Objective: To study the mechanisms and treatment of ischemia/reperfusion injury. Expression of E selectin was measured and the effect on suppression of E selectin by the Pyrrolidine Dithiocarbamate was investigated. Methods: Endothelial cells were exposed to hypoxia, then returned to reoxygenation condition. ELISA methods were used to detect expression of E selectin. Results: E selectin expression on hypoxia/reoxygenation stimulated endothelial cells increased, PDTC could suppress translation of E selectin effectively. Conclusion: It seems that E selectin may act as a critical factor. PDTC may prove beneficial in the treatment of ischemia/reperfusion injury.

Objective To explore the isometric attachment site of the posterolateral structure in the femoral lateral condyle and introduce the method of knee posterolateral complex(PLC) reconstruction with the semitendinosus tendon. Methods Isometric reconstruction of the chronic PLC injury of knee joint in 18 cases, were performed with the semitendinosus tendon from February 2001 to February 2005. Of all patients, there were 12 males and 6 females, average age was 39 years old(range, 19-52 years old). All cases were chronic injuries, with duration of 1.5-14 months. 3 cases were simple PLC injury, 10 cases were PLC injury with posterior cruciate ligament(PCL) injury, 2 of which had undergone PCL reconstruction about 6.5 months. 3 cases combined with anterior cruciate ligament(ACL) injury, 2 cases combined with ACL and PCL injury. To put in the double semitendinosus tendon from the bony tunnel of anatomical insertion of the fibular collateral ligment in caput fibulae and put out from the bony tunnel of anatomical insertion of the popliterofibular ligment in the caput fibulae, then fix them respectively in the isometic bony tunnel of the femoral lateral condyle. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results It was relatively isometric from the femoral attachment site of the popliteal tendon to the anatomical insertion of the popliterofibular ligment in the caput fibulae. The better isometric attachment site was from the anatomical caput fibulae attachment site to 8-10 mm in front of the anatomical femoral attachment site of the lateral collateral ligament. The average follow-up period was 14 months(12-24 months). There was no varus knee instability in full extension. At 30? flexion, one-grade varus instability was found in 2. At 30? and 90? flexion, external rotation range increased by 6? in 3 cases, remained the same in 14 cases, and decreased in 1 case, all compared with the healthy side. Conclusion The method provided good stability for the knee and acquired satisfactory clinical results.

Objective To observe the application of ultrasound-guided femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) for patients undergoing hip fracture surgery.Methods 60 patients scheduled for hip fracture surgery undergoing LMA general anesthesia were randomly divided into 3 groups,20 cases in each group.Before transfer patients from bed to operating table,A group received dezocine 5mg iv,B group received fascia iliaca compartment block(FICB),C group received FNB combined with LFCNB.40mL of 0.375％ ropivacaine was injected guiding by ultrasound in B group and C group.The time of sufficient sensory block and awake,the dosage of propofol and remifentanil,MAP and HR at pre-block (T1),20min after block (T2),transfer bed (T3),LMA insert (T4),skin incision(T5),LMA remove(T6) and sober(T7) were recorded.Pain was assessed using visual analogue scale(VAS) pre-and post block.The incidence of using vasoactive drugs,agitation,pain and adverse reaction were also recorded.Results The time of sufficient sensory block and awake,the dosage of propofol and remifentanil in A,B and C groups were as following:A group (not measured),(20.3 ± 1.3) min,(835 ± 6.7) mg,(1 285 ± 18) μg;B group (i2.2 ±2.7)min,(13.3 ± 1.4)min,(610 ±9.9)mg,(835 ± 15) μg;C group (9.7 ± 2.4)min,(12.8 ± 1.5) min,(555 ± 6.5) mg,(785 ± 16) μg.The time of awake,the dosage of propofol and remifentanil in B group and C group were significantly lower than those in A group(F =2.62,2.41,2.45,all P ＜ 0.05).The time of sufficient sensory block in C group was lower than that in B group (p ＜ 0.05).The MAP and HR at T2,T3,T5 and T7 in A,B and C groups were:A group (115 ± 4) mmHg,(90 ± 8) beats/min,(135 ± 6) mmHg,(98 ± 8) beats/min,(104 ±6) mmHg,(87 ± 4) beats/min,(120 ± 5) mmHg,(88 ± 8) beats/min;B group (102 ± 3) mmHg,(81 ± 6) beats/min,(112 ± 5)mmHg,(82 ± 8)beats/min,(89 ±6) mmHg,(72 ± 3) beats/min,(100 ±6)mmHg,(76 ± 8) beats/min;Cgroup (100 ± 3) mmHg,(80 x 6) beats/min,(109 ± 6) mmHg,(83 ± 5) beats/min,(86 ± 5) mmHg,(70 ± 3) beats/min,(99 ± 5) mmHg,(75 ± 5) beats/min.The levels of MAP and HR in B group and C group were significantly lower thanthose in A group(F =2.25,2.85,2.87,2.91,all P ＜ 0.05).The VAS scores at T2,T3,and T7in A,B and C groupswere:A group (3.9 ± 0.7) points,(8.2 ± 0.3) points,(6.0 ± 0.8) points;B group (2.3 ± 0.4) points,(4.1 ±0.4) points,(2.2 ± 0.7) points;C group (2.1 ± 0.5) points,(2.4 ± 0.4) points,(1.2 ± 0.4) points.The VAS scoresin B group and C group were significantly lower than those in A group (2.36,2.82,2.88,all P ＜ 0.05).The VASscores at transfer bed and sober in C group were significantly lower than those in B group (F =2.32,2.38,all P ＜0.05).The incidence of using ephedrine/atropine,urapidil/esmolol,PONV,agitation,pain and incision pain in A,Band C groups were:A group 30％,30％,25％,25％,40％;B group 10％,10％,0％,0％,10％;C group 10％,5％,0％,0％,0％.The number of patients who required vasoactive drugs and adverse reaction in B group and C group were significantly lower than those in A group(x2 =7.58,8.81,9.11,9.11,8.89,all P ＜0.05).The incidence of incision pain at sober in C group was lower than that in B group(x2 =9.21,P ＜ 0.05).Conclusion The ultrasound -guided FNB and LFCNB can obviously shorten the onset time,reduce the dosage of general anaesthetic and maintain the stability of henodynamics during the perioperative period.It has effective analgesia during transfer of patients from bed to operating table and sober.

Adolescent ; Adult ; Child ; Elliptocytosis, Hereditary ; diagnosis ; genetics ; Female ; Humans ; Male

Objective To explore associations between SG13S114A/T and SG13S32A/C polymorphisms of ALOX5AP gene and the genetic susceptibility of ischemic cerebrovascular diseases (ICVD) in Henan Han population.Methods Two hundred and forty-six ICVD patients and 245 healthy controls were recruited from Han population in Henan province. Polymorphisms of SG13S114A/T and SG13S32A/C in ALOX5AP gene were genotyped in these samples by SnaPshot minisequencing method.Each genotype frequency and allele frequency were statistically analyzed and compared between ICVD group and control group using SPSS16.0 software.Haplotype and linkage disequilibrium were analyzed by SHEsis software.Results The SG13S114 AA genotype frequency ( 18.7％ ) and A allele frequency (41.3％) in ICVD group were significantly higher than those in control group (9.0％ and 32.7％,respectively; P =0.002 and P =0.005 ).It was also found that in male ICVD group and in younger ICVD group ( ＜50 years old),the SG13S114 AA genotype frequencies (22.1％ and 22.0％,respectively) and A allele frequencies (42.1％ and 42.7％,respectively) were significantly higher than those in male control group and younger control group (SG13S114 AA genotype:9.0％ and 8.9％ ; P =0.010 and P =0.006,respectively) ;A allele frequencies,34.0％ and 32.0％ ; P =0.048 and P =0.020,respectively.Finally,the prevalence of A-A haplotype in ICVD group was significantly higher than that in control group(30.4％ vs 23.5％,OR =1.419,95％ CI 1.068-1.885,P =0.015).T-C haplotype frequency of ICVD group was significantly lower than that in control group (22.0％ vs 28.8％,OR =0.698,95％ CI 0.523-0.932,P =0.014 ).Conclusions The A allele in SG13S114 loci of ALOX5AP may be a genetic risk factor for ICVD in Han population in Henan province.The association is predominant in ICVD patients of male and younger than 50 years old.Maybe A-A haplotype increases the risk of ICVD and T-C haplotype and has a protective effect against ICVD in Henan Han population.

BACKGROUND: As a micro-injurying and reduplicative treatment of osteoarthritis,the arthroscopic debridement has got the affirmation of numerous scholars. But as one of the standard procedures in artnroscopic debridement,synovectomy is called in question recently.OBJECTIVE: To explore the applied value of synovectomy in the arthroscopic debridement of osteoarthritis.DESIGN: Retrospective controlled analysis.SETTING: Department of Orthopaedics, Fushun Central Hospital.PARTICIPANTS: Sixty-five patients received synovectomy in the arthroscopic debridement of knee joint osteoarthritis in the Department of Orthopaedics,Fushun Central Hospital from February 1997 to December 2000.Thirty-two among them,with complete data and over 1 year's followup,were taken for synovectomy group. Forty-eight patients received the arthroscopic debridement of knee joint osteoarthritis without synovectomy in the Department of Orthopaedics,Fushun Central Hospital from January 2001 to November 2003.Thirty among them,with complete data and over 1 year's follow-up,were taken for control group.METHODS: Synovectomy was taken as the factor of intervention in the operation to perform grouping. The analysis of curative effect was performed to control with joint douching,corpus liberum removal,osteophyma cleaning,meniscus fitting,cartilage gouging,synovectomy and without synovectomy or part synovectomy. Lysholm evaluation standard of knee joint osteoarthritis was used to the knee joint functional evaluation beween preoperation and postoperative 1 year in two groups. And operative time,postoperative draining quantity,postoperative 7-day visual analog score,postoperative 1-year Lysholm score of knee joint, were recorded.MAIN OUTCOME MEASURES: Preoperative and postoperative 1-year Lysholm score of knee joint,operative time,postoperative draining quantity,postoperative 7-day visual analog score.RESULTS: Sixty-two patients were included and all of them entered the result analysis.The preoperative patients in two groups were comparable with each other and the differences of Lysholm score were not significant (t=0.127,P=0.899).The operative time was longer in synovectomy group than in control group,the differences were significant (t=9.547,P ＜ 0.001)and the postoperative draining quantity was more in synovectomy group.The postoperative visual analog score was bigger in synovectomy group than in control group and the differences were significant [the scores of synovectomy and control groups were respectively (4.6±1.1),(2.8±1.4),t=6.206,P ＜ 0.001].The differences of knee joint score in 1-year follow-up were not significant [the scores of synovectomy and control groups were respectively (77.6±11.9),(79.0± 10.3),t=0.562,P=0.576].CONCLUSION: Synovectomy can not increase the curative effect in the near future in the arthroscopic debridement of osteoarthritis. On the contrary,the operative time was longer,the operative wound was larger and postoperative reaction was more serious. It should not be used in the debridement generally.

Objective To explore the effect of wash pipe frequency on complications of double-lumen power peripherally inserted central catheter (PICC) connected to infusion pump during continuous chemotherapy. Methods A total of 160 patients with malignant lymphoma whose PICC connected to infusion pump were divided into 4 groups by random digits table method with 40 cases each: flushing and sealing the tube once every 4 hours(group A), every 8 hours(group B), every 12 hours(group C) and every 24 hours (group D). The incidence of blocking pipe and phlebitis were observed. Results The incidence of blocking pipe were 0,2.5%(1/40) , 27.5%(11/40), 42.5%(17/40) in group A, B, C, D, the differences among them were significant, χ2= 30.870, P<0.01. There was no significant difference in the incidence of phlebitis among 4 groups, P>0.05. Conclusions Flushing and sealing the tube of PICC connected to infusion pump once every 8 hours during continuous chemotherapy seems to be appropriate and worthy of being applied clinically due to its low blocking pipe incidence, and low incidence of phlebitis.

Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.

Objective To analyze the correlation between miR-31 and ESCC in expression of miR-31 in the plasma of ESCC in Xinjiang Kazak and Han nationality patients. Methods The plasma samples were collected respectively from patients with ESCC in 20 cases and healthy subjects in 20 cases. The relatively expression of miR-31 was detected by real-time Q-PCR. Results The expression of miR-31 with ESCC were higher than those of the normal control group, which related to the degree of tumor differentiation in Kazak ESCC patients (P < 0.01); the levels of miR-31 relative expression in Kazak were higher than that of Han (P = 0.008, P = 0.027). Conclusion miR-31 may be involved in the occurrence of ESCC in Han and Kazak nationality. miR-31 might be another risk factor in high incidence of ESCC in Kazak than Han nationality.

Objective To investigate the frequencies of circulating dendritic cell (DC) subsets and the function of monocyte-derived dendritic cells in patients with hepatitis B-related acute-on-chronic liver failure.Methods Peripheral blood was collected from hepatitis B-related acute-on-chronic liver failure patients (ACLF,n =40) and chronic hepatitis B (CHB,n =40) as well as normal controls (NCs,n =20).Circulating myeloid dendritic cell (Mdc) and plasmic dendritic cell (pDC) frequencies in peripheral blood mononuclear cells (PBMC) were analyzed by flow cytometric analysis.Purified monocytes were isolated by combination of Histopaque-1.077 and CD14 Microbeads.Monocyte-derived dendritic cells (MoDCs) generated in vitro in the presence of interleukin (IL)-4 and granulocyte macrophage colony-stimulating factor upon activation by poly I:C.Costimulatory molecule expression and allostimulatory mixed lymphocyte reaction (AMLR) of MoDCs were detected in patients with hepatitis B-related ACLF.Results The number of circulating mDC decreased only in patients with hepatitis B-related ACLF compared with that in normal controls.However,pDC numbers decreased in both CHB and ACLF patients.We observed a further decrease the pDC numbers in ACLF compared to CHB patients without statistical significance (P ＞ 0.05).MoDC from ACLF patients showed lower expression of costimulatory molecules CD80,CD86 and the mature marker CD83,as well as MHC Ⅱ molecule (HLA-DR) compared to CHB and NC group.Interestingly,MoDC impaired allostimulatory mixed lymphocyte reaction from ACLF patients compared to those in CHB patients and NCs.Conclusions Patients with hepatitis B-related ACLF have a significantly lower expression of surface markers and impaired AMLR of MoDC,as well as decreased number of circulating mDC and pDC,which may be partially related to HBV disease progression in these patients.