Objective To observe the protective and repairing effects of bone mesenchymal stem cells(BMSCs) transplantation on cerebral infarction in rats and to study the different effect of transplantation at different time points. Methods Middle cerebral artery occlusion(MCAO) models were set up,and the rats were divided into a control group,a group with PBS transplantation and five groups with BMSCs transplantation 3,6,12,24 and 72 h after MCAO,respectively.The volume of infarction area and the neurological severity score(NSS) in all the groups were compared. Results Twenty-eight days after MCAO,the TTC staining indicated that the volume of infarction area in the groups with BMSCs transplantation decreased remarkably compared with the control group and the group with PBS transplantation(P

OBJECTIVETo evaluate the effectiveness of anterior versus posterior surgical treatments of thoracolumbar fractures.

METHODSRandomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified from MEDLINE (1966 - 2006.7), EMBASE (1966 - 2006.7), PubMed (1996 - 2006.7), Cochrane Library (Issue 2, 2006).We hand-searched Chinese Journal of Orthopedics (from establishment to May 2006) and Orthopaedic Journal of China (from establishment to May 2006). RCTs and CCTs were included. Data were extracted by two reviewers with designed extraction form. RevMan 4.2.8 software was used for data analysis.

RESULTSTwo RCTs and four prospective clinical trials were included. The combined results showed that compare with posterior surgical management, anterior approach in the treatment of thoracolumbar fractures proved the less incidence of complications; better neurologic recovery and corrected kyphosis angle; more complete and reliable decompression of the canal. However, there was not difference between the two groups in the general status outcomes.

CONCLUSIONSTo compare with posterior fixation system, anterior surgical managements in the thoracolumbar spinal trauma might be the optimal choices because the lower rates of complications and loss of corrected kyphosis angle; better neurologic recovery, also. Besides, due to the lack of Evidence-based guidelines for the treatment of thoracolumbar spinal injuries, the results which indicated above need further study.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome

OBJECTIVE: To investigate the advantages of nitric acid digestion method and its differences with the traditional method. METHODS: Ethanol was used to fully fix the testing sample. About 80-100 g of the testing samples were cut into pieces and digested with nitric acid. It was then centrifuged and washed to remove organic components. Smears were prepared and examined under the light microscope. RESULTS: The diatom had been identified with clear striations, counted conveniently and classified easily. CONCLUSION The improved nitric acid digestion method is not only simple with a higher successful rate of detection, but also can prevent interference from contamination. It can improve the stability of the experimental results, avoid harm to human and environment, and provide higher safety in the course of experiment.
Autopsy ; Diatoms/isolation & purification* ; Drowning ; Forensic Pathology ; Humans ; Kidney/metabolism* ; Liver/metabolism* ; Lung/metabolism* ; Nitric Acid/chemistry* ; Postmortem Changes ; Tissue Fixation/methods*

Objective To find out the arsenic pollution in Yangzonghai lake and its influence to the surrounding drinking water source and the local food and to provide a scientific basis for arsenic pollution control,drinking water and food safety. Methods Arsenic monitoring were carried out in 10 points of Yangzonghai lake,45 water sources within 5 km of Yangzonghai lake, and locally produced food. Results From September 2008 to December 2009, the water arsenic concentrations of Yangzonghai lake ranged 0.06 - 0.18 mg/L, the average arsenic concentrations were 0.12 mg/L and 0.10 mg/L for 2008 and 2009, respectively, the value of 2009 was higher, and the difference was statistically significant(t = 3.284, P ＜ 0.05). There were no significant difference in the average of arsenic concentration of Yangzonghai lake between the dry and rainy season in 2009(t = 0.905, P ＞0.05). The arsenic concentrations from the No. 3 spring water ranged from 0.12 - 30.36 mg/L. After a peak value early in October 2008, the No. 3 spring water showed a downward trend month by month. In 2008 the average arsenic concentration was 23.92 mg/L, 2009 was 2.41 mg/L, down 89.92% over the previous year, the difference was statistically significant(t = 9.582, P ＜ 0.05 ). In January and February 2009, the average arsenic concentration (11.96 mg/L) was significantly higher than those of March-December(0.50 mg/L, t = 57.759, P＜ 0.05). In Yangzong town, the arsenic concentration in the drinking water and river met the national drinking water health standards. Among 78 samples monitored of the locally produced food in Yangzong town, 77 passed, with a pass rate of 98.72%. Conclusions Arsenic contamination has been effectively controlled. The drinking water and local food production has not been contaminated by arsenic except aquatic products in Yangzonghai Lake. It is recommended to take effective measures to prevent water contamination.

OBJECTIVETo evaluate the safety and efficacy of individual cylindrical abdominoperineal resection (CAPR) for locally advanced low rectal cancer.

METHODSFrom June 2011 to February 2012, 11 patients with locally advanced low rectal cancer underwent individual CAPR. There were 7 male and 4 female patients, aged from 32 to 74 years with a median of 64 years. Forty-seven patients underwent classic CAPR from January 2008 to February 2012. Preoperative and postoperative parameters such as clinical information of patients, tissue morphometry and complications were compared.

RESULTSIn the individual surgical group, 6 patients were treated with one side levator ani muscle totally or partially reserved, 3 patients with sacrococcyx reserved, and 2 patients with dissection close to the anterior rectal wall. Compared with classical surgery, the individual surgical specimens of horizontal section area ((2197 ± 501) mm(2)) and intrinsic muscle layer outer area ((1722 ± 414) mm(2)) were small, but the difference was not statistically significant (P = 0.150 and 0.167). The operative time, intraoperative blood loss, circumferential resection margin, total cross sectional tissue area, cross sectional tissue area outside the muscularis propria and bowel perforation rate between the two groups were not significantly different. Individual CAPR showed less incidence of chronic perineal pain (2/11, χ(2) = 6.116, P = 0.013) and sexual dysfunction (2/9, χ(2) = 4.412, P = 0.036) compared with classic CAPR.

CONCLUSIONSIndividual CAPR has the potential to reduce the risk of chronic perineal pain and sexual dysfunction without influencing the radical effect when compare with classic CAPR for the treatment of low rectal cancer.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; epidemiology ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo evaluate the oncological and functional outcomes of intersphincteric resection (ISR) in T(1-2) ultra-low rectal cancer.

METHODSFrom March 2000 to March 2007, ISR with total mesorectal excision (TME) was performed in 40 patients with very low rectal cancer,among whom total ISR in 5 patients, partial ISR in 23 patients, and partial ISR with partial dentate line preservation (modified partial ISR) in 12 patients. The preoperative tumor staging was T(1-2)N(0-1)M(0).

RESULTSMorbidity was identified in 3 patients including anastomotic leakage in 1 patient and wound infection in 2 patients, and there was no postoperative mortality. The 5-year overall survival rate was 97%, and 5-year disease-free survival rate was 86%. Both patients with modified partial ISR (P=0.004) and patients with partial ISR (P=0.008) had significantly better continence than those with total ISR, and patients with a diverting stoma had significantly better continence (P=0.043) than those without a stoma at 12 months after surgery.

CONCLUSIONSISR is a safe procedure for sphincter-saving rectal surgery in selected patients with very low rectal tumors. A temporary diverting stoma may be beneficial to the improvement of anal function. Modified partial ISR under the precondition of radical resection shows better anal function and lower rate of incontinence.

Adult ; Aged ; Anal Canal ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; pathology ; surgery ; Treatment Outcome

OBJECTIVETo report nine cases of descending necrotizing mediastinitis (DNM) and to summarize the management experience.

METHODSBetween December 2005 and December 2008, nine patients (mean age, 55.7 years; age range, 38 to 78 years) with DNM were treated. Eight patients underwent surgical drainage of the involved cervical region and mediastinum (4 with cervical drainage alone; 4 with cervical drainage and right thoracotomy).

RESULTSTwo patients died, one of them refused surgical therapy and the other one died of multiorgan failure related to postoperative septic shock. Seven patients recovered. The mortality rate was 22%.

CONCLUSIONSDelayed diagnosis and inadequate drainage are the main causes of high mortality rate of DNM. Aggressive surgical drainage and debridement of the neck and mediastinum by a multidisciplinary team of surgeons are very important in the treatment of DNM.

Adult ; Aged ; Focal Infection ; complications ; Humans ; Male ; Mediastinitis ; etiology ; Middle Aged

OBJECTIVETo study the histopathologic features, differential diagnosis and pathogenesis of diabetic cardiomyopathy.

METHODSThe clinicopathologic features of 40 autopsy cases of diabetes mellitus were studied. The hearts from another 40 cases of non-diabetic elderly deceased were used for comparison.

RESULTSIn the 40 cases of diabetes studied, 36 cases (90.0%) showed microscopic myocardial cell death. Focal interstitial fibrosis was observed in 37 cases (92.5%). On the other hand, similar myocardial cell death and patchy interstitial fibrosis was seen in 8 cases (20.0%) and 9 cases (22.5%) of non-diabetic hearts, respectively. The difference between the two groups was statistically significant (P < 0.01). The mural thickness of intramyocardial blood vessels was significantly increased in diabetic group (20.6 microm +/- 4.2 microm) than in non-diabetic group (7.2 microm +/- 5.2 microm), P < 0.01.The myocardial changes in diabetic group however were similar to those in non-diabetic group with systemic hypertension.

CONCLUSIONSPathologic diagnosis of diabetic cardiomyopathy relies on detailed histologic examination of heart tissue and clinical correlation of a long history of diabetes mellitus. Exclusion of other possible etiologies is also essential. The myocardial cell death observed may be due to the ischemic effect induced by diabetic microangiopathy in cardiac muscle.

Aged ; Aged, 80 and over ; Autopsy ; Cardiomyopathies ; complications ; diagnosis ; Cell Death ; Coronary Vessels ; cytology ; pathology ; Diabetes Complications ; pathology ; Diagnosis, Differential ; Female ; Fibrosis ; diagnosis ; pathology ; Humans ; Male ; Myocardium ; cytology ; pathology

OBJECTIVETo study surgical treatment of postoperative stricture of anastomosis for lower rectal cancer.

METHODSThe data of 9 cases who were diagnosed as postoperative stricture of anastomosis after operation of intersphincteric resection for lower rectal cancer during January 2008 to June 2011 were analyzed retrospectively. Transanal excision of stricture were used in 3 cases diagnosed as membranous stricture. Transanal radial incision of stricture were used in 5 cases diagnosed as tubulous stricture. Biologic patch was used to repair the defect of the posterior wall of rectum after excision of severe stricture in 1 case.

RESULTSAll 9 cases of postoperative stricture of anastomosis were cured by surgery. Anal dilation were performed every day by patients themselves after discharge. Digital examination showed that 1 to 2 fingers could pass through the anastomosis after operation. The patient whose rectal defect was repaired by biological patch underwent colonoscopy examination two weeks after operation. Colonoscopy showed that the biological patch had been filled with granulation and integrated into the surrounding intestinal tissue. All patients defecated without difficulty and the anal function of all patients was good after restoration of intestinal continuity.

CONCLUSIONAggressive surgery, combining with the use of biological patch if necessary is an effective therapy of postoperative stricture of anastomosis for lower rectal cancer.

Aged ; Anastomosis, Surgical ; Constriction, Pathologic ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Rectal Neoplasms ; surgery ; Rectum ; surgery ; Retrospective Studies

Objective To investigate the molecular mechanisms of upregulated expression of cellular Fas-associated death domain-like interleukin-1 beta converting enzyme inhibitory protein(c-FLIP)by calreticulin(CRT)in patients with rheumatoid arthritis (RA). Methods The semi-quantitative analysis and localization of c-FLIP in RA and osteoarthritis (OA)synovium were detected by immunohistochemistry.The fibroblast-like synoviocytes(FLS)were isolated by enzymatic digestion of synovial tissue specimens obtained from RA and OA patients,and cultured as an in vitro experiment model.The expressions of c-FLIP in RA and OA synovial fibroblasts were detected by immunofluorescence and Western blot assay. Whether CRT influenced c-FLIP expression and its molecular mechanism were explored by Western blot assay. Results The high expression of c-FLIP was found in RA synovium, mainly in the lining and sublining areas of FLS and vascular endothelial cells detected by immunohistochemistry.Meanwhile,weak staining of c-FLIP was observed in OA synovium.The expression of c-FLIP was significantly higher in RA synovium than that of OA synovium(t=11.717,P<0.001).Results of immunofluorescence and Western blot assay showed that c-FLIP was mainly located in cytoplasm, and which was higher expressed in FLS of RA than that of OA. The increased c-FLIP expression and phosphorylation of NF-κB were detected after being co-incubated with exogenous CRT (0, 10, 50, 100 μg/L), in dose-dependent manner. The effect of CRT upregulating c-FLIP expression was blocked by NF-κB inhibitor BAY 11-7082.Conclusion CRT can increase c-FLIP expression at least partly through NF-κB pathway in RA,which may provide therapeutic target for the treatment of RA.