砄bjective: To seek for the method of reinnervation of denervated pectoralis major myoflap. Method:The model of pectoralis major myoflap transposition in 20 New Zealand rabbits was used. After the myoflaps were transferred (original nerve innervation,ON) and ON denervation followed by hypoglossal genioglossus muscle neuromuscular pedicle implantation (NMP) wre performed. The flaps were examined at the intervals of 4,8,12 and 16 weeks respectively after operation. Results:In NMP myoflaps contracted when the hypoglosal nerve was stimulated,some type Ⅱ fibers in the myoflaps transformed into type I, but the pattern of distribution of the muscle fibers displayed mosaic and was similar to that of genioglossus muscle. Conclusion:The denervated pectoralis major myoflap can be reinnervated by hypoglossal-genioglossus muscle neuromuscular pedicle transplantation.

[Objective]To analyze the causes of complication following percutaneous vertebroplasty and to find out the methods on its prevention and treatment.[Method]Complications of 140 patients (233 vertebral bodies) performed percutaneous vertebroplasty from August 2002 to July 2006 and long-term complications and its correlative prognosis after followed-up 7-52 months (average 28.4 months were observed and analyzed.[Result]Sixty-one patients of 140 cases showed complications (43.6%).Forty-five of the 61 patients with complications revealed with leakage of bone cement,2 with transient low blood pressure or lethargy,3 with dyspneic respiration or slight cough or chest discomfort,1 with subcutaneous herniation.In 12 patients complicated with leakage of bone cement,10 complained aggravation of pain,1 of radiating pain of back and low limb,1 with incomplete paraplegia. The 11 patients complicated with various postoperative pain induced by bone-cement leakage were complete recovery after treatment with anti-imflamatory analgetics orally for 3-7 days.One patient with incomplete paraplagia caused by leakage of bone cement demonstrated satisfactory walking function recovery but still remained slight disability of lower limbs after 26 months by treatment of laminectomy decompression,with drawing of bone cement combined with anti-biotics,dehydration agent,hormone,nerve-nourisling agent and 3-month acupuncture. Two patients with transient low blood pressure or lethargy were treated and recovery after fluid infusion and 30-60 oxygen taking. Three patients with dypneic respiration or slight cough or chest discomfort but without abnormality on radiographs were convalesced after treatment of fluid infusion,taking oxygen and anti-biotics for 3-5 days.The subcutaneous homotoma of 1 patient was absorbed 7 days later.Ten patients complicated with new adjacent vertebral body fracture 1-12 months postoperatively were healed after conservative treatment of PVP operation.[Conclusion]Complications after percutaneous vertebroplasty are not uncommon(43.6%).Leakage of bone cement is most common complication. Strict pre-operation plan and improving operation skill are the most important preventive measures.

Objective To evaluate the systolic and diastolic function in hypertrophic segments by myocardial strain rate imaging in the patients with hypertrophic cardiomyopathy (HCM).Methods Ten patients with HCM in the mid segment of the ventricular septum and 20 age-matched healthy controls were included.The myocardial strain rate (SR) curves in bas,mid and apical segments were respectively acquired on the left ventricular septum longitudinal axis position for all the participants,and the SR curves of endocardial,mid-myocardial,epicardial layers in mid segment were also acquired.The SR values including the peak systolic SR,the peak early-diastolic SR,the peak late-diastolic SR were respectively measured,the left ventricular eject fraction (EF) and the Doppler transmitral filling velocities (E and A values) were also measured.Results SR values measured from the hypertrophic segments were significantly lower than those from the corresponding segments of the septum in control group (P

0.05).Conclusion Omeprazole and Tegaserod improved the reflux symptoms of the NERD patients.Omeprazole improves abnormal acid exposure but not abnormal bile exposure.Tegaserod improved neither abnormal acid exposure nor abnormal bile exposure.

Pain is a common complication after spinal cord injury. Clinical studies involve pain mechanisms, classifications and treatments,etc. Pain after spinal cord injury needs comprehensive treatment. However, each of these interventions may produce only small curative effect, so this article aims to emphasize the best evidences and provide clear, wise and prudent evidences for clinical decision by reviewing clinical researches about pain after spinal cord injury.

BACKGROUND:Occluder closure of atrial septal defect exhibits clear function, safety and efficiency advantages ＜br> OBJECTIVE:Using real-time three-dimensional echocardiography (RT-3DE) technique to evaluate the effect of atrial septal defect occlusion using different occluders on left ventricular structure and motion of the mitral annulus. ＜br> METHODS:Thirty-seven cases diagnosed as atrial septal defect underwent atrial septal defect occlusion, including 20 males and 17 females, aged 20-60 years. The occluder was chosen individual y according to defect size and edge hardness. Conventional and RT-3DE examinations were performed at 1 day prior to occlusion, 1 and 3 months after occlusion. ＜br> RESULTS AND CONCLUSION:Four of 37 patients were withdrawn from the study because of poor RT-3DE results. The other 33 patients harvested good occlusion results. At 1 and 3 months after occlusion, left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume were significantly increased (P＜0.05). Moreover, the more increase in these parameters occurred at 3 months after occlusion (P＜0.05). There were no significant changes in left ventricular ejection fraction and mitral annular displacement at three different time points. Left ventricular volume change rate and left atrial volume change rate were positively correlated to the type of occluders, while there was no correlation between endocardial cushion stump and mitral annular displacement. These findings suggest that atrial septal defect occlusion can increase the volume of the left ventricle and left atrium, but exhibit no effect on the motion of the mitral annulus.

Objective To investigate the effects of acupuncture on the improvement of esophageal motility disorder in patients with refractory gastroesophageal reflux disease (GERD).Methods From September 2012 to March 2014,40 patients with refractory GERD were enrolled and evenly divided into the treatment group and the control group. High resolution esophageal impedance manometry was conducted in patients.After the first examination,patients of the control group lay down for 30 minutes, and patients of the treatment group received acupuncture treatment at Neiguan,Gongsun and Zusanli points for 30 minutes.Then all the patients underwent high resolution esophageal impedance manometry again.ManoView ESO 3.0 software was used for analysis.The parameters included swallowing peristalsis defect,lower esophageal sphincter (LES)pressure,LES residual pressure,LES length,upper esophageal sphincter (UES)pressure,distal wave amplitude,peristalsis duration time,starting speed of peristalsis wave,speed of edge contraction and integration of the peristaltic waves.Chi-square test or t test was performed for data analysis.Results The percentage of normal swallows of the treatment group before and after treatment was 56.0% (112/200)and 74.0% (148/200),the percentage of delayed esophageal emptying was 31 .5 % (63/200 )and 11 .5 % (23/200 ),and the differences were statistically significant (χ2 =14.242 and 23.700,both P <0.01 ).However there was no significant difference in those of the control group (both P > 0.05 ).The LES resting pressure of the treatment group before and after treatment was (20.2 ±18.8)mmHg (1 mmHg=0.133 kPa)and (26.3±10.1)mmHg,the length of LES was (2.2 ±0.6 )cm and (3.3 ±0.8)cm,the distal esophageal peristaltic amplitude was (60.2 ± 21 .9)mmHg and (41 .1 ± 16.8 )mmHg,and the differences were statistically significant (t = 5 .519, 6.580 and 6.881 ,all P <0.01 ).There was no significant difference in LES residual pressure before and after treatment (P >0.05 ).There as no significant difference in LES resting pressure and LES residual pressure of the control group before and after lying down (both P >0.05 ).However,before and after lying down,there were significant differences in the length of LES ((2.3 ±0.6)cm vs (2.5 ±0.6)cm) and UES resting pressure ((67.4 ±21 .2 )mmHg vs (53.5 ±18.1 )mmHg)in the control group (t =2.530 and 6.652,both P <0.05 ).The distal wave amplitude of the treatment group before and after treatment was (73.7 ±28.3)mmHg and (88.5 ±29.1 )mmHg,the duration of peristalsis was (2.9 ± 0.4)s and (3.2 ± 0.4 )s,the distal contraction integral was (977.7 ± 733.2 )mmHg · cm · s and (1 225 .9±945 .1)mmHg·cm·s.All the differences were statistically significant (t=7.907,3.404 and 3.325 ,all P <0.01).There were no statistically significant difference in the beginning speed of peristaltic wave and the contractile front velocity (CFV)(all P >0.05).Before and after lying down,there was no significant difference in distal wave amplitude,duration of peristalsis,the beginning speed of the peristaltic wave and CFV of the control group (all P >0.05 ).Conclusion Acupuncture can help increase the LES resting pressure,extend the length of LES,improve the overall peristaltic pressure and completeness of esophageal somatic part,meanwhile,it increases the percentage of normal swallows of patients with refractory GERD.

0.05). ALP activity of the cells on deproteinized bone was higher than that on decalcified bone(P

Objective To evaluate left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiography to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Systolic strain rate (SRs), early diastolic strain (SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured. Results Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA. After 3 months,SRa and SRe in anterior, inferior and septal were significantly improved, however, SRs showed no significant difference. LAVmax and LAVpre were significantly decreased. LAPEF and LAAEF were significantly improved. Conclusions The patients with circumferential pulmonary vein ablation were in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.

Objective　To investigate the role of cytotoxic T lymphocyte associated molecule-4Ig(CTLA-4Ig) in the prevention of C57BL/6 mice autoimmune hepatitis. Methods　The C57BL/6 mice were intraperitoneally immunized with C57BL/6 mice liver-specific protein in complete Freund's adjuvant. At the same time CTLA-4Ig were given to observe the pathologic alteration of C57BL/6 mice liver. Results　With the increase of time of immunization, the results in the treatment group were similar to those of the control group; but inflammatory cell infiltration, hepatic cell swelling, focal necrosis and severe hepatocyte damage were found in the pathologic model group. There was a significant difference between the pathologic model group and control one. Conclusion　Autoimmune hepatitis of C57BL/6 mice can be effectively prevented by CTLA-4Ig.