BACKGROUND:Extracorporeal cardiac shock wave therapy (CSWT) can up-regulate angiogenic factors and its receptors,promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium,however,the specific mechanisms remain unclearly.OBJECTIVE:To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase (eNOS) in pigs following acute myocardial infarction (AMI).METHODS:Pig AMI model was established by embolizing the distal of left anterior coronary artery.Following model preparation,pigs were randomly divided into 2 groups.In the experimental group received three CSWT at days 1,3 and 5,200 hits per point,totally 12 points,with 0.09 mJ/mm~2 energy.Pigs with simple AMI were served as the control group.The serum eNOS level was detected by ELISA method before,immediate postoperative,and at days,1,3,5,and weeks 1,2,3,and 4 after operation.RESULTS AND CONCLUSION:The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation.At day 1 after CSWT,eNOS level was increased in the experimental group,which was still decreased in the control group.It revealed that CSWT play a positive effect on ischemia rnyocardium.The eNOS level reached a peak in the experimental group after 3 times of CSWT,lasted for 2-3 weeks,and began to decrease at week 4.The difference between the experimental group and control group had significance (P＜0.01).The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.

BACKGROUND: Coronary occlusion and balloon occlusion are two major methods in preparing acute myocardium infarction models. The pigs were expensive and the modeis will periorm further study,therefore,it is necessary to prepave a model with advantage of short time consuming, few trauma, and high survival rate.OBJECTIVE: To establish acute myocardium infarction in miniature pigs induced by coronary occlusion and balloon occlusion,and to compare the differences.DESIGN, TIME AND SETTING: The randomized grouping, contrast observation animal experiment was performed at the heart intervention room of The First Affiliated Hospital of Kun Ming Medical College between May 8~(th) and August 3~(rd), 2009.MATERIALS: A total of 20 Banna miniature pigs, weighing 20-30 kg, irrespective of genders, were purchased from animal department of Kunming Medical College. The animals were equally divided into embolism and occlusion groups.METHODS: In the embolism group, the balloon was implanted into distal end of anterior descending coronary via femoral artery,blocked the forward flow with 202.65 kPa pressure for 1, 2, and 5 minutes, with 60 seconds interval. The same operation was performed in the occlusion group, followed by blocked the forward flow for successive 60 minutes.MAIN OUTCOME MEASURES: Differences of modes established by 2 methods were compared by coronary opacification, ECG,myocardium zymogram, ultrasonic cardiogram and pathology detection.RESULTS: Nine pigs were survived in the embolism group, and the remained 1 pig died of coronary artery rupture. After operation, T wave inversion could be found, without ST stage raise. At day 1 after operation, correlated lead ST stage was raised 0.1-0.2 mV. The operation duration was 11 hours. In the occlusion group, 5 pigs survived, 4 pigs died of ventricular fibrillation,and 1 died without definite cause. The operation cost 24 hours, and the correlated lead ST stage was increased 0.2-0.3 mV postoperatively. Motion abnormality in infarction place was exhibited in both groups; ventricular aneurysm was formed in 3 pigs in the embolism group, and 1 in the occlusion group. Levels of creatine kinase isoenzymes serum troponin T were obviously stepped up and presented dynamic changes. The myocardiolysis was obviously showed in the infarcted areas, but the differences were no obviously in 2 groups.CONCLUSION: Both coronary occlusion and balloon occlusion can induce models of acute myocardium infarction. The coronary occlusion method is superior to balloon occlusion with few trauma, faster postoperative recover and low mortality rates.

OBJECTIVETo study effects of autogenous femoral head bone grafting combined with total hip replacement for the treatment of old center dislocation of hip joint, and to evaluate the superiority of acetabular defect reconstruction with autogenous bone.

METHODSFrom March 2008 to December 2013, 16 patients (16 hips) with old center dislocation of hip joint were treated with autologous bone graft combined with total hip replacement. There were 11 males and 5 females, ranging in age from 41 to 72 years old, with an average of 56.3 years old. The duration of the disease ranged from 3.6 to 37.2 years. Twelve patients had injuries caused by traffic accidents and 4 patients were caused by falling down. The hip joint pain at the first month after operation, Harris score and hip joint movement of all patients were observed by using electronic case follow-up system.

RESULTSAll the patients were followed up, and the duration ranged from 11 to 78 months, with an average of 27.3 months. The postoperative hip joint movement of (56.2±23.4)° VAS 86.3±7.2 and Harris score 32.6±12.6 were all better than preoperative (181.8±17.6)°, 11.1±2.6 and 86.3±7.2. The joint pain was reduced and the function limitation was improved after operation, and the prosthesis position was good.

CONCLUSIONWhen the autologous femoral head bone grafting combined with total hip arthroplasty is used to treat old hip central dislocation, the initial and long-term stability of acetabular bone grafting is good, and the technique can avoid allogeneic bone complications, bone source rationally and reduce the economic burden of patients.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur Head ; transplantation ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Transplantation, Autologous

Objective To explore the relationship between the activity of cholinesterase in hemolyzed blood sample and non-hemolyzed blood sample. Methods The activities of cholinesterase in hemolyzed blood samples and non-hernolyzed blood samples from 112 healthy individuals in Ji'nan were determined by the ferric trichloride chro-mometry, and the activities of cholinesterase in hemolyzed blood samples were adjusted by the concentration of ho-moglobulin (Hb) in blood samples. Results Highly significant correlation was found in the activities of cholinesterase between hemolyzed blood samples and non-hemolyzed blood samples (r = 0.728, F

[Objective]To study the clinical result of Endo-Model rotating-hinge prosthesis in the treatment of severe knee deformity. [Method]Twenty-two patients(10 males and 12 females;12 right knees,8 left knees,and 2 bilateral knees) were selected for total knee arthorplasty using Endo-Model rotating-hinge prosthesis.The average age was 56.2 years.All the patients were evaluated by HSS score system.[Result]All incisions healed at one-stage and all malformations were corrected.The functional result was good.Mile deep vein thrombosis was found in one case after operation.All the patients were followed up for 6-55 months.No infection or prosthetic loosening was developed.[Conclusion]Endo-Model rotating-hinge prosthesis is an effective and reliable prosthesis for severe knee deformity.

Objective To compare the effects of sedation induced with midazolam and propofol on blood pressure(BP), heart rate(HR) and heart rate variability (HRV) during operation on lower extremity preformed under continuous epidural anesthesia in patients with the type Ⅱ diabetes. Methods Forty patients with type Ⅱ diabetes scheduled for lower limb surgery were randomized to receive either midazolam (group M n - 20) for propofol (group P n = 20) for sedation during operation, all patients were classified as ASA physical status Ⅱ or Ⅲ . The patients were unpremeditated. Epidural catheter was inserted at L2-3 or L3-4 . The local anesthetic used was 2% lidocaine. MAP,HR,HRV and SpO2 were monitored during anesthesia and operation. After onset of epidural analgesia a loading dose of midazolam(0.03 mg?kg-1 ) or propofol (0.7 mg?kg-1 ) was given i.v. followed by intermittent i.v. boluses of 1 /4-1 /2 loading dose to maintain the depth of sedation at OAA/S score of 3 (respond to name outer if called repeatedly) . Changes in HRV before and during sedation were recorded and compared between the two groups. Results The demographic data including sex, age and body weight were comparable between the two groups. LF and TP decreased significantly during sedation as compared with baseline in both groups ( P

Objective To investigate the expression of C/EBP homology protein (CHOP) in peripheral brain tissue of patients with severe traumatic brain injury (TBI) and its correlation with the injury severity.Methods The study included peripheral brain tissues of 41 TBI patients (TBI group).Another 16 autopsy specimens succumbed to other diseases (except for TBI or other central nervous system diseases) were selected as controls.The control group and TBI group were subdivided into immaturity group (≤18 years),adult group (18-59 years) and elderly group (＞59 years).According to Glasgow Coma Scale (GCS) on admission,TBI group was classified as severe TBI group (GCS of 6-8) and particularly-severe TBI group (GCS of 3-5).CHOP expression in peripheral tissues after TBI was compared in between different age,gender and GCS.Nerve cell apoptosis was detected by TUNEL technique and correlation between CHOP level and apoptotic number was analyzed.Results There were no age and gender differences regarding CHOP expression in control group (P ＜ 0.05).Compared with control group,expression of CHOP presented notable up-regulation in TBI group (P ＜ 0.05).Expression of CHOP presented no gender difference in TBI group (P ＞ 0.05),but its expression was lower in the aged than in adult or immaturity (P ＜ 0.05) as well as notably higher in particularly-severe TBI group than in severe TBI group (P ＜ 0.05).Nerve cell apoptosis in TBI group was far greater in number than that in control group (P ＜0.05).A positive correlation was observed between CHOP level and apoptotic index (r =0.72,P ＜ 0.05).Conclusion Expression level of CHOP after TBI is closely related to the injury severity and nerve cell apoptosis,but the apoptosis pathway induced by CHOP may not be a major factor in secondary brain injury after TBI in the aged patients.

ObjectiveTo study the ability of response inhibition of depression.Methods30 depressed patients( depression group) and 30 healthy subjects (control group)were recruited in this study.The two groups were age,gender and education matched.All the subjects performed three visual Go/Nogo tasks using E-prime.The three Go/Nogo tasks were Happy Nogo Task(HNT),Normal Task (NT)and Sad Nogo Task (SNT).The two groups were instructed to press a button as quickly and correctly as possible when the Go trials were presented,but not to response when the Nogo trials were presented.In each task,the differences of accuracy (ACC) and response Time (RT) between the two groups were compared.Results ( 1 ) In HNT,during Go trials,ACC of depression group ( 0.85 ± 0.12 ) was higher than that of control group (0.75 ± 0.15 ) (P ＜ 0.05 ) ; during Nogo trials,ACC of depression group ( 0.91 ± 0.63 ) was lower than that of control group ( 0.95 ± 0.05 ) (P ＜ 0.05 ).(2) In NT,During Nogo trials,ACC of depression group(0.95 ± 0.04) was higher than that of control group (0.97 ± 0.03 ) (P ＜0.05 ).(3) There were no significant differences in RT between the two groups in any trails (P ＞ 0.05 ).ConclusionCompared with control group,depressed patients have a much higher recognize incline to the stimulus of sad emotion and a lower ability to complete normal response inhibition task.This is a new way to explain the depression pathogenesis mechanisms.

Objective To study the mechanics of improved memory alloy fixators for salvage of periprosthetic femoral fracture (PFF) after hip arthroplasty in the elderly.Methods Thirty countrymen fresh cadaveric femurs with no pathological defect,fracture,deformity or tumor were randomly divided into experimental group and control group with 15 femurs in each according to the random number table.A model of Vancouver type B1 periprosthetic femoral fracture following hip arthroplasty was induced.The fracture was treated with modified memory alloy embracing fixators in experimental group;instead general memory alloy embracing fixators in control group.All specimens were tested biomechanically.Results Under the same mechanical loading,the two groups showed respective 30％ and 48％ maximum differences in stress value and displacement.Results in three-point bending test did not differ significantly between the two groups (P ＞ 0.05),but there were significant differences in axial compression and torsion test (P ＜ 0.05 or 0.01).Conclusion The improved memory alloy embracing fixators present better resistance to compression and torsion compared to the general fixators.

ObjectiveTo establish a central nervous system axonal mechanical transection model in vitro and observe the axonal regeneration style and speed following the transection. MethodsThe cortical explants the mice were cultured in vitro,of which the axon and dendrite parts were marked using immunofluorescence.The model was built by mechanically transecting the axons and removing the severed axons.The axonal regeneration style was observed by tracing the undeveloped cellular bodies adhering to the residual axonal surface.The growth speed of the regenerated axons and normal axons were measured as well.Results ( 1 ) After mechauically transecting the axons of explants,the axonal regeneration was largely founded at the transected line.The undeveloped cellular bodies went over the transected line and spread to the distal area with axonai regeneration. (2) The axonal growth speed was (118 ± 32) μm/d and (72 ±41) μm/d in the transection group,but was (41 ± 17) μm/d and (32 ± 19) μm/d in the control group at 24 and 48 hours respectively. ConclusionThe regeneration style of the transected axons is the extension of the axonal stumps,rather than sprouting growth,and the growth speed is faster than that of the normal axons.