OBJECTIVE:To evaluate the use of narcotic analgesics in eight hospitals of Lianyungang,Jiangsu Province. METHODS:Consumption of narcotic analgesics in eight hospitals of Lianyungang was audited and analyzed in terms of variety,volume,sales value and DDDs.RESULTS:Narcotic analgesics as used in the eight hospitals of Lianyungang recorded year-on-year growths in both consumption volume and sales value,with their growth rates in sales value being significantly higher than those of other drugs.Consumption of Pethidine hydrochloride was on the down while that of Morphine was picking up year-on-year.The DDDs of Fentanyl patch remained small.CONCLUSIONS:The use of narcotic analgesics in the eight hospitals of Lianyungang tends to be rational in recent years.

ObjectiveTo evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.MethodsThe clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).ResultsAll the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score(KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.ConclusionsThe intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up.

Background Gene encoding optineurin (OPTN) is a causative gene for glaucoma and amyotrophic lateral sclerosis,with a more expression in retina.Our previous study isolated OPTN-interacting proteins and identified that the gene encode the basic leucine zipper (bZIP) transcription factor neural retina leucine (NRL) zipper,a causative gene for retinitis pigmentosa,and further study demonstrated the interaction between OPTN and NRL proteins in nuclei of cultured HeLaS3 cells.Objective This study was to determine the protein binding site of OPTN necessary for NRL binding.Methods A deletion series of OPTN-expression plasmids were constructed and co-expressed with hemagglutinin (HA)-tagged NRL in HeLaS3 cells,respectively.The cytoplasmic and nuclear fractions were used to perform co-immunoprecipitate (CoIP) and Western blot with anti-tag antibodies.Results In the nuclear fractions of cells transfected with the del1 st,del2nd or del3rd plasmid,a band of coimmunoprecipitated HA-labelled NRL (HA-NRL) was detected.However,the del4th plasmid did not produce a band.The NRL band was not found in cytoplasmic fractions from transfected cells with any of the deletion plasmids or with the whole-length OPTN plasmid.Conclusions The protein binding site of OPTN necessary for NRL binding is determined.This result demonstrates the binding of Flag-OPTN and HA-NRL in HeLaS3 cells.A series of partial-deletion OPTN plasmids demonstrated that the tail region (423-577 amino acids) of OPTN was necessary for binding with NRL.

BACKGROUND: The key to success in laryngeal transplantation is to control the infection. In practice, how to minimize the risk of infection should be considered first, so that the laryngeal allograft can survive after revascularization under the immunosuppressive state. Then the therapeutics methods should be focused on the functional recovery of respiratory, swallowing and phonation.OBJECTIVE: To explore the feasibility of staged allogeneic larynx transplant for dogs in order to decrease the infection rate.METHODS: Ten male conspecific Beagle dogs were assigned into five pairs of donor and receptor according to body mass and the size of larynx. The allogeneic larynx was embedded under the neck skin by allotransplantation. The dogs were treated with immunosuppressant daily to resist immnological rejection. The pharynx and trachea were contraposed after larynx survived to establishⅡstage laryngeal transplantation animal model.RESULTS AND CONCLUSION: InⅠstage of laryngeal transplantation, the laryngeal allograft survived well, blood supply was passable. Receptor dog 1 with vertical midline incision in the neck, receptor dogs 4 and 5 with transverse incisions in the neck grew well. No infection phenomena was found in receptor dogs 4 and 5. The lastⅡstage laryngeal transplantation was performed in the 4th week afterⅠstage laryngeal transplantation. Skin flap necrosis occurred in receptor dogs 2 and 3 with U-shape incisions. The donor larynx had different degree infection. Laryngeal allograft of receptor dog 2 died; laryngeal allograft of receptor dog 3 survived after treatment. The survival period of donor larynx in receptors was as long as 4 weeks. These findings indicate that the larynx infection is avoid or reduced by staged larynx transplantation with pre-embed laryngeal allograft after total laryngectomy. The receptor dog is tolerant; the donor larynx is easy to survive. The main histological change occurs in the epithelial mucosae which can be used as an inspect index of immunosuppressive agents. However, glandular organ secretion is a troublesome problem and immunodepressant must be continuously administrated for a long time.

Objective To develop a better method for preparation of porcine model of acute myocardial infarction by permanent occlusion of the left circumflex coronary artery and minimally invasive surgery, evaluate its validity and stability, and explore its application in experimental studies of ischemic heart diseases.Methods 25 healthy female 3-month-old Bama minipigs, body weight 25±3 kg, were used in this study.The porcine model of myocardial infarction was established by minimally invasive surgery and the left circumflex artery ligation at the site of OM1 posterior position under general anesthesia.Heart function was assessed by echocardiography at 15 min before surgery, 1 hour and 4 weeks after surgery.Pathological examination was performed at 4 weeks after the left circumflex artery occlusion.The mortality and cause of death were statistically analyzed.Results The 1-hour and 4-week postoperative cardiac function was considerably decreased, showing a decreased ejection fraction from 64.2±4.6% to 48.2±5.3% (1hour after MI) and 49.7±6.1% (4 weeks after MI) (P<0.01).Pathological examination revealed that the ventricular wall was thinner and the amount of collagens was increased in the infracted area.The ventricular fibrillation rate at 1-hour after myocardial infarction was 17.3% and the infarction area was 19.2%.Conclusions A pig model of acute myocardial infarction can be prepared by our modified left circumflex coronary artery ligation at the obtuse marginal artery (OM1) and minimally invasive surgery.This model exhibits advantages such as minimal surgical trauma, high stability of the model, and low mortality, therefore, provides an ideal and economic animal model for experimental studies on acute ischemic heart diseases.

OBJECTIVE To explore the feasibility of transnasal endoscopic surgery to treatment of intraorbital space occupying by ethmoidal-lamina papy-racea approach. METHODS The clinical data of 10 cases who underwent intraorbital surgery via transnasal endoscopic ethmoidal-lamina papyracea approach from June 2003 and Aug. 2006 were retrospectively studied. The patients included foreign body 1 case, cavernous hemangioma 2 case, lipoma 2 cases, inflammatory pseudotumor 2cases and hematoma 3cases. All intraorbital space occupying were operated by transnasal endoscopic ethmoidal-lamina papyracea approach but for one cavernous hemangioma which was dealt with through extra orbitectomy. The inflammatory pseudotumors were prescribed with glucocorticoid after operation.RESULTS Foreign body was removed successfully. One case of cavernous haemangioma was removed completely by transnasal endoscopic surgery and the other by extroorbital operation. All symptoms of proptosis and diplopia disappeared. One vision was enhanced from hand moving to 0.3 and another from light to hand moving. However, there was one hematoma which had been hindered about 14 days after damaged lost eyesight after operation. All cases were cured but one pseudotumor which recurred and was operated again. All cases were followed up 3 to 24 months. CONCLUSION Intraorbital surgery via transnasal endoscopic ethmoidal-lamina papyracea approach was available and feasible for the advantages of clear operation field, direct vision operation, less damage, rapid recovery and avoiding of facial scar, and intranasal endoscopic surgery can treat the rhino-orbital related diseases and nasal diseases at the same time.

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.

OBJECTIVE: To investigate the therapeutic outcomes of Laryngectomy and prognostic factors in senile patients with laryngeal carcinoma. METHOD: A retrospective study of long-term therapeutic outcomes was performed on 110 patients with laryngeal carcinoma over 65, treated mainly by surgery, from 1990 to 2005. Different kinds of operations were as follows: cordectomy(1 case) or stripping (2 cases) by suspended laryngoscope, laryngofissure (4 cases), vertical partial laryngectomy without tracheotomy (8 cases), vertical partial laryngectomy (8 cases), extended vertical partial laryngectomy (1 case), horizontal laryngectomy (4 cases), subtotal laryngectomy (4 cases), cricohyoidoepiglottopexy (30 cases), Arslan's procedure (8 cases), and total laryngectomy (40 cases). Forty-eight patients were treated with preoperative or postoperative radiotherapy, and five patients were treated with induction chemotherapy followed by radiotherapy. RESULT: There were four missing cases among all 110 cases. The 5- and 10-year overall survival rate were 66.6% and 44.2%, respectively. The 5- and 10-year diseases-free survival rate were 57.0% and 38.4%, respectively. The median survival was 84 months. Decannulation rate was 87.1% (54/62). Well-differentiation, surgery alone, node-negative, glottic carcinoma, early stage, partial laryngectomy, non-recurrence and male were favorable prognostic factors with univariate analysis (P < 0. 05). Well-differentiation and surgery without combined therapy were also favorable prognostic factors with multivariate analysis. CONCLUSION Conservation laryngectomy was an efficient method to treat senile patients with laryngeal carcinoma. Combined therapy should better not be adopted to patients with negative surgical margins.
Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; diagnosis ; surgery ; Laryngectomy ; methods ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

This study aimed to observe the protective effect of momordicine I, a triterpenoid compound extracted from momordica charantia L., on isoproterenol (ISO)-induced hypertrophy in rat H9c2 cardiomyocytes and investigate its potential mechanism. Treatment with 10 μM ISO induced cardiomyocyte hypertrophy as evidenced by increased cell surface area and protein content as well as pronounced upregulation of fetal genes including atrial natriuretic peptide, β-myosin heavy chain, and α-skeletal actin; however, those responses were markedly attenuated by treatment with 12.5 μg/ml momordicine I. Transcriptome experiment results showed that there were 381 and 447 differentially expressed genes expressed in comparisons of model/control and momordicine I intervention/model, respectively. GO enrichment analysis suggested that the anti-cardiomyocyte hypertrophic effect of momordicine I may be mainly associated with the regulation of metabolic processes. Based on our transcriptome experiment results as well as literature reports, we selected glycerophospholipid metabolizing enzymes group VI phospholipase A 2 (PLA2G6) and diacylglycerol kinase ζ (DGK-ζ) as targets to further explore the potential mechanism through which momordicine I inhibited ISO-induced cardiomyocyte hypertrophy.Our results demonstrated that momordicine I inhibited ISO-induced upregulations of mRNA levels and protein expressions of PLA2G6 and DGK-ζ. Collectively, momordicine I alleviated ISO-induced cardiomyocyte hypertrophy, which may be related to its inhibition of the expression of glycerophospholipid metabolizing enzymes PLA2G6 and DGK-ζ.

Objective:To explore the clinical efficacy of Kinesio taping combined with extracorporeal shock wave and the plantar pressure evaluation in the treatment of plantar fasciitis. Method:A total of 67 patients with unilateral plantar fasciitis were randomly divided into the control group(ESWT group)and the experimental group(KT combined group).The patients in the two groups were given the same health education and extracorporeal shock wave treatment(ESWT),and the experimental group was treated with Kinesio taping(KT).The pain and functional activity were evaluated by pain visual analogue scale and AOFAS ankle and hind-foot function scale;The insole plantar pressure measuring system was used to mea-sure the peak pressure values of each plantar regions.The clinical efficacy and plantar pressure of the affected side were compared before treatment,the 3rd week of treatment and 5th week of treatment. Result:There was no significant difference in various indcators of the measurements between the two groups before treatment(P＞0.05).The score of pain rating,functional activity scale score and plantar pressure of pa-tients in both groups were significantly improved at the 3rd week and the 5th week of treatment(P＜0.05),com-pared with those before treatment.At the 3rd week of treatment,there was no significant difference between the two groups in pain degree and functional activity scale score(P＞0.05),but there was statistical difference in plantar pressure analysis(P＜0.05).The peak force weight ratio of the medial heel in the KT combined group was significantly greater than that in the control group.At the 5th week of treatment,there were statisti-cally significant differences between the two groups in the score of pain rating,functional activity scale score and plantar pressure(P＜0.05).The KT combined treatment group was significantly better than the control group in the pain improvement and functional activity,and the weight bearing of the middle foot and hind foot was also significantly higher than the control group. Conclusion:Compared with the simple extracorporeal shock wave therapy,the combination of KT therapy can better relieve pain,improve the function of hind foot,correct abnormal foot weight bearing,and improve the gait of patients.