Objective To explore the therapeutic effect of total hip replacement (T HR) in treating osteonecrosis of the femoral head (ONFH) after failed internal fixation of femoral neck fracture .Methods From January 2003 to June 2012 ,32 cases (19 left hips and 13 right hips) of ONFH after failed internal fixation of femoral neck fracture were treated with THR .There were 18 males and 14 females with an age range from 35 to 62 years (mean ,50 .6 years) .The ONFH was diagnosed at 8-26 months (mean ,17 .1 months) after internal fixation ;the THR were conducted 15-48 months after first surgery (mean ,27 .2 months) .According to Fi‐cat classifi cation ,there were 8 cases at stage Ⅲ and 24 cases at stage IV .The Harris score was (40 .9 ± 9 .8) .The prosthesis of bi‐ology was used .Results All wounds healed by first intention .All cases were followed up for 6-48 months (mean ,28 .3 months) . The Harris score was (90 .8 ± 4 .4) at last follow‐up ,showing significant difference when compared with the preoperative value (P<0 .05) .The hip function were excellent in 25 hips ,good in 5 hips ,fair in 2 hip ,and the excellent and good rate was 93 .8% . There were 1 cases of periprosthetic femoral fracture(type C) ,2 cases of proximal femoral splitting fractures fractures .After corre‐sponding treatment ,fracture was healed in all cases .There were no complications (infection ,loosening dislocation or subsidence , etc) .Conclusion Total hip replacement is an effective method for the treatment of ONFH after failed internal fixation of femoral neck fracture .

BACKGROUND:Mkx (Mohawk, transcription factor) is one of the crucial factors in tendon formation, development and differentiation.
OBJECTIVE:To summarize the molecular structure, distribution and function of Mkx and its research process in the signaling pathways during tendon differentiation.
METHODS:The first author retrieved the databases of CqVip, CNKI and Medline from1990 to 2016 using the keywords of“Mkx, Mohawk, Irxl, tendon, tendon differentiation, tissue engineering, TGFβ, stem cel”in Chinese and English, respectively. The articles related to research process of Mkx in tendon tissue engineering were retrieved, and a total of 55 literatures were enrol ed final y.
RESULTS AND CONCLUSION:Mkx that expresses in various mesoderm-derived tissues plays an important role in the formation and development of tendon and tissue-engineered tendon formation. Although Mkx does not directly act on Scx (Scleraxis), it can regulate the differentiation of tendon progenitor cel s via transforming growth factor-β2 signaling pathway. Cel s from different species and different cel lines as wel as various cytokines for certain make different effects on Mkx involved in tendon tissue engineering.

Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.

BACKGROUND: The traditional treatment for skin donor site wound was focus on anti-infection and wound protection, which roof a long time for healing. Studies demonstrated that recombinant human epidermal growth factor (rhEGF) has accelerated effect or epidermal regeneration. OBJECTIVE: To observe the effect of rhEGF on wound healing of skin donor site. METHODS: A total of 32 cases needs wound healing by skin grafting were collected, including 18 males and 14 females. The 32 skin graft donor site wounds were randomly divided into control and treatment groups. In the treatment group, the absorbent gauze was sprinkle soaked with rhEGF (15 mL/ramus, 2 000 IU/mL) and covered the donor site, twice per day. In the control group, donor site was covered by physiological saline gauze and wrapped with dressing, twice per day. After 48 hours, semi-exposed therapy was performed. The healing time of wounds, the systemic and local adverse reactions of patients and blood routine examination and renal function detection prior to and after treatment were observed. RESULTS AND CONCLUSION: The healing time of wound in the rhEGF treatment group was shorter than that in the control group with significant differences (P < 0.01). No Adverse events or side effects were observed in the rhEGF treatment group. rhEGF can shorten wound healing time, reduce scar hyperplasia, and accelerate epithelization at the graft donor.

OBJECTIVEThe aim of this study is to investigate the occurrence and mechanism of Cheyne-Stokes breathing pattern in patients with heart failure.

METHODSFifty-six patients who performed polusomnography sleep testing at National Center of Cardiovascular Diseases Fuwai Hospital from March to May in 2015. We divided them into chronic heart failure (CHF) group and non-CHF group.

RESULTSThe occurrences of sleep apnea in two groups were high. In CHF group (n = 11) , there were 10 patients with apnea hypopnea index (AHI) > 5; and their AHI was 23.93 ±14.63. In non-CHF group (n = 45), there were 33 patients whose AHI > 5; and their AHI was 16.20 ± 18.76. The ratio of center sleep apnea to all gross sleep apnea ratio in CHF group was higher than that in non-CHF group (80.21% ± 30.55% vs 27.16% ± 35.71%, P < 0.01 ).

CONCLUSIONBased upon the new theory of holistic integrative physiology and medicine, we explain the mechanism of circulatory dysfunction induce the oscillation breathing in patients with CHF. The sleep apnea and C-S respiration in CHF should be called circulatory sleep apnea, rather than central sleep apnea.

Cheyne-Stokes Respiration ; Chronic Disease ; Heart Failure ; physiopathology ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; physiopathology ; Sleep Apnea, Central

Objective To explore the application value of three-dimensional (3D) female pelvic visualization model on transvaginal gynecological ultrasound imaging.Methods The second digital Chinese woman visible human datasets was selected,and a female pelvicvoxel-based model was constructed in Amira software for analog simulation combined with transvaginal gynecological ultrasound.The main structures and the space position variation of female pelvic cavity were observed,and the comparison study with conventional section of ultrasound was carried out.Results A high accuracy 3D visualization model of female pelvic was successfully constructed,and the anatomy structures can be dynamically and clearly displayed in any section orientation.An analog simulation research was carried out according to the scan mode of gynecological ultrasound,and a series of high resolution images consistent with scan sections of dynamic ultrasound were obtained,which had provided the optimal scan pathway for the fast inspection of the uterus,fallopian tubes and ovaries.Conclusion The 3D female pelvic visualization model based on digital Chinese woman human datasets has provided detailed and accurate anatomy information for transvaginal gynecological ultrasound imaging,which could be the benefit for doctors to understand the ultrasound images of female pelvic,as well as the accurate positioning ability to the lesions of female pelvic cavity.

ObjectiveTo investigate characteristics in vitro and contrast-enhanced effect in vivo with self-made nano-scale ultrasoud-enhanced contrast agent.MethodsNano-lipid microbubbles were prepared by machine vibration and low-speed centrifugation.The surface potential and the microbubbles size were assessed by Zetasizer nano ZS90.The bubbles dispersity and micromorphous were observed under light microscopy and electron microscope.The characteristics of microbubbles were studied at various times at 4℃ environment.The enhancement duration time and intensity of nano-lipid microbubbles in nude mice livers,kidneys and subcutaneous implanted tumors were observed,and compared with micro-scale microbubbles.ResnltsThe mean diameter of nano-lipid microbubbles was (580.6 ± 36.3) nm.The contrast imaging study in vivo showed the nano-lipid microbubbles could significantly enhance ultrasonic imaging in nude mice livers,kidneys and subcutaneous implanted tumors.ConclusionsSelf-made nano-scale ultrasoudenhanced contrast agent showed good stability and contrast-enhancement effect in vitro,and provide a experimental basis for ultrasound imaging and therapeutics of malignant tumors.

BACKGROUND:The decel ularized porcine smal intestinal submucosa is a kind of bioactive extracel ular matrix, which is mainly composed of col agen, glycoprotein, proteoglycan and rich in col agen, glycosaminoglycan and various growth factors, and these components play an important role in promoting the differentiation and proliferation of tissue cel s. OBJECTIVE:To prepare the injectable smal intestinal submucosa and to investigate its co-culture with rat adipose-derived mesenchymal stem cel s in vitro. METHODS:The injectable smal intestinal submucosa and rat adipose-derived stem cel s were prepared. Cel counting kit-8 test for cel proliferation:Passage 3 adipose-derived stem cel s were seeded onto the injectable smal intestinal submucosa (experimental group) and cel s cultured under normal condition as control group. The cel proliferation was observed at 1, 3, 5 and 7 days of incubation. Live/dead staining test for the survival of cel s:Passage 3 adipose-derived stem cel s were respectively cultured in the injectable smal intestinal submucosa extracts (experimental group) and complete culture medium (control group). Cel survival was determined at 1, 3, 5 and 7 days of culture. RESULTS AND CONCLUSION:Scanning electron microscope oval and strip adipose-derived stem cel s adhered onto the material. The absorbance values in the experimental group were higher than those in the control group at 1 and 5 days of incubation (P<0.05). Cel survival:The number of cel s appeared to be in a rising trend with time in both two groups;after 1-day co-culture, al cel s in the two groups survived. Then dead cel s appeared in both two groups, showing no significant difference. These results show that the injectable smal intestinal submucosa exhibits a good cytocompatibility.

OBJECTIVEThis study aimed to investigate the feature of D(L)CO (Diffusion Lung Capacity for Carbon Monoxide) in CHF (left ventricular heart failure) patients, underlying pathophysiological mechanism and clinical significance.

METHODSWe retrospectively studied the D(L)CO, pulmonary ventilation function, cardiopulmonary exercise testing and related clinical information in severer HF patients.

RESULTSPeak VO2 severely decreased to 34 ± 7 percentage of predicted(%pred) and anaerobic threshold to 48 ± 11%pred in all patients. D(L)CO moderately decreased to 63 ± 12%pred and there were 25 patients lower than 80%pred. FVC, FEV1, FEV1/FVC and TLC were 75 ± 14%pred, 71 ± 17%pred, 97 ± 11%pred, and 79 ± 13%pred, which indicated borderline or mild restrictive ventilatory dysfunction. The decrease of D(L)CO was more severe than those of TLC, FEV1 and FVC.

CONCLUSIONFor patients with severe CHF, cardiopulmonary exercise function is extremely limited, D(L)CO generally moderately declines and ventilation function is merely mildly limited. D(L)CO is the parameter for cardiopulmonary coupling, reflecting limitation of the cardiovascular dysfunction while without ventilatory limit.

Blood Gas Analysis ; Heart Failure ; physiopathology ; Humans ; Respiratory Function Tests ; Retrospective Studies ; Ventricular Dysfunction, Left ; physiopathology

OBJECTIVETo observe the changes in motilin (MTL), substance P (SP), vasoactive intestinal peptide (VIP) and somatostatin (SS) in plasma of rats with severe scald injury at early stage and the effect of rheum on their changes.

METHODSEighty-eight Wistar rats were randomly divided into normal control group (NC, n = 8), scald group (S, gavage of distilled water after full-thickness scald, n = 40), therapeutic group (T, gavage of rheum solution after full-thickness scald, n = 40). The blood samples were harvested from inferior vena cava at 6, 12, 24, 48, 72 post scald hours (PSH) to determine the levels of MTL, SS, SP and VIP with radioimmunoassay.

RESULTS(1) The levels of MTL and SP were (198 +/- 28), (61 +/- 10) ng/L, respectively, in NC group. The levels of MTL and SP in S group reached their minimum values [(110 +/- 15), (30 +/- 5) ng/L, respectively] at 6 PSH, then ascended slowly, peaked at 72 PSH but still lower than those in NC group (P < 0.05). The levels of MTL and SP slowly descended in T group, reached normal levels at 48 PSH, and obviously higher than those in NC group at 72 PSH [(232 +/- 32), (73 +/- 11) ng/ L, respectively, P < 0.05], which were higher than those in S group at 6 -72 PSH. (2) The levels of VIP and SS were (35 +/- 6), (30 +/- 5) ng/L, respectively, in NC group. The levels of VIP and SS in S group were (70 +/- 12), (49 +/- 9) ng/L at 6 PSH, which were obviously higher than those in NC group (P < 0.01), then descended slowly, but still higher than normal level at 72 PSH (P < 0.05). The levels of VIP and SS in T group ascended slowly, reached the normal level at 48 PSH, which were lower than those in S group at each time points, and VIP reached peak value at 12 PSH.

CONCLUSIONRheum may regulate secretion and release of gastrointestinal hormones to plasma in rats with severe scald injury at early stage.

Animals ; Burns ; blood ; drug therapy ; Motilin ; blood ; Phytotherapy ; Rats ; Rats, Wistar ; Rheum ; chemistry ; Substance P ; blood ; Vasoactive Intestinal Peptide ; blood