The revascularization of island flap were studied on rats by angiogram and Spalteholz method. The results indicated that capillary anastomosis was present on the 2nd postoperative day between flap and recipient bed and some recipient vessels entered the flap. Afterwards, the anastomosed vessels increased in number and enlarged in diameter gradually. A good opposition between flap and recipient bed was an important factor influencing anastomosis. Marked proliferation of the vessels was present both in the flap and recipient bed in revascularization.

Objective To evaluate the influence of epidural block on blood coagulation and rhedogy in patients undergoing esophagectomy or lobectomy. Methods Twenty-two ASA Ⅰ-Ⅱ patients (14 male, 8 female) aged 40-65 yr undergoing esophagectomy or lobectomy were randomized to receive either combined general-epidural anesthesia (GEA group , n = 11) or general anesthesia (GA group, n = 11). The patients were premedicated with intramuscular pethidine 50 mg, promethazine 25 mg and scopolamine 0.3 mg. In GEA group epidural catheter was placed at T9-10 interspace before general anesthesia. A test dose of 4 ml 2% lidocaine was given. When correct positioning of the epidural catheter was confirmed, general anesthesia was induced with propofol 1.5-2.0 mg? kg-1 , fentanyl 2?g?kg-1 and rocuronium 0.6 mg? kg-1 , after placement of double- lumen endobronchial tube the patients were mechanically ventilated (VT 10 ml?kg-1 , RR 12 bpm, I: E = 1:2). Anesthesia was maintained with isoflurane inhalation and intermittent i. v. boluses of vecuronium. A mixture of 2 % lidocaine and 0.33% dicaine (1:1) was continuously infused at a rate of 4-6 ml?h-1 during operation. After operation PCEA was commenced with 0.12% ropivacaine and morphine 80 ?g?ml-1 (background infusion 4 ml?h-1 , bolus dose 2 ml, lockout interval 6 min) . In GA group the patients received the same general anesthesia technique. Postoperatively the patients were placed on PCIA with morphine 0.5 mg?ml-1 (background infusion 1 ml?h-1 , bolus dose 2 ml, lockout interval 6 min) Pain intensity was measured using VAS (0-10). Blood samples were taken before induction of anesthesia (T0, baseline), 1 and 3 h after skin incision (T1 , T2 ) and on the morning of 1st and 3rd postoperative day (T3 , T4 ) . Blood samples were tested immediately in a thromboelastograph (TEG) coagulation analyzer. Usual clotting tests (PT, APTT, platelet count, Hb, Hct), fibrinolysis tests (t-PA, PAI-A) and rheology tests were performed at the same time. Results PT and APTT were significantly prolonged during and after operation (T2,T3 ) as compared with the baseline values in both groups (P

Objective To study the effect of individual and environmental factors of diabeties on their glycemic and lipidic metabolism. Methods While educating diabeties with diabetic informations, we inguired their individual data questionnaires. According to their diabetic periods,cultural levels,compliance to their doctors,daily work times and ocupations respectively,we grouped these patients and compared their fasting and postprandial glycemia (FBG & PBG), GHb,serum lipids and serum uric acid (BUA). Results Among 2 856 diabetic patients,the type I was about 4. 9% and the type Ⅱ about 95. 1% ; the family patients was about 9. 91% and the overweight about 44. 29K. According to patients' compliance to their doctors,blood glucose,GHb and lipids and BUA was lower in absolute compliance group than the basical group or the non compliance one (P＜0. 02),and the levels of glycemia and GHb and TG all related to their compliance (respectively r=- 0. 059, - 0. 055, - 0. 075, - 0. 063 ; and P＜0. 05, 0. 05, 0. 01, 0. 025 ). Considering the diabetes periods,the 1-5 year metabolic control of group was best (P＜0. 02) and the 5- 10 year and above 10 year metabolic control groups were better than the group within one year (P ＜0. 05). To patients' cultural levels, the metabolic control senior or higher middle school groups was better than the junior middle school or lower (P＜0. 05). Thinking their daily work time and occupation,the metabolic control of groups working more than seven hours was worst (p respectively less than 0. 05 and 0. 02). Conclusion diabetic patients' individual and environmental factors are all affecting their metabolic control,among them the complicance is most effective.

Objective To know the accumulation and movement of heavy metals in the environment through sewage sluge using in agriculture. Methods The sewage sludge samples were collected from sewage treatment farms of Suzhou, Wuxi and Changzhou in the different seasons of 1998. The content and states of heavy metals were determined by AAS. The accumulation and movement of heavy metals were analyzed as sewage sludge was used in agriculture. Results The content of heavy metals in the sewage sludge was greatly higher than that in the soil background. Especially, the contents of zinc in the sewage sludge in three cities exceeded the related standard, the means were 1 199.00, 784.00 and 1 216.00 mg/kg respectively. A long term using of sewage sludge might induce heavy metal accumulation in the soil. Conclusion Sewage sludge used in agriculture may induce heavy metal accumulation in the soil and the organisms, so the risk of environmental heavy metals accumulation may increase.

In order to make early diagnosis of the ischemic heart disease in the aged NIDDM patients. 500 patients underwent a series of examinations including maximal plate exercise with 59M Tc-MIBI ECT myocardiography. maximal plate exercise ECG and 24-hour ambulatory ECG. The serum lipid. glucose and insulin levels, daily urine protein, glomerular filtration rate,body weight index and eyeground were also studied. The results showed that 56 patients had obvious myocardial ischemia (group A),49 patients had slight myocardial ischemia (group B)and 395 patients were free from myocardial ischemia (group C). With positive 59MTc-MIBI ECT myocardiography, 15 among 16 patients in group A and 6 among 12 patients in group B and none among 5 in group C showed coronary artery narrowing in coronary radiography. The average course of DM,serum total cholesterol,fasting serum glucose and insulin, glucosylated hemoglobin.daily urine protein and the incidence of proliferative retinopathy of group A were higher than those of group B or C(P

126 adult male Wistar rats were used.A 4?6 cm~2 standard island skin flap wasraised on one side of the abdominal wall of the rats.In the flaps of the experim-ental group,only the superficial epigastric and lateral thoracic vein were preserved.The process of revascularization,histological changes,glycogen content and lactatedehydrogenase (LDH) activity of the flap were observed postoperatively with Indian ink injection,X-ray,microscopy and microspectrometry.The shrinking rateand degree of edema of the experimental flap were also observed and all comparedwith those of the control flaps.The results indicated that the flaps of experimentalgroup had a higher survival rate and lower degree of edema,and its glycogencontent and LDH activity decreased markedly on the lst postoperative day,andincreased gradully afterwards.Revascularization started on the 2nd postoperative day,such as capillary anastomoses passing through the cut edges of the flap,vesselsentering the flap from the recipient bed,vessels becoming tortous,dilated,andmarkedly proliferated.The results suggest that there was a true plasmatic circulationat the early stage in the simple venous flap and turns to a normal vascular type byrevascularization.The vividness of a flap may be indicated by the variance of themetabolism of carbohydrate in the skin flap.

Objective:To investigate the efficacy of pidotimod in the treatment of elderly patients with bronchial pneumonia and its effect on immune function. Methods: Totally 85 cases of elderly patients with bronchial pneumonia were randomly divided into two groups:the pidotimod treatment group (43 cases) and the conventional therapy group (42 cases). The conventional therapy group was given moxifloxacin 400 mg·d-1 , ivd, the pidotimod treatment group was additionally with pidotimod oral solutions 800 mg,po,bid, and the treatment course was 10 days. The changes of immune function in the two groups were detected, and the symptoms including fever, cough, asthma, rale and lung spots in X-ray radiation and the symptom duration in the two groups were also compared. Results:After the treatment, the levels of CD4, CD4 / CD8 and NK cells in the two groups were significantly higher than those before the treat-ment, the level of CD8 cells and IgA, IgG, IgM expression levels were significantly lower than those before the treatment (P<0. 05), and the changes in the pidotimod treatment group were much notable than those in the conventional therapy group(P<0. 05). The in-cidence of fever, cough, asthma, rale and lung spots in X-ray radiation in the pidotimod treatment group was lower than that in the con-ventional therapy group(P<0. 01), and the symptom duration was shorter than that in the conventional therapy group(P<0. 01). Conclusion:The mechanisms of pidotimod in the effective treatment of bronchial pneumonia in elderly patients are relative to the im-provement of T cell subsets, NK cells and humoral immunity levels and the enhancement of immunity.

Objective To explore the effects of brain derived neurotrophic factors (BDNF) on concentrations of cerebral endogenous opioid peptides(EOP)in neonatal rats subject to with hypoxic ischemic brain injury (HIBI). Methods Seven day old Sprague Dawley rats were randomly divided into a HIBI+BDNF group (group A),a HIBI group (group B) and a sham operation group (group C). Models of HIBI were established by use of permanent ligation of the left common carotid artery followed by 2.5 hours ofinhalation of 8%O 2+92%N 2, then 0.5 ?g BDNF was injected into the parietal cerebral ventricle in group A immediately. Contents of dynorphin A 1 13 like, ? endorphin like and leu enkaphalin like immunoreactivities (ir DynA 1 13 , ir ? EP and ir LEK) in cortex and hippocampus were measured at 0, 60, 120 min after administration of BDNF. Results The concentrations of ir DynA 1 13 and ir ? EP in the cortex and hippocampus in group B were increased significantly than those in group C at most time points( P

BACKGROUND: Osteoporosis and fracture type are two important reasons for the postoperative failure of proximal femoral nail anti-rotation. The treatment of elderly patients with type AO31-A3.3 femoral intertrochanteric fractures by bone cement augmented proximal femoral nail anti-rotation can effectively reduce the failure rate, but the specific amount of bone cement injected remains to be discussed. OBJECTIVE: To investigate the optimal amount of bone cement in the treatment of type A3.3 intertrochanteric femur fracture with augmented proximal femoral nail anti-rotation in elderly. METHODS: CT data of one volunteer were imported into Mimics 19.0 and Geomagic studio 2017 to extract and optimize the three-dimensional model of the right femur. Internal fixation model was drawn and assembled with femur model according to the standard operation technology, then imported into Hypermesh 14.0 software to simulate type AO31-3.3 intertrochanteric femur fracture. The spongy bone around the proximal helical blade was redefined as bone cement, obtaining A, B and C models with 2.2 mL, 4.2 mL, and 6.4 mL of bone cement, respectively. The material property parameters, boundary conditions, and applied loads were set and imported into LS-DYNA software for solution. RESULTS AND CONCLUSION: (1) There was no significant difference in the inversion and rotation angles of the head and neck fragment and the overall stress in three models, but the blade cutting in model B and model C was severe and the helical blade was broken, while the blade cutting in model A was slight and did not break. (2) The strong anchoring force of bone cement could stabilize the helical blade, but easily led to local stress concentration. (3) The amount of bone cement injected into the proximal femoral nail anti-rotation for the treatment of type A3.3 intertrochanteric femur fracture in elderly should not be too much, and less than 3 mL may have the best biomechanical effect.

Objective To investigate the remote liver injury induced by reactive oxygen species (ROS) after intestinal ischemia/reperfusion (I/R) and the mechanism of liver protection afforded by methylene blue (MB) Methods Thirty-two rabbits weighing 2.3-2.9 kg were randomly divided into four groups: (1) normal group in which sham operation was performed; (2) I/R group in which intestinal I/R was produced by clamping anterior mesenteric artery for 1 hour; (3) in treatment group A MB 3 mg?kg-1 was given iv immediately ofter before declamping and (4) in treatment group B MB 15 mg?kg-1 iv was given. Common carotid artery was cannulated for direct continuous blood pressure monitoring. Blood samples were taken before anterior mesenteric artery occlusion, immediately after and 30 min, 1 h and 2 h after decalmping for determination of blood MDA concentration. At the end of the experiment a small piece of hepatic tissue was obtained for determination of its superoxide dismutase (SOD), catalase (CAT), xanthine oxidase (XO) and MDA levels.Results In I/R group blood MDA level increased significantly after I/R as compared with the baseline value before I/R and blood pressure decreased significantly after I/R, while in treatment group A and B there was no significant increase in blood MDA level after I/R. In I/R group liver MDA level was significantly higher than that in normal group, but there was no significant difference in liver MDA level between normal group (group 1) and treatment groups (group 3,4) .Conclusion Methylene blue can reduce the generation of ROS during intestinal I/R and protect liver from ROS-induced injury.