Objectives:To study the clinical results and feasibility of continuous brachial plexus nerve block and postoperative anagesia with catheters located by nerve stimulator in interscalene approach. Methods:60 ASAⅠ~Ⅱ patients receiving continuous interscalene brachial plexus block and postoperative analgesia for forearm,wrist or hand surgery were randomized into two groups.In group I,nerve blocks were performed using a normal venous needle located with traditional method which elicites numbness of the limb. Then a epidural catheter was passed and secured. Group Ⅱ were guided by nerve stimulator and special catheters were placed. Results:Compared with group I,time to perform the block,time to block and time to obtain satisfactory sensory and motor blockade in group II were shorter(P

Innovation team is an independent and open complex adaptive system, which provides new ideas for recognizing and understanding the inner operating mechanism of innovation teams. This article analyzed the mechanisms of communication and exchange, competition and cooperation, incentive and con-straint as well as the conflict management from the perspective of complex adaptive system.

BACKGROUND:Anterior cervical discectomy and bone graft fusion are effective method to treat cervical spondylosis. This method can provide firm fixation and the fusion rate is high. However, for cervical vertebra involved in more than two segments, the stability of fixator and bone graft is poor due to big bone graft span, which may easily cause fusion failure and pseudarthrosis, and impact curative effects. OBJECTIVE:To investigate biomechanical stability of anterior cervical pedicle screw implantation for osteoporosis in the vertebra. METHODS:A total of 12 human cervical vertebrae were col ected, including 6 vertebrae with normal bone density and 6 vertebrae with osteoporosis. Data of 60 vertebra specimens were analyzed. 30 osteoporotic specimens implanted in anterior cervical pedicle screw were set as anterior cervical pedicle screw group. 30 normal specimens implanted in anterior cervical pedicle screw were set as anterior vertebral screw group. According to bone density, 40 vertebrae were col ected in above two groups, and were considered as normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group (n=10). Bone mineral density of each vertebra was detected using dual-energy X-ray absorptiometry. Biomechanical index of two kinds of screws was detected using ElectroForce 3510 material testing machine. RESULTS AND CONCLUSION:Bone mineral content, vertebral screw pul-out strength, vertebral screw pul-out stiffness, pedicle screw pul-out strength, and pedicle screw pul-out stiffness were significantly higher in the anterior cervical pedicle screw group than in the anterior vertebral screw group (P<0.05). The maximum axial pul-out strength of normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group was significantly higher than in the anterior vertebral screw group (P<0.05). The results confirmed that osteoporotic vertebral biomechanical performance is more stable in anterior pedicle screws compared with the anterior vertebral screw.

Objective To Discuss the Clinical Recognition of Acute Myocardial Infarction(AMI) caused by aortic valve incompetence.Methods Data of 275 AMI patients in our hospital recent two years,7 of them were caused by aortic valve incompetence; all of patients(7 AMI) were received coronary artery angioplasty,ultrasound,left ventricular angiography examination,its clinical feature was analyzed.Results All of 7AMI patients have normal coronary without limited constriction or plaque and with aortic valve incompetence.

Objective To observe the expression and the distribution of Netrin-1 in the spastic and normal segment of colon in patients with Hirschsprungs disease (HD) and investigate the relationship between Netrin-1 and development of HD.Methods Colon specimens of 36 cases with HD were selected for this study.Normal segment of colon served as the control group,while the spastic segments of colon as the lesion group.Immunohistochemical staining was applied to detecte the expression and the distribution of Netrin-1.Results Immunohistochemical staining showed that the expression of netrin-1 was positive in the intestinal muscular layers (longitudinal muscle,circular muscles),myenteric ganglias and mucosal layers in the control group.However,the expression of Netrin-1 was also positive in muscular layers and mucosal layer in the lesion group.There was no significant difference in the expression intensity of Netrin-1 between the two groups (P ＞0.05).Conclusion The expression of Netrin-1 in both the control group and the lesion group may indicate that netrin-1 have no significant correlation with genesis of HD.

Objective To discuss and summarize the effects of arthroscopic treatment of posterior ankle impingement syndrome.Methods The study enrolled 30 patients with posterior ankle impingement syndrome treated from January 2008 to November 2015.There were 18 males and 12 females,aged 19-58 years old (mean,37.6 years old).Right ankle injury was noted in 19 patients and left in 11 patients.A total of 27 patients had a history of obvious ankle injury (7 cases of acute sprains and 20 cases of chronic sprains).Arthroscopic surgery,including osteophyte removal,cartilage formation and joint clearance,was performed through the posterolateral and posteromedial approaches.Postoperative outcome was evaluated by using the American Orthopedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS) scores.Results All the patients were followed up for 8-27 months (mean,22 months).These patients got a good healing without nervous and vascular injuries.At the last follow up,the AOFAS score was (89.8 ± 3.8) points,significantly higher than before operation [(35.0 ± 10.1) points,t =-26.456,P =0.000].The VAS score was (2.5 ± 1.3) points,significantly lower than before operation [(6.6 ± 1.9) points,t =12.427,P =0.000].The ankle joint flexion angle was improved significantly from 29.4° ± 2.3° to 43.4° ± 1.4° as compared to preoperative status (t =-32.625,P =0.000).There were 21 cases of excellent result and 9 cases of good result,with an excellent and good rate of 100％.Conclusion Debridement and treatment of complications under arthroscopy is one of the effective methods for the posterior ankle impingement syndrome,which has advantages of minimal invasion,safety,targeted operation,and fast postoperative recovery.

The thesis,from the aspect of professional guidance of education,focuses on the outstanding problems that exist in the work of professional guidance,analyzes the main reasons that caused those outstanding problems,and gives the feasible suggestions to professional guidance in current university education.

Objective To observe the effect of ischemic postconditioning on neuron structure plasticity and memory after global cerebral ischemia injury in rats and discuss the protection mechanism from aspect of Morphology. Methods A total of 36 SD male rats were randomly divided into sham operation group, global cerebral ischemia for 15 min group and global cerebral ischemia plus postconditioning group, 12 rats per group. The pullsinelli 4 vessel occlusion was applied to produce the models of global cerebral ischemia reperfusion injury, common carotid arteries (CCA) occlusion with 15 min and postconditioning with three cycles, of 15 sec release and 15 sec occlusion (15s/15s). Six rats from each group were evaluated by Morris Maze test for the ability of space learning and memory and the other six rats were evaluated by golgi stain for morphologic change of neuron. Results The ischemic postcondtioning group showed significant shorter mean escape latency compared with the sham operated group ( at day 3, P =0. 014; at day 4, P =0.040; at day 5, P =0.001 ). The density of dendritic spine in ischemic postcondtioning group was increased more significantly compared with ischemic group ( F = 562. 820,P ＜ 0. 01 ). Conclusion Ischemic postconditioning has obvious protective effect on cerebral ischemiainduced memory impairment, which may be related to alleviation of dendritic spine injury.

BACKGROUND:The quantity and quality of seed cel s is a critical bottleneck of the development of vascular tissue engineering. To address this issue, stem cel-derived endothelial cel s have been a hot spot in this field due to their potential in providing the ideal seed cel s.
OBJECTIVE:To elucidate the effect of vascular endothelial growth factor (VEGF) supplementation combined with hypoxic culture condition on the lineage-specific differentiation of embryonic stem cel s into endothelial cel s.
METHODS:Serum-free medium mTeSR?1 was applied to cultivate H9 cel s in vitro. A conditioned medium containing 50μg/L vascular endothelial growth factor was utilized to induce H9 cel s to differentiate into endothelial cel s under the hypoxic culture condition (5%O2). The cel under normal condition (5%CO2) with or without vascular endothelial growth factor served as controls. The phenotype and function of human embryonic stem cel s-derived endothelial cel s were assayed by immunofluorescence staining, quantitative RT-PCR, and low-density lipoprotein uptake experiment.
RESULTS AND CONCLUSION:Compared with the control group, the H9 cel s were induced to be differentiated into endothelial-like cel s more efficiently when they were cultivated under a conditioned medium with vascular endothelial growth factor supplementation under the hypoxic condition. These differentiated cel s not only expressed some important surface markers of endothelia cel s, including kdr, pecam, but also took in low-density lipoprotein to form microvessle-like structures. This culture system supports a synergy effect of vascular endothelial growth factor and hypoxic environment that can efficiently promotes the lineage-specific differentiation
of embryonic stem cel s into endothelial cel s with good phenotype and functionality.

Objective To explore the histological properties of isolated chondrons and chondrocytes from rabbit knee cartilage,and to determine if these properties vary with age.Methods Three groups of rabbit knees were evaluated according to different age:(1) young (2 months,n=10);(2) adult (8 months,n=10);and (3) old (31 months,n=10).The cartilage structure,proteoglycan,collagen-2,and collagen-6 content were determined by light microscopic using hematoxylin-eosin (HE),Toluidine Blue,and col-2,6 staining.The chondrons were enzymatically isolated using 0.3 g/L dispase and 0.2 g/L collagenase-2 by shaking for 3 hours.The morphology and composition of isolated chondrons were observed by HE and collagen-6 immunostaining staining after overnight coverslip monolayer culture under a microscopy.Results The chondrocytes became sparser and the total content of proteoglycans and collagen-2 were decreased in the articular cartilage with age.Compared to the chondrocytes,the surrounding rim or capsule was more obvious in the isolated chondrons,and they exhibited obvious differences in shape.The cells within one cluster from different age groups were similar to the morphology observed in cartilage in situ.The adult and old chondrons generally possessed a thicker pericellular matrix with more enclosed cells,and the chondrons contained more cells can reach 47％.Conclusion These findings further suggest that the properties of the chondrons and pericellular matrix have an important influence on the biomechanical microenvironment of the knee joint cartilage degeneration that occurs with age.