Aim Effect of various absorption enhancers on the insulin colonic absorption was investigated. Methods The hypoglycemic effect was examined after colon delivery of INS SOL co administered with various absorption enhancers and the pharmacological bioavailability (PA) was calculated. Results INS SOL (5 U?kg -1 ) containing eucalyptol, sodium caprate, sodium deoxycholate and menthol significantly decreased the blood glucose level ( P

ObjectiveTo investigate the changes in stroke volume variation (SVV) monitored by FloTrac/Vigileo system during mechanical ventilation in patients undergoing pulmonary lobectomy.MethodsForty-four ASA Ⅰ or Ⅱ patients aged 44-64 yr weighing 47-86 kg undergoing elective pulmonary lobectomy performed under general anesthesia were studied.Blood volume was maintained by fluid (crystalloid∶ colloid 1∶1) infusion at a rate of 6-8 ml·kg-1 ·h-1.Cardiac output index (CI),stroke volume index (SVI) and SVV were measured based on arterial pressure wave form analysis by FloTrac/Vigileo System (Edwards Co.,USA) and recorded at following time points:at 5 min of two-lung ventilation (TLV) in supine position,2 min TLV in lateral position,during one-lung ventilation (OLV) before thoracotomy,at 5 and 30 min of OLV after thoracotomy,1 and 15 min OLV + PEEP of 5cm H2 O,before and immediately and 1 min after reflation of the remaining lobes.The normal value for SVV is less than 13％.ResultsThe hemodynamic parameters were stable during lobectomy.CI and SVI were within normal range.SVV was less than 13％ at all time points except that at immediately after reflation of the remaining lobes.ConclusionSVV obtained with FloTrac/Vigileo system can be used to guide fluid therapy during OLV in mechanically ventilated patients undergoing pulmonary lobectomy.

Humans ; Precision Medicine ; Temporomandibular Joint Disorders ; diagnosis ; psychology ; surgery ; therapy

Humans ; Temporomandibular Joint Disorders ; diagnosis ; therapy

BACKGROUND: Biological fixation refers to the treatment of coarse or porous prosthetic surface. It is favorable to "bone ingrowth" prosthesis to achieve long-term stability. Porous tantalum is the latest scientific product that appears suitable to prosthetic surface owing to its porous feature and has been attracting a great deal attention.OBJECTIVE: To investigate the therapeutic efficacy of a porous tantalum uncemented acetabular cup in acetabular revision arthroplasty.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA between April and November 2006.PARTICIPANTS/MATERIALS: Sixteen patients (16 hips), 7 males and 9 females, aged 54-81 years old, who received treatment at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA were included in this study. Of these patients, 2 suffered from femoral neck fracture, 6 from aseptic femoral head necrosis, and 8 from osteoarthritis. Trabecular metal cup (Zimmer, Warsaw, Indiana) provided a titanium alloy bottom layer and porous tantalum-coated surface, which was realized by technical combination of bone trabecular tantalum and titanium alloy. The prosthesis contained an ultrahigh modulus polyethylene lining.METHODS: All patients underwent acetabular revision with modular porous tantalum uncemented acetabular cup. Prior to replacement, acetabular defects and femoral prosthesis were evaluated. A posterolateral approach of hip joint was made. Following acatabular prosthesis removal, bone cement was cleared with osteotome, simultaneously scar tissue, granulation tissue, and fibrous limiting membrane in the acetabular fossa were erased with curette to avoid further damage to sclerotin. Bacteriological examination and susceptibility test with respect to intraarticular tissue fluid confirmed aseptic loosening. Antibiotics were used in each patient to prevent infection. Antibiotics and low molecular heparin were used afterwards to prevent infection and thromboembolism, respectively. Patients could not load within 4 weeks but could walk with the aid of two canes within subsequent 6 weeks. One week after surgery, plain X-ray films were taken in the lateral plane.MAIN OUTCOME MEASURES: Prior to and 6, 12, and 24 months after surgery, Harris hip score and University of California Los Angeles (UCLA) activity score were assessed. The position of acetabular prosthesis was observed through an anteropostedor pelvic radiograph.RESULTS: The average follow-up time was 24 months (range 18-25 months). Harris hip score significantly increased from 32.6 points (range 21-54 points) prior to revision to 87.5 points (range 56-90 points) after revision (P < 0.05). UCLA activity score significantly increased from 3.8 points (2-5 points) prior to revision to 8.2 points (range 6-9 points) after revision (P<0.05). The anteropostedor pelvic radiographs taken in the last follow-up displayed no phenomena regarding non-stability including prosthesis aversion and subsidence and revealed that the in-growth of sclerotin surrounding the bone trabecular tantalum acetabular cup. Postoperative complications were found in none of 16 patients. By the last follow-up, there had been 14 cases who did not complain of pains while walking and 2 cases that had slight pain and slight limp while walking. Deep venous thrombosis or nerve injury did not appear afterwards. No cases needed another acetabular revision arthroplasty.CONCLUSION: For cases of failed primary fixation of artificial acetabular cup, application of porous tantalum uncemented acetabular cup can produces favorable results in acetabular revision if no bone defects exist.

This paper introduces the perioperative nursing of 47 patients undergoing intraperitoneal parastomal hernia repair.After the surgery,two cases suffered from incision infection and two cases with subcutaneous hydrops.Three patients suffered from chronic pain or foreign bodies sensation,which disappeared at 3-6 months later.No recurrence occurred at 6-24 months after the surgery.It is suggested that the key points of perioperative nursing were careful preoperative symptom care and bowel preparation,as well as postoperative observation and correct discharge instruction.

Objective To detect the expression of epidermal growth factor receptor (EGFR) and cyclooxygenase-2(COX-2 ) in laryngeal squamous cell carcinoma and to investigate their clinical significance.Methods Resected tissue of laryngeal squamous cell carcinoma (observation group)and adjacent normal laryngeal mucosa ( control group) from 54 patients were collectod.Accooding to histological differentiation degreo,cervical lymph node metastasis,clinical TNM staging,EGFR and COX-2 were compared.Results The expression rate of EGFR in observation group [63.0％ (34/54)] was higher than that in control group [42.6％ (23/54)] (P ＜ 0.05 ).And COX-2 in observation group [68.5％(37/54)] was higher than that in control group [35.2％ (19/54)] (P ＜0.01).The expression of EGFR and COX-2 in observation group (0.584 ±0.136,0.561 ±0.134) were significantly higher than those in control group (0.161 ±0.045,0.114 ±0.027),respectively (P ＜0.01).The expression of EGFR and COX-2 had significant difference among histological differentiation degree,with or without cervical lymph node metastasis,different clinical TNM staging (P ＜ 0.05 or ＜ 0.01 ).Correlation analysis showed that the expression of EGFR and COX-2 in laryngeal squamous cell carcinoma had positive correlation (r =0.602,P ＜ 0.01 ).Conclusions The expression of EGFR and COX-2 have some contribution to the incidence and development of laryngeal squamots cell carcinoma.They can be used for the different diagnosis of benign and malignant carcinoma,clinical staging and prognosis estimating.They have significant clinical values.

Through referring to relevant works and the latest literature, the application and research progress of the traditional Chinese medicine inducing mesenchymal stem cells were summarized. The researching results focusing on induction and proliferation of mesenchymal stem cell by salvia, notoginseng, tortoise plastron, pilose antler, ginseng, astragalus were introduced.

BACKGROUND:Platelet-rich plasma has benefit in diabetic wound healing;however, the effect of al ogeneic platelet-rich plasma is stil unclear. OBJECTIVE:To observe the effect of al ogeneic platelet-rich plasma on col agen synthesis during diabetic wound healing. METHODS:Streptozocin-induced diabetic rats were randomly divided into al ogeneic platelet-rich plasma group and saline control group. Each group had 15 rats. A 1 cm2 ful-thickness skin defect on the rat dorsum was excised. Platelet-rich plasma or saline was applied. Platelet-rich plasma was prepared from the whole blood of al ogeneic healthy rats. Animals of each group were sacrificed on 3, 7, 14 days post operation. The differences of the wound closure rate, morphological character, hydroxyproline content and the relative mRNA expression of the col agen were observed. RESULTS AND CONCLUSION:The wound closure rates were lower in control group on day 3, 7, 14 post operation (P<0.05). Masson staining showed a decreased, disorder, loose col agen fibers distribution in diabetic control wound tissue. The results of the hydroxyproline test showed hydroxyproline content was significantly higher in platelet-rich plasma group at each time point (P<0.01). The relative mRNA expression of type I and III col agen presented a higher expression in platelet-rich plasma treated wound tissue at each time point (P<0.05). And the ratio between type I and III col agen was higher in platelet-rich plasma group at each time point (P<0.05). In summary, al ogeneic platelet-rich plasma can promote diabetic wounds healing, which may attribute to an enhanced col agen synthesis.

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.