Left atrial appendage ( LAA) arises from the left atrial free wall. It is the remnant of the original embryonic LA, distinct from the rest of the left atrium. It has a unique anatomical structure, physiological function, hemodynamic characteristics. LAA has complex surrounding structures, great variability, and close relation with thrombosis. This paper reviews the morphological and functional characteristics of LAA. Familiar with adjacent relationship of LAA and correlation between LAA and thrombus formation has important clinical significance that can reduce the risk of postoperative complications in interventional procedures, the incidence of car?dioembolic stroke, the clinical misdiagnosis on LAA thrombosis.

Amygdala ; Animals ; Disease Models, Animal ; Electroencephalography ; Epilepsy ; etiology ; physiopathology ; Kindling, Neurologic ; Male ; Rats ; Rats, Wistar

Animals ; Cerebral Cortex ; drug effects ; physiology ; Epilepsy ; chemically induced ; physiopathology ; Female ; Flunarizine ; pharmacology ; Hippocampus ; drug effects ; physiology ; Male ; Penicillins ; adverse effects ; Rats ; Rats, Wistar

Angina Pectoris ; drug therapy ; Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Technology, Pharmaceutical

Agouti Signaling Protein ; Animals ; Central Nervous System ; abnormalities ; metabolism ; pathology ; Energy Metabolism ; Hair Color ; genetics ; physiology ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Membrane Proteins ; genetics ; metabolism ; physiology ; Mutation ; Obesity ; genetics ; metabolism

OBJECTIVETo investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic.

METHODSFrom March 1995 to July 2011, 28 patients with knee joint synovial chondromatosis were treated. Among them, 18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain, swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery (10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed, Lysholm scoring was used to evaluate effects.

RESULTSAll patients were followed up except one lost, the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from (41.89 +/- 6.81) preoperatively to (67.73 +/- 7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78 +/- 7.54) preoperatively to (77.46 +/- 8.43) postoperatively.

CONCLUSIONArthroscopic surgery, which has no risk of rupture of incision, nonunion, earlier to exercise, is a good method to diagnosis and treat knee joint synovial chondromatosis.

Adult ; Aged ; Aged, 80 and over ; Chondromatosis, Synovial ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Laparoscopy ; Male ; Middle Aged ; Treatment Outcome

Valve replacement represents the most common surgical therapy for valvular heart diseases. However, the long-term results of the valve protheses in clinical use are not satisfying. Recently, with the development of tissue engineering, more and more studies are focusing on creating ideal valve substitutes through seeding autologous cells on biodegradable scaffold. This article describes the definition of valvular tissue engineering, the choice of scaffold biomaterials, the methods of cell culture and seeding, and the evaluation of tissue-engineered heart valves. Furthermore, the problems which should be resolved in the future are also presented in the article.
Animals ; Bioartificial Organs ; Biocompatible Materials ; Biodegradation, Environmental ; Cells, Cultured ; Heart Valve Prosthesis ; Polymers ; Tissue Engineering

OBJECTIVE Toinvestigatetheantidepressantandantianxietyeffectofproanthocyani-dins(OPC)inchronicallystressedratsanditsunderlyingmechanism.METHODS Onemethodwas selected from 8 different stress methods each day,and the rats were treated with OPC (25,50 and 1 00 mg·kg -1 )1 h before the stress method.The chronically stressed model was established.After 21 d stress experi ment,the i mmobility ti me in force swi mming test,sucrose consu mption and the nu mber of marbles buried in the marble burying test were observed respectively each day.OPC (25,50 and 1 00 mg·kg -1 )was given 1 h before each test.In addition,Western blotting was used to analyze the expression of brain derived neurotrophic factor (BDNF) and phosphorylated cyclic AMP response element-bindingprotein(p-CREB)inthehippocampusandfrontalcortex.RESULTS Comparedwith the control group,the chronically stressed group showed obvious depressive-like and anxiety-like behav-ior,while the immobility time decreased from (90.57 ±4.27)s in chronically stressed group to (78.25 ± 2.53)s (P<0.05),(72.12 ±3.21 )s(P<0.05)and (60.77 ±3.41 )s (P<0.05)when ig given OPC 25,50 and 100 mg·kg -1 respectively,the ratio of sucrose preference increased from (42.80 ±4.92)%to (67.54 ±4.32)%(P<0.05)and (72.21 ±7.99)%(P<0.05)when ig given OPC 50 and 1 00 mg· kg -1 respectively,the number of buried marbles decreased from 1 .57 ±0.21 in chronically stressed group to 0.63 ±0.26 (P<0.05)and 0.44 ±0.1 8 (P<0.05)when ig given OPC 50 and 1 00 mg·kg -1 respectively.The expression of p-CREB in the hippocampus and frontal cortex distinctively increased in OPC group (25,50 and 100 mg·kg -1 )(P<0.05),so did the expression of BDNF in the hippocampus andfrontalcortexinOPCgroup(50and100mg·kg-1)(P<0.05).CONCLUSION OPCcanreverse the depressive-like and anxiety-like behavior in chronically stressed rats,which may be related to the cAMP-CREB-BDNF signal transduction cascades.

Objective To explore the clinicopathological features of IgA nephrolpathy associated with malignant hypertension (IgAN-MHT) and to analyze their correlation with renal vascular lesions. Methods Twenty-nine patients of IgAN-MHT were screened from 2000 biopsy-proven eases with primary IgA nephropathy (IgAN) in our department from April 1997 to May 2007. Data of clinicopathology and follow-up of these 29 patients were collected. Semi- quantitative analysis was performed to evaluate the pathological changes. Inner lumen, outer lumen, intimal thickness, tunica media-to-internal lumen ratio of 436 arterioles, 124 interlobular arteries and 5 arcuate arteries were measured. The primary endpeint was the composite of a doubling of serum creatinine level and ESRD. Correlations of renal vascular lesions with clinical manifestation, pathological change and prognosis were examined by Spearman and Cox methods. Results 1.5% of all the IgAN patients presented malignant hypertension. The common clinical features were renal failure (100%), hyperurieacidemia (62.7%) and hypertriglyceridemia (51.7%). The average amount of urine protein excretion was 2.8 g/d. The common pathological changes were moderate mesangial proliferation, severe global sclerosis, severe interstitial inflammation and severe interstitial- tubular fibrosis. The small arteries (arcuate arteries and interlobular arteries) and arterioles (afferent arterioles) were both involved in IgAN-MHT. The characteristic lesions of intrarenal arteries included vascular occlusion, media thickening, proliferative endarteritis (onionskin lesion, musculomucoid intimal hyperplasia), hyaline arteriosclerosis, but mainly vascular occlusion (86.2%). The arteriole lesion was negatively correlated with age and total protein level; vascular occlusion was positively correlated with uric acid level. The average foUow-up period was 21.1 months. Forteen patients reached the endpoint. The arteriole lesion was the main independent risk factor for the progression of IgAN-MHT (RR=10.21, 95%CI=1.16～89.67). Conclusions The main clinical feature of IgAN-MHT is renal failure. The main histological feature of intrarenal vascular lesions is occludes arterioles. Arteriole lesion is the main independent risk factor for the progression of IgAN-MHT.

Objective To investigate the anatomic structure of the Chinese people,develop the procedure of minimally invasive total hip arthroplasty through the anterolateral intermuscular approach and investigate its clinical outcome.Methods Three fresh adult cadavers(6 hips)were used for study of the anatomic construction of the anterolateral intermuscular approach in Chinese people.Sixteen patients were treated with minimally invasive total hip arthroplasty through anterolateral intermuscular approach.The clinical results and operation technique were recorded.Results The anterolateral intermuscular approach was a triangle muscular interval slightly parallel to the femur.The medial-superior angle of the triangle muscular interval consists of the anterior border of gluteus medius and tensor fascia lata muscle with juncture of muscles,where the inferior branch of superior gluteal nerve entered into tensor fascia lata muscle.The average incision length was 8.8 cm(7-10 cm),with mean blood loss of 350 ml(250-550 ml).The patients took out-of-bed activity 3-5 days after operations.During operations,anterior border injury in deep portion of the gluteus medius muscle was observed in seven patients and the injured muscles were trimed or repaired.All patients were followed up for 18-39 months(averaged 27.7 months).Most of the patients had excellent location of the phantoms,except that one acetabulum had a little pitch angle and two acetabulums had a little abduction angle.No complication was observed.The mean Harris scores of hip for all patients was increased from preoperative(39.1±6.7)points to(80.6±11.3)points on six month,(88.7±9.6)points on 12 month and(91.4±13.5)points on 24 months(11 patients).No patient suffered from gluteus medius muscle weakness during the follow-up.ConclusionAnterolateral intermuscular approach has the advantages of simple anatomic construction,small incision,little operative injury,muscle sparing and fast recovery without separate muscle or tendon and is suitable for the Chinese patients.Exact incision and special operative instruments should be emphasized to avoid the increase of acetabular pitch angle and abduction angle.