Animals ; Ca(2+) Mg(2+)-ATPase ; metabolism ; Ischemic Preconditioning, Myocardial ; Male ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

Objective To probe the difference in outcome between genders treated by a modern unisex design of total knee replacement. Methods Eighty OA patients treated with unilateral total knee replacement between January 2001 and December 2004 were evaluated retrospectively. There were 40 patients in male and female group each.The inclusion criteria included:age ranged from 53 to 77 years;The flexion deformity was less than 40 degrees, the genu varum or genu valgum deformity was less than 20 degrees. Patients who had a diagnosis other than primary osteoarthritis and who had had previous open knee surgery were excluded. There were 20 patients treated with posterior cruciate ligament-retained mobile-beating prosthesis and 20 patients treated with posterior stabilized fixed-bearing prosthesis in each group. The patients were assessed clinically with use of American Knee Society score (KSS score). Results All patients were followed up, with the mean time of 6.3 years. At the final follow-up, the improvement of KSS knee score was 34.87±27.14 in males and 30.23±26.13 in females (U=0.78, P=0.0519). The improvement of KSS function score was 21.45±19.47 in males and 22.79±17.31 in females (U=0.2, P=0.1635).There was no difference between the genders in terms of improvement in the knee function score and function score. Conclusion There was little difference in outcome between the genders treated by a modem unisex design of total knee replacement in this study.

BACKGROUND: New porous β-tricalcium phosphate (TCP) was made by appropriate prescription and unique technology, with a porosity of (75±10)%, spheroidal hole>80%, micropore<20%, interlink rate between the holes of 100% and mechanical strength>2MPa.OBJECTIVE: To assess the application outcome of the new porous β-TCP as a scaffold for bone tissue engineering.DESIGN, TIME AND SETTING: The control experiment was performed at the Laboratory of Tissue Engineering of Southern Medical University, China from July 2005 to March 2006.MATERIALS: Twelve 6-month New Zealand rabbits were used to create 1.5cm large bone and periosteum defects of the left radial bone. Porous β-TCP was purchased from bio-lu, France.METHODS: Osteoblasts differentiated from rabbit bone marrow mesenchymal stem cells (BMSCs) were co-cultured with porous β-TCP. Inverted phase contrast microscope and scanning electron microscope were used to observe the growth of BMSCs. MTT assay was employed to assess cell proliferation and compatibility. Cytotoxicity was detected by analyzing the effects of different concentrations of porous β-TCP leaching liquor on cell proliferation.MAIN OUTCOME MEASURES: Cell compatibility and cytotoxicity of β-TCP were measured. The status of bone defect repair was appraised by histology, radionuclide bone scan and X-ray at 2, 6, 12 weeks after surgery.RESULTS: The new porous β-TCP had good cell adhesion and its cytotoxicity was in 0 grade. Histology, imageology and radionuclide bone scan showed the new porous β-TCP could repair large radial bone defect in rabbits. At the same time, its degradation rate was accordance with bone formation rate in vivo.CONCLUSION: The new porous β-TCP with a good compatibility is a good scaffold for bone tissue engineering, and obtains good outcomes in repairing large bone defect of rabbit radial bone.

Objective To investigate the operative techniques and clinical significance in the treatment of large area soft tissue defect in children limbs by sequential vacuum-assisted closure and free flaps. Methods Twenty-two cases of children patients, with a range between 3 and 10 years, were treated by sequential vacum-assisted closure (VSD) and free flaps. All the patients suffered from large area soft tissue defect after severe trauma of limbs, with bone, tendon and other deep tissues exposed or partial defected. The wound area varied from 12 cm × 8 cm to 34 cm × 25 cm, and among the wound 9 cases were fresh and the other 13 were necrotizing infection. After strictly cleaned, the wound was covered with VSD according to the condition of the soft tissue defect and its underlying tissue damage. For the patients complicated with unsteady fracture, the fracture was fixed with outside-fixed frame or inside-Kirschner nails. The VSD negative pressure membrane was removed after 5 to 9 days, then the wound was repaired by free flaps grafting in 8 cases and by free flap combined with skin grafting in the other 14 cases. The survival and recovery conditions were followed up after the operation. Results After treatment by VSD, no obvious infection was seen in 22 cases of children patient with large area soft tissue defect complicated by underlying tissue exposure, and granulation tissue surrounding tendons and bone exposure area grew well. The survival rate of the free flaps was 100% whithout vascular crisis.The infection was well controlled, and no fistula tract was seen. The patients were followed up for 6-24 months and the flaps had soft texture and good appearance with satisfactory functional recovery of the affected limbs.Conclusion For pediatric patients with large area soft tissue defect complicated by underlying tissue exposure, after strict debridement, the treatment circle will be obviously shortened by the application of sequential vacuan seding dranage and microsurgical technique, and the success rate of the operation is improved. Therefore, function of the affected limbs in children will be recovered as far as possible.

Objective To evaluate the effect of the combination of dexmedetomidine and sufentanil on monitoring anesthesia care during burr-hole surgery for patients with chronic subdural hematoma. Methods 96 pa-tients underwent burr-hole surgery for chronic subdural hematoma with MAC were randomly divided into two groups:Group D and Group DS (n=48 in each group). Local anesthetic block was started at least 10 min after DEX and sufentanil infusion. Ramsay sedation scale of the two groups was maintained to 3. Anesthesia onset time, hemo-dynamics, the amount of rescue midazolam or fentanyl, the time to first dose of rescue midazolam or fentanyl, the to-tal number of intraoperative patient movements, postoperative recovery time, patient and surgeon satisfaction scores, and the adverse events were recorded. Results Compared with group D, anesthesia onset time was significantly less in group DS (13.68 ± 3.13 vs. 11.82 ± 2.43 min, P=0.002). More patients in group D required rescue midazol-am to achieve RSS=3 compared with group DS (31.25%15/48 vs. 12.50%6/48, P=0.023). Compared with group D, significantly fewer patients in group DS required rescue fentanyl to relieve pain (10.42%5/48 vs. 27.08%13/48, P = 0.036). Additionally, the total dose of rescue fentanyl in group DS was significantly higher (89.48 ± 23.27 vs. 125.28 ± 33.52μg, P=0.000), and the time to first dose of rescue fentanyl was longer than group D(18.34 ± 4.45 vs. 14.34 ± 3.63 min, P=0.000). The total number of patient movements during the burr-hole surgery was higher in group D than group DS (35.42%17/48 vs. 16.67%8/48, P=0.036). The time to recovery for discharge from the PA-CU (time to an Aldrete score ≥ 9) was significantly shorter in group DS compared with group D (17.54 ± 5.92 vs. 12.57 ± 5.28 min, P=0.000). Results from the patient and surgeon satisfaction scores showed significant differenc-es favoring group DS (P<0.05). More patients in group D showed higher levels of the overall incidence of bradycar-dia (37.50% 18/48 vs. 18.75% 9/48, P = 0.041) and hypotension(37.50%18/48 vs. 14.58%79/48, P=0.011)com-pared with group DS. Conclusions Compared with DEX alone, DEX-sufentanil associated with fewer number of in-traoperative patient movements, less amount of rescue scheme, could be safely and efficiently used for MAC during burr-hole surgery for patients with chronic subdural hematoma.

Objective To determine the effect of suppressing TrkA expression on pancreatic cancer chemosensitivity to gemcitabine and further disclose the role of PI3K/Akt signal transduction pathway in pancreatic cancer chemoresistance. Methods Human pancreatic cancer cell lines PANC-1, MIA-PaCa-2 and ASPC-1 were studied. The expression and kinase activity of TrkA were determined by Western blot analysis and in vitro kinase assay, respectively. RNA interference was used to suppress TrkA expression. Gemcitabine-induced cytotoxicity was determined by tetrazolium reduction assay and caspase profiling was performed. The effect of TrkA-specific siRNA on PI3K/Akt activity was also quantified. Results TrkA expression and kinase activity in cell lines were directly correlated with gemcitabine chemoresistance. TrkA-specific siRNA suppressed TrkA expression and kinase activity, and furthermore increased gemcitabine-induced, caspase-mediated apoptosis. PI3K/Akt activity was decreased by suppression of TrkA expression. Conclusion TrkA is a determinant of pancreatic adenocarcinoma chemoresistance and PI3K/Akt is a key signaling component by which NGF activation of the TrkA signal transduction pathway protects pancreatic cancer cells from chemotherapy-induced cell death.

Objective To introduce the transfer of anterolateral thigh flap with iliotibial tract in repair of massive skin and soft tissue defects of the forearm and reconstruction of extension or flexion of the forearm. Methods Eight cases of complicated raw wounds of the forearm were repaired with transfer of anterolateral thigh flap with iliotibial tract. Flexor tendons of 3 cases and extensor tendons of 5 cases were repaired with iliotibial tract. The axial vessel of the flap was used to rebuild blood supply of the hand. Results All the flaps survived completely. A follow-up ranging from 3 months to 2.5 years re- vealed that the reconstructed forearms were good in appearance and soft in texture and restored protective sensation. Affected limbs could perform extension or flexion. Total range of motion (TRM) of the hands was excellent in 6 cases and poor in 2. Conclusion Anterolateral thigh flap with iliotibial tract can not only repair soft tissue defects of the forearm, but also reconstruct the main extension or flexion of the forearm simultaneously.

Objective:To explore the value of two-dimensional speckle tracking echocardiographic imaging (2D-STI) for assessing partial and global left ventricular functional changes at pre-and post-percutaneous coronary intervention (PCI) in patients with chronic total coronary occlusion.
Methods:Echocardiograph was conducted in 23 chronic total coronary occlusion patients at pre-PCI and 1 day, 3, 6 months post-PCI to examine left ventricular ejection fraction (LVEF), meanwhile 2D-STI was applied to obtain the global longitudinal strain (GLS) value of left ventricle.
Results:In all 23 patients, for LVEF, compared with pre-PCI (59.29±12.15)%, it was increased at 3 and 6 months post-PCI (60.00±12.35)%and (61.37±11.8)%respectively, all P<0.05;for GLS value, compared with pre-PCI (-12.77d wit )%, it was decreased at 1 day and 3, 6 months post-PCI (-13.23ecrea)%and (-15.67ecrea)%, (-16.97ecrea)%respectively, all P<0.05.
Conclusion:PCI could effectively improve left ventricular function in patients with chronic total coronary occlusion, 2D-STI technology may quantitatively assess those changes at the early stage.

AIM: To observe the effect of piceatannol on the kidney of diabetic nephropathy rats in early stage, and to explore the possible mechanisms.METHODS: The rats were randomly divided into 5 groups: control group, model group, low dose of piceatannol treatment group, medium dose of piceatannol treatment group and high dose of piceatannol treatment group.The rat model of diabetic nephropathy was induced accordingly, and the rats received 20 mg/kg, 40 mg/kg or 60 mg/kg of piceatannol by gavage once a day for 4 weeks.Blood glucose was detected by glucometer.The urea nitrogen and creatinine levels in the serum were measured by urease-glutamate dehydrogenase enzymatic and inosine acid oxidase methods, respectively, and 24 h urinary microalbumin was analyzed by immune transmission turbidimetry test.Moreover, the pathological changes of the kidney tissues were observed under microscope with HE staining.The protein expression of TGF-β1 and Smad 7 and the phosphorylation levels of Smad2 and Smad3 were determined by Western blot.RESULTS: Compared with model group, piceatannol treatment significantly decreased the levels of blood glucose, blood urea nitrogen and urinary microalbumin, but had no effects on serum creatinine.Furthermore, HE staining showed that the increased mesangial cells, matrix hyperplasia and degenerated epithelial cells in model group were markedly inhibited after piceatannol treatment.Additionally, piceatannol treatment also reduced the protein expression of TGF-β1 and Smad 7, and the phosphorylation levels of Smad2 and Smad3.CONCLUSION: Piceatannol attenuates pathological progression in the kidney of diabetic nephropathy rats in early stage, which may be through inhibiting TGF-β/Smad signaling pathway.

Background The visual system of animal have to optimally adjust in various environmental conditions in order to obtain stable and effective visual funetion.However,the color vision system of animals which encounter uncertainty of spectral signals should be plastic.Whether the densities of various cones and expression of opsins change with long-time spectral deprivation is unclear.Objective This study was to investigate the changes of cone density as well as the expression of corresponding opsin and mRNA following the long-term illumination of monochromatic light.Methods Thirty 3-day-old guinea pigs were randomized into 3 groups and exposed tO the 530 nm green light,400 nm purple light and white light for consecutive 8 weeks respectively.The flat-mounted retinal sample was prepared and divided into dorsal zone,ventral zone and mixed zone anatomically according to the distribution of difierent light-sensitive cone.The changes in density of cone cells sensitivited to different colored light were detected by single-1abel or double-label immunocytochemistry.The levels of opsin and its mRNA were determined using Western-blot and real-time PCR respectively.Results The density of green-sensitivity cones was significantly different in the dorsal zone of retina among green light group,purple light group and white light group (F=234.28,P<0.01).Compared with white light group,the density of green-sensitive cones in dorsal retina of green light group was obviously higher but that of purple light group wag evidently lower(q=389.68,P<0.01；q=67.11,P<0.01).No significant difference was found in the density of purple-sensitive cones in the ventral zone of retina among green light group,purple light group and white light group(F=3.14,P>0.05).The density of coexpression of the mixed cone cells was increased in green light group(q=157.55,P<0.01)but decreased in purple light roup (q=254.85,P<0.01)in comparison with white light group.The expression levels of green-opsin and green-opsin mRNA in green light group was significantly elevated(q=184.45,P<0.01；q=4.71,P<0.05),but those of purple light group were evidently declined(q=5.87,P<0.05；q=346.66,P<0.01)in comparison with white light group.There was no statistically significant differences were found in the expression of purple-opsin and its mRNA among all the groups(F=1.24,P>0.05；F=3.27,P>0.05).Conclusion After the exposure of long-time monochromatic light illumination,monochromatic cones density and its opsin in guinea pig occur the corresponding alteration to gain good spatial vision as a compensatory reaction.These outcomes imply that there is some plasticity during the development of color vision.The increase of green-sensitive cones might be from the differentiation of coexpression cones in transition region.