Objective To evaluate development of postoperative complications of calcanens fracture by employing Evidence-based medicine method so as to provide basis for clinical treatment strategy. Methods Eligible literatures on surgical treatment of calcalneus fractures from 1989 to 2008 were retrieved through Medline, Cochrane Database, Embase Database and Science Direct. The retrieved literatures were organized and analyzed by using SPSS14.0 and RevMan5 software. Results A total of 1823 literatures on calcaneus fractures were originally obtained based on preset retrieval conditions. With screening and evaluation, 29 clinical reports involving 2 661 patients (2 800 feet) met the criteria of meta-analysis. The results of recta-analysis indicated that the incidence rates (IR) and confidence interval (CI) of the complications that included infection (IC =8.6%, 95% CI =7.53-9.61), wound-edge necrosis (IC =2.6%, 95% CI =2.05-3.24), subtalar arthritis (IC =2.0%, 95% CI = 1.42-2.44), peroneal tendinitis (IC = 1.3% , 95% CI = 0.84-1.66), vascular or nerve damage (IC = 1.2%, 95% CI 0.81-1.62), osteotitis of calcaneus (IC = 1.0% ,95% CI 0. 60-1.33), non-union (IC =0.2%, 95% CI = 0. 04-0. 39) , malreduetion (IC = 0. 1%) and painful implants (IC = 0.7% , 95% CI = 0.4-1.03) respectively. Conclusion The postoperative complications of calcaneus fracture are common clinical problems, to which professional care without delay can attain satisfactory outcome.

Objective To evaluate the inhibitory effect of mesenchymal stem cells (MSCs) in lesions of patients with psoriasis on T lymphocyte proliferation.Methods Tissue specimens were obtained from the lesions of 15 patients with psoriasis vulgaris (7 at progressive stage and 8 at resting stage) and normal skin of 15 human controls from the Department of Urology and Plastic Surgery,Taiyuan City Centre Hospital.MSCs were isolated from these skin specimens,cultured,and identified using flow cytometry and in vitro differentiation assay.Enzyme-linked immunosorbent assay (ELISA) was performed to detect the concentration of interleukin (IL)-6,IL-1 1,hepatocyte growth factor (HGF) and transforming growth factor (TGF)-β1 in the culture supernatant of third-passage MSCs.Peripheral blood T cells were obtained from a healthy adult and cocultured with the third-passage MSCs for four days.Then,cells were counted and methyl thiazolyl tetrazolium (MTT) assay was conducted to evaluate the proliferation of T cells.One-way analysis of variance (ANOVA) and Student-Newman-Keuls (SNK) test were carried out to compare the proliferation of T lymphocytes,and two independent samples t test to compare the concentrations of cytokines.Results Inverted microscopy revealed that the patient-and control-derived MSCs shared similar morphological properties and multi-directional differentiation capacity,along with the expression of CD29,CD44,CD73,CD90 and CD105,but absence of CD34,CD45 and HLA-DR on cell surface.After coculture with MSCs from the patients and controls for four days,the count of T lymphocytes per milliliter was (1.67 ± 0.34) × 105 and (1.04 ± 0.29) × 105 respectively (P＜ 0.01),and the proliferative activity (expressed as absorbence at 492 nm)was 0.317 ± 0.021 and 0.275 ± 0.007 respectively (P ＜ 0.01).Compared with the control-derived MSCs,the patient-derived MSCs showed a significantly higher level of IL-1 1 ((181.37 ± 31.74) vs.(130.07 ± 29.20) ng/L,t =5.32,P ＜ 0.01),but a lower level of lL-6 ((61.67±17.53) vs.(76.74±18.96) ng/L,t=2.61,P＜0.05)and HGF ((319.24 ± 41.03) vs.(352.35 ± 51.47) ng/L,t =2.25,P＜ 0.05),as well as a similar level of TFG-β1,in the culture supernatant.Conclusions The inhibitory effect of MSCs in psoriatic lesions on T lymphocyte proliferation is diminished,which may contribute to the pathogenesis of psoriasis.

Objective To study the characteristics of its pathologic and neurophysiologic changes of a ani-mal model of cervical spinal cord compression, and to explore the relationship between the severity of spinal cord inju-ry and its functions. Methods Thirty-two rabbits were divided into 4 groups randomly. A catheter was inserted intothe vertebral canal and a balloon was inflated to compress spinal cord in epidural space. According to the diameter ofballoon, the animals were divided into 4 groups (A, B, C, D group), Each group consisted of 8 rabbits. The corti-cal somatosensory evoked potential (CSEP) and motor evoked potential (MEP) were used to assess neurologicalfunction. Motor function behavior was scored before and on 1, 3, 7 and 14 days after surgery. Histological observa-tions were performed, pathological changes were observed by light and electron microscope. Results Spinal cordcompression resulted in a gradual increase of the peak latency and significant decrease of the peak amplitude. The la-tency and amplitude of MEP were changed more dramatically than those of CSEP. The result indicated that MEP wasmore sensitive than CSEP to the compression. Analysis also revealed that the severer the pathologic changes, the lon-ger the latency and the lower the amplitude of the evoked potentials. Conclusion The animal model presented inthis paper was simple and standardized. Evoked potentials as a noninvasive technique have great value in monitoringspinal cord function. The variance of amplitude and the latency in significantly correlate with the degree of compres-sion of the spinal cord.

AIM: To study the alterations of heme oxygenase-1 mRNA in vascular smooth muscle cells(VSMC) induced by lipopolysaccharide(LPS) and the role of heme oxygenase(HO)/carbon monoxide(CO)pathway in the disorders of regulation of cardiovascular system by LPS. METHODS: LPS (final concentrations 10 mg/L,30 mg/L and 50 mg/L) was added in cultured VSMCs for 6 h respectively or 10 mg/L LPS for 9 h and 18 h. MDA content, LDH release and the rate of trypan blue uptake of VSMC were measured. HO-1 mRNA expression was examined by Northern Blot. RESULTS: VSMC HO-1 mRNA expression was increased gradually with the increasing of LPS concentration. When final concentration of LPS was 50 mg/L, the HO-1 mRNA expression of VSMC was increased by 176.7% compared with control. When LPS final concentration was 10 mg/L, the HO-1 mRNA expression increased gradually along with the culture time. When cultured for 18 h, the HO-1 mRNA expression of VSMC was increased by 195.6% compared with control. Only at LPS 50 mg/L for 6 h and 10 mg/L for 18 h, the rate of trypan blue uptake，MDA content and LDH release were significantly increased. CONCLUSION: LPS can induce the HO-1 mRNA expression of VSMC and that were dose-dependent and time-dependent. The inducible HO may play an important role in the pathogenesis of vascular system under LPS.

OBJECTIVETo observe and compare the effects of two kinds of lung recruitment maneuvers, namely sustained inflation (SI) and incremental positive end-expiratory pressure (PEEP) (IP) on oxygenation, respiratory mechanics, and hemodynamics of dogs with severe smoke inhalation injury.

METHODSAfter being treated with conventional mechanical ventilation, 12 dogs were inflicted with severe smoke inhalation injury. They were divided into group SI and group IP according to the random number table, with 6 dogs in each group. Dogs in group SI were subjected to continuous positive airway pressure ventilation, with inspiratory pressure of 25 cmH2O (1 cmH2o = 0. 098 kPa), and it was sustained for 20 s. PEEP level in group IP was gradually increased by 5 cmH2O every 5 min up to 25 cmH2O, and then it was decreased by 5 cmH2O every 5 min until reaching 2-3 cmH2O. Then the previous ventilation mode was resumed in both groups for 8 hours. Blood gas analysis (pH value, PaO2, and PaCO2), oxygenation index (OI), respiratory mechanics parameters [peak inspiratory pressure (PIP), mean airway pressure, and dynamic lung compliance], and hemodynamic parameters [heart rate, mean arterial pressure (MAP), pulmonary arterial pressure (PAP), and cardiac output (CO)] were recorded or calculated before injury, immediately after injury, and at post ventilation hour (PVH) 2, 4, 6, 8. Data were processed with analysis of variance of repeated measurement and LSD-t test.

RESULTS(1) At PVH 6 and 8, pH values of dogs in group SI were significantly lower than those in group IP (with t values respectively 2. 431 and 2. 261, P values below 0.05); PaO2 levels in group SI [(87 ± 24), (78 ± 14) mmHg, 1 mmHg =0. 133 kPa] were lower than those in group IP [ (114 ± 18) , (111 ± 17) mmHg, with t values respectively 2. 249 and 3.671, P <0.05 or P <0.01]; OI values in group SI were significantly higher than those in group IP (with t values respectively 2.363 and 5.010, P <0.05 or P <0.01). No significant differences were observed in PaCO2 level within each group or between the two groups (with t values from 0. 119 to 1. 042, P values above 0.05). Compared with those observed immediately after injury, the pH values were significantly lowered (except for dogs in group IP at PVH 6 and 8, with t values from 2.292 to 3.222, P <0.05 or P <0.01), PaO2 levels were significantly elevated (with t values from 4. 443 to 6.315, P <0.05 or P <0.01), and OI values were significantly lowered (with t values from 2.773 to 9.789, P <0.05 orP <0.01) in both groups at all the treatment time points. (2) The PIP level at each time point showed no significant differences between two groups (with t values from 0. 399 to 1. 167, P values above 0. 05). At PVH 4 and 8, the mean airway .pressure values of dogs in group SI were significantly higher than those in group IP (with t values respectively 1.926 and 1. 190, P values below 0.05). At PVH 4, 6, and 8, the dynamic lung compliance levels of dogs in group SI [(9.5 ± 1.9), (12.8 ± 2. 1), (13. 1 ± 1.8) mL/cmH2O] were significantly lower than those in group IP [(11.6 ± 1.2), (15.4 ± 1.8), (14.9 ± 0.8) mL/cmH2O], with t values respectively 2. 289, 2. 303, 2. 238, P values below 0.05. Compared with those observed immediately after injury, PIP and the mean airway pressure values of dogs in two groups were significantly lowered at each treatment time point (with t values from 2. 271 to 7. 436, P <0. 05 or P < 0.01); the dynamic lung compliance levels were significantly elevated in both groups at PVH 6 and 8 (with t values from 2. 207 to 4. 195, P < 0.05 or P <0.01). (3) Heart rate, MAP, and PAP levels at each time point between two groups showed no significant differences (with t values from 0. 001 to 1. 170, P values above 0. 05). At PVH 4, 6, and 8, CO levels in group IP [(0. 6 + 0. 3), (0. 6 + 0. 4), (0. 5 + 0. 7) L/min] were significantly lower than those in group SI [(1.5 0.7), (1.8 + 1.1), (1.6 +0.9) L/min], with t values respectively 3. 028, 2.511, 2.363, P values below 0.05. Compared with that observed immediately after injury, CO level in group IP was significantly lowered at PVH 4, 6, or 8 (with t values respectively 2. 363, 2. 302, 2. 254, P values below 0. 05).

CONCLUSIONSBoth lung recruitment maneuvers can effectively improve oxygenation and lung compliance of dogs with severe smoke inhalation injury. IP is more effective in improving lung compliance, while SI shows less impact on the hemodynamic parameters.

Animals ; Blood Gas Analysis ; veterinary ; Dogs ; Hemodynamics ; Lung Compliance ; physiology ; Oxygen ; blood ; Oxygen Consumption ; physiology ; Positive-Pressure Respiration ; methods ; Respiration, Artificial ; Respiratory Mechanics ; Severity of Illness Index ; Smoke ; adverse effects ; Smoke Inhalation Injury ; physiopathology ; therapy

AIM: To study the alterations of heme oxygenase-1 mRNA in vascular smooth muscle cells(VSMC) induced by lipopolysaccharide(LPS) and the role of heme oxygenase(HO)/carbon monoxide(CO)pathway in the disorders of regulation of cardiovascular system by LPS. METHODS: LPS (final concentrations 10 mg/L,30 mg/L and 50 mg/L) was added in cultured VSMCs for 6 h respectively or 10 mg/L LPS for 9 h and 18 h. MDA content, LDH release and the rate of trypan blue uptake of VSMC were measured. HO-1 mRNA expression was examined by Northern Blot. RESULTS: VSMC HO-1 mRNA expression was increased gradually with the increasing of LPS concentration. When final concentration of LPS was 50 mg/L, the HO-1 mRNA expression of VSMC was increased by 176.7% compared with control. When LPS final concentration was 10 mg/L, the HO-1 mRNA expression increased gradually along with the culture time. When cultured for 18 h, the HO-1 mRNA expression of VSMC was increased by 195.6% compared with control. Only at LPS 50 mg/L for 6 h and 10 mg/L for 18 h, the rate of trypan blue uptake,MDA content and LDH release were significantly increased. CONCLUSION: LPS can induce the HO-1 mRNA expression of VSMC and that were dose-dependent and time-dependent. The inducible HO may play an important role in the pathogenesis of vascular system under LPS. [

Aim To compare the inhibition of lipid peroxidation of ethyl acetate extract( EAE) and n-buta-nol( BE) extract from Coreopsis tinctoria Nutt. in vitro. To investigate the parameters such as body weight, bio-chemical indexes in plasma, and viscera indexes on type 2 diabetes mice by intraperitoneal injection of streptozotocin ( STZ ) . Methods The extracts were prepared by response surface methodology. The ex-tracts were suspended in distilled water and defatted with petroleum ether. The aqueous layer was succes-sively extracted with ethyl acetate and n-butanol. The inhibition of lipid peroxidation activity was determined by thiobarbituric acid method. The effects of extract BE on diabetic mice were observed at the dosage of 0. 2,0. 4,0. 8 g·kg-1 ( ig) for 4 weeks. The parame-ters were observed such as weight of body changes, or-gan coefficients of liver, pancreas and kidney, bio-chemical indexes in plasma and viscera pathological sections. Results In the linoleic acid reaction system, the SC50 value of the EAE and BE was ( 443. 96 ± 11. 24) mg·L-1, (840. 29 ± 16. 38) mg·L-1, re-spectively, and that in rat liver homogenate was (23. 59 ± 3. 67 ) mg · L-1 , ( 60. 37 ± 4. 27 ) mg · L-1 , respectively. Compared with diabetic model group, BE could significantly improve the trend of weight loss, and increase viscera indexes. The patho-logical sections showed that BE had the recovery and improvement effects on the damage of liver, pancreas and kidney. Conclusions The extracts of C. tinctoria have a certain anti-lipid peroxidation activity in vitro. And BE has a certain capacity to improve and repair damaged organs for DM mice.

Objective To evaluate the functional features of motor function area in patients with meningioma by blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods fMRI were obtained from 10 patients who suffered from meningioma which was adjacent to the motor function cortex.Probabilistic independent component analysis method was used for data analysis.Preoperative and postoperative line Karnofsky Performance Scale (KPS)score was used to assess the patient’s condition.Re-sults Contralateral primary motor cortex and the supplementary motor cortex motor functions were observed in all the activation clusters,in which one side activation area compared with the contralateral activation zone was symmetrical in 6 cases,and significant shift in 4 cases.In 4 patients with the movement function activated,tumor extrusion function shift forward or backwardwith tensile deforma-tion were found.Conclusion BOLD-fMRI imaging technology can effectively locate motor functional area for patients with meningi-oma,which can provide preoperative surgical planning.

Objective To explore the efficacy and safety of 980 nm diode laser therapy for treatment of benign prostatic hyperplasia (BPH). Methods Data of 170 patients with BPH treated with 980nm diode laser system were reviewed. The mean operative time, blood loss, surgical complications, the international prostate symptom score (IPSS), bladder residual urine volume and flow rate changes were collected and analyzed. Results One hundred and seventy cases were safe during the perioperative period. The average operation time was (74 ± 11) min, surgical removal of prostate tissue mass of (54±12) g, blood loss (72±11) ml. There was no TUR syndrome occurred. 170 patients were followed up 2 to 24 months. The IPSS decreased from preoperative 25.0±5.5 to 9.0±2.5. The maximum flow rate increased from preoperative (6.2±2.3)ml/s to post-operative (17.4±3.5) ml/s. The residual urine volume decreased from preoperative (210.0±25.6) ml to postoperative (25.2±4.6) ml. All the differences were statistically significant (P＜0.05). Conclusion Transurethral vaporization of 980 nm diode laser could be a safe and effective treatment modality for BPH.