Objective To observe the effects of aerosolized prostaglandin E1 (PGE1 )via right lung before one-lung ventilation (OLV ) on shunt rate (Qs/Qt ) and oxygenation in patients undergoing surgery for oesophageal cancer.Methods Sixty patients scheduled for elective trans-left-thoracic esophagectomy for esophageal cancer were randomly and single-blindly located into two groups.Patients in each group received different therapy before OLV,namely inhaling PGE1 0.2μg/kg via right lung in group P and inhaling normal saline in group C.The PaO 2 and hemodynamic indicators of two groups were recorded at these points:before OLV(T1 ),OLV 10 min (T2 ),OLV 1 5 min (T3 ),OLV 30 min (T4 ),OLV 60 min (T5 ),OLV 120 min (T6 ),.Results PaO 2 in both groups were declined straightly since OLV and fell to the lowest point at T4 in group C.PaO 2 in group P at T2-T4 were significantly higher than that in group C (P <0.05),and the lowest point of which was recorded at T5 .Qs/Qt in group P was significantly lower than that in group C at T2-T4 (P <0.05).There were no significant differences in hemodynamics indicators between the two groups. Conclusion Inhalation of 0.2 μg/kg PGE1 before OLV via one lung can reduce pulmonary shunt and improve PaO 2 in thoracic surgery patients.

BACKGROUNDOverexpression of Bcl-2 protein in cancer cells can inhibit programmed cell death and engender chemoresistance. Bcl-2 antisense oligonucleotide (G3139) has shown its antitumor effects enhanced in preclinical models when combined with taxol-based chemotherapy. This study aimed to investigate the efficacy of G3139 combined with epirubicin in the androgen-independent prostate cancer.

METHODSPC3 prostate cancer cell line was cultured and treated with epirubicin and Bcl-2 antisense oligonucleotide alone or in combination. The effects of therapeutic agents on cells were determined by the MTT assay. Expression of Bcl-2 mRNA and protein was documented by RT-PCR and Western blotting. Apoptosis induction was confirmed by flow cytometric analysis.

RESULTSBcl-2 antisense oligonucleotide alone produced no cytotoxic effects and the combination of Bcl-2 antisense oligonucleotide with epirubicin sensitized PC-3 cells to the killing effects of chemotherapy. A marked down-regulation of Bcl-2 mRNA and protein was observed after antisense and epirubicin cotreatment. A statistically significantly higher fraction of apoptotic cells was detected by flow-cytometric analysis after epirubicin treatment with prior antisense Bcl-2 transfenction, as compared with mono antisense Bcl-2 or epirubicin treatment.

CONCLUSIONThese data suggested that inhibition of Bcl-2 expression combined with epirubicin may be an attractive therapeutic strategy in hormone-refractory prostate cancer.

Apoptosis ; drug effects ; genetics ; Blotting, Western ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; genetics ; Epirubicin ; pharmacology ; Flow Cytometry ; Humans ; Male ; Oligonucleotides, Antisense ; genetics ; Prostatic Neoplasms ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; antagonists & inhibitors ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUNDThe major neuropathological symptoms of Parkinson's disease (PD) consist of a loss of pigmented dopaminergic neurons in the substantia nigra and the presence of Lewy bodies. This study was to investigate the effects of bilateral subthalamic nucleus (STN) stimulation on resting-state cerebral glucose metabolism in advanced PD, and investigate the mechanism of deep brain stimulation (DBS).

METHODSSeven consecutive advanced PD patients (4 men and 3 women, mean age 64 +/- 4 years, mean H-Y disability rating 4.4 +/- 0.65) receiving bilateral STN DBS underwent 18F-fluorodeoxyglucose (18F-FDG)/positron-emission tomography (PET) examinations at rest both preoperatively and one month postoperatively, with STN stimulation still on. The unified PD rating scale was used to evaluate the clinical state under each condition. Statistical parametric mapping (SPM) was used to investigate the regional cerebral metabolic rates of glucose (rCMRGlu) during STN stimulation, and to compare these values to rCMRGlu preoperation.

RESULTSSTN stimulation clearly improved clinical symptoms in all patients. A significant increase in rCMRGlu was found in the bilateral lentiform nucleus, brainstem (midbrain and pons), bilateral premotor area (BA6), parietal-occipital cortex, and anterior cingulated cortex, and a marked decrease in rCMRGlu was noted in the left limbic lobe and bilateral inferior frontal cortex (P < 0.05).

CONCLUSIONBilateral STN stimulation may activate the projection axon from the STN, improving clinical symptoms in advanced PD patients by improving both ascending and descending pathways from the basal ganglia and increasing the metabolism of higher-order motor control in the frontal cortex.

Brain ; metabolism ; Electric Stimulation ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Parkinson Disease ; metabolism ; Subthalamic Nucleus ; physiology

Objective By analyzing and summarizing the acupoint application rules in the treatment of dry eye syndrome (DES) with acupuncture, to provide references and evidences for acupuncture prescriptions.Method Clinical articles published during the recent 10 years on the treatment of DES with acupuncture were collected to summarize and assort the frequency, meridian affiliation and attribution of the commonly-used acupoints.Result Jingming (BL 1) had the highest frequency, and the selected acupoints, predominantly the periocular points, were majorly from the Bladder Meridian of Foot Taiyang.Conclusion In the treatment of DES with acupuncture, periocular acupoints such as Jingming (BL 2), Cuanzhu (BL 2), Taiyang (EX-HN 5) and Sizhukong (TE 23) were mainly selected, and the selection of acupoints should follow the along-meridian and syndrome-differentiation principles.

BACKGROUNDEndogenous nitric oxide and adenosine increase simultaneously to keep the balance of energy demand and supply when the oxygen supply is insufficient, which suggests that nitric oxide and adenosine might exert a synergistic myoprotection during tissue hypoxia. In this study, we tested this hypothesis utilizing a canine model of prolonged global myocardial ischaemic reperfusion injury.

METHODSIn this double blind, controlled study, the hearts of 24 anaesthetized mongrel dogs were arrested for 2 hours with aortic cross clamping and blood cardioplegia. The treatment groups were those supplemented with 2 mmol/L L-arginine (ARG), supplemented with 1 mmol/L adenosine (ADO), ARG + ADO supplemented with both, and no supplementation (control) (n = 6 in each group). Haemodynamics, biochemical indices, adenosine triphosphate (ATP) content and myeloperoxidase activities of myocardium were determined to evaluate myocardial injury. Statistical comparison was performed by two way ANOVA.

RESULTSAlthough the requirements for inotropic supports were higher, the cardiac outputs were lower in control group than in ARG, ADO and the combination groups. Plasma cardiac troponin I levels were higher and the areas of hydropic changes were larger in control group than in ARG and ADO groups. Combination of arginine and adenosine provided further myoprotection with respect to better cardiac performance, lower release of cardiac troponin I, and smaller areas of hydropic changes compared with ARG and ADO groups. ATP content was higher, but myeloperoxidase activities of myocardium were significantly lower in the combination group than in control, ARG and ADO groups (P < 0.05).

CONCLUSIONSCombination of L-arginine and adenosine provides synergistic myoprotection in a canine model of global myocardial ischaemia. Thus, the combination is recommended when the heart is exposed to a prolonged ischaemia during cardiac surgery.

Adenosine ; therapeutic use ; Adenosine Triphosphate ; analysis ; Animals ; Arginine ; therapeutic use ; Cardiotonic Agents ; therapeutic use ; Disease Models, Animal ; Dogs ; Drug Synergism ; Energy Metabolism ; Female ; Heart Arrest, Induced ; Male ; Myocardial Reperfusion Injury ; prevention & control ; Myocardium ; metabolism ; pathology ; Peroxidase ; metabolism

OBJECTIVETo study the value of high-frequency ultrasound in the diagnosis of duchenne muscular dystrophy diseases (DMD) in children.

METHODSEight children with DMD were enrolled as DMD group and 10 healthy children as the control group. The echogenicity of the rectus femoris muscle and the gap between the gastrocnemius and soleus muscles in the two groups were detected by high-frequency ultrasound.

RESULTSCompared with the control group, rectus femoris and gastrocnemius muscles in the DMD group showed increased echogenicity and their muscle fibers were arranged irregularly, and the gap between the gastrocnemius and soleus muscles became wilder (P<0.01).

CONCLUSIONSHigh-frequency ultrasound is valuable in the diagnosis of DMD.

Child ; Child, Preschool ; Female ; Humans ; Male ; Muscular Dystrophy, Duchenne ; diagnostic imaging ; Ultrasonography

OBJECTIVETo explore the clinical effects of combined medial and lateral malleolus in treating severe fracture of ankle.

METHODSFrom May 2007 to January 2011,89 patients with ankle fracture who underment surgical treatment and had complete follow-up, the data were retrospectively analyzed. In this study, there were 66 males and 23 females with an average age of 30.9 years (ranged, 26 to 62 years). Cause of injury included road accidents in 52 cases,sprains from fall down in 17, construction injury in 16 and other injuries in 4. According to type of Denis-Weber, type A were in 13 cases, type B in 24, type C in 52. Operative technique was as follows. Chosen two-incision of combined medial and lateral malleolus, and reduced lateral malleolus fracture firstly, fixed it with 1/3 tubular armor plate or rebuilt-titanium plate. To chose one or two hollow screws according to the size of fracture block. If fracture of fibula was syntripsis,it can be multi-segmental fixed. If fracture line of posterior malleolus was no more than 1/3 articular surface of ankle or the bone displacement was not serious, it can be disregarded. And if the lesion level was over 1/3, or shift position more than 3 mm,it can be fixed with lag screw after reduction. Either front-to-back or back-to-front fixed direction was OK. At the third day after operation, the patients were instructed to exercise with affected limb, weight training after 6 weeks.

RESULTSEighty-nine patients were followed up from 6 to 24 months with an average of 16 months. Healing time of the fracture was 10 to 12 months. According to standard of the Baird-Jackson scoring system, 68 cases got excellent results, 18 good and 3 fair.

CONCLUSIONSurgical treatment is quite effective for severe fracture of ankle. It should be chosen correctly according to types of the fracture and degree of ligament injury. At the same time, damage degree of the ligament around the ankle should be considered and properly treated.

Adult ; Ankle Injuries ; physiopathology ; surgery ; Female ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo assess the effect of electroacupuncture in different frequencies by electromyography and walking function measure in post-stroke patients with lower-extremity (OLE) spasticity and hemiparesis.

METHODSFifty cases of post-stroke whose motor deficit was classified into Brunnstrom stage II - IV were randomly divided into a 100 Hz group, a 50 Hz group and a 2 Hz group. They were accepted 100 Hz, 50 Hz or 2 Hz of electroacupuncture (EA) therapy combined with standard rehabilitation program. Main outcome measures included integrated electromyography (IEMG) score during maximum isometric voluntary contraction (MIVC) of the knee flexors and extensors, ankle dorsiflexors and planterflexors in the affected LE recorded by surface EMG, Co-contraction ratio calculated by IEMG score of the antagonist over that of the agonist plus antagonist, Composite Spasticity Scale (CSS), Fugl-Meyer Motor Scale (FMS) and Functional Ambulation Categories (FAC) on LE. All outcomes were assessed at the baseline and after treatment by the professional practitioners who blinded to the treatment.

RESULTSAfter EA treatment, IEMG of rectus femoris were decreased in 100 Hz and 50 Hz groups (P < 0.01, P < 0.05), and better than that in 2 Hz group (both P < 0.05); gastrocnemius IEMG were decreased in 100 Hz and 50 Hz groups (P < 0.05, P < 0.01); but IEMG of tibialis anterior muscle was increased only in 50 Hz group (P < 0.05). During knee flexion, EMG co-contraction ratio in MIVC declined in 100 Hz and 50 Hz groups were decreased significantly (P < 0.05, P < 0.01), and the co-contraction ratio between the non-affected and affected side were increased significantly in all the 3 groups after treatment (P < 0.01, P < 0.05). During ankle dorsiflexion, co-contraction ratio were decreased significantly in all the 3 groups (P < 0.05, P < 0.01), and cocontraction ratio between the non-affected and affected side was increased significantly only in 100 Hz after treatment (P < 0.01). FMS score, CSS and FAC were improved in all the 3 groups after treatment (all P < 0.01), but only FAC in 100 Hz group showed better effect than that in 50 Hz group or 2 Hz group (both P < 0.05).

CONCLUSIONElectroacupuncture therapy combined with rehabilitation program is effective for the spasticity status of lower-extremity in post-stroke. The therapeutic effect of EA in the frequencies of 100 Hz or 50 Hz is superior to that of 2 Hz stimulation and parameter of 100 Hz may be optimal.

Aged ; Electroacupuncture ; Electromyography ; Female ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; therapy ; Paresis ; etiology ; physiopathology ; therapy ; Stroke ; complications ; Treatment Outcome ; Walking

BACKGROUND: How to efficiently and uniformly disperse carbon nanotubes (CNTs) into a tissue-engineered scaffold is crucial to construct an ideal CNTs-Polymer composite scaffold and it is also a hotspot of research in the tissue engineering. OBJECTIVE: To review the advances in the methodology progress of constructing a scaffold for cardiac tissue engineering, which contains uniformly and stably dispersed CNTs. METHODS: The Web of Science Core Collection and PubMed were searched by the first author for related papers about CNTs dispersion in the cardiac tissue engineering published from October 2004 to January 2017. The key words were "carbon nanotubes, dispersion, cardiac tissue engineering" in English. Original research papers were searched, which were screened through titles, abstracts and contents, and then reviewed. RESULTS AND CONCLUSION: CNTs are easy to aggregate because of high surface area, high aspect ratio and rough surface. Thus, it is one of the key points to construct an ideal CNTs-Polymer composite scaffold that whether CNTs could be uniformly and stably dispersed in polymer scaffolds. In the cardiac tissue engineering, covalent or non-covalent surface modification of CNTs significantly enhances the uniformity and stability of CNTs in the polymer scaffolds, which is conducive to construct the uniformly and stably CNTs-dispersed scaffold for cardiac tissue engineering, leading to notable improvement in mechanical and electrical properties of engineered cardiac tissues.

Objective:To explore the clinical safety and efficacy of transurethral oral mucosa urethroplasty for urethral meatus and navicular fossa stricture reconstruction.Methods:Retrospective analysis of 9 patients who underwent transurethral repair of urethral meatus and navicular fossa stricture by oral mucosa in our hospital from October 2021 to December 2022. The average age was (58.4±10.4) years old. 5 patients had a history of transurethral endoscopic surgery, 2 had penile lichen sclerosis, and 2 had no obvious causes. Nine patients were diagnosed with urethral meatus and navicular fossa stricture through retrograde urethrography before surgery. The average maximum preoperative urine flow rate was(3.2±0.7)ml/s. Surgical procedure: The incision was firstly made at 6 o'clock using ophthalmic scalpel, the entire layer of urethral scar was opened, and gradually penetrated into the urethral cavity until it reached the normal mucosa of the urethra. A fan-shaped wound was obtained by cutting the scar of 4 to 8 o'clock. The enlarged urethral lumen could smoothly pass through the F24 urethral probe. Measure the stricture length and width, and trim the oral mucosa to the appropriate shape. One arm of the 5-0 absorbable suture passed through the tip of the oral mucosal flap and the normal urethral mucosa outside the apex of the urethral fan-shaped wound, and then passed through the skin on the ventral side of the penis. The other arm of the suture passed through the apex of the fan-shaped wound and passes through the skin on the ventral side of the penis. Tighten the suture to bring the oral mucosa into the urethral cavity and cover the wound surface. If the narrow length was longer, we could suture three stitches to fix the oral mucosa with the V-shaped apex of the fan-shaped wound in a similar way, and the rest could be sutured and fixed with the urethral wound edge in direct vision. The actual measured average length of urethral stricture during the surgery was(1.6±0.5) cm. The appearance of the glans penis, stricture recurrence, maximum urine flow rate, and patient's urination symptoms were recorded after surgery 1 to 3 months. Functional success was defined as the lack of patient reported obstructive voiding symptoms, satisfaction with the appearance of the glans penis, and a slit like external urethral orifice.Results:All 9 patients successfully completed the surgery and the average maximum urine flow rate was(21.5±3.7)ml/s after 3 months of follow up. The overall successful rate was 100%.One patient experienced spraying urination 1 month later after removing the catheter. Examination revealed that protrusion and separation were found at the urethral anastomosis, and symptoms disappeared after urethral dilation. The other patients did not have any obvious complications, satisfactory with the appearance of the penis head and urination.Conclusions:Transurethral oral mucosal repair of urethral meatus and navicular fossa stricture could be a safe, and effective surgical method. It not only solves the problem of urination, but also takes into account the cosmetic effect of penis.