Objective To summarize the clinical experience of 38 cases of cardiac surgery with full sternotomy through minimal skin incision.Methods A total of 38 cases of selective cardiac surgery were performed from June 2004 to December 2005.The operation was conducted under full sternotomy through a skin mini-incision.Results The operation was successfully completed in all the 38 cases.The total operation time was 175~359 min(mean,84 min),the drainage volume was 110~760 ml(median,380 ml),and the postoperatine hospital stay,7~32 d(mean,10 d).Postoperative short-term complications included 1 case of arrhythmia and 2 cases of pyrexia,all of which were cured.No thoracotomy for hemostasis was required.The incision healed by first intention without infection or separation.Follow-up examinations for 3~18 months(mean,9 months) in 38 cases showed significat improrement of symptoms.The left ventricular ejection fraction after operation was 0.45~0.73(mean,0.62).Conclusions Full sternotomy through minimal skin incision for cardiac surgery is safe and micro-traumatic.This procedure provides advantages of simplicity of performance,no need of special surgical instruments,and good cosmetic outcomes.

Osteoarthritis is a common chronic degenerative disease, which is currently the main drug therapy.Hyaluronic acid (HA) is a kind of glycosaminoglycan in the interstitial cells, which has the character of viscoelasticity, lubricity, biocompatibility,biodegradability and anti-inflammatory. It is wide applicated in the treatment of osteoarthritis.However, the half-life of the common hyaluronic acid injected into the joint cavity is shorter, patients need frequent dosing and the compliance is poor, research on new uses of hyaluronic acid formulations and clinical pharmacy workers is the new direction of research.In this paper, the recent advance of HA on function, safety, effectivity and novel application in osteoarthritis therapy are summarized.

In this paper, a segmentation method, supervised FCM, is used to segment multi-spectrum MR imaging. The qualitative evaluation of human brain can be provided by the results for diagnostics. It can improve the results using FCM.

Objective To evaluate serum TPSA and F/T ratio in the differential diagnosis of BPH and PCa. Methods Serum TPSA,FPSA and F/T ratio in 177 cases of BPH and 60 cases of PCa were assessed and evaluated both in patients within and outside the "gray zone". Results TPSA and F/T ratio were both significantly discriminating between benign and malignant diseases (0.010.05) whereas F/T ratio could ( P 0.05). Conclusions Serum TPSA is a prostate carcinoma marker,F/T ratio being an adjuvant marker of TPSA of importance on the differential diagnosis in patients within the "gray zone".

Objecfive To investigate the effects of endotoxin on nuclear factor-κB p65(NF-κB p65)mRNA expression and ahtosteron secretion in rat hepatic stellate cells(HSCs).Methods Cultured rat HSCs(HSC-T6)were divided into endotoxin-treated group and control group.Cells in endotoxin-treated group were exposure to 1 mg/ml.endotoxin.Aldosteron secretions of HSCs were determined by radioimmunoassay,and NF-κB p65 mRNA expressions of HSCs were detected by one-step RT-PCR.Results At 6,12,24 and 48 h,aldosteron secretions in endotoxin-treated group were significantly hisher than those in the control group(t=3.063,4.577,6.847 and 9.317,P<0.05),and the expressions of NF-κB p65 mRNA in endotoxin-treated group were also higher than those in control group(t=5.155,6.095,7.875 and 9.313,P<0.01).Aldosteron secretions and NF-κB p65 mRNA expressions in HSCs displayed a positive correlation(r=0.886,P<0.01).Conclusion Endotoxin can up-regulate the aldosteron secretion and NF-κB p65 mRNA expression in rat HSCs,which may be one of the mechanisms of liver fibrosis induced by endotoxin.

Objective To investigate ultrasound guidended nerve block of femoral nerve in emergency operation.Methods 40 patients who planned to accept surgery of feet,lower limb under knee.They were randomly devided into 2 groups:ultrasound guidended group and the control group.Femoral nerve and Sciatic nerve were blocked by ultrasound guidended technique or classic landmark technique.1.5% lidocaine was administered for nerve block.Sensory block was observed every 5 minutes in 30 minutes.Onset time,effect of anesthesia,algesia time and complications were recorded.T-test and varience difference were applied.Results The onset time of local anesthetics was faster in the ultrasound guided group than that of the control group.Effect of analgesia was better in in the ultrasound guided group than that of the control group. Conclusion Nerve block of femoral nerve and the sciatic nerve guided by ultrasound was better than the classic technique.

Purpose:To evaluate the effect and toxicity of gemcitabine cisplatin combination in elderly patients with advanced NSCLC.Methods:32 elderly patients were treaded with Gemcitabine 1 000 mg/m 2 on day 1,8 and DDP 70 mg/m 2 on day 1. The second treatment cycle was given on day 22.Results:Each patient was given at least 2 cycle chemotherapy. All together 134 cycles were given. The overall response rate (the completed response plus partial response) was 43.8%. The main toxicity was bone marrow depression. The proportion of WHO grade 3 4 hemoglobin, leukocyte and thrombocyte decrease cycles was 7.5%, 12.7%, 23.1%, respectively.Conclusions:Gemcitabine cisplatin combination is effective and well tolerated for elderly patients with NSCLC.

Objective To investigate the effect of intrathecal morphine preconditioning (ITMP) on the excitability of substantia gelatinosa (SG) neurons in the dorsal horn of the spinal cord in a rat model of myocardial ischemia-reperfusion (I/R).Methods Thirty-six adult male Sprague-Dawley rats,weighing 200-300 g,in which intrathecal catheters were successfully placed without complications,were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (group S),group I/R,and group ITMP.Myocardial I/R injury was produced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min reperfusion.In group ITMP,the rats received intrathecal morphine 3 μg/kg (10 μl) by three cycles of 5 min infusions interspersed with 5 min infusion-free periods starting from 30 min before ischemia,and the equal volume of normal saline was given instead of morphine in group I/R.At 10 min of reperfusion,6 rats randomly selected in each group were sacrificed,and the T2-6 segments of the spinal cords were acutely isolated to prepare spinal cord slices.The resting potential,threshold of action potential (APT),peak of action potential (APP) and action potential duration in SG neurons in the dorsal horn of spinal cord slices were determined using the whole-cell patch-clamp technique,and the number of action potentials evoked by currents of 40,60,80 and 100 pA was recorded.At 120 min of reperfusion,6 rats randomly selected in each group were sacrificed,and myocardial specimens were obtained for determination of myocardial infarct size (IS) and area at risk (AAR),and IS/AAR ratio was calculated.The expression of c-fos in the T2-5 dorsal horns of the spinal cords was detected by Western blot.Results Compared with group S,the IS/AAR ratio was significantly increased,the expression of c-fos was up-regulated,the number of action potentials in SG neurons in dorsal horns of spinal cord was increased,APT was decreased,and APP was increased in group I/R (P＜0.05).Compared with group I/R,the IS/AAR ratio was significantly decreased,the expression of c-fos was down-regulated,the number of action potentials in SG neurons in dorsal horns of spinal cord was decreased,APT was increased,and APP was decreased in group ITMP (P＜0.05).Conclusion The mechanism by which ITMP attenuates myocardial I/R injury is related to decrease in the excitability of SG neurons in the dorsal horn of the spinal cord and reduction of responses to nociceptive stimuli in rats.

Objective To investigate the effect of rapid eye movement (REM) sleep deprivation on spatial memory and hippocampal cellular prion protein (PrPC) expression and to explore the underlying mechanism of cognitive impairment induced by sleep deprivation.Methods Adult Sprague-Dawley rats were sorted by weight,randomly divided into three groups:the cage control (CC) group,the tank control (TC) group,and the sleep deprivation (SD) group.Rats were deprived of REM sleep for 72 h using the modified multiple platform method.The Morris water maze task was used to assess hippocampal-dependent spatial memory.After sleep deprivation,the rats were sacrificed and their brain tissue was analyzed for PrPC protein expression via Western blotting.Hippocampal neuron axon elongation was examined as well after lentivector-mediated RNA interference (RNAi) of PrPC in primary cultured rat hippocampal neurons.Results REM sleep deprivation for 72 h resulted in spatial memory impairment.The number of times of rats passing through the platform was decreased significantly in the SD group (3.17 ±0.95) compared with the CC (7.17 ±0.95) and TC (6.50 ±0.62) groups (Z =2.026 6,Z =2.026 6,P ＜0.05),the mean value of proximity to the platform (mm) was greater for rats of the SD group (711.74 ± 33.99) compared to those of theCC (592.32±31.31) andTC (580.86±11.36) groups (Z=-2.001 6,Z=-2.4820,P ＜ 0.05).REM sleep deprivation for 72 h resulted in reduced PrPC level in the hippocampus (0.33 ± 0.10) compared with the CC (1.01 ±0.33) and TC (0.96 ±0.27) groups (Z=2.152 9,Z=2.152 9,P ＜ 0.05).In primary cultured hippocampal neurons,axon elongation(μm) was inhibited 7 days in infected neurons (326.28 ± 12.53) compared with normal (555.00 ±30.43) or negative control (558.70 ±23.10) cells (Z =4.768 4,Z =4.877 0,P ＜ 0.05).Conclusion These findings suggest that PrPC-mediated hippocampal neuron axon elongation inhibition is probably involved in spatial memory impairment induced by sleep deprivation in rats.

Objective To evaluate the advantages and disadvantages of different puncture positions in percutaneous nephrolithotomy. Methods Three hundred fifty-six patients who underwent PCNL were analyzed from March 2012 to October 2015. The passage caliber was 16F-20F. There were 217 cases in prone position and 139 cases in supine position. Results The successful operation in PCNL was 354 cases , while the remaining 2 cases were performed by open surgery. The primary stone clearance rate was 75.5%. The additional PCNLs were performed in 23 cases, and 63 cases of residual calculi were treated by ESWL. 11 patients were treated due to infection or bleeding by the additional PCNLs. There were 3 cases with massive hemorrhage which were treated by Interventional embolization therapy , 12 cases in postoperative fever , no renal resection , no intestinal injury, no deaths. There was no significant difference in stone clearance rate and complication rate between the two groups. Conclusion The puncture position of PCNL can be optional based on the stone size , stone location, degree of hydronephrosis ,and patient′s cardiopulmonary condition individually.