Objective To explore the application effect of sacubitril valsartan in patients with chronic heart failure(CHF).Methods A total of 66 CHF patients admitted to Xinyu Yuanhe Hospital from September 2021 to September 2022 were selected and divided into control group and study group according to random number table method,with 33 cases in each group.The control group was treated with benazepril + spironolactone + metoprolol,and the study group was treated with sacubitril valsartan + spironolactone + metoprolol.The clinical efficacy,ventricular remodeling,cardiac function,serum factor levels and adverse reactions were compared between two groups.Results The total effective rate in study group was significantly higher than that in control group(χ2=5.974,P=0.015).After treatment,left ventricular mass index,myocardial wall stress,left ventricular posterior wall thickness,left ventricular ejection fraction,N-terminal pro-brain natriuretic peptide(NT-proBNP),angiotensin Ⅱ and aldosterone in study group were significantly lower than those in control group,and left ventricular remodelling index,stroke volume and left ventricular end-diastolic volume were significantly higher than those in control group(P<0.05).There was no significant difference in adverse reactions between two groups(P>0.05).Conclusion The treatment effect of sacubitril valsartan in CHF patients is significant,which can effectively improve cardiac function indicators,reverse ventricular remodeling,reduce serum NT-proBNP level,and have fewer adverse reactions.

BACKGROUND:At present, dexamethasone has been widely used in the perioperative period of major surgery in the orthopedics for reducing postoperative pain and nausea and vomiting, but the study on the application of methylprednisolone to reducing postoperative nausea and vomiting and pain after unilateral total knee arthroplasty is rarely reported.OBJECTIVE:To evaluate the effects and safety assessment of the application of methylprednisolone on postoperative nausea and vomiting and pain after unilateral total knee arthroplasty. METHODS:A total of 86 patients undergoing unilateral total knee arthroplasty were randomly assigned to two groups. Patients in the methylprednisolone group were given methylprednisolone 40 mg in intravenous drip within 24 hours during and after replacement. Patients in the control group were given an equal volume of saline in intravenous drip at the same time. The incidence of postoperative nausea and vomiting was observed and recorded at 0-6 hours, 6-24 hours, 24-48 hours, and 48-72 hours after surgery, as wel as the total incidence was recorded in both groups. Pain visual analogue scale (VAS) score at 6, 24, 48 and 72 hours after replacement, and knee joint scoring system (KSS) score at 3 days after replacement were recorded. C-reactive protein and fasting blood glucose were determined. The occurrence of adverse reactions postoperatively was recorded in 6-month fol ow-up in both groups. RESULTS AND CONCLUSION:(1) The total incidence rate of postoperative nausea and vomiting during 0-72 hours after surgery, and incidence rates of nausea and vomiting at 6 and 24 hours were significantly lower in the methylprednisolone group than in the control group (P<0.05). (2) Pain VAS score was significantly lower in the methylprednisolone group than in the control group at 6 and 24 hours after surgery (P<0.05). (3) KSS scores were significantly higher in the methylprednisolone group than in the control group after surgery (P<0.05). (4) C-reactive protein and fasting blood glucose were not significantly different between two groups before and after surgery (P>0.05). (5) The surgical incision was found to heal in 3-month fol ow-up and no postoperative infection occurred in both groups. (6) Results show that methylprednisolone can obviously reduce postoperative nausea and vomiting and pain in unilateral total knee arthroplasty, and did not increase the incidence of postoperative infection.

BACKGROUND:It is particularly important to search favorable scaffolds and seed cells in bone tissue engineering. However, no existing studies have reported the co-culture of adipose-derived stem cells and absorbable gelatin sponge.
OBJECTIVE:To induce rabbit adipose-derived stem cells to osteoblasts, observe the adhesion, proliferation and biological characteristics of adipose-derived stem cells on absorbable gelatin sponge, and to provide experimental base for absorbable gelatin sponge as an effective carrier of fat stem cells transplantation in vivo.
METHODS:Adipose-derived stem cells were cultured in vitro and identified with immunohistochemistry and flow cytometry. The passage 3 adipose-derived stem cells were induced to differentiate into osteoblasts and then seeded onto absorbable gelatin sponge after treatment with polylysine. The adhesion and proliferation of adipose-derived stem cells on scaffolds were observed under scanning electron microscope.
RESULTS AND CONCLUSION:The rabbit adipose-derived stem cells were mainly round and oval shaped at 48 hours, and became long spindle shaped after 48 hours. Adipose-derived stem cells were positive for CD29 and CD44, and negative for CD33 and CD34. Adipose-derived stem cells can be induced to differentiate into osteoblasts after culture in the osteogenesis induced fluid for 72 hours. The induced osteoblasts that were co-cultured with absorbable gelatin sponge had an 85%adherence rate at 24 hours. The cells began to extend pseudopodium at 48 hours, and osteoblasts adhered in clumps and secreted a large amount of cellmatrix at 7 days. Absorbable gelatin sponge began to absorb and degrade. Experimental findings indicate that, adipose-derived stem cells have good histocompatibility with absorbable gelatin sponge, and absorbable gelatin sponge can be used as a biological carrier of adipose-derived stem cells.

Objective To investigate the cause and treatment experience for traumatic renal subcapsular hematoma.MethodsThe data of eleven cases with traumatic renal subcapsular hematoma were reviewed.four cases were caused by external injury,and seven cases were iatrogenic,including four cases of postESWL patients,two cases of post-ureteroscopic lithotripsy patients and one case after percutaneous renal biopsy.The patients were treated with conservative treatment,percutaneous drainage of the hematoma and surgical exploration,respectively.Results Four cases received conservative treatment,six cases received percutaneous drainage of the hematoma,and one case received surgical exploration.Seven of the ten cases who received conservative treatment or percutaneous drainage of the hematoma were continuously followed up for 1 to 3 years.They recovered well without complications such as renal hypertension,renal function impairment,hydronephrosis and renocortical pyogenic infection.One case was performed nephrectomy due to severe trauma and hemorrhage during the surgical exploration.ConclusionTraumatic renal subcapsular hematoma usually occurs after flank abdomen injury,iatrogenic injury such as ESWL,ureteroscopic lithotripsy and percutaneous renal biopsy.CT and ultrasound examination are the major means to diagnose traumatic renal subcapsular hematoma and determine the severity.Optimistic prognosis can be obtained after conservative treatment and percutaneous drainage of the hematoma.Surgical exploration should be avoided as far as possible.

BACKGROUND: Hormone use has become the primary cause of steroid-induced avascular necrosis of femoral head (SANFH). OBJECTIVE: This study used a combination of injection of horse serum and a large dose of corticosteroid to develop a hormone-induced rabbit model of early avascular necrosis of femoral head (ANFH), and preliminary discussed the pathogenesis of ANFH. METHODS: New Zealand rabbits were randomly divided into three groups. Methylprednisolone with horse serum group: horse serum (10 mL/kg) was injected. Three weeks later, 6 mL/kg of horse serum was injected. Two weeks later, 45 mg/kg of methylprednisolone was daily injected for 5 consecutive days. Methylprednisolone group: 45 mg/kg of methylprednisolone was daily injected for 5 consecutive days. Control group: no treatment was given. Serum cholesterol and triacylglycerol levels were detected at 1, 3, 7 and 14 days before and after hormone injection. MRI and histopathological detection was done in femoral head at 2, 4 and 8 weeks after hormone injection. RESULTS AND CONCLUSION: The serum triglyceride and total cholesterol in methylprednisolone with horse serum group and methylprednisolone group were higher than control group at 1 and 3 days after hormone injection (P < 0.01). MRI results displayed abnormal signal in femoral head at 4 weeks in methylprednisolone with horse serum group, but in the methylprednisolone group at 8 weeks. Histological detection results exhibited that at 4 weeks, some trabeculae were broken into fragments, and the empty bone lacunae increased. At 8 weeks, the trabeculae showed thinning and broken. There were large amount of empty bone lacunae with bone cell atrophy and larger fat cells which were fused into bubbles. In methylprednisolone group, the level of necrosis was lighter than methylprednisolone with horse serum group during each period. Results suggest that hormone combined with horse serum can successfully prepare early-stage hormone-induced ANFH.

Objective To explore the effect on radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle. Methods The patients with pre-T3a stage kidney cancer were divided into two groups, 50 patients in traditional surgical group (traditional group) and 52 patients in post-pyelic retrograde free control of renal pedicle group(research group). The surgical duration, hemarrhage volume, local tumor recurrence in one year after operation, and distal metastasis rate had been compared between the two groups. Results One hundred and two patients underwent successful operations and had one year of follow-up as scheduled after being discharged from hospital. The traditional group took (130± 37) min for surgical duration, and had (400 ± 306) ml of hemarrhage volume; and the research group took (99 ± 28) min for surgical duration, and had (280 ± 225) ml of hemarrhage volume,there were significant difference between the two groups (P < 0.05). After one year of follow-up, 2% (1/50) of local recurrence rate and 6%(3/50) of distal metastasis rate occurred in the traditional group,and only 2% (1/52) of local recurrence rate and 4% (2/52) of distal metastasis rate happened in the research group. There were no obvious difference between the two groups. Conclusion The radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle has such features as easy performance, short surgical duration, less hemarrhage, and can lower the surgical risk, achieve satisfactory efficacy and deserve popularization.

BACKGROUND: Traditional methods of repairing bone defect such as autograft and allograft have some disadvantages that are hard to deal with, gene treatment may be a new approach. OBJECTIVE: To investigate the biological properties of cultured human osteoblasts transfected with vascular endothelial growth factor (VEGF) gene. DESIGN, TIME AND SETTING: A controlled experiment based on cytology was carried out in the Scientific Experiment Centre of Liaoning Medical College from May 2005 to May 2006. MATERIALS: Human lilac born block was harvested from a cervical spondylosis patient who required lilac bone graft with his informed consent of this patient. Plasmid pCDI/VEGF_(121) was given as gift from Professor Ma, Peking Unviersity Human Disease Genomics Research Center. Competent Escherichia coU was given as gift from Professor Liu, Liaoning Medical College. METHODS: Human osteoblasts were isolated and cultured in vitro. There were a VEGF transfection group and a control group in the experiement. Using cation liposome, the pCDINEGF_(121) eukaryotic expression plasmis was induced into human osteoblasts.MAIN OUTCOME MEASURES: At 1, 3, 5, 7 days following passage culture, the expression of VEGF in human osteoblasts was detected. Its effects on the call proliferation, the secretion of osteocalcin and alkaline phosphatase were investigated.RESULTS: After the plasmid pCDI-VEGF_(121) was transferred into human osteoblasts 3 and 7 days, VEGF mRNA expression was detectable by RT-CPR method. The call number of transfection group was larger than that of control group (P < 0.05 or P < 0.01).When the cells were cultured for 3 days, the positive rate of alkaline phosphatase in the transfection group was increased compared with control group (P < 0.01 ); the secretion of osteocalcin in the transfection group was higher than that of control group (P < 0.05 or P < 0.01 ).CONCLUSION: VEGF gene transfection can improve the proliferation and biological function of human osteoblasts cultured in vitro.

Objective To discuss the experiences of management of female duplicated kidney with urinary incontinence. Methods The clinical data of 25 cases with duplicated kidney with urinary incontinence were retrospectively analyzed. They were all female, age ranged from 2 to 12 years old, averaging 7. Fifteen cases were with right side lesions, 10 with left side. The main complaint was urinary incontinence and itching of pudendum. The diagnosis was set up by physical examinations and imaging methods. Results Twenty-five cases reported continent after operation. For the patients taken ureteral replant, the upper kidney function kept or recovered during follow-up. Conclusions Sonography, IVU, and MRU play an important part in the diagnosis of duplicated kidney with urinary incontinence. Operation is the key treatment for this disease.

The treatment of avascular necrosis of the femoral head whose pathological procedure is femoral head avascularity and osteocyte necrosis induced by many etiological factors is one of the difficult subjects in orthopaedics. As a newly-developed technology, cytokines and gene therapy have been widely used in the research of avascular necrosis of the femoral head. Many cytokines and transduced genes have the effects of promoting vascular reconstruction and bone repairment so that it could recover the blood supply and repair the osteonecrosis of femoral heads. Most current researches remain in the experimental phase. Therefore, the research focus in the future comes down to the lengthening of gene transfection expression as well as the selection of vectors and tissue engineering bones that have low immunereaction and low toxicity.

Objective To evaluate the feasibility of interstitial implantation of ~(125)I seeds for malignant tumor at the Head and Neck. Methods From Oct 2006 to Oct 2008,26 patients received interstitial implantation of ~(125)I seeds in our hospital because of recurrent or metastatic malignant tumors at the head or neck after surgery or chemotherapy. ~(125)I seeds were implanted into the tumor tissues under guidance of CT. Results The operation was completed in all the patients. A median of 23 seeds (12～54) were implanted in each case. No complications, such as hemorrhage, infection, or seed migration, occurred in the patients. The patients were followed up for 3～24 months. During the period,the rate of local control was 54% (15/28) at 3 months,72% (18/25)at 6 months,47% (11/23)at 12 months,and 37% (6/16)at 2 years. Conclusion Interstitial implantation of '2!I seeds is feasible for ecurrent or metastatic tumor at the head or neck with a good short - term outcome.