Objective To evaluate the clinical results of an anatomical reconstruction technique for the lateral ligaments with semitendinosus autografts in treatment of chronic lateral ankle instability.Methods From October 2008 to October 2009, 16 patients with lateral instability of the ankle underwent surgery using the proposed methods. They were 8 men and 8 women, with a mean age of 28.2 years (range,19 to 47 years) . Nine patients received only the anterior talofibular ligament reconstruction. Seven patients received both the anterior talofibular ligament and the calcaneofibular ligament reconstruction. Standard stress radiographs under anesthesia were taken to determine which ligament would be reconstructed. The semitendinosus autografts were secured to the fibular insertion site with suture anchors and to the talar or calcaneus insertion site with interference screws. The American Orthopaedic Foot and Ankle Society (AOFAS) scores and standard stress radiographs were used to assess the patients preoperation and at the last follow-up.Results We had a mean follow-up of 12. 1 months (range, 6 to 18 months). In the 16 patients, the average preoperative AOFAS score was 70. 50 ± 3.98, and the final average AOFAS score increased to 93.06 ± 4. 78 ( t = - 24. 010, P = 0. 000). Their average anterior drawer sign improved from 8. 75 ± 3.38 mm to 3.51 ±1.63 mm ( t = 7. 028, P = 0. 000). In the 7 patients who had received both lateral ligaments reconstruction,their average talar tilt improved from 16. 18° ± 7.30° to 5.57° ± 2. 99° ( t = 5. 661, P = 0. 001 ). No significant complications were found in all but one patient who had a 10° limitation of dorsal flexion of the ankle.Conclusions Our short-term results reveal that anatomical reconstruction of the ligaments with chronic lateral ankle instability using the above-mentioned methods may be effective and have the advantages of precise anatomical reconstruction, firm fixation of the grafts, mini-invasive procedure for the fibular skeletal structure and peroneal tendons, and saving the length of grafts.

The DNA microarray study showed that in STZ-induced diabetic rats the elevatedexpression of 42 genes in artery were depressed markedly after atorvastatin treat ment .This suggeststhat atorvastatin may have the protective effects on the diabetic vascular lesion.

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 study the effects of peroxisome proliferators-activated receptor (PPAR) ? on the growth of human hepatocellular carcinoma cells and explore the roles of phosphatase and tensin homologue deleted on chromosome ten (PTEN) and phospho-Akt in this process. Methods SMMC-7721 cells were treated with 15-d-PGJ2 or pioglitazone, which were two kinds of PPAR? ligands, at different concentrations. The viability of SMMC-7721 cells was evaluated by MTT assay. The cell cycle was analyzed by flow cytometry. PTEN mRNA level was determined by RT-PCR. The protein expressions of PTEN and pAkt were measured by Western blot analysis. Results It was demonstrated through MTT assay that both 15-d-PGJ2 and pioglitazone had an inhibitory effect on the growth of SMMC-7721 cells in a time- and dose- dependent manner. According to flow cytometry detection, more cells were arrested in G0/G1 phase. Increased expression of PTEN mRNA was detected in 15-d-PGJ2 or pioglitazone-treated cells through RT-PCR. Increased expression of PTEN protein and decreased expression of pAkt were confirmed by Western blot analysis. Conclusion The ligands of PPAR? could inhibit SMMC-7721 cells proliferation in a time- and dose- dependent manner. The upregulation of PTEN may be involved in the underlying mechanism.

AIM To establish an HPLC method for the simuhaneous content determination of five flavonoids in Duchesnea indica (Andr.) Focke at five picking time (April,May,June,July and August).METHODS The analysis of D.indica methanol extract was performed on a 25 ℃ thermostatic Agilent ZORBAX SB-C18 column (250 mm×4.6 mm,5 μm),the mobile phase comprising of acetointrile-0.1％ methanoic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 350 nm.RESULTS Rutin,hyperoside,isoquercitrin,celereoin and kaempferol showed good linear relationships within their own ranges (R2 ≥0.998 6),whose average recoveries were 97.1％-101.5％ with the RSDs of 1.37％-2.37％.The contents of five constituents in samples at different picking time exhibited obvious differences,among which lutin and hyperoside contents were the highest in June,isoquercitrin content was the highest in July,and celereoin and kaempferol contents were the highest in August.CONCLUSION The suitable picking time of D.indica is June and July.

Objective To describe a minimal invasional surgical procedure for the treatment of avulsion fracture of tibial intercondylar eminence. Methods From July 1999 to December 2000, 26 cases of avulsion fracture of tibial intercondylar eminence were treated. With the arthroscope, reduction and absorbable suture fixation of anterior cruciate ligament or the avulsion fracture were performed. Taking the advantage of ACL－ aimer, bone tunnels, through which the suture can be pulled out and tied outside the joint, could be accurately produced. Results Twenty-two patients were available for 2－ 17 months(mean 10.5 months) follow-up. Seventeen patients gained normal range of motion, 5 have limited flexion but exceeded 90 degrees. X－ ray demonstrated bone union in all the cases and anatomical reduction obtained in 21 cases. Conclusion Arthroscopically guided operation, gives less trauma, and is a simple and effective method for the avulsion fracture of the tibial intercondylar eminence.

Objective To study the effect of specific hammerhead ribozyme (Rz) to hepatitis C virus (HCV) in vitro. Methods Rz 1 Rz 2 were designed to cleavage at 5′-NCR nucleotide positions under 136～160 and 313～337, Rz 3 was designed to cleavage at C region nucleotide position under 373～388. As a control, cleavage deficient Rzm that have A→G point mutations in the catalytic loop of the hammerhead domain. 32P-labeled transcript of target HCV RNA was incubated with gel-purified Rz ( Rz 1, Rz 2, Rz 3 and Rzm ) respectively at different concentration based on specified condition and autoradiographed after denaturing gel-electrophoresis. Results Except Rzm, Rz 1 Rz 2 Rz 3 were active at 37 ℃ and more so at higher concentration, and more so with cleavage site nearly to the HCV initial code. Conclusions The HCV specific hammerhead ribozyme can be designed in vitro, further study about cleavage in vitro and in vivo will continue.

AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients,to observe the patients` visual quality,to evaluate the patients` distance visual acuity,near visual acuity,Pseudo-accommodative power,residual astigmatism,the rotational stability of AcrySof IQ Toric Restor intraocular lens (IOLs),contrast the rate of off-distance glass,the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.METHODS:Carried out in 46 patients (48 eyes) with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016.All the cases were randomly divided into 2 groups: experimental group: 23 cases (24 eyes),AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification;control group: 23 cases (24 eyes),AcrySof IQ was implanted.Uncorrected distance visual acuity (UCDVA) and best corrected distance visual acuity (BCDVA),uncorrected near visual acuity (UCNVA) and best-corrected near visual acuity(BCNVA),Pseudo-accommodative power,residual astigmatism,preoperative and postoperative corneal astigmatism,the rate of off-distance glass,the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05).At 1wk,1,3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group (P<0.05).UCNVA were also statistically better than the control group (P<0.05).The mean residual astigmatisms 1wk,1,3 and 6mo postoperatively were statistically differences between the control group and experimental group (P<0.05).At 6mo postoperatively,patients satisfaction of experimental group were significantly better than control group (P<0.05).Spectacles independence for near vision achieved 83% and 17% in experimental group and control group,experimental group were statistically better than control group(P<0.05).Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group,experimental group were statistically better than control group(P<0.05).CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity,which can significantly reduce preexisting corneal astigmatism in cataract surgery,improve spectacles independence for distance vision and spectacles independence for near vision,have a high patient satisfaction.

Acupuncture ; Acupuncture Points ; Animals ; Brain ; physiopathology ; Electroacupuncture ; Humans ; Magnetic Resonance Imaging ; Pain ; physiopathology ; Pain Management

Objective To compare traditional arthroscopic reconstruction of anterior cruciate ligament (ACL) and the arthroscopic ACL reconstruction assisted by fluoroscopy-based navigation system in accuracy and reproducibility of the tunnel placement. Methods Fluoroscopy-based navigation system was used in 40 cases of arthroscopic ACL reconstruction from December 2005 to March 2006. Another 40 cases of traditional arthroscopic ACL reconstruction performed between June 2005 and March 2006 were used as control. The positions of the femoral and tibial tunnels were measured on their radiograms and compared statistically. Results The femoral tunnel position measurements averaged 62. 3%?5. 6% (52% - 73% ) in navigation-assisted ACL reconstruction, and 56. 6%?7. 3% (46% - 77% ) in the traditional arthroscopic operation. The tibial tunnel position measurements averaged 45.4%?3. 8% (37%-53% ) in the navigation-assisted ACL reconstruction, and 41. 1%?6. 0% (25% - 54% ) in the traditional arthroscopic operation. The differences were statistically significant ( P