Objective To investigate the relationships between septic shock and vascular endothelial cells (VECs)injury by measuring the plasma CEC,vWF,and NO in septic shock patients and to explore its potential clinical values. Methods 72 patients were divided into group A including 34 infection patients but without septic shock,and group B including 38 patients with septic shock. Circulating endothelial cell(CEC),von willebrand factor(vWF),and nitric oxide(NO)in plasma were measured in all patients at the time points of accessing ICU (T0)and 24 hours after staying in ICU(T1). And the blood pressures of studied patients were also recorded at the same time points. Results The levels of CEC and vWF at each observing time point were higher in group B than those in group A(P < 0.01),while the levels of NO were lower in group B than those in group A(P < 0.01). In group B,the levels of CEC and vWF at T1 were higher than those at T0(P<0.01),while the level of NO was low-er at T1 than that at T0(P<0.01). With contrary to those of group A,circulation conditions of group B were obvi-ously unstable and high doses of vasoactive agents were needed during the therapy period. MAP in group B at each time point was obviously lower than that in group A(P<0.05). There were 7 dead cases(18%)in group B but no death in group A during the whole therapy period. Conclusion Obvious injury of vascular endothelial cells exists in septic shock patients and the injury degree is related to the severity of the disease.

Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiac surgery patients in intensive care unit. Methods A total of 90 cardiac surgery patients in the intensive care unit (ICU)were randomly assigned into dexmedetomidine group(D group,45 cases)and propofol group(P group,45 cases)to receive dexmedetomidine or propofol respectively for post-operative sedation. The ratio of sedation satisfac-tion was evaluated and calculated by Riker sedation-agitation scale(SAS),and the duration of mechanical ventila-tion,24-hour consumption of sufentanil,ICU staying time,and the incidences of side-effects(such as hypoten-sion,bradycardia,delirium etc)were recorded during the observation period. Results No significant differences were found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the two groups (P > 0.05). The duration of mechanical ventilation and ICU staying time were significantly shorter in D group than that in P group(P<0.01),while the 24-hour consumption of sufentanil and the incidences of hypoten-sion and delirium were significantly lower than that in P group(P<0.05). Conclusion Using the dexmedetomi-dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe ,and the postoperative recovery of patients may be enhanced by the drug using.

Boosting spatial resolution of visual prostheses is an effective method to improve implant subjects' visual perception. However, power consumption of visual implants greatly rises with the increasing number of implanted electrodes. In respond to this trend, visual prostheses need to develop high-efficiency wireless power transmission and high-speed data transmission. This paper presents a review of current research progress on wireless power and data transmission for visual prostheses, analyzes relative principles and requirement, and introduces design methods of power and data transmission.
Electric Power Supplies ; Prosthesis Design ; Visual Prosthesis ; Wireless Technology

From August 1996 to October 2004,totally 22 patients(22 eyes) of entire blepharocoloboma after malignant palpebrae superior tumorectomy,admitted to Department of Ophthalmology in the Affiliated Hospital of Binzhou Medical College,were repaired with sclera transplantation for the eyelid reconstruction.The alcohol-preserved scleral allograft was utilized for a substitute of tarsal plate.The internal surface of scleral graft was covered with remaining fornical conjunctiva and the external surface with musculus orbicularis oculi and skin.Bilateral sutures were fixed on the stump of tarsal plate or exterior and interior external palpebral ligament.Then eyelid margin was sutured and cut off after 6 months.All patient were followed up after operation for average 28.8 months.No reject reaction was found,catacleisis was fine and external appearance was satisfying.The eyelid reconstruction with scleral allograft is effective to keep eyelid normal function and external appearance.

OBJECTIVE To establish the isolation and identification system of human mesenchymal stem cells(hMSCs)in vitro, and then to establish a stable cultured system in which the hMSCs can be induced to osteoblasts, chondroblasts and lipoblasts in vitro. To study the possibility if hMSCs can be used as the seed cells in bone tissue engineering.This study would lay a foundation for the clinical application of tissue engineering. METHODS 5ml bone marrow of the patient was aspirated from iliac crest. The human MSCs were isolated using Percoll gradient centrifugation. The hMSCs were cultured in DMEM medium in vitro, FACS(fluorescence axtivated cell sorter)was used to identify the phenotype of hMSCs. The hMSCs were cultured in vitro, and induced to osteoblasts, chondrocytes and lipocytes. The changes of phenotype were tested by mmunohistochemisty and molecular biology technique. RESULTS The hMSCs were isolated by Percoll gradient centrifugation from patient’s bone marrow. The expression rate of MSC markers including CD105, CD166, CD29 were(78?6)%, (43?7)%, (69? 12)% respectively. The phenotype of osteoblasts induced from hMSCs was verified by the mineralized nodes formation when cultured in vitro and Col, and OCN expression showed by immunohistochemistryand RT-PCR. The phenotype of chondrocytes induced from hMSCs was verified by type, collagen, SOX9 expression with immunohistochemical staining technique and type, collagen, aggrecan mRNA expression with RT-PCR. The lipocytes’ phenotype was verified by positive result of oil red O staining and PPAR 2mRNA expression by RT-PCR. CONCLUSION The highly pure hMSCs can be harvested by means of density gradient centrifugation, and the hMSCs have multi-potentiality of cell differentiation via induced culture in vitro. The third passage of hMSCs can be induced to express osteoplast phenotype and meet the qualitative and quantitative demands of seed cells when bone tissue engineering was used in clinical practice.

Objective To compare the clinical effect of proximal femoral nail anti-rotation(PFNA) and dynamic hip screw(DHS) internal fixation in the treatment of femoral intertrochanteric fracture.Methods 80 patients with femoral intertrochanteric fracture were selected as research subjects.They were divided into PFNA group and DHS group by random number table,40 cases in each group.The operation time,intraoperative blood loss,postoperative wound drainage,postoperative weight-bearing time,healing time,complication rate,Harris hip function score between two groups were compared.Results The operation time of the PFNA group was lower than that of DHS group(t=22.66,P＜0.05),the amount of bleeding in operation was less than that in the DHS group(t=54.85,P＜0.05),the postoperative wound drainage volume was less than that of the DHS group(t=16.85,P＜0.05),the weight-bearing time after operation was shorter than that in the DHS group(t=20.18,P＜0.05),and the healing time was shorter than that in the DHS group(t=22.00,P＜0.05).The excellence rate of Harris hip function score in the PFNA group was 95.00％,which was significantly higher than 80.00％ in the DHS group,the difference was statistically significant(χ2=4.11,P＜0.05).The incidence rate of complication of the PFNA group was 7.50％,which was significantly lower than 25.00％ of the DHS group(χ2=4.50,P＜0.05).Conclusion Compared with DHS,PFNA internal fixation has the advantages of less operation time,less intraoperative blood loss,shorter healing time and low complication rate in the treatment of femoral intertrochanteric fracture.It is worthy to be promoted clinically.

Objective:To investigate the effects of experimental periodontitis on serum C reactive protein(CRP) and insulin resistance in obese rats.Methods:4 week old SD rats (n=35)were fed with high fat diet for 16 weeks to establish the model of obesity.According to the obesity criteria,5 rats were screened out.According to the proportion of 1:2,10 rats were randomly selected as obese control group,20 obese rats were used for the establishment of the obesity with periodontitis model(combination group) by periodontal ligation using silk thread.4 rats died after ligation.Before periodontal ligation,1 and 4 weeks after periodontal ligation,orbital venous blood were collected for the detection of fasting blood glucose and fasting insulin.Homeostasis model assessments of insulin resistance index(HOMA-IR) and beta cell function index(HOMA-β) were calculated.The level of serum CRP was examined by ELISA.Results:The level of CRP in the combination group was increased 1 week after periodontal ligation,and then gradually decreased in the following 4 weeks(F=7.773,P=0.004).HOMA-IR in the combination group were higher than that in the obese group(F=-4.691,P=0.000),and beta cell function index was significantly lower(F=3.672,P=0.002) than that in the control group 4 weeks after periodontal ligation.Conclusion:The experimental periodontitis may affect the serum level of CRP in obese rats,aggravate insulin resistance and decrease the function of beta cells in obese rats.

Spinal muscular atrophy (SMA) is a group of neuromuscular disorders, caused by degeneration of the motor neurons in the anterior horn of the spinal cord, with prevalence of about 1 in 6000 to 1 in 10000 in newborn. The gene carrying frequency is about 1 in 40 to 1 in 50 all over the world. SMA is one of the most common autosomal recessive diseases causing infant death. SMA mainly refers to SMN1 dependent caused by SMN1 gene mutations. Noninvasiveness and specificity make genetic testing a recommended method for diagnosis of SMA. In addition to conventional methods such as neural nutrition, muscle exercise, etc., there is no specific treatment for SMA up to now. Nevertheless, HDAC inhibitors deserve attention as they are the only drugs completed Phase Ⅲ clinical trials to date. Furthermore, other ways as small-molecule SMN enhancers, induced pluripotent stem cell (iPSC), antisense oligonucleotides to correct SMN2 splicing, etc, were still on the way of in vitro stage at present.

Objective To explore the effect of using pedicle skin flaps for treatment of skin and soft tissue defects.Methods From January 2004 to September 2010,87 patients with skin and soft tissue injury which had been treated by using pedicle skin flaps without vessel anastomosis were retrospectively analyzed,including 61 males and 26 females with an average age of 40 years (range,14-61).The pedicle skin flaps selected were known vessel skin flaps or unknown vessel random skin flaps.The reconstruction treatment increased multiple selections of skin flaps for patients.Skin and soft tissue defects were located at the hand in 21 cases,at the lower extremities in 66.The kinds of skin flaps included adjacent transposition flaps in 50 cases,distal skin flaps in 37.The areas of the skin flaps were 2.0 cm×1.5 cm-18 cm×12 cm.Donor sites were as follows:lower leg in 61 cases,abdomen in 18,and hand in 8.Results Three patients appeared skin flaps hematoma after operation,which were removed immediately with no effect on flaps survival.Pedicle skin flap was compressed due to unstable fixation in 1 case,which made distal flap tissue necrosis approximately 2 cm in width.After dressing change for 6 weeks,the flaps got survival.Thirty seven patients underwent the second stage operation for breaking the perdicle 3 weeks after the first operation.All 87 patients were obtained follow-up for an average of 13 months (range,3-60).The total of 90.80％ patients treated with pedicle skin flaps were satisfied with the results.Conclusion Pedicle skin flap surgery can be performed more easily with less limitations of surgical designs.The survival rate of the flap is high,and the treatment of pedicle skin flaps could be well applied for soft tissue defects.

Objective To evaluate the effects of penehyclidine hydrochloride pretreatment on the expression of nitric oxide synthase (NOS) and cell apoptosis in lung tissues in rats with endotoxin-induced acute lung injury (ALI).Methods Forty adult male Sprague-Dawley rats,weighing 220-270 g,were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C),endotoxin-induced ALI group (ALI group),and penehyclidine hydrochloride 0.03,0.10,0.30 mg/kg groups (Pi-3 groups).ALI was induced with lipopolysaccharide (LPS) 5 mg/kg which was injected via the caudal vein.In P1-3 groups,penehyclidine hydmchloride 0.03,0.10 and 0.30 mg/kg were injected intraperitoneally,respectively,at 1 h before LPS injection,while the equal volume of normal saline was administered in C and ALI groups.The animals were sacrificed at 4 h after ALI models were successfully established and pulmonary specimens were obtained for determination of the cell apoptosis (by TUNEL),expression of NOS mRNA (using PT-PCR),and Bcl-2 and Bax protein (by Western blot),NOS activity (using chemical colorimetry) and NO content (by using nitrate reductase method) and for examination of pathological changes (by light and electron microscopes).Apoptotic index (AI) and the ratio of Bcl-2/Bax was calculated.Results Compared with group C,NOS mRNA and Bax protein expression was significantly up-regulated,NOS activity,NO content and AI were increased,Bcl-2 protein expression was down-regulated,the ratio of Bcl-2/Bax was decreased (P ＜ 0.01),and the degree of pathological changes of the lung was aggravated in ALI and P1-3 groups.Compared with ALI and P1 groups,NOS mRNA and Bax protein expression was significantly down-regulated,NOS activity,content of NO and AI were decreased,Bcl-2 protein expression was up-regulated,the ratio of Bcl-2/Bax was increased (P ＜ 0.01),and the degree of pathological changes of the lung was alleviated in P2-3 groups.There was no significant difference in the indexes mentioned above and results of pathological changes of the lung between group ALI and group P1,and between group P2 and group P3 (P ＞ 0.05).Conclusion Penehyclidine hydrochloride pretreatment ameliorates endotoxin-induced ALI by inhibiting NOS expression and cell apoptosis in rat lung tissues.