OBJECTIVE: To investigate the factors affecting shoulder joint functions following artificial humeral head replacement. METHODS: A total of 22 patients with complex fracture of proximal humerus, managed by humeral head replacement in Changhai Hospital of The Second Military Medical University from June 2006 to December 2008 were collected, including 12 males and 10 females, with average age of 67 years (52-86 years). During the procedure, soft tissue damage was minimized, the bone of the tuberosity was reserved as much as possible, appropriate matching size of humerus head prosthesis was selected, and early staging functional rehabilitation was performed. Neer's scoring system was used to evaluate the treatment results after replacement. RESULTS: The 22 patients were followed up for 10-30 months, mean 22.6 months. The shoulder joint functions of 14 cases were recovered more quickly through early post-operative staging rehabilitation, No shoulder joint unstable and stiff occurred. The shoulder joint functions of 8 cases were recovered slowly as they complained pain and did not perform early physical therapy after surgery, shoulder joint of 2 cases presented little unstable and 1 case presented stiff. Only 4 cases of all complained occasionally slight shoulder pain, but could continue daily work. The mean movement ranges of shoulder were as follow: mean flexion for 96°(80°-103°), mean extension for 38° (32°-45°), mean abduction for 86°(80°-110°), mean adduction for 31°(30°-35°), mean external rotation for 32°(30°-37°) and internal rotation for 42° (10°-75°). No vasculardamage, nerve damage, lessening prosthesis or prosthesis dislocation was found in all cases. Based on Neer's scoring system, 5 cases were rated as excellent, 11 as good and 4 as fair, with excellent rate of 82% and case satisfaction rate of 87%. CONCLUSION: In order to recover maximally the shoulder joint functions for post-artificial humeral head replacement, we must try our best to avoid soft tissue damage, reserve the bone of the tuberosity, select appropriate humerus head prosthesis, perform early post-operative staging rehabilitation, as well as maintain a normal retroversion of the prosthesis.

Objective To investigate the detection of peritoneal free cancer cells and its clinical significance. Methods The peritoneal free cancer cells,the positive rates of CK20 protein and CK20 mRNA expressions of peritoneal lavage fluid were detected by peritoneal lavage cytology (PLC),flow cytometry (FCM) and real-time fluorescent quantitative RT-PCR in 50 cases of gastric cancer patients,respectively. The sensitivity of three kinds of detection method to peritoneal free cancer cells was compared. Results The positive rates of peritoneal free cancer cells,CK20 protein and mRNA expression of peritoneal lavage fluid were 20.0% (10/50),36.0% (18/50) and 58.0% (29/50),respectively. The positive rate of CK20 mRNA expression detected by real-time fluorescencequantitative RT-PCR in peritoneal lavage fluid was significantly higher than those of the CK20 protein expression detected by FCM and peritoneal free cancer cells detected by PLC (P0.05). The positive rate of CK20 mRNA expression of peritoneal lavage fluid was related to the tumor invasion depth,differentiation degree,TNM stage,and lymph node metastasis (P

Objective To assess the change of CEA in the peritoneal lavage fluit at pre-,post-laparoscopy-assisted radical gastrectomy, and after hyperthermic perfusion chemotherapy, and to investigate the influence of laparoscopy-assisted radical gastrectomy on drop off of cancer cells, the efficiency of hyperthermic perfusion chemotherapy. To investigate whether CEA in the peritoneal lavage fluit detected by flow cytometry (FCM) is an effective predictor of intraperitoneal free cancer cells and peritoneal metastasis. Methods Peritoneal washings of 40 patients with gastric carcinoma were collected to detect CEA using FCM. The peritoneal lavage cytology examinations ( PLC)were detected by H-E staining. Results Laparoscopic surgery in patients with gastric cancer,before resection of gastric cancer the peritoneal washing CEA positive rate 35. 0% (14/40) ,and after operation, the positive rate was 40. 0% ( 16/40) .which was not significantly higher than that before operation ( P > 0. 05 ). After intraperitoneal hyperthermic perfusion chemotherapy the CEA positive rate was 7. 5% (3/40) ,which was significantly lower than that pre-operation(P<0. 05). Before operation there were 4 cases of positive PLC in the peritoneal lavage fluid, 14 CEA-positive detected by flow cytometry, and there was significant difference ( P < 0. 05 ) . All PLC-positive cases were positive for CEA, whereas 10 PLC-negative cases showed CEA-positive. None of CEA-negative cases showed PLC-positive. Conclusions Laparoscopic radical gastrectomy does not increase the intra-abdominal gastric cancer cell shedding. Intraoperative hyperthermic perfusion chemotherapy is simple and feasible approach with high efficiency.Peritoneal washing CEA detected by flow cytometry is an effective index to predictor for intraperitoneal free cancer cells and prediction of peritoneal metastasis.

Gastric stump carcinoma (GSC) generally refers to the primary cancer in the remnant stomach,which occurs 5 years or latter after subtotal gastrectomy for gastric or duodenal ulcer,or 10 years or latter after gastric cancer resection.Laparoscopic radical gastrectomy for GSC is difficult with low resection rate.Although laparoscopic gastrectomy is technically mature in recent years,there is still few reports about laparoscopic resection for GSC.From January 2009 to June 2012,18 patients with GSC received laparoscopic radical gastrectomy at the General Hospital of Lanzhou Military Area of PLA.Laparoscopic gastrectomy for GSC is technically feasible and safe with satisfactory short-term outcome.Surgeons who have mastered laparoscopic D2 dissection could perform this procedure.

Colorectal cancer is one of the most common malignant tumors.With the improvement of living condition and peoples' life-span,the incidence rate of colorectal cancer has been ascending year by year.In developed countries and developed district of China,colorectal cancer has become the second common malignant tumor.More than one million people were diagnosed as with colorectal cancer,and 500,000 of them died yearly.Colorectal cancer is one of the most common reasons of the death of cancer patients.With the development of molecular targeted agents research,the therapeutic effects for colorectal cancer patients have been improved,and the current status and prospect of targeted therapy for colorectal cancer patients were introduced in this review.

Background and purpose: Cervical conization is a common operation to treat precancerous tissues performed under non-intubated anesthesia. As common opioid analgesics have side effects of inhibiting respiration and circulation, other kinds of analgesic drugs should be coordinated to improve the anesthetic effect, without interfering the respiration and circulation. This study aimed to evaluate the effects of dezocine or flurbiprofen combined with propofolremifentanil in cervical precancerosis conization. Methods: Sixty patients who underwent cervical conization were equally randomized into dezocine group (group D), flurbiprofen group (group F) and 0.9％ natural saline (group N) with 20 patients in each group, and received dezocine 0.1 mg/kg, flurbiprofen 1 mg/kg or 0.9％ natural saline in 5 mL respectively before anesthesia induction. During the anesthesia induction, the targeted control infusion of remifentanil in effect concentration was set at 1.5 ng/mL, and the plasma concentration of propofol was set at 2 μg/mL. Heart rate (HR), respiratory rate (RR), surplus pulse O2 (SPO2) and mean arterial pressure (MAP), MAP were monitored before the anesthesia induction (T0) and after (T1), at the start of cervical conization (T2), and at the end of operation (T3). The incidence of respiratory depression and body movements during surgery were observed. The satisfaction degree of the surgeon to the opening status of cervix was evaluated. The post-operative recovery time, visual analogue scale (VAS) scores, nausea and vomiting in the following 12 hours were also recorded. Results: The HR, RR, SPO2 and MAP in three groups did not have any significant change (P＞0.05) at T0, T1 and T3. At T2 the HR and MAP decreased significantly in group D and group F compared with group N (P＜0.05), and there was no significant difference between group D and group F (P＞0.05). The surgical satisfaction degree of "Good" in group D was 80％, significantly higher than that in group N (30％) and group F (50％), indicating a better cervix opening in group D. The recovery time in three groups had no significant difference, and the VAS scores in group D and group F were lower than those in group N (P＜0.05) after operation, and patients did not have nausea or vomiting in the following 12 hours. Conclusion: Both the dezocine and flurbiprofen could improve the anesthetic effect in cervical conization and post-operative comfort, with less respiratory or circulation depression. Dezocine showed better improvement than flurbiprofen in cervix opening and the inhibition of stress response and body movements during surgery.

BACKGROUNDA proinflammatory milieu emerging in the lung due to neutrophil accumulation and activation is a key in the pathogenesis of acute lung injury (ALI). 15-deoxy-Δ(12, 14)-prostaglandin J2 (15d-PGJ2), one of the terminal products of the cyclooxygenase-2 pathway, is known to be the endogenous ligand of peroxisome proliferator-activated receptor γ (PPAR-γ) with multiple physiological properties. Growing evidence indicates that 15d-PGJ2 has anti-inflammatory, antiproliferative, cytoprotective and pro-resolving effects. We investigated whether 15d-PGJ2 has a protective effect against endotoxin-induced acute lung injury in rats.

METHODSTwenty-four male Wistar rats were randomly assigned into four groups (n = 6 per group): sham+vehicle group, sham+15d-PGJ2 group, LPS+vehicle group, and LPS+15d-PGJ2 group. The rats were given either lipopolysaccharide (LPS, 6 mg/kg intravenously) or saline, and pretreated with 15d-PGJ2 (0.3 mg/kg intravenously) or its vehicle (dimethyl sulphoxide) 30 minutes before LPS. Histological alterations, wet/dry weight (W/D) ratio and myeloperoxidase (MPO) activity as well as tumor necrosis factor (TNF)-α and cytokine-induced neutrophil chemoattractant-1 (CINC-1) levels were determined in lung tissues four hours after LPS injection. Immunohistochemical analysis for intercellular adhesion molecule-1 (ICAM-1) expression and Western blotting analysis for nuclear factor (NF)-κB p65 translocation and IκBα protein levels were also studied.

RESULTS15d-PGJ2 pretreatment significantly attenuated LPS-induced lung injury, and reduced the increased W/D ratio, MPO activity, TNF-α, CINC-1 levels, and ICAM-1 expression in the lung. 15d-PGJ2 also suppressed the nuclear NF-κB p65 translocation and increased cytosolic IκBα levels.

CONCLUSIONS15d-PGJ2 protects against endotoxin-induced acute lung injury, most likely through the reduction of proinflammatory protein levels during endotoxemia subsequent to the inhibition of NF-κB activation.

Acute Lung Injury ; chemically induced ; drug therapy ; immunology ; Animals ; Chemokine CXCL1 ; metabolism ; I-kappa B Proteins ; metabolism ; Intercellular Adhesion Molecule-1 ; metabolism ; Lipopolysaccharides ; toxicity ; Male ; NF-KappaB Inhibitor alpha ; NF-kappa B ; metabolism ; Prostaglandin D2 ; analogs & derivatives ; therapeutic use ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; metabolism