Analysis of the Inhibitory Effect of Tirofiban on Shear-Induced Platelet Aggregation by Microfluidic Technique / 医用生物力学

Objective To observe the inhibitory effect of Tirofiban on different shear-induced platelet aggregation, and to provide medication suggestions for the treatment of thrombosis in different hemodynamic environment. Methods Polydimethylsiloxane ( PDMS)-glass microchannel chips were fabricated by soft lithography. The whole blood of healthy volunteers anticoagulated with sodium citrate was collected and incubated with different concentrations of Tirofiban in vitro. The blood flowed through the straight microchannel or channel with 80% narrow for 150 seconds at the speed of 11 μL/ min and 52 μL/ min, respectively. The wall shear stress rates in straight channel at 11 μL/ min and 52 μL/ min were 300 s-1 and 1 500 s-1, respectively. The maximum wall shear rates in the channel with 80% occlusion at 11 μL/ min and 52 μL/ min were 1 600 s-1 and 7 500 s-1, respectively. The adhesion and aggregation images of fluorescent labeled platelets on glass surface were photographed with the microscope, and the fluorescent images were analyzed with Image J. The platelet surface coverage ratio was used as a quantitative index of platelet aggregation behavior, and the IC50 of Tirofiban for platelet inhibition was calculated under different shear rates. Flow cytometry was used to detect the platelet activation index (CD62P, PAC-1) in the whole blood at 52 μL/ min in channel with 80% occlusion. Results Tirofiban inhibited platelet aggregation in a dose-dependent manner, and the inhibitory effect was related to the shear rate. Under the shear rates of 11 μL/ min and 52 μL/ min, the aggregation was almost completely inhibited when the concentration in straight channel reached 100 nmol / L. When the concentration in channels with 80% occlusion reached 1 μmol / L, the aggregation was almost completely inhibited. IC50 values at 11 μL/ min and 52 μL/ min in straight channel were 2. 3 nmol / L and 0. 5 nmol / L, respectively. IC50 values at 11 μL/ min and 52 μL/ min in channels with 80% occlusion were 20. 73 nmol / L and 4. 5 nmol / L. Pathologically high shearforce induced an increase in platelet activation, which could be inhibited by Tirofiban. Conclusions Tirofiban can effectively inhibit shear-induced platelet aggregation, and different concentrations of Tirofiban should be given according to the thrombus formed in different shear force environment in clinic practice

Clinical efficacy and safety of Treprostinil in the treatment of children with early decompensation after the Fontan procedure / 中华实用儿科临床杂志

Objective:To investigate the efficacy and safety of Treprostinil in the treatment of children with early decompensation after the Fontan procedure.Methods:A retrospectively analysis was performed on the clinical data of 16 children with early decompensation after the Fontan procedure treated with Treprostinil injection from December 2017 to June 2020 at Fuwai Central China Cardiovascular Hospital.A total of 16 patients were included, including 5 boys (31.2%) and 11 girls (68.8%). The age was (4.6 ±1.2) years, the weight was (16.0±2.1) kg.The changes of central venous pressure (CVP), heart rate (HR), systolic blood pressure (SBP), central venous oxygen saturation (ScvO 2), lactic acid (Lac), oxygenation index and B-type natriuretic peptide (BNP) were recorded at the infusion of Treprostinil and 3 hours, 24 hours, 48 hours and 72 hours after the infusion.The short-term efficacy of Treprostinil was observed[mortality, mechanical ventilation time, and length of intensive care unit (ICU) stay]; paired t-test was used to analyze the above indexes at different time points.The adverse reactions during the administration were also recorded. Results:Of the 16 children, the median mechanical ventilation time was 9 (5, 22) h, and the median ICU stay time was 2 (1, 12)days.After 72 hours of drug administration, CVP, Lac, BNP and HR decreased: CVP decreased from(16±5) mmHg (1 mmHg=0.133 kPa) to (11±2) mmHg ( P<0.001), Lac decreased from(6.8±3.2) mmol/L to (3.2±1.2) mmol/L ( P=0.002), BNP decreased from(980±223) ng/L to (250±120) ng/L( P<0.001), HR decreased from(150±20) times/min to (125±16) times/min( P=0.002); SBP, ScvO 2 and oxygenation index increased: SBP increased from(83±10) mmHg to (98±12) mmHg( P<0.001), ScvO 2 increased from 0.53±0.13 to 0.65±0.11 ( P=0.003), oxygenation index increased from (200±72) mmHg to (298±13) mmHg ( P<0.001), and the differences were statistically significant(all P< 0.05). One case died (6.3%), 2 cases (12.5%) had transient blood pressure drop and 1 case (6.3%) had nausea and vomiting.Besides, no other treatment-related complications were observed. Conclusions:As for children with early decompensation after the Fontan procedure, the intravenous application of Treprostinil can reduce pulmonary artery pressure rapidly, effectively improve circulatory status and oxygenation and ultimately improve the prognosis.

Efficacy of Levosimendan on postoperative low cardiac output syndrome of infants with congenital heart disease / 中华实用儿科临床杂志

Objective@#To investigate the efficacy of Levosimendan in the treatment of postoperative low cadiac output syndrome (LCOS) in infants with congenital heart disease (CHD).@*Methods@#Clinical data of patients with CHD developed postoperative LCOS in the Children Heart Center of Fuwai Central China Cardiovascular Hospital from January to December 2018 was collected.In patients that traditional vasoactive drugs failed to alleviate LCOS, the efficacy of continuous infusion of 0.1 μg/(kg·min) Levosimendan was observed.Besides, the mechanical ventilation time, ICU stay time, mortality, the changes of ejection fraction (EF) and central venous oxygen saturation (ScvO2) at the infusion of Levosimendan and 48 h after infusion, as well as the changes of heart rate (HR), systolic blood pressure (SBP), vasoactive drugs score (VIS) and lactic acid at the infusion of Levosimendan and 3 h, 6 h, 12 h, 24 h and 48 h after infusion were recorded.@*Results@#There were 29 cases, including 17 males (58.6%) and 12 females (41.4%), with median age of 2 (0.5, 40.0) months, median body mass of 4.7 (2.6, 13.5) kg, median mechanical ventilation time of 109.5 (42.5, 367.0) h, ICU stay time of 187.5 (83, 446) h, and 1 case died (3.4%). EF (48% vs.52%) and ScvO2 (53% vs.58%) increased 48 h after infusion, and the differences were statistically significant (all P<0.01). HR level (173 times/min, 176 times/min, 175 times/min, 173 times/min, 170 times/min, 170 times/min) and lactic acid level (4.72 mmol/L, 4.65 mmol/L, 4.34 mmol/L, 3.79 mmol/L, 3.28 mmol/L, 2.74 mmol/L) gradually decreased after infusion, and the differences of both between the beginning of infusion and 48 h after infusion were statistically significant (P=0.029); SBP decreased and then increased (74 mmHg, 70 mmHg, 71 mmHg, 73 mmHg, 74 mmHg, 75 mmHg, 1 mmHg=0.133 kPa), and VIS increased and then decreased (26 scores, 27 scores, 27 scores, 26 scores, 25 scores, 25 scores) at different time points after infusion, however, the data of both between the beginning of infusion and 48 h after infusion had no significant differences (P=0.294, 0.151).@*Conclusions@#Levosimendan can increase EF, enhance myocardial contractility and systemic tissue perfusion, thus improving the prognosis, when Levosimendan was applied for the treatment of postoperative LCOS of infants with CHD.

Advance in Contents and Standard of Disability-related Data / 中国康复理论与实践

@#This paper reviewed international documents of disability statistics. The results showed that all disability measurements had been adopted International Classification of Functioning, Disability and Health (ICF) terminology and approach. Disability statistics in US tailored to ICF framework and classification. Disability statistics in China had partially adopted ICF approach.

The efficacy and safety of preoperative biliary drainage for hilar cholangiocarcinoma: A Meta-analysis / 中华普通外科杂志

Objective To evaluate the efficacy and safety of preoperative biliary drainage (PBD) for hilar cholangiocarcinoma (HC).Methods A thorough search of Cochrane Library,Medline,Embase,CBM,CNKI and WanFang database was performed.The literatures were screened according to the inclusion and exclusion criteria,and data processed for a meta-analysis by RevMan 5.2 software.Results Seventeen papers with a total number of 1 724 patients were included.Meta-analysis showed that there were no statistical differences between PBD and no preoperative biliary drainage (NPBD) in postoperative mortality,postoperative overall morbidity,postoperative infectious morbidity (wound infection,intra-abdominal infection,sepsis),postoperative noninfectious morbidity (bile leakage,abdominal hemorrhage),other perioperative outcomes (operative time intraoperative blood loss,postoperative hospital stay,curative resection rate) (all P ＞ 0.05).The incidence of liver failure in the PBD group was lower than that in the NPBD group (RR =0.50,95％ CI:0.33-0.75,P ＜ 0.01).Conclusions PBD did not reduce the postoperative mortality and postoperative overall morbidity.However,PBD reduces the incidence of postoperative liver failure.

Effects of H2 on osteoclast differentiation of RAW264.7 cells induced by RANKL and RANKL/TNF-α / 中国生化药物杂志

Objective To discuss the effect of H2 on osteoclast differentiation of RAW264.7 cells induced by RANKL and RANKL/TNF-α.MethodsRAW264.7 cells were treated with H2 in the presence of RANKL and RANKL/TNF-α.RAW264.7 cells viability was assessed by CCK-8.Test the Oxidative Stress of the induced RAW264.7.The number of TRAP-positive cells were counted under light microscopy.The levels of cathepsin K (CTK) and matrix metalloprotein-9(MMP-9) mRNA were analyzed by real-time PCR.ResultsH2 can not influence the RAW264.7 cell viability but can lower oxidative stress.The significant difference(P<0.05) indicated that H2 could significantly decrease the number of TRAP-positive MNCs.The significant difference among the 4 groups in CTK and MMP-9 genes (P<0.05) indicated that H2 could down-regulate their mRNA expression.ConclusionH2 can reduce the oxidative stress and inhibit differentiation of RAW264.7 cells into osteoclasts.

Simultaneous Determination of 4 Constituents in Yaotong Capsules by HPLC / 中国药房

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen in Yaotong capsules.METHODS:HPLC method was adopted.The determination was performed on Agilent-C18 column with mobile phase consisted of acetonitrile-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelengths were set at 240 nm (paeoniflorin,psoralen,isopsoralen) and 290 nm (cinnamaldehyde).The column temperature was 35 ℃,and sample size was 10 μL.RESULTS:The linear ranges of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen were 0.004 02-0.100 6 mg/mL(r=0.999 8),0.024 50-0.612 7 mg/mL(r=0.999 8),0.005 24-0.131 0 mg/mL(r=0.999 9),0.005 11-0.127 8 mg/mL(r=0.999 9),respectively.LOQ were 37.17,1.47,21.76,25.57 ng,respectively;LOD were 11.15,0.44,6.53,7.67 ng,respectively.RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 99.02％-100.83％ (RSD=0.68％,n=6),98.58％-100.99％ (RSD=0.83％,n=6),99.78％-101.69％ (RSD=0.89％,n=6),100.06％-102.46％ (RSD=0.92％,n=6),respectively.CONCLUSIONS:The method is simple,accurate and suitable for simultaneous determination of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen in Yaotong capsules.

Affecting factors of corneal epithelial healing following de-epithelized corneal collagen cross linking in keratoconus patients / 中华实验眼科杂志

Background Corneal collagen cross-linking (CXL) shows good clinical effects for keratoconus,and de-epithelized CXL appears to be benefit to the distribution and absorption of riboflavin in cornea stroma.However,de-epithelization of CXL will increase the infective risk and corneal healing time.It is very important to understand and control the affecting factors of corneal repair after de-epithelization of CXL.Objective This study was to evaluate the characteristics of corneal epithelial repair and analyze the relevant factors affecting corneal healing time after de-epithelized CXL.Methods A series-cases observational study was performed.De-epithelized CXL was performed on 77 eyes of 68 keratoconus patients in Shandong Eye Hospital from September 2013 to September 2015 under the approval of Ethic Committee of this hospital and informed consent of each patient.The age,corneal curvature,corneal thickness,breakup time of tear film (BUT),corneal front astigmatism (Astig) and epithelial healing time of the patients were recorded after surgery.The correlations between corneal epithelium healing time and above-mentioned factors were analyzed.Results De-epithelized CXL was smoothly finished in all the eyes.The corneal epithelium healing time was 2-12 days after surgery,with the average healing time 5 (4,6) days.The mean age,thickness at corneal thinnest point,minimal cornea curvature (Kf),maximal corneal curvature (Ks),corneal average curvature (Km) and Astig was 22.00 (18.00,25.00) years,436 (412,470) μm,47.40 (44.70,50.45) D,52.10 (49.00,54.55) D,50.00 (47.15,53.15) D and-3.30 (-5.45,1.70) D,respectively.Spearman rank correlation analysis showed significant negative correlations between corneal epithelium healing time and BUT or the thickness at corneal thinnest point (BUT:rs =-0.334,P =0.003;corneal thickness:rs =-0.417,P =0.000),and thesignificant positive correlations were found between corneal epithelium healing time and Km,Kf and Ks (Km:rs =0.449,P =0.000;Kf:rs =0.300,P =0.008;Ks:rs =0.432,P =0.000).There were no considerable correlarions between corneal epithelium healing time and age or Astig (age:rs =0.023,P =0.845;Astig:rs =-0.190,P =0.098).Multiple linear regression analysis were carried out to study the dependent variable and independent factors.Because of the multiple co-linearity between variables,this paper corrects the model by using ridge regression.There is significant negative correlation between BUT,corneal thickness and corneal healing time,respectively (both at P＜0.05),corneal curvature Km and Kf is positively correlated with corneal healing time (both at P ＜ 0.05).Conclusions The corneal thickness,Kf,Km,as well as BUT are influencing factors of epithelial healing after CXL.

Simultaneous Determination of Bavachin and Bakuchiol in Psorslea corylifolia by HPLC / 中国药房

OBJECTIVE:To establish a method for content determination of bavachin and bakuchiol in Psoralea corylifolia.METHODS:HPLC method was adopted.The determination was performed on Shim-Pack VP-ODS column with mobile phase consisted of acetonitrile-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 246 nm,the column temperature was 30 ℃,and the sample size was 10 μL.RESULTS:The linear ranges of bavachin and bakuchiol were 48.9-489 ng(r=0.999 8),784-7 840 ng(r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 2.0％.Average recoveries ranged 95.30％-99.63％ (RSD=1.45％,n=9),96.89％-100.82％ (RSD=1.36％,n=9).CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for the simultaneous determination of bavachin and bakuchiol in P corylifolia.

Utilization of Glasses Aids Adaption Service for Persons with Low Vision in Shanghai, China / 中国康复理论与实践

@#Objective To investigate the condition of utilization of glasses aids adaption in Shanghai. Methods The numbers who accepted the services, funds invested, the models, etc. in 16 districts of Shanghai between 2012 and 2014 were collected, and analyzed with descriptive analysis, concentration index and correlation analysis. Results A total of 17,498 persons accepted glasses aids adaption services, which cost 335.37 yuan per person. The concentration index was 0.0951. Conclusion The glasses aids adaption service works well in Shanghai, but is variable among the districts.

Removal Algorithm of Power Line Interference in Electrocardiogram Based on Morphological Component Analysis and Ensemble Empirical Mode Decomposition / 生物医学工程学杂志

Electrocardiogram (ECG) signals are susceptible to be disturbed by 50 Hz power line interference (PLI) in the process of acquisition and conversion. This paper, therefore, proposes a novel PLI removal algorithm based on morphological component analysis (MCA) and ensemble empirical mode decomposition (EEMD). Firstly, according to the morphological differences in ECG waveform characteristics, the noisy ECG signal was decomposed into the mutated component, the smooth component and the residual component by MCA. Secondly, intrinsic mode functions (IMF) of PLI was filtered. The noise suppression rate (NSR) and the signal distortion ratio (SDR) were used to evaluate the effect of de-noising algorithm. Finally, the ECG signals were re-constructed. Based on the experimental comparison, it was concluded that the proposed algorithm had better filtering functions than the improved Levkov algorithm, because it could not only effectively filter the PLI, but also have smaller SDR value.

Differential expressions of surface-associated proteins of streptococcus mutans strains isolated from clinical samples under acid condition / 天津医药

Objective To investigate the changes in the surface-associated protein expression of streptococcus rnutans (Sm) isolated from clinical samples at pH7.0 and pH5.0. Methods The proteins were extracted from cells at pH7.0 and pH5.0 by Homer method. The proteins were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and two-dimensional gel electrophoresis followed by image analysis. Proteins were identified by matrix-assisted la?ser desorption ionization time of flight mass spectrometry and computer-assisted protein sequence analysis. Results Image analysis revealed that four high expression levels of protein loci and two specific protein loci were existed in two strains at pH7.0. Two high expression levels of protein loci and two specific protein loci were existed in two strains at pH 5.0. Three high expression levels of protein loci and six specific protein loci were existed in Sm593 at pH5.0. Two-component system histidine kinases Lyts and glyceraldehyde-3-phosphate dehydrogenase were highly modulated, and NADH oxidase were modulated specifically. Conclusion The two clinical isolations in acid have high expression of some special proteins, which are presumed to be the resemblance of acid reaction.The difference of protein expression of two clinical isolations in acid may represent their distinct acid resistance.

Study on the situation of hospital management teaching in Xuzhou Medical College and its measures / 中华医学教育探索杂志

Objective To explore the influential factors of hospital management teaching and to apply new plans to improve quality of teaching. Methods Questionnaire survey was conducted among 94 students majored in health management in Xuzhou Medical College to investigate student' learning behavior as well as contents, applying value, procedures, and teaching effects of the course. Data was put in by Epidata 3.02, described and analyzed by SPSS 18.0. Continous variables were ana-lyzed by t test and classified variables were analyzed by X2 test. Results 25.6%(24/94) students were not interested in this course. 61.7%(58/94) students thought that the course was highly correlated with profession. 56.4%(53/94) students thought that the course was valuable. 35.1%(33/94) students thought that the course was not good in combining theory with practice in teaching. 19.1%(18/94) stu-dents thought that the course was deficient in interactive teaching and teaching methods. 62.8%(59/94) students were satisfied with the teaching effect. Conclusions Main influential factors of hospital man-agement teaching are learning interest, curriculum evaluation and teaching evaluation. To improve quality of hospital management teaching, it is necessary to communicate the importance of the course and to apply new teaching plans to arouse the interests of students.

Clinical effect of elbow anterolateral approach with internal fixation in the treatment of capitellum fractures / 中华老年医学杂志

Objective To investigate the clinical effect of elbow anterolateral approach with internal fixation in the treatment of capitellum fractures.Methods 12 patients with capitellum fractures were divided into types according to Bryan-Morrey classification:type Ⅰ (n=8),type Ⅱ (n=2),type Ⅳ (n=2).Patients were treated with anterolateral approach with AO cannulated screw fixation.Curative effect was evaluated according to Broberg-Morrey scale.Imaging evaluation was conducted.Results No lateral collateral ligament injury,blood vessels or nerve injury were found in patients.Primary healings were obtained after operation.All patients were followed up for 8 to 26 months postoperatively (averaged 16 months).All fractures were healed at 5 to 9 weeks after operation (averaged 7.2 weeks).Postoperative elbow flexion and extension was averaged (127.2±12.8) ° and forearm rotation was averaged (154.6 ± 15.3)°.Postoperative Broberg-Morrey score was averaged 90.5.The 8 cases were excellent,3 cases good and 1 case poor.Conclusions Operation should be applicated according to fracture classification in the treatment of capitellum fractures.Anterolateral approach is better to expose the fracture,which is convenient for operation,and AO cannulated screw fixation can fix the fractures firmly.Clinical effect is satisfactory when taking early functional exercise for elbow joint.

A comparative study of difference internal fixation methods for calcaneal fracture / 中国医师进修杂志

Objective To observe the therapeutic effect of titanium plate and Kirschner wire system for treatment of calcaneal fracture.Methods The data of 189 patients with calcaneal fracture treated with operation were retrospectively studied,of which 102 patients of calcaneal fracture were treated with titanium plate fixation (titanium plate group),87 patients were treated with Kirschner wire system (Kirschner wire group).The operative time,blood loss,postoperative complication,healing time,before and after treatment Bohler angle,Gissane angle and middle calcaneal width,and Maryland foot function score were observed.Results The patients of the 2 groups were observed with 12-36 (24.0 ± 9.5) months follow-up.The operative time and blood loss in Kirschner wire group were significantly lower than those in titanium plate group [(42.3 ± 12.5) min vs.(67.5 ± 23.1) min and (137.7 ± 42.8) ml vs.(245.0 ± 55.6) ml],there were statistical differences (P ＜ 0.05).The Bohler angle,Gissane angle and middle calcaneal width in the 2 groups after treatment were significantly better than those before treatment [titanium plate group:(32.80 ± 6.35)° vs.(7.81 ± 8.75)°,(130.42 ±6.93)° vs.(175.80 ± 6.05)°,(30.77 ± 3.56) mm vs.(42.60 ±5.24) mm; Kirschner wire group:(30.11 ±4.91)° vs.(9.54 ±8.90)°,(132.89 ±9.54)° vs.(173.11 ±9.05)°,(32.00 ± 4.18) mm vs.(42.78 ± 4.96) mm],there were statistical differences (P＜ 0.05).The excellent rate of Maryland foot function score after treatment in titanium plate group was significantly higher than that in Kirschner wire group [92.2％ (94/102) vs.81.6％ (71/87)],there was statistical difference (P ＜ 0.05).Therewere 6 cases appeared infection of incisional wound in titanium plate group,there was no complication in Kirschner wire group,there was statistical difference (P ＜ 0.05).Conclusions Titanium plate and Kirschner wire system are the commonly used methods in treatment of calcaneal fractures,each has its advantages and disadvantages,titanium plate has long time operation,much blood loss and prone to infection,but the excellent rate is higher.Also note that the incision location,restoration and reconstruction of calcaneal anatomy subtalar joint.

Application of the standardized nursing ward round in nursing management / 现代临床护理

Objective To probe into the effects of applying standardized nursing ward round in nursing management.Method The nursing ward round was regularly conducted to analyze and discuss the difficulties in intensive care.Results After formulating the nursing ward round,the qualification rate of the basic nursing,specific nursing,the nursing of critical paitents,nursing records and the patient's satisfaction were higher than those before the use of nursing ward round(P<0.05).Conclusion The standardized nursing ward round may strengthen the training of nurses' core ability and the initiative of studying,reduce medical disputes,and improve the satisfaction of patients together with the quality of nursing.

Clinical analysis with combined thrombolysis versus systemic anticoagulation for cerebral venous and sinus thrombosis / 中华神经科杂志

ObjectiveTo compare the safety and efficacy of combined thrombolysis and systemic anticoagulation therapy for the treatment of cerebral venous and sinus thrombosis (CVST).MethodsA retrospective review of consecutive inpatients with CVST was undertaken. Patients were divided into two groups,combined thrombolysis group (CTG) and systemic anticoagulation group (SAG).CTG underwent improved thrombolysis scheme which included mechanical thrombus maceration and unremitting microdosis urokinase injection into the venous sinus besides low molecular weight heparin anticoagulation.Neurological deficits before and after treatment were graded with the National Institute of Health Stroke Scale (NIHSS).Functional outcomes at discharge were graded on the modified Rankin Scale (mRS).ResultsThere were 30 cases in CTG ( male =9) and 86 cases in SAG ( male =23 ).There was no significant difference of neurological deficits before treatment between two groups(0-19 vs 0-17,Z =-0.474,P =0.636).After treatment,NIHSS and mRS at discharge were significantly decreased in CTG compared to SAG.There was no significant difference on the incidence of intracerebral hemorrhage.Conclusions Combined thrombolysis is better than systemic anticoagulation in improving neurological function.Combined thrombolysis does not increase incidence of ICH compared to systemic anticoagulation.

Effect of pronator teres tendon reconstructing the forearm interosseous membrane central band on restoring the longitudinal stability of forearm after Essex-Lopresti injury / 中华创伤杂志

Objective To evaluate the effect of pronator teres tendon reconstructing the forearm interosseous membrane(IOM)central band on restoring the longitudinal stability of the forearm after Essex-Lopresti injury.Methods A total of ten fresh-frozen adult cadaveric forearms were loaded axially through the humeral and the distal radius.Each forearm was tested as following six steps:radial head excision,radial head plus excision of triangular fibrocartilage complex(TFCC),radial head plus TFCC plus excision of IOM central band,reconstructing central band with pronator teres tendon,metallic radial head prosthesis replacement,central band reconstruction plus radial head prosthesis replacement.The difference of the load exerted to displace the radius to the proximal for 5 mm was compared at different steps by using single-factor analysis of variance.Then,the effect of each step on restoring the forearm longitudinal stability of the forearmwas evaluated.Results There was statistical difference upon load for the radial displacement to the proximal for 5 mm in all six steps,ie,(74.51±15.17)N,(49.23±6.14)N,(17.83±4.73)N,(27.40±3.56)N,(140.25±25.39)Nand(164.21±28.26)N,respectively(P＜0.01).With migration of the radius to proximal for 5 mm,the load for pronator teres reconstruction was 55.66% of radial head plus TFCC,and the load for pronator teres reconstruction plus radial head prosthesis replacement was 559.31% of IOM reconstruction step and 333.56% of radial head excision.Conclusions Reconstruction of the central band with pronator teres tendon is insufficient to restore the longitudinal stability of the forearm after Essex-Lopresti injury.Reconstruction of the central band in combination with metallic radial head prosthesis replacement are beneficial to restoring the longitudinal stability of the forearm.

Biocompatibility of Filtek~(TM) Z350 resin with dental pulp tissues of beagle dogs / 中国组织工程研究

BACKGROUND:Nano-size inorganic filling greatly improves mechanic characteristic of composite resin.However,its effects on pulp tissue remain unclear.OBJECTIVE:To evaluate the biocompatibility of FiltekTM Z350 nano-composite resin on dog pulp tissue by means of histology observation.DESIGN,TIME AND SETTING:Randomized control animal experiment was performed at the animal experiment center of Fuzhou General Hospital,Nanjing Military Area Command of Chinese PLA from April 2007 to April 2008.MATERIALS:Sixty healthy teeth from three adult male beagle dogs were recruited in this study.METHODS:Buccal Class V deep cavities were prepared in beagle dogs,which were then divided into four groups at random.FiltekTM Z350 resin,Dyract AP compomer and TPH resin were used to restore the cavities in three testing groups and glass ionomer cement was used as control.All cavities were treated with Clearfil SE BOND before filling.Intact healthy teeth were used as blank control.MAIN OUTCOME MEASURES:The pulp condition of each tooth was studied histologically.The remaining dentine thickness of each cavity was measured.RESULTS:After 7 days,mild inflammatory response was observed in most of the specimens.After 30 and 90 days,normal histological characteristics were observed in almost all specimens except TPH resin group.The histological structure disturbance of dentin cell layer emerged in some specimens of TPH group,which was higher than other testing groups(P 0.05).CONCLUSION:FiltekTM Z350 nano-composite resin has similar biocompatibility as Dyract AP compomer and glass ionomer cement,better than TPH resin.

Perioperative nursing of gastric carcinoma patients undergoing fast track surgery / 医学研究生学报

This article summarizes our experience in nursing 40 gastric carcinoma patients receiving fast track(rapid recovery) surgery,proposing that the emphasis of nursing should be placed on psychological care and health education before the operation,warm-keeping during the operation,pain control,early food intake,early movement and management of complications after the operation,and necessary follow-up after discharge.