BACKGROUND:Extracorporeal cardiac shock wave therapy (CSWT) can up-regulate angiogenic factors and its receptors,promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium,however,the specific mechanisms remain unclearly.OBJECTIVE:To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase (eNOS) in pigs following acute myocardial infarction (AMI).METHODS:Pig AMI model was established by embolizing the distal of left anterior coronary artery.Following model preparation,pigs were randomly divided into 2 groups.In the experimental group received three CSWT at days 1,3 and 5,200 hits per point,totally 12 points,with 0.09 mJ/mm~2 energy.Pigs with simple AMI were served as the control group.The serum eNOS level was detected by ELISA method before,immediate postoperative,and at days,1,3,5,and weeks 1,2,3,and 4 after operation.RESULTS AND CONCLUSION:The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation.At day 1 after CSWT,eNOS level was increased in the experimental group,which was still decreased in the control group.It revealed that CSWT play a positive effect on ischemia rnyocardium.The eNOS level reached a peak in the experimental group after 3 times of CSWT,lasted for 2-3 weeks,and began to decrease at week 4.The difference between the experimental group and control group had significance (P＜0.01).The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.

BACKGROUND: Coronary occlusion and balloon occlusion are two major methods in preparing acute myocardium infarction models. The pigs were expensive and the modeis will periorm further study,therefore,it is necessary to prepave a model with advantage of short time consuming, few trauma, and high survival rate.OBJECTIVE: To establish acute myocardium infarction in miniature pigs induced by coronary occlusion and balloon occlusion,and to compare the differences.DESIGN, TIME AND SETTING: The randomized grouping, contrast observation animal experiment was performed at the heart intervention room of The First Affiliated Hospital of Kun Ming Medical College between May 8~(th) and August 3~(rd), 2009.MATERIALS: A total of 20 Banna miniature pigs, weighing 20-30 kg, irrespective of genders, were purchased from animal department of Kunming Medical College. The animals were equally divided into embolism and occlusion groups.METHODS: In the embolism group, the balloon was implanted into distal end of anterior descending coronary via femoral artery,blocked the forward flow with 202.65 kPa pressure for 1, 2, and 5 minutes, with 60 seconds interval. The same operation was performed in the occlusion group, followed by blocked the forward flow for successive 60 minutes.MAIN OUTCOME MEASURES: Differences of modes established by 2 methods were compared by coronary opacification, ECG,myocardium zymogram, ultrasonic cardiogram and pathology detection.RESULTS: Nine pigs were survived in the embolism group, and the remained 1 pig died of coronary artery rupture. After operation, T wave inversion could be found, without ST stage raise. At day 1 after operation, correlated lead ST stage was raised 0.1-0.2 mV. The operation duration was 11 hours. In the occlusion group, 5 pigs survived, 4 pigs died of ventricular fibrillation,and 1 died without definite cause. The operation cost 24 hours, and the correlated lead ST stage was increased 0.2-0.3 mV postoperatively. Motion abnormality in infarction place was exhibited in both groups; ventricular aneurysm was formed in 3 pigs in the embolism group, and 1 in the occlusion group. Levels of creatine kinase isoenzymes serum troponin T were obviously stepped up and presented dynamic changes. The myocardiolysis was obviously showed in the infarcted areas, but the differences were no obviously in 2 groups.CONCLUSION: Both coronary occlusion and balloon occlusion can induce models of acute myocardium infarction. The coronary occlusion method is superior to balloon occlusion with few trauma, faster postoperative recover and low mortality rates.

[Objective]To study the clinical result of Endo-Model rotating-hinge prosthesis in the treatment of severe knee deformity. [Method]Twenty-two patients(10 males and 12 females;12 right knees,8 left knees,and 2 bilateral knees) were selected for total knee arthorplasty using Endo-Model rotating-hinge prosthesis.The average age was 56.2 years.All the patients were evaluated by HSS score system.[Result]All incisions healed at one-stage and all malformations were corrected.The functional result was good.Mile deep vein thrombosis was found in one case after operation.All the patients were followed up for 6-55 months.No infection or prosthetic loosening was developed.[Conclusion]Endo-Model rotating-hinge prosthesis is an effective and reliable prosthesis for severe knee deformity.

Objective To compare the effects of sedation induced with midazolam and propofol on blood pressure(BP), heart rate(HR) and heart rate variability (HRV) during operation on lower extremity preformed under continuous epidural anesthesia in patients with the type Ⅱ diabetes. Methods Forty patients with type Ⅱ diabetes scheduled for lower limb surgery were randomized to receive either midazolam (group M n - 20) for propofol (group P n = 20) for sedation during operation, all patients were classified as ASA physical status Ⅱ or Ⅲ . The patients were unpremeditated. Epidural catheter was inserted at L2-3 or L3-4 . The local anesthetic used was 2% lidocaine. MAP,HR,HRV and SpO2 were monitored during anesthesia and operation. After onset of epidural analgesia a loading dose of midazolam(0.03 mg?kg-1 ) or propofol (0.7 mg?kg-1 ) was given i.v. followed by intermittent i.v. boluses of 1 /4-1 /2 loading dose to maintain the depth of sedation at OAA/S score of 3 (respond to name outer if called repeatedly) . Changes in HRV before and during sedation were recorded and compared between the two groups. Results The demographic data including sex, age and body weight were comparable between the two groups. LF and TP decreased significantly during sedation as compared with baseline in both groups ( P

OBJECTIVETo study effects of autogenous femoral head bone grafting combined with total hip replacement for the treatment of old center dislocation of hip joint, and to evaluate the superiority of acetabular defect reconstruction with autogenous bone.

METHODSFrom March 2008 to December 2013, 16 patients (16 hips) with old center dislocation of hip joint were treated with autologous bone graft combined with total hip replacement. There were 11 males and 5 females, ranging in age from 41 to 72 years old, with an average of 56.3 years old. The duration of the disease ranged from 3.6 to 37.2 years. Twelve patients had injuries caused by traffic accidents and 4 patients were caused by falling down. The hip joint pain at the first month after operation, Harris score and hip joint movement of all patients were observed by using electronic case follow-up system.

RESULTSAll the patients were followed up, and the duration ranged from 11 to 78 months, with an average of 27.3 months. The postoperative hip joint movement of (56.2±23.4)° VAS 86.3±7.2 and Harris score 32.6±12.6 were all better than preoperative (181.8±17.6)°, 11.1±2.6 and 86.3±7.2. The joint pain was reduced and the function limitation was improved after operation, and the prosthesis position was good.

CONCLUSIONWhen the autologous femoral head bone grafting combined with total hip arthroplasty is used to treat old hip central dislocation, the initial and long-term stability of acetabular bone grafting is good, and the technique can avoid allogeneic bone complications, bone source rationally and reduce the economic burden of patients.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur Head ; transplantation ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Transplantation, Autologous

Objective To explore the relationship between the activity of cholinesterase in hemolyzed blood sample and non-hemolyzed blood sample. Methods The activities of cholinesterase in hemolyzed blood samples and non-hernolyzed blood samples from 112 healthy individuals in Ji'nan were determined by the ferric trichloride chro-mometry, and the activities of cholinesterase in hemolyzed blood samples were adjusted by the concentration of ho-moglobulin (Hb) in blood samples. Results Highly significant correlation was found in the activities of cholinesterase between hemolyzed blood samples and non-hemolyzed blood samples (r = 0.728, F

ObjectiveTo study the ability of response inhibition of depression.Methods30 depressed patients( depression group) and 30 healthy subjects (control group)were recruited in this study.The two groups were age,gender and education matched.All the subjects performed three visual Go/Nogo tasks using E-prime.The three Go/Nogo tasks were Happy Nogo Task(HNT),Normal Task (NT)and Sad Nogo Task (SNT).The two groups were instructed to press a button as quickly and correctly as possible when the Go trials were presented,but not to response when the Nogo trials were presented.In each task,the differences of accuracy (ACC) and response Time (RT) between the two groups were compared.Results ( 1 ) In HNT,during Go trials,ACC of depression group ( 0.85 ± 0.12 ) was higher than that of control group (0.75 ± 0.15 ) (P ＜ 0.05 ) ; during Nogo trials,ACC of depression group ( 0.91 ± 0.63 ) was lower than that of control group ( 0.95 ± 0.05 ) (P ＜ 0.05 ).(2) In NT,During Nogo trials,ACC of depression group(0.95 ± 0.04) was higher than that of control group (0.97 ± 0.03 ) (P ＜0.05 ).(3) There were no significant differences in RT between the two groups in any trails (P ＞ 0.05 ).ConclusionCompared with control group,depressed patients have a much higher recognize incline to the stimulus of sad emotion and a lower ability to complete normal response inhibition task.This is a new way to explain the depression pathogenesis mechanisms.

Objective To investigate the feasibility of ADC values that derived from MR DWI with multiple b values in reflecting the amplitude of enhancement and degree of differentiation in cervical squamous cell carcinomas on 3.0T MR scanner.Methods DWI and multiple phase contrast enhanced MRI images of 31 patients with pathologically diagnosed cervical squamous cell carcinomas were retrospectively analyzed.All ADC values in different b values and the amplitude of signal intensity enhancement were measured in various areas of tumors.Correlations of differences of ADCs in high and low b values with early and late enhancement,and the relationship of ADC and differences of ADCs with pathologically tumor differentiation grades were analyzed.Results ADC value in high and low enhanced areas of cervical cancer was inversely related with different b values.Differences of ADCs between low b value (200 s/mm2) and high b values (800,1 000,1 200,1 400 s/mm2) had weak positive correlation with early enhancement (r=0.315-0.339,all P＜0.05).While b=800 s/mm2 and 1 000 s/mm2,ADCs in highly enhanced areas of tumor were significantly lower in well-differentiated cancer lesions compared with those of poorly differentiated cancer lesions.There was no statistically significant of ADC value in other b values,and also of differences of ADCs in all b values in different differentiation foci (all P＞0.05).No differences were found in ADC values under other b values in various degree of differentiation foci,nor in differences of ADCs in all b values (all P＞0.05).Conclusion Combination of multiple b values of DWI may have the potential to reflect blood supply and tumor differentiation grades in cervical squamous cell carcinomas,while low b value of 200 s/mm2 and high b values of 800 s/mm2 and 1 000 s/mm2 will be the preferable choice on 3.0T MR scanner.

Purpose To explore the correlation between quantitative parameters from intravoxel incoherent motion (IVIM) with prognostic factors of rectal adenocarcinoma.Materials and Methods Eighty-six patients with rectal adenocarcinoma who were underwent surgery without neoadjuvant therapy in our hospital between September 2015 and July 2016 were selected in this retrospective study.The image data included multiple b-values diffusion weighted imaging (DWI) examination and the corresponding D,D* and f values of the lesions.Relationships between the quantitative parameters and tumor pathology indexes including histological differentiation grade,tumor T/N stage,lymphangiovascular invasion state,the expression level of epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor-2 (Her-2) were assessed.Results The average D values of different differentiation degree (high,middle and low) of rectal adenocarcinoma were (0.541±0.093)×10 3mm2/s,(0.490±0.156)×10-3mm2/s and (0.342 ± 0.147)× 10-3 mm2/s,and the difference was statistically significant (P＜0.05).TheD values were significantly different between the lymphangiovascular invasion and non invasion state [(0.511 ±0.154)× 10-3 mm2/s vs (0.387±0.130)×10-3 mm2/s,P＜0.05)].However,there were no significant differences in the mean D,D* and f values among different tumor T/N stage (P＞0.05).The average f value of EGFR or Her-2 high expression group was higher than that of low expression group (0.379±0.076 vs 0.298±0.099,P＜0.01;0.356±0.097 vs 0.298±0.098,P＜0.05,respectively).Conclusion Quantitative parameters of IVIM in rectal adenocarci-noma can be used as noninvasive imaging biomarkers to predict the biologic behavior of tumor and the prognosis of the patients.

Purpose Heart damage occurs frequently in patients with systemic lupus erythematosus(SLE), and most of the patients have no obvious symptoms. In this study, three-dimensional speckle tracking imaging (3D-STI) was used to assess the systolic function of left ventricle, for early diagnosis of cardiac function changes in patients with mild SLE. Materials and Methods Thirty-six patients with clinical diagnosed mild SLE were enrolled and 40 healthy volunteers were selected as control group. All the participants underwent both conventional echocardiographic and 3D-STI examinations, left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs), interventricular septal depth (IVSd), left ventricular posterior wall depth (LVPWd), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (GLS), left ventricular global circumferential strain (GCS), left ventricular global radial strain (GRS) and left ventricular global area strain (GAS) were compared between the two groups. Results The GLS, GCS, GRS and GAS of the study group were all lower than the control group, and the difference was statistically significant (P<0.05). There was no statistically significant difference between the two groups on LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV and LVEF (P>0.05). Conclusion 3D-STI is able to make an objective evaluation of the left ventricular systolic function for patients with mild SLE, and provide help for clinical cardiac function monitoring.