Objective To evaluate the clinical results of reconstruction of the posterior cruciate ligament by implanting the middle one third of patellar tendon graft under arthroscope. Methods Twelve patients with the posterior cruciate ligament injury reconstructed with middle one third of bone-patellar tendon-bone graft through an anterior approach under arthroscope were reviewed. Results The average follow up period was 17.3 months. The Larson score rose from 60.7 points to 93.4 points. The Lysholm score rose from 55.0 points to 91.6 points. All patients had positive posterior drawer test and positive Lachman test preoperatively,while only 2 patients had slight positive posterior drawer test and one had slight positive Lachman test at the latest follow up study. Conclusion Under direct visulization of arthroscope, one can accurately locate the anatomic insertion of the PCL, drill holes and transplant tissue grafts. Without capsulular incision, this technique has the advantages of less trauma and lower incidence of adhesion.

OBJECTIVE:To reduce the risk of single dispensing,and to improve the quality of pharmaceutical care in emergen-cy pharmacy. METHODS:Single dispensing environmental factors,human factors and social factors of emergency pharmacy in our hospital were analyzed;the suggestions and measures were put forward,risk intervention mechanism was established and manage-ment effects were evaluated. RESULTS:Through improving the pharmacy hardware and software,carrying out the relevant sys-tem,enhancing training,improving the process of dispensing and window order,promoting the drug management and carrying out near error management. Compared with before management(Oct.-Dec. 2014),the times of near error and disputes significantly re-duced after management(Feb.-Apr. 2015)(P<0.05),and medication error reduced to zero. CONCLUSIONS:As single dispens-ing,risk management and the improvement of prescription audit ability can improve pharmaceutical care in emergency pharmacy.

PurposeTo study the effect of phospholipid on the ability of HDL3 mediated cholesterol efflux from rat skin fibroblasts. Methods At the present of phosphatidylcholine (PC) or sphingomyelin (SPM), to measure the changes of HDL3-mediated cellular cholesterol efflux, cellulax phospholipid content and balance between free cholesterol and cholesteryl ester.Results① BSA (control) ,HDL3,PC,SPM, PC + HDL3 and SPM + HDL3 group mediated 4.70 %, 31.55 %, 7.35 %, 8.06 %,42.95 % and 46.98 % of cellular cholesterol efflux from the cells respectively. ② After the incubation of the cells with BSA, HDL3, HDL3 +SPM and HDL3 + PC, the cellular phosphorous content in PC(PC-p) and SPM (SPM-p) were 20.02,5.56; 17.56,5.28; 18.62,7.00 and 22.50,5.52 μg/plate respectively. ③ After the incubation of the cell with PC and SPM, ratio of free cholesterol to total cholesterol were 49.65 and 59.57 respectively. The ratio was 48.64 before incubation.ConclusionsO PC and SPM couldn' t mediated directly cellular cholesterol effiux, but they could enhance significantly HDL3 mediated cellular cholesterol efflux, and this ability of SPM was stronger than PC. ① With cellular cholesterol efflux,a part of cellular PC went out of the cells, but the content of cellular SPM didn' t change significantly. ③ SPM could induce cholesterol ester to convert into free cholesterol in the cells.

Objective: To analyze the chemical composition and predict the pharmacological mechanism of Baihe Dihuang Decoction by chromatography-mass spectrometry and network pharmacology. Methods: LC/MS and GC/MS were used to analyze the chemical components of Baihe Dihuang Decoction. The target information of chemical components was collected by TCMSP database. TTD and CTD databases were used to collect diseases associated with targets, and depression was targeted for screening. Cytoscape software was carried out to draw “chemical composition-target-disease” network diagram, KEGG pathway analysis of target was performed by DAVID online analysis and its pharmacodynamic components and mechanism were explored. Results: A total of 52 chemical constituents were obtained by chromatography-mass spectrometry analysis. The 31 targets corresponding to 25 components in Baihe Dihuang Decoction by network pharmacology were associated with depression. Conclusion: Baihe Dihuang Decoction has the effect of “multi-directional pharmacology” and “superimposition” in the treatment of depression, reflecting the characteristics of the complex system of traditional Chinese medicine. It may play a role in the treatment of depression by acting on 31 targets, regulating the signaling pathway and participating in inflammatory reaction, apoptosis, and neurotransmitter regulation.

Objective To study the impact and mechanism of continuous venovenous hemofiltration (CVVH) in different uhrafihration rates on plasma cytokines in porcine endotoxemic shock. Methods Eighteen anesthetized mechanically ventilated pigs weighing 21-34 kg were randomly divided into three groups. In control group (n=6), the pigs received a 15.7 μg/kg endotoxin (E.coli 0111:84) infusion. In CVVH group (n=6) and high volume hemofihration (HVHF) group (n=6), the pigs received CVVH after the endotoxin infusion for 24 hours with an was taken before endotoxin infusion and at 0, 1, 6, 12, 24 h during CVVH. The plasma levels of TNF-α, IL-6, IL-10 and IL-18 were tested by ELISA. Results The survival time in control group was (15.4±5.2) h,CVVH group was (21.4±7.1) h,HVHF group was (22.4±6.7) h. The survival time in CVVH and HVHF group was significantly longer than that of control group (P< 0.05 ). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and cardiac output (CO) showed no significant differences among three groups. Plasma BUN and Ser increased gradually after the establishment of porcine endotoxemic shock model. BUN and Scr of CVVH and HVHF group were lower compared to control group (P<0.05), but there was no significant difference between CVVH and HVHF group (P>0.05). Plasma TNF-α and IL-6 peaked at T1, IL-10 peaked at TO, then they declined gradually. While IL-18 increased at TO and did not change after TO. A significant decrease of plasma IL-10 level was observed at T6, T12 and T24 in CVVH group compared with control group (P<0.05). HVHF group accomplished a greater decrease in plasma TNF-α (T6) and IL-10 (T6, T12, T24) levels compared with control group and CVVH group (P< 0.05). The levels of IL-6 and IL-18 showed no significant differences among three groups. There was a negative correlation between IL-6 and survival time (P<0.05). Conclusions HVHF and CVVH can prolong the survival time of porcine endotoxemic shock. IL-10 can be removed effectively with CVVH and HVHF. HVHF can also remove TNF-α effectively. CVVH and HVHF treatment can both remove BUN and Scr effectively. IL-6 is a powerful independent predictive factor for survival time of porcine endotoxemic shock.

Objective To analyze the expression and regulation of components of intrarenal renin-angiotensin system (RAS) and the correlation between intrarenal angiotensin Ⅱ (Ang Ⅱ) expression and clinicopathological injury index in primary IgA nephropathy patients. Methods Expressions of intrarenal RAS components were assessed by immunohistochemistry staining (IHCS). Correlation among intrarenal RAS components and of intrarenal Ang Ⅱ expression with blood pressure, estimated glomerular filtration rate (eGFR), 24-h urinary protein and Katafuchi score in 36 primary IgA nephropathy patients were examined. Results There were positive correlations between positive IHCS area of intrarenal renin and Ang Ⅱ (r=0.43, P＜0.01), angiotensiongen and Ang Ⅱ (r=0.34, P＜0.05). There was negative correlation between positive IHCS area of intrarenal Ang Ⅱ and eGFR (r=-0.61, P＜0.01). There was positive correlation between positive IHCS area of intrarenal Ang Ⅱ and pathological chronicity index (ρ=0.39, P＜0.05), index of interstitial cell infiltration (ρ =0.52, P ＜0.05). Conclusion Expression of intrarenal Ang Ⅱ is positively correlated with expression of intrarenal renin and angiotensinogen, and plays an important role in kidney fibrosis in primary IgA nephropathy.

Objective To analyze the correlation of urinary angiotensinogen (AGT) with clinical index of kidney injury and intrarenal renin-angiotensin system (RAS) activity in chronic kidney disease (CKD) patients. Methods Urinary or plasma renin activity, AGT, angiotensin Ⅱ (Ang Ⅱ ), aldosterone were measured by RIA or ELISA in 129 CKD patients. Expression of intrarenal renin, AGT, Ang Ⅱ and angiotensinⅡ receptor was examined by immunohistochemistry staining (IHCS) in 73 CKD patients undergoing renal biopsy. Correlation of urinary AGT with other indexes was performed. Results Average urinary AGT in 129 CKD patients was (159.08 ± 125.18) μg/g Cr, Scr was (113.20± 105.05)μmol/L, and urinary AGT was positively correlated with Scr (r=0.51, P<0.01). Average estimated glomerular filtration rate (eGFR) was (58.52±27.15) ml·min-1·(1.73 m2)-1, which was negatively correlated with urinary AGT (r=-0.55, P<0.01). Average urinary protein was (2.03±2.65) g/24 h, which was positively correlated with urinary AGT (r=0.30, P<0.01). Average urinary Ang Ⅱ was (164.71 ±139.25) ng/g Cr, which was positively correlated with urinary AGT (r=0.20, P<0.05). Average urinary type Ⅳ collagen was (447.60± 800.66) μg/g Cr, which was positively correlated with urinary AGT (r=0.47, P<0.01). Average urinary soduim was (162.17±81.61) mmol/24 h, which was negatively correlated with urinary AGT (r=-0.20, P<0.05). Multiple regression analysis indicated that low eGFR (P<0.01), high Scr (P< 0.01), high urinary protein (P<0.05), high urinary Ang Ⅱ (P<0.05) and high urinary type Ⅲ collagen (P<0.01) were significantly correlated with high urinary AGT. In renal tissues of CKD patients, there was positive correlation of urinary AGT with positive IHCS area of AGT (r=0.45, P< 0.01), Ang Ⅱ (r=0.52, P<0.01) and angiotensin Ⅱ type 1 receptor (r =0.28, P <0.05). Conclusions Urinary AGT level may indicate the kidney injury severity, especially in chronic kidney injury, and may be used as a non-invasive marker of intrarenal Ang Ⅱ activity in CKD patients.

Objective To study the relationship between spinal shifting and C5 palsy after posterior approach cervical decompression surgery (PACDS).Methods Twenty-four patients underwent PACDS were examined with MRI before and one month after operation.The spinal shifting were measured.Clinical and imaging characteristics of patients with post-operative C5 palsy were observed.Analyzed the correlation between C5 palsy and spinal shifting after operation.Results The average spinal shifting was (2.41 ± 0.46) mm.Three cases developed C5 palsy,whose spinal shifting at C5 level was significantly greatert han those without C5 palsy.Conclusion Excessive posterior spinal shifting after PACDS can drag C5 nerve root leading to C5 palsy.

The understanding of anatomical structures and their adjacent relationship is the founda-tion and key to the development of surgical skills and clinical thinking. In clinical teaching for residents and graduate students , we took the advantage of donor operations in organ transplantation and showed abdominal anal operations anatomical features and relationships through different view angles and compre-hensive ways. This new teaching approach was designed in accordance with processes of organ donation, procurement and back-table operation. The main contents included anatomy of abdominal wall layers, rela-tionships among abdominal organs, locations and courses of important structure, as well as medical human-istic education. In the context of organ donation becoming more and more popular and standardized after the cardiac death of Chinese citizens, this teaching approach is worth exploring.

BACKGROUND:There were certain differences in the anatomical structure of knee joint between man and woman. Gender knee solution is a new type of artificial knee joint prosthesis, which is specialy designed for women. Theoreticaly, the outcome of unisex total knee arthroplasty prosthesis should be related to gender, but we did not find very obvious differences in practical clinical work.
OBJECTIVE:To analyze the differences in curative effects of the unisex knee arthroplasty prosthesis between male and female patients undergoing total knee arthroplasty so as to find out if it is necessary to apply female knee prosthesis among appropriate crowd.
METHODS: We retrospectively analyzed the clinical data of patients undergoing total knee arthroplasty from May 2001 to June 2011. Among 312 patients (350 knees receiving total knee arthroplasty), patients who died within 3 years after surgery, lost to folow-up and underwent revision were excluded. Changes in knee functions and imaging were observed between males and females.
RESULTS AND CONCLUSION:The women and men had similar mean pre-operative knee scores, flexion function, pain score among 285 patients (300 knees). However, the women had significantly lower mean extension function and function scores than the men. There were no significant differences in improvement in the knee scores, flexion, the pain and knee function between women and men before and after surgery. Nevertheless, men had better extension than women. No significant difference in radiolucencies and complications was seen between females and males. Therefore, there was little difference in outcomes between women and men who used the unisex total knee arthroplasty prosthesis.