BACKGROUND: Ginsenoside Rb1 has been extensively used in the protection and treatment of heart, encephalon, lung, kidney and liver damage. However, its application in skin flap is rare.OBJECTIVE: To investigate the effects of intraperitoneal injection of ginsenoside Rb1 on the survival of the dorsal random-pattern skin flap with large length-to-width ratio in rats.METHODS: Healthy adult SD rats were randomly divided into experimental and control groups. A caudally based dorsal random pattern skin flap, 80 mmx20 mm (length: width = 4:1), was symmetrically made. Ginsenoside Rb1 (2 mg/kg) was intraperitoneally injected into the experimental group rats, and the same volume of normal saline was injected into the control group. Malonyl dialdehyde (MDA) and nitric oxide (NO) level of the flaps were tested 1 day after operation; the amount of viable tissues of the flaps were examined by planimetry 10 days after operation. Specimens from the proximal, middle and distal flaps were harvested for HE staining to examine the microstructure.RESULTS AND CONCLUSION: At the first day after operation, NO level was higher in the experimental group than the control group (P< 0.01), while MDA level was lower than the control group (P< 0.01). At the 10th day after operation, the survival rate of the flap was significantly greater in the experimental group than the control group (P < 0.001). Histological observation showed that compared with the control group, the edema and inflammatory cells infiltration were less, while the fiber hyperplasia and the microvascular growth were more obvious in the experimental group. Results show that intraperitoneal injection of ginsenoside Rb1 can enhance the blood supply of the flaps and improve the survival of the random-pattern skin flaps with large length-to-width ratio in rats. This may involve its effects of improving NO activity, decreasing lipid peroxidation, and promoting angiogenesis of skin flaps.

Objective To investigate the clinical efficacy and safety of combined acupuncture and medicine in treating polycystic ovarian syndrome infertility.Methods Ninety patients with polycystic ovarian syndrome infertility were randomly allocated to treatment and control groups, 45 cases each. The control group received oral administration of clomifene citrate tablets plus muscular injection of chorionic gonadotropin and the treatment group, electroacupuncture in addition. The ovulation rates, pregnancy rates, incidences of ovarian hyperstimulation syndrome (OHSS), ectopic pregnancy rates and early miscarriage rates were compared between the two groups of patients. Results The ovulation rate and the pregnancy rate were 97.8 % and 37.8%, respectively, in the treatment group and 75.6% and 17.8%, respectively, in the control group; there was a statistically significant difference between the two groups (P<0.05). Of 17 pregnant patients in the treatment group, 2 had early miscarriage, accounting for 11.8% and none had ectopic pregnancy, accounting for 0.0%. Of 8 pregnant patients in the control group, 4 had early miscarriage, accounting for 50.0% and none had ectopic pregnancy, accounting for 0.0%. The incidence of OHSS was 4.4% in the treatment group and 6.7% in the control group; there was no statistically significant difference between the two groups (P>0.05).Conclusions Combined use of acupuncture and medicine can increase the ovulation rate and the pregnancy rate in patients with polycystic ovarian syndrome infertility. It does not significantly cause ovarian hyperstimulation and ectopic pregnancy and may decrease the early miscarriage rate.

Objective To retrospectively review the diagnosis and treatment of intraarticular synovial hemangioma of the knee under arthroscope. Methods Six cases of intraarticular synovial hemangioma of the knee were included. The examination of X ray and MRI before surgery indicated intraarticular synovial hemangioma in 5 cases and pigmented villonodular synovitis in 1 case, then arthroscopic diagnosis and excision of the lesions were followed. Results The six cases were definitely diagnosed as intraarticular synovial hemangioma. Under arthroscope, the lesions exhibited as irregular dark blue or purple capillary clumps of different sizes. The postoperative follow-up of 10.7 months in average (range 4-23 months) shows good joint function for all the patients and no signs of recurrence at the last follow-up. Conclusion Intraarticular synovial hemangioma is rare with a high rate of misdiagnosis. Careful physical examination and MRI can help to make the diagnosis. Arthroscopic surgery is a choice of diagnosis and treatment for intraarticular synovial hemangioma of knee.

To report the clinical course of 5 cases of pediatric plastic bronchitis and review the related literature.A total of 113 cases of pediatric plastic bronchitis occurring in China from 2000 to 2012 were retrieved through the databases of CNKI and Wanfang Med Online.Retrospective analyses were performed for the main symptoms,courses,etiologies,imaging findings,histopathological classifications,therapies and prognosis of 118 cases.Pediatric plastic bronchitis was one of critical diseases.Most of them had a rapid onset and a mortality rate.Bronchoscopy examination was essential for definite diagnosis and effective treatment.Airway management and chest physiotherapy were primary adjuvant tools.Early diagnosis and bronchoscopic treatment might result in improved prognosis.

Objective To investigate the relationship between nasal colonization of Staphylococcus aureus(SA) and nosocomial infection in intensive care unit(ICU), and observe the therapeutic effect of Anerdian III in nasal decolonizaion. Methods Bacterial cultures were made by means of nasal swabs among inpatients whom the occurrence of nosocomial infection were observed.Patients with SA colonization were randomly divided into two groups:control and treatment.Control group were given regular treatment, and treatment group were administered Anerdian III in addition to regular treatment.Then the clearance rate of SA and the occurrence of nosocomial infection of two groups were observed. Results A total of 751 patients were enrolled, of whom 108(14.4%) were with nosocomial infection and 85(11.3%) with SA nasal colonization. Methicillin resistant Staphylococcus aureus ( MRSA ) was detected in 33 patients (4.4%).The nosocomial infection rate of patients with MRSA colonization was 51.5%, which was significantly higher than those in patients with other bacterial colonization(P<0.05).The SA clearance rate in treatment group was significantly higher than that in control group(81.4% vs.42.8%,P<0.05).The nosocomial infection rate in treatment group was significantly lower than that in control group ( 16 .3% vs. 40.5%,P <0.05).After decolonization treatment,the nosocomial infection rate of patients with MRSA colonization was significantly lower than that in control group(25.0% vs.76.5%,P <0.05). Conclusion The incidence rate of nosocomial infection in patients with MRSA nasal colonization is markedly increased in ICU, and the decolonization treatment by Anerdian III increases the clearance rate of nasal SA and decreases the incidence rate of nosocomial infection.

Objective:To evaluate the relationship between thalamocortical glutamate and neuronal activity in mice with neuropathic pain-induced sleep disorders.Methods:SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 15-25 g, were divided into 2 groups ( n=14 each) using a random number table method: sham operation group (Sham group) and neuropathic pain group (CCI group). Neuropathic pain was induced by chronic constrictive injury (CCI). The animals were anesthetized with intraperitoneal 10% chloral hydrate 3 ml/kg.The right sciatic nerve was exposed and 4 ligatures were placed on the sciatic nerve at 1 mm intervals.The mechanical paw withdrawal threshold and thermal paw withdrawal latency on the operated side were measured at 1 day before CCI (T 0) and 3, 5, 7, 14 and 21 days after CCI (T 1-5). Electroencephalogram recording electrodes were stereotaxically implanted in visual cortex at T 3, and electroencephalogram were monitored for 6 h, the percentages of non-rapid eye movement, rapid eye movement and wakefulness in the total time were calculated.Microwire electrodes were implanted epidurally over the ventral posterior (VP) nucleus of the thalamus and primary somatosensory cortex (S1) using a brain stereotaxic apparatus at T 3, and the data acquisition system was used to record field potentials at T 4, the percentage of power of each wave was calculated, and the coherence of the field potentials of VP and S1 was simultaneously evaluated.The mice were sacrificed at T 4, brain tissues were collected, and proton nuclear magnetic resonance spectroscopy was used to determine the level of neurotransmitter in the thalamus and cortex. Results:Compared with group Sham, the mechanical paw withdrawal threshold was significantly decreased and thermal paw withdrawal latency was shortened at T 1-5, the percentage of non-rapid eye movement time was decreased, the percentage of wakefulness time was increased, the percentage of δ wave power in the VP area was decreased, the percentage of δ wave power in the VP and S1 areas was increased, and the coherence of the field potentials of VP-S1 was increased in the frequency range of δ wave (1-4 Hz) and α wave (8-14 Hz), and the levels of glutamate, glutamine and glutamate-glutamine in the thalamus and cortex were increased in group CCI ( P<0.05). Conclusions:Neuropathic pain-induced sleep disturbance is related to increased thalamocortical glutamate levels, resulting in changes in the electrical activity of thalamocortical neurons of mice.

Objective:To evaluate the role of P2X 7 receptor in microglia in the medial prefrontal cortex (mPFC) in neuropathic pain (NP) and the relationship with autophagy in rats. Methods:Sixty-four healthy SPF male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 4 groups ( n=16 each) using a random number table method: sham operation group (S group), NP group, sham operation+ P2X 7 receptor blocking group (SP group), and NP+ P2X 7 receptor blocking group (NP+ P group). The NP model was established by ligation of the sciatic nerve.Fourteen days later a cannula was placed in the mPFC with a brain stereotactic instrument, P2X 7 receptor blocker A-740003 0.5 μg/0.5 μl was injected into bilateral mPFC for 3 consecutive days starting from the 14th day in SP and NP+ P groups, and DMSO 0.5 μl was injected instead of A-740003 in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 3, 7 and 10 days after establishing the model and 14, 15 and 16 days after administration.Then the rats were sacrificed, and the mPFC was removed for determination of the expression of P2X 7 receptor and mRNA and autophagy-related proteins Beclin1 and LC3Ⅱ/Ⅰ (by quantitative real-time polymerase chain reaction or by Western blot) and co-expression of P2X 7R and microglia (by immunofluorescence) and the number of autophagosomes in mPFC (with a transmission electron microscope). Results:Compared with group S, MWT was significantly decreased, and TWL was shortened at 3, 7 and 10 days after establishing the model, the expression of P2X 7 receptor and mRNA, Beclin1 and LC3Ⅱ/Ⅰ was up-regulated at 30 min after administration on 16 days after establishing the model, and the number of cells co-expressing P2X 7 receptor and IBA-1 and the number of autophagosomes were increased in NP and NP+ P groups ( P<0.05), and no significant change was found in the indexes mentioned above in group SP ( P>0.05). Compared with group NP, MWT was significantly increased, and TWL was prolonged at 30 min after administration on 14, 15 and 16 days after establishing the model, the expression of P2X 7 receptor and mRNA, Beclin1 and LC3Ⅱ/Ⅰ was down-regulated, and the number of cells co-expressing P2X 7 receptor and Iba-1 and the number of autophagosome were decreased in group NP+ P ( P<0.05). Conclusion:Up-regulation of P2X 7 receptor expression in microglia in mPFC is involved in the process of NP in rats, which is associated with the promotion of autophagy.

Objectives： This study was designed to observe the histological localization of SNC73 gene expression in colorectal cancer, and to investigate their expression in different phases from normal epithelium, transitional mucosa, adenoma to carcinoma, and to discuss the relationship between SNC73 gene expression and the clinic factors of colorectal cancer. Method： With in situ hybridization, the expression of the SNC73 was determined in 29 patients with colorectal cancer group specimens as the above. Results： SNC73 gene expression was observed in normal mucosal tissue and some lymph follicles of the mucosa, but seldom in cancer tissue. The positive rate of SNC73 expression was 20.69％ in colorectal cancer; was 62.07％ in normal mucosa; was 31.03％ in adjacent tissue; and was 20.00％ in adenoma. Statistical difference was found between expressions in normal mucosa and those in colorectal carcinoma from the same patient (P<0.01). Conclusions： The positive rate of SNC73 expression in colorectal cancer is lower than that in corresponding normal mucosa. The biological function of SNC73 may be different from that of common immunoglobulins.

Objective:To observe the effects of moxibustion on the levels of glucose-6-phosphate dehydrogenase(G6PD)and reduced nicotinamide adenine dinucleotide phosphate(NADPH)in the plasma and spleen and the CD4+T-cell number in the spleen of rats with adjuvant arthritis,thus to explore the mechanism in rheumatoid arthritis(RA)treatment with moxibustion by regulating the CD4+T-cell proliferation through G6PD-mediated pentose phosphate pathway. Methods:Twenty-seven male Sprague-Dawley rats were randomly divided into a blank group,a model group,and a moxibustion group,with 9 rats in each group.Incomplete Freund's adjuvant was used to induce inflammation in the model group and the moxibustion group.The blank group and the model group were not intervened.In the moxibustion group,suspended moxibustion was performed at bilateral Zusanli(ST36),Guanyuan(CV4),and Ashi points for 30 min,once a day for 24 times in total.Hematoxylin-eosin staining was used to evaluate the histopathological changes of rat synovial tissue;the swelling degree of the rat toes was observed by measuring the toe volume;G6PD and NADPH in the spleen and plasma were detected by Western blotting and enzyme-linked immunosorbent assay.Flow cytometry was used to detect the CD4+T-cell number in the spleen. Results:Compared with the blank group,the levels of G6PD and NADPH in the plasma and spleen and the CD4+T-cell number in the spleen were significantly increased in the model group(P<0.01 or P<0.05).Compared with the model group,the NADPH level in the spleen and plasma and the CD4+T-cell number in the spleen in the moxibustion group decreased significantly(P<0.05 or P<0.01),and the G6PD level in the plasma decreased significantly(P<0.05),but there was no significant difference in the G6PD level in the spleen(P>0.05). Conclusion:Moxibustion can regulate immunity and improve joint synovial inflammation in RA.The mechanism may be that the G6PD-mediated pentose phosphate pathway reduces the production of metabolite NAPDH in CD4+T cells,thereby inhibiting the proliferation of naive CD4+T cells.

BACKGROUNDFoetal echocardiography has become a diagnostic method to detect foetal congenital heart disease with high probability. However, it is not only time consuming and but also difficult to visualize outflow tract of foetus early in the second trimester of pregnancy, even for an experienced obstetric ultrasonographer. Recently, many methods for screening foetal cardiac anomalies were explored, but much more work is needed to develop an effective and suitable screening method. The aim of this study was to investigate the clinical significance of utilising the ductus venosus (DV) Doppler examination and the four-chamber view of heart to screen for foetal cardiac malformation in early second trimester of pregnancy.

METHODSHeart and DV of 401 consecutive foetuses in early second trimester (12(+1) - 17(+6) weeks) in high risk pregnancies were examined with Acuson 128 xp/10 or Sequoia 512 ultrasound diagnostic systems. Absent or reversed flow during atrial contraction (A-wave) in the DV was defined as sufficiently abnormal to screen for foetal cardiac malformations. The foetal echocardiographic diagnosis was confirmed by postnatal echocardiography (or postmortem). The sensitivities of screening tests were compared among the three methods: DV Doppler examination, four-chamber view alone, and the combination of both techniques.

RESULTSSatisfactory examinations were obtained in 383/401 foetuses (95%). Thirty foetuses with cardiac abnormalities were confirmed by neonatal echocardiography (or postmortem). The sensitivity of DV Doppler examination or four-chamber view alone is 63% (19/30) and 60% (18/30), respectively. The sensitivity of combining information, DV Doppler flow waveform and four-chamber view, to screen for foetal cardiac malformation is 83% (25/30) and significantly better than that of either DV Doppler flow waveform or four chamber view alone (P < 0.05).

CONCLUSIONDoppler flow waveform of DV can be used to screen for foetal cardiac malformation early in the second trimester. Combining information from Doppler flow waveform of DV and four-chamber view will improve the overall sensitivity of the screening.