Objective To find the inpact(s) of Losartan on myocardial apoptosis in rats with heart failure. Methods Eight-week-old male SD rats were divided into control group(group C),heart failure(group HF) and treatment group(group LS). Use of doxorubicin injection model,group LS at the same time in a row to the oral losartan,myocardial ultrastructure was examined by TEM. DNA-situ terminal labeling (TUNEL method) was used to detect myocardial apoptosis and myocardial BAX,BCL-2 protein expression was detected by immunohistochemistry.ResultsGroup HF showed significant myocardial cell injury,and apoptotic bodies were found,serum CPK,CK-MB and LDH were increased. In LS group,myocardial apoptosis index was lower (P

Objective To find the inpact(s) of Losartan on myocardial apoptosis in rats with heart failure. Methods Eight-week-old male SD rats were divided into control group (group C) , heart failure (group HF) and treatment group (group LS). Use of doxorubicin injection model, group LS at the same time in a row to the oral losartan, myocardial ultrastructure was examined by TEM. DNA-situ terminal labeling (TUNEL method) was used to detect myocardial apoptosis and myocardial BAX, BCL-2 protein expression was detected by immunohistochemistry. Results Group HF showed significant myocardial cell injury, and apoptotic bodies were found, serum CPK, CK-MB and LDH were increased. In LS group, myocardial apoptosis index was lower (P <0. 01) , myocardial cells BCL-2 expression, BAX expression reduced as compared with those in HF group. Conclusion Losartan can effectively inhibit the process of heart failure occurred in cardiomyocyte apoptosis, reverse myocardial damage and improve the prognosis of heart failure.

Objective To evaluate and analyse the morphological structure in late pregnancy women of pelvic hiatus by appli-cation of transvaginal three-dimensional ultrasound .Methods The 60 cases pregnant women who were checked pregnant weeks for 31 to 40 weeks from January 2012 to December 2014 came to our hospital were chosen as the observation group ,and other 60 cases women who were nulliparous women because of irregular menstruation at the same period treatment as control group .All patients underwent transvaginal three-dimensional ultrasound examination by observed the morphological structure of pelvic hiatus in each period ,and the research object of pelvic hiatus left and right diameter ,anteroposterior diameter and area were compared and meas-ured between the two groups .Results (1)The normal pelvic hiatus morphology was rhombic column crack-like structure ,but the observation group who had 43 .33% abnormal pelvic hiatus morphology and there was kind oval ;(2)The observation group were pelvic diaphragm hiatus of left and right diameter ,anteroposterior diameter and area were significantly larger than the control group in three conditions of the resting period ,anal contraction period and tension period ,and the difference was statistically significant(P< 0 .05) ;all the research object of the pelvic diaphragm hiatus left and right diameter ,anteroposterior diameter and area were de-crease in the anal contraction and increases in tension period for compared with the resting period ,so the difference was statistically significant (P< 0 .05) .Conclusion The three-dimensional ultrasound can be clearly observed the morphology of the female pelvic diaphragm hiatus ,and can be effectively evaluated .The late pregnancy women who will be significantly increases of pelvic dia-phragm ,occurs the relaxation phenomenon and some abnormal morphology for compared with nulliparous women .

BACKGROUNDTo compare the efficacy and side effects between cisplatin solution and cisplatin powder combination regimens for lung cancer.

METHODSA total of 223 patients were enrolled into this study. EP protocol was given to patients with small cell lung cancer (SCLC), and NP protocol to non small cell lung cancer (NSCLC). The 223 patients were randomly divided into cisplatin solution group and cisplatin powder group, and the same drugs and dosage were used in the two groups for the same type of lung cancer.

RESULTSResponse rates of the cisplatin solution group and the cisplatin powder group were 84.8% and 82.4% for SCLC ( P > 0.05), and 31.6% and 29.9% for NSCLC ( P > 0.05), respectively. The major side effects were gastrointestinal reactions and myelosuppression. Significantly higher incidence of nausea/vomiting was found in cisplatin solution group than that in cisplatin powder group for either SCLC or NSCLC ( P < 0.05). There was a remarkable difference in cost of hospitalization between the two groups ( P < 0.05).

CONCLUSIONSCisplatin solution is as effective as cisplatin powder in the treatment of lung cancer. However, the more severe nausea/vomiting reactions and higher cost of cisplatin solution should be considered in its clinical application.

BACKGROUNDMalignant pleural effusions commonly occur in patients with advanced cancer. Treatment is often palliative, such as pleural aspiration or tube thoracostomy with large bore chest tube. Tube thoracostomy with large bore chest tube can cause significant discomfort of patients. The aim of this study is to evaluate the efficacy of small bore catheter for drainage and administration of sclerosing agent in the treatment of malignant pleural effusions.

METHODSSixty patients with malignant pleural effusions were randomly assigned to small bore catheter thoracostomy closed drainage group or conventional pleural aspiration group. Cisplatin and interleukin-2 were infused into the thoracic cavity in eligible patients after drainage. Responses were evaluated 30 days later.

RESULTSOverall response rate (complete response plus partial response) was 80.00% in small bore catheter thoracostomy closed drainage group and 36.67% in conventional pleural aspiration group respectively (P < 0.01). And the side effects in small bore catheter thoracostomy closed drainage group were obviously less than that in conventional pleural aspiration group.

CONCLUSIONSSmall bore intercostal catheter for drainage and administration of sclerosing agent is a valid and safe option for malignant pleural effusions.

Objective:To investigate the effect of the replantation in situ of donor skin graft with perforation and expansion in small and medium-sized skin transplantation. Methods:Patients were selected as group A with skin and soft tissue defects caused by various reasons treated in the Plastic and Aesthetic Surgery Department of Henan Provincial People’s Hospital from January 2002 to December 2019. A medium thick skin piece was harvested from the donor area with a drum dermatome, covering an area of 200-220 cm 2. The skin piece at the root of the drum dermatome was not broken, but the free skin piece of the drum dermatome was removed to the required area, transplanted to the wound surface, stitched intermittently and dressed with packing heap. The remaining skin graft in the donor area was punctured evenly with No. 15 surgical blade, then covered all the wounds in the donor area, sutured intermittently, and bandaged under pressure. The same kind of patients treated in other medical groups in our department in the same time were selected as group B. The skin donor area was not covered with skin graft in situ, but wrapped with traditional gauze. The patients were followed up in the outpatient department after operation, when the healing of the donor skin area and the degree of local scar was evaluated for data statistical analysis. The scars were scored according to Vancouver Scar Scale. The quantitative data were expressed in M( Q1, Q2), and were analyzed by Mann-Whitney U test. The qualitative data were analyzed by Chi-square test. P< 0.05 was statistically significant. Results:Group A had 63 cases, except for 1 case of graft avulsion, 2 cases of hematoma under the skin with partial survival of skin graft, 1 case of poor survival of infected skin graft after operation, the other skin grafts in the recipient area survived well. Group B included 59 patients, 38 males and 21 females, aged from 4 to 78 years old, with a skin defect area of 40 to 80 cm 2. The patients in both groups were followed up for 7-12 months. The healing time in group A was 11.1(10.2, 12.2) days. There were no skin pigmentation, severe hypertrophic scar and delayed healing of donor area. Four cases had mild scar hyperplasia and no keloid. The score of Vancouver Scar Scale was 3(2, 4). The healing time of group B was 15.8(13.9, 17.5) days with 23 cases of hypertrophic scar and 2 cases of keloid after healing. The score of Vancouver Scar Scale was 17(17, 17). There was significant difference in healing time between group A and group B ( P<0.01); there was significant difference in Vancouver Scar Scale scores between the two groups( P<0.01); what’s more, there was significant difference in the number of cases of hypertrophic scar between the two groups ( P<0.01). Conclusions:Compared with the traditional skin transplantation, the improved technology of the replantation in situ of donor skin graft with perforation and expansion has the advantages of intact skin, uniform thickness, timely blood circulation establishment after transplantation, no wound exposure in the donor area, natural skin color after primary healing, less scar and more in line with the skin function and aesthetic requirements of human body.

Objective:To investigate the effect of the replantation in situ of donor skin graft with perforation and expansion in small and medium-sized skin transplantation. Methods:Patients were selected as group A with skin and soft tissue defects caused by various reasons treated in the Plastic and Aesthetic Surgery Department of Henan Provincial People’s Hospital from January 2002 to December 2019. A medium thick skin piece was harvested from the donor area with a drum dermatome, covering an area of 200-220 cm 2. The skin piece at the root of the drum dermatome was not broken, but the free skin piece of the drum dermatome was removed to the required area, transplanted to the wound surface, stitched intermittently and dressed with packing heap. The remaining skin graft in the donor area was punctured evenly with No. 15 surgical blade, then covered all the wounds in the donor area, sutured intermittently, and bandaged under pressure. The same kind of patients treated in other medical groups in our department in the same time were selected as group B. The skin donor area was not covered with skin graft in situ, but wrapped with traditional gauze. The patients were followed up in the outpatient department after operation, when the healing of the donor skin area and the degree of local scar was evaluated for data statistical analysis. The scars were scored according to Vancouver Scar Scale. The quantitative data were expressed in M( Q1, Q2), and were analyzed by Mann-Whitney U test. The qualitative data were analyzed by Chi-square test. P< 0.05 was statistically significant. Results:Group A had 63 cases, except for 1 case of graft avulsion, 2 cases of hematoma under the skin with partial survival of skin graft, 1 case of poor survival of infected skin graft after operation, the other skin grafts in the recipient area survived well. Group B included 59 patients, 38 males and 21 females, aged from 4 to 78 years old, with a skin defect area of 40 to 80 cm 2. The patients in both groups were followed up for 7-12 months. The healing time in group A was 11.1(10.2, 12.2) days. There were no skin pigmentation, severe hypertrophic scar and delayed healing of donor area. Four cases had mild scar hyperplasia and no keloid. The score of Vancouver Scar Scale was 3(2, 4). The healing time of group B was 15.8(13.9, 17.5) days with 23 cases of hypertrophic scar and 2 cases of keloid after healing. The score of Vancouver Scar Scale was 17(17, 17). There was significant difference in healing time between group A and group B ( P<0.01); there was significant difference in Vancouver Scar Scale scores between the two groups( P<0.01); what’s more, there was significant difference in the number of cases of hypertrophic scar between the two groups ( P<0.01). Conclusions:Compared with the traditional skin transplantation, the improved technology of the replantation in situ of donor skin graft with perforation and expansion has the advantages of intact skin, uniform thickness, timely blood circulation establishment after transplantation, no wound exposure in the donor area, natural skin color after primary healing, less scar and more in line with the skin function and aesthetic requirements of human body.