BACKGROUND:Previous studies demonstrated that ischemia can be compensated by establishing collateral circulation and microangiogenesis,and exercise training can ameliorate blood supply of ischemic lower limb.However,whether exercise training accelerate establishment of collateral circulation remains poorly understood.OBJECTIVE:To explore the mechanism of exercise training on accelerating microangiogenesis of rat ischemic lower limb.METHODS:Sprague-Dawley rats were randomly divided into the exercise training,model and sham-surgery groups.All animals were established left lower limb ischemia models except those in the sham-surgery group.Rats in the exercise training group were forced running 30 minutes per day at 1 week after model preparation and those in other groups were performed daily activities.The adductor of ischemic lower limb was obtained for the examination of microvessel density and the expressions of vascular endothelial growth factor and basic fibroblast growth factor.Simultaneously,bone marrow-derived endothelial progenitor cells were harvested for detection of microangiogenesis.RESULTS AND CONCLUSION:Number of endothelial progenitor calls,expressions of vascular endothelial growth factor and basic fibroblast growth factor,as well as microvessel density of the exercise training group was obviously greater than those in the model and sham-surgery groups(P<0.01).Compared with the model and sham-surgery groups,in vitro vasculogenesisof bone marrow-derived endothelial progenitor cells in the exercise training group was increased(P<0.05).These findings demonstrated that lower limb ischemia increases microangiogenesis,and exercise training enhances this effect.

Objective: To investigate the effect of administrative HDL-C (high density lipoprotein cholesterol) level on adverse cardiovascular events after discharge in elder patients with ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 325 STEMI patients treated in our hospital from 2010-04 to 2012-07 were retrospectively studied. According to administrative HDL-C level, the patients were divided into 2 groups as High HDL-C group, n=139 and Low HDL-C group, n=186. The basic and clinical conditions, in-hospital treatment, death and the medication, adverse cardiovascular events during 6 and 12 months follow-up period were compared between 2 groups.
Results: The patients with in-hospital reperfusion therapy was higher in Low HDL-C group, and Low HDL-C group had the higher ratio of emergent PCI treatment, all P<0.05. During follow-up period, High HDL-C group had less patients with β-receptor blocker treatment, less non- fatal MI, adverse cardiovascular events and re-hospitalization, all P<0.05. Cox regression analysis showed that low HDL-C level (HR=0.558, P=0.024) and diabetes mellitus (HR=1.528, P=0.040) were the risk factors of adverse cardiovascular events, while emergent PCI (HR=0.47, P=0.001) was the protective factor in STEMI patients after discharge.
Conclusion: The lower administrative HDL-C level in elder patients with STEMI had the higher risk of adverse cardiovascular events after discharge.

Objective To investingate the expression method of bcl-2 and it's significance in osteogenic tumor and tumor-like diseases.Method The protein of PCNA, p53, Fas and bcl-2 were examined immunohistologically in osteosarcoma, ossifying fibroma, fibeous dysplasia of bone and normal bone callus. The results were analysed combing with the information of metastasis and hisomorphology.Results PCNA and p53 were highly expressed in low-differentiated osteosarcoma, bcl-2 were highly expressed at high-differentiated osteocoma and ossifying fibroma. When PCNA, p53 and bcl-2 were all expressed at high level, the metastasis rate was high, when only bcl-2 was expressed at high level, the progmosis was better. Conclusion The mechanism for benign and malignant tumor are different, the benign and low-degree malignant tumor may be caused by over accumulated mutation cells sipported by high level of bcl-2, while malignant tumor may be the result of multi-gene cooperation abnormally.

Objective To investigate the influence of the cardiac function on the prognosis in the patients with acute myocardial infarction(AM I) complicating multivessel disease (M VD ) treated by revascularization .Methods 152 cases of AM I complicating MVD treated by routine percutaneous coronary intervention (PCI) were divided into the normal group(94 cases ,LVEF≥50% ) and the lower group(58 cases ,LVEF<50% ) according to the left ventricular ejection fraction (LVEF) ,and the influence of the cardiac function on the prognosis was analyzed .Results The myocardial infarction history ,history of atrial fibrillation ,NYHA classifica-tion ,hs-CRP ,LADp ,ISR ,left ventricular structure and function had statistically significant difference between the two groups (P<0 .05) .The multivariate Logistic regrossion analysis showed that NYHA classification ,LVEF ,LVMI and LVEDd were the inde-pendent risk factors affecting the prognosis after PCI .Conclusion The reduced cardiac function is a risk factor affecting the prog-nosis of AMI complicating MVD treated by PCI ,the improvement of the cardiac function will be beneficial to the prognosis of the patients .

BACKGROUND: Human lower limb system under different motion statuses exhibits great difference in terms of kinetic characteristics and joint deformation magnitude. Total hip replacement has been shown to be the best method to solve the severe illness of hip joints today. A good understanding of the responses of human lower limb system, in particular the knee joint, following total hip replacement is significant for rehabilitation training of patients.OBJECTIVE: To analyze the effects of total hip replacement on knee joint deformation during motions by comparing the data collected from a patient who underwent total hip replacement 19 months ago and a healthy control subject under the same testing environment and method.METHODS: The patient was measured through the use of Optotrak Certus motion capture system (Northern Digital Inc.,California), and simultaneously measurements were performed in a healthy control subject presenting with similar body weight and body mass. Measurement indices included step length, step frequency, joint corner, and joint displacement curves. Speed and acceleration of each joint were calculated based on measured data.RESULTS AND CONCLUSION: Following total hip replacement, the structure of natural hip joint was destroyed. Although the gait did not change greatly, experimental data showed that knee joint deformed more greatly than normal gait, indicating the self-accommodation of human body, i.e., increasing the loading and deformation magnitude of knee joints can avoid the injuries caused by hip joint surgery.

Objective To explore the early diagnostic significance of anti-cyclic citrullinated peptide(CCP) antibody and hidden rheumatoid factor immunoglobulin M(HRF-IgM) detected by ELISA in patients with juvenile rheumatoid arthritis(JRA). Methods The synthesized CCP was used as the antigen to detect anti-CCP antibody. Anti-CCP antibody and HRF-IgM were detected dynamically in 27 patients with early diagnosed JRA and their specificity and sensitivity were determined for early diagnosed JRA by calculating the positive predicting value (PPV) and negative predicting value (NPV). Results The total positive rate of anti-CCP antibody and HRF-IgM were 58.5 % and 65.0 % respectively in patients with JRA. The sensitivity of HRF-IgM was more predominant than that of anti-CCP antibody. There was a positive correlation between the positive rate of antibodies and the subtype of JRA. The specificity of anti-CCP antibody for predicting early JRA was superior to that of HRF-IgM. When using these two tests in combination, the PPV predicting rate of early JRA was 93.7 % . Conclusions Both anti-CCP antibody and HRF-IgM are elevated in patients with JRA, which show positive correlations with the subtype of the disease. The specificity of anti-CCP antibody testing is considerably higher for diagnosing early JRA, and when it was used together with HRF-IgM testing, the PPV for JRA can be raised further.

Objective To investigate clinical characteristics and emergency managements of postrenal acute renal failure(ARV)induced by melamine in infant.Method Fluid therapy for urine alkalization and hydration,cistoscope drainage and peritoneal dialysis step by step were exerted in those who had both a history of certain milk intake and ARF according to the definition of pediatric ARF which developed by Pediatric Nephrology Assembly of Chinese Pediatric Association in 1994.Results Thirty-four postrenal ARF cases with anuria due to melamine in Nanjing Children's Hospital of Nanjing Medical University were involved in the study.Seventy cases(50%)re-ceived fluid therapy only.Nine cases(26.5%)received fluid thempy and eistoscope drainagemand 4 cases (11.8%)received fluid therapy and cistoscope drainage and peritoneal dialysis.Four cases(11.8%)received ur-gent peritoneal dialysis due to severe hyperkalemia.All cases(100%)survived.The urine pH at the first day.the second day,and after the second day in those who just pass away urine were 6.1±1.0、6.5±0.7.5.3±0.4,respectively(F=4.563,P=0.026).Conclusions Fluid therapy for urine alkalization and hydration and stop sequential thempy are effective in infant with postrenal ARF induced by melamine.

Parkinson's disease (PD) is the second major neurodegenerative disease.The pathogenesis of PI) is still unclear.It is generally believed that neural damage, mitochondrial dysfunction, inflammation, oxidative stress and autophagy dysfunction caused by the transmission and aggregation of a- synuclein play an important role in the occurrence and development of PD.More and more research show- that metabolic disorder is one of the pathogenesis of PD.We examined whether overexpression of a- synuclein could induce metabolic disorder in mice and the possible mechanisms.Mice were divided into two groups: Thyl-aSYN transgenic mice (TG) and the control wild-type (WT) group.The rotarod test was used to analyze motor function in mice.We detected the body weight, plasma insulin content, glucose tolerance and insulin tolerance in the two group mice.The morphology of islets in the two groups were observed by hematoxylin eosin (HE) staining, and the islets were isolated to detect the glucose- stimulated insulin secretion (GSIS).The results showed that compared with the WT group, exercise tolerance of 12-month-old TG group decreased by 23.1% (P < 0.05) , body weight increased by 7% (P < 0.01), glucose tolerance decreased (P < 0.05), insulin tolerance decreased (P < 0.05), and insulin contents in the peripheral blood decreased by 20% (P < 0.05).Compared with the WT group, the levels of ce -syn proteins in the pancreas of the TG group increased by 1.32 times (P < 0.05) , the area of islets in the TG group decreased (P < 0.05 ) , the number of islets decreased (P < 0.01) , and the insulin secretion function decreased (P< 0.01).This study showed that the role of a-synuclein in PD is not limited to the damage of dopaminergic neurons, it also can affect metabolism and the morphology and function of peripheral organs, which provides a new theoretical basis for the pathogenesis of PD.

Objective　To investigate the effect of cardiopulmonary bypass (CPB) on vascular endothelial cell injury and plasma endothelin-1 and nitric oxide equilibrium in patients undergoing cardiovascular operation with CPB. Methods　A total of 20 patients with congenital heart disease (Group Ⅰ) and 20 with valvular problem (group Ⅱ) were operated on under CPB respectively. Blood samples were collected from central vein before skin incision, before CPB, 30 min after CPB, at the end of CPB, and end of operation, the first morning and third morning after operation. The levels of plasma thrombomodulin(TM), endothelin-1(ET-1) and nitric oxide(NO) were measured. Results　The plasma TM level was significantly elevated during CPB (P<0.01, P<0.05) and 1 d after operation, reached its peak as (4.88±1.12) ng/ml in Group Ⅰand (8.34±1.84) ng/ml in group Ⅱ at the end of surgery and came back to the level as before operation. The plasma level of ET-1 was also increased significantly after CPB and reached peak as (129.04±22.29) in Group Ⅰ and (156.62±29.66) in Group Ⅱ at the end of operation. And the level was still higher than before operation in 2 groups 3 d after operation. No change was found on the level of NO in 2 groups. Conclusion　CPB may cause extensive acute endothelial cells damage for about 24-48 h and recovered about 72 h and it may also cause an imbalance of ET-1 and NO.

Objective: To explore the ethical and juristic signif-icance of hearing with living-related kidney transplantation. Methods: This study involved 18 donors and recipients who received medical e-valuating and informing the related medical risk between Jul.2006 and Jun.2007. Our experience of 18 hearings with living-related kidney transplantation, which comprised members of Human Organ Transplant Te-chnique and Ethics Committee,donors,recipients and their direct rela-tives,was analyzed. Results the 16 hearings were successful, one res-igned donation,and two were controvertible and succeeded after re-ev-aluating. Conclusion:The hearing should have known,voluntary,equitab-le, unclassified and no commercial principle,and endeavour to ensure the medical,ethical and juristic entirety and integrity of living-re-lated kidney transplantation.