Objective The olecranon is likely to become shorter following the treatment of its comminuted fractures, which will lead to the compromise of the function of elbow joint. So through the cadaver experiment, introduce the method of making different thickness and direction in osteotomy so as to intimate the shape change of the olecranon after the comminuted fractures, and explore its effect on the flexion-extension function of the elbow joint. Methods Through three cadaver(six arms), osteotomy at 25 mm below the olecranon process was made horizontally and fixed with two screws temporarily, furthermore, the bone fragment of 1 mm, 3 mm and 5 mm in length was resected in order, then specimens were divided into two groups: In the first group, osteotomy was made up to 7 mm and 8 mm continually, and the changes of the range of the elbow joint movement were measured; in the second group, the additional wedge osteotomy of 5 mm and 7 mm was performed respectively, then the outcomes between the two groups were compared. Results If the osteotomized bone was within 3 mm, shortening internal fixation was satisfactory for the reconstruction of the elbow joint function. However, in cases of osteotomized bone of 5 mm, the extension function would be limited as the loss of the trochlear notch is too much. In order to keep the normal range motion of the elbow, the dorsal cortex distal to osteotomy should be scarified about 3 mm for the wedge osteotomy. When the shortage attained to 7 mm, the elbow instability would occur, even if advanced wedge osteotomy was accomplished. Conclusion In cases of the comminuted olecranon fractures, if the osteotomy is made within 3 mm, the shortening fixation is appropriate; if it has not exceeded 5 mm, the fracture should be treated with advanced wedge osteotomy tilting back to keep the radian of the trochlea; and if it has reached 7 mm, bone grafting is necessary for recovering of the flexion-extension of the elbow joint.

Objective To analyze the surveillance data from 2003 to 2007 for Hubei province,investigate the epidemic characteristics of human rabies in these years,so as to provide scientific basis for its control and prevention.Methods Rabies data collected from the National Disease Surveillance Reporting System from 2003 to 2007 in Hubei province and 134 Rabies cases investigated in 2007 were analyzed in detail.Results The results showed that the trend of the number of rabies reported cases in Hubei province was obviously increased from 2003 to 2007.The involved counties and districts of the epidemic situation were widely expanded accordingly.Each month had Rabies case,but a lot of cases were dominated in August to November for every year.Most of the cases were farmers and students.The sex ratio of male to female was 2.38∶1.The age of the cases were mainly ranged from 5 to 15 and from 40 to 70 years old.Investigation of 134 cases indicated that the median of the incubative period was 66 days;94.78% of cases were injured by the dog;only 15.67% of injured cases were treated by the medical institution;the vaccinate ratio was 14.93%;the proportion of patients who received wound treatment,vaccinate and passive immunization were 5.80% of all the grade-Ⅲ-exposed patients.Conclusions The epidemic situation of Rabies was serious from 2003 to 2007 for Hubei province.The main reasons of the increase of rabies cases in Hubei province are absence of the effective management of the dog,the lack knowledge of rabies prevention,low rate of vaccine and passive immunization after exposure,and the lack of the standardized management for some of the low level medical institutions.

Objective To introduce a new bilateral triceps brachii approach for the treatment of intercondylar fractures of the humerus, and explore the possibility for the operation without injuring the mechanism of extension of the elbow. Methods With fresh cadaver specimens, the triceps brachii was stripped off from the distal end of the humerus, the muscle belly was elevated and retracted bilaterally, then the height was recorded, and the exposure of the distal humerus was observed, especially to the trochlear region when the elbow were flexed at 15? , 30? , 45? , 60? , 80? respectively. Results Through the cadaver specimen observation and the clinical application, the reduction and fixation of the intercondylar fractures of humerus should be performed when the elbow is flexed at 45?－ 60?， at 15?－ 30? flexion, fracture over the supracondylar can be treated and finally at 80? flexion, the reduction of the trochlear region can be examined. Conclusion This bilateral approach through the triceps brachii is suitable for the treatment both of the intercondylar and epicondylar fractures.

BACKGROUND:There are a variety of methods for establishing osteoarthritis animal model, and different methods and different animals have their own characteristics.
OBJECTIVE:To review the status of the research on osteoarthritis animal models.
METHODS:The relevant articles to the osteoarthritis animal models were searched in Medline database from January 2002 to October 2011, with the key words of“animal model, osteoarthritis”in English by the computer. Similarly, Chinese Journal Ful-text Database was retrieved for related articles published in Chinese from January 2002 to October 2011, with the key words of“animal model, osteoarthritis, research development”in Chinese. Total y 423 relevant articles were col ected and 128 of them conformed the standard. At last 40 articles were included to review after ful-text reading.
RESULTS AND CONCLUSION:The artificial induced animal models are the principal means to establish animal models of osteoarthritis and they have been widely used in the study of osteoarthritis pathogenesis, drug efficacy, cartilage physiology and pathology. Spontaneous osteoarthritis animal models have great advantages in the study addressing the initial mechanism of osteoarthritis, the biochemical changes of articular cartilage and the comparison of prevention and cure effects. Transgenic animal models have great application prospects on studying cartilage repairing mechanisms and testing a gene to prevent, delay or reversal the morphological changes. Accordingly the choice of models should be based on research needs.

BACKGROUND:Col agen type II and proteoglycan loss are two most obvious manifestations of cartilage damage in the onset of osteoarthritis. Changes in col agen type II and proteoglycan as the main components of cartilage matrix directly lead to cartilage degeneration and subsequently result in osteoarthritis. How to reverse or prevent the development of this process becomes the focus of medical research. OBJECTIVE:To observe the effect of warming yang and benefiting marrow recipe on the expression of col agen type II and proteoglycan in the articular cartilage of knee osteoarthritis rabbits as wel as to further explore the mechanism underlying chondrocyte protection. METHODS:Ninety-six New Zealand rabbits, aged 9 months old, male and female, were selected to prepare osteoarthritis models in extension position using cast immobilization method, and were randomly divided into four groups:blank group (untreated), model group (simple modeling), Chinese medicine group (intragastric administration of extracts of warming yang and benefiting marrow recipe, 24 mL/kg/d) and western medicine group (intragastric administration of glucosamine hydrochloride, 24 mL/kg/d). Intragastric administration was done once a day for 6 weeks. RT-PCR technology was used to observe the effect of warming yang and benefiting marrow recipe on the expression of col agen type II and proteoglycans in the articular cartilage, and pathological examination was also done. RESULTS AND CONCLUSION:The cartilage surface was smooth in the blank group and Chinese medicine group, with uniform toluidine blue staining, but in the model group and western medicine group, the cartilage surface was rough and the toluidine blue staining was extremely uneven with obvious loss of surface and middle layer dying. The expressions of cartilage proteoglycan and col agen type II in the model group were significantly lower than those in the blank group (P<0.01) as wel as in the Chinese medicine group and western medicine group (P<0.05). In addition, the expressions of cartilage proteoglycan and col agen type II in the Chinese medicine group were higher than those in the western medicine group (P<0.05). These findings indicate that the recipe of warming yang and benefiting marrow can enhance the expressions of col agen type II and proteoglycan, which can maintain the normal col agen phenotype and protect the articular cartilage.

BACKGROUND:There are few reports concerning effects of warming the yang and benefiting the marrow for the knee osteoarthritis on the expression of matrix metal oproteinase.
OBJECTIVE:To observe the effect of warming the yang and benefiting the marrow on the expression of matrix metal oproteinase in rabbit models of knee osteoarthritis.
METHODS:Of 96 healthy adult New Zealand rabbits, 72 rabbits were randomly selected for making rabbit models of knee osteoarthritis using plaster external fixation. After success model establishment, the rabbits were randomly assigned to three groups. Model group was left intact. Chinese medicine group received daily intragastric administration of drug extract 24 mL/kg. Drug control group was daily intragastrical y administered Puli Capsule (glucosamine hydrochloride) 24 mg/kg, once a day, until the eighth week of success model induction. An additional 24 New Zealand rabbits served as blank controls.
RESULTS AND CONCLUSION:Using quantitative PCR, matrix metal oproteinase-1, matrix metal oproteinase-3 and matrix metal oproteinase-13 expression was significantly higher in the model group than that in the other three groups. Matrix metal oproteinase-1, matrix metal oproteinase-3 and matrix metal oproteinase-13 expression was significantly lower in the Chinese medicine group and drug control group than that in the model group. These results indicated that warming the yang and benefiting the marrow for knee osteoarthritis in rabbits could effectively inhibit the expression of matrix metal oproteinase in rabbits.

Objective Changes of small intestine villus microcirculation perfusion in sidestream dark-field (SDF) imaging in the rabbits during endotoxic shock after fluid resuscitation with different target mean arterial pressure (MAP), and evaluation of feasibility of monitoring small intestine villus microcirculation by SDF were studied. Methods Sixty standard New Zealand white rabbits were randomly divided into two groups: low target MAP group (group A, n = 30) and high target MAP group (group B,n = 30). Fistula operation of ileum was madein vitro, and lipopolysaccharide (LPS, 2 mg/kg) was injected to establish endotoxic shock model. Group A was administered with the lower dose fluid resuscitation (lactated Ringer solution, 20 mL·kg-1·h-1) for target MAP of 65 mmHg (1 mmHg =0.133 kPa); group B was administered with the higher dose fluid resuscitation (lactated Ringer solution, 30 mL·kg-1·h-1) for MAP of 80 mmHg. Continuous norepinephrine intravenous injection (0.5-1.0μg·kg-1·min-1) was administered only after fluid therapy couldn't reach the target MAP. The changes of small intestine villus microcirculation perfusion indexes such as vessels per villus (VV), proportion of perfused villi (PPV), microvascular flow index (MFI), borders of villus score (BVS), vessels villus score (VVS) were continuously observed and recorded before the shock, during the shock and after fluid resuscitation using SDF imaging. The differences of microcirculation perfusion were compared between two groups using the specific parameter evaluation system to determine severity of villi microcirculation and injury scores at different stages.Results VV and borders of villus were clear and contact before shock in two groups. After shock, VV, PPV were significantly decreased in both two groups, the borders of villus were destroyed, MFI, BVS, VVS and the total score of villi injury microcirculation were obviously and severely decreased. Partial blood flow of villous capillaries after fluid resuscitation was recovered in two groups, but the perfusion of some region was un-balanced with the outworn borders of villus. VV were rose as compared before and after fluid resuscitation in groups A and B (vessels: 1.21±0.22 vs. 0.81±0.12, 1.54±0.28 vs. 0.79±0.13), and PPV [(31±4)% vs. (12±2)%, (38±5)% vs. (13±3)%], MFI (1.55±0.09 vs. 1.09±0.03, 1.97±0.11 vs. 1.05±0.03), VVS (points: 1.22±0.08 vs. 0.89±0.02, 2.06±0.15 vs. 0.90±0.02) and the sum of MFI, BVS, VVS (3.70±0.19 vs. 2.85±0.07, 5.01±0.29 vs. 2.88±0.08) were significant rose (allP< 0.05). The recovery of group B was better than that of group A, and the injury score was reduced. But BVS were not increased in both groups compared with before and after shock (points: 0.93±0.05 vs. 0.87±0.03, 0.98±0.09 vs. 0.93±0.05, bothP > 0.05).Conclusions For the small intestine villus microcirculation perfusion, the higher target MAP (80 mmHg) after fluid resuscitation or/and vasoconstrictor drugs usage were probably better than the relatively lower target MAP (65 mmHg) during endotoxic shock. SDF imaging is a very promising technique for intestinal villi microcirculatory visualization and assessment.

AIM: To investigate the changes of small intestine villus and sublingual microcirculation perfusion in the rabbits during endotoxic shock by sidestream dark-field imaging (SDF) after resuscitation to a mean arterial pressure (MAP) level.METHODS: New Zealand white rabbits (n=60) were randomly divided into 2 groups (group of villus and group of sublingua).The fistula operation of ileum was performed.Lipopolysaccharide was injected to establish endotoxic shock model, and fluid resuscitation (lactated Ringer's solution, 30 mL·kg-1·h-1) was given to maitain the MAP of the animals to 80 mmHg.Continuous norepinephrine was intravenously injected at 0.5~1 μg·kg-1·min-1 only if fluid therapy did not maintain the MAP level.The changes of microcirculatory perfusion indexes in small intestine villus and sublingual tissues such as vessels per villus (VV), microvascular flow index (MFI), proportion of perfused villi (PPVi), villus border score, villus vessel score, total vessel density (TVD), perfused vessel density (PVD) and proportion of perfused vessels (PPVe) were continuously observed and recorded by SDF before shock, during shock and after fluid resuscitation.RESULTS: MFI and PPVi in small intestine villus, and MFI, PPVe, TVD and PVD in sublingual tissues were significantly decreased after shock (P<0.01).Compared with MFI in sublingual microcirculation, MFI in villus was significantly decreased (P<0.01).MFI and PPVi in small intestine villus, and MFI, PPVe, TVD and PVD in sublingual tissues were improved after recovered to the target MAP by fluid resuscitation (P<0.05).However, MFI in small intestine villus was significantly lower than that in sublingual tissues after fluid resuscitation (P<0.01).CONCLUSION: The difference between small intestine villus and sublingual microcirculation perfusion during endotoxic shock is observed.The descent degree of microcirculation perfusion in small intestine villus is larger than that in sublingual tissues after shock, and the recovery degree of small intestine villus microcirculation is lower than that of sublingual microcirculation afer fluid resuscitation.