Objective To investigate the protective effects of ursolic acid (UA) on global cerebral ischemic-reperfusion injury in rats.MethodsThe experimental rats were divided into the sham operation group, the model group, the UA low, medium and high dose groups, 20 in each group. Except the rats in the sham operation group, the rats in other groups were dealed by four arteries occlusion to made global cerebral ischemia-reperfusion model. The rats in the UA low, medium, high dose groups were given UA as 40, 80, 120 mg/kg immediately after the occlusion line was inserted; the rats in the sham operation group and the model group were given equal-volume saline. And 6 hours later, the recovery time of righting reflex and electrical activity of brain were recorded, water content of the brain were evaluated, and the activity of LDH, MDA, SOD, CAT in brain tissue were determined; the inflammatory cytokines content of TNF-α, IL-1β, IL-6 were determined by ELISA. Results Compared with the model group, the recovery time of righting reflex (20.6 ± 7.2 min, 18.2 ± 6.9 min vs. 27.3 ± 8.8 min) and electrical activity of brain (16.2 ± 5.8 min, 14.9 ± 5.6 min vs.24.1 ± 7.2 min) of the UA medium and high dose groups were shortened (P<0.05 orP<0.01); the water content were significantly decreased (79.0% ± 0.7%, 78.6% ± 0.5%vs. 80.7% ± 0.9%;P<0.05 orP<0.01); the activity of SOD (158.5 ± 8.4 U/mg, 165.4 ± 9.0 U/mgvs. 143.0 ± 7.1 U/mg), CAT (3.3 ± 1.4 U/mg, 3.9 ± 1.5 U/mgvs. 2.4 ± 0.9 U/mg) in brain tissue of the UA medium and the high dose groups were significantly improved; the content of LDH (16.0 ± 2.6 mmol/g, 18.4 ± 2.8 mmol/gvs. 12.4 ± 1.9 mmol/g) were significantly increased; the content of MDA (18.6 ± 2.8μmol/g, 17.2 ± 2.4μmol/gvs. 24.9 ± 3.4μmol/g), TNF-α (45.8 ± 6.3 nmol/L, 40.1 ± 5.6 nmol/Lvs. 56.3 ± 7.2 nmol/L), IL-6 (187.2 ± 18.5 nmol/L, 136.8 ± 15.7 nmol/Lvs. 238.4 ± 22.9 nmol/L) were significantly decreased, and the content of IL-1β in UA 120 mg/kg treated group was significantly decreased (713.6 ± 56.3 nmol/L vs. 915.7 ± 70.5 nmol/L;P<0.05 orP<0.01).Conclusion UA can effectively promote righting reflex and EEG recovery, reduce brain water content, which perhaps related with its pharmacological effects of enhanceing the activity of antioxidant enzymes, lower oxidative stress, and inhibit inflammation.

Objective To investigate the effects of ursolic acid (UA) on oxidative stress and apoptosis in focal cerebral ischemia reperfusion in rats. Methods One hundred and twenty SD rats were randomly divided into 6 groups:sham operation group, model group, and groups of 20, 40, 80 120 mg/kg UA, with 20 rats in each group. A model of focal cerebral ischemic reperfusion was induced using the intraluminal thread method. Drugs were administrated immediately via tail vein injection when the suture was inserted. At 6h later, the total antioxidative capacity (T-AOC), malondialdehyde (MDA) level, and the activity of creatine kinase (CK), lactate dehydrogenase (LDH) in the serum, and the activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) in the ischemic cortex were measured. Apoptosis in the ischemic cortex was detected by TUNEL staining. Results Compared with the model group, the activity of CK (301.2 ± 86.8 U/L, 258.5 ± 58.4 U/L, 228.7 ± 49.2 U/L vs. 352.6 ± 88.1 U/L), LDH (327.5 ± 87.1 U/L, 288.6 ± 69.5 U/L, 243.7 ± 74.9 U/L vs. 395.4 ± 98.6 U/L) in the serum in the groups of 40, 80 120 mg/kg UA were significantly decreased (P<0.05 or P<0.01), MDA (5.5 ± 1.4 mmol/L, 4.8 ± 1.1 mmol/L, 4.4 ± 1.3 mmol/L vs. 7.8 ± 2.0 mmol/L) and T-AOC (9.4 ± 2.2 U/L, 10.5 ± 2.9 U/L, 11.8 ± 3.1 U/L vs. 8.0 ± 2.1 U/L) were significantly increased (P<0.05 or P<0.01); the activity of SOD (10.1 ± 2.7 U/mg, 11.6 ± 2.5 U/mg vs. 6.9 ± 2.6 U/mg),GSH-Px (12.9 ± 2.9 U/mg, 14.2 ± 3.2 U/mg vs. 9.5 ± 2.3 U/mg), CAT (3.3 ± 1.3 U/mg, 3.9 ± 1.2 U/mg vs. 2.3 ± 0.9 U/mg) in the ischemic cortex in the groups of 80 120 mg/kg UA were significantly increased (P<0.05 or P<0.01). TUNEL staining showed that apoptosis in the ischemic cortex in all the UA groups were significantly decreased compared with the model group. Conclusion UA could effectively enhance the activity of antioxidant enzymes and free radical scavenging capacity, ameliorate oxidative stress and inhibit apoptosis in focal cerebral ischemia reperfusion in rats.

Objective To study the anatomical character of compartment syndrome of foot after calcaneal intra-articaular by experimental model. MethodSix intact human cadaver lower extremities were used to produce calcaneal intra-articular fracture models, fracture patterns of the model were observed with radiographical technique, and anatomical study was proceeded to observe the fractures and their effects on soft tissues and compartments in foot.ResultAll specimens were sustained calcaneal intra-articular fractures successfully, 4 were joint depression fracture in x-ray, 2 were tongue type; 3 were Sander Ⅱ type and others were Sander Ⅲ type in CT. the primary fracture line coursed from anterolateral to posteromedial, and from anterosuperior to posteroinferior. It damaged all the soft tissue arosed from fractures medially and laterally, included adductor hallucis,quadratus plantae, flexor digitorum brevis and abductor digiti minimi as well.ConclusionFrom anatomical view, soft tissues of many compartments in foot rather than of simple compartmen are injuried when calcaneal intra-articular fractures occur, decompressive fasciotomies should be performed in all compartments involved. The present experimental protocol is useful to reproduce calcaneal intra-articular fractures.

Objective To discuss the classification and treatment of the degloving hand.Methods All 68 degloving hand treated between January, 2005 and December, 2014 in our department were reviewed.The cases were divided into three types according to the extent of the injury.Type Ⅰ the degloving tissue had enough blood supply which was debrided and stitched.Type Ⅱ the degloving tissue had less or no blood supply which was revascularized with replantation or vein anastomosis, some degloving palm or dorsum resurfaced the wound by the degloving skin graft.Type Ⅲ the degloving tissue had no blood supply or severely damaged,the tissue defect should be resurfaced with other tissue reconstruction.Type Ⅱ and Ⅲ were further divided into subtype A, B and C depending on the degloving scope and location, each subtype has its own surgical procedure.Results The total survival rate was 83.8％.The survival rate decreased with the increasing extent of the injury and the increasing degloving scope.Conclusion Classification of the hand degloving injuries depending on the extent of the injury, the degloving scope and location is useful for the assessment of injury and the selection of proper operation procedures.

Objective To explore the anatomical basis for the flexor pollicis brevis branch of median nerve transfer to the deep branch of ulnar nerve.Methods Eight fresh upper limb were dissected and observed.The specimen were dissected under the loup.Observed the number of the flexor pollicis brevis branch and measured the distances from pisiform bone to the flexor pollicis brevis branch.Then the transfer operation on the cadaver were imitated.After the anastomosis was completed,the stumps of the nerves were sectioned and stained with HE.The crossing-sectional area and the density of nerve fiber were obtained by Image-Pro Plus version 6.0,then the number of the nerve fiber were calculated.The data analyzed by SPSS 17.0.Results The flexor pollicis brevis branch constantly appear,there were two branches in 2 specimens,one branch in 6 specimens.The flexor pollicis brevis branch could transfer to the deep branch of ulnar nerve by end-to-end surture without tension.The regeneration distances was (37.3 ± 5.76) mm.The crossing-sectional area were (0.0575 ± 0.0086)mm2 and (0.2039 ± 0.0396)mm2,the number were (492.50± 62.62) and (1651.13± 79.01),the density were (8781.4246 ± 1676.2894)/mm2 and (8371.1592 ± 1677.6509)/mm2 in the flexor pollicis brevis branch and the deep branch of ulnar nerve,respectively.There were no significant differences in the density of the nerve fiber between the donor and recipient nerve (P ＜0.05).But there were differences in the crossing-sectional area and number of the nerve fiber(P ＜ 0.05).Conclusion The flexor pollicis brevis branch transfer to the deep branch of ulnar nerve can provide a short regenerating distance,but can supply a part of recipient nerve to reinnervate.

OBJECTIVETo study the classification and individualized treatment of the terminal phalanx of thumb duplication.

METHODSFrom Apr. 2003 to Dec. 2012, 76 patients with 77 involved thumbs duplication at the level which is distal to the interphalangeal joint were retrospectively studied. Based on the morphology (the nail width and the thumb circumference) and the deviation of the thumb, we classified the terminal phalanx of thumb duplication into 5 types as Type A (no bony connection called floating thumb), Type B(asymmetry and no deviation), Type C(asymmetry and deviation), Type D (symmetry and no deviation) and Type E(symmetry and deviation). Different surgical procedures were selected according to different types. Simple excision of the smaller thumb was adopted for Type A case. Removement of the smaller thumb (usually the radial) and of the collateral ligament of the interphalangeal joint were selected for Type B. Removement of the smaller thumb (usually the radial) and reconstruction of the collateral ligament of the interphalangeal joint, as well as corrective osteotomies at the neck of the proximal phalanx were performed for Type C. The modified Bilhaut-Cloquet procedure with reconstruction of the collateral ligament of the interphalangeal joint were adopted in Type D. The classical Bilhaut-Cloquet procedure, or the modified Bilhaut-Cloquet procedure with reconstruction of the collateral ligament of the interphalangeal joint and corrective osteotomies at the neck of the proximal phalanx were performed in Type E. The results were assessed by an evaluation form for thumb duplication by the Japanese Society for Surgery of the Hand.

RESULTSAccording to our new classification standard, there were 3 cases with Type A duplicated thumbs, 36 with Type B, 13 with Type C, 15 with Type D, 10 with Type E. All the 76 patients underwent the individualized surgical treatment. The patients were followed up for 6-60 months. According to the evaluation form, excellent results were achieved in 66 thumbs, good in 9 thumbs and fair in 2 thumbs.

CONCLUSIONSThe new classification could comprehensively describe the clinical features of the terminal phalanx of congenital thumb duplication. Individualized therapy, including basic and repeated surgical procedure could be adopted for each type with satisfactory results.

Child ; Collateral Ligaments ; surgery ; Finger Phalanges ; surgery ; Humans ; Orthopedic Procedures ; methods ; Osteotomy ; methods ; Polydactyly ; classification ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Thumb ; abnormalities

Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.

Objective: To evaluate the efficacy and the adverse reactoions of cetuximab combined with cheomotherapy (oxapliplatin or iriticon) for metastastic colorectal cancer. Methods: A total of 22 patients with metastastic colorectal cancer were treated with cetuximab combined with FOLFIRI or mFOLFOX6. The patients received cetuximab at an initial dose of 400 mg/m~2 intravenously on day 1 in the first cycle, followed by weekly infusion of 250 mg/m~2; FOLFIRI: irinotecan 180 mg/ m~2 on day 1, CF 400 mg/m~2, 5-FU bolus 400 mg/m~2, 5-FU infusion 2400 mg/m~2 over 46 hours, once every 2 weeks; mFOLF-OX6: oxaliplatin 85mg/m~2 on day 1, CF 400 mg/m~2, 5-FU bolus 400 mg/m~2, 5-FU infusion 2400 mg/m~2 over 46 hours, once every 2 weeks. The immediate response, complete response and partial response and changes in tumor marker levels were observed. Results: There were 12 PR cases, 6 SD cases, and no CR cases. The rate of (CR+PR) was 57.1% and the rate of (CR+PR+SD) was 85.7%. The adverse reactions during the theraphy were skin toxicity and neutropenia. Conclu-sion: Safe and effective for metastastic colorectal cancer, cituximab combined with oxaliplatin or irinotecan can increase the resectabiliy rate and prolong patient survival.

One strain of PRRSV was isolated from tissue of piglets died of obvious respiratory syndrome and high fever.It was identified as a strain of American type PRRSV by serological test and gene sequencing.According to American type PRRSV VR-2332,we designed 3 pairs of primers to aim directly at N gene,GP5 gene and variation sequence of NSP2.The results of sequence analysis indicated a discontinuous deletion of 30 amino acids in nonstructural protein 2 (NSP2).N and GP5 gene is conservative relatively.

Objective To explore the efficacy and side effects of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients with different CD4+ cell counts.Methods The clinical data of HIV-infected patients who accepted TDF (tenofovir disoproxil fumarate) + 3TC (lamivudine) + EFV (efavirenz) treatment were retrospectively collected in Jiangmen region.All patients were divided into group A(350/μl ≤ CD4 + ＜ 500/μ1),group B (200/μl ≤ CD4 + ＜ 350/μl) and group C(CD4+ ＜ 200/μl)according to their CD4+ cell counts.The efficacy and side effects in different groups were compared.Results A total of 132 clinical cases was collected,including 32 cases in group A,42 cases in group B,and 58 cases in group C.No statistically difference was found among three groups in terms of gender,age,or route of transmission.CD4 + cell counts after treatment was significantly higher than that before treatment in each group (P ＜ 0.05).The increase of CD4 + cell counts in groups A,B,and C was 75.6 ± 52.1,80.5 ± 58.7,and 97.5 ± 78.7 after 6-month HAART,respectively ; and 71.4 ± 58.9,110.8 ± 71.6,and 113.7 ± 88.3 after 12-month HAART,respectively.Statistical analysis showed no significant difference among three groups (P ＞ 0.05).The incidence of side effects in groups A,B,and C was 4/32,14/42,and 32/58 in 3-month HAART,respectively; and 1/32,8/42,and 22/58 in 3 ～ 12 month HAART,respectively.Statistical analysis showed significant difference among three groups (group C ＞ group B ＞ group A,P ＜ 0.05).Conclusions It was effective to begin the anti-retroviral treatment in all stages.The incidence of side effects may be less if anti-retroviral treatment began in early period.