BACKGROUND: Most of the displaced fractures of calcaneus reed operation treatment. Because early postoperative dirigation is sometimes ignored,most patients receive only good anatomic reduction but less pleased functional reduction.OBJECTIVE: To compare the effect of different starting time of the postoperative dirigation on the functional recovery of the joint of the foot after the operation of the fracture of calcaneus with joint surface displacement.DESIGN: Non-randomized and concurrently controlled retrospective analysis with blind evaluation.SETTING: Orthopedic Department of Renji Hospital of Shanghai Second Medical University.PARTICIPANTS: Cases with the fracture of the calcaneus with joint surface displacement, in the Orthopedic Department of Renji Hospital of Shanghai Second Medical University were chosen from October 2000 to June 2003. There were totally 64 cases(72 sides), male 40 sides and female 32sides, whose ages varied from 22 to 68 years old. According to the starting time of the postoperative dirigation, the cases were divided into two groups,the 1-week dirigation group with 34 cases(38 sides), male 20 sides and female 18 sides, and the 6-week dirigation group with 30 cases(34 sides), male 20 sides and female 14 sides.METHODS: Totally 64 cases were involved in the result analysis. In the two groups, the same operative therapeutic methods and postoperative dirigation were taken except the starting time of the dirigation. The dirigation was started respectively 1 or 6 weeks after the operation and lasted for 6weeks. Six months later, follow-ups were done according to the Maryland Grade(excellent 90-100, good 75 -89, moderate 50 -74, poor ＜ 50) to evaluate the activity of the talocrural joint and the stability of the anterior half of the foot and the gait as well.MAIN OUTCOME MEASURES: Primary results: the postoperative function of the injured foot of the two groups. Secondary results: the adverse events and side effect.Maryland Grade: In the 34 cases(38 sides) of the 1-week dirigation group,the average mark was 87. 8, and in the 30 cases(34 sides) of the 6-week dirigation group, the average mark was 73.2, and the difference had signifigroup, 3 cases had poor healing of the incision, and achieved the healing after 2-week medication. And 2 cases had injury of the lateral dorsal cutaneous nerve of the foot. In the 6-week dirigation group 2 cases had poor healing of the incision and achieved the healing after 2-week medication, and 1 case had injury of the lateral dorsal cutaneous nerve of the foot. There was no significant difference between the two groups.CONCLUSION: After the operation of the fracture of calcaneus with joint surface displacement, early application of dirigation is beneficial to the functional recovery of the foot and talocrural joint without unsafety.

Objective To investigate the expression changes of acetylcholinesterase (AChE) related microRNAs derived from peripheral blood mononuclear cells (PBMCs) in patients with stroke. Methods The microRNAs for targeting AChE mRNA were selected via prediction software and previous studies. PBMCs were extracted from venous blood samples of acute ischemic stroke patients (onset<24 h) and healthy controls. The expressions of microRNAs and AChE mRNA were quantified using real-time PCR (RT-PCR). The protein level of AChE was detected by Western blot assay. Results Thepredicted microRNAs included microRNA (miR)-24,-28,-124,-132,-182*,-194 and-484. The expression levels of miR-24,-124,-132 and-194 were significantly elevated in stroke patients compared with those of controls (P<0.05). There were no significant changes in expression levels of miR-28,-182*and-484. Additionally, the relative expression levels of intracellular AChE mRNA and protein decreased significantly in stroke patients (P<0.05). Conclusion MiRNAs can enhance cholinergic anti-inflammatory pathway by targeting AChE in patients with acute ischemic stroke.

Abstract Objective:To establish an animal model of experimental rheumatoid arthritis(RA) and to investigate the preventing effect of orally administrated soluble chicken II collagen(CCII) on RA. Methods:The animal model of RA was induced in Wistar rats by immunization of intradermal injection with CCII in Fneund's complete adjuvant(CFA) .The arthritis degree of the experimental and control group was pros-pected and the serum levels of anti-CCII antibody were analyzed by ELISA method. Results:The RA in Wistar rats were successfully induced with CCII-CFA and the incidence of RA was 90% .The clinical expression of the disease was suppressed whether animals were fed with CCII before or relapsing sensitization. The incidence of RA was dramatically decreased in animals which were fed with CCII before disease induction, and the duration of disease was shorted significantly in animals which were fed with CCII. In addition, DTH responses to whole CCII were sup-pressed. The result of ELISA analysis showed that oral administration of soluble CCII partially suppressed Ab production. Conclusion:RA can be prevented by oral administration of CCII to induce specific immunological tolerance.

Objective To develop a modified method of adherent culturing NSCs to replace the traditional suspension culturing method.Methods Neural stem cells(NSCs)were isolated from brain of fetal mouse at 15.5-day fetal age.In culture bottle which had been pre-coated with poly-L-ornithine hydrochloride/fibronectin(PO/FN),the cells were adherently cultured and passaged.The cell morphology was observed under inverted microscope.NSCs and their differentiated cells were identified by immunofluorescence.Results NSCs obtained in this study were successfully adherently cultured and expressed specific markers.Conclusion NSCs are successfully adherently cultured in this study.As compared with the traditional suspension culturing method,adherent culturing is simpler and has lower wastage of passage.It is easy to observe cell morphology and differentiation by this method.It is also helpful to culturing and storage of NSCs.

BACKGROUND: Previous studies have confirmed that nano-hydroxyapatite/collagen (nHAC) and mesenchymal stem cells for repair of bone defect have the ability of bone formation in vivo. OBJECTIVE: To observe the effects of vascular endothelial growth factor (VEGF) and bone marrow mesenchymal stem cells (BMSCs), nHAC composite in the repair of femoral defect in rats. METHODS: Sprague-Dawley rat models of middle part of the femur defect were established and randomly assigned to two groups. Control group was implanted with BMSCs/nHAC composite. Experimental group was implanted with VEGF/BMSCs/nHAC composite. At 2, 4 and 8 weeks postoperation, imaging and histology observation of femoral samples were performed. At 8 weeks postoperation, scanning electron microscopy was performed in new bony callus environment. RESULTS AND CONCLUSION: nHAC composite implantation in the rats did not show rejection or inflammatory reaction. Moreover, bone formed rapidly using VEGF and BMSCs, nHAC composite, which exhibited better bone regeneration capacity compared with BMSCs/nHAC composite. The way of ossification mainly was endochondral ossification. It is presumed that VEGF promoted the formation of local microvessels, differentiation and proliferation of osteoblasts, speeded up the speed of endochondral ossification, shortened bone repair time, and elevated the quality and velocity of osteanagenesis.

Objective To study the function of human chorionie gonadotrophin(HCG) in adjus-ting the vascular endothelial growth factor(VEGF) in rabbit phallus with hypospadias. Methods Rabbit hypospadias mode was made by Finasteride. After the spontaneous delivery, 35 rabbits were divided into 5 groups with 7 in each group. Four groups accepted HCG intramuscular injection for 7 consecutive days with dosages of 100,200,400 and 600 U, respectively. The control group accepted the same dosage of saline injection. Another 7 normal rabbits were used as normal controls without in-tervention. After 3 weeks, the rabbit phallus tissue was collected and the VEGF levels were detected by ELISA. Results Rabbits with hypospadias accepted HCG 100, 200, 400, 600 U injection had the phallus tissue VEGF level of 5.00±2.37,5.63±1.73, 10.35±2.34 and 16.91±2.34 pg/ml, respectively. While the rabbits accepted saline injection had VEGF levels of 3.99±1.19 pg/ml. The normal rabbit phallus tissue contained VEGF level of 14.82±3.32 pg/ml. There were significant differences between normal group and the rabbits accepted HCG 100, 200, 400 U injection (P＜ 0.05), but there was no difference with the rabbits accepted HCG 600 U injection (P＞0.05). The VEGF level in rabbits accepted 400 U HCG injection had significant difference with rabbits accepted 100, 200, 600 U HCG (P＜0.05). The VEGF levels in rabbits accepted 100, 200 U HCG injection had no difference with rabbits accepted saline injection(P＞0.05). Conclusions The VEGF in rabbit phallus with hypospadias is decreased. HCG of certain dosage could increase VEGF level in rabbit phallus with hypospadias.

An improvement of chemiluminescent system for determination of peroxynitrite anion (ONOO－) has been made. In this system, the effect of some antioxidants for scavenging ONOO－ was tested. The constitute of this system and the program of starting were followed as: The ozone (O3) was bubbled through a glass-frit into 10 ml 0.01 mol/L solution of sodium azide in CB(pH 10.5) to generate ONOO－. The 800 μl ozonized solution of azide was injected into a glass tude in situ which contains 100 μl sample and 100 μl luminol solutions to initiate chemiluminescence (CL). The pluses / 6 seconds (CP6S) were determined immediately and continually for 10～30 times. A certain CL intensity (CP6S) was chosen as evaluation index to compare the activity of antioxidants. This chemiluminescent system is sensible, simple and stable. The determination limit was 8.74 μmol/L ONOO－. The linear rang was 8.74～74.04 μmol/L ONOO－. The intra batch and inter batch variation coefficient (CV%) of the analysis were 3.35%(n=10) and 5.52%(n=10) respectively. It was tested that Vit.C, teapolyphenol, procyanidin and thiourea all have effects on scavenging ONOO－.

BACKGROUND:Open reduction and plate internal fixation has become a major repair and treatment method for clavicle fracture, however, this method often causes postoperative local skin numbness and hypoesthesia. Currently, there was stil controversial about the effect of internal fixation on the free protection of supraclavicular nerve. OBJECTIVE:To investigate the clinical significance of supraclavicular nerve dissection and protection on open reduction and plate internal fixation of clavicle fracture. METHODS:Total y 57 patients with the middle third of the clavicle fracture were randomly divided into control group (n=34) and nerve protection group (n=23). Patients in these two groups al underwent plate internal fixation treatment. Patients in the nerve protection group underwent precious identifications and dissections of supraclavicular nerve when approaches were being done, careful y protections in the process of internal fixation. The incidence of local numbness, numbness severity, size, degree of influence on life, the improvement of the degree of numbness and pain were compared during the telephone fol ow-up after 1 year of surgery. RESULTS AND CONCLUSION:Total y 17 patients were fol owed up in each group. At the time of most serious symptom, 100%of al patients appeared local numbness in the control group, while 16 (94%) patients affected numbness in the nerve protection group. Until the latest fol ow-up, the number of patients with mild numbness symptoms decreased to 7 (41%) in control group and 3 (18%) in the nerve protection group, but there was no significant difference between the two groups (P>0.05). The severity of numbness and the degree of influence on daily life al improved over time. These results suggest that local skin numbness is a higher incidence of complications after the internal fixation for clavicle fracture. The protection of the supraclavicular nerve may help the improvement of the long-term numbness symptoms, but not as good as expected.

Objective To investigate the curative effect of Quadrant channel transforaminal lumbar interbody fusion(TLIF) in the treatment of recurrent lumbar disc herniation(RLDH).Methods Seventy-six cases patients with RLDH were divided into traditional TLIF group(36 cases) and Quadrant group(40 cases) by the different operation modes.The operation,VAS scores and ODI scores were compared between the two groups.Results Operation time((98.2±18.1) min vs.(118.5±27.2) min,t=3.79,P<0.05),incision length((2.7±0.6) cm vs.(5.5±1.0) cm,t=14.97,P<0.05),intraoperative blood loss((90.7±20.1) ml vs.(170.3±33.5) ml,t=12.71,P<0.05) and intraoperative drainage((43.8±12.4) ml vs.(117.1±28.9) ml,t=14.62,P<0.05) in Quadrant group were less than that in traditional TLIF group.The ambulation time((2.8±0.6) d vs.(6.8±1.1) d,t=19.95.P<0.05) and hospitalization time((7.1±2.0) d vs.(14.2±2.7) d,t=13.11,P<0.05) of Quadrant group were shorter than those of TLIF group.VAS scores in both groups were significantly decreased.VAS in Quadrant group was significantly lower than that in traditional TLIF group from 3 d to 6 months after operation((4.4±1.0,3.9±1.2,3.4±0.8,1.9±0.6,1.3±0.4) points vs.(5.0±1.4,4.5±1.1,4.1±0.9,3.6±0.7,2.5±0.6) points,P<0.05).ODI scores in both groups were significantly decreased.ODI in Quadrant group was significantly lower than that in traditional TLIF group from 1 d to 6 months after operation((36.7±7.1,33.4±6.2,30.7±4.1,27.8±5.3,24.5±5.4,18.4±4.7) points vs.(39.8±6.0,36.8±5.8,33.5±6.6,31.3±5.1,28.9±6.6,22.3±5.2) points,P<0.05).Conclusion The treatment of RLDH by Quadrant channel TLIF has obvious curative effect,short operation time,less trauma,faster recovery and shorter hospital stay.

Objective:To assess the clinical value of Gore C-TAG stent-graft segmented release mode combined with 'periscope’ technique in dealing with distal reentry tear of aortic dissection after thoracic endovascular aortic repair (TEVAR).Methods:The clinical data of 5 patients of distal false lumen enlargement after thoracic endovascular aortic repair for Stanford type B aortic dissection (TBAD) from 2019 to 2020 was retrospectively analyzed.Results:All five patients were male. Combining Gore C-TAG stent-graft segmented release mode with 'periscope’ technique was used. All five patients successfully underwent secondary endovascular repair, no intraoperative thoracotomy or major postoperative complications during hospitalization occurred . Compared to aortic CTA imaging in pre- and post-secondary endovascular repair, the curative efficacy of this method in the treatment of distal reentry tear of aortic dissection was evaluated. It showed that distal reentry tears were covered completely without reperfusion of aortic false lumen, as well as branch stents with well-perfusion based on aortic CTA imaging during the first year following-up.Conclusions:Gore C-TAG stent-graft segmented release mode combined with 'periscope’ technique in dealing with distal reentry tear of aortic dissection is technically applicable and highly successful with satisfactory short-term results.