Acute Disease ; Adult ; Altitude Sickness ; blood ; pathology ; Bronchoalveolar Lavage Fluid ; chemistry ; Case-Control Studies ; Humans ; Inflammation Mediators ; metabolism ; Male

Objective To investigate the influence of citalopram on the fast response action potential,slow response action potential,in vitro electrocardiogram(ECG) and in vivo ECG of cardiac myocytes,and explore its mechanism of adverse cardiac effects. Methods Conventional microelectrode technique was employed to record the fast and slow response action potentials of the isolated papillary muscles of guinea pigs.In vivo and in vitro ECG were recorded from anesthetized animals and Langendorff-perfused hearts,respectively. Results Citalopram could prolong the RR interval and QRS duration of in vivo ECG.The premature ventricular contraction and atrial ventricular block were induced by 12.5?10-6 mol/L citalopram.The maximum ascending velocity of 0 phase(Vmax),action potential amplitude(APA) and action potential duration(APD50 and APD90) were dose-dependently decreased by citalopram in the fast and slow response action potentials of guinea pigs,respectively. Conclusion Citalopram can inhibit sodium and calcium channels effectively,which may be the ionic mechanism that citalopram induces arrhythmia in the clinical practice.

OBJECTIVETo investigate the effects of local injections of recombinant soluble human receptors on experimental orthodontic tooth movement in the rat.

METHODS64 male Sprague-Dawley rats were observed. Starting at day 1, three groups of animals each received local injections of soluble interleukin-1 receptor II (sIL-1-R II ), soluble' tumor necrosis factor receptor I (sTNF-R I ) and their combinations. One group served as the control. The amount of tooth movement was recorded and selected tissue sections were stained with hematoxylin-eosin (HE) to observe the histological morphologic alterations of the periodontal tissues and also were stained with tartrate-resistant acid phosphatase (TRAP) histochemistry to analyze the changes of the amount and distribution of osteoclasts and odontoclasts.

RESULTSThe time-depended histomorphology changes in each receptor group were similar to those in the control group, but the resorption of alveolar bone was slighter at each time point and the surface of root appeared no or a few cement resorption signs. On day 14, the TRAP-positive cells on the surface of alveolar bone and root were reduced by approximately 50% relative to those in the control group (P<0.05). Whereas statistical tests revealed there were no significant differences among the experimental groups (P>0.05).

CONCLUSIONLocal injections of recombinant human sIL-1-R II and sTNF-R I in the orthodontic tooth of rats could reduce the amount and velocity of orthodontic tooth movement and reduce the incidence of root resorption.

Animals ; Dental Cementum ; Interleukin-1 ; Male ; Osteoclasts ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Receptors, Tumor Necrosis Factor ; Receptors, Tumor Necrosis Factor, Type I ; Root Resorption ; Tooth Movement Techniques ; Tooth Root

OBJECTIVESA retrospective study was used to evaluate the short to intermediate outcomes of open reduction and internal fixation of acute Lisfranc joint injuries.

METHODSFrom January 2003 to December 2009, 47 patients with Lisfranc injuries were treated in the study,41 patients were analyzed in current study with an average age of thirty-one years old. All of patients were treated with open reduction and internal fixation. According to the Myerson classification system, there were 9 type-A fractures, 7 type-B1, 11 type-B2, 10 type-C1, 5 type-C2. The AOFAS scale and VAS scale were used for the outcome measurement at the final follow-up.

RESULTSThere were 41 patients with 42 operations were followed up and with a mean time of 36 months (ranged, 12 to 71 months). The mean AOFAS score was (84.2 +/- 2.8) points (ranged, 65 to 100 points), with an excellent and good rate of 81 percent. The mean VAS score was (2.6 +/- 0.5) points (ranged, 0 to 6 points). Three patients developed superficial infection, and two developed skin necrosis. Nineteen patients had weight-bearing or walking pain. All of the patients had radiographic evidence of degenerative change, four with malunion of the second tarsometatarsal joint, and two of the patients with hallux valgus deformity change.

CONCLUSIONAccording to the results of the study, anatomic reduction and internal fixation can get the satisfactory results for the treatment of acute Lisfranc injuries during a short to intermediate follow-up time. All of the patients would have different degree of tarsometatarsal joint degenerative changes, but these changes are non-progressive and associated with minimal loss of function.

Acute Disease ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; injuries ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Retrospective Studies ; Tarsal Joints ; injuries ; surgery

Single sodium channel currents were recorded by patch clamp technique in isolated guinea-pig ventricular myocytes, and action potentials of papillary muscle and ECG were conventionally measured. Sea anemone toxin (ATXⅡ), a high affinity toxin to sodium channel, was used to change the sodium channel dynamics. Changes in the duration of action potentials and the QT interval of ECG depending on the channel modes were studied in order to provide hints to an understanding of pathogenesis of the long QT syndrome (a genetic disease). With the binding of ATXⅡ to the sodium channel, the occurrence frequency and the open time constant of the “long opening” mode of single Na channels increased significantly, whereas the action potential durations, APD50 and APD90, were prolonged by 23% and 27% respectively. Following application of ATXⅡ, on the other hand, the QT interval and the QTc, a rectified QT interval, increased by 18. 6% and 18. 9% respectively. The results suggest that the dynamics or modes of Na channel play an important role in determining the action potential duration and the QT interval of ECG. The dynamical changes in Na channels induced by genetic mutation may be partially responsible for the long QT syndrome.

PURPOSETraumatic diaphragmatic rupture (TDR) needs early diagnosis and operation. However, the early diagnosis is usually difficult, especially in the patients without diaphragmatic hernia. The objective of this study was to explore the early diagnosis and treatment of TDR.

METHODSData of 256 patients with TDR treated in our department between 1994 and 2013 were analyzed retrospectively regarding to the diagnostic methods, percentage of preoperative judgment, incidence of diaphragmatic hernia, surgical procedures and outcome, etc. Two groups were set up according to the mechanism of injury (blunt or penetrating).

RESULTSOf 256 patients with a mean age of 32.4 years (9-84), 218 were male. The average ISS was 26.9 (13-66); and shock rate was 62.9%. There were 104 blunt injuries and 152 penetrating injuries. Preoperatively diagnostic rate was 90.4% in blunt injuries and 80.3% in penetrating, respectively, P < 0.05. The incidence of diaphragmatic hernia was 94.2% in blunt and 15.1% in penetrating respectively, P < 0.005. Thoracotomy was performed in 62 cases, laparotomy in 153, thoracotomy plus laparotomy in 29, and combined thoraco-laparotomy in 12. Overall mortality rate was 12.5% with the average ISS of 41.8; and it was 21.2% in blunt injuries and 6.6% in penetrating, respectively, P < 0.005. The main causes of death were hemorrhage and sepsis.

CONCLUSIONSDiagnosis of blunt TDR can be easily obtained by radiograph or helical CT scan signs of diaphragmatic hernia. For penetrating TDR without hernia, "offside sign" is helpful as initial assessment. CT scan with coronal/sagittal reconstruction is an accurate technique for diagnosis. All TDR require operation. Penetrating injury has a relatively better prognosis.

Abdominal Injuries ; diagnostic imaging ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Diaphragm ; diagnostic imaging ; injuries ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; diagnostic imaging ; Retrospective Studies ; Rupture ; Thoracic Injuries ; diagnostic imaging ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating ; diagnostic imaging ; Wounds, Penetrating ; diagnostic imaging

OBJECTIVEReview the series cases of open calcaneal fractures, to discuss the clinical outcome and evaluate the effective factors associated with the prognosis.

METHODSBetween 2004 and October 2009, 427 calcaneal fractures were treated, 22 of these fractures were open, 15 feet of 15 patients were available for the follow-up. There were 9 males and 6 females with a mean age of 34.7 years (range 18 to 66). According to the Sanders classification, there were 2 type I fractures, 3 type II, 6 type III and 4 type IV. According to the Gustilo classification, there were 1 of type 1, 4 of type II, 5 of type III A, and 5 of type III B open fracture. According to the open calcaneal injury subtypes (OCIS), there were 1 of type IA, 2 of type II A,7 of type II B, 2 of type IIIA and 3 of type III B. All patients were treated with intravenous antibiotics, immediate and repeat irrigation and debridement, temporary wound coverage, and initial stabilization of the limb. Clinical examination, radiographs and AOFAS ankle-hindfoot scores were used for outcome measurement.

RESULTSThe average follow-up time was 16.4 months (8 to 31 months). The mean AOFAS score was (74.6 +/- 10.4) (range 58 to 94). There were 4 feet required tissue transfer for wound coverage. An infection developed at the sites of 5 fractures,4 of witch were Gustilo type III, 2 deep infections with osteomyelitis developing at the site of 1 patient, no patient required amputation.

CONCLUSIONThese findings do not reflect as high a deep infection and osteomyelitis rate for open calcaneal fractures as previously reported, if early and satisfying debridement, evaluate the soft tissue injury carefully, and choose the right time and indications for internal fixation. In addition, early internal fixation should be avoided for Gustilo type III and OCIS type B calcaneal fractures.

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; Female ; Follow-Up Studies ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Time Factors

Female ; Hernia, Ventral ; surgery ; Humans ; Laparoscopy ; methods ; Middle Aged

Objective: To review the surgical modality with pterional keyhole approach in treatment of anterior circulation aneurysm.Methods: Three hundred and thirteen patients with ruptured anterior circulation intracranial aneurysm treated surgically with pterional keyhole approach between January 2009 and June 2014 in Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, were included in the analysis. Complete occlusion rate of aneurysms and incidence of major complications including delayed cerebral ischemia and chronic hydrocephalus were documented.Surgical outcomes at 6-month follow up were assessed by modified Rankin Scale.Results: Totally 348 aneurysms were treated with pterional keyhole approach, 326 aneurysms were completely clipped, 16 aneurysms were partly clipped, and 6 aneurysms were wrapped with gauze material. Among 313 patients, 15 patients (4.79%) suffered from delayed cerebral ischemia, and 10 patients (3.19%) suffered from hydrocephalus.At the 6-month follow up, the rate of good outcome was 66.77% (209/313).Conclusions: The pterional keyhole approach can be used to clip most of anterior circulation aneurysms, and it seems to have advantages over the traditional approaches with lower incidence of complications and similar outcomes.

Objective To compare the stress relaxation and mechanical properties of creep viscoelasticity in the young and old’s spine and to provide the reference for the mechanical mechanism of viscoelasticity of yellow ligament degeneration. Method Twenty specimens of elderly patients with degenerative lumbar yellow ligament degeneration as the older group, and twenty specimens of young patients with lumbar yellow ligament injuries as the youth group were used respectively. All the yellow ligament specimens were from the yellow ligament between the fourth and fifth of lumbar vertebra (L4~L5). Stress relaxation experiment and creep experiment were conducted on the specimens by the strain increasing speed as 1%/s and the stress increasing speed as 0.5 MPa/s respectively. The experimental temperature was (36.5±0.5) ℃ and the experimental time was 7 200 s. Ninety stress relaxation and creep data were collected, and the data were dealt with the statistical analysis and normalization methods. Results The 7 200 s stress of yellow ligament in the youth group decreased by 1.42 MPa, while the 7 200 s stress of yellow ligament in the older group decreased by 1.91 MPa. The 7 200 s strain of yellow ligament in the youth group increased by 3.39%, while the 7 200 s strain of yellow ligament in the older group increased by 2.07%. The 7 200 s stress in two groups all increased and the increased strain data showed statistically significance (P<0.05). The stress relaxation curve changed in the form of logarithm and the creep curve changed in the form of index. Conclusions The 7 200 s stress relaxation and creep in the yellow ligament of the older group all decreased and the mechanical properties of viscoelasticity changed.