Objective To establish the rat model of experimental subarachnoid hemorrhage (SAH) and to detect the expression of ADAMTS-4 in early brain injury(EBI) after SAH in rats .Methods Totally 72 adult male SD rats were randomly divided into 2 groups ,the control group and SAH group .The expression of ADAMTS-4 and the content of brain Evans Blue(EB) were detected . The ADAMTS-4 inhibitor α2-macroglobulin was used to study the relationship between the expression of ADAMTS-4 and blood-brain barrier permeability .Results The expression of the mRNA and protein of ADAMTS-4 increased dramatically at 24 h and the contents of EB increased progressively at 12 h after SAH .The protein expression of ADAMTS-4 and the content of brain EB was positive correlated(r=0 .917 ,P<0 .05) .The expression of ADAMTS-4 was inhibited by α2-macroglobulin(P<0 .05) and the con-tents of EB decreased dramatically (P<0 .05) .Conclusion ADAMTS-4 may be involved in the pathological progression of early brain injury after SAH .

Most of patients received in hospital with the upper and lower extremity fracture are caused by the earthquake.These fractures have apparent characters,such as:the serious situation,complexity and lots of complications which can be divided two periods:the early and the late.These complications include shock,the nerve and vascular injury,the acute kidney failure,fat embolism,infection,deep venous thrombosis,decubitus ulcer and so on.These complications should be known completely and the therapy should be given early.Practice can not be taken because of pain and some other reasons,and this will lead to the muscle atrophy,adynamia and the joint disfuction.Finally the abilty to work was lost partly or completely.If some measures about rehabilitation were taken early,we can reduce the complication and the disability possibly.

Most of patients received in hospital with the upper and lower extremity fracture are caused by the earthquake.These fractures have apparent characters,such as:the serious situation,complexity and lots of complications which can be divided two periods:the early and the late.These complications include shock,the nerve and vascular injury,the acute kidney failure,fat embolism,infection,deep venous thrombosis,decubitus ulcer and so on.These complications should be known completely and the therapy should be given early.Practice can not be taken because of pain and some other reasons,and this will lead to the muscle atrophy,adynamia and the joint disfuction.Finally the abilty to work was lost partly or completely.If some measures about rehabilitation were taken early,we can reduce the complication and the disability possibly.

Objective To compare the efficacy and complications among three surgical treatments of femoral intertrochanteric fractures in elderly patients.Methods Totally 209 elderly patients with femoral intertrochanteric fracture were divided into 3 groups:DHS group[n =115,patients treated with dynamic hip screws (DHS)],PFNA group [n=57,patients treated with proximal femoral nails anti-rotation (PFNA)] and SEFT group [n=37,patients treated with singlearm external fixator technique (SEFT)].The length of hospitalization,operative time,bleeding volume,hip function scores and complications were compared among the three groups.Results All patients were followed up for 5-12 months (10.6 months in average).The length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months were (14.3±2.7) d,(102.4±22.7) min,(240.8±38.4) ml,(50.2±7.7) d,(88.7±12.8) min in DHS group,(11.2±3.4) d,(50.3±15.6) min,(80.5±18.7) ml,(22.6±4.8) d,(92.6±15.4)min in PFNA group,(15.1±3.3) d,(35.8±10.9) min,(52.6±12.9) ml,(55.4±10.1) d,(87.3 ± 12.6) min in SEFT group,respectively.There were significant differences in the length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months among the three groups (all P ＜ 0.05),while there was no significant difference in healing time among the three groups (all P＞0.05).The incidence of complications was highest in DHS group,higher in SEFT group,and lowest in PFNA group (all P＜0.05).Conclusions DHS is more suitable for patients with good physical condition and stable fractures.SEFT is suitable for patients with poor condition,who can not tolerate trauma,anesthesia and bleeding.PFNA has more advantages including stable fixation,less invasive,less complications and wide indications,which is more suitable for femoral intertrochanteric fractures than the other two treatments.

Objective Watanabe Heritable Hyperlipidaemic (WHHL) rabbits with low density lipoprotein receptor (LDLr) gene mutation have provided unprecedented opportunities for the study of human atherosclerosis, in order to confirm LDL receptor gene status in rabbits, we developed a simple PCR technique to detect LDL mutations in rabbits. Methods Rabbits genomic DNA were extracted from ear biopsy, and amplified by PCR to detect 12 bp deletion mutation in WHHL rabbits. PCR products were directly digested with BglⅠ, and then applied to polyacrylamide gel electrophoresis. Results PCR products from homozygous LDLr +/+ rabbits generated 2 bands of 212 and 94 bp after BglⅠ digestion, LDLr +/- rabbits generated 3 bands (294, 212, and 94 bp), LDLr -/- animals, however, generated only 1 product (294 bp). Conclusion This modified PCR method is simple and reliable.

Object To investigate the effect of PPARαactivation on PPARγ-induced fatty liver in the mouse. Methods Wild type mice ( C57BL/6) aged 4 to 5 weeks were used as animal models.All mice were divided into four groups.The mice in the first group were fed with chow diet.The mice in the second group were fed with a diet containing 0.125%Wy-14,643, an agonist of PPARa, for 8 days.The mice in the third group were injected with Ad/PPARγvia tail vein for 5 day.The mice in the fourth group were firstly fed with Wy-14,643 diet for 3 days and then injected with Ad/PPARγvia tail vein for another 5 day.Mouse livers were collected and photographed.The effect of PPARαactivation on PPARγ-induced fatty liver was observed by H&E and Oil red O staining.Results Compared with the controls, wild-type mice treated with Wy-14,643 for 8 days exhibited marked hypertrophy of hepatocytes with increased cytoplasmic eosinophil-ia and proliferation of peroxisomes.The liver size was significantly increased in the wild-type mice treated with Ad/PPARγfor 5 days, and over-expression of PPARγstrongly induced hepatic steatosis.Importantly, the wild-type mice pretreated with Wy-14,643 for 3 days and then given Ad/PPARγinjection exhibited dramatically the increase of liver size, which might be due to the dual function of PPARa and PPARγ.Compared with the Ad/PPARγgroup, the Wy-14,643 pretreat-ment group showed a reduced hepatic steatosis.Conclusions Activation of PPARαby Wy-14,643 effectively improves PPARγ-stimulated hepatic steatosis, which provides a novel target for prevention and therapy of fatty liver.

Orthopaedic rehabilitation is an important part of rehabilitation resident standardization training, that is complex and unique. Introduction of the discipline, as well as optimizing teaching methods, clinical practice and test are very important for a satisfactory out-come, such as combination of theory and practice, and systematical rehabilitation procedures, principles and operation.

Objective To assess the influencing factors of perioperativc delirium in the elderly with hip fracture and to define strategies for prevention and management. Methods DSM-Ⅳ was adopted to diagnosis of perioperative delirium in the elderly with hip fracture, The data of 148 elderly patients with hip fracture were analyzed retrospectively and classified according to the clinical characteristics. The differences were analyzed statistically between the delirious group and the control group. Results There were 26 (17.6%) cases diagnosed with delirium in the perioperative period, including 22 cases with postoperative delirium, and the delirious symptom lasted 3 days in average. For the type of delirium, there were 15 cases with mania type, 4 cases with inhibitory type and 7 cases with mixed type. Compared with patients in control group, patients with perioperative delirium were older [(79.67±7.7) years old vs. (75.5±7.0)years old, t=2.668, P=0.008)]. Five cases who had previous delirium occurred perioperative delirium, and five patients who received external fixator showed no perioperative delirium. Conclusions Perioperative delirium is a heterogeneous symptom on the basis of brain aging and degeneration. It affects the prognosis of the elderly patients with hip fracture and should be viewed as a separate entity, which can be prevented and treated through comprehensive management.

Phantom limb pain(PLP) is a common sequela of amputation. With the lucubration of the pathophysiological mechanisms underlying PLP, lots of progression for the treatment of PLP has been achieved. Combined modality therapy is very important especially in psychological, behavior and operative therapy.

Objective To screen the parameter of CT scan for distinguishing patellofemoral malalignment. Methods 22 patients (42 knees) with patellofemoral pain and 12 asymptomatic volunteers (24 knees) were studied. The patellofemoral joints were examined with CT scan at 0°, 15°, 30° and 60° flexion. The parameters including femoral trochlear angle, lateral patellofemoral angle, patellar tilt angle, congruent angle and patellofemoral index were compared. Results Congruent angle and patellofemoral index in symptomatic group were bigger than those in asymptomatic group (P<0.01), but others were not different significantly between two groups (P>0.05). Conclusion CT scans is useful in diagnosis of patellofemoral malalignment. Congruent angle and patellofemoral index are more susceptible parameters for it.