Objective To investigate the effects of lappaconitine on the perioperative immune function.Methods Twenty-four ASA I or II patients aged 23-64 yr undergoing elective radical mastectomy (8 patients),iaminectomy and vertebral canal decompression (8 patients) or femoral head replacement (8 patients ) were randomly divided into 2 groups (n=12 each): control group (C) and lappaconitine group (L).In group L ondansetron 4 mg was given IV and lappaconitine 8 mg was infused IV over 30 rain before induction of anesthesia.In group C equal volume of normal saline was infused instead of lappaconitine.Anesthesia was induced and maintained with propofol,remifentanil and rocuronium.Lappaconitine 0.28 mg/ml was continuously infused at 2 ml/h after induction of anesthesia in group L.When the patients recovered from anesthesia after operation,PCA with 0.28 mg/ml lappaconitine was started (background infusion 2 ml/h,bolus dose 0.5 ml and lockout interval 15 min).In group C pethidine 50 mg and droperidol 2.5 mg were given IM on demand.Venous blood samples were taken at 30 rain before induction of anesthesia(T1,baseline),immediately (T2) and at 24 h(T3) and 48 h (T4)after operation for determination of TNF-α,IL-2,IFN-γ and sIL-6R concentration by ELISA.CD3,CD4,CD8 and NK cell expression was determined using flow cytometry and the ratio of CD4/CD8 was calculated.The concentrations of IgA,IgM,IgG,CD3 and CD4 were determined by radioimmunoassay.Results Plasma SIL-6R and TNF-α concentrations were significantly lower while IL-2,IgA,IgG,IgM concentrations and CD4/CD8 ratio were significantly higher after operation in group L than in group C.Conclusion Lappaconitine can improve perioperafive humoral immune function thus contributing to its analgesic and anfi-inflammatory effects.

AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy ( PTK ) assisted by anterior segment optical coherence tomography ( OCT ) in the treatment of non II type granular corneal dystrophy.
METHODS: A retrospective case series were studied. Totally 8 patients ( 12 eyes ) who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the II type granular corneal dystrophy ( Avellino corneal dystrophy ) by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.
RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.
CONCLUSION: In patients with non type II granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

Objective To recognize the possibility of Y fragment deletion of Amelogenin gene intuitively and simply according to the genotyping graphs.Methods By calculating the ratio of total peak height of genotyping graphs, the statistics of equilibrium distribution between Amelogenin and D3S1358loci,Amelo-genin X-gene and Amelogenin Y-gene, and different alleles of D3S1358loci from 1968 individuals was analyzed after amplified by PowerPlex? 21 detection kit.Results Sum of peak height of Amelogenin X allele was not less than 60% that of D3S1358loci alleles in 90.8% female samples, and sum of peak height of Amelogenin X allele was not higher than 70% that of D3S1358loci alleles in 94.9% male samples.Conclusion The result of genotyping after amplified by PowerPlex? 21 detection kit shows that the possibility of Y fragment deletion should be considered when only Amelogenin X-gene of Amelo-geninis detected and the peak height of AmelogeninX-gene is not higher than 70% of the total peak height of D3S1358loci.

Objective To study the relationship of surgical procedures with clinical effect in herniat-ed lumbar disc in order to improve operative methods and obtain a better outcome.Methods Retrospec-tive analysis was carried out in7235patients with herniated lumbar disc,who had been operated by removal of nucleus pulposus using small incision and fenestration in our hospital since1983,313cases of whom re-ceived second operation because of postoperative complications.There were187males and126females aging from27to62years(mean,45.8years),the incidence of morbidity was4.32%.During the same period,552patients,who had less approved operative result primarily treated in other hospitals,were admitted to our hospital.There were317males and235females aging from31to64years(mean,46.0years).Results The postoperative complications could be divided into short term(within1month after operation)and mid-dle to long term(more than1month after operation)groups.The total446cases with short term compli-cation were133cases primarily treated in our hospital and313cases in other hospital,including of re-herni a-tion or incomplete nuclear extirpation in77treated with second operation,discitis in106treated with con-servative therapy for 67and second operative management for 39,canal hematoma compression in76treated surgi cally,multi-level herniation and leakage in21and mislocalization in59re-operated,injury of nerve root or cauda equina in85treated with nerve exploration,release and anastomosis,residual materials in canal in17with removal of foreign body,venous thrombus in2,and arachnoiditis in3.The total424cases with middle to long term complications were185cases primarily treated in our hospital and239cases in other hospitals,including of nerve root adhesion in159,recurred disc herniation in122,segmental instability in81,and ia-trogenic spinal stenosis in62.Conclusion Many factors may influence the outcome of herniated lum bar disc which can be abolished by sufficient preparation,careful operation and proper managememt.

Objective To identify the expressions and distributions of aquaporin-1(AQP 1) and microvessel density(MVD) in human cervical carcinomas and their relationship,and investigate the roles of AQP1 and MVD in human cervical carcinomas. Methods The expressions of AQP1 and MVD in 74 cases of cervical carcinoma(46 cases of squamous-cell carcinoma of the uterine cervix,28 cases of in adenocarcinoma of the uterine cervix),in 34 cases of cervical intraepithelial neoplasia(CIN) and in 15 cases of normal cervices by immunohistochemical technique.Results The expression of AQP1 was found in vascular endothelial cell of CIN,squamous-cell carcinoma and adenocarcinoma of the uterine cervix,with the largest amount in adenocarcinoma and a same amount in CIN and squamous-cell carcinoma of the uterine cervix.There was distinct difference in the intensities of squamous-cell carcinoma,adenocarcinoma of the uterine cervix and control groups.The expression rates of MVD gradually increased with the progress of cervical lesion.There were significant differences between the above 4 groups for MVD(P

Objective To explore clinical application of single utility port or single port video-assisted thoracoscopic lobectomy.Methods Conducting a prospective study to 191 patients with lung disease who underwent complete video-assisted thoracoscopic surgery (VATS) lobectomy in Department of Thoracic Surgery of The People's Hospital of Wuhan University from June 2013 to Dec 2014.Results Of the 191 patients, 35 underwent left upper lobectomy, 42 underwent left lower lobectomy, 43 underwent right upper lobectomy, 11 underwent right middle lobectomy, 47 underwent right lower lobectomy, and 13 underwent bilobectomy.Operations were successful in all patients with 3 patients transferred for open thoracotomy for severe adhesion or bleeding.A total of 7 of 78 upper lobectomy and 8 of 113 middle or lower lobectomy was done with adding another incision for severe adhesion.The mean operative time was 50 ～ 190 (80.3 ±43.2) min.The mean blood losing was 90 ～ 350 (145.4 ± 56.2) ml.Thirty nine patients underwent upper lobectomy, who were placed two chest tubes, respectively.The upper chest drainage duration was (1.5 ±0.8) d, and the lower chest drainage duration was (4.2 ± 1.3) d.Forty eight patients underwent lower lobectomy, middle lobectomy, or bilobectomy, who were placed one chest tube, respectively.The chest drainage duration was(4.0 ± 1.7)d.The mean recovery time after operation was (6.1 ± 2.5) d.Seventy six patients were diagnosed with lung cancer, and the average number of dissected lymph nodes from each patient was (14.7 ±6.9).The lung cancer was classified as tumor node metastasis (TNM) stage Ⅰ A, Ⅰ B,ⅡA, ⅡB and ⅢA in 67, 61, 34, 22 and 7 cases, respectively.No serious complications, such as bronchopleural fistula or death, occurred in perioperation.Conclusions In consideration of placing two chest tubes after upper lobectomy and placing one chest tube after lower lobectomy, middle lobectomy, or middle and lower lobectomy, we think single utility port-VATS (2-port) for upper lobectomy and single port-VATS lobectomy for lower lobectomy, middle lobectomy, or middle and lower lobectomy are technically safe and have the advantages of drainage, lessening pain, rapid postoperative recovery, and have no significant difference in operation time, the incidence of complications and the number of removed lymph nodes, compared to traditional 3-port-VATS.

RNA interference ( RNAi) is a process in which double-stranded RNA ( dsRNA) induces specific postranscriptional silencing of homologous transcripts. Systematic silencing of genes on a genome-wide scale using RNAi library targeting many thousands of genes provides a powerful research tool in functional genomics. RNAi libraries, which may be derived from plasmids cloning, virus packaging, PCR amplification, chemically synthesis or enzymatic digestion, have been successfully used to identify gene function, dissect signaling pathway and discover drug targets, etc. Promising progresses have been made in this field. The development, application and problems of RNAi library methodology and future prospects were reviewed.

OBJECTIVETo observe the clinical effects of two different circumcision procedures with the Shang Ring and compare their advantages and disadvantages.

METHODSA total of 527 adult males with phimosis or redundant prepuce underwent Shang Ring circumcision by conventional outward replacement (n = 254) and inward placement (n = 273), respectively. We observed the in-ring nocturnal pain, complications, ring-removal pain, degree of edema, recovery time, and patients' satisfaction after surgery, and compared them between the two groups.

RESULTSCompared with the conventional outward placement (5.9%) of the Shang Ring, the inward placement method showed the advantages of mild in-ring nocturnal pain, a low complication rate, significantly reduced ring-removal pain, and mild edema, but exhibited longer healing time.

CONCLUSIONIn Shang Ring circumcision for phimosis and redundant prepuce in adult males, each of the outward and inward placement methods has advantages and disadvantages of its own, but the latter is more advantageous and feasible.

Adult ; Circumcision, Male ; adverse effects ; instrumentation ; Edema ; etiology ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Pain, Postoperative ; Patient Satisfaction ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Prostheses and Implants ; Wound Healing

Background Chondroitin sulphate proteoglycans (CSPGs) can cause the termination of ocular dominance plasticity in the visual cortex.Recently,protein tyrosine phosphatase σ (PTPσ) has been identified as a receptor that inhibits CSPGs.However,whether PTPσ and its downstream molecules participate in the reactivation of ocular dominance plasticity in adult visual cortex has not been studied.Objective The present study was to investigate the changes in the expression of the PTPσ,probabilistic neural networks (PNNs),and molecules downstream of PNN,such as N-cadherin/β-catenin,after the reactivation of adult visual cortical plasticity.Methods Fifty-four SPF Long Evans rats were grouped according to different postnatal week (PW) as the PW1 (6 rats),PW3 (6 rats),PW5 (6 rats),PW7 (24 rats),and PW9 (12 rats) groups,and the upper and lower eyelids were sutured in the 12 rats from the PW7 group for 14 days to establish the binocular plasticity reactivation models.Expression of PTPσ and PNNs in the rat visual cortex was detected using immunochemistry,and changes of PTPσ mRNA,N-cadherin mRNA and β-catenin mRNA expression in the rat visual cortex with plasticity reactivation were assessed by real-time fluorescence quantitative PCR (RT Q-PCR).The use of animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The expression level of PTPσ mRNA was significantly higher in the PW9 group than that of the binocular plasticity reactivation models and the PW7 group (t =1.965,3.526,P＜0.01).The staining of the rat visual cortex for PTPσwas localized to the cellular membrane,cytoplasm and axon.Cell densities of the PW9 group in the Ⅱ-Ⅲ layer,Ⅳ layer and Ⅴ-Ⅵ layer of the visual cortex were elevated in the PW9 rats compared with the PW7 rats (t =24.593,23.444,13.556,P＜0.01) and rats from the binocular plasticity reactivation model (t =44.111,43.000,16.556,P＜0.01).Cell densities for PNNs in the Ⅳ and Ⅴ-Ⅵ layers were significantly increased in the PW9 rats in comparison with the PW7 rats (t=1.926,P＜0.01 ;t=1.370,P＜0.05),but the cell density in the Ⅱ-Ⅱ layer has no statistical significance (t=0.889,P＞0.05).However,cell densities for PNNs in the Ⅱ-Ⅲ and Ⅳ layers in the binocular plasticity reactivation models were lower than those of the PW9 rats (t =2.556,4.585,P＜0.01).Compared with PW1 rats,the expression levels of the N-cadherin mRNA in the PW3,PW5,PW7,PW9 rats were lower (t =28.932,28.988,27.083,28.908,P＜0.01),but those in the PW7 rats were enhanced in comparison with the PW3 rats,PW5 rats and PW9 rats (t =1.848,1.904,1.825,P＜0.01).No significant difference was seen in the expression of the N-cadherin mRNA between the PW9 rats and rats from the binocular plasticity reactivation model (t =0.072,P＞0.05).A statistically significant increase was found in the β-catenin mRNA expression in the PW1 rats compared with the PW3,PW5,PW7 and PW9 rats (t =3.918,3.534,2.645,4.652,P＜ 0.0 1),as well as between rats from the binocular plasticity reactivation model and the PW9 rats (t =0.570,P＜0.01).Conclusions PTPr,PNNs and β-catenin are involved in the reactivation of ocular dominance plasticity in the adult visual cortex.