Objective To investigate the effects of salvianolate on noradrenaline(NE), angiotension-Ⅱ(Ang-Ⅱ)and tumor necrosis factor-α(TNF-α)in rats with congestive heart failure. Methods Sixty male SD rats were randomly divided into 6 groups, the normal control group(NCG), the model group, the captopril group(CAG), the low dosage of salvianolate group(LSG), the high dosage of salvianolate group(HSG), the captopril and high doseage of salvianolate group(CSG). The rats of Congestive Heart Failure were established with peritoneal injection of adriamycin except the rats in normal control group. The rats in normal control group were injected with the equal volume of normal saline once per week for 6 weeks. The medication was started in every group at the same time. Eight weeks later, the Left Ventricular Systolic Pressure(LVSP), Left Ventricular End-diastolic Pressure(LVDP), +dp/dtmax, -dp/dtmax were measured. The serum levels of NE, Ang-Ⅱ and TNF-αwere measured. Protein expressions of Ang-Ⅱ and TNF-αin cardiac muscle were detected by Western blot. Results Compared with the model group[(90.77±14.75)mmHg, (22.52±2.58)mmHg, (3 290.16± 109.61)mmHg/s, (3 114.07±112.39)mmHg/s], HSG[(114.10±13.71)mmHg, (19.97±1.14)mmHg, (3 504.97 ± 163.94)mmHg/s, (3 303.02 ± 121.98)mmHg/s ] and CSG [ (141.18 ± 15.42)mmHg, (15.58 ± 1.46)mmHg, (3 766.56±159.93)mmHg/s, (3 566.70±154.57)mmHg/s]had significant difference in LVSP, LVDP, +dp/dtmax, -dp/dtmax(P<0.05 or 0.01). Compared with the model group[(85.06±9.07)ng/ml, (180.11±25.45)pg/ml, (205.80±15.73)pg/ml], the serum levels of NE, Ang-Ⅱand TNF-αwere decreased in groups of HSG[(75.33±8.60)ng/ml, (149.21±25.39)pg/ml, (188.84±13.79)pg/ml], CAG[(71.49± 6.21)ng/ml, (139.15 ± 24.83)pg/ml, (183.73 ± 10.99)pg/ml ] and CSG [ (60.02 ± 7.38)ng/m, (110.68 ± 28.63)pg/ml, (165.93±16.22)pg/ml]in different degree(P<0.05 or 0.01), those of CSG were significantly lower than CAG(P<0.05). Compared with the model group[(1.043±0.044), (1.167±0.048)], the expression of protein in Ang-Ⅱand TNF-α were decreased in groups of HSG[(0.981±0.024), (1.069±0.055)]CAG [(0.954±0.031), (1.046±0.053)]and CSG[(0.886±0.044), (0.955±0.038)]in different degree(P<0.05 or 0.01), those of CSG were significantly lower than CAG(P<0.05). Conclusion Salvianolate can reduce the serum levels of NE, Ang-Ⅱand TNF-αin rats with congestive heart failure, decrease the expression of Ang-Ⅱand TNF-αin its cardiac muscle, improve the cardiac function.

Aiming at the cultivation goal and requirements as well as the current status of learning and applying medical statistics for medical doctoral students, a new idea of medical statistics teaching for medical doctoral students that combined theory with practice, science research and paper writing was proposed, with respect to improving the teaching content, teaching with clinical cases, enhancing the teaching material development, paying attention to the computer practice, and providing the writing standard for research papers.

Objective To find out whether the benefits entitled to peasants have increased since NRCM is in place in Beijing, and to analyze the extent of such benefit increase if any. Methods The first is to calculate changes to the reimbursement ratio of hospitalization charges for the peasants covered by NRCM; the second is to calculate the role played by NRCM for alleviating the catastrophic health expenditure of peasants. Results The reimbursement ratio of hospitalization charges for peasants covered by NRCM rose from 32.4% in 2004 to 45.4% in 2007. Survey data from districts and counties in the sampling test indicate that NRCM has gained an ever growing power in alleviating the catastrophic expenditure of peasants. Conclusion Recent years have witnessed a marked growth in medical charges, peasants' income, and peasants' demand for medical services. Against such a background, NRCM can still sharply downsize their catastrophic health expenditure, and its role keeps intensifying. This proves that the fund raising speed of NRCM has greatly outpaced the growth of medical charges and peasants' demand for medical services, and NRCM is playing a more effective role in alleviating the peasants from poverty caused by diseases.

BACKGROUND:Arthroscopy can observe the involutive relation of patelofemoral joint directly and dynamicaly, which can be used to judge whether the patelofemoral joint abnormalities can be completely corrected. OBJECTIVE:To analyze the clinical effect of lateral retinacular release and ligament reconstruction under arthroscope for patela recurrent dislocation. METHODS: A total of 58 patients diagnosed as having recurrent patelar dislocations were divided randomly into control and experimental groups, with 29 cases in each group. Patients in the control group received lateral retinacular release and ligament reconstruction under common operation and those in the experimental group received lateral retinacular release and ligament reconstruction under arthroscopy. RESULTS AND CONCLUSION:There was no significant difference in the Lysholm and Kujala scores before treatment in the two groups (P > 0.05), but at 12 months after treatment, the Lysholm and Kujala scores were both increased in the two groups, especialy in the treatment group (P < 0.05). No difference was found in the congruence angle and lateral patelofemoral angle with CT value at 30° of knee flexion (P > 0.05), and CT measurement values of the congruence angle and lateral patelofemoral angle were both decreased in the two groups, especialy in the experimental group, at 12 months after treatment. In addition, the operation time, healing time, and total effective rate were better in the experimental group than the control group (P < 0.05). These results indicate that the lateral retinacular release and ligament reconstruction under arthroscopy has a better effect on recurrent patelar dislocation.

AIM: To provide experimental evidence for gene therapy of thrombophilia disease, we constructed the eukaryotic expression plasmid with human thrombomodulin (hTM) gene and observed the alteration of hTM expression on the surface of human umbilical vein endothelial cells (HUVECs) with and without the reconstructive plasmid. METHODS: The whole expressive fragment of hTM gene was amplified by PCR from human genome. Both hTM gene and pcDNA3.1(+)/neo empty vector was digested by HindⅢ and EcoRⅠ. Two digested fragments were ligated into pcDNA3.1/hTM with T_4DNA ligase. After identifying, the reconstructive plasmid transfected into HUVECs using lipofectin. The hTM antigen on the HUVECs was detected by immunohistochemistry. RESULTS: The hTM reconstructive plasmid was confirmed by double endonuclease redigesting and sequencing. About 10% HUVECs were transfected by pcDNA3.1/hTM plasmid with lipofectin and the high-level hTM was detected on the transfected cells. CONCLUSION: We constructed the pcDNA3.1/hTM plasmid successfully, and it could be expressed on the HUVECs. [

Objective To develop the clinical application of tandem mass spectrometry in earlystage diagnosis of patients with growth retardation.Methods Tandem mass spectrometry was used to quantitatively detect blood amino acids and acyl carnitine in 155 cases of children with growth retardation.The tandem mass spectrometry results,clinical symptoms,and treatment tracking results were analyzed.Results Ten patients with inborn metabolic absence of amino acids and acyl carnitine were confirmed including four cases of methylmalonic acidemia,one case of propionic acidemia,one case of medium-chain acyl-coenzyme A dehydrogenase deficiency,one case of ornithine transcarbamylase deficiency,and three cases of phenylketonuria.Conclusions Tandem mass spectrometry was helpful for some patients in etiologic diagnosis and therapeutic effect assessment of cerebral developmental retardation.

Objective To investigate the relationship between esophageal motility and distal latency (DL) in gastroesophageal reflux disease (GERD) using high resolution manometry (HRM).Methods A total of 51 GERD patients underwent HRM and 24 h-esophageal pH monitoring.According to the HRM topography (characterized as either break peristalsis or normal esophageal movement),all GERD patients were divided into two groups:hypomotility group (n =28) and normal group (n =23).Fourteen non-GERD controls were enrolled.The monitoring results were analyzed.Results The HRM DL of 28 esophageal hypomotility patients(54.9％,28/51) were the longest (7.27 ± 1.44) s.Patients with normal peristalsis also had longer latency (6.70 ± 1.41)s than the non-GERD controls (5.86 ± 0.96)s.All the differences were statistically significant (P ＜ 0.01).DCI of hypotensive peristalsis patients (712.49 ± 703.10) mmHg · s · cm was lower compared with the other groups [(1 285.85 ± 850.83) mmHg · s · cm,(1 109.74 ± 611.70) mmHg · s · cm] (P ＜0.O1).Other indicators such as LES pressure,CFV and IBP showed no significant differences among groups (P ＞ 0.05).Conclusion Esophageal manometry of GERD patients indicates that esophageal hypomotility is accompanied with prolonged DL.Because DL of all GERD sufferers are extended,esophageal dysmotility has great implications for GERD's development.

BACKGROUND:With the development of surgical techniques and reconstruction material technology, joint replacement has also been widely used in the dislocation of the shoulder;especial y al kinds of custom-made or assembled prosthesis make replacement indications improved evidently. OBJECTIVE:To investigate the long-term effects of arthroscopy or arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects. METHODS:144 patients with recurrent anterior dislocation of the shoulder joint with severe bone defects were enrol ed in this study. They were divided into treatment group and control group based on a random drawing (n=72). The control group was given arthroscopic surgery, and the treatment group was subjected to arthroplasty. The 3 years of fol owed-up were done by telephone investigation and further consultation. Neer shoulder score, shoulder activity and complications were recorded.
RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

BACKGROUND:Traditionaly, non-surgical treatment was used to treat degenerative femoral intercondylar fossa impingement syndrome, but it can cause function loss of cruciate ligament, or knee instability. With the development of medical technology, more and more views believed that ligament damage and combined with other knee structural damage should receive surgery as soon as possible.
OBJECTIVE: To investigate the repair effect of knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome, and compare with AO cannulated screw fixation.
METHODS:A total of 72 patients with degenerative femoral intercondylar fossa impingement syndrome were equaly and randomly divided into treatment group and control group. Patients in the control group were treated with open AO cannulated screw fixation, and patients in the treatment group were subjected to knee arthroplasty. At 7 days after treatment, repair effect was evaluated. Before treatment and 7 days after treatment, knee function was assessed by using Lysholm knee Scoring Scale and the international knee documentation committee knee evaluation form. Al patients were folowed up for 6 months after treatment to investigate the occurrence of complications.
RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. At 7 days after treatment, the excelent and good rate was 94% in the treatment group and 75% in the control group. The excelent and good rate was significantly higher in the treatment group than in the control group (P < 0.05). Lysholm scores were significantly greater, but the international knee documentation committee knee evaluation form scores were significantly lower at 7 days after treatment compared with that before treatment in the treatment group (P < 0.05). Simultaneously, Lysholm scores and the international knee documentation committee knee evaluation form scores were significantly better in the treatment group than in the control group at 7 days after treatment (P < 0.05). During 6-month folow-up, wound infection, intra-articular infection, joint pain, and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). These findings indicate that knee arthroplasty for degenerative femoral intercondylar fossa impingement syndrome can improve short-term efficacy, effectively restore knee function and reduce the incidence of postoperative complications.

Objective To further improve the morphological materials of AGs by micro-dissection, histology and CT, we observed the arachnoid granulations (AGs) in middle cranial fossa. Methods Thirty-three adult cadaveric heads were used for microsurgical dissection;Histological sections of AG specimens from 3 cadaver heads were examined. Forty patients who had both normal conventional brain CT and computed tomographic venography (CTV) were retrospectively reviewed. Results In middle cranial fossa the AGs occur in the following situations in order of frequency: the middle meningeal sinus, sphenoparietal sinus, lateral foramen rotundum and cavernous sinus. AGs usually show round, oval in shape and irregular in shape. AGs can be divided into individual type and leaflet type under light microscope. The numbers of AGs were observed by microanatomy and CTV were 8.72 and 3.52 respectively. The AGs of cavernous sinus was not localized precisely on CTV. Conclusion Study of the AGs in the middle cranial fossa systematically and comprehensively enriches anatomy and image knowledge. It is helpful in neurosurgical planning and choosing operalion procedure to avoid postoperative complications.