Left atrial appendage ( LAA) arises from the left atrial free wall. It is the remnant of the original embryonic LA, distinct from the rest of the left atrium. It has a unique anatomical structure, physiological function, hemodynamic characteristics. LAA has complex surrounding structures, great variability, and close relation with thrombosis. This paper reviews the morphological and functional characteristics of LAA. Familiar with adjacent relationship of LAA and correlation between LAA and thrombus formation has important clinical significance that can reduce the risk of postoperative complications in interventional procedures, the incidence of car?dioembolic stroke, the clinical misdiagnosis on LAA thrombosis.

Amygdala ; Animals ; Disease Models, Animal ; Electroencephalography ; Epilepsy ; etiology ; physiopathology ; Kindling, Neurologic ; Male ; Rats ; Rats, Wistar

Animals ; Cerebral Cortex ; drug effects ; physiology ; Epilepsy ; chemically induced ; physiopathology ; Female ; Flunarizine ; pharmacology ; Hippocampus ; drug effects ; physiology ; Male ; Penicillins ; adverse effects ; Rats ; Rats, Wistar

Agouti Signaling Protein ; Animals ; Central Nervous System ; abnormalities ; metabolism ; pathology ; Energy Metabolism ; Hair Color ; genetics ; physiology ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Membrane Proteins ; genetics ; metabolism ; physiology ; Mutation ; Obesity ; genetics ; metabolism

Angina Pectoris ; drug therapy ; Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Technology, Pharmaceutical

OBJECTIVETo investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic.

METHODSFrom March 1995 to July 2011, 28 patients with knee joint synovial chondromatosis were treated. Among them, 18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain, swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery (10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed, Lysholm scoring was used to evaluate effects.

RESULTSAll patients were followed up except one lost, the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from (41.89 +/- 6.81) preoperatively to (67.73 +/- 7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78 +/- 7.54) preoperatively to (77.46 +/- 8.43) postoperatively.

CONCLUSIONArthroscopic surgery, which has no risk of rupture of incision, nonunion, earlier to exercise, is a good method to diagnosis and treat knee joint synovial chondromatosis.

Adult ; Aged ; Aged, 80 and over ; Chondromatosis, Synovial ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Laparoscopy ; Male ; Middle Aged ; Treatment Outcome

Objective To study the effect of ganoderma lucidum polysaccharides combined with metformin on oxidative stress of type 2 diabetic rats. Methods SD rats were fed with high fat diet for 4 weeks and injected with streptozotocin (30 mg·kg-1 ) to produce type 2 diabetic model. The diabetic rats were randomly divided into diabetes model group, ganoderma lucidum polysaccharides group (600 mg·kg-1 ), metformin group (600 mg·kg-1 ), combination group (ganoderma lucidum polysaccharides 300 mg·kg-1+ metformin 300 mg·kg-1 ), After 12 weeks of treatment, the level of fasting blood glucose was determined, and the activity of superoxide dismutase ( SOD), malondialdehyde ( MDA), catalase ( CAT), glutathione peroxidase (GSH-Px), total cholesterol (TC) and triglyceride (TG) were detected. Results The levels of fasting blood glucose in the treatment groups were significantly lower than that in the diabetes model group (P<0. 01). Furthermore, fasting blood glucose in the combination group was significantly lower than that in ganoderma lucidum polysaccharides group and metformin group (P<0. 01). Compared with diabetes model group, serum TC and TG in the treatment groups were significantly lower (P<0. 05, P<0. 01). Serum TC and TG were significantly lower in the combination group than in ganoderma lucidum polysaccharides group and metformin group (P<0. 05, P<0. 01). Compared with diabetes model group, serum SOD levels in the treatment groups were significantly higher (P<0. 01). Compared with ganoderma lucidum polysaccharides group and metformin group, serum SOD levels in the combination group was significantly higher (P<0. 05). Compared with diabetes group, serum MDA levels in the treatment groups were significantly lower (P<0. 01). Serum MDA in the combination group was significantly lower than that in ganoderma lucidum polysaccharides group and metformin group ( P<0. 05). Compared with diabetes model group, serum CAT and GSH-Px in the treatment groups were significantly higher (P<0. 05, P<0. 01). Serum CAT and GSH-Px in the combination group were significantly higher than those in ganoderma lucidum polysaccharides group and metformin group (P<0. 05). Conclusion Ganoderma lucidum polysaccharides combined with metformin could effectively inhibit oxidantion stress in type 2 diabetic rats. The effect was better than ganoderma lucidum polysaccharides or metformin used alone. The possible mechanism may be related to increased activity of SOD, CAT, GSH-Px in vivo and regulation of dyslipidemia.

Objective To detect the expression of VIP1R and VIP2R mRNA in gallbladder tissues of patients with gallbladder diseases. Methods The expression of VIP1R and VIP2R mRNA in gallbladder tissues were detected in 25 patients with gallstone, 8 patients with gallbladder polyps and 7 control liver transplantation donors by RT-PCR. Results The VIP2R mRNA level of the control group (1. 09 ?0. 58 ) was lower than that of the gallbladder polyps group (1.64?0.56 ),P

Objective To explore the clinicopathological features of IgA nephrolpathy associated with malignant hypertension (IgAN-MHT) and to analyze their correlation with renal vascular lesions. Methods Twenty-nine patients of IgAN-MHT were screened from 2000 biopsy-proven eases with primary IgA nephropathy (IgAN) in our department from April 1997 to May 2007. Data of clinicopathology and follow-up of these 29 patients were collected. Semi- quantitative analysis was performed to evaluate the pathological changes. Inner lumen, outer lumen, intimal thickness, tunica media-to-internal lumen ratio of 436 arterioles, 124 interlobular arteries and 5 arcuate arteries were measured. The primary endpeint was the composite of a doubling of serum creatinine level and ESRD. Correlations of renal vascular lesions with clinical manifestation, pathological change and prognosis were examined by Spearman and Cox methods. Results 1.5% of all the IgAN patients presented malignant hypertension. The common clinical features were renal failure (100%), hyperurieacidemia (62.7%) and hypertriglyceridemia (51.7%). The average amount of urine protein excretion was 2.8 g/d. The common pathological changes were moderate mesangial proliferation, severe global sclerosis, severe interstitial inflammation and severe interstitial- tubular fibrosis. The small arteries (arcuate arteries and interlobular arteries) and arterioles (afferent arterioles) were both involved in IgAN-MHT. The characteristic lesions of intrarenal arteries included vascular occlusion, media thickening, proliferative endarteritis (onionskin lesion, musculomucoid intimal hyperplasia), hyaline arteriosclerosis, but mainly vascular occlusion (86.2%). The arteriole lesion was negatively correlated with age and total protein level; vascular occlusion was positively correlated with uric acid level. The average foUow-up period was 21.1 months. Forteen patients reached the endpoint. The arteriole lesion was the main independent risk factor for the progression of IgAN-MHT (RR=10.21, 95%CI=1.16～89.67). Conclusions The main clinical feature of IgAN-MHT is renal failure. The main histological feature of intrarenal vascular lesions is occludes arterioles. Arteriole lesion is the main independent risk factor for the progression of IgAN-MHT.

Objective To investigate the anatomic structure of the Chinese people,develop the procedure of minimally invasive total hip arthroplasty through the anterolateral intermuscular approach and investigate its clinical outcome.Methods Three fresh adult cadavers(6 hips)were used for study of the anatomic construction of the anterolateral intermuscular approach in Chinese people.Sixteen patients were treated with minimally invasive total hip arthroplasty through anterolateral intermuscular approach.The clinical results and operation technique were recorded.Results The anterolateral intermuscular approach was a triangle muscular interval slightly parallel to the femur.The medial-superior angle of the triangle muscular interval consists of the anterior border of gluteus medius and tensor fascia lata muscle with juncture of muscles,where the inferior branch of superior gluteal nerve entered into tensor fascia lata muscle.The average incision length was 8.8 cm(7-10 cm),with mean blood loss of 350 ml(250-550 ml).The patients took out-of-bed activity 3-5 days after operations.During operations,anterior border injury in deep portion of the gluteus medius muscle was observed in seven patients and the injured muscles were trimed or repaired.All patients were followed up for 18-39 months(averaged 27.7 months).Most of the patients had excellent location of the phantoms,except that one acetabulum had a little pitch angle and two acetabulums had a little abduction angle.No complication was observed.The mean Harris scores of hip for all patients was increased from preoperative(39.1±6.7)points to(80.6±11.3)points on six month,(88.7±9.6)points on 12 month and(91.4±13.5)points on 24 months(11 patients).No patient suffered from gluteus medius muscle weakness during the follow-up.ConclusionAnterolateral intermuscular approach has the advantages of simple anatomic construction,small incision,little operative injury,muscle sparing and fast recovery without separate muscle or tendon and is suitable for the Chinese patients.Exact incision and special operative instruments should be emphasized to avoid the increase of acetabular pitch angle and abduction angle.