Objective - - To analyze the prevalence and influencing factors of multi site work related musculoskeletal disorders （ ） Methods WMSDs in surgeons. A total of 102 surgeons from four hospitals were selected as study subjects by convenient sampling method. The Chinese version of Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of ， Results WMSDs in the past one year the related individuals and occupational factors. The total prevalence of WMSDs among （ ）， （ ） （ ） surgeons was 54.9%. The top three sites were neck 48.0% lower back 35.3% and shoulder 32.4% . The prevalence of （ vs ，P ） WMSDs in multiple sites was higher than that in a single site 43.1% 11.8% <0.01 . Multivariate logistic regression ， ， analysis showed that surgeons who smoked were tired at work and had a bent back had a higher risk of developing WMSDs ［ （ - ）， （ - ）， （ - ）， P ］ odds ratios and 95% confidence intervals were 3.66 1.41 9.46 8.33 2.15 32.20 and 18.74 2.14 166.77 all <0.01 Conclusion - after excluding the influence of confounding factors. The prevalence rate of multi site WMSDs among surgeons is ， high and the influencing factors include bad living habits and occupational factors such as working load and working posture.

Objective To investigate the related factors of lymph node detection number in rectal cancer patients underwent laparoscopic surgery. Methods 98 patients with rectal cancer who underwent laparoscopic surgery were selected from January 2014 to January 2010. All the patients general information [gender, age, body mass index (BMI)], preoperative imaging findings and pathological data (tumor size, gross type, TNM stage, distant metastasis, histological differentiation and depth of invasion, et al), surgery related data (experience of surgeon, operation time) and preoperative radiotherapy and chemotherapy were collected. Results The age, BMI, tumor size, length of specimen, invasive depth, surgeon and preoperative radiotherapy and chemotherapy was correlated with the number of lymph nodes in patients with laparoscopic surgery (P < 0.05), but gender, TNM staging, general type, histological differentiation, operation time were not associated with the number of lymph nodes detected in minimally invasive surgery for rectal cancer (P > 0.05). Multiple linear regression analysis showed that BMI, tumor size, length of specimen, invasive depth, surgeon and preoperative radiotherapy and chemotherapy were the independent influencing factors of lymph node detection in patients with minimally invasive rectal cancer (P < 0.05). Conclusion The factors of patients, tumor status, surgical factors and preoperative chemoradiotherapy are related to the number of lymph nodes in patients with rectal cancer.

OBJECTIVETo analyze lymph node (LN) metastasis patterns and determine the appropriate extent of LN dissection in distal-third gastric cancer.

METHODSClinical data of 545 patients with distal third gastric cancer undergoing radical operation in the Fujian Provincial Hospital between 2001 and 2010 were analyzed retrospectively. The metastasis rate for each LN station was analyzed stratified by the depth of tumor invasion.

RESULTSThe incidence of LN metastasis in this cohort was 38.2% (208/545). LN metastasis rate in mucosal cancer was 2.0% (2/99) and involved LNs were limited to station 1 LN stations. LN metastasis rate in submucosal cancer was 18.9% (18/95), significantly higher than that in mucosal cancer (P<0.01). The metastasis rates to groups No.7, 8 and 9 in station 2 were 5.3% (5/94), 3.2% (3/94), and 1.1% (1/89) respectively. In addition, 3 cases (3.2%) had metastasis in station 2 outside the range of groups 7, 8 and 9 including groups No.1, 11p and 12. Gastric cancer invading the muscularis propria or deeper layers showed an significant increased rate of metastasis (P<0.01).

CONCLUSIOND1 dissection seems to be sufficient for mucosal cancer. Standard D2 dissection should be performed for cancers of the muscularis propria or deeper. For submucosal cancer, an extended D1+ dissection is required for complete removal of metastatic nodes.

Aged ; Female ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo investigate the influence of microtubule intervention drugs on the energy metabolism of myocardial cells after hypoxia.

METHODSThe primary passage of cultured myocardial cells from neonatal rats were divided into A (with hypoxia), B (with hypoxia and administration of 10 micromol/ml colchicine), C (with hypoxia and administration of 5 micromol/ml taxol), D (with hypoxia and administration of 10 micromol/ml taxol) and E (with hypoxia and administration of 15 micromol/ml taxol) groups. The creatine kinase (CK) activity and contents of ATP and ADP were assayed with colorimetry and HPLC, respectively, and the vitality of myocardial cells were determined by trypan blue method at 0.5, 1.0, 3.0, 6.0, 12.0, 24.0 post-hypoxia hours (PHH).

RESULTSThe mortality was obviously higher in B and E groups than those in A group( P < 0.05) at each time-points, but that in C and D groups were markedly lower than those in A group during 6.0 to 24.0 PHH (P < 0.01). The CK activity was significantly higher in B group than that in A group during 1.0 to 24.0 PHH, while that in E group was evidently higher, but it was lower in C and D groups than that in A group at each time-points (P < 0.05 or 0.01). The ATP contents in C group during 0.5 to 6.0 PHH were [(49.9 +/- 2.8), (40.7 +/- 2.0), (25.8 +/- 1.9), (19.1 +/- 1.2) microg/10(6) cells, respectively], which were obviously higher than those in A group [(42.9 +/- 5.8), (29.5 +/- 1.8), (18.2 +/- 0.9), (14.1 +/- 0.7) microg/10(6) cells, respectively, P < 0.05 or P < 0.01, and those in E group at each time-point were significantly lower than those in A and D groups (P < 0.01). The changes in the contents of ADP were on the contrary to the above.

CONCLUSIONMicrotubule-destabilizing drugs and high concentration microtubule-stabilizing drugs can sharply decrease ATP content in myocardiocytes under hypoxic conditions, while suitable amount of microtubule-stabilizing drugs can protect myocardiocytes by promoting its energy production.

Animals ; Cell Hypoxia ; Cells, Cultured ; Colchicine ; pharmacology ; Energy Metabolism ; drug effects ; Microtubules ; drug effects ; metabolism ; Myocytes, Cardiac ; drug effects ; metabolism ; Paclitaxel ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the role of p38 mitogen activated protein kinase ( p38 MAPK) in the regulation of cytosolic phospholipase A2 ( cPLA2 ) expression and degradation of membrane phospholipids in myocardium in early stage of burn rats.

METHODSWistar rats were randomized into normal group (n = 8), burn(n =40) , burn and SB203580(n = 16), burn and isotonic saline( n = 16) groups, with 8 rats at each time-points. There were 5 time-points in burn group, and 2 time-points in other groups. The rats in the latter 3 groups were inflicted with 40% TBSA full-thickness burns, and those in burn and SB203580, burn and isotonic saline groups were administered with SB203580 (p38 MAPK inhibitor) or isotonic saline, respectively. The levels of cPLA2 mRNA and membrane phospholipids in myocardium were detected with RT-PCR. In the same experiment, the effect of SB203580 on cPLA2 expression in rat myocardial cells was determined after hypoxia and burn serum treatment in vitro.

RESULTSThe level of myocardial cPLA2 mRNA in burn group at each time-point was obviously higher than those in normal group (0. 280 +/- 0. 020) , and it reached the peak value at 3 PBH. In contrast, the level of cardiac membrane phospholipids was lowered immediately after burns, and it reached the lowest level at 6 PBH [(0. 052 +/- 0. 017) mg phosphorus/mg protein]. Herein, a significant negative correlation was showed between the levels of cPLA2 mRNA and cardiac membrane phospholipids ( r = - 0. 53, P < 0. 05). Administration of SB203580, however, inhibited the increased activity of p38 MAP kinase, suppressed the upregulation of cPLA2(72% and 51% of those in burn and saline group, P <0. 01) , and markedly increased the levels of membrane phospholipids in myocardium at 6 and 12 PBH. In addition, treatment of cardiac myocytes with SB203580 also abolished the upregulation of cPLA2 mRNA elicited by hypoxia and burn serum challenge.

CONCLUSIONp38 MAP kinase play an important role in the burn-induced degradation of cardiac membrane phospholipids in rat through the upregulation of myocardial expression of cPLA2 mRNA in the myocardial cells.

Animals ; Burns ; metabolism ; Disease Models, Animal ; Myocytes, Cardiac ; metabolism ; Phospholipases A2 ; metabolism ; Phospholipids ; metabolism ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo investigate the effect of Shengmai injection on the management of "shock heart" after burns.

METHODSTwenty patients with severe burns were enrolled in the study and randomly divided into two groups according to the clinical research method, i.e. treatment group (n= 10, with intravenous infusion of 40 ml Shengmai injection together with 250ml 50 g/L glucose solution for 3 days, 1 time/ per day) and control group(n = 10, with intravenous infusion of 290 ml 50 g/L glucose injection liquid for 3 days, 1 time/per day). Beside the venous line used for routine fluid resuscitation for burn shock, another venous line was set up after hospitalization for the administration of the drug. Blood samples were obtained from the femoral vein in both groups at 12 post-burn hour( PBH) , and on 1, 2, 3, 4 and 5 post burn days (PBD) for the determination of serum contents of creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH) and cardiac troponin I (cTnI). The changes in hepatic and renal function, as well as coagulability were determined before drug infusion and on 1 , 2, 3, 5 and 7 PSDs.

RESULTSThe serum content of CK-MB, LDH and cTnI reached the peak at 12 PBH in both groups[ (52+/-20)U/L, (5.9+/-1.3) micromol x s(-1) L(-1), (0. 274+/-0. 231) microg/L in treatment group and [(9+/-31)U/L, (8.5+/-1l.8) micromol x s(-1) x L(-1) , (0. 584+/-0. 192) microg/L in control group]. All of them decreased with the passage of time, but in the treatment group they decreased more markedly within 2 or 3 PBD compared with those in control group ( P < 0.05).

CONCLUSIONEarly administration of Shengmai intravenously is beneficial to the protection of myocardial cells and in the management of the "shock heart" damage.

Adolescent ; Adult ; Burns ; complications ; drug therapy ; Cardiomyopathies ; prevention & control ; Creatine Kinase ; blood ; Female ; Humans ; L-Lactate Dehydrogenase ; blood ; Male ; Middle Aged ; Phytotherapy ; Prospective Studies ; Shock, Traumatic ; drug therapy ; Troponin I ; blood

OBJECTIVETo investigate the alleviation of myocardial injury of rats after early escharectomy en masse of severe burns, and to explore its molecular mechanism.

METHODSTotally 66 SD rats were randomly divided into normal control (n=6), non-escharectomy (NE, n=30) and escharectomy (E, n=30, with total escharectomy 20 minutes after burns ) groups. The rats in the NE and E groups were inflicted with 30% TBSA full-thickness scald. The content of ATP in mitochondria, troponin I (Tn I) in serum and 4.8-kb deletion of myocardial mitochondrial DNA (mtDNA) of the rats in each group were determined at 1, 3, 6, 12 and 24 post-scald hours (PSH).

RESULTS(1) The content of ATP in myocardial mitochondria was decreased in both E and NE groups, but it was obviously increased at 1 and 6 PSH (0.90 +/- 0.27 microg/mg 0.66 +/- 0.19 microg/mg) in E group when compared with those in NE group (0.74 +/- 0.18 microg/mg, 0.46 +/- 0.21 microg/mg, P < 0.05). (2) There was no obvious change in the serum content of Tn I in E group at 1 and 3 PSH, but the respective content in 1, 3 and 6 PSH was markedly lower than those in NE group (P < 0.05). (3) The 4.8 kb deletion of myocardial mtDNA was found at 1, 3, 24 PSH in NE group, while it was observed only at 1, 12 PSH in E group. The partial and whole deletion rate in E group was lower than that in NE group.

CONCLUSIONEarly escharectomy en masse can significantly alleviate the myocardial injury after burns,which might be related to its effect in lowering the deletion rate of myocardial mtDNA at early postburn stage.

Adenosine Triphosphate ; metabolism ; Animals ; Burns ; metabolism ; surgery ; DNA, Mitochondrial ; genetics ; Disease Models, Animal ; Female ; Male ; Mitochondria, Heart ; metabolism ; Myocardium ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Sequence Deletion ; Troponin I ; blood

OBJECTIVETo investigate the influence of hypoxia induction factor-1alpha (HIF-1alpha) on glycosis of rat myocardial cell under hypoxic condition.

METHODSThe myocardial cells of the rats were routinely isolated and cultured. The cells were divided into single hypoxia (H) and HIF-1alpha inhibiting (I) groups. The cells in H group were cultured in glucose-free medium with mixed low-oxygen gas [1% O2, 94% N2 and 5% CO2 (v/v)]. While the cells in I group were cultured with low-oxygen gas after the cell model of low expression of HIF-1alpha protein constructed by RNAi technique. The cells in both groups were all observed before hypoxia (routine culture) and at the time points of 1, 3, 6, 12 and 24 hours of hypoxia. The LA (lactate acid ) content in the supernatant of the culture and the activity of the key enzymes in glycolysis such as hexokinase (HK), phosphofructokinase (PFK) and lactate dehydrogenase (LDH) of both groups of cells were determined at all the time points.

RESULTS(1) After hypoxia, the HK and PFK activities of the rat myocardial cells in H and I groups were obviously increased at the beginning and decreased thereafter when compared with that before hypoxia. While the activities of HK and PFK in H group at 1, 3 and 6 hours after hypoxia were evidently higher than those in I group (P <0.05 or 0.01), and the peak activity of them in H and I groups was 159 +/- 13 U/g vs 133 +/- 55 U/g, and 298 +/- 44 U/g vs 188 +/- 55 U/g, respectively. (2) Compared with normal control (92 +/- 12 U/g), the LDH activity of the cells in H group after hypoxia increased significantly, reaching the peak at 6 hours after hypoxia (2 568 +/- 125 U/g, P < 0. 01), and it decreased thereafter, while that in I group peaked at 3 hours after hypoxia (2125 +/- 126 U/g, P <0.01). The LA content in the culture supernatant in H group increased significantly after hypoxia with the passage of time, while that in I group increased in smaller magnitude (P <0.01).

CONCLUSIONHigh expression of HIF-1alpha in the rat myocardial cells after hypoxia could directly cause continuous enhancement of cell glycolysis, which was beneficial to the protection of myocardial cells under hypoxic condition.

Animals ; Cell Hypoxia ; Cells, Cultured ; Glycolysis ; Hexokinase ; metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Myocytes, Cardiac ; metabolism ; Phosphofructokinase-1 ; metabolism ; RNA Interference ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the protective effect of glycine (Gly) on hypoxic rat myocardial cells and its mechanism.

METHODSSdfetal rat myocardial cells were isolated and cultured in vitro. The released amounts of creatine kinase (CK) and lactate dehydrogenase (LDH) from the myocardial cells in the culture supernatant at 6 hour after hypoxia and after glycine treatment were determined with ultraviolet spectrophotometer. The expression of the alpha1 subunits of glycine receptor (GlyRalpha1) in the myocardial cells was detected by immunofluorescent histochemistry. The changes in the intracellular calcium content and the membrane potential of the myocardial cells were determined by laser confocal microscopy.

RESULTSThe release of CK and LDH in the culture supernatant increased significantly at 6 h after hypoxia [(393.8 +/- 5.3), (1564 +/- 41) U/L] compared with those before hypoxia, while their levels were obviously decreased after glycine treatment [(56.3 +/- 2.7), (716 +/- 18) U/L, (P <0.01)] compared with those before glycine treatment. There was positive expression of GlyRalpha1 in myocardial cells before and after hypoxia. The average fluorescent intensity of intracellular calcium at 6 hours after hypoxia (139 +/- 29) was significantly higher than that before hypoxia (27 +/- 8, P < 0.01), while it was obviously lower (51 +/- 11) after glycine treatment compared with that at 6 hours after hypoxia,but it was evidently higher than that before hypoxia (P <0.01). The membrane potential 6 hours after hypoxia (62 +/- 9) was obviously lower than that before hypoxia (177 +/- 20, P < 0.01), but it was obviously higher after glycine treatment (123 +/- 16) than that at 6 hours after hypoxia (P < 0.01).

CONCLUSIONGlycine might be beneficial in the protection of myocardial cells against hypoxia. The underlying mechanism may involve attenuation of membrane potential depolarization after hypoxia by conjugation of glycine with its receptor, depleting in turn voltage-dependent calcium channel on the cellular membrane, preventing calcium overload due to influx of calcium ions after hypoxia.

Animals ; Calcium ; metabolism ; Cell Hypoxia ; drug effects ; Cells, Cultured ; Creatine Kinase ; metabolism ; Glycine ; pharmacology ; L-Lactate Dehydrogenase ; metabolism ; Membrane Potentials ; drug effects ; Myocytes, Cardiac ; cytology ; drug effects ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo construct hypoxic induction factor-1alpha (HIF-1alpha) siRNA expression cassette containing U6 promoter, alpha HIF-1alpha sense or antisense target sequence, and to observe its influence on the expression of cardiomyocytic HIF-1alpha during hypoxic state.

METHODSNeonatal murine cardiomyocytes cultured in the mixed gas were employed as the hypoxic model and were divided into normal control (cultured in normal oxygen), RNAi control (invalidated transfection interference sequence IV) and RNAi effective inhibition (effective transfection interference sequence, which was further divided into I, II and III groups according to the difference of downstream primer) groups. Three pairs (I, II and III) of PCR downstream primer containing HIF-1alpha encoded gene fragments (sense and antisense) and one pair of randomize sequence (IV) PCR downstream primer were designed and synthesized. U6 starter expression frame was constructed by PCR method. The cardiomyocytes were transfected simultaneously by sense and antisense sequence expression frame. Five plates of the cells were set at each time points in each group. The expression of HIF-1alpha mRNA was detected by RT-PCR at 6 hours of hypoxia. The change in the protein expression level at 1 hour of hypoxia was determined by Western blot, and the interference effects were monitored by immunohistochemistry.

RESULTSThe best inhibition fragment screened was group II sequence. After the transfection and hypoxic culture, it was found that the cardiomyocytic HIF1alpha mRNA and protein levels in RNAi effective inhibition group were evidently lower than those in normal control and RNAi control groups (P < 0.01). While the protein inhibition rate (60% - 80%) between the former group and normal and RNAi control groups was no difference (P > 0.05).

CONCLUSIONThe expression of the HIF1alpha in hypoxic rat cardiomyocytes could be effectively inhibited by our constructed HIF1alpha siRNA expression cassette group II.

Animals ; Cell Hypoxia ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Myocytes, Cardiac ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Rats ; Rats, Sprague-Dawley