Objective To investigate the effect of ulinastatin on postoperative cardiac troponin I ( cTnI) in patients underwent carotid endarterectomy ( CEA) under general anesthesia. Methods Forty patients with severe symptomatic carotid artery stenosis underwent unilateral CEA under general anesthesia from January 2011 to March 2012 were divided into either a ulinastatin group or a control group according to a random number table ( n=20 in each group) . Patients in the ulinastatin group received 500 000 U of ulinastatin via veins before induction of anesthesia. The patients in the control group were given the same amount of isotonic saline. The serum concentrations of cardiac troponin I ( cTnI ) were detected before surgery and at day 1,2,and 3 after procedure. Myocardial injury was defined as the cTnI peak concentration>0. 04μg/L . Results The levels of serum cTnI before procedure and at day 1,2,and 3 after procedure in the ulinastatin group were median (M) 0. 00 (0. 00-0. 03) μg/L,0. 07 (0. 00-1. 45) μg/L,0. 01 (0. 00-1. 21)μg/L,and 0. 05 (0. 00-0. 89)μg/L,respectively;those in the control group were 0. 00 (0. 00-0. 01)μg/L,0. 00 (0. 00-1. 42)μg/L,0. 00 (0. 00-1. 39)μg/L,and 0. 00 (0. 00-1. 24)μg/L, respectively. At day 1 after procedure,6 patients ( 30%) in the control group and 11 ( 55%) in the ulinastatin group occurred myocardial injury. There was no significant difference between the two groups (P<0. 05). In all the patients with the increased cTnI levels,the peak cTnI occurred at the first day after procedure,however,they did not reach the level ( >1. 5μg/L) of indicating patients occurring myocardial infarction. Conclusion Ulinastatin may not decrease the postoperative serum cTnI levels in CEA patients under general anesthesia. For whether to the CEA patients have myocardial protective effect,more samples are needed to be confirmed.

Objective To observe the effect of clapping acupoint on hyperosteogeny of lumbar vertebra. Methods Ninety-eight cases were randomly divided into 65 cases treated by clapping Ashi point in treatment group and 33cases treated by simple acupuncture in control group.Results Among 65 cases in treatment group, 52 cases were cured and 13 cases were not cured; of 33 cases in control group, 19 cases were cured and 14 cases were not cured, and there had significant difference in cure rate between the two groups, x2 =5.51, P ＜0.05. Conclusion Treatment of hyperosteogeny by clapping acupoint was better than simple acupuncture therapy.

An analysis of the results of examination of diagnostics teaching in the middle of the semester of 2008 grade is made to discuss the pnoblems existing in teaching and learning so as to improve the teaching quality.

ve To explore the mutagenicity of selenium and lead, the antagonistic effects of selenium on lead. Methods The ICR mice were orally perfused with sodium selenite (Na2SeO3) at different concentrations of 2.5,5.0 and 10 mg/kg and lead acetate [Pb(Ac)2] at different concentrations of 5,10 and 25 mg/kg jointly and con-tinuously for 3 days, and then the numbers of bone marrow polychromative erythrocytes were counted. Results The frequencies of micronucleus of mice only exposed to 10 mg/kg Na2SeO3, 10, 25 mg/kg Pb(Ac)2 respectively showed higher levels compared with those of control (P

Objective To investigate the treatment of combined subclavian artery and brachial plexus injury. Methods Since 1994, we have treated 5 cases of combined subclavian artery and brachial plexus injury. 2 of them were cut wound, 1 gun shot wound, and 2 blunt trauma. 2 cases had combined aneurysm and 1 had combined aneurysm plus A V fistula. According to the sites of subclavian artery injury, vein graft( 1 case) , suture repair( 1 cases) and ligation (1 case) were performed. The 2 cases of blunt trauma underwent only neurolysis because of masses of hematoma and tissue adhesion. Results The 3 cases of open injury who had underwent early repair of artery and nerve had various degrees of recovery of nerve functions and experienced no pain in the injured extremities. As for the 2 cases of blunt trauma, 1 got only pain relief and 1 had no recovery. Conclusion Dysfunction due to hematoma or progressive pseudoaneurysm compression on the brachial plexus can be relieved and patients can get maximal rehabilitation if hematoma or aneurysm is managed in time and the brachial plexus nerve is decompressed early.

Objective To explore the influence of type 2 diabetes mellitus combined with subclinical hypothyroidism on diabetic vascular complications.Methods One hundred and two patients with type 2 diabetes mellitus were selected.The serum free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),anti-thyroid peroxidase antibody (TPO-Ab),thyroglobulin antibody (TG-Ab) levels were measured by chemiluminescence method.The patients were divided into type 2 diabctes mellitus combined with subclinical hypothyroidism group (47 cases) and type 2 diabetes mellitus with normal thyroid function group (55 cases) according to the thyroid function.The glycated hemoglobin (HbA1c),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and albumin levels were measured.The estimated glomerular filtration rate (eGFR) was calculated according to the formula of modification of diet in renal disease (MDRD).The presence of diabetic retinopathy was examined by fundus examination,and the presence of lower limb artery lesions was measured by vascular ultrasound.All indicators were compared between 2 groups.Results There were no statistical differences in age,disease course,HbA1c,body mass index (BMI),TC,TG,HDL-C,LDL-C,incidence of lower limb artery lesions and incidence of diabetic retinopathy between 2 groups (P＞ 0.05).TheeGRF in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significantly lower than that in type 2 diabetes mellitus with normal thyroid function group:(83.74 ± 21.55) ml/(min· 1.73 m2) vs.(115.02 ± 12.29) ml/(min· 1.73 m2),and there was statistical difference (t =4.274,P ＜ 0.01).The incidence of diabetic nephropathy in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significanlty higher than that in type 2 diabetes mellitus with normal thyroid function group:48.9％ (23/47) vs.23.6％(13/55),and there was statistical difference (x2 =7.103,P＜ 0.01).Logistic regression analysis showed that subclinical hypothyroidism was a risk factor for diabetic nephropathy (OR =0.524,95％ CI 0.12-0.93,P ＜ 0.05),but it was not the risk factor for diabetic retinopathy (OR =0.618,95％ CI0.19-2.16,P =0.475) and lower limb artery lesions (OR =0.485,95％ CI 0.32-2.13,P =0.689).Conclusion Subclinical hypothyroidism in patients with type 2 diabetes mellitus has no obvious effect on lower limb arterial complications and diabetic retinopathy,but may increase the risk of diabetic nephropathy.

Objective To investigate the biomechanical properties of the posterior tibial anatomic plate. Methods A total of 25 fresh frozen adult tibial top and matching femur specimens were randomly divided into four groups. One specimen was used as normal control ( N group), and the remaining 24specimens were with Schatzker Ⅵ tibial plateau fracture and accompanied by rear split and backward fracture displacement. The lateral margin of the tibia was fixed with a L-type plate, and the medial margin was fixed with the same plate after remodeling. The 24 specimens were divided into three groups, eight specimens per group. The posterior margin of the tibia was fixed by posterior tibial anatomic plate ( Group A), T-type plate ( Group B) or straight reconstruction plate ( Group C). The strength, stiffness, torsional biomechanics and failure load performance of the plates in each group were evaluated. Results The strength and stiffness of test groups was superior to that of Group N ( P ＞ 0.05 ), and the torsional biomechanics of test groups was close to that of Group N ( P ＞ 0.05 ). The posterior tibial anatomic plate was superior to T-type plate and straight reconstruction plate in aspects of strength, stiffness, torsional biomechanics and failure load performance ( P ＜ 0.05 ). Conclusions Posterior tibial anatomic plate has excellent biomechanical properties, and it is superior to other materials in treating posterior tibial plateau fracture and restoring the stability of the knee.

Adult ; Humans ; Lead Poisoning ; etiology ; Male

Objective To investigate the application of transthoracic echocardiography (TTE) and 320-row CT in diagnosis of complex congenital heart disease(CCHD).Methods A retrospective analysis was performed in 68 patients with CCHD,which contained the echocardiographic apprarance,320-row CT and surgical outcoming.All of malformations were divided into three groups:intracardiac group,heart-large vascular connecting group and extracardiac group.Results One hundred and eighty-four malformations were comfirmed by surgery in the 68 cases.The misdiagnosis and missed diagnosis rate of CT and TTE:for the intracardiac anomalies were 12％ (11/93),1％ (1/93) respectively (P ＜ 0.05),for the heart-large vascular connecting malformation were 4％ (2/49),6％ (3/49) respectively (P ＞ 0.05),and for the extracardiac anomalies were 2％(1/42),19％(8/42) respectively (P ＜0.05),for the total anomalies were 8％(14/184),7％ (12/184) respectively (P ＞0.05).While it was 1％ (2/184) in diagnosis of total anomalies by both CT and TTE.Conclusions Both 320-row CT and TTE have their own advantages and shortcomings in the diagnosis of CCHD.Joint application of two methods could reduce the rate of misdiagnosis and missed diagnosis of CCHD.

Objective To investigate the effect and the mechanism of different G-CSF-priming protocols on leukemia cell lines (HL-60 and U937) in vitro and provide the clinical guidance to clinical treatment of acute leukemia.Methods The leukemia cell lines HL-60 and U937 were used as model to detect the effects of three drugs alone and combined two drugs (HA) or three drugs (HAG) respectively.Cell viability and cell growth inhibition were performed by cell count kit-8 (CCK-8) assay.Apoptotic marker AnnexinV/PI,cell membrane surface antigen CD11b,cell cycle,mitochondrial membrane potential (JC-1) and Caspase-3 were determined by flow cytometry.Results After using of HAG for 48 h,HL-60 and U937 cells counts were decreased significantly and the apoptotic marker Annexin V was significantly increased. To compare the single drug group with two drug combination group,the result was significantly different (P ＜0.05),and the apoptosis of U937 cells was higher than HL-60 cell line.CD11b expression among the three groups did not change (P ＞ 0.05).Using of CAG and MAG,the mitochondrial nembrane potential of HL-60 and U937cells was increased,the three-drug combination group was significantly higher than single-drug group and control group (P ＜0.05); Caspase-3 was activated,the fluorescence intensities of Caspase-3 of the three-drug combination group and single drug group were significantly higher (P ＜0.05) comparing with the control group.Conclusion HAG regimen could induce leukemia cells to apoptosis through the reduction of mitochondrial membrane potential and the activation of Caspase-3 to induce apoptosis of leukemia cells.