Deep venous thrombosis (DVT) is initiated intraoperatively and may display symptoms postopera- tively following total hip or total knee arthroplasties. Pulmonary embolism (PE) and DVT cause morbidity and mortality. It has been established that patients who undergo a major lower-extremity joint replacement should receive prophylaxis due to the increased risk of DVT. Despite use of thrombo-prophylaxis, elective replacement surgery carries a high risk of venous thromboembolic complications. The early detection of DVT and treatment with systemic anticoagulation to pre- vent DVT are essential in the management of patients undergoing total joint arthroplasty. Extended medical throm- bo-prophylaxis is indicated for some high-risk patients. Routine postoperative duplex surveillance for DVT may be clinically useful. In the early post-operative phase, combined prophylaxis such as low-molecular-weight heparins and mechanical methods may be more effective than single intervention measures. However, the efficacy and safety of an- ticoagulation therapy, using various medicines administered after total arthroplasty of large joints are still undetermined and controversial.We should also be alert to the frequency and extent of postoperative hematomas. There are still many uncertainties in treatments to prevent DVT in terms of safety and cost-effectiveness. Therefore, prospective, ran- domised, controlled and multicenter studies may be necessary to obtain valuable information according to evidence based medicine.

Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.MethodsFrom Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification.Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months.No necrosis of humeral head appeared and 30 (83.3％) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.

Objective To investigate MR imaging features of femoral marrow in treated ?-thalassemia major.Methods MR imaging of the proximal femoral marrow was performed in 35 cases of ?-thalassemia major and 45 age-and sex-matched normal children as control.Coronal images of femoral marrow with the techniques of spin echo and fast field echo(FFE)were obtained.On T_1-weighted imaging the red and yellow femoral marrow were judged and marrow distribution was classified into five groups.The hemosiderosis of marrow was judged on the basis of signal intensity of marrow on FFE imaging.The marrow distribution classification and the hemosiderosis on MR imaging were correlated with clinical features.Results On FFE,marrow hemosiderosis occurred in 15 patients with a marked hypo-intensity signal and was related to the age(P=0.032).On T_1-weighted imaging,the femoral marrow in 35 patients was classified as groupⅢand IV,while the marrow distribution was groupⅠorⅡin all normal children,there was statistically significant difference(P

Objective To compare of the effect of intravenous zoledronic acid and calcitonin on the elderly with osteoporotic intertrochanteric fractures.Methods From June 2009 to November 2012,610 patients with osteoporotic intertrochanteric fractures were treated with closed reduction and internal fixation.543 consecutive patients were grouped sequentially according to the admission time.From June 2009 to April 2011,control group (n=325)received calcitonin for osteoporosis (male 107,female 218,mean age 75.02±5.65 years).The number of Evans-Jensen type Ⅰ,Ⅱ,and Ⅲ type patients were 87,136,and 102,respectively.Average lumbar bone mineral density (BMD) and hip BMD were 0.737±0.08 g/cm2 and 0.725±0.05 g/cm2,respectively.From May 2011 to November 2012,218 patients (male 82,female 136,mean age 74.71±5.32 years) received zoledronic acid for osteoporosis.The number of Evans-Jensen type Ⅰ,Ⅱ,and Ⅲ type patient were 62,91 and 65,respectively.Average lumbar BMD and hip BMD were 0.738±0.05 g/cm2 and 0.722±0.06 g/cm2,respectively.All patients received once-yearly intravenous zoledronic acid in one week after operation.The BMD during hospitalization and one year after operation were compared between the two groups.Harris score and VAS score were applied to evaluate the function and pain degree of the operated hip joint.Results The average follow-up time were 12.8 months (range,5 to 22 months) in control group and 12.5 months (range,4 to 19 months) in treatment group.The average fracture union time,Harris score,VAS score were 14.25±1.38 weeks,68.88±5.71 points,and 0.36±0.55 points respectively in treatment group and 14.39± 1.12 weeks,69.47±4.60 points,and 0.33±0.48 points respectively in control group.There were no statistical differences between two groups in fracture union time,Harris score and VAS score.The average lumbar BMD and hip BMD were 0.76±0.06 g/cm2 and 0.75±0.04 g/cm2 in treatment group,which were 0.75±0.07 g/cm2 and 0.74± 0.07 g/cm2 in control group one year after operation,respectively.Compared with the baseline,the BMD of lumbar spine and hip one year after operation slightly increased without statistically significant difference in control group.The BMD increased significantly in treatment group.Conclusion Early administration of intravenous zoledronic acid does not influence bone healing and it could increase BMD one year after closed reduction and internal fixation.

Objective To study the expression level and clinical significance of bcl-XL gene in childhood medulloblastoma.Methods The expression of Bcl-XL protein and bcl-XL mRNA were determined by immunohistochemical staining and in situ hybridization in 41 samples of medulloblastoma tissues,as well as 20 normal brain tissues.Results The positive rate of Bcl-XL protein(90.2%) and bclXL mRNA(95.1%) in medulloblastoma group were significantly higher than those in normal human brain tissues(all P

OBJECTIVETo evaluate the sedative effect of continuous intravenous infusion of midazolam in treating severe dental phobia.

METHODS31 patients with severe dental phobia were enrolled and all of them had good communication with dentists. Two teeth in each patient were assigned to control group and experiment group seperately. The control group received root canal therapy. The experiment group were sedated by intravenous midazolam and received root canal therapy. The treat dependence and behavior therapy efficacy were evaluated. The vital signs and side effects during treatment were noted.

RESULTSContinuous intravenous infusion of midazolam showed a significant good sedative effect on patients with severe dental phobia. There were statistical difference in the Houpt score and the Frankl score between experiment group and control group (z = -4.846, P = 0.000; z = -4.907, P = 0.000). The total dose of midazolam was (9.58 +/- 3.76) mg, and mean infusion rate was (0.28 +/- 0.06) mg x kg(-1) x h(-1). The blood pressure, heart rate and respiration of experiment group were depressed. But these changes didn't interfere with the completion of the whole treatment. No severe side effects were detected.

CONCLUSIONThe single use of midazolam as an intravenous sedation agent has satisfactory effect on patients with severe dental phobia.

Blood Pressure ; Conscious Sedation ; Dental Anxiety ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Infusions, Intravenous ; Male ; Midazolam

BACKGROUND: Chinese traditional osteopathy is long in history, unique in manipulation and miraculous in therapeutic effect. But people understand it more m perception rather than in theory, more in application rather than in development. There is little research truly on the bioseience.OBJECTIVE: To probe into the macro-idea of Chinese traditional osteopathy, micro-mechanisms on characters and mathematics-physics models, aiming to provide new principles and approaches of treatment for the daily increased bone trauma, fracture and sport injury.SETTING: Physics and machine-electron college of a university, and its affiliated hospital.METHODS: Based on the natural concept of "integration between heaven and human being" and new concept of holistic medicine in Chinese traditional osteopathy, the macro-idea and characters of reduction and union of fracture are generalized from the characters of natural therapy and the biomechanical mechanisms and characters of reduction and union of fracture are summarized from the micro-reaction of bone repair and union so as to discover biomechanical mechanisms and characters of reduction and union of fracture and further to set up biomechanical models and mathematics-physics expressions during the treatment.RESULTS: Chinese traditional osteopathy envelopes macro-idea of "initiative reduction-functional union" in fracture and micro-mechanism on "stress adaptability-functional adaptability" of bone repair and union.CONCLUSION: Chinese traditional osteopathy compiles with the natural,green and non-traumatic therapy in bio-natural law of bone repair and union and supports the theme of "high thought and high skill".

OBJECTIVETo investigate the protective effect of soyasaponins on acute liver injury induced by D-galactosamine (GalN) and lipopolysaccharide (LPS) in mice.

METHODThe mice were randomly divided into five groups: the normal control, the model group, the silymarin (positive control) group, and soyasaponins high and low-dose groups. They were administered with drugs once every day for 7 days. At the end of the experiment, GalN and LPS were injected intraperitoneally to all of the groups except for the normal group to establish the acute liver injury model. The pathological changes were detected with hematoxylin & eosin (HE) staining, tumor necrosis factor-alpha (TNF-alpha) was detected by ELISA method, and the alanine aminotransferase (ALT), aspartate aminotransferase (AST), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST), reduced glutathione (GSH), malondialdehyde (MDA), nitric oxide (NO), and the activation of Caspase-3 and Caspase-8 were detected by the colorimetric method.

RESULTSoyasaponins could reduce the activities of serum ALT and AST, the acute hepatic injury induced by GalN/LPS, serum TNF-alpha level, hepatic NO and MDA contents, and the Caspase-3 and Caspase-8 activations of liver tissues, and increase the hepatic CAT, GPx, GST and GSH levels.

CONCLUSIONSoyasaponins shows the protective effect on acute liver injury induced by GalN and LPS in mice, which may be related to its antioxidative ability and anti-liver apoptosis.

Alanine Transaminase ; blood ; Animals ; Antioxidants ; metabolism ; Apoptosis ; drug effects ; Aspartate Aminotransferases ; blood ; Caspases ; metabolism ; Chemical and Drug Induced Liver Injury ; metabolism ; pathology ; prevention & control ; Galactosamine ; toxicity ; Lipopolysaccharides ; toxicity ; Liver ; pathology ; Male ; Mice ; Saponins ; pharmacology ; Soybeans ; chemistry

Objective To study the influence of fluoride on the expression of osteoprotegerin(OPG) mRNA and protein in suckling rat osteoblasts. Methods Osteoblasts obtained from calvarial of suckling Wistar rats were cultured in vitro in the media supplemented with NaF at a series of doses[O(control), 1,2 and 4 mg/L groups], and OPG mRNA expression and protein were evaluated by RT-PCR and ELISA methods, respectively. Results OPG mRNA expression in suckling rat osteoblasts cultured in vitro significantly increased after exposure to NaF for 48 h and 72 h(F=333.48,808.34,P<0.05). OPG mRNA expression in suckling rat osteoblasts cultured in vitro after exposure to NaF for 48 h at different doses(0.810±0.003, 0.819±0.031 and 0.870±0.044 for 1,2 and 4 mg/L groups, respectively) compared with that of control (0.800±0.040, all P<0.05). OPG mRNA expression further increased for 72 h exposure to NaF(0.933±0.047,1.031±0.051,1.240±0.062 for 1,2 and 4 mg/L, respectively), significantly higher than that of the control (0.805±0.020,all P<0.05) and corresponding groups at 48 h. NaF doses and time exposure exhibited a significant synergistic effect on OPG mRNA expression(F=2004.16, P<0.05). NaF also enhanced OPG protein expression in suckling rat osteoblasts cultured in vitro. Significant differences were observed only in 4 mg/L group(0.228±0.014,0.277±0.048) and control(0.205±0.012,0.229±0.010) at 48 h and 72 h (P<0.05). In addition, OPG protein expression at 72 h post-exposure was higher than that at 48 h,but there was no synergistic effect between concentration and time(F=1.21,P>0.05). Conclusions The results suggested that NaF could increase OPG mRNA and protein expression in suckling rat osteoblasts with a synergistic effect between the doses and exposure time.

OBJECTIVE: For the purpose of solving a problems of DNA testing of burned bones. METHODS: We present a novel strategy to obtain DNA from burned bones based on the use of cetyltrimethylammonium bromide (CTAB) lysis buffer and isoamyl alcohol-chlorophorm extraction with subsequent DNA purification using the DNA IQ System. RESULTS: The methods were found to be effective in removing the PCR inhibitors from the burned bone. Then the extracted DNA was successfully genotyped by using the florescence labeling STR multiplex method. CONCLUSION The results of this research will assist forensic scientists in the identification of DNA from victims whose bodies underwent significant trauma or burning, precluding the utilization of traditional forensic DNA identification techniques.
Bone and Bones/chemistry* ; Burns/metabolism* ; Cetrimonium Compounds ; DNA/isolation & purification* ; DNA Fingerprinting/methods* ; Female ; Forensic Medicine/methods* ; Humans ; Male ; Polymerase Chain Reaction/methods* ; Sensitivity and Specificity ; Tandem Repeat Sequences ; Time Factors