Objective To explore the regulating mechanism of the astrocytes on the expression of ?-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors(AMPARs) subunit in epileptogenesis. Methods The astrocytic conditional medium(ACM) was collected after being stimulated by glutamate,and then ACM was added to the cultured hippocampal neurons.The expression changes of neuronal GluR2 and protein interacting with C-kinase-1(PICK1) mRNA were detected by RT-PCR. Results In the cultured hippocampal neurons,the GluR2 mRNA expression was significantly decreased at the 2nd,8(th),and 12(th) hours after the administration of ACM compared with that in the control group(P

Objective To study the arthroscopic operative procedure and the result for knee osteoarthritis. Methods 49 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to September 1999 were reviewved.Arthroscopic lavage,debridement or debridement Combined with drilling was performed on different patients. Results The average follow-up period was 5 years.The scale improved 36.0 after operation.No serious complication was found. Conclusions Arthroscopic debridement for osteoarthritis is satisfactory in the long-term efficacy and drilling of grade Ⅳ subchondral bone does not improve long-term outcome.

Objective To study the values of arthroscopy in the diagnosis and treatment of knee osteoarthritis. Methods A retrospective survey of 75 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to Sep 1999 was conducted.the Tindings by radiograph and those in operation were compaired. Results The average follow-up period was nearly 5 years.The scale improved 35.7 after operation.No serious complication arose. Conclusions The more severe the condition, the more consistent radiographic diagnosis is with arthroscopic findings.Radiography reflects the site of the lesion better.50% of the patients at the intermediate and late stage have meniscal lesions.It seems that meniscal lesion does not affect surgical results;having loose body indicates better results.

OBJECTIVE:To investigate the effects and safety of Xingnaojing injection combined with butylphthalide on neuro-logical function,cognitive function,coagulation function and living activity. METHODS:A total of 106 patients with middle cere-bral artery infarction in Wuhan University People's Hospital during Jun. 2014-Dec. 2015 were divided into control group and obser-vation group according to random number table,with 53 cases in each group. Besides routine symptomatic treatment,control group was given Butylphthalide soft capsules 0.2 g,po,tid. Observation group was additionally given Xingnaojing injection 20 mL added into 0.9% Sodium chloride injection 250 mL,ivgtt,qd. Both groups were treated for 14 d. The neurological function score (NI-HSS,NFDS),cognitive function score (MoCA,MMSE),coagulation function indexes (PT,APTT,FIB),BI score were ob-served in 2 groups before and after treatment. The occurrence of secondary remote damage and ADR were recorded. RESULTS:Eight patients withdrew from the study,including 3 patients of control group and 5 of observation group. Before treatment,there was no statistical significance in neurological function scores(NIHSS,NFDS),cognitive function scores(MoCA,MMSE),coag-ulation function indexes or BI scores between 2 groups (P>0.05). After treatment,NIHSS,NFDS scores and FIB of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). MoCA,MMSE,BI scores in 2 groups were increased significantly,and PT and APTT in 2 groups were prolonged significantly,and the observation group was significantly higher or longer than the control group, with statistical significance (P<0.05). The incidence of secondary remote damage in observation group (11.3%) was significantly lower than control group (41.5%),with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For middle cerebral artery infarction,the application of Xingnaojing injection combined with butylphthalide can reduce the risk of remote damage,promote the recovery of neurological function and cognitive func-tion,and improve coagulation function and living activity with good safety.

OBJECTIVE:To provide reference for improving the clopidogrel rational use in cerebral infarction secondary preven-tion. METHODS:Medical cases of 471 patients with acute cerebral infarction in neurology department in a hospital from 2013 to 2014 were retrospective surveyed to collect the utilization rate of clopidogrel and the combination of clopidogrel with proton pump inhibitors(PPIs)and aspirin,and the rationality was analyzed. RESULTS:The utilization rate of clopidogrel in cerebral infarction secondary prevention was 93.84%;the combination rate with PPIs was 52.49%,of which,51.72% had no drug selection or com-bined treatment basis;the combination rate with aspirin was 40.72%,cardiogenic cerebral infarction accounted for only 3.9%, non-cardiogenic cerebral infarction accounted for 96.1%,and recurrence of cerebral infarction in high-risk patients accounted for 31.11%. CONCLUSIONS:Clopidogrel in patients with cerebral infarction secondary prevention is widely used in the hospital,has high combination rate with PPIs and aspirin and low guide compliance rate. Clopidogrel should be enhanced pharmacy services, comply with evidence based medicine and improve the rationality of medication.

Objective To evaluate the clinical efficacy of continuous irrigation with recombinant human acid fibroblast growth factor (rh-aFGF) combined with negative-pressure drainage in the treatment of refractory skin ulcer.Methods A clinical trial was performed from January 2010 to December 2012.Sixty patients with refractory skin ulcer were randomly and equally classified into three groups:group A receiving continuous irrigation with rhaFGF combined with negative-pressure drainage,group B receiving irrigation of raw surfaces with rh-aFGF followed by bandaging after debridement,group C receiving covering of raw surfaces with Vaseline gauze and absorbent gauze followed by bandaging after debridement.Dressings were changed once daily in every group.The treatment lasted 21 days.The efficacy of these regimens was evaluated on day 7,14 and 21.Results At the above time points for observation,both the granulation and epithelium tissues of ulcers grew well in group A,with a decrease in the volume of wounds and area of exposed deep tissues.There was a significant increase in the cure rate and reduction rate of wound volume in group A compared with the other two groups (all P ＜ 0.01).Conclusion Refractory dermal ulcer can be treated with continuous irrigation with rh-aFGF combined with negative-pressure drainage.

Robot-assisted surgery is becoming a widely popular technology and now entering total knee replacement. The development of total knee replacement is introduced in this paper with the emphasis on femur positioning technologies. The experiments and error analysis of robot-assisted surgical system for total knee replacement demonstrate that femur positioning technologies have a high precision and thus deserve to be popularized theoretically and practically.

Objective To explore the clinical effect of lubar intervertebral disc protrusion treatment with ozone injection combined radiofrequency thermocoagulation. Methods 36 patients with lubar intervertebral disc protrusion confirmed by clinical and imaging examination were underwent radiofrequency thermocoagulation followed ozone injection guided with CT. Results All the patients were followed up for 3 ～6 months,and statistic the improvement rate was evaluated according to Macnab standard. The total effective rate was 94.4%, and the improvement rate was 86.1%. Conclusion CT guided treatment could greatly elevate the accuracy of puncture. Radiofrequency target point thermocoagulation combined with ozone injection was a minimally invasive、safet and markedly effective method for lubar intervertebral disc protrusion treatment.

Objective To study the clinical effect of percutaneous laser disc decompression(PLDD) combined with ozone injection in the treatment of cervical spondylosis.Methods 183 cases of cervical spondylosis were randomly divided into two groups.One group of 80 cases with 118 cervical discs herniation were treated with PLDDonly.while the other group of 103 cases with 142 cervical discs herniation were treated with PLDD combined with ozone injectlon.The patients were followed up for 3 to18 months(mean 7 months).The clinical effects were assessed according to the Japanese Orthopaedic Association scoring system(JOA score)and the improvement rates of the two groups were compared.Results 167 cases were followed up.The average point of the group treated with PLDD is 15.2 and the improvement rate is 74.7%.The average point of the group treated with PLDD combined with ozone injection is 16.3 and the improvement rate is 91.3%.The difference between two groups has statistical significance(P＜0.05).Conclusion The treatment of cervical spondylosis with PLDD combined with ozone injection is safe.painless and minimally invasive.The clinical effect is impmved tremendously and much better than monotherapy.

BACKGROUND: It is still controversial whether antibiotic-loaded bone cement can prevent wound deep infection in the primary hip arthroplasty. OBJECTIVE: To retrospectively observe the effect of antibiotic-loaded bone cements in primary hip arthroplasty. DESIGN, TIME AND SETTING: A retrospective case analysis was performed for the patients undergoing primary hip arthroplasty at Department of Orthopedics, Peking University Third Hospital from February 2004 to January 2007. PARTICIPANTS: 227 consecutive patients (233 hips) underwent primary hip arthroplasty with the same antibiotic-loaded bone cement, including 69 male and 115 female, and 184 cases (191 hips) were followed up for 3-46 months. METHODS: Fifty-four patients over 71 years old with femoral neck fracture were treated with bipolar femoral head replacement. 130 patients underwent total hip arthroplasty. Seventeen patients with massive acetabular bone defect were reconstructed with impaction autogenous and heterogenous bone grafting plus mesh; 3 patients underwent acetabular structural bone grafting. Both acetabular and femoral side prosthesis were antibiotic-loaded bone cements (Refobacin~-Palacos~R 40 or Cemex~ Genta). MAIN OUTCOME MEASURES: Deep infection after operation. RESULTS: 227 patients (233 hips) did not develop early deep infection after surgery. 184 cases (191 hips) did not occur deep infection during the follow up. However, 15 cases developed swelling on the affected site or skin temperature increase, or pain surrounding joint, and underwent blood sedimentation and C-reactive protein examinations; 12 cases had normal blood sedimentation and 3 had increased blood sedimentation including 1 with rheumatoid, 1 with senile chronic bronchitis, and 1 with undetermined cause. All the 3 patients restored one month later. Fourteen patients had C-reactive protein within normal scope, and 1 with increased C-reactive protein caused by rheumatoid arthritis, but restored 6 weeks later. CONCLUSION: Antibiotic-loaded bone cements in primary hip arthroplasty can reduce incidence of deep infection.