Objective:To study the effects of pioglitazone on atherosclerosis on ApoE-/-mice,and to investigate the roles of adiponectin and its receptors.Methods:ApoE-/-mice were fed with high-fat chow for the induction of atherosclerosis and were divided into three subgroups:placebo(n=10),low-dose[10 mg/(kg?d),n=10] pioglitazone therapy,and high-dose[20 mg/(kg?d),n=10] pioglitazone therapy.C57BL/6J wild type mice(n=9) were used as control.Aortic atherosclerosis and intima-media thickness(intima-media thickness,IMT) of abdominal aorta were monitored,and plasma adiponectin was also measured.Expression levels of the adiponectin receptor 1(AdipoR1)and adiponectin receptor 2(AdipoR2) in vessels were analyzed(RT-PCR).Results:(1) Aortic atherosclerotic lesions were observed in ApoE-/-mice but not in wild type mice.Interestingly,these lesions were significantly prevented by high-dose pioglitazone therapy.Compared with wild type mice,ApoE-/-mice had increased IMT of abdominal aorta [(0.290?0.063 vs 0.178?0.012) cm,P

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

OBJECTIVEApneaGragh is a new device for simultaneous determination of obstructive sleep apnoeic events and continuous pressure measurements for localization of upper airway obstructive site. This study is to evaluate the clinical value of it.

METHODSFrom April to October in 2006, 32 obstructive sleep apnea (OSA) patients diagnosed by polysomnography (PSG) were examined by two methods: Endoscopy with müller's maneuver at daytime and continuous upper airway pressure recording with ApneaGraph at night in Peking Union Medical College Hospital. The upper airway obstructive sites determined by the two methods were compared. ApneaGraph transducer catheter contains two pressure sensors and two temperature sensors used for obstruction site determination and detection of apnoeic events during sleep. Obstructive sites were divided into upper (retropalatal oropharynx) or lower level (retroglossal region). The lower limit of upper airway obstruction was determined by observed pressure pattern. Used constituent retio to reflect the obstructive proportion of different levels. The apnea hypopnea index (AHI) measured by PSG and ApneaGraph were also compared.

RESULTSTwo patterns of obstruction were observed in our group: 1. The site of obstruction was located only at the upper level. 2. The obstruction of upper and lower level all present. Site of obstruction determined by Apneagraph: 28 (87.5%) cases had predominant sites of obstructions in upper level (the constituent retio of retropalatal obstruction > 50%), the others in lower level (the constituent retio of retroglossal obstruction > 50%). Endoscopy localization of obstruction: 18 cases had retropalatal obstructions alone, 13 cases had obstructions of retropalate combined with retroglossa, only 1 patient didn't have obstruction. Defined the constituent retio higher than thirty percent the criteria of obstruction, then identical results were obtained by both methods in retropalatal segment in 27 (84.4%) of the patients, while in only 17 (53.1%) obstructions was determined by the both methods in retroglossal areas. The polysomnograpic AHI (x +/- s) was 52.2 +/- 18.1, versus 50.2 +/- 16.0 obtained by ApneaGraph. There was a significant correlation between them (r = 0.876, P < 0.001).

CONCLUSIONSApneaGraph can identify the level of upper airway obstruction more accurate than fiberoptic pharyngoscopy. In the meantime, it also can serve as a portable PSG to diagnose sleep disordered breathing qualitatively.

Adult ; Aged ; Continuous Positive Airway Pressure ; instrumentation ; methods ; Endoscopy ; methods ; Humans ; Middle Aged ; Monitoring, Ambulatory ; instrumentation ; methods ; Polysomnography ; instrumentation ; methods ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; Young Adult

Taxus is the source plant of anti-cancer drug paclitaxel and its biosynthetic precursor, analogs and derivatives, which has been studying for decades. There are many endemic Taxus species in China, which have been studied in the field of multiple disciplines. Based on the recent studies of the researchers, this review comments on the study of Taxus biology and chemistry. The bibliometric method is used to quantify the global scientific production of Taxus-related research, and identify patterns and tendencies of Taxus-related articles. Gaps are present in knowledge about the genomics, epigenomics, transcriptomics, proteomics, metabolomics and bioinformatics of Taxus and their endophytic fungi. Systems biology and various omics technologies will play an increasingly important role in the coming decades.
Computational Biology ; Endophytes ; chemistry ; isolation & purification ; Epigenomics ; methods ; Fungi ; chemistry ; isolation & purification ; Gene Expression Profiling ; Genomics ; methods ; Metabolomics ; Molecular Biology ; Paclitaxel ; biosynthesis ; chemistry ; isolation & purification ; Phylogeny ; Plants, Medicinal ; chemistry ; classification ; genetics ; microbiology ; Proteomics ; Systems Biology ; Taxus ; chemistry ; classification ; genetics ; microbiology

OBJECTIVETo investigate the relationship between thrombolysis in myocardial infarction (TIMI) risk score and efficacy of different treatment strategies in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS).

METHODSFrom Oct. 2001 to Oct. 2003, 545 consecutive patients with NSTE-ACS were randomly assigned to early conservative strategy (n = 284) or early invasive strategy group (n = 261). The combined cardiovascular events (a combination of cardiac death, nonfatal myocardial infarction, nonfatal heart failure and re-hospital admission due to recurrent ischemia angina) within 30 days and 6 months were analyzed and related to the TIMI risk score at admission.

RESULTSRehospitalization due to recurrent ischemia angina of 30 days and the combined cardiovascular events of 30 days and 6 months were significantly lower in early invasive strategy group (3.5%, 10.0%, 21.1%) compared with early conservative strategy group (8.1%, 16.9%, 28.2%, all P < 0.05). Subgroup analysis indicated early invasive strategy could significantly decrease the 30 d incidence of the combined end point events in patients with high TIMI risk score and the 6 months incidence of the combined end point events in patients with moderate and high TIMI risk score (all P < 0.01), but the incidence was similar between the two different strategies in patients with low TIMI risk score.

CONCLUSIONSEarly invasive strategy may significantly reduce combined cardiovascular events in NSTE-ACS patients with moderate and high TIMI risk score compared with early conservative strategy.

Aged ; Angina, Unstable ; drug therapy ; physiopathology ; Coronary Disease ; drug therapy ; physiopathology ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; Risk Assessment ; Thrombolytic Therapy

OBJECTIVETo explore the assessment methods of dysphagia.

METHODSThe data of 37 patients with dysphagia were retrospectively analyzed. These patients took the Kubota drinking test, Tengdao's evaluation, videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES).

RESULTSFourteen out of thirty-seventh patients showed abnormal results during Kubota drinking test. Tengdao's evaluation results showed that 29/37 patients were abnormal. There 27/37 and 33/37 patients showed abnormalities in positive-aspiration score and swallow dysfunction score of VFSS. The number of abnormal patients in aspiration score of FEES was 19/21. The Kappa values were 0.137, 0.416 between Kubota drinking test. Tengdao's evaluation and VFSS. The FEES was measured against the VFSS for sensibility, specificity, positive predictive value, and negative predictive value, the values were 88.9%, 66.7%, 94.1% and 50.0%.

CONCLUSIONSKubota drinking test and Tengdao's evaluation can be applied for screening purpose and evaluating result after treatment; VFSS and FEES can be used as more accurate assessments, they can study the dysphagia's character, position and severity. The combination of a variety of dysphagia evaluation methods is the most important basis for diagnosis and treatment of deglutition disorders.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Deglutition ; Deglutition Disorders ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVESevere nasopharyngeal stenosis (NPS) is a rare complication of uvulopalatopharyngoplasty (UPPP) and very difficult to manage. This report presents our successful treatment experience.

METHODSFrom Nov 1997 to Feb 2006, 6 adults patients with NPS secondary to UPPP were treated in Peking Union Hospital. Two cases was grade II stenosis, received surgery of local pharyngeal and soft palate mucosa flap rotation to enlarge nasopharyngeal airway with stenosis; For the remaining 4 cases with more severe NPS (grade III) who had received 1-3 times unsuccessful repair procedures previously, prolonged nasopharyngeal hollow obturators were used for 6 months after stenosis repair surgery.

RESULTSWith 9-48 months follow-up, All cases results were satisfactory. Nasal obstruction symptom was eliminated, NPS corrected, no velopharyngeal insufficiency complication happened. Daytime removable nasopharyngeal hollow stent obturators with palate support device is more comfortable for patients.

CONCLUSIONSLocal flap rotation to enlarge stenosis airway and prolonged use nasopharyngeal hollow obturators are reliable methods of correction NPS following UPPP.

Adult ; Cicatrix ; complications ; surgery ; Humans ; Male ; Middle Aged ; Nasopharyngeal Diseases ; etiology ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Reoperation ; Treatment Outcome ; Uvula ; surgery

Objective To investigate the efficacy ofpoly (lactic acid co castor oil) microspheres containing ropivacaine for sciatic nerve block of mice.Methods A total of 150 Kunming male mice were randomly assigned into 3 groups,namely placebo microspheres (lactic acid co castor oil) group (group A,n=50),ropivacaine injection group (group B,n=50) and ropivacaine microspheres group (group C,n=50).After sevoflurane anesthesia,the mouse was fixed on the operating table and the bilateral sciatic nerve was exposed.The corresponding preparations were implanted or injected near the sciatic nerve.Five mice were randomly selected from each group for the next experiments.Paw withdrawal thermal latency,the ability to splay and flex of the hind paw and plasma ropivacaine concentration were measured 10min,30min,1h,3h,5h,7h,10h,15h,30h and 48h after drug administration.Results The anesthetic effect of group C began to work at 3h.Compared with group B,the duration of sciatic nerve sensory block of group C was significantly longer and the effect of motor block was weaker.No anesthetic effect was observed in group A.The sensory and motor block of group B reached the peak at 1h,and the pharmacodynamics subsided at 7h.Compared with group B,the concentration of ropivacaine in group C increased slowly,and the peak value at 10h after administration was gradually decreased.Conclusions Ropivacaine loading poly (lactic acid co castor oil) microspheres can significantly extend the effect of ropivacaine on sciatic nerve sensory block.Compared with ropivacaine injection,motor block effect of ropivacaine loading poly (lactic acid co castor oil) microspheres is reduced and its plasma ropivacaine concentration fluctuation range is small.

Objective: To explore the virulence related risk factors based on the enterovirus A71 (EV-A71) genome. Methods: The pairwise distance of each section of gene between mild and fatal cases was analyzed. The ⅴ domain of 5′UTR from mild and fatal cases in this study were constructed. Amino acid sequences of EV-A71 were analyzed to find the potential virulence regions which were statistically different between fatal and mild cases. Results: The two EV-A71 genome sequences in this study belonged to C4a genotype with the genomic homology of 96.2%-97.5%. The nucleotides in the ⅴ domains of the 5 ′UTR of EV-A71 from mild and fatal cases were the same. Each gene of EV-A71 from 31 mild cases and 30 fatal cases shared high homology. A total of four potential virulence sites (2 A: R68 M、2C: K41R、3 A: T/V47 A and 3C: I158 V) which were significantly different between mild cases and fatal cases were obtained. Conclusions The four sites in the unstructured protein coding region might be related with the virulence of EV-A71.

Objective:To investigate the effect of vector sum concept in fine-tuning posterior column screw channel via ilioinguinal approach for the treatment of bi-column acetabular fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 42 patients with acetabular double column fracture admitted to Weifang People′s Hospital from July 2015 to May 2021, including 22 males and 20 females, aged 23-77 years [(49.3±16.3)years]. The ilioinguinal approach was used in all patients with the anterior column fixed with a plate and posterior column fixed with a lag screw. The vector sum concept was used intraoperatively to fine-tune the posterior column screw channel in 19 patients (channel fine-tuning group): namely, a 2.5 mm Kirschner wire was inserted into the bony channel of the posterior column screw under fluoroscopy of iliac oblique and obturator oblique positions; when the Kirschner wire was not located in the middle of the ischial ramus under single fluoroscopy, the vector only needed to be adjusted in one direction, with zero in the other direction; when the Kirschner wire was not located in the middle of the ischial ramus under fluoroscopy of both the iliac oblique and obturator obturator oblique positions, the sum of the deviation vectors in the two directions was calculated before fine-tuning. The vector sum concept was not used to fine-tune the posterior column channel screw in 23 patients (channel non-fine-tuning group). The time of posterior column screw placement, intraoperative blood loss, frequency of guide wire adjustment and fracture healing time were recorded and compared between the two groups. At 6 months after operation, the quality of fracture reduction and hip function were assessed by Matta score and Merle D′Aubigne-Postel score, respectively. The complications were observed.Results:All patients were followed up for 7-71 months [(35.7±8.5)months]. In channel fine-tuning group, the time of posterior column screw placement was (5.1±1.5)minutes, with intraoperative blood loss of (798.8±83.9)ml, frequency of guide wire adjustment of (1.8±0.5)times and fracture healing time of (12.4±3.2)weeks; while these parameters [(39.8±12.0)minutes, (1 119.3±172.0)ml, (5.6±1.6)times and (15.6±4.2)weeks] were significantly shorter or less in channel non-fine-tuning group ( P<0.05 or 0.01). There were no significant difference in the quality of fracture reduction and hip function between the two groups at 6 months postoperatively (all P>0.05). After operation, symptoms of lateral femoral cutaneous nerve was found in seven patients, superficial incision infection in two who was healed after debridement and dressing change, deep venous thrombosis of lower limbs in three. There was no significant difference in the incidence of postoperative complications between the two groups [channel fine-tuning group: 26%(5/19), channel non-fine-tuning group: 30%(7/23)] ( P>0.05). Conclusion:For bi-column acetabular fractures via ilioinguinal approach, application of vector and concept to fine-tune the posterior column screw channel is beneficial for rapid screw placement into the osseous channel, significant reduction of intraoperative blood loss and early fracture healing.