ABSTRACT
Objective:To explore the predictive values of neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR) for postoperative delirium in the elderly patients with hip fracture.Methods:The data of 1,278 elderly patients with hip fracture were analyzed retrospectively who had been admitted to Department of Orthopedics, The 7th Medical Center, General Hospital of Chinese People's Liberation Army from January 2012 to December 2018. There were 418 males and 860 females, with a median age of 81 (75, 90) years. There were 728 intertrochanteric fractures and 550 femoral neck fractures. The working characteristic curves (ROC) of NLR, MLR, and PLR used to predict postoperative delirium in the elderly patients with hip fracture were worked out to obtain the best cutoff points (sensitivity, specificity, and area under the curve) respectively. According to the best cutoff points, the NLR, MLR, and PLR were respectively divided into an increase group and a normal group. According to whether postoperative delirium occurred or not, the patients were divided into a delirium group and a delirium-free group. After univariable analysis was conducted to screen out the risk factors, binary logistic regression analysis was conducted of the factors with P<0.05 to determine the risk factors. Results:The median values of NLR, MLR and PLR in the 1,278 elderly patients with hip fracture at admission were 5.43 (3.87, 7.88), 0.40 (0.29, 0.54) and 158.40 (118.00, 222.50), respectively. Postoperative delirium occurred in 153 patients (12.0%). In the study of the predictive values of NLR, MLR, and PLR using ROC curves for postoperative delirium in the elderly patients with hip fracture, the best cutoff points (sensitivity, specificity, and area under the curve) for prediction were 7.613 (57.5%, 77.1%, 0.726), 0.512 (52.3%, 74.0%, 0.663), and 201.125 (68.6%, 73.3%, 0.751), respectively. The risk factors for postoperative delirium were increased NLR ( OR=2.046, 95% CI: 1.322 to 3.166, P<0.001), increased MLR ( OR=1.568, 95% CI: 1.039 to 2.367, P=0.032), and increased PLR ( OR=3.489, 95% CI: 2.290 to 5.317, P<0.001). Conclusion:As NLR≥7.613, MLR≥0.512 and PLR≥201.125 may be risk factors for postoperative delirium in elderly patients with hip fracture, NLR, MLR and PLR may have a positive value in prediction of postoperative delirium.
ABSTRACT
Objective:To investigate the prognosis of hip fracture in elderly patients with dementia.Methods:From January 2012 to December 2017, 91 dementia patients aged (82.7±6.6)y (21 males and 70 females) with hip fracture were enrolled in the study; 91 non-dementia patients matched by age, gender and fracture type were selected as controls. There were 54 cases of intertrochanteric fracture and 37 cases of femoral neck fracture. The length of hospital stay, mortality within 30 days and 1 year, walking ability and risk of reoperation were compared between the two groups. The effect of dementia on the mortality after surgery was analyzed by adjusting confounding factors through multivariate logistic regression analysis.Results:There was no significant difference in the length of hospital stay between dementia group and non-dementia group [(13.95±7.33) vs.(12.63±8.68)d, t=1.12, P=0.266]. The incidence rate of perioperative complications in dementia group was higher than that in non-dementia group [63.7%(58/91) vs. 23.1%(21/91), χ 2 = 44.59, P<0.001]. The incidence of delirium in dementia group was higher than that in non-dementia group [35.3%(42/91) vs.13.2%(12/91), χ 2 = 5.71, P=0.017]. The incidence of pulmonary infection in dementia group was higher than that in non-dementia group [11.0%(10/91) vs. 2.2%(2/91), χ 2= 11.989, P<0.001]. There was no significant difference in 30-day fatality rate [7.7%(7/91) vs. 1.1%(1/91), χ 2= 3.27, P=0.071] between two groups; while the 1-year fatality rate in dementia group was higher than that in non-dementia group [27.5%(25/91) vs. 14.3%(13/91), χ 2= 4.79, P=0.029]. After adjusting for the differences of confounding factors between the two groups, dementia was an independent risk factor for 1-year mortality after hip fracture surgery ( OR = 1.852, 95 %CI:1.048-3.043, P= 0.022). For walking ability of 1 year after operation, 22 (33.3%) patients in dementia group walked independently, 38 (57.6%) patients partially walked independently, 6 (9.1%) patients were in bed; while in non-dementia group, 45 (57.7%) patients walked independently, 27 (34.6%) patients partially walked independently, 6 (7.7%) patients were in bed; there was significant difference between the two groups (χ 2= 8.82, P=0.012). There was no significant difference in reoperation rate between two groups [6.6%(6/91) vs. 5.5%(5/91), χ2=0.10, P=0.756]. Conclusion:Compared to non-dementia patients, dementia patients with hip fracture have poorer prognosis, higher incidence of perioperative complications, pulmonary infection and delirium, higher risk of mortality 1 year after operation, and poorer ability of independent walking.
ABSTRACT
Objective:To study the relationship between hyperlactatemia and hip fracture complications, length of hospital stay, and mortality; And to study the predictive value of serum lactic acid on the risk of death after hip fracture surgery.Methods:The data of 1 004 cases of hip fracture admitted to our unit from January 2012 to December 2016 were retrospectively analyzed. The levels of lactate at admission, 1 day, 3 days and 5 days after operation were recorded. According to whether the average lactate level during hospitalization was higher than 2 mmol/L, the patients were divided into hyperlactic acid and control group. Finally, according to receiver operating characteristic (ROC), the predictive value of lactic acid in predicting the risk of death 30 days and 1 year after hip surgery was obtained.Results:Lactate level: 1.84±0.84 mmol/L on admission, 1.89±0.77 mmol/L at 1 day after operation, 1.79±0.78 mmol/L 3 day after operation, and 1.75±0.72 mmol/L at 5 day after operation. The incidence of lactic acid was 27.1% (272/1 004) in 272 patients with average lactic acid higher than 2 mmol/L during hospitalization. The mortality of 30 days (12.5%, 34/272) and 1 year (29.4%, 80/272) in the hyperlactemia group were significantly higher than that of 1.2% (9/732) and 10.8% (79/732) in the control group (30 days, t=61.448, P<0.001; 1 year, t=51.581, P<0.001). The incidence of perioperative complications in the hyperlactemia group was 28.7% (78/272), which was higher than 22.3% (163/732) in the control group ( χ2=4.465, P=0.035). The average length of hospital stay in the hyperlactemia group (13.95±9.02 d) was significantly higher than that in the control group (12.53±7.71 d) ( t=2.775, P=0.036). Lactic acid level could predict the 30 day mortality risk of hip fracture ( P<0.001). The cutoff value was 2.25 mmol/L, the sensitivity and specificity were 0.721 and 0.820, respectively, and the area under the curve was 0.832. Conclusion:The incidence of serum hyperlactatemia after hip fracture was high. Compared to patients with control group, the length of stay was longer, the incidence of complications was higher, and the mortality within 30 days and 1 year after operation were higher in serum hyperlactatemia group. Lactate level (2.25 mmol/L) could be used to predict the risk of mortality within 30 days after hip fracture operation.
ABSTRACT
Objective:To study the predictive value of high serum lactate for the risk of death after hip fractures.Methods:Data of hip fracture patients admitted to the authors' unit from January 2012 to December 2016 were analyzed retrospectively.A total of 1004 patients were included.According to the receiver operating characteristic(ROC), the predictive values of lactate for predicting the risk of death 30 days and 1 year after hip surgery were obtained.Results:The mortality rates of patients with serum hyperlactatemia were 10.8% and 23.3% for 30 days and 1 year after surgery, respectively.The 30-day and 1-year mortality rates for patients in the normal group were 1.3% and 11.8%, respectively.The differences between the two groups were statistically significant( χ2=47.764, 27.433, P=0.000 for both). The average survival time was(23.9±16.6)m for patients in the hyperlactatemia group and(28.8±16.5)m for subjects in the normal group, with a significant difference between the two groups( t=4.340, P=0.000). The incidences of complications were 28.6% for the serum hyperlactatemia group and 21.9% for the normal lactate group.There were significant differences between the two groups( χ2=5.249, P=0.022). The average length of stay was(13.6±8.7)d for the hyperlactatemia group and(12.5±7.8)d for the normal group, with the difference showing statistical significance( t=1.988, P=0.047). Lactate levels were able to predict the risk of death 30 days after hip fracture surgery.The predicted cutoff value was 2.35 mmol/L, the sensitivity and specificity were 0.744 and 0.834, respectively, and the area under the curve was 0.829. Conclusions:The incidence of hyperlactatemia after hip fractures is high.Compared with hip fracture patients with normal lactate levels, patients with hyperlactatemia show longer hospital stays, a higher incidence of complications, and higher mortality rates within 30 days and 1 year of surgery.Lactate levels(2.35 mmol/L)may be used to predict the risk of death within 30 days of hip fracture surgery.
ABSTRACT
Objective:To investigate the mortality and related risk factors for hip fractures in elderly patients within 30 days of surgery.Methods:Clinical data of elderly hip fracture patients in our hospital from January 2012 to December 2016 were retrospectively analyzed.Based on whether they survived within 30 days of surgery, patients were divided into the death group and the survival group.Differences in age, gender, comorbidities, timing of operation and fixation mode between the two groups were compared.Univariate analysis was conducted to detect significant factors, and Logistic regression analysis were performed to identify independent risk factors for 30-day mortality after operation.Results:A total of 1350 elderly hip fracture patients were treated in our hospital, and 1004 cases met the inclusion criteria.Forty-three cases(4.28%)died within 30 days of operation.Univariate analysis showed that, compared with the survival group, the death group had a higher average age, a higher white blood cell count, lower hemoglobin and albumin levels, higher proportions of patients with arrhythmia, more pulmonary infections, higher cardiac insufficiency and more people with ≥4 comorbidities.Multivariate Logistic analysis showed that arrhythmia( OR=2.36, P=0.038), pulmonary infection( OR=2.50, P=0.020), cardiac insufficiency( OR=3.15, P=0.016), high white blood cell count( OR=1.14, P=0.006), and low albumin( OR=1.08, P=0.037)were independent risk factors for increased mortality within 30 days of operation. Conclusions:The 30-day mortality rate is high in elderly hip fracture patients.Arrhythmia, pulmonary infection, cardiac insufficiency, high white blood cell count, and low albumin level are independent risk factors for mortality in elderly hip fracture patients.
ABSTRACT
Objective@#To explore the predictive effect of American Society of Anesthesiologists (ASA) classification on prognosis of elderly patients with hip fracture.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 814 elderly patients with hip fracture admitted to the 7th Medical Center of the General Hospital of the PLA from January 2012 to December 2015. There were 272 males and 542 females, with the age range of 60-99 years [(80.0±8.0)years]. According to ASA classification, the patients were divided into four groups: 23 cases (2.8%) of ASA grade I, 380 cases (46.7%) of ASA grade II, 389 cases (47.8%) of ASA grade III and 22 cases (2.7%) of ASA grade IV. Data compared among the groups included gender, age, comorbidities, fracture type, anesthesia methods, surgical methods, length of hospital stay, complications, and 30-day and 1-year mortality rates. Multiple Logistic analysis was conducted to seek independent risk factors for 1-year mortality.@*Results@#There were no significant difference among the four groups with regards to gender, fracture type, surgical methods (P>0.05 ). With the improvement of ASA classification, the age of patients increased gradually, the length of hospital stay increased, and the rate of nerve block anesthesia increased ( allP<0.01). Incidence of complications of ASA grade IV patients was the highest [59%(13/22)], followed by 31.4%(122/389) of ASA grade Ⅲ patients, 17.6%(67/380) of ASA grade II patients, 4%(1/23) of ASA grade I patients (all P<0.01). The 30-day and 9-0day mortality of ASA grade IV patients were 32% (7/22), 64% (14/22), ASA grade III patients were 4.6% (18/389), 17.0% (66/389), ASA grade II patients were 3.4% (13/380), 12.1% (46/380), and ASA grade I patients were 0 and 4% (1/23), respectively. The differences between these groups were significantly different ( allP<0.01). Univariate analysis showed that male, advanced age, coronary heart disease, pulmonary infections, chronic obstructive pulmonary diseases (COPD), renal insufficiency, ASA classification, anesthesia methods, and length of hospital stay were related to postoperative 1-year death (P<0.05 or 0.01). A total of 127 patients (15.6%) died within 1 year after operation. Multivariate Logistic regression analysis showed age (OR=1.037, 95%CI 1.007-1.068), ASA grade(ASA grade II : OR=1.851, 95%CI 1.238-14.386; ASA grade III : OR=2.092, 95%CI 1.266-16.482; ASA grade IV: OR=15.368, 95%CI 1.626-145. 283), length of hospital stay (OR=1.038, 95%CI 1.015-1.061) were independent risk factors for 1-year mortality.@*Conclusions@#The outcome of the elderly hip fracture is poor. The ASA classification is closely related to the incidence of complications, 30-day mortality, and 1-year mortality. Advanced age, ASA grade II, III and IV, hospital length of stay are the independent risk factors for poor prognosis of hip fractures. The ASA classification can be used as a screening tool to intervene for the high-risk population as early as possible.
ABSTRACT
Objective:To evaluate the clinical outcome of 3D printing titanium cage combined with Masquelet technology for the treatment of calcaneus infective defect.Methods:Data of 5 cases with chronic calcaneus infectivedefect treated with regional flap, 3D printing titanium cage combined with Masquelet technology with rib autograft from January 2017 to January 2019 were retrospectively analyzed. There were 3 males and 2 females, with an average age of 37 years old (range, 17-52 years). The mechanism of the five patients included two motor vehicle incidents, two high fall injuries and one rolling compaction. All patients were treated by two-stage procedures. First stage included debridement, polymethyl methacrylate (PMMA) filling and regional flap coverage. The soft tissue defect of the 5 cases included 10 cm×8 cm in 2 cases, 8 cm×7 cm, 8 cm×5 cm, and 5 cm×3 cm each in one case. Bone defect included 4 cm×3 cm×2 cm in two cases, 3 cm×3 cm× 2 cm in two cases and 3 cm×1 cm×1 cm in one case. Second stage was 3D printing titanium cage combined with masquelet technology of rib autograft. Time of bone union, morphology of calcaneus, position of implant, Maryland score and AOFAS hind foot score were recorded to evaluate the clinical outcome.Results:All five patients were followed up for an average time of 18.2 months (range, 12-30 months). Infection happened in one patient 2 months after first stage operation and successfully treated by debridement and PMMA replacement. Incision of the rest 4 cases all healed successfully. Germiculture of the five cases included Methicillin-resistant Staphylococcus aureus (MRSA) in three cases, Staphylococcus epidermidis in one case and Bacterium coli in one case. All five patients got calcaneus bone union after second stage operation. The average time for bone union was 4.32 (range, 3-8) month. Bone trabecular were observed in CT scan 13 (range, 10-22) month post-operation. Average Maryland score in 12 months post-operation was 92 (range, 86-98) and average AOFAS ankle hind foot score was 89.8 (range, 83-100).Conclusion:3D printing titanium cage and Masquelet technology maybe an effective treatment for calcaneus infective defect.
ABSTRACT
Objective:To analyze the impacts of operative timing on the operative outcomes in elderly patients with hip fracture.Methods:A cohort of 814 elderly patients with hip fracture were analyzed retrospectively who had been treated at Department of Orthopaedics, The 7th Medical Center, General Hospital of Chinese People's Liberation Army from January 2012 to December 2015. They were 272 males and 542 females, aged from 60 to 99 years (average, 79.9 years). They were divided into 2 categories according to their systemic status by the American Association of Anesthesiologists (ASA) classification. There were 403 cases of ASA class Ⅰ and Ⅱ in the good status category and 411 cases of ASA class Ⅲ and Ⅳ in the poor status category. Each category was further divided into one early operation group and one late operation group depending on whether the patients were operated on within 48 hours after admission. The 2 groups were compared in terms of hospital stay, incidence of complications, 30-day and 1-year mortalities, and 1-year activities of daily living(ADL) scores.Results:In the good status patients there were no significant differences between the 2 groups in the preoperative general data, showing compatibility ( P>0.05). The early operation group showed significantly lower 30-day mortality [0% (0/94)] and 1-year mortality [5.3% (5/94)], significantly shorter hospital stay (9.6 d ± 5.2 d) and significantly higher 1-year ADL scores [75 (70, 85)] than the late operation group [4.2% (13/309) and 14.2% (44/309), 12.3 d ± 5.9 d, and 70 (60, 80), respectively] (all P< 0.05). There was no significant difference in incidence of complications between the 2 groups ( P>0.05). In the poor status patients there were no significant differences between the 2 groups in the preoperative general data, showing compatibility ( P>0.05). The incidence of complications in the early operation group [42.2% (35/83)] was significantly higher than in the late operation group [30.5% (100/328)] ( P< 0.05). There were no significant differences between the 2 groups in 30-day mortality, 1-year mortality, hospital stay or 1-year ADL score ( P>0.05). Conclusion:For the elderly patients with hip fracture, operation can be carried out as soon as possible if they are in good physical condition, and early operation is not necessary if they are in poor systemic condition because operation should be carried out at an appropriate time after evaluation of their physical condition allows.
ABSTRACT
Objective To explore the predictive effect of American Society of Anesthesiologists (ASA) classification on prognosis of elderly patients with hip fracture.Methods A retrospective casecontrol study was conducted to analyze the clinical data of 814 elderly patients with hip fracture admitted to the 7th Medical Center of the General Hospital of the PLA from January 2012 to December 2015.There were 272 males and 542 females,with the age range of 60-99 years [(80.0 ± 8.0) years].According to ASA classification,the patients were divided into four groups:23 cases (2.8％) of ASA grade Ⅰ,380 cases (46.7％) of ASA grade Ⅱ,389 cases (47.8％) of ASA grade Ⅲ and 22 cases (2.7％) of ASA grade Ⅳ.Data compared among the groups included gender,age,comorbidities,fracture type,anesthesia methods,surgical methods,length of hospital stay,complications,and 30-day and 1-year mortality rates.Multiple Logistic analysis was conducted to seek independent risk factors for 1-year mortality.Results There were no significant difference among the four groups with regards to gender,fracture type,surgical methods (P ＞ 0.05).With the improvement of ASA classification,the age of patients increased gradually,the length of hospital stay increased,and the rate of nerve block anesthesia increased (allP ＜ 0.01).Incidence of complications of ASA grade Ⅳ patients was the highest [59％ (13/22)],followed by 31.4％ (122/389) of ASA grade Ⅲ patients,17.6％ (67/380) of ASA grade Ⅱ patients,4％ (1/23) of ASA grade Ⅰ patients (all P ＜ 0.01).The 30-day and 9-0day mortality of ASA grade Ⅳ patients were 32％ (7/22),64％ (14/22),ASA grade Ⅲ patients were 4.6％ (18/389),17.0％ (66/389),ASA grade Ⅱ patients were 3.4％ (13/380),12.1％ (46/380),and ASA grade Ⅰ patients were 0 and 4％ (1/23),respectively.The differences between these groups were significantly different (allP ＜0.01).Univariate analysis showed that male,advanced age,coronary heart disease,pulmonary infections,chronic obstructive pulmonary diseases (COPD),renal insufficiency,ASA classification,anesthesia methods,and length of hospital stay were related to postoperative 1-year death (P ＜0.05 or 0.01).A total of 127 patients (15.6％) died within 1 year after operation.Multivariate Logistic regression analysis showed age (OR =1.037,95％ CI 1.007-1.068),ASA grade(ASA grade Ⅱ:OR =1.851,95 ％ CI 1.238-14.386;ASA grade Ⅲ:OR =2.092,95％ CI 1.266-16.482;ASA grade Ⅳ:OR =15.368,95％ CI 1.626-145.283),length of hospital stay (OR =1.038,95％ CI 1.015-1.061) were independent risk factors for 1-year mortality.Conclusions The outcome of the elderly hip fracture is poor.The ASA classification is closely related to the incidence of complications,30-day mortality,and 1-year mortality.Advanced age,ASA grade Ⅱ,Ⅲ and Ⅳ,hospital length of stay are the independent risk factors for poor prognosis of hip fractures.The ASA classification can be used as a screening tool to intervene for the high-risk population as early as possible.
ABSTRACT
Objective To investigate the outcomes of hip fracture surgery in patients aged 90 and over. Methods Clinical data of patients aged 90 years and over admitted to our hospital from January 2012 to December 2016 were collected. The data included age ,gender ,comorbidities ,type of fracture , timing of surgery , operation method , complications , mortality , and functional outcomes.Differences in these items were compared between patients who died one year after surgery and those who survived.Independent risk factors for one-year mortality were analyzed. Results A total of 101 patients who met the inclusion criteria were enrolled in the study. There were 43 males and 58 females ,with a mean age of (92.3 ± 2.7)years ;66 cases had intertrochanteric fractures and 35 cases had femoral neck fractures ;in 45 cases patients could walk independently and in 56 cases walking aids were needed before operation. The mortalities at 30 days ,6 months ,and 1 year post-operation were 8.9% (9 cases ) ,16.8% (17 cases ) ,and 26.7% (27 cases ) ,respectively. Pulmonary infection and malnutrition were the main causes of death. Ambulation with walking aids was an independent risk factor for 1-year mortality (OR=7.298 ,P=0.020). Conclusions Surgery for the treatment of hip fractures in patients aged 90 and over is appropriate. Poor preinjury mobility is an independent risk factor for mortality after operation. The main causes of death are pulmonary infection and malnutrition ,and frailty plays an important role in this process.
ABSTRACT
OBJECTIVE:To investigate the effects of Compound changpu yizhi decoction combined with nimodipine on clini-cal symptoms,cognitive function and cerebral blood flow velocity of patients with mild cognitive impairment(MCI)after stroke, and its medication safety. METHODS:84 MCI patients after stroke in our hospital from Feb. 2012 to Oct. 2014 were selected as re-search objects and randomly divided into observation group and control group,42 cases in each group. All patients received basic preventive treatment;control group was additionally given Nimodipine tablet 30 mg,tid,po;based on it,observation group was given Compound changpu yizhi decoction,one dose a day,taking with warm water every morning and evening. They were treated for 3 months. Clinical symptoms of patients were compared by vascular dementia TCM syndrome table before and after treatment, mini-mental state examination(MMSE)was used to compare the cognitive function of patients before and after treatment,cerebral blood flow velocity before and after treatment and incidence of adverse reactions in 2 groups were compared. RESULTS:Before treatment,there was no statistical significance in clinical symptom scores,cognitive function score and blood flow velocity of main artery between 2 groups(P>0.05). Clinical symptom scores of 2 groups were decreased significantly,while cognitive function and cerebral blood flow velocity were increased significantly;there was statistical significance,compared to before treatment (P0.05). CONCLUSIONS:Compound changpu yi-zhi decoction combined with nimodipine helps to relieve clinical symptoms of MCI patients after stroke,improve cerebral blood circulation and cognitive function,with good safety.
ABSTRACT
Objective To compare the short‐term clinical effects of single segment and two segments of Dynesys dynamic in‐ternal fixation system for treating lumbar degenerative disease .Methods 40 cases of degenerative lumbar disease treated by the Dynesys dynamic fixation system combined with posterior approach decompression from 2009 July to March 2012 were selected and performed the evaluation on the clinical effects by the waist and leg pain visual analogue scale (VAS) ,the Oswestry disability index (ODI) and the orthopaedic spinal association of North America (NASS) index .The imaging method was used to observe the mobili‐ty of operative segment and proximal adjacent segment and the degenerative change of intervertebral height .Results All of the 40 cases were followed up .The VAS score and ODI score at postoperative 3 months and last follow‐up were significantly decreased when compared with the pre‐operative scores (P 0 .05) .The NASS index showed no statistically significant difference in the postoperative effect satisfaction between the two groups (P>0 .05);there was no statistically significant difference in the variation of the intervertebral height between before operation and at the last follow‐up (P>0 .05) .There was statistically significant difference in the motility of proximal adjacent segment at the last follow‐up between the two groups (P<0 .05);but comparing the motility of proximal adjacent segment between the last follow‐up and pre‐operation , only the single segment group showed statistically significant difference (P< 0 .05) .Conclusion The Dynesys dynamic fixation system combined with posterior approach decompression operation has good clinical effect in the treatment of lumbar degenerative disease .Meanwhile ,the single segment method has more significant effect on the motility of proximal adjacent segment than the double segments method .
ABSTRACT
Objective To observe the effect of Huazhuo-Jiedu-Huoxue Tongluo recipe on local inflammation of cerebral ischemia reperfusion injury in mice. Method Fifty Kunming Mice were randomly divided into five groups: model group, high-dose group of TCM, low-dose group of TCM, nimodiping group and sham operation group. Each group had 10 mice. Mice models of the right middle cerebral artery CIRI in the first four groups were established through thread embolism method. Physiological saline was given to the mice in the model group and sham operation group. Nimodipine solution was given to the mice in the Nimodipine group. High and low dose of Huazhuo-Jiedu-Huoxue-Tongluo Chinese medicine decoction were given to the mice in the high dose of TCM group and low dose of TCM group respectively after the models were successfully established. To assess the expression level of IL-6 and TNF-α by radioimmunoassay after the treatment. Results Compared with model group [(219.29±39.28) pg/ml, (1.325 ± 0.236) ng/ml] , the level of IL-6 and TNF-α of high dose of TCM group[(120.69±49.23)pg/ml, (1.086±0.178)ng/ml], low dose of TCM group[(173.97±49.03)pg/ml, (0.937 ± 0.105)ng/ml]and nimodipine group[(170.88± 47.06)pg/ml, (1.092±0.184) ng/ml]decrease (P0.05). Conclusion Huazhuo-Jiedu-Huoxue-Tongluo recipe can restrain the expression of inflammatory cytokines and reduce the infiltrating of leukocytes in mice with cerebral ischemia reperfusion injury.
ABSTRACT
Objective To study the effect of nerve growth factor(NGF)in survival of super-length random flap.Methods The experiment employed the animal model of random flap in Wistar's rat back,applied 66.7 μg NGF locally in trial group's flap at the first day after operation with auto-control.The survival proportion,skin temperature and survival rate of random flap were observed,and the blood flow,the blood flow velocity,the blood flow volume change of random flap were measured by the laser and photic-conduct fiber means in differ time.Results The survival proportion(7.12±1.54)cm2 and survival rate(92±5)%of random flap of trial group was obviously higher(P＜0.05)than those in control group[(5.23±0.19)cm2,(69±5)%]after pedicle division.The blood flow,the blood flow velocity,the blood flow volume and skin temperature in the midge and at the end of random flap in the trial group were obviously higher than those in control group 1 day after operation(P＜0.05),and the blood flow velocity in the pedicle of random flap in the trial group was increased markedly(P＜0.05).The blood flow volume and skin temperature in the pedicle of random flap in the trial group were higher than those in control group 3 days after operation(P＜0.05).The survival of randomflapinthetrial groupwere very significantly increased than those in control group 7 days after operation(P＜0.01).Conclusion NGF can increase flap's blood flow,blood flow velocity and blood flow volume,enhancing survival of the big-proportioned and super-length random flap.
ABSTRACT
BACKGROUND: Studies concerning muscle-derived stem cell transplantation mainly focused on treatment of muscular dystrophy. There are no studies on muscle-derived stem cells for treatment of denervated amyotrophy combined therapy. OBJECTIVE: To explore effects of muscle-derived stem cell transplantation on denervated gastrocnemius atrophy. DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Shenyang Medical College from February 2007 to July 2008. MATERIALS: A total of 19 adult healthy male Wistar rats were supplied by Animal Experimental Center, Shenyang Medical College. METHODS: Triceps brachii was sterilely collected from 3 rats, and muscle-derived stem cells were isolated in vitro, and purified by adherence method. The tibial nerve of right posterior limb was cut in remaining 16 rats to establish animal models of denervated gastrocnemius. In the cell transplantation group, 0.2 mL DAPI-labeled muscle-derived stem cell suspension was infused into the denervated gastrocnemius. The same volume of saline was injected into the model control group, for 4 weeks. MAIN OUTCOME MEASURES: Computer biological signal collection processing system was used to measure recovery rate of threshold intensity of gastrocnemius and the optimal intensity recovery rate. Electronic balance was utilized to calculate residual rate of wet weight. Image analysis system was used to measure residual rate of cross section area. RESULTS: Compared with the model control group, the recovery rate of threshold intensity of denervated gastrocnemius and the optimal intensity recovery rate were significantly lower in the cell transplantation group (P
ABSTRACT
Objective To examine the chracteristics of distribution of the FGF R before and after the flap transplantation and the influence of exogenic bFGF on the distribution of FGF R. Method Caudally based random skin flaps were raised on the backs of Wistar rats,bFGF was instilled under flaps after closure.An immunohistochemical techniques stanining method was used. Results FGF receptors distributes in the stratum basal of epidermis,the vascular endothelial cells in the dermis and hypodermis,the fibroblasts and the epithelial cells of the hair follicle and the sweat gland.In compared with preoperation,the quantity of increased gradually from the 1st day to the fifth day after operation,and the peak value is on the fifth day,it then recovered to the pre operation level on the serventh day.After applying the exogenic bFGF,the positive immunoreactive cells in the experimental group,increased remarkably from the Ist day to the 3rd day after operation in contrast with the control group.The peak value is on the 3rd day which was two days earlier than that of the control group and the peak value of the experimental group is remarkably higher than that of the control group.Conclusion\ FGF R distributes in the stratum basal of epidermis,the vascular endothelial cells in the dermis and hypodermis,the fibroblasts,and the epithelial cells of the hair follicle and the sweat gland.In compaired with pre operation,the quantity of the positive immunoreactive cells of FGF R were increased gradually from the Ist day to fifth day after operation,and the peak value is on the fifth day.After applying the exogenic bFGF,the positive immunoreactive cells of FGF receptors were increased.\;[