To solve the problems of induction of anesthesia in patients with extreme trachea occulusion, femoral-femoral cardiopulmonary bypass (FFCPB) was used in 9 patients with nearly total tracheal obstruction prior to induction of anesthesia. After FFCPB was set up under local anesthesia, general anesthesia and surgery began soon. The results showed the patients were quiet and co-operative 3 to 5 mins following FFCPB with the disappearance of tissue hypoxia syndrome and attenuation of hypertension and taehycardia. During FFCPB PaO_2 increased from 7.6～9.8 to 16～40kPa, PaCO_2 decreased from 7.4～8.2 to 4.5～5.9 kPa, SaO_2 increased from 71.6～79.9 to 98.0～99.9%, urine volume, blood pressure and heart rate were maintained at satisfactory levels. The results indicate that FFCPB prior to induction of anesthesia is a rapid, safe and effective method in rescuing patients with nearly complete obstruction of the main trachea.

Objective To investigate the advantages of treating pediatric indirect inguinal hernia by laparoscopic high ligation of hernia.Methods Two hundred and forty-four pediatric indirect inguinal hernia cases were admitted from August 2012 to May 2014,and were divided into conventional surgery group and laparoscopic surgery group according to the operation methods,with 122 cases in each group.The differences between the two groups regarding operation time,bleeding volume,postoperative pain,surgical scars,complications and recurrence were compared.Results Contralateral recessive hernia was observed in 52 cases (46.4％) of laparoscopic surgery group.The differences in operation time [unilateral hernia:(16.1 ± 5.3) min vs (14.3 ±4.4) min],[bilateral hernia:(29.2 ± 6.4) min vs (31.4 ± 5.2) min],bleeding volume [(2.2 ± 1.1) mL vs (2.9 ± 1.4) mL],surgical scars and recurrence between the two groups were not statistically significant,and no scrotal hematoma and latrogenic cryptorchidism were observed in both groups.But the differences regarding post-operative pain,time to ambulation,scrotal swelling were statistically significant (P ＜ 0.05).Conclusions Laparoscopic surgery showed advantages in small operation wound,rapid recover,less complications and possibility of exploration of contralateral processus vaginalis,so it is much more secure and reliable.

ObjectiveTo construct and identify a DNA vaccine of Schistosoma japonicum (Chinese strain) thioredoxin. MethodsAccording to a cDNA sequence of S.japonicum (Philippine strain) thioredoxin, a couple of primers was designed with the BamH I restriction endonuclease site introduced in forward primer with ATG as start condon and EcoR I in reverse primer with TCA as termination codon. The gene encoding S.japonicum (Chinese strain) thioredoxin (SjcTrx) was amplified by RT-PCR using total RNA of schistosome as the template. The PCR products and the pcDNA3 plasmids were digested by restriction endonucleases BamH I and EcoR I. The target DNA fragment were purified and cloned properly into the eukaryotic expression vector of pcDNA3. The recombinant plasmids were then transformed into competent E.coli JM109 and identified by endonucleases digestion, PCR, agarose gel electrophoresis and sequencing. ResultsThe RT-PCR product was around 334 bp judged by agarose gel electrophoresis. The same fragments were obtained by restriction enzyme digestion from the recombinant plasmid and PCR with the plasmid DNA as a template. The recombinant plasmid, designated pcDNA3-SjcTrx, was sequenced and shown to be 97% and 43% identical in deduced amino acid sequences to that of S.japonicum (Philippine strain) and S.mansoni thioredoxin, respectively. ConclusionThe S.japonicum thioredoxin DNA vaccine had been constructed successfully, and further studies will be made in different animal models for its immunogenicity.

Obstract: Objective To study the effect of Guyanding Decoction(GYD) on the metabolism of oxygen-derived free radicals in the chicken model of knee osteoarthritis and to explore its therapeutic mechanism.Method Forty chickens were randomized into 5 groups: normal group,model group,low-dose GYD group,high-dose GYD group and Fenbid group.Low-dose group was administered 5 g/kg GYD and high-dose group with 10 g/kg GYD by gastric gavage.Fenbid group was given Fenbid 0.15 g/kg.The SOD activity and the MAD content in serum were detected in each group.Result The activity of SOD in model group was significantly lower than that in normal group(P 0.05).For the content of MDA,model group had a higher level than normal group(P 0.05).Conclusion The decoction of GYD exerts curative effect on experimental osteoarthritis by improving the activity of SOD,eliminating excessive oxygen-derived free radicals,decreasing the content of MDA,and preventing osteoarthritis patients from the injury of oxygen-derived free radicals.

Objective To investigate the diagnosis and treatment of mutinous cystadenoma of the pancreas.Method The clinical data of 12 cases with pancreatic mutinous cystadenoma was confirmed by pathology from May 2000 to May 2009 was retrospectively analysed.Results The accuracy rates of ultrasound,CT and MRCP were 50.0%(5/10),66.7%(6/9)and 83.3%(5/6)respectively.Pancreaticoduodenectomy,duodenum-preserving pancreatic head resection,distal pancreatic resection,distal pancreaticresection and splenectomy,segment pancreatic resection were performed according to the site of tumors.Completed resectable rate was 91.7%(11/12),palliative resection in 1 case,postoperative pancreatic leakage in 3 cases.2 cases cured;1 case died of intra-abdominal infection caused by pancake fistula 1 month later;1 case died of tumor recurrence and metastasis 25 months later.Conclusions Pancreatic cystic neoplasms is lack of specific clinical manifestations.Combined with application of imaging methods,can improve the diagnosis rate.Operation is the most effective therapy.The feasible procedures for mucinous cystadenoma of the pancmas should be choiced according to the site of tumors.

Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.

Objective To evaluate the efficacy of circinal stapled suture and manual suture in cervical esophagogastric anastomosis in esophageal resection.Methods The clinical data of 187 patients with esophageal cancer who were admitted to the Cancer Hospital of Sichuan Province from January 2010 to January 2012 were retrospectively analyzed.All the patients were divided into the stapled suture group (98 patients) and manual suture group (89 patients).The time of anastomosis,operation time,time for dieting,duration of hospital stay,the incidence of postoperative complications and positive rate of esophageal remnant cancer cells of the 2 groups were compared.All data were analyzed using the t test or chi-square test.Results The time of anastomosis,operation time,time for dieting and duration of hospital stay were (7.8 ± 1.4) minutes,(227 ± 60) minutes,(6.3 ± 0.9) days and (14 ±4)days in the stapled suture group,which were significantly shorter than (28.5 ±2.3)minutes,(301 ±81)minutes,(8.4 ± 1.0)days and (22 ±9) days in the manual suture group (t =75.44,7.14,7.71,7.41,P ＜0.05).The incidence of anastomotic fistula was 1％ (1/98) in the stapled suture group,which was significantly lower than 8％ (7/89) of the manual suture group (P ＜ 0.05).The incidence of anastomotic stricture was 5％(5/98) in the stapled suture group,which was lower than 7％ (6/89) in the manual suture group,but no significant difference was detected (P ＞0.05).The positive rate of esophageal remnant cancer cells was 0(0/98),which was signifiantly lower than 4％ (4/89) in the manual suture group (P ＜0.05).Conclusion Circinal stapled suture in esophagogastric cervical anastomosis not only reduce the time of anastomosis,operation time and duration of hospital stay,but also decrease the incidence of anastomotic fistula and the positive rate of esophageal remnant cancer cells.

Objective To assess the prognostic value of progesterone receptor (PR) in Luminal B HER2(-) lymph-node-negative breast cancer.Methods The clinical data of 196 Luminal B HER2 (-) lymph-node-negative breast cancer patients were collected in this study.The correlation between PR and clinicopathological factors and its influence on prognosis was analyzed.Results Among 196 patients with Luminal B HER2 (-) lymph-node-negative breast cancer,14.8％(29/196)were PR-negative and 85.2％(167/196)were PR-positive (HR=3.25,95.0％ CI:0.73-1.45,P=0.123).PR negativity indicated postmenopausal status (P=0.029) and high tumor grade (P=0.001).Mter a median follow-up of 60 months,9.7％(19/196) of the patients had relapses and 4.1％(8/196) died of breast cancer.The 5-year disease-free survival(DFS) was 75.9％ in PR-negative group and 92.8％ in PR-positive group (Log-rank P=0.001).The 5-year overall survival (OS) was 89.7％ in PR-negative group and 97.0％ in PR-positive group (Log-rank P=0.023).In multivariate analysis,PR negativity was significantly associated with a poor 5-year DFS (HR=2.85,95.0％ CI:1.05-7.72,P=0.039)but not with 5-year OS (HR=1.78,95.0％ CI:0.34-9.35,P=0.495).Conclusion In this study,PR is a prognostic factor for relapse in Luminal B HER (-) lymph-node-negative breast cancer.

【Objective】To observe the effect of Guyanding(GYD)decoction,a prescription with the actions of tonifying kidney,strengthening Qi and activating blood on proliferation of vascular endothelial cells(VEC).【Methods】New Zealand rabbits were randomized into blank control groups and GYD decoction groups in the dosages of 2.5,5 and 10g/kg respectively.GYD in the dosage of 10g/kg was given to rats for 7 successive days,and blood sampling was collected 0.5,1,1.5,2,2.5,3,3.5 and 4 hours after the last administration to prepare serum containing GYD.Then human umbilical vein endothelial cells were cultured with serum containing GYD,and the effects of GYD-containing serum at different time points on the proliferation of VEC were observed by methylthiazolyltetrazolium(MTT)assay.GYDcontaining serum collected 2h after the last administration was partially inactivated and its effect on VEC proliferation was compared with that of non-inactivated GYD-containing serum.Meanwhile,the effect of non-inactivated GYD-containing serum on VEC proliferation was observed 12,24 and 36 hours after the culturing.GYD in three different dosages was given to rats for 7 successive days,and serum containing GYD collected 2h after the last administration was prepared to observe the effect of GYD in different doses on VEC proliferation.【Results】Serum containing high-dose GYD collected 0.5～4h after the administration had obvious effect in promoting VEC proliferation(P

OBJECTIVE: To explore the value of computer-aided design/computeraided manufacturing (CAD/CAM) technology for individual reconstruction of the thyroid cartilage defects. METHOD: Select the 20 New Zealand white rabbits (male or female). Randomly divided into two groups. Group A in the pre-operative CT scan of the throat, three-dimensional reconstruction of the thyroid cartilage imaging, surgical removal of either side of the thyroid cartilage, defect implanted in the use of CAD/CAM technology and mirror technology to produce personalized restorative materials; Group B surgical resection either side of the thyroid cartilage, defect implanted production of non-personalized probably according to the experimental animals unilateral thyroid cartilage repair materials. After surgery by gross observation, electronic laryngoscopy observed experimental animals throat. RESULT: General check and electronic laryngoscopy show: the use of CAD/CAM technology to prepare the individual repair materials throat plays better supporting role than the non personalized materials. CONCLUSION CAD/CAM technology before surgery designed to provide a personalized solid model to improve the accuracy of the surgery, time saving surgery to reduce surgical complications.
Animals ; Computer-Aided Design ; Female ; Image Processing, Computer-Assisted ; Male ; Prostheses and Implants ; Rabbits ; Reconstructive Surgical Procedures ; Thyroid Cartilage ; surgery ; Tomography, X-Ray Computed