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Objective@#To explore the therapeutic effect of salvianolic acid B (Sal B) on rat abdominal island flap after ischemia-reperfusion injury, and to explore the related mechanisms.@*Methods@#Fifty-four male Sprague-Dawley rats were randomly divided into 3 groups and rat lower abdomen island flap models were established: ①Sham-operated group (Sham group): non-blocking blood vessels, intraperitoneal injection of equal volume of saline as Sal B group; ②Model group: blocking blood vessels for 8 h, intraperitoneal injection of the same volume of saline as Sal B group; ③salvianolic acid B group (Sal B group): blocking blood vessels for 8 h, intraperitoneal injection of 40 mg/Kg of Sal B per day. Seven days after continuous drug administration, the survival rate of the flaps in each group was evaluated, and then the animals from each group were sacrificed for the specimens which were used for the following tests: HE staining was performed to evaluate the microvessel density (MVD), and immunohistochemistry was used to detect the level of vascular endothelial growth factor (VEGF) and superoxide dismutase 1 (SOD1). The contents of superoxide dismutase SOD and malondialdehyde (MDA) in flap tissue were tested using the corresponding kit.@*Results@#Seven days after flap operation, the survival rate of Sal B group flap[(65.62±13.20)%] was significantly higher than that of the model group, while HE staining showed an increase in MVD in Sal B group [(28.27±3.19)/mm2 and (15.79±6.12)/mm2, respectively]. The differences were statistically significant (P<0.05) . Moreover, immunohistochemistry demonstrated that the expression of VEGF and SOD1 obviously increased in Sal B group, and the content of SOD increased significantly. In addition, the expression of MDA decreased after Sal B treatment. The differences were statistically significant (P<0.05) .@*Conclusion@#Sal B is able to increase the expression of VEGF and SOD in the rat abdominal island flaps after ischemia-reperfusion injury, to reduce the content of MDA, and then to promote survival rate of rat abdominal island flap.
ABSTRACT
Objective To explore the therapeutic effect of salvianolic acid B (Sal B) on rat abdominal island flap after ischemia-reperfusion injury, and to explore the related mechanisms. Methods Fifty-four male Sprague-Dawley rats were randomly divided into 3 groups and rat lower abdomen island flap models were established: ①Sham-operated group (Sham group): non-blocking blood vessels, intraperitoneal injection of equal volume of saline as Sal B group;②Model group: blocking blood vessels for 8 h, intraperitoneal injection of the same volume of saline as Sal B group; ③salvianolic acid B group (Sal B group): blocking blood vessels for 8 h, intraperitoneal injection of 40 mg/Kg of Sal B per day. Seven days after continuous drug administration, the survival rate of the flaps in each group was evaluated, and then the animals from each group were sacrificed for the specimens which were used for the following tests: HE staining was performed to evaluate the microvessel density (MVD), and immunohistochemistry was used to detect the level of vascular endothelial growth factor (VEGF) and superoxide dismutase 1 (SOD1).The contents of superoxide dismutase SOD and malondialdehyde (MDA) in flap tissue were tested using the corresponding kit. Results Seven days after flap operation, the survival rate of Sal B group flap[(65.62±13.20)%] was significantly high鄄er than that of the model group, while HE staining showed an increase in MVD in Sal B group [(28.27±3.19)/mm2 and (15.79±6.12)/mm2, respectively]. The differences were statistically significant (P＜0.05). Moreover, immunohistochem鄄istry demonstrated that the expression of VEGF and SOD1 obviously increased in Sal B group, and the content of SOD increased significantly. In addition, the expression of MDA decreased after Sal B treatment. The differences were sta鄄tistically significant (P＜0.05). Conclusion Sal B is able to increase the expression of VEGF and SOD in the rat abdominal island flaps after ischemia-reperfusion injury, to reduce the content of MDA, and then to promote survival rate of rat abdominal island flap.
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Objective To investigate the risk factors of perioperative heart failure in the elderly patients with femoral neck fracture treated with hip joint replacement so as to provide relevant clinical reference.Methods A retrospective case control study was conducted to analyze the clinical data of 155 elderly patients with femoral neck fractures who underwent total hip or hemiarthroplasty in Wenzhou Traditional Chinese and Western Medicine Hospital from May 2012 to August 2016.There were 62 males and 93 females,aged (75.6 ± 7.4)years.The patients were divided into heart failure group (26 patients)and non heart failure group (129 patients).Heart failure group included 10 males and 16 females,aged (78.3 ± 8.2)years.There were 52 males and 77 females in the non heart failure group,aged (74.5 ±6.7) years.Information including age,gender,history of hypertension,history of heart diseases,American Society of Anesthesiologists (ASA) physical status classification,duration from injury to surgery,preoperative renal function,perioperative fluid balance,operation method,operation time,postoperative pain score,perioperative blood loss,and constipation were collected.Univariate analysis was firstly performed on the above data,and multivariate logistic regression analysis was conducted on the significant factors generated by the univariate analysis so as to identify independent risk factors for perioperative heart failure.Results According to the univariate analysis,age,history of heart diseases,preoperative renal function,and perioperative fluid balance were statistically different between the two groups (P ＜ 0.05).Multivariate analysis results showed that the independent risk factors of perioperative heart failure included age (OR =5.351,95％ CI 1.459-19.623,P ＜ 0.01),history of heart diseases (OR =5.717,95 ％ CI 2.399-13.624,P ＜ 0.01),preoperative renal function (OR =2.670,95％ CI 1.125-6.336,P ＜ 0.05),perioperative fluid balance (OR =2.980,95％ CI 1.287-6.899,P ＜0.01).Conclusions Age,history of heart diseases,preoperative renal function,and perioperative fluid balance are the risk factors of perioperative heart failure in elderly patients with femoral neck fracture.Therefore,more attention should be paid to these risk factors and corresponding preventative measures should be taken to reduce the incidence of perioperative heart failure.
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Objective To evaluate the efficacy of percutaneous internal fixation with hollow screw for femoral neck fractures.Methods From June 2001 to June 2004,48 cases of femoral neck fractures,including 22 cases of fracture without displacement(type Garden I and II) and 26 cases of fracture displacement(type Garden III and IV),were treated by close reduction and percutaneous internal fixation with 3 hollow screws forming inverse triangle.Results The intraoperative blood loss was less than 10 ml,and the average operation time was 32.5 min(range,18-54 min).48 cases were followed up for 24-61 months(mean,38.2 months),union of fracture found in 97.9%(47/48) of cases,union time being 4-12 months(mean,6.2 months).According to Harris score of hip joint function,32 cases were excellent,11 cases good,3 cases fair,2 cases bad,the rate of excellent and good results being 89.6%(43/48).In 22 cases of fracture without displacement,there was no nonunion and ischemic necrosis of head of femur.In 26 cases of fracture displacement,the rate of nonunion and ischemic necrosis of head of femur were 3.8%(1/26) and 11.5%(3/26) respectively.Conclusions Percutaneous internal fixation with hollow screw has the advantages of ideal curative effects,simple procedure,reliable fixation and less complications.