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Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P＜0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.
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Objective To explore the biomechanical function of PCL and its different bundles and examine the biomechanical impact of posterior cruciate ligament (PCL) integrity on the medial femoral condyle. Methods Twelve fresh human cadaveric knee specimens were subjected to different axial load (0-800 N) at 0°, 30°,60°, and 90°of knee flexion. Four surgical treatments were carried out for biomechanical testing: PCL intact, anterolateral bundle (ALB) rupture, posteromedial bundle (PMB) rupture and PCL rupure. During the test, strains of middle part of the medial femoral condyle were calculated. Results At O°knee flexion, increasing strain of the medial femoral condyle was detected in PMB rupture and PCL rupture under all loading conditions. No significant difference of strain of the medial femoral condyle was noted between PCL intact and ALB rupture under any loading conditions. Compared to PMB rupture, PCL rupture had not higher strain of the medial femoral condyle under all loading conditions. At 30°, 60° and 90° knee flexion, increasing strain of the medial femoral condyle was noted in ALB rupture under higher loading conditions and PCL rupture under all loading conditions. ALB rupture under lower loading conditions and PMB rupture under all loading conditions did not significantly increased strain of the medial femoral condyle. PCL rupture had higher strain of the medial femoral condyle than ALB rupture under most of loading conditions.Conclusion The data suggest that PMB is the major stabilizing bundle of PCL in full extension, ALB is the major stabilizing bundle of PCL in knee flexion, and both bundles function through the ROM in a codominant fashion. Partial and complete ruptures of PCL may have hazardous biomechanical impacts on the medial femoral condyle during normal movement.
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Objective To investigate the expression of VEGF-C,CD31 and MVD,in human ovarian epithelial carcinoma tissues,development and metastasis of epithelial ovarian carcinoma by observing their expression and analyzing their correlation.Methods 40 samples of ovarian epithelial carcinoma tissues and 20 samples normal ovary tissues were selected from 2004 to 2005 in the third affiliated hospital of Harbin Medical University,as well as 20 cases of normal ovarian tissues samples as control using immunohisrochemical staining assay,we analyzed the expression of VEGF-C,MVD detected by CD31.The relationship of these three factors with patients age tumor stage,differentiation,pathohistological type,were analyzed.Results 67.5%(27/40)had high expression of VEGF-C,15%(3/14)had low espression.The survival of patients with high VEGF-C expression was significantly worse than that of patients with low and negative expression.Conclusion VEGF-C and CD31 may play an important role in the occurrence and development of epithelial ovarian tumors,while MVD maybe associated with the ivasion and metastasis of carcinoma.The detection of VEGF-C combined with CD31 and MVD can objectively reflect the biological behavior of epithelial ovarian tumor.
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Objective To study whether focal mild hypothermia can prolong the therapeutic time window in ischemic stroke, and inquire into the protection mechanisms of focal mild hypothermia on cerebral ischemia. Methods The focal cerebral ischemia and reperfusion model of rats was achieved by intraluminal middle cerebral artery occlusion (MCAO). The adult rats were randomly divided into sham-operation group, normothermia ischemia and reperfusion group and hypothermia ischemia and reperfusion group. The two ischemic groups were respectively further divided into 5 subgroups (subjected ischemia for 2, 3, 6, 8 and 12 h respectively and then all reperfused for 4 h, n=14 per time point). Brain mild hypothermia was achieved 30 minutes after ischemia and maintained to reperfusion period. The neurological deficit scores were assessed. The infarct volumes were evaluated by TTC staining and measured with a computerized image analysis system. TUNEL method was used to observe the neuron apoptosis. The expressions of NF-?Bp65 and NF-?BP65mRNA were detected by immunohistochemistry and hybridation in situ. Results The infarct volumes of hypothermia group were respectively (57.39?37.62) mm~3, (74.09?61.00) mm~3, (81.26?25.46) mm~3, (87.43?54.81) mm~3 and (111.10?43.67) mm~3, which saw significant reductions of 63%, 55%, 56%, 70% and 63% as compared with the normothermia group. In comparison with the normothermia group, focal mild hypothermia also greatly reduced the neurological deficit scores (P
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Aim To investigate the gender differences in electrophysiology and neuroanatomy of myelinated and unmyelinated visceral and baroreceptor afferent neurons(VANs and ABNs) of adult rats.Methods VANs and ABNs were isolated enzymatically and Vagus-nodose slice preparation was also applied in this study.For identification of ABNs,aortic depressor nerve(ADN) was labeled using fluorescent dye.Whole-cell patch technique was used to record action potential(AP).Electronic microscopy was selected for morphological analysis of ADN.Results(1) A-and C-type VANs were identified and significant differences of AP discharge profiles between female and male were not established;(2) except for the traditionally classified A-and C-types,myelinated Ah-type VGNs were also identified with faster conduction velocity,lower firing threshold,and higher neuronal excitability.Importantly,these Ah-types were found in female rats with a similar frequency like A-types but rarely seen in males.(3) Ah-type ABNs were also identified by fluorescence.(4) Morphological data showed that myelinated fiber in ADN was ~25% of total and this result was consistent with our electrophysiological data.(5) Firing frequency of Ah-types(20~40 Hz) was lowered than that of A-types(40~150 Hz,P