lschemic postconditioning(IPo)is a way that after long ischemia on liver graft,animals are given one or several brief reperfusion-ischemia before persistent reperfusion to improve the hepatic tolerance and relieve the ischemie reperfusion injury.It has been proved an effective and controlled method to attenuate the ischemic reperfusion injury.Protective mechanism of ischemic postconditioning on hepatic graft is related with protecting sinus hepaticus endotheliocyte and hepatic microcirculation,relieving hepatic cells injury and inflammatory reaction induced by oxygen free radicals,relieving calcium ovedoad in hepatic cells and mitochondria,regulating apoptosis genes,transforming ion channels condition in mitochondria.This article will makes a brief review on protective mechanism ofhepatic ischemic posteanditioning.

Objective To investigate early renal damage of chronic hepatitis B (CHB) patients and the risk factors related to their renal function. Methods CHB patients who visited the second people’s hospital but did not receive systemic treatment were enrolled in our study. Those who visited for general check-up with no hepatic findings during the same period were selected as control group. Glomerular filtration rate (GFR) of all the participants were estimated by simplified MDRD equation and CKD-EPI equation (designated as M-eGFR and C-eGFR respectively). Influence factors of eGFR were statistically analyzed. Results In the total 528 cases in CHB group, 88 (16.67%) and 62 (11.74%) suffered declined M-eGFR and C-eGFR respectively. By contrast, 10 (8.77%) and 6 (5.26%) cases in the total 114 cases in control group present declined M-eGFR and C-eGFR ac?cordingly. Percentages of renal function impairment, estimated by both M-eGFR and C-eGFR, were higher in the CHB group than those in control group. The difference was statistically significant (χ2=4.518, P<0.05;χ2=4.156, P<0.05). Multiple linear regression analysis indicated that age, HBsAg and body mass index (BMI) were risk factors of M-eGFR while age, HBsAg, gender and serum albumin were risk factors of C-eGFR. On the other hand, HBV-DNA and HBeAg were not risk factors for M-eGFR or C-eGFR. Conclusion HBV infection can lead to early renal damage. Age and HBsAg are main risk factors of renal function impairment. Therefore, renal function should be scrutinized in CHB patients.

Objective To investigate the effect of partial sleep deprivation (PSD) on cardiac electric activity and function of vascular endothelium. Methods Eighteen Sprague-Dawley rats were randomly divided into two groups (9 each):PSD group and control group. PSD lasted 10 days,20 hours each day. Body weight and surface electrocardiogram (S-ECG) were examined and recorded 1d before PSD,and 1d,4d,7d and 10d after PSD. Serum concentrations of glucose,total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),creatin kinase (CK),creatin kinase-MB (CK-MB),high-sensitivity C-reactive protein (hs-CRP),nitric oxide (NO),von Willebrand factor (vWf),endothelin-1 (ET-1) and E-selectin were determined the next day after 10d of PSD. Results Compared to that 1d before PSD,body weight in PSD groups decreased significantly,while increased obviously in control group. Compared to that in control group,the body weight of rats decreased significantly (P

Objective To explore the effect of atorvastatin on postoperative complications after the burr hole drainage of chronic subdural hematoma (CSDH). Methods The clinical data of 172 CSDH patients who had underwent the burr hole drainage were retrospectively analyzed. Among them 82 patients were given atorvastatin (atorvastatin group), and 90 patients were not given atorvastatin (control group). The postoperative complications were compared between 2 groups. Results All patients were followed up for 6 months. The total incidence of postoperative complications in control group was significantly higher than that in atorvastatin group:47.78%(43/90) vs. 31.71%(26/82), and the recurrent rate of subdural hematoma and incidence of subdural effusion in control group were significantly higher than those in atorvastatin group: 22.22% (20/90) vs. 8.54% (7/82) and 28.89% (26/90) vs. 12.20%(10/82). There were statistical differences (P<0.05). There were no statistical difference in the incidences of pneumocephalus, acute epidural/subdural hematoma and brain damage induced by drainage tube (P>0.05). Conclusions Atorvastatin can improve the prognosis of CSDH patients, especially in reducing the incidence of recurrent subdural hematoms and subdural effusion.

Objective To investigate the effects of atorvastatin on the experimental autoimmune encephalomyelitis(EAE)and the underlying mechanism of immunoregulation.Method The Wistar rats were used to establish EAE model.After oral administration of 2, 8 mg? kg~(1)?d~(1)of atorvastatin, the rats were examined for the development of neurological signs, changes of histopathology and the expression of IL-4 and MMP-9.Result Though high dose treatment with atorvastatin, the frequency of EAE attacks degreased from 76.67% to 33.33%(P=0.008);the extent of inflammation degreased from 3.2?1.1 to 1.3?0.4(P=0.01);and the number of MMP-9 positive cells degreased from 37?7 to 26?5(P= 0.001), the expression of IL-4 could be increased from(0.35?0.12)ng/ml to(0.68?0.23)ng/ml (P=0.05).Conclusion Atorvastatin can reduce the inflammation and produce the recover of the neurological harm because of the changes of MMP-9 and IL-4.

Objective To summarize the efficacy of cervical pedicle screw fixation in the treatment of cervical spinal cord injury without fracture and dislocation.Methods From September 2007 to March 2010,21 patients with cervical spinal cord injury without fracture and dislocation combined with developmental cervical stenosis were managed by pedicle screw fixation in unstable segments,and then single open-door laminoplasty in stenosis segments.The clinical outcomes were reviewed and summarized.Results All the patients received follow-up of 1-3 years.Two patients had superficial wound infection,which was cured by dressing change.One presented intra-incisional hematoma one week post-operatively and was cured by hemostasis and drainage.One had door-reclosing without symptom aggravation.There was neither perforation of pedicle screws nor breakage,loosening or displacement of internal fixation.The curvature of cervical lordosis at follow-up had significant rectification in comparison with that at preoperation,but showed unobvious change as compared with that immediately after operation.According to the modified Japanese Orthopedic Association (JOA) score,the neurological score improved from preoperative 4-15 points to 9-17 points at the final follow-up,which revealed more than 80％ of recovery in 13 patients,50％ -80％ of recovery in six and 5％ -50％ of recovery in two,with the average recovery rate of 75％.Conclusion For unstable segments in patients with cervical spinal cord injury without fracture and dislocation combined with developmental spinal stenosis,posterior pedicle screw fixation can avoid the risk of further spinal cord injury in single open-door laminoplasty and restore the physiological curvature of cervical vertebrae,which provides solid foundation for backward drift of spinal cord and creates favorable condition for recovery of spinal cord function.

AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI) in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes) with diabetic retinopathy(Ⅲ~Ⅳstage) from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department.The health control (HC) group of 55 normal people was established simultaneously.Ocular blood flow velocity of the 55 normal people (110 eyes) and the 60 patients (120 eyes) was examined by CDFI of central retinal artery (CRA) and posterior ciliary artery (PCAs) using the PHILIPS HD6.Peak systolic velocity(PSV) was recorded.The examinations of CDFI, electroretinogram(ERG) and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of CRA of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the PSV of PCAs of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of PCAs of the DR group after photocoagulation with the data before, there was a significant difference at 1d postoperatively(P<0.05), there was no significant difference at 7d, 1, 3 and 6mo(P>0.05).Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05).Compared the aA and bA of ERG of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the aT and bT of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the aT and bT of ERG of the group DR after photocoagulation with the data before, there was no significant difference(P>0.05).The vision of 49 cases(98 eyes) was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes) remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect.Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic` eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.

Objective To explore the clinical curative effect and complications of digital three-dimensional molding of titanium mesh for repairing skull defect. Methods The clinical data of 42 patients having underwent repairing skull defect with three-dimensional molding of titanium mesh were retrospectively analyzed. Results The average operation time was about 2 h, and 42 patients were operated successfully. The bilateral skull was symmetry and the appearance was good. In 42 patients, subcutaneous dropsy occurred in 1 case, epilepsy occurred in 3 cases, and intracranial bleeding again surgery occurred in 1 case. Patients were satisfied with the results of cranioplasty. Conclusions Repairing skull with digital three-dimensional molding of titanium mesh is simple, with shorter operation time, lower operation risk, and lower postoperative complication, and the clinical curative effect is satisfactory.

OBJECTIVETo compare therapeutic effects between arthroscopic medial retinaculum plication and plaster external fixation for the treatment of acute patellar dislocation.

METHODSFrom February 2006 to October 2012,29 patients with acute patellar dislocation were divided into two groups: operation group and non-operation group. The patellar dislocation duration was 2 weeks. In operation group, there were 7 males and 10 females, with an average age of (16.2 ± 6.2) years old, and the patients were treated with arthroscopic medial retinaculum plication. In non-operation group, there were 5 males and 7 females,with an average age of (16.3 ± 5.0) years old,and the patients were treated with plaster external fixation. The Kujala scores, patellar tilt angle measured on CT film, apprehension test and recurrence rate of patellar instability were observed before and 1 year after treatment.

RESULTSIn operation group, the pre-treatment and post-treatment patellar tilt angles had no statistical difference, but the post-treatment Kujala score was lower than that of pre-treatment; while in non-operation group, the post-treatment patellar tilt angle was larger than that of pre-treatment, and the post-treatment Kujala score was lower than that of pre-treatment. At 1 year after treatment, the patellar tilt angle (21.2 ± 5.3) of patients in non-operation group was larger than (13.5 ± 3.5) of operation group, and the Kujala score 73.3 ± 10.5 of patient in non-operation group was lower than 84.1 ± 5.6 of operation group.

CONCLUSIONDuring 1 year after operation, arthroscopic medical retinaculum plication is a more effective treatment for acute patellar dislocation compared with plaster external fixation.

Adolescent ; Adult ; Arthroscopy ; Case-Control Studies ; Casts, Surgical ; Child ; Female ; Fracture Fixation ; Humans ; Male ; Patellar Dislocation ; surgery ; therapy ; Patellar Ligament ; surgery ; Treatment Outcome ; Young Adult

The patient,a 51-year-old veterinarian,was hospitalized for a two-month history of painful oral ulcers without fever.Physical examination revealed two superficial ulcers in the palate.Laboratory examination showed a decrease in peripheral blood leucocytes as well as a hyperplasia of bone marrow.No abnormality was found by X-ray radiography or B-mode ultrasonography.The paileat tested negative for anti-HIV antibody.Classification Of CD+ cells showed that CD3+ cells amounted to 0.559,CD4+ cells 0.289,CD8+ cells 0.207,CD4:CD8 ratio 1.4,and all the parameters were in a normal range.Histopathological analysis of the ulcer tissue revealed a chronic inflammatory granuloma with clustered yeast-like cells.Fungal culture of the sample from ulcer tissue at 25℃on the slant of PDA yielded white filamentous colony;typical rudder-like macroconidias were observed with electronic microscopy following microculture;and the isolate showed a biphasic growth pattern.PCR was performed to amplify the internal transcribed spacer 1 (ITS1)and D1/D2 region of the isolated fungus followed by sequence analysis,and a homology of 97%and 99%was observed in the sequence of ITS1 and D1/D2 region,respectively,between the isolate and standard strain of Histoplasma capsulatum.A diagnosis of primary oral histoplasmosis Was made.The lesions subsided after 2-month treatment with oral itraconazole 400 mg per day.