Objective To evaluate the clinical outcome of alcohol-deactivated autograft-prosthesis composite after resection of bone giant cell tumor in distal femur.Methods From January 2007 to October 2008,5 patients with bone giant cell tumor in distal femur were treated with alcohol-deactivated autograftprosthesis composite,including 3 males and 2 females with an average age of 29.6 years(range,22-40).Three patients were diagnosed with postoperative recurrence,and 2 with pathological fracture.All patients were of Campanacci Ⅲ.Three-dimensional finite element models with 40% bone defect in distal femur were established based on CT images of a healthy volunteer.Three times of body mass load corresponding to the normal walking gait cycle was applied.The influence on stress distribution of femur-cement and prosthesis stem was analyzed.Results All patients were followed up for average 37 months,there was no infection,recurrence,loosening and limb length inequality.The bony healing time was 6 to 11 months.The mean MSTS function score was 25.7(range,25-27).The mean ISOLS graft score was 31.4 (range,28-35).The finite element analysis showed that for the short-term model,the maximum stress was 145.82 MPa in the proximal femur,40.90 MPa in the medial side of 1/4 proximal cement,and 389.24 MPa in the proximal prosthesis stem.The maximum stress was not exceeding the fatigue strength in three sites.For the long-term model,with the bone healing,the maximum stress on three sites decreased to 139.05,36.95,and 253.65 MPa,respectively.Conclusion These results suggest that the alcohol-deactivated autograft-prosthesis composite after resection ot bone giant cell tumor in distal femur can reduce the tumor recurrence and improve the short-term limb function,It is stable in short term and can reduce stress shielding in long term.

An endogenous element-label plus exogenous element-tag strategy was proposed for inductively coupled plasma mass spectrometry ( ICP-MS) to screen and discriminate a family of ultratrace but biological important biomolecules. The feasibility of this novel idea has been demonstrated when setting seleno ( SeCys) and Se-containing ( SeMet) proteins ( peptides) as an example. Se-label naturally occurring in the biomole-cules acts an identifier for picking them up out of large amount of various coexisting proteins ( peptides) , and CH3 Hg-tag that can bind to SeCys but not SeMet fulfills the task of discriminating seleno and Se-containing ones based on the Se and Hg signals on ICP-MS. After confirmed using SeCys and GPx1, the Se-Hg dual-element labeling strategy together with ICP-MS was applied to screen and discriminate seleno and Se-contai-ning proteins ( peptides) in the water-soluble extracts of Se-enriched yeast, and seven selenoproteins ( pep-tides) were detected with both 202 Hg and 82 Se signals out of fifteen Se-containing species using RPLC/ICP-MS, providing valuable information for further identification using a high-resolution structure-selective mass spectrometer. This endogenous element-label plus exogenous element-tag dual-element approach implies that ICP-MS is not only able to quantify targeted proteins ( peptides) but also helpful to recognize targeted proteins during a discovery-based proteomic study.

ObjectiveTo observe the effect of community-based rehabilitation (CBR) on older stroke patients in ability of activities of daily living (ADL).Methods50 older stroke patients were randomly divided into the rehabilitation group and control group. The rehabilitation group was treated with motor function exercise and ADL training, while the control group only took medicine. Two groups were evaluated with Barthel index before and after treatment. ResultsScores of Barthel index on the rehabilitation group were higher than that on the control group after treatment, and there was a significantly difference between two groups (P<0.01). Conclusions CBR has the significant effect on improving ADL in older stroke patients.

Objective To evaluate the efficacy of different doses of dexmedetomidine combined with propofol for drug-induced sleep endoscopy (DISE) in the patients with snoring.Methods Sixty patients with snoring,aged 24-62 yr,with body mass index of 24-37 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective DISE,were randomly divided into either group Ⅰ or group Ⅱ,with 30 patients in each group.In Ⅰ and Ⅱ groups,dexmedetomidine was infused over 10 min in a loading dose of 0.4 and 0.8 μg/kg,respectively,followed by an infusion of 0.4 μg · kg-1 · h-1.At 15 min of dexmedetomidine infusion,propofol was given by target-controlled infusion with the initial target plasma concentration (Cp) of 1.0 μg/ml.At 2 min after the target effect-site and plasma concentrations were balanced,the Cp of propofol was increased/decreased by 0.2 μg/ml to maintain the Cp of propofol stable during DISE.Bispectral index (BIS) value was recorded before anesthesia (T1),at 10 and 15 min of dexmedetomidine infusion (T2,3),at 2 min after the target effect-site and plasma concentrations were balanced (T4),at the beginning of DISE (T5),when the fiberoptic laryngoscope was placed at the site of oropharynx (T6),at the end of DISE (T7),at emergence (T8),and while discharge from the examination room (T9).Richmond Agitation Sedation Scale (RASS) scores were recorded at T1-4.Sleep was recorded within 15 min of dexmedetomidine infusion.The emergence time,discharge time,and anesthetics-related adverse events were recorded.Results All the patients completed DISE successfully.BIS values were maintained at 75-90,and RASS scores ≤ 4 during dexmedetomidine infusion.BIS values were maintained at 65-75 during DISE.Compared with group Ⅰ,BIS values were significantly decreased at T4,and RASS scores were significantly increased at T2-4,the sleep rate was significantly increased within 15 min of dexmedetomidine infusion,the Cp of propofol was significantly decreased during DISE,the emergence time was significantly prolonged (P＜0.05),and no significant change was found in the discharge time and anesthetics-related adverse events in group Ⅱ (P＞ 0.05).Conclusion Dexmedetomidine infused at 0.4 μg · kg-1 · h-1 after infusion of a loading dose of 0.8 μg/kg combined with propofol provides better efficacy for DISE in the patients with snoring.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

BACKGROUND:Compared with hydroxyapatite materials and other nano-hydroxyapatite composites, carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composites have been significantly improved in the mechanical strength, toughness, elastic modulus and other aspects. It can be used for repairing bone defects of loading parts. OBJECTIVE:To investigate the biocompatibility of carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composites in bone tissues. METHODS:Eight Bama mini pigs were taken to establish models of thoracic vertebral defects and implanted with carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composites. At 8, 16 and 24 weeks after implantation,the animals were sacrificed, respectively, for bone mineral density detection and hematoxylin-eosin staining. Blood samples for kidney and liver function tests were taken before and 1 and 8 weeks after implantation. RESULTS AND CONCLUSION: Hematoxylin-eosin staining of bone samples showed that the materials could bond with the bone defect interface without rejection, and could induce osteogenesis of chondrocytes. At 8 weeks after surgery, the broken ends of cancelous bone closed and the composite material was wrapped by granulation tissues. At 16 weeks after surgery, granulation tissues were organized and new bone developed directly from fibroblast cels. The new bone tissues were nearly fused with the end of cancelous bone. At 24 weeks after surgery, new bone tissue became mature lamelar bone, and the end of cancelous bone was connected tightly with the composite material. Bone mineral density of the implanted vertebra showed an increase trend at 8, 16 and 24 weeks after implantation. Over time, the bone mass was increased. The liver and kidney function tests showed that there was no significant difference before and after implantation. It is preliminarily believed that the carbon fiber-reinforced nano-hydroxyapatite/polyamide 66 composite has excelent histocompatibility and bioactivity without hepatic toxicity and nephritic toxicity.

Objective:To study the effect of portal vein occlusion on intestinal mucosal barrier in rats and the protection of ulinastatin to the injury,to present the experimental data for the clinical surgery.Methods:70 Sprague-Dawley rats were randomly divided into controlled group (n=10),operation group (n=30) and operation+medication group (n=30).The portal vein were occlused 40 min in the operation groups and operation+medication groups.2ml blood from portal vein,lymph nodes around appendix,1cm small intestine wall were taken for endotoxin levels,bacterial translocation and pathiology examinations in the all rats 280 mins after operation.The mocusal barrier and microscopic structure of intestine were observed.Results:Compared between the control group and the operation group,endotoxin levels,bacterial translocation rates rise greatly and gut structure change obviously in the latter.Compared between the operation group and operation+medication group,the former changes is also obvious.Conclusion:The occlusion of portal vein can leads the decrease of intestine mocusal barrier and the increase of its permeability.Ulinastatin has a good protective effect on the damages above.

Objective To study CT features of thymoma,so that to improve the accuracy of CT diagnosis and differential diagnosis.Methods 31 cases of thymomas proved by surgery and pathology were examined with conventional CT scans.CT findings of thymoma were analyzed.Results The lesions in 27 cases(87.1%)were located in the anterior upper and middle mediastinum.There were benign lesion in 11,including mass-cardiovascular interface(MCI) with convex type(8 cases),flatness type(1 cases) and concave type(2 cases).20 cases were malignant lesion,including MCI with cast type(18 cases) and concave type(2 cases).Irregular invasion to adjacent organs was found in 11 cases,others included pericardiac effusion(n=6),pericardial and mediastinal invasion(n=2),pleural effusion(n=4),pneumonia(n=2),lung,bone,mediastinal lymphadens metastasis(n=2) and liver,pancreas metastasis(n=1).Conclusion CT scans is of significant value in diagnosis and differential diagnosis of thymoma.

AIM:To observe the effect of spironolactone on myocardial fibrosis of spontaneously hypertensive rats(SHR).METHODS:Sixteen fourteen-week-old male SHRs were randomly assigned to spironolactone and SHR group equivalently(n=8).Rats in each group were given 30 mg ? kg-1 ? d-1 spironolactone and equal sodium chloride respectively for 12 weeks by gavage.Eight fourteen-week-old male SD rats were as control group.Connective tissue growth factor(CTGF),transforming growth factors beta-1(TGF?1),collagenⅠand Ⅲ were measured by qualitative and semiquantitative immunohistochemical staining and semiquantitative reverse transcription polymerase chain reaction.Masson staining was used to determine total collagen in left ventriculum.Alkaline hydrolysis method was used to detect the concentration of hydroxyproline(Hypro)in the myocardium of left ventricle.RESULTS:Left ventricular index(LVI),collagen volume fraction(CVF),Hypro and the expression of TGF?1,CTGF,collagenⅠand Ⅲ in SHR group were significantly higher than those in SD group(P

Objective To observe the clinical effect of bicyclol combined with polyene phosphatidyl choline in elderly non-alcoholic fatty liver disease (NAFLD).Methods One hundred and twenty elderly patients with NAFLD were divided into 3 groups by block randomization method,40 cases in each group.Therapeutic group was treated by bicyclol combined with polyene phosphatidyl choline; bicyclol group was only treated by bicyclol; and polyene phosphatidyl choline group was only treated by polyene phosphatidyl choline.The blood biochemical indexes,liver ultrasound score and clinical curative effect of 3 groups were compared after treated for 24 weeks.Results The total cholesterol (TC),triglyceride (TG),alanine aminotransferase (ALT),aspartate aminotransferase (AST) and gamma glutamine transferase (GGT) in 3 groups after treatment were lower than those before treatment,and the difference was statistically significant (P ＜ 0.05) ; TC,TG and ALT levels in therapeutic group after treatment were significantly lower than those in bicyclol group and polyene phosphatidyl choline group [(1.36 ± 0.84) mmol/L vs.(2.77 ± 1.27),(2.84 ±1.35) mmol/L; (1.32 ±0.71) mmol/L vs.(1.89 ±0.87),(1.92 ±0.90) mmol/L; (38.26 ± 12.75) U/L vs.(57.83 ± 16.67),(62.07 ± 18.16) U/L],and the difference was statistically significant (P ＜ 0.05).The liver ultrasound score in 3 groups after treatment was significantly decreased compared with that before treatment,and the difference was statistically significant (P ＜ 0.05).Liver ultrasound scores in therapeutic group after treatment were significantly lower than those in bicyclol group and polyene phosphatidyl choline group [(2.08 ± 0.93) scores vs.(3.17 ± 1.14),(3.34 ± 1.07) scores],and the difference was statistically significant (P ＜ 0.05).The total effective rate in therapeutic group was significantly higher than that in bicyclol group and polyene phosphatidyl choline group [85.0％ (34/40) vs.67.5％ (27/40),65.0％ (26/40)],and the difference was statistically significant (P ＜0.05).Conclusions Bicyclol combined with polyene phosphatidyl choline has better clinical effect in elderly patients with NAFLD.It is better than single bicyclol and polyene phosphatidyl choline and worth clinical promotion.