ObjectiveTo investigate the effect of glucose and insulin on the synthesis and secretion of adrenomedullin (ADM) by rat aortas in vitro.MethodsThe rat aortas were cut into pieces and divided into several equal groups. All the groups were incubated in K-H buffers including different levels of glucose,insulin and insulin+glucose for 3 hours,the group incubated in K-H buffer without glucose was used as control. To determine ADM in K-H buffers and tissues using RIA method.ResultsADM levels in insulin groups (100.0 μIU/ml,200.0 μIU/ml) and insulin+glucose groups were higher than that in control (P<0.05),the ADM levels in glucose groups and low level insulin group (20.0 μIU/ml) were not significantly difference compared with the control. ConclusionHigh levels of insulin can stimulate the synthesis and secretion of ADM.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion in intervening acute ischemic stroke. Methods: A total of 112 patients were divided into a control group and an observation group by the random number table method, with 56 cases in each group. The control group was treated with conventional treatment, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. The National Institute of Health stroke scale (NIHSS) and modified Barthel index (MBI) were evaluated, and the intracranial hemodynamic indicators including mean velocity (Vm), pulsatility index (PI) and resistance index (RI) were recorded, and the serum levels of superoxide dismutase (SOD) and homocysteine (HCY) were measured before and after treatment. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the NIHSS scores in both groups decreased significantly (both P<0.05), and the MBI scores increased significantly (both P<0.05). The improvements of NIHSS and MBI scores in the observation group were superior to those in the control group (both P<0.05). Vm in both groups increased significantly (both P<0.05), PI and RI decreased (all P<0.05), and Vm, PI and RI in the observation group were superior to those in the control group (all P<0.05). The serum levels of SOD and HCY in the observation group were significantly improved, and were statistically different from those in the control group (both P<0.05). Conclusion: Conventional treatment plus heat-sensitive moxibustion is effective in intervening acute ischemic stroke. It can promote the recovery of neurological function, improve daily activities, and improve intracranial blood flow, which may be related to the regulation of serum SOD and HCY levels.

BACKGROUND:The limb ischemia model in rats has been widely applied in China to study the pathological process and treatment method of limb ischemia, but there are some controversies on the model construction and evaluation, so a reliable, convenient and economical disease model is needed for the related research. OBJECTIVE:To compare limb ischemia degree, duration and changing rule of acute hind limb ischemia models prepared by different ways in Sprague-Dawley rats, and find a method to prepare models that have moderate and stable limb ischemia and maintain a longer time. METHODS: 72 Sprague-Dawley rats were randomly divided into four groups, with 18 rats in each group. Group A: sham operation group, abdominal aorta below renal artery and iliolumbar artery, right superficial femoral artery, popliteal artery, saphenous artery were separated. Group B: the right superficial femoral artery, popliteal artery, saphenous artery were cut off, and the right femoral artery was resected to establish acute hind limb ischemic model. Group C: abdominal aorta and bilateral abdominal perineal artery were ligated to establish acute hind limb ischemic model. Group D: abdominal aorta, iliolumbar artery and lumbar artery were ligated to establish acute hind limb ischemic model. RESULTS AND CONCLUSION:Right hind limb muscle strengths of rats in groups B, C, D were weaker than that in group A at weeks 2, 4, 6 after operation; muscle strengths in group D was weaker than that in groups B, C at week 4 after operation; muscle strengths in groups B, D was stil weaker than that in group C at week 6 after operation. The partial venous oxygen pressure of right hind limbs in groups B, C, D was lower than that in group A at weeks 2, 4, 6 after operation; the partial venous oxygen pressure in group D was lower than that in groups B and C at weeks 2, 4 after operation; and group D was stil lower than group C at week 6 after operation. At weeks 2, 4 after operation, some muscle cels in the right hind limb muscle tissue were disrupted, fibrous connective tissue hyperplasia and capilary hyperplasia were detected, inflammatory cels infiltrated in the groups B, C, D. These pathological findings were more apparent in group D. Fiber connective tissue hyperplasia was attenuated, capilary hyperplasia, expansion and congestion were found in each group at week 6 postoperatively. The method of ligating abdominal aorta, iliolumbar artery and lumbar artery below renal artery for hind limb ischemia model can obtain moderate and stable ischemia conditions, maintain a long time, and is convenient to prepare.

BACKGROUND:Ultrasonic therapy is one of several physical therapy modalities suggested for the management of pain and loss of function due to osteoarthritis. However, its effectiveness stil remains controversial in the previous studies.
OBJECTIVE:To analyze the effect of ultrasonic therapy for the treatment of relieving knee osteoarthritis pain.
METHODS:A retrieval of Pubmed, Ovid/Medline, Ovid/EMBASE, and Cochranee database was performed. The relevant literatures were manual y retrieved. The retrieval deadline was set on March 31, 2014. Randomized control ed trials on ultrasonic therapy of knee osteoarthritis were col ected.
RESULTS AND CONCLUSION:A total of eight studies of meta-analysis were accumulated. Among them, six studies adopted visual analog scale and Western Ontario and McMaster Universities Arthritis Index, one study adopted visual analog scale only, and one study adopted Western Ontario and McMaster Universities Arthritis Index. Then the Western Ontario and McMaster Universities Arthritis Index scores were transformed into visual analog scale scores for data analysis. There was a statistical difference between the groups in the visual analog scale pain score (standardized standard deviation:-0.51;95%confidence interval:-0.68,-0.33;P=0.05). Ultrasonic therapy is an effective method for knee osteoarthritis pain.

BACKGROUND:Large randomized trials have demonstrated carotid endarterectomy or stenting for symptomatic and asymptomatic extracranial carotid stenosis is effective.
OBJECTIVE:Using the meta analysis method, to evaluate efficacy and safety of carotid stenting and carotid endarterectomy for the treatment of carotid stenosis.
METHODS:Computer-based retrieval of databases both at home and abroad was performed for randomized control ed trials related to carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. According to exclusion criteria, literature screening was done fol owed by quality evaluation. Then, the enrol ed literatures were analyzed by Cochrane col aboration with RevMan5.0 Meta analysis software.
RESULTS AND CONCLUSION:There were 14 enrol ed studies, including 7 693 patients among whom, 3 835 cases were in stenting group and 3 858 in carotid endarterectomy group. Compared with the carotid endarterectomy group, the stroke event rate within 30 days postoperatively, death and stroke event rate within 30 days postoperatively, myocardial infarction event rate within 1 year postoperatively and non-disabling stroke event rate within 30 days postoperatively were higher in the stenting group (P ≤0.000 1);the myocardial infarction event rate within 30 days postoperatively was lower in the stenting group (P=0.001 0). There were no significant differences in the death event rate and disabled stroke event rate within 30 days postoperatively between the two groups. These two treatments are complementary rather than antagonistic. We should optimize the treatment choice based on the comprehensive analysis of each patient's condition.

Objective To investigate the effect of progressive decompression elasticity socks therapy on life quality of the lower extremity deep vein thrombosis patients.Methods 50 qualified patients were divided into 2 groups receiving respectively compression therapy or not.Analysis and comparison were made based on results of SF36 questionnaire.Results There were no demographic differences between the two groups.Average follow-up time was (5.6 ± 2.4) months,the cronbach α coefficient was 0.8652 in compression therapy group,there was significant improvement on every evaluated stage and in every dimension after standard treatments (P ＜ 0.01),while in control group,only 4 dimensions (PF,RP,RE,BP) improved (P ＜ 0.05),there were statistical differences on every dimension between the two groups (P ＜ 0.01).Conclusions Progressive decompression elasticity socks therapy helps make the recovery of patients of acute deep vein thrombosis of the lower extremities.

Objective To investigate on the incidence of gynecological laparoscopic operation complications within ten years.Methods From January 2003 to December 2012,clinical data and the complications of 4 897 cases undergoing gynecological laparoscopic operation in First Hospital of Peking University were studied retrospectively.Those surgeries included 876 cases with hysterectomy,662 cases with myoectomy,3 266 cases with adnexa surgery,93 cases of diagnostic laparoscopy operation.Results The complications occurred in 29 cases,the incidence rate was 0.59％ (29/4 897).The Incidence rate in Hysterectomy group was 1.83％ (16/876),which was significantly higher than 0.60％ (4/662) in myoectomy group and 0.28％ (9/3 266) in adnexa surgery group.Twenty nine cases of complications were 14 cases with organ injures (48％,14/29),5 cases with hemorrhage complications (17％,5/29),8 cases with infectious complications (28％,8/29),2 cases with incisional hernia(7％,2/29).Conclusion The major complication of gynecological laparoscopic operation complication was organs injuries,which was associated with difficulty and scope of the operation.

Objective To explore the expressions and significances of the tumor stem cell markers CD133-2,CD24 and CD44s in head and neck squamous cell carcinoma (HNSCC) tissues and their association with the clinical pathologic characteristics.Methods Expressions of CD133-2,CD24 and CD44s were analyzed by immunohistochemistry (SP) in 83 cases of primary HNSCC tissues and 46 cases of normal epithelia.Clinicopathological indexes were assessed.Results In primary HNSCC tissues and normal epithelia,the expression rates of CD133-2 and CD24 were 9.64 ％ (8/83),21.74 ％ (10/46) and 90.36 ％ (75/83),46.67 ％ (21/46)respectively,which had statistically significances (x2 =15.040,5.818,P ＜ 0.05).CD44s expression was detected in primary HNSCC tissues and normal epithelia,but their staining scores had statistical significance (Z =-4.262,P ＜ 0.05).In primary HNSCC tissues,the expression of CD133-2 had negative correlation with differentiation degree (x2 =7.246,P ＜ 0.05),but CD24 and CD44s had positive correlation with differentiation degree (x2 =9.005,44.765,P ＜ 0.05).In addition,the expression of CD44s in primary HNSCC tissues had negative correlation with T classification (x2 =4.650,P ＜ 0.05).Conclusion The expressions of CD24 and CD44s in primary HNSCC tissues are highly up-regulated with tumor cells differentiation,and further research needs to be performed to discover whether or not CD24 and CD44s could be the markers of tumor stem cells of HNSCC.The expression of CD133-2 in primary HNSCC tissues is highly down-regulated with tumor cell differentiation.As one of the tumor stem cell markers of HNSCC,CD133-2 may play an important role in the development and clinical outcomes of tumor.

OBJECTIVETo compare the therapeutic effects between anatomical locked plate combined with coracoclavicular ligament reconstruction and clavicular hook plate for treatment of distal clavicle fracture of Neer type II b.

METHODSFrom August 2010 to August 2013, 42 patients with Neer II b distal clavicle fractures were randomly divided into two groups as group A and group B. In group A, there were 22 cases including 14 males and 8 females with an average age of (44.2±11.6) years old. In group B, there were 20 cases including 11 males and 9 females with an average of (45.6±12.4) years old. The patients of group A were treated with anatomical locked plate combined with coracoclavicular ligament reconstruction,the patients of group B were treated with hook plate. All fractures were fresh, the time between injuries and operation was 24 hours to 7 days (mean,72 h). General information between the two groups was comparable before operation(P>0.05). Postoperative radiographic were followed up to observe the fracture healing,internal fixation and to measure coracoclavicular distance of two groups. Shoulder function after operation was evaluated by Constant-Murley score system.

RESULTSAll patients were followed up with an average of 16.8 months (ranging 12 to 24 months). There was no nonunion,infection and other complications between two groups. The clavicular stress fracture occurred in 1 clavicular hook patient at 6 months after the operation. According to the Constant-Murley score system, that the scores of group A were 90.6±6.2, 91.8±4.8, 94.7±3.6 and 97.8±1.2 at 1st, 3rd, 6 month and last follow-up after operation were higher than those of group B 74.8±3.4, 78.4±4.4, 82.2±2.8 and 94.6±3.6 (P 0.05). The fracture healing time of group A (21.6±2.2) weeks was shorter than that of group B (25.8±2.5) weeks (P 0.05). There were no statistically significant differences between two groups in coracoclavicular distance at last follow-up (P>0.05).

CONCLUSIONThe anatomical locked plate combined with coracoclavicular ligament reconstruction need not expose shoulder and can reduce the incidence of postoperative pain and limited activity of shoulder, with fewer complication, it is advantageous to the shoulder joint function early recovery.

Adult ; Bone Plates ; Clavicle ; injuries ; surgery ; Female ; Fractures, Bone ; surgery ; Humans ; Ligaments, Articular ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods

ObjectiveTo study prognostic factors and surgical extent of papillary thyroid microcarcinona (PTMC). MethodsLiteratures about PTMC were searched. Relationship between prognostic factors and recurrence after initial operation was analyzed by meta analysis. The surgical extent of PTMC was discussed. Results A total of 12 retrospective studies were included. Meta analysis results showed that factors such as male, tumor size ＞ 5 mm, nonincidental, positive lymphnode, multifocus, and capsular invasion were related to recurrence after initial surgery. Age above 45 years had nothing to do with the recurrence rate of PTMC. There was no signifi.cant difference in recurrence rate between prophylactic neck dissection groups and the groups without prophylactic neck dissection. ConclusionsMany factors are related to the prognosis of PTMC. The surgical extent depends on prognostic factors. Prophylactic neck dissection is not supposed to be conventional surgical procedure for PTMC. Bilateral central lymph node dissection is appropriate to PTMC with positive lymph node.