Objective To observe the biomechanics of the anterior and posterior interosseous talo-calcaneal ligaments (ITCLs) . Methods Load-displacement characteristics of the subtalar joint were studied in 12 cadaver specimens whose ankle joints were mutilated. The ankle articular surfaces of the talus and the post-calcaneus were exposed. Bone blocks were then embedded in polymethylmethacrylate. The an-terior ITCLs were abscised in 6 of them, and the posterior ITCLs in the other 6. A multi-functional biome-chanical machine was used to perform the biomechanical tests on the specimens. Results When the anterior ITCLs were cut, the tali moved to the anterior-lateral side. When the posterior ITCLs were cut, the tali mostly moved to the anterior-interior side. Conclusions The anterior and posterior ITCLs have dif-ferent roles in maintaining stability of the subtalar joint. Since the posterior ITCLs seem more important than the anterior ones, they should have priority in ITCL reconstruction.

Objective To explore the clinical value of microsurgery in the treatment of lateral ventricle tumors. Methods Microsurgery was conducted in 14 cases of lateral ventricle trmors in this department from May 1996 to August 2002. According to the location of tumors, we selected the approach close to the focus, protected the surrounding nerve tissue and the deep venous system, and resected the tumor in fractions. Results Among the 14 cases, 13 (92.9%) received total resection and 1 (7.1%) subtotal resection. A total of 11 cases of complications occurred postoperatively, including 3 cases of intracranial infection, 2 cases of hemiparalysis, 1 case of hydrocephalus, 3 cases of frontal lobe mental symptoms, 1 case of intraventricular hematoma and 1 case of nominal aphasia. Except for 1 case of hemiparalysis who were not able to resume the ability to take care of his own basic needs, the remaining 10 cases obtained full recovery. Follow-up in 9 cases for 6～60 months (mean, 29 months) showed 2 cases of recurrence of astrocytoma. Conclusions Microsurgery offers good visualization, minimal invasion and a high total resection rate for tumor.

Digital angiography system is mainly composed of Digital Subtraction Angiography(DSA)equipment and mostly used in angiography and interventional radiology.With the improvement of image quality,modern DSA equipment has a higher radiation output capacity,which increases the potential radiation damage to the operators and patients.Dose optimization studies the relationship between image quality and radiation dose for reasonable reduction of radiation dose and good image quality.

Objective To observe the effect of acute hypervolemic hemodilution(AHH) combined with nicardipine controlled hypotension on hemodynamics changes in revision operation of total hip replacement.Methods Forty patients were divided into two groups according to the sequence of the surgery(odd number came into group A,even number came into group B,20 in each group).In group A,AHH was carried out with nicardipine controlled hypotension;group B was control group.AHH was carried out in both groups before anesthesia induction.6%voluven was transfused in group A at 15 mL?kg-1 and 30 mL?min-1 and nicardipine was transfused at 0.3-0.5 mL?kg-1?h-1 with MAP altering between 60 and 65 mmHg;Same quantity of physiological saline was transfused in group B.HR,MAP,CVP,Hb,Hct and Plt were recorded and observed at preoperation,1 h after AHH and 24 h after the operation.Results In group A after AHH with nicardipine controlled hypotension,MAP was obviously lower than pre-operation(P

Objective To investigate the killing effect and molecular mechanism of different doses of ~(125)I seed interstitial brachytherapy for human hepatoma HepG2 cells in nude mice transplanted tumor.Methods Twenty nude mice bearing human hepatoma HepG2 cells were randomly divided into 4 groups (each n=5) and given ~(125)I seed interstitial brachytherapy at different doses including 18.5 MBq ~(125)I,29.6 MBq ~(125)I,37.0 MBq ~(125)I and 0 (the control group) ,respectively.~(125)I seeds were percutaneously implanted into tumors,each mouse with 1 ~(125)I seed implanted.Twenty-eight days later,nude mice were sacrificed and routine pathological examination was performed,.The expression of Bcl-2 and Bax was detected with immunohistochemical methods.Results Pathological examination showed serious coagulation necrosis of tumor cells surrounded by extensive fibrosis in all treatment groups,whereas rich tumor cells with proliferative growth were observqed in the control group.Immunohistochemical analysis showed that the expression of Bax in all treatment group were higher than that in the control group.the expression of which was up-regulated with increasing doses of ~(125)I seed.The expression of Bcl-2 and the ratio of Bcl-2/Bax in all treatment groups were lower than those in the control group.the expression of which was down-regulated with increasing doses of ~(125)I seed.The expression of Bcl-2.Bax and the ratio of Bcl-2/Bax among treatment groups and control group had statistical difference (P＜9.05) ,so as the difference among treatment groups (P＜0.05) .Conclusion ~(125)I seed interstitial brachytherapy induces apoptosis in human hepatoma HepG2 cells by reducing the ratio of Bcl-2/Bax and thereby inhibits the growth of tumor in nude mice,and the extent positively correlates with dosage in a certain range.

Objective Production of autotoxin protein in sf9 insect cells with biological activity. Methods Autotaxin cDNA was cloned into pFastBacTMHTA from melanoma cell by extraction of total RNA using TRIzol method and RT-PCR. Bacmid-ATX is isolated from transformed competent bacterial DH10 which carries Bac genomic sequences and transfected into sf9 using lipofectamine 2000. Recombinant ATX virus was amplified in sf9 and further used for infection and expression of ATX protein. Two step purification product using HistrapTMHP and Hiload 16/600 Suerdex 200pg was determined for lysophospholipase D (lysoPLD) activity. Results Correct insertion of PCR fragment is confirmed by BamH I/Xho I digestion and sequencing. ATX virus can infect sf9 and induced enzymatic activity. Column purification and SDS-PAGE resulted 95% in purity and 6mg/liter in yield with significant lysoPLD activity. Conclusion ATX Baculovirus was successfully constructed that can infect sf9 cells and express active lysoPLD. Production of active ATX can be used for crystalography studies and screening for small pharmaceutical inhibitors.

Objective To investigate the effect of isoflurane preconditioning on the expression of 5-lipoxy-genase (5-LOX) during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty-nine male adult Sprague-Dawley rats weighing 250-300 g were randomly divided into 3 groups (n =13 each):sham operation group (group S); focal cerebral I/R group (group I/R); isoflurane preconditioning group (group Ⅰ).Focal cerebral I/R was produced by mid-cerebral artery occlusion in anesthetized rats.The rats inhaled 2 h of 2％ isoflurane and focal cerebral I/R was produced 24 h later in group I.The neurological deficits were scored at 24 h of reperfusion.The animals were then sacrificed.The brains were immediately removed for determination of the infarct size.The expression of 5-LOX,myeloid differentiation factor88 (MyD88) and nuclear factor kappa B (NF-κB) protein and mRNA was detected using Western blot and RT-PCR respectively.Results Compared with group S,the neurological deficit score was significantly increased,the infarct size was enlarged in groups I/R and I,the expression of 5-LOX,MyD88 and NF-κB protein and mRNA was up-regulated in group I/R,and the expression of 5-LOX mRNA and MyD88 protein and mRNA was up-regulated in group I (P ＜ 0.05).Compared with group I/R,the neurological deficit score was significantly lower,the infarct size was smaller,and the expression of 5-LOX,MyD88 and NF-κB protein and mRNA was lower in group I (P ＜ 0.05).Conclusion Isoflurane preconditioning can reduce focal cerebral I/R injury by down-regulating the expression of 5-LOX and inhibiting MyD88/NF-κB signaling pathway in rats.

Objective To analyze the clinical characteristics,diagnosis,treatment and outcome of patients with cardiac amyloidosis (CA).Methods Clinical data from 18 patients diagnosed as CA by endomyocardial biopsy (EMB) from 1995 to 2005 were retrospectively analyzed.Results Among the 18 patients with CA,all patients had reduced diastolic dysfunction; 12 had mitral valve early diastolic blood flow peak velocity/late diastolic blood flow peak velocity (E/A) ＞ 2.0 and ventricular diastolic early filling deceleration time (DT) ＜ 150 ms; 12 had left ventricular ejection fraction (LVEF) ＜50％ ; and 13 had New York Heart Association (NYHA) classification Ⅲ or Ⅳ.The 1-year,3-year and 5-year survival rates of 18 patients with CA were 67％,44％ and 17％,respectively.Kaplan-Meier analysis showed,NYHA functional class ＞ Ⅱ,E/A ＞ 2.0 and DT ＜ 150 ms were associated with increased mortality (log-rank statistic P =0.026 and 0.001,respectively).CA patients with chemotherapy before heart failure were associated with decreased mortality and extend survival.Conclusions The mortality rate goes up and survival rate gradually descends as prolonged onset time.NYHA functional class ＞ Ⅱ and E/A ＞ 2.0 (DT ＜150 ms) are associated with mortality.

Objective To investigate the effect of isoflurane preconditioning on Toll-like receptor 4 (TLR4)-myeloid differentiation factor 88 (MyD88) signaling pathway in ischemic penumbra following focal cerebral ischemia-reperfusion (I/R) in rats.Methods Fifty-four healthy male SD rats,aged 3 months,weighing 250-280 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),I/R group and isoflurane preconditioning group (group IP).Focal cerebral I/R was induced by middle cerebral artery occlusion.In groups I/R and IP,a nylon thread with rounded tip was inserted into the right internal jugular vein and threaded cranially until resistance was met.The middle cerebral artery was occluded for 2 h,followed by 24 h reperfusion.In group IP,the animals inhaled 2.0％ isoflurane for 2 h,and middle cerebral artery occlusion was performed at 24 h after the end of preconditioning.Neurological deficit was scored at 24 h of reperfusion and then the rats were sacrificed.Five rats in each group were chosen and the brains removed for measurement of the cerebral infarct volume.The right cerebral ischemic penumbra was removed for detection of the expression of HSP60,TLR4,MyD88 protein and mRNA by Western blot analysis and real time-PCR.Apoptosis was detected in the ischemic penumbra in the left 3 rats in each group using TUNEL.Apoptosis index (AI) was calculated.Results Neurological deficit scores and AI were significantly increased,the cerebral infarct volume was significantly enlarged,and the expression of HSP60,TLR4,MyD88 protein and mRNA was up-regulated in groups I/R and IP as compared with group S ( P ＜ 0.05).Isoflurane preconditioning significantly reduced the cerebral infarct volume and decreased neurological deficit scores and AI,and down-regulated the expression of HSP60,TLR4,MyD88 protein and mRNA (P ＜ 0.05).Conclusion The mechanisn by which isoflurane preconditioning protects ischenic penumbra following focal cerebral I/R may be related to inhibition of TLR4-MyD88 signaling pathway.