Objective To analyse the causes of non-union and delayed union in distal femur and assess the clinical outcomes of retrograde intramedullary interlocking nail(RIIN). Methods Between June 1995 and December 1998, 15 cases of non-union and delayed union of distal femur were treated with RIIN. There were 9 males and 6 females, the average age of the patients was 34.5 years(range 23 to 46 years). At surgery, the failed implants were removed in all 15 cases, bone graft was performed in 10 cases, closed reaming was done in 5 cases. 11 patients also received knee adhesion release operation. The X-ray examination and KSS knee functional score were used to evaluate the results. Results The average duration of follow-up was 14.5 months. All patients achieved solid bone union at an average of 6.4 months. There were no malunion, infection and refracture in this series. According to the KSS rating system, the average range of motion(ROM) was 93.5 degrees, increased by 28 degrees(42.7％ ) compared with the preoperation ROM. The average knee score was 96 points. The excellent result was obtained in 13 cases, good in 2 cases. The average knee function score was 90.5 points. Conclusion The main reasons for non-union and delayed union were improper selection of the indications and use of implants. Retrograde intramedullary interlocking nail is one of the effective alteratives for treatment of distal femur non-union and delayed union. It can provide a stable and reliable fixation which is of benefit for early functional exercise. Bone grafting, closed reaming technique and knee joint adhesion release should be considered in order to enhance the bone healing and the improvement of knee ROM and function.

Objective: To study the bioactivity of human cementum extract . Methods: Cementum was harvested from freshly extracted heatlhy teeth and cementum extract was prepared by guanidine. Human gingival fibroblast and MC3T3 E1 osteoblast were cultured. The cells were incubated in DMEM with cementum extract concentration 0, 2.5, 5, 10 or 20 ?g/ml for an hour respectively, the cell attachment rate was measured by cell counting. The attachment rate of the cells in different incubation time(30 min,60 min, 90 min, 120 min) in DMEM containing 10 ?g/ml cementum extract was also assayed.Results: The extract increased the cell attachment rate in a concentration and time dependent effect. The extract at the concentration of 10 ?g/ml and with exposuse time of 90 min gave the most effective increase of cell attachment. Conclusion: Human cementum extract prepared by guanidine contains some bioactive proteins that promote the attachment of gingival fibroblasts and osteoblasts.

Objective To study the internalization mediated by heat shock protein 70 (HSP70) receptors expressed on the surface of dendritic cells (DCs). Methods DCs from C57BL/6 mouse bone marrow were divided into HSP70 receptor-blocking group, non-receptor-blocking group and control group. The HSP70-FITC positive cells were detected by flow cytometry (FCM). Results FCM indicated that in HSP70 receptor-blocking group, the HSP70 receptors could be almost totally blocked by 50?g HSP70. With the increase of HSP70-FITC dosage, the number of HSP70-FITC positive cells increased. In non-receptor-blocking group, the rates of the HSP70-FITC positive cells were up to 90% either when 50?g HSP70-FITC or 100?g HSP70-FITC was used with no remarkable difference between them. Conclusions The internalization mediated by HSP70 receptors plays a major role in the stage of ingestion of HSP70 with the characteristics of saturation and priority. Once the receptors are blocked, non-receptor pathway participates in internalization in a dose-dependent manner.

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

Objective:To observe the effects of real-time and retrospective analyze of cardiac remote monitoring based on differential threshold method.Methods: Xin An Bao XAB - M3AG ECG remote monitoring system which based on the differential threshold method of improvement being used to determine the parameters of electro cardio signal was installed in 8957 patients.Results: We had collected all 46967 ECG real-time data, including 9564 manual transmission, 25830 timing transmitting and 11573 automatically transmission. 5728 of automatically transmission was with arrhythmia (49.5%) and the others of automatically transmission was attribute to inference.Conclusion: The results showed that algorithm complexity based on the improved differential threshold method is low, the precision is high and it has a good real-time performance. It realized the real-time monitoring of ECG.

Objective To summarize the experience of establishing a split liver transplantation pig model using extracorporeal normothermic machine perfusion (NMP).Methods Twenty miniature pigs were purchased with ten as donors and another ten as receptors.The graft was spliced along Taira line and the right half was reserved for transplantation.Hemodynamics and bile production volume were monitored,and blood biochemical and blood gas analysis indicators were detected during machine perfusion.Pathological change was observed by HE stain.Hemodynamics during liver transplantation,5-day survival rate and the cause of death were recorded.Results Hemodynamic,biochemical and blood gas analysis indicators remained stable during NMP.All receptor pigs were successfully extubated and awake after surgery.Two receptors died on the second day after the operation.The 5-day survival rate was 80％.Conclusion The split liver transplantation pig model using extracorporeal normothermic machine perfusion is feasible and appropriate,and it lays the foundation for further investigation.

OBJECTIVE: To determine the protective effects of nourishing spleen yin recipe (Zibu Piyin Recipe, ZBPYR), a compound traditional Chinese herbal medicine, on endoplasmic reticulum (ER) in neuronal cells responding to the stress by using sero-pharmacological method. METHODS: The mouse neuroblastoma cell line Neuro2a cells were treated with tunicamycin (Tm, an inhibitor of N-glycosylation). The ZBPYR-treated cell group was established by incubating cells with ZBPYR serum for one hour and treated with Tm. Reverse transcriptase PCR (RT-PCR) was utilized to detect the mRNA expressions from two genes after treatments, ER molecular chaperone glucose regulated protein 78 (GRP78) and transcriptional factor CCAAT/ enhancer-binding protein-homologous protein (CHOP). Lactate dehydrogenase (LDH) assay was also carried out to determine the LDH leakage from Neuro2a cells after treated with Tm and staurosporine (STS). RESULTS: The ZBPYR-treated cell group at all tested ZBPYR dosages showed significantly reduced expressions of both genes compared with Tm (5 microg/ml) treated control group (P<0.05). Therefore, ZBPYR serum inhibited the expressions of GRP78 and CHOP in mRNA level under ER stress induced by Tm. Different concentrations of ZBPYR serum pretreatment reduced the LDH leakage compared with the Tm and STS groups (P<0.05). Therefore, ZBPYR serum may inhibit the LDH leakage induced by Tm and STS. CONCLUSION: ZBPYR has neuroprotective effects. The mechanisms may be associated with inhibition of ER stress and mitochondrial dysfunction.

Objective To observe and compare the efficacy and safety between propofol-remifentanil and propofol-fentanyl for anesthesia of artificial abortion.Methods 200 ASA I patients scheduled for painless artificial abortion were randomly divided into two groups.R group were given intravenous remifentanil 1.0μg/kg then propofol 1～1.5mg/kg(n=100);F group were given intravenous fentanyl 0.05mg then propofol 1～1.5mg/kg(n=100).Total propofol dosage,analgesic effect during intro-and post-operative,consciousness loss time,wake-up time and independenly leaving time were recorded.BP,HR,SpO2 and side effects such as nausea and vomiting were observed during intro-and post-operative.Results The dosage of propofol was less in group R than that in group F[(80.4±10.8)mg vs(110.1±13.6)mg,P＜0.01)];consciousness loss time,wake-up time and independenly leave hospital time were shorter in group R than that in group F(P＜0.05);SpO2 down range and rate were significandy higher in group R(P＜0.05);Incidence of nausea and somnolence in group R was obviously lesS than that in group F.Conclusion Artifical abortion can be preformed effectively and safely with propofol-remifentanil or propofol-fentanyl,but propofol-remifentanil especially fits for painless artificial abortion compared with propofol-fantanyl.

Objective To study the relationship between nitric oxide within cervical microenvironment and different HPV types as well as the effect of sodium nitroprusside( SNP), a nitric oxide donor, on the proliferation and apoptosis of cervical cancer cell lines. Methods HPV typing test was assessed from 115 women by using high-risk HPV (HR-HPV) 21 typing test and the release of cervical nitric oxide(NO) was assessed as nitrate, nitrite in cervical fluid. Cervical NO was then compared between women showing different HPV types. Proliferation of Caski and HeLa cervical cells was determined by methyl thiazolyl tetrazolium (MTT) assay, cell apoptosis was detected by flow cytometry after 24 hours treated by different final concentration of SNP (0. 125,0. 25,0. 5,1.0 and 2. 0 mmol/L, respectively). The expressions of HPV E6,E7 gene mRNA and p53 protein were detected by SYBR Green Ⅰ quantitative real-time PCR and western blot. Results ( 1 ) The cervical NO release of women with HR-HPV was higher compared to that in HPV negative women [ (47. 6 ± 1.4) μmol/L vs ( 22. 8 ± 0. 3 ) μmol/L; P ＜ 0. 05 ]; but there was no statistical difference between low-risk HPV (LR-HPV) group [ (24. 1 ± 1.2 ) μmol/L] and control group (P ＞0. 05 ). (2)After 24 hours treated by different final concentration of SNP, the results shown that SNP could inhibited the proliferation and increased apoptosis rate in Caski and HeLa cells, in which the concentration of SNP ≥ 1.0 mmol/L , there were significantly different ( P ＜ 0. 05 ), while when SNP ≥2. 0mmol/L, the proliferation of cells inhibited seriously. Treated by SNP ( 1.0 mmol/L ) 24 hours, the expressions of HPV18 E6, E7 mRNA in HeLa cells were reduced from 27. 362 ±0. 191,22. 962 ±0. 053 to19. 181 ±0. 360, 17. 571 ±0. 010 and the protein expression of p53 increased from 1. 17 ±0. 03 to 0. 23 ±0. 05, there were statistically significant differences between adding SNP group and the control group ( P ＜0. 05); but there were no statistically significant differences in HPV16 E6, E7 mRNA and that of p53 in Caski cells( P ＞ 0. 05 ). Conclusions The presence of HR-HPV is associated with an increased release of NO in the human uterine cervix; NO could inhibit the growth and proliferation and enhance the apoptosis of cervical cancer cells, inhibit the expression of HPV18 E6, E7 mRNA in HeLa cells and activate the expression of p53 protein, the mechanism may be due to higher sensitivity of HeLa cells (cervical adenocarcinoma cell) to SNP. The increasing release of NO may play a role in regulating the elimination of HPV in cervical microenvironment, which is a part of mucous membrane immunity.

Objective To investigate the effect of ropivacaine combined with dexanmethasone sprayed intratracheally in patients with resistant tubes and postoperative sore throat.Methods Eighty patients ASA Ⅰ-Ⅱ grade undergoing laparoscopic cholecystectomy were randomly divided into four groups by random digits tabel method,20 patients in each.2 ml of 0.75％ ropivacaine combined with 1 ml dexamethasone (group A) ; 2 ml of 0.75％ ropivacaine combined with 1 ml 0.9％ sodium (group B) ; 3 ml of 1％ tetracaine (group C); 3 ml of 0.9％ sodium (group D) were immediately intratracheal sprayed before intubation.The resistant tubes and degree of postoperative 24 h sore throat [by visual analog scale (VAS) scores],comfort [by Bruggrmann comfort scale (BCS) scores] and the incidence of sore throat were recorded.Results The resistant tubes appraised rate in group A,B and C was higher than that in group D [65.0％ (13/20),60.0％ (12/20),70.0％ (14/20) vs.5.0％ (1/20)] (P ＜ 0.05),but there was no significant difference among group A,B and C (P＞ 0.05).The incidence of sore throat at 24 h after surgery in group A,B and C was lower than that in group D [20.0％(4/20),25.0％ (5/20),25.0％ (5/20) vs.90.0％ (18/20)] (P ＜ 0.05),but there was no significant difference among group A,B and C (P＞ 0.05).The VAS and BCS scores in group A were better than those in group B,C and D [(0.52 ± 1.14) scores vs.(1.68 ± 1.42),(1.59 ± 1.33),(4.22 ± 1.95) scores,(2.80 ± 1.54) scores vs.(1.60 ± 1.19),(1.80 ± 1.20) and (0.45 ± 0.81) scores] (P ＜ 0.05),but there were no significant differences between group B and group C (P ＞ 0.05).Conclusion Ropivacaine combined with dexamethasone sprayedintratracheally can significantly increase the degree of postoperative resistant tubes,decrease the rate of sore throat after general anesthesia,and increase patient' s comfort.