Plasma homocystein (Hcy) level and 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism were investigated in 50 normal subjects, 32 cases of hypothyroidism and 48 cases of hyperthyroidism. As compared with normal group, plasma Hcy level was increased in hypothyroidism group (P

[Summary] Ankle joint injury is one of the most common sports injuries , and some patients with chronic ankle instability need surgical treatment .Traditional incision surgeries are characterized with traumatic performance and high complication rates , and the exploration of the joint lesion is not comprehensive .With the development of minimally invasive surgery , the application of arthroscopy in the treatment of chronic ankle instability is increasing , which is conducive to the treatment of intra-articular lesions , while reducing the surgical trauma and improving the postoperative effects .In this paper , we summarized the current status of the application of arthroscopy in the surgery for chronic ankle instability from two aspects , which were arthroscopic surgery in the diagnosis and treatment of the disease, and total arthroscopic repair technology of ankle ligament .We also introduced domestic and overseas operation effects and new concepts .

AIM: To investigate the influence of GM-CSF on human vascular endothelial cells induced to form new blood vessels and the role of VEGF.METHODS: HUVECs were cultured by Matrigel to set up a stable angiogenesis system with the stimulating factors.The rhGM-CSF concentration-dependent and time-dependent effects and the role of VEGF165 were detected.CD34 was measured by immunochemical staining and numbers of vessel formation was calculated under microscopic observation.RESULTS: After treatment with rhGM-CSF at various concentrations and at different time points,the numbers of vessel formation increased in a dose-dependent and time-dependent manner.In the presence of VEGF165,the numbers of vessel formation increased evidently.CONCLUSION: HUVECs were induced to develop tubular structure in vitro cultured with Matrigel.GM-CSF promotes human vascular endothelial cells to form vessel-like structure in vitro in a dose-dependent and time-dependent manner.VEGF also in vitro promotes human vascular endothelial cells to form new vessel-like structure.

Objective To study the adsorption effect of activated charcoal suspension on paraquat (PQ) in gastrointestinal tract of beagles exposed to PQ.Methods Twenty healthy male beagles were randomly divided into experimental group and control group,with 6 beagles in each group.20％ PQ solution (a dose of 30 mg/kg) was prescribed through stomach for beagles in both groups.After exposure to PQ for 30 minutes,the beagles in experimental group were given activated charcoal suspension (1.0 g/kg of type Ⅰ activated charcoal powder mixed with 100 mL of normal saline) by gavage,while the control group was only given equal volume of normal saline.After exposure to PQ for 10 minutes,30 minutes,and 1,2,4,8,12,24,and 48 hours,blood was collected from hepatic portal veins and peripheral veins to detect the PQ concentration change in the plasma.The toxicokinetics software DAS 2.1.1 was applied to analyze PQ concentration and compare the change in toxicokinetics parameters between the both groups.The change in vital signs including heart rate (HR),respiratory rate (RR) and pulse oxygen saturation (SpO2) was dynamically monitored 10 minutes before exposure,4 hours and each day from the 1st to the 7th day after exposure.Results After exposure to PQ,the poison concentration in the plasma of hepatic portal veins and peripheral veins in the control group rose quickly and reached peak 4 hours later.It fell quickly at first,and fell slowly 8 hours later.But in the experimental group,the increase rate to the peak was significantly slow.Besides,PQ peak fell more obviously than that in the control group and it was about 50％ of the control group (μg/L:123.50 ± 11.67 vs.255.18 ± 12.29 in blood from hepatic portal veins,122.35± 11.72 vs.250.86± 11.15 in blood from peripheral veins).After 8 hours it fell much more quickly than that of the control group.After exposure to PQ for 48 hours,PQ concentration in the plasma was still lower than that of the control group (μg/L:0.53 ± 0.18 vs.15.98 ± 5.58 in blood from hepatic portal veins,0.31 ± 0.01 vs.15.03 ± 4.82 in blood from peripheral veins,both P ＜ 0.01).With the toxicokinetics analysis,compared with the control group,the maximum concentration (Cmax) and area under the curve (AUC) of PQ in the plasma of hepatic portal veins and peripheral veins in the experimental group were significantly decreased [Cmax (μg/L):125.07 ± 9.49 vs.255.18 ± 12.29 in blood from hepatic portal veins,123.38 ± 9.52 vs.250.86 ± 11.15 in blood from peripheral veins;AUC (mg· L-1· h-1):1.6±0.2vs.3.3 ± 0.4 in blood from hepatic portal veins,1.5 ± 0.2 vs.3.2 ± 0.3 in blood from peripheral veins],time to the peak (Tmax) of PQ was slowed (hours:5.3 ± 1.9 vs.4.0 ± 0.0 in blood from hepatic portal veins,4.7 ± 1.5 vs.4.0 ± 0.0 in blood from peripheral veins),and PQ plasma half-life (t1/2) and mean retention time (MRT) were significantly shortened [t1/2 (hours):3.8 ± 1.2 vs.15.4± 3.7 in blood from hepatic portal veins,3.5 ± 1.0 vs.15.5 ± 2.7 in blood from peripheral veins;MRT (hours):8.0± 1.5 vs.13.4± 1.2 in blood from hepatic portal veins,7.6± 1.3 vs.13.3± 1.2 in blood from peripheral veins;all P ＜ 0.01].After exposure to PQ,HR and RR in both the experimental group and the control group increased and reached to the peak about the 4th day and then the increase rate began to slow down gradually;SpO2slowed down gradually and reached to the valley about the 4th day and then it began to recover,but the change range of vital signs in the experimental group was smaller than that of the control group,and the parameters were significantly better than those of control group [4-day HR (bpm):134.50±3.00 vs.142.00±6.43,4-day RR (times/min):31.00±0.58 vs.34.33±0.94,4-day SpO2:0.900±0.006 vs.0.873±0.005,all P ＜ 0.05].Conclusion Activated charcoal administrated at 30 minutes after PQ poisoning can slow down the increase rate of PQ concentration in the plasma,decrease the peak concentration and has less influence on vital signs in beagles.

Objective:The feasibility of a minimally invasive cosmetic transbilical laparotomy was studied in fifty-seven pediatric patients.The advantages of this technique will be discussed.Methods:The circumferential incision was made following the ring fold of the right umblilicus,which was less than 2700.The peritoneum was opened in the midline via rectus abdominis.Intra-peritoneal lesions were detected and explored.The surgical procedures were able to be carried out either inside or outside of the peritoneum.After closure of peritoneum,the umbilical incision was closed subcutaneously with an absorbable suture.Results:From January 2001 to January 2005,58 procedures via transumbilical route have been done in 57 pediatric patients.None of those cases required conversion to a traditional abdominal incision.The duration of surgery was from 20 to 170 minutes.All patients were discharged five days postoperatively and follow-up was conducted from 3 months to 4 years.No complications were observed in all but one patient.This patient had a leaking anastamosis.No visible scars were present and the cosmetic results were excellent.All patients had shorter hospital stay and lower operating cost.Conclusion:Transumbilical approach is a feasible,safe,economical,minimally invasive procedure with excellent cosmetic results which appears to be superior to traditional procedures.It suggests that the transumbilical route should be widely used clinically and might be applicable for elder children and possibly would be of benefit in the treatment of other conditions.

Objective: To study the expression of hepatocyte growth factor(HGF) in acute pulmonary embolism, and the diagnostic value of HGF thereof. Methods: The acute autoblood pulmonary thromboembolism was used to establish rat pulmonary embolism model. There were blood plasma HGF detection group,organization HGF mRNA detection group and control group respectively. The expressions of plasma HGF and organization HGF were observed during the different periods of acute pulmonary embolism. Results:The expression of HGF was much higher in blood plasma HGF detection group than that of control group at different time points(P ＜ 0.01). The expression of HGF mRNA increased in organization HGF detection group compared with that of control group at 12 h after pulmonary embolism(P ＜ 0.01). Conclusion: The expression of HGF increased in acute pulmonary embolism, which can be used as a diagnosis indicator in acute pulmonary embolism.

Objective To establish an animal model by placing one end of PICC in the hepatic portal vein of a beagle dog and leaving the other end out of its body.Methods Six Beagle dogs were given respiration anesthesia through orotracheal intubation.An incision was made through the right rectus abdominalis to locate the superior mesenteric vein (SMA) and the main hepatic portal vein.The left branch of SMA was separated and cut to put PICC into the main hepatic portal vein before being ligated and fixed.The other end of PICC was elicited through the right abdominal wall and passed beneath the skin to the back neck and fastened in case of movement.Results The anesthetic effect was good and all the operations were successful.The mean operation time was about an hour and the mean blood loss was about 15 ml.The incision healed 5-7 d after operation.Conclusion The establishment of the model can improve the effects of liver-targeting drugs,which can cut down the dosage,lower the cost of treatment and experiment and reduce the adverse effect of medicines.Through PICC,we can directly draw blood from the hepatic portal vein to measure the blood concentration before the first pass elimination.Then according to the concentration,we can calculate the absorption rate in the gastrointestinal tract,which can facilitate related experimental studies.

Objective: To explore the correlation between depression severity and neurocognitive function in patients with late-onset depression . Methods: The patients with late-onset depression treated in Jinhua Second hospital from February 2015 to December 2017 were assigned into the mild,moderate and severe groups according to the severity of depression assessed by the Hamilton Depression Scale-17（HAMD-17）. At the same time,some healthy persons were selected as the control group. Wisconsin Card Sorting Test（WCST）,Verbal Fluency Test（VFT）and Stroop Test were carried out,and the scores of these tests were compared in the four groups. The correlations of WCST, VFT, Stroop Test and HAMD-17 scores were analyzed . Results: There were 32,28,35 and 35 subjects involved in the mild,moderate,severe and control group,respectively. The subjects of the mild group,moderate group and severe group had more total errors,perseverative responses and perseverative errors than the control group,and less percent conceptual level responses than the control group （all P<0.05）. The total errors,perseverative responses,perseverative errors and percent perseverative errors increased and the percent conceptual level responses decreased gradually with the severity of depression（all P<0.05）. The correct numbers of Stroop-consistent group and VFT in the severe group were less than those in the control,mild and moderate group（all P<0.05）,which was significantly different between the mild,moderate and control group （P>0.05）. The HAMD-17 scores were negatively correlated with the correct numbers of Stroop congruent group（r=-0.448,P<0.001）and VFT（r=-0.401,P<0.001）,and were positively correlated with perseverative responses in the WCST（r=0.784,P<0.001） . Conclusion The neurocognitive impairment in patients with late-onset depression aggravated with the severity of depression.

10.3969/j.issn.2095-4344.2013.25.016

Objective: To determine the scavenging effect and the change of metabolism of paraquat (PQ) using hemoperfusion (HP) once and twice within 12 hours after intoxication and explore the better scheme of HP. Methods: 18 beagles were randomly divided into 3 groups. Single HP group, Double HP group and Control group. Peripheral veins blood was collected at different times within 48 hours after exposure in each group. Toxin concentration was measured, analyzed and compared among 3 groups. Results: 6 hours after exposure, Single HP group and Double HP group has finished the first HP treatment, and the concentration of PQ was lower than that of the control group, the difference was statistically significant (P<0.05) . 10 hours after exposure, there was no statistical difference of toxin concentration among 3 groups (P>0.05) . 12 hours after exposure, Double HP group has finished the second HP treatment, the concentration of PQ was significantly lower than that of Single HP group and Control group (P<0.05) . 24 hours and 48 hours after exposure, there was no statistical difference of toxin concentration among 3 groups (P>0.05) . Statistical difference were not observed in toxicokinetical parameters among 3 groups (P>0.05) . Conclusion HP treatment once and twice within 12 hours after intoxication could effectively reduce the toxin concentration in the peripheral veins blood after HP for about 4 hours, then the toxin concentration would return to the same level as Control group quickly. It was suggested that at the beginning of poisoning, HP treatment once or twice could not significantly change the metabolism of paraquat.