[Objective] To investigate the results and to evaluate the validity of the supracondylar femoral osteotomy and internal fixation for treatment of flexion deformity of the knee joint in adult polio patients.[Methods]From April 2002 to August 2008,141 knees in 127 cases with flexion deformity of knee from poliomyelitis were treated with supracondylar femoral extension osteotomy and internal fixation.They were 14~45 years old with an average of 18.3.Of them,62 knees in 56 cases were male,79 knees in 71 cases were female.Eighty-three cases needed pressing knee on walking.Thirty-five cases walked with a crutch and 9 cases walked with two crutches.It should be treated with soft tissue release and skeletal traction before osteotomy in severe flexion deformity(over 40 degrees).All cases took weight-bearing X-ray films of lower extremities before and after operation.Angle of knee flexion,operative complications,bone healing and final function were recorded.Patients can undertake continuous passive flexion and extension motion from the 2nd day postoperatively.The knee operated was put in 10~20? flexion after operation and extended to full extension gradually in 2 weeks.[Results]All patients felt comfortable after operation and no neurovscular complications and infection happened.Follow-up time was 12-72 months with an average of 18 months.Solid bone union showed in all femoral cutting ends.No mal-union,non-union and implant failure happened.All flexion deformities of knees were corrected.The angle of flexion contracture of knee was from 36.4?(18?～61?)preoperatively to 2.8?(-5?～8?)postoperatively.The amount of correction was 18?to 56?with an average of 32.9?.One hundred and eight patients can walk stably by hinself or with brace,19 cases still need some help for walking(pressing knee in 6 case,one crutch in 10 cases and two crutches in 3 cases)at last follow-up.No ankylosis of knee joint or peroneal nerve paralysis occurred.All cases were satisfying with their range of motion of knee.[Conclusion]Supracondylar femoral osteotomy and rigid internal fixation and early rehabilitation exercise is a safe and effective strategy for the adult flexion deformity of knee joint.

The effects of cyanide poisoning on the contractibility of the cardiac muscle were observed after the dogs were infused intravenously with a lethal dose of NaCN (2.5 mg/kg) within 2 minutes through a cannulated femoral vein. Heart rate (HR) , left ventricular pressure (LVP) , the largest changing rate of LVP (LVP?dp/dtmax), cardiac muscle contractibility (CMC) , the largest changing rate of CMC (CMC?dc/dtmax) , and ECG changes were recorded. It was found that there was an initial excitatory response of cardiac functions in the first minute of NaCN infusion, and then a drastic cardiac failure occurred, which resulted in the rapid death of the dogs within 10 minutes after NaCN administration. The changes of myocardial contractibility were slower than those of .other cardiac parameters, which implies that cyanide can exert an excitation on the myocardium initially. Our results indicate that the effects of cyanide on myocardial contractibility may be one of the important factors to induce serious arrhythmia,which in turn results fatal cardiac failure.

Objective To Observe the adjusting effect of bone morphogenetic protein 4 (BMP4) on cholinergic-expression in embryo rats' neurons. Method Neurons isolated from hippocampus and cerebral cortex of 15-20 days gestational age SD rat's brain were cultivated in a DMEM/F12 medium containing Ara-C and identified with morphological characters and microtubulin associated protein 2 (MAP2 ) immunocytochemical test. The medium was replaced with BMP4 96 hours after Ara-C adding, and cultivated another 10 days. The expression of choline acetyltransferase (ChAT) of the adjusted cells was observed by immunocytochemical staining and FITC-labeled cholinergic nerve cells Flow Cytometry. Results It has been showed that cultured neurons accorded with the typical morphological characters and the immunologic markers of neurons; the percentage of ChAT-positive cells in BMP4 group was prominently higher than that in control group(13.3?1.37% vs 6.44?0.81%, P

Objective To compare the clinical effects of open kinetic chain (OKC) exercises with those of closed kinetic chain (CKC) exercises and limited open kinetic chain combined with closed kinetic chain exercises on rehabilitation after the anterior cruciate ligament reconstruction.Methods Ninety-four patients recovering from single-bundle anterior ligament reconstructions were enrolled and randomly divided into an OKC group (n =33),a CKC group (n =30) or a limited open kinetic chain combined with closed kinetic chain group (combined group) (n =31).Lysholm score,International Knee Documentation Committee (IKDC) score,KT-1000,and active and passive range of motion were evaluated for the 3 groups three and six months after the surgery.Results Three months after surgery,significant differences were found among the 3 groups in Lysholm scores [(87.00±4.79),(83.67± 3.55) and (86.71±3.62) respectively],IKDC scores [(89.45±4.79),(86.40±3.76) and (88.58±3.60) respectively],KT-1000[(1.99±0.30),(1.05±0.26) and (1.02±0.24) mm],as well as active and passive range of motion [(10.06±2.06),(7.73±1.41) and (8.10±1.35) mm;(9.76±2.26),(7.87±1.89) and (8.39±1.62) mm] (P＜ 0.05).Six months after surgery,no significant differences were found in Lysholm scores and IKDC scores(P＞0.05),but significant differences were found in KT-1000,and active and passive range of motion(P＜0.05) compared to those at 3 months after surgery.Moreover,there were no significant differences between the OKC and combined groups in Lysholm scores and IKDC scores(P＞0.05),but significant differences between them in active and passive range of motion (P＜0.05).There were no significant differences between the CKC and combined groups in Lysholm scores,IKDC scores,KT-1000,and active and passive range of motion(P＜0.05).Conclusion Combining limited open kinetic chain exercise with closed kinetic chain exercise is safe and reliable in the rehabilitation after anterior cruciate ligament reconstruction.

Objective To evaluate the effects of different concentrations and different duration of sevoflurane anesthesia on cognitive function in mice.Methods Fifty adult male C57BL/6 mice,weighing 20-24 g,aged 10 weeks,were randomly divided into 5 groups (n =10 each) using a random number table:control group (group C),1.3％ sevoflurane inhaled for0.5 h group (group S1),1.3％ sevoflurane inhaled for 2.0 h group (group S2),2.5％ sevoflurane inhaled for 2.0 h group (group S3),and 2.5％ sevoflurane inhaled for 4.0 h group (group S4).At 2 weeks after anesthesia,Morris water maze test was performed,and the escape latency and frequency of crossing the original platform were recorded.After the end of the test,the mice were sacrificed,and brains were removed to detect the expression of 2B subunit-containing N-methyl-D-aspartate receptors (NR2B) and activated caspase-3 in the hippocampus.Results Compared with group C,the escape latency was significantly shortened,and the frequency of crossing the original platform was increased in S1-3 groups,and the escape latency was prolonged,and no significant change was found in the frequency of crossing the original platform in group S4.Compared with group C,the expression of NR2B in hippocampal tissues was up-regulated in S1-4 groups,and the expression of activated caspase-3 in hippocampal tissues was up-regulated in S3 and S4 groups.Conclusion The reason for different effects of sevoflurane anesthesia on cognitive function is related to the concentration and duration in mice.

Objective:To investigate the training needs of nursing students during their practice in the emergency department, and to provide evidence for further improvement and development of the training.Methods:A total of 279 nursing students from 24 hospitals in Guangdong Province and 4 undergraduate universities running nursing specialty were investigated by convenience sampling. The contents of the questionnaire included general information and emergency training needs, including teaching contents and teaching methods.Results:Among the surveyed nursing students, 97.13% (271 students) believed it was very necessary to learn first aid knowledge and skills, and 85.66% (239 students) were very interested in learning first aid knowledge and skills. The score of "acute and critical skills" in the emergency training needs was the highest (88.91 points), and the score of "department rules and regulations" was the lowest (76.08 points). Univariate analysis showed that there were significant differences in gender, willingness to engage in nursing work in the future, interest in learning first aid knowledge and willingness to learn first aid knowledge independently by network ( P < 0.05). The three teaching methods ranked the highest in the survey of emergency teaching methods were situational teaching, problem-based learning and action teaching method. Conclusion:Nursing students have a strong demand for training during the emergency internship. Clinical nursing administrators and educators should combine the internship demand of nursing students and the teaching outline of medical colleges to carry out the training arrangement during the emergency practice, so as to meet the learning needs of nursing students during the emergency practice.

Objective To investigate the efficacy comparison of endovascular therapy and simple medical therapy for symptomatic intracranial artery stenosis. Methods A total of 145 patients with intracranial artery stenosis were analyzed retrospectively. They were divided into either an endovascular therapy group (n=72) or a medical therapy group (n=73). They were treated with endovascular therapy (gateway balloon,wingspan stents,Apollo stents) or medical therapy (aspirin 100 mg/d,clopidogrel 75mg/d, and atorvastatin 20-40 mg/d) according the willingness of the patients or their family members. The incidences of stroke and transient ischemic attack ( TIA ) , and restenosis rate ( stenosis rate >50% as a standard) during 1-,3-,6-,9-,and 12-month follow-up periods were observed and compared. Results On the basis of medical therapy,the patients of the endovascular therapy group were successfully stented. The success rate of stenting was 98. 6% (70/71). Seven patients had complications in the endovascular therapy group (9.9%),2 of them complicated with hemorrhage(one of was died),drinking cough,hoarseness, dizziness,headache,and excitement were one case in each, the other patients were cured and discharged with active medical treatment, and they did not have serious sequelae. At 12 months after treatment, the stroke recurrence rate of the endovascular therapy group was 8. 4% (n=6,both were TIA),and that of the medical therapy group was 26. 0% (84. 2% was minor stroke). There was significant difference (χ2 =7. 752,P<0. 01);at 12 months after treatment,the incidences of restenosis and aggravated stenosis were 5. 6% (n=4) and 6. 8% (n=5) respectively. There was no significant difference (χ2 =0. 091,P>0. 05). Conclusion Compared with the medical therapy,the efficacy of endovascular therapy for symptomatic intra-cranial arterial stenosis is more significant. The improvement of clinical prognosis is superior to medical therapy.

Objective To investigate the biomechanicai characteristics of flexor profundus tendons repaired after decimeter wave therapy, and to observe the effect of decimeter wave therapy on early active mobilization. Methods A total of 56 Leghorn chickens were randomly divided into a therapy group and a control group with 28 chickens in each. The 3rd and 4th toes of their left feet were employed for the establishment of a tendon injury model. The flexor profundus tendons were cut and repaired. Gypsum support was applied and fixed with an adhesive plaster after the operation. The operated sites on toes Ⅲ and Ⅳ were exposed. The external fixation was removed 3 weeks later and the chickens were left free to move. Decimeter wave therapy ( frequency 915 MHz, power 8 Watts) was ap-plied for 10 minutes once daily on the left foot of each chicken in the therapy group from day 1 until 3 weeks after the operation. Sham decimeter wave therapy was applied to chickens in the control group. Four chickens from each group were randomly selected at the 1st, 7th, 10th, 14th, 18th, 21st and 28th days for biomechanical analysis. Biome-chanical parameters including tensile strength of rupture (Pmax), elongation ratio at rupture (δimax) and the tensile adhesion strength of the rupture zone (W0>) were observed at each time point. Results At the 7th, 10th, 14th, 18th, 21st and 28th day after the operation, the differences in Pmax, δmax and W0 between the therapy and control groups were statistically significant. The results of the therapy group were better than those of the control group. Conclusions Local decimeter wave therapy after flexor tendon repair can promote intrinsic healing and reduce ex-trinsic healing. The speed and quality of healing are improved. The elasticity and tenacity of the injured tendons are enhanced. Therefore decimeter wave therapy is helpful for early active mobilization training.

BACKGROUND: Heme oxygenase-1 (HO-1) promotor region has a pair of dinucleotide(guanosine thymidine, GT) repeats with a lengthy polymorphism, also named microsatellite polymorphism. Experiments in vitro have shown that we can indirectly learn about the level of gene transcription by measuring the number of GT repeats.OBJECTIVE: To investigate if an association exists between restenosis after percutaneous coronary intervention(PCI) and microsatellite polymorphism in HO-1 gene promoter.DESIGN: A case-control study based on the observation of the patients with coronary heart disease after undergoing coronary stenting.SETTING: Wards of the department of cardiology of a university hospital.PARTICIPANTS: A total of 118 patients were admitted from April 1996 to May 2002 at the Department of Cardiology of the First Hospital of Peking University who underwent successful coronary stenting. Inclusion criteria: The patients with coronary heart disease who underwent coronary stent implantation for more than 3 months now came to perform coronary angiography in follow-up. Exclusion criteria: Angiography showed that the stenosis of lumen in diameter in the patients with coronary heart disease was less than 50%and the follow-up in angiography was less than three months. There were 92males and 26 females aged(62±10) years old and the informed consents were obtained. The patients were divided into two groups according to the criteria stipulated by American Heart,Lung and Blood Association: in-stent restenosis(68 cases) and non-restenosis (50 cases).METHODS: DNA of the peripheral blood was isolated from the whole blood. The length of GT repeat was confirmed by PCR amplification and Spreadex Gel electrophoresis. Selected samples were sequenced with Sanger's method.MAIN OUTCOME MEASURES: Microsatellite gene frequency of HO-1promoter and its relationship with restenosis RESULTS: Patients with GT repeats <25 GT in the HO-1 gene promoter on either allele had significantly less often restenosis than patients without (47.5% vs. 68.4% ,P<0.05). After controlling some possible confound ing factorsfor coronary heart diseases, multivariate analysis indicated that still there was a significant difference between the two groups in restenosis rate(odd ratio 0. 418,95% CI: 0. 197 to 0. 887,P<0.05).CONCLUSION: The present study indicated that short(GT) n repeats of HO-1 gene promoter is associated with reduced post-PCI restenosis, which suggests the genetic contribution to in-stent restenosis after stent implantation. It may have important meanings to prevent the occurrence of restenosis.

BACKGROUND: Literatures report that double-bundle reconstruction is a better choice for posterior cruciate ligament (PCL),but Tibial-inlay technique exhibits no significant difference.OBJECTIVE: To evaluate the effect of Tibial-inlay technique used in the PCL reconstruction with allograft tendons.METHODS: Thirty-one patients with PCL rupture were verified by arthroscopy in the Department of Orthopaedics, at the Affiliated Hospital of Chengde Medical College between February 2006 and May 2008, including 14 knees caused by traffic accident injury,9 knees by crashing, and 8 knees by athletic injury. All the damaged PCLs were reconstructed with allograft tendons by Tibial-inlay technique under arthroscopy. During surgery, the remnants of the original PCL were retained as much as possible,PCL femoral tunnel was prepared. By using of allogeneic patella tendon with bone block at both ends or achilles tendon allograft with bone block at one side, the lateral bone block was chipped into trapezoidal block at a width of 1.0-1.5 cm and a length of 2 cm, that is, in addition to relying on friction force to fix between bone groove and bone graft, it can also generate compressive stress and increase its stability. The PCL tibial attached point was stripped, the trapezoid bone groove was prepared according to the size of bone block at the insertion site, and allogeneic bone block was embedded into bone groove, then the other end was introduced to femoral tunnel using pulling wire through the joint, after tensed at anterior drawer site, the extrusion screw was twisted forward to fix the tendon or bone. Before operation and during follow-ups, the posterior drawer test knee instability, joint activity, Lysholm knee function scores were recorded.RESULTS AND CONCLUSION: No severe complications, such as vascular nerve injury, rejection or infection, occurred in early stage after operations in 31 patients. All of them were followed up for 12-24 months. Posterior drawer test of all the subjects were above 2+ before operation, of which, 3+ and 4+ were 84%; the posterior drawer test re,suits were as the following after operation:4 cases of 0+ (normal), 17 cases of 1 +, 9 cases of 2+ and 1 case of 3+, which shows the improvement of retroposition (P ＜ 0.05);Lysholm score was remarkably improved at follow-up compared with preoperation (P ＜ 0.05), and there were significant improvements in the joint range of motion (P ＜ 0.05). The reconstruction of PCL by Tibial-inlay technique with allograft tendons has advantages of minimal trauma in surgery, reliable fixation and satisfactory outcome.