Objective To evaluate the effect of intra-arterial infusion of basic fibroblast growth factor(bFGF) on improving neovascularization, vascular perfusion and the function of partially ischemic limbs of rabbits. Methods Twenty-seven New Zealand male rabbits were selected. Partial ischemia model was induced by surgical ligation of the primary branches of right femoral artery in each animal, and the left hind limb of each animal was served as a nonischemic control. Then, 27 rabbits were randomly assigned to three groups: intra-arterial (IA) infusion of bFGF (n=9), intravenous (IV) infusion of bFGF and IA infusion of saline (n=9). Infusion was separately performed immediately after vascular ligation, 8th and 15th days post-surgery with 10 ?g (4 ml) of bFGF per-time (or the same volume of saline). The differences between three groups and between ischemic and nonischemic limbs of the same group were compared and evaluated by the following indexes: (1) vessel section count (VSC), vessel section surface area (VSS) and vessel section perimeter (VSP) in the field of ischemic muscle tissues taken at 22nd day postoperatively; (2) capillary refilling time of ischemic limbs; and (3) functional and trophic changes of ischemic limbs. Statistical differences were evaluated by one-way ANOVA and T test. Results VSC, VSS and VSP of the IA-bFGF group were significantly increased than those of the IV-bFGF and IA-saline groups (P

Objective To evaluate the efficacy of preoperative transarterial chemotherapy for invasive bladder cancer. Methods A total of 60 cases of invasive bladder cancer have been confirmed on open surgery and pathological studies were retrospective studied.The cases were allotted to preoperative transarterial chemotherapy group (30 cases) and operation alone group (30 cases).Preoperative transarterial chemotherapy was performed by infusing anticancer drugs into internal iliac artery.Surgery was performed in 1～2 weeks after transarterial chemotherapy.The bladder preservation rate,recurrence rate,metastasis rate and survival rate were compared between the 2 groups. Results In the preoperative transarterial chemotherapy group,the bladder preservation rate was improved and the recurrence rate dropped (P0.05). Conclusions Preoperative transarterial chemotherapy is a safe and effective method in the treatment of invasive bladder cancer.

Objective To compare the difference of function regain level of spinal cord after operative or non-operative treatments of cervical spinal cord injury without fracture dislocation. Methods Twenty-four cases with cervical spinal cord injury without fracture dislocation were retrospectively analyzed and divided into operative treatment group ( n =13) and non-operative treatment group ( n =11). JOA (Japanese Orthopaedic Association) scores at injury and during follow-up were recorded to make a comparison between operative treatment group and non-operative treatment group before and after treatment. Results JOA scores three months after treatment were 1.64?0.58 in the non-operative group and 3.29 ?0.90 in the operative treatment group. JOA scores 12 months after treatment were 2.00? 0.73 in the non-operative group and 4.93?0.96 in the operative treatment group. There was a significant difference statistically between both groups through t test ( P

[Objective] To explore the effect of B-Twin intervertebral cage for degenerative lumbar instability with posterior mini-incision.[Methods]Thirteen patients(13 disc-spaces)treated with B-Twin intervertebral cage in combination with autogenous morselized bone were enrolled in this study.Among the patients,11 had degenerative instability in L4、5 and 2 in L5S1.Patients were graded postoperatively with JOA scoring system.[Results]The lower back pain and leg pain were relieved significantly in all patients after operation.All were followed-up for an average of 16.2 months,and the JOA scores inproved from 4.2 preoperatively to 14.4 at the final follow-up.The good to excelleat rate was 92.3%.The bony fusions presented in an average of 19.8 weeks postoperatively by CT scan.Neither cage loosening nor neurological injury was found.[Conclusion]B-Twin intervertebral cage combined with autogenous morselized bone insertion for lumbar degenerative instability by posterior mini-incision operation is a good technique,which could achieve satisfactory clinical results with less injury.

Objective To discuss the differences between hemiarthroplaty and dynamic hip screws (DHS) by comparing their effect in treatment of osteoporotic femoral intertrochanteric fractures. Methods A retrospective study was done on 86 patients with femoral intertrochanteric fractures treated by hemiarthroplasty and dynamic hip screws respectively. After a follow-up for six months, the operation duration time, loss of ambulatory grades and prosthesis loosing were compared between two groups. Re-suits Operation was lasted for hmgcr time in DHS group, with significant difference between two groups. Loosening rate varied with different degree of osteoporosis in high-, moderate- and low-risk groups but not in hemiarthroplaty group. Internal fixators penetrating cortical bone occurred in DHS group, with inci-dence rate of 51.2%. On the contrary, no evidence proved loosening of prosthesis in hemiarthroplaty group. Conclusion For osteoporosis patients with intertrochanteric fracture, the hemiarthroplaty is a reasonable alternative to DHS device, for it can help obtain earlier and better functional recovery and less postoperative complication.

The clinical significance of a myeloperoxidase (MPO) gene polymorphism and inducible nitric oxide synthase (iNOS) expression in cirrhotic patients with hepatopulmonary syndrome (HPS) was explored. Enrolled subjects were divided into three groups according to their disease/health conditions: the HPS group (cirrhotic patients with HPS; n=63), the non-HPS group (cirrhotic patients without HPS; n=182), and the control group (healthy subjects without liver disease; n=35). The distribution of the MPO -463 G/A genotype and its relationship with iNOS expression in a typical cell block from ascitic fluid were detected by immunohistochemistry and polymerase chain reaction-restricted fragment length polymorphism analysis (PCR-RFLP). In the HPS group, the partial pressure of oxygen in blood and ascitic fluid was significantly decreased (8.95+/-1.58 kPa and 6.81+/-0.95 kPa, respectively; both P<0.01), while the partial pressure of carbon dioxide significantly increased (4.62+/-0.20 kPa and 5.92+/-0.45 kPa, respectively; P<0.01). MPO and iNOS levels were significantly increased in the HPS group as compared with the non-HPS group. These increases were even more remarkable in ascitic fluid (41.36+/-11.62 and 13.23+/-4.81 mug/L; 10.27+/- 3.20 and 4.95+/-1.12 mug/L) than in blood (16.66+/-5.24 and 4.87+/-1.73 mug/L; 5.79+/-2.31 and 2.35+/-0.84 mug/L). The distribution of the MPO genotypes GG, GA, and AA were 76.2%, 22.2% and 1.6% in the HPS group, and 57.7%, 37.9% and 4.4% in the non-HPS group (P<0.05). The expression of iNOS was significantly higher in patients with the G alleles (G/G and G/A) (61.54%, 48/78) than in patients with A alleles (G/A and A/A) (38.46%, 30/78) (P<0.01). It was suggested that the expression levels of iNOS and MPO were correlated with HPS-induced hypoxemia. The MPO-463 G/A mutation might be a protective factor that prevents the development of HPS. The MPO might be involved in the regulation of iNOS expression. In humans, MPO pathways, the iNOS/NO system, and their interaction might have an impact on the occurrence and development of HPS.

Objective To observe the changes of serum soluble CD40 ligand (sCD40L) and fibrinogen in acute myocardial infarction (AMI) patients and to investigate the clinical predictive value of increased serum sCD40L and fibrinogen. Methods Serum sCD40L level of 60 AMI patients was determined by enzyme-linked im-munosorbent assay (ELISA). Plasma level of fibrinogen was measured. The patients were followed up for 2 years af-ter discharge from the hospital and were observed for cardiovascular event. Results AMI patients had higher sCD40L and fibrinogen levels than those of controls [(15.36±7.32) μg/L vs. (5.79±2.78) μg/L, (4.60±1.37)g/L vs. (3.03±0.82) g/L,P<0.001] ,which were significantly higher in the patients experiencing cardio-vascular event than those without cardiovascular event [(18.14±6.34) μg/L vs. (14.38±6.67) μg/L and (4.97±1.33)g/L vs. (4.20±1.24} g/L] (P<0.05). The patients with sCD40L≥14.5 μg/L or fibrinogen≥ 4.4 g/L experienced increased risk of adverse cardiovascular events (P<0.05). In AMI patients, sCD40L level was significantly higher in patients with diabetes than in nondiabetics [(18.38±6.71) μg/L vs. (14.46±6.48) μg/L, P<0.05)]. Fibrinogen level was related to sCD40L (r=0.27, P<0.05) and LVEF(r=-0.319, P<0.05). Conclusion Increased sCD40L and fibrinogen levels,which maybe related to the pathogenesis of AMI,can be found in AMI patients and can indicate an independent increased risk of major adverse cardiovascular events. Diabetes is independently associated with elevated sCD40L level in AMI patients.

Objective To observe the individualized insertion choice in treatment of upper cervical injury with posterior atlantoaxial short-segmental pedicle screws or lateral mass screws and the relevant clinical outcome.Methods A total of 23 cases of upper cervical injuries received skull traction preoperatively.Individual surgery plan including internal fixation using pedicle screws or lateral mass screws as well as diameter,length,entry point,direction,and angle of screws was determined according to their atlantoaxial CT scan and three-dimensional reconstruction results.Results Six cases of Frankel grade C and eight of grade D were all recovered to grade E after operation.All cases presented rigid fixation and bony fusion in the follow-up of 6 to 36 months.Besides,screws were removed after bony fusion for three young cases and one case with left atlas pedicle screws emerged laterally out of cortex.Clinical outcome was all satisfactory.Conclusion Individualized posterior atlantoaxial fixation using pedicle screws or lateral mass screws is an effective way to treat upper cervical injury and gains advantages of stable threedimensional structures,short fixation segments,and few postoperative complications.

The clinical significance of a myetoperoxidase (MPO) gene polymorphism and inducible nitric oxide synthase (iNOS) expression in cirrhotic patients with hepatopulmonary syndrome (HPS) was explored. Enrolled subjects were divided into three groups according to their disease/health conditions: the HPS group (cirrhotic patients with HPS;n=63), the non-HPS group (cirrhotic patients without HPS;n=182), and the control group (healthy subjects without liver disease;n=35). The distribution of the MPO -463 G/A genotype and its relationship with iNOS expression in a typical cell block from as-citic fluid were detected by immunohistochemistry and polymerase chain reaction-restricted fragment length polymorphism analysis (PCR-RFLP). In the HPS group, the partial pressure of oxygen in blood and ascitic fluid was significantly decreased (8.95±1.58 kPa and 6.81±0.95 kPa, respectively;both P<0.01), while the partial pressure of carbon dioxide significantly increased (4.62±0.20 kPa and 5.92±0.45 kPa, respectively;P<0.01). MPO and iNOS levels were significantly increased in the HPS group as compared with the non-HPS group. These increases were even more remarkable in ascitic fluid (41.36±11.62 and 13.23±4.81 μg/L;10.27± 3.2 0 and 4.95±1.12 μg/L) than in blood (16.66±5.24 and 4.87±1.73 μg/L;5.79±2.31 and 2.35±0.84 μg/L). The distribution of the MPO genotypes GG, GA, and AA were 76.2%, 22.2% and 1.6% in the HPS group, and 57.7%, 37.9% and 4.4% in the non-HPS group (P<0.05). The expression of iNOS was significantly higher in patients with the G alleles (G/G and G/A) (61.54%, 48/78) than in patients with A alleles (G/A and A/A) (38.46%, 30/78) (P<0.01). It was suggested that the expression levels of iNOS and MPO were correlated with HPS-induced hypoxemia. The MPO-463 G/A mutation might be a protective factor that prevents the development of HPS. The MPO might be involved in the regulation of iNOS expression. In humans, MPO pathways, the iNOS/NO system, and their interaction might have an impact on the occurrence and development of HPS.

Somatic symptom disorder are common in childhood, and associated with high-risk adult psychiatric disorders and more unexplained hospitalization.They are one of the factors that seriously hinder health sound growth of children.In this article, domestic and foreign studies on somatic symptom disorders were reviewed to discuss their concept change, etiology and pathogenesis, clinical manifestation, diagnosis, evaluation and treatment, in order to facilitate early identification and treatment of somatic symptom disorders in childhood.