Objective To observe effects of 17?-estradiol on phenylephrine-induced hypertrophy in cultured neonatal rat cardiomyocytes and to explore its mechanisms. Methods Using cultured neonatal rat cardiomyocytes treated with different factors as a model,surface area of cardiomyocytes was measured by computer photograph analysis software;the protein synthesis rate was assayed with leucine intake method;the proto-oncogene c-fos protein expression was assessed with immunocytochemistry technique;the markers of cardiomyocyte hypertrophy,embryonic genes such as ?-MHC\,?-skA and ANP mRNA expressions were assessed with semiquantitative reverse transcription-PCR. Results 17?-estradiol inhibited obviously phenylephrine-induced increase of surface area and the protein synthesis rate of cardiomyocytes,reduced c-fos protein expression of hypertrophic cardiomyocytes,and down-regulated ?-MHC、?-skA mRNA expressions and up-regulated ANP mRNA expression.Conclusion 17?-estradiol inhibits hypertrophy of cardiomyocytes and its mechanisms might be related with the suppression of c-fos protein expression,the reversion of the embryonic switching of contractile protein genes(?MHC and ?-skA),the increase of ANP mRNA expression.

Objective To evaluate the clinical treatments and results of traumatic osteoarthritis of the hip joint after acetabular fracture. Methods One hundred and seven patients with acetabular fractures admitted from March 1995 to December 2003 were reviewed. Twenty-five cases of traumatic osteoarthritis were found during an average follow up of 2.5 years (8 month to 5.5 years). There were 18 male and 7 female with an average age of 42.7 years (28 to 71). According to Letournel classification, there were anterior-column fractures in 3 patients, anterior-wall in 2, posterior column in 3, posterior wall in 6, posterior wall and column in 3, transvers combined posterior wall in 5, and both-column in 1 patients. The operative related complication of heterotopic ossification was found in 6 , and bone defect in 3 patients. The pathological changes ofⅠ-stage was in 4,Ⅱ-stage in 5, Ⅲ-stage in 10,Ⅳ-stage in 5, and Ⅴ-stage in 1 patient. The mean Harris score of these patients was 52.6 points. Fourteen cases of traumatic osteoarthritis were treated with conservative treatment and 11 cases with total hip arthroplasty. Results Fourteen patients with conservative treatment were followed up 16 months in average (8 to 30 months) .The symptom of traumatic osteoarthritis in 12 cases had improved with the same initial radiographic findings and 2 cases deteriorated with narrowing of the joint space and hyperplasia. The latest mean Harris score for these patients was 61.8 points in average. Eleven patients with total hip arthroplasty were followed up for an average of 32 months(13 to 60 months) and the latest mean Harris score was 87.6 points in average. There were no complications related to the surgery occurred. Conclusion The traumatic osteoarthritis of acetabular fractures after operation is relative higher. The quality of reduction is an important factor influencing the long-term results of acetabular fractures and resulting traumatic osteoarthritis. For the patients with Ⅰ to Ⅲ-stage of pathological changes, conservertive treatment may obtain a relative good results. For the Ⅳ to Ⅴ-stage, total hip arthroplasty can gain an early satisfactory results.

BACKGROUND:After co-culture with osteoblasts, bone marrow stem cells can be induced to differentiate into osteoblasts. Whether adipose-derived stem cells co-cultured with osteoblasts can differentiate into osteoblasts or not? OBJECTIVE:To observe whether adipose-derived stem cells co-cultured with osteoblasts can differentiate into osteoblasts. METHODS:Adipose-derived stem cells and osteoblasts were isolated from New Zealand white rabbits. Then, passage 3 adipose-derived stem cells were co-cultured with passage 2 osteoblasts in 10%or 5%fetal bovine serum for 14 days. RESULTS AND CONCLUSION:After 7 days of co-culture, some adipose-derived stem cells became round in the two groups. After 14 days of co-culture, adipose-derived stem cells highly differentiated and differentiated cells were similar to mature osteoblasts that were positive for alkaline phosphatase staining and alizarin red staining. The mRNA expression of type I col agen and osteocalcin increased in both two group, especial y in the 10%fetal bovine serum group. These findings indicate that adipose-derived stem cells co-cultured with osteoblasts can differentiate into osteoblasts induced by high-concentration serum culture.

Objective To explore a management strategy for disinfection supply in hospital. Methods A PDCA (plan, do, check, and action) model was applied to establish a manngement strategy for the disinfection supply, strengthen the education among all staff, promote the competence level of disin-fection supply center, organize joint inspection group for regular union supervision, give feedback promptly and implement strictly. Results By applying the PDCA model, the staff in the disinfection supply center strengthened the consciousness in standard cleanness, disinfection and sterilization, the number of pack-ages prepared by clinic room was reduced, and the supply of sterilized materials were more centralized. Conclusion The management strategy based on PDCA model of disinfection supply in hospital is effec-tive.

Objective To study the reasons and prophylaxes of conversion to laparotomy during gy-necological laparoscopic surgery. Method Clinical records of 36 cases of conversion to laparotomy out of 1143 cases of gynecological laparescopic surgery were analyzed retrospectively. Results The rate of conver-sion to laparotomy was 3.15%. The reasons of conversion to laparotomy were abdominopelvic cavity adhesion in 23 cases, technical difficulty and complication in 8 cases, malignant tumor in 3 cases, accounting for 63.89%, 22.22%, 8.33%, respectively. The rate of conversion to hparotomy in patients with a history of laparotomy was significantly higher than that without a history of laparotomy. The rate of conversion to laparoto-my in early stage of developing laparoscopic surgery was significantly higher than that in other stages. Con-clusions Abdominopelvic cavity adhesion is the primary reason of conversion to laparotomy during gyneco-logical laparoscopic surgery. Careful evaluation before surgery and improving ability of performance can de-crease the rate of conversion to laparotomy.

Objective: Our aim was to study the relationship between nitric oxide and ovarian neoplasm. The concentrationg of nitrite /nitrate (NO-2/NO-3),glutathione(GSH), and the activity of superoxide dismutase(SOD) were detected in ovarian tissues.Methods:A modified copper-coated cadium reduction method was used to detect NO-2/NO-3. Dithio-bis-nitrobenzoic acid (DTNB) method was used to detect the GSH concentration. The activity of SOD was measured by an ultramicroanalytic and rapid assay. All the data were obtained from 21 patients with ovarian neoplasm(10 with benign ovarian neoplasms,and 11 with ovarian carcinomas). This paper is concerned with the analysis of matched case-control studies. The carcinoma tissues and normal ovarian tissues were obtained from the same patient. We performed Paired-Samples t test to determine whether the NO-2/NO-3,GSH and the activity of SOD in carcinomas and normal ovarian tissues have significantly difference. Results:No significant difference for the concentration of NO-2/NO-3,GSH and activity of SOD was shown in the normal ovarian tissues and neoplasm tissues of benign neoplasm . The concentrations of GSH and activity of SOD in normal ovarian tissues were significantly higher than ovarian carcinomas(P<0.05). No significant difference of concentration of NO-2/NO-3 was shown in normal ovary and ovarian carcinomas. In the normal tissues of all patients, NO-2/NO-3 was positively correlated with GSH and SOD. Glutathione was positively correlated with SOD. In the ovarian neoplasms, there was no significant correlation between NO-2/NO-3 and GSH, NO-2/NO-3 and SOD,GSH and SOD.Conclusion: Nitric oxide and the other matters which attend the course of its metastasis may closely related to ovary neoplasms.

[Objective]To retrospectively analyze the therapy comparison between the unilateral hinged external fixator assisting the internal fixation, soft tissue repair and reconstruction and routine surgery for elbow instability of fracture dislocation.[Method]A total of 117 cases of elbow fracture dislocation were collected from Jan. 2001 to Jun. 2005. Some patients were treated by unilateral hinged external fixator, and others were treated by routine surgery and casting external fixation.The JOA assessment was applied for the pain, function, arc of motion, articular instability and deformity of elbow joint before surgery and after operational follow-up. [Result]Eighty-six cases were followed up by telephone and mail appointment.The average follow-up time was 18.6 months (from the range of 8 months to 30 months).The function and arc of motion of two group patients were assessed by JOA in post-operational follow-up, showing statistical significant difference (P0.05). The total assessment score between two groups indicates statistical significant difference.[Conclusion]The operation in combination with unilateral hinged external fixator for treating elbow instability of fracture dislocation will enhance lateral stability of elbows, guaranteen early safe elbow function exercises, facilitate stable environment for ligaments healing,suggesting a good subsidiary operational method.

[Objective]To assess the early diagnosis and treatment and outcome of patients with crush syndrome in earthquake disaster.[Method]We conducted a retrospective analysis of 27 patients with crush syndrome and subsequent acute renal failure (ARF) and wound complication who were treated in our university hospital.All of patients had been extricated from buildings that collapsed in the Wenchuan earthquake.Crush injury involved the upper extremities and low extremities.Each patient received intravenous fluids and diuretic drugs.Twenty-one patients received hemodialysis.Emergency fasciotomy performed in 11 patients and amputation were performed in 16 patients,4 to 102 hours after extrication.[Result]No patient died.Twenty-one patients among the ARF patients were retracted from hemodialysis.Among the patients who were performed fasciotomy or amputation,13 patients had wound complication including infection,however,the wounds in 10 patients were healed by dressing change,debridement and coordinate treatment with ICU and related subjectives.[Conclusion]Crush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF.Wound healing is a difficult task for the crush syndrome patients.The authors believe that immediate intensive care therapy and multisubjective coordination would improve the survival rate.

Objective This study compared the cleaning effect of gastroscope by different cleaning mehtods and discuss practical and reliable evaluation method for the cleaning degree of gastroscope.Methods Three cleaning methods were selected and used in the cleaning of gastroscope.The Endocheck lumen was used to examine the cleaning degree of gastroscope and the effects of different methods were compared. Results The qualification rate by using ordinary cleaning method was 50.0%and it reached 60.0%and 73.3%by elevation of polyenzyme concentration and adding bedside pre-washing.which Was statistically different from that by using ordinary cleaning method(P＜0.05).Conclusions Bedside pre-washing could increase the cleaning degree of gastroscope;Endocheck lumen could be regarded as an evaluation method for the cleaning degree of gastroscope.