With advances in arthroscopic surgery, arthroscopic repair for rotator cuff tears is often used by surgeons. Surgi?cal methods have already developed from simple single?row fixation and double?row fixation to complicated suture?bridge fixation. Although arthroscopic suture?bridge rotator cuff repair has been proposed to be advantageous over single?row and double?row fixa?tion in biomechanical constructs, the failure of rotator cuff repair is still higher. Different suture methods of medical row anchor in arthroscopic suture?bridge technique may change the suture?tendon loading and decrease the retear of suture?tendon. And differ?ent fixation methods of lateral row anchor in arthroscopic suture?bridge technique may decrease the anchor pull?out. These will be useful to decrease the failure of arthroscopic suture?bridge technique. There will be a good outcome if optical suture and fixation approach can be chosen according to the quality and retraction of rotator cuff, suture tension and the bone quality of the greater tu?berosity in arthroscopic suture?bridge technique.

Objective To explore the effect of donepezil combined with memantine in ameliorating the cogni-tive function and psychological behavior of patients with Alzheimers'disease(AD).Methods 214 AD patients were randomly divided into the control groupand observation group.The control group were treated with memantine,and the observation group were treated donepezil combined with memantine.Before and after treatment,MMSE and WHO -UCLA AVLT,BEHAVE -AD were utilized to assess the cognitive function,psychological behavior,respectively.The adverse effects were observed using TESS and laboratory examination.Results The scores of MMSE and its subitem, WHO -UCLA AVLT(Immediate memory,short -term memory and long -term memory)after treatment significantly increased as compared with those before treatment in the control group and the observation group(P <0.01 or P <0.05),while the cases of psychological behavior,the score of BEHAVE -AD and its subitem decreased(P <0.01 or P <0.05).The observation group showed statistically significant difference in the increasion of the scores of MMSE and its subitem,WHO -UCLA AVLT,and the decreasion of the cases of psychological behavior,the score of BE-HAVE -AD and its subitem comparison with the control group(t =-1.742,-1.431,-1.626,-2.173,-1.448,-1.026,-1.016,-1.279,-1.971,χ2 =12.295,7.609,8.917,t =0.778,1.139,2.004,1.153,0.822,1.944, P <0.01 or P <0.05).The total effective rate of the observation group was 90.65%,and 71.96% of the control group,there was a significant difference between the two groups(χ2 =12.299,P <0.01).There was no obvious side effects during the treatment in both groups.Conclusion Donepezil combined with memantine can significantly improve the cognitive function and psychological behavior of AD patients,and there are fewer adverse events.

Objective To adopt 5 kinds of platelets aggregation function analyzer to explore and study the reliable method for detecting the platelets aggregation function and accurate parameters .Methods The platelets aggregation function in the control group and the single clopidogrel group was simultaneously detected by utilizing the ADP induced light turbidimetric platelet aggre‐gation analyzer (LTA) test ,flow cytometry for PAC‐1(receptor of Fg ,Ca2+ ,GPⅡb/Ⅲa forming complex) and CD62p(P selectin) activation percentage detection test ,Innova PL‐11 for platelets analysis test ,VerifyNow anti‐platelet therapy monitoring system and thrombelastogram(TEG) .Results (1)The 6‐parameter differences of ADP% ,PAC‐1 and CD62p receptor activation percentage ac‐tivated by ADP ,MAR% ,INHI% ,ADP induced MA value(mm) detected by TEG had statistical differences between the control group and the case group(P< 0 .05);PRU of BASE and P2Y12 receptor ,thrombin induced MA value (mm) had no statistical differences between these two groups(P>0 .05) .(2)ADP% was positively correlated with (100‐INHI)% ,MAR% ,ADP activated CD62p and PAC‐1 receptor activation percentage(r=0 .565 ,0 .939 ,0 .769 ,0 .583 ,P<0 .05 );while which had no correlation with ADP induced platelets aggregation value(% Agg) detected by TEG(r=0 .794 ,0 .715 ,0 .889) .Conclusion (1)Clopidogre has the anti‐platelets effect .(2)LTA is easily operating ,cheap and stable in detection results ,has high popularizing rate in hospitals and is the first option method for clinically monitoring the platelets aggregation function .

Objective To investigate the effects of homocysteinemia (HHcy) and hypertension on left ventricular re?modeling. Methods A total of 275 patients with coronary heart disease were divided into four groups including H-type hy? pertension group (n=96), non-H-type hypertension group (n=44), HHcy+non-hypertension group (n=53) and control group (n=65) based on their blood pression levels and plasma HHcy levels. The serum levels of glucose (Glu), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL) were compared between groups. The left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (IVST) and left ventricular mass index (LVMI) were observed in four groups. The proportion of patients with left ventricular remodeling was also compared between four groups. The influence fac?tors of left ventricular remodeling were analysed. Results There were no significant differences in biochemical parameters except Hcy level between frour groups. The values of LVMI, left ventricular wall thickness and the proportion of patients with left ventricular remodeling were significantly higher in H-type hypertension group than those of other three groups ( P<0.05). The Hcy level was positively correlated with LVMI and left ventricular wall thickness. Logistic regression analysis showed that HHcy and hypertension were the risk factors of left ventricular remodeling (OR=7.443, 7.754 and 9.948,P<0.05). The risk factors of left ventricular remodeling were higher in patients with both HHcy and hypertension than those in patients with HHcy or hypertension. Conclusion Homocysteine and higher systolic pressure are independent risk factors for left ventricular remodeling and they have a synergistic effect on leading to left ventricular remodeling.

Objective To detect clopidogrel effect with light transmission aggregometry (LTA)and flow cytometry (FC). Methods ①Venous blood samples were taken from 71 inpatient with acute corotary syndrome (ACS)in PLA General Hos-pital,including unstable anqina,ST segment elevation myocardial infarction and non ST segment elevation myocardial infarc-tion (46 males,25 females)by random number table from June 2011 to March 2012,whose average age was 69(57~92).②All of them were served 160 mg aspirin and 300 mg clopidogrel after they were in hospital in the beginning,and then served with 75 mg/d clopidogrel for 6 months.On some day,firstly,they were required withdrawing drug for 10 days,and then ve-nous blood samples were separately taken from them before their served-clopidogrel again and their severd-clopidogrel 2 hours later.③The samples were assayed with LTA and FC simultaneously and the platelet aggregation rates before served-clopidogrel (ADPLTA-before serving ),platelet aggregation rates after served-clopidogrel (ADPLTA-after serving ),inhibition rates (ADPLTA-INDU ),PAC-1 activity percentage before served-clopidogrel (PAC-1 before serving ),PAC-1 activity percentage after served-clopidogrel (PAC-1 after serving ),inhibition rates (PAC-1 INHI ),CD62p activity percentage before served-clopidogrel (CD62pbefore serving ),CD62pactivity percentage after served-clopidogrel (CD62pafter serving ),inhibition rates (CD62pINHI )weregotten.All volunteers were signed informed consents and the experiment was approved by the hospital ethics committee.Re-sults ①The paired samples t-test was (t=-2.082,P =0.041)between ADPLTA-before serving (0%~97%)and ADPLTA-after serving (12%~97%),the paired samples t-test was (t = 3.663,P < 0.01)between PAC-1 before serving (15.1% ~ 78.9%)and PAC-1 after serving (14.5% ~ 78.3%);the paired samples t-test was (t = 2.082 and P = 0.041)between CD62pbefore serving (1.5% ~80.8%)and CD62pafter serving (1.4%~41.4%).②The pearson coeffcient correlation results were:ADPLTA-INDU (0%~28.2%) and PAC-1 INHI (0.6%~ 9.1%)(r = 0.297,P = 0.012);ADPLTA-INDU (0% ~ 28.2%)and CD62pINHI (0.1% ~ 48.5%)(r =0.220,P =0.065);PAC-1 INHI (0.6%~9.1%)and CD62pINHI (0.1%~48.5%)(r=0.736,P <0.001).Conclusion Because the correlation was bad between the inhibition rates of clopidogrel detected by FC and them by LTA,FC didn’t apply to clin-ical routine examination of the platelet aggregation.But it could be used to scientific researchs and auxiliary confirmation of routine examination results.

Objective To analyze the construction of mouse liver phosphoproteome and phosphorylated kinases to provide useful information for integrating mouse kinase phosphorylation regulatory networks.Methods A new method was established to identify phosphoproteome from the mouse liver.First of all, liver protein was digested with trypsin before the resulting peptides were subjected to a two-step phosphopeptide enrichment and separation procedure consisting of TiO2 chro-maphy enrichment combined with high pHHPLC separation.Samples were injected onto aNanolC-Ultra-2Dplus system cou-pled to an AB-Sciex 5600 Triple TOF mass spectrometer instrument.Then data analysis was performed to provide information of new identified phosphorylation sites of kinase.Results and Conclusion Using our efficient and high-throughput platform, we reported the identification of 5386 phosophorylation sites and 4553 phosphopeptides from 1533 proteins of the mouse liver.126 new phosphorylation sites were identified from 116 kinases, which provides valuable infor-mation for phosphorylation networks in the mouse liver.

BACKGROUND:A few studies have reported that autologous chondrocyte implantation is better than microfracture for treating cartilage defects of the knee. But there are few meta-analyses on the clinical outcomes of autologous chondrocyte implantation versus microfracture. OBJECTIVE:To evaluate the effects of autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee based on existing clinical data. METHODS:A systematic search for control ed clinical trials or control ed prospective observational studies published from 1979 to January 2015 was done in electronic databases MEDLINE, EMBASE, CINAHL, the Cochrane Central Register, Wanfang, CNKI and VIP. The literatures about the effects of autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee were retrieved. We screened the retrieved literature according to the inclusion and exclusion criteria and performed a Meta-analysis with the software RevMan 5.2 after identification of the relevant data. RESULTS AND CONCLUSION:Eight studies were enrol ed according to the selection criteria, which revealed a statistical y significant difference, representing a clinical y relevant superiority of autologous chondrocyte implantation over microfracture, in IKDC scores at final fol ow-up [weighted mean difference (WMD),-9.93;95%confidence interval (CI):-13.16 to-5.43;P<0.000 01] and available scores at 5-year fol ow-up [standard mean difference (SMD),-0.30;95%CI: -0.55 to-0.05;P=0.02). In contrast, there were no significant differences, thus representing no clinical relevant superiority of microfracture versus autologous chondrocyte implantation, in Tegner scores at final fol ow-up (WMD=0.44;95%CI:0.04 to 0.84;P=0.03), Lysholm scores at final fol ow-up (WMD=-10.21;95%CI:-33.68 to 13.26;P=0.39), and available scores at 2-year fol ow-up (SMD=-0.25;95%CI:-0.92 to 0.43;P=0.47). These findings demonstrate that autologous chondrocyte implantation can result in a better long-term outcome than microfracgure. However, whether autologous chondrocyte implantation has a better treatment effect than microfracture in general needs more research.

Objective To explore the variation of E-index and M-index of rabbits with acute pulmonary embolism (APE) under the status of pulmonary hypertension (PHT). Methods Rabbit models of APE with PHT were established. A series of parameters [including peak early diastolic mitral inflow velocity (EM), peak late diastolic mitral inflow velocity (AM) and so on] were obtained with routine echocardiography and tissue Doppler imaging (TDI);and then E-index, M-index were calculated. The parameters before and after APE were compared. Results Twenty-three rabbit models with APE were successfully established, but 3 with atrial fibrillation were excluded. After APE, pulmonary artery pressure increased significantly, EM decreased observably, whereas right ventricular myocardial performance index (RVMPI) increased more evidently than left ventricular myocardial performance index (LVMPI) (P<0.01) did and E-index decreased and M-index increased remarkably. Conclusion Changes of E-index and M-index may provide reference for quantitative assessment of early APE.

Objective To study the effect of early mechanical ventilation in treatment of patients with severe acute pancreatitis(SAP).Methods Fifty-two patients with SAP admitted in the First People's Hospital of Zhaoqing from January 2010 to January 2015 were randomly allocated into two groups (n =26),early mechanical ventilation group(observation group) and conventional mechanical ventilation group(control group).Patients in the observation group treated with early lung protective ventilation when PaO2 ＜ 13.3kPa.Patients in the control group treated without mechanical ventilation untill PaO2 ＜ 8kPa.The symptoms,the extent of inflammatory reaction,the severity of lung lesions and the mortality of two groups were compared through monitoring vital signs,abdominal circumference,APACHE Ⅱ score,bladder pressure,oxygenation index (PaO2/FiO2),C reactive protein (CRP),procalcitonin (PCT),hospital stay and mortality.Results No statistically significant differences in the APACHE Ⅱ score,bladder pressure,oxygenation index,CRP and PCT in two groups before treatment were observed(P ＞ 0.05).The APACHE Ⅱ score (12.8 ± 7.6) points,bladder pressure (14.9± 7.9) cmH2O,CRP (48.8 ± 30.1) rmg/L,PCT (1.25 ± 0.55) μg/L,mortality (3.84％) of the observation group after treatment were significantly lower than those of the control group (t =2.057,2.091,3.252,2.697,x2 =4.305,all P ＜ 0.05),while the oxygenation index in the observation group [(300.0 ± 34.9) mmHg] was significantly higher than that in the control group [(278.1 ± 32.8) mmHg],the difference of the two groups was statistically significant (t =3.322,P ＜ 0.05).Conclusion Early lung protective ventilation is safe and effective for treatment of the patients with SAP.

Objective To systematically review the efficacy of arthroscopic distal clavicle resection (DCR) in repair of rotator cuff (RCR) with acromioclavicular arthritis.Methods The Cochrane Library,PubMed,Medline EMbase,CBM and WanFang Data were searched for studies up to May 2016 concerning the efficacy of arthroscopic distal clavicle resection in repair of rotator cuff with acromioclavicular arthritis.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data and assessed the methodological quality of the studies included.Next,meta-analysis was performed using RevMan 5.3 software to compare the efficacy between the patients undergoing arthroscopic DCR plus RCR and those undergoing simple arthroscopic RCR.The randomized control trails (RCT) and clinical control trials (CCT) included were evaluated according to Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) and Methodological Index for Non-randomized Studies (MINORS),respectively.Results A total of 5 studies (3 RCTs and 2 CCTs) involving 465 patients were included.No statistically significant difference was found between the RCR and the DCR plus RCR patients in Visual Analogue Scale (VAS) score,Constant score,American Shoulder and Elbow Surgeons (ASES) score,shoulder range of motion (ROM),postoperative acromioclavicular pain or rotator cuff retear (P ＞ 0.05).The 3 RCTs showed moderate bias risk and the 2 CCTs scored 21 MINORS points.Conclusion Since current evidence shows no advantages of arthroscopic DCR over RCR in repair of rotator cuff with acromioclavicular arthritis in VAS score,Constant score,ASES score,shoulder ROM,postoperative acromioclavicular pain or rotator cuff retear,arthroscopic DCR should not be recommended for routine use in clinic.