BACKGROUND:Autologous peripheral blood stem cels have pluripotent characteristics, promote ischemic limb angiogenesis, improve and restore the blood supply to the affected limb.
OBJECTIVE:To observe the therapeutic effect of autologous peripheral blood mononuclear cel transplantation in rats with thromboangitis obliterans.
METHODS:Twenty-four rats were randomized into control, model and granulocyte colony stimulating factor (G-CSF) groups. In the latter two groups, animal models of thromboangitis obliterans were established by femoral arterial injection of sodium laurate. In the G-CSF group, rats were injected with recombinant human G-CSF for 5 successive days for peripheral blood mononuclear cel mobilization, and then underwent peripheral blood mononuclear cel transplantation at day 7. In the control and model groups, rats were given normal saline injection.
RESULTS AND CONCLUSION:After modeling, foot dorsum temperature and the percentage of CD4+CD25+ regulatory T cels decreased significantly in the model and G-CSF groups, and the area of leg ulcers was enlarged notably in these two groups. In the G-CSF group, the number of white cels and percentage of CD34+ cels to mononuclear cels were increased at 6 days after mobilization; the foot dorsum temperature and the percentage of CD4+CD25+ regulatory T cels increased significantly at 1 month after peripheral blood mononuclear cel transplantation, which were close to the normal values. These findings indicate that autologous peripheral blood mononuclear cel transplantation folowing cel mobilization increases the percentage of CD4+CD25+ regulatory T cels in rats with thromboangitis obliterans, thus promoting relief of symptoms and ulcer healing.

BACKGROUND:Studies have shown that neural stem cel transplantation has a certain effect on neuropathic pain, but the efficacy of transplanted cel number on neuropathic pain is not exactly understood. OBJECTIVE:To observe the effect of different amount of neural stem cels administered intrathecaly on the neuropathic pain and expression of glial-derived neurotrophic factor in the spinal cord dorsal horn and dorsal root ganglion in rats after partial sciatic nerve transaction. METHODS:A Sprague-Dawley rat at 14-16 days of pregnancy was used to prepare neural stem cel suspensions that were injected intrathecaly into rat models of partial sciatic nerve transaction at doses of 1×103, 1×104, 1×105, 1×106, 1×107cels per 30 μL, respectively. Additionaly, model group and sham-operated group were set up. Threshold values of mechanical and thermal pain were recorded 1 day before operation, 1, 3, 7, 14, 21 days after operation. Expressions of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were detected by immunohistochemistry and RT-PCR, respectively, at 7 and 21 days after partial sciatic nerve transaction. RESULTS AND CONCLUSION: Pain threshold values were decreased in al the groups except the sham-operated group at 1 day after operation, and reached the peak at 7 and 14 days after operation (P < 0.05). Compared with the model group, the pain threshold values and the expression of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were increased gradualy in a dose-dependent manner in the 1×104, 1×105, 1×106, 1×107 groups at 7 days after operation (P < 0.05). At 21 days post-operation, the pain threshold values showed no differences from the preoperative findings in the 1×105, 1×106, 1×107 groups, but the expression of glial-derived neurotrophic factor was significantly higher in the 1×105 group than the other groups (P < 0.05). Taken together, intrathecal transplantation of neural stem cels at a dose of 1×105 is the most effective in aleviating partial sciatic nerve transaction-induced neuropathic pain in rats.

Objective To evaluate the effect of fast track surgery nursing in perioperative nursing of patients undergoing laparoscopic resection of colorectal cancer. Methods 60 cases undergoing laparoscopic resection of colorectal cancer were divided into the control group and the obserevation group with 30 patients in each group.The control group was given routine nursing,the observation group accepted fast track surgery nursing.The operation situation,clinical effect and the rate of postoperative complications were compared between two groups. Results There was no significant difference of anesthesia duration,operation time and intraoperative blood loss in two groups.Time of getting out of bed,exhaust time and hospital stay in the observation group were much shorter than those in the control group.The rate of postoperative complications were 26.7％ and 46.7％ in the observation group and the control group respectively,the difference was significant. Conclusions Application of fast track surgery nursing in perioperative nursing of patients undergoing laparoscopic resection of colorectal cancer can promote the quick recovery of patients and reduce the hospital stay and postoperative complications.

Objective To explore the clinical value of using pectoralis major myocutaneous flap in surgery with various adverse factors for advanced oropharyngeal cancer.Methods 15 patients who presented with advanced oropharyngeal cancer were performed for radical surgery,and pectoralis major myocutaneous flaps were applied for immediate reconstruction of surgical defect.In all cases,various adverse factors(advanced age,diabetes,cardiovascular disease,radiation damage,etc.)were existed.The effect of reconstruction was observed.Results All surgeries were successful,and all patients tided over perioperative period.The average time of operation was 5 hours with a range of 4 to 6 hours.The average time cost for flap preparation was 40 minutes with a range of 40 to 55 minutes.The completely survival rate of flaps was 93%.Partial skin necrosis occurred in 1 case(7%);and submandibular fistula occurred in another one(7%).Two patients(13%)developed wound infection.All of them were healed by symptom-atic treatment.Conclusion For the patients with advanced oropharyngeal cancer and various adverse factors of sur-gery,pectoralis major myocutaneous flap can be used as salvage measure in reconstruction of surgical defect,which is more secure than free flap.

Objective To evaluate the changes of soft tissue and hard tissue in the correction of Class II division 1 malocclusion by functional appliance, and to investigate the correlation between these changes and the mechanism underlying the soft tissue profile changes. Methods A total of 32 cases of developing class II division 1 malocclusion were selected. They were in the spurt or pre-spurt phase of growth and development and treated with functional appliance, the molar relationship was corrected to either Class I or overcorrected Class I occlusal relationship. Soft tissue and hard tissue variables on the cephalograms were selected and analyzed. Firstly, paired t-tests were performed to compare the changes between before and after-treatment. Secondly, those variables that had statistically significant differences were selected and analyzed with the Pearson coefficient of correlation (r) between soft tissue and hard tissue changes. Results All variables had statistically significant differences between before and after treatment except for soft tissue facial angle and basic upper lip thickness, mandible plane angle and position of basic upper bone; Correlations between soft tissue and hard tissue changes were as follows: height of lower lip to Me' and S-Go (r=0.54); soft tissue chin thick and N-ANS (r=0.55); height of upper lip and ii/OLp (r=0.52); inferior sulcus to H-line and ii/OLp (r=0.60), pg/OLp, saggital relationship between upper-and lower-jaw (ss/OLp-pg/OLp) (r=0.47). Conclusion The changes of soft tissues profile results from the change of lower incisors' position, mandible' moving forward and its subsequent changes of facial heights and saggital relationship between upper-and lower-jaws.

Objective To explore the clinical effect of laparoscopic uterine artery occlusion combined with uterine myomectomy for uterine myomas.Methods 120 patients with uterine fibroids were selected and randomly divided into research group and control group according to the digital table,60 cases in each group.Patients of the control group directly received conventional laparoscopic myomectomy,and patients of the research group received uterine artery occlusion before laparoscopic myomectomy.The intraoperative blood loss,operative time,postoperative anal exhaust time,hospitalization time of the two groups were observed and recorded.The patients were followed up with menstrual with improvement and luteinizing hormone,estradiol,follicle stimulating hormone.Results The intraoperative blood loss,operative time,postoperative anal exhaust time,menstrual improvement,fibroids relapse and other indicators of the research group were better than those of the control group,the differences were statistically significant [(82.85 ± 19.32) mL vs.(153.26 ± 21.18) mL,(60.56 ± 12.21) min vs.(153.38 ± 21.34) min,(15.62 ± 1.66) h vs.(25.03 ± 1.98) h,96.7 ％ vs.78.3 ％,3.3 ％ vs.16.7 ％,t =28.06,27.67,28.21,x2 =9.21,5.92,all P ＜ 0.05].Two months after operation,the E2 and FSH levels of the research group were significantly different with those before operation (t =3.90,3.51,all P ＜ 0.05),but after 12 months,there were no statistically significant differences in E2,FSH and LH compared with before operation (t =0.42,0.50,P =0.68,0.62).There were no statistically significant differences in E2,FSH and LH compared with before operation at two or twelve months after operation(t =0.19,0.39,0.69,P =0.85,0.70,0.49;t =0.58,0.20,0.37,P =0.56,0.83,0.71).Conclusion Uterine artery occlusion before laparoscopic myomectomy can significantly reduce blood loss,shorten the operation time,speed up the recovery and reduce the recurrence rate,and its influence on ovarian function is temporary and reversible,it is worthy of clinical popularization and application.

Objective To assess the value of outer thimble of epidural anesthesia needle in laparoscopic high ligation for indirect inguinal hernia in children.Methods From April 2003 to May 2006,outer thimble of epidural anesthesia needle,instead of sledge-like hook needle,was utilized in 230 cases during laparoscopic high ligation for indirect inguinal hernia in chilren.Results All the operations on 230 patients were successfully performed.The operation time was 8-10 minutes in 161 patients with unilateral hernia,15-20 minutes in 39 patients with incarcerated hernia,16-20 minutes in 30 patients with bilateral hernia.Edema of scrotum,testis pain and ischemia were not found after operation.Follow-up for 2-6 months in 111 cases,6-12 months in 52 cases,12-24 months in 37 cases,24-36 months in 30 cases showed no recurrence.Conclusions Outer thimble of epidural anesthesia needle can be substituted for sledge-like hook needle in children hernia high ligation,with the advantages of simple procedure and economy.

OBJECTIVETo compare the differences in the clinical efficacy on insomnia between shujing massage therapy and medication with estazolam.

METHODSEighty patients of insomnia were randomized into a shujing mass age therapy group (40 cases) and a medication group (40 cases). In the shujing massage therapy group, the spreading massage manipulation was applied along the running course of the gallbladder meridian of foot-shaoyang on the temporal area. The pressing and kneading manipulation was done at Yangbai (GB 14), Benshen (GB 13), Toulinqi (GB 15), Zhengying (GB 17), Chengling (GB 18), Shuaigu (GB 8), and Fengchi (GB 20), etc, 1 min at each acupoint. In the medication group, 1 mg estazolam was taken orally half an hour before sleep. The treatment was given once every day in the two groups. After the continuous treatment for 1 month, every dimensional score and the total score in the Pittsburgh sleep quality index scale (PSQI) and the clinical efficacy were evaluated between the two groups.

RESULTSAfter the intervention, the each item score of PSQI was improved as compared with that before treatment in the patients of the two groups (all P<0. 05). The differences in sleep time and the time for falling into sleep were not significant between the two groups (both P>0. 05). In the shujing massage therapy group, the scores of sleep quality, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total score were all lower than those in the medication group (all P<0. 05). The total effective rate was 92. 1% (35/38) in the shujing massage group and was 84. 2% (32/38) in the medication group, indicating the significant difference (P<0. 05).

CONCLUSIONShujing massage therapy achieves the superior efficacy on insomnia compared with the oral administration of estazolam.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Male ; Massage ; Meridians ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

Type 1 diabetes mellitus and autoimmune thyroid disorders are the most common combination of autoimmune polyendocrine syndrome type Ⅲ(APS Ⅲ). However, APS Ⅲ combined with myasthenia gravis is rare. We described a male patient with myasthenia gravis, type 1 diabetes mellitus, and Hashimoto thyroiditis, who was diagnosed as APS Ⅲ. The human leukocyte antigen (HLA)type was analyzed in this patient. We subsequently reviewed 11 cases of APS Ⅲ combined with myasthenia gravis. This review revealed that HLA-DR9/DQ9 might be a specific HLA subtype associated with APS Ⅲ and complicated with myasthenia gravis .

Objective To observe the fluctuations of blood glucose in type 2 diabetic patients treated by insulin hypodermic injection in different sites.Methods 30 patients with type 2 diabetes were randomly divided into three groups:abdominal,edltoid region and lateral femoral subcutaneous injection group.After half a year of insulin therapy,dynamic glucose monitoring for consecutive(71±10)hours was conducted,and(847±80)results of glucose Level were obtained.Results The average glucose had no difference in three group,but diurnal maximum and maximum fluctuation amplitude in patients of abdominal subcutaneous injection group were significantly lower than the Other groups(P＜0.05).The time percentage of glycemic fluctuations within 3.6～10.0mmol/L and diurnal minimum was higher compared to other groups(P＜0.05).Conclusion The site choice of insulin subcutaneous injection can influence the fluctuations of blood glucose in type 2 diabetes mellitus and abdominal subcutaneous tissue was the most ideal of the three subcutaneous injection sites.