the femoral neck was made on one of every couple in different conditions:core decompression,core decompression with titanium alloy cage implanting.The other of every couple was tested as normal control.In the third group,one of every couple was tested in condition of core decompression with titanium alloy cage implanting.The other of every couple was tested in condition of core decompression.[Result]The stiffness and the max load of the single core decompression were less than that of the normal control.The max load of femoral head after titanium alloy cage implanting were lager than that of the core decompression or the normal control.[Conclusion]The titanium alloy cage implanting could increase mechanical support for femoral neck significantly and prevent femoral neck broken after manipulation.