Objective To evaluate the effect and safety of low or medium heparinization in porcine model for coronary artery restenosis and investigate the rational dose of unfractionated heparin.Methods According to the doses of unfractionated heparin given to the animal models 24 porcines were randomized into low heparinization group(100 U/kg) and medium heparinization group(150 U/kg).We took blood samples from each porcine and measured the ACT value before intravenous injection of unfractionated heparin and 5 minutes,20 minutes,30 minutes and 60 minutes after heparinization.We compared the effects of anticoagulation,compression hemostasis and the occurance of adverse events.Results Both low and medium heparinization groups achieved the ACT peak value(245.3?93.64 s vs.241.0?37.29 s,P=0.824) 5 minute after intravenous injection of heparin and maintained high ACT value(191.8?53.06 s vs.184.6?42.82 s,P=0.707) within 20 minutes.The ACT value of medium heparinization group was higher than low heparinization group 30 minute later(193.9?58.95 s vs.154.0?28.20 s,P=0.005).The compression time for hemostasis in medium heparinization group was longer than low heparinization group(17.7?2.96 mins vs.14.3?4.44 mins,P=0.042).No peri-operation adverse events were found in both groups.Conclusion Low heparinization can provide adequate anticongulation for a 20-minute-operation and at the same time reduce the compression time for hemostasis in the porcine model for coronary artery restenosis.

Objective:To investigate the role of PUMA,a Bcl-2 family member,in oxaliplatin-induced apoptosis in colorectal cancer cells.Methods:In vitro,LoVo cells were treated with 1.2,2.4,4.8 ?mol/L oxaliplatin for 24 h and 4.8 ?mol/L oxaliplatin for 6,12,24 h,PUMA expression was assessed by Western blot analysis.The anti-sense PUMA plasmid was constructed by gene recombination.PUMA expression was suppressed by stable transfecting anti-sense PUMA plasmid into LoVo cells.The apoptosis was assessed by flow cytometry analysis(FCM) and proliferation rate was assessed by MTT assay.Results:Oxaliplatin induced PUMA expression in a time-and dose-dependent manner;stable cell lines expressing the anti-sense PUMA vector were established and named LoVo puma(-/-) cells;oxaliplatin-induced apoptosis was decreased by suppression of PUMA expression;the proliferation rate in LoVo puma(-/-) cells was higher than that in LoVo cells after oxaliplatin treated.Conclusion:Our data suggest that PUMA plays an important role in oxaliplatininduced apoptosis in LoVo cells and the sensitivity of LoVo cells to oxaliplatin was abrogated by suppression of PUMA expression.

Background The rejection following keratoplasty still is a leading cause of corneal transplantation failure.Studies showed that the interleukin-22 (IL-22) ,one of the effector molecules of T helper cell 17 (Th17) participated on the rejection after heart,liver and bone marrow transplantation.However,the effect of IL-22 on corneal graft rejection is not well understood.Objective This study was to investigate the expression of IL-22 mRNA in the corneal grafts and the role of IL-22 in the immune rejection after corneal transplantation in rats.Methods Seventy-two Wistar rats were randomized into autologous keratoplasty group,allograft keratoplasty group and anti-rejection group,and other 4 normal Wistar rats served as normal control group.Autologous keratoplasty was operated on the Wistar rats of the autologous keratoplasty group,and allograft keratoplasty were carried out with the 24 SD rats as donors and 48 Wistar rats as recipients.Tobramycin and dexamethasone eye drops were topically administrated after autologous keratoplasty for 2 weeks in the anti-rejection group.The experimental eyes were examined by slit lamp microscope after surgery and graft survival was evaluated based on the rejection scoring criteria of Larkin.Intergroup accumulated survival rates of grafts were compared using Kaplan-Meier analysis.Histopathological examination of grafts was carried out in 5 and 14 days after operation respectively,and the related expression levels of IL-22 mRNA and aryl hydrocar-bon receptor (AhR) mRNA were carried out by real-time fluorescence quantitative PCR.The feeding and use of the experimental animals followed the Guangdong provincial regulations on the management of experimental animals.The experimental design was approved by the ethics committee of Southern Medical University.Results The median survival time of grafts in the allograft keratoplasty group was 10 days,and that in the anti-rejection group was 17 days,showing a significant survival extention in the anti-rejection group (x2=16.442,P =0.000).Significant differences were found among the 4 groups in the related expression levels of IL-22 mRNA in both 5 days and 14 days after surgery (postoperative 5 days : F=2.44,P =0.00;postoperative 14 days: F=267.92, P =0.00), and the related expression levels of IL-22 mRNA were remarkably higher in the allograft keratoplasty group than those in the anti-rejection group at different time points (postoperative 5 days :9.70±0.35 vs.0.46±0.21;postoperative 14 days : 23.12 ± 1.89 vs.3.14±0.94) (both at P＜0.05).The related expression levels of AhR mRNA in the grafts were considerably different among the 4 groups (postoperative 5 days : F =395.73, P =0.00;postoperative 14 days : F =942.37, P =0.00) , and the expression levels were significantly elevated in the allograft keratoplasty group compared with the anti-rejection group at various time points (postoperative 5 days:2.52±0.32 vs.1.89±0.10;postoperative 14 days:7.20±0.25 vs.2.60±0.17) (both at P＜0.05).Conclusions The expression level of IL-22 RNA up-regulates in the grafts with immuno-rejection.Topical administration of tobramycin and dexamethasone eye drops inhibits the rejection after keratoplasty.AhR plays a regulative role to the expression of IL-22 in rats after keratoplasty.

Objective To introduce a two-stage operative method to treat ma lu nion after the distal femoral fracture. Methods From Aug. 1992 to Aug. 2000, 12 patients underwent osteotomy and secondary fixation due to malunion after the di stal femoral fracture. There were 10 closed fractures and 2 open ones. The prima ry treatment was conservative for 2 patients, and operative for 10. We first per formed the osteotomy along the primary fracture line where the deformity was the most severe. When the roentgenogram confirmed that the deformity had been corre cted satisfactorily, a secondary operation of ORIF (open reduction with internal fixation) was performed. Results On average, all the 12 patients gained bone un ion 5.1 months postoperatively. The mean follow-up duration was 7.2 years (rang e: 3.5 to 11.5 years). None of the patients was afflicted by infection or loosen ing of the internal fixator. According to the Schatzker scoring scale system, al l the patients were evaluated as poor preoperatively, but as excellent in 7, goo d in 4 and fair in 1 at the last follow-up. Conclusion Osteotomy and secondary fixation is not only simple and accessible but also can lead to confirmed clinic al results. However, it is still very important to reduce and fix the acute frac tures stably to avoid malunion.

OBJECTIVETo compare two kinds of method for treating lumbar tuberculosis with psoas abscess, to provide reference for clinical reasonable select of therapy treatment.

METHODSFrom January 2010 to January 2013,42 patients with lumbar tuberculosis combined with psoas abscess with obvious surgical indications were enrolled, including 24 males and 18 females with an average age of (38.5 ± 10.2) years old ranging from 21 to 63 years old. All patients were followed up for 18 to 24 months with an average of 20.9 months. Twenty-two patients underwent posterior vertebral body lesions cleared, bone graft fusion and internal fixation and percutaneous puncture catheter drainage for treatment of psoas major abscess as group A, and twenty patients underwent one-stage extraperitoneal approach to remove abscess, posterior vertebral body lesions cleared, bone graft fusion and internal fixation as group B. The operative time, loss of blood, length of hospital stay, clinical cure rate and other clinical results for the two groups were analyzed and compared.

RESULTSThe loss of blood was (452.3 ± 137.6) ml in group A and (603.5 ± 99.6) ml in group B, there was significant statistical difference (P < 0.05). The time of operation was (193.6 ± 91.2) min in group A and (230.5 ± 56.6) min in group B, there was significant statistical difference (P < 0.05). The time of operation and the loss of blood in group A were obviously less than which in group B. In group A 20 cases were cured and 2 cases relapsed, 19 cases were cured and 1 case relapsed in group B, there was no significant statistical differences between two groups regarding cure rate with chi-square test (χ² = 0.000, P = 1.000). All patients in two groups obtained good clinical curative effect. There were no significant statistical difference between two groups regarding for length of hospital stay with t-test (P > 0.05).

CONCLUSIONLumbar spinal tuberculosis with psoas abscess is not absolute indications for anterior open operation. Compared with the combined anterior and posterior surgical procedure, the percutaneous puncture catheter drainage combined with posterior debridement, interbody fusion and internal fixation can achieve the same clinical effect but less trauma for the patients.

Adult ; Case-Control Studies ; Debridement ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Psoas Abscess ; etiology ; surgery ; Spinal Fusion ; Tuberculosis, Spinal ; complications ; surgery ; Young Adult

Objective To investigate the effects of postoperative sleep deprivation on the expression of choline acetyltransferase (ChAT) in hippocampi of aged rats.Methods Forty-eight male Wistar rats,aged 20 months,weighing 500-600 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (group C) ; operation group (group O) ; sleep deprivation group (group S) ; postoperative sleep deprivation group (group OS).Sleep deprivation was induced in the rats by housing them on small platforms over water.They fell into the water if they lost muscle tone.All the rats had free access to food and water.In group OS,splenectomy was performed,and all the rats underwent 24 h sleep deprivation after the rats were awake.All the rats underwent 24 h sleep deprivation at the corresponding time point in group S.Morris water maze test was carried out at 24 h after operation.The number of ChAT positive cells in the hippocampal CA1 region was counted after completion of Morris water maze test.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,and the frequency of crossing the original platform and the number of ChAT positive cells in the hippocampal CA1 region were decreased after operation in O and OS groups,and no significant changes were found in the parameters mentioned above in group S.Compared with group O,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,and there was no significant difference in the numberof ChAT positive cells in the hippocampal CA1 region in group OS,and no significant changes were found in the parameters mentioned above in group S.Compared with group S,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,and the frequency of crossing the original platform and the number of ChAT positive cells in the hippocampal CA1 region were decreased after operation in group OS.Conclusion The mechanism by which postoperative sleep deprivation induces cognitive decline is not related to the expression of ChAT in hippocampi of aged rats.

Objective To observe the clinical efficacy of acupuncture in treating malignant pleural effusion (MPE).Method Eighteen MPE patients confirmed by histopathological and/or cytological examinations were treated by acupuncture by selecting Yunmen (LU 2), Qimen (LR 14), Zhangmen (LR 13), Jingmen (GB 25), Guanyuan (CV 4), Zhongji (CV 3), Shuidao (ST 28), and Guilai (ST 29) as the major points. The treatment was given once every other day, 3 times a week, 4 weeks as a treatment course, and the therapeutic efficacy was evaluated 1 course later.Result Of the 18 patients, 6 got complete remission, 9 got partial remission, 2 achieved stable condition, while 1 didn’t respond to the treatment, and the total effective rate was 83.3%. Of the 5 cases with encapsulated pleural effusion, 2 got complete remission and 3 got partial remission, and the total effective rate was 100.0%. The amount of pleural effusion (anteroposterior diameter of the fluid), comprehensive score of symptoms, item scores of the symptoms, and Karnofsky Performance Status (KPS) score were changed significantly after treatment (P<0.01).Conclusion Acupuncture is an effective method in treating MPE of moderate volume, and it can swiftly improve the symptoms and promote the quality of life.

Objective To understand the psychological health status of the middle and primary school students,and to provide some advice of their mental health care.Methods In 11 611 middle and primary school students in 18 schools in Maojian area of Shiyan city,the students,teachers and parents at 5 schods were investigated a randomely,targets were examined by Achenbach Child Behavior Checklist(CBCL),Pupil Rating Scale Revised Screening for Learning(PRS),Conner's Parent Symptom Questionnaire(PSQ)and Conner's Teacher Rating Scale(TRS)and self-established questionnaires for general information.Results The investigation demonstrated:89.29% of students possessed very promising dreams and sublime pursuits,and had correct outlook on life and values;10.71% of students had comparatively severe psychological problems.The major problems appeared to be indefinite purpose of study,shorted of mental endurance and severe impulsivetrend.Moreover,an-xiety,emotion instability and solitary trend caused indifference,sheepish ness and difficulty in their communication.Conclusion Schools,families and society pay close attention to students,mental health and help the youngsters develop in a healthily psychdogical way.

Objective:To investigate the characteristics and significance of insulin-like growth factor 1(IGF- 1) and insulin-like growth factor binding protein 2 (IGFBP2) expressions in ankle cartilage of patients with Kashin-Beck disease (KBD).Methods:In this case-control study, 10 KBD patients who were hospitalized in the Department of Orthopedics of Shaanxi Provincial People's Hospital from January 2010 to December 2016 were selected as KBD group, and 10 patients with ankle fracture caused by trauma but without talus injury during the same period were selected as control group, the cartilage tissues of the two groups were collected. IGF-1, IGFBP2 positive cells, the mRNA and protein expressions of IGF-1, IGFBP2 in the cartilage tissues were detected by immunohistochemistry, real-time fluorescent quantitative PCR and Western blotting, respectively. According to the expressions of IGF-1 and IGFBP2 in ankle cartilage of KBD patients, a patient with amputation caused by trauma was selected in Shaanxi Provincial People's Hospital, and ankle joint cartilage was taken to prepare chondrocytes for in vitro cell verification experiments. The chondrocyte were divided into control group (0 ng/ml T-2 toxin), T-2 treatment group (20 ng/ml T-2 toxin) and T-2+ IGFBP2 silenced group (20 ng/ml T-2 toxin+ 50 nmol/L IGFBP2 siRNA), the MTT method and dimethyl methylene blue staining were used to detect the activity of chondrocyte and the secretion of sulfated glycosaminoglycan (sGAG). Results:In the control group and the KBD group, the number of IGF-1[(47.26 ± 8.97), (68.15 ± 7.42) cells] and IGFBP2 positive cells [(27.56 ± 5.40), (71.85 ± 7.62) cells] in the cartilage tissues were significantly different ( t = 4.487, 9.402, P < 0.01). Compared with the control group, the IGF-1, IGFBP2 mRNA and protein expression levels in KBD group were significantly higher, the differences were significantly different ( t = 3.340, 20.700, 4.684, 8.699, P < 0.05 or < 0.01). In cell experiment, the chondrocyte activitives and sGAG contents of the control group, T-2 treatment group, and T-2+ IGFBP2 silenced group were significantly different ( F = 226.70, 80.66, P < 0.01); among them, the cell activitives and sGAG contents of the T-2 treatment group and T-2+ IGFBP2 silenced group were lower than those of control group ( P < 0.05), and the T-2+ IGFBP2 silenced group were higher than those of the T-2 treatment group ( P < 0.05). Conclusions:The expressions of IGF-1 and IGFBP2 in the ankle cartilage of KBD patients are significantly higher. Silencing IGFBP2 gene can reduce the inhibitory effect of T-2 toxin on chondrocyte activity and the secretion of sGAG.

To investigate and analyze the epidemiology of serious corneal ulcer.
● METHODS: A total of 133 serious corneal ulcercases from June 2010 to December 2013 in Xiangya Hospital Affiliated to Central South University were retrospectively reviewed for risk factors, demographic characteristics and diagnosis.
●RESULTS: There were 91 male patients (68. 4%) in the 133 patients. A peak incidence age was from 41 to 60 years old (82 cases, 44. 4%). Most of patients were peasant (77 cases, 57. 9%) and the percentage of the low schooling patients was 85. 0% (113 cases). The number of patients who had been sick was 73 before hospitalization (54. 9%) in all cases. The peak incidence season was January (34. 6%). Average length of stay was 9. 84d. The number of emergency cases was 44 (33. 1%). Most of patient were not only corneal ulcer cases but the hypopyon (92 cases, 69. 2%). The figure of inpatients who received operations was 102 cases ( 76. 7%). And the most of operations was amniotic membrane transplantation (31 cases, 39. 2%). Additionally, this data was classified regard to gender differences.
● CONCLUSlON: The peasant of the middle age and elderly represents a distinct clinical group in the serious corneal ulcer in hospital. Severity, ocular trauma in agriculture and health awareness are the major predisposing factors.