The present preliminary study was to observe the feasibility of the use of polylactic acid gel (PLA-G) in modified radical mastectomy and the ability of the PLA-G in the prevention of flap adhesion after operation. Sixty-eight patients were diagnosed with breast cancer, and received modified radical mastectomy from Jan. 2004 to Dec. 2006. The patients were divided randomly into a treatment group and a control group (with 34 cases each). The PLA-G was used under the surface of the auxiliary operative wound in the treatment group, and nothing was used in the control group. The wound healing, the wound complication, the amount of drainage solution, the indwelling time of the drainage tube and the auxiliary skin adhesion were evaluated after operation in both groups. There were no statistical difference on wound healing between the first intension (29:27) and the second intention (5:7), and the wound dehiscence after taking the stitches out (0:0) between the two intensions, the hematoma (0:1) and the effusion of the wound (5:6), and the flap necrosis (1:2) between two groups. There were also no statistical difference on the amount of drainage solution per day (6 +/- 3) and indwelling time of the drainage tube (6 +/- 4) after operation between the two groups (P > 0.5). After the operation, the case load with no flap adhesion in the treatment group was significant higher compared with the control group (22:8). The case load with complete acquired skin flap adhesion in the treatment group was visibly lower than in the control group (3:19), which proved that there was a significant statistical difference between the two groups (P < 0.05). This study suggested that the using of PLA-G in the breast cancer modified radical mastectomy could prevent skin flap adhesion without any harmful effects in the wound healing.
Breast Neoplasms ; surgery ; Drainage ; Female ; Gels ; therapeutic use ; Humans ; Lactic Acid ; therapeutic use ; Mastectomy, Modified Radical ; Necrosis ; Polyesters ; Polymers ; therapeutic use ; Surgical Flaps ; Tissue Adhesions ; prevention & control ; Wound Healing

Objective To explore the lesion distribution pattern of poststroke pathological laughing or crying (PSPLC) by using MRI,and to discuss its pathogenesis. Methods All 24 cases selected from stroke patients who were treated in the department of neurology from May 2012 to December 2015 and had complete follow?up information after their discharge through 6 months were screened for pathological laughing and crying( PLC) . MRI characteristics of cases were analyzed retrospectively to identify lesion distribution. 28 cases with acute isolated pontine infarction who did not demonstrate PLC were enrolled as a comparison group. Lesion pattern difference between 14 cases of the pontine infarction with PLC and 28 cases of acute i?solated pontine infarction without PLC was compared. Results In these 24 cases,the highest occurrence rate of PLC was 41.67% in the second month. 15 cases had forced crying (62.5%),3 cases had forced laughing (12.5%),6 cases had pathological laughing or crying (25%). MRI studies showed lesion location in the left side were 3 cases,in the right side were 1 case,in the bilateral brain were 20 cases,in the basal ganglia were 9 cases,in the thalamus were 8 cases,in the corona radiata were 6 cases,in the semioval center were 5 cases, in the cerebral cortex were 4 cases,in the cerebellum were 4 cases and in the brain stem were 14 cases. In the cases of PLC with brain stem lesion,only 1 case was isolated pontine infarction,the other patients all combined with lesions of other parts. Compared with the pontine infarction with PLC,the isolated pontine in?farction without PLC was more likely to suffer with unilateral brain lesions(71%vs 50%),but there was no significant difference (χ2=0.844, P=0.358) . Conclusion PSFLC is not a rare complication after stroke, which is associated with multiple site of brain involvement especially pontine infarction.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin and ferulic acid in Naoxuesh-uan pill. METHODS:HPLC was performed on the column of Waters SunfireTM C18 with mobile phase of acetonitrile-water-glacial acetic acid(17:82:1,V/V/V)at a flow rate of 1.0 ml/min,detection wavelength was 230 nm,column temperature was 35 ℃,and the volume injection was 20 μl. RESULTS:The linear range was 0.024-0.240 mg/ml for paeoniflorin(r=0.999 9)and 0.009 4-0.141 0 mg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 95.00-97.90%(RSD=0.59%,n=6) and 95.29-98.24%(RSD=0.54%,n=6),respectively. CONCLUSIONS:The method is simple and repro-ducible,and can be used for the quality control of Naoxueshuan pill.

Objective To analyze effects of maternal passive smoking at different exposure level in different period of pregnancy on fetal birth weight and to reveal the influence of different measurement methods on the effects of maternal passive smoking.Methods Meta analysis was applied.NCBI,OVIDC-MEDLINE,CNKI,VIP and CBM were searched,all searched studies were retrieved,and their references were checked for other relevant publications,with the language limited to Chinese and English.The search was finished by April 2008.Pooled mean differences with 95% confidence interval were estimated using data extracted from papers.Results A total of 38 papers were searched,and 19 of them were prospective studies and 19 were retrospective studies,respectively.Maternal passive smoking was associated with a reduction of 67.62 g(95% CI:-90.15～-45.09)in mean birth-weight,and the adjusted reduction was 44.92 g(95% CI:-67.07～-22.77).Based on biochemical markers measurement,the pooled effect size was-73.87 g(95% CI:-113.41～-34.34),based on self-report measurement,the pooled effect size was-62.93 g(95% CI:-84.49～-41.37).The lowest and highest level exposure's effect sizes were-44.61 g(95% CI:-78.36～-10.87)and-116.37 g(95% CI:-180.74～-52.01),respectively.Maternal passive smoking in early pregnancy can reduce the birth-weight by 2.70 g(95% CI:-37.74～32.33),however,it was not statistically significant.Conclusions Maternal passive smoking during pregnancy could reduce infant birth-weight.The middle or late period of pregnancy might be the sensitive period for passive smoking's effect.There is no clear threshold value for passive smoking causing low birth weight.

Objective To observe the effect of dexmedetomidine on patients′ inflammation during CPB and protective effect on kidney and liver. Methods 60 cases undergoing cardiac valve replacement under CPB were randomly divided into NS group and Dex group. Blood samples were taken before induction , before ascending aorta blocked, end of CPB, 24, 48 and 72 hours after operation. The serum level of HMGB-1, TNF-α, IL-6, BUN, Cr and ALT are tested. Blood WBC and N% are also counted. Results WBC, N% and HMGB-1, TNF-α, IL-6, BUN, Cr in Dex group significantly decreased at time point T2 ~ T6 (P < 0.05) compared with NS group. But ALT in Dex group only decreased at time point T 2 and T5 compared with NS group (P < 0.05). Conclusion Dexmedetomidine can significantly decrease inflammatory factor during CPB and improve renal function after surgery.

[ABSTRACT]AIM:TodeterminetheeffectsofShensongyangxincapsule(SSYX)ontheventricularelectrical properties, structural remodeling and cardiac function in the rats with diabetes mellitus (DM).METHODS:Male SD rats (n=45) were randomly divided into control group (n=15), DM group (n=15) and SSYX group (n=15).The rats in DM group and SSYX group were injected with streptozotocin (60 mg/kg, ip), while the rats in control group were given normal saline (1 mL/kg, ip).The blood samples were collected 72 h after treatment for determining the blood glucose lev-els in DM group and SSYX group .The model rats in SSYX group were administered with SSYX (1 g· kg-1 · d-1 , ig) for 6 weeks, while the other rats received normal saline (2 mL· kg-1· d-1, ig).The echocardiography was used to assess the cardiac function , and the lead II electrocardiogram was also recorded in all the animals .The radioimmunoassay and Masson trichrome staining were used to measure the plasma levels of endothelin -1 (ET-1) and the collagen deposition in the ventricles, respectively.A whole Langendorff-perfused heart model was used to conduct the electrophysiologic study .The monophasic action potential ( MAP) and the ventricular effective refractory period ( VERP) were recorded in the left anteri-or free wall ( LAF) , and the burst pacing was used to induce ventricular arrhythmia ( VA) .RESULTS: Compared with control group, the VERP, action potential duration (APD), QT interval, incidence of VA, degree of myocardial fibrosis and plasma level of ET-1 were increased , while the cardiac function was declined in DM group .Compared with DM group , the VERP, APD, QT interval, incidence of VA, degree of myocardial fibrosis and plasma level of ET-1 were all de-creased, while the cardiac function was improved in SSYX group .CONCLUSION: SSYX attenuates the electrical and structural remodeling and improves the cardiac function in DM rats .

Objective To investigate the factor relateted to the prognosis in HFRS patients with ARF oliguresis stage and the applied chance of hemodiaglysis in HFRS patients. Methods 46 cases of HFRS patients with ARF, with hemodiaglysis applied hospitalized in the department of infectious disease of Luohe centre hospital during 1996 to 2004 were retrospectively investigated and the factor related to the prognosis were analyzed,divided into three groups:successful group,delayed group, died group, and 14 sorts of clinical factors and common lab test items compared. Results Between live groups, the following factors are statistics value,such as the age, platelet,serum albution before HD,frequency of HD and the days of oliguresis stage, the difference of the other factors such as chance of HD,laboratory indicators and complication occuring rate of are no notable. The age of died group is in one′s prime, died in 3 hospitalized days, given HD only 1~2 times,so,chance of HD and days of oliguresis stage were without comparing value,but,the rate of acute complication is 100 percent,the difference is notable.Conclusions The influence of HD time is no notable,and, to prevent acute complication before HD is the key factor relateted to the prognosis.

Objective There is still controversy over the effect of hyperglycemia on the tolerance of heart to ischemia/reperfusion(I/R)injury in patients with diabetes mellitus. The aim of this study was to evaluate the effect of hyperglycemia on I/R-induced ventricular arrythmia in isolated diabetic rat hearts. Methods Twenty-four healthy male SD rats weighing 210-250g were randomly divided into two groups: control group(C, n=10) and diabetes mellitus group(DM, n=14). Diabetes mellitus was induced by intraperitoneal injection of streptozotocin 60 mg?kg~(-1). Blood glucose was measured 72h later and every week thereafter. Diabetes mellitus was defined as persistent hyperglycemia(blood glucose≥16.7 mmol/L after meal). The diabeticrats received no insulin. The rats were anesthetized with pentobarbital 60mg?kg~(-1). The hearts were immediately removed and perfused with oxygenated(95% O_2, 5% CO_2)Krebs-Henseleit buffer(KHB)in a Langendorff apparatus at a constant perfusion pressure of 80 mm Hg. The 14 diabetic rats were further divided randomly into 2 subgroups: (1)DM+KHB (n=7) and (2) DM+GLU(n=7) in which glucose 3.6 g was added to KHB 1000ml. After 20 min equilibration all hearts were subjected to 30 min global ischemia followed by 40 min reperfusion. Epicardial electrocardiogram was monitored. The incidence of ventricular tachycardia(VT) and ventricular fibrillation(VF) and their duration were measured. The severity of arrhythmia was quantified by arrythmia score(AS). Coronary outflow was collected for determination of creatine kinase(CK) release. Results The incidence of ischemia-induced arrythmia was significantly lowered in diabetic hearts. The incidence of VT was 14.3% and VF 28.6% in DM+KHB subgroup as compared to 60%(VT) and 100%(VF) in the control group. The CK release was significantly lower in diabetes group(DM) than in control group(C); furthermore the CK release in DM=KHB subgroup was lower than that in DM=GLU subgroup. Conclusion Diabetic rat hearts are less susceptible to I/R induced arrythmia. Hyperglycemic perfusion reduces to some extent the increased tolerance to I/R injury in diabetic rat hearts as shown by increased CK release in DM+GLU subgroup but hyperglycemic perfusion has anti-arrhythmic action as shown by 0% incidence of VT and VF in DM+GLU subgroup.

BACKGROUND:There are few clinical control ed trials about the clinical effects in patients with pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation.
OBJECTIVE:To compare the clinical outcomes in patients with AO/ASIF-A1/2 pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation.
METHODS:A total of 98 patients with AO/ASIF-A1/2 pertrochanteric femur fractures were treated by proximal femoral nail antirotation. They were divided into two groups according to the type of proximal femoral nail antirotation:short nail group (n=50) and long nail group (n=48). The operative time, blood loss, and hospital stay were recorded in both groups. In fol ow-up, fracture healing time, imaging and clinical complications were evaluated. In the final fol ow-up, Harris hip score was used to evaluate functional recovery.
RESULTS AND CONCLUSION:Compared with the short nail group, operative time was shorter and blood loss was less in the long nail group (P<0.05). No significant difference in hospital stay was detected between the short nail and long nail groups (P>0.05). Average fol ow-up periods were respectively (15.8±6.4) months and (16.2±5.7) months in the long nail and short nail groups.“Cutting-out”or infection occurred in five patients in the long nail group and three in the short nail group. Besides above-mentioned patients, the remaining patients in the two groups achieved fracture healing. No significant difference in average fracture healing time was detected between groups (P=0.588). In the final fol ow-up, no significant difference in Harris hip score was detectable in the two groups (P=0.204). The incidence rates of total postoperative complications in the long and short nail groups were 31.2%and 16.0%, respectively (P=0.075). Results suggested that no differences in the union and complication rates between the two groups were identified, suggesting that long nails offer no advantage compared with short nails for stabilizing AO/ASIF-A1/A2 pertrochanteric femur fractures.

Angina Pectoris ; prevention & control ; Coronary Disease ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; History, Ancient ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; history ; methods