Objective Through the optical microscopic observation to investigate the pathological influence of topical oxygen therapy on wounds of rats' muscles in hot and humid environment. Method The rat traumatic models were established. Twenty-four rats were randomly divided into four groups, including normal envi-ronment comparison group (NEC group, n=6), normal environment oxygen therapy group (NEO group, n=6). hot and humid environment comparison group (HHE group, n=6), hot and humid environment oxygen therapy group (HHO group, n=6).Then all rats were sampled to observe the changes of rats' muscle under optical microscope. Results Pathologic histology of muscle cells were obviously changed in HHE group. In these rats. disorganized myofibrillae with some loss of myofilaments. The damage of the muscle fibers in HHO group were better than that in HHE group. The damage of muscle ceils in NEC group were slighter than that in HHE group, the muscle of rats in NEO group are all normal. Conclusion In hot and humid en-vironment pathologic histology changes of wounds were serious, topical oxygen therapy could relieve muscle tissue ultrastructures change.

Objective To investigate the effects of nitric oxide (NO) and cholecystokinin (CCK) on the regulation of the motility of sphincter of Oddi (SO).Methods The basal pressure,action rate and contraction range of the SO were examined before and after the injection of CCK,sodium nitroprusside (SNP) and NG-nitroL-argininemethyl ester hydrochloride (L-NAME).The expression of neurons with positive expression of NO synthase was detected by immunohistochemical staining.The measurement data were analyzed by using the t test.Results The basal pressure,contraction rate and contraction range of the SO were (27 + 10)mm Hg (1 mm Hg =0.133 kPa),( 10 ± 3 ) times/minute and (32 + 8 ) mm Hg before injection of CCK,and (61 + 14) mm Hg,(64 +21 ) times/minute,(44 ± 15 ) mm Hg after injection of CCK of 20 ng/kg.After injection of CCK of 100 ng/kg,the basal pressure,contraction range and contraction rate of the SO were (77 ± 31 )mm Hg,(69 ± 18 ) times/minutes,(79 + 14) mm Hg when the inhibition effect of CCK reached peak,and were ( 140 ± 21 ) mm Hg,( 129 ± 25 )times/minutes,( 173 ± 63 ) mm Hg when the excitatory effect of CCK reached peak.After injection of SNP into the common bile duct,the basal pressure,contraction range and contraction rate of the SO decreased significantly ( t =3.706,5.183,P ＜ 0.05),while the 3 indexes increased significantly after injection of SNP (t =5.859,3.588,P ＜O.05).Conclusion Different from physiological dose (20 ng/kg) of CCK,large dose of CCK enhances motility of SO intensively.NO relaxes SO,which may play an important role in the inhibitor pathway of CCK.

BACKGROUND: 5-azacytidine (5-Aza) has been frequently used to induce bone marrow mesenchymal stem cells (BMSCs)differentiation into cardiomyocyte.OBJECTIVE: To observe expression of cardiomyocyte-related receptors in cardiomyogenic differentiation of rat BMSCs.METHODS: BMSCs of passage three were assigned to four groups: group Ⅰ: L-DMEM solution alone was replaced; Ⅱ:L-DMEM solution was replaced after induction of 100 mg/L AST+5 μmol/L 5-Aza for 24 hours; group Ⅲ: L-DMEM solution wasreplaced after induction of 10 μmol/L 5-Aza for 24 hours; and group Ⅳ: L-DMEM solution was replaced after induction of 5 μmol/L5-Aza for 24 hours. Culture medium was replaced every 3 days in each group. Differentiated cells were identified after 30 days ofinduction.RESULTS AND CONCLUSION: Expression of cardiomyocyte specific proteins Nkx2.5, cTnT and Desmin was detected in groupsⅢ, Ⅳ and Ⅱ after induction compared with group Ⅰ , with significant differences (P < 0.01). The amount of cTnT and Desminexpression expression was significantly higher in groups Ⅱ and Ⅲ compared with group Ⅳ (P < 0.01). The level of Nkx2.5expression was significantly higher in groups Ⅱ (P < 0.01) and Ⅲ (P < 0.05) compared with group Ⅳ. No Nkx2.5, cTnT andDesmin espression was detected in group Ⅰ. After induction for 2 weeks, cells with spontaneous contractility were observed ingroups Ⅱ and Ⅲ, indicating differentiation towards cardiomyocyte after induction. Results demonstrated that induction effectswere similar between 100 mg/L AST+5 μmol/L 5-Aza and 10 μmol/L 5-Aza. This may contribute to cytoprotective effects of AST,which can promote vascular endothelial cell proliferation, enhance celss tolerance to 5-Aza-induced cytotoxicity and upregulatecardiac-specific protein expression.

Objective To determine the diagnostic value and necessity of excretory phase of CT urogrphy (CTU). Methods One hundred and one cases with 197 sides of cohort CTU studies were enrolled from PACS system retrospectively, and 44 cases had the records of radiation dosage. Three different seniority senior radiologists reviewed the images and diagnosed 2 times blindly with the clinical information. At the first time, plane scan, contrast enhanced renal cortical phase and renal parenchymal phase images (Diag. A) were reviewed. At the second time, with 3 kinds of images mentioned above plus excretive phase images (Diag. B) were reviewed, with interval of 3 months between the two reviews. With Diag. B as reference standard, accordance rate of diagnoses of Diag. A was calculated. The difference of the 3 rediologists's accordance rates were analyzed with Chi-square test, and the lesions with accordance rate ≤80% were recorded. The cases of 197 urinary tracts were divided into 4 groups: lesions of renal pelvic and ureter, lesions of bladder, lesions of kidney and extra-urinary tract, without lesion. The filling of contrast media in the urinary tract was recorded with 5-scale scoring system. The differences of the urinary tract filling among the 4 groups were analyzed with Kruskal-Wallis test. The effective radiation dosages of CTU with and without excretory phase scan were recorded and calculated, and the difference was analyzed with t test. Result The diagnostic accordance rate of CTU with and without excretory phase of the 3 radiologists was 95.4%(188/197), 93.9%(185/197), 92.4%(182/197)respectively(χ2=1.60, P>0.05). Lesions with diagnostic rate≤80%were parapelvic cyst and caliceal diverticulum. The median score of urinary tracts filling in the lesions of renal pelvic and ureter, lesions of bladder, lesions of kidney and extra-urinary tract, without lesion group were 2, 3, 3, 4, and the differences were significant (HC=31.7, P<0.05). The effective radiation dosages of CTU with and without excretory phase scan were (32.36±11.04)mSv and (41.47±14.27) mSv respectively (t=3.35, P<0.01). Conclusions No significant effect of excretive phase imaging is found on the diagnosis of most urinary system diseases. Poor contrast filling and high rate of failure of filling of the urinary tract with intra luminal pathologies, and increase of the radiation dosage make the excretory phase scan in CTU less useful and it should be used carefully and selectively.

OBJECTIVE: To retrospectively evaluate the effect of locking compression plate (LCP) combined with scaled cancellous bone graft on postoperative nonunion of humeral shaft fracture. METHODS: A total of 19 cases with postoperative nonunion of humeral shaft fracture were collected from Department of Orthopaedics, Affiliated Hospital, Xiangnan University between August 2005 and January 2009. There were 12 males and 7 females, aging 28-59 years with the mean age of 36 years. All patients were treated with LCP fixation combined with scaled cancellous bone graft. The key points of the operation were as follows: beck-median or lateral approach, protection of the radial nerve and ulnar nerve, removal of the cicatrix, reopening of humeral canal, and limited periosteum striping. For minimally invasive plate osteosynthesis technique, length of LCP was appropriate, 3-4 locking screws at least were used on either stump, and double cortices were penetrated with locking screws and treated with scaled cancellous bone graft. RESULTS: All the fractures healed with a mean period of 7.2 months (from 6 to 8 months). Two cases showed temporary radial nerve palsy after the operation, which gradually recovered 3 and 6 weeks, respectively after appropriate treatment. Shoulder and elbow functions were somewhat impaired in 7 cases, but the dysfunction could not influence daily living. Infection, screw loosening, blade plate breakage, and other complications were not found. CONCLUSION:The integrity of locking screws and plate prevents screw breakage and plate loosening. The combination of autoallergic cancellous bone graft and scaled decorticating technique can improve healing of humeral shaft fracture.

BACKGROUND: As it results in minimal trauma and physical influence or interference, and a better curative effect, the minimally invasive surgery is preferred in clinic. However, the perioperative stress reaction of minimally invasive surgery needs further study.OBJECTIVE: To evaluate the levels of neurohormone, C-reactive protein (CRP) and the changes of resting energy expenditure (REE) resulted from the operative stress reaction due to minimally invasive surgery in arthroscopy on knee joint.DESIGN: Controlled observation and analysis.SETTING: Department of Orthopaedics, Affiliated Hospital of Xiangnan University and Department of Orthopaedics,Xiangya Hospital of Central South University.PARTICIPANTS: Sixteen patients with meniscal lesions in knee and 26 with cruciate ligament injury, which were closed injury, were selected from the Department of Orthopaedics of Affiliated Hospital of Xiangnan University and Xiangya Hospital of Central South University between January 2003 and April 2004. Meniscal lesions were diagnosed according to the physical examination, drawer test combined CT and MRI examination, and the patients were in accordance with the indication of arthrotomy; cruciate ligament injury according to the physical examination, grinding test combined CT and MRI examination. Those with open injury, body multiple injury, combined injury and emergency operation were excluded. Ten patients with meniscal lesions and 12 with cruciate ligament injuries underwent minimally invasive surgery on knee joint as minimally invasive surgery group (MIS). The others were given traditionally invasive surgery on knee joint as the traditional group. The informed consent was obtained from the patients.METHODS: Fasting venous blood was taken on the morning of 1 day before, and 1 and 3 days after operation, which was analyzed within 2 hours after sampling. ①All hormones were quantitatively assayed. Serum insulin was determined by competitive radioimmunoassay (RIA); growth hormones levels by double-antibody RIA; serum cortisol by competitive RIA; CRP by nephelometry, respectively. ②Energy metabolism detection: The energy consumption was assessed by indirect calorimeter on the morning of 1 day before, 1 day and 3 day after operation, respectively. All the detection was performed by medical graphics critical care monitor desktop analysis system. Based on the indirect calorimeter theory,REE and respiratory quotient (RQ) were figured out.MAIN OUTCOME MEASURES: ①Concentrations of insulin, growth hormones and cortisol of patients at 1 day before, 1 day and 3 day after operation; ②Resting energy consumption, RQ and CRP of patients at 1 day before, 1 day and 3 day after operation.RESULTS: Totally 42 patients were involved in the result analysis. ①On the third postoperative day, the insulin levels of the traditional group were lower than those before operation [(12.4±1.1), (17.5±2.2) mlU/L, P ＜ 0.05]; On the first postoperative day, the levels of growth hormone of the traditional group were significantly higher than the MIS group [(2.8±0.9), (5.3±2.4) μg/L, P ＜ 0.05], and on the third day after operation, the levels of the MIS group were remarkably increased compared with those before operation [(1.4±0.5), (1.0±0.3) μg/L, P ＜ 0.05]; the cortisol levels of the traditional group on the first postoperative day were higher than the MIS group [(1.12±0.25), (0.59±0.11) μmol/L, P ＜ 0.05]. ②REE levels of the traditional group and MIS group on the first day after operation were(1437.8±415.9) and (1223.8±179.9) K,higher than those before operation [(1 186.4±297.4), (1 160.7±158.6) K, P ＜ 0.05]; on the first and third days after operation, REE levels of the MIS group were higher than the traditional group [(1 223.8±179.9), (1 151.7±150.8) K;(1 437.8±415.9), (1 329.4±350.5) K, P ＜ 0.05]. ③RQ of the traditional group and MIS group on day 1 after operation were all (0.8±0.05), lower than that before operation (0.9±0.11, 0.9±0.15, P ＜ 0.05). ④On the first and third days after operation, CRP of the MIS group were lower than the traditional group [(14.8±2.5), (34.37±7.5) mg/L; (64.1±14.4),(93.87±12.7) mg/L, P ＜ 0.05], but higher than that before operation [(8.0±0.11) mg/L, P ＜ 0.05].CONCLUSION: Minimally invasive surgery on knee joint results in less trauma, low stress reaction and slight influence on metabolism of patients, moreover, it benefits the restoration of stress hormones, nitrogen balance and energy metabolism.

Objective To investigate the micro-vessel density and vascular endothelial growth factor receptor 2 (VEGFR2) expression in mucosa and submucosa tissue of the patients with hemorrhoids. Methods Sixty hemorrhoids patients were randomly recruited and involved into experiment group and 20 cases of normal patients involved in control group. RASP, MASP, RSTV, RMTV, Expression of VEGFR2 and microvessel density in two groups were detected by immunohistochemistry. The expression abundance of VEGFR2 mRNA was detected by RT-PCR. Results Excessive angiogenesis was found in hemorrhoids tissue (5.59 ± 0.98) in experiment group as compared with that in control group (3.92 ± 0.81), the difference was statistically significant (P < 0.05). Staining score of hemorrhoid tissue and the control tissue were 5.95 ± 1.01, 2.32 ± 0.72, respectively (P < 0.05). Abundance of VEGFR2 mRNA expression in hemorrhoid tissue was significantly higher than that in control tissue (P < 0.05). Conclusion VEGFR2 plays an important role in angiogenesis during the development of hemorrhoids, which may be closely related to the occurrence of hemorrhoid disease and clinical symptoms.

This study was aimed to explore pharmacological effects of epimedium pubescen flavonoid (EPF) on biomechanical properties among ovariectomized rats. Sixty female Sprague-Dawley (SD) rats (aged 2-month-old) were randomly divided into six groups (n = 10), which were the sham control group (Group A), the model group (GroupB), the standard group (Group C), the treated 1 group (Group D), the treated 2 group (Group E), and the treated 3 group (Group F). Except the sham control group (Group A), rats in other groups had been ovariectomized. All rats were given the same feedstuff. Meanwhile, Group C was given calcium 75 mg·kg-1 combined with VitD3 21 IU·kg-1 by gastrogavage every day for 4 months; Group D was given EPF 75 mg·kg-1; Group E was given EPF 150 mg·kg-1;Group F was given EPF 300 mg·kg-1. At the end of the 4th month, all rats were sacrificed. Bones, which included tibia, femur and humerus of both sides and all lumbar vertebra bodies, had been taken out. Measurement was made on the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of biomechanical properties of the fourth lumbar vertebra body (LV4); the maximum loading capability, bone break load, potential energy of deformation, structural rigidity of the structural dynamics properties of the femur com-pact bone; the elastic modulus, maximum stress, maximum inherent strain, bone break stress, and bone break strain of the mechanical properties of a material of the femur compact bone in the experimental rats. The results showed that compared with Group B, the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of LV4; the maximum loading capability, bone break load, potential energy of de-formation, structural rigidity of the structural dynamics properties of the femur compact bone; the elastic modulus, maximum stress, maximum inherent strain, and bone break strain of the mechanical properties of a material of the fe-mur compact bone were obviously increased in Group A, D, E and F (P< 0.05). Group C had increasing tendency. There were no statistical differences among Group A, C, D, E and F. Group D, E, and F had increased with EPF dose-dependently. However, there were no statistical differences among them. There were no statistical differences on bone break strain of the mechanical properties of a material of the femur compact bone among Group A, C, D, E, and F. It showed that ovariectomization reduced the biomechanical properties of vertebra bodies, structural dynamics properties of the femur compact bone, and the mechanical properties of a material of the femur compact bone. The application of EPF can effectively prevent and treat the decreasing of biomechanical properties of ovariectomized rats, so as to keep them in a relatively higher level.

Objective To investigate the efficacy and safety of low-dose and standard-dose intravenous alteplase for acute ischemic stroke. Methods The patients with acute ischemic stroke treated with intravenous alteplase from August 2012 to January 2016 were analyzed retrospectively. According to the dosage of the drug, the patients were divided into either a low-dose group (0. 6-0. 8 mg/kg) or a standard-dose group (0. 9 mg/kg). The efficacy was evaluated with the modified Rankin Scale (mRS) at 90 days, and a favorable functional outcome was defined as mRS 0-1. The safety was evaluated by the mortality at 90 days and the incidence of symptomatic intracerebral hemorrhage (SICH) within 7 d after onset. Results A total of 790 patients were enrolled, including 612 in the low-dose group and 178 in the standard-dose group. There was no significant difference in each baseline clinical data between the 2 groups. Compared with the standard-dose group, there was no significant difference in the good outcome rate of the small-dose group at day 90 (35. 6% vs. 37. 6% ; χ2 = 0. 872, P = 0. 35) and mortality (5. 1% vs. 6. 2% ;χ2 = 2. 173, P = 0. 14), but the incidence of SICH was significantly lower (1. 8% vs. 5. 1% ; χ2 = 5. 875, P =0. 015). Conclusion The efficacy of low-dose intravenous alteplase for acute ischemic stroke is equivalent to the standard-dose and the safety is better.

Objective To investigate the effects of gambogic acid on proliferation,invasion and protein expression of MMP-2 in LoVo human colon cancer cell line.Methods The CCK-8 assay was used to determine the anti-proliferation ability.Transwell chamber assay was used to study the invasion of LoVo colon cancer cells.Western Blot was applied to examine the protein expression of MMP-2.Results CCK-8 assay showed that after cells treated with 1,2,4 μmol/L GA for 24 h,48 h the inhibition rates were(0.16±0.11)％,(0.24±0.08)％,(0.58±0.01)％,(0.67±0.03)％,(0.79±0.01)％ and (0.27±0.05)％,(0.69±0.09)％,(0.85±0.01)％,(0.87±0.01)％,(0.89±0.01)％,and there had statistically significant differences between control group (0 μmo/L) with experimental group (P＜0.05).Gambogic acid can effectively inhibit LoVo cells invasion at a low-dose concentration,which the numbers of cells that digested the matrigel in control group (0 μmo/L)was 120.50± 8.69 and 69.83 ±4.75 in experimental group (1 μnol/L),P＜ 0.05).Western Blot revealed that Gambogic acid can down-regulate the expression of MMP-2,which the levels of down-regulating the expression of MMP-2 after treated with 1,2,4 umol/L GA were 48.67％,74.72％and 82.70％ (P＜0.05) Conclusion Gambogic acid can effectively inhibit the growth and invasion of the LoVo cells,which may be related with down-regulating the expression of MMP-2.