BACKGROUND: Rehabilitation training after sports injury is of so great importance in the remaining and relieving of exercise ability that the researches in thisfield need to develop.OBJECTIVE: To evaluate the influence of isokinetic training on the functional recovery of knee flexors and extensors and the muscle force around the joint after knee meniscus injuries receiving arthroscopy.DESIGN: Case-control observation SETTING: Department of Police Training, Liaoning Advanced Police Officer School PARTICIPANTS: A total of 20 patients with acute meniscus injury of lateral knee joint were selected from the Department of Surgery, Affiliated Hospital of Dalian Medical University between September 2004 and January 2005. They were randomly divided into experimental group and control group,including 11 cases respectively. METHODS: All the patients were treated with arthroscope operation, additionally the control patients received routine blocking, physiotherapy and massage, etc. To recover the function. From the 2nd to 4th days postoperative, the patients of experimental group began to carry out the functional rehabilitation, and received isokinetic exercise in both knees flexors and extensors with the Cybex-6000 isokinetic dynamometer 3 weeks later.MAIN OUTCOME MEASURES: Peak torque values, total work, torque accelerating energy and average power in both knee flexors and extensors at different angular velocities [60, 120 and 180(°)/s].RESULTS: A total of 22 patients were involved in the result analysis.①After arthroscope operation and isokinetic training, the range of joint movement were extended, and the maximum flexion angle changed from (132±25)° to (158±21)°. There were significant differences before and after training by t test (P ＜ 0.01).②The experimental group had statistical significance compare with control group in the test index at 60, 120 and 180(°)/s(P ＜ 0.05).CONCLUSION: The arthroscope combining with isokinetic training can speed up the rehabilitation after knee meniscus injury, enhance the muscle force around knee joint and maintain the stability of knee joint and motor ability.

BACKGROUND:Autologous hamstring Rigidfix and Intrafix has been frequently used to fix and reconstruct anterior cruciate ligament. However, it lacks of evaluation of middle and long period of clinical outcomes. OBJECTIVE:To retrospectively evaluate the medium term clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. METHODS:The 39 cases of anterior cruciate ligament injury were subjected to anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix under arthroscope. They were fol owed up for 2 years or more. The clinical outcomes were evaluated using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:In the fol ow-up, IKDC2000 score and Lyshlom score were significantly increased fol owing Rigidfix and Intrafix fixation than before treatment (P<0.01). Results indicate satisfactory clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. However, long-term fol ow up is needed to verify the feasibility of extensive application.

Objective To investigate the expression of the hypoxia-inducible factor (HIF)-1α in rat brain neurons and the intervention of β-sodium aescinate after restoration of spontaneous circulation (ROSC).Methods Sixty SD adult rats were randomly (random number) divided into 3 groups (n =20),namely experiment group,control group and sham operation group.(1) The rats of experiment group were injected intraperitoneally with β-sodium aescinate (5 mg/kg) immediately after ROSC.(2) The rats of control group received normal saline injected intraperitoneally instead of β-sodium aescinate solution.(3)The rats of sham operation group did not have cardiac arrest and β-sodium aescinate intervention.Cardiac arrest rat model was established by using asphyxiation and intra-venous potassium chloride solution.Blood samples were taken 1 h,6 h,12 h and 24 h after ROSC,and subsequently rats were sacrificed and their brain tissues were harvested.The expressions of HIF-1 α mRNA,vascular endothelial growth factor (VEGF)mRNA and erythropoitin (EPO) mRNA and their protein levels in rat brain neurons were detected by using RT-PCR and immunohistochemistry,and the levels of serum neuron-specific enolase (NSE) and S100β proteins were determined by using enzyme-linked immunosorbent assay.The t test or one-way ANOVA was used to assess overall differences among groups for each of the variables,followed by Bonferroni test for multiple comparisons.Pearson method was used for correlation analysis.Results Compared with the sham operation group at intervals of 1 h,6 h,12 h and 24 h after ROSC,levels of serum S100β and NSE proteins were significantly increased in rats of the control group (P ＜ 0.05).Meanwhile,the expressions of HIF-1 α mRNA,VEGF mRNA and EPO mRNA and their protein levels in rat brain neurons were significantly increased in the control rats (P ＜0.05).Compared with the control group at intervals of 1 h,6 h,12 h and 24 h after ROSC,levels of serum NSE and S100β proteins were significantly decreased in rats of the experiment group (P ＜ 0.05).Whereas,the expressions of HIF-1 α mRNA,VEGF mRNA and EPO mRNA and their protein levels in rat brain neurons were significantly increased in rats of the experiment group (P ＜0.05).HIF-1 α mRNA was positively correlated with EPO mRNA and VEGF mRNAs (r =O.866,P ＜0.05 ; r =0.952,P ＜ O.01).Conclusions The expression of hypoxia-inducible factor-1 α is increased in rat brain cells after ROSC,and β-sodium aescinate up-regulates the expression of hypoxia-inducible factor1 α mRNA and protein levels.The up-regulated expression of hypoxia-inducible factor-1α improves the resistance of brain cells to ischemia and hypoxia contributing neuronal protection,which might be due to upregulated EPO and VEGF expressions induced by hypoxia-inducible factor-1α.

Objective To investigate pulmonary circulation effects of protamine different infusion ways on the acyanotic congeni -tal heart disease(CHD) patients with pulmonary arterial hypertension(PAH) after extracorporeal circulation surgery .Methods Se-lect 80 cases of the CHD patients prepared for extracorporeal circulation surgery ,according to the different routes of administration and with or without PAH ,80 patients are divided into 4 groups (n= 20) :A1(non-PAH ,aortic root administration) ,A2(non-PAH , central venous administration) ,B1(PAH ,aortic root administration ) ,B2 (PAH ,central venous administration) .pulmonary artery pressure(PAP) ,pulmonary venous pressure (PVP) ,central venous pressure (CVP) ,peak airway pressure (Ppeak) ,plateau airway pressure(Pmean ) at the time point of preoperative(T0) ,before infusion of protamine (T1) ,1 minute after infusion of protamine (T2) ,3 min (T3) ,5 min (T4) ,10 min (T5) ,15 min (T6) and 25 min (T7) were recorded .The level of venous blood thromboxane B2(TXB2) was detected .Results After infusion protamine ,the PAP ,PVP ,CVP ,Ppeak and Pmean of group A2 and group B2 are higher compared to group A1(P< 0 .05) and group B1(P< 0 .01) respectively ;Compared with preoperation (T0) ,the TXB2 in 4 groups increased obviously after infusion protamine (T2 to T7) (P< 0 .05) ;Compared with group A1 and group B1 ,the TXB2 of group A2 and group B2 increased more significantly (P< 0 .01) .Conclusion Patients with congenital heart disease after intracardi-al surgery with extracorporeal circulation use trace pump infusion protamine through the aortic root ,which have little effect on pul-monary circulation ,can significantly reduced TXB2 release compared with central vein administration ,it can avoid a high concentra-tion of protamine directly into the pulmonary circulation that can strongly stimulate the pulmonary vascular and tracheal smooth muscle .Especially in the CHD patients with PAH .

BACKGROUND:Alogeneic tendon has been frequently used to reconstruct the anterior cruciate ligament. However, there is a lack of middle- and long-term clinical evaluation. OBJECTIVE:To evaluate the middle- and long-term curative effect of alogeneic tendon reconstruction of the anterior cruciate ligament under arthroscopy. METHODS:Twenty-five patients with anterior cruciate ligament injury under alogeneic tendon transplantation were reviewed retrospectively. They were al folowed up for 3 years or more. The clinical outcomes were evaluated and compared using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:Al the patients were folowed up. Lysholm scale scores on the knee function, Tegner scores and IKDC scores were significantly increased after transplantation (P < 0.05). No complications of infection and compartment syndrome occurred. Symptoms were relieved and the function of knee joint was improved. There was one case weakly positive for anterior drawer test. Both Lachman test and pivot shift test showed negative signs. Overal, the reconstruction of anterior cruciate ligament with alogeneic tendon has less trauma and complications, with good middle-term efficacy.

Aim To study the effect of different doses of l-Tetrahydropalmatine( l-THP) on morphine-induced conditioned place preference(CPP) and observe whether l-THP itself induces CPP.Methods ①♂SD rats were administered with morphine (5.00 mg?kg -1 ,sc) or saline and trained for 8 days;on d 9,the rats were tested CPP with no treatment or 40 min after they were given different doses of l-THP(1.25～5.00 mg?kg -1,ip) to observe the effect of l-THP on morphine-induced CPP;② With daily injection of l-THP (ip) at different doses,effect on the extinguishment of morphine-induced CPP was tested weekly; ③ Normal saline (NS) or l-THP (1.25～5.00 mg?kg -1 , ip) was used as a training drug to test whether l-THP could induce CPP in the rats. Results 5.00 mg?kg -1 morphine (sc) induced CPP; l-THP of 2.50 mg?kg -1 and 5.00 mg?kg -1 administered prior to the testing reduced the expression of morphine-induced CPP significantly (P

BACKGROUND:Autologous hamstring tendon reconstruction of the medial patel ofemoral ligament is now more popular surgical procedure.
OBJECTIVE:To study the clinical mid-term outcomes of isolated medial patel ofemoral ligament reconstruction for recurrent lateral patel ar dislocation.
METHODS:The clinical data of 24 patients (25 knees) undergoing medial patel ofemoral ligament reconstruction for recurrent patel ar dislocation from September 2006 to September 2009 were retrospectively studied. Clinical, functional, and CT outcomes were assessed at an average of 3.1 years after surgery (range, 2-5 years), using recurrent instability as the primary end point.
RESULTS AND CONCLUSION:The success rate of medial patel ofemoral ligament reconstruction for preventing recurrent dislocations was 92%. Two patients (8%) experienced a recurrent lateral patel ar dislocation, and required a reoperation. At final fol ow-up, the mean IKDC, Tenger and Lycholm scores were significantly higher than those before operation (P<0.01). Reconstruction of the medial patel ofemoral ligament for recurrent patel ar instability is a minimal y invasive operation and has a number of benefits. The mid-term clinical outcome was satisfactory.

BACKGROUND:The treatment method of tibial avulsion fractures of anterior cruciate ligament is varied;each has its advantages. OBJECTIVE:To investigate the methods and clinical effects of the treatment of avulsion fractures of tibial insertion of anterior cruciate ligament by the means of making two decussate lines and four strands of non-absorbable Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy. METHODS:From December 2014 to November 2015, 23 cases of avulsion fractures of tibial insertion of anterior cruciate ligament were treated in the Second Hospital of Inner Mongolia Medical University. Under the arthroscopy, avulsed fracture was fixed in tibial intercondylar eminence by the means of making two decussate lines of Arthrex sutures passing through. At the same time, pushlock free knotting anchor beside tibial tubercle provided a tightening of tension for Arthrex sutures, which could strengthen the fixation of avulsion fracture blocks. Knee joint Lysholm and Tegner scores were fol owed up. Knee stability was evaluated by anterior drawer test and Lachman test. Postoperative reset and healing were evaluated with X-ray films. RESULTS AND CONCLUSION:(1) Al 23 patients were fol owed up for 6 months to 1 year. (2) Lysholm scale of the knee function was (47.31±6.16) preoperatively and (94.69±1.28) postoperatively (P<0.05). Tegner score was (3.14±1.58) preoperatively and (7.74±1.69) postoperatively (P<0.05). (3) Lachman test of al cases was negative. X-ray films demonstrated that fracture healing was good. There was no repeated swel ing or cross locking of the joint. The knee was not limited by flexion or extension. No infection or deep venous thrombosis of lower extremity occurred. (4) The method of Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy has the advantages of minimal y invasive, simple operation, reliable fixation, no metal implants and satisfactory result to treat the tibial intercondylar eminence fracture of anterior cruciate ligament.

Objective To observe the effects of modifiedDanshen Decoction on spermidine/spermine acetyltransferase (SSAT) /polyamine pathways of SD rats with IRI; To investigate its protective mechanism. Methods The model of IRI was established by ligating left anterior descending coronary artery for 30 min followed by reperfusion for 90 min. The SD rats were randomly divided into the control group, sham-operation group, model group and modifiedDanshen Decoction group, with 10 rats in each group. The myocardial infarction size was measured by using TTC staining. The contents of SSAT were measured by ELISA. The SSAT mRNA and SSAT protein expression level were detected with real-time fluorescent quantitative PCR method and Western blot, respectively. The contents of polyamines (putrescine, spermidine, spermine) in cardiac tissue were detected by HPLC. Results Compared with sham-operation group, the myocardial infarction size, the SSAT content, the SSAT mRNA and SSAT protein expression levels of model group increased significantly, the contents of polyamines decreased significantly, with statistical significance (P<0.01); Compared with model group, the myocardial infarction size of modifiedDanshen Decoction group was significantly reduced, while the SSAT content and SSAT mRNA and protein expression level decreased significantly, the contents of polyamines increased, with statistical significance (P<0.05, P<0.01).ConclusionModifiedDanshen Decoction can adjust the SSAT polyamine pathways and increase polyamine content in cardiomyocytes, and thus play a role of protection of myocardial ischemia-reperfusion injury.

Based on the clinical skill competition of college students of the advanced medical colleges and universities nationwide,we aimed at the analysis on the weaknesses of medical emergency clinical practical teaching and emphasis on the theoretical education and neglect the practical education,and humanistic care,etc.In the clinical practice teaching of emergency,we combined the clinical skill training with physician occupation quality training,pay attention to the practice of advanced simulation exercises,gradual transition,clinical thinking,training medical students hands-on,team cooperation ability and humane accomplishment,to improve their ability of analyzing and solving problems and eventually optimize medical emergency clinical practical teaching,formulate the clinical practice standards as well as promote the reform and innovation of clinical teaching.