Objective To evaluate the foot function after Lisfranc injury with local soft tissue in-jury. Methods From November 2000 to April 2006, 43 patients (at mean age of 32 years) with fresh Lisfranc injuries (45 sides) were managed with open reduction and internal fixation with screws, Kir-schner wires and AO plates. All patients had no joint surface damage and received no fusion surgery. Ac-cording to the Quenu-Kuss classification of Lisfranc injury, there were 14 patients with type-A injury, 21 with type-B and 10 with type-C. According to AO classification, there were 29 feet without severe soft tis-sue injury and 16 feet with severe soft tissue injury, of which 10 patients were combined with severe local soft tissue injury (one patient with Foot compartment syndrome). The period from injury to surgery was seven days. All patients received cast immobilization for 8-12 weeks and the foot function was evaluated by anteroposterior and lateral X-rays and American Orthopedic Foot and Ankle Society (AOFAS) score. Results All patients were followed up for 12-69 months (average 37 months), which showed that all pa-tients obtained anatomic reduction and 32 patients were satisfied with operative outcome. The average postoperative AOFAS score was 97 points for patients without severe soft tissue injury and 82 points for pa-tients with severe soft tissue injury (P<0.05). Conclusion After Lisfranc injury, the foot function is related to severity of both joint injury and local soft tissue injury.

Objective To evaluate the clinical results of flexor hallucis longus (FHL) tendon transfer in treatment of patients with Achilles tendon defects of more than 6 cm. Methods Between January 2005 to February 2009, 19 patients with Achilles tendon defects, 13 males and 6 females, were treated with FHL tendon transfer. Their ages ranged from 20 to 61 years, with an average of (42. 6 ± 8.2)years. Fifteen defects were found during tendonitis debridement, and 4 were old ruptures. Time from rupture to surgery ranged from 0 to 6 months (average, 2.6 months). Defects were 6 cm to 10 cm long. Procedures were performed in a two-incision manner. The postoperative ROM of ankle joint, American Orthopaedic Foot and Ankle Society(AOFAS) and visual analogue scale(VAS) scores were recorded at 3 months, 12 months,and the last follow-up. The results were statistically analyzed to evaluate the functional recovery. Results Follow-ups lasted from 12 to 48 months (average, 22. 2 months). At the last follow-up, the average ROM of ankle joint was 17.8°± 1.9° at dorsal flexion and 39.1°±2.3° at plantar flexion, and the last average AOFAS score was up to (91.8 ± 1.7), significantly different from those at 3 months after surgery (P＜0.05), but not significantly different from those at 12 months (P＞0.05). The difference were significant between the results of 3 months and 12 months (P＜0.05). The last average VAS score was (1.0±0.7),significantly different from those at 3 months and 12 months(P＜0.05) . There was also significant differences between the VAS scores of 3 months and 12 months (P＜0.05). Patient's satisfaction was 100%.Conclusion FHL tendon transfer is an efficient procedure for long Achilles tendon ruptures associated with tendonitis in relieving pain and maintaining the function of ankle joint.

OBJECTIVETo investigate clinical effects of arthroscopy in the treatment of medial meniscal cyst.

METHODSFrom June 2011 to January 2013, 7 patients with medial meniscal cyst were treated with arthroscopy. There were 3 males and 4 females,ranging in age from 27 to 63 years old,with a mean age of (43.93±2.10) years old. The cysts have been discovered for 3 to 30 months,with a mean time of (10.6±1.3) months. All the patients complained of knee pain,especially in the medial joint gap. The Pisani sign, Caklin sign and medial McMurray sign were all positive. Preoperative MRI examination confirmed the diagnosis. Lysholm score changes and clinical efficacy were observed through a six-month follow-up.

RESULTSThe postoperative Lysholm scores were all significantly higher than the preoperative scores. According to Sarimo standard, 6 patients got an excellent result, and 1 good.

CONCLUSIONArthroscopic treatment of medial meniscal cyst has replaced the traditional method, which could retain the normal meniscus as much as possible and repair the meniscus injury simultaneously, as well as get a good curative effect and a good recovery of knee function. This method is worthy of clinical application.

Adult ; Arthroscopy ; methods ; Cysts ; physiopathology ; surgery ; Female ; Humans ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged

The author analyzes the basic information in recent years,including overall students scale,students' age,application trends,etc.Some suggestions are made,regarding to recruiting plan,applicant qualification,recruiting mode,etc,in order to further improve the recruiting and graduate management.

Background The special pathological change of diabetic retinopathy(DR)is microvascular disorder.Angiopoietin-like protein 2(Ang-2)is a new protein associated with genesis of blood vessels.Quercetin has multiple pharmacological action,including improving the microcircularion and the permeability of blood capillary.However,the action mechanism of Ang-2 on DR was unclear.Objective The present study was to investigate the effects of quercetin on Ang-2 and its receptor Tie2 expression in retina with diabetes mellitus.Methods Sixty clean male Wistar rats were randomized into 7 groups and 10 rats for each group,and 10 rats served as blank control group.Streptozotocin of 35 mg/kg was intraperitoneally injected in 60 rats to establish the diabetic models.Quercetins encapsulated by liposome with the doses of 50,150 and 250 mg/(kg · d)(3-5 ml)were used to gavage in different groups of models for 12 weeks,and normal saline solution and calcium dobesilate were used at the same fashion as the negative control group and positive control group,respectively.Twelve weeks later,the animals were sacrificed and retinas were isolated.Expressions of Ang-2 protein and Tie2 mRNA in retinas were detected by ELISA and RT-PCR,respectively.The usage and rearing of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Sciences and Technology Commission.Results ELISA showed that the A450 of Ang-2 in 150 and 250 mg/(kg · d)quercetin groups was 0.796±0.057 and 0.842±0.043 respectively and was lower than that negative group(1.012±0.046),showing statistically significant differences(q =2.95,2.698,P＜0.05).RT-PCR assay showed that expression of Tie2 mRNA(Tie2 mRNA/GAPDH mRNA)in retinas was 0.712±0.092 and 0.821±0.087,presenting statistically significant differences in comparison with negative group(1.182±0.098)(q =3.497,2.852,P＜0.05).The expression levels of Ang-2 and Tie2 mRNA in retina were lowest in 150 mg/(kg · d)quercetin group.Conclusions Quercetin can improve the retinal microcirculation by downregulating the expressions of Ang-2 and its receptor in early period of diabetic rats.

Objective To evaluate the pharmacokinetics of remifentanil in adult patients undergoing general anesthesia.Methods Ten ASA Ⅰ or Ⅱ adult patients of either sex undergoing elective surgery under general anesthesia were enrolled in this study.The patients were premedicated with atropine 0.5 mg.Anesthesia was induced with fentany1-2 ?g?kg~(-1),lidocaine 0.5-1.0 mg?kg~(-1),propofol 1.5-2.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with isoflurane -O_2 inhalation and intermittent i.v.boluses of vecuronium after tracheal intubation.The patients were mechanically ventilated.P_(ET)CO_2 was maintained at 30-40 mm Hg. Remifentanil 5 ?g?kg~(-1) was injected i.v.over lmin after induction of anesthesia.Arterial blood samples were taken before(baseline)and at 1,2,3,5,7,10,15,20,25,30,45,60 and 90 rain after drug administration for determination of blood remifentanil concentration using high performance liquid chromatography/mass spectrometry. The data were analyzed using 3P87 pharmacokinetic program.Results The pharmacokinetic profile of remifentanil was best described by a “two-compartment” model.The distribution half-life(t_(1/2?))(1.6?0.5)min,the elimination half-life(t_(1/2?))(22?10)min,total clearance(CL)(2.1?0.4)L/min and the volume of distribution (V_d)(66?29)L.Conclusion The volume of distribution calculated in this study is significantly different from that reported in previous studies,indicating that there may be some difference in the pharmacokineties of remifentanil between different populations.

Adult ; Dental Implantation, Endosseous ; instrumentation ; Dental Implants ; Female ; Humans ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design

ObjectiveTo analysis the clinical features of thoracic spine and spinal cord injury (SCI) and summarize the inclusive standard of cellular transplant clinical trial for SCI.MethodsThe data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively.ResultsMean follow-up period was 20 months (6～48 months). There was no recovery in 12 spinal cord injury without radiographic abnormality (SCIWORA) patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B (sense recovery), rate of recovery was 9.6%; recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief.ConclusionIncidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.

OBJECTIVEEndothelial apoptosis plays an important role in the initiation of atherosclerosis. It would be useful to clarify whether activation of non-neuronal muscarinic receptor (NNMR) could prevent endothelial apoptosis and atherosclerosis. We investigated the effects of NNMR activation on regulating rat aortic endothelial cells (RAECs) apoptosis induced by homocysteine, an independent risk factor of atherosclerosis, and further studied its molecular mechanism.

METHODSRAECs were incubated using homocysteine at the concentration of 2.7 mmol/L for 36 h. RAECs were also pre-treated with carbachol or arecoline to examine their effects. RT-PCR was used to assess changes in the gene expression related to cell apoptosis.

RESULTSIncubation of RAECs with homocysteine at the concentration of 2.7 mmol/L resulted in morphologic changes, such as cellular shrinkage, membrane blebbing, chromatin condensation and margination. These could be attenuated by pretreatment with carbachol and arecoline at the concentration of 10 micromol/L for 12 h. Homocysteine induced apoptosis in RAECs and the molecular mechanisms were associated with the regulation of fas, fas-L and caspase-8 in the death receptor pathway, bcl-2, bcl-xL and bax in the mitochondrial pathway, caspase-12 in the endoplasmic reticulum pathway and caspase-3, caspase-6 and p53 as downstream effectors. Carbachol and arecoline attenuated the effects of homocysteine on genes in the death receptor pathway, in the mitochondrial pathway and in the downstream pathway. Atropine could reverse all of the effects of arecoline.

CONCLUSIONActivation of NNMR by carbacol and arecoline inhibits homocysteine-induced endothelial cell apoptosis mainly through regulation of death receptor pathway, mitochondrial pathway and downstream effectors.

Animals ; Aorta ; cytology ; Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Arecoline ; Carbachol ; Cell Cycle ; Endoplasmic Reticulum ; metabolism ; Endothelial Cells ; cytology ; drug effects ; Homocysteine ; adverse effects ; Mitochondria ; metabolism ; Rats ; Receptors, Muscarinic ; metabolism

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition in urological outpatients, and is often improperly treated for its multifactorial etiology and non-specific clinical phenotype. Doctor Shoskes proposed a clinical phenotype system for CP/CPPS--the UPOINT system, which is a new diagnostic/therapeutic algorithm addressing 6 CP/CPPS phenotypic domains, including the urinary, psychosocial, organ specific, infection, neurological/systemic and muscle tenderness domains. Under the guidance of UPOINT, doctors can give a multimodal therapy for patients with CP/CPPS according to its clinical phenotype, and several clinical studies have demonstrated obvious clinical benefit from the UPOINT-based therapy.
Algorithms ; Humans ; Male ; Pelvic Pain ; classification ; diagnosis ; therapy ; Prostatitis ; classification ; diagnosis ; therapy