Objective The investitgation of vascularized periosteal flap with dorsal branch of anterior interossea vessel was performed to provide anatomical basis for periosteal flap transposition. Methods The courses, branches, distribution and anastomosis of the dorsal branch of anterior interossea vessel were observed on 30 sides of adult cadavers' upper extremities and stimulated operation were perfomed. Results The dorsal branch penetrate out of interosseous membrane of forearm at (6. 6? 1. 4) cm upper the styloid process of the radius. It also sent off branches to the dorsal of ulna and radius that consist the periosteal flap. The dorsal branch send off lateral and medial branch about (2. 6?0. 8) cm upper the styloid process of the radius. The end of the branch anastomoses with dorsal carpal branch of the ulnar and radial vessel' Conclusion The pedicled osteoperiosteal flap can be transferred for repairing the fracture nonunion of ulna and radius and transpose reversely to repair scaphoid and innate bone disease'

Objective To analyze the clinical conditions and emergency treatment experiences of acute and chronic renal failure with hyperpotassemia. Methods Retrospective analyzed 542 clinical cases of supervening hyperpotassemia, which were treated by hemodialysis on 186 patients of renal failure with hyperpotassemia for 5 years. Results 540 cases clinical symptom was improved, serum potassium concentration was down to normal range and hyperpotassemia disappeared in electro cardiogram. 2 cases died after salvage. Rate of success was 99.6%. Conclusion Hemodialysis therapy is the most effective treatment to hyperpotassemia. Use bicarbonate with kalium pH indicator of 3.0～3.5mmol/L in dialysis is useful to lower hyperpotassemia, and safe also. In the early stage of hemodialysis, pure ultrafiltration dehydration treatment is not suitable. There is still danger of heartbeat stop deal to high kalium in the early stage of dialysis; emergency treatments should be standby all the time.

Objective To observe the effects of Melatonin on hippocampal neuron apoptosis and caspase-3 expression in epileptic rats. Methods Using model of status epilepticus (SE) induced by Pilocarpine, the rats were administered with melatonin (melatonin group) or saline (Pilocarpine group) before Pilocarpine injection. The apoptotic neuron was detected by TdT-mediated dUTP Nick End Labeling (TUNEL) and caspase-3 expression was observed by immunocytochemistry method, respectively.Results In Pilocarpine group, the number of TUNEL positive neurons began to increase at 6 h post-SE, peaked at 72 h post-SE, and decreased at 7 d post-SE. Caspase-3 immunoreactivity began to increase at 6 h post-SE, peaked at 48 h post-SE, especially in CA1 and CA3 region of hippocampus, began to decrease at 72 h post-SE and dropped to normal level at 7 d post-SE. The numbers of TUNEL positive neurons and caspase-3 expression in Melatonin group were significantly decreased compared to Pilocarpine group at different time points (all P

Objective To probe the changes of nitric oxide (NO) content and caspase-3 mRNA expression in hippocampus and the correlation between NO and caspase-3 mRNA expression post-status epilepticus (SE). Methods The models of SE were induced by pilocarpine. The nitric oxide content was detected by chromatometry and caspase-3 mRNA expression was observed by reverse transcription polymerase chain reaction (RT-PCR) method. Results The level of NO increased rapidly at 6~72 h post-SE,and was still significantly higher than that of the controls (all (P)0.05).Conclusions The peak expression of nitric oxide is earlier than caspase-3 mRNA post-SE, although they have the similar diversity tendency. Nitric oxide pathway is definitely involved in the seizure initiation and correlated with caspase-3 activation.

Objective To identify the role of resistin in insulin resistance(IR) by endoplasmic reticulum(ER) stress in human umbilical vein endothelial cells ( HUVECs) and in rats.Methods HUVECs were cultured in vitro and disposed by resistin (R) or tauro ursodesoxycholic acid (tudca).Expressions of GRP78, P-akt and P-eNOS were determined using Western blotting.Thoracic aortic rings were made and their dilation function exposed to different concentrations of insulin was detected.Changes of vascular morphology were observed by HE staining.Results Results of Western blotting showed that expression of GRP78 was remarkably increased,but P-akt and P-eNOS were markedly decreased in R group.However, there was no difference in expressions of GRP78, P-akt and P-eNOS between tudca group and control group.The insulin induced vasodilation was decreased in R group and there was no difference between tudca group and control.Using HE staining, the R group showed significant medial thickening and proliferation of smooth muscle.Conclusion Resistin can induce insulin resistance in vascular endothelium cells by ER stress.

Objective To study the feasibility and safety for using anesthesia gastroscopy in aged-patients over 80 years old.Methods Selecting 84 cases of aged-patients over 80 years old as anesthesia group(group 1),22 cases of aged-patients over 80 years old as normal gastroscopy group(group 2)and 100 cases of young-middle age as anesthesia control group(group 3).Low dose propofol and fentanyl combined atropine were injected into venous in anesthesia gastroscopy.The BP,HR,SpO2,patients reactions during gastroscopy,stomach peristalsis rates,awake time were detected before,during and after gastroscopy.Results Patients in group 1 felt much less discomfortable than those in group 2.Anesthesia group felt much satisfactorily than normal gastroscopy group.The BP,HR,SpO2 in group 1 were decreased transitorily during examination and resumed rapidly after examination.There were no severe complications in anesthesia gastroscopy.However,the BP and HR were increased obviously in normal gastroscopy group.The dosage of propofol in group 1 was much less than that in group 3.Conclusions The use of anesthesia gastroscopy with low dose propofol and fentanyl combined atropine intravenously in aged-patients over 80 years old is safe and comfortable.

We report a case of a 35-year-old right-handed male patient with drug-resistant mesial temporal lobe epilepsy who developed ipsilateral occipital hematoma after right temporal anterior lobectomy and amygdalohippocampectomy. Patient did not report taking any drugs with anticoagulant effect, such as aspirin or valproate. There was no past history of hypertension and the pre-operation tests were normal. Pre-operative brain magnetic resonance imaging revealed no abnormality in the right occipital lobe. Overdraining of cerebrospinal fluid may have triggered this remote cerebellar hemorrhage.

Eight cases of hypothyroid myopthy admitted in Zhanshan Hospital Xiamen University from 1995 to 2011 were retrospectivrely analyzed.The main clinical features were proximal muscle weakness,susceptibility to fatigue,and elevation of muscle enzymes.Electromyography revealed no specific findings.All patients obtained clinical recovery after thyoid hormone replacement.Hypothyroid myopathy should be considered in cases of muscle weakness and elevation of muscle enzymes.

Objective To investigate the role of soluble cytotoxic T-lymphocyte associated antigen-4 (sCTLA-4) in the pathogenesis of myasthenia gravis (MG) in Fujian province.Methods A total of 80 patients with MG and 80 sex-and age-matched healthy controls were enrolled in the study .MG patients were divided into non-glucocorticoid treatment group and glucocorticoid treatment group , and the latter was further divided into immunosuppressive therapy group and thymusectomy group .Concentrations of sCTLA-4 in ser-ums from above mentioned groups were measured by enzyme-linked immunosorbent assay (ELISA).Results The concentrations of sCTLA-4 in both non-glucocorticoid treatment group and glucocorticoid treatment group were significantly higher than those in the healthy control group (6.03 ng/ml±3.58 ng/ml, 3.44 ng/ml± 2.36 ng/ml vs.0.49 ng/ml±0.95 ng/ml) (χ2=100.67, P<0.001), but sCTLA-4 concentrations in glu-cocorticoid treatment group were lower than those in non-glucocorticoid treatment group (Z=-3.37,P=0.001).With the treatment of glucocorticoid, the sCTLA-4 concentrations were reduced (6.03 ng/ml± 3.58 ng/ml vs.4.56 ng/ml±2.08 ng/ml;t=3.10, P=0.005), and the concentrations of sCTLA-4 were also decreased after thymusectomy therapy (3.86 ng/ml±2.53 ng/ml vs.2.59 ng/ml±2.37 ng/ml; Z=-2.21, P=0.04).However, there was no significant difference in the concentrations of sCTLA-4 before and after immunosuppressive drugs treatment (Z=-1.26,P=0.21).Conclusion The concentration of sCTLA-4 was increased in patients with MG , but with the treatment of glucocorticoid or thymusectomy it could be reduced .

Objective To study the effect and safety of intra-arterial thrombolysis combined with mechanical ad-juvant in the treatment of acute large artery occlusive infarction of anterior circulation and posterior circulation. Methods Fourty-tow patients were divided into anterior circulation group (24 cases) and posterior circulation group(18 cases). The recanalization rate, NIHSS score (National Institute of Health stroke scale), GCS score ( Glasgow coma score,GCS), BI ( Barthel Index) excellent rate, symptomatic intracranial hemorrhage rate and mortality was analyzed after intra-arterial thrombolysis combined with mechanical aids therapy. Results The anterior circulation group was mainly caused by car-diogenic embolism (15/24, 62.5%) and posterior circulation group was mainly caused by atherosclerosis thrombosis (5/18, 72.2%). The NIHSS score was significantly lower after treatment (8.3±4.9 vs. 8.1±5.7) than before treatment(15.1±5.3 vs. 16.8±7.8)(P=0.001 vs. P=0.001), the GCS score was significantly higher after treatment(13.9±4.4 vs. 12.8±4.2)than be-fore treatment(9.5 ± 3.8 vs. 9.6 ± 3.7)(P=0.001 vs. P=0.021). The symptomatic intracranial hemorrhage rate was signifi-cant higher in anterior circulation group (5/24, 20.8%) than in posterior circulation group (0,0%) (P<0.05). Compared with the anterior circulation group, the recanalization rate trended to increase in posterior circulation group (P=0.830).The symptomatic intracranial hemorrhage rate in anterior circulation group (5/24,20.8%) was significant higher than in pos-terior circulation group (0,0%) (P<0.05), the mortality was similar between these two groups. Conclusions Intra-arterial thrombolysis combined with mechanical adjuvant therapy can improve neurological deficit in acute large artery occlusive infarction and increase the recanalization rate,which is more suitable for the treatment of posterior circulation infarction.