Objective To investigate the effects of acupuncture on astrocyte proliferation in hippocampus of rats after cerebral ischemia-reperfusion. Methods Ischemia-reperfusion injury was induced by temporary middle cerebral artery occlusion(MCAO)in 36 Sprague-Dawley rats,who were divided randomly into a control group,a model group and an acupuncture group.The expression level of Cyclin D 1 and glial fibrillary acidic protein(GFAP) was analyzed by immunoreactivity and Western blot. Results It was shown that the expression of Cyclin D1 and GFAP increased significantly(P＜0.01)at 2 and 7 days after cerebral ischemia-reperfusion,respectively.It was also shown that application of acupuncture could inhibit Cyclin D1 and GFAP(P＜0.01). Conclusion Acupuncture may inhibit glial proliferation by regulating cell cycle factor.

To analyze clinical, neuro-electrophysiologocal, imaging and pathological characteristics of Hirayama disease (HD) and review its relevant literatures to improve its diagnosis. Clinical data of two HD cases admitted to Fujian Provincial Hospital, Fuzhou during 2005 to 2008 were analyzed with literatures review. HD occurred more in males, often onset at their adolescence with muscular weakness and atrophy in one or two upper limbs, but without sensory dysfunction or pyramidal signs. Neuro-electrophysiology showed neurogenic abnormality in the body areas dominated by the 4th cervical vertebra to the 1 st thoracic vertebral (C4-T1) spinal nerves in all the patients. Magnetic resonance imaging (MRI) showed slight atrophy of the lower cervical spinal cord at routine position and its compression and forward displacement to varied extent at flexion position, with posterior epidural capsular space widening, crescent or striped high signal, and voids of vessels in some patients. Enhancement magnetic resonance scanning showed crescent sign enhanced in some patients. Biopsies of the inflicted muscles appeared slight neurogenic abnormality in some cases, and normal in other cases. HD is rarely seen clinically, but it can usually be diagnosed according to its symptoms, neuro-electrophysiology and MRI.

Clinical ophthalmic surgery is a special branch of general surgery,the microsurgery of ophthalmology has properties of high-precision,high-risk and longer learning curve.The ophthalmology department of Tongji University Hospital has explored a set of step-by-step and efficacious postgraduate student education method,including theoretical basis,in vitro stimulation and in vivo practice.The intervention of quality control and incentive mechanism were also included.

Objective To investigate the effect of meisoindigo inducing primary K562 cell apoptosis and its influence on the expression of conduction signal STAT5.Methods K562 cell was treated with meisoindigo for 12 h、24 h、48 h respectively.Flow cytometry was used to detect cell apoptosis and cell cycle,and Western blot was employed to examine the alteration of the expression of STAT5.Results ①The rate of K562 cell apoptosis treated with meisoindigo for 12 h、24 h、and 48 h was 12.5 ± 0.69,19.4± 1.07 and 42.5 ± 3.22,showing statistical significance compared with the control group (P＜0.05).②Meisoindigo could block K562 cell at the S stage,the ratio of S stage cell was increased to 70.48±6.34 with the decrease of cells at G0/G1 and G2/M stage.③Gradually reduced expression of STAT5 showed after K562 cells treated with meisoindigo from 12h to 48h.Conclusion Meisoindigo accelerrates the apoptosis of K562 cell and the mechanism may relevant to the decreased expression of STAT5.

Objective To analyze the diagnosis and treatment of airway stenosis in a consecutive series of bronchial anastomosis after lung transplantation in our center.Methods We performed a retrospective study on 100 cases of lung transplants in our center from September 2002 to December 2010.Seventy-two cases were subjected to single lung transplants (SLT), and twenty-eight to bilateral sequential single lung transplantation (BSSLT). There were totally 128 bronchial anastomoses.All recipients received long-term follow-up to monitor the lung function.Lung CT and fibrobronchoscopic examinations were done when necessary. Results Twenty-five cases with 37 bronchial anatomoses were died.A total of 12 airway stenosis occurred in 10 cases (12/128,9.4 ％).Four cases underwent telescopic anastomosis and 6 cases underwent end-to-end anastamosis.Mean diagnosis time was 60.1 35.6 days post-operation (ranging from 15-120 days,median 59 days).There were 8 cases of unilateral airway stenosis (3 on the left,and 5 on the right) and 2 cases of bilateral airway stenosis.The number of simple airway stenosis was 3,that of exophytie granulation tissue was 8,and that of bronchus intermedius stenosis was 1.Culture of bacteria by fibrobronchoscopy with protected specimen brush revealed:3 strains of Pseudomonas aeruginosa,2 strains of Klebsiella pneumoniae,2 strains of Aspergillus,1 strain of Escherichia Coli. 10 cases were treated with fiberoptic bronchoscopic balloon dilation:5 cases with high-frequency electrotome,4 cases with stent placement,and 1 case with argon plasma coagulation (APC).Seven cases were cured or improved and 3 cases died.Conclusion Airway stenosis after lung transplantation remains a major problem.The fiberoptic bronchoscopic procedure is the gold standard to diagnose. The preferred treatment is fiberoptic bronchoscopic balloon under expansion,and other approaches include high-frequency electrotome,APC and stem placement,etc.

Objective To investigate the clinical efficacy and safety of Ganciclovir combined with interferon-α1 b inhalation for children with infectious mononucleosis(IM).Methods A total of 177 childhood cases of IM were selected,and they were divided into 3 groups,59 cases in each group according to the random number table.Three therapeutic methods were applied in different groups for 5-7 days in different groups:Ganciclovir (group A),Ganciclovir + interferon-α1 b inhalation (group B) and Ganciclovir + interferon-α1b intramuscularly (group C).The time of post-drug recovery from isthmitis,less than 0.05 of heterotypic lymphocytes,shrink of cervical lymph nodes shrink,liver retraction,spleen retraction among groups were compared.The Epstein-Barr virus (EBV)-DNA copy number and T lymphocyte subsets were compared before and after treatment.Adverse reactions were observed in each group.Results Compared with group A,the time to defervescence [(3.20 ± 1.81) d,(3.17 ± 1.76) d vs.(4.01 ± 2.34) d],duration of isthmitis was [(3.15 ± 1.33) d,(3.09 ± 1.37) d vs.(3.98 ± 1.31) d],and the time of heterotypic lymphocytes less than 0.05 [(3.12 ± 1.55) d,(3.10 ± 1.33) d vs.(3.95 ± 1.26) d] in group B and group C,were obvious shorter,and there were significant differences(F =4.150,4.580,4.060,all P ＜ 0.05).EBV-DNA negative conversion rate of group B and group C were higher than that of group A [53 cases(89.8％),52 cases (88.1％) vs.41 cases (69.5％),x2 =10.403,P ＜ 0.05],and the cellular immune function was improved significantly than that of group A after treatment for 7 days [CD3 +:(63.00 ±4.39)％,(62.75 ±4.84)％ vs.(68.70 ± 7.70)％;CD4+:34.08(30.21,41.70)％,33.94(29.17,45.17)％ vs.32.34(28.16,43.53)％;CD8+:30.59 (27.14,40.22)％,30.09(27.54,40.48)％ vs.32.57(28.68,41.17)％;CD4+/CD8+:1.12(1.03,1.31),1.11 (0.99,1.64) vs.0.94 (0.87,1.59),F/x2 =11.020,1.217,1.121,6.728,all P ＜ 0.05].The differences in indexes between B group and C group were not significant,and there was no statistical significance (all P ＞ 0.05).There were 2 cases with fever in the group C,and 2 cases of granulocytopenia in all group.Conclusions Ganciclovir combined with interferon-α1 b inhalation or intramuscular injection is effective and safe in treating children with IM.It can improve clinical symptoms,cellular immune function and EBV-DNA negative conversion rate.Since inhalation is of less side effects and no pain,it can be accepted by children and their parents easily.Therefore,it is recommended that Ganciclovir be used together with interferon-α1 b inhalation in the treatment of children with IM.

Objective To observe the therapeutic effects of lung transplantation for diffuse pulmonary disease. Methods From September 2002 to April 2009, lung transplantation was performed on 72 cases in our hospital. Thirty-seven cases of these recipients were suffered from diffuse pulmonary disease, including idiopathic pulmonary fibrosis (30/37), pneumosilicosis (4/37), vascular leiomyoma (2/37) ,diffuse panbronchiolitis (1/37),30 males and 7 females with age ranging from 22 to 73 years old (mean 52.9 ± 13.2). All the patients received pulmonary function test and echocardiography (ECHO) to test the pulmonary artery systolic pressure before transplantation and artery blood gas to calculate the oxygenation index (PaO2/FiO2 ). Results The systolic pulmonary artery pressure (Ppa,syst) was monitored by Swan-Gans catheterization one week post-transplant, and decreased significantly from 54. 30 ± 17. 41 to 41.52 ± 9. 36 mm Hg (P＜0. 05). Simultaneously, oxygenation index was improved from 185. 89 ± 77. 25 to 392. 12 ± 98. 23 (P＜0. 05). The pulmonary function was also improved significanzly one month post-operation. The volume in the first second was improved from (1.33 ± 0. 64) to (1.81 ± 0. 57) L, and the diffusion capacity of carbonmonoxide was increased from (2. 87 ± 1.26) to (4. 22 ± 2. 05) L. Conclusion Lung transplantation is feasible and efficient to deal with diffuse pulmonary disease.

Objective To explore the value of color Doppler ultrasonography(CDU)as preoperative diagnosing and postoperative monitoring in patients with stenosis of subclavian or innominate artery(SIA)before and after percutaneous transluminal angioplasty and stent(PTAS).Methods A total of 45 patients with stenosis of SIA were selected.Their extracranial vertebral artery and subclavian artery were observed with CDU.In 36 patients with one-sided stenosis of SIA.blood flow direction and spectrum of extracranial vertebraI artery were analyzed.Subclavian steal grade confirmed by spectrum change of vertebral artery was compared with the stenosis grade on quantitative angiography(QA).Among 45 patients with stenosis of SIA,PTAS was performed successfully in 36 patients(36 stents implanted).After stents implanted, hemodynamie parameters such as peak systolic velocity(PSV)in stent, follow-up velocity ratio in stem(VR)were measured.Restenosis in stent were observed.Results In 36 patients with one-sided stenosis of SIA,the ultrasonographic steal grade correlated with the QA stenosis grade significantly(r=0.752,P<0.01).Among 36 patients with stent implanted,follow up 8-12 months, 4 patients with restenosis in stent were found.Compared with the patients without restenosis in stent,PSV and VR in stent increased significantly(P<0.01).Conclusions As a fast and non-invasive imaging technique,CDU could allow diagnosis of stenosis of SIA before PTAS,and detection of restenosis after PTAS.

In order to train the clinical ophthalmic seven-year students to further comprehend their professional knowledge and further stimulate their imagination and creation ability, we developed several steps to promote these students' patent designing ability. These steps include: trained targets selection, theoretical knowledge training, clinical practice training, comprehensive quality control, et al. In the implementation of the concrete steps, we put emphasis on the elements such as step by step training, the high quality computer assisted mapping and the internationally compatible contents, et al., and encouraged the students to propose the assumption of solving the problems in the clinical and sci-entific research. And the stimulation mechanism and medical humanity were infiltrated all the while.

Objective To investigate the institution of extracorporeal membrane oxygenation (ECMO) for primary graft dysfunction (PGD) after lung transplantation (LT) and analyze its clinical outcome.Method A retrospective analysis was performed on 22 patients with grade 3 PGD in early stage after LT from September 2002 to December 2013.There were 7 patients with single LT and 15 patients with bilateral LTx.Ventilatory support was used at early stage for 6 cases,and at later stage,ECMO assistant circulation was used for 16 cases.Result Of 6 patients treated by adjusting low volume,high frequency and high positive end expiratory pressure ventilation (PEEP) mode,2 cases reversed,and 4 cases died of respiratory failure.In 16 cases accepting ECMO support,10 cases were given venous-venous mode and 6 cases venous-artery mode.The average flow time was 5.5 days.ECMO was successfully withdrawn in 10 cases and 6 cases died of multiple organ failure,infection and cardiac arrest.Conclusion The high incidence of PGD causes high mortality peri-operatively after LT.Preventing ECMO can improve the survival rate of the lung transplant patients.Once PGD happens,appropriate treatment should be given as soon as possible.ECMO can effectively promote the transplanted lung function recovery,and reduce the perioperative mortality.If the indications of ECMO use was reached,the institution of ECMO should be used as soon as possible.