Objective To investigate the protective effects of combination alprostadil and dexmedetomidine preconditioning treatment on skeletal muscle ischemia reperfusion and secondary lung injuries.Methods Sixty patients aged less than 70 years old undergoing unilateral lower extremity surgery were randomly assigned into four groups:control group(group A),dexmedetomidine group(group B),alprostadil group(group C)and combined treatment group(group D) with 15 cases in each.In group C and D,10 μg alprostadil was given from vein at 15 min before tourniquet inflation,in group B and D 1 μg/kg dexmedetomidine was given from vein at 10 min before tourniquet inflation,the equal volume of normal saline was infused in control group.The blood samples were drawn from vein and artery for blood gas analysises and determination of malondialdehyde(MDA) and human pulmonary surfactant specific protein D (SP D) concentrations at the time before oxygen inhalation(T1),2 h after tourniquet deflation(T2),6 h after tourniquet deflation(T3) respectively.Results In group B,C and D,the alveolar arterial oxygen pressure difference(PA-a DO2)and respiratory index(R1) were significantly lower than those in group A at T2(P＜0.05).PA-aDO2 and R1 were significantly higher at T3 than those at T1 in every groups(P＜0.05);In group B,C and D,MDA and SP D were significantly lower than those in group A at T2 and T3(P＜0.05).In group D,MDA and SP D were significantly lower than those in group B and group C at T3(P＜0.05).Conclusion Alprostadil and dexmedetomidine are infused from vein preconditioning can attenuate the damages of skeletal muscle ischemia reperfusion and secondary lung injuries.The combination of alprostadil with dexmcdetomidine can produce stronger effects.

Objective To investigate the effectiveness of target-controlled infusion (TCI) of etomidate and remifentanil for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixtynine ASA Ⅰ or Ⅱ patients of both sexes,aged 35-71 yr,weighing 41-83 kg,scheduled for elective EBUS-TBNA,were randomly divided into 3 groups ( n =23 each).In group Ⅰ,anesthesia was induced with TCI of propofol and iv injection of fentanyl 4 μg/ml,and the target plasma concentration (Cp) of propofol was set at 3-4 μg/ml.In group Ⅱ ,anesthesia was induced with TCI of propofol ( Cp 3-4 μg/ml) and remifentanil ( Cp 5 ng/ml).In group Ⅲ ,anesthesia was induced with TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml).After the patients lost consciousness,laryngeal mask airway was inserted to perform mechanical ventilation.PETCO2 was maintained at 30-40 mm Hg.BIS value was maintained at 40-60.The use of vasoactive agents (perdipine,ephedrine,atropine and esmolol) and occurrence of bucking during operation,emergence time,and the occurrence of nausea and vomiting within 24 h after operation were recorded.Blood samples were collected from the femoral vein at 30 min before induction,at the end of operation and at 24 h after operation for determination of the plasma cortisol concentration.Results The incidence of bucking and nausea and vomiting was significantly lower,the emergence time was significantly shorter,and the number of patients who needed vasoactive agents during operation was significantly smaller in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05).The number of patients who needed vasoactive agents during operation was significantly smaller in group Ⅲ than in group Ⅱ (P ＜0.05).Compared with groups Ⅰ and Ⅱ,the plasma cortisol concentration was significantly decreased at the end of operation in group Ⅲ (P ＜ 0.05).There was no significant difference in the plasma cortisol concentration at each time point between groups Ⅰ and Ⅱ (P＞0.05).Conclusion TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml) can provide satisfactory anesthesia for EBUS-TBNA with few adverse effects.

Objective To observe the clinical characteristics of gestational diabetic retinopathy (DR)of 13 pregnants with vitreous hemorrhage.Methods The clinical data of 26 eyes retinopathy with 13 cases of gestational diabetes were retrospectively analyzed.After bilateral eyes were mydriatic by Pyrazole MAO amine compound,ophthal-mologist used fundus camera to check bilateral fundus.B ultrasonic was used to examine vitreous hemorrhage and the surfaces of vitreous and retinal.Results In 13 cases,26 eyes vision were between hand motion-0.6.Sudden vitre-ous hemorrhage in 13 eyes,accounted for 50.0%(13/26).Among them,the classⅠvitreous hemorrhage in 10 eyes, 76.9%(10/13).Ⅱ,Ⅲ grade vitreous hemorrhage in 2 eyes,15.4%(2/13).LevelⅣvitreous hemorrhage in 1 eye, accounted for 7.7%(1/13).26 eyes were diagnosed with stage IV(early or fiber hyperplasia period)DR.The fundus photography:the size,number of retinal neovascularization were found in 13 eyes without vitreous hemorrhage.Ultra-sound confirmed that the 13 eyes vitreous hemorrhage were fresh bleeding,and found 4 eyes with fiber membrane, accounted for 30.8%(4/13).The eyes without vitreous hemorrhage were timely treated by laser,and the eyes with vitreous hemorrhage were treated by stage laser treatment according to the condition of vitreous hemorrhage absorp-tion.Followed up for 4 to 6 months,in a stable condition.Conclusion Obstetrics and gynecology doctors and oph-thalmologists should pay attention to pregnancy DR with vitreous hemorrhage.Because they are all early or fiber hyper-plasia period.Timely and reasonable laser treatment can prevent permanent damage of visual function.

Objective To construct markless gene deletion mutant at the clpP loci on the chromosome of Streptococcus mutans(S.mutans).Methods ASp resistance gene was amplified by PCR,to construct the Sp resistance cassette where the Sp resistance gene was flanked with two loxP site.After the clpP gene was cloned into the pGEM-T-Easy TA cloning vector,it was digested and linked with the Sp resistance cassette,yielding homologous recombination vector pIB △ clpP-Sp.The vector was linearized and used for the transformation of S.mutans UA159,with transformants selected on TPY plates containing Sp.The selected strain was transformed with the thermosensitive plasmid pCrePA to excise the Sp resistance gene.The pCre-PA was then easily eliminated at nonpermissive temperature,resulting in a markless mutant strain carrying a deletion at the clpP loci,which was verified by PCR and DNA sequencing.Results The result of the PCR analysis and DNA sequencing indicated that a part of the clpP gene was deleted.There was a loxP at this loci without the Sp resistance gene.Conclusion The markless clpP-deletion mutant of S.mutans was constructed successfully,which laid a foundation for further study of its biological function and its influence on the cariogenicity of S.mutans.

BACKGROUND:Deep vein thrombosis after total knee arthroplasty has attracted increasing attention in recent years,but how to detect deep vein thrombosis in the early time in clinical practice remains unclear.Whether it is necessary to perform type-B ultrasonic or other invasive examination in lower limbs has become a hot issue.OBJECTIVE:To explore the significance of D-Dimer and fibrin degradation products in the prediction of deep vein thrombosis after total knee arthroplasty.METHODS:56 patients received total knee arthroplasty were colected from Department of Orthopedics,The 306th Hospital of Chinese PLA,between December 2012 and February 2014.The D-Dimer and fibrin degradation products were dynamicaly monitored before operation and at 1,3,5,7,10 days post-operation.Al the patients received type-B ultrasonic examination in double lower limbs at 10 days post-operation,and divided into thrombus group and non-thrombus group.The D-Dimer and fibrin degradation products in the two groups were compared.RESULTS AND CONCLUSION:Deep vein thrombosis was found in 13 cases by ultrasonic-B postoperation,D-Dimer and fibrin degradation products showed no significant difference between the two groups at 1 week after operation (P＞0.05),but the difference was significant at 10 days (P＜0.01).D-Dimer and fibrin degradation products index should be monitored dynamicaly for at least 10 days after operation,which is helpful for the earlydiagnosis of thrombosis.

Objective To study the influence of CTP-OD1-HA and CTP-OD2-HA fusion peptides and combined with imatinib on proliferation of K562 cells.Methods K562 cells were treated with CTP-OD1-HA and CTP-OD2-HA peptides or together with imatinib.The proliferation of cells were detected and compared by MTT and clone formation methods.Results MTT examination demonstrated that CTP-OD1-HA and CTP-OD2-HA peptides could inhibit the proliferation of K562 cells,and the effect was more obvious when acted along with imatinib;Clone formation showed that CTP-OD1-HA and CTP-OD2-HA peptides suppressed the continuous colony forming ability of K562 cells.Conclusion CTP-OD1-HA and CTP-OD2-HA could specially inhibit the proliferation of K562 cells,and increase the sensitivity of imatinib.

Objective To compare the lower limb alignment and prosthesis position after total knee arthroplasty (TKA) with or without using electromagnetic navigation.Methods Sixty-four patients (100 knees) underwent TKA under electromagnetic navigation,while 62 patients (100 knees) underwent conventional TKA.Three months after operation,the mechanical axial line angle and prosthesis position (angels α,β,γ) were measured via the full-length radiograph of both lower limbs and anteriorposterior and lateral Xrays of the knee.Results The average mechanical axial line angle and angle α were 1.20°±1.92°and 89.33°±1.64° in navigation group,respectively,and 2.31°±2.25° and 88.68°±2.57° in conventional group.And the differences were significant with regard to the above two indexes between two groups.The average angle β and angle γ were 89.64°±1.47° and 90.86°±2.37° in navigation group,respectively,and 89.26°±2.05° and 90.59°±3.44° in conventional group.However,the differences were not significant with regard to the above two indexes between two groups.After operation,mechanical axial line angle error was within ±3°in 86％ of patients in navigation group,while in 79％ of patients in conventional group; there was no significant difference between them.The angle α error was within 90°±3° in 92％ of patients in navigation group,while in 77％ of patients in conventional group; there was significant difference between them.However,there were no significant differences in percentage of patients whose errors of angle β and angle γ were within 90°±3° between two groups.Conclusion With using electromagnetic navigation in TKA,more precise prosthesis position and the mechanical axis can be achieved compared with the conventional technique.And its advantages mainly contribute to the coronal plane of the femoral side rather than the tibial side.

Objective To compare the discrepancy and consistency in mechanical axis and component position measured by electromagnetic navigation and radiograph in total knee arthroplasty (TKA)to assess whether the navigation system can be used as a substitute for radiograph.Methods A perspective study was performed on 40 cases (61 knees) undergone primary TKA under electromagnetic navigation from July 2006 to December 2006.There were 4 males and 36 females,at a mean age of (66.9 ±8.1) years (range,58-79 years).Mechanical axis angle,distal femoral and proximal tibial cut slope in coronal view (angles cα,β) were recorded both pre-and post-operatively with an intraoperative navigation system and compared against the mechanical axis angle,coronal femoral and tibial slope (angles α,β)measured via full-length radiograph of the lower limb preoperatively and at postoperative 3 months.Consistency in measurement of the same parameters with the two methods was assessed using intraclass coefficiency correlation (ICC).Results Mechanical axis determined by navigation and radiograph showed a mean valgus angle of 9.60° and 9.99° preoperatively and of 1.23° and 1.64° postoperatively,but the two pair parameters revealed no significant differences in the non-parametric test.Mean angle α determined by navigation and radiograph was 89.98° and 88.96° respectively (P ＜ 0.05),and mean angleβ was 90.21 ° and 89.59°respectively (P ＜ 0.05).With deviation value ≤3°,ICC for pre-and post-operative mechanical axis angles,angle α and angleβ was 0.887,0.754,0.632,0.640 respectively.Conclusions Within the acceptable range of deviation,intraoperative navigation data can reflect the pre-and post-operative mechanical axis and prosthesis position evaluated by radiograph.However,the advantages over the consistency of the two measurement methods rest with the evaluation of pre-and post-operative mechanical

Objective To investigate the effect of erythropoietin(EPO)on the expression of aquaporin - 2 (AQP2)in the kidney of young SD rats after release of bilateral ureter obstruction(BUO - R). Methods Thirty - two young SD rats were equally divided into 4 groups randomly(BUO group,BUO - R group,BUO - R ﹢ EPO group and Sham group,8 rats in each group). The BUO model was built through bilateral ureteral ligation. EPO(500 U/ kg)was given to BUO - R ﹢ EPO rats at 2 h after release of BUO,and then repeated 6 h,12 h,24 h and 36 h thereafter and the same volume of 9 g/ L saline was simultaneously given to BUO - R rats. The Sham group was prepared in parallel by laparotomy and free dissection of bilateral ureters but not ligated. Both side kidneys were harvested 48 h(72 h for Sham group)after release of BUO to examine the effect of EPO on the expression of AQP2 in inner medulla by immunohisto-chemistry,Real - time PCR and Western blot. The urine samples were collected by using metabolic cage before death. Results The osmotic pressure of BUO - R ﹢ EPO group was higher than that of BUO - R group,but lower than that of Sham group(P ﹤ 0. 05). Immunohistochemistry showed that the collecting duct wall thinned and lumen enlarged. After the pictures were analysized by using Image - Pro Plus software,it showed that the expression of AQP2 in collecting duct in BUO group was significantly down - regulated compared with that in Sham group,whereas,it was slightly weaker in BUO - R group and BUO - R ﹢ EPO group than Sham group(P ﹤ 0. 05). These results were further confirmed by a-dopting Western blot,and the relative quantity of AQP2 in BUO group was also the lowest of the four groups(P ﹤0. 05). Real - time PCR showed that the level of AQP2 mRNA in Sham group was(24. 30 ± 1. 03)folds of BUO group,(10. 60 ± 1. 05)folds of BUO - R group and(5. 70 ± 1. 01)folds of BUO - R ﹢ EPO group,respectively. Conclusion EPO could promote not only the recovery of AQP2 mRNA and protein expression but also the recovery of AQP2 function in young BUO - R rats.

BACKGROUND:It is generaly believed that the spine wil be extended, and vertebral muscle atrophy, bone loss of vertebral body, increased height and area of intervertebral disc, changes of composition of intervertebral disc wil occur in the condition of weightlessness. These are likely to be the cause of high incidence of low back pain. OBJECTIVE:To observe changes in lumbar spine bone microstructure analysis of simulated weightlessness on rhesus lumbar spine biomechanics. METHODS:Fourteen young rhesus monkeys were randomly divided into two groups: control group (n=7;free activities in the cage during the experiment), and experimental group (n=7; the use of head-down-10° on a special bed by bundle lying to simulate weightlessness). RESULTS AND CONCLUSION:(1) The results of Micro-CT examination: in the experimental group, structure model index in trabecular bone of increased. Trabecular bone changed from plate-like to the rod-like change. The intersection number of bone tissue in unit length to non-bone tissue declined. The average width of the canal between the trabecular bone increased, suggesting that there have been signs of osteoporosis in the experimental group. (2) Under an optical microscope, in the experimental group, bone hyperplasia line was disordered and irregular. Thick endplate trabecularbone became smal, shalow, and arranged substantialy perpendicular to the direction of trabecular bone and cartilage endplate. The closer the endplate surface, the smaler trabecular bone was. Compared with the control group, these smal trabecular bones were thin and curved. Bone marrow cavity was oval. The degree of the connection between the trabecular bones is poor, reflecting the structural characteristics of significant osteoporosis. (3) It is indicated that weightlessness affected the biomechanical properties of rhesus lumbar motion unit.