ObjectiveTo investigate the influence of Tanshinone Ⅱ A on the expression of HMGB1 in rats with cerebral ischemia-reperfusion (I/R) injury and its neural function protection.MethodsThe 32 male SD rats were randomly (random number) divided into 4 groups (8 rats per group):Sham group,I/R group,group with low dose of Tanshinone Ⅱ A ( TaLD group) and group with high dose of Tanshinone Ⅱ A (TaHD group).The cerebral I/R models were established by the method of right middle cerebral artery occlusion (MCAO).Cerebral infarct volume was detected by TTC staining.Apoptotic cell and apoptotic index were calculated by Tunnel assay.The HMGB1 levels in brain and serum was detected by Western blot and ELISA.Calmodulin (CaM) activity and malondialdehyde (malondiadehyde,MDA) content in the brain were also detected.ResultsCompared with the Sham group,the volume of cerebral infarction,the number of apoptotic cells,CaM activity,MDA content,HMGB1 levels in the brain tissue and serum in group I/R,TaLD group and TaHD group increased significantly (P ＜ 0.01 ).Compared with the group I/R,the volume of cerebral infarction,the number of apoptotic cells,CaM activity,MDA content and the HMGB1 levels in brain tissue and serum in TaLD groupand TaHDgroup decreased significantly (P ＜ 0.01 ).The difference of the above index between TaLD groupand TaHDgroup was significant ( P ＜ 0.01 ).ConclusionsTan Ⅱ A could reduce the cerebral ischemic reperfusion injury in rats which was likely related with decreasing the inflammatory response in the late stage via HMGB1.

Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.

Objective:To analyse ZHOU Zhong-ying’effective combination drugs in preventing and treating the systemic lupus erythematosus(SLE).Methods:Association rules based on Chi-squared analysis and influence degree was used.Results:73 Rules of TCM couples were selected in the high frequency drugs distribution,and the drugs were mainly those for heat clearing,antidote medicines and blood act stasis remove medicines,which was in accordance with the main pathological mechanism factor for SLE given by Professor Zhou.Conclusion:The new method could find out many significant TCM couples in the study of the compatibility of TCM.

Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o＇lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE ＜-4.5 mnol/L,CR ＞ 120μmol/L,CRP ＞ 100 mg/L,FIB ＞5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P ＜ 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.

The paper probed into key challenges in talents introduction of hospitals ,especially introduction strategy and practical considerations.In its"MVPPS"(Money ,Value ,Platform ,Promise , Service)theory framework ,V(value)is the core ,and P(platform)is the key ,while P(promise)and M (money ,remuneration)are the cornerstone.The hospital can attract excellent talents by means of common value ,reasonable material conditions ,ideal development platform and service ,and promises fulfilled ,thus achieving fast disciplines development .

Objective To investigate the efficacy of ultrasound-guided cervical plexus block in radiofrequency ablation of thyroid and parathyroid benign lesions . Methods One hundred and twenty-five patients with thyroid nodules or hyperparathyroidism , who were undergone ultrasound guided radiofrequency ablation ,were randomly assigned to receive either ultrasound-guided cervical plexus block or local infiltration anesthesia ,and the pain grading was evaluated by numerical rating scale ( NRS ) . The anesthetic dosage and the effect of thermal ablation surgery of ultrasound-guided cervical plexus block anesthesia and local anesthesia were compared . Results The anesthetic dosage in ultrasound-guided cervical plexus block was lower than that in local infiltration anesthesia( t = 17 .681 , P < 0 .05) . The pain grading of ultrasound-guided cervical plexus block was lower than that of local infiltration anesthesia( χ2 = 33 .738 , P < 0 .05) . Conclusions Ultrasound-guided cervical plexus nerve block has lower anesthetic dosage and pain grading in the radiofrequency ablation of thyroid and parathyroid benign lesions ,which may be widely applied in clinical .

ObjectiveTo evaluate the safety and efficacy of firofiban in gerontal patients with acute coronary syndrome(ACS). MethodA total of 106 elderly patients with ACS admitted form December 2006 to June 2008 were enrolled in a prospective case-control study. Patients were divided into percutaneous coronary intervention (PCI) group and medicine group. Both groups were randomly divided into two sub-groups, tirofiban sub-group and placebo sub-group. Patients in the PCI group received tirofiban infused in dose of 10 μg·kg- within 3 minutes as loading dose before operation and then an infusion of 0.15μg'kg-1·min-1 as maintenance dose for 24～36 hours. In medicine group,the loading dose was 0.4 μg·kg-1·min-1×30 min and the maintaining dose was 0.1 μg·kg-1·min-1×48 hours, The rates of major adverse cardiac events (MACE) consisting of death, myocardial infarction or refractory ischemia during hospital stay stay and 30 days' follow-up, bleeding rates TIMI grade, corrected TIMI frame count (CTFC) and myocardial blush grade(MBG) after PCI were compared between sub-groups of PCI group. ResultsThe basic clinical data were similar among the sub-groups. In medicine group,the MACE rate during 30 days' follow-up was much lower in the tirofiban sub-group than in the placebo sub-group (12.0% vs. 36.4 %, P < 0.05). In comparison with medicine group, in PCI group, there were fewer TIMI frames [(23.5 ±5.1) frames vs. (31.4±5.2) frames, P < 0.01] and higher percentage of myocardial blush grade 3(64.3% vs. 29.0%, P < 0.01) in firotiban sub-group of PCI group. No significant differences in bleeding rates were found between all sub-groups. ConclusionsTirofiban is safe and effective in gerontal ACS patients with blood flow and reperfusion improved.

OBJECTIVETo evaluate the feasibility and efficacy of Zhu's trocar placement (ZTP) in laparoscopic appendectomy (LA) in the treatment of complicated appendicitis.

METHODSClinical data of 139 complicated appendicitis patients undergoing LA at the First Affiliated Hospital of Wenzhou Medical University from June 2013 to December 2017 were retrospectively analyzed. ZTP-LA group comprised 59 cases and its procedure was as follows: 10 mm umbilical trocar was used as lens port; 12 mm trocar at crossing point of umbilical hole horizontal line and right midclavicular line was used as main operating port; 5 mm trocar at the crossing point of horizontal line 0-3 cm below umbilicus and right anterior axillary line was used as assist operating port with the drainage function for Douglas fossa and right iliac fossa; The operator and the assistant stood on the right side and the left side of the patient respectively. Traditional three-port group comprised 80 cases (8 cases converted to laparotomy, 72 cases enrolled finally) and its procedure was as follows: 10 mm lens port below umbilicus; 10-12 mm main operating port at lateral border of left lower rectus abdominis; 5 mm assist operating port above pubis; The operator and the assistant stood on left side of the patient. The operative time, time to oral semi-fluid, postoperative hospital stay, cost during hospitalization, and postoperative morbidity of complication were compared between two groups.

RESULTSBaseline data such as gender, age, WBC count, percentage of leukocyte, pathological finding and type were not significantly different between two groups(all P>0.05). The conversion rate in ZTP-LA was significantly lower than that in traditional three-port group [0%(0/59) vs. 10.0%(8/80),χ²=4.552,P=0.033]. Compared with traditional three-port group, ZTP-LA group showed shorter operative time [(47.8±20.1) minutes vs. (66.0±27.3) minutes, t=4.383,P<0.001], shorter time to oral semi-fluid [(35.0±20.7) hours vs. (59.3±32.8) hours, t=5.158,P<0.001], shorter postoperative hospital stay [(4.1±1.6) days vs. (5.5±2.2) days, t=4.162, P<0.001], lower postoperative morbidity of complication [3.4% (2/59) vs. 18.1%(13/72), χ²=6.879, P=0.009], lower incidence of postoperative intra-abdominal abscess [0%(0/59) vs. 11.1%(8/72), χ²=5.179, P=0.023], lower incidence of paralytic ileus [1.7%(1/59) vs. 12.5%(9/72), χ²=3.946, P=0.047] and less cost during hospitalization[(13 585±2909) yuan vs.(16 861±5334) yuan, t=4.463, P<0.001].

CONCLUSIONZTP-LA is safe, feasible and effective with advantages of faster recovery and less cost in the treatment of complicated appendicitis.

Appendectomy ; methods ; Appendicitis ; surgery ; Humans ; Laparoscopy ; methods ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments ; Treatment Outcome

【Objective】 To explore the efficacy of negative pressure ureteral access sheath combined with disposable flexible ureteroscope (UAS+FRUS) in the treatment of renal calculi of 2-3 cm, so as to provide reference for the treatment. 【Methods】 A retrospective analysis was conducted on 130 cases of renal calculi of 2-3 cm treated with surgery in Xiamen Third Hospital during Sep.2021 and Sep.2023, including 68 cases with UAS+FRUS and 62 cases with super-mini percutaneous nephrolithotripsy (SMP).The perioperative indexes and stone-clearance rate (SFR) were compared between the two groups. 【Results】 All operations were successful.There were no statistically significant differences in the total SFR and incidence of complications (5.88% vs. 9.67%) between the two groups 3 days (88.24% vs. 90.32%) and 1 month (91.18% vs. 93.55%) after surgery (P>0.05).For patients with lower calyceal calculi with infundibulopelvic angle (IPA)<45°, the SFR of the UAS + FRUS group was significantly lower than that of the SMP group (57.14% vs.100%, P<0.05).The UAS + FRUS group had a longer operation time than the SMP group \[(104.94 ± 8.79) minutes vs. (77.98±6.60) minutes, P<0.001\], higher hospitalization costs \[(23 112.82±1152.34) yuan vs. (21 975.84±1512.24) yuan, P<0.001\], less postoperative decrease in hemoglobin \[(6.71±2.07) g/L vs. (9.81±4.80) g/L, P<0.001\], and shorter postoperative hospitalization time \[(3.28±0.51) d vs. (5.58±0.71) d, P<0.001\].The UAS + FRUS group had lower postoperative VAS score at 6, 24, and 48 hours than the SMP group \[(6.38±0.69) vs. (7.87±0.88); (3.62±0.73) vs. (5.81±0.83) and (3.12±0.33) vs. (3.81±0.60)\], with statistical significance (P<0.05). 【Conclusion】 Both surgical methods have a high SFR in the treatment of renal calculi of 2-3 cm.SMP has the advantages of short operation time, low hospitalization costs, and high SFR for lower calyx calculi, while UAS+FURS has the advantages of little bleeding, minimal trauma, and short hospital stay.Surgeons can make reasonable choices based on the patients’ condition and willingness, combined with their own surgical experience.

Objective    To evaluate the quality of life (QOL) in patients with primary palmar hyperhidrosis (PPH) after endoscopic thoracic sympathicotomy (ETS) and analyze the influencing factors. Methods    A total of 243 patients (118 males and 125 females, with an average age of 21.99±6.31 years) with PPH who were successfully treated with ETS (only T3 level thoracic sympathicotomy) in our hospital from January 2017 to January 2018 were enrolled, and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) was used to assess the QOL scores before and after ETS. By establishing a linear regression model of gender, age, body mass index, compensatory hyperhidrosis (CH) and palm dryness, and the relationship between the changes of the QOL scores and various factors was studied. Results    The total QOL score after surgery was higher than that before surgery (63.01±4.58 vs. 48.11±1.95, P<0.05). Compared with the negative group of CH, the QOL score decreased by 4.662 in the postoperative CH patients. For every grade of CH severity increasing, the QOL score decreased by 3.449. Compared with the negative group, the QOL scores decreased by 1.804 and 2.400 respectively for every grade of CH severity increasing in the patients with postoperative chest and back CH. Conclusion    ETS can not only improve the symptoms of abnormal palmar hyperhidrosis, but also significantly improve the QOL. Severe chest and back CH is an important factor affecting the QOL of patients.