Bone and Bones ; drug effects ; metabolism ; Humans ; Lead ; adverse effects ; Osteogenesis ; drug effects

Objective: To study the optimum particle size of Cordyceps sinensis for liver fibrosis in combination with in vitro dissolution experiment from serum pharmacology. Methods: To prepare the powder samples with different grinding degrees, Cordyceps sinensis was crushed through 100-, 150-, 200-, and 300-mesh sieves. The in vitro dissolution of adenosine was measured at different time points. Meanwhile, the powder sample was ig administered to rats, and pharmacodynamic approach was adopted to study the inhibition of medicated serum on HSC-T6 proliferation. Results: The accumulative in vitro dissolution of C. sinensis by 200-300 meshes was higher than that of other meshes. Medicated serum could significantly inhibit HSC-T6 cell proliferation. The AUC of HSC-T6 inhibition kinetics of medicated serum crushed to 200-300 meshes was significantly higher than that in other groups. Conclusion: The in vitro dissolution and pharmacodynamic method could be used for the study on different particle sizes of C. sinensis for anti-hepatic fibrosis, and 200-300 meshes are the optimal particle size.

Objective: To investigate the anatomic characteristics of the pudendal-thigh flap and provide anatomic basis for clinical design and application. Methods: The perineal regions of 15 male cadavers were anatomized. The flap was designed on the cadavers and the blood vessels/nerves contained in the flap were studied. Based on the above anatomic findings, we designed the flaps in our operation. The axial arteries were isolated according to the designing and the tissue adjacent to the vessel pedicles was preserved. The flaps were transferred to the recipient site. The incision of donor site was directly sutured; skin graft was transplanted when the incision could not be directly sutured. Results: The perineal regions had rich and constant blood supply and had stable nerve innervation. The blood supplies of the perineal region included external pudendal artery, anterior cutaneous branches of obturator artery, lateral branch of posterior labial or scrotum arteries. The location of the above vessels was comparatively constant, especially external pudendal arteries and posterior scrotum arteries. Three groups of blood vessels went through the lower, middle and upper parts, and there were 4 groups of major nerves responsible for the innervation of the pudendal region. We have used 23 cases of pudenal-thigh flaps, with the largest flap being 17 cm × 9 cm and the smallest being 8 cm × 5 cm, and satisfactory outcomes were achieved in all the cases. Conclusion: The pudenal thigh flap has rich blood supply, convenient incision, and covert donor site. It has satisfactory outcome (morphologic and sensory) in repairing and reconstructing male perineal region and is worth popularizing.

OBJECTIVE To evaluate distribution and resistance of pathogens in patients with pulmonary infection after abdominal operation by stages,and provide reference to select antibiotics in clinics.METHODS Forty five patients with pulmonary infection after abdominal operation were included from Jan 2004 to Sep 2007.Their course was divided into 3 stages: onset stage,middle stage and last stage,at every stage to identify pathogens and to test drug sensitivity and the sputa and broncho-alveolar lavage fluid(BALF) were sampled.RESULTS A total of 189 strains of pathogens were isolated,from them 110(58.2%)were Gram-negative bacilli including Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae;and 59(31.2%)were Gram-positive cocci including Staphylococcus aureus and Enterococcus;and 20(10.6%)were fungi,Candida albicans was the main fungus.At onset stage the most pathogens were Gram-negative bacilli;at middle stage the Gram-positive cocci increased distinctly;and the fungi were detected at middle and last stages.The mixed infection rate was high.The result of drug sensitive test showed that there were high rates of multidrug resistance in P.aeruginosa.The resistance rates of all isolates of Enterobacteriaceae to imipenem or meropenem were 0.The resistance rates of all Gram-positive cocci to linezolid or vancomycin were 0.CONCLUSIONS Distribution of pathogens in patients with pulmonary infection after abdominal operation is different at each stage.The most are multidrug resistant,and rationl use of antibacterial drug in clinics must be based on the distribution and drug-resistance of pathogens.

Objective To study the effect of the combination of rivaroxaban and Xuesaitong injection on deep venous thrombosis (DVT) of lower extremity after spinal surgery.Methods The clinical data of 90 patients undergoing spinal surgery from May 2013 to May 2015 were retrospective analyzed.The patients were divided into two groups randomly: the treatment group and control group.Forty-five patients in treatment group were treated with rivaroxaban and Xueshuantong injection from 1 st day after surgery to one week after off-bed activity, and forty-five patients in control group were treated with rivaroxaban alone.The vessels of lower extremity were detected by doppler ultrasonography pre-surgery, 7-10d and 3 months post-surgery, then the rates of DVT and pulmonary embolism were statistically analysed.Results The DVT rate in treatment group was 8.89%(4 cases), which was significantly lower than 24.4% (11 cases) in control group (P<0.05).Conclusion The anticogulant effect of the combination of rivaroxaban and Xuesaitong injection is stronger than rivaroxaban alone.

Objective To explore the diagnosis for early stage lung cancer with "normal" plain CT scan in order to draw the concern of physician to these patients. Methods We reviewed and analyzed 3 cases of central bronchogenic carcinoma with normal plain CT scan at first visit who were confirmed through fiber bronchoscope examination and PET/CT scan later. Then we compared the values of some diagnostic methods for early-stage central bronchogenic carcinoma. Results Three patients were all males with long smoking history. They came to hospital for cough and bloody sputum. All their plain CT scan showed "no abnormal findings", but their symptom continued. Later, the fiber bronchoscope examination and PET/CT scan strongly suggested that they were suffered from central bronchogenic carcinoma, and then the pathological findings and sputum cytology confirmed the diagnosis. Two patients received lobectomy, and the other one was suggested to accept radiotherapy because of his poor lung function. Conclusions The positive rate of plain CT scan for early-stage central bronchogenic carcinoma is relatively low. Thus, some of these patients lost the chance of surgery and combined therapy. So physicians should pay more attention to these patients with symptoms of persistent bloody sputum or obstructive pneumonia, even if the plain CT scan is negative at first visit. Using PET/CT and fiber bronchoscope examination, physicians can confirm the diagnosis of central bronchogenic carcinoma. So these two methods are important in the diagnosis for early-stage central bronchogenic carcinoma without any abnormal plain CT scan findings.

Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen ( SPF) , vidian canal ( VC ) , and foramen rotundum ( FR ) with regard to an endoscopic endonasal approach to the pterygopalatine fossa(PPF)using three-dimensional reconstruction of high resolution computed tomography (HRCT) scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were(6.26 ±1.59)mm,(2.35 ± 0.77)mm and(2.75 ±0.77)mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was (4.03 ±1.15) mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were(4.94 ±1.35)mm and(9.22 ±3.07)mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%(33/36) of the VC and lateral to the posterior margin of the SPF in 97%(35/36) of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.

Objective To investigate the perioperative nursing of patients with Stanford type B aortic dissections treated with endovascular graft exclusion.Method The clinical data of 22 cases undergoing thoracic endovascular aortic repair from February 2011 to August 2013 were retrospectively analyzed to summarize the nursing experience.Results Twenty-two patients survived successfully through operation.One case had retrograde type A dissection after operation,another 15 had hyperthermia,and all of them were cured and discharged due to symptomatic treatment.The postoperative 3 months follow-up showed no type I endoleak.Conclusion Preoperative psychological nursing,postoperative blood pressure control,nursing of complications,strengthening instruction of diet and physical activity,are critical for the promotion of early rehabilitation of patients after discharge.

Objective: To investigate the effect of astragalus on the serum levels of hepatocyte growth factor (HGF), renal function and the damage of renal morphology in ischemic acute renal failure (IARF). To study the protective mechanism of astragalus in IARF. Methods: The rats were pretreated with astragalus or vehicle for 3 days. IARF was induced by left renal artery clipping for 60 min, after the right kidney was removed. Biochemical parameters for serum HGF,blood urea nitrogen(BUN),creatinine(Cr) were measured and histological analyses of the kidneys were performed by tubular grading. Results: There have no significant difference between the serum HGF levels of I/R controls and the levels observed in sham-operated group (P > 0.05). Serum HGF levels in astragalus treated group was significantly increased than those of I/R control group(P < 0.01) .After 4 h of I/R, serum levels of BUN and Cr were increased in I/ R control rats compare with Sham-operated rats(P < 0.01). Astragalus treatment reduced the levels elevation(P < 0.05). Simultaneously,. I/R-induced severe damage in renal morphology were significantly ameliorated by astragalus treatment(P < 0.01). Conclusions: Astragalus pretreatment can alleviate the damage of renal function in IARF. It is may be one of the mechanisms of astragalus for protecting renal tissue in IARF that astragalus can induce the expression of HGF.

Objective To evaluate the effects of dexmedetomidine used to supplement analgesia with sufentanil on the stress response and inflammatory response after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-four patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into sufentanil analgesia group (group S,n =20) and dexmedetomidine supplementing sufentanil analgesia group (group DS,n=24) using a random number table.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated.Combined intravenous-inhalational anesthesia was used to maintain anesthesia.Dexmedetomidine was infused at 0.3 μg · kg-1 · h-1 from closure of the chest to the end of surgery in group DS,while the equal volume of normal saline was given instead in group S.The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline in group S,or sufentanil 2 μg/kg plus dexmedetomidine 3 μg/kg in 100 ml of normal saline in group DS.The PCIA pump was set up with a 0.5 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 1.5 ml/h.Visual analogue scale score was maintained ≤ 3.When visual analogue scale score ≥ 4,morphine 0.1 mg/kg was injected intravenously.The occurrence of analgesics-related respiratory depression,bradycardia and hypotension was recorded.At the end of surgery (T0),and 12,24,48 and 72 h after surgery (T1-4),blood samples were collected from the central vein for determination of serum cortisol,β-endorphin,C-reactive protein,interleukin-2 (IL-2),and IL-6 concentrations by enzyme-linked immunosorbent assay.Results No analgesics-related adverse events were detected in the two groups.Compared with group S,the requirement for morphine was significantly decreased,the serum cortisol concentration was decreased at T2-4 and the serum β-endorphin,C-reactive protein concentrations were decreased at T1-4,the serum IL-2 concentrations were increased at T1-4,and the serum IL-6 concentrations were increased at T3 in group DS (P＜0.05).Conclusion Dexmedetomidine used to supplement analgesia with sufentanil can alleviate the stress response and inflammatory response after cardiac valve replacement with CPB.