Objective To explore the operation timing and technique selection of floating knee injury in children.Methods According to Letts types,36 cases were divided into 5 types.The function outcome in every group was compared by Karlstrorm criterion according operation timing or technique selection respectively.Results Thirty-six cases were followed up for an average of 25 months(19 to 84 months).The rate of excellent and good results accounted for 94.12%(16/17) in one stage operation,78.95%(15/19)in stages,60%(6/10)in 2 stages,respectively.Conclusions It may be recommended to treat children with floating knee injury with open reduction intenal fixation or external fixation.The best operation time shall be urgent treatment of both femur and tibia fracture.

AIM: To observe the effect of cannabinoid receptor (CB1R) agonist WIN55-212-2 on the expression of brain-derived neurotrophic factor (BDNF), c-Fos and protein kinase A beta-catalytic subunit (PKAC-β) in cerebrum cortex after intracerebral hemorrhage (ICH) in rats. METHODS: The intracerebral hemorrhage model of rat was made by the injection of collagenase Ⅶ, and WIN55-212-2 was intraperitoneally (ip) injected 30 min later. The rats were killed for sampling the brain tissues as specimens 24 h after ICH. The methods of immunohistochemical analysis and Western blotting were adopted to detect the expression of PKAC-β and BDNF. The mRNA expression of PKAC-β, c-Fos and BDNF was determined by RT-PCR. RESULTS: WIN55-212-2 obviously improved some nervous deficit symptoms and increased the expression of BDNF at mRNA and protein levels with upregulating the mRNA expression of c-Fos and downregulating the expression of PKA at mRNA and protein levels in the ipsilateral cerebral cortex. The proteins of PKAC-β, c-Fos and BDNF were expressed on the membrane or nucleus of the neuron or in the cytoplasm of glial cells, respectively. CONCLUSION: The expression of BDNF is induced not only by upregulation of c-Fos, but also by downregulation of PKA in WIN55-212-2 treated rats.

The currently unfavorable physician - patient relationship has lead to a total loss of interests from multiple sides of hospitals,patients,medical staff,medical education and the society,which specifies in the wellbeing loss of patients and the whole population.The social stability has also been affected.The health care reform should aim to minimize the conflicts between doctors and patients,thus the above mentioned losses will be diminished and a harmonious physician - patient relationship will be built up and the win - win pattern of benefits between doctors and patients will also be realized.Multiple efforts from the government,society,hospitals,medical staff,and patients are all needed to achieve such a goal.

Aim To explore the effects of cannabinoid (WIN55,212-2) on mRNA and protein expressions of PKAC-β,c-fos and BDNF in cerebral cortex after intracerebral hemorrhage(ICH)in rats.Methods ICH model of rats were made by Ⅶ Collagenase,which were injected by the intraperitoneal route,thirty minutes after the operations.The rats were killed for brain tissue as specimens with 24 hours.The localizations of PKAC-β,c-fos and BDNF were assessed by immunohistochemistry;The expressions of PKAC-β,c-fos and BDNF mRNA were detected by RT-PCR;The expressions of PKAC-β and BDNF protein were revealed by Western blot.Results WIN55,212-2 increased not only the levels of BDNF mRNA and protein,but also c-fos mRNA in ipsilateral cerebral cortex.However,it decreased the levels of PKAC-β mRNA and protein.PKAC-β,c-fos,and BDNF proteins were expressed on membrane of neurons,nucleus of neurons or the cytoplasm of glial cells respectively.Conclusion WIN55,212-2 induces the expression of BDNF in the cerebral cortex,which provides a theoretical basis for the treatment of cerebrovascular disease.

Aim To explore the effects of cannabinoid (WIN55,212-2) on mRNA and protein expressions of PKAC-?,c-fos and BDNF in cerebral cortex after intracerebral hemorrhage(ICH)in rats.Methods ICH model of rats were made by Ⅶ Collagenase,which were injected by the intraperitoneal route,thirty minutes after the operations.The rats were killed for brain tissue as specimens with 24 hours.The localizations of PKAC-?,c-fos and BDNF were assessed by immunohistochemistry;The expressions of PKAC-?,c-fos and BDNF mRNA were detected by RT-PCR;The expressions of PKAC-? and BDNF protein were revealed by Western blot.Results WIN55,212-2 increased not only the levels of BDNF mRNA and protein,but also c-fos mRNA in ipsilateral cerebral cortex.However,it decreased the levels of PKAC-? mRNA and protein.PKAC-?,c-fos,and BDNF proteins were expressed on membrane of neurons,nucleus of neurons or the cytoplasm of glial cells respectively.Conclusion WIN55,212-2 induces the expression of BDNF in the cerebral cortex,which provides a theoretical basis for the treatment of cerebrovascular disease.

Objective To explore the relation between the level of oxygen pressure and lactate in arterial blood and prognosis of cardiopulmonary resuscitation (CPR).Methods 36 patients with sudden cardiac arrest received CPR were selected.Patients were divided into 3 groups.The 21 patients who 30 minutes of CPR didn't regain heart beats were group A,those 10 who kept blood circulation for over 2 hours but finally died were group B,and the remaining 5 who survived were group C.Control group was made up of 20 people with no disease.In CPR immediately (0h),1h,3h,6h,12h were measured in blood specimens from arterial partial pressure of oxygen and lactate levels were compared among groups of patients dynamic changes of the index.Results The 3 groups A,B,C significantly reduced blood oxygen pressure,blood lactate increased significantly the CPR in the early,and compared with the control group there was significant difference( P ＜ 0.01 ).The group B CPR 3h,6h,and continue until no significant changes in 12h;The group C CPR 3h,6h began to increase blood oxygen pressure and blood lactate levels begin to decline,blood oxygen pressure increased significantly,lower blood lactate to a lower level after 12h.Taken with marked changes in B group,the difference was significant ( P ＜ 0.05 ).Conclusion Arterial partial pressure of oxygen and blood lactate levels could be used as indicators of prognosis of patients with CPR.Sustained increase in arterial oxygen partial pressure showed a good prognosis,lactate levels continued to rise that a poor prognosis.

Objective To study the effect of dexmedetomidine and midazolam on hemodynamics and sedation in patients with nasal intubation.Methods Forty patients whose ASA grade Ⅰ-Ⅱ and anticipated difficult airway were randomly divided into dexmedetomidine group(group D,20 cases)and midazolam group(group M,20 cases)according to the admission number.In group D,dexmedetomidine 1 μ g/kg were constant speed pumped in 10 minutes.In group M,midazolam 0.03 mg/kg were intravenous injected.Then nasal intubation were carried.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial blood pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),Ramsay sedation score,rate-pressure product(RPP),tip perfusion index(TPI)were recorded and compared before anesthesia (T0),fiberoptic bronchoscope pass by later nostril(T1),to spy on epiglottis(T2),intubation succeed(T3),after intubation 1 minute(T4)and after intubation 3 minutes(T5).Airway score and postoperative visit were evaluated.Results SBP,DBP,MAP,HR,RPP in group M were significantly higher at T1-T3 than those at T0 (P＜0.05),and were significantly higher than those in group D at the same time(P＜ 0.05).There was no significant difference in group D(P ＞ 0.05).Ramsay sedation score and TPI at T1-T3 in group M were significantly lower than those at To(P ＜0.05).Ramsay sedation score and TPI at T1-T5 in group D were significantly higher than those at T0(P ＜ 0.05),and were significantly higher than those in group M at the same time(P ＜ 0.05).The rate of airway score 1 score and intubation satisfaction in group D were significantly higher than those in group M[100％(20/20)vs.30％(6/20),90％(18/20)vs.50％(10/20)](P＜ 0.05).The rate of throat ache in group D was significantly lower than that in group M[5％(1/20)vs.35％(7/20)](P ＜0.05).Conclusions For difficult airway patients with nasal intubation during dexmedetomidine infusion,hemodynamics is stable and sedation is satisfied.

Objective The purpose of this study is to evaluate Surgical Procedure and Prognosis for elderly stage 1NSCLC patients above 70 years old.Methods The patients who were stage Ⅰ non-small cell lung cancer from 2003 to 2007were enrolled ( n =71 ).The median age was 74 years ( ranged from 70 to 84 years).The median follow-up of patients was 30months( ranged from 2 to 81 months).Results The percentages of postoperative complications after sublobar resection and lobectomy patients were 36.4％ and 46.9％,respectively.The period in hospital were 11.36 days and 12.24 days.The 3 year survival was 85.9％ for patients undergoing sublobar resection and 78.8％ for lobectomy.The 5 year survival was 56.4％ and 56.9％ respectively.No significant difference was observed between two types of surgical procedure in the elderly.Staging is the independent factor of prognosis.Conclusion Lobectomy is still the main therapy method for elderly stage Ⅰ NSCLC patients.Especially,for those who can undergo radical resection.But sublobar resection also appears to be a viable surgical treatment for patients with cardiopulmonary physiologic impairment.

Animals ; Carcinoma, Hepatocellular ; blood supply ; pathology ; therapy ; Cell Line, Tumor ; Cells, Cultured ; Cytotoxicity, Immunologic ; immunology ; Female ; Humans ; Interleukin-12 ; pharmacology ; Interleukin-2 ; pharmacology ; Killer Cells, Natural ; cytology ; drug effects ; immunology ; Liver Neoplasms, Experimental ; blood supply ; pathology ; therapy ; Lymphocyte Activation ; drug effects ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Microcirculation ; drug effects ; Random Allocation ; Xenograft Model Antitumor Assays