[Objective] To evaluate the clinical efficacy of treatment of humeral shaft fracture with revolving intramedullary nails.[Method]Sixty-two cases with fracture of hume ral shaft were treated by revolving intramedullary nails between January 2000 and February 2006.Their were 38 male cases and 24 female cases.Their average age was 36.9(ranged 20～58).Fifty-fous cases were closed fractures,and eight cases were opened.Sixty-two cases with fracture of humeral shaft according to AO classification,41 cases were type A,15 cases were type B,6 cases were type C.Sixty-two patients with the humeral shaft fracture were treated with limited open reduction and minimally invasive internal fixation with revolving intramedullary nails.Scientific and rational rehabilitative treatment was carried out in each case after the operation.All patients were follow-up between 14 months and 30 months.The average follow-up period was 24 months.[Result]The fracture union occurred in sixty-two patients.The average healing time was 15 weeks.According to Rodriquez-Merchang shoulder functional score system,the excellent result was achieved in 36 patients,good in 20 and fair in 6.The excellent and good rate was 90.3%.All cases got good function recovery.The effects were satisfactory.There were no complications in all cases,such as infection,iatrogenic fracture,shortening,break of nail,fat embolism syndrome and peripheral nerve injury.[Conclusion]Revolving intramedullary nails for treatment of humeral shaft fracture is effective with litter interference with the blood supply of the bone fracture and with stable immobilization.Due to the abutment of the longitudinal bars along the entire length of the medullary canal wall,highly resistant to the rotational strength was achieved.The advances of revolving intramedullary nails are convenient in operative procedure with little invasive of operation,early function exercise,high raito of fracture healing and safety compared with the normal operative therapy.The operation indication and timing should be controlled strictly.The manipulation should be familiar.This kind of treatment is worth to be recommended.

Object To study the causes for the occurrence of red skin and dark green skin of Panax quinquefolius L. during processing and its mechanism. Methods To observe the phenomena and analyze the result which simulated the processing condition of P. quinquefolius based on its components. Results The cross section of P. quinquefolius began to appear light red at 40 ℃, lasting 72 h. Whereas the time of browning was shortened with the temperature rising. The cross section of P. quinquefolius turned green while dipping in solution of Fe 3+ ion of 0 01 mol/L for 25 min. The time of turning green was shortened with the increasing concentration of Fe 2+ , Fe 3+ solution. Conclusion The results show that red skin of P. quinquefolius was caused by the Maillard reaction while drying at the excessive higher temperature. Whereas the complex reaction between phenolic substances in P. quinquefolius and metal ions during processing might result in dark green skin of P. quinquefolius. This expounds the mechanism of red skin and dark green skin turning during the P. quinquefolius processing in the theory.

Objective:To establish an HPLC method for determining the contents of related substances in vinpocetine injections. Methods:The chromatographic separation was performed on a Kromasil C18 column (150 mm × 4. 6 mm,5 μm). The mobile phase consisted of 0. 2 mol·L-1 ammonium acetate -acetonitrile (40∶60), the flow rate was 1. 0 ml·min-1, the detection wavelength was 280 nm,and the injection volume was 20μl. Results:Vinpocetine and the related substances such as ethyl vincaminate, apovincamine, methoxyvinpocetine and dihydrovinpocetine were separated completely. The calibration curves of related substances showed good linear-ity. The average recoveries of related substances were all above 99. 8%. Conclusion:The method is accurate, sensitive and specific, and can be applied in determining the related substances in vinpocetine injections.

ObjectiveTo investigate the effect of intrathecal injection of TRPV3-siRNA lentivirus on bone cancer pain(BCP) behaviors in rats.Methods40 female SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 4 groups (n=10 in each group):Sham group (S),BCP group (B),negative control lentivirus group (C) and TRPV3-siRNA lentivirus group (T).Group B,C and T were induced bone cancer pain by intra-right-femur inoculation of Wallker 256 cells,while rats in group S were injected of inactivated cell.Rats in group T were intrathecally treated with 5 μl TRPV3-siRNA lentivirus while rats in group C received 5 μl negative lentivirus on 1~6 d after surgery.All the rats received pain behaviors including paw withdrawal thermal latency(PWTL) and paw withdrawal mechanical threshold (PWMT) at 1 d before BCP and 1,3,6,9,12,15,18 and 21 d after BCP.L4~L6 spinal cords were reserved for RT-PCR and Western Blot.ResultsCompared with group S,PWTL and PWMT of group B were decreased (P<0.05).On the 9th day,PWTL of group T was higher than that of group C((17.52±2.15)s vs (14.36±1.67)s,P<0.05).However,there was no significant difference in PWMT between group T and group C((16.89±1.54)g vs (15.53±1.36)g,P>0.05).The results of RT-PCR and Western blot demonstrated that the expression of TPPV3 in group T was decreased compared with that in group C(P<0.05).ConclusionIntrathecal injection of TRPV3-siRNA lentivirus can inhibit the expression of TRPV3 and thus alleviate symptom of PWTL,but not PWMT.

Objective:To observe therapeutic effects of dexmedetomidine combined metoprolol on subarachnoid hemorrhage (SAH) complicated myocardial injury (MI) .Methods:According to random number table , a total of 131 SAH + MI pa‐tients were divided into control group (n=31) ,metoprolol group (n=34) ,dexmedetomidine group (n=32) and combined treatment group (n=34 ,received metoprolol combined dexmedetomidine ) .Plasma levels of norepinephrine (NE) ,epi‐nephrine (E) ,brain natriuretic peptide (BNP) and cardiac troponin I (cTnI ) were measured ,echocardiography etc .were used to assess MI recovery condition before and after treatment in all groups .Results:Compared with before operation , there was significant rise in LVEDd on 1d after operation ,significantly reduced on 3d after operation and recovered to nor‐mal on 7d after operation ( P<0.05 all);significant reduction in LVEF on 1d after operation ,significantly rose on 3d after operation and recovered to normal on 7d after operation ( P<0.05 all);significant rise in levels of cTnI ,BNP ,NE and E on 1d after operation ,started to reduce on 3d after operation and recovered to normal on 7d after operation in metoprolol group ,dexmedetomidine group and combined treatment group , P< 0.05 all;compared with control group ,metoprolol group and dexmedetomidine group on 7d after operation ,there was significant reduction in LVEDd ,and significant rise in LVEF and significant improvement in cardiac function ;significant reductions in plasma levels of NE [ (1.37 ± 0.08) pmol/L ,(1.05 ± 0.09) pmol/L ,(1.19 ± 0.07) pmol/L vs .(1.01 ± 0.06) pmol/L] ,E [ (6.17 ± 0.41) pmol/L ,(6.02 ± 0.34) pmol/L ,(6.06 ± 0.29) pmol/L vs .(5.26 ± 0.26) pmol/L] ,cTnI [ (0.22 ± 0.02)μg/L ,(0.11 ± 0.03)μg/L ,(0.17 ± 0.02)μg/L vs .(0.09 ± 0.01)μg/L] and BNP [ (1126.81 ± 11.27) ng/L ,(1014.09 ± 14.29) ng/L ,(1154.09 ± 16.52) ng/L vs .(954.09 ± 9.31) ng/L] in combined treatment group ,P<0.05 all .Conclusion:Either dexmedetomidine or meto‐prolol ,or their combination can effectively inhibit SAH complicated myocardial injury ,improve cardiac function ,but com‐bined treatment possesses the best effective effect .

The course of fundamental operations in surgery is an important part of surgical teaching.It helps students to adapt to surgical practice quickly.During the teaching,there are some ways to improve teaching efficiency and quality,such as to know the new Chinese-English teaching material,the teaching purpose,the training of basic skills and aseptic principles of operation,the examination reform and regular teaching summery.

BACKGROUND: Stem cell factors are hypoxia-induced neural regeneration factors. They stimulate animals' neural regeneration.OBJECTIVE: To observe Nestin and stem cell factor mRNA expressions after ischemia/reperfusion injury in rat brain, and to analyze the time rule of the two.DESIGN: A randomized controlled animal experiment.SETTING: Department of Ultrasound Diagnosis, Affdiated Hospital of Qingdao University Medical College.MATERIALS: Thirty-six healthy female adult Sprague-Dawley (SD) rats were provided by the Shanghai Laboratory Animal Center, Chinese Academy of Science. Nestin and stem cell factor mRNA in situ hybridization kits and 3,3'-diaminobenzidine (DAB)kit were provided by Boster Bioengineering Co.,Ltd (Wuhan, China).METHODS: This study was performed at the Shangdong Key Laboratory for Prevention and Treatment of Encephalopathy from January to June 2005. Thirty-two rats were created into models of ischemia/reperfusion models by occluding left middle cerebral artery with suture. At ischemia 1.5 hours and reperfusion 2, 6, 12, 24 hours, 2, 3, 7, 14 days, 4 rats were separately used in order to observe the expressions of Nestin and stem cell factor mRNA. The other 4 rats were used for sham-operation,in which, suture insertion was omitted, and the other procedures were identical to experimental groups. The expressions of Nestin and stem cell factor mRNA were detected in the cortex, corpora striatum and paraventricular nucleus region in rat brain by in situ hybridization.MAIN OUTCOME MEASURES: Nestin and stem cell factor mRNA expressions in the cortex, corpora striatum and paraventricular nucleus region in rat brain.RESULTS: Thirty-six rats were included in the final analysis. Nestin mRNA and stem cell factor were weakly expressed in the cortex, corpora striatum and paraventricular nucleus region in rats of sham-operation group. After ischemia/reperfusion, Nestin mRNA expression at each time point was significandy higher in the experimental groups (except in the cortex at ischemia 1.5 hours and reperfusion 2 hours, in the corpora striatum at ischemia 1.5 hours and reperfusion 2 and 6 hours and in the paraventricular nucleus region at ischemia 1.5 hours and reperfusion 2, 6 hours and 14 days) than in the sham-operation group (P＜0.05). While stem cell factor mRNA expression at each time point was significandy higher in the experimental groups (except in the cortex at ischemia 1.5 hours and reperfusion 2,6 and 12 hours, in the corpora striatum at ischemia 1.5 hours and reperfusion 2 and 6 hours and in the paraventricular nucleus region at ischemia 1.5 hours and reperfusion 2 hours and 14 days) than in the sham-operation group (P＜0.05).CONCLUSION: The time rule of stem cell factor mRNA expression is basically the same as that of neural stem cell proliferation. It indicates that following cerebral ischemia/reperfusion, stem cell factor mRNA expression may promote the proliferation of neural stem cells.

Objective To report a consanguineous family with lamellar ichthyosis and to detect the mutations in transglutaminase 1 (TGM1) gene in this family. Methods Genomic DNA was extracted from the blood samples of a 19-year-old male patient with lamellar ichthyosis, his family members and 100 normal human controls. PCR was carried out to amplify all the encoding sequences (15 exons) and adjacent flanking sequences of TGM1 gene followed by bidirectional sequencing. Results A C1666T mutation in the 11th exon in TGM1 gene, which resulted in the substitution of ACA (threonine) by ATA (isoleucine) at codon 529, was detected in the proband, while both his parents carried the C1666T mutation in heterozygous form, and his sister was a C/C homozygote. None of the 100 normal control individuals carried the mutation in TGMlgene. Conclusions The de novo mutation from ACA (threonine) to ATA (isoleucine) at codon 529, may contribute to the development of lamellar ichthyosis. Consanguineous marriage can increase the risk for lamellar ichthyosis by raising the probability of homozygosis of C 1666T mutation in TGM 1 gene.

Objective To explore the damage effect of sonoporation on the prostate of rabbit,while opening up the blood-prostate barrier by microbubble mediated sonoporation.Methods Fifteen male New Zealand white rabbits were randomly divided into 3 groups:ultrasound (US) group,microbubble (MB) group,ultrasound and microbubble (US+MB) group.Ultrasound was insonated directly on the prostate.Optical microscope,electron microscope and apoptosis index (AI) with TUNEL method were applied to trace the changes of the prostate of rabbit under different conditions.Results There was no significant change in prostatic tissues of group US and MB under the optical microscope.Cytoplasm and nucleoli were stained equally,cells of glandular epithelium were intact and formed orderly.Glandular cavities in these two groups were change very slightly.Glandular epithelium cells of Group US+MB were organized optical under the optical microscope,and there was a mass of eosinophilic liquid in the glandular cavities.Vascular endothelial cell were intact and formed orderly and swollen mitochondria were observed under the electron microscope in MB group and US group.Swollen mitochondria,tight junctions among gland cells were opened,and infiltrated erythrocyte could be found under the eletron microscope in US+MB.AI of group US+MB was markedly higher than that of group US and group MB (P<0.01),and AI of group US was higher than that of group MB (P<0.01).Conclusions Microbubble mediated sonoporation causes damage in the prostate tissue of rabbit,while opening up the blood-prostate barrier with an increased permeability of the prostate.

Objective To study the clinical, histopathologic and ultrastructural characteristics of achromic naevus (AN). Methods Clinical data, including sex, age, age of onset, pattern of lesions, involved sites, shape and number of lesions and associated systemic diseases, were collected from 85 patients with AN. Skin melanin index was detected in 34 lesions of 19 patients with AN, 30 lesions of 12 patients with vitiligo and 64 contralateral normal skin islands of the 31 patients. Reflectance confocal microscopy (RCM) was performed to analyze the lesion, normal skin and junctional area between lesional and normal skin of 62 patients with AN. Tissue samples were obtained from lesions and perilesional normal skin of 17 patients with AN and subjected to pathological examination as well as ultrastructural study with transmission electron microscopy; also, skin biopsy specimens were immunostained for tyrosinase, HMB45, tyrosinase-related protein-1 (TRP-1), TRP-2 and CD117. Results Of the 85 patients with AN, 23 (27.1%) developed lesions at birth, and 21 (24.7%) after 3 years of age; 72 (84.7%) had irregularly shaped lesions, 54 (63.5%) had only a single lesion. The mean melanin index and relative melanin index of AN lesions were 186.56 ± 52.86 and 80 ± 11, respectively, significantly lower than those in normal skin islands (223.88 ± 63.19 and 100, both P < 0.01), but higher than those in depigmented lesions from 12 patients with vitiligo (128.57 ± 64.31 and 60 ± 20, both P < 0.01). RCM revealed a decline in the number of melanocytes and brightness of melanin caps, even distribution of melanin in lesions, as well as obscure demarcation between lesions and normal skin from patients with AN. Fontana-Masson stain showed that the melanin content was lower in lesions than in perilesional skin (1810.12 ± 327.96 vs 2064.24 ± 260.41) from patients with AN. Microscopic examination demonstrated a decrease in melanocyte and melanosome number, presence of immature melanocytes at stage Ⅱ and Ⅲ in cytoplasm and dendrites of melanocytes and keratinocytes, aggregated melanosomes in affected keratinocytes in lesions of AN. In 17 patients with AN, the relative expression levels of tyrosinase and TRP-1 were 1827.35 ± 307.09 and 6102.54 ± 1642.64, respectively, in normal skin specimens, significantly higher than those in lesional skin (1477.35 ± 224.05, 5322.33 ± 1565.26, both P< 0.01); no statistical difference was observed in the expression levels of HMB45, TRP-2 or CD117 between lesional and normal skin. Conclusions AN is an early-onset, nonfamilial aggregated, stable leukoderma with irregular margins, and in lesions of AN, the number of both melanocytes and melanosomes is decreased with the presence of immature melanosomes. The measurement of relative melanin index and reflectance confocal microscopy may offer a non-invasive approach to the diagnosis of AN.