Objective: The purpose of this study was to evaluate the safety and effectiveness of fast track surgery in laparoscopic gastrectomy for gastric cancer. Methods: All patients received elective gastric cancer resection, and were divided into three groups: group Ⅰ (open gastrecomy, n = 30) , group Ⅱ (open gastrecomy with fast track surgery, n = 30) , and group Ⅲ (laparoscopic gastrecomy with fast track surger-y ,n =30) . Clinical data and gut function were assessed in three groups. Results: There were no significant differences in postoperative complication and the number of lymph node harvest between 3 groups. Blood loss was less in group Ⅲ than group Ⅰ and group Ⅱ (P <0.01) ,but its operative time was longer and its cost was more than other two open surgery groups (P < 0. 01). Recovery of bowel function in group Ⅲ was faster,and postoperative hospital stay was shorter than group Ⅰ (P<0.01). However, recovery of bowel function and postoperative hospital stay in group Ⅲ was not different from group Ⅱ (P > 0. 05). Conclusion: Postoperative hospital stay can be shorter and recovery of bowel function can be faster in laparoscopic gastrectomy with fast track surgery plan compared to traditional care group. But when using fast track surgery plan, laparoscopic gastrectomy was not superior to open surgery.

Objective To investigate the diagnostic value of DTI anisotropy parameters in breast malignant tumors.Methods Fifty four patients,including 33 patients with malignant tumors and 21 patients with benign lesions,were retrospectively analyzed.The E1,MD and FA of lesions were measured and compared by paired t test between the malignant tumors and the contralateral healthy breast tissue.The difference between malignant tumors and benign lesions was analyzed by independent sample t test.Logistic regression analysis was made using E1,FA,MD as predictors in detecting and differentiating the malignant tumors,ROC curve analysis was performed to compare diagnostic performance based on the area under the curve (AUC).Results E1,MD and FA in malignant tumors were (0.99 ± 0.12) × 10-3mm2/s,(0.85 ±0.26) × 10-3mm2/s and 0.20 ±0.08 respectively,and those in normal breast tissues were(1.46 ± 0.55) × 10-3 mm2/s、(1.48 ± 0.44) × 10-3 mm2/s and 0.29 ± 0.17 respectively.Those parameters in benign lesions were (1.80 ±0.42) × 10-3mm2/s,(1.38 ±0.52) × 10-3mm2/s and 0.22 ± 0.10 respectively.Significant statistic differences were found between malignant tumors and normal breast tissues in E1,MD and FA (t =-4.889,-6.449,-2.842 ; P ＜ 0.01).Significant statistic differences were also found between malignant tumors and benign lesions in E1 and MD (t =-10.476,-4.394; P ＜ 0.01) with no difference found in FA (P ＞ 0.05).E1,MD and FA are independent predictors in malignant tumors' detection,and the combination of E1,MD and FA significantly improved discrimination between cancer and normal tissue over each one alone with the sensitivity 97.0％ (32/33),specificity 97.0％ (32/33),accuracy 97.0％ (64/66).Combination of E1 and MD had a similar AUC with E1 and a more AUC than MD and FA,with the sensitivity 97.0％ (32/33),specificity 100.0％ (21/21),accuracy 98.1％ (53/54).Conclusion The regression model combining E1,MD and FA is most valuable in breast cancer detection and E1 is the preferred index for the differentiation of breast cancers from benigin lesions.

Objective To develop an interlocking-style vascular shunt device for the treatment of distal limb ischemia resulting from vascular disconnection and defect.Methods A one-way interlocking buckle was designed with the space between the clamping teeth being 0.5 mm,which prevented the device from moving backwards and fixed the vessel and shunt tube conveniently.The interlocking buckle combined with silicone tube was used to connect the two ends of the defected vessel,which was compared with conventional method by suture ligation and silicone tube by the tests on vessel bursting pressure and tensile biomechanics.Results The vessel repaired with the developed device behaved better than that by the conventional method in the tests on vessel bursting pressure and tensile biomechanics (P＜0.05).Conclusion The vascular shunt device can be used for the treatment of distal limb ischemia resulting from vascular disconnection and defect,and thus facilitates the vascular graft in rear hospital after evacuation.

Objective To investigate the injury mechanism, fracture characteristics, treatment strategy and prognosis of Pilon fracture without fibula fracture. Methods 28 cases of Pilon fracture without fibula fracture (29 fractures) treated in our hos?pital were adapted from January 2009 to December 2014. 22 cases were male, 6 were female, aged 46 years old (23-75). Cause of injury:tumble in 14 cases, fall from high place in 8 cases, traffic accident in 5 cases, bruise in 1 case. 10 cases had associated in?juries, and 2 cases were open injuries. The OA/ATO fracture type, Rüedi&Allgower fracture type, and characteristics of fractures were summarized. The appropriate treatments were selected, and the operative method, operative time, surgical approach, fixation, fracture healing time, ankle Mazur score, Burwell?Charnley reduction score and postoperative complications were recorded. Re?sults On the mechanism of injury, 28 cases mostly had a median?low energy injury mechanism with little open injuries. On the fracture characteristics, there was a 96.6%anterior distal tibia articular fracture involved with no other specific fracture character?istics occurred. The treatment of the fracture mostly received a single operative approach to complete open reduction and internal fixation operation. The average operation time was 119 minutes, the average fracture healing time was 7.1 months, the excellent and good rate of ankle Mazur score was 86.2%and the satisfactory rate of Burwell?Charnley fracture reduction score was 93.1%. Skin infections occurred in 3 patients after operation. After effective antibiotic and correct clinical treatment, the incisions got healed in these 3 patients. Conclusion Pilon fracture with intact fibula mostly is caused by median to low energy injury when an?kle at neutral or varus position, most with anterior distal tibia articular fracture by foot dorsal flexion. Generally use a single anteri?or approach can complete open reduction and internal fixation operation with satisfactory clinical treatment. This kind of fracture could achieve good reduction, good bone healing, good function and little complications after correct treatment.

The paeonol proniosomes ointment and ordinary ointment were administered to rats. Physiological saline served as perfused solution. The perfusion rate was 5 mL x L(-1) and the microdialysis samples were collected every 20 min intervals. The paeonol concentration in perfused solution was determined by HPLC. Investigation of the pharmacokinetics of paeonol proniosomes ointment and ordinary ointment by the skin-blood synchronous microdialysis coupled with HPLC is reported in this study. The results show that the recovery was (54.80 +/- 1.50)% in vitro and (54.58 +/- 4.61)% in vivo. The results showed that paeonol proniosomes ointment significantly raised the drug concentrations in skin more than the paeonol ordinary ointment. The paeono proniosomes ointment has less drugs into the blood as the ordinary ointments in blood, but its blood drug concentrations were steadier. The paeonol proniosomes ointment may be developed into a new preparation.
Acetophenones ; administration & dosage ; blood ; chemistry ; pharmacokinetics ; Animals ; Drug Delivery Systems ; instrumentation ; methods ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; pharmacokinetics ; Male ; Microdialysis ; Ointments ; administration & dosage ; chemistry ; pharmacokinetics ; Paeonia ; chemistry ; Rats ; Rats, Wistar ; Skin ; metabolism

Objective: The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in colorectal cancer patients.Methods: Sixty colorectal cancer patients were prospectively divided into fast track surgery(FTS)group(n=30)and conventional perioperative care group(n=30).In addition to clinical parameters(recovery of gastrointestinal function,complication rates and postoperative length of stay), the parameters of perioperative cell-mediated immunology function,and the serum level changes of CRP and IL-6 were determined.Results: FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group(P<0.05).Serum concentration of CRP and IL-6 in FTS group were lower(P<0.05) than in the conventional care group on postoperative day(POD) 1 and POD 3(P<0.05).CD4/CD8 ratio in FTS group were higher(P<0.05) than in the conventional care group on postoperative day(POD)1 and POD 3(P<0.05).Conclusion: Fast track surgery for colorectal cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care.

Objective To study the psychological and psychosomatic status of children with pectus exca vatum and the significance of orthotherapy. Method Eighty-seven patients and 87 healthy children were interviewed with the Achenba ch Child Behavior Checklist (CBCL),the symptom Checklist (SCL-90)and the psycho logical and psychosomatic status checklist contrived. Results The children with pectus excavatum showed higher frequency in interpersonal sens itivity, depression,anxiety,obsession compulsion and also more mental difficul ties than those of control group.The differences between the patients and health y children were significant statistically.Conclusions The psychological and psychosomatic status of children with pectus excavatum are worse than those of healthy children,so it is reasonable to perform an operati on earlier for improvement of physiological, psychological ,social aspects in ch ildren with pectus excavatum. J Appl Clin Pediatr,2005,20(2):178-179

OBJECTIVETo investigate the changes of mercury (Hg) levels in cerebrospinal fluid (CSF) in patients with chronic mercury poisoning and elucidate the neurotoxic mechanism of mercury.

METHODSNine patients with chronic mercury poisoning (poisoning group) as well as eight patients without exposure to mercury were included in this study. Mercury concentrations of 24 hour urine (U-Hg) and CSF (CSF-Hg) were measured with cold-vapor atomic absorption spectrometry-alkali stannous chloride method. The concentration of blood (B-Hg) at the same day was measured with cold-vapor atomic absorption spectrometry-acidic stannous chloride method. In five patients of poisoning group, these concentrations before chelation therapy were compared with those after chelation therapy.

RESULTSThe levels of B-Hg, U-Hg, and CSF-Hg in poisoning group (250.00 +/- 48.54, 160.07 +/- 91.15, 20.22 +/- 10.21 nmol/L, respectively) were significantly higher than those in control group (81.04 +/- 63.01, 24.73 +/- 9.96 nmol/L, undetectable, respectively; P < 0.01). In nine patients of poisoning group, CSF-Hg concentrations were correlated with B-Hg (r = 0.675, P < 0.05), but not U-Hg. After chelation therapy with dimercaptopropane sulfonate in five patients of poisoning group, the levels of B-Hg, U-Hg, and CSF-Hg were decreased significantly (P < 0.05). The reduction of CSF-Hg was not related with B-Hg and U-Hg.

CONCLUSIONCSF-Hg concentration in chronic mercury poisoning patient is increased with the rise of B-Hg, but not U-Hg. When the levels of B-Hg and U-Hg drop to normal, the CSF-Hg level is still high enough to be detected. It indicates that mercury is combined with protein after entering brain and this complex is difficult to cross through blood-cerebral barrier. The complex may cause neuromuscular disorder and fremitus in chronic mercury poisoning.

Adult ; Antidotes ; therapeutic use ; Chronic Disease ; Female ; Humans ; Male ; Mercury ; cerebrospinal fluid ; Mercury Poisoning ; cerebrospinal fluid ; drug therapy ; Middle Aged ; Occupational Exposure ; Spectrophotometry, Atomic ; Unithiol ; therapeutic use

BACKGROUNDAtrial fibrillation (AF) is the most common supraventricular arrhythmia in clinical practice. Chronic atrial fibrillation (CAF) is associated with ionic remodeling. However, little is known about the activity of ATP-sensitive potassium current (IK, ATP) during CAF. So we studied the changes of IK, ATP density and allosteric modulation of ATP-sensitivity by intracellular pH during CAF.

METHODSMyocardium samples were obtained from the right auricular appendage of patients with rheumatic heart disease complicated with valvular disease in sinus rhythm (SR) or CAF. There were 14 patients in SR group and 9 patients in CAF group. Single atrial cells were isolated using an enzyme dispersion technique. IK, ATP was recorded using the whole-cell and inside-out configuration of voltage-clamp techniques. In whole-cell model, myocytes of SR and CAF groups were perfused with simulated ischemic solution to elicit IK, ATP. In inside-out configuration, the internal patch membranes were exposed to different ATP concentrations in pH 7.4 and 6.8.

RESULTSUnder simulated ischemia, IK, ATP current density of CAF group was significantly higher than in SR group [(83.5 +/- 10.8) vs. (58.7 +/- 8.4) pA/pF, P < 0.01]. IK, ATP of the two groups showed ATP concentration-dependent inhibition. The ATP concentration for 50% current inhibition (IC50) for the SR group was significantly different in pH 7.4 and pH 6.8 (24 vs. 74 micromol/L, P < 0.01). The IC50 did not change significantly in CAF group when the pH decreased from 7.4 to 6.8.

CONCLUSIONSDuring CAF, IK, ATP current density was increased and its allosteric modulation of ATP-sensitivity by intracellular pH was diminished.

Adenosine Triphosphate ; pharmacology ; Adult ; Allosteric Regulation ; Atrial Fibrillation ; metabolism ; Chronic Disease ; Dose-Response Relationship, Drug ; Female ; Humans ; Hydrogen-Ion Concentration ; Male ; Middle Aged ; Potassium Channels ; physiology

OBJECTIVETo investigate the functional role of hippocampal mossy fiber sprouting in the pathophysiologic mechanism of initiation and propagation of epilepsy.

METHODSThe authors examined hippocampal mossy fiber synaptic reorganization and the changes of hippocampal neurons in P77PMC rats at different stages in the course of recurrent seizures using Timm's method of silver sulfide staining and Nissl staining and observed the effects of recurrent audiogenic seizures (AGSs) on seizure behavior of P77PMC rats.

RESULTSFrequent recurrent AGSs could cause neuronal loss in CA(1) region of hippocampus and hippocampal mossy fiber sprouting got into the inner molecular layer of dentate gyrus in P77PMC rats, and could decrease the latency of IV/V grade of AGSs, increase the durations of AGSs. The mean A of CA(1) region of hippocampus in Nissl staining after 50 times of AGSs was 35.3 +/- 0.8, which was markedly lower than that of the control (44.1 +/- 0.5; F = 333.89, P < 0.001). The mean A of the inner molecular layer of dentate gyrus in Timm's staining after 50 times of AGSs was 49.3 +/- 4.6, which was markedly higher than that of the control (26.8 +/- 1.7; F = 76.83, P < 0.001). After 30 and 50 times of AGSs, the latent periods of IV/V grade of AGSs were 12 +/- 8 (t = 3.805; P < 0.02) and 17 +/- 7 (t = 5.927; P < 0.002) seconds shorter than the initial period of stimulation respectively on average, and the durations of AGSs were 19 +/- 18 (t = 2.644; P < 0.05) and 10 +/- 7 (t = 3.780; P < 0.02) seconds longer.

CONCLUSIONHippocampal mossy fiber sprouting and neuronal loss not only presents in limbic seizure, but also in AGS, the seizure can be initiated in brainstem but rapidly generalized;in AGS-prone rats, recurrent AGSs can cause mossy fiber synaptic reorganization and neuronal loss in hippocampus, and can also enhance seizure susceptibility of P77PMC rats. In the course of recurrent AGSs, enhanced seizure susceptibility happened before hippocampal mossy fiber sprouting. Their temporal relationships indicate that the anatomical changes may be preceded by functional changes of elevated excitability in the brain.

Acoustic Stimulation ; adverse effects ; Animals ; Epilepsy ; pathology ; Mossy Fibers, Hippocampal ; pathology ; Rats ; Rats, Wistar ; Seizures ; etiology ; pathology