Objective: To summarize the short-term clinical experience of minimally invasive direct cardiac surgery (MIDCS) with right anterolateral thoracotomy incision by closed cardiopulmonary bypass. Methods: A total of 42 patients received MIDCS in our hospital from 2013-09 to 2015-05 were summarized. There were 18 male and 24 female patients including 16 with atrial septal defect (ASD) repair, 4 with ventricular septal defect (VSD) repair, 16 with mitral valve replacement (MVR), 1 with mitral valve plasty (MVP) and 5 with aortic valve replacement (AVR). Direct cardiac surgery was performed by cardiopulmonary bypass through femoral artery-vein and right jugular vein annulations. A right anterolateral thoracotomy incision (length 3-5 cm) was made to enter the chest and complete the operation. Results: All 42 patients received successful operation, no peri-operative or early post-operative death, no incision infection occurred. Cardiopulmonary bypass time was [98-142 (122.4 ± 23.7) min], aortic cross-clamp time [0-118 (48.3 ± 26.2) min]. Post-operative mechanical ventilation time was [8-76 (17.4±13.1) h], intensive care unit stay time [45-124, (54.6 ± 32.6) h], hospital stay time [6-12, (8.2 ± 1.3) d]. Incision length was [3-7, (4.8 ± 1.5) cm], the draining volume at the 1st post-operative day was (356.9 ± 283.8) ml and there were 27 (64.3%) patients without transfusion. Conclusion: The short-term outcomes for MIDCS were good, it with superior safety, broad application range with minimal invasion and less complication.

AIM:To observe the effect of Wnt/β-catenin signaling pathway on diabetic ulcer.METHODS:Diabetic animal model was established in the female Wistar rats by intraperitoneal injection of low-dose streptozotocin fol-lowing high-fat diet feeding.A circular wound was made on the dorsum of the rats in both control group and diabetic group. The condition of wound healing was recorded and the structures of the wound tissues were observed by HE staining in the 2 groups at 3, 7 and 14 d after wounding.The expression ofβ-catenin, GSK-3βand Rspo-3 at mRNA and protein levels in the wound tissues was detected by RT-PCR and ELISA.RESULTS:In diabetic group, the wound healing rate was lower (P<0.05), and the inflammatory cells, fibroblast cells and new capillaries in the wound tissues were fewer than those in control group.The expression of β-catenin and Rspo-3 at mRNA and protein levels in the wound tissues in control group was significantly higher than those in diabetic group, and the expression of GSK-3βwas exactly the opposite (P<0.05). CONCLUSION:The down-regulation of Wnt/β-catenin probably resultes from the decreased level of Rspo-3, which may be one of the reasons for delaying the diabetic ulcer healing.

Objective To design a patient-specific distal femoral cutting guide for total knee arthroplasty using rapid prototyping and 3D printing technology and compare with conventional instrumentation.Methods A prospective self-control study was performed in 32 patients who underwent bilateral total knee arthroplasty between March 2015 and November 2015 in our department.The bilateral knee joints were randomly divided into patient-specific guide group and traditional surgery group.The patient-specific guide group obtained CT data of the lower extremities preoperatively.Patient-specific distal femoral cutting guides were designed and manufactured using rapid prototyping and 3D printing techniques.The traditional surgery group were performed using conventional instrumentation.The operation time of the two groups was recorded,and the amount of distal femoral osteotomy was measured.Postoperative alignments were measured including the angle of the lower limb mechanical axis angle (hipknee-ankle Angle,HKA),the mechanical lateral distal femoral angle (mLDFA),and the mechanical proximal tibial angle (mMPTA).In different follow-up points Hospital for Specific Surgery scores of the knee were recorded.Results In the coronal position,the postoperative mLDFA was 90.34°± 1.6° in the patient-specific guide group and 91.37°± 1.8° in the conventional surgery group.The difference between the two groups was statistically significant (t=-2.452,P=0.020).In the patient-specific guide group,the HKA angle was 0.36°±2.35°,and the conventional surgery group was 0.87°±1.85°.The difference between the two groups was statistically significant (t=-2.332,P=0.043).If preoperative mLDFA≤93°,there was no significant difference in postoperative mLDFA between the two groups (t=-1.409,P ＞ 0.05).If preoperative mLDFA ＞ 93°,there was a significant difference in postoperative mLDFA between the two groups (t=-4.145,P=0.004).In addition,the operation time of the patient-specific guide group was significantly shorter (t=-2.425,P ＜ 0.05),but the two groups did not have significant functional differences in the early postoperative period.Conclusion The 3D-printed patient-specific distal femoral cutting guide can significantly shorten the operation time and improve postoperative alignments.It is simple to operate.However,large sample sizes and long-term follow-up studies are still needed to verify their long-term effects.

OBJECTIVETo make a study of the effect of Chaihu Shihuang soup on blood serum level TNF, IL-6 and IL-10 of severe acute pancratitis.

METHODSixty SAP cases were divided at random into treatment group and control group (30 cases each). The treatment group were given chai-hu-shi-huang-soup once a day; the control group were given Dachaihu soup once daily, with both treatment period for 7 days. The tumor necrosis factor-alpha (TNF-alpha), interleukin level 6 (IL-6) and 10 (IL-10) of both groups were determined before and after the treatment. We also had 30 healthy cases.

RESULTIL-10 level in both groups was lower than healthy group while TNF-alpha and IL-6 were higher than healthy group (P < 0.01). After treatment, the treatment group's TNF-alpha, IL-6 level were comparatively lower than that in the control group (P < 0.01), and IL-10 level were clearly higher than that of the control group (P < 0.01), comparison of the treatment group before treatment (P < 0.01).

CONCLUSIONChaihu Shihuang soup can significantly regulate cytokine and improve early recovery of SAP.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; blood ; drug therapy ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo make a study of the influence of the intervene of traditional Chinese medicine on cytokine level in benign prostatic hyperplasia.

METHODThe patients were divided into treatment group (group A), control group (group B) and healthy group (group C) with the randomly compared researching method. Group A were given Qianliening Tang (QLNT), daily potion, two times a day. Group B were given Qianliekang, three times a day, three pills each time. The course of both treatment lasted for 8 weeks.

RESULTBefore treatment, TNF-alpha, IL-17/IL-10, IL-4 in group A and B are obviously out of order compared with group C (P < 0.01). After the treatment, TNF-alpha, IL-17 in group A decreased dramatically and IL-10, IL-4 increased, which shows great differences compared with those before treatment and with group B (P < 0.01), but still can't reach to group C level.

CONCLUSIONQian liening Tang can efficiently regulate the level of suppressive inflammatory cytokines and proinflammatory cytokines. It provides scientific experimental basis for clinical diagnosis and treatment of the disease.

Adjuvants, Immunologic ; Aged ; Aged, 80 and over ; Cytokines ; blood ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-17 ; blood ; Interleukin-4 ; blood ; Leukocytes, Mononuclear ; drug effects ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; Prostatic Hyperplasia ; blood ; drug therapy ; RNA, Messenger ; Synovial Membrane ; drug effects ; Tumor Necrosis Factor-alpha ; blood

Bacterial ghost is intact envelope of Gram-negative bacteria, which is produced by the function of the lysis gene E from bacteriophage PhiX174. The expression of the lysis gene E is usually controlled by the thermosensitive lambdapL/pR-cI857 promoter. In this study, we described a mutation (T --> C) at the ninth nucleotide of the OR2 in the lambdapR promoter of the lambdapL/pR-cI857 system by overlap PCR. The bacteriolytic assay showed that the mutation in the lambdapL/pR-cI857 system enhanced the temperature of repressing the expression of gene E up to 37 degrees C. The lysis efficiency of altered lambdapR promoter in Escherichia coli DH5a and avian pathogenic E. coli DE17 was up to 99.9%. The expanded range of temperature will benefit for the production of bacterial ghost.
Bacteriolysis ; physiology ; Bacteriophage lambda ; genetics ; Base Sequence ; Cell Membrane ; physiology ; DNA, Bacterial ; analysis ; Escherichia coli ; genetics ; growth & development ; physiology ; virology ; Gene Expression Regulation ; genetics ; Molecular Sequence Data ; Mutation ; Promoter Regions, Genetic ; genetics ; Viral Proteins ; genetics ; metabolism

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.