Objective: To explore the preventive efficacy of local injection of hyaluronidase and topical administration of Hirudoid cream against skin damage caused by vinorelbine extravasation in rats. Methods: Vinorelbine was iv infused into the hinder limbs of SD rats to establish the extravasation model. The 48 rats were randomly divided into 6 groups. The model group received no treatment. The other five groups were given local injection of hyaluronidase, topical administration of Hirudoid cream, local injection of hyaluronidase plus topical administration of Hirudoid cream, local injection of normal saline (NS), or topical administration of normal saline, respectively. The lesion area and the healing time were observed and recorded on d 1, d 4, d 8, d 12, d 18, d 24, and d 30. Results: The lesions were cured by local injection of hyaluronidase on d 30. The lesion area were significantly reduced in hyaluronidase group compared with that in topical Hirudoid cream group, combined therapy group, local NS injection group, topical NS administration group, and the model group on d 1, d 4, d 8, d 12, d 18 and d 24 (P < 0.05). The healing time was significantly shorter in hyaluronidase group than that in other 5 groups [(21.9 ± 3.0) d vs (28.8 ± 3.5) d, (28.0 ± 2.9) d, (28.6 ± 4.1) d, (29.8 ± 2.6) d, and (30. 6 ± 3.0) d, P < 0.01]. Conclusion: Local injection of hyaluronidase is effective for skin damage caused by vinorelbine extravasation, but topical administration of Hirudoid cream is ineffective and combined therapy can not further improve the efficacy of hyaluronidase monotherapy.

Objective To evaluate the expression of Survivin,PTEN in tongue squamous cell carcinoma (TSCC) and the correlation with vascular endothelial growth factor (VEGF) and its clinical significance.Methods The expression of Survivin,PTEN and VEGF of 72 TSCC samples and 15 normal tongue mucosa (NTM) samples were detected by immunohistochemical method.Results The positive expression rate of Survivin,PTEN and VEGF in TSCC were 66.7％(48/72),61.1％(44/72),70.8％(51/72)respectively,while the positive expression rate in NTM were 0,100.0％ (15/15),0.There were statistical significance between the rate in TSCC and NTM respectively (P ＜0.01 ).The expression of Survivin and VEGF in TSCC were positively correlated with TNM stage,histological grade and lymph node metastasis (P＜ 0.05 or ＜ 0.01 ),while the expression of PTEN had negative correlation with them (P＜ 0.05 or ＜ 0.01 ).The expression of Survivin was positively correlated with VEGF expression in TSCC (r=0.6482,P＜0.01),while the expression of PTEN was negatively correleted with VEGF expression (r =-0.4027,P ＜0.01).Conclusions The expression of Survivin and PTEN in TSCC are associated with tumor occurrence and development closely,and are both significantly correlated with VEGF.Joint detection of Survivin,PTEN and VEGF have important reference value in clinical diagnosis,metastasis and prognosis of TSCC.

Objective To analyze the causative of damaged bioprosthetic valves implanted in 41 patients (with total 47 valves) over one year. Methods From June 1993 to June 2004,re-replacement of valves was performed in 41 patients with dysfunctional bioprosthetic valves. The interval between the two operations was 1～16 years [mean (9.7?4.1) years]. The 47 dysfunctional bioprosthetic valves were carefully observed and pathologically examined. Results Of the 47 valves, no valve frame was damaged; tear or perforation existed in 42 valves (89.3%); calcification was found in 35 valves (74.5%), with fibrosis; excrescence and thrombus coexisted in 2. Heavily damaged ones were sent for pathological examination, and infiltration of abundant phagocytes and monocytes was found. Conclusion Early damages were mainly tear or rupture, while late damages were compound outcomes of multiple damaging factors such as calcification, rupture, and tear.

Adenocarcinoma of exocrine pancreas is a highly malignant tumor with extremely low resectability.Radiotherapy,by inducing necrosis and apoptosis of tumor cells through irradiation effects on cellular DNA,in combination with chemotherapy,has made great contribution to multimodal treatment of this malignancy.The development of radiation therapy for pancreatic carcinoma in recent years was reviewed in neoadjuvant and adjuvant settings,and for locally advanced disease.Further evidence is required to show the impact of radiochemotherapy in the treatment of unresectable disease.

Objective: To study the effect of early rehabilitation on motor function of upper and lower extremities and activities of daily living(ADL) in patients with hemiplegia after stroke; and to observe whether motor function recovery of upper and lower extremities is different. Method: 96 patients were randomly divided into two groups, rehabilitation group (48 cases) and control group(48 cases). Prospective method was used in this study. Patients in the rehabilitation group were given clinical treatment and regular rehabilitation training, while those in control group were given clinical treatment and unguided self- training. The evaluation was done in pre- treatment and post- treatment(6- 8 weeks) respectively.Motor function was assessed in Fugl-Meyer assessment(FMA), ADL assessed in Barthel Index. Result: The motor scores (measured by FMA) and ADL scores (measured by Barthel index) in the two groups were improved after 6-8 weeks treatment, but there was a significant difference between the two groups, the scores in the rehabilitation group were obviously superior to those in the control group (P ＜ 0.01 ). The mean of the Fugl-Meyer Scale (transferred to percentage of maximal motor scores) of the lower extremities was higher than that of the upper extremities pre-and post-treatment (P＜0.01). However, the improvement degree of FMA scores between upper and lower extremity had no statistical difference (P＞0.05). Conclusion:Early rehabilitation training of the patients with stroke hemiplegia may obviously improve motor function of the limbs and raise ADL scores. However, the degree of improvement in upper and lower extremity is similar in the first two months after early training.

In order to understand the natural evalution of the motor function and the activities of daily living(ADL) in post stroke patients,and to provide scientific basis for the early treatment and rehabilitation training of the stroke patients,the motor function and ADL of 150 stroke patients without systematic rehabilitation training were evaluated at 5-6 week and 6 month of post stroke,respectively.The results showed that most patients had functional improvements.The functional recovery of upper limbs and especially hands was worse than that of lower limbs.The average ADL scores increased from 59.80 to 69.54,but the improvements were unsatisfactory.The results suggested that it is necessary to carry on the early rehabilitation training for the stroke patients fo that the patients motor function and ADL could improve more quickly and better to greater degree.

Objective To discuss the lung protective effect of Shenfu injection on the legs' ischemia-reperfusion injury.Methods Sixty patients (6 males, 24 females, ASA grade Ⅰ or Ⅱ)with unilateral lower limb surgery, were randomly divided into Shenfu injection group (group SF, n=32) and control group (group C, n=28).All patients were treated by combined spinal epidural anesthesia, with the same dose of local anesthetic (0.75% bupivacaine 1.5 ml and the same pressure (300mm Hg) of tourniquet.Patients in group SF were given intravenous infusion of Shenfu injection with the dose of 1 ml/kg (added in normal saline 100 ml) 30 min before apply tourniquet and 1 ml/kg (added in nomal saline 50 ml) 5 min before tourniquet deflation.Patients in group C were injected with equal dose of compound sodium lactate at the same time.Recorded the hemodynamic changes before apply tourniquet (T0) and 5 min (T1), 15 min (T2) and 30 min (T3) after tourniquet deflation.Took venous blood to determine concentrations of plasma thromboxane B2 (TXB2) and malondialdehyde (MDA).Results Compared with T0, MAP in the two groups were significcantly lower at T1-T3 (P＜0.05).MAP in group SF at T2 and T3 were higher than those in group C (P＜0.05).There was no significant difference in HR between the two groups.TXB2 and MDA in group SF at T2 and T3 were significantly lower than those in group C (P＜0.05 or P＜0.01).Conclusion Shenfu injection with antioxidation has a protective effect on lower limb ischemia-reperfusion lung injury induced by tourniquet.

Objective To investigate precise and regulable animal model of benign bile duct strictures.Methods Mini pigs were divided into four groups as sham surgery group, conventional surgery group, small caliber group and large caliber group according to random number table, with 6 pigs in each group.For the small caliber group, outside diameter 3.0mm catheter were inserted into bile duct and partial sutured.For the large caliber group, outside diameter 6.0mm catheter were inserted into bile duct and partial sutured.Conventional surgery group were treated with 5-0 absorbable suture on distal bile duct and controlled stricture severity visually.For sham surgery group, bile duct were exposed without suture.Observe the general condition of four groups.Test liver function on 1st, 3rd, 7th, 14th, 21st and 28th day postoperative.Perform cholangiography on 30th day postoperative.All four groups were put to death to observe the histological changes of liver and bile duct.Results Liver function of sham surgery group showed no obvious change during observation.On 28th day postoperative, compared to conventional surgery group, the liver enzymes ALT, AST, γ-GT, ALP, bilirubin level of small caliber group elevated(P<0.05)and the liver enzymes ALT, AST, γ-GT, bilirubin level of large caliber group elevated(P<0.05),while ALP level lowered(P<0.05).Cholangiography showed bile duct stenosis of different degree on 6 pigs of small caliber group with average diameter 2.7mm (from 2mm to 4mm).As for large caliber group, 5 pigs showed stenosis with average diameter 5.5mm (from 5mm to 7mm).3 pigs of conventional surgery group showed no obvious bile duct stenosis.The 6 pigs of sham surgery group showed no bile duct stenosis.According to designed stenosis standard, the success rate of small caliber group and large caliber group are both higher than conventional surgery group.(P<0.05).30 days after surgery, all 6 pigs of small caliber group had postoperative intraperitoneal adhesion, hepatomegaly, obvious expansion of intrahepatic bile duct and gallbladder expanded by 4~5 times.5 pigs of large caliber group had hepatomegaly, slight dilation of intrahepatic bile duct, obvious expansion of gallbladder, clear choledochal edema, sutured tissue thickening and visible bile duct stenosis.HE staining with the small caliber group showed hepatocyte spotty degenerative necrosis, expanded cholestatic intrahepatic small bile duct, swelling hepatocyte and fibrous septa.HE staining with the large caliber group showed intrahepatic small bile duct slightly expanded and hepatocyte arranged basically normal.VG staining with the small caliber group showed excessive accumulaton of collagen fibers outside bile duct mucous cells, randomly and densely arranged and irregularly shaped.VG staining with the large caliber group showed increased collagen fibers in bile duct submucosa, densely and banded arranged.Conclusion This animal model of mini pig is an relatively ideal large animal model of biliary stricture with high surgical success rate and few postoperative complications.

With regard to the ethical nursing for patients suffering from cervical cancer,eight strategies are developed: To help establish credible relationship between nurses and target patients by psychological and ethical nursing and health education such as nursing on nutrition,skin,vaginal irrigation,radio-colitis,radio-cystitis and discharge instruction to the patients.

Objective To investigate the protective effect of matrine on lung injury associated with single lung ventilation during thorac-ic surgery,and to explore and consummate the prevention and control measures of single lung ventilation related lung injury.Methods To-tally 97 cases of non small cell lung cancer patients were randomly divided into the observation group ( 50 cases ) and the control group (47 cases) .The two groups of patients were given the same way of anesthesia.Patients of the observation group received intravenous drip of 2 mL matrine injection which were dissolved in 100 mL saline solution 30 min before anesthesia, while patients of the control group were merely given 100 mL saline solution 30 min before anesthesia.The pulmonary shunt fraction( Qs/Qt) ,xanthine oxidase( XOD) ,myeloperoxi-dase(MPO),superoxide dismutase(SOD) and nitric oxide(NO) of the following points in time were compared:before anesthesia induction (T0),the instant of OLV (T1),60 minutes after OLV(T2),120 minutes after OLV(T3),after lung inflation (T4),and 24 hours after opera-tion ( T5) .Results At the time of T1 to T4,pulmonary shunt fraction of the two groups were both significantly higher than that at T0 with sig-nificant difference ( P<0.05) ,but there was no statistical difference in terms of intra-group comparison at different time points ( P>0.05) .The PMN counts of the two groups at the time of T2 to T5 were significantly higher than that of T0 with significant difference (P<0.05),and the PMN counts at the time of T2 to T5 in the control group were significantly higher than that in the observation group with significant difference (P<0.05).The levels of serum XOD,MPO,and SOD at T2 to T4 in both of the two groups were significantly higher than that at T0 with signif-icant difference (P<0.05),and the serum levels of XOD,MPO and SOD at T2 to T4 in the control group were significantly higher than those in the observation group with significant difference (P<0.05).The levels of serum NO at T2 to T4 in both of the two groups were significantly higher than that at T0 with significant difference (P<0.05),and it was significantly lower than that in the observation group with significant difference (P<0.05).Conclusion The matrine pretreatment of lung injury in the patients with single lung ventilation has a protective effect, which can reduce the levels of oxidative stress and promote the NO release in patients by reducing PMN,XOD and MPO levels.