Objective To investigate the possible role of mRNA expression of nitric oxide synthase in the abnormal intestinal motility and visceral perception in patients with diarrhea predominant IBS. Methods Anorectal manometry and rectal visceral sensory thresholds were examined in 25 patients with diarrhea predominant IBS and 15 healthy controls by means of electric barostat and perfusion catheter manometer. The quantity of NO was measured using nitrate/nitrite colorimetric assay. The nerve fibers containing NOS in mucosal muscular layer of colon was quantitatively measured with NADPH diaphorase histochemistry assay and computer image analysis. The expression of neuronal nitric oxide synthase (nNOS) mRNA was determined with fluorescence quantitative polymerase chain reaction (FQ PCR). Results Thresholds of first perception, defecation and pain in patients with IBS were significantly lower than those of controls. The motility indexes of sigmoid and rectum were significantly higher than those of normal controls ( P

Objective To investigate the postmortem redistribution of Avermectin in acute poisoning death of rabitts. Methods According to the minimum lethal dose intragastric of 250mg/kg avermectin, the avermectin contents in the heart blood and major organs and tissues of the rabitts after death of 0h~72h were assayed by HPLC method. Results Determination of clinical death time was 120.6±9.2min(x±s, n=10)by intragastric 250mg/kg avermectin to the rabitts; Lethal blood concentrations and lethal tissue concentrations of Avermectin were determined; Presence of postmortem redistribution of avermectin contents in the heart blood and major organs and tissues of the rabitts after death of 0h~72h were proved; Determination of the liver, kidney and lung were the best tissue samples for toxicological anaysis. Conclusion The data of Avermectin postmortem redistribution in the rabbits have important reference value for the forensic management of such cases.

With the advent of the modern medical mode,rehabilitation medicine teaching becomes an important part of the whole system of medical education.Theory on rehabilitation medicine education infiltrates clinical specialities and brings about a great advance in promoting subject development throughly during clinical education.

Objective To evaluate the intracranial arterial collateral blood flow pathways and the changes of hemodynamics. Methods A total of 29 patients with unilateral internal carotid artery occlusion were selected. In these cases, their ophthalmic arteries(OA) and cerebral arteries were observed using transcranial color Doppler ultrasonography (TCCD), color Doppler energy imaging(CDE) and contrast-enhanced color Doppler ultrasonography. Collateral pathways through the ill-lateral OA, anterior and ill-lateral posterior communicating artery(ACoA and PCoA, respectively) were demonstrated by reversal of blood flow in the ipsilateral OA, reversal of blood flow in the ipsilateral A1 segment of the anterior cerebral artery(ACA) or decrease of blood flow velocity in ipsilateral middle cerebral arteries (MCA) during contralateral common carotid artery(CCA) compression and the increase of blood flow velocity in ipsilateral P1 segment of the posterior cerebral artery(PCA) during ipsilateral CCA compression, respectively. Results ①Among 29 cases, bilateral OA of 29 patients(100%) and bilateral MCA, ACA and PCA of 16 patients ( 55.2 %) could be visualized by TCCD and CDE. The other 13 patients( 44.8 %) can be seen clearly only after contrast-enhanced color Doppler ultrasonography. ② There were intracranial arterial collateral blood flow pathways of 29 patients(100%) through OA, 24 patients( 82.7 %) ACoA and 2 patients ( 6.8 %) PCoA, respectively. ③ The blood flow velocity was higher in ill-lateral OA than in contralateral OA, but PI and RI lower( P

Objective To study the extracranial and intracranial arterial hemodynamic changes before and after carotid artery stenting(CAS). Methods Thirty-eight patients with extracranial internal carotid arterial(EICA) stenosis were selected.Before and after CAS, the vessel diameter,the peak systolic velocity(PSV) in bilateral EICA and the PSV, pulsatility index(PI) in bilateral middle cerebral artery(MCA),ophthalmic artery(OA) were measured respectively by color Doppler flow imaging(CDFI) and transcranial color-coded duplex sonography(TCCD).Results Compared with pre-CAS,the diameter of ipsilateral EICA showed obviously increase post-CAS(P 0.05 ).The established collateral circulation were closed. Conclusions The extracranial and intracranial arterial hemodynamic data measured by CDFI and TCCD are valuable in evaluation of CAS.CAS is an effective and safe treatment for carotid stenosis,and the long time follow-up remains to be.

Objective To estimate the prevalence and related risk factors of post-stroke depression (PSD) in ischemic stroke survivors from community-based medical centers in urban areas of Beijing.Methods Five community-based medical centers in urban areas of Beijing were selected.Patients with first-ever or recurrent ischemic stroke were evaluated from January 2003 to December 2006. The prevalence of PSD was evaluated by Self-Rating Depression Scale (SDS), and the information on the onset of stroke, vascular risk factors and living style was also collected.Results Totally 1089 stroke patients were registered, 1074 cases among which had complete information and met inclusion criteria. The mean age of the patients was (65.0 ± 8.9) years with a median stroke course of 13.0 months. The overall prevalence of PSD was 49.9% (536/1074), and the proportions of mild, moderate and major PSD were 52.2%, 36.0% and 11.8%, respectively. There were no significant differences in prevalence of PSD among different stages of stroke and the prevalence of PSD was 51.3% within 6 months after stroke onset, 47. 1% during 6-18 months and 53.2% after 18months. Low education, activities of Daily Living (ADL) dependence, cognition impairment and recurrence of stroke were independent risk factors for PSD.Conclusions The prevalence of PSD among ischemic stroke patients is higher in community-based medical centers, but most of PSD patients are mild or moderate. More effective early intervention should be adopted to decrease PSD,promote the recovery of neural function and improve their quality of life.

Objective To investigate the possible role of abnormal signal transduction in smooth muscle cell in the pathogenesis of diabetic gastroparesis. Methods Healthy male SD rats were randomly divided into 2 groups: normal,model group,diabetes was induced by Ⅳ of alloxan,50mg/kg. Gastric emptying was measured by method of nutritious semisolid paste. The level of cAMP in gastric smooth muscle cell was measured by radioimmunoassay. Gsαand GiαmRNA positive cells were quantitatively measured by in situ hybridization and computer image analysis system respectively. Results ( 1 ) Gastric emptying rate of the normal was significantly higher than that of model group (P < 0.05 ) ; (2)the level of cAMP of the normal was significantly lower than that of model group( P < 0.05 ) ; (3)the expression of GsαmRNA in the model group was significantly higher than that of the normal groups( P < 0.05 ) ; (4) there was no marked difference in the expression of GiαmRNA between 2 groups( P > 0.05). Conclusion Altered expression of GSαmRNA may play a key role in the pathogenesis of diabetic gastroparesis.

OBJECTIVETo report the first case of laparoendoscopic single-site surgery (LESS) for gynecologic malignancy in China and discuss the application of LESS in minimally invasive gynecologic surgery.

METHODSA 57-year-old postmenopausal woman presented with vaginal bleeding for 5 years and diagnostic curettage revealed endometrial cancer. Staged LESS for endometrial cancer was performed using a single multiple-channel port (Tri-port) inserted through a solitary 2.5 cm upper umbilicus incision.

RESULTSThe operation was completed successfully. The total operative time was 4.5 h, the duration of the LESS procedure was 4.0 h, and the establishment of the operative access took 1.0 h. No other port incision or transfer to open procedure was needed. The intraoperative blood loss was 100 ml. Bowel peristalsis and micturition recovered 2 days after the operation, and the peritoneal drainage tube was removed 4 days after the operation without vaginal bleeding. No obvious scar was left on the surface of umbilicus.

CONCLUSIONLESS can be a promising minimally invasive approach to effective management of benign and malignant gynecological diseases.

China ; Endometrial Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Middle Aged ; Uterine Neoplasms ; surgery

Objective To investigate the possible role of interstitial cell of Cajal (ICE)in the pathogenesis of diabetic gastroparesis and the protective effect of"Xiaopi prescription (消痞方)".Methods Fifty healthy male Spregue-Dawley (SD) rats were randomly divided into 5 groups (each n=10):normal, model,and 3 Xiaopi prescription groups:low,middle and high dosages.Diabetes was induced by intravenous injection of alloxan,and equal amount of normal saline was intravenously injected in the normal group.Gastric lavage method was used to administer the traditional Chinese medicine decoction of Xiaopi prescription in corresponding amount (5,10 and 20 g?kg~(-1)?d~(-1)) in respective low,middle and high dosage groups.In the normal control group and diabetic model group,only equal amount of normal saline was administered into the stomach.Gastric emptying rate was measured by method of nutritious semisolid paste;c-kit positive cells of ICC were quantitatively measured with immunohistochemistry assay and computer image analysis system;c-kit mRNA positive cells were quantitatively measured with in situ hybridization and computer image analysis system.Results①Gastric emptying rate:The rate was significantly lower in the model group than that in the normal control group (P0.05),but higher than those in the model group and the low dosage group (all P0.05).②c-kit immmunohistochemistry:c-kit positive cell presented yellow in color,and its membrane was stained yellow,this kind of cells primarily were distributed around the neural plexus in the inter-space between the circular and longitudinal muscular fibers, and around the ganglionic cells forming"sheath-like"structure.The results of numbers of c-kit positive cells in the various groups:the number of the cells in the model group was significantly lower than that in the normal group (P0.05),but the numbers in the former two dosage groups were obviously higher than those in the model group (all P0.05),being significantly lower than that in the normal group,middle and high dosage groups (all P0.05),but obviously higher than those in the model group (all P0.05),being significantly lower than that in the normal,middle and high dosage groups (all P

OBJECTIVETo report the first case of transumbilical laparoendoscopic single-site surgery-assisted vaginal hysterectomy in South China, and discuss its feasibility and safety.

METHODSA 42-year-old woman with multiple myoma of the uterus underwent laparoendoscopic single-site surgery-assisted vaginal hysterectomy performed using a single multiple-channel port inserted through a solitary 2 cm upper umbilicus incision.

RESULTSThe total operative time was 3 h, and duration of the laparoendoscopic procedure was 2 h. The surgery was completed uneventfully without an additional port incision or transfer to open surgery. The intraoperative blood loss was 100 ml. Bowel peristalsis was recovered 3 days after the operation. The vaginal stump and abdominal incision healed smoothly without occurrence of vaginal bleeding.

CONCLUSIONWith the development of surgical instruments and improvement of the surgeons' skills, laparoendoscopic single-site surgery, due to its invasiveness, can be a promising approach to the management of gynecological disease including gynecological malignant tumors.

Adult ; Female ; Humans ; Hysterectomy, Vaginal ; methods ; Laparoscopy ; methods ; Leiomyoma ; surgery ; Uterine Neoplasms ; surgery