Objective:To observe the effect of emergency airway established by laryngeal mask for cerebral protection, and to popularize using laryngeal mask for establishing emergency airway in cardiopulmonary resuscitation(CPR) among paramedics.Methods:To compare the rescuing effect, 49 cases of patients with cardiac arrest were divided into 2 groups as different rescue method: laryngeal mask group (23 cases), emergency airway established by laryngeal mask airway(LMA); face mask group (26 cases).Results: After aerating 5 minutes, the average oxyhemoglobin saturation has recovered to 94.1% in laryngeal mask group, and it was 78% in face mask group; heartbeat recovery rate was 100% in laryngeal mask group, and face mask group was 84.62%, and there was no statistical significant (x2=2.94,P>0.05); breathing recovery rates were 86.96% and 19.23%, respectively, in laryngeal mask group and face mask group, and there was statistical significant (x2=19.772,P<0.05); consciousness recovery rates were 43.48% and 7.69%, respectively, between the two groups, and there was statistical significant (x2=6.627,P<0.05). Conclusion: Compared with the face mask group, to establish airway for cardiac arrest patient by using laryngeal mask airway(LMA) would got efficient results in improving anoxia in cerebral, increasing spontaneous breath rate and consciousness recovery rate.

Objective To introduce a new flap of cutaneous branches of posterior tibial artery on the part of superior medial malleolus to repair soft tissues defect on the feet and the ankles Methods From October 1997 to December 2001,a flap with the pedicle called cutaneous branches of posterior tibial artery on the part of superior medial malleolus were used to repair 11 cases which suffered skin and soft tissue defect on the feet and the ankles due to various trauma Results The flaps were survived completely on 10 cases and the flaps distal had about 2 cm necrosis on 1 case,the size of the flap ranged from 28 cn?11 cm to 8 cm?6 cm,all of the 11 cases were evaluated as satisfactory after 6 months to 2 years follow-up Conclusions The new procedure can repair mostly soft tissue defect on the foot and the ankle and does not sacrifice the major arteries. The flap is easy to be performed,and it is an safety and ideal method.

In order to study the role of prostaglandin E2(PGE_2)on the pathogenesis of candidal vaginitis,the effect of Candida albicans and histamine on the production of PGE_2 by peripheral blood mononuclear cells from patients with candidal vaginitis and normal controls,the effect of PGE2 on germ tube formation of Candida albicans,and the effect of PGE2 on Candida albicans adhering to vaginal ep- ithelial cells were observed.The results showed that:Candida albicans and histamine induced PGE2 synergistically,and the production of PGE2 increased markedly.PGE2 enhanced germ tube formation in Candida albicans,increased the number of Candida albicans adhering to the vaginal epithelial cells, and the pathogenicity of C.albicans.The above results indicate that PGE_2 plays a role in the pathogene- sis of candidal vaginitis.

BACKGROUND: How to effectively treat recurrent osteoporotic vertebral compression fractures in the elderly over 65 years has become an issue of attention in the clinic. OBJECTIVE:To evaluate the clinical efficacy of percutaneous vertebroplasty with polymethylmethacrylate bone cement for treating elderly recurrent osteoporotic vertebral compression fractures. METHODS:Twenty-four patients with elderly osteoporotic vertebral compression fractures were divided into polymethylmethacrylate bone cement group (minimaly invasive group) and conservative treatment group on a voluntary basis (n=12 per group). Visual analog scale score for low back pain, Oswesty dysfunction index, ratio of the anterior/posterior margin height of the injured vertebra, Cobb angle and adverse reactions were compared between the two groups before and after treatment. RESULTS AND CONCLUSION:The 12-month folow-up was completed in al the patients. There was one case of bone cement breakage during treatment in the minimaly invasive group and one case of lower limb deep venous thrombosis in the conservative treatment group at 1 month after treatment. Compared with the conservative treatment group, the visual analog scale score, Oswesty dysfunction index, and Cobb angle were significantly lower, but the ratio of the anterior/posterior margin height of the injured vertebra was significantly higher in the minimaly invasive group at 3 days, 1, 3, 6 and 12 months after treatment (P < 0.05). These findings indicate that percutaneous vertebroplasty with polymethylmethacrylate bone cement for elderly recurrent osteoporotic vertebral fractures can strive for short-term pain relief and long-term recovery of the vertebral height and spinal Cobb angle, thereby significantly improving patient’s quality of life.

Objective To explore the clinical features and risk factors causing recurrent cerebral hemorrhage, as well as effective prevention and control measures.Methods The data of 25 patients with recurrent cerebral hemorrhage were analyzed retrospectively in order to investigate the clinical characteristics, pathogenesis and prevention and control measures.Results 25 patients had a total of 27 times recurrence and 78 per cent of them were within two years. Recurrent types were mainly basal nuclei-basal nuclei type, followed by the cerebral lobe-cerebral lobe type, and the recurrence more occurred in the contralateral hemisphere. Re-bleeding risk factors included complications, poor prognosis. For bleeding aneurysm, it was a major measure of effectively controlling bleeding recurrence to fine out the cause of disease in time.Conclusion Actively looking for major risk factor causing cerebral hemorrhage is the key of effectively controlling recurrence of cerebral hemorrhage.

Objective To study the influence of 4-aminopyridine(4-AP)on proliferation,production,and apoptosis through inhibiting voltage-gated K+channel(Kv)in ovarian luteinized granulosa cells.nethods Ovarian luteinized granulosa cells were recovered from 25 women with regular menses who underwent in vitro fertilization programme.The cultured granulosa cells were divided into 4 groups:blank group,4-AP treated group,human chorionic gonadotropin(hCG)-induced group and hCG+4-AP cotreated group.The final concentrations of hCG and 4-AP were 1250 U/L and 5 nmol/L respectively.The progesterone production WaS detected by the chemoluminescence method.The expression of Kv mRNA on human ovarian luteinized granulosa cell was detected by RT.PCR The influence on the early apoptosis of gTanulosa cells bv 4-AP was observed by flow eytometry.Cellular caSpage-3 activities were observed with colorimetric method and the inhibition of the cell proliferation was studied using methyl thiazolyl tetrazolium(MTT)method.Results(1)Kv mRNA wag expressed in granulosa cell.(2)The progesterone production64),(206±32),(1991±172)and(763±79)nmol/L,respectively after24 hours culture.Exposure of the(3)The flow cytometry analysis and the cellular caapase-3 A405 showed that 4-AP increased the percentage ofearly phase apoptosis(P<0.01):4-AP treated group VS blank group[(40±5)%and 0.049 ±0.009]VS[(17±4)% and 0.029±0.008],hCG+4-AP CO-treated group VS hCG-induced group[(25±4)%and0.039 ±0.0081 VS[(15±3)%and 0.022 ±0.007].(4)24 hours after treated with 4-AP and hCG,theinhibitory rate of cultured granulosa cells of 4-AP treated group was higher than the blank group(19.7%VS0).and that of hCG+4-AP co-treated group was obviously higher than hCG-induced group(34.6% VS O,P<0.01).Conclusions The voltage-gated K+ channels expressed by ovarian luteinized granulosa cellplay an important role in cell proliferation,production,and apoptosis.4-AP may inhibit differentiation ofprogesterone in granulosa ceHs through the inhibition of proliferation and induction of apoptosis.

Objective To investigate the distribution of HLA-B27 subtypes in ankylosing spondylitis(AS) patients of Chinese Han population by using the updated HLA-B27 typing data. Methods One hundred AS subjects were randomly selected from spondyloarthritis patients data bank of the third affiliated hospital of Sun Yat-sen university. All subjects were independent individuals, and the duplicated samples in the same family were excluded. Salt fraction method was used to prepare genome DNA. Luminex liquid array combining PCR-SSOP was used to perform the low resolution HLA-B genotyping. PCR-SSP was applied to perform the high resolution HLA-B27 typing for HLA-B27 positive subjects. Results Ninety-eight independent AS patients were recruited randomily, of which, 93 were HLA-B27 positive, with positive rate 94.9%, and covered 96% patients with family history of AS. Three subtypes were detected in this population including B * 2704 (n=76, 81.7%), B * 2705 (n=12, 12.9%) and B * 2715 (n=5, 5.4%). Compared with the two reports about HLA-B27 subtype distribution in healthy HLA-B27 positive Han population there was no significant difference between AS patients and healthy controls. But no B * 2715 case was found in those two reports of healthy population. Three reports (including 1 report in Chinese) could found about B * 2715 subtype, but all positive cases were oriental people. Furthermore, all B * 2715 positive patients were AS patients. Conclusion B * 2704 is the predominant subtype ,in AS patients of Chinese Han population, and followed by B * 2705. We found five cases with positive B * 2715, a considerable rare allele. This may suggest association between B * 2715 and AS.

Objective To study T lymphocyte subsets and expression of costimulatory molecule CD154 on T-cells in peripheral blood from patients with ankylosing spondylitis and their changes after treated with Enbrel. Methods Sixty-six patients with AS(39 active and 27 inactive, 35 axial and peripheral joint involvement and 31 axial involvement only), 30 patients with rheumatoid arthritis(RA), 30 healthy volunteers were analyzed. The expression of CD154 on CD3+ T cell as well as T-cells subsets were evaluated using flow cytometry respectively. The changes of the expression of costimulatory molecule CD154 in 39 active AS patients(Enbrel treatment or placebo treatment) were observed in a randomized, double-blind, placebothan that of healthy volunteers, and CD154 expression on CD3+ T cells in peripheral blood in AS patients was on CD3+ T cells in the peripheral blood of active AS or AS patients with peripheral joint involvement were significantly higher than those in inactive or axial involvement only AS patients(P＜0.05), and CD154 on CD3+ placebo, in AS patients group, there was significant reduction in CD154 expression on CD3+ T cells in Enbrel group at week 6(P＜0.05), there was no significant difference between Enbrel group and healthy volunteers at week 6(P＞0.05). Conclusion T lymphocyte subsets are significantly abnormal and CD154 is overexpressed on T-cells in peripheral blood of patients with AS. A six-week course of treatment with Enbrel in active AS can induce a down-regulation of the expression of CD154 on T cells.

AIM: To investigate the effects of homocysteine (Hcy) on apoptosis and expression of caspases-3 in cultured human vascular smooth muscle cells (HVSMCs). METHODS: HVSMCs were cultured in vitro. The rate of apoptosis in HVSMCs was detected by flow cytometry. The expression of caspases-3 mRNA in HVSMCs was detected by reverse-transcription polymerase chain reaction (RT-PCR). RESULTS: The rates of apoptosis in HVSMCs incubated with 500 ?mol/L Hcy for 0 h, 6 h, 12 h, 24 h and 48 h were 2.39%?0.47%, 2.45%?0.64%, 7.58%?1.02%, 13.37%?4.71% and 17.69%?3.13%, respectively. The ratio of the absorbance of caspases-3 mRNA/GAPDH was 0.24?0.08, 0.29?0.10, 0.89?0.26, 1.37?0.24 and 1.82?0.53,respectively, suggesting that Hcy induces the apoptosis and expression of caspases-3 mRNA in HVSMCs in a time-dependent manner. The rates of apoptosis in HVSMCs incubated with 0, 100, 200, 500 or 1 000 ?mol/L Hcy for 24 h were 2.68%?0.23%, 2.79%?0.12%, 8.45%?2.41%, 13.37%?4.71% and 23.75%?5.56%, respectively, revealing that Hcy induced the apoptosis in HVSMCs in a concentration-dependent manner. CONCLUSION: Hcy induces the apoptosis in HVSMCs by regulating the expression of caspases-3, which may be one of the mechanisms involved in atherosclerotic effects of Hcy.

Objective To evaluate the therapeutic effect of modified dual plating and less invasive stabilization system(LISS) in the complex fractures of tibial plateau.Methods One hundred and sixty-eight patients with complex fractures of tibial plateau were divided into two groups by the therapeutic methods,89 patients were in modified dual plating group while 79 patients were in LISS group.The advantages and curative effect of two groups were retrospectively analyzed.Results The excellent and good rate in modified dual plating group was slightly higher than that in LISS group [89.9％ (80/89) vs.86.1％ (68/79)],and there was no significant difference (P ＞ 0.05).No patient occurred deep site infection,severe nerve damage,phlebothrombosis in two groups.In modified dual plating group,the operation time and bleeding volume was (89.2 ± 13.6) min and (188.4 ± 45.6) ml,the hospital stay and healing time was (16.5 ± 1.8) d and (13.3 ±2.1) months.In LISS group,the operation time and bleeding volume was (74.3 ± 12.5) min and (236.5 ±65.5) ml,the hospital stay and healing time was (16.7 ± 2.1) d and (11.4 ± 1.5) months.There was no significant difference (P ＞ 0.05).Conclusion The therapeutic effect of modified dual plating and LISS have no significant difference for complex tibial plateau fractures.