0.05). There were 7 cased in the polypropylene mesh group had abdominal discomfort due to stiffness, which higher than that of the expanded polytetrafluroethylene patch and control groups (P 0.05). CONCLUSION: Both prosthetic patches are safe and effective when used in the repair of inguinal hernia in aged patients with low recurrence rate, especially, the expanded polytetrafluroethylene patch, which is more comfortable than polypropylene mesh.

Objective To study the effect of erythropoietin on cardiac function of the patients with acute mycardial infarction (AMI). Methods 48 patients with AMI successfully treated with thrombolytic therapy were randomized into two group,2000 units of recombinant human erytfu-opoietin(rh-EPO) were administrated once a time in therapeutic group,3 times on alternate days in one week and total for 4 weeks. The peak value of serum creatine kinase(CK) and creatinkinase isozyme MB (CK-MB)were measured, myocardial infarct size (S) was estimated by Hindmen's QRS scoring system, and the diameter of left ventricular end diastolic(LVEDd) and left ventricular injection fraction (LVEF) were determined with echocardiography at the 4th weekend in both groups. Results CK, CKMB and S in therapeutic group were lower than in control group (P < 0.05). LVEDd and LVEF were also improved in the therapeutic group. Conclusion rh-EPO can significantly lessen the size of isehemia and infarct myocardium, mitigate the infarction degree and improve the cardiac function slightly in AMI patients.

Objective To evaluate regenerative nerve and functional recovery of target muscle in rats with sciatic nerve defect bridged by acellular nerve allograft made through chemical extraction.Methods Sciatic nerve of SD rats was processed in a volume fraction of 3％ Triton X-lO0 solution and 40 g/L sodium deoxycholate solution.Morphology of myelin sheath,axons and basal lamina tubes of sciatic nerve segments was observed under the light microscopy before and after the chemical processing.Twenty-five Wistar rats were divided into acellular nerve allograft group (n =10),autograft group (n =10) and normal control group(n =5) according to the random number table.A 1 cm sciatic nerve defect was created in acellular nerve allograft group and autograft group,and was respectively bridged by acellular nerve allograft and autograft.Sciatic nerve function index (SFI) was measured every two weeks.Twelve weeks after surgery,nerve conduction velocity (NCV),recovery rate of compound muscle action potential (CMAP) and recovery rate of muscle force were measured in each group.Results Cellular components including myelin sheath and axons were removed thoroughly,but the basal lamina tubes were preserved completely.At postoperative 2,4,6,8,10 and 12 weeks,SFI in normal control group (-1.7±5.9,-0.3 ±2.5,0.8 ±4.1,-1.4±3.6,-2.5 ±5.7 and-2.1±3.2) was superior over autograft group (-94.3±3.7,-90.1±4.1,-63.7±7.8,-51.9±8.2,-48.8±8.6 and -44.3 ± 10.5) and acellular nerve allograft group (-97.1 ± 5.3,-91.2 ± 6.1,-70.6 ± 5.5,-60.4±6.2,-58.2 ±10.2 and-56.4 ±8.0) (P ＜0.01).At postoperative 6,8,10 and 12 weeks,SFI in autograft group were better than those in acellular nerve allograft group (P ＜0.05).NCV [(61.6 ± 8.1) m/s],recovery rate of CMAP[(98.7 ± 5.9) ％] and recovery rate of muscle force [(101.8 ± 6.6) ％] in normal control group were higher than those in acellular nerve allograft group [(22.3 ± 4.7) m/s,(40.3 ± 9.2) ％ and (43.8 ± 9.3) ％] and those in autograft group [(29.0 ±5.5) m/s,(52.5 ± 10.6) ％ and (54.3 ± 10.5) ％] (P ＜ 0.01).NCV,recovery rate of CMAP and recovery rate of muscle force in autograft group were better than those in acellular nerve allograft group (P ＜ 0.05).Conclusions Acellular nerve segments are harvested satisfactorily by chemical extraction.Sciatic nerve defect in rats can be cured with the acellular nerve allograft,but the repair effect of autograft is relatively better.

Objective To evaluate the pattern of lateral cervical metastases and to investigate the risk factors for lateral cervical lymph node metastases in paoiuary thyroid carcinoma patients with clinical negative lateral neck lymph node.Methods 73 patients with paoiuary thyroid carcinoma who underwent prophylactic lateral neck dissections(level Ⅱ-Ⅵ or level Ⅱ-ⅣandⅥ) were reviewed retrospectively on their medical records paoiuary thyroid carcinoma.None of patients in this study had a clinically positive lymph node.Neck dissection specimens were obtained for histological analysis for node metastasis with respect to the individual neck levels.Results Occult metastases in lateral neck were observed in 12(16.4 ％)patients.9.6 ％,0,13.6 ％,9.6 ％,0,4.8 ％ and 42.4 ％ patients had histologically positive lymph nodes in levels Ⅱa,Ⅱb,Ⅲ,Ⅳ,Va,Vband Ⅵ respectively.In multivariate analysis,lymphatic metastases in level Ⅵ was associated with lateral neck metastasis(OR=7.3,P=0.020)in cN0 patients with paoiuary thyroid carcinoma.Conclusion Levels Ⅲ,Ⅱa and Ⅳwere the most common stages showing occult lymph node metastases.Prophylactic lateral neck dissections may be omitted in the treatment of cN0 PTC patients ff level Ⅵ lymphatic metastases are not found on histological exam.

Objective To study the values of neck dissection for thyroid carcinoma who received nonstandard operation and help to choose good re-operation methods. Methods Retrospective investigation was carried out in 38 cases of neck dissection for thyroid carcinoma patients who received nonstandard operation during 1997 to 2005, and 32 cases were treated with neck dissection. Results Pathological results confirmed there were 73.68 % with residual tumor, positive rate of thyroid was 47.38 %, and that cervical lymph node was 57.89 %. Conclusion The residual rate of cervical lymph nodes of reoperated patients with thyroid carcinoma was relatively higher, so neck dissection for thyroid carcinoma who received nonstandard operation was necessary.

Objective To evaluate if Ⅵ region lymph nodes metastasis status can be a reliable indicator in prediction of lateral lymph nodes metastasis in papillary thyroid carcinoma (PTC) with negative cervical lymph nodes (cN0).Methods Retrospectively reviewed the medical records from January 2003 to October 2011 of 73 patients with PTC who underwent prophylactic lateral neck dissection (Ⅱ-Ⅴ region or Ⅱ-Ⅳ region).The relationship between cervical lymph nodes metastasis and lateral lymph nodes metastasis was assessed.Results The rate of lateral lymph nodes metastasis was 16.4％(12/73).The rate of Ⅵ region lymph nodes metastasis was 42.5％(31/73).Multivariate analysis showed that Ⅵ region lymph nodes metastasis was the risk factor of lateral lymph nodes metastasis in cN0 patients with PTC(OR =7.3,P=0.020).Conclusion Ⅵ region lymph nodes metastasis status can be a reliable indicator of lateral lymph nodes metastasis in cN0 patients with PTC.

Objective To explore the diagnostic value of the combined detection of serum Dickkopf-1 (DKK1 )and EB viral capsid antigen immunoglobulin A (VCA-IgA)in patients with nasopharyngeal carcinoma (NPC).Methods Serum levels of DKK1 and VCA-IgA were measured by enzyme-linked immunosorbent assay (ELISA)for the 80 patients with NPC and 65 normal controls.Receiver operating characteristic (ROC) curve was used to calculate the diagnostic value.Results The serum levels [M(QR )]of DKK1 in patients with NPC were significantly higher than those in normal controls [580.773 (429.1 46 )pg/ml vs.31 6.1 74 (252.965)pg/ml],with a significant difference (Z=4.846,P<0.000 1 ).ROC curves showed that the opti-mum diagnostic cutoff for serum DKK1 was 611.981 pg/ml,with an area under curve (AUC)of 0.734 (95%CI:0.654-0.81 5,50.0% sensitivity,96.9% specificity).Measurement of VCA-IgA demonstrated an AUC of 0.71 4 (95%CI:0.631-0.798,47.5% sensitivity,95.4% specificity).The combined detection of DKK1 and VCA-IgA demonstrated an AUC of 0.849 (95%CI:0.783-0.91 4,76.3%sensitivity,95.4%spe-cificity).For patients with early-stage NPC,the detection effect of combined detection of DKK1 and VCA-IgA was much better than that in normal controls,with a significant difference (χ2 =23.784,P <0.001 ). Conclusion Serum DKK1 has potential diagnostic value for NPC.Combined detection of DKK1 and VCA-IgA may aid the early diagnosis of NPC.

Objective To compare the treatment outcome of underwent surgery plus radiotherapy and radiotherapy/chemoradiotherapy plus salvage surgery for stage Ⅲ/Ⅳ laryngeal carcinoma,to investigate an optimized treatment for the patients of stage Ⅲ/Ⅳ laryngeal carcinoma.Methods Clinical data from 103 patients with stage Ⅲ (39 cases) or stage Ⅳ (64 cases) laryngeal carcinoma were retrospectively analyzed.The patients were divided into surgery plus radiotherapy group (S±R,46 cases) and radiotherapy/chemoradiotherapy plus salvage surgery group (R±S,57 cases).Overall survival,relapse free survival,and laryngeal preservation rate were used to compare the treatment outcome between two groups.Multivariate regression models were used to analyze the independent factors for survival and laryngeal preservation rate.Results Survival rate was higher in S±R group than in R±S group [2 year overall survival/relapse free survival 74.7 ％ (34/46) / 72.4 ％ (33/46) vs 46.4 ％ (26/57) / 40.9 ％ (23/57),P ＜ 0.05].Laryngeal preservation rate was higher in R±S group than in S±R group [93.0 ％ (15/46) vs 32.6 ％ (53/57),P ＜ 0.05].Multivariate analysis demonstrated that treatment modality and T stage were independent factors for long-term survival,while treatment modality was the only an independent factor for laryngeal preservation rate.Conclusions Surgery plus radiotherapy result in better survival and lower laryngeal preservation rate than radiotherapy/chemoradiotherapy plus salvage surgery in treatment of stage Ⅲ/Ⅳ laryngeal carcinoma.Surgery plus radiotherapy should be the first choice for treatment of locally advanced laryngeal carcinoma.Improvement of the quality of life could be achieved by laryngeal preservation surgery and phonation reconstruction procedures.

AIM: To prepare m 1AChR-G 11 and m 4AChR-G 16 fusion protein in Baculovirus-Sf9 cell system and detect the effects of various muscarinic ligands on the interaction between m 1AChR and G 11 and m 4AChR and G 16 ,and screen different kinds of ligands specific for m 1 and m 4. METHODS: To prepare fused DNA of m 1AChR-G 11 and m 4AChR-G 16 in two PCR, then expressed in Sf9 cells and detect the pharmacological function of m 1AChR-G 11 fusion protein and m 4AChR-G 16 fusion protein by [ 3H]QNB and [ 35 S]GTP?S binding experiments; To expore the way of the activation of m 1AChR-G 11 and m 4AChR-G 16 fusion protein by various ligands includingcetylcholine (ACh), Pilocarpine (Pilo), 4-hydroxy-2-butynyl-1-trimethylammonium-m-chloro-carbanilatechloride (McN-A-343),tetrandrine, pirenzepine (PZ), alcuronium, atropine,R-(+)-hyoscyamine and gallamine by displacement by GDP on [ 35 S]GTP?S binding experiments. RESULTS: The expression levels of m 1AChR-G 11 and m 4AChR-G 16 fusion protein were (45 39?2 62) nmol?g -1 protein, (47 04?1 58) nmol?g -1 protein. The affinity of GDP to G 11 and G 16 partner changed in the presence of different muscarinic ligands. CONCLUSION: The m 1AChR-G 11 and m 4AChR-G 16 showed the pharmacological specificity to m 1 and m 4 receptor and the efficient signaling of the two partners. Ligands of m 1AChR and m 4AchR mediated different signal transduction by changing the affinity of G 11 /G 16 and GDP. So m1AChR-G 11 fusion protein and m 4AChR-G 16 fusion protein can be taken as a tool to screen ligands specific for m 1AChR and m 4AChR.

Aim To investigate the effects of mmLDL on the up-regulation ofα1 receptors in moues mesenter-
ic arteries. Methods Mice tail intravenous injection of mmLDL was used . Vitro sensitive myograph was empl-
oyed to examine Noradrenaline ( NA) induced vascular contraction on mice mesenteric artery, and the mRNA and protein expressions ofα1 andα2 receptors were an-alyzed by real-time PCR and Western blot, respective-ly. Results mmLDL significantly increased NA in-duced concentration-contractile curve, and the data of Emax and pEC50 were from ( 122. 61 ± 9. 40 )% and (5. 65 ± 0. 05 ) in normal saline ( NS ) group to (161. 01 ± 6. 90 )% and ( 6. 20 ± 0. 08 ) in mmLDL group (P <0. 01, P <0. 01), respectively. The α1 adrenoceptor antagonist prazosin shifted the concentra-
tion-contractile curve induced by NA towards right. Af-ter using mmLDL, the mRNA and protein levels of α1 adrenoceptor were significantly increased, but the mR-NA and protein levels of α2 adrenoceptor were not changed. Conclusion Tail intravenous injection of mmLDL enhances the vascular expressions of α1 adre-noceptors and the contractile effects mediated byα1 ad-renoceptors.