Objective To explore the application value of hand-assisted laparoscopic splenectomy and pericardial devascularization in the treatment of liver cirrhosis and portal hypertension. Methods Hand-assisted laparoscopic operations of splenectomy in 10 patients and pericardial devascularization in 13 patients were completed by using the LigaSure device and harmonic scalpel. Results All the operations were completed successfully under laparoscope. Of splenectomy, the operative time was 63?15.5 min and the estimated blood loss was 32.4?21.2 ml. Of pericardial devascularization, the operative time was 115.3?25.5 min and the estimated blood loss was 52.4?24.2 ml. All the patients got out of bed and moved around at 12.2?3.8 h after operation. Conclusions [WTBZ]Hand-assisted laparoscopic splenectomy and pericardial devascularization using the LigaSure device and harmonic scalpel has advantages of high reliability, little blood loss, and quick postoperative recovery. The procedure can be used in the management of portal hypertension and hypersplenism.

Objective To develop an early diagnosis strategy for radiation-associated breast angiosarcoma after breast cancer radiotherapy (RABASBCR) and to avoid the misdiagnosis of this disease.Methods A systematic search of PubMed for published reports of RABASBCR cases was performed.The clinical manifestations and radiological features in the early stage of disease,as well as biopsies,were analyzed to screen out valuable markers for early diagnosis and develop the early diagnosis strategy for RABASBCR.Results Fifty-five original articles involving 80 RABASBCR patients were selected for this analysis.Twenty-four (30％) of the 80 patients were misdiagnosed;the median time of misdiagnosis was 3 months (1-24 months).The earliest symptom was skin changes in 76 (95％) of the 80 patients.The misdiagnosis rates of ultrasound,mammography,computed tomography,and magnetic resonance imaging for RABASBCR were 9/9,31/32,2/2,and 1/5,respectively.The misdiagnosis rates of fine needle biopsy,core needle biopsy,and incisional biopsy were 7/14,12/25,and 10/26,respectively.Conclusions By analyzing published case reports,we have set up the early diagnosis strategy for RABASBCR with reference to the Cahan criteria.

Objective To study the effects of different type of parathyroid damage to the postoperative functional recovery of parathyroid,through establish an animal model by simulating total thyroidectomy and parathyroid damage during surgical operation.Methods Experimental rabbits for the study were randomly divided into A,B,C,D four groups (n =8),Group A (control group):simple exposure,exploration thyroid and parathyroid;group B (vascular injury group):total thyroidectomy and ligation bilateral parathyroid blood supply but keep the surrounding membrane;Group C (membrane damage group):total thyroidectomy and damage membrane but reservations blood supply.Group D (composite damage group):total thyroidectomy plus membrane and blood both damage;All animals were monitored of serum calcium and PTH,preoperative 1 days and postoperative 1 st day,3rd day,5th day,7t day;cut the parathyroid HE staining to observed survival of parathyroid tissue and pathology damage when 7th day after operation.Results (1) Animals in each group preoperative serum calcium and PTH were no significant difference (P ＞0.05);(2)Group A postoperative serum calcium decreased,but at 5th day returned to preoperative level (P ＞ 0.05);Group B and C postoperative 1st day,3rd day,5th day serum calcium decreased significantly(P ＜ 0.05)and to the lowest at 1 d and then gradually recovered,but group C faster recovered than group B (P ＜ 0.05);Group D postoperative 1 st day,3rd day serum calcium continued to decline significantly (P ＜ 0.05);(3) Group A postoperative serum PTH decreased,but at 7th days returned to preoperative level (P ＞ 0.05).Group B and C postoperative 1st day,3rd day,5th days serum PTH decreased significantly(P ＜0.05)and to the lowest at 1 d and then gradually recovered,but from postoperative 3rd day group C faster recovered than group B(P ＜ 0.05);Group D postoperative 1 st day,3rd day serum PTH continued to decline significantly (P ＜ O.05);(4) Pathology results:Group A parathyroid filled with chief cells and a small amount of vacuolar changes (5％ to 10％);Group B parathyroid hemorrhage,necrosis (40％ to 50％),part of the cell degeneration (30％ to 40％),center with fibrosis,seen granuloma and hyperplasia of parathyroid tissue in surrounding;Group C parathyroid bleeding (10％ to 20％),part of the cell degeneration (10％ to 20％);Group D parathyroid severe necrosis,almost no normal parathyroid tissue,significant fibrosis,less residual parathyroid tissue was scattered.Conclusions (l) The recover of Parathyroid function is influenced by the type of parathyroid in situ injury during thyroidectomy,composite damage of blood supply and membrane of parathyroid is the most serious,parathyroid ischemia necrosis,the function can not be restored,pure blood supply damaged,some can restore function,and the parathyroid gland with vascular pedicle can be recovered quickly.(2) Severe blood supply and membrane damaged,and even free parathyroid should be transplanted immediately during operation.

The double-window technique was applied in 30 patients with thoracic diseases in CT examination. The pictures of lung window, mediastinum window and double-window were read respectively and the diagnostic accuracy were compared. The principle, advantage and limitation of double-window technique were discussed.

Objective To establish a treatment proposal of thyroid adenoma by using percutaneous radiofrequency ablation(RFA) and investigate its techniques and skills, means and steps, and safety and efficacy. Methods Contrast-enhanced ultrasound-guided percutaneous RFA of thyroid adenomas were conducted on 202 patients by using an auto-controlled bi-polar electrode system. The indications of thyroid RFA,the optimal puncture route,the ways of anesthesia administration, protection of vital neck vessels and recurrent laryngeal nerve(RLN) and reduction of bleeding from core biopsy, indicators of ending ablation procedure following a complete ablation were investigated and analyzed. Resalts An adenoma smaller than 20 mm in maximal diameter was the optimal candidate for RFA. Either of two puncture routes could be selected upon the target lesion's location. Areas surrounding to the thyroid capsule needed adequate local anesthesia to kill pain. Liquid-isolating maneuver could effectively protect carotid artery and RLN from core needle cutting and electrode heating injury. Advanced block of supplying arteries with heating markedly reduced bleeding involved in the biopsy. Multipoint and multicenter ablation was essential to a complete coagulation. Filling-defect in the ablated adenoma on CEUS was the key sign to terminate ablation procedure. Conclusions Percutaneous bi-polar RFA was proved feasible, effective, safe and supermicroinvasive for treating thyroid adenoma under the way stated here of puncture and technical points and use of CEUS for monitoring.

Objective: To investigate the effect of inhibitng C-myc expression by actinomycin D on intimal hy-perplasia in vein graft. Methods: The vein graft model was established in rats. The different dises of actinomycin D (0.015 mg/kg; 0.15 mg/kg) were given just before and after operation. The vein grafts were harvested at 2 hrs and 1 week after grafting. C-myc mRNA was measured by in situ hybridization method. The intimal thickness was measured using a computerised image analysis system. Results: The expression of C-myc mRNA and the intimal thickness were both significantly reduced in large dose (0.15 mg/kg) group of actinomycin D, with 6.5%; 18.7 μm compared with control group in 12.5%; 28.5 μm respectively. Conclusion: Actinomycin D can inhibit expression of C-myc mRNA and intimal hyperplasia in graft. Expression of C-myc plays an important role in inducing proliferation of smooth muscle cell in vein graft.

Objective To investigate the physicochemica l properties and immunobiological activity of a polysaccharide (RAP-B-1) from stems of Rubus amabilis. Methods The crude polysaccharide (RAP) was obtained successively by boiling, ethanol precipitating and dialyzing. RAP was isolated with DEAE-cellulose and Sephadex G-100 to obtain a polysaccharide RAP-B-1. The physicochemical properties of RAP-B-1 were studied by hydrolysis, periodate oxidation, Smith degradation and methylation, CE, IR, NMR and GC-MS. The immunobiological activities were estimated by the proliferative activity of spleen lymphocytes and phagocytic activity of peritoneal macrophages in mice. Results The molecular weight of RAP-B-1 was 4.80×104 with specific optical rotation value [α] 20D+68.3 (c=1,H2O), and was composed of eight monosaccharides. The molar ratios were as Xyl: Ara: Glc: Rha:Gal: Man: GlcA: GalA = 1.0:6.9:0.8:1.1:6.9:0.3:0.5:3.3. RAP-B-1 was an arabinogalactan. The linkages of arabinose were →1) Ara (2,3→,→1) Ara(5→and→1) Ara, and the linkages of galactose were→1) Gal(4→,→1) Gal(6→and→1) Gal. RAP-B-1 could improve the proliferative activity of spleen T cells(P<0.05) and booste phagocytic activity of peritoneal macrophages at 50μg/ml concentration(P<0.01). Conclusion RAP-B-1 is an arabinogalactan and has immunobiological activity.

Objective To study the effect of temporary in vitro preservation of parathyroid on the activity of cells in the process of parathyroid auto-transplantation and function of postoperative in order to improve the survival rate of transplantation.Methods (1)Experimental rabbits for the study were randomly divided into three groups:group A,group B,group C,with 8 rabbits in each group.Then we remove the bilateral inferior parathyroid,in group A,the parathyroid glands were immediately formaldehyde-fixed;in group B and group C,the parathyroid glands were placed in normal saline in 4 ℃ and in room temperature (22-24 ℃) for 30 minutes respectively and then fixed;HE staining was performed on the left parathyroid glands to observe the morphology of the cells;Electron microscopic examination of the right parathyroid glands were performed to observe the ultrastructural changes of the cells.(2)Experimental rabbits were randomly divided into three groups:group D group E and group F,with 8 rabbits in each group,after total thyroidectomy,the double inferior parathyroid glands were took out,in group D,the parathyroid glands were immediately transplanted in bilateral anterior cervical muscles;in group E and group F,the parathyroid glands were placed in normal saline 4 ℃ and in room temperature (22-24 ℃) for 30 minutes respectively and then transplanted.All animals were monitored of serum calcium and PTH on preoperative 1 d and postoperative 1 d,3 d,5 d,7 d;the parathyroid was took out for HE staining to observed survival of parathyroid tissue and pathology damage when 7d after operation.Results (1) The normal parathyroid gland is mainly dominated by the chief cells,the nucleus of the chief cell was round and centered under electron microscope;there were no significant change in the morphology of parathyroid cells,and the mitoehondria of the cells were slightly swollen under 4 ℃;but the parathyroid gland cells were slightly swollen and partially vacuole degeneration,the morphology of the nucleus was irregular,and the mitochondria were extremely swollen and deformed,and the ridge was broken under room temperature.(2)three groups of rabbits after transplantation of parathyroid,serum calcium and PTH decreased significantly,and increased gradually,there was significant difference on the 7th day after the operaion between the two groups (P＜0.05);(3)in group D,the normal parathyroid cells densely distributed in the anterior cervical muscle tissue;in group E,A large number of parathyroid cells survived in muscle tissue,with some vacuolated;in group F,only part of healthy parathyroid ceils scattered in the muscle.Conclusion Parathyroid should be preserved in 4 ℃ normal saline during the operation,and the transplant should be completed in 30 minutes as far as possible.

ObjectiveTo investigate the effective approach for the treatment of detrusor underactivity. Methods98 patients with detrusor underactivity were randomly divided into electrotherapy group (electroacupuncture, interference current stimulation, n=32), medicine group (n=32) and electrotherapy-medicine group (n=34). The patients were assessed with examination of urodynamics and clinical parameters before and after treatment. ResultsThe detrusor strength were stronger after treatment in all the 3 groups (P<0.001), but electrotherapy-medicine group was more stronger than the other 2 groups (P<0.01). The cure rate in the 3 groups were 68.75%, 59.38% and 88.23% respectively, the patients in electrotherapy-medicine group gained significantly better results than the other 2 groups (x2=9.976, P<0.01). The difference of cure rate between the electrotherapy group and the medicine group was not significant (P>0.05). ConclusionElectric stimulation therapy combined with medicine is an effective intervention for treatment of detrusor underactivity and is better than electric stimulation therapy or drugs only.

OBJECTIVETo prepare a rabbit meniscus acellular matrix scaffold and explore the histomorphological and biomechanical properties of the scaffold.

METHODSRabbit meniscuses were collected and acellularized using a modified eight-step detergent process with hydrogen peroxide, distilled water, Triton X-100, and sodium deoxycholate. Its color and texture were observed. Histomorphological assessment was performed using routine hematoxylin-eosin stain, toluidine blue stain, Saffron stain, Hoechst-33258 stain, and immunohistochemical staining of collagen I. The ultrastructure of the specimens was observed with inverted phase contrast microscopy. Transient recovery rate of deformation, maximal recovery rate of deformation, and maximal compressive strength were tested to determine the biomechanical properties of the scaffold.

RESULTSThe processed meniscus was milk-white in color with loose structure. It histologically appeared cell-free, stained positively for collagen I, and had abundant micropores according to phase-contrast microscopy. The transient recovery rate of deformation was (76.65∓4.61)%, the maximal recovery rate of deformation was 100%, and the maximal compressive strength was (4.51∓0.69) N when the specimens were compressed 40%.

CONCLUSIONSThe rabbit meniscus acellular matrix scaffold, with numerous micropores, is easy to be recovered from deformation and suitable for the adhesiveness and growth of breeding cells. This scaffold can be used as an ideal implant for future tissue engineering of the meniscus.

Animals ; Biocompatible Materials ; analysis ; Biomechanical Phenomena ; Materials Testing ; Menisci, Tibial ; chemistry ; cytology ; ultrastructure ; Rabbits ; Tissue Engineering ; Tissue Scaffolds