BACKGROUND:The patients are suffering from peritoneal adhesions that are caused after abdominal operation. As so far, there is stil no effective drug or method that can completely prevent peritoneal adhesions. Carboxymethyl chitosan is a biocompatible and biodegradable biomedical material with anti-adhesion effects, which is an ideal biomaterial for prevention of peritoneal adhesion theoreticaly.
OBJECTIVE:To investigate the novel anti-adhesion properties of carboxymethyl chitosan anti-adhesion solution on the prevention of postsurgical adhesion in vivo in a rat model.
METHODS:Fifty-six adult male Wistar rats were randomly divided into four groups: 0.9% normal saline solution (group A), hyaluronic acid gels (group B), medical chitosan gels (group C) and carboxymethyl chitosan anti-adhesion solution (group D). The model of postoperative intestinal adhesion was established by making cecal scratches/abdominal wal defects. Al the rats were scarified after 2 or 3 weeks. Whole blood was colected by cardio-puncture, lung tissue and tissue adhesion were stripped. The incidence and degree of adhesions, histological effects, expression of transforming growth factor-β1 (TGF-β1), the amounts of hydroxyproline and white blood cels were observed.
RESULTS AND CONCLUSION:The formation of postsurgical adhesions in groups B, C and D was significantly decreased, which was lighter than that of group A (P < 0.05). Furthermore, the adhesion formation in group D was significantly decreased in comparison with group A (P < 0.01). At the same time, the levels of transforming growth factor-β1, hydroxyproline and white blood cels in group D were lighter than those of group A (P < 0.05), and the histopathological results indicated that a marked reduction in inflammatory cels and fibroblasts. Carboxymethyl chitosan anti-adhesion solution can effectively reduce the degree and incidence of postoperative adhesion, and it is becoming a promising drug delivery system in the context of postsurgical anti-adhesion.

ObjectiveTo investigate the influence of fast track surgery (FTS) on insulin resistance indexes in esophageal cancer patients.MethodsA total of 68 esophageal cancer patients receiving radical operation in our hospital from November 2009 to March 2011 were randomly divided into 2 groups by envelope method:FTS group ( n =34) and control group ( n =34 ).The postoperative first passage of gas by annus and defecation,postoperative hospital stay,hospitalization expenditure,and postoperative complications were recorded.Insulin resistance indexes were measured before operation as well as on the 1st,3rd,and 7th postoperative days,including fasting blood-glucose (FBG),fasting insulin (FINS),serum level of interleukin-6 (IL-6),and C-reactive protein (CRP).The insulin resistance index (HOMA-IR) was calculated at the same time points.ResultsThe postoperative time of first passage of gas [ ( 1.91 ± 1.13 ) d vs.(2.95 ± 1.25 ) d,P =0.000 ] and defecation [ ( 3.75 ± 1.54 ) d vs.(4.84 ± 1.76) d,P =0.007] in FTS group were significantly shorter compared with control group,and the total hospitalization expenditure was significantly lower in FTS group [ (3.19±0.42) ten-thousand yuan vs.(3.98 ±0.36) ten-thousand yuan,P =0.000 ].The preoperative insulin resistance indexes showed no signifcant differences between the two groups ( all P ＞ 0.05 ).One day after operation,the levels of log-HOMA-IR (0.97 ± 0.52vs.1.54±0.57,P=0.000),FINS [ (11.87±4.55) μU/ml vs.(17.16±6.90) μU/ml,P=0.000],IL-6[ (124.15±21.39) ng/Lvs.(138.78±23.60) ng/L,P.=0.009],and CRP [ (62.92±14.78) mg/L vs.(71.07 ± 14.51 ) mg/L,P =0.025 ] in FTS group were significantly lower than those in control group.Three days after operation,the levels of log-HOMA-IR (0.86 ± 0.47 vs.1.27 ± 0.58,P =0.002),FINS [ ( 9.56 ± 4.37 )μU/mlvs.(14.91±6.54) μU/ml,P=0.000],IL-6 [ (140.94±25.12) ng/Lvs.(153.89±24.06) ng/L,P=0.035],and CRP [ (138.59 ±21.61) mg/L vs.(153.17 ±25.20) mg/L,P=0.019] in FTS group were significantly lower than those in control group.Seven days after operation,the level of CRP in FTS group was significantly lower than that in control group [ (53.07 ± 15.84 ) mg/L vs.( 61.59 ± 16.28 ) mg/L,P =0.032 ].ConclusionFTS may promote the early recovery of gastrointestinal function,reduce stress reaction and postoperative insulin,thus being conducive to fast rehabilitation of esophageal cancer patients.

Objective: To observe the clinical efficacy of Xingnao-Kaiqiao acupuncture("醒脑开窍"针法) on patients with cerebral infarction.Methods: Sixty-three patients with the disease were randomly divided into treatment group(n=32) treated with Xingnao-Kaiqiao acupuncture and control group(n=31) with(traditional) acupuncture.In addition,routine medicine therapies were given to the two groups(including(dehydration),(decrease) of intracranial pressure,enhancement of nerve nutrition and supportive treatment).(Xingnao-)(Kaiqiao acupuncture) was used and adjusted the number of points with different syndromes in the treatment group,main points were as follows: Neiguan(内关PC6),(Rengzhong)(人中GV26),Sanyinjiao((三阴交)SP6) and vice points were Jiquan(极泉HT1),Chize ((尺泽LU5)),Weizhong(委中BL40),Fengchi(风池GB20),Yintang (印堂EX-HN3),Shangxing((上星DU23)-through-Baihui)(百会GV20).Traditional acupuncture was used in the control group.Points at the upper limbs were Jianjing(肩井GB 21),Quchi(曲池LI 11),Waiguan(外关(S)51),Hegu(合谷LI 4) and at the lower limbs were Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Huantiao(环跳GB30),Fenglong(丰隆ST40),Kunlun(昆仑BL60) etc..Acupuncture was given twice a day for 15 days in both groups.Before and after therapy,the hemorrheology,blood lipid,blood,urine,stool and biochemical routine examinations,white blood cell (WBC) count in(peripheral) blood and neurological deficit score(NDS) were(determined).Curative effects of two groups after treatment were observed.Results: After treatment,the total effective power was 93.75% in the treatment group,while it was 67.74% in the control group,the difference being significant (?~2=4.85,P

Background The incidence of dry eye is gradually increased,and researches showed that inflammation participated in the pathogenesis and development of dry eye.The current therapy for dry eye can only relieve symptom but not achieve final cure.Stem cell therapy has been used in the treatment of limbal stem cell deficiency.However,whether it is feasible for the stem cell treating dry eye is still unclear.Objective This study attempted to investigate a new approach to treat dry eye syndrom by using human umbilical cord mesenchymal stem cells (HUCMSCs).Methods The use and care of experimental animals complied with the Tsinghua University School of Medicine Laboratory Animal Care Details.HUCMSCs were cultured and cell suspension was prepared with the cell density of 5×105/ml.Twenty 24-week-old male NOD/Ltj mice were randomized into 4 groups.0.1 ml PBSHUCMSCs suspension was injected via tail vein or lacrimal respectively in the caudal vein injection group and lacrimal injection group,and 10 μ1 PBS-HUCMSCs suspension was topically administed in the eye drops group.The NOD/Ltj mice without any treatment served as the model group.Five male ICR mice were used as the normal control group.Tear secretion was quantitatively detected with phenol red cotton thread in 1,2,3 weeks after injection,and corneal epithelial defect was scored by fluorescein staining.The serum levels of interleukin (IL)-6,IL-17a,tumor necrosis factor-α (TNF-αt) and interferon-γ (IFN-γ) were assayed by ELISA.The relative expression levels of p65,Stat3,Stat5 and extracellular signal-regulated kinases (Erk)-1 in lacrimal gland were detected by Western blot.Results The tear secretion amount was significantly different among the model group,caudal vein injection group,lacrimal injection group and eye drops group in various time points (1 week:F =3.700,P =0.040;2 weeks:F =5.150,P =0.008;3 weeks:F=10.130,P＜0.001).The tear secretion amount was increased in the caudal vein injection group and lacrimal injection group compared with the model group in different time points (all at P＜0.05),and no significant difference was seen in tear secretion amount between eye drops group and model group among various time points (all at P＞0.05).The fluorescein staining score was 3.00±0.63,9.40±1.62,5.20±1.17,4.20±1.17 and 7.20±0.98 in the ICR mouse control group,model group,caudal vein injection group,lacrimal injection group and eye drops group 1 week after injection respectively,and the scores were significantly lower in the caudal vein injection group,lacrimal injection group and eye drops group than those in the model group (P =0.001,0.000,0.033).The serum levels of IL-6,IL-17a and TNF-α in the caudal vein injection group were evidently lower than those in the model group (t =4.70,3.46,11.0,all at P＜0.01),but no significant difference was displayed in the serum IFN-γ level among the five groups (F=1.740,P=0.170).The expressions of STAT5 were significantly decreased in the mice treated with tail vein injection and lacrimal injection compared with mice without treatment (both at P＜0.05).Conclusions Administration of HUCMSCs via intravenous and lacrimal injection can alleviate the inflammatory response during progression of dry eye syndrome by down-regulating the serum level and expression of inflammation-related factors in NOD/Ltj mice.The topical administration of HUCMSCs eye drops can attenuate the symptom of dry eyes by lubricating the cornea and suppling nutrition.

Objective To study on bioactive chemical compounds against ultraviolet irradiation in antarctic ice microalgae.Methods Four kinds of Antarctic ice microalgae were cultured under the conditions of low temperature,illumination,UV-A and UV-B irradiation.The chemical compounds were extracted by methanol and analyzed by spectrophotometer and HPLC/MS.The molecular structures were elucidated according to these data.The chemical compounds were irradated by sunshine to observe the speed of degradation and to estimate the bioactivity.Results There were five active compounds in Chlorophyceae L-4 and 7 active compounds in Diatom HF-9,in which 6 compounds belong to MAAs(mycosporine-like amino acids) and were of more bioactivity against ultraviolet irradiation.Conclusion MAAs from of Antarctic ice microalgae play an important role in resisting ultraviolet irradiation.

According to inpatient records, data managing demand of cardiac remote monitoring network and computer, this software was designed with relative database ACCESS. Its interface, operational button and menu were designed in VBA language assistantly. Its design included collective design, amity, practicability and compatibility. Its function consisted of registering, inquiring, statisticing and printing, et al. It could be used to manage users effectively and could be helpful to exerting important action of cardiac remote monitoring network in preventing cardiac-vascular emergency ulteriorly.
Electrocardiography, Ambulatory ; instrumentation ; methods ; Humans ; Monitoring, Ambulatory ; instrumentation ; methods ; Remote Consultation ; methods ; Software Design ; Telemedicine ; instrumentation ; methods ; User-Computer Interface

OBJECTIVETo evaluate the effect of early enteral nutrition(EEN) on immune response and clinical outcomes after esophageal cancer operation.

METHODSSixty patients with esophageal cancer undergoing radical operation between March 2010 and July 2011 were randomly divided into two groups using envelope method: EEN group(n=30, administration of water and enteral nutrition early after operation) and TPN group(n=30, administration of total parenteral nutrition). Two groups both received 7-day nutrition support. Immune indexes(CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+)) and serum nutritional indexes(albumin, pre-albumin, transferrin) were measured before operation and 1-, 3-, and 7-day after operation. The time to first flatus, length of postoperative hospital stay, total hospitalization cost, and postoperative complication were recorded.

RESULTSAs compared to TPN group, the time to first flatus was significantly shorter in EEN group[(66.5±7.3) h vs. (75.1±6.8) h, P<0.01], as was hospital stay[(7.8±1.1) d vs. (9.3±1.3) d, P<0.01]. Total hospitalization cost[(36 210±3810) yuan vs. (39 731±4013) yuan, P<0.01] was lower in EEN group as compared to TPN group. There was no significant difference in postoperative complication rate between the two groups[13.3%(3/30) vs. 20.0%(6/30), P>0.05]. The levels of CD3(+), CD4(+), CD4(+)/CD8(+), albumin, prealbumin and transferrin were significantly higher in EEN group as compared to TPN group on postoperative day 3 and 7(all P<0.05), while CD8(+) was significantly lower in EEN group(P<0.05).

CONCLUSIONEEN can promote early recovery of gastrointestinal function, improve nutritional and immune function, and therefore lead to fast postoperative recovery in esophageal cancer patients.

Objective To access the value of three dimensional gradient echo two-point Dixon water-fat separation sequence (3 D-DIXON) in quantitative diagnosis of non-alcoholic fatty liver disease(NAFLD) by comparing with in-phase/opposed-phase (IN/OPP)and proton magnetic resonance spectroscopy (1 H-MRS).Methods A total of 69 patients with NAFLD diagnosed by CT were divided into two groups by the ratio of liver spleen in CT (group A,low-grade fatty liver,n=32;group B,moderate and severe fatty liver,n=37).All patients underwent MR 3D-DIXION,1H MRS and IN/OPP examination twice within 1 week after CT examination.Fat fraction(FF) was evaluated and analyzed respectively.Results Pearson linear correlation analysis showed significant positive correlation between group A and group B about FF3D-DIXON,FFMRs and FFIN/OPP.Area under ROC curve (AUC) was different:AUCsYNTHESIZE＞AUCMRs＞AUCIN/OPP＞AUC3D-DIXON.Kruskal-Wallis H revealed significant difference among the three sequences no matter in group A or group B (P＜0.05).FF values of the three sequences (FF3D-DIXON,FFMRs and FFIN/OPP) were negatively correlated with CT liver/ spleen ratio in each group.The cut-off value of 3D-DIXON,IN/OPP and 1 H-MRS to diagnose presence or absence of fatty liver was 4.9 3 9 ％,5.2 8 4 ％ and 10.4 6 0 ％.Conclusion FF values measured by MRI methods might significantly vary based on different sequences.1 H-MRS is also the main method for quantitative assessment of fatty liver,3D-DIXON showed significant advantage in quantifying moderate and severe fatty liver.

Objective To evaluate the value of 1.5T MRI in differential diagnosis of circular enhanced brain lesions.Methods A total of 120 patients,admitted to our hospital from April 2009 to March 2013 and confirmed by clinical pathology,including 40 of brain metastasis,40 of astrocytoma and 40 of brain abscess,were chosen in our study; The characteristic signs of MRI findings of these patients were retrospectively analyzed.Results There were significant differences in the location,number,size,morphology,ring structure,multiple mural nodules,and smooth outside wall of the lesions between patients with brain metastasis and astrocytoma.There were significant differences in the number,size,ring structure,ring wall thickness,and smooth outside wall of the lesions,T2-weighted imaging (T2WI) low signal ring sign,hydraulic fluid level sign,lesion center diffusion weighted imaging (DWI) hyperintensity and apparent diffusion coefficient (ADC) map low signal between patients with brain metastasis and abscess.There were significant differences in the location,shape and multi locular lesions between patients with astrocytoma and abscess.The signs indicating brain metastasis included multi lesions,grade Ⅲ peripheral edema,small lesions,lesions located at the juncture of gray and white matter,with displaying percentages of 79.5％,70.3％,67.5％,48.5％ and 47.9％.The signs indicating astrocytoma included multi locular lesion,lesions located at the white matter,multi mural nodule,rough outside wall and irregular in shape,with displaying percentages of 85.7％,78.0 ％,77.8％,65.4 ％ and 51.9％.The signs indicating abscess included daughter ring sign,DWI hyperintensity and ADC map low signal,circular wall notch sign,hype-intensity rim on T2WI and fluid-fluid level,with displaying percentages of 100％,100％,100％,92.6％ and 82.4％.Conclusion The 1.5T MRI can displaythe characteristic signs of brain metastases,gliomas and brain abscess,which enjoys high value in differential diagnosis.

Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.