This study was aimed to observe the influence of Catalpol on real-time gait analysis of early recovery after permanent middle cerebral artery occlusion (pMCAO) in rats to evaluate its effect on the improvement after cerebral ischemia. Rats were randomly divided into 6 groups, which were the normal control group, model group, Tianbaoning group, Catalpol 15, 30, 60 mg·kg-1 group. Rats were trained on the gait instrument for 7 days before pMCAO, 3 times/day. After the training, pMCAO model was made. And continuous infusion was performed from the 3rd to the 14th day after the operation. Then, the real-time gait behavior was detected on the 14th day. The re-sults showed that 14 days after the surgery, compared with the normal control group, the models had a significant extending in the duty cycle (P < 0.01), and obvious increasing of the average body angle of absolute value (P <0.05), the shortening of the two feet supporting time (P < 0.05), and extending of three feet supporting time (P <0.01), and increasing of the coordination index (P < 0.01). Compared with the model group, the Catalpol of 30 mg·kg-1 and 60 mg·kg-1 group has obviously decreased duty cycle and average body angle of absolute value (P <0.05, or P < 0.01). The Catalpol of 30 mg·kg-1 can obviously reduce the coordination index of the right front foot relative to the other three feet (P < 0.05), which improved the coordination of cerebral ischemia animals. It was concluded that Catalpol can improve the real-time gait behavior changes of cerebral ischemia model rats. There-fore, Catalpol have a neural protective effect on cerebral ischemia.

Objective To determine the clinical value of real time interventional ultrasound guidance in family planning reproduction operation.Methods Under the guidance of ultrasound monitoring,522 cases with high risk and difficult uterine operation were undertaken in our department.Results The abdominal endoscopic contraceptive uterine operation under real time ultrasound monitoring was carried out for 522 cases in 4 years,with successful rates for high risk pregnancy as 287/289 cases,high risk troublesome withdrawal of contraceptive ring as 129/130 cases and puzzling uterine operation as 103/103 cases.The total successful rate reached 99.42%,without uterine rupture and other complications.Conclusion The former complex,blind and difficult uterine operations turn to be simple,safe and reliable under the guidance of real time ultrasound.

OBJECTIVETo investigate the clinical characteristics of Segond fracture combined with injuries, and to explore the operative method and opportunity.

METHODSFrom June 2010 to December 2014, 10 patients with Segond fracture were treated. There were 10 males, ranging in age from 26 to 69 years old, with a mean of 42 years old. Under arthroscopy examination within 7 to 10 days after injury, 6 patients had compete rupture of anterior cruciate ligament and meniscus injury; 2 patients had tibial avulsion fractures of the ACL combined with meniscus injury. At 4 to 8 weeks after injury, 2 patients were performed with arthroscopy examination; 1 patient had complete rupture of anterior and posterior cruciate ligament combined with meniscus injury; and the other patient had complete rupture of anterior cruciate ligament alone. All the patients with cruciate ligament rupture were treated with reconstruction of cruciate ligament; 9 patients had meniscus injuries were treated with menisus plasty or suture; and 2 patients had tibial avulsion fractures of the ACL were treated with non-absorbable Ethicon suture fixation under arthroscopy. After operation, the Lysholm scoring system was used to evaluate clinical effects.

RESULTSEight patients were operated within 10 days after injury, the knee joints swelling was obvious at the 3rd day after operation, and blood oozing was found by joint puncture. These 8 patients did out-of-bed activity with assistance at 1 week postoperatively. Other 2 patients performed operation in 4 to 8 weeks after injury without knee joint obvious swelling at the 3rd day after operation, and no blood oozing was found by joint puncture. These 2 patients did out-of-bed activity with assistance after 3 days postoperatively. All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 18 months. Postoperative Lysholm score of all patients was higher than preoperative scor, and the results were satisfactory.

CONCLUSIONFor Segond fractures, firstly, it is important to gain early diagnosis for treatment. Secondly, it is often associated with the rupture of anterior cruciate ligament and meniscus injuries, and the best time of cruciate ligament rebuilding and meniscus repairing maybe between 4 to 8 weeks after injury. Thirdly, personalized treatment should be chosen according to different complications.

Adult ; Aged ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Humans ; Male ; Middle Aged ; Tibial Fractures ; complications ; diagnosis ; surgery ; Tibial Meniscus Injuries

Objective To evaluate the effect of dexmedetomidine on the expression of c-fos protein in the dorsal root ganglion neurons in a rat model of neuropathic pain (NP).Methods Seventy-two adult male SpragueDawley rats,weighing 180-240 g,were randomly divided into 3 groups (n =24 each) using a random number table:sham operation group (group S),group NP,and dexmedetomidine group (group Dex).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex,dexmedetomidine 50μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before ligation (T0,baseline) and 3,7 and 14 days after ligation (T1-3).Eight animals were sacrificed after measurement of pain threshold at T13 and the dorsal root ganglions of the lumbar segments (L44) were removed for detection of c-fos expression (by immuno-histochemistry).Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of c-fos protein was up-regulated at T1-3 in NP and Dex groups.Compared with NP group,MWT was significantly increased,TWL was prolonged,and the expression of c-fos protein was down-regulated at T1-3 in Dex group.Conclusion Dexmedetomidine can inhibit upregulation of c-fos protein expression,thus attenuating NP in rats.

Objective To explore the relationship between the gait behavior changes and cognitive function in APP/PS1 transgenic mice .Methods 16 APP/PS1 transgenic mice were divided into model group and Huperzine A group, C57/BL6J mice with the same age were chosed as control group .After a 150 days consecutive treatment , Morris water maze(MWM) was used to detect the learning and memory ability and Gait analysis system (GAS-2) was used to detect the gait behavior after the treatment when the mice were 8-month-old.Results The escape latency of the model group was significantly higher than that of the control group ( P <0.05 ) , the time spended in the target quadrant , swimming distance in the target quadrant significantly lower than that of the control group ( P <0.05 ) , the first time passing through the platform prolonged significantly than the control group (P <0.05), and the number of passing though the platform reduced significantly than the control group (P <0.05).In the gait behavior experiments , compared with the control group, the average walking speed of the model group reduced significantly (P <0.05), the average walking cycle, the absolute average body angle and lateral movement increased significantly (P <0.05);The percentage of support time in a walking cycle of the left and right foot increased significantly (P <0.05).Accordingly, the percentage of swing time in a walking cycle of the left and right foot reduced significantly (P <0.05).The propulsion index of the left hand , right hand, right foot increased significantly ( P <0.05), and then the braking index of the above three feet decreased significantly ( P <0.05) .Huperzine A can improve the cognitive function , rectify the changes in the gait behavior .The two behavioral relevance shows that cognitive function and the front two feet braking , propulsion index have a high correlation index (correlation coefficients were -0.433, -0.379, P values were 0.039,0.079), the others were not. Conclusion APP/PS1 transgenic mice of 8-months-old have a remarkable impairment of learning and memory ability and disorder of gait behavior , and these two behaviors have a correlation in some extent .

Objective Off-pump coronary artery bypass grafting (OPCAB) is used more widely in recent years in China. However, there is an argument on benefits and risks of off-pump surgery. Many studies shown that OPCAB had more benefits in short-term outcomes than conventional coronary artery bypass grafting(CCABG). But evidences from other studies suggested that OPCAB resulted in less long-term graft patency as compared with on-pump surgery. This study examined the longterm graft patency of OPCAB and CCABG performed by one surgeon. Methods 50 patients who had received surgical revascularization by a surgeon for more than 5 years were reviewed, 25 patients received conventional coronary artery bypass grafting ( group 1 ) and 25 patients received OPCAB ( group 2). All patients had angiograms for compareing the graft patency between the two groups. Results Among 25 patients in group 1,21 were male and 4 were female. The mean age of patients at surgery was (55.4 ±8.9) years. 15 cases had unstable angina, 16 patients had old myocardial infarction and 6 cases had diabetes.The ejection fraction (EF) was 0.58 ±0.14. The mean number of bypasses per patient was 3.32 ±0.63. Mean duration of operation was (3.58 ± 0. 82) hours. Mean follow-up duration was ( 86.52 ± 12.48) months. 83 grafts were evaluated for patency ( open vs. closed) and were graded by Fitzgibbon as grade A ( excellent graft), B ( impaired graft, with a stenosis of ≥50%, or a diameter less than 50% of the grafted artery), or O ( completely occluded). The graft patency was 73.49%, 61grafts were graded as Fitzgibbon A, 6 grafts as Fitzgibbon B and 16 grafts as Fitzgibbon 0. 25 patients were in group 2, 21males and 4 females. The mean age of patients at procedure was (58.2 ± 9.09) years, 11 patients had unstable angina, 13 patients had old myocardial infarction and 6 cases had diabetes. The ejection fraction (EF) was 0.59 ± 0. 14. Conclusion No 2011.03.013 difference in long-term graft patency was identified between on-pump and off-pump coronary artery bypass grafting. Off-pump oronary artery bypass grafting preformed by an experienced surgeon may gain similar long-term graft patency to that of conventional bypass.

Objective Global brain atrophy was reported as an important structural change in Alzheimer's disease (AD), while it has been detected in the older person with normal cognitive function. Therefore, this study was aimed at investigating the difference of the neural metabolites in the left hippocampus (HIP) and left frontal cortex (FC) among patients who showed global brain atrophy but with different cognitive function. Methods The 33 patients with global brain atrophy confirmed by MRI scan, underwent a comprehensively clinical and neuropsychological assessment including mini-mental state examination (MMSE), activities of daily living scale (ADL) and clock drawing test(CDT). According to the diagnostic and statistical manual of mental disorders, fourth edition(DSM-Ⅳ) and Mayo clinic rochester(MCR), 14 patients were diagnosed as AD, 9 patients as amnestic mild cognitive impairment(aMCI), and 10 patients as normal cognition. Every person was taken a cerebral proton magnetic resonance spectroscopy(1H-MRS) scan to measure the levels of n-acetylaspartate(NAA), choline(Cho), myo-inositol(MI) and Creatine(Cr) in the left HIP and the left FC. Results While compared with the group with normal cognition, the ratio of NAA/Cr in the AD group reduced 10.2% in the left HIP and 5.3% in the left FC, and the ratio of Cho/Cr increased 17.5% in the left HIP and 16.7% in the left FC, and the ratio of MI/Cr increased 39.5% in the left HIP and 19.2% in the left FC. The ratio of NAA/Cr of the left HIP in the AD group was lower than that in the aMCI group at the decrease rate of 6.4%, while the ratio of NAA/Cr of the left FC was not significantly different between the two groups. The AD group had higher ratios of Cho/Cr at the increase rate of 9.3% in the HIP and 12.3% in the FC, and higher MI/Cr ratios at the increase rate of 30% in the HIP and 17% in the FC than in the aMCI group. The aMCI group showed significantly lower ratio of NAA/Cr at the decrease rate of 4.1% and higher ratio of Cho/Cr at the increase rate of 7.5% in the left HIP than in the normal cognition group. Conclusions Among patients with global brain atrophy, the decrement of ratio of NAA/Cr in the left HIP and the increment of the ratio of Cho/Cr and MI/Cr are predictive of the progress from aMCI to AD. Moreover, the decrement of ratio of NAA/Cr in the left HIP and the increment of the ratio of Cho/Cr are helpful to distinguish the aMCI and the persons with normal cognition.

Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.

Background Cataract phacoemulsification combined with intraocular lens (IOL) implantation is a primary treatment for cataract.However,tear film stability and ocular surface structure are affected after surgery,especially some cataract patients with diabetes.Researches determined that tear film dysfunction is an important causative factor of dry eye.Objective This study was to investigate the change of tear film after phacoemulsification in cataract patient with diabetes.Methods A non-randomized cases-controlled study was designed.Thirty-six cataract patients with diabetes (54 eyes)and matched 32 patients (40 eyes)with age-related cataract were included in this study in Tianjin First Center Hospital from October,2010 to May,2011.Phacoemulsification and IOL implantation was performed on the all patients with the same topical eyedrops in both groups.Dry eye-related symptom was surveyed and scored by questionnaire,and tear film break-up time (BUT),Schirmer Ⅰ test(S Ⅰ t)and corneal fluorescein(FL) were examined 3 days before operation and 1 day,1 week,1month,3 months after operation.Written informed consent was obtained from each patient before entering this trial.Results The percentage with preoperative symptoms of dry eye was 36.2％ and postoperative dry eye symptoms accounted for 75.8％.Significant differences were seen in dry eye symptom score,FL score,BUT value and S Ⅰ t value between the diabetic cataract group and only cataract group as well as among 4 time points(dry eye symptom score:Fgroup =139.347,P =0.000 ; Ftime =342.741,P =0.000 ; FL score: Fgroup =14.073,P =0.000 ; Ftime =332.697,P =0.000 ; BUT value: Fgroup =28.198,P =0.000 ; Ftime =868.364,P =0.000 ; S Ⅰ t value: Fgroup =2.848,P =0.095 ; Ftime =564.017,P=0.000).FL scores of 2 groups were significantly higher in postoperation than those in preoperation (P＜0.05),and those of diabetic cataract group were significantly higher than only cataract group(P＜0.05),but no significant difference was found between postoperation 3 months and preoperation (P＞0.05).BUT was shorter in postoperation than that in preoperation in the diabetic cataract group(P＜0.05).S Ⅰ t values in postoperative 1 day and 1 week were significantly lower than in preoperation in both groups(P＜0.05).However,S Ⅰ t values returned to normal from 1 month through 3 months in both groups(P＞0.05).Conclusions Tear film dysfunction occurs after operationin cataract patient with type 2 diabetes.It is thought that cataract patient with diabetes is susceptible population of dry eye.Dry eye appears more early and severer in diabetes patients after phacoemulsification combined with IOL implantation.

OBJECTIVE: The study is to evaluate our results of patients with sinonasal inverted papilloma (SIP) undergoing endoscopic sinus surgery and to investigate the recurrence relative factors of SIP. METHOD: A retrospec- tive analysis was performed of medical records for 54 cases SIP treated with endoscopic resection. Compared to pre operation imaging evaluation and intraoperative observation, efficacy assessments included endoscopy during follow-up after operation and combined with CT examination results. RESULT: The incidence of 54 cases with ethmoid sinus, part of the lateral wall of the nasal cavity was higher. The recurrence rate was higher in the cases invaded front and/or inferior wall of maxillary sinus, frontal recess. There was no case with middle turbinate. Canceration with the same time accounted for 1.85%. CONCLUSION Misdiagnosis as polyps, the lesion sites of tumour, involving the frontal recess, front and inferior wall of maxillary sinus are the risk factors of recurrence. The preoperative accurate judgment of the primary tumor site and surgical resection completly are the most effective means of preventing recurrence. Postoperative endoscopy examination combined with CT examination is an effective means for the evaluation of recurrence.
Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; surgery ; Papillomavirus Infections ; Paranasal Sinus Neoplasms ; surgery ; Turbinates