RESUMO
Objective:To study the effects of insulin and berberine on osseointegration of titanium implant in type Ⅱ diabetic rats.Methods:10 out of 53 SD rats were randomly selected and selected into H group(healthy group)(n =10).The remaining rats were treated with high glucose diet plus low dose of streptozotocin(STZ) and 40 rats were induced into the models of type Ⅱ diabeties.The 40 dibetic rats were randomly divided into group B(berberine),group Ⅰ(insulin),group IB(insulin + berberine) and group N(without treatment).2 pure titanium implants were implanted into the bilateral femoral metaphysis of each rat.Mter 7,32,38,66 and 101 d,the body weight(BW) and fasting blood glucose(GLU) were measured.After 10 week,the rats were sacrifice,femoral metaphysis samples were subjected to Micro-CT scan,VG staining and implant pull-out test.Hard tissue slices were observed;bone volume fraction(BV/TV),Liang Houdu (Tb.Th),trabecular bone trabecular number(Tb.N),Liang Jianxi (Tb.Sp),trabecular bone trabecular bone volume (TBV),bone contact ratio(BIC) and the maximum pull-out strength (MPF) were measured.Results:There was no significant difference of BW and GLU between IB group and H group(P ＞ 0.05),but the BW and GLU of IB group was better than those of Ⅰ group and B group,Ⅰ group and B group were better than those of group N (P ＜ 0.05).BV/TV,Tb.Th,Tb.N,Tb.Sp,TBV,BIC and MPF of IB group were not statistically different from those of H group(P ＞0.05);but the indexes of IB group were higher than those of Ⅰ group and B group,those of Ⅰ group and B group were higher than those of N group (P ＜ 0.05).Conclusion:The combination of insulin and berberine can effectively reduce blood glucose and can promote osseointegration of titanium implants in type Ⅱ diabetic rats.
RESUMO
AIM: To investigate the clinic effect of the femoral neck fracture (FNF) with percutaneous internal fixation of hollow screw Ti-nails. METHODS: A total of 57 patients with closed FNF were recruited from Department of Orthopaedics in the First Mine Hospital of Pingdingshan Coal Group from February 2001 to December 2005. They were treated with 3 hollow screw Ti-nails (produce by Shanghai Qunli Medical Devices Co., Ltd) in 5-mm diameter under C-arm X-ray monitoring after close reduction by hand, punctured with 4-6 bone round nails in 2.5-mm diameter through skin for prefixation. The patients were encouraged to stretch and flex muscles early and perform articular physiological movement. The criteria of outcomes: Excellent: the patients were completely cured in six months after surgery, no pain was found in diseased coxa, the articular movement was normal, and they could walk freely half one year after surgey. Good: The fracture was cured in 9 months lately or no healing, there was a little ache in diseased coxa, the articular movement was limited, and they could walk normally in 10-12 months after surgery and recover slight work. Bad: The fractures were not cured, there were absorption, shifting, and aching in fracture joint early, and they need walk with walking stick. RESULTS: There were 55 cases followed up for 9 months, 51 cases for 18 months, and 57 cases for 42 months.①The curative effect of FNF by internal fixation was excellent in 27 cases, good in 20 cases and bad in 10 cases. ②Host response: 6 patients suffered from fracture shift due to screw-nail displacement, 4 patients got bone un-union, 6 patients experienced femoral head necrosis, and 2 patients got ache at bone fracture and were limited for articulation movement. No infection and rejection happened among 57 patients. CONCLUSION: The treatment of AO cannula Ti-screws internal fixation under closed reduction is effective for FNF, and no abnormal biocompatibility between materials and host appears in the clinical follow-up.
RESUMO
Objective:To study the changes of platelet and blood coagulating function during endovascular graft exclusion(EVGE), providing reference for reasonable use of heparin and platelet. Methods:Using sonoclot analysis (SCT), 20 patients accepted EVGE were measured for ACT, clot rate, platelet function and hematocrit (HCT) and platelet count (PLT) after anesthesia induction(T 1), heparination(0.3 0.5 mg/kg)(T 2) and EVGE(T 3), respectively. The reasons for variability were analyzed. Results:ACT, clot rate and blood platelet function were normal at T 1. At T 2 ACT was prolonged [(289? 61.1) s,] clot rate and platelet function were decreased ( P
RESUMO
Objective To investigate the effect of midazolam on expression of adhesion molecules on the platelet membrane surface in patients with coronary heart disease (CHD) .Methods Blood samples were taken from 10 healthy volunteers and 40 patients with CHD and anticoagulated with 3.8% sodium citrate. Platelet rich plasma (PRP) was obtained by centrifugation at 800 r/min for 8 min at room temperature. Ten volunteers served as control group (group E). The 40 patients with CHD were randomly divided into 4 groups ( n = 10 each) : group A, B, C and D. In group E and group A PRP was incubated without midazolam while in group B, C and D PRP was incubated with midazolam 100 (B) , 200 (C) and 400 ng?ml-1 (D) for 3 min. The inhibitory effect of midazolam on expression of CD154, CD41/61 and CD26p on the platelet membrane surface was determined by flow cytometry. Results The five groups were comparable with respect to age, sex (M/F ratio) , body weight, platelet count, bleeding and coagulation time. The expression of CD154, CD41/61 and CD62p on the platelet surface was significantly increased in patients with CHD. Midazolam 200 and 400 ng?ml-1 inhibited the expression of CD154, CD41/61 and CD62p on the platelet membrane surface in patients with CHD, whereas midazolam 100 ?g?ml-1 had no significant effect on CD154, CD41/61 and CD62p. Conclusion The expression of adhesion molecules on the platelet membrane surface is greater in patients with CHD than in healthy adults. Midazolam 200 and 400 ng?ml-1 can inhibit the expression of CD154, CD41/61 and CD62p on the platelet membrane surface.
RESUMO
Objective The normothermic isolated contracting rat heart model was used to investigate the mechanism of protective effect of propofol on left ventricular function and myocardial metabolism against ischemia-reperfusion injury by determination of the catecholamme concentration in the coronary outflow. Methods forty healthy male SD rats weighing 310-450 g were randomly divided into 4 groups of each 10 animals: control group, propofol 10?mol/L (P10), 50?mol/L (P50) and 100?mol/L (P100). The animal were sacrificed by knock-out and the heart was immediately removed. The aorta was connected to a Larigendorff apparatus and retrogradely perfused with oxygenated (95% O, and 5% CO2) Krebs-Henseleit buffer (KHB) for 5 min. Then the left ventricle was perfused through a cannula inserted in pulmonary vein at a constant pressure of 12.5 cm H2O (preload). The pressure at aorta outflow was 90 cm H2O (afterload). Different concentrations of propofol in KHB were prepared. Global ischemia of the heart was induced by suspension of perfusion for 25 min followed by 30 min reperfusion. Coronary flow (CF), aortic flow (AF), cardiac output (CO = AF + CF), HR, left ventricular peak systolic pressure (LVPSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP = LVPSP-LVEDP) and the product of LVDP and HR were measured and recorded 5 min and immediately before ischemia and 5, 10, 15, 20, 25 and 30 min following reperfusion. Coronary outflow was collected for determination of creatine kinase (CK) and catecholamine ( epinephrine, norepinephrine and dopamine) concentrations.Results Before ischemia CF was significantly higher and CO, HR, LVPSP and LVDP ? HR were significantly lower in the 3 propofol groups in comparison with the controls. During reperfusion CF, CO, HR, LVPSP and LVEDP recovered much better in the propofol groups than those in control group. In group P50 LVDP ? HR reached 88.7% of the pre-ischemic value while in control group only 56.3% . The CK and catecholamine concentrations were not significantly different among the 4 groups before ischemia. During reperfusion CK, epinephrine and noeepinepherine concentrations were significantly lower in propofol groups than in control group (P
RESUMO
Objective This study was designed to evaluate the change in coagulation and platelet function during cardiac surgery using SONOCLOT(SCT), a new coagulation and platelet function analyser which can analyse the whole process of coagulation including platelet function , fibrin formation and fibrinolysis with only 0 4ml of whole blood Methods Thirty ASA Ⅱ Ⅲpatients scheduled for cardiac surgery were studied 15 patients underwent valve replacement (group V) and another 15 patients coronary artery bypass graft (CABG, groupC) under combined intravenous and inhalation anesthesia Anesthesia was induced with midazolam 0 05mg?kg -1 ,fentanyl 5 10?g kg -1 or propofol 1 1 5mg?kg -1 and vecuronium 0 1 0 2mg?kg -1 and maintained with isoflurane(0 8 1 5MAC) supplemented with intermittent boluses of propofol and fentanyl ECG,SpO 2, P ET CO 2, BP, CVP, PAP, HCT and T were monitored during operation And dopamine, adrenaline, nitroglycerin, milrinone and other vasoactive drugs were used to maintain hemodynamic stability Blood samples were taken before anesthesia (T 1), after induction (T 2), after heparinization 3mg? kg -1 ( T 3) and 5min after protamine administration (T 4) for determination of ACT, clot rate and platelet function using SONOCLOT analysis Platelet counts were checked at T 1 and T 4 Results CPB time was less than 2h in all 30 patients Clot rate was significantly faster at T 2 than at T 1(P
RESUMO
Objective:To investigate changes of platelets and coagulation function in patients undergoing cardiac valvular replacement surgery during cardiopulmonary bypass(CPB).Methods: Thirty patients scheduled for elective cardiac valvular replacement were equally randomlized to 2 groups: control group and propofol group. In control group anesthesia was induced with midazolam 0.05 mg?kg -1,fentanyl 0.01 mg?kg -1 and vecuronium 0.1-0.2 mg?kg -1, and maintained with isoflurane,fentanyl and vecuronium. In propofol group anesthesia was induced with midazolam 0.05 mg?kg -1,fentanyl 0.005-0.01 mg?kg -1,propofol 1.5 mg?kg -1 and vecuronium 0.1-0.2 mg?kg -1, and propofol 4-5 mg?kg -1?h -1 was administered during operation with isoflurane,fentanyl and vecuronium. Blood samples were taken from jugular vein to assay SonACT, clot rate and platelet function with Sonoclot ananlysis, and to measure platelet count, PT and APTT before anesthesia, 5 min after induction,before CPB,10 min after CPB and at the end of operation.Results: Compared with those before anesthesia, PF, clot rate, platelet count, PT and APTT in both groups significantly decreased 10 min after CPB and at the end of operation(P