Objective:To investigate the in vivo absorption kinetics of caffeine at different intestine segments in rats.Methods: The rat intestine was cannulated for in situ recirculation.The absorption kinetics of caffeine,including the absorption segments of intestine,drug concentration and pH value,were investigated in all the rats under light anesthesia.Ultraviolet light spectrometry and high-performance liquid chromatography were used to determine the concentrations of phenol red and caffeine,respectively.Results: The absorption rate constants(Ka) of caffeine in the small intestine at the concentrations of 2.5,5,10 and 25 mg?L-1 were 0.252,0.247,0.304 and 0.232 h-1,respectively.The Ka values at pH of 7.8,6.8,and 5.4 were 0.267,0.274 and 0.247 h-1,respectively.The Ka values in the duodenum,jejunum,ileum,and colon were 0.112,0.099,0.095 and 0.069 5 h-1,respectively.Conclusion: Concentration and pH value have no obvious effect on the absorption kinetics of caffeine.Caffeine can be better absorbed in the duodenum,jejunum and ileum than in the colon.The absorption of caffeine in the intestine is a first-order process through passive diffusion mechanism.

Adult ; Air Pollutants ; adverse effects ; Humans ; Male ; Military Medicine ; Monitoring, Physiologic ; Noise, Occupational ; adverse effects

OBJECTIVETo inquire into the relationship between lipoprotein lipase (LPL) gene D9N, N291S and S447X polymorphisms and the development of cardiovascular diseases in children with obesity.

METHODSThe polymerase chain reaction (PCR) and restriction fragment length polymorphism (RLFP) techniques were used to detect three common mutations of LPL gene exon D9N, N291S and S447X in 157 obese children and 175 normal controls. Plasma lipid and lipoprotein levels between children with different genotypes were compared.

RESULTSThe D9N and N291S gene mutations were not detected in either the obese or the control groups. There were no significant differences in the frequency of S447X gene mutation between the two groups. There were no significant differences in the levels of plasma lipid and lipoprotein between children with S447 and X447 genotypes.

CONCLUSIONSD9N and N291S gene mutations may not be risk factors associated with cardiovascular diseases in children with obesity. S447X gene mutation might not play an important role in the development of cardiovascular diseases in childhood.

Adolescent ; Cardiovascular Diseases ; etiology ; genetics ; Child ; Female ; Humans ; Lipoprotein Lipase ; genetics ; Male ; Mutation ; Obesity ; genetics ; Risk Factors

BACKGROUNDMany kinds of approaches have been used for minimally invasive surgery of total hip arthroplasty (MIS-THA). However, until now when considering the balance of efficacy and associated surgical injury there is no approach widely accepted for MIS-THA. In this study, a modified anterolateral muscle sparing approach was developed to optimize MIS-THA.

METHODSTwenty adult cadaver specimens (40 hips) were used for anatomic research. The distance from anterior origin of the gluteus medius on the iliac crest to the anterior superior iliac spine was measured; the course of the superior gluteal nerve and the distances from the nerve to the regional anatomic landmarks were recorded. Simulated surgeries were performed in three fresh cadaver specimens to evaluate the soft tissues injury around incisions. From October 2004 to June 2006, 57 patients (57 hips) were treated with anterolateral muscle sparing minimally invasive total hip arthroplasty, of which 17 were femoral neck fractures, 9 osteoarthritis, 16 developmental dysplasia of hip (DDH) and 15 avascular necrosis (AVN). All the operations were performed by the same senior surgeon. Operation time, blood loss and drainage volume were recorded and the correlation between the local complications and the native anatomical characteristics was especially noted. All cases were followed for at least 12 months.

RESULTSThe distance from the anterior origin of the gluteus medius to anterior superior iliac spine along the iliac crest was (61+/-4) mm (range, 55-68 mm), and the distance from inferior branch of the superior gluteal nerve to the anterior tubercle of the greater trochanter was (74+/-6) mm (range, 60-88 mm). In simulated surgeries, excessive distraction of tissue was found to be the main cause of the anterior border injury of the gluteus medius muscle. Of the 57 patients treated with anterolateral muscle sparing MIS-THA, the average incision length was 9 cm (range 7.5-13 cm). Blood transfusions were performed in 11 patients. During the operations, anterior border injury in deep layers of the gluteus medius was found in 9 patients. Posteromedial perforation of the prosthesis stem on the femoral side was found in 2 patients, which were revised immediately. No positive Trenderlenburg sign was found during the 12 months of follow-up.

CONCLUSIONSThe incision of the anterolateral muscle sparing approach should be directed from the anterior tubercle of the greater trochanter toward 6 cm posterior to the anterior superior iliac spine. The proximal part of the incision should be within 6 cm from the anterior tubercle of the greater trochanter, and it is safe to be extended distally. The anterolateral muscle sparing approach is a minimally invasive approach for total hip arthroplasty, through which the surgeon can operate on the acetabulum and femoral sides in a single incision without muscle detachment, and fluoroscopy assistance is not needed. The surgeon should pay more attention to protecting the gluteus medius from injury by distraction before femoral neck cutting and during the preparation of the femoral side.

Adult ; Arthroplasty, Replacement, Hip ; methods ; Autopsy ; Female ; Hip ; anatomy & histology ; Humans ; Male ; Minimally Invasive Surgical Procedures ; methods ; Muscle, Skeletal ; surgery

OBJECTIVETo evaluate the short term clinical results of minimally invasive total knee arthroplasty (MIS-TKA) through a quadriceps sparing (QS) approach compared with a standard TKA using a medial parapatellar exposure.

METHODSBetween March 2005 and March 2006, 26 consecutive unilateral primary MIS-TKA through a QS approach were performed. It was compared that the short term clinical results of this group with an age-matched and sex-match cohort of total knee arthroplasty done with a standard medial parapatellar approach. Length of incision, tourniquet time, blood loss, flexion degree, visual analog scale (VAS) score, Knee Society score, tibiofemoral angle and the ability to do a straight leg raising maneuver were evaluated respectively.

RESULTSThe mean follow-up time were 17 months (range 12-23 months). The average length of incision was (9.5+/-1.5) cm in the QS group and (14.0+/-2.3) cm in the standard group (P<0.05). Average tourniquet times were (83+/-16) minutes in the QS group and (55+/-11) minutes for the standard group (P<0.05). Postoperative tibiofemoral angles averaged (5.7+/-1.5) degrees valgus in the QS group knees and (6.0+/-1.4) degrees valgus in the standard group knees (P>0.05). The average VAS scores were significantly lower at the first, the third and the seventh postoperative days in the QS group compared with that of the standard group, and the difference was not significant after 6 weeks between two groups. Mean flexion at one week was greater for the QS group (107+/-12) degrees than that in the standard group (95+/-11) degrees. Improved ROM also was seen 6 and 12 weeks postoperatively in the QS group with significant difference. There were no differences in ROM between the two groups in 12 months. The ability to straight leg raised at one week postoperatively was better in the QS group (23/26, 88%) than that of the standard group (21/33, 64%). At the 6 weeks follow-up, the average knee score was (78+/-15) points in the QS group and (71+/-20) points for the standard group (P<0.05). Deep vein thrombosis were found in 1 case of the QS group and 3 cases for the standard group. One patient in the QS group developed superficial wound necrosis that healed uneventfully. There were no other complications such as deep infection, neurovascular injury and so on.

CONCLUSIONSThe MIS-TKA through a QS approach is associated with a more rapid functional recovery and improves range of motion. But higher specifications and more restrictive indications are of importance with the QS technique.

Arthroplasty, Replacement, Knee ; methods ; Follow-Up Studies ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Quadriceps Muscle ; Treatment Outcome

OBJECTIVETo analyze the clinical and radiographical result of acetabular revisions with wire mesh, impacted irradiated frozen allografts and cemented cups.

METHODSFrom February 2006 to January 2009, a total of 20 patients with 21 acetabular revisions were performed with wire mesh, impacted irradiated frozen allografts and cemented cups. Eighteen cases (19 hips) were followed up. There were 5 hips in 4 males and 14 hips in 14 females. The average age of patients was 64.4 years (43 to 81 years). Acetabular bone defects were classified according to Paprosky classification. There were Paprosky II B in 4 hips, Paprosky II C in 8 hips, Paprosky IIIA in 5 hips and Paprosky IIIB in 2 hips. Wire mesh was used to converted segmental defects into cavity defects. Irradiated frozen allografts were impacted and cemented cup was inserted to complete the revision. Patients were followed up regularly with clinical and radiographical assessment. Harris score, migration and loosening of prosthesis grafts integration and complications were observed.

RESULTSThe average follow-up time was 22.4 months (12 - 48 months). Harris score improved from 42.5 points (31 - 56 points) pre-operation to 88.6 points (82 - 96 points) at the final follow up. Pain score was 14.4 point (10 - 20 point) before revision and 42.3 points (40 - 44 point) at the final follow up.

COMPLICATIONSthere was 1 infection and healing after debridement. One patient had weakness of quadriceps and returned to normal after 1 year. Greater trochanter fracture occurred in 1 patient. Cup migration and loosening were observed in 1 Paprosky IIIB patients. There was no cup migration more than 1 mm or change of abduction angle in the remaining 18 hips. Grafts incorporation defined as the presence of trabecular bone crossing the graft-host bond could also be seen in these 18 hips.

CONCLUSIONSImpacted bone grafting technique combined with wire mesh and cemented cup is an effective method for biological acetabular revision. Irradiated frozen allografts implanted with impaction bone grafting technique can integrate with the surrounding host bone.

Acetabulum ; surgery ; Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Bone Cements ; Bone Transplantation ; methods ; Female ; Follow-Up Studies ; Freezing ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Reoperation ; Surgical Mesh ; Transplantation, Homologous ; Treatment Outcome

BACKGROUNDLumiracoxib is a highly selective cyclooxygenase-2 (COX-2) inhibitor with antiinflammatory, analgesic and antipyretic activities comparable with class specific drugs, but with much improved gastrointestinal safety. No studies have examined lumiracoxib for antitumorigenic activity on human nonsmall cell lung cancer cell lines in vitro or its possible molecular mechanisms.

METHODSThe antiproliferative effect of lumiracoxib alone or combined with docetaxol on A549 and NCI-H460 lines was assessed by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Drug-drug interactions were analyzed using the coefficient of drug interaction (CDI) to characterize the interactions as synergism, additivity or antagonism. Morphological changes were observed by acridine orange fluorescent staining. Extent of apoptosis was determined by flow cytometry.

RESULTSLumiracoxib (15 - 240 micromol/L) has an inhibitory effect on the proliferation of A549 and NCI-H460 cell lines in concentration- and time-dependent manners with the IC50 values of 2597 micromol/L and 833 micromol/L, respectively. The synergistic effect was prominent when lumiracoxib (15 - 240 micromol/L) was combined with docetaxol (0.2 - 2 micromol/L) (CDI < 1). Fluorescent staining showed that lumiracoxib could induce apoptosis in A549 and NCI-H460 cells. Lumiracoxib treatment also caused an increase of the sub-G1 fraction in each cell line and resulted in an increase of G0/G1-phase cells and a decrease of S-phase cells.

CONCLUSIONSLumiracoxib had antiproliferative effect on the human nonsmall cell lung cancer cell lines A549 and NCI-H460 and had a significant synergy with docetaxol, which may be related to apoptotic induction and cell cycle arrest.

Apoptosis ; drug effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Diclofenac ; analogs & derivatives ; pharmacology ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Taxoids ; pharmacology

Objective　To establish animal model for hypertrophic scar and study the characters of its morphology and collagen metabolism. Methods　A total of 64 round wounds (diameter of 6 mm each) with total skin loss were made on the ventral side of rabbit ear using a trephine. Morphology and collagen metabolism of scar wounds were studied at 14,21,35,70 and 98 days after operation, respectively. Results　There were 76% elevated scars developed (45/59 wounds) on the ventral side of rabbit ear at 21 days and 46% elevated scars disappeared (11/24) at 98 days after operation. There were numerous fibroblast proliferation and whorl-arranged collagen fibers at 21 and 35 days. The number of fibroblast decreased, but irregular-arranged fibers still presented in the elevated scars at 70 and 98 days after operation. Hydroxyproline content in elevated scars at 21 days was higher than that in normal skin (P<0.05), and at 35 days was 3 times as that in normal skin and at 98 days was also markedly higher than that in normal skin (P<0.05). Conclusion　Excessive deposition of collagen is a characteristic of hypertrophic scar in rabbits. The conversion of normal scarring to hypertrophic scarring in rabbits occurs at 14～21 days after operation. Both development and regression of hypertrophic scar in rabbit are quicker than that in human.

Objective　To establish animal model for hypertrophic scar and study the characters of its morphology and collagen metabolism. Methods　A total of 64 round wounds (diameter of 6 mm each) with total skin loss were made on the ventral side of rabbit ear using a trephine. Morphology and collagen metabolism of scar wounds were studied at 14,21,35,70 and 98 days after operation, respectively. Results　There were 76% elevated scars developed (45/59 wounds) on the ventral side of rabbit ear at 21 days and 46% elevated scars disappeared (11/24) at 98 days after operation. There were numerous fibroblast proliferation and whorl-arranged collagen fibers at 21 and 35 days. The number of fibroblast decreased, but irregular-arranged fibers still presented in the elevated scars at 70 and 98 days after operation. Hydroxyproline content in elevated scars at 21 days was higher than that in normal skin (P<0.05), and at 35 days was 3 times as that in normal skin and at 98 days was also markedly higher than that in normal skin (P<0.05). Conclusion　Excessive deposition of collagen is a characteristic of hypertrophic scar in rabbits. The conversion of normal scarring to hypertrophic scarring in rabbits occurs at 14～21 days after operation. Both development and regression of hypertrophic scar in rabbit are quicker than that in human.

OBJECTIVETo develop the method and investigate the value of the application of multislice helical computed tomography (CT) in the maxillofacial distraction osteogenesis.

METHODSTwelve cases of maxillofacial distraction osteogenesis (3 in zygoma, 2 in maxilla, and 7 in mandible) were scanned by the multislice helical CT, then the reconstruction of three dimensional and fault image and the relative measurement were carried out to study the effect of distraction and osteogenesis.

RESULTSThe three dimensional image provided clear and high resolution stereoscopic view that the effect of distraction osteogenesis could be evaluated easily and exactly. The fault image could be set up in private computer by Mimics and the measurements, such as distance, thickness and density, could be performed as expected. The effect of 12 cases was satisfied, and the average distracted distance was 16.73 mm.

CONCLUSIONBasing on multislice helical CT scanning, the high resolution image reconstruction and relative measurement data could be obtained which could meet the need of clear and direct observation. Its application in the maxillofacial distraction osteogenesis is expecting and promising.

Humans ; Imaging, Three-Dimensional ; Mandible ; Maxilla ; Osteogenesis, Distraction ; Tomography, Spiral Computed ; Tomography, X-Ray Computed