BACKGROUND:The standard angle between the coronal level of tibial tunnel and the joint surface is 65°-70°. The larger angle is easy to cause impacts, and inversely, the medial joint surface of the tibia plateau wil be worn.
OBJECTIVE:To investigate the application and effects of patel ar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combined with arthroscopy.
METHODS:Forty patients with anterior cruciate ligament injury were selected, and randomly al otted into two groups (n=20 per group). Patients in traditional surgery group underwent reconstruction by the operator’s experiences, and patients in combination surgery group received the patel ar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combinied with arthroscopy, both based on the same location standard. Subsequently, patients underwent CT continuous CT scans, and the tibial tunnel of anterior cruciate ligament was measured to compare the reconstruction effects.
RESULTS AND CONCLUSION:The tibial tunnel and femoral tunnel positions in the combination surgery group were significantly higher than those in the traditional surgery group (P<0.05). The Lysholm scores in the combination surgery group were significantly higher than those in the traditional surgery group at 3, 6 and 12 months after surgery (P<0.05). Compared with the traditional surgery group, the number transmission times was significantly decreased in the combination surgery group (P<0.05). Furthermore, sagittal CT and three-dimensional CT results showed that, in the combination surgery group, the posterior wal of the tibial tunnel closely adhered to the rear cortical bone of the proximal tibia with a distance of<2 mm;a mild rupture appeared at the posterior wal excit of the 1/3 proximal tunnel in traditional surgery group. These results suggest that anterior cruciate ligament reconstuction under computer assisted navigation system combined with arthroscopy achieves satisfactory effects on location of the femoral tunnel. The use of navigation virtual probe avoids the subjective location by surgeons;therefore, it is feasible for clinical treatment.

Objective To evaluate the effect of nitroglycerin (NTG)-induced hypotension on cognitive function after endoscopic sinus surgery performed under isoflurane anesthesia in elderly patients.Methods Forty ASAⅠ or Ⅱ patients aged 65-85 yr weighing 40-75 ks undergoing endoscopic nasal sinus surgery for chronic sinusitis under isoflurane anesthesia were randomly divided into 2 groups(n=20 each):control group(group C) and controlled hypotension group(group H).Anesthesia was maintained with isoflurane inhalation in both groups.In group H controlled hypotension was induced and maintained with continuous iv infusion of NTG at function was assessed 1 day before(baseline)and at 6,12,24 and 72h after surgery using Minimental State examination (MMSE) and scored.Results The MMSE scores were significantly decreased after surgery from 6h to 24h in both groups and were significantly lower in group H than in group C.There was no significant difference in MMSE scores between the 2 groups at 72h after surgery.The incidence of cognitive deficit was significantly higher in group H(55%) than in group C(25%).Conclusion Controlled hypotension induced by NTG may aggravate transient cognitive deficit after isoflurane anesthesia in elderly patients.

Objective To explore the feature of epileptiform discharges during day and night in patients with sleep epilepsy and its diagnosis value. Methods Ambulatory EEG (AEEG) was performed continuously for 24 hours in 91 patients with sleep epilepsy. The frequency of epileptiform discharges in wake phase and sleep phase were analyzed. Results Epileptiform discharges were observed in 71 patients. 4 patients showed epileptiform discharges only in wakefulness, 41 only in sleep and 26 both in wakefulness and sleep. 34 patients showed epileptiform discharges only in stage 1 and 2 of NREM sleep, and 33 patients displayed epileptiform discharges in whole cycle of sleep. Seizure frequency in the patients with epileptiform discharges in wakefulness was higher than those without epileptiform discharges or with epileptiform discharges in sleep (both P

Objective To evaluate the role of diffusion tensor imaging(DTI)in finding brain damage,and to explore the clinical features and cognitive function changes in patients with posttraumatic epilepsy.Methods The clinical data,collected from 175 outpatients with posttraumatic epilepsy and registered from June,1999 to August,2007 in General Hospital of PLA,were summarized.All the patients were divided into lesion identifiable group and lesion obscure group according to neuro-imaging results.The cognitive function of epilepsy group consisted of 37 posttraumatic epilepsy patients were compared with that of 37 age-matched healthy people.13 patients of the epilepsy group underwent DTI examination.Results Among all patients,the frequency of simplex partial and complex partial attacks were both significantly higher than that of secondary generalized seizures(P0.05).Compared with healthy control group,the patients in epilepsy group showed significantly lower VIQ,PIQ,PIQ,digit span score and digit symbol score,and longer reflex time in Stroop test and produced significantly less words in one minute(P

To study the relationship between the expression of the DMBT1 gene in colon carcinoma and its clinical significance. Expression of the DMBT1 gene in colon carcinoma was measured by reverse transcriptase polymerase chain reaction (PT PCR). RT PCR amplification demonstrated that 13 of 36 (36 1%) cases showed an apparent reduction in DMBT1 mRNA in tumor tissues compared with paired normal tissues. Furthermore, the expression of the DMBT1 gene mRNA was reduced in the tumor tissues with lymph nodes metastasis, depth invasion and Dukes`s classification ( P

Objective To evaluate the effects of FTY720 pretreatment on lung injury induced by limb ischemia-reperfusion (I/R) in rats.Methods Thirty healthy male Sprague-Dawley rats,weighing 230-260 g,were divided into 3 groups (n=10 each) using a random number table:sham operation group (group S),I/R group and FTY720 group (group F).Bilateral hind limb I/R was induced by applying rubber band tourniquet high around each thigh for 3 h followed by 3 h of reperfusion.FTY720 was given by intragastric gavage at 3 mg · kg-1 · d-1 for 7 consecutive days before I/R in group F,while the equal volume of normal saline was given instead in group I/R.At the end of reperfusion,blood samples were collected from the carotid artery for blood gas analysis,and oxygenation index (OI) was calculated.The rats were then sacrificed and lungs removed for examination of pathological changes (with light microscope) and for determination of apoptosis rate (using flow cytometry) and expression of CCAAT/enhancer-binding protein homologous protein (CHOP),caspase-12,c-Jun N-terminal kinase (JNK),Bcl-2 and Bax protein in lung tissues (using Western blot).Bax/Bcl-2 ratio was calculated.Results Compared with group S,OI was significantly decreased in group I/R,and apoptosis rate was increased,the expression of CHOP,caspase-12,JNK and Bax protein was up-regulated,and the expression of Bcl-2 was down-regulated,and Bax/Bcl-2 ratio was increased in I/R and F groups (P＜0.05).Compared with group I/R,OI was significantly increased,apoptosis rate was decreased,the expression of caspase-12,CHOP,Bax and JNK protein was down-regulated,and the expression of Bcl-2 was up-regulated,and Bax/Bcl-2 ratio was decreased in group F (P＜0.05).The pathological changes of lungs were significantly attenuated in group F as compared with group I/R.Conclusion FTY720 pretreatment can attenuate lung injury induced by limb I/R in rats,and the mechanism may be related to inhibition of endoplasmic reticulum stress-related cell apoptosis.

Objective To examine the effectiveness and safty of intraperitoneal injection of rapamycin on epileptogenesis in a rat model of pentylenetetrazole-induced kindling epilepsy. Method The Sprague Dawley rats at 6-8 weeks old were randomly divided into group PTZ+RAPA and group PTZ+NS. The body weight, mortality and seizures were recorded at 1, 4 and 6 weeks after treatment. Mossy fiber sprouting in the hippocampal CA3 area and DG area was examined by Tim staining. Results 1.The rats mortality was 22.9% in PTZ+RAPA and 10.4% in PTZ+NS. Weight alteration was statistically significant between PTZ+RAPA and PTZ+NS at the corresponding time points (P< 0.001); 3. The kindling rate was 66.7% in PTZ+RAPA and 58.3% in PTZ+NS at 6 weeks and the difference was statistical significant between these two groups (P>0.05). There was no statistical significance in the seizure scores be-tween PTZ+RAPA and PTZ+NS (P> 0.05). 4.The scores of mossy fiber sprouting in hippocampal CA3 and DG areas was higher in PTZ+NS than in PTZ+RAPA (P<0.05). Conclusion Rapamycin cannot reduce or curb epileptic seizures in young rats. It can obviously reduce the weight of the young SD rats which may be associated with its side effects.

The principal goal of opening the course of Medical Communication is to develop medical students'basic communication skills which involve three aspects:the proper use of language tools,communication and problem-solving skills in the course of general interper-sonal relationships,information communication skills between doctors and patients in the process of making a diagnosis or treatment,public communication skills on medical education and communication skills in dealing with a medical dispute or crisis between doctors and patients. This paper presents clearly the connotation of medical communication and puts forward specific programs on the organization and implementation of the course.

Objective To study the effects of FTY720 pretreatment on ventilator-induced lung injury (VILI) in rats in order to explore the role of sphingosine-l-phosphate receptor 1 (S1PR1).Methods Forty healthy adult male SD rats weighing 300-350 g were randomly (randlom number) divided into 4 groups (n=10 each):group CV (conventional tidal volume VT =8 mL/kg),group HV (high tidal volume VT =40 mL/kg),group HF and group HFW.The rats in group HF received intra-gastric administration of FTY720 10 mg · kg-1 · d-1 for 7 days,while additional dose of W146 (S1PR1 antagonist) 1 mg · kg-1 · d-1 was administrated in group HFW before high tidal volume ventilation.After 4-hour mechanical ventilation,arterial blood samples were obtained for blood gas analysis before the animals were sacrificed.The lungs were harvested for histopathologic observation.Apoptosis rate in lung tissue was determined with flow cytometry.W/D lung weight ratio,pulmonary permeability index (PPI),total protein,and TNF-α,IL-1β in bronchoaveolar lavage fluid (BALF) were measured.All data were analyzed by oneway analysis of variance (ANOVA),The intergroup comparisons were analyzed by the least-significantdifference (LSD) test by using SPSS version 20.0 software.Differences were considered statistically significant if P ＜ 0.05.Results Compared with group CV,the level of PaO2 [(73.6 ± 8.9) vs.(50.5 ± 6.0)] was decreased,the levels of W/D [(3.12 ± 0.27) vs.(5.12 ± 0.56)],PPI [(0.08 ±0.03) vs.(0.30 ± 0.06)],apoptosis rate [(10.6 ±2.9) vs.(48.5±6.7)],total protein [(5.8 ±2.1) vs.(15.4±5.6)] and TNF-α [(24.3±5.7) vs.(108.4±16.0)] andIL-1β [(90.6±14.1) vs.(338.5 ± 44.3)] were increased in group HV (P ＜ 0.05).Compare with group HV,PaO2 [(50.5 ± 6.0) vs.(65.9±10.3)] was increased,W/D[(5.12±0.56)vs.(3.85±0.37)],PPI[(0.30± 0.06)vs.(0.14±0.03)],apoptosis rate [(48.5 ±6.7)vs.(25.6 ±5.3)],total protein [(15.4±5.6) vs.(8.9±2.5)],TNF-cα [(108.4±16.0) vs.(75.6±10.3)] andIL-1β [(338.5 ±44.3) vs.(188.9 ±33.8)] in BALF were decreased in group HF (P ＜0.05).PaO2 [(50.5±6.0) vs.(59.7±7.8)] was higher,W/D[(5.12±0.56) vs.(4.44±0.30)],PPI [(0.30±0.06)vs.(0.19±0.09)] andIL-1β[(338.5-±44.3) vs.(246.8±24.6)] levels were lower in group HFW than those in group HF There were no significant differences in apoptosis rate[(48.5±6.7)vs.(41.3±6.8)],totalprotein[(15.4±5.6)vs.(10.4±2.7)] and TNF-α level [(108.4 ± 16.0) vs.(97.5 ± 10.3)] between HFW group and HF group (P ＞ 0.05).Compare with group CV,The histopathologic damage of lung tissue was obvious in group HV and group HFW,it was attenuated by pretreatment with FTY720 in group HF.Conclusions FTTY720 pretreatment provides protective effects against ventilation-induced lung injury in rats,and S1PR1 may mediate the protection through reducing apoptosis rate and inflammatory reaction.

Objective To evaluate the role of cyclooxygenase-2 (COX-2) in ventilator-induced lung injury in rats.Methods Thirty healthy adult male Sprague-Dawley rats,aged 3.0-3.5 months,weighing 300-350 g,were randomly divided into 3 groups (n =10 each) using a random number table:traditional tidal volume group (group T,VT =8 ml/kg),large tidal volume group (group L,VT =40 ml/kg) and NS398 (selective COX-2 inhibitor,VT =40 ml/kg) group (group N).In group N,8 mg/kg NS398 (in 2 ml of 10％ dimethyl sulfoxide) was injected intraperitoneally at 1 h before ventilation,while dimethyl sulfoxide 2 ml was administrated instead of NS398 in T and L groups.After 4 h of mechanical ventilation,arterial blood samples were obtained for blood gas analysis and PaO2 was recorded.The animals were sacrificed and lungs removed for microscopic examination and for determination of wet/dry lung weight ratio (W/D ratio) and concentrations of total protein,intercellular adhesion molecule-1 (ICAM-1),tumor necrosis factor-alpha (TNF-α),NO and 6-keto-prostaglandin F1alpha (6-keto-PGF1 α) in bronchoaveolar lavage fluid (BALF).Pulmonary permeability index (PPI) and TXB2/6-keto-PGF1 α ratio were calculated.Results Compared with group T,PaO2 was significantly decreased,W/D ratio and PPI were increased,the total protein,ICAM-1,TNF-α and NO levels and TXB2/6-keto-PGF1 α ratio in BALF were increased in group L(P ＜ 0.05).PaO2 was significantly higher,W/D ratio and PPI were lower,and total protein,ICAM-1,TNF-α and NO levels and TXB2/6-keto-PGF1 α ratio in BALF were lower in group NS than in group L (P ＜ 0.05).The damage to lung tissues was severe in group L,and obviously alleviated in group N.Conclusion COX-2 is involved in ventilator-induced lung injury in rats.