[Objective]To appraise the indications,essential technical points and selection of prostheses of hemi or total arthroplasty of the shoulder for severe damages of proximal part of humerus.[Method]Twelve cases had an arthroplasty of the shoulder;4 total-arthroplasties and 8 hemi-arthroplasties of the shoulder;6 cases of four parts fractures,2 cases of humeral head osteonecrosis,1 case of osteonecrosis of humeral head and glenoid cavity,2 cases of proliferative arthritis with the shoulder rigidity,1 case of bone humor.The function of the shoulder was evaluated postoperatively according to the methods of Amercian Society of Surgeons for Shoulder and Elbow Joints.All cases were followed up with a mean duration of 14 months.[Result]Twelve cases revealed obvious relief of pain with absence of pain in 8 and mild in 4.Twelve cases had no prosthetic stems loosening.The motion range of the shoulder was improved with a mean abduction of 100.Ten cases had the satisfactory results for treatment.[Conclusion]Hemi or total arthroplastyof shoulder is effective for complicated proximal humeral damages.The key of success is related with scientific operative method,appropriate selection of prostheses,effective rehabilitation plan.

BACKGROUND: Glutamine (Gln) supplementation is known to decrease oxidative stress and inflammatory response, enhance resistance to infectious pathogens, shorten hospital stay, and decrease medical costs of patients. This study was undertaken to evaluate the relationship between the effect of early parenteral glutamine (Gln) supplement on acute liver injury (ALI) and heat shock protein 70 (HSP-70) expression in critical patients. METHODS: Forty-four patients who had been admitted to the emergency intensive care unit (EICU) of Nanjing First Hospital Affiliated to Nanjing Medical University were randomly divided into a control group (n=22) and a Gln group (n=22). The patients of the two groups received enteral and parenteral nutrition. In addition, parenteral Gln 0.4 g/kg per day was given for 7 days in the Gln group. Serum HSP-70 and Gln were measured at admission and at 7 days after admission. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBiL), serum levels of HSP-70 and Gln, mechanical ventilation (MV) time, ICU stay, peripheral blood of TNF-α, IL-6, CD3, CD4 and CD4/CD8 levels were also measured in the two groups. RESULTS: In the Gln group, the levels of serum HSP-70 and Gln were significantly higher after Gln treatment than those before the treatment (P<0.01). HSP-70 level was positively correlated with the Gln level in the Gln group after administration of parenteral Gln (P<0.01). The levels of serum ALT, AST, TBiL and TNF-α, IL-6 were lower in the Gln group than in the non-Gln group (P<0.01). MV time and ICU stay were significantly different between the two groups (P<0.05). The levels of CD3, CD4 and CD4/CD8 were significantly higher in the Gln group than in the control group after treatment (P<0.05). CONCLUSION: Parenteral Gln significantly increases the level of serum HSP70 in critically ill patients. The enhanced expression of HSP70 is correlated with improved outcomes of Gln-treated patients with acute liver injury.

Hide melting presents itself as one of the most critical processes in the production of donkey-hide gelatin. Here a NIR-based method was established for the rapid analysis of in-process hide melting solutions as well as for end-point determination of this process. Near infrared (NIR) spectra of hide melting solutions were collected in transflective mode. With the contents of total nitrogen determined by the Kjeldahl method as reference values, partial least squares regression (PLSR) was employed to build calibration models between NIR spectra and total nitrogen. Model parameters including wavelength range and PLS factors were optimized to achieve best model performance. Based on the contents of total nitrogen predicted by calibration model, end point of hide melting was determined. The constructed PLS model gave a high correlation coefficient (R2) of 0.991 3 and a root mean square error of prediction (RMSEP) of 0.807 g x L(-1). With the predicted total nitrogen and predefined limit, decisions concerning the proper times of melting were made. This research demonstrated that NIR transflectance spectroscopy could be used to expeditiously determine the contents of total nitrogen which was subsequently chosen as the indictor for determining the end-point of hide melting. The proposed procedure may help avoid unnecessary raw material or energy consumption.
Animals ; Calibration ; Endpoint Determination ; methods ; Equidae ; anatomy & histology ; Gelatin ; chemistry ; Least-Squares Analysis ; Nitrogen ; analysis ; chemistry ; Skin ; chemistry ; Spectrophotometry, Infrared ; Time Factors ; Transition Temperature

Inner fistula by abdomino-back anastomosis of cephalic vein to radial artery was erformed in 86 patients with hemodialysis (test group) and end-to side arteriovenous anastomosis was performed in 85 cases (control group).There were no significant differences in postoperative anastomotic blood flow and vascular complications between two groups (P ＞ 0.05);however the average time consuming for operation in test group was shorter than that in control group (36 min vs.75 min,P ＜ 0.01).The minimally invasive abdomino-back anastomosis is a desired arteriovenous fistula method for hemodialysis patients.

OBJECTIVE:To study the effects of Xiaoruzeng capsule on the gastric acid and pepsin in rats. METHODS:Rats were randomized into a blank group (distilled water),a positive control group (3.6 mg/kg omeprazole ) and the groups of low, middle and high doses of Xiaoruzeng capsule [2.25,4.5,9.1 g(crude drug)/kg]. These groups were respectively marked as groups A,B,C,D and E,with 10 rats in each group. All the rats were given corresponding drugs,ig,for consecutive 10 d. Their suc-cus gastricus was collected 3 h after the last administration,and determined for pH value with precision pH test strip and for free acidity and total acidity by acid-base neutralization titration method. The content and activity of pepsin were determined and calculat-ed with the test kit and microplate reader. The pathological change of the stomach was observed under the electron microscope. RE-SULTS:Compared with group A,groups B,C and D had higher pH value of succus gastricus;groups C,D and E had lower free acidity;groups B,C and D had lower total acidity,group E had higher total acidity;groups B,D and E had lower activity of pep-sin;and group C had higher content of pepsin. Compared with group B,group D had lower pH value of succus gastricus;group C had lower total acidity;group E had higher acidity;and groups C,D and E had higher activity of pepsin. There was statistical sig-nificance(P<0.01 or P<0.05). Gastric mucosal erosive haemorrhage was noted in three rats in group E,and other groups demon-strated no obvious pathological change. CONCLUSIONS:Low dose of Xiaoruzeng capsule can slightly inhibit the gastric acid in rats,but will not effect the activity of pepsin.

Objective: To study the role of clinical classification of adult polycystic liver disease (APLD) in guiding the selection of treatments for the patients. Methods: The clinical data of 43 APLD patients who were treated in our hospital from May 1995 to Oct. 2007 were retrospectively analyzed. The patients were divided into 3 stages according to the clinical manifestations and imaging examination: non-symptom or slight symptom stage, obvious symptom stage, and lethal symptom stage. Seventeen patients in our group received outpatient clinical follow-up; 26 were treated by partial hepatectomy combined with fenestration. Results: Among the 15 cases at non-symptom or slight symptom stage, one had primary hepatic carcinoma simultaneously and died 4 mouths after diagnosis; the rest 14 case were followed up for a mean of (42.8±37.9) months; 12 of them had slow progression and 2 had rapid progression of APLD; the latter 2 cases received operatioa The 24 cases at obvious symptom stage were treated by partial hepatectomy combined with fenestration. There were no perioperation deathes and the mean follow-up period was (61.4±43.0) months; 2 cases died of renal failure and 3 had post-operation recurrence. Two of the 4 cases at the lethal symptom stage were treated by partial hepatectomy combined with fenestration: one had no symptom relieve after operation and one developed hepatic dysfunction and received liver transplantation 8 months after operation; the other 2 patients received percutaneous cyst aspiration at the outpatient department, one patient died of upper gastrointestinal hemorrhage 5 months later, and one had the symptom slightly relieved. Conclusion: Our classification of APLD can help to select treatments for patients: patients at non-symptom or slight symptom stage should be followed up, those at the obvious symptom stage can be treated surgically, and those at the lethal symptom stage are not suitable for routine operation and liver transplantation may be the best choice for them.

ObjectiveTo explore the effect of carotid artery sympathetic net exfoliation combined with hyperbaric oxygen therapy on athetosic type cerebral palsy (CP).Methods46 CP children (athetosic type) were divided into the treatment group (n=25) and control group (n=21). All cases of two groups were treated with carotid artery sympathetic net exfoliation as well as children of the treatment group were added with drug and hyperbaric oxygen therapy. Therapeutic effect of two groups was compared.ResultsOne week after operation, the effect rate was 66.67% in control group and 64% in treatment group with no significant difference between two groups. 3 months after operation, the effect rate of the treatment group increased to 96.00%, but that of the control group was not changed, there was a significant difference between two groups (P<0.05).ConclusionCarotid artery sympathetic nerve net exfoliation can improve the symptoms of athetosic type CP children, if combined with hyperbaric oxygen therapy, the curative effect will be further improved.

Astragalus polysaccharides was lounded to 4-(2-aminoethylphenol), followed by labeling the APS-Tyr with fluorescein-5-isothiocyanate (FITC) at the secondary amino group. The absorption enhancement effects of low molecular weight chitosan and protamine on astragalus polysaccharides were evaluated via Caco-2 cell culture model. The results show that the fluorecent labeling compound has good stability and high sensitivity. On the other hand low molecular weight chitosan and protamine also can promoted absorption of the astragalus polysaccharides without any cytotoxity, and the absorption increase was more significant with increasing the amount of low molecular weight chitosan and protamine. At the same time, the low molecular weight chitosan has slightly better effect. The transepithelial electric resistance (TEER) of Caco-2 cells show that absorption enhancers could improve its membrane transport permeability by opening tight junctions between cells and increasing the cell membrane fluidity.
Absorption ; Astragalus Plant ; chemistry ; Biological Transport ; Caco-2 Cells ; Fluorescein-5-isothiocyanate ; chemistry ; Fluorescent Dyes ; chemistry ; Humans ; Plant Extracts ; chemistry ; pharmacokinetics ; Polysaccharides ; chemistry ; pharmacokinetics

Objective:New Zealand rabbits were immunized with VLPs-MEpS,VLPs-E2S,and the levels of neutralizing antibodies in serum were determined.Methods: New Zealand rabbits were immunized with 10 μg VLPs-MEpS and VLPs-E2S,serum was collected at diffferent time with a two-weeks interval.The neutralizing antibodies were determined by ELISA.HCV(type 1b) had been prepared and mixed with serum from immunized rabbit before infected Huh7.5 cell.The protection of neutralizing antibodies in serum was assessed.Results: Neutralizing antibodies had been induced in rabbit after immunized with VLPs-MEpS and VLPs-E2S.VLPs-MEpS group had higher titer of antibodies than that of VLPs-E2S group(P<0.05),both group had higher titer of antibodies than that of control groups significantly(P<0.01).VLPs-MEpS group had higher neutralization than that of VLPs-E2S group(P<0.05),the highest neutralization rate was 61.49%.Both groups were higher than control group notably(P<0.01).Conclusion: Protective neutralizing antibodies have been induced in New Zealand rabbit after immunized with VLPs-MEpS and VLPs-E2S.It′s the basement for development of neutralizing antibodies vaccine.

Objective To build the cohort of drug resistance and analyze treatment efficiency of AIDS patients and situation of drug resistant mutations among HIV-1 infected individuals.Methods A cohort of 116 HIV-1 infected patients was built and their treatment progress were acquired once every 6 months.At the sanle time CD4+ T cell counts and HIV-1 viral load were measured and genotyping for drug resistance was determined by a home brew nested PCR.Results The CD4+ T cell count(470±251/ml)was higher than that before treatment in patients who were treated by AZT/DDI/NVP or D4T/DDL/NVP.The viral load was lower than that before treatmenL The drug resistant mutation frequency increased gradually along with treatment.The CD4+ T cell count was decreased and viral load was increased and the prevalence of drug resistant mutation was increased in the patients who changed regimens to AZT/3TC/NVP or D41/3TC/NVP.Only one primary mutation that was resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs)was detected in the naive patients.The cross-resistant mutation was detected in two patients after 6 months treatment. The intermediate resistance to lopinavir(LPV) was detected after 12 months treatment.The prevalence of high-grade resistances to NNRTIs was increased obviously,and the prevalence of multi-resistance and cross-resistance was detected in 5 patients after 36 months treatment.Conclusions The prevalence of primary mutation was rare in naive HIV-1 infected patients.The prevalence of drug resistant mutation was inereased gradually along with treatment.Ahhough few regimens were available,the treatment effect could last relatively long period of time if patients keep taking medicine stably.The regimens could be changed according to the results of drug resistant test.