Objective To evaluate the effect of sufentanil on autophagy during myocardial ischemia-reperfusion (I/R) in rats.Methods Eighteen adult male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n =6 each) using a random number table:sham operation group (group SH),I/R group,and sufentanil group (group S).Myocardial I/R injury was produced by occlusion of the anterior descending branch of the left coronary artery for 30 min followed by 120 min reperfusion in the rats anesthetized with chloral hydrate in I/R and S groups.Sufentanil 3 μg/kg was injected via the caudal vein at 30 min prior to ischemia in group S.The equal volume of normal saline was given in SH and I/R groups.At 120 min of reperfusion,arterial blood samples were collected for determination of serum creatine kinase-MB (CK-MB) and lactic dehydrogenase (LDH) concentrations,and myocardial specimens were obtained for examination of the ultrastructure of myocardial cells (using transmission electron microscopy) and for determination of autophagy-related proteins microtubule-associated protein 1 light chain 3 Ⅱ (LC3Ⅱ),Beclin-1 and Bcl-2 expression (by Western blot).Results Compared with group SH,the serum CK-MB and LDH concentrations were significantly increased,the expression of LC3 Ⅱ and Beclin-1 was significantly up-regulated,and Bcl-2 expression was significantly down-regulated in group I/R,and the serum CK-MB concentration was significantly increased,the expression of Beclin-1 and Bcl-2 was significantly down-regulated in group S (P＜0.05).Compared with group I/R,the serum CK-MB concentrations were significantly decreased,the expression of LC3 Ⅱ and Beclin-1 was significantly down-regulated,Bcl-2 expression was significantly up-regulated (P＜ 0.05),no significant change was found in serum LDH concentrations (P＞0.05),and the pathological changes were reduced in group S.Conclusion The mechanism by which sufentanil reduces myocardial I/R injury may be related to decreased autophagy in rats.

Objective To investigate the effect of remote ischemic preconditioning on myocardial infarction and the involved protective mechanisms. Methods Twenty-four male SD rats were randomly divided into four groups: ischemia-reperfusion (I/R) group, rote ischemic preconditioning (RIPC) group, remote ischemic preconditioning + ischemia-reperfusion (RIPC+I/R) group, and RIPC+AG490+I/R group. The blood samples and myocardial specimens were collected and prepared for tests. The related enzymes were detected and the size of myocardial infarction was measured. The cardiac cells were determined by electron microscopy and light microscopy. Results The size of myocardial infarct and myocardial enzymes were significantly reduced in RIPC+I/R group compared to those in I/R group (P < 0.05). The size of myocardial infarction and myocardial enzymes were significantly increased in AG490 group compared to those in RIPC+I/R group (P < 0.05), but were significantly reduced in AG490 group compared to those in I/R group (P < 0.05). Conclusions Remote ischemic preconditioning may be effective in cardioprotection. The JAK/STAT pathway is involved in the cardioprotection of remote ischemic preconditioning.

Objective To evaluate the effect of remifentanil preconditioning on myocardial ischemia-reperfusion (I/R) injury in aged rats.Methods Twenty-four healthy male Sprague-Dawley rats,aged 15-18 months,weighing 465-580 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),group I/R and remifentanil preconditioning group (group RP).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Myocardial I/R was induced by 30 min occlusion of anterior descending branch of left coronary artery followed by 120 min reperfusion in group I/R.In group RP,remifentanil 10 μg · kg-1 · min-1 was infused intravenously for 20 min followed by 10 min washout before myocardial I/R.In group S,the anterior descending branch was only exposed but not ligated.At 30 min before ligation and 120 min of reperfusion,the activities of serum lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were determined.The hearts were removed at 120 min of reperfusion for determination of myocardial infarct size,the percentage of myocardial infarct size was calculated,and myocardial specimens were obtained for observing myocardial ultrastructure.Results Compared with group S,the activities of serum LDH and CK-MB were significantly increased at 120 min of reperfusion in I/R and RP groups.Compared with group I/R,the activities of serum LDH and CKMB were significantly decreased,the percentage of myocardial infarct size was decreased,and the pathological changes were attenuated in group RP.Conclusion Remifentanil preconditioning can attenuate myocardial I/R injury in aged rats.

ObjectiveTo investigate the value of “streaks” sign in diagnosis of central neurocytoma.MethodsFifty-two cases of central neurocytoma confirmed by pathology from 2008 to 2011 were collected.In 52 cases,both MRI and CT scan were performed on 12 patients,MRI only on 36 patients and CT only on 4 patients.MRI and CT features were analyzed retrospectively.ResultsIn MRI,the “streaks” sign was found in 39 cases,accounting for 81.25％(39/48).In CT,the“streaks” sign was found in 11 patients,accounting for 68.75％(11/16).The “streaks” sign in CTwas also found in MRI.ConclusionsThere is a certain specificity of“streaks” sign in central neurocytoma imaging.In combination with other imaging findings,it can be helpful for an accurate preoperative diagnosis of the disease.

Objective: To explore three dimensional (3D) visualization of membranous labyrinth using a voxel model. Methods: 3D Slicer software was used to deal with MRI images of the temporal bone, volume clipping with the model, three-dimensional display of the membranous labyrinth by both surface rendering and volume rendering. Results With the inner voxel model we explored not only the surface of inner ear,but also the membranous labyrinth inside. The file size of inner ear voxel model file was smaller than surface model file. Conclusion: Inner ear voxel model is invaluable in the study of inner ear anatomy.

Objective To introduce the clinical types of perforator branches of anterosuperior malleolus flap and explore its application.Methods Anterosuperior malleolus flap coupling with dorsal pedal flap was used for repairing the soft tissue defect of hands in 18 patients,in which anterosuperior malleolus flap-dorsal pedal single flap in 12 cases,anterosuperior malleolus flap-dorsal pedal bilobate flap in 4 cases,anterosuperior malleolus flap-dorsal pedal trilobate flap in 2 cases;Anterosuperior malleolus retrograde island (bone) flap was used in recovering pedal soft tissue in 22 patients,the flap pedicled from stem of anterior tibial artery in 16 cases,dorsal pedal flap-anterosuperior malleolus flap in 2 cases,the flap from perforate vessels without injuring the anterior main tibial artery in 2 cases,the bone flap combined with the distal of tibia in 2 cases.Results In the 18 cases of hands,17 cases survived,and 1 case of flap mild necrosis at the distal site took a second-phase skin-grafting to repair.Twenty cases of anterosuperior malleolus retrograde island (bone) flap survived,and the other 2 cases needed secondary skin-grafting to repair the necrosis edge of flaps because of venous limited.After a follow-up from 3 to 6 months,30 cases showed the satisfied postoperative outlook,with the good healing of the donor sites.Typing the 40 cases according to the location of perforator branches of the anterosuperior malleolus flap,20 cases locate in the medial of anterior tibial muscle,16 cases locate between the anterior tibial muscle and extensor hallucis longus,4 cases locate between extensor hallucis longus and extensor digitorum longus.Conclusion Knowing the clinical types of the perforator branches of anterosuperior malleolus flap is not only helpful for the accurate processes of operations、preventing cutaneous branches,but also improving the success rate of surgery.

Objective Investigate the effect of EC50 of propofol target-injection in the different TCM (traditional Chinese medicine) physique types of patients who are in unconscious phase. Methods Depend on the standard protocol of TCM physique types sort and determination, we sorted 60 patients into three groups:Ping He (group A), Yang Xu (group B) and Yin Xu (group C), 20 patients per group. We applied the sequential experiment to measure the minimal EC50 and NI values of propofol when the patients were in the unconscious phase. Results The EC50 of propofol of group A, B and C are 3.85 μg/mL, 4.12 μg/mL and 3.43 μg/mL respectively. 95% confidence intervals of group A, B and C are 3.64 ~ 4.07 μg/mL, 3.92 ~ 4.33μg/mL and 3.26 ~ 3.60 μg/mL respectively. Conclusion There is a correlation between the different TCM physique types and the dosage of propofol target-injection.

Objective To explore the effect of complement activation on bone marrow mesenchymal stem cells (BMSCs)and evaluate the effect after transfection of complement regulatory proteins.Methods Bone marrow aspirate was harvested from 10 cases of patients suffered from fractures.Mesenchymal stem ceils were isolated,indentified cultured and then experimented in vitro.The complement cytotoxicity on the mesenchymal stem cells in autologous serum was measured by Europium cytotoxicity assay.The samples were divided into BMSCs group,BMSCs+ autologous human serum (AHS) group and BMSCs+ inactivated autologous human serum (iAHS) group.The complement membrane attack complex (MAC) deposited on the membranes was detected by flow cytometry.Finally,the cytotoxicity on BMSCs was measured after transfected with membrane complement regulatory proteins (mCRPs).All samples were divided into BMSCs with mCRPs untransfected group and BMSCs with mCRPs transfected group.Results More than 95％ of cells derived from bone marrow were identified to be mesenchymal stem cells through detection of cell surface markers by flow cytometry.The cytotoxicity of untreated cells was 0.41％± 1.48％.BMSCs harvested from the 10 patients all had cytotoxicity after incubated with autologous serum,and the cytotoxicity was 32.59％±2.73％,while cytotoxicity after incubated with complement inactivated autologous serum was 2.59％±3.08％,which was similar to control group.Complement attack complex (MAC) could be detected on the BMSCs incubated with autologous serum,which implied the complement activation.After transfection of mCRPs,the cytotoxicity of autologous serum on transfected cells was decreased.The cytotoxicity of untransfected cells (41.70％±4.47％) had significant difference compared to the cells transfected with CD55 (21.87％±2.19％),the cells transfected with CD59 (18.67％± 1.42％),and the cells transfected with CD46+CD55+CD59 (28.43％±2.14％).CD55,CD59 and CD46+CD55 +CD59 transfected groups could impair effectively the cytotoxicity from complement.However,the cytotoxicity impairment was less effective in CD46 transfected cells (39.30％±3.96％),which had no significant difference compared to untransfected cells.Conclusion Membrane complement regulatory proteins could effectively protect bone marrow mesenchymal stem cells from attacks by complement.

Objective To investigate the clinical efficiency and safety of femoral head reduction osteotomy for young patients with coxa magna or coxa plana.Methods Between June 2012 and September 2015,the clinical characteristics of 12 patients (13 hips) with coxa magna or coxa plana who underwent femoral head reduction osteotomy were analyzed retrospectively.There were 6 males (7 hips) and 6 females (6 hips) with average age 18.1 years (range,10-25 years).The etiology of the femoral head deformity was multiple epiphyseal dysplasia in 6 hips and Legg-Calvé-Perthes sequela in 7 hips.The head reduction osteotomy was conducted through the surgical hip dislocation approach combined with extended retinacular soft-tissue flap extending technique.All patients underwent simultaneous periacetabular osteotomy and relative lengthening of the femoral neck,of which four also underwent proximal femur derotational osteotomy.All patients received the standardized rehabilitation procedures.The postoperative complications,gaits,the range of motion (ROM) of the hip,Harris hip scores,iHOT scores and VAS were analyzed postoperatively.In addition,the lateral center-edge (LCE) angle,sphericity index and coverage rate of femoral head were assessed as well.Results The average follow-up duration was 28.8 months (range,12-45 months).All patients achieved osteotomy healing of the femoral head and greater trochanter with average healing time 3.7 months (range,3-7 months).Nine of 12 patients had significant gaits improvement.The Harris hip scores (81.08± 12.36 vs.88.38 ± 8.96,t=2.41,P=0.033),iHOT score (51.90± 15.07 vs.67.69±8.70,t=3.63,P=0.003),LCE angle (-1.82°±16.57° vs.36.02°±7.72°,t=10.52,P=0.000),sphericity index of anteroposterior pelvic radiographs (71.08％± 10.32％ vs.81.22％±8.61％,t=7.17,P=0.000) and the coverage index (48.79％±11.85％ vs.87.46％± 10.44％,t=8.56,P=0.000) were all significantly improved when compared to those preoperatively.The VAS score (4.46± 2.37 vs.1.23±0.93,t=4.25,P=0.001) was significantly decreased when compared with that preoperatively.However,for the sphericity index of 65° false profile (78.96％± 10.39％ vs.80.36％±8.42％,t=0.411,P=0.688) and the average hip ROM (264.62°± 32.05° vs.255.00°±40.31°,t=0.89,P=0.391),they did not achieve statistical significant difference.One case of femoral head necrosis site was localized at the lateral-superior part of femoral head,and there was no progression after 3 years follow-up.Moreover,no revision or total hip arthroplasty were observed due to other complications (osteoarthritis,hip pain or non-union).Conclusion The femoral head reduction osteotomy can correct deformity,improve femoral head sphericity,relieve pain and improve gaits and hip function.This procedure leads to satisfied clinical outcomes for patients with coxa magna or coxa plana in early follow-up.

Objective The purpose of this paper was to use a new biphasic poroelastic tibia model to develop a two-dimensional numerical method for simulating impact responses of human tibia in car-pedestrian accidents. Methods The geometry of tibia model was reconstructed from CT scans of the left tibia of a living human volunteer. A poroelastic approach was utilized to establish the governing equations of the model and the finite element method was applied to solve these governing equations. Both cortical and cancellous components of tibia were represented using a poroelastic material model consisting of solid phase (matrix) and fluid phase (marrow). A lateral-medial impact direction was selected in the simulation analysis and the impact responses of the pedestrian tibia during 0-200 ms were analyzed. Results The bending deformation of the tibia predicted by the computer simulation was primarily concentrated on the impact zones. The displacement response of Node 107 in the impact zone indicated a peak displacement of -6 mm at around 75 ms, and the significant time delay between the impact force and the displacement response of the skeleton. The axial stress response at the center of element E77 in the impact zone indicated a peak stress of 140 MPa at around 30 ms,and the significant time delay was observed between the impact force and the axial stress response of the skeleton, too. Conclusion This research developed a two-dimensional numerical method for simulating impact responses of human tibia in car-pedestrian accidents. It was able to approximately simulate the bending deformation, lateral displacement response and axial stress response of pedestrian tibia in the impact zones,and the effects of the fluid phase on the solid phase. More in-depth investigation is helpful to further the biofidelity of tibia dynamics model.