The histological and biomechanical aspects of the osteogenesis in metaphysioto-my lengthening of the tibia were observed in 45 immature rabbits,which were divided into 3 groups as follows:(1)Group A:After metaphysiotomy,the periosteum and endosteum of the transected boneends were well-preserved.(2)Group B:After metaphysiotomy,the periosteum about 0.7 cm in width on the 2 bone ends was circumcised.Then the 2 bone ends were aligned without disturbing the endosteum.(3)Group C:After metaphysiotomy,a part of the bone marrow and endosteum in the 2 bone ends wwere removed.Then the 2 bone edns were well aligned and the periosteum was sutured up.In all the experimental animals,the tibia was lengthened by 1mm/day.It was found that in Group A,the formation and remodelling of the new bone in the lengthened area occurred quite early after metaphysiotomy and the new bone was good in its biomechanical quality;in Group B,the formation of new bone was retarded and the biomechanical quality of the new bone was not satisfactory;and in Group C,new bone formation was sluggish in the early stage after metaphysiotomy but it wwas active in the late stage,and the neww bone formed was similar to that of Group A in its histological morphology and biomechanical quality.The periosteum could grow synchronously with the slow traction without any tearing.In addition,osteotomy and mechanical traction could stimulate and accelerate periosteal osteogenesis.It is believed that an intact periosteal cuff is of significance in the osteogenesis of the lengthened area since it serves as a restriction framework for the adherent growing of the connection between the new bones of the 2 bone ends and periosteal osteogenesis plays a more important role than endosteal osteogenesis in the bony healing of the lengthened area.

Objective To compare the effects of point contact-dynamic compression plates (PC-DCP) and dynamic compression plates (DCP) on cortical bone blood flow in an intact sheep tibia model. Methods Fifteen mature goats were used in this experiment. After the bilateral tibia of goats were fixed with DCP and PC-DCP respectively, the regional cortical bone blood flow was measured at four time intervals (1 day, 2, 6 and 12 weeks after operation) using radiolabelled microsphere technique. Results After operation, the cortical bone blood flow was acutely decreased at the first day, kept lower than normal level until six weeks and recovered at the 12th week. The blood supply under PC-DCP recovered to normal, even over normal level two weeks after operation and remained at a high level until 12 weeks. Conclusions PC-DCP can markedly protect cortical bone blood flow.

Objective To compare the effects of point contact-dynamic compression plates (PC-DCP) and dynamic compression plates (DCP) on bone structure and mechanical properties of the plated bone in the intact goat tibia model. Methods Ten matured goats were used. The bilateral intact tibia of goats were fixed with DCP and PC-DCP respectively. The goats were sacrificed at 12 and 24 weeks after operation, and the tibiae were harvested. The structure of bone under plate was studied both by CT scan and histomorphology. The mechanical properties of the plated bone were examined by torsional test. Results At 12 weeks after internal fixation, there was obvious osteoporosis in the cortical bone underneath the plate in the DCP group compared with that of the PC-DCP group. Both of the cortical bone thickness underneath the plate and the torsion strength of the plated tibiae were significantly higher in the PC-DCP group than that in DCP group (P0.05). Conclusion The underlying bone resorption after rigid plate fixation is induced by both the disturbance of the bone blood supply and stress shielding. However, the former is the main cause in the early stage of fixation. PC-DCP is able to prevent bone resorption in the early stage of fixation.

Objective To evaluate the effect of dexmedetomidine on the intestinal mucosal injury in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty patients of both sexes with rheumatic heart disease,aged 32-64 yr,weighing 40-75 kg,of ASA physical status Ⅱ or Ⅲ (NYHA class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and dexmedetomidine group (group D).After induction of anesthesia,the patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with 0.8％-2.0％ sevoflurane inhalation and intermittent iv boluses of sufentanil 0.5-1.0 μg/kg and vecuronium 0.04-0.06 mg/kg.Before routine induction of anesthesia,a loading dose of dexmedetomidine 1 μg/kg was injected intravenously over 10 min,followed by continuous infusion at 0.3 μg · kg-1 · h-1 until the end of surgery in group D,while the equal volume of normal saline was given in group C.Before CPB,at 30 min after aortic clamping,at the termination of CPB,at the end of surgery and at 6 and 24 h after surgery,central venous blood samples were taken for determination of concentrations of tumor necrosis factor-alpha,interleukin-6 (IL-6) and IL-10 and intestinal fatty acid binding protein in plasma (by ELISA),and the plasma concentration of endotoxin (using turbidimetry).The time of postoperative mechanical ventilation and duration of ICU stay were recorded.Results Compared with group C,the concentrations of tumor necrosis factor-alpha,IL-6,IL-10 and endotoxin and intestinal fatty acid binding protein in plasma were significantly decreased,and the time of postoperative mechanical ventilation and duration of ICU stay were shortened in group D.Conclusion Dexmedetomidine infused continuously at 0.3 μg · kg-1 · h-1 (until the end of surgery) after a loading dose of 1 μg/kg before routine induction of anesthesia can reduce intestinal mucosal injury in the patients undergoing cardiac valve replacement with CPB.

Objective To investigate the value of pulse-indicate continuous cardiac output(PICCO) in septic shock patients.Methods In a retrospective study,58 patients who were diagnosed to be suffering from septic shock in the intensive care unit (ICU) were enrolled,from January 2010 to December 2011,and were divided into two groups:PICCO group(n =28) and the conventional group (n =30).We compared their 6 h-EGDT compliance rate,the level of lactate and central venous pressure (CVP),the oxygenation index,the characteristics of fluid intake and balance within 72 hours,duration of mechanical ventilation,and ICU stay of the two groups.The incidence of MODS after 72 hours in ICU,28-day mortality were recorded and compared.Results (1) Fluid intake((9565 ±1623) ml vs (12245±2253) ml,t=2.673,P=0.021) and balance ((3656 ± 1904) ml vs (5465 ± 2765) ml,t =2.357,P =0.012) were significantly lower in PICCO group compared the conventional group within 72 hours.(2) The oxygenation index ((252.6 ± 87.4) vs (226.8 ± 69.4),P ＜ 0.05) in PICCO group increased significantly and duration of mechanical ventilation ((134.7 ±42.8) h vs (193.3 ± 92.4) h,t =1.356,P =0.023) reduced significantly compared with the conventional group after 72 hours.(3) There was no difference in the 6 h-EGDT compliance rate,the level of lactate and CVP,6 h EGDT,ICU stay,the incidence rate of MODS after 72 hours,28-day mortality in ICU(P ＞0.05).Conclusion In contrast with classic methods as CVP monitoring,PICCO catheter may assess more accurately the volume status and guide early fluid resuscitation in septic shock patients.

Treating from liver is an important thought to treat esophageal cancer.Regulating the liver has very important significance in the process of treating esophageal carcinoma,which embodies at regulating liver is the key of soothing emotional injuries of esophageal carcinoma,removing esophageal pathology product and coordinating rising-descending function of spleen and stomach,and improving accompainedg symptoms of esophageal cancer.The thought of treating from liver should be used throughout the whole process of the treatment.So we must pay morn attention to regulate the liver and prevent liver injury during the differentiation and treatment of esophageal carcinoma.

ObjectiveTo investigate the role of phosphatidylinositol 3-kinase/protein-serine-threonine kinases (PI3K-Akt) signal pathway in the protection of myocardium against ischemia-reperfusion (I/R) injury by diasoxide postconditioning in rats.MethodsThirty-six male SD rats weighing 250-300 g were randomly divided into 4 groups using random number table (n =9 each):group I/R; group diazoxide (group D); group wortmannin (PI3K inhibitor) (group W) and group wortmannin + diazoxide (group WD).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 4 ml/kg,intubated and mechanically ventilated.Myocardial I/R was produced by 30 min occlusion of left anterior descending coronary artery followed by 120 min reperfusion.0.1％ dimethyl sulfoxide (the vehicle for diazoxide and wortmannin)/diazoxide at 0.47 mg· kg-1 · min-1/wortmannin at 1 μg·kg-1 ·min-1 was infused for 15 min starting from 25 min of ischemia in groups I/R,D and W respectively.In group DW wortmannin was infused at 5 min before diazoxide infusion.Blood samples were collected from left ventricle at the end of 120 min reperfusion for measurement of lactate dehydrogenase (LDH) activity.Myocardial infarct size was measured.Myocardial specimens were obtained for determination of apoptosis index (the number of apoptotic cells/the total number of cells examined) and expression of Bcl-2 and Bax.Bcl-2/Bax ratio was calculated.ResultsDiazoxide postconditioning significantly decreased plasma LDH activity,myocardial infarct size,apoptosis index and Bax expression in myocardium and increased myocardial Bcl-2 expression and Bcl-2/Bax ratio in group D compared with group I/R.Wortmannin partly counteracted the protective effects of diazoxide postconditioning against myocardial infarct.There was no significant difference in the above variables between groups I/R and W.ConclusionPI3K-Akt signal pathway is involved in the protective effects of diazoxide postconditioning on myocardium against I/R injury.

ONYX-015 and H101 are E1B 55-kDa protein-deficient replicating C group adenoviruses that are currently in clinical trials as antitumor agents. However, their application in cancer gene therapy is limited by the native tropism of C group adenoviruses. This is in part due to low expression of the C group adenovirus receptor (coxsackievirus-adenovirus receptor, CAR) on malignant tumors. An H101-based chimeric virus vector containing sequences encoding the Ad35 fiber domain instead of the Ad5 fiber (H101-F35) was constructed. This modification allowed infection of tumor cells through CD46, a membrane protein over-expressed on tumors. The CAR and CD46 RNA expression was evaluated by RT-PCR method. H101-F35 conferred a stronger cytocidal effect than H101 and ONYX-015 in tumor cell lines that lacked CAR expression (MDA-MB-435 and MCF-7), while the cytocidal effect of H101-35, H101 and ONYX-015 was similar in high-level CAR expressing cancer cell lines (A549, NCI-H446, Hep3B, LNCaP, ZR-75-30 and Bcap-37). In an MDA-MB-435 xenograft mouse tumor model, tumor growth in mice receiving H101-F35 was significantly inhibited compared with mice injected with H101. These results suggest that the chimeric oncolytic adenovirus H101-F35 vector might be a useful candidate for gene therapy of cancer.

Objective To explore the risk,diagnosis,treatment and prognosis of newborns suffering from congenital latent tuberculosis infection (CLTBI) by vertical transfer of mycobacterium tuberculosis(VTRTB) from mothers with active tuberculosis (TB) mothers during pregnancy.Methods The clinical data of 7 children with CLTBI follow-up of 1-6 years in Children's Hospital of Nanjing Medical University and 2 cases from literatures were reviewed,and they were divided into simple CLTBI group (n =5) and active TB group (n =4).Combined with the maternal history,the epidemiology,clinical features,treatment,prognosis and relative factors of the children were analyzed.Results Eight mothers had active TB during pregnancy,and premature delivery rate and low birth weight rate were 55.56％ (5/9 cases) respectively.The positive conversion rates of purified protein derivative tests (PPD),acid-fast bacilli (AFB) and TB culture were 6/9 cases,0/9 cases and 1/9 cases,respectively.Positive results of T cell enzyme-linked immunospot tuberculous test (T-SPOT.TB) and TB-DNA by fluorescent quantitative polymerase chain reaction (FQ-TB-DNA) were detected in 4 cases respectively,1 of 3 patients with T-SPOT.TB and 1 of 3 patients with FQ-TB-DNA were positive.There were 5 cases with chemoprophylaxis of anti-TB drugs for 1-6 years with isonicid or rifampicin;3 cases with pulmonary hilar or mediastinal lymph nodes enlargement,and 3 cases with pulmonary diffuse punctate,nodular or patchy high density shadow in 3 cases;the rate of VTRTB in 9 cases was 8/9 (88.89％) based on laboratory examination of etiology and immunology,and the risk of active TB in infants and early childhood was close to 50％ in neonates with CLTBI;the incidence of active TB was reduced from 100％ (4/4 cases) of non-intervention down to 0 (0/5 case) of intervention.Conclusions Etiology,immunology,imaging examination of TB and clinical efficacy,can prompt active TB and retrospective diagnosis of CLTBI,and application of T-SPOT.TB and FQ-TB-DNA for early diagnosis of CLTBI has a higher applied value;prophylactic and treatment of anti-tuberculosis drugs can reduce the progression of CLTBI to active TB and improve outcomes.

Objective To examine how early life exposure to famine would impact on liver and kidney functions and related chronic metabolic diseases during adulthood.Methods A random cluster sampling method was adopted in Anhui province,2011 from a physical examination center,in a first-class hospital.4 252 study subjects were born between 1957 and 1963.According to the time of birth:the study subjects were divided into three groups,respectively:1957-1958 (983 persons as pre-famine),1959-1961 (1 247 persons as exposed to famine) or 1962-1963 (2 022 persons as controls,also the post-famine).Variances between groups AST,ALT,r-GGT,differences in the levels of SCr,UA,UREA and the change trend were compared.Results ALT,IBIL,TBIL,SCr,UREA were statistically different (P＜0.05) among subjects born in the different years.r-GGT,ALT,AST,ALB,SCr were statistically different (P＜0.05) among males bornin different years so as the r-GGT,AST,ALB,GLB,TP,SCr,UA,UREA in females (P＜0.05).r-GGT,ALT,ALB,SCr differences statistically significant (P＜0.05) and r-GGT,AST,ALB,GLB,TP,SCr,UA,UREA in females were statistically significantly different (P＜0.05).Conclusion Early life poor nutrition could lead to developmental disorders,organ function damage in liver and kidney function during adulthood.Women appeared to have balanced diet nutrition during pregnancy which was far important in the prevention on adulthood chronic metabolic diseases.