Objective:To provide anatomic data for accurately localizing aperture of sphenoidal sinus without injurying sphenopalatine arteries in endoscopic transsphenoidal sella surgery.Methods: The anterior walls of spheroid sinus were observed and measured(layout,position,external diameter,distances to other structures of interest) with a vernier caliper and an angle gauge on 15 adult cadavers.Results: The distances from the root of columella nasi to the inforior pole of sphenoidal sinus aperture and the sphenopalatine foramen were(60.40?3.21,58.10-72.76) mm and(62.14?1.93,59.50-73.40) mm,respectively.The distance from the inforior pole sphenoidal sinus aperture to the sphenopalatine foramen was(12.20?1.10,8.10-16.35) mm.The diameter of the sphenopalatine artery was(1.99?0.13,1.50-2.80) mm.The distances from the inforior pole of sphenoidal sinus aperture to the superior and inferior posterior artery of nasal septum were(3.49?0.24,2.78-5.20) mm and(6.42?1.08,(4.30-8.50)) mm,respectively.Conclusion: Aperture of sphenoidal sinus is an important marker in endosopic transsphenoidal sella surgery.The anterior wall of sphenoid sinus should be opened from the inforior pole of sphenoidal sinus aperture to avoid injurying sphenopalatine artery.

Objective To explore the rat's abdominal pressure decending law by applying quantitative analytical technique.Methods Intra-abdominal hypertension rat model is made by Nitrogen aeroperitonerm.Nitrogen is exhausted the abdomen at fixed quantity and fixed time cell.MP-100A-CE type physiological monitor is used to record the changes of intra-abdominal pressure.The pressure numerical average value at different time are recorded,and the volume of Nitrogen exhausted and the pressure of intra-abdominal scatterplot are drawed.Regression analysis is used to study the functional relation between them.Results The regularity of the intra-abdominal pressure decrease was as follows:In Intra-abdominal Hypertension condition,discharge little Nitrogen could cause intra-abdominal pressure decrease greatly.Then the rate of decay is slowed.Intra-abdominal pressure(y)and Nitrogen in the abdomen(y)present decrement exponential function relation,the formula is:y=36.3190?0.9769x,and the pressure-volume index is-0.01.Conclusion Regularity of intra-abdominal pressure decengding is exponential function between intra-abdominal pressure and Nitrogen volume exhausted from the abdomen.

Percutaneous endoscopic gastrostomy (PEG) is an convenient, effective, and safe technique,and is especially useful for the nutritional support of patients who are unable to befedorally. PEG should be carefully arranged based on indications, ethical criteria, and contraindications. Early PEG can remarkably improve the quality of life.

Objective To investigate the effects and their potential mechanisms of splenectomy plus esophagogastric devascularization on non-invasive indexes of liver fibrosis and the cirrhosis progress in portal hypertensive patients with HBV-related cirrhosis. Methods Twenty consecutive portal hypertensive patients with positive HBsAg,negative HBV-DNA and Child-Pugh A(n=14)or B(n=6)were collected in this study. ELISA method was used to test the level of serum MMP-1 and TIMP-1;electrochemilumines-cence was used to measure hyaluronic acid( HA),N-terminal type Ⅲ procollagen peptide( PC-Ⅲ),lami-nin(LN)and collagen typeⅣ(C-IV). Results The serum TIMP-1,HA,PCⅢ,LN,and C-Ⅳwere signifi-cantly lower than the preoperative levels(p<0. 05),and MMP-1 slowly increased compared with the pre-operative levels(p<0. 05). The changes between TIMP-1 and HA,PC-Ⅲ,LN,or C-Ⅳ were positively correlated(r=0. 458~0. 783,p<0. 01/0. 05). The changes between MMP-1 and HA,PC-Ⅲ,LN,or C-Ⅳ were negatively correlated(r= -0. 545~ -0. 873,p<0. 01/0. 05). Conclusion Splenectomy plus esophagogastric devascularization can decrease non-invasive hepatic fibrosis serum markers and cytokines (TIMP-1),conducive to slowing down the disease progression in patients with cirrhosis.

Objective: To explore the changes of activity of antioxidases in hippocampus of the rats with multi-infarct dementia and the intervention effects of acupuncture.Method: The multi-infarct dementia model was made by injected emboli into the internal carotid artery.The demented rats were allocated to 3 groups randomly: model,acup and sham-acup;meanwhile normal and sham-operated rats were used as control.The parameters of oxidative stress were assessed by measuring the malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT) and glutathione peroxidase(GSH-Px) levels in hippocampus after acupuncture treatment.Result: Compared to normal group,MDA levels of hippocampus in model animals increased significantly,while SOD and GSH-Px decreased much more;No significant difference was observed in CAT among groups.Interestingly,the acupuncture treatment could significantly improve all those indexes.Conclusion: SOD/GSH-Px pathway may be playing a major role in combating oxidative stress in the brain of MID rats,the CAT activity not the key enzyme.Acupuncture treatment could increase the activity of antioxidase SOD/GSH-Px,alleviate the injury of free radical and maintain the oxidant-antioxidant balance to a great extent.This may be one of the mechanisms of its therapeutic effect.

Objective To observe the feasibility and efficacy of small-incision high-ligation of great saphenous vein combined with endovascular microwave coagulation plus local injection of lauromacrogol for varicose veins of lower limbs . Methods From October 2012 to October 2013, there were 60 patients (70 legs) treated by high-ligation of the great saphenous vein , during which endovascular microwave coagulation was performed by using radiator and an additional injection of sclerotherapy at local tortuous vessels was carried out ( observation group ) .The control group ( between August 2011 and September 2012 ) underwent the traditional saphenous vein ligation plus superficial vein stripping surgery .The operation time , blood loss during operation , number of incisions , length of groin incision , and postoperative complications were compared between the two groups . Results As compared with the control group , the observation group had singnificantly shorter operative time , fewer blood loss , fewer surgical incisions , and shorter groin incision, respectively [(50.8 ±2.6) min vs.(103.5 ±16.0) min, t=-25.183, P=0.000;(43.2 ±4.6) ml vs.(107.5 ± 35.2) ml, t=-14.030, P=0.000;2.2 ±0.7 vs.6.3 ±2.5, t=-12.233, P=0.000;(2.3 ±0.3) cm vs.(4.8 ±0.3) cm, t=-17.697, P=0.000].There was no significant difference in complications rates between the two groups : local skin numbness occurred in 40 cases in the observation group and in 38 cases in the control group (χ2 =0.147, P =0.702 ) and subcutaneous congestion was noted in 4 cases in the observation group and in 9 cases in the control group (χ2 =2.157, P=0.142). Conclusion Small-incision high-ligation of the great saphenous vein combined with endovascular microwave coagulation plus local injection of lauromacrogol for varicose veins of lower limbs has advantages of minimal invasion , good cosmetic outcomes , quick recovery , high efficacy, fewer complications , and easy performance .

Objective It is purposed to evaluate clinical efficacy of adefovir dipivoxil combined with anti-tuberculosis (TB) drugs in treatment for chronic hepatitis B (HB) complicated with pulmonary TB. Methods Ninety-four eases of pulmonary TB complicated with chronic HB receiving anti-TB drug treatment at Liaocheng Hospital for Infectious Disease during September 2006 to September 2008 were divided into treatment and control groups matched on their pulmonary TB lesion, damage in liver function and HB virus (HBV) DNA load. Forty-seven cases in the treatment group were administered with anti-TB drugs, i.e., isoniazid (INH) 0. 3 g daily, rifapentine (RFT) 0.45 g twice a week, pyrazinamide (PZA) 1.5 g daily, streptomycin (SM) 0. 75 g daily or ethambutol (EMB) 0. 75 g daily, and regular liver-protection drags, as well as oral adefovir dipivoxil 10 mg daily for eight months, and another 47 cases in the control group were administered with the same anti-TB drugs and regular liver-protection drugs as the treatment group. Two to eight weeks after treatment, clinical symptoms, liver function, HBV DNA load, negative conversion of acid-fast staining bacteria in sputum smear, and absorption of pulmonary TB lesion were evaluated for all the patients in both groups. Data were analyzed with U-test and χ2-test, respectively. Results After treatment, damage in liver function worsened in three cases (6.4%), as compared to that in 47.3 percent of the control group (P<0.05). Clinical symptoms, including tiredness, loss of appetite, abdominal distension, uncomfortable in upper abdomen, and so on, appeared in three cases of the treatment group (6.4%) during anti-TB treatment, as compared to those in 18 cases of the control group (47.3%) (P<0.05). HBV DNA conversed to negative (less than 1.0×103 lg copies/ml) in 24 cases of the treatment group (51.1%), HBV load went down to 1.0×103-1.0×104 lg copies/ml in 23 cases (48. 9%), sputum smear bacteria conversed to negative in 41 cases (87. 2%) and pulmonary lesion absorbed in 45 cases (95.7%), all with statistically significance as compared to those in the control group (47. 3% , 0. 0% , 2. 6% , 39. 5% and 50. 0% , respectively, P <0. 05). Renal function was all in normal in both groups and no patient with drug resistant variant HBV was found during and after treatment, and no obviously adverse reaction was found in patients with adefovir dipivoxil. Conclusion Adefovir dipivoxil has a good safety and can reduce laver damage in anfi-TB drug treatment for patients of chronic hepatitis B complicated with pulmonary TB.

BACKGROUND: It was reported that the reason why the fracture healing become more and more difficult with the increasing age may be associated with the varied gene regulation of bone marrow mesenchymal stem cells differentiation into osteoblast and lipoblast. However, the exact mechanism under it remains poorly understood.OBJECTIVE: To explore the association of the age-related changes on expression of peroxisome proliferator-activated receptor γ (PPARγ) and core binding α1 (Cbfα1) with the age-relatad fracture healing impairment, we studied the expression changes of PPARγ and Cbfα1 during aging fracture healing.DESIGN, TIME AND SETTING: A randomized control animal trial was performed in the Third Xiangya Hospital of Central South University between October 2007 and Febuary 2008. MATERIALS: Six male SD rats of 3 months and the other six of 23 months, randomly-selected, were divided into two groups: the old experiment group (23 months) and the young control group (3 months). METHODS: Transverse osteotomies on the middle-upper parts of left tibiae were performed to the rats, with the self-made extemal mini-fixator implanted there simultaneously. Tractions were taken twice a day (0.2 mm/d) for 14 days from day 2 till day 15 post operation. On day 15 post operation, rats were sacrificed to harvest left tibea samples. MAIN OUTCOME MEASURES: Both imaging examination and histological observation were performed to the fractures of rats. The PPARγ and Cbfα1 expression were detected with reverse transcription-polymerase chain reaction (RT-PCR) technique. RESULTS: All samples were involved in the results analyses. The imaging examination showed that many osteotylus generated between the broken ends of fractures in the young control group; that the bone formation of the young control group was much better than that of the old experiment group. The histological observation showed that large amounts of osteotylus growth occurred to every animal in the young control group and their membrane bone formation was remarkable; comparatively, the osteotylus growth in the old group was weakened dramatically, and only fibrous joints were seen. The RT-PCR detection showed that differences of significance existed in both PPARγ and Cbfα1 mRNA expressions between the two groups, with the much higher Cbfol mRNA expression in the bone marrow of rats in the young group and the much higher PPARy mRNA expression in the bone marrow of rats in the old group.CONCLUSION: Rats of different ages show different fracture healing abilities, i.e. the higher ages, the lower fracture healing abilities. In addition, expressions of PPARγ and Cbfα1 in the bone marrow of rats alter with the increasing age, which indicates that there are certain associations between the changed expression level of the two factors and the fracture healing impartment.

U plus DHA.

Objective:To prove the production process( pulverzation processing) by stainless steel pharmaceutical machines of tra-ditional Chinese medicines, including various batches of raw materials, decoction pieces, patent drugs and medicinal subsidiary materi-als, lead to heavy metal chromium exceed the standard. Methods:According to ChP 2010 version Vol 1 appendixⅨB“lead, cad-mium, arsenic, mercury, copper determination method”, referring to ChP 2010 version Vol 2 gelatin capsules “chrome check stand-ard”. Results:Most of the test data showed that the chromium content of the sample exceeded the standard in varying degrees. Con-clusion:Pharmaceutical machinery and equipment using stainless steel lead to chromium exceed the standard in Chinese medicine pro-duction process, bring hidden trouble to the quality of the products.