Objective To investigate the therapeutic effect of modified S-P approach without disconnecting the rectus femoris in patients with Pipkin typeⅠandⅡfractures. Methods The clinical data of 58 patients with Pipkin type Ⅰ and Ⅱfractures were retrospectively analyzed. Among the patients, 29 patients were treated with conventional S-P approach (conventional group), and 29 patients were treated with modified S-P approach (modified group). The incision length, operation time, bleeding, visual analogue score (VAS), postoperative complications and hip joint function at the final follow-up were compared between 2 groups. Results The patients of 2 groups had not incision infection, and showed primary. X-ray of 3 months after surgery showed fracture healing. There was no statistical difference in the time of follow-up between conventional group and modified group:(16.1 ± 5.2) months vs. (15.8 ± 5.6) months, P>0.05. The incision length, bleeding, VAS 3 d and 4 weeks after surgery in modified group were significantly lower than that in conventional group:(8.1 ± 0.8) cm vs. (12.3 ± 1.2) cm, (144.3 ± 16.5) ml vs. (172.4 ± 21.6) ml, (4.5 ± 1.1) scores vs. (5.9 ± 1.5) scores and (1.6 ± 0.7) scores vs. (2.4 ± 0.8) scores, and there were statistical differences (P<0.05). There were no statistical differences in operation time, VAS 3 months after surgery, incidence of postoperative complications and excellent and good rate of hip joint function at the final follow-up between 2 groups (P>0.05). Conclusions The modified S-P approach without disconnecting the rectus femoris is a better method in patients with Pipkin type ⅠandⅡ fractures, and it has the advantages of revealing more clearly, minimal invasion, lower bleeding and slight postoperative pain.

Objective To evaluate the effect of sevoflurane on the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in hippocampal neurons of rats.Methods Forty-eight pathogen-free healthy adult Sprague-Dawley rats of both sexes,weighing 210-280 g,aged 3-4 months,were divided into 4 groups (n=12 each) using a random number table:control group (group C) and 1%,3% and 5% sevoflurane groups (S1,S2 and S3 groups).In S1,S2 and S3 groups,1%,3% and 5% sevoflurane were inhaled for 1 h,respectively.Morris water maze test was performed at 1 and 7 days after anesthesia to assess the cognitive function.Six rats in each group were sacrificed after the end of the test.The brains were then removed and the hippocampi were isolated for detection of the expression of α7nAChR (by Western blot) and contents of tumor necrosis factor-alpha and interleukin-1 (by enzyme-linked immunosorbent assay).Results Compared with group C,the number of crossing the platform was significantly decreased at 1 and 7 days after anesthesia in group S1,the time of staying at the target quadrant was significantly shortened,the number of crossing the platform was decreased,and the rate of time of staying at the original platform quadrant and rate of swimming distance at the original platform quadrant were decreased at 1 and 7 days after anesthesia in S2 and S3 groups,and the contents of tumor necrosis factor-alpha and interleukin-1 were significantly increased,and the expression of α7nAChR was down-regulated at 1 and 7 days after anesthesia in S1,S2 and S3 groups (P<0.05).Compared with group S1,the expression of α7nAChR was significantly down-regulated at 1 and 7 days after anesthesia in S2 and S3 groups (P<0.05).Compared with group S2,the expression of α7nAChR was significantly down-regulated at 1 day after anesthesia in group S3 (P<0.05).There was no significant difference in each parameter of Morris water maze test among group S1,group S2 and group S3 (P>0.05).Conclusion The mechanism by which sevoflurane induces inflammatory responses in hippocampi is related to down-regulation of α7nAChR expression in hippocampal neurons of rats.

Transient receptor potential A1 (TRPAl) is a cold sensitive cation channel, which could also be activated by various pungent compounds. As a transduction channel in a number of sensory modalities, TRPAl expressing in heterogonous systems serves to provide great convenience in pharmacological analysis and functional investigation. Due to cellular toxicity, establishment of stable TRPAl cell line has always been challenging. Nevertheless, the first stable human embryonic kidney (HEK-293) cell line with un-controlled expression of TRPAl was successfully established. It was also confirmed that this stable cell line retained TRPAl expression for more than 25 passages in culture. The functional analysis of the cell response verified the stability and specificity of this novel recombinant TRPAl cell line. Altogether, the data indicated this TRPAl-HEK cell line would be a useful tool for functional analysis of TRPAl and for the development of high throughput screening (HTS) compatible assay in the effort to identify TRPAl modulators.

Objective To detect CYP2J3 gene expression and contents of 11,12-EET in heart,liver,lung,kidney and aorta thoracalis after CYP2J3 gene transfection.Methods The rat transgenic model was developed by injecting plasmid through vena dorsalis penis.The animals were divided into control group、 pcDNA3.1 transgenic group and pcDNA3.1-CYP2J3 transgenic group.The expression of CYP2J3 mRNA was detected by RT-PCR and content of 11,12-EET was examined by the HPLC at 14 days and 28 days after injection.Results Twenty eight days after injection,both expression of CYP2J3 mRNA and the content of 11,12-EET were significantly increased as compared with that of control and pcDNA3.1 transgenic group(P

Objective To evaluate the effect of sevoflurane anesthesia on the expression of hippocampal α4 subunit-containing nicotinic acetylcholine receptor (α4nAChR) in rats.Methods One hundred and forty-four Sprague-Dawley rats of both sexes,aged 3-4 months,weighing 220-270 g,were divided into 4 groups (n =36 each) using a random number table:control group (group C),sevoflurane anesthesia for 1 h group (group S1),sevoflurane anesthesia for 3 h group (group S2) and sevoflurane anesthesia for 5 h group (group S3).Group C inhaled air,and S1,S2 and S3 groups inhaled 3％ sevoflurane for 1,3 and 5 h,respectively.Twelve rats in each group were selected at 1 and 7 days after emergence from anesthesia to undergo spatial probe test.Rats were then sacrificed immediately after anesthesia and at 1 and 7 days after emergence from anesthesia,and hippocampi were removed for determination of the expression of α4nAchR protein and mRNA in hippocampal neurons (by Western blot or real-time polymerase chain reaction).Results Compared with group C,the duration of staying at the target quadrant was significantly shortened,and the ratio of duration of staying at the original platform quadrant to the total duration and ratio of swimming distance in the original platform quadrant to the total distance were decreased on 1 and 7 days after emergence from anesthesia,the expression of α4nAchR protein and mRNA was down-regulated,and the number of positive cells was reduced in S1,S2 and S3 groups (P＜0.05).Compared with S1 and S2 groups,the duration of staying at the target quadrant was significantly shortened,the ratio of duration of staying at the original platform quadrant to the total duration and ratio of swimming distance in the original platform quadrant to the total distance were decreased on 1 day after emergence from anesthesia in group S3 (P＜0.05).There was no significant difference in the expression of α4nAchR protein and mRNA or number of positive cells at each time point between group S1,group S2 and group S3 (P＞0.05).Conclusion The mechanism by which sevoflurane anesthesia induces cognitive dysfunction may be partially related to down-regulating the expression of hippocampal α4nAchR in rats.

Objective To compare the effects of isoflurane compare sevoflurane on postoperative cognitive function and the level of serum β-amyloid in elder patients at 12 months after surgery.Methods Seventy-seven patients undergoing abdominal surgery,43 males and 34 females,aged 65-75 years,ASA physical status Ⅰ-Ⅲ,were divided into two proups:isoflurane group (group Ⅰ,n =32) and sevoflurane group (group S,n =45).The patients' cognitive function were assessed using mini-mental state examination (MMSE) 1 d before operation,3 d and 12 months after opertion.Blood samples were taken before operation,3 d and 12 monthes after operation for determination of serum Aβ42 and Aβ40 concentrations.Results The MMSE scores of the two groups 3 d after operation were significantly lower than those before operation (P＜0.05).The MMSE score 3 d after operation in group Ⅰ was significantly lower than that in group S (P＜0.05).The incidence of cognitive dysfunction 12 months after operation had no significant difference between two groups [13 (40.6％) cases vs 15 (33.3％) cases].There was no significant difference in the serum Aβ42 and Aβ40 concentration between groups.Conclusion Sevoflurane has less effect on postoperative cognitive function in short time than isoflurane,but its long-term effect seemed to be similar.The levels of Aβ42 and Aβ40 showed no difference between two groups.

Objective To evaluate the relationship between sevoflurane-induced cognitive impairment and α1B adrenoceptors (ADRA1B) and ADRA1D in the cerebral cortex of rats.Methods Forty-eight SPF adult Sprague-Dawley rats (half male,half female),weighing 220-260 g,were divided into control group (C group,n =24) and sevoflurane group (S group,n =24) using a random number table method.Group C and group S inhaled air and 3％ sevoflurane,respectively,for 5 h.Eight rats in each group were sacrificed immediately after anesthesia,and the cerebral cortex was removed.Eight rats in each group were selected on days 1 and 7 after anesthesia and underwent Barnes maze test.The rats were then sacrificed,and the cerebral cortex was removed.The expression of ADRA1B and ADRA1D protein and mRNA in cerebral cortex tissues was detected by Western blot and fluorescent quantitative real-time polymerase chain reaction,respectively.Results Compared with group C,the number of entering incorrect holes was significantly increased at 1 and 7 days after anesthesia,the latency and total distance to enter the target hole were prolonged,and the expression of ADRA1B and ADRA1D protein and mRNA in cerebral cortex was down-regulated immediately after anesthesia and at 1 and 7 days after anesthesia in group S (P＜0.05).Conclusion The mechanism underlying sevoflurane-induced cognitive impairment may be related to the down-regulated expression of ADRA1B and ADRA1D in cerebral cortex of rats.

Objective To study the operation approach and operation method for giant dumbbell neurogenic tumors of the posterior mediastinum,and summarize the experience ofthoracoscopic surgery via posterior midline approach in tumor resection.Methods The clinical data of 11 patients with posterior mediastinum dumbbell tumor,admitted to our hospital from February 2003 to May 2013,were analyzed retrospectively.Traditional posterolateral incision combined with thoracic tumor resection was performed in the 7 patients of control group;and thoracic laminectomy combined with intraspinal tumor mass resection was performed in the 4 patients of treatment group.Results The operation went smoothly.Patients in the treatment group accepted no auxiliary incision or conversion to thoracotomy,without occurrence of dysneuria and cerebrospinal fluid leakage and other serious complications.As compared with the control group,the treatment group had smaller volume of bleeding,shorter chest drainage time and hospital stays,and longer operation time.Postoperative pathology implied 8 neurofibromas and 3 schwannomas.No dysneuria or recurrence was found during the follow-up of 12-36 months.Conclusion Double-hole thoracoscopic surgery via posterior midline approach is a safe,effective,minimally invasive method in the treatment of dumbbell neurogenic tumors of the posterior mediastinum.

Objective To investigate the effect of maternal separation (MS) on cognitive function in adult male rats through the expression of neuronal nitric oxide synthase (nNOS) in hippocampus, and to reveal the roles of early life stress (ELS) on neural development in rats. Methods Healthy SD pregnant rats (n=12) were randomly divided into maternal separation group (MS group) and control group (NMS group) (n=6 for each group). The newborn rats in the MS group were separated from the mother rats for 3 h every day from postnatal day 3 to 22 whereas no intervention was taken in the NMS group. At the age of 10 weeks, Morris water maze was used to test the learning and memory abilities of two groups of offspring male rats. Neuron immunofluorescence staining was used to examine the number and distribution of neurons in dentate gyrus (DG) of two groups of offspring male rats. Western Blot method was used to detect nNOS, eNOS, Bax/BCL2, Caspase-3 and P53 levels in the hippocampus of the two groups. Ki67/DCX immunofluorescence staining were used to examine the proliferation and differentiation of neurons in the DG area of the hippocampus. TUNEL staining was used to detect the neuronal degeneration and death in the DG area of the hippocampus. Results Behavioral tests showed that the escape latency of male rats in MS group was prolonged, the target quadrant residence time and the number of platform crossing decreased (P<0.05) compared with NMS group. Compared with NMS group, the number of normal and degenerated neurons in hippocampal DG area of MS group had no significant change (P＞0.05). However, the expression of nNOS and eNOS in hippocampus was decreased (P<0.05) and the expression of Bax/BCL2 was increased (P<0.05), but the expression of caspase-3 and P53 remained unchanged (P＞0.05). In addition, Neuronal proliferation and differentiation were decreased and apoptosis was increased in MS group (P<0.05). Conclusion Repeated MS reduces the expression levels of nNOS in the hippocampus, affects the neuronal function in the DG area, and has a long-term influence on the neurodevelopment, which results in cognitive deficits related to learning and memory abilities in adult rats.

Objective To investigate the effectiveness of evoked potential in monitoring cerebral perfusion during carotid endarterectomy by a retrospective cohort study.Methods A retrospective cohort survey of clinical data of 59 patients,who underwent carotid endarterectomy in our hospital from September 2013 to December 2016,was performed.All patients were monitored by transcranial doppler ultrasonography (TCD) and somatosensory evoked potential (SEP),motor evoked potential (MEP) for changes of cerebral blood flow;the monitoring of TCD was defaulted as "gold standard",recording monitoring results at different time points.By drawing the four table,the sensitivity,specificity,positive predictive value,negative predictive value of SEP and MEP during cerebral hypoperfusion were calculated,and correlation analyses between SEP and TCD,and between MEP and TCD were performed.Through receiver operating characteristic (ROC) curve,SEP monitoring threshold of cerebral hypoperfusion was predicted.Results The sensitivity,specificity,positive predictive value,and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 60.00％,91.84％,60.00％,and 91.84％ when SEP amplitude declined beyond 50％;the sensitivity,specificity,positive predictive value and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 70.00％,93.88％,70.00％ and 93.88％ when SEP latency extended beyond 10％.The sensitivity,specificity,positive predictive value,and negative predictive value of MEP in predicting intra-operative cerebral hypoperfusion were 30.00％,97.96％,75.00％,and 87.27％ when MEP amplitude declined beyond 50％.Decline of SEP and MEP amplitudes and extension of SEP latency have positive correlations with TCD.ROC indicated that the amplitude of somatosensory evoked potentials could predict intraoperative hypoperfusion when it decreased by 51.0％ than the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 89.8％ and area under the curve of 0.918 (95％CI:0.846～0.990,P=0.024).ROC also showed that the latent phase of somatosensory evoked potentials could predict intraoperative hypoperfusion when it was prolonged ＞9.8％ compared to the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 92.9％and area under the curve of 0.941 (95％CI 0.878～0.995,P=0.014).Conclusion Evoked potentials can real-time monitor intra-operative cerebral hypoperfusion continuously in carotid endarterectomy,enjoying high sensitivity and specificity;in addition,decline of SEP amplitude and extension of SEP latency have higher sensitivity than MEP.