Objective To investigate the technical success rate of operation,safety,efficacy and clinical value of super-selec-tive uterine arterial embolization(SSUAE)in the treatment of massive postpartum hemorrhage.Methods The clinical data of 65 patients with massive postpartum hemorrhage who were not cured by medical treatment were retrospectively analyzed.Forty-one patients who underwent successful SSUAE were set as research team (group A)and 24 patients who underwent hysterectomy were set as control group (group B).The indications,success rate of hemostasis,bleeding volume and postoperative complications were compared.Results In group A,1 1 patients were in a critical condition and couldn′t tolerate the hysterectomy (26.8%),success rate of hemostasis was 95.1% (39/41 ),and 2 patients who with a poor outcome of embolization underwent hysterectomy after SSUAE (4.9%).In group B,the success rate of hemostasis was 95.8% (23/24),there was no statistical significance of hemostasis success rate between the two groups (P >0.05).There was significant statistical significance between the two groups in average operation time and bleeding volume in surgery,which were 33.8 min and 61.5 min,2 1 55.5 mL and 3 21 5.7 mL respectively(P <0.01).No postoperative complications occurred in group A,but 3 postoperative complications occurred in group B,which had signif-icant statistical significance (P <0.01).Conclusion SSUAE performed its excellent advantages,such as wide indications,minimal trauma,high success rate of hemostasis,low complications and reach the purpose of reserving uterus.

Objective To compare the survival of isolated chromaffin cells with that of adrenal medullary pieces implanted into the subarachnoid space .Methods Forty male Sprague Dawley rats, 180 220g, were randomly allocated to be implanted into the subarachnoid space with the homologous adrenal medullary pieces washed with PBS(group A,n=20) or the isolated chromaffin cells 5?107 in 10?l suspension (group B,n=20), respectively, after the implants were in vitro cultured in three days . The thermal threshold was determined before ,5 and 10 weeks after the transplantation. Five or ten weeks after the transplantation, 6 rats of either group were randomly selected to obtain the adrenal medullary grafts from the subarachnoid space or the sediments of cerebrospinal fluid ,observed with an electron microscopy.Results Five weeks after transplantation, the thermal threshold in both groups increased markedly,but without significant difference between them ,and there were intact chromaffin cells in the sections of both groups. Ten weeks after the operation, the thermal threshold in group A decreased to basaline, and was significantly lower than in group B; no intact chromaffin cells were found ,with the infiltration of a large number lymphocytes in the sections of group A , and in the sections of group B, the intact chromaffin cells were found with the infiltration of lymphocytes in lower amount and density. Conclusions The isolated chromaffin cells implantation is superior to the adrenal medulla pieces implantation for analgesia.

Objective To investigate the changes in small-diameter sensory neuron (SNS)/ peripheral nerve type 3(PN3) Na+ channel transcript and in tetrodotoxin-resistant (TTX-R) Na+ current in dorsal root ganglion (DRG) neurons in a chronic constriction injury (CCI) model of neuropathic pain. Methods Eighteen rats were divided into 6 groups of 3 animals each. Chronic constriction injury model was established after Dib-Hajj et al. Pain threshold was significantly lowered after CCI as compared with that in control group. The animals were deeply anesthetized and rapidly decapitated 14 days after surgery. The L4-5 DRG of the operated side was removed and crushed and total RNA was extracted with trizol reagent. The DRG of the contralateral side was used as control. The change in SNS/PN3 Na + channel expression was determined by semi-reverse transcriptase-PCR. The DRG neurons were isolated enzymatically and the change in voltage-gated TTX-R Na+ current was recorded using whole-cell patch clamp technique. Results Sensory neuron specific TTX-R Na+ channel transcript SNS/PN3 was down-regulated by 60% 14 days after CCI as compared with that in control group. TTX-R Na+ current density was significantly reduced but its activation and steady state inactivation were unchanged. Conclusions Na+ channel SNS/PN3 is involved in the hyperextability of the primary sensory neurons after CCI.

BACKGROUND: Based on previous technique prepared for encapsulating living cells with alginate-polysine- alginate (APA) microcapsules, it has been confirmed that microencapsulated chromaffin cells have good analgesic effects. The immunoisolated effects of such microcapsule materials need to be evaluated. OBJECTIVE: This study aimed to investigate the immunological rejections of APA microencapsulated chromaffin cells transplanted into rat anterior chamber of eyes and tendon of feet, and to evaluate the immunoisolated effect of microencapsulation.DESIGN: A randomized controlled animal experiment. SETTING: Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Forty-eight female SD rats, with the age of 3 months, were provided by the Laboratory Animal Center, Tongji Medical College, Huazhong University of Science and Technology. The protocol was carried out in accordance with ethical guidelines for the use and care of animals. Alginate and polylysine used in the experiment were the products of Sigma Company, USA. Microcapsule generator was gifted by Germany. METHODS: This study was performed at the Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from September 2002 to September 2003. Suprarenal medulla was taken from 6 healthy adult cadavers of brain death. After isolated, digested and cultured, suprarenal medulla was prepared into chromaffin cell suspension. Written informed consents were obtained from the family members of donors, and the protocol was given approval by the Ethics Committee of the hospital. Empty microcapsules and microencapsulated cells were prepared by APA. The 48 rats were randomly divided into the human chromaffin cell (HCC) group, the empty microcapsule group and the microencapsulated HCC (ME-HCC) group. In each group, there were two transplanted regions of anterior chamber of eyes and tendon of feet, with 8 rats used for each region. Each rat in the HCC group was perfused 2×1010 L-1 cell suspension into the anterior chamber of eyes and tendon of feet. Those in the empty microcapsule group and the ME-HCC group were perfused 100 empty capsules and ME-HCCs (100 microcapsules, 400-500 HCCs per microcapsule) into the same regions, respectively. MAIN OUTCOME MEASURES: On day 7 after transplantation, serum interleukin (IL)-2 level was determined by ELISA. Serum IgG and IgM levels were determined with a laser turbidimeter. On day 28 after transplantation, rat right eyeball and left feet were harvested, routinely sliced and stained by haematoxylin-eosin (HE). Histo-morphological structure was observed under a 40×light microscope. RESULTS: Forty-eight rats were included in the final analysis. Serum IL-2, IgG and IgM levels were significantly lower in the empty microcapsule group and ME-HCC group than in the HCC group (t=8.544-21.64, P < 0.01). A lot of lymphocyte and neutrophile infiltration could be found in the anterior chamber of eyes and tendon of feet of rats in the HCC group, but a little seen in that of the empty microcapsule group and ME-HCC group. CONCLUSION: APA microencapsulation has an effective immunoisolated effect on immunological rejection due to its good biocompatibility and mechanical stability.

Objective To discuss the operational technique and clinical effect of metallic stent placement in treating malignant gastroduodenal obstruction.Methods Metallic stent placement under fluoroscopic monitoring and endoscopic direct vision was performed in 47 patients with malignant gastroduodenal obstruction.A total of 54 metallic stents was used.Results The procedure was successfully completed in all 47 patients.During the follow-up period,all the patients could take liquid or ordinary diet and were markedly relived of vomiting.The living quality was much improved and no serious complications occurred.Conclusion Under fluoroscopic monitoring and endoscopic direct vision,stent placement is a safe,effective,technically-simple and time-saving procedure for the treatment of malignant gastroduodenal obstruction with less sufferings to the patient.Therefore,it is definitely worth popularizing this technique in clinical practice.

ObjectiveTo study the effects of dexamethasone local injection as an adjunctive therapy for Hashimoto thyroiditis (HT). Methods60 HT cases were equally divided into 2 groups at random. The patients in the control group were given euthyrpx while the patients in the treated group were injected dexamethasone in addition to the medicine used in the control group. The thyroid characters such as thickness, lymphocytic infiltration and changes of thyroid follicle were observed. The patients were followed up before treatment and 4, 12, 24weeks and 1 year after treatment. ResultsIn the treatment group, all thyroid glands turned significantly softer,and the mass became smaller compared with that in the control group. The pathology of thyroids indicated that lymphocytic infiltration decreased, local immune reaction was ameliorated, and no obvious hormone side effects were observed. ConclusionLocal use of dexamethasone can modify the structure and function of thyroid.

Objective:To investigate the efficacy and characteristics of subarachnoid xenogenetic adrenal medullary transplants on neuropathic pain. Method: Eighty rats were assigned to 4 different groups before their right sciatic nerves were tied according to the method described by Bennet. Each rat received subarachnoidly xenogenetic medullary pieces or isolated chromaffin cells according to the groups. The basal pain thresholds to thermal and electrical stimuli were determined before nerve ligations,and the analgesiometric tests were repeated at weekly intervals following transplantation for 10 weeks. Behavioral indications of spontaneous pain were recorded concomitantly. The effects of naloxone, phentolamine and fentanyl on the antinociception of chromaffin cells were evaluated. Result:The pain thresholds to noxious thermal and electrical stimuli increased after transplantation of medullary pieces or isolated chromaffin cells subarachnoidly. The Behavioral indications of spontaneous pain and hyperalgesia to thermal and electrial were also eliminated after the transplantation. These antinociceptive effects can be reversed by naloxone and phentolamine. Conclusion:Transplanting xenogenetic chromaffin cells into subarachnoid space can reduce neuropathic pain effectively,and this antinociception is conducted via adrenoreceptors and opiate receptors.

Objective To investigate the reaction kinetics between the stone-dissolving solution and the urinary stone in a model simulating the condition of a kidney for further clinical administration. Methods An artificial upper urinary tract was made by silica gel. Lactic acid prepared in the preliminary study was used to react with artificial stone in the model. The concentration of reaction product in the effluent was measured to identify the reaction velocity. Relationships between the efficiency and dissolution rate or stone surface was investigated. Results The highest utilization rate of dissolution was 100 ~ 150 mL/h. Dissolution efficiency is in positive rela-tion with stone surface. The efficiency correlates with the stone surface and infusion speed in the range of 50~400 mL/h. Conclusions Before dissolution treatment ,the stone should be shattered as deeply as possible to in-crease the surface of reaction. If possible ,the irrigating speed should be as high as possible to eliminate the stone sooner.

Objective To investigate the clinical effectiveness of chemoablation for the treatment of lumbar disc herniations (LDH) to provide reference for its clinical treatment .Methods A total of 191 cases of LDH were divided into the group A and B . All cases were performed the CT-guided chemoablation for treating LDH .The group A conducted the intra-disc injection treatment , while the group B conducted the intra-disc and extra-disc combined injection .The cases were followed up by the modes of outpatient department or telephone on postoperative 30 ,90 ,180 d .The follow up and statistical analysis were conducted by referring to the Macnab effect evaluation criteria .Results The two groups conducted the outpatient department follow up or telephone follow up on postoperative 30 ,90 ,180 d .All cases did not appear the complications such as nerve damage ,spinal cord damage and intervertebral disc infection .In the intra-group comparison ,the VAS score had statistical difference between before and after treatment ( P<0 .05) .In the inter-group comparison ,the score after treatment in the group B was lower than that in the group A (P<0 .05) .The good effect rate on postoperative 30 d in the group A was 81 .1% (77/95) ,which on postoperative 90 d was 83 .2% (79/95) and which on postoperative 180 d was 85 .3% (81/95) .The good effect rate in the group B was 85 .4% (82/96) on 30 d ,88 .5% (85/96) on 90 d and 91 .7% (88/96) on 180 d .Conclusion CT-guided lumbar intervertebral disc minimally invasive interventional chemoab-lation has good and rapid analgesic effect ,and the intra-disc and inter-disc combined treatment has better curative effect .

OBJECTIVE：To discuss the mechanism of synovitis of knee osteoarthritis （KOA）relieved by “Sanse powder ” volatile oil based on the activation of Nod-like receptor family 3（NLRP3）inflammasome. METHODS ：“Sanse powder ”volatile oil was extracted by distillation- condensation process and the components of it were analyzed by GC-MS. Fibroblast-like synovial cells（FLS）were extracted from the knee joint of male SD rats. The effects of 10，25，50，100，250，500，1 000 μg/mL“Sanse powder”volatile oil on the viability of FLS were examined by CCK-8 assay. KOA inflammatory cell model was induced by lipopolysaccharide for 12 h. The effects of 10，250 μg/mL“Sanse powder ”volatile oil on the protein and mRNA expression of NLRP3，caspase-1 and apoptosis-associated speck-like protein （ASC）were detected. The levels of IL- 1β and IL-18 in supernatants of FLS were determined . RESULTS ：Totally 0.51-0.61 g volatile oil with yellow clear and unique aromatic odor were extracted from“Sanse powder ”，and the extraction rate was 0.33％-0.41％（n＝9）. A total of 41 chemical components were isolated ，and 30 of them were identified and their peak area accounted for 90.073 6％ of the total peak area. The components with high relative content were gingerol flavonoids （17.573 9％），δ-junionene（15.434 5％），gingerol（11.509 5％），etc. When the concentration of volatile oil was 10-250 μg/mL，there was no significant effect on survival rate of FLS （P＞0.05）. Compared with blank group ，the relative protein and mRNA expression of NLRP 3，caspase-1 and ASC and the levels of IL- 1β and IL-18 in supernatant were significantly increased in model group （P＜0.05）. Compared with model group ，relative expression or levels of above indexes were all decreased significantly in FLS and supernatant of “Sanse powder ”volatile oil 10 and 250 μg/mL groups（P＜0.05）. CONCLUSIONS：“Sanse powder ”volatile oil can inhibit NLRP 3 inflammasome activation in FLS and reduce the downstream inflammatory cascade response ，thus exerting its efficacy in ameliorating synovial inflammation of KOA.