Objective To explore the efficacy and safety of the treatment of Xuezhikang and fluvastatin in elderly angina patients with mildly abnormal liver function .Methods 84 cases of ALT in 40-80u/L very elderly patients with coronary heart disease were randomly selected and divided into the two groups , the Xuezhikang group received Xuezhikang (0.6g,bid,orally),the fluvastatin group received fluvastatin (40mg,1time/night,oral),the total course was 12weeks,the TC,TG,LDL-C,HDL -C were measured before and after treatment ,liver function was measured once 2 -4times.If ALT was 3 times higher than before , Xuezhikang was instead of statins , if ALT was 5 times higher than before ,both of the two drags were withdrawaled .Results The TC,LDL,TG,HDL-C and ALT of the two groups were no significant difference before treatment (P >0.05),the TC,LDL,TG were decreased after treatment in the both group .There was no case of increased of ALT to three times in Xuezhikang group ,however ,ALT of 6 patients were increased more than three times in fluvastatin group ,four weeks after exchange of Xuezhikang ,the ALT were not continued to rise .Conclusion Both the two medicine can significantly lowered the cholesterol in very elderly patients with angina ,but the Xuezhikang were more safety in the patient with mild increased of liver function .

Objective To investigate the expression levels of Interleukin(IL)?6 and matrix metalloproteinases(MMP)?13 in synovial fluid by in?vigorating kidney and activating blood formulae in treating rabbit knee osteoarthritis model. Methods A total of 30 New Zealand rabbit were ran?domly divided into blank group,model group,invigorating kidney group,activating blood group and invigorating kidney and activating blood group. Rabbits model with knee osteoarthritis were established by improved Hulth method. To give corresponding respectively the medicinal broth,model group was given saline,knee joint synovial fluid was collected after 4,8 and 12 weeks. Enzyme linked immunosorbent assay(ELISA)was used to measure the levels of IL?6 and MMP?13. Results The levels of IL?6 in rabbit knee osteoarthritis were obviously higher than that of normal control group at both 4 weeks and 8 weeks(P<0.001). But there was no statistical difference on the levels of IL?6 compared with controls in 12 weeks. In addition,the level of MMP?13 at 4 weeks,8 weeks and 12 weeks were significantly higher than the blank control group(P<0.001). After 8 weeks of Chinese medicine administration,the levels of IL?6 in synovial fluid were significantly decreased in invigorating kidney group,activating blood group and invigorating kidney and activating blood group(P<0.001),but there was no statistical difference among groups in 12 weeks. The MMP?13 levels of synovial fluid was significantly lower than the model group(P<0.001). Conclusion Our results indicate that IL?6 and MMP?13 par?ticipate in the pathological development of the rabbit knee osteoarthritis. Invigorating kidney and activating blood formulae could reduce the expres?sion of IL?6 and MMP?13 and alleviate osteoarthritis progression,and which is superior to the pure invigorating kidney formulae and activating blood formulae.

BACKGROUND:Patients with elder hip fracture has more complications, poor affordability and high perioperative risk, so the preoperative ful preparation and evaluation are needed.
OBJECTIVE:To predict the accuracy of the prognosis of elderly patients with hip fracture through comparing the difference between American Society of Anesthesiologists score and Daping orthopedics operation risk scoring system for senile patients.
METHODS:A retrospective study was performed on 300 cases with elderly hip fracture selected from January 2011 to December 2012 from Department of Orthopedics, Gongli Hospital of Pudong. American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients were conducted before treatment, and the predictive values of two scoring systems on the incidence of complications and mortality were compared.
RESULTS AND CONCLUSION:According to the American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients, 148 cases and 97 cases had complications respectively. On the contrary, the actual number of complications was 89. The former predicted value was significantly higher than the actual value, and there was no significant difference between the latter forecast value and the actual value. The numbers of death predicted by American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients were 27 cases and six cases, but the actual number of death was three cases, indicating that former predicted value was significantly higher than the actual value, and there was no significant difference between the latter predicted value and the actual value. The American Society of Anesthesiology score has a certain errors in predicting the postoperative complications and mortality of patients with elderly hip fractures, but it is simple and useful in clinic. The Daping orthopedics operation risk scoring system for senile patients can accurately evaluate elderly hip fracture operation risk, and can predict the postoperative complications and mortality more objective when compared with the American Society of Anesthesiology score.

BACKGROUND:Repair programs of posterolateral tibial plateau fracture included posterior plate screws, lateral plate screw and anterior and posterior lag screw fixation. To choose which fixation methods depends on clinical experiences of physicians. Study results are mainly clinical reports, and lack of mechanical evidence.
OBJECTIVE:To compare biomechanical changes in three fixed manners (lateral plate screw group, posterior plate screw group and anterior and posterior lag screw group) in the repair of posterolateral fracture of tibial plateau from the angle of biomechanics.
METHODS:A total of tibial specimens of six adult male antisepsis corpses (12 samples) were used for measuring bone mineral density of metaphysis. 1/2 posterolateral tibial plateau fracture model was established by electric pendulum saw. The model was randomly divided into three groups:lateral plate screw group, posterior plate screw group and anterior and posterior lag screw group. Finite element method and biomechanics were used to test axial displacement value and the maximal displacement distribution area under the axial loads of 250, 500, and 1 000 N.
RESULTS AND CONCLUSION:There was no significant difference in average bone density in three groups of metaphysis (P>0.05). The minimum axial displacement of the fracture fragments was in the anterior and posterior lag screw group (0.013 521 mm), fol owed by posterior plate screw group (0.016 991 mm), and the maximum was visible in the lateral plate screw group (0.138 200 mm) under 250 N load. Displacement value was similar to the 250 N under 500 and 1 000 N. According to the results of biomechanics, displacement values of anterior and posterior lag screw was obviously less than the lateral plate screw group and posterior plate screw group (P<0.05). There was no significant difference between the lateral plate screw group and posterior plate screw group (P>0.05). The maximal displacement distribution area was proximal tibiofibular joint border zone in two methods. These data indicated that the biomechanical stability was most advantageous in the anterior and posterior lag screw group, and poorest in the lateral plate screw group. In the clinic, anterior and posterior lag screw fixation can be used as a first choice for repair of posterolateral tibial plateau fracture.

Objective:To analysis the effect of two methods of transposition of pectoralis major in different degrees deep sternal wound infection(DSWI) after undergoing cardiac surgery.Methods:128 patients with DSWI after cardiac surgery were treated, 72 were mild, and 56 were severe. 66 cases of pectoralis major muscle flap docking method(medial muscle flap docking group) and 62 cases of lateral pectoralis major muscle flap turnover method(lateral muscle flap turnover group) were implemented respectively. Drainage tube indwelling time, reoperation rate, incidence of lung infection, long-term thoracic stability and other aspects were observed to compared the treatment effect.Results:In the mild patients, the medial muscle flap docking group and the lateral muscle flap turnover group were compared( P<0.05). The postoperative hospital stay [(14.2±4.7)days vs.(17.1±3.9)days], drainage tube retention time[(6.2±1.7)h vs.(9.1±2.9)h], and reoperation rate(2.4% vs. 6.7%), the incidence of lung infection(14.3% vs. 23.3%), long-term thoracic stability[73.8%(31/42)vs.43.3%(13/30)]. In the severe patients, the medial muscle flap docking group and the lateral muscle flap turnover group were compared. The postoperative hospital stay[(24.2±7.2)days vs.(20.1±3.5)days], drainage tube retention time[(20.2±6.6)h vs.(13.2±3.1)h], reoperation rate(20.8% vs.12.5%), incidence of pulmonary infection(41.7% vs. 31.3%), long-term thoracic stability[25.0%(6/24)vs.68.8%(22/32)]. The differences of the indicators in each group were significant , P<0.05. In the mild group, each index of the pectoralis major medial muscle flap docking method was superior to the lateral muscle flap turnover method, but the treatment results of the two methods in the severe group were opposite. Conclusion:Patients with mild deep DSWI treated with medial pectoralis major muscle flap docking and suture have less hospital stay, less reoperation rate, less complications and better treatment effect than reverse lateral pectoralis major muscle flap turnover. But the two treatments in the severe DSWI have the opposite effect.

OBJECTIVETo investigate the impact of prenatal exposure to diethylstilbestrol (DES) on the specific receptor LGR8 of insulin-like factor 3 (INSL3) in the mouse gubernaculum testis, and that of exoestrogens on descensus testis in mice.

METHODSA total of 120 pregnant KM mice aged 8 to 10 weeks were assigned to a normal, a blank control and 4 DES groups of equal number, the blank controls injected subcutaneously with dimethyl sulfoxide plus normal saline, and the DES groups with DES at 0.1, 1, 10 and 100 microg/kg body weight, respectively, from embryonic day 9 (ED9) through ED17. Immunohistochemistry and RT-PCR were used to detect the expressions of LGR8 protein and mRNA in the gubernaculum testis of the ED18 fetuses and PND20 (postnatal day 20) offspring of the mice.

RESULTSHistological analysis showed that the gubernaculum testis of the ED18 fetuses were well developed in both the normal and control groups, with an inner mesenchymal core and muscular outer layer. In contrast, the gubernaculum testis were poorly developed in the experimental groups, morphologically abnormal and without visible dividing line between the mesenchymal tissue and the muscular outer layer. No obvious differences were found in the gubernaculum testis development of the neonates between the normal and experimental groups. Positive immunostaining was seen in the mesenchymal core and muscular outer layer, but mainly in the latter. The expression of LGR8 was weaker in the experimental groups than in the normal group (P < 0.05), but that of LGR8 mRNA was increased in the high-dose (10 and 100 microg/kg) DES groups (P < 0.05). No obvious mutations were observed in the PCR products in any of the experimental groups.

CONCLUSIONPrenatal exposure to diethylstilbestrol affected the expression of LGR8 mRNA in the mouse gubernaculum testis, which suggests that diethylstilbestrol may induce cryptorchidism by interfering with the INSL3-LGR8 signaling system and consequently the development of the gubernaculum testis.

Animals ; Diethylstilbestrol ; pharmacology ; Female ; Male ; Mice ; Mice, Inbred Strains ; Pregnancy ; Receptors, G-Protein-Coupled ; metabolism ; Testis ; drug effects ; embryology ; metabolism

Objective To investigate the effects of three-dimensional(3D)screws and circular plates on the biomechanical stability of Sanders ABⅢ calcaneal fractures.Methods Calcaneal computed tomography(CT)and magnetic resonance imaging(MRI)data from a 26-year-old volunteer were collected to establish a 3D finite element model of Sanders ⅢAB calcaneal fracture fixed with 3D screws and circular plates.A longitudinal load of 700 N was applied to compare the variations in the stress,displacement of the bone block,and internal fixation in the different models.Results Under 700 N longitudinal loads,the maximum displacement of the bone block and the maximum stress of the bone block and internal fixation were concentrated at the intersection of the posterior talar articular plane internal fixation and fracture line.The overall displacements of the bone blocks in the 3D screw and circular plate models were similar.Compared with the circular plate model,the maximum and average stresses of the bone block and internal fixation in the 3D screw model were lower,and the displacement and stress changes of the 3D screw model were closer to those of the complete calcaneal bone model.Conclusions In the fixation of Sanders ⅢAB calcaneal fractures,both 3D screw and circular plate fixation method can provide good stability.The biomechanical properties of the 3D screws were better than those of the circular plates,which is consistent with the biomechanical characteristics.

Objective To investigate the effect of medial collateral ligament (MCL) repair and coronoid process fracture fixation on stability of the Terrible Triad of the elbow. Methods CT and MRI scan images of elbow joints from one healthy 28-year-old male volunteer were used to establish three elbow models. Model A: normal model. Model B: repair of coronoid process fractures, without MCL repair. Model C: repair of MCL, without repair of ulnar coronoid processes. Longitudinal loads were applied on the three models to analyze the displacement and stress distributions of the elbow joint under different working conditions and compare the stability of the elbow joint. Results The displacement and stress distributions of the three models were similar. The maximum displacement and maximum stress of the articular surface were located at the ulna pulley notch, while the minimum displacement was located at the coronoid process and its medial side. The minimum stress was located at the lower lateral side of the coronoid process. There were no statistical differences in the maximum displacement and stress among the three models (P>0.05). Conclusions When the lateral column is stable, the effect of repairing the MCL and fixing the fracture block of ulnar coronoid process is similar.