Objective To investigate the cause of air emboli during hysteroscopic surgery.Methods Thirty-five ASA Ⅰ or Ⅱ patients,aged 22-59 yr,with a body mass index of 18-25 kg/m2,undergoing hysteroscopic surgery under spinal anesthesia,were involved in this study.Electrocision and electric coagulation were performed using the electrotome during surgery.Air emboli in the common iliac vein,superior vena cava,inferior vena cava and heart were continuously monitored using color Doppler ultrasonic imaging.The patients were divided into 2 groups according to the occurrence of the air embolus:air embolus group and no air embolus group.The possible factors which induced air emboli were analyzed.Results Air emboli developed in 15 patients at ( 19 ±10) min after perfusion with 5％ glucose injection and the incidence was 43％.A small number of air emboli (the numberof bubble ＜ 10/s) occurred in 4 cases.A moderate number of air emboli (10/s≤ the number of bubble≤20/s) occurred in 7 cases.A large number of air emboli (the number of bubble ＞ 20/s) occurred in 4 cases.Compared with no air embolus group,the using time of electrotome was significantly prolonged in air embolus group ( P ＜ 0.05).Conclusion The cause of air emboli during hysteroscopic surgery may be related to the using time of electrotome.

Objective To explore the methodology and the indications of applying the porous high-density polyethylene(Medpor)combined with auricular cartilage in nasal plasty.Methods A total of 36 cases of nasal plasty were treated with the 8.5 mm thick Medpor implant(speader strut graft)and combined with the auricular cartilage graft to highlight the nasal tip.Results All 36 cases were satisfactory with the effects,and there were no complications such as infection,exposure of the implants and so on.Conclusions Medpor can supply the powerful supporting strength to the nasal tip,and it is a safe,effective implant to rebuild the supporting constructions of nasal tip,especially suitable to correct the over-rotation of nasal tip,flat nasal tip,and short nose.

Objective To explore an epicanthoplasty with good effect and small scar. Methods A V shape incision was designed in medial canthus and the two lines: point A is the top point of medial canthus and point A' is the top point of new medial canthus. The length of line AA' is about 4 to 8 mm according to the medial canthus and th incision is Y shape, and then Y-V epicanthoplasty is raised and enlarged. Results From January 2005 to December 2008, 98 cases were treated with this method to eliminate the medial epicanthal fold of the upper eyelid with simple procedures. Scarring of the medial canthal area had not been a problem with this technique because we designed incisions along the eyelashes and skin-mucosal junctions. By raising the point of new medial canthus to physiological position the angle of medial canthus was enlarged to reveal a lacrimal lake. Conclusion This technique is a simple, easy procedures with no visible scar.

Objective To investigate the effect and mechanism of valproic acid in preventing astrocyte proliferation around the central canal of rats following spinal cord injury.Methods Forty-five Wister rats were divided into normal control group (n =5),injury group (n =20) and treatment group (n =20) according to random number table.Animal models of acute spinal cord injury were produced at T10 using Allen' s method by dropping a 10 g weight from a 15 mm height.Rats in treatment group received intraperitoneal injection of valproic acid (300 mg · kg-1 · d-1 in two divided doses) at 30 minutes postinjury.Instead,rats in injury group were injected with an equal volume of saline in the same way.Hindlimb function was evaluated using BBB scoring system at 1,3,7,and 14 days postinjury.Astrocytes proliferation around central canal and expression of glial fibrous acid protein (GFAP) were examined.Results In normal control group,few astrocytes around spinal central canal and a low expression of GFAP were detected.In injury group,astrocytes began to increase at 24 hours postinjury; fluorescence intensity for GFAP was 24.6 ± 3.6 at 24 hours,reached a peak of 69.2 ± 6.4 at 3 days,maintained a high level of 56.7 ± 5.6 at 7 days,and reduced to 35.4 ± 4.3 at 14 days,a level that remained higher than that in normal control group (11.2 ± 1.6).Whereas in treatment group at 3 and 7 days,astrocyte proliferation around spinal central canal was lower than that in injury group; GFAP expressions (47.8 ± 5.3 and 42.2 ± 6.7) were lower than those in injury group (F =177.6,P ＜ 0.05).At 3,7,and 14 days,BBB scores in treatment group (7.80 ± 0.83,12.00 ± 1.58,and 16.60 ± 1.12 respectively) were significantly higher than those in injury group (4.60 ± 0.54,6.65 ± 0.67,and 9.40 ± 1.14 respectively) (F =1 113.6,P ＜ 0.05).Conclusion After spinal cord injury,valproic acid reduces astrocyte proliferation around central canal via inhibiting GFAP expression to promote functional recovery.

Objective To explore the aging mechanisms of human adult adipose-derived stem cells (hADSCs) in vitro.Methods The hADSCs came from the production of normal patients with liposuction.The hADSCs were cultured in the 37℃ incubator and passed until the cells were senescent.The senescence-associated β-gal staining (SA-β-gal) and histone protein γH2AX staining were carried out in both young and old hADSCs.The quantitative real-time PCR (qRT-PCR) was conducted to check the difference of the transcription function of the young and old hADSCs.Results The cultured hADSCs would be the senescent cells when the PD number was more than 35.The aging cells became big and had large flat nuclei and much more lososomes in the cytoplasm.The SA-β-gal staining and γH2AX staining were mostly positive in the aging hADSCs (PD>35) compared with the self-renewing hADSCs (PD<20).The qRT-PCR results showed that the transcription levels of Nanog and Oct4 gene were very low in aging hADSCs compared with the self-renewing ones.Conclusions The hADSCs will be senescent (SEN) when cultured and passed in vitro for long time and the aging process is similar to that of stem cells in vivo.The aging model of hADSCs can be established by this method and will be very useful in the anti-aging drug, regeneration medicine, tissue engineering and stem cell therapy.

Objective To investigate the mechanism of sleeve gastrectomy combined with modified jejunoileal bypass (SG/MJIB) in improving the blood glucose of Goto-kakizaki (GK) rats.Methods According to the random meter method,the 28 GK rats were divided into 4 groups:sleeve gastrectomy with modified jejunoileal bypass (SG/MJIB),sleeve gastrectomy (SG),modified jejunoileal bypass (MJIB) and sham operation (SHAM).The changes of weight,food intake,fasting blood glucose,oral glucose tolerance test (OGTT),insulin tolerance test (ITT),plasma insulin and gastrointestinal hormonal (ghrelin and GLP-1) were monitored before and 16 weeks after surgery respectively.Results After surgery,the fasting blood glucose level in SG/MJIB group was obviously lower than that in SG,MJIB and SHAM groups (P＜0.05).From the 2nd week after surgery,OGTT of the SG/MJIB group was obviously improved compared to SG,MJIB,and SHAM groups (P＜0.02).In our post-op erative study,the insulin levels in SG/MJIB group were lower than those in SG,and SHAM groups (P＜0.05).Compared to MJIB and SHAM groups,ghrelin levels of SG/MJIB group were significantly decreased (P＜0.001),while GLP-1 levels of SG/MJIB group were higher than those of SG and SHAM groups (P＜0.01).Conclusions SG/ MJIB can improve insulin sensitivity and insulin secretion,and this effect is independent of the body weight and food intake.This study further validates that the gastrointestinal hormones play an important role in the pathogenesis and treatment mechanisms of type 2 diabetes mellitus.

To explore the causes of the postoperative complications of the penile elongation and the measures to prevent them in order to raise the success rate of the penile elongation. 1,000 patients who had received the penile elongation were reviewed and analyzed for the causes of postoperative complications, and the measures of prevention and treatment were discussed. Our results showed that, of the 1,000 cases, 64 had the postoperative complications, including 20 cases of edema of prepuce, 15 cases of flap necrosis, 12 hematoma, 9 infections, and 8 cases of fat and clumsy penis. It is concluded that correct operative manipulation, strict aseptic measures and necessary postoperative care and management could avoid or reduce the postoperative complications. When complications happened, a satisfactory result can be achieved with timely and correct treatment in the majority of the patients.
Edema/etiology ; Edema/prevention & control ; Hematoma/prevention & control ; Penis/*abnormalities ; Penis/injuries ; Penis/*surgery ; Postoperative Complications/*prevention & control ; Postoperative Complications/therapy ; Reconstructive Surgical Procedures/methods ; Surgical Flaps ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control ; Urologic Surgical Procedures, Male/methods

Objective To prepare VP1 protein vaccine of Coxsackievirus A16(CA16) and evalu-ate immunngenicity the subunit vaccines of Coxsackievirus (VP1), and to establish foundation for studying CA16 vaccine. Methods CA16 VP1 was amplified by RT-PCR and cloned into pFastBac HT A plasmid, recombinated with Bacmid DNA by transposition reaction and then transfected Sf9 cell, mixed with adjuvant AI(OH)_3. After immunization BALB/c mice, evaluating immune effectiveness after booster injections 2 weeks. Results The expressed protein was analyzed by SDS-PAGE and Western blot, mice immunized with CA16 (VP1) both induced specific IgG antibody and neutralization antibody. The best immunization antigen was 20 μg, IgG antibody was 1: 1600, neutralization antibody was 1:250, typical Th1/Th2 immune response was determined by lymphocyte proliferation assay and cytokine analysis. Conclusion The CA16 VP1 gene was cloned successfully and expressed in Sf9 insect cells, CA16 VP1 protein vaccine induced both humoral and cellular immune response, to lay solid foundation for further study on CA16 vaccine.

Objective To investigate the application of the parietal branches of superficial temporal artery island flap in the complex scalp defects.Methods A parietal branches of superficial temporal artery island flap on the ectatic scalp flap was designed to repair the complex scalp defects in 25cases and the repairing effect was observed.Results The island flaps were survived completely in 24patients,in which 1 patient had partial necrosis because of the flap tension was too large,but healed after local dressing and debridement.After followed up 6～ 12 months,the color and texture of the flap were the same to the surrounding normal scalp,and the shape was satisfactory.The flap donor site of hair growth was good,with well healing and no obvious complications.Conclusions The parietal branches of superficial temporal artery island flap can repair the complex scalp defects with the flexible flap design and movement.The flap survives well and the repair area is large.The flap and the surrounding scalp connects good.Therefore,it is a good method strongly recommended for small area complex scalp defects repair in clinics.

Objective: To investigate the association between dietary selenium intake and hypertension among Zhejiang residents . Methods: By multistage stratified random sampling method,four urban sites and two rural sites out of Zhejiang Province,four communities or villages out of each site,then 20 households out of each community or village were selected,and all the family members of the selected households were recruited as participants. The questionnaire of Chinese Health and Nutrition Survey was used to collect information about socio-demographic characteristics and dietary selenium intake. The blood pressure,blood lipid and other data were collected via physical examination. A multivariate logistic regression model was used to analyze the relationship between dietary selenium intake and hypertension . Results: A total of 1 222 participants with complete dietary selenium intake data were included for analysis. The number（%）of participants with selenium intake higher than the level of estimated average requirement（EAR）,between the levels of EAR and recommanded nutrient intake （RNI）,between the levels of RNI and upper intake（UI）and higher than the level of UI were 729 （59.66%）,151（12.36%）,341（27.91%）and 1（0.01%）,respectively. There were 283 （30.53%）patients with hypertension out of 927 participants examined. The mean amount of selenium intake in patients with hypertention was（43.06±20.96）μg/d,which was significantly lower than（51.56±30.06） μg/d in non-hypertention participants（P<0.05）. After adjusting for age,body mass index,total cholesterol,triglyceride and diabetes mellitus in the multivariate logistic regression model,dietary selenium intake significantly reduced the risk of hypertension（OR=0.985,95%CI：0.978-0.993） . Conclusion About 60% of residents in Zhejiang Province had lower dietary selenium intake than estimated average requirement. Higher selenium intake was associated with lower risk of hypertension.