Objective To improve lower eyelid blepharoplasty by using myocutaneous flap and lateral one-third skin flap.Methods A total of 37 patients were recruited in this study and received lower eyelid blepharoplasty.Incision was made at the lower palpebral margin,and the extension of incision was hided into the outer canthus rhytids.Myocutaneous flap was made first followed by the preparation of skin flap at the lateral one-third of the lower eyelid.Results All the patients experienced a quick recovery from the surgery.The excess skin at the lateral canthus was completely removed,the incision was sutured under moderate tension,and the eyelid skin was flattened.No lid-retraction or lower eyelid ectropion was observed in the 6-to 12-month postoperative follow-up.The lateral incision sear was hidden and the operation outcome was satisfactory.Conclusions The lower eyelid blepharoplasty with myocutaneous flap and lateral one-third skin flap may lead to a satisfactory outcome with the formation of natural outer canthus angle and make the patients younger.

BACKGROUND: Panax notoginseng saponins (PNS) could significantly improve the learning and memory ability of rats, but its influence to peripheral nervous system still needs further investigation.OBJECTIVE: To observe the effects of PNS on the fast-excitatory postsynaptic potential (f-EPSP) in stellate ganglion (SG) of rats.DESIGN: Observation and controlled trial.SETTING: Pharmacological Laboratory of Guangxi Medical University.MATERIALS: The experiment was carried out at the Pharmacological Laboratory of the Experimental Center of Guangxi Medical University from January 2005 to February 2006. Thirty healthy male SD rats of clean grade and (220±20) g, provided by the Experimental Animal Center of Guangxi Medical University; SEN-7203 digital three track strip stimulator, microelectrode amplifier (MEZ8301, Japan NIHON KOHDEN COMPANY); glass microelectrode puller, and microelectrode manipulator, both the products of Narishige Company, Japan; PNS, provided by Kunming Jacobson Pharmaceutical Co., Ltd, and acetylchloride chline (Ach), the product of Sigma, U.S.A.METHODS: After the animals were executed acutely, their chest wall was opened to isolate SG rapidly under microscope, which was transferred to the perfusion chamber, and fixed with wire needles after peeling the connective tissue membrane. The ganglia were perfused continuously with the mixture of volume fraction 0.95 O2 and 0.05 CO2 plus Krebs solution with pH (7.4±0.05). Meanwhile, 0.08-0.16 g/L PNS was employed to perfuse and culture SG.①The glass microelectrode filled with 3 mmol/L KCI was used to puncture the isolated SG and record the amplitude and duration of depolarizing reaction of postsynaptic membrane.②PNS with the maximum concentration of 0.16 g/L, which could inhibit the f-EPSPs, was perfused to observe the effect of PNS on the amplitude and duration of depolarizing reaction of postsynaptic membrane induced by exogenous Ach (1 mmol/L, 1 minute).③PNS with the maximum concentration of 0.16 g/L, which could inhibit the f-EPSPs, was perfused to observe the effect of PNS on membrane resistance and membrane potential.MAIN OUTCOME MEASURES:①Amplitude of depolarizing reaction of postsynaptic membrane; ②Effect of PNS on the amplitude and duration of depolarizing reaction of postsynaptic membrane induced by exogenous Ach, and membrane resistance and membrane potential.RESULTS: Thirty rats were involved in the result analysis. ①PNS ranged 0.08 to 0.16 g/L could reversibly depress the f-EPSPs amplitude of, or change the forward active potential into f-EPSP; the higher the concentration of PNS, the more obvious the inhibition was. The depression appeared in 3-10 minutes after PNS perfusion, and the effect reached the peak at 0.16 g/L; f-EPSP was decreased evidently in 3 to 4 minutes. The inhibition nearly recovered to the control level after washing the ganglia with Krebs solution for 15 to 20 minutes. ②Effect of PNS on exogenous ACh-induced depolarization: The amplitude and duration of the Ach-induced depolarization did not significantly change before and 5 minutes after 0.16 g/L PNS perfusion [before: (15.5±2.4) mV, (256.1±21.5) seconds; after: (14.3±1.9) mV, (228.6±24.5) seconds, P＞0.05].③Effects of PNS on membrane potential and membrane resistance: The mean membrane potential and membrane resistance were not significantly changed after PNS perfusion [before:-(55.5±12.1) mV, (53.9±5.1) MΩ; after: -(54.3±10.4) mV, (55.1±4.8)MΩ, P＞0.05].CONCLUSION: PNS could reversibly depress the fast-excitatory postsynaptic potential in stellate ganglion of rats by presynaptic mechanism.

Objective To observe the influence of Fibronectin-Thrombopoietin(FN-TPO) gene modified human bone marrow mesenchymal stem cells(MSCs) on the engraftment of cord blood hematopoietic stem cells.Methods FN-TPO gene modified human bone marrow MSCs combined with cord blood mononuclear cells(CB-MNC) were transplanted to sublethal dose treated severe combined immunodeficiency disease(SCID) mice.After transplantation,these mice were observed for 4 weeks.Peripheral blood cell counts were performed at different time point to assay the hematopoietic system status of the mice.Four weeks after the transplantation,human-sourced cell integration was assayed by flow cytometry(FCM) and polymerase chain reaction(PCR).Results One week after the cell transplantation,every main index of the peripheral blood cell counts in the gene modified group was higher than that in the control groups(P

Objective To investigate the differential diagnostic features of subtypes of renal cell carcinoma(RCC) using dynamic contrast-enhanced MRI(DCE-MRI).Methods The MRI appearances of 77 RCCs, including 55 clear cell RCCs(CCRCC),14 papillary RCCs(PRCC) and 8 chromophobe RCCs(CRCC), were retrospectively analyzed and compared with findings of pathology. DCE-MRI was conducted in each case after intravenous administration of contrast agent. Region of interest measurements (cortical, nephrographic and delayed Phases) of signals within tumor and uninvolved renal cortex were used to calculate percentage signal intensity change and tumor-to-cortex enhancement index, and the data was analyzed by AVONA and t test. Results On unenhanced and enhanced MRI, most CRCCs showed homogeneous signal(7/8). CCRCC and PRCC often show inhomogenous signal with necrosis(36/55, 7/14). Hemorrhage and cystic degeneration were often found in PRCC (9/14). On the cortical, nephrographic and delayed phase images, CCRCCs showed greater signal intensity change[(296.15±60.27)%, (236.33±58.31)% and (216.83±46.72)%,respectively than PRCCs (79.70±18.84)%, (122.81±27.35)% and (117.55±20.63)%, respectively], and CRCCs showed intermediate change [(119.56±40.76)%, (163.06±33.91)% and (179.72±32.89)%, respectively].A phenomenon of quick staining and quick fainting was observed in CCRCCs. Both of CRCCs and PRCCs showed delayed enhancement. The tumor-to-cortex enhancement index at the cortical, nephrographic and delayed phases was highest for CCRCCs (1.26±0.34, 0.92±0.23 and 0.76±0.14, respectively), lowest for PRCCs (0.33±0.12, 0.41±0.23 and 0.35±0.11, respectively), and intermediate for CRCCs (0.54±0.10, 0.62±0.15 and 0.69±0.12, respectively,P＜0.01). The degree of enhancement was significantly different among the 3 subtypes at the every contrast enhanced phase (F=940.931, 124.515 and 38.194, P＜0.01), so was the tumor-to-cortex enhancement index(F=798.625,78.308 and 73.699, P＜0.01). There was a good consistency between MR appearances of the 3 RCC subtypes and pathological characteristics. Conclusion DCE-MRI could distinctly show imaging features of CCRCC, PRCC and CRCC, which were related to their pathological characteristics, and these features were helpful in predicting a specific subtype of RCC.

Objective To investigate the expression of LKB1 and p53 in human gastric tissues and their correlation with clinical pathological factors.Methods The expression of LKB1 and p53 in 115 cases of gastric carcinoma and 20 cases of normal gastric tissues were detected by immunohistochemistry method,and the relation between the expression and the clinicopathological parameter of gastric carcinoma was analyzed.Results The positive rates of LKB1 in gastric carcinoma and normal tissues were 20.9 ％ (24/115) and 95.0 ％ (19/20),respectively (P ＜ 0.01).The positive rates of p53 in gastric carcinoma and normal tissues were 45.2 ％ (52/115) and 5.00 ％ (1/20),respectively (P ＜ 0.05).The analysis revealed that the high expression of LBK1 was associated with tumor lymph node metastasis,stage,Lauren classification and worse survival (P ＜ 0.05).The expression of p53 was associated with tumor lymph node metastasis,stage,distant metastasis and worse survival (P ＜ 0.05).Conclusions LKB1 protein expression may play an important role in the development and progression of gastric cancer.LKB1 may be used to assess the malignant biological behavior and prognosis of gastric cancer.

Objective To explore the risk factors of prognosis for children with acute kidney injury (AKI). Methods Clinical data of 118 children with AKI, including the causes,clinical characteristics, laboratory features, renal pathological findings, treatment and outcome, were reviewed retrospectively. Association between risk factors and prognosis was analyzed. AKI was defined by the new classification criteria of the Acute Kidney Injury Network. Prognostic factors were determined by univariate methods and stepwise multiple logistic regression analysis. Results One hundred and eighteen patients (83 male, 35 female) were enrolled in the study, who admitted in our department between January 1, 2005 and May 31, 2008. Median age at the time of AKI children was 7.5 years (range 1 day-14 years), among whom 28.0% (33 cases) was less than 3.0years, 17.8% (21 cases) between 3.0 and 7.0 years and 54.2% (64 cases) more than 7.0 years.Patients' AKI was classified according to the staging system as follows: 52.5% stage 1, 32.2%stage 2 and 15.3% stage 3. The common causes of AKI children were infectious and autoimmune diseases (39.8%), renal vascular disease (27.1%) and circulatory disturbance (11.9%). Hospital mortality was 21.2%. Multivariate analysis showed that independent risk factors for death were need for mechanical ventilation (OR=51.75, P＜0.01＝, sepsis/septic shock (OR=14.76, P＜0.01＝, severe acidosis (OR=11.38, P＜0,01＝, and white blood cells (WBC) count more than 20.0×109/L (OR=8.51, P＜0.01＝. Conclusion Infectious and autoimmune diseases, renal vascular disease and circulatory disturbance are the common causes of AKI children. The important risk factors of death in AKI children are need for mechanical ventilation, sepsis/septic shock, severe acidosis, and WBC count more than 20.0×109/L.

OBJECTIVE:To establish a method for the contents determination of paeoniflorin,hesperidin,baicalin,palmatine, berberine,glycyrrhizic acid,magnolol in Xianglian huazhi pill. METHODS:HPLC was conducted on the column of Agilent Porlshell 120 SB-C18 with mobile phase of 90% acetonitrile(A)-0.1% phosphoric acid 5% aqueous acetonitrile(B)(gradient elu-tion)at a flow rate 1.0 ml/min,the column temperature was 30 ℃,the injection volume was 3 μl,and the detection wavelength was 230 nm for paeoniflorin(0-10.0 min),283 nm for hesperidin(10.1-13.0 min),277 nm for baicalin(13.1-14.4 min),265 nm for palmatine and berberine (14.5-20 min),250 nm for glycyrrhizic acid (20.1-25.0 min) and 290 nm for magnolol (25.1-60.0 min). RESULTS:The linear range was 0.013 88-0.694 5μg for paeoniflorin,0.039 93-1.996 8μg for hesperidin,0.070 08-0.389 3μg for baicalin,0.006 48-0.324 0μg for palmatine(counted by palmatine hydrochloride),0.010 52-0.526 2μg for berberine(counted by berberine hydrochloride),0.008 816-0.440 7 μg for glycyrrhizic acid(counted by ammonium glycyrrhizinate)and 0.007 224-0.361 2 μg for magnolol(r≥0.999 0);RSDs of precision,stability and reproducibility tests were lower than 2.0%;average recoveries were 97.47%-102.88%(RSD=1.91%,n=6),102.06%-102.81%(RSD=0.25%,n=6),97.91%-100.80%(RSD=1.25%,n=6), 97.53%-101.60%(RSD=1.66%,n=6),97.54%-100.68%(RSD=1.15%,n=6),96.23%-99.00%(RSD=1.11%,n=6) and 97.91%-101.44%(RSD=1.36%,n=6),respectively. CONCLUSIONS:The method is simple,rapid and accurate,and can be used for the quality control of Xianglian huazhi pill.

Hilar cholangiocarcinoma is a common bile duct cancer.The radical resection rate of end-stage malignancies reported in literature is about 20％.Half of the patients have lost the chance of operation at the time of care,while the average survival time in the patients who can not be operated is about six months.Therefore,for most patients,looking for a palliative treatment which can prolong the survival time is particularly important.From June 2013 to June 2014,our hospital applied iodine-125 brachytherapy,to treat 7 patients with unresectable hilar cholangio carcinoma.All the patients are still alive,the average survival time of 7 patients is 5.2 months up to now,with median survival time being 7.8 months,and longest survival time being 12 months.With good outcomes,few complications,as well as significantly prolonged survival time,iodine125 brachytherapy is regarded with broad clinical applications.

Objective To study Medpor combined with autogenous outer table of calvarial in management of deformities secondary to orbitozygomatic fracture.Methods In the reconstruction of the orbitozygomatic fracture,we firstly did the operation of osteotomies to reset reliable internal fixation,then Medpor combined with autogenous outer table of calvarial was used to repair wall and in correction of depressed orbitozygomatic region.Results From January 2007 to December 2010,13 cases of deformities secondary to orbitozygomatic fracture were repaired.The enlarged orbital volume was reduced,enophthalmos and facial asymmetry were corrected or improved.Facial deformity was significantly improved and no complications occurred.Conclusions Medpor combined with autogenous outer table of calvarial is benefit to most of secondary deformities to orbitozygomatic fracture.It is an effective solution to the orbital content shift and double vision problem,and it also can reduce the autologous damage and foreign body rejection.

Objective To evaluate the effect of sildenafil on the expression of tumor necrosis factor-alpha (TNF-α) in lung tissues of rats with pulmonary hypertension.Methods Twenty-four male Sprague-Dawley rats,aged 8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),pulmonary hypertension group (group PH),and sildenafil group (group S).Sildenafil 50 mg/kg was injected through a gastric tube into stomach once a day for 35 consecutive days starting from 1 day after lelf pneumonectomy in group S.Pulmonary hypertension was induced by left pneumonectomy and subcutaneous monocrotaline injected at 7 days after operation in PH and S groups.At 35 days after operation,mean pulmonary arterial pressure (mPAP),relative medial thickness of pulmonary artery (RMT),right ventricular systolic pressure (RVSP),and muscularization of small pulmonary arteries were measured in the lung.The ratio of the right ventricular weight to the sum of the weights of the left ventricle and septum (RV/(LV + S)) was calculated.The expression of TNF-α mRNA and protein was determined using RT-PCR and Western blot analysis,respectively.Results Compared with group C,mPAP,RVSP,muscularization of small pulmonary arteries,RMT and RV/(LV + S) ratio were significantly increased,and the expression of TNF-α mRNA and protein was upregulated in group PH,and RVSP,muscularization of small pulmonary arteries and RV/(LV + S) ratio were increased in group S.Compared with group PH,mPAP,RVSP,muscularization of small pulmonary arteries,RMT and RV/(LV + S) ratio were significantly decreased,and the expression of TNF-α mRNA and protein was downregulated in group S.Conclusion Sildenafil can down-regulate the expression of TNF-α in lung tissues of rats with pulmonary hypertension,inhibit reconstruction of pulmonary artery,and decrease the pulmonary arterial pressure.