Objective To evaluate the operation and review the clinical effectiveness of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon.Methods From January 2010 to January 2013,55 patients (25 men,30 women) with the mean age of 52.4 (range,37-65) years old who underwent arthroscopic tenodesis through double-needles positioning portal to treat proximal lesions of Biceps tendon were retrospectively analyzed.Shoulder pain of all the patients occurred in pre-operation and aggravated at the time of abduction shoulder joint,which affected the normal life for reasons of weakness.Diagnosis of magnetic resonance imaging (MRI) was proximal lesions of Biceps tendon,which was failed to respond to conservative management of six months.All patients underwent biceps tenodesis under arthroscopy with fixation of two suture anchors through bone,and removed tendon stump finally.All the portals of operation and observation of tendon fixation used double-needles positioning portal.We recorded the general condition of shoulder as the level of pain,sphere of activity,active forward flexion and intensity of adduction in pre-operation,3 months,6 months,12 months and 18 months after operation with American Shoulder and Elbow Surgeons (ASES),shoulder function score of Constant-Murley (Constant) and University of California,Los Angeles (UCLA).Then all data were analyzed statistically.Results All patients were operated successfully and got the mean follow-up of 20 months (range,18-24).The result of MRI showed well healing of tendon without rupture.The shoulder function had basically recovered.In pre-operation,ASES,constant and UCLA scores was 10.22±3.02,35.89±7.25,8.53±2.07 respectively.In 18 months after operation,the scores were 32.07± 1.26,89.75±4.07,31.87±2.07 respectively.The outcomes demonstrated that all scores in 18 months after operation had significantly improved,compared to pre-operation.Conclusion The technique of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon is reliable and simple,and can achieve satisfactory clinical outcomes.

BACKGROUND: Intraocular contract lens (ICL) implantation emerges as a crystal refrangibilit operation to rectify and cure high myopia in recent years. Collagen, a new material, is consisted of collagen Ⅳ and aquagel in Starr Company. It is an ideal material for ICL; however, high price is restricted to its development at a certain degree.OBJECTIVE: To find out ideal method of collagen ICL implantation through animal experiment in rabbit eyes and evaluate intraocular biocompatibility by observing inflammatory reaction and variation of inflammatory mediators.DESIGN: Single exponent and opening study.SETTING: Department of Ophthalmology, Xinhua Hospital affiliated to Medical College of Shanghai Jiaotong University.MATERIALS: The experiment was carried out in Xinhua Hospital affiliated to Medical College of Shanghai Jiaotong University and Shanghai Nanyang Radio-immunity Testing Center from August 1999 to March 2000.Twenty New Zealand rabbits were divided into three groups according to randomly digital table: ICL implantation group (n=8), operative control group (n=6) and blank control group (n=6).METHODS: ① Right eyes of rabbits in ICL implantation group were suffered from ICL implantation and peripheral operation of iris [1]; however,right eyes of rabbits in operative control group were only suffered from peripheral operation of iris. After operation, hormone-antibioltic eyedrops were dribbled into eyes four times a day for total 10 days. At 1, 4 and 7days after operation, 2.5 mg dexasone + 40 000 U cidomycin were subconjunctivally injected into eyes. Rabbits in black control group did not receive any operation. ② At 1, 4, 7, 14 days and 1 month after operation,indexes of operative eyes in ICL implantation group and operative control group were measured including luctuation of intraocular pressure, damage of corneal endothelium, protein leakage in anterior chamber, depth of anterior chamber, hyphema, posterior synechiae of iris, ICL decentration and lens opacity. ③ At 1, 4, 7, 14 days and 1 month, samples of aqueous humor were aspirated from operative eyes of rabbits in ICL implantation group, operative control group and blank control group. Radioimmunoassay (RIA) was used to examine the concentration of prostaglandin-E2 (PGE2)in aqueous.MAIN OUTCOME MEASURES: ① Results of reaction in anterior chamber at each time point before and after operation; ② results of PGE2 concentration of inflammatory mediators in aqueous humor after operation.RESULTS: All 20 rabbits were involved in the final analysis. ① Changes of intraocular pressure at each time point before and after operation: As compared with that before operation, intraocular pressure was not changed in ICL implantation group and operative control group at each time point after operation (P ＞ 0.05). ② Damage of corneal endothelium and leakage in anterior chamber after operation: ICL implantation group: Five eyes were shown as shallow anterior chamber at various degrees on the first day after operation, and recovered normally within 1 week; hemorrhage was observed in anterior ch amber of two eyes and absorbed after 2 weeks; two eyes had anterior and posterior synechiae of iris, respectively, and pupil was deformed slightly; ICL decentration at various degrees was observed in two eyes; point-like opacity was observed in anterior bursal membrane of crystal in one eye after 1 month. Operative control group: Leakage of grade 1-2 was observed in 6 eyes on the first day after operation and was absorbed within 1 week. Cornea was clearing, and hyphema, shallow anterior chamber, posterior synechiae of iris and lens opacity were not changed. ③ PGE2 concentration of inflammatory mediators in aqueous humor after operation:PGE2 oncentration was the highest in ICL implantation group at 1-4 days after operation, and then it was decreased gradually; however, PGE2 concentration was similar at 14 days and 1 month after operation (P＞0.05).CONCLUSION: There is no obvious occurrence of chronic uveitis in anterior chamber after ICL implantation. PGE2 concentration in anterior chamber is decreased gradually, and this suggests that a classic foreignbody granulomatous inflammation emerges after ICL implantation, which reflects a good tolerance of ICL for ocular tissue.

BACKGROUND: A new type of materials, Collamer, is polymerized with type V collagen and HEMA by Staar company, which is a good material for the establishment of intraocular contact lens(ICL). There is no similar material in our country.OBJECTIVE: To evaluate the biocompatibility of ICL made mainly by collagen-polymer in animals.DESIGN: A randomized controlled trial.SETTING: Testing Center of Shanghai Institute of Biomaterial.MATERIALS: Our study was conducted in the Testing Center of Shanghai Institute of Biomaterial from January 2000 to April 2000. Cell strain: hearty L-929 cells(fibroblast of mouse) after 48-72 hours of passage; Twenty white guinea pig of either gender aged between 1 month and 3 months with a body mass between 300 g and 500 g; Seven healthy adult New Zealand rabbit of either gender(female rabbits were not required pregnant for pyrogenic reaction test) with a body mass between 1.7 kg and 3.0 kg or between 2.5 kg and 3.5 kg(experimental animals were obtained from Shanghai experimental animal center, ordinary grade).INTERVENTIONS: Collagen was used to perform the following biological tests: ① cytotoxicity test (cell growth rate); ② anaphylaxis test; ③ pyrogenic reactions test; ④ subcutaneous implant test. The data were analyzed and evaluated according to criteria.MAIN OUTCOME MEASURES: ① Growth and proliferation of fibroblast in mice; ② Reactions of erythema and edema of every provocation site and every observatory time after the induction of intradermal injection and local patch test; ③ Increase of body temperature of the rabbit after the injection of the extraction of the material into auricle marginal vein; ④ Reactions around the materials after 4 weeks of collagen implantation in rabbits subcutaneously.RESULTS: ① Cytotoxicity test: relative growth rate of collagen group was 99％ to 106%, and the toxicity grade was level 0 - 1. ② Anaphylaxis test:there was no erythema or edema reaction at every provocation site at each time point of collagen group. The skin reaction to collagen-polymer was level 0. ③ Pyrogenic reactions test: the temperature increased in rabbit was below 0.6 ℃ and the total increase of the temperature was below 1.4 ℃ in rabbits. ④ Subcutaneous implant test: there was very little lymphocyte infiltration around the sample in both collagen group and control group with Level I inflammatory reaction. And the evaluation of the formation of fiber cyst was level I.CONCLUSION: Results of material biological evaluation tests demonstrate that this collagen-polymer has high biocompatibility, and can become an ideal material for ICL.

Objective To screen the altered gene expression profile of hippocampus after traumatic brain injury(TBI)in rats. Methods Rats(n=3)in experimental group underwent moderate fluid-percussion(F-P)brain injury and the hippoeampus sample in the injured hemisphere was removed and conserved in liquid nitrogen three hours later.The rats(n=5)of the control group underwent the same procedure except for injury.Mfymetrix rat genome 230 2.0 array was used to detect the gene expression profile of hippocampus in two groups and find the altered gene expression profile. Results A total of 159 genes in the experimental group changed significantly(≥2 folds)compared with the control group,of which 136 genes were up-regulated and 23 genes down-regulated. Conclusions The significant gene expression changes of hippocampus,especially a large mount of up-regulated genes,are detected after moderate TBI in rats,suggesting that the secondary injury following TBI is a procedure involving multiple factors.

Forty cases of hyperlipidemia were treated by herbal moxa stick moxibustion and compared with 22 cases treated by Oenothera Oil Capsules. The results showed that LipidDecreasing Herbal Moxibustion could decrease the serum cholesterol and triglyceride and elevate high-density lipoprotein and change the ratio of TC-HDL-C/HDL-C in the patients, and its therapeutic effect was better than that of the control group treated by Oenothera Oil Capsules (P ＜ 0.01). Lipid-Decreasing Herbal Moxibustion can also improve the clinical symptoms and reduce the body weight.

ObjectiveTo evaluate the clinical benefits of early right median nerve electrical stimulation on coma patients following craniocerebral trauma. MethodsCraniocerebral trauma patients with up to two weeks of coma in the years 2005-2011 were involved in the study and were randomly divided into control group (received routine management ) and treatment group (routine management plus right median nerve electrical stimulation).The treatment lasted for a period of more than two weeks.The clinical efficacy of the right median nerve electric stimulation and the conscious status of the patients within six months after craniocerebral trauma were observed.ResultsA total of 456 patients were enrolled in the study,of whom 437 patients completed the treatment course,including 221 patients in the treatment group and 216 in the control group.There was no complication related to electric stimulation during the treatment.Cerebral blood flow (CBF) imaging and brain stem evoked potential (BEP) examination demonstrated significant improvement in the treatment group.A total of 386 patients were followed up for six months postoperatively,which showed that there were 122 patients with regained consciousness,46 in minimally conscious state and 36 in vegetative state in the treatment group (204 patients) and there were 84 patients with regained consciousness,40 in minimally conscious state and 58 in vegetative state in the control group ( 182 patients).The patients in the treatment group showed a higher ratio of regained consciousness and a lower ratio of vegetative state compared with the control group,but the ratio of minimally conscious state showed no statistical difference between two groups. ConclusionsRight median nerve electrical stimulation is a suitable coma awaking means at early stage after craniocerebral trauma.

Objective : To study the effect of leucine rich repeat kinase 2 ( LRRK2) on pain sensitivity in neuro- pathic pain (NP) rats and explore its possible mechanism． Methods : 48 SD rats were randomly divided into four groups : sham surgery (Sham) ，model，LRRK2 inhibitor(MLi-2) ，and LRRK2 inhibitor + p38 mitogen activated pro- tein kinase (MAPK) agonist (MLi-2 + Anisomycin) ，with 12 rats in each group．The NP rat model was induced by chronic constriction injury ( CCI) of the sciatic nerve．Intrathecal injection of MLi-2 ( 1 mg / kg，10 μl) or Anisomy- cin (20 μmol / L，10 μl) was started from the 8 th day after surgery，once a day for 7 consecutive days．Pain sensi- tivity tests were conducted before surgery (day 0) and on postoperative days 7 and 14，respectively．The changes in mechanical withdrawal threshold (MWT) and paw withdraw thermal latency (PWTL) were analyzed in each group of rats．ELISA was used to detect the levels of interleukin-1 β (IL-1 β) ，IL-6 and tumor necrosis factor-α (TNF-α) in the dorsal horn of the rat spinal cord．Nissl staining was used to observe the pathological changes of neurons in rat spinal cord tissue．Immunofluorescence staining was used to observe the expression levels of ionized calcium-binding adapter molecule-1 (Iba-1) ，a marker of microglia in the spinal cord of rats ．Western blot was used to detect theprotein expression levels of LRRK2，p-p38 mitogen activated protein kinase (MAPK) ，p38 MAPK，and Iba-1 in the dorsal horn of the rat spinal cord. Results : Compared with the sham group，the model group showed a significant decrease in MWT and PWTL in the right hind limb of rats (P＜0. 01) ．The levels of IL-1，IL-6，and TNF in the spi- nal dorsal horn tissue，as well as the expression levels of LRRK2，Iba-1 proteins and p-p38 MAPK / p38 MAPK pro- tein ratio significantly increased (P＜0. 01) ．The proportion of Iba-1 positive cells in the spinal cord tissue signifi- cantly increased (P＜0. 01) ，while Nissl bodies were significantly reduced (P＜0. 01) ．Compared with the model group，the MLi-2 group showed a significant increase in MWT and PWTL in the right hind limb of rats (P＜0. 01) ， a significant increase in Nissl bodies (P＜0. 01) ，a significant decrease in the proportion of Iba-1 positive cells in the spinal cord tissue (P＜0. 01) ，and a significant decrease in the levels of IL-1，IL-6，and TNF and the expression levels of LRRK2，Iba-1 proteins and p-p38 MAPK / p38 MAPK protein ratio (P＜0. 01) ．However，Anisomychin in- tervention could activate the p38 MAPK signaling pathway and partially reverse the beneficial effects of MLi-2 on pain sensitivity and neuroinflammation in rats with neuropathic pain． Conclusion Inhibiting the expression of LRRK2 can alleviate pain sensitivity in NP rats induced by microglia activation mediated neuroinflammation，and its mechanism of action may be related to regulating the p38 MAPK signaling pathway.

Objective To investigate the role and mechanism of silent information regulator 1 (SIRT1)-NOD-like receptor protein 3 (NLRP3) axis in the effect of remifentanil against ischemia-reperfusion injury (IRI) in rat livers. Methods SD rats were randomly divided into sham operation group (sham group), IRI group, IRI+remifentanil pretreatment group (IRI+RPC group), IRI+SIRT1 inhibitor EX-527 group (IRI+EX-527 group) and IRI+RPC+EX-527 group, with 8 rats in each group. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), interleukin (IL)-1β and IL-18 of rats in each group were detected. The liver tissue pathology was observed. The apoptosis rate of hepatocytes in rats was detected. The expressions of SIRT1, NLRP3, cleaved cysteinyl aspartate specific proteinase-1 (Cleaved Caspase-1) and Gasdermin D (GSDMD) proteins in rat liver tissue were detected. Results Compared with the sham group, the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI group were increased, the serum ALT, AST, LDH, IL-1β, and IL-18 levels were increased, the relative expression of SIRT1 protein in liver tissue was decreased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were increased (all P<0.05). Compared with the IRI group, the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+RPC group were decreased, the serum ALT, AST, LDH, IL-1β, and IL-18 levels were decreased, the relative expression of SIRT1 protein in liver tissue was increased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were decreased; the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+EX-527 group were increased, the ALT, AST, LDH, IL-1β, and IL-18 levels were increased, the relative expression of SIRT1 protein in liver tissue was decreased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were increased (all P<0.05). Compared with the IRI+RPC group, the liver tissue pathological score and hepatocyte apoptosis rate in the IRI+RPC+EX-527 group were increased, the levels of ALT, AST, LDH, IL-1β, and IL-18 were increased, the relative expression of SIRT1 protein in liver tissue was decreased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were increased (all P<0.05). Conclusions SIRT1 may participate in the regulation of remifentanil against rat liver IRI by inhibiting NLRP3 mediated cell pyroptosis.