TraumaistheNo .1causeofdeathinpersonsundertheageof 4 5andtheNo .3causeof alldeaths .Manytraumapatientsdieofmultipleorganfailure(MOF) ,inducedbysystemicinflammatoryre sponsesyndrome(SIRS) .Thispaperreviewstherelationsoftraumaticshockwithsystemicinflammation . [

ObjectiveTo study the toxic effect of bupivacaine encapsulated in liposomes on spinal cord in rats.MethodsOne hundred and eight SD rats (200-225 g) in which intrathecal (IT) catheter was successfully implanted without complications were randomly divided into 6 groups ( n =18 each):control group (group C) ; liposome group (group L) ; 0.5％ and 1.0％ bupivacaine groups (groups B1 and B2 ) and 0.5％ and 1.0％ bupivacaine encapsulated in liposomes groups (groups LB1 and LB2 ).In groups L,B1,B2,LB1 and LB2,liposome,0.5 ％ bupivacaine,1.0 ％ bupivacaine,0.5 ％ liposomal bypivacaine and 1.0 ％ liposomal bupivacaine 20 μl were injected IT respectively once a day for 7 consecutive days,while in group C nothing was injected IT.Pain threshold was measured by mechanical stimulation of the plantar surface of hindpaw.Motor function of the hindlimbs was also assessed.The animals were sacrificed at 8 day after IT injection.The lumbar segment of the spinal cord was removed for microscopic examination,detection of neuronal apoptosis (by flow cytometry) and Fos protein expression (by immuno-histochemistry).Results1.0％ bupivacaine IT significantly increased the percentage of apoptotic neurons in group B2 as compared with control group.0.5％ and 1.0％ bupivacaine IT significantly increased the number Fos protein positive cells in group B1 and B2 as compared with group C.1.0％ bupivacaine IT induced severe histologic damage including shrinkage of nucleus and vacuole formation in mitochondria.Encapsulation of bupivacaine in liposomes significantly attenuated bupivacaine-induced increase in apoptosis and Fos protein expression and histologic damage in group LB2 as compared with group B2.ConclusionThe encapsulation in liposomes can decrease the neurotoxicity of 1.0 ％ bupivacaine administered IT in rats.

Activities of N-acetyl-?-glucosaminidase (NAG) in sera of normal subjects and patients with hepatocellular carcinoma (HCC) and other diseases were microquantitatively determined by spectrophotometry. The results showed that after the reaction for 4 h, activity of serum NAG in patients with HCC (397.10 ? 174.97 nmol/ml) was obviously higher than that in normal subjects (280.00 ? 63.83 nmol/ml). The elevation of serum NAG in HCC patients had no relationship with their serum a-fetoprotein. However, the increase of serum NAG activity in some patients with benign liver diseases was always accompanied by the abnormality in their liver functions. It is suggested that serum NAG has some referable values in the diagnosis of HCC.

Objective: To clone human augmenter of liver regeneration (hALR) cDNA, construct the recombinant expression vector, express and purify its product. Methods: The hALR cDNA was obtained by using RT PCR method with total RNA extracted from the fetal hepatic tissue. Then it was cloned into the pGEM T vector, and subcloned into expression vector pGEX 4T 3.After proved to be correct by sequencing, recombinant expression plasmid pGEX 4T 3(hALR) was transformed into E.coli BL21(DE3). The fusion protein GST hALR was produced by IPTG induction, isolated by affinity chromatography glutathione Sepharose 4B and cleaved by Thrombin. Results and Conclusion: Recombinant expression plasmid pGEX 4T 3(hALR) is constructed. The hALR is highly expressed in E.coli . The fusion protein in the plasma is resoluble. The procedure of purification and cleavage of fusion protein is easy and simple.

Objective To evaluate the role of miRNA-214 in myocardial injury in septic mice.Methods Sixty-six healthy male Kunming mice,weighing 25-30 g,were randomLy (random number) divided into4 groups:sham operation group (Sham group,n =18),cecal ligation and puncture group (CLP group,n =18),CLP + miRNA-214 precursor treated group (pre-miR-214 group,n =12),CLP + miRNA-214 inhibitor treated (anti-miR-214 group,n =12),and the rest six mice were treated with miRNA-214 precursor or inhibitor intravenously.Sepsis was induced by CLP,pre-miR-214 group and anti-miR-214 group were respectively treated with miRNA-214 precursor or miRNA-214 inhibitor before the CLP,Sham group were exposed to the cecum only.Mice were sacrificed and hearts were removed for determination of miRNA-214 expression by RT-PCR in Sham and CLP group at 6 h,12 h,and 24 h.Blood samples were collected from inferior vena cava at 12 h and 24 h after CLP for determination of the B-type natriuretic peptide (BNP) and cardiac troponin-I (cTnI) concentration by ELISA,then the mice were sacrificed and hearts were removed for determination of the inflammatory factor concentration by ELISA,cardiac myocyte apoptosis rate by flow cytometry and histopathological changes by microscopic examination.Statistical analysis was carried out with SPSS 13.0 software for One-way ANOVA.Results (1) The miRNA-214 expression was higher in CLP group than that in Sham group at 6 h,12 h and 24 h;(2) Compared with CLP group,the miRNA-214 expression in pre-miR-214 group was increased,but decreased in anti-miR-214 group at 12 h;(3) Compared with CLP group,the concentrations of the serum BNP,cTNI,tumor necrosis factor-alpha (TNF-α) and the interleukin-6 (IL-6) were lower than those in pre-miR-214 group,whereas the interleukin-10 (IL-10) was increased.However,the levels of these variables changed just in opposite direction in anti-miR-214 group at 12 h,24 h;(4) Compared with CLP group,the myocardial cell apoptosis rate was decreased in pre-miR-214 group,but increased in anti-miR-214 group at 24 h;(5) The microscopic examination showed that myocardial injury was attenuated in pre-miR-214 group compared with CLP group.Conclusions The miRNA-214 expression was increased in myocardial injury in CLP mice,suggesting miRNA-214 expression relating to myocardial protection in sepsis.

Objective To investigate the clinical efficacy of mini-plate fixation for ulnar coronoid process fracture via anteromedial approach.Methods A retrospective review was made on 28 cases of ulnar coronoid process fracture treated with open reduction and mini-plate fixation from April 2010 to December 2014.There were 18 males and 10 females,with age range of 21-60 years (mean,34.3 years).Causes of injury were falls in 21 cases and traffic accidents in 7 cases.According to the O' Driscoll classification,there were 14 cases of type Ⅰ,11 cases of type Ⅱ and 3 cases of type Ⅲ.Time from injury to operation was 2-10 d (mean,3.7 d).Reduction loss,fracture healing time and complications were documented.Elbow function was evaluated at the last follow-up by Mayo elbow performance score (MEPS) and Broberg & Morrey score.Results All cases were followed up for 12-25 months (mean,15.1 months).Restricted elbow activity was initiated one week after operation.Bone united in mean 10.6 weeks (range,8-14 weeks).No nerve injury or fracture redisplacement occurred.At the final follow-up,mean flexion was (124 ± 15)° (range,90°-140°),mean extension loss was (18 ± 20) °(range,0°-50°),mean pronation was (65 ± 18)°(range,40°-85°),and mean supination was (63 ±16)°(range,35°-85°),showing significant difference in comparison with the preoperative measure (P＜0.05).According to the MEPS,the results were excellent in 17 cases,good in 8,fair in 2 and poor in 1.According to the Broberg & Morrey score,the results were excellent in 16 cases,good in 8,fair in 3 and poor in 1.Conclusion Through anteromedial approach,mini-plate fixation of the ulnar coronoid process fracture provides rigid fixation,which benefits joint stability and bone union,and allows early functional exercise.

BACKGROUND:With the development of science and technology and improvement in living quality, telemedicine has played an important role in daily life, in particular in disease diagnosis and treatment as wel as rescue process for elderly people. OBJECTIVE: Based on Web of Science and ClinicalTrials.gov databases, to analyze the international telemedicine and elderly disease development so as to provide referential basis for the related study in China. METHODS: An online retrieval of Web of Science and ClinicalTrials.gov databases was performed with the key words “telemedicine” and “geriatric diseases” for papers regarding telemedicine for geriatric diseases published from 2003 to 2013. RESULTS AND CONCLUSION: (1) 239 papers regarding telemedicine for geriatric diseases were retrieved in Web of Science from 2003 to 2013. As per distribution by country for publications, USA published the highest number of papers (n=93, 38.912%). As per distribution by institute for publications (2003-2013), University of Washington was most prolific, folowed by Columbia University, The University of Queensland and The University of Western Australia (Australia). Among the included journals,Journal of Telemedicine and Telecare published the greatest number of papers (n=20, 8.368%). The number of included papers gradualy increased over the 10-year study period. Among these 239 papers, only 4 of them were from China, indicating that Chinese scholars paid relatively little attention in this research field, and the number and quality of Chinese papers on telemedicine for geriatric diseases need to be improved. (2) 18 studies regarding telemedicine for geriatric diseases were registered in ClinicalTrials.gov database from 2003 to 2013. Interventional studies (n=15) accounted for the largest proportion, folowed by observational studies.

Objective To discuss the methods of the operative treatment for posterior tibial tendon dysfunction (PTTD). Methods From December 2002 to June 2005, 8 cases of PTTD were treated with operations, including 2 males and 6 females with an average age of 47 years (range, 36 to 56 years). Left side was involved in 6 cases, and right side was affected in 2 cases. Stage Ⅱposterior tibial tendon dysfunction were 2 feet and stage Ⅲ were 6 feet. Every case with special operative treatment, for instance lateral column lengthening, arthrodesis, repair posterior tibial tendon, spring ligament reefing, flexor digitorum longus tendon transfer and so on. Every bone operation was combined with one or more than one sofe tissue operation. Anterior transfer and strengthening of posterior tibial tendon were performed in 4 cases, spring ligament reefing in 2 cases, flexor digitorum longus tendon transfer in 4 cases. All patients were fixed with plaster cast at inversion position for 4-6 weeks, then changed to plaster splint fixing at neutral position for 4 weeks. Functions of ankle and foot were evaluated before and after operation. Results All patients were followed up for an average of 28 months(range, 12 to 40 months). According to Maryland foot score, 2 were fair and 6 were failure in preoperative, 4 were excellent, 3 were good and 1 was fair in postoperative. The total excellent and good rate was 87.5%. The specific index of X-ray improve obviously(P

0.05 ) and Hb were elevated significantly( P

OBJECTIVE To discuss the best scheme for fungemia detection by analyzing and comparing the ability and performance characteristics of the BACTEC 9120 automated blood culture system and 4 kinds of blood culture bottles in the detection of simulated fungemia.METHODS Simulated blood culture was produced using 65 fungi isolates from clinical specimens and BACTEC Plus Aerobic/F,Plus Anaerobic/F,Peds Plus/F and Myco/F Lytic blood culture bottles and detected by BACTEC 9120 automated blood culture system.The final inoculum densities were 1-5 CFU/ml blood.The(time to detection TTD) of simulated blood culture with different concentrations of suspension produced using 2 kinds of standard strains and 4 kinds of blood culture bottles was compared.RESULTS From the 260 bottles in this study 216 had growth detected by the BACTEC 9120 blood culture system.The positive rates of BACTEC Plus Aerobic/F and Anaerobic/F,which were 90.77%and 41.54%,respectively,were significantly(P