Objective To summarize the perioperational nursing strategies for patients undergoing mandibular defect repair by forearm flap composite fibula flap.Methods From January 2009 to December 2012,9 patients with mandibular defect and soft tissue defects after resection of malignant tumors received fibula flap and forearm flap.Before operation,the patient received psychological education and the preparation of donor flap and receptor area together with oral preparation was performed.After operation,the vital signs and blood circulation in the flap were observed.Results The fibula and forearm flaps in 8 patients survived.The fibula flap in one patient survived while the forearm flap developed with vascular crisis.The success rate for the transplanted flap was 89.9%. Conclusion The perioperative nursing strategies are key to increase survival rate of flaps and the success rate of operation.

Objective To determine the effects of a 12-week aerobic exercise program on brachial-ankle pulse wave velocity ( baPWV) in sedentary and under-exercised healthy older adults. Methods A total of 35 sedentary and unfit but healthy older adults with mean age of 74.7 years were randomly assigned to a progressively increased intensity aerobic exercise group ( n = 17) or a control group ( n = 18). The exercise group performed aerobic exercise 3 times each week for 12 weeks. The control group didn't participate in the exercise program. Heart rate,blood pressure and baPWV were evaluated at admission to the aerobic exercise program and at the end of the 12 weeks in both groups. Results The mean baPWV in the aerobic exercise group decreased from 15.88 m/s to 14.62 m/s after exercise, a significant reduction. Blood pressure in the exercise group showed a decrease which was not significant. No significant improvement was identified in the control group. Conclusions Only 12 weeks of aerobic exercise with progressively increased intensity can improve arterial elasticity in sedentary and unfit older adults.

Objective To analysis the effective ingredients in Huanglianjiedu decoction under different decocting conditions. Methods The detecting method of HPLC was established and the ingredients in Huanglianjiedu decoction under different decocting time and times were analyzed. Result Water- soluble glycoside of gardenoside and baicalin reached balance of dissolution within 20 min and their dissolution rate were about 82% and 60% respectively. Water-soluble alkaloids of berberine and palmatine reached balance of dissolution within 30 min and their dissolution rate were about 45%. The dissolution rate of wogonin was 31% at 60 min. The dissolution rate of Crocin-Ⅰ reached top at 20 min and fell down after 20 min. Decocting times for fat-soluble constitutes was more important than water-soluble constitutes. Conclusion The decocting condition has effect on the dissolution rate and stability of the ingredients in Huanglianjiedu decoction. The decocting condition is very important to the quality control of decoction.

Objective To observe the clinical curative effect of zhidanhuayu decoction on patients with carotid atherosclerotic plaque.Methods 80 patients with carotid atherosclerosis were randomly divided into two groups, each group of 40 cases, the control group was treated with rosuvastatin calcium 20 mg, once every night.The treatment group in the control group on the basis of a scheme based on the use of night zhidanhuayu decoction water 500 mL temperature and heat to 200 mL, then add water and cook until 200 mL to 100 mL, on the afternoon of two phase decoction against half amount of clothes, a daily agent;the two groups were 3 months for 1 courses.Before and after treatment, the mean medial thickness(IMT), plaque score, blood lipid and adverse reactions were observed.Results There was significant difference between the two groups before and after treatment, the difference was significant between the medial and middle thickness(IMT), plaque score and blood lipid(P< 0.05).After treatment, compared with the control group, the treatment group and the control group, IMT, plaque score, blood lipids were statistically significant(P< 0.05).Conclusion Zhidanhuayu decoction can adjust the blood lipids, but also has the effect of anti atherosclerosis.

AIM: To determine the effects of NF-?B on the development of rat pancreatic fibrosis mediated by angiotensin II. METHODS: Spraque-Dawley rats (200-300g) were randomly divided into normal group, control group and losartan-treatment group. Pancreatic fibrosis was induced by injection of 2% TNBS into biliopancreatic duct. Rats in losartan-treatment group and control group were respectively treated with losartan (10 mg?kg~(-1)?d~(-1)) by gavage and the same volume of saline vehicle. The expression, distribution, and activation of NF-?B were studied by Western blot, immunohistochemistry and TransAM~(TM). Toluidine blue staining and transmission electron microscopy were also used to observe the number, distribution and degranulation of mast cells. In addition, RT-PCR was performed to detect the intrapancreatic ICAM-1 mRNA expression. RESULTS: The expression and activity of intrapancreatic NF-?B p65 protein were significantly increased on day 3 after operation, reaching peak on day 7 [(0.406?0.086) mg/g total protein]. Mast cell activation was observed and ICAM-1 mRNA levels on day 3 and 7 were up-regulated in control group. Losartan treatment inhibited NF-?B expression and activation, reduced mast cell infiltration and degranulation and decreased ICAM-1 mRNA expression compared with control rats. CONCLUSION: It might be associated with the expression and activation of NF-?B that angiotensin II mediates inflammation and fibrosis in the early stage of pancreatic fibrosis. [

AIM: To examine the effects of PPAR? activation on the growth of human pancreatic carcinoma in vitro and to explore the role of NF-?B and activator protein-1 (AP-1) in this process. METHODS: SW-1990 pancreatic cancer cells were treated with ligand of RXR?, 9-cis-RA, ligand of PPAR?, 15d-PGJ_2, and both. Antiproliferative effect was evaluated by using MTT assay; the expression of NF-?B p65 active protein was assayed by using TransAM~TM technique. Expression of c-jun and c-fos by SW1990 cells, which were treated with 15d-PGJ_2, 9-cis-RA and both at varying concentrations, were detected by RT-PCR. RESULTS: MTT assay demonstrated that 15d-PGJ_2, 9-cis-RA and the combination of both had a potent inhibitory effect on the growth of SW1990 cells in a dose-dependent manner. 9-cis-RA had a synergic action with 15d-PGJ_2 on the growth inhibition of pancreatic carcinoma. TransAM~TM showed a down-regulation trend of P65 active protein in SW1990 cells treated with 15d-PGJ_2, 9-cis-RA and both. RT-PCR demonstrated that the expression of c-jun mRNA in 15d-PGJ_2, 9-cis-RA and the combination of both-treated cells were firstly increased and then decreased, the expression of c-fos was decreased in 15d-PGJ_2 or 9-cis-RA treated SW1990 cells, but increased in cells treated with both 15d-PGJ_2 and 9-cis-RA. CONCLUSION: Activation of PPAR? exerts a negative regulatory effect on the growth of pancreatic carcinoma in vitro. Activation of RXR? has a synergic action with PPAR? agonist. The mechanism is probably associated with down-regulating the expression of NF-?B and AP-1. [

AIM:To investigate the protective effects of adenosine on cultured rat hippocampal neurons after oxygen-glucose deprivation. METHODS:The control and adenosine-treated hippocampal neurons cultured for 12 d were exposed to oxygen-glucose deprivation environment for 0.5-4 h and then cultured with original medium in normoxia for 24 h . The soma area,survival rate, effluxes of lactate dehydrogenase (LDH)and apoptosis of neurons were observed. RESULTS:The soma area, effluxes of lactate dehydrogenase from neurons and apoptosis were increased while survival rate of neurons was decreased after oxygen-glucose deprivation compared with those pre-oxygen-glucose deprivation. Compared with the control, after oxygen-glucose deprivation the soma area, effluxes of lactate dehydrogenase from neurons and apoptosis were decreased, however, the survival rate of neurons was increased in the adenosine group.CONCLUSION: Oxygen-glucose deprivation can lead to the severe damage of cultured hippocampal neurons, and adenosine can reduce neuronal injury induced by oxygen-glucose deprivation.

Objective To retrospectively analyze clinical manifestations of autonomic nervous system (ANS) and skin sympathetic response (SSR) in Lambert-Eaton myasthenic syndrome (LEMS).Methods Fifty-three LEMS patients' medical records were reviewed and information regarding clinical symptoms and signs of ANS and SSR testing results were collected.Results ( 1 ) The most common initial symptom of LEMS was weakness of lower extremities ( n =41 ) and the most common symptom of ANS dysfunction was constipation ( n =25 ) and dry-mouth ( n =23),which could be occurred before the onset of the legs (n =7).(2) In symptoms of ANS,cardiovascular system dysfunction was found in 4 patients include one of ingone of bradycardia,one of postural hypotension and 2 of tachycardia- Secretory glands dysfunction was found in 34 patients:23 dry-mouth,6 dry-eyes,and 8 patients sweating dysfunctions.Twenty-eight patients complained of alimentary dysfunction including constipation and diarrhea.Bladder dysfunction was found in 2 patients,who complained of urinary incontinence.Seven male patients complained of sexual dysfunction.Abnormal skin scratch test was found in 17 patients.(3) SSR was performed in 33 patients and 18 found abnormal.Conclusions ANS manifestations are common and prominent in LEMS patients.SSR abnormality is also common in LEMS.More electrophysiology tests are needed in LEMS patients.

Objective To explore the effects of rhubarb navel therapy on fecal continence in rectal cancer patients with colostomy.Methods 60 patients with colostomy were randomly divided into the experimental group and the control group with 30 patients in each group.Patients in the control group received routine therapy and health education whereas the experimental group received 30-day extra rhubarb navel therapy started on the 15th day after the operation.The two groups were compared in postoperative 3 months with the following factors:the functions of colostomy and the formation of bowel regularity.Results The scores of the scale about the functions of permanent abdominal colostomy were improved in both groups.However,the score in the experimental group was much higher than that in the control group.The number of patients forming bowel regularity in the experimental group was more than that in the control group (19 and 4 cases respectively).Conclusions Rhubarb navel therapy is beneficial to rectal cancer patients with colostomy to improve the functions of colostomy and form the bowel regularity.

Objective To understand the endemic characteristics and regularity of cystic echinococcosis by evaluating and classifying its endemic situation in Non Tibetan Plateau regions,so as to provide the evidence for formulating effective preventive and control measures. Methods The prevalence data of cystic echinococcosis in 174 counties(cities,districts,banners)in Non Tibetan Plateau regions from a national survey were collected and analyzed by the sample cluster method in 2012. Results The 174 counties(cities,districts,banners)could be classified into 4 clusters by spatial distribution. The first cluster with human high prevalence rate,low infection rate of livestock,and positive rate of dog stool antigen included 3 counties. The second cluster with high infection rate of livestock,low prevalence rate of human,and positive rate of dog stool antigen included 20 counties(cit-ies). The third cluster with high positive rate of dog stool antigen,low prevalence rate of human,and low infection rate of livestock included 39 counties(cities,districts,banners). The fourth cluster with low rates of the above 3 indices included the rest 112 counties. Conclusions The results of the cluster analysis conform to the current epidemiological status of cystic echinococcosis in the Non Tibetan Plateau regions. The epidemiological characteristics and geographical distributions of the four area types will pro-vide a basis for the classified management and guidance of cystic echinococcosis control in these areas.