AIM:To investigate the inhibition of breviscapine on apoptosis of cultured myocardial cell of neonatal rat induced by hypoxia/reoxygenation. METHODS:Myocardial cell hypoxia/reoxygenation model was established by culturing primary myocardial cells of neonatal rats in vitro. Cultured myocardial cells were divided into 5 groups:control group,hypoxia/reoxygenation group and 3 groups pretreated with breviscapine of final concentration 25,50 and 100 mg/L,respectively. The cell viability was measured with MTT; apoptotic rates were determined by AnnexinV-FITC/PI; the expression of Bcl-2 was detected by immunohistochemical method. Expressions of Cytochrome C (CytC) and Caspase-3 were detected by Western blot. RESULTS:Compared with the control group,the viability of myocardial cell decreased and apoptosis rate elevated after hypoxia/reoxygenation. However after pretreatment with 25,50 and 100 mg/L breviscapine,respectively. Cell viabilities increased and apoptotic rates lowered,and the protective effect on myocardial cell had concentration-dependent. In addition,Expression of Bcl-2 decreased but Caspase-3 activity and CytC release increased in myocardial cells induced hypoxia/reoxygenation. Pretreated with breviscapine,expression of Bcl-2 elevated but Caspase-3 activity and CytC release reduced obviously. CONCLUSION:It is associated with the increase in Bcl-2 expression,inhibition of CytC release and Casepase-3 activity that breviscapine could significantly protect myocardial cell against apoptosis induced by hypoxia/reoxygenation.

Objective To investigate the effect of recurrent patella dislocation by grafting dual-bundle semitendinosus to anatomically reconstruct of medial patellofemoral ligament(MPFL)under arthroscopy.Methods From January 2006 to January 2010,29 cases(31 knees)with recurrent dislocation of the patella were performed arthroscopic surgery,including 11 males and 18 females(20 knees)with an average age of 22 years(range,16-32).The key point of surgery was reconstruction MPFL with dual-bundle free autogenous semitendinosus by using two anchors and bone groove to fixed on the patella,and using the interference screw to fixed on the femur.Adjusting the patella reset under arthroscopy.Tibial tubercle were transferred to inside in 5 cases.All patients were followed up for an average of 14 months(ranging 9-22).The imaging evaluation included congruence angle,lateral patellofemoral angle and lateral shift.The clinical therapeutic effect was evaluated with International Knee Documentation Committee(IKDC),Lysholm and Tegner scores.Results The fear test was negative after operation.There was no redislocation and fracture of the patella during follow-up.The congruence angle,lateral patellofemoral angle and lateral shift were 5.65°±2.23°,3.52°±2.63° and 0.25±0.46 respectively at the final follow-up.The mean IKDC,Lysholm and Tegner scores were 93.20±5.33,93.02±6.08 and 6.58±0.87 respectively at the final follow-up.All were showed statistically significant differences compared with preoperation(P＜0.05).Conclusion It is demonstrated that there was a reliable short-term effect to treat recurrent patella dislocation by grafting dual-bundle semitendinosus to anatomically reconstruct of MPFL under arthroscopy.

Objective To investigate the clinical efficiency of repairing ankle and calf wounds by antegrade or retrograde perforating flap of posterior tibial artery. Methods 13 cases with skin defects of ankle and calf wounds were reviewd. The defects were repaired using antegrade or retrograde perforating flap of posterior tibial artery from January 2011 to February 2013, 8 males and 5 females; aged 19 to 65 years old. Wounds were located in the ankle and calf, area which the tibial artery support contu-sioned slightly;defects were associated with exposed bone or tendon, exposed blood vessels. Of the 13 cases, 5 cases have multiple ankle fracture with blood circulation disorders, internal and external fracture fixation were performed emergency with blood ves-sels and nerves exposed, at the same time emergency line wound repair by posterior tibial artery perforating flap. The other 8 cases have no blood vessels and nerves exposure, and accepted vacuum sealing drainage emergency external fixation and flap surgery. Seven cases accepted V-Y antegrade perforating flap of posterior tibial artery, 6 cases using retrograde tibial artery perforator flap. Whose defects were ranged from 1.5 cm×2.0 cm to 9.0 cm×5.0 cm. Antegrade or retrograde perforating flap of posterior tibial ar-tery with 1.5 cm×3.0 cm to 14.0 cm×7.0 cm was used to repair ankle or lower leg medial defect. Antegrade flap donor site sutured directly, but retrograde flap donor site take full thickness skin graft repair from abdomen. Results Circulations of the all 13 cases were stable, with wound healing well after 2 weeks. The patients were followed up for 6 months to 24 months, average of 13 months. All flap graft survived, pedicle no bloated andcat eardeformity. Flaps were soft, no bloated appearance;color was con-sistent with normal skin. Fracture line in the 5 patients was disappeared. Bone healing time was 3.0 to 4.0 months. At the direct su-ture skin donor sites, postoperative scar was small;skin graft donor sites had no obvious scar. Postoperative ankle dorsiflexion 10° to 25°, plantar flexion 15° to 45°. Patients were extremely satisfied with the results of repair. Conclusion Using antegrade or ret-rograde posterior tibial artery perforator flap without sacrificing the main vessel, it is a simple and effective method to repair the medial malleolus and calf wounds.

Objective To observe the change of serum smooth muscle myosin heavy chain (smMHC) level in the patients with aortic dissection (AD),and evaluate the effect of smMHC in the early diagnosis and prognosis of AD.Methods Forty-two patients with AD were selected as AD group,30 healthy subjects were selected as control group.Blood samples were collected at four time periods (within 3 h of onset,6 h,12 h,24 h),and serum smMHC level were measured by enzyme-linked immunosorbent assay.Results Serum smMHC level of AD group,which collected (within 3 h of onset,6 h,12 h) were significantly higher than that of control group [(88.6 ±21.7),(59.4 ± 18.7),(41.3 ± 10.7) ng/L vs.(17.2 ± 8.3) ng/L,P ＜ 0.01].There was no significant difference between the serum smMHC level of AD group and control group at 24 h after onset [(18.9 ±9.5) ng/L vs.(17.2 ±8.3) ng/L,P ＞ 0.05].Serum smMHC level of Stanford A type group (25 cases) was higher than that of Stanford B type group (17 cases) within 3 h of onset [(95.4 ± 17.8) ng/L vs.(78.5 ± 18.3) ng/L,P＜0.01],and there was no significant difference bewteen the two groups which collected at 6,12 h and 24 h after onset (P ＞ 0.05).Preoperative serum smMHC level was significantly higher than that after intracavitary isolation operation [(58.6 ± 15.9) ng/L vs.(30.1 ± 12.5) ng/L,P ＜ 0.01].Serum smMHC level decreased rapidly after the operation,and there was no significant difference between the two grougs when 12 h after operation [(18.7 ± 8.9) ng/L vs.(17.2 ± 8.3) ng/L,P ＞ 0.05].The serum smMHC level of the deaths (7 cases),which collected within 3 h of onset,6 h,12 h,was significantly higher than that of the survivors (35 cases) [(101.2 ± 20.7) ng/L vs.(86.1 ± 18.9) ng/L,(65.2 ± 16.7) ng/L vs.(58.2 ± 14.2) ng/L,(50.4 ± 10.8) ng/L vs.(39.5 ± 8.3) ng/L,P ＜ 0.05],and there was no significant difference at 24 h after onset (P ＞ 0.05).Detecting serum smMHC level within 3 h of onset,the area under the receiver operating characteristic curve was 0.913,with 51.7 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 88.1％ (37/42) and 96.7％ (29/30).When detecting at 6 h after onset,the area under the curve was 0.865,with 38.5 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 90.4％(38/42) and 90.0％ (27/30).Conclusions The level of serum smMHC in patients with AD increase rapidly after onset,and detecting serum smMHC level within 6 h of onset have important clinical significance in early diagnosis and prognosis of AD.

Objective To introduce the surgical method of reverse radial side of dorsal artery the fascial pedicle island bone flap for the treatment of thumb composite tissue defects,and to evaluate its short term clinical outcome.Methods From May 2010 to March 2012,9 cases with composite tissue defects at thumb were treated with reverse radial side of dorsal artery the fascial pedicle island bone flap,including 5 males and 4 female with an average age of 38 years (range,13-68).All injuries were caused by planer.The time of injury to operation was 3-8 hours,all patients showed in both thumb root plane beyond volar or dorsal,skin and soft tissue defect accompanied by distal phalanx defect.Skin and soft tissue of thumb defect size was 1.0 cm ×1.8 cm to 2.0 cm × 2.2 cm.Preoperative hands anteroposterior and lateral X-ray were routine taken.Imaging findings were associated with the thumb base beyond the distal phalanx fractures,bone defect length was 0.4-0.7 cm.We cut thumb radial side of the dorsal artery fascia flap during surgery operation according to the thumb side wound defect case.The size of the bone flap was 0.2 cm× 0.6 cm to 0.4 cm × 0.8 cm,properly inserting intramedullary distal phalanx fixed base,9-0 line will flap inside the dorsal nerve and a nerve suture flap reconstruction feeling.Results All bone flaps were survived completely,no case occur venous disorders,flap blood circulation was stable,donor skin graft was survival in stage Ⅰ.This group of patients incision were healing 2 weeks after surgery.All the patients were followed up as scheduled,and the follow-up time was 6-12 months.All flaps survived,and the colors,texture,contour of the flaps were good.The two-points discrimination distance was 7.0-10.0 mm on the flap,Thumb distal phalanx healing time was 1.0-1.5 months.Bone absorption was not observed in graft.The thumb function was assessed as excellent in 7 fingers,good in 2 fingers,no complication occurred in donor site.Conclusion The main artery and nerve will not be sacrifice,when the bone flap is used.There are blood into the backbone of the first metacarpal nearly 1/3 of the bone to reconstruct thumb bone defect,the operative procedures is available and easy to be performed,which is a new method for the treatment of thumb composite tissue defects.

Objective The images of CT Equipment without DICOM interface are stored by means of film all along,and they can't be digitally stored,shared,retrieved,integrated to diagnostic reports.This paper introduces a method to capture images,mainly focus on the image capture and crop technology.Methods The hardware is composed of Philip Tomoscan AV CT,PC,OK_RGB20B image capture card,foot switch.The software is programmed by Microsoft Visual C++6.0,OK_RGB20B SDK and GDI+ Class Library on Windows 2000 operating system.Results The system can capture the CT image successfully,and make the images stored and shared permanently.Conclusion This method is a valuable clew for capturing images from other types of non-DICOM-based medical equipment such as ECT,X-ray,Ultrasound,Endoscope and so on.

Objective To find a programming method of magnifying two-dimentional medical image for clearer view and more precise diagnosis. Methods The software was programmed by using Microsoft Visual C++6.0 and GDI+ Class Library on Windows 2000 operating system. Results The software could magnify the medical images with high quality and definition. Conclusion This method is valuable for medical image digital post-processing.

Objective To realize foot switch long-distance control of PC for medical image acquisition. Methods The foot switch was connected with PC through RS232 DB9 port, and the software was programmed by Microsoft Visual C++6.0 on Windows 2000 operating system. Results Foot switch control of PC was successfully achieved in acquiring medical images. Conclusion The foot switch has the advantages of long-distance and foot control of PC. It not only saves manpower but ensures the accuracy and real time of images acquired. This method can be applied to image acquisition workstations for medical equipments such as CT apparatus, X-ray apparatus, Ultrasound apparatus, Endoscope apparatus and so on.

OBJECTIVETo investigate the therapeutic effect of V-Y advanced flap pedicled with posterior perforator from medial malleolus for small skin defect at achilles tendon region.

METHODSFrom Mar. 2011 to Sep. 2012, 7 cases with small skin defect at achilles tendon region were treated by V-Y advanced flap pedicled with posterior perforator from medial malleolus. The flaps was 6.0 cm x 3.0 cm-9.0 cm x 4.5 cm in size. The defects at the donor sites were closed directly.

RESULTSAll flaps survived completely. 7 cases were followed up for 6-8 months after operation. The flaps had good texture and color match. The function of ankle was normal. All patients were satisfied with postoperative function and shape.

CONCLUSIONIt is an ideal reconstruction method for skin defect at achilles tendon region with V-Y advanced flap pedicled with posterior perforator from medial malleolus. It is easily performed with low risk and short recovery time.

Achilles Tendon ; injuries ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Treatment Outcome ; Young Adult

OBJECTIVE To explore clinical results of fat liquefaction of incision wound following cesarean section for obese pregnant women.METHODS Totally 300 obese pregnant women with cesarean section were randomly divided into three groups: group A,iodine(PVP-Ⅰ) group(using PVP-Ⅰ(0.5%) after suturing the abdominal rectus sheath);group B(normal saline group);group C(control group without any liquid).All patients were preoperatively used antibiotics to control the infection.The rate of puerperal morbidity,white cell count and wound infection were observed.RESULTS All parameters of group A were lower than group B or C.There were significant differences among three groups(P