Objective To explore the apoptosis of alveolar epithelial cell(AEC)and the dynamic changes of Caspase-3 mRNA and Bax and Bcl-2 expression in premature rat with hyperoxia-induced chronic lung disease(CLD).Methods Sixty premature rats within 1 day after birth were randomly divided into 2 groups:hyperoxia group(n=30)and control group(n=30).Hyperoxia-induced premature rat CLD models were prepared,and situ nick end-labeling(TUNEL),reverse transcription polymerasechain reaction(RT-PCR)and immunohistochemical technique were used to determine apoptosis index(AI)of AEC and the expressions of Caspase-3 mRNA and Bax and Bcl-2 proteins in lung tissues at 1,3,7,14 and 21 d after birth.Results Compared with control group,in the hyperoxia group,on the third day after exposured to hyperoxia,the AI of AEC and the expressions of Caspase-3 mRNA and Bax began to increase,and the expression of Caspase-3 mRNA was kept at high level on 7-21 d.The expression of Bcl-2 began to decrease on 7 d,and significantly decreased on 7-21 d.AI of AEC was positively correlated with the expression of Caspase-3 mRNA and Bax,and negatively with the expression of Bcl-2.Conclusions Hyperoxia may induce the increased expression of Caspase-3 mRNA,which might result in the abnormal expression of Bax and Bcl-2 in lung tissues and their imbalance,which might be one of the underlying mechanisms of apoptosis of AEC in premature rats with CLD.

Aged ; Aged, 80 and over ; Corynebacterium ; isolation & purification ; Cross Infection ; epidemiology ; microbiology ; Female ; Humans ; Male ; Random Amplified Polymorphic DNA Technique

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

Objective To explore the relationship between reduction of regional cerebral blood flow in the normal appearing white matter (NAWM) and the extent of age-related white matter lesions (WML).Methods We used Fazekas scale to divide all participants into four groups (normal,mild,moderate,severe) according to the extent of the lesions showed on MRI.Regional cerebral blood flow (rCBF) in the area of WML and NAWM was measured by xenon contrast CT examination.Results A total of 56 cases were selected.The average rCBF (ml · 100 g-1 · min-1) in the lesions (WML) around ventricle,in right centrum ovale and in left centrum ovale respectively was 20.33 ± 2.52,21.27 ± 1.02,21.03 ± 1.83 for mild; 16.33 ±2.03,15.55 ±1.71,15.91 ±0.98 for moderate; 14.05 ±2.63,14.46 ±2.17,14.23 ± 1.95 for severe.The average rCBF (ml · 100 g-1 · min-1) in the NAWM around ventricle,in right centrum ovale and in left centrum ovale respectively was 20.79 ± 2.78,22.26 ± 1.9,22.15 ± 2.4 for normal; 21.12 ± 2.95,22.17 ± 1.50,22.25 ± 2.13 for mild,18.02 ± 2.41,19.45 ± 1.94,19.62 ± 1.54for moderate; 16.38 ± 3.22,18.18 ± 2.84,16.74 ± 2.97 for severe.The decrease of rCBF in the severe and moderate lesion areas was more serious than that in the mild lesion areas and reached statistic significance (P ＜ 0.05) ; The decrease of rCBF in the severe and moderate lesion areas was more serious than that in the area of NAWM in the same grade and reached statistic significance (P ＜ 0.05).The decrease of rCBF in the area of NAWM around severe and moderate lesion areas was more serious compared with that around mild lesion areas or normal areas (P ＜ 0.05) ; But the difference of rCBF in the area of NAWM around mild lesion areas and normal areas did not show any statistic significance.Conclusions Chronic ischemia was found to be existed not only in the lesions (WML) but also in the area of NAWM around the lesions,and was related to the extent of the lesions.Chronic ischemia may play a key role in the mechanism of aged-related WML.

Objective To investigate the therapeutic effect of the sandwich method (medical glue +gelatin sponge+medical glue) in the repair of spinal dura mater to prevent the cerebrospinal fluid leakage.Methods From February 2007 to June 2011,54 patients with spinal subdural tumors underwent excision of tumor in our hospital.According to manner of repairing spinal dura mater,all patients were classified into two groups:routine group and sandwich group.There were 16 males and 7 females with an average age of 45.2±7.2 years in the routine group,while 19 males and 12 females with an average age of 44.2±6.4 years in sandwich group.In routine group,the spinal dura mater was repaired through running locked suture.In sandwich group,the spinal dura mater was repaired through running locked suture,painting medical glue around the dural incision,covering with gelatin sponge,and painting medical glue on the surface and margin of gelatin sponge successively.Results Compared with the routine group,the total volume of postoperative drainage in sandwich group decreased significantly on the very day,the first day,the second day,and the third day,and the incidence of cerebrospinal fluid leakage decreased significantly.Before discharge,hydrops happened in 3 cases in the routine group,and got well through aspiration,continuous pressure by sandbag,and prone position.Three months after operation,5 cases from the routine group got deep hydrops under the incision and no treatment was applied to them.There was no obvious abnormality in the sandwich group.Conclusion The sandwich method can improve the repair effect of spinal dura mater injury,reduce the volume of postoperative drainage,and decrease the incidence of cerebrospinal fluid leakage

Objective To evaluate the outcome of surgical treatment of tricuspid valve regurgitation after valve replacement.Methods Twenty one patients with tricuspid valve insufficiency after valve replacement were performed surgical treatment.Tricuspid valve-plasty was performed in 17 patients and tricuspid valve replacement was done in 4 patients.Three patients underwent edge-to-edge tricuspid valveplasty.DeVega procedure was performed in 5 patients.Cosgrove-Edward annuloplasty ring was used in 15 patients.Four patients' valve were replaced by SJM bileallet mechanical prostheses.Results There was 3 patients dead early after operation with a mortality of 14.3％(3/21).The causes of death including multiple organ failure,cardiac arrest and low cardiac output syndrome.The rate of early postoperative complications was 33.3％ (7/21),including pulmonary edema,arrhythmia,acute renal failure and low cardiac output syndrome.The patients were followed up 9-60 months.The rate of readmission was 23.8％ (5/21).Two patients went to hospital again for pleural effusion,1 patient for left ventricular dysfunction and 2 patients for right ventricular dysfunction.The other patients recovered well.Conclusions Surgical therapy is effective on severe tricuspid valve regurgitation after valve replacement.Preoperative aggressive treatment of heart failure,a reasonable grasp of surgical indications and timing of surgery,strict perioperative management are the keys to guarantee patients a smooth recovery.

To observe therapeutic effects of acupuncture on female's climacteric depression and to study on the mechanism. Methods Sixty cases enrolled were randomly divided into an acupuncture group and a control group, 30 cases in each group. In the acupuncture group, acupuncture were given at Ganshu (BL 18), Shenshu (BL 23), Xinshu (BL 15), etc. with uniform reinforcing-reducing method, once each day, and the control group were treated with oral administration of fluexertine hydrochloride, 20 mg, once daily. HAMD scale was used for assessment before treatment and 2,4,6 weeks after treatment. Blood dopamine (DA), norepinephrine (NE) and 5-hydroxy-indoleacetic acid (5-HIAA) contents were detected before treatment and after one therapeutic course. Results The total effective rate was 86.7% in the acupuncture group and 92.9% in the control group with no significant difference between the two groups (P > 0.05). After treatment, DA content increased significantly in the acupuncture group with a significant difference as compared with that of the control group (P < 0.05); and after treatment NE and 5-HIAA contents in the two groups significantly increased as compared with that before treatment (P < 0.05, P < 0.01), with no significant difference between the two groups (P > 0.05). Conclusion Acupuncture can benignly and comprehensively regulate general functions, and increase contents of monoamines in the body, so as to play the role of anti-depression.
Acupuncture Therapy ; Adult ; Climacteric ; psychology ; Depression ; blood ; therapy ; Dopamine ; blood ; Female ; Humans ; Hydroxyindoleacetic Acid ; blood ; Medicine, Chinese Traditional ; Middle Aged ; Norepinephrine ; blood

Background One of the features of the pathogenesis of primary angle-closure glaucoma(PACG) is anterior synechia of peripheral iris.Goniosynechialysis and combination of phacoemulsification and goniosynechialysis have been applied for the treatment of the disease recently,but the selection of operative types has great impact on clinical efficacy.Objective This study was to investigate the long-term efficacy of goniosynechialysis and combination of phacoemulsification and goniosynechialysis for the management of chronic PACG.Methods A non-randomized clinical controlled trial was designed.This clinical trial complied with Declaration of Helsinki and was approved by Medical Ethic Committee of Nanjing Medical University.Written informed consent was obtained from each patient.One hundred and ten eyes of 110 patients with chronic PACG were assigned to the goniosynechialysis group and combined operative group from March,2008 to February,2011 in Wuxi People's Hospital.180° goniosynechialysis was performed on 34 patients in the goniosynechialysis group,and phacoemulsifieation +intraocular lens (IOL) implantation + goniosynechialysis were carried out in 78 patients of the combination operative group.All the patients were followed-up for 2 years.Vision acuity,intraocular pressure (IOP),anterior chamber depth(ACD),unltrasound biomicroscopy and perimetry were recorded and compared between before and after operation.Results No significant difference was found in vision acuity between preoperation and postoperative 2 years in the goniosynechialysis group ([0.65 ± 0.15] vs.[0.45 ± 0.15]) (t =1.57,P＞0.05),but in the combination operative group,the vision acuity was significantly different between the before and after operation ([0.25±0.15] vs.[0.85 ±0.05]) (t =9.12,P＜0.001).The lOPs at 2 years after operation were (14.2±4.1) mmHgand(13.7±4.8) mmHg,respectively in the goniosynechialysis group and combination operative group and were significantly lower than(47.2 ±6.3) mmHg and(46.9±7.0) mmHg before operation(t =4.95,P＜0.001 ;t=5.03,P＜0.001).The ACD values in the goniosynechialysis group and combination operative group were(3.38±0.02)mm and (3.54±0.03) mm 2 years after operation,which were significantly increased in comparison with (1.33 ±0.24)mm and (1.56±0.37) mm before operation(t=7.65,P＜0.001;t=6.76,P＜0.001).Conclusions Both combination of phacomulsification with goniosynechialysis or 180° goniosynechialysis are effective for the treatment of PACG.Suitable operation should be alternated depending on the indicators of PACG patients.

Objective To explore the effectiveness of the unsaturated disaccharides derived from chondroitin sulfate(CS)in urine using post column derivation fluorometric method of high performance liquid chromatography (HPLC).Methods Urine samples were prepared with the centrifugal flirtation and the routine precipitation methods separately,then digest the sample with CS lyses,use the post column derivation method of HPLC to fluorometric determine the unsaturated disaecharides(△Di-0S,△Di-4S and △Di-6S),compare the recovery differences of the CS standard in the urine pretreated by the two methods.Results The HPLC system ran well,the lowest detection limit of the method was 10 ng.When the urine was pretreated by the centrifugal flirtation method,the recovery of △Di-0S,△Di-4S and △Di-6S produced from the CS standard were 86.93%,87.28%and 85.03%,respectively,while the recovery of the three disaccharides in routine precipitation method were 75.09%,72.96%and 77.70%merely.Conclusions The HPLC post column derivatization fluorometric method is comparatively sensitive,it can be used to determine unsaturated disaccharides decomposed by CS.In the pretreatment procedure of the urine,the centrifugal flirtation method was superior to the routine precipitation method,it can be used as microdetermination for the unsaturated disaccharides.

Objective To evaluate the diagnostic value of ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) SPECT scintigraphy combined Iocalizable CT in the localization of ectopic parathyroid glands in hyperparathyroidism.Methods Retrospective data of surgery,pathology and imaging were collected from 28 patients with hyperfunctioning ectopic parathyroid glands.All cases underwent CT studies.Twenty-five patients had ~(99)Tc~m-MIBI planar imaging first:SPECT scintigraphy combined localizable CT was performed for the patients with abnormal radionuclide foci immediately.The fusion images obtained after reconstruction showed the exact location of the ectopic foci.Operative histopathologic results were regarded as "gold standards".Presuming 4 parathyroid glands as normal findings,findings confirmed by operation and pathology were regarded as positive,otherwise negative.The results of CT and radionuclide imaging were compared by X~2-test of four-foId table.Results Twenty-eight ectopic parathyroid glands were found in 28 patients,all pathologically confirmed as adenomss.CT found 22 foci,of which 17 were true positive,5 false positive,11 false negative,and 79 true negative.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT found 23 foci,no false positive,2 false negative,and 75 true negative.The results showed that the sensitivities were 61% (17/28),92%(23/25),specificities 94%(79/84),100%(75/75),accuracies 86%(96/112),98% (98/100),positive predictive values 77%(17/22),100%(23/23),and negative predictive values 88% (79190),97%(75/77),respectively,for CT and radionuclide imaging.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT was therefore significantly higher than CT in sensitivity(X~2=6.98,P＜0.01),specificity (X~2=4.61,P＜0.05),accuracy (X~2=10.30,P＜0.01),positive predictive value(X~2=5.88,P＜0.05) and negative predictive value (X~2=5.36,P＜0.05).Conclusion ~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT is superior to CT alone in the localization of ectopic parathyroid glands in hyperparathyroidism,but false negative can be found in some patients.