Objective To observe the effects of different doses of dexmedetomidine combined with ropiva-caine for ultrasound-guided fascia iliaca compartment block on postoperative analgesia and rehabilitation in patients undergoing total hip replacement surgery. Methods 80 patients with ASAⅠ~Ⅱundergoing total hip arthroplasty were ramdonly divided into 4 groups. Records of patients with ultrasound guided fascia iliaca compartment block onset time,block fading time,VAS at 4 h,8 h,12 h,24 h,48 h;duration of operation,intraoperative remifent-anil and propofol requirement;24 h and 48h of sufentanil use;after the operation were recorded for the first time , ambulation time,hospitalization time and observe whether bradycardia,intraoperative awareness and other adverse reactions. Results Compared with group A and B,the onset time of C were shorter(P<0.05);the VAS was less (P<0.05);the remifentanil equirement was significantly was reduced(P<0.05);the amount of sufentanil after operation 24 h and 48 h was reduced(P<0.05);the first time out of bed time and total hospitalization time was shorter(P < 0.05);patient satisfaction increased(P < 0.05);The extubation time was significantly longer and the occurrences of tachycardia were significantly increased in group D compared to other groups respectively. Conclusion 1.0μg/kg dexmedetomidine combined with 0.3%ropivacaine ultrasound-guided fascia iliaca compart-ment block can provide better postoperative analgesic and recover rapidly with fewer side effects in total hip replace-ment surgery.

Objective To introduce a new classification system for femoral intertrochanteric fractures and propose classification to assist surgical management.Methods A total of 176 cases of femoral intertrochanteric fractures treated from September 2007 to October 2011 were enrolled in the study.X-ray and three-dimensional spiral CT reconstruction were performed to define fracture shape,location,number of major fragments and displaced direction.As combined with the intraoperative findings and cadaveric anatomical study,the femoral intertrochateric fractures was simulated using a three-dimensional entity of normal proximal femur produced by Mimics 11.1 program.A new classification system for femoral intertrochateric fractures was proposed.Results The new system categorized intertrochateric fractures of the femur into five types (Type Ⅰ,Type Ⅱ,Type Ⅲ,Type Ⅳ and Type Ⅴ) based on the integrity or destruction of the medial column,lateral column and posterior column set and divided on the basis of bone connection of femoral head-neck fracture fragments with the bone in intertrochanteric region.Conclusions The new classification system with introduction of three-column concept is brief and practical and has a clear definition of fracture stability.Besides,the new classification-based treatment is recommended.

Objective To investigate the effect of pregnancy-induced hypertension (PIH) syndrome on the blood lipid level of neonate. Methods Eighty neonates, whose mother had PIH, were enrolled and divided into three groups according to the 6th version of diagnostic standard from published Obstetrics and Gynecology:gestational hypertension group (PIH group 1 ,n = 30) ,mild pre-eclampsia group (PIH group 2,n =30),serious pre-eclampsia group (PIH group 3,n =20) ,and 40 infants with healthy mother were enrolled as normal control group. The blood lipid was measured by automatic biochemical analyzer. Results (1) The TG levels of the cord blood were (0.28±0. 10)mmol/L in PIH group 1,(0.33 ±0.09)mmol/L in PIH group 2,(0.39 ±0.06) mmol/L in PIH group 3,and (0. 23 ±0. 07)mmol/L in normal control respectively. TG levels were significantly higher in PIH groups compared to normal control,and the TG concentration increased gradually with the mothers' gestational hypertension (F = 2. 765, Ps <0. 05). (2)The HDL-C levels of the cord blood were (0. 61 ±0. 23) mmol/L in PIH group 1, (0. 54 ± 0. 25) mmol/L in PIH group 2, (0.47 ± 0. 15) mmol/L in PIH group 3, (0. 65 ±0. 14) mmol/L in the normal contral respectively;and the ApoA levels of the cord blood were (0. 63 ±0.24)g/L in PIH group 1 ,(0. 59 ±0. 16)g/L in PIH group 2, (0.53 ±0.21)g/L in PIH group 3,(0.69 ±0. 12)g/L in the normal contral respectively. Both index were significantly higher in PIH groups compared to normal control, and the concentrations decreased gradually with the mothers' gestational hypertension (F=2.783,P<0.05;F=2.831,P<0.05). (3)The TC levels of the cord blood were (1.41 ± 0. 37) mmol/L in PIH group 1, (1. 51 ±0.45) mmol/L in PIH group 2, (1. 56 ±0. 56) mmol/L in PIH group3, (1. 36 ±0.41) mmol/L in the normal contral respectively;and the LDL-C levels of the cord blood were (0. 79 ±0. 26)mmol/L in PIH group 1,(0. 80 ±0. 18)mmol/L in PIH group 2,(0. 82 ±0. 30)mmol/L in PIH group 3,(0.74 ±0. 18) mmol/L in the normal contral respectively. The data showed that the cord blood TC and LDL-C levels of PIH were higher than normal control and increased gradually with the mothers'gestational hypertension, but they didn' treach the significant level (F = 0. 695,P>0. 05;F = 0. 483,P>0. 05). (4)The LPA levels of the cord blood were (24. 50 ± 12. 01) g/L in PIH group 2, (22. 68 ± 9. 50) g/L PIH group 3,which were lower than normal control (25.70 ±11.90) g/L, and the LPA levels of the cord blood were higher in PIH group 1(33.46 ± 20. 10)g/L,while the differences didn't reach significant level compared among four groups (F = 1.480,P> 0.05). Conclusion The unhealthy intrauterus condition of PIH lead abmoral fat metabolism in fetus, and itmight get worse along with the severity of the mother's gestational hypertension. We presumed that the neonates of PIH mothers would be more prone to have coronary heart disease,atherosclerosis and abnormal fat metabolism related disease compared with newboms from normal control group.

Objective To evaluate the application of improved belly board in postoperative patients of rectal cancer radiotherapy and explore the influence of its set-up repeatability.Methods CBCT was used to measure the intra fractional and inter fractional setup errors using normal or improved belly board respectively.The data was analyzed with statistic method.Results There was no significance of intra fractional setup errors on x-axis (P ＞ 0.05).There was significance on y and z-axis (P ＜ 0.05).There was no significance of interfrational setup errors on x-axis (P ＞ 0.05) and there was significance on y and z-axis (P ＜ 0.05) using normal belly board.There was no significance of intrafractional setup errors on x,y and z-axis (P ＞ 0.05).There was also no significance of interfractional setup errors on x,y and z-axis (P ＞ 0.05) with using improved belly board.Conclusion The method of improved belly board has more advantage than nomal belly board in controlling set-up repeatability,and it is conductive to improve accuracy of patients treatment.

Objective To investigate the effects of electromagnetic irradiation on the activity of protein kinase C(PKC)in the cerebellum of rabbit.Methods Thirty rabbits were randomly divided into control and electromagnetic irradi.ation group (including 0 hour,3 hours,12 hours,24 hours and 72 hours subgroups after irradiation),rabbits in the electromagnetic irradiation group were exposed to 65 mW/cm~2 S frequency range electromagnetic irradiation for 30 minutes,the rectal temperature was taken immediately after irradiation and the specific absorption rate(SAR)values were calculated,the activity of PKC the cerebellum was determined with improved TaKai method.Results The rectal temperature of rabbits increased 2.35 ℃ after irradiation,SAR value was 4.54 kcal/kg.PKC activity decreased significantly after irradiation.Conclusion After 30 min of electromagnetic irradiation at 65 mW/cm~2,obvious heating effect will be detected in the rabbit and PKC activity in the cerebellum decreased significantly.

BACKGROUND:Hemostatic dressing can directly contact with the body tissues on the wound surface. The biocompatibility is one of the important indicators of evaluating the advantages and disadvantages of dressing. The hemostatic dressing prepared with calcium alginate as raw material has become a research focus owing to its low cost and good compatibility. OBJECTIVE:To observe the cytotoxicity of calcium alginate hemostatic dressings and to compare the cytotoxicity between calcium alginate hemostatic dressing and gelatin hemostatic sponge, absorbing cotton, ordinary gauze. METHEDS:Leaching solution method: the DMEM high glucose culture solution was taken as the leaching medium. The calcium alginate hemostatic dressing, gelatin hemostatic sponge, absorbing cotton and ordinary gauze leaching solution were respectively prepared. Five concentration gradients of 100%, 75%, 50%, 25%, 50% were set. The fibroblast cels of L-929 mouse were cultured for 24 hours with the above material leaching solution. The volume fraction of 10% DMEM high glucose culture medium was taken as control group, and DMEM high glucose culture medium containing 5% DMSO was taken as positive control group to observe the cel proliferation and morphological changes. Direct contact method: The fibroblast cels of L-929 mouse were respectively seeded in calcium alginate hemostatic dressing, gelatin hemostatic sponge, absorbing cotton and ordinary gauze and cultured for 24 hours. The changes in cel morphology were observed.
RESULTS AND CONCLUSION: Leaching solution method: The cytotoxicity of alginate fiber hemostatic dressing, gauze, absorbing cotton leaching solution with different concentration gradients was grade 1, which was in line with GB/T16886/ ISO10993 biological evaluation standard of medical apparatus and instruments. The cytotoxicity of 100%, 75% gelatin hemostatic sponge extract solution was grade 3, causing severe inhibition of cel proliferation. Direct contact method: The cytotoxicity of gauze and alginate fiber hemostatic dressing was grade 1, absorbing cotton was grade 2, gelatin hemostatic sponge was grade 3. These results demonstrate that calcium alginate hemostatic dressing has no cytotoxicity.

BACKGROUND:Adipose-derived stem cels under osteogenic induction can be combined with biodegradable silk fibroin/hydroxyapatite scaffold, which is expected to develop a new biocompatible and osteogenic bone fusion material. OBJECTIVE:To study the effect of silk fibroin/hydroxyapatite composite on the viability and osteogenic properties of adipose-derived stem cels after osteogenic induction. METHODS:Adipose-derived stem cels were obtained from rat’s fat tissue, then adherently cultured, proliferated and passaged in vitro. Passage 3 cels were cultured in conditioned medium for osteogenic induction, and then seeded onto silk fibroin/hydroxyapatite scaffold as experimental group. Adipose-derived stem cels cultured on the cover glasses at the same condition acted as control group. The celular morphology, proliferation and differentiation were assessed respectively by means of phase contrast microscope, MTT assay and alkaline phosphatase activity measurement. RESULTS AND CONCLUSION:After osteogenic induction, adipose-derived stem cels could adhere to the scaffold material and proliferate on the surface of silk fibroin/hydroxyapatite scaffold normaly. No significant difference was found in cel proliferation and alkaline phosphatase activity between the experimental and control groups (P > 0.05), suggesting the celular activity and function were not affected by the material. These findings indicate that silk fibroin/hydroxyapatite composite material has good cytocompatibility. Subject headings: Silk; Hydroxyapatites; Stem Cels; Adipose Tissue; Biocompatible Materials; Tissue Engineering.

Objective To compare the efficacy and safety of Etomidate-Dexmedetomidine and Propofol-Dexmedetomidine sedation in patients undergoing endoscopic radiofrequency ablation of gastroesophageal relfux disease (GERD).Methods Sixty adult patients, scheduled for elective endoluminal radiofrequency ablation for GERD under sedation were prospectively randomized into Etomidate-Dexmedetomidine (Group-E,n = 30) or Propofol-Dexmedetomidine (Group-P,n = 30) group. A bolus of 0.2 μg/kg of intravenous Dexmedetomidine was followed by intermittent Etomidate or Propofol injection during the procedure in order to maintain a proper depth of sedation with a Ramsay sedation scores of 5~6. Heart rates, mean blood pressure, oxygen saturation, respiratory rates and Ramsay sedation scores were recorded before sedation (T0), at the beginning of the examination (T1), during radiofrequency energy delivery (T2), at the time of gastroscopy (T3) and at the end of therapy (T4). Inter-group differences in sedation proifles (duration, time to recovery, incidence of body movement, Ramsay sedation scores and satisfaction of patient and endoscopist) and cardio-respiratory responses (heart rate, mean arterial pressure, oxygen saturation) were determined during and after radiofrequency ablation.Results No difference was found for therapy duration, anesthesia time or the time to recovery between Group-P and Group-E. Patients receiving Propofol experienced more bradycardia (Ρ = 0.032) and had higher incidences of vasoactives used (Ρ = 0.002) compared with that receiving Etomidate. Oxygen saturation in T1 (Ρ = 0.023) and T2 (Ρ = 0.009) was lower in the Group-P. No significant difference was found for other indicators.Conclusion Etomidate-Dexmedetomidine sedation was superior to Propofol-Dexmedetomidine sedation for GERD radiofrequency therapy with more stable cardio-respiratory responses.

AIM: Changes of endoxin level, ATPase activities, intramitochondrial Ca2+ concentration, and gene expression of Na+-K+-ATPase isoforms in myocardium of rats with MIR and effect of verapamil were observed, in order to investigate mechanism of endoxin mediating intracellular calcium overload of myocytes. METHODS: Twenty four male Sprauge Dawley rats were randomized into 3 groups. Sham operation group: silk suture was threaded the left anterior descending coronary artery without ligature; MIR group (MIR): left anterior descending coronary artery was subjected to 30 min ligation followed by 45 min reperfusion; verapamil group: MIR model was given 5 mg/kg verapamil. Verapamil was injected via femoral vein 5 min before reperfusion. Left ventricle myocardium samples were processed immediately after reperfusion in order to measure the activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase, endoxin level, and intramitochondrial Ca2+ concentration. The levels of ?1, ?2, ?3 and ?1 isoforms of Na+-K+-ATPase were measured by immunohistochemical assay. RESULTS: After MIR, the level of endoxin in myocardium was substantially increased; the activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in myocardial membrane were significantly decreased while the concentration of intramitochondrial Ca2+ was increased; the levels of the ?1, ?2, ?3 and ?1 isoforms of Na+-K+-ATPase were reduced markedly. Verapamil had only effect on reducing the concentration of intramitochondrial Ca2+. CONCLUSION: MIR increases endoxin secretion. The latter may depress the activity of Na+-K+-ATPase by changing the gene expression of ?1, ?2, ?3 and ?1 isoforms of Na+-K+-ATPase in myocardial membrane, inducing intramitochondrial Ca2+ overload.

Objective:To observe the lens zonule infrastructure changes in experimental myopia. Methods; The eye lids were sutured to induce the myopia in guinea pigs and the zonule ultrastructure changes were observed. Results: There were significant differences in the eye axial length and diopter between lid-sutured eyes and controls(P