ObjectiveTo evaluate the influence of different surgical technique on the pup and　adult rats after the rupture of upper trunk and middle trunk so as to find the best way of surgical therapy.MethodsFrom January 2010 to June of 2010, forty-eight Sprague-Dawley male rats were divided into two　groups of 24 each, i.e., pup groups at the age of 7 days postnatal (P7)and one adult (3 months old)group.After C5-7 injured,each group was subdivided into three equally:group A (repair C5-7),B(repair C5,6),and C (no reinnervation performed).In the 3rd month postoperatively,the following tests were performed to estimate the recovery of each group:(1)Compared the rate of carpoptosis of each group.(2)Compared the regenerated nerve traversing rate of the radial nerve in each group.(3)HE stain to compared the cross-sectional area recovery rate.(4)The MyoD1 and Myogenin of the affected extensor of forearm were measured by Western blot.Results(1) The ethology test:there were no carpoptosis in group of adult A and pup A; the carpoptosis rate of pup B and pup C were higher than that of adult A(P ＜ 0.05) ;the carpoptosis rate of pup A was lower than that of B and C(P ＜ 0.05); there was no difference between carpoptosis rate of adult A and B,but they were both lower than C(P ＜ 0.05).(2) Histological test of radial nerves:The percentage of myelinated both higher than C (P ＜ 0.05).(3) Western blot:The protein level of MyoD1 and Myogenin in radial nerve fiber in experimental side of pup A,B and C descended progressively (P ＜ 0.05).There was no difference between adult A and B,but they were both higher than C (P ＜ 0.05).(4) Histological test of the extensor digitorium:There was no difference between cross-sectional area recovery rate of adult A and B,but they were pup A,B and C increased progressively (P ＜ 0.05).There was no difference between protein level of MyoD1 and Myogenin in adult A and B,but they were both lower than C (P ＜ 0.05),ConclusionIn adult rats, there is no difference between the recovery of wrist extensor of the two surgical procedure after the C5-7 injured. The restoration of C5-7 but not C5,6 can do more good to the recovery of wrist extensor in pup rats.It's important to repaire the C7 by nerve graft after injury of C5-7 in newborn.

Objective To compare the clinical effectiveness of incision-thread-drawing procedure and incision and drainage procedure in the treatment of perianal abscess.Methods Clinical data collected from 110 patients with perianal abscess were retrospectively analyzed.Forty-six cases were treated with incision-thread-drawing procedure(therapy group) and 64 with incision and drainage procedure(control group).Results Recurrence rate and incidence of anal fistula were 4%(2/46) and 4%(2/46) in therapy group,respectively,significantly lower than those in control group(19% and 23%,P

Objective To investigate the efficacy of the clinical pathway in geriatric orthope-dics clinical teaching. Methods From March 2010 to December 2011, 80 clinical undergraduates, who practiced in the Department of Orthopedics in the Second Affiliated Hospital of Chongqing Medi-cal University, were equally randomized divided into two groups. One group was taught by the con-ventional methods and the other group was taught by the clinical pathway teaching. After the teaching, the theoretical exam and operational skill test were performed among students in both groups. SPSS 17.0 software was employed and the scores before and after the teaching and scores between two groups was analyzed by paired t-test(inspection level α=0.05). Results There was no significant difference in average scores between two groups before teaching(theoretical exam: P=0.81, operating skill test:P=0.65) while significant increases were observed in scores of theoretical exam and operational skill test after teaching (theoretical exam and operating skill test: P<0.05) and clinical pathway teaching group had higher scores than conventional teaching group (theoretical exam and operating skill test:P=0.02 and P=0.01). Conclusions Better effects can be achieved by clinical pathway approach re-garding geriatric orthopedics teaching.

ObjectiveTo explore the effects of the serum of traditional Chinese medicine Nao Yi An on glutamate induced cell death in cultured hippocampal neurons of rat and the underlying mechanisms. MethodsHippocampal neurons were cultured. The excitatory amino acid induced toxicity on cultured neurons was investigated. The viability of injured neurons was determined with the measurement of Lactate dehydrogenase (LDH) activity. Mitogen activated protein kinase (MAPK) were determined by immunoprecipitation /kinase assays /western blot detection.ResultsThe serum of Nao Yi-An raised cell viability. The serum of Nao Yi-An upregulated the expression of extracellular regulated protein kinases(ERK) and downregulated the expression of c-Jun N terminal kinase/stress activited protein kinase(JNK) in cultured neurons. The serum of Nao Yi-An induced upregulation of ERK and its anti death action were prevented with the specific ERKs inhibitor PD98059. Conclusions Activation of ERK signaling together with inhibition of JNK signaling by Chinese medicine Nao Yi-An appears to be an important mechanism for its survival effects on cultured hippocampal neurons.

BACKGROUND:Open reduction and internal fixation cause big trauma and many complications. With the progression of minimal y invasive concept, percutaneous pedicle screw fixation gradual y showed its obvious superiority. ＜br> OBJECTIVE:To compare clinical outcomes of minimal y invasive percutaneous pedicle screw fixation versus open surgery in the treatment of thoracolumbar fracture. ＜br> METHODS:From October 2012 to January 2014, 50 cases of thoracolumbar fractures, including 25 cases in the minimal y invasive percutaneous pedicle screw fixation group and 25 cases in the open surgery group, were retrospectively analyzed. The differences in length of skin incision, intraoperative blood loss, operation time, postoperation hospital stay, and visual analog scale scores were compared. Serum creatine kinase activity and C-reactive protein levels were measured before surgery and at 24 and 48 hours after operation. Imaging results were used to observe vertebral height and kyphosis Cobb’s angle changes. ＜br> RESULTS AND CONCLUSION:Compared with the open surgery group, the length of skin incision was smal er and intraoperative blood loss was less, operation time, bed time and hospital stay were shorter, and pain of the wound was lighter in the minimal y invasive group. No significant difference was found in serum creatine kinase activity and C-reactive protein levels between the two groups. Serum creatine kinase activity and C-reactive protein levels were higher at 24 and 48 hours after treatment compared with before treatment in both groups. Serum creatine kinase activity and C-reactive protein levels were higher in the open surgery group than in the minimal y invasive group at 24 and 48 hours. There were significant differences in vertebral height and kyphosis Cobb’s angle in both groups after treatment compared with before treatment (P＜0.01). No significant difference in vertebral height and kyphosis Cobb’s angle was detected between the two groups after treatment (P>0.05). Results indicated that minimal y invasive percutaneous pedicle screw fixation and open surgery in repair of thoracolumbar fractures had similar outcomes. However, the trauma of minimal y invasive percutaneous pedicle screw fixation was apparently less than open surgery.

A direct current glow discharge mass spectrometry ( GD-MS) for the determination of Li, Be, Na, Mg, Si, P, K, Ca, Ti, V, Cr, Mn, Co, Ga, Sr, Mo, Ag, Cd, Sn, Sb, W and Pb in nickel-zinc ferrites was developed. Copper powder as the conductive medium was evenly mixed with nickel-zinc ferrites powder for tableting, and then the impurity elements in nickel-zinc ferrites were determined by GD-MS. The influence of sample preparation and the glow discharge conditions including discharge current, discharge voltage, discharge gas flow rate and pre-sputter time on discharge stability and analysis sensitivity were investigated. The mass spectrometry interferences of analytes were investigated, as well as appropriate isotopes were selected. Most of the mass spectrometry interferences were avoided by measuring in medium resolution mode and high resolution mode. Total signal of Fe, Ni, Zn, O and Cu normalization was adopted, and the impurity elements in nickel-zinc ferrites were calculate in subtraction. The results showed that the detection limits for the investigated elements were in the range of 0. 001-0. 29 μg/g, the relative standard deviations of each element were within 3 . 5%-18 . 6%. The analysis results were consistent with those obtained by inductively coupled plasma mass spectrometry.

Objective To observe the effect of Sanqi Oral Liquid on the podocytes and the expression of slit diaphragm-associated molecules (including Nephrin, Podocin and CD2AP proteins) of diabetes mellitus (DM) rats after unilateral nephrectomy, so as to explore its mechanism for protecting renal function. Methods SD male rats were randomized into sham operation group, model group and Chinese medicine group. The experimental diabetes mellitus ( DM) model was given unilateral nephrectomy and intraperitoneal injection of 35 mg/kg of streptozocin (STZ). And then the model rats were given intragastric administration of Sanqi Oral Liquid (2.5 g· kg-1·d-1) and the same volume distilled water respectively for 8 weeks. After treatment, the density of podocytes and the podocytic foot process width of different groups were measured. Immunohistochemistry was used to observe the changes of the expression of Nephrin, Podocin and CD2AP in renal tissues of different groups. Results After treatment with Sanqi Oral Liquid, the density of podocytes was increased, the foot process lesion was relieved, and the expression levels of Nephrin, Podocin and CD2AP proteins were increased (P<0.05 or P<0.01 as compared with those in the model group). Conclusion The protective mechanism of Sanqi Oral Liquid for renal function of unilateral nephrectomy DM rats is possibly related with the alleviation of podocyte injury and with the regulation of the expression of Nephrin, Podocin and CD2AP proteins in podocytes.

Objective To investigate the clinical characteristic,diagnosis and treatment of familial adenomatous polyposis (FAP).Methods According to family history of the proband,we surveyed the pedigree and retrospectively analyzed the clinical characteristics of 10 FAP patients in 3 generations of the family.Result Among all 10 cases,3 died of colorectal cancer including two of whom had history of intestinal obstruction.Seven people of the third generation were all diagnosed as FAP.Among them,only 2 patients had clinical symptoms.Colonoscopy was done in all 7 patients before 35 years old.However,none of them had polyps or evidence of cancer.Surgical operation was performed on 1 patient and high frequency electric cutting under endoscopy was performed on 6 patients.Conclusions The early clinical manifestations of FAP are nonspecific.Pedigree investigation and colonoscopy screening for high-risk population are important to find early asymptomatic FAP patients.

Objective To evaluate the value of bypass graft in the treatment of critical lower limb ischemia with distal single outflow artery.Methods Forty-nine lower limbs in 42 patients with single outflow artery were collected and underwent arterial bypass graft.The operation methods included femoropopliteal artificial graft to single outflow artery with autograftand popliteal artery to calf vessel and so on.The results were analyzed finally.Results All of 42 patients,postoperative grafts occlusion occured in 1 case,the occlusion rate was 2.4％(1/42) and the success rate was 97.6％(41/42),1 case died of respiratory failure 4 d postoperatively,the mortality was 2.4％(1/42).The patency rate of graft was 100.0％(41/41) on discharge.Healing rate of foot ulcer was 33.3％ (11/33).Conclusions It's difficult to reconstruct blood flow for critical ischemic limb with single outflow artery,but good result is still expected by distal lower limb bypass graft.Distal bypass can provide a better nutritional support for the healing of foot ulcer and result in a lower limb salvage or lowering of amputation level.

Objective To study the effects on inhibit tumor growth and enhance immune function of Ganoderma lucidum polysaccharide(GLP)combined with low-dose cisplatin in tumor-bearing mice.Methods 2 × 106 Lewis cells in 0.1 mL PBS were injected subcutaneously into the flanks of healthy female BALB/c nude mice (5～6 weeks old).When the tumor volume reached 100 mm3,mice were randomly assigned to 4 groups,control group (Oral gavage of 0.5 ml PBS and intraperitoneal injection of 0.5 ml),GLP group (gavage once every two days,40 mg/kg GLP in 0.5 ml),cisplatin group (intraperitoneal injection once every two days,2 mg/kg cisplatin in 0.5 ml) and the combination group (such as the above dose of cisplatin and GLP).After the treatment regimen was complete,the mice were sacrificed,and the tumors were removed,photographed,weighed,and prepared for histological analysis.The immune cells in spleen and peripheral blood were analyzed by flow cytometry.Results GLP can effectively increase anti-tumor effect of the small dose cisplatin,improve the survival of tumor-bearing mice,promote Th cells convert to Th1 in peripheral blood,increased the expression of CD 11c + on DC cell surface (GLP group 4.59％ VS the control group 1.06％,the combined group 7.21％ VS the cisplatin group 2.8％).Conclusion GLP can improve the immune function of tumor-bearing mice,had synergistic anti-tumor growth with low dose cisplatin,moreover,reduce renal toxic effects of cisplatin.