Objective:To examine the relationship between brain natriuretic peptide (BNP) and the recurrence of atrial fibrillation (AF) after successful electrical cardioversion (EC) by a meta analysis approach.Methods:Based on PubMed,Medline and China National Knowledge Infrastructure (CNKI) databases,related literatures,published from 1980-2008,were searched; a manual search was also performed.The included trials were analyzed by RevMan4.2 software for meta analysis.Results:Totally seven studies were finally included.The analysis revealed that the baseline BNP level were greater in patients with AF recurrence than those without AF recurrence,with the standardized mean difference in the BNP levels being 0.82 units (95% confidence interval 0.12 to 1.52).The test for overall effect Z-score was 2.30,with a P value of 0.02; there was significant difference.Conclusion:It is suggested that the higher BNP level after successful electrical cardioversion is associated with greater risk of AF recurrence.The level of BNP may serve as an indicator for AF recurrence after successful EC.

[Objective]To compare the osteoinductive activity of calcium sulfate(CS),allogenetic demineralized bone materials(ADBM) and heterogenetic demineralized bone materials(HDBM) by observing their efficiency in inducing bone formation.[Method]CS,ADBM and HDBM were transplanted into thigh muscle pouches of mice.Thirty-six mature Sprague-Dawly mice were divided into 2 groups at random.CS was transplanted into the left(group A 1,n=9) and ADBM into the right(group A2,n=9) thigh muscle pouches.HDBM was transplanted into the left thigh muscle pouches(group B 1,n=9) and the right sites were taken as blank controls(group B2,n=9).Experiments were done to induce ectopic bone formation.At 2,4,6 weeks postoperatively,specimen were collected to evaluate gross and tissue structures and biochemical tests for alkaline phosphatase(ALP) and Ca2+ so that osteoinductive activities of different bone graft materials could be assessed.[Result]At 2 weeks postoperativly,ADBM and HDBM were wrapped up by fibrous tissues and stromal cells gathering around the DBM slices.At 4 weeks postoperativly,formation of cartilage and osteoblasts were observed,and at 6 weeks,materials like cartilage matrix were observed to grow.The concentration of ALP and Ca2+ in study groups was higher than that of control group,which meant that 2 types of DBM had osteogenic potential and that the differences of osteogenetie potential in ADBM and HDBM relied on the donors,whereas CS could be degraded and absorbed fast with light inflammatory reaction and no ectopic bone formation was observed in CS graft.[Conclusion]Both ADBM and HDBM have osteoinductive potential.ADBM is better in inducing ectopic bone formation than HDBM.Differences in donors and preparation of ADBM and HDBM have impacts on their abilities of inducing ectopic bone formation.CS is good at biocompatibility and could be used as bulking agents to repair bone defects.

[Objective]To investigate the relationship between inoculation dose of staphylococcus aureus versus radiological and microbiological changes of rabbit tibial infection with bone defect.[Methods]Staphylococcus aureus(ATCC 29213) with total number of colony from 6?101 to 6?106 were prepared.The bacteria were injected in the tibia after an area of bone defect was made.The inoculated lesions were assessed for changes in radiological and bacteriological parameters at 3 weeks after infection.[Results]Development of significant histological and radiological signs of infected bone defect required an inoculum of at least 6?105 CFU/5 ?l.[Conclusion]These results suggest that strain staphylococcus aureus(ATCC 29213) induces the development of chronic rabbit tibial infection with bone defect,and that this model may be applied to identification of virulence factors in studies of posttraumatic osteomyelitis.

AIM:To study the effect of panax notoginseng saponins on the left atrial appendage(LAA)of the guinea pigs.METHODS:Standard microelectrode intracellular recording technique was used to record the LAA action potential(AP)and the effective refractory period(ERP)in the guinea pigs during the pouring with different density of PNS.RESULTS:The effect of PNS in concentration of 0.7,7,70,700 mg/L was significant at 20 min,the APD50 and APD80 of the pouring at 20 min,30 min,40 min of the 70 mg/L was longer than the reference group(P

BACKGROUND: Previous studies demonstrated that recombinant human bone morphogenetic pretein-7 (hBMP-7) can effectively promote the synthesis of extracellular matrix, repair of damaged disc matrix, restore of degenerative disc height. It is hoped that BMP-7 can be used to control and reverse the intervertebral disc degeneration. However, because of the short half-life of recombinant protein and low biological activity, it is difficult to maintain BMP-7 high concentrations on degenerative disc. Gene therapy can prevent these defects effectively.OBJECTIVE: To study the effect of hBMP-7 gene transfeotion on biological activity of primary cultured rabbit nucleus pulposus cells in vitro, to determine the feasibility of hBMP-7 gene which will on gene therapy research of intervertebral disc degeneration,and to provide basis for further study.DESIGN, TIME AND SETTING: A randomized and controlled observation was performed at the Institute of Cardiothoracic Surgery of Changhai Hospital from December 2005 to September 2006.MATERIALS: Six healthy New Zealand white rabbits of either gender, averaging 4 weeks old and weighing 500 g, were used in this study, and Ad-hBMP7 was constructed by the Cardiothoracic Surgery Institute of Changhai Hospital.METHODS: After rabbits sacrifice under aseptic condition, the nucleus pulposus was got. After digested with Pronase, type Ⅱcollagenase and type Ⅱ DNAase (4 hours, 37 "(2), the cells were seeded in the Petri dishes and were kept in the incubator. After 7 days and then twice a week, the media were refreshed. The nucleus pulposus cells were infected by adenovirus integrated with hBMP7 gene. The cells which were transfected by adenovirus vector for Lac-Z gene and which were not transfected were adopted as control.MAIN OUTCOME MEASURES: The expression of hBMP-7 was determined by RTopCR and Western blot. The effect of hBMP-7 on cell proliferation was surveyed by MTT. Furthermore, the effect of hBMP-7 gene on synthesis of proteoglycan and type Ⅱcollagen was detected by modified dimethylmethylene blue method and ELISA, respectively.RESULTS: Gene sequencing and PCR showed that hBMP-7 gene was inserted correctly and no mutation happened. The pdmary cultured rabbit nucleus pulposus cells were identical with those reported in literature. After Ad-hBMP7 transduct into the nucleus pulposus cells, high level of hBMP-7 expression was observed and lasted over 3 weeks. Also hBMP-7 gene can promote cell proliferation and synthesis of proteoglycan and type II collagen with significant difference compared with control groups (P < 0.05).CONCLUSION: hBMP-7 gene mediated by adenovirus can be the target gene for the further study on gene therapy of intervertebral disc degeneration.

The morbidity of deep vein thrombosis (DVT) after total hip replacement,total knee replacement or hip fractures surgery is high,and there is no effect way to prevent.Rivaroxaban is an oral,direct factor Xa inhibitor.The prevention effect of rivaroxaban to DVT after orthopedic surgery is stronger than enoxaparin.The view summarizes the mechanism,pharmacokinetics,interaction of drugs and the antithrombotic effect after orthopedic surgery.

Objective To evaluate the clinical outcome of reconstruction of the superior peroneal retinaculum (SPR) by using a portion of Achilles’s tendon and suture anchors in the treatment of chronic peroneal tendon dislocation .Methods Seven patients in our hospital from January 2010 to January 2015 who underwent surgical reconstruction of SPR by using a portion of Achilles ’ s tendon and suture anchors were evaluated .The ankle ’ s range of motion ( ROM) and The American Orthopaedic Foot and Ankle Society ( AOFAS) ankle-hindfoot score were used to evaluate the clinical outcome .Results All 7 cases were followed up for 6 to 24 months,the average time was 14 months,with-out recurrence.The ankle’s ROM improved from (23.6 ±1.9) °preoperative to (30.0 ±1.5) °at the final follow-up,and the AOFAS An-kle Hindfoot Scale improved from (60.6 ±3.6) point preoperative to (93.6 ±3.9) point at the final follow-up.Conclusion Surgical re-construction of SPR by using a portion of Achilles ’ s tendon and suture anchors may be an effective alternative surgical method for chronic peroneal tendon dislocation .

BACKGROUND: Scar hypertrophy is always followed by the wound healing in burn and trauma. Endothelial cells play a key role in scar hypertrophy, so inhibitory growth of endothelial cells can relieve scar hypertrophy to a certain degree. OBJECTIVE: To construct a recombinant adenovirus vector expressing human endostatin (Ad/hEnd), and to investigate the cooperative effect of Ad/hEnd and keratinocyte on endothelial cell proliferation. DESIGN, TIME AND SETTING: Observational study, which was performed in the State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital of the Third Military Medical University of Chinese PLA between September 2006 and May 2007. MATERIALS: pAdTrack-CMV and pAdEasy-1 were obtained from Stratagene Company, USA; 293 cell and Ecoli.DH5α were stored in our laboratory. METHODS: The endostatin gene sequence was obtained by reverse transcription-polymerase chain reaction (RT-PCR) and polymerase chain reaction (PCR) based on mRNA of human fetal hepatic tissue and inserted into the adenovims shuttle plasmid pAdTrack-CMV to obtain recombinant plasmid pAdTrack-ES. After identification, positive recon was transformed into pAdeasy 1 recipient virus to screen positive clones. The adenovirus Ad/hEnd was generated from 293 cells and identified by PCR and fluorescence microscope. Then the keratinocytes were infected with Ad/hEnd, and co-cultured with endothelial cells by nest dish culture method. The content of endostatin was detected, and the non-transfection keratinocytes were used as the controls. MAIN OUTCOME MEASURES: Homologous recombination and identification of pAd/hEnd; generation and identification of Ad/hEnd; endostatin expression after 293 cell transfection; purification and titer measurement of Ad/hEnd; content of endostatin in culture solution; apoptotic percentage of endothelial cells; inhibitory ratio of endothelial cells. RESULTS: Ad/hEnd was constructed and the virus titer was generally up to 1.65×1012 PFU/L. Ad/hEnd-infected keratinocytes could effectively express and secrete endostatin of which the content reached 226 μg/L after 3 days of co-culture. The apoptotic percentage and inhibitory ratio of the endothelial cells co-cultured with Ad/hEnd-infected keratinocytes were significantly higher than those in control group (P<0.05). CONCLUSION: Ad/hEnd-infected keratinocytes co-cultured with endothelial cells can promote apoptosis and inhibit proliferation of endothelial cells through excretion of endostatin.

BACKGROUND:There is little evidence on the use of al ogeneic tendon graft in the reconstruction of ankle joint.
OBJECTIVE:To explore the clinical outcome of anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon graft in patients with chronic ankle instability.
METHODS:Twenty-six patients with chronic lateral instability underwent anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon. There were 18 cases of simultaneous injury or chalasia in calcaneofibular ligament and anterior talofibular ligament, and 8 cases of anterior talofibular ligament injury or chalasia. The ankle joint function was evaluated according to AOFAS scale and Good classification. The affect ankle and healthy ankle were compared in the extension, plantar flexion activity, and metaleg activity.
RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 9-24 months with a mean of 15 months. No cases appeared recurrent ankle lateral instability. The mean AOFAS score in the group of calcaneofibular ligament and anterior talofibular ligament was improved from (48.4±3.7) points preoperatively to (88.2±3.8) postoperatively, while that in the group of anterior talofibular ligament was improved from (50.0±6.4) points preoperatively to (89.5±3.4) points postoperatively. According to Good score, there were excellent in 19 feet, good in 6 feet, fair in 1 foot, with an excellent and good rate up to 96%. No serious complication was occurred in this group. Anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon graft can increase the tendon-bone contact area, improve the rate of tendon healing, and enhance the stability of ankle joint in patients with chronic ankle instability. Further studies are needed to verify its long-term efficacy.