Objective: To review the influencing factors of medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation. Methods: The literature of MPFL reconstruction for patellar dislocation at home and abroad in recent years were summarized and analyzed. Results: The influencing factors such as the location of the femoral insertion point, the tension and the fixed angle of the grafts, the dysplasia of the femoral trochlear before operation, the abnormal tuberositas tibiae-trochlear groove value, the high position of the patellar, and the tilting angle of the patellar, are all the factors affecting the effectiveness of MPLF reconstruction. Conclusion: During MPFL reconstruction, the surgical techniques and elimination of other factors that caused patellar instability need to be focused in order to reduce the complications and operation failure.

Objective To study the feasibility and necessity of radial artery angiolgraphy in advance on transradial coronary intervention.Methods A total of 682 patients undergoing transradial coronary intervention were divided into two groups by random digits table method.Previous radial artery angiography (pre-RAA) group of 341 cases underwent radial artery angiography;post radial artery angiography (post-RAA) group of 341 cases in the guide wire,catheter in resistance immediately for radial artery angiography.The radial artery imaging characteristics were observed and the radial artery related complications were recorded in two groups.Results The ratio of radial artery spasm in post-RAA group was higher than that in pre-RAA group [11.4％(39/341) vs.6.2％(21/341),P=0.015].The ratio of operation failed in post-RAA group was higher than that in pre-RAA group [3.2％ (11/341) vs.0.6％ (2/341),P =0.014].The radial artery perforation rate and postoperative 1-6 months of radial artery occlusion rate increased significantly in post-RAA group,and there was significant difference between two groups (P ＜ 0.05).Conclusion Transradial coronary intervention in advance for radial artery angiography therapy can effectively observe the radial artery morphology,reduce the radial artery related complications.

Objective To investigate the effect of CT guided percutaneous targeted coblation nucleoplasty in treatment of cervical intervetebral disc herniation.Methods Fifty patients who were diagnosed with cervical intervetebral disc herniation by CT or MRI were received the treatment of CT guided percutaneous targeted coblation nucleoplasty and the follow-up check after operation.The effects according to Macnab therapeutic criteria and VAS method were evaluated and recorded before operation and after operation at the third day,2 weeks,3 months.Results All patients accepted follow-up three months after operation.The effects were assessed by Macnab therapeutic criteria:1 9 cases were excellent (37.5%),29 cases good (58.3%),2 cases bad (4.2%),and the effective rate was 92.5%.The VAS scores in three months after operation were significantly lower than that before operation (P <0.05 ). Conclusion Computed tomography guided percutaneous targeted coblation nucleoplasty is a safe,effective and minimally invasive method for treating cervical intervetebral disc herniation.

Objective To investigate the influence of extracellular high mobility group box 1 (HMGB1) on viral replication in HTLV-1 infected T cells.Methods HMGB1 in culture supernatants of adult T-cell leukemia virus 1 (HTLV-1) virus-negative cell:Jurkat,MOLT4 cells and HTLV-1 virus-positive cells:MT2,MT4,was detected by ELISA;The HTLV-1 long terminal repeat reporter gene (pHTLV-1-LTR-luc) was transfected into MT2 cells by Tfx-50-mediated transfection,and 0.25,0.50,0.75 μg/ml of HMGB1 polyclonal antibody(HMGB1 PcAb) and its isotype control rabbit IgG antibodies,0.03,0.1,0.3 μg/ml rhHMGB1 and its control PBS,were added into culture supernatant respectively,then luciferase activity was detected after 48 h;Similarly,0.25 μg/ml HMGB1 PcAb and the isotype control antibody,0.3 μg/ml rhH-MGB1 and the control PBS were added to the culture supernatant of MT2 cell,the viral gene,pol1,pol2,gag,env,etc,were performed by real-time PCR.Results Culture supernatant HMGB1 levels has no significant difference between HTLV-1 positive cells MT2 and MT4 and the other two virus-negative T cell lines;Compared with isotype control antibody group,the culture supernatant,to which is added 0.25 μg/ml HMGB1 PcAb,can significantly inhibit the HTLV-1-LTR transcriptional activity and suppress the expressions of the viral gene pol1,pol2,gag,env.Compared with the control PBS,0.3 μg/ml rhHMGB1 significantly promotes the transcriptional activity of the HTLV-1-LTR and the expressions of the viral gene pol1,pol2,gag,env.Conclusion The extracellular HMGB1 can promote viral replication of HTLV-1 infected T cells.

Hydroxyethyl chitin (HECH) is a water soluble chitin derivative made by etherification of chitin, ethylene chlorohydrin was used as etherification reagent in this reaction. A novel interpenetrating polymer network (IPN) composed of HECH/PAA was prepared. The IR spectra confirmed that HECH/PAA was formed through chemical bond interaction. The sensitivity of this hydrogel to temperature and pH was studied. The swelling ratio of this hydrogel in artificial intestinal juice is much greater than that in artificial gastric juice. The IPN hydrogel exhibited a typical pH-sensitivity, and its degree of swelling ratio increased with the increase of temperature. The sustained-release drug system of Dichlofenac potassium was prepared by using HECH/PAA as the drug carrier. The release experiment showed a perfect release behavior in artificial intestinal juice. This IPN is expected to be used as a good drug delivery system of enteric medicine.
Acrylates ; administration & dosage ; chemistry ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; Chitin ; administration & dosage ; analogs & derivatives ; chemistry ; Delayed-Action Preparations ; Diclofenac ; administration & dosage ; Drug Carriers ; chemical synthesis ; Drug Delivery Systems ; Hydrogel, Polyethylene Glycol Dimethacrylate ; administration & dosage ; chemistry ; Hydrogen-Ion Concentration

BACKGROUND: Vitamin D receptor (VDR) gene shows restriction fragment length polymorphism with incision enzyme Bsm Ⅰ ,Apa Ⅰ ,Taq Ⅰ ,which is related to bone mineral density (BMD).However, it is unclear that the relationship between VDR gene (Bsm Ⅰ ) polymorphisms and BMD,osteoporosis.OBJECTIVE: To analyze the distribution regularity of vitamin D receptor gene polymorphism related to BMD in postmenopausal women of Han,Uygur, Kazak and Mongoloid nationality in China. DESIGN: controlled observation.SETTING: Institute of Gerontology,General Hospital of Chinese PLA.PARTICIPANTS: Totally 179 women of Han,who were taking physical examination in General Hospital of Chinese PLA from January 2002 to December 2003, at the average age of (59±3) years,were selected. A total number of 122 women of Uygur with average age of 56.49 years; 63 women of Kazak with average age of (55±3) years; and 112 women of Mongoloid with average age of (57±3) years,who were all taking physical examination in department of geriatrics, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA from January 2001 to December 2003.All of them were informed consent.METHODS: VDR genotypes(Bsm Ⅰ ) were defined with polymerase chain reaction-restriction fragment length polymorphism,so as to analyze distribution of Vitamin-D receptor gene (Bsm Ⅰ )polymorphisms of postmenopausal women in Han,Uygur, Kazak,Mongoloid nationality,and compared with the data of USA,Australia,France,Japan,Korea. Enumeration data were compared with Chi-square test.MAIN OUTCOME MEASURES: VDR (Bsm Ⅰ ) polymorphisms in healthy postmenopausal women from Han, Uygur, Kazak, Mongoloid populations in China, which were compared with the data of USA, Australia,France, Japan, Korea.RESULTS: For women of Han, Uygur, Kazak and Mongoloid nationality,the BB genotypes accounted for 0, 4.1%, 6.35% and 4.46%, the bb genotypes accounted for 90.5%, 69.67%, 38.1% and 50% respectively. There was a significant difference between women of Han, Uygur, Kazak, and Mongoloid nationality(P ＜ 0.01). There was insignificant difference in comparation of distribtuion of VDR genotype between Kazak nationality and the west races, but it was significantly different to that in Japan,Korea races.CONCLUSION:VDR genotype polymorphisms is characterized by obvious racial diversify in postmenopausal women of Han,Uygur, Kazak,Mongoloid populations in China;Distribution of VDR gene frequency of Kazak population is similar with the west race ,but is different to Japanese and Korea's race.

Objective: To evaluate the risk factors for contrast-induced nephropathy (CIN) in patients of acute coronary syndrome (ACS) with normal or slightly impaired renal function after percutaneous coronary intervention (PCI).
Methods: A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF≥60 ml (min?1.73 m2) and they were divided into 2 groups:CIN group, the patients with serum creatinine increased by 0.5mg/dl (44.2μmol/L) or elevated to 25%higher than the baseline, n=23;Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients.
Results: There were 9%(23/254) patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI (OR=0.370, 95%CI 0.060-2.297), increased plasma level of NT-proBNP (OR=4.209, 95%CI 1.202-14.742) and without pre-operative aspirin administration (OR=7.950, 95%CI 1.108-57.034) were the clinical risk factors for post-operative CIN occurrence.
Conclusion: Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.

AS1. 398 neutral protease was immobilized onto carboxymethyl chitosan with glutaraldehyde as cross-linking agent. The effects of pH, time of cross-linking, amount of cross-linking agent and the ratio of enzyme to carrier on the activity of the immobilized enzyme were demonstrated, and the optimum immobilization condition of AS1. 398 neutral protease was established. Also studied was the characterization of immobilized enzyme,including pH, temperature, Km and the stability of storage.
Bacterial Proteins ; chemistry ; Chitosan ; analogs & derivatives ; pharmacology ; Endopeptidases ; chemistry ; Enzymes, Immobilized ; chemical synthesis ; chemistry ; Glutaral ; pharmacology ; Microspheres

Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P<0.05). The incidence of water-electrolyte imbalance was lower in NPDI group than that in NNPDI group (P<0.05). There were no significant differences in the incidence of the ventilator-associated pneumonia (VAP), the hepatic and renal insufficiency, the intracranial infections and stress ulcers between the two groups (P>0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P<0.05). And the discharge rate from NICU was higher in NPDI group than that of NNPDI group (P<0.05). There was no significant difference in the rate of patients left hospital without treatment between the two groups (P>0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.

Objective: To explore the feasibility, safety and long-term efficacy of laparoscopic total gastrectomy combined with distal pancreaticosplenectomy for the treatment of T4b gastric cancer. Methods: A retrospective cohort study was performed. Clinical data of consecutive patients with T4b gastric cancer invading pancreatic tail undergoing laparoscopic or open total gastrectomy combined with distal pancreaticosplenectomy from January 2010 to December 2014 were analyzed retrospectively. Enrollment criteria: (1) primary gastric cancer confirmed by pathology as T4b adenocarcinoma; (2) chest+abdominal+pelvic enhanced CT indicated cancer invading pancreatic tail without distant metastasis, and R0 resection was evaluated as feasible before operation; (3) physical status was ECOG score 0 to 2, and was tolerant to operation. Patients with peritoneal implant metastasis and tumor invasion of other organs during operation, or changes in surgical methods for other reasons were excluded. All the operations were performed by the same surgical team, which had the experiences of more than 100 cases of laparoscopic and 100 cases of open radical gastrectomy with D2 lymph node dissection. The choice of surgical procedure was discussed by the surgeon and the patient, and decided according to the patient′s intension. Patients were divided into the laparoscopic group and open group according to the surgical method. Intraoperative and perioperative findings were compared between the two groups. The 3-year disease-free survival rate were analyzed with Kaplan-Meier survival curve and compared by using log-rank test. Results: A total of 37 consecutive patients were enrolled, including 21 in the laparoscopic group and 16 in the open group, and no one receiving laparoscopic procedure was converted to open surgery. The baseline data of two groups were comparable (all P>0.05). Compared with the open group, the laparoscopic group had significantly longer operation time [(264.0±35.1) minutes vs. (226.6±49.9) minutes, t=2.685, P=0.011], significantly less intraoperative blood loss [(65.7±37.4) ml vs. (182.2±94.6) ml, t=-4.658, P<0.001], significantly shorter time to postoperative flatus [(2.8±0.7) days vs. (4.1±0.7) days, t=-5.776, P<0.001] and significantly shorter postoperative hospital stay [(13.3±2.8) days vs. (16.6±4.3) days, t=-2.822, P=0.008]. Morbidity of postoperative complications, including anastomotic leakage, pancreatic fistula, abdominal abscess, intraperitoneal hemorrhage and duodenal stump leakage, in two groups was similar [19.0% (4/21) vs. 4/16, P=0.705]. There were no cases of anastomotic bleeding or stenosis. The 30-day postoperative mortality was 0 in the laparoscopic group and 1/16 in the open group, respectively (P=0.432). The 3-year disease-free survival rates were 38.1% and 37.5% in the laparoscopic and open group, respectively (P=0.751). Conclusion Laparoscopic total gastrectomy combined with distal pancreaticosplenectomy performed by experienced surgeons for T4b gastric cancer is safe and effective.