Objective To study the factors leading to intramedullary pressure (IMP) change during openintramedullynailing (OIMN) of fresh femoral fractures and the relation between fat intravasation and IMP. MethodFifty patients with femoral fractures were submitted to OIMN in early stage after injury. Before operation, a hollow probe was screwed into the medullary cavity and linked with a monitor to record the dynamic pressure change during the OIMN process. The patients were divided into 2 groups according to their IMP. 5ml blood was taken from femoral vein of the affected limb individually before operation and just after fixation of the intramedullary nail. The blood clots were made into frozen sections and stained by oil red-O to find the free fat.The positive rate of free fat in pathological detection between patients with increased IMP and those without were compared.Result(1) Increased IMP could be recorded in some patients with "piston effect" resulted from a certain condition during OIMN. (2) For patients with increased IMP, the positive rate of free fat through pathological detection during the operation was significantly higher than that of before (p(o. ol),but that of patients without increased IMP did not change significantly. The positive rates of the two groups did not have significant difference than those of before operation. During operation, the positive rate of patients with increased IMP was significant higher than that of patients without pressure imcreasing(P

Objecfive To observe the effect of high thoracic epidural block(HTEB)for preventing myocardial isehemia(MI)in pailents with coronary heart disease undergoing upper abdominal surgery. Methods Twenty patients undergoing upper abdominal surgery were randomly divided into two groups:M group(treated with HTEB,10 patients)was given both general anesthesia and HTEB and patient controlled epidural analgesia(PCEA)after operation and C group(without HTEB.10 patients)was given only general anesthesia and patient controlled intravenous analgesia(PCIA)after operation.The hemodynamies.ECG changes and serum troponin I and myoglobin and ereatine-kinase isozyme,the analgesia efficacy in M group were compared with those in C group.Results The hemodynamics in M group Was more stable than that in C group(P＜0.05).ComparedwithMgroup,thetotalnumberofST-segment depression attracheal extuba- tion moment and 10 hours after operation were significantly increased in C group(P＜0.05).The positive rates of Serum troponin I and creatine-kinase isozyme at 10 hours and 24 hours after operation in C group were much higherthan those in M group(P＜0.05).The an~tgesia effect in M group Was superiortothat in C group (P＜0.05)Conclusion The HTEB combined with general anesthesia may reduce mvocardial is- chemia in patients with coronary heart disease undergoing upper abdominal surgery.

Objective To explore the treatment of traumatically amputated penis and the causes of success and failure in the varieties of procedures used to heal the wound and restore function. Methods Two patients with traumatically amputated penis were treated by operation. Results In one case the operation was successful, and in the other case it was unsuccessful. Conclusion There were numerous variables contributed to the success or failure of penile replantation. The most important factors were contamination and exsanguine time of the amputated portion of the penis. The actual surgical procedures and the appropriate pre-operative and post-operative treatments were crucial to the outcome as well.

Objective To investigate the influence of recombinant neuregulin-1 beta (rhNRG-1β) on neural stem cell proliferation through extracellular regulated protein kinases (ERK) signaling pathway in oxygen and glucose deprivation (OGD) environment.Methods Neural stem cells were obtained from embryonic brain of mice pregnant for 14-17 d,cultured and identified by immunochemical staining through detection of the indicator nestin using the SABC-FITC (POD)double standard kit.Neural stem cells were divided into three experiment groups (OGD group,control group and OGD + rhNRG-1β group).Control group:identified neural stem cells,2 × 107,were cultured for 3 h in the 24-hole culture plate with DMEM/F12 complete culture medium;OGD group:neural stem cells,2 × 107,were cultured in the 24-hole culture plate deprived glucose DMEM/F12 in a wet airtight container (37 ℃ constant temperature),cells were cultured with mixed gas of nitrogen (950 ml/L) and oxygen (50 ml/L) for 1 h,and then the culture medium was replaced with complete culture medium and cultured for 3 h;OGD + rhNRG-1β group:before OGD intervention,100 μg/L rhNRG-1β was given for 3 h.Neurospheres formation:the three groups of stem cells were dispersed into single cells,1 × 106/ml cells were inoculated to culture plates containing cover slips coated with poly lysine,and cultivated for 7 d,and neurospheres formation of the 3 groups of neural stem cells was observed under microscope,which was aimed to record neural stem cells proliferation changes.Colony formation:the three groups of stem cells,vaccinated in 60 mm in a petri dish,2 × 107 in number,were cultivated in complete culture medium for 24 h.The colony formation of the three groups of cells was observed under microscope,and neural stem cells proliferation changes were observed.Western blotting:the change of phosphorylation ERK (pERK) protein of the three groups of stem cells was determined,and the effect of pERK protein expression regulated by rhNRG-1β in mice neural stem cells proliferation through ERK signaling pathway was observed.Results Microscopically the primary cultured stem cells grew in single or in pairs,in a round shape;neural stem cell proliferated in clumps or colony;neural stem cells expressed the specificity of nestin protein markers with fluorescent yellow-green color.The differences in the aspects of the average diameter of neurospheres and neurospheres quantity in the neural stem cells between groups were statistically significant (F =693.66,1 002.09,all P ＜ 0.01),and among them the neuropheres formation of OGD group was significantly suppressed.Formation quantity and average diameter in OGD group [(88.78 ± 7.14) numbers,(62.12 ± 2.52) μm] were significantly lower than those in the control group [(246.34 ± 8.67) numbers,(128.45 ± 2.33) μm] and those in OGD + rhNRG-1β group [(237.87 ± 6.61) numbers,(118.37 ± 2.71) μm,all P ＜ 0.01].The difference of colony formation rate of neural stem cell was statistically significant (F =132.03,P ＜ 0.01),and among them colony formation of OGD group significantly suppressed.Formation rate in OGD group [(11.65 ± 0.94)％] was significantly lower than that in the control group [(33.23 ± 2.93)％] and that in OGD + rhNRG-1β group [(31.42 ± 2.61)％,all P ＜ 0.01].Western blotting showed that the difference of pERK protein expression of neural stem cells between groups was statistically significant (F =63.76,P ＜ 0.01).Relative expression of the pERK protein in OGD group (0.487 ± 0.072) was significantly lower than that in the control group (1.013 ± 0.112) and that in OGD + rh-NRG-1β group (1.752 ± 0.278,all P ＜ 0.01).Conclusion rhNRG-1β preserves neural stem cell proliferation with phosphorylation ERK protein expression up-regulated in oxygen and glucose deprivation environment.

Objective To analyze the clinical efficacy of desloratadine citrate disodium and fexofenadine in the treatment of refractory urticaria . Methods 100 patients with refractory urticaria were randomly divided into observation group and control group according to the digital table method, with 50 cases in each group.The control group were treated with desloratadine citrate disodium, and the observation group were treated with fexofenadine on the basis of control group.The efficacy, immunity function ( CD3 +, CD4 +, CD4 +/CD8 +) , the changes of inflammatory factors [ procalcitonin ( PCT) , C-reactive protein ( CRP) ] and the quality of life were compared between the two groups.The adverse reaction rate in two groups was recorded in two groups.Results The total efficacy in observation group (88.0%) was significantly higher than that in control group (72.0%)(P<0.05).The indicators of immunity function in observation group were significantly higher than those in control group(P<0.05).The inflammatory factors in observation group were significantly lower than those in control group ( P<0.05 ) .The sleep and exercise quality rate of the observation group were significantly higher than those in control group(86.0% vs.68.0%,84.0% vs.66.0%,P<0.05).Conclusion The combination of desloratadine citrate disodium and fexofenadine in the treatment of refractory urticaria has a good effect, can effectively improve the immune function, reduce the secretion of inflammatory factors, thus effectively relieve the clinical symptoms, improve their quality of life, and has high security.

Objective To investigate the effect of the isotretinoin combined with Dazhui acupoint bloodletting in the treatment of adolescent acne.Methods78 patients with adolescent acne from department of dermatology in our hospital were selected and randomly divided into the control group and the experiment group,39 cases in each group.The control group were treated by isotretinoin and the experiment group were treated on the base of the control group with Dazhui acupoint bloodletting.The clinical total effective rate, incidence of adverse reactions and recurrence rate after 6 months were compared between control group and experiment group.ResultsCompared with the control group after treatment, the clinical total effective rate were higher(P<0.05), the incidence of adverse reactions were lower(P<0.05), the 6 months after the recurrence rate of acne were lower(P<0.05).ConclusionThe application of different dimension an acid combined with Dazhui acupoint bloodletting treatment can improve the adolescent acne clinical total efficiency, reduce the incidence of adverse reaction rate and recurrence rate, and suitable for clinical, it is worth popularization and application.

Objective To investigate the changes in CREB_1 proteins in five brain regions of rats with morphine addiction and withdrawal with the technique of immunohistochemistry. Methods Thirty six adult male Sprague-Dawley rats were randomly divided into six groups (n=6 for each), i.e. acute morphine dependent group, acute abstinence group, acute control group, chronic morphine dependent group, chronic abstinence group and chronic control group. Animals in dependent groups and abstinence groups were administered with morphine by intraperitoneal injection till morphine dependent models were established. The rats in abstinence groups withdrawal syndromes were induced with naloxone 5mg/kg for 30min. The rats in control groups were injected with saline. All rats were sacrificed by decapitation. The coronal sections of discrete brain regions (hypothalamus, nucleus accumbens, prefrontal cortex, locus coeruleus, hippocampus) were obtained. The relative concentrations of CREB_1 protein were determined with immunohistochemistry. Results In acute morphine dependent and abstinence groups, CREB_1 protein decreased significantly compared with the acute control group in locus coeruleus (P0.05). Conclusion The morphine-induced CREB_1 protein changes may reflect differential G protein-cAMP-CREB signal transduction pathways in morphine dependent and abstinence rats.

Objective To explore the effect of lipo-prostaglandin E1 plus dextran 40 in the prophylaxis of hepatic veno-occlusive disease(HVOD) after hematopoietic stem cell(HSC) transplantation.Methods Two hundred and thirty-four patients,162 males and 72 females,mean age 30.6(ranged from 3 to 64),were admitted during May 1999 to April 2007 and undergone HSC transplantation.Lipo-prostaglandin E1 associated with dextran 40 were administered to all patients for the prophylaxis of hepatic veno-occlusive disease.Lipo-prostaglandin E1,10?g dissolved in 100ml saline,20?g per day iv,were administered from day 7 before transplantation(-7 day) to day 30 after transplantation(+30 day).Dextran 40,500ml per day iv,were administered from-1 day to +5 day.In order to identify the risk factors inducing HVOD,patients were allocated to 2 groups according to following factors:age(

Objective To study the feasibility of regional network platform for wound care technical training.Methods Micro-letter pubic number and internet technologies were used to develop a regional network platform of wound care which has one center with multiple branches,training nurses how to take care of wound by the educational column.Results There were 383 nurses had browsed the web site and took part in the learning since regional network platform was working 3 months,931 nurses paid close at-tention to Micro-letter pubic number.Performance examination was improved obviously after training,the percent of pass was 17.8% before training and 80.7% after training,the difference was with statistical significance (χ2=303.629,P<0.01).Conclu-sion The regional network platform of wound care based on micro-letter and internet technologies has a promising application.

The combination of high-speed countercurrent chromatography and rapid bioactive assay is a desirable method in the screening of bioactive components from CMM and natural products.This review focused on the application status of high-speed countercurrent chromatography to the rapid screening of bioactive components from CMM and natural products based on our previous studies and the recent progress over it.