The plasma level of endogenous digitalis-like substance(EDLS) was measured in 15 patients who underwent cardiac operation under cardiopulmonary bypass (CPB). Blood samples were taken before and after anesthesia induction,immediately before CPB and removing the aortic crossclamp,and at 5,30min after heart rebeating. Resluts showed that the plasma EDLS level slightely decreased after anethesia indction, and significantly decreased immediately before removing the aortic crossclamps and at 5 min after heart rebeating (P

ObjectiveTo evaluate the clinical value of infrahyoid myocutaneous flap in the reconstruction of mouth floor tissue defects. MethodsInfrahyoid myocutaneous flap was made including stenohyoid,thyrohyoid,omohyoid and the affiliated skin based on the axis of superior thyroid artery,vein and ansa cervicalis. The clinical data of 11 patients with reconstruction of mouth floor tissue defects using infrahyoid myocutaneous flap (maximum area was 8 cm × 3 cm) from Match 1993 to June 2009 were retrospectively reviewed.ResultsSeven infrahyoid myocutaneous flaps which reserved platysma branch of superior thyroid artery were all alive, while 2 patients presented epidermal necrosis of 4 un-protected patients. The follow-up period was range from 24 months to 195 months, one patient received salvage surgery for local regional lymphatic recurrence in level Ⅰ,which survived without diseases until now.The rest cases had turned out a success.No dysphagia,dysphonia,and tongue extension difficulty was reported in any patient.ConclusionInfrahyoid myocutaneous flap is one of the valuable donor sites for the reconstruction of mouth floor tissue defects after radical oncologic operations,especially for those with early stage carcinoma of the mouth floor.

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

Objective Unstable intertrochanteric fractures (ITFs) are mostly treated by proximal femoral nail antirotation (PFNA),Inter-Tan,Asian Hip,and other new internal fixation devices.But for complex unstable fractures,such as crushed lateral wall of the greater trochanter,the loss of fixation point on lateral wall slightly reduces the fixing effect.This study aimed to compare the biomechanical strengths between reversed less invasive stabilization system (LISS) and PFNA for treatment of unstable ITFs.Methods Forty synthetic femurs were used to simulate unstable ITFs in vitro and were fixed using the reversed LISS or PFNA.These fractures were divided into two groups depending on whether the lateral wall of the greater trochanter is intact or not (AO classification:31-A2.3 and 31-A3.3,respectively).The load-displacement of femur,stiffness,ultimate load,and cyclic fatigue resistance were detected using an incremental load test and a dynamic fatigue test through an MTS 858 test system.Results For both 31-A2.3 and 31-A3.3,the vertical sinking displacement (VSD) of the femoral head under 500 N load was insignificantly smaller after treatment with reversed LISS than with PFNA,and when the displacement was 5 mm,the femoral head bore insignificantly greater load.The fixation with reversed LISS resulted in greater axial stiffness of the femur but smaller ultimate load.During the same cycle in the dynamic fatigue test,the VSD was insignificantly smaller with the fixation of reversed LISS.Conclusion Reversed LISS and PFNA have similar biomechanical strength for unstable ITFs.This conclusion should be supported by additional large-size research on basic biomechanics and clinical application.This is the first comparative biomechanical study comparing reversed LISS and PFNA for unstable ITFs.

Objective To investigate cyclic mechanical stimulation on expression of connective tissue growth factor (CTGF) in osteoblast-like cells (MG63) and to explore the rote of MAPK involved in the process.Methods Expressions of CTGF protein and mRNA in MG63 cells were detected by Western blot and RT-PCR,respectively. Phosphorylation levels of p38, ERK, JNK were examined by Western blot. Results Cyclic mechanical stimulation upregulated expressions of CTGF protein and mRNA. The levels reached a maximal response of 2-3 fold after 3-6 h. ERK and JNK signal pathways were activated by cyclic mechanical stimulation, the phosphorylated proteins increased within 10 min of stretch, phosphorylated ERK reached maximal levels by 60 min of stretch, phosphorylated JNK reached maximal levels by 15-30 min of stretch, but not for p38 signal pathway.Only the inhibitior of JNK signal pathway (SP600125) markedly suppressed stretch-induced CTGF expression,meanwhile the inhibitors of ERK (PD98059) and p38 (SB203580) did not show such effect. Conclusion Cyclic mechanical stimulation upregulates CTGF expression via JNK-dependent pathway in MG63 cells.

The poorly water-soluble drug curcumin was prepared into oral nanocrystalline solid preparation by nanocrystal technology to improve the solubility, dissolution rate, and bioavailability. Curcumin nanocrystals were prepared by media grinding technology, and two types of stable curcumin nanocrystal suspension formulations were developed. The stabilizers in the two formulations were polyvinylpyrrolidone (PVP K30)/sodium lauryl sulfate (SDS)(1∶1) and Tween 80, respectively. The prepared curcumin nanocrystal suspension was loaded onto microcrystalline cellulose pellets through fluidized bed coating technology, and the nanocrystalline capsules were obtained after filling. The results of nanocrystal redispersion stability and scanning electron microscope (SEM) showed that the morphology of drug-loaded pellets was uniform when PVP K30 and SDS were used as stabilizers, and the diameter of nanocrystals before and after redispersion was about 200 nm, which was determined as the optimal formulation. In vitro dissolution study showed that curcumin nanocrystals at the size of 200 nm exhibited significantly promoted dissolution. The results of X-ray powder diffraction (XRPD) and differential scanning calorimetry (DSC) showed that the curcumin crystalline partly turned amorphous during the preparation of nanocrystals.Pharmacokinetic studies in rats showed that the bioavailability of curcumin nanocrystals was 9.3 times higher than that of the bulk drug. The curcumin nanocrystalline capsules developed in this research can significantly improve the dissolution rate and bioavailability, which is of great significance in improving the poor solubility of drugs, and is expected to become a new dosage form for clinical treatment.

Objective To observe the blood biochemical and histological changes before and after pancreas freezing, to provide evidence for cryosurgery for pancreatic cancer. Methods Fifteen healthy pigs were divided into deep frozen group (n = 5), shallow frozen group (n = 5), non-frozen group (n = 3) and normal group (n = 2). After anesthesia and Iaparotomy, a probe of the Argon-Helium Surgical System was inserted into the pancreas, 100% and 10% argon output power were used in deep and shallow frozen group, respectively;and the temperature were - 130 ～ - 140℃ and - 110 ～ - 120℃, respectively;which results in an ice-ball with 15 ～ 20 mm in diameter. Then helium gas was inputted to increase the temperature to 10 ～ 20℃ for three minutes;then the whole process was repeated. A probe was inserted into the pancreas in the non-frozen group only and only laparotomy was performed in non-grozen group normal group and normal group. Serum amylase, IL-6, CRP levels before and after the experiment was determined;the pigs were sacrificed at day 7 and the pancreas was harvested for light microscope and electron microscope examination. Results The frozen pancreatic tissue became pitchy necrosis zone, and it could be distinguished from non-frozen tissue;there were obvious tissue necrosis in the center and para-center of frozen area, and the ultra-structure were destroyed and disappeared, mitochondria degranulation and rough endoplasmic reticulum degrannlation were observed. Serum amylase was elevated in 13 (86.7%) pigs and most returned to normal at 6th day. Serum IL-6 was slightly elevated in 5 (33.3%) pigs. There was no significant difference among all the groups in term of serum CRP. All the pigs were alive until the time of sacrifice. Conclusions Cryosurgery has affirmative fatal ablative effects on pancreatic tissue, and it is safe with no serious complications.

Two hundred and seventy two type 2 diabetes mellitus (T2DM) patients with negative anti-thyroid autoantibody were enrolled in Shanxi Provincial People's Hospital from November 2016 to September 2017.According to serum vitamin D levels,patients were classified as serious deficiency of vitamin D group([25(OH)D]＜25 nmol/L,n=119),vitamin D deficiency group (≥25 ～ ＜50 nmol/L,n=124)and normal vitamin D group (≥ 50 nmol/L,n=29).There were significant differences in total T4(P=0.04),TSH (P＜0.01),parathyroid hormone (P=0.03) among these groups (P＜0.05).After adjusting gender,age,BMI,glycosylated hemoglobin (HbA1c) and duration of diabetes,serum 25(OH)D level was negatively correlated with TSH (r=-0.24,P＜0.05).After adjusting gender,age,BMI,duration of diabetes and serum 25(OH)D level,HbA1c level was negatively correlated with free T3 (r=-0.18,P＜0.01) and TSH (r=-0.20,P＜0.01).Multiple linear regression analysis revealed that TSH was correlated with 25(OH) D (β=-0.224,P＜0.01) and HbA1c (β=-0.206,P＜0.01).In conclusion,the serum vitamin D and HbA1c levels are independently correlated with thyroid function in patients with T2DM.

Objective To analyze the influencing factors of hematoma complicated from ultrasound-guided minimally invasive surgery for benign breast masses.Methods Retrospective analysis was performed in 412 patients with a total of 516 masses underwent the ultrasound-guided minimally invasive surgery for benign breast masses from January 2011 to December 2015 in Xiaoshan Hospital. Theχ2 test was used to univariately analyze risk factors of hematoma formation after ultrasound-guided minimally invasive surgery for benign breast masses. Logistic regression analysis was used to multivariately analyze risk factors of hematoma formation.Results All masses were resected completely, however, hematomas with long diameter≥1.0 cm were formed in 43 masses one week after surgery, and all hematomas were completely absorbed after six months. There were significant differences in the incidence of hematoma between the groups of different needle sizes, numbers of needle cutting, masses sizes, blood flow grades, depth, resection numbers and effective compression time of postoperative bandages (χ2=16.917, 14.548, 39.971, 23.333, 29.137, 36.819 and 39.864, respectively, allP<0.001). The needle sizes, the numbers of needle cutting, the masses sizes, blood flow grades, depth, resection numbers and the effective compression time constituted the risk factors of hematoma formation after the minimally invasive surgery.Conclusions The risk factors of the hematoma formation after ultrasound-guided minimally invasive surgery for benign breast masses included the different size of the needle, the number of different cutting needles, different size of the masses, the grade of blood flow, the number of resection and the different effective compression time of postoperative bandages. We could prevent the occurrence of hematoma in advance by screening patients and take corresponding measures.

Objective: To report the pedicled anterolateral thigh flap with kiss technique for reconstruction of vulva. Methods: From Mar.2015 to Mar.2017, 17 patients with vulvar tumor were treated with radical resection and transfer of the pedicled anterolateral thigh flap with kiss technique. Results: All the flaps survived completely with no complication. The contour and function of reconstructed vulva was satisfactory. Conclusions The pedicled anterolateral thigh flap with kiss technique for reconstruction of vulva has the advantages of reliable blood supply, low morbidity at donor sites, and good therapeutic effect.