Objective To study the clinical implementation strategy analysis about fast track surgery ( FTS) used in right co-lon cancer radical.Methods 72 patients with right colon cancer laparoscopic treatment in our hospital from June , 2013 to Decem-ber, 2014 were randomly selected and divided into observation group ( n=36 ) and control group ( n =36 ) by numeric randomized method.Observation group adopted treatments based on FTS while control group treated with conventional laparoscopic radical prosta-tectomy.Stress reaction, operation time, intraoperative blood loss, exhaust time, defecation time, stop the infusion time, drainage a-mount and postoperative drainage tube root out time, postoperative hospital stay and postoperative complications of two groups were sta-tistically analyzed.Results Preoperative blood cortisol, fasting blood glucose, serum IL-6 and plasma CRP level of two groups, op-eration time and compare differences of 2 groups had no statistical significance (p>0.05).Postoperative 24 h blood cortisol, fasting blood glucose, serum IL-6 and plasma CRP level of two groups were higher than that of preoperative.Postoperative 24 h blood corti-sol, fasting blood glucose, serum IL-6 and plasma CRP level of observation group were lower than that of the control group, and the difference was statistically significant (p<0.05).In observation group, the exhaust time, defecation time, drainage tube root out time, stop infusion time and postoperative hospital stay of observation group were (43.62 ±8.21) h, (50.42 ±6.85) h, (5.51 ± 1.08), (4.12 ±0.85)d and (5.42 ±1.13)d respectively, which were shorter than the (56.65 ±8.26)h , (64.78 ±8.26) h, (9.53 ±4.13)d, (7.78 ±1.43) d and (10.62 ±2.14)d of the control group, and the difference was statistically significant (p <0.05).Rainage amount of observation group[(602.54 ±165.78) ml] was less than that of the control group[(1265.28 ±572.94) ml];And the total complications incidence of observation group (8.33%) was lower than that of the control group (25.00%), and the difference was statistically significant (p<0.05).Conclusion Implementation of laparoscopic treatment based on FTS used in right colon cancer radical can effectively promote patients recovery and reduce complications.thus it is worthy of clinical promotion use.

Objective To observe effects of shuxuetong injection combined with edaravone injection on the neurological, sermn lipid, c-reactive protein and interleukin 6 Levels in serum in patients with acute cerebral infarction. Methods 100 patients with acute cerebral infarction were randomly recruited into a control group and a treatment group by means of random number table. The control group was treated with 30mg edaravone injection, which was added to 100 ml normal saline, twice a day, continuous therapy for 14 days, and the treatment group was treated with 6mg shuxuetong injection, which was added to 2S0 ml normal saline, once a day, continuous therapy for 14 days based on the control group. The neurological was observed, triglyceride (TG) , cholesterol (TO , low density lipoprotein cholesterol (LDL-C) , high density lipoprotein cholesterol (HDL-C) , c-reactive protein and interleukin 6 Levels in serum were detected before and after the treatment.Results Compared with the control group, neurological deficit score, c-reactive protein and interleukin 6 Levels in serum in the treatment group decreased significantly (χ2=4.351, 3.81, 3.617 respectively, P<0.05) .TG, TC, LDL-C in serum in the treatment group were lower than that of the control group (χ2=2.135,P<0.01; χ2=3.061, 3.655, P<0.05 ); HDL-C in serum was higher than that of the control group (χ2=2.762,P<0.01) . The total effective rate of the treatment group and the control group was 86.0% and 66.0% respectively, there was a significant difference (χ2=3.393, P<0.05) . Conclusion Shuxuetong injection combined with edaravone injection is better than edaravone injection to treat acute cerebral infarction.

Objective To evaluate the effect of auxiliary trocar located on various positions on obese patients treated with retroperitoneoscopic radical nephrectomy.MethodsRetrospective analysis was performed for 61 consecutive obese patients who underwent retroperitoneoscopic radical nephrectomy for localized renal cell carcinoma at our institution from March 2004 to December 2010.An auxiliary trocar was placed into retroperitoneal space according to the position of tumor.It was placed infro-costal magin in the mid-axillary line with uppre-median pole tumor,and 4 cm medial to mid-axillary line and 1 cm cephalad to illac spine with lower-median pole,respectively.ResultsAll 61 patients were completed successfully with no conversion to open surgery.Mean operating time was ( 153.1 ± 23.5 ) min.Mean estimated blood loss was (57.6 ±29.7) ml.Mean hospital stay after operation was (5.7 ±2.6) d.The rupture of peritoneum and liquefaction of fat were occurred in 5 and 4 patients respectively.There was no major intraoperative and postoperative complications occurred.Conclusions Reasonable position of the auxiliary trocar according to the tumor's location would be safe and feasible on obese patients treated with retroperitoneoscopic radical nephrectomy.Obese patients with localized renal cell carcinoma would better benefit from minimally invasive procedure.

Objective To explore the clinical value of transumbilica single-port laparoscopic surgery in the treatment of bilateral varicocele.Methods From Jan. 2010 to Sep. 2010,42 patients with bilateral varicocele underwent laparoscopic high ligation of bilateral spermatic vein.Of these patients,20 were treated with transumbilica single-port laparoscopic surgery,22 with traditional laparoscopic surgery.The two groups of patients were compared for the parameters such as intraoperative blood loss,testicular artery preservation,operating time,time of activities after surgery,time of intestinal function recovery and hospitalization duration.The semen quality 1 year after the surgery was compared with that before treatment.At the out-patient re-examination at 1,3,6months and 1 year after the surgery,the incision,scrotum,spermatic cord,testis were checked for possible complications.The relief of discomfortness in the scrotum was also followed up.Results Both operation procedures were successful,without severe complications.In the single-port laparoscopic surgery produced blood lose ( [ 5 ± 1 ] ml vs.[ 5 ± 1 ] ml,t =- 0.452,P ＞ 0.05 ),the operating time ( [ 41 ± 7 ] min vs.[ 39 ± 3 ] min,t =0.686,P ＞ 0.05 ),postoperative intestinal function recovery time ( [ 11 + 1 ] h vs.[ 11 + 2 ] h,t =- 1.631,P ＞0.05 ) and postoperative hospital stay ( [ 3.1 + 0.7 ] d vs.[ 3.4 + 0.7 ] d,t =- 1.447,P ＞ 0.05 ) which were all comparable to that from conventional laparoscopic surgery.There was significant difference in the population using analgesics,single-port laparoscopic surgery vs.conventional laparoscopic surgery ( 1 case [ 5.0％ ] vs 7case [ 31.8％ ].The difference was statistically significant (x2 =4.886,P ＜ 0.05 ).The single-port laparoscopic surgery produced neglectable scar at the incision.All of the patients were questionaired for their satisfaction with the incision 1 year after the surgery.The difference was statistically significant (x2 =7.636,P ＜ 0.01 )Conclusion Single-port laparoscopic high ligation of bilateral spermatic vein produces comparable outcomes to that of conventional laparoscopic surgery,but it is a more microinvasive procedure producing good aesthetic appearance,representing the trend of laparoscopic technique.

Objective To evaluate the diagnostic accuracy of coronary artery stenosis caused by calcified coronary artery plaques with 64-detector row CT under different conditions. Methods Totally 165 patients with coronary artery calcification accompanied by one or more branches stenosis more than 50% detected with computed tomography coronary angiography (CTCA) were collected. The Agatston calcium score (ACS) and stenosis rate were calculated based on per-patient, per-vessel, per-segment, various stenosis degree and different morphology of calcification as the analysis object, respectively. The measurement results of coronary angiography (CAG) were taken as the gold standard. The diagnostic accuracy was evaluated with receiver operating characteristic (ROC) curves which were created to assess the diagnostic value and to determine the diagnostic cutoff level (threshold). Results When per-patient analyzed, the greatest diagnostic accuracy rate was obtained with ACS threshold of 113.5, and the area under curve (AUC) value of ROC was 0.791. With the analysis object of per-vessel, the greatest diagnostic accuracy rate was found in right coronary artery and its sub-branches, and the AUC value was 0.897. Per-segment analyzed, the highest accuracy rate was obtained in RCA1 segment, and the AUC value was 0.894. When the analysis object was the morphology of calcification, the range of AUC value was merely 0.601-0.667, while the diagnostic value was rather low. The highest accuracy of CTCA was obtained in stenosis less than 50%, and the AUC value was 0.856. Conclusion Coronary artery calcification has different influence on the diagnostic accuracy rate of coronary artery stenosis with CTCA in various situations. Moreover, the morphology of the calcification may not be the main impact factors of the diagnostic accuracy.

Objective To evaluate the risk of in-stent restenosis (ISR) after coronary artery stenting according to features of plaques on coronary artery CTA.Methods Totally 166 patients underwent coronary artery CTA before and 6-18 months after stent placement.Then the patients were divided into ISR group (n=16) and non-ISR group (n=150).The stenosis degree and plaque features were observed and compared between the two groups.Multivariate Logistic regression analysis was performed to evaluate ISR risk factors,and ROC curve was used to evaluate the diagnostic efficacy of plaques features in prejudgement of ISR.Results The lesion length,the ratio of noncalcified plaque,spotty calcium,positive remodeling and positive remodeling index in ISR group were higher than those in non-ISR group (all P ＜ 0.05).Multivariate Logistic regression analysis showed that noncalcified plaque (B=1.89,odd rate [OR] =6.63,P=0.01),spotty calcium (B=1.28,OR=3.59,P=0.01),positive remodeling (B=2.17,OR=8.71,P＜0.01) and lesion length (B=0.05,OR=1.05,P=0.04) were the risk factors of ISR.The area under the ROC curve (AUC) of lesion length and positive remodeling index for diagnosing ISR was 0.70 and 0.82 (both P＜ 0.01),respectively.The AUC of the combination of above plaque features for prejudgement of ISR was 0.87 (P＜0.01).Conclusion Lesion length,positive remodeling,noncalcified plaque and spotty calcium can be used to evaluate ISR after coronary artery stent placement.

Objective To study the characteristics of the sciatic nerve injuries inflicted by highvelocity triangle fragments in swine.Methods According to the injury position,14 swines weighing (34.29±5.2)kg were divided into two groups.All swines were shot by 0.37 g triangle fragments at (773.1±12.4)m/s aimed at the midpoint of the lateral body surface projection of the right sciatic nerve in Group A(n=7)and at 2 cm aside from sciatic nerve in Group B(n=7).The entrance,exit and length of wound tract,distance between nerve and wound tract were detected,and the pathology of sciatic nerve and wound tract at 48 hours after injury were observed under light microscope and electron microscope.Results The course of the fragments was deviated to different extent.Six sciatic nerves were in primary wound tract,four of which were lacerated and ruptured at different degrees.The light microscope showed pathological changes including severe hemorrhage and edema,leukocytic infiltration,neurotmesis,axonotmesis and light myelin coloration;while electron microscope showed severe degeneration of myelin sheath and neuraxon distortion.Six nerves(one in Group A and five in Group B)were in the concussion zone,with the distance between sciatic nerve and primary wound tract for(2.07±0.45)cm.Hyporrhea and hyperemia under perilemma and perineurium,partial nerve fiber disrupt and axonotmesis were observed by light microscope and partly myelin sheath delamination by electron microscope.Two nerves (one in Group A and another in Group B)were in the contusion zone,with moderate pathological changes.Conclusions The track of high velocity triangle fragments is unstable in the tissues.High disrupt rate,severe and wide extent lesion,early Wallerian degeneration are the main characteristics of direct injuries of swine's sciatic nerves.Indirect injuries can induce pathologic changes too,for which the lesion severity is related to the distance between nerves and primary wound tract.

OBJECTIVETo study the effects of Zhuhong ointment on accumulation in the body of mercury and the pathological morphology changes of kidney, via the measurement of related indicators of the skin-impaired model rat.

METHODEighty-eight SD rats were randomly divided into the impairment control group, and high-, middle-, low-dose Zhuhong ointment groups. Each group was treated by corresponding methods for 4 weeks, and recovering for 4 weeks. Urinary potein (PRO), pH, Beta N-acetyl aminoglycosidase enzymes (NAG) and beta2-microglobulin (beta2-MG) contents in urine were taken as monitoring indexes, blood urea nitrogen (BUN) and serum creatinine (SCr) in blood and the levels of mercury in urine, blood and kidney were tested, and the pathological morphology changes of kidney were observed.

RESULTAfter treatment for 4 weeks, compared with impairment control group, the levels of mercury in urine, blood and kidney in every dose group increased significantly (P < 0.01). And the relation exists between toxicity and dose on Zhuhong ointment. After recovery for 4 weeks, the levels of mercury in urine and blood in every dose group restore normal, while the level of mercury in kidney in high- dose group still increased (P < 0.01). The level of NAG increased only in high-dose group. There was no significant difference in NAG contents between Zhuhong ointment groups and the impairment control group (P < 0.05).

CONCLUSIONExcess using Zhuhong ointment repeatedly may lead to accumulation of mercury and pathological morphology changes of kidney. So the levels of mercury in the body and related indicators of renal functions should be tested in clinical when long-term using Zhuhong ointment.

Acetylglucosaminidase ; drug effects ; urine ; Animals ; Blood Urea Nitrogen ; Creatinine ; blood ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; toxicity ; Female ; Hydrogen-Ion Concentration ; drug effects ; Kidney ; drug effects ; enzymology ; metabolism ; pathology ; Male ; Mercury ; blood ; metabolism ; urine ; Ointments ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Retinol-Binding Proteins ; drug effects ; urine ; Skin ; drug effects ; injuries ; Time Factors ; beta 2-Microglobulin ; urine

OBJECTIVETo study the effect of repeated administration of Zhuhong ointment on renal antioxidant capability of ulcerous skin in rats, in order to further discuss the mechanism of mercury contained in Zhuhong ointment on the antioxidant capability of kidney in skin ulcer rats.

METHODEighty SD rats were randomly divided into eight groups: Zhuhong ointment A, B, C, D, E (1.219, 0.609, 0.305, 0.152, 0.76 g x kg(-1)) groups, the vaseline group, the ulcer model group and the impairment control group. The levels of NAG and RBP of toxicity for early kidney tubular injury and T-AOC, SOD, GSH-PX and GSH in kidney were determined after consecutive administration for 14 days.

RESULTCompared with ulcer model group, the levels of RBP in groups A, B, C and D increased, while the levels of NAG increased only in the group A. The level of T-AOC increased in groups A, B and C. The level of T-SOD increased in the group E, while it dropped down greatly in the group A. The level of GSH-PX increased in groups A, B and C. The content of GSH increased in every dose groups.

CONCLUSIONAntioxidant capacity in rats can be increased in a reasonable dose of Zhuhong ointment, but some antioxidant activity can be notably inhibited by with the increase of dose.

Acetylglucosaminidase ; drug effects ; urine ; Animals ; Antioxidants ; analysis ; metabolism ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; toxicity ; Glutathione ; drug effects ; metabolism ; Glutathione Peroxidase ; drug effects ; metabolism ; Kidney Tubules ; drug effects ; injuries ; metabolism ; Male ; Mercury ; metabolism ; Ointments ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Retinol-Binding Proteins ; drug effects ; urine ; Skin Ulcer ; metabolism ; microbiology ; Specific Pathogen-Free Organisms ; Staphylococcal Skin Infections ; metabolism ; Superoxide Dismutase ; drug effects ; metabolism ; Time Factors

OBJECTIVETo compare the effects of Badu Shengji San (BDSJS) on rats with different injured skins.

METHODThe injured and ulcerous skin rat model was established to observe the renal injury induced by BDSJS, a mercury-containing external preparation of Chinese medicine, with urinary N-acetyl-beta-D-glucosaminidase (NAG) and retinol binding protein (RBP) as indicators of renal toxicity.

RESULTCompared to injured skin rats with the same dose, both of high and low-dose ulcerous skin groups showed obvious increase in urinary RBP and kidney coefficients, significant pathomorphological changes in renal tubules and notable epithelial cytopathic effects. In terms of NAG, the high-dose ulcerous skin group saw no significant increase, but the low-dose group recorded sharp rise.

CONCLUSIONThe renal toxicity induced by BDSJS in ulcerous skin rats was more toxic than that in injured skin ones.

Acetylglucosaminidase ; urine ; Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; toxicity ; Epithelial Cells ; drug effects ; metabolism ; pathology ; Kidney Tubules ; drug effects ; metabolism ; pathology ; Male ; Mercury ; toxicity ; urine ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Retinol-Binding Proteins ; urine ; Skin ; drug effects ; injuries ; Skin Ulcer ; drug therapy ; microbiology ; Staphylococcal Skin Infections ; drug therapy