Objective To investigate the safety and feasibility of minimally invasive stealth lateral release operation in the treatment of chronic anal fissure . Methods Clinical data of 42 patients with chronic anal fissure who underwent minimally invasive stealth lateral release from May 2012 to May 2014 was analyzed retrospectively .We use the homemade fine steel wire to pierce into the sphincter ditch with a distance from the anus of 1 cm, and put the steel wire out above the dentate line .Then the wire was took out from the other edge under the skin through the needle of bobbin .After the needle was fixed by an assistant , the free end of the steel wire was pulled quickly to cut the internal sphincter tissue instantly . Results All the 42 patients were successfully treated and discharged without complications .The recovery time was in 7 -14 d, with an average of 9 d.The healing standards included disappeared symptoms and totally healed wound .All the patients were followed up for 3-6 months, with an average of 4 months.No recurrence was found . Conclusion Minimally invasive stealth lateral release in the treatment of chronic anal fissure is safe and feasible, with many advantages such as simple performance , reliable curative effect, fast recovery time, and less postoperative complications .

The recombinant human fusion protein GM-CSF/LIF was used to study the effects of different doses rhGM-LIF, rhGM-CSF,rhLIF,and rhGM-CSF plus rhLIF on tumor cells in our paper. The results showed that rhGM-LIF induced myeloid leukemia cells differentiation and inhibited the growth of the cells significantly. Its effect was dose-related, more significantly than rhGM-CSF,rhLIF,and rhGM-CSF plus rhLIF in some dose range. It is important that rhGM-LIF can inhibit the growth of human liver cancer cell. The rhGM-LIF might be a useful recombinant protein for tumor thera-py.

BACKGROUND:During the progress of focal cerebral ischemia-reperfusion in rat with transient suture occlusion, bleeding combating and the line being plugged into the cerebral middle artery smoothly are important for successful modeling and research focus.
OBJECTIVE:To improve Longa suture occlusion method for focal cerebral ischemia reperfusion model in Sprague-Dawley rats in order to establish a simple surgical procedure with low rate of intraoperative bleeding and high rate of successful models.
METHODS:The two ends of the external carotid artery were clipped with electric knife, in addition to ligation of surgery lines intraoperatively;with the help of pincett, a fishing line was plugged into the carotid artery along the anteriomedialis artery wal (the direction of the internal carotid artery from the pterygopalatine arterial bifurcation). Postoperative behavior scores in rats, infarct volume calculation and histopathological evaluation under optical microscope were done.
RESULTS AND CONCLUSION:Transverse sections of the external carotid artery were changed from a“O”
shape to a“-”shape after being clipped with electric knife. Subsequently, line nodes were not easy to fal off any more, effectively preventing intraoperative bleeding. With the power of pincett, the rate of plugging the fishing line into artery was significantly increased. Rat’s neurological score and infarct volumes were significantly increased, and brain tissue pathological injury worsened. The modified suture occlusion method for focal cerebral ischemia reperfusion models effectively prevented line nodes off, successful y increased the rate of suture occlusion and models in Sprague-Dawley rats were developed successful y.

Objective To explore the management strategy of hepatic trauma. Methods From January 1997 to January 2008, a retrospective study was performed on 112 cases of hepatic trauma. Base on the classification of AAST,non-operative treatment was used in 40 hemodynamic steady patients (grade Ⅰto Ⅱ), hepatic repair was therapeutic method to grade Ⅱ to Ⅳ (48 cases), while hepatectomy or plus selective ligation of hepatic artery were chosen for grade Ⅳ to Ⅴ (13 cases). Peripheral hepatic tamping or plus selective ligation of hepatic artery were effective therapeutic approaches to grade Ⅳ to Ⅴ (11 cases) according to damage control surgery. Results In the operative case.s, 60 cases were cured, 12 died. All non-operative cases were cured. Conclusions Non-operative management is widely becoming one of the most important strategies in the treatment of hepatic trauma with stable hemodynamics. Surgical intervention is still the principal measure of treatment for severe hepatic trauma. According to specific condition, appropriate operative procedures, damage control surgery and prompt management of associated injury will earn a higher success rate.

Objective To explore the electrophysiological features of triggering atrial premature contraction(APC) in patients with hypertension combined paroxysmal atrial fibrillation (PAf).Metbods The originating sites and prematurity index (PI) of triggering APC were analyzed in 46 PAf patients with hypertension (hypertension group)and in 35 PAf patients without hypertension( non-hypertension group)from April,2008 to March,2011 in Shanghai Punan Hospital of Pudong New District.Results Triggering APCs in 46 cases with hypertension combined PAf in the hypertension group originated mainly in the left atrium( 81.6％ ).The coupling interval (CI)of triggering APC in hypertension group was significantly shorter than that in non-triggering APC ( [ 374.1 ± 31.5 ] ms versus [ 443.6 ± 32.6 ] ms,t =23.361,P ＜ 0.001 ) and that in triggering APC in nonhypertensive group ( [374.1 ±31.5]ms versus [395.7 ±38.2]ms,t =5.549,P ＜0.001 ).PI in triggering APC was lower than that in non-triggering APC in hypertension group(0.50 +0.05 versus 0.63 ±0.06,t =22.544,P ＜ 0.001 ) and that in triggering APC in non-hypertension group (0.50 + 0.05 versus 0.55 ± 0.08,t =5.849,P ＜ 0.001 ).Conclusion The triggering APC in patients with hypertension combined PAf mainly originates in the left atrium,the PI of triggering APC is significantly lower than that in non-hypertension patients with PAf and PAf occurs more easily in patients with hypertension.Prompt measures should be taken for hypertension patients with lower prematurity index to prevent the occurrence of PAf.

Objective To investigate the characteristics of blood pressure variability during 24 hours and pre-thrombotic state(PTS) in elderly patients with essential hypertension.Methods One hundred cases of old patients with essential hypertension in the department of Cardiology (hypertension group) and 65 controls with normal blood pressure from Punan Health Check Center (control group) were recruited.The systolic and diastolic blood pressure variability (SBPV,DBPV) during 24 h daytime and nighttime were monitored for all subjects by ambulatory blood pressure monitor.The plasma levels of P-selectin (PS),fibrinogen (Fg) and plasminogen activator inhibitor-1 (PAI-1) were measured.Results The systolic blood pressure variability (SBPV) in hypertension group was significantly larger than that of control group (P ＜ 0.05) in daytime,and no significant difference regarding of the diastolic blood pressure variability (DBPV) between two groups.While in nighttime,SBPV and DBPV in hypertension group were significantly higher than those of control group (P ＜ 0.05).The levels of plasma Fg and PAI-1 in hypertension group were significantly higher than those of control group ((2.8 ±0.9) g/L vs.(2.3 ±0.7) g/L and (29.8 ±2.7) μg/L vs.(25.6 ± 1.2) μg/L,respectively).While no significant difference was found between two groups for PS (P ＞ 0.05).Conclusion That indicated pre-thrombotic state including higher blood pressure variability during 24 hours,especially during nighttime in elderly patients with essential hypertension and plasma fibrinogen.

With the development of Chinese education system, academic students in medical university can not meet the demand of current social development. The combination of teaching and research ideas should run through the whole teaching process, which is an important approach to bring up innovative talents. This article focuses on teaching process of rehabilitation medicine, and how to run research ideas through each sections of rehabilitation medicine. Research ideas begins with teaching, shaped in clinical practice, and being applied for clinical work. That is just the right thinking for cultivating outstanding medical specialists in the 21st century.

Objective To establish the quality standard of common selfheal fruit-spike granules. Mehtods Rosmarinicacid in the granules were identified by TLC. The extractives were tested by the method for determination of water-soluble extractives. The contents of rosmarinicacid were determined by HPLC. Results TLC had obvious characteristics with the spots clear and well-separated. The extraction limit was no less than 10.0%. Rosmarinicacid showed a good linear relationship at 0.062 5~2.008 0 mg/ml (r=0.999 8,n=6) with average recovery of 99.50% (RSD=1.21%,n=9). The content limitation of rosmarinicacid was discussed as 10.0 mg per pack according to the experiment data.Conclusion The method is easy-operated and accurate which has a good specificity for the quality control of common selfheal fruit-spike granules.

Objective:To establish the quality standard for Isatidis folium dispensing granules. Methods:Indigo and indirubin in the granules were identified by TLC. The extract content was determined by a hot dipping method for the determination of alcohol-solu-ble extract. The content of indirubin was determined by HPLC. Results:The spots in TLC were clear and well-separated. The extrac-tion limit no less than 12. 0% was preliminarily drawn up. Indirubin showed a good linear relationship within the range of 0. 50-8. 04μg·ml-1(r=0. 999 9) with the average recovery of 99. 41%(RSD=1. 21%, n=9). The content limit no less than 50. 0 μg per pack was preliminarily drawn up for indirubin. Conclusion: The method is easy-operated and accurate with good specificity for the quality control of Isatidis folium dispensing granules.

Objective To evaluate the impact of positive end-expiratory pressure (PEEP) on hemodynamic variables including central venous pressure (CVP),mean arterial pressure (MAP) and heart rate (HR) in patients with central respiratory failure treated by mechanical ventilation.Methods Thirty two neurosurgical patients with central respiratory failure,male 19,female 13,mean age (58.8 ± 13.9)years,GCS ≤ 8 points,were enrolled in this prospective,self-control study between June 1,2009,and May 31,2011.Patients were excluded in cases of severe cardiopulmonary disorders,pericardial diseases,person machine confrontation,administration of vasoactive drugs,and hypervolemia or hypovolemia.On admission to neurosurgical intensive care unit,all patients were mechanically ventilated in the mode of synchronized intermittent mandatory ventilation.Hemodynamic effects of six randomly set levels of end-expiratory pressures (0,3,6,9,12,15 cm H2O,every 10 min,1cm H2O =0.098 kPa) were studied in all patients.CVP,MAP and HR were recorded at each of the six end-expiratory pressure levels.One-way analysis of variance and simple linear regression model were used for data analysis.Results The levels of central venous pressure were elevated with increase in end-expiratory pressures.CVP levels were positively correlated with the levels of PEEP (R =0.468,P =0.000),with a simple linear regression equation expressed as:CVP (cm H2O) =7.870 +0.344 ×PEEP (cm H2O),The levels of MAP showed no statistically significant changes at different PEEP levels (F =1.390,P =0.227).No linear correlation between MAP,HR and PEEP levels was found (R =0.042 and 0.160,P =0.413 and 0.002).Conclusions CVP values would be overestimated during mechanical ventilation at different PEEP levels in mechanically ventilated patients due to central respiratory failure,positive correlation existed between CVP values and PEEP levels,whereas MAP was unaffected by different PEEP levels.This study could probably offer a quantitative reference for correct assessment of such a hemodynamic variable as CVP for mechanically ventilated patients without discontinuance of PEEP.Further studies are needed to determine whether these findings could be confirmed in a prospective manner.