Objective To study the application of percutaneous dilatational tracheostomy in the critical pa- tient. Methods Twenty eight critical patients performed percutaneous dilatational tracheostomy have been followed up in our hospital during 1996 - 2000, and the operating time, the perioperative complications and the following - up results were reviewed. Results all of the 28 patients were operated on successfully,no complication occurred dur- ing the operation , and little bleeding was observed, most of the patients have been followed up, the longest following - up period was 18 months, and the cosmetic effect was good. Conclusions The percutaneous dilatational tracheo- somy is a good less invasive surgical technique. It can meet the needs of the clinical tasks and worth to apply to some critical area.

Objective:To investigate the biological characteristics of cultured salivary gland cells in vitro. Methods: Submandibular gland cells of rat were primarily cultured and subcultured in DMEM supplemented with ?=10% fetal bovine serum. The growth of the cells was studied by cell counting and MTT assay. The morphological characteristic was observed with microscope and transmission electron microscope.The specific protein expression was investigated by immunohistochemical technic. Results:Morpholgy of the cells was epidermoid with well developed organella and zymogen granules.The cells could subultured to 4～5 passages and kept in culture for 30～40 days.The cells of primary culture and passage 2 grew faster than those of passage 4.The cells were CK8.13, keratin and ?-SMA positive. Conclusion:Rat submandibular gland cells can be primarily cultured and subcultured in vitro.The primarily cultured and first subcultured cells may be more potential in growth.

Objective: To investigate the effect of astragalus on the serum levels of hepatocyte growth factor (HGF), renal function and the damage of renal morphology in ischemic acute renal failure (IARF). To study the protective mechanism of astragalus in IARF. Methods: The rats were pretreated with astragalus or vehicle for 3 days. IARF was induced by left renal artery clipping for 60 min, after the right kidney was removed. Biochemical parameters for serum HGF,blood urea nitrogen(BUN),creatinine(Cr) were measured and histological analyses of the kidneys were performed by tubular grading. Results: There have no significant difference between the serum HGF levels of I/R controls and the levels observed in sham-operated group (P > 0.05). Serum HGF levels in astragalus treated group was significantly increased than those of I/R control group(P < 0.01) .After 4 h of I/R, serum levels of BUN and Cr were increased in I/ R control rats compare with Sham-operated rats(P < 0.01). Astragalus treatment reduced the levels elevation(P < 0.05). Simultaneously,. I/R-induced severe damage in renal morphology were significantly ameliorated by astragalus treatment(P < 0.01). Conclusions: Astragalus pretreatment can alleviate the damage of renal function in IARF. It is may be one of the mechanisms of astragalus for protecting renal tissue in IARF that astragalus can induce the expression of HGF.

Objective To explore the effects of fat on healing of porcine skin wounds so as to provide a new strategy to promote skin wound repair after injury. Methods Forty-eight full-thickness skin wounds were produced on both sides of the back in 6 male minipigs (8 wounds in each animal). These wounds were then randomly divided into 4 groups, i.e. saline control group, fat autografting group, fibroblast growth factor (bFGF) treatment group and epidermal growth factor (EGF) treatment group. On day 3, 7, 14 and 21 after wounding, the area and the volume of wounds were measured, and histological examination was performed to evaluate the speed and quality of wound healing in different groups. Results On days 3 and 7, the amount of granulation tissue and vessel density in fat treatment group were significantly more abundant compared with other groups. Wound area and volume in fat treatment wounds were markedly decreased compared with those in other groups (P

Objective To establish a three-dimensional finite element model of thoracolumbar fractures treated by mono-segmental instrumentation in the fractured part for testing effect of such fixation mode on adjacent segments.Methods CT scanning data of T10-L2 were used to build a normal model at T10-L2 region,a fracture model at T12 segment as well as a mono-segment fixation or short-segment fixation model.Stress of discs and vertebral body adjacent to the fixed vertebrae were tested in axial compression,anteflexion,extention,lateroflexion,and axial rotation.Results The fracture model presented significant increase concerning stress of nucleus pulposus and annular fibrosus at T10-T11 segments and annular fibrosus at L1-L2 segments in anteflexion,extention,and lateroflexion when compared with the normal model.General raise range of the stress reached around 75％,but was dropped to 23％ after short-segment fixation and to 18％ after mono-segmental fixation.And again,stress of nucleus pulposus at L1-L2 segments was increased by 46％ or so,which was declined to 12％ after short-segment fixation and to 8％ after mono-segmental fixation.Stress at lower endplate of T10 and at upper endplate of L2 in the fracture model group were increased by 24％ and 43％ respectively when compared to the normal model,but both presented a notable drop after internal fixation.The latter was decreased to a level slightly higher than that of model group,namely 8％ more after short-segmental fixation and 4％ more after mono-segmental fixation; the former was decreased to a level even lower than that of control group,namely 2％ less after short-segmental fixation and 8％ less after mono-segmental fixation.Conclusion Mono-segmental fixation reduces adjacent disc stress in contrast to conventional short-segmental fixation and hence is an effective alternative treatment of monosegmental thoracolumbar fractures.

The ABO blood group antigens in the spermatozoa from 40 donors were studied using the indirect immunofluorescence method.Group A antigens in the spermatozoa from group A donors and group B antigens in the spermat- ozoa from group B donors were detected.Some of the spermatozoa from group AB donors carry the A antigens and others carry the B antigens.The spermatozoa from four ABO blood group donors all carry H antigens.The blood group antigens in the spermatozoa are inherent,not from the seminal plasma.The amount of ABO blood group antigens from different individuals was different and was independens of the secrete status and the amount of ABH substances in the secretor's seminal plasma.The ABO blood group antigens of spermatozoa were mainly distributing in the regions of spermat- ozoals neck and acrosome.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.

A reversed phase high-performance liquid chromatography method for the simultaneous analysis of 23 kinds of phenolic components in water extract of porpolis (WEP) was developed. The separation was performed on ZORBAX Eclipse XDB C_(18) column (150 mm×4.6 mm, 5 μm) by gradient elution. The mobile phase consisted of ethanol with 0.1% formic acid at the flow rate of 1.0 mL/min. The detection wavelengths were 256 and 280 nm. The injection volume was 20 μL, and the column temperature was maintained at 35 ℃. The method showed good linear relationship, precision and repeatability. The recoveries were between 93.3% and 106.6%. Eighteen Reference compounds were detected in WEP of Hehei by this method. The content of Catechin was the highest(30.50 mg/g), the next was 3,4-dimethoxycinnamic acid (15.41 mg/g). Nine Reference compounds were detected in WEP of Yunnan. The content of catechin was also the highest (11.23 mg/g), the next was chrysin (15.41 mg/g). Similarity of WEPs between the products of Hebei and Yunnan were 0.099 (256 nm) and 0.194 (280 nm). The chemical compositions of two WEPs were remarkably different.

AIM: To investigate the changes of oxidative stress in the kidneys and their roles in nephropathy in diabetic rats. METHODS: Diabetic rats were induced by streptozotocin (STZ). 36 rats were divided into three groups randomly: (1) NC group, normal control rats; (2) DM group, diabetic rats received protamine zinc insulin (PZI) 2U-4U/2 d; (3) DT group, diabetic rats received PZI 9-12 U/kg body weigh/day. 12 weeks later, rats were killed, blood glucose, blood cholesterol, serum creatinine, blood urea nitrogen, HbA1c, urinary creatinine, and urinary protein for 24 h were measured. The activities of antioxidant enzymes in renal cortex, including total superoxide dismutase (TSOD), Cu-Zn superoxide dismutase (Cu-Zn SOD), Mn superoxide dismutase (Mn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and maleic dialdehyde (MDA) were measured by chromatometry. RT-PCR was performed to detect the expression of different antioxidant enzymes mRNA. RESULTS: For all the targets we measured, there was no significant difference between NC and DT groups. Compared with the other two groups, the levels of blood glucose, cholesterol, trigalloyl glycerol, HbA1c in DM group increased significantly. The activities of TSOD, Cu-Zn SOD and CAT decreased significantly. The activity of GSH-Px increased significantly. There was no significant difference among the activities of Mn SOD in all three groups. The level of MDA in DM group was much higher than that in NC or DT group. The relative expression levels of GSH-Px and Cu-Zn SOD mRNA in DM group were higher than those in other two groups, while the relative expression level of CAT decreased. Mn SOD mRNA was expressed without significant difference in all groups. Compared with NC or DT group, urinary protein in DM group increased significantly, while creatinine clearance rate decreased. CONCLUSIONS: Hyperglycemia affected the expression of antioxidant enzymes. Oxidative stress was caused by hyperglycemia in diabetic rats and may be an important factor in the etiology of diabetic nephropathy.

Background and purpose:We investigated whether lfuorine-18 lfuorodeoxyglucose (18F-FDG) maximal standard uptake value (SUVmax) of the primary tumor (SUV-T), SUVmax of the regional lymph nodes (SUV-N) or the overall loco-regional lesion SUVmax (SUV-TOTAL) was related to survival of patients with stage Ⅲ non-small cell lung cancer (NSCLC) who received Cetuximab and combined definitive chemoradiotherpay. Methods:From September 2009 to July 2012, seventeen patients with unresectable stageⅢNSCLC receiving cetuximab with cisplatin/vinorelbine (NP) followed by concomitant NP and intensity-modulated radiotherapy (IMRT) at the Fudan University Shanghai Cancer Center were enrolled onto a prospectively study. All patients received positron emission tomography/computerized tomography (PET/CT) scans within 2 weeks before enrolment. Univariate analysis were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumour-node-metastasis (TNM) stage, performance status (PS) as well as smoking status and survival. The factors which showed statistical signiifcance entered into multivariate Cox-regression model. Survival functions of different populations were estimated by Kaplan-Meier method and compared by Log-rank test. Results:In the univariate analysis, SUV-T, SUV-N, SUV-TOTAL, PS and smoking status were prognostic factors. The best cut-off values for SUV-T, SUV-N and SUV-TOTAL were 11, 11 and 20, respectively. Multivariate analysis revealed that SUV-TOTAL (P=0.012), SUV-T (P=0.025), and SUV-N (P=0.033) were independent predictors of survival with hazard ratio (HR) of 14.7, 11.2, and 6.2, respectively. Conclusion:Local, regional and locoregional maximal SUVs deifned by 18F-FDG PET-CT scanning may have a strong correlation with survival in this patients setting, which merits further study.