1.Rabbit model of retinal artery occlusion established by photochemistry therapy
Yan LIU ; Ruifan ZHANG ; Huan WENG ; Qiuhua LI
Fudan University Journal of Medical Sciences 2010;37(1):106-109
Objective To establish an experimental retinal artery occlusion (RAO) model by means of photochemistry therapy with 532 nm frequency-doubled laser, and to evaluate the feasibility of this method. Methods Ten eyes from ten healthy adult New Zealand rabbits were intravenously injected 5% rose bengal solution, then their monocular retinal artery was irradiated by 532 nm frequency-doubled laser. Both eyes of these rabbits were examined by direct ophthalmoscope and fundus photographic camera on the 1st hour, 24th hour and 3rd day. Meanwhile, the experimental eyes were examined by fundus fluorescein angiography (FFA). These rabbits were killed on the 3rd day, experimental eyes were enucleated, the retina was observed under light microscope. Results There were 9 eyes approved having RAO by direct ophthalmoscope and FFA. Thrombi in retinal arterials could be found by light microscope in all these 9 experimental eyes, and the walls of blood vessel were intact without any obvious necrosis or attenuation. Conclusions RAO animal model can be induced by photochemistry therapy with 532 nm frequency-doubled laser. There are thrombi in the retinal artery without trauma of the artery wall. Photochemistry therapy is an efficient, secure and reproducible method to induce animal model of RAO.
2.Rudimentary uterine horn pregnancy: 4 cases report
Fudan University Journal of Medical Sciences 2010;37(1):100-102
Objective To study the current situation of diagnosis and treatment of rudimentary uterine horn pregnancy through 4-cases report. Methods We made a clinical study of 4 cases of rudimentary uterine horn pregnancy admitted to our hospital between 1995 and 2005. Results Three patients had been undergone artificial abortion before they were admitted to our hospital. All the patients were asymptomatic. Ultrasonography was made in 3 cases. Two cases were diagnosed as rudimentary uterine horn pregnancy. Three patients were cured with surgery. Conclusions Rudimentary uterine horn pregnancy is rare and with atypical clinical manifestation in the first trimester. Although diagnosis before surgery is difficult, ultrasonography and MRI make a great role. Surgery is the most important therapeutic method.
3.Short-term outcomes of laparoscopy surgery for colorectal cancer: a comparative study
Fudan University Journal of Medical Sciences 2010;37(1):92-99
Objective To investigate the short-term outcomes and oncological safety of laparoscopy resection for colorectal cancer. Methods Between January 2004 and March 2009, 35 patients with colorectal cancer underwent laparoscopic-assisted surgery in our hospital, among which 32 underwent radical resection, 1 underwent laparoscopic exploration, and 2 were converted to open surgery. These patients were allocated in the laparoscopic group. Same numbers of patients who underwent conventional open surgery during the same period of time were identified and allocated in the open group. Short-term data, including surgical time, intra-operative blood loss, intra-operative blood transfusion, length of incision, histopathological data, post-operative complications and post-operative functions, were collected and compared between the two groups. Results A total of 67 patients were enrolled (32 in both laparoscopy and open groups). The other 3 cases were analyzed separately (1 underwent laparoscopic exploration and 2 converted to open surgery). The two groups were well balanced as to age, gender, and TNM staging and location of tumour. Histopathologically, the laparoscopic approach was equal to conventional approach as regard to resection margin (distal margin, 5 cm vs 5 cm, P=0.664) and lymph node yield (7 vs 8, P=0.228). This study also showed a longer surgical time (250 min vs 180 min, P=0.006), but shorter length of incision (10 cm vs 20 cm, P<0.001), less demand of intra-operative blood transfusion (1 case vs 10 cases, P=0.003), reduced use of analgesics (12 cases vs 25 cases, P=0.004), shorter post-operative stay (9.5 days vs 11 days, P=0.008) and earlier recovery of bowel function of the laparoscopic group. There was no statistical difference of intra-operative blood loss (200 mL vs 200 mL, P=0.098), incidence of post-operative complications (8 cases vs 6 cases, P=0.545) and volume of post-operative negative drainage (507.5 mL vs 669.0 mL, P=0.475) between the two groups. Conclusions Though limited by a relatively small sample size, our study showed that laparoscopy approach for colorectal cancer is equal to open approach in terms of oncological safety and short-term outcome.
4.Evaluation of cardiopulmonary allograft function for a combined heart-lung transplantation patient survived 5 years
Shouguo YANG ; Chunsheng WANG ; Hao CHEN ; Shijie ZHU ; Ying ZHANG ; Tao HONG ; Yamin ZHUANG ; Kejian HU
Fudan University Journal of Medical Sciences 2010;37(1):88-91
Objective To evaluate the cardiopulmonary allograft function and to analyze key factors for long-term survival of heart-lung transplantation in a patient survived more than 5 years. Methods On December 17th, 2003 at Zhongshan Hospital of Fudan University, a homologous heart-lung transplantation was performed on a female who diagnosed with cardiopulmonary failure secondary to congenital atrial septal defect with severe pulmonary hypertension. Heart-lung allograft was preserved with 1 000 mL UW solution and 4 000 mL HTK solution.Postoperative immunosuppressive therapies were managed with Zenapax, cyclosporine A (or tacrolimus), mycophenolate mofetil and corticosteroids. Cyclosporine A maintained with serum trough levels of 100-200 μg/L and tacrolimus with serum trough levels of 8-20 μg/L. Cardiopulmonary allograft functions were evaluated by echocardiogram, pulmonary function test and thoracic CT periodically. Results The patient survived operation and experienced normal daily life with NYHA cardiac function of class Ⅰ-Ⅱ during the follow-up of 5 years and 6 months. Echocardiogram showed left ventricular ejection fraction of 65% to 86%. Pulmonary function test exhibited with nearly normal oxygen exchange, meanwhile, small airway obstruction was detected from one year after operation and keeping stable from then on. Two episodes of severe pneumonia were complicated and treated with antibiotics and fhconazob, no severe acute allograft rejection episode was experienced. Conclusions Heart-lung transplantation proves to be a reliable therapy modality for terminal cardiopulmonary failure. Excellent donor organ preservation, accurate balance of the risk between acute allograft rejection and infection, and strict preventive measures against infection are key factors for long-term survival of heart-lung transplantation.
5.Application of ultrasound locatization during craniocerebral operations
Jianming ZHU ; Wei TU ; Xinggen ZHU ; Zhifeng DENG ; Guohua MAO
Fudan University Journal of Medical Sciences 2010;37(1):85-87
Objective To investigate the application of ultrasound localization during craniocerebral operations. Methods Thirty-one cases with intracranial space occupying lesion were surgically treated with guidance of ultrasound, which was applied to real-time localization while revealing skull, tracing during operation and evaluation of the operation's effect before locking up the skull. Results In our group, 31 cases were checked using ultrasound localization during operation. Ultrasound could level the lesion's size and position, which was in accordance with the result of CT and MRI before operation. With the application of ultrasound localization, the lesion could be probed exactly. Conclusions Ultrasound localization during operation is simple, effective and secure, and is helpful to enhance the accuracy of the craniocerebral operations, reduce the blindly exploration, shorten the operation time, and what is more important, reduce unnecessary tissue damage of normal brain tissue, which obviously possess much clinical utilization.
6.Effects of β_2 agonist salbutamol aerosol on the uptake of sevoflurane in elderly patients with chronic obstructive pulmonary disease
Zongming JIANG ; Shengjin GE ; Yan FANG ; Jing CANG
Fudan University Journal of Medical Sciences 2010;37(1):34-38
Objective To investigate the effects of β_2 agonist salbutamol aerosol on the uptake of sevoflurane in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A randomized, placebo-controlled and double-blinded trial was designed. Twenty-six patients were recruited and randomly allocated to salbutamol group (group E, n=13) and placebo group (group C, n=13). Eligible patients were elderly patients with ASA physical status Ⅱ-Ⅲ, a body mass index (BMI) between 18 and 30 kg/m~2, well-defined clinical diagnosis of COPD. Routine monitoring (consists of a three-lead ECG, pulse oximetry, noninvasive blood pressure and expired gas analysis) was instituted and 500 mL Ringer's lactate solution was administered. Bispectral index (BIS) monitoring was initiated prior to induction. All subjects were received inhaled aerosol 200 μg according to manufacturers' recommendations 30 minutes before induction of anesthesia. Controlled ventilation was applied after the trachea was intubated. When stable hemodynamics was maintained for 5 minutes, fresh gas flow was set to 2 L/min with 2% sevoflurane in admixture, then HR, invasive arterial blood pressure (IABP), SpO_2, P_(ET)CO_2, bispectral index (BIS), minimum alveolar concentration (MAC), concentrations of inhaled sevoflurane (F_I) and end-tidal (F_E) were recorded at 1, 2, 3, 4, 5, 7,10, and 15 minutes after inhalation of sevoflurne. The P_(peak) and P_(plat) were also measured in 1, 5, and 10 minutes after the successful endotracheal intubation. Results Compared to the placebo group, the F_E was significantly higher at 2, 3, 4, and 5 minutes in experiment group. Peak airway pressure and plateau pressure in experiment group were strikingly lower than control group (P<0.05). There was no statistical significance about BIS variations between these groups in respective time in spite of increased MAC (P>0.05). Conclusions The increasing rate of alveolar concentration of sevoflurane was accelerated after the administration of inhaled salbutamol aerosol (200 μg) 30 minutes before induction of anesthesia, it might increase the uptake of sevoflurane.
7.Clinical significance of lymph node micrometastasis of colorectal cancer detected by immunohistochemistry
Mingrong CHENG ; Zhijian CHENG ; Yuankun CAI ; Jiaying ZHAO ; Hongzhi XU
Fudan University Journal of Medical Sciences 2010;37(1):29-33
Objective To evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with stage Ⅰ and Ⅱ colorectal cancer, and to investigate the prognostic value of lymph node occult disease (micrometastasis) in disease-free survival rate detected by immunohistochemistry with epithelial membrane antigen and carcinoembryonic antigen. Methods The study included 126 patients operated on by a single surgeon for stage Ⅰ and Ⅱ colorectal tumors. The postoperative follow-up was performed for 64 to 106 months. At least 10 lymph nodes were harvested and examined in all the specimens. The prognostic value of 10 pathologic parameters, including lymph node occult disease (micrometastasis) detected by immunohistochemistry was investigated. Results Multivariate analysis identified lymphatic vessel invasion (absent or present;P=0.009) in lymph node positive and negative by immunohistochemistry. The five-year disease-free survival rates were 78.7%, 65.5% and 43.8% for the lymph node negative, isolated tumor cells and micrometastasis groups, respectively. There was significant difference between the lymph node negative and micrometastasis groups (P=0.005). However, the difference between the lymph node negative and isolated tumor cells groups was not statistically significant (P=0.144). Conclusions We propose that for patients found micrometastasis in lymph node with high-risk stage Ⅰ and Ⅱ colorectal cancer, adjuvant therapies are justified and effective.
8.CXCR4 and vascular endothelial growth factor expressions in esophageal squamous cell cancer and their correlations
Chunlai LU ; Di GE ; Qun WANG
Fudan University Journal of Medical Sciences 2010;37(1):25-28
Objective To investigate the correlations of the expressions of CXCR4 and vascular endothelial growth factor (VEGF) in esophageal cancer and their associations with patients' clinicopathological features.Methods The paraffin-embedded samples of 127 patients with esophageal cancer treated by thoracic surgery in Zhongshan Hospital in 2005 were collected. The CXCR4 and VEGF expressions in esophageal cancer tissues were detected with immunohistochemical technique. The immunostaining was evaluated according to the staining area and intensity. Results The overall expression rate was 88.2% and 79.5%, respectively. CXCR4 expression was significantly associated with tumor grade, size, tumor depth, regional lymph node metastasis and TNM stage (P<0.05);VEGF expression was significantly associated with tumor depth, TNM stage and tumor grade.In addition, there were significant correlations between CXCR4 and VEGF (P<0.01). Conclusions There was significant association between CXCR4, VEGF expressions and clinicopathological features of esophageal cancer. There might be some potential correlation between CXCR4 and VEGF expression in esophageal cancer.
9.Evaluation of reproducibility and validity of food group intakes measured by a food frequency questionnaire for Chinese men
Dake LIU ; Ke YU ; Yuting TAN ; Rurong FANG ; Yongbing XIANG
Fudan University Journal of Medical Sciences 2010;37(1):20-24
Objective To evaluate the factors influencing the reproducibility and validity of food group intakes measured by a food frequency questionnaire (FFQ) for Chinese men. Methods A total of 214 adult men were randomly selected from the Shanghai Men Health Study (SMHS), an ongoing cohort study conducted in urban Shanghai. Each subject who had completed the first FFQ survey at recruitment took 24-hour dietary recall (24-HDR) surveys which were conducted once a month for 12 consecutive months and a second FFQ at the end of the study. Two FFQs were administered approximately 1.2 years apart. The food items listed in FFQ and obtained from 24-HDR were categorized into 11 food groups. The factors influencing the reproducibility of the FFQ was assessed by comparing the Pearson correlation of intake levels from the two FFQs, while the factors influencing the validity was evaluated by comparing intake levels from the second FFQ with the multiple 24-HDRs. Results A total of 195 men completed all 12 times of 24-HDR and twice FFQ surveys. The median Pearson correlation coefficients of the food groups between the two FFQs in older vs younger age group were 0.62 vs 0.50;in higher vs lower education level group were 0.58 vs 0.50;in higher vs lower income group were 0.51 vs 0.50;in higher vs lower BMI group were 0.50 vs 0.49. The median Pearson correlation coefficients of the food groups between the second FFQ and 24-HDRs in older vs younger age group were 0.61 vs 0.45;in higher vs lower education level group were 0.49 vs 0.47;in higher vs lower income group were 0.43 vs 0.57;in higher vs lower BMI group were 0.48 vs 0.51. Conclusions Age is the main factor influencing the reproducibility of the food group intakes by a FFQ used in the SMHS, while the factors influencing the validity are age and family income.
10.Change of niclosamide concentration in soil through heaping and the effect of Oncomelania control
Mingzhen HE ; Yibiao ZHOU ; Ying ZHOU ; Haiyin WANG ; Qingwu JIANG
Fudan University Journal of Medical Sciences 2010;37(1):16-19
Objective To analyze the concentration, distribution and decreasing trend of niclosamide in soil through soil heaping mixed with niclosamide and the effect of Oncomelania control, and to explore the appropriate dosage for the 'heaping' method. Methods The soil samples were collected from six groups in Tezi township, Puge county, Sichuan Province, and the dosages were 16, 8, 4, 2, 1 and 0 g/m~2, respectively. After ultrasonic extraction, centrifugence and concentration, the samples were finally determined by high-performance liquid chromatography (HPLC). The mortality rate of snails was observed after 3 days and 7 days. Results The standard error and range of niclosamide in soil were large. There was no significant difference in concentration of niclosamide between the surface layer and deep layer of soil (P>0.05). After 5 months, niclosamide still could be determined in groups of 4 g/m~2. The mortality rate of snails decreased as the concentration of niclosamide decreased (P<0.05). After 5 months, in the group of 4 g/m~2 dosage, the 3 and 7 days mortality rate of snails were 5.33% and 9.33% in the surface layer, higher than the control group (P<0.05). Conclusions The heaping method is an efficacious measure of controlling snails and its recommended dosage is 4 g/m~2.