In this study a combination of HRP retrograde tract tracing and immunocytochemistry was employed to investigate the afferent projections of neuropeptide Y(NPY) -and neurotensin (NT)-immunoreactive(ir) neurons in the cervical, thoracic, lumbar and sacral spinal segments to the parabrachial nucleus in the rat. It was demonstrated that the retrogradely labeled neurons were scattered in bilateral laminae I, II, IV, V, VII, gray matter commissure dorsal to the central canal, lateral cervical nucleus and lateral spinal nucleus. The NPY-ir neurons were situated in bilateral lamina I, superficial portion of the lamina II, lateral cervical nucleus and lateral spinal nucleus. The NT-ir cells were seen in bilateral lamina I and lamina II of dorsal horn. In lamina I, lateral cervical nucleus and lateral spinal nucleus a few of NPY-HRP double labelled neurons could be observed. Individuals of NT-HRP double labeled neurons were identified only in lamina I. The results of this study suggest that NPY and NT neurons probably involved in the nociceptive transmission of the spino-parabrachial pathway.

By introducing a mixture of WGA-HRP and HRP or fluorogold into the parabrachial nucleus, the cell origin of the spinoparabrachial projections in the rat have been carefully examined. The labelled neurons were found in bilateral spinal gray matter, lateral spinal nucleus and lateral cervical nucleus with contralateral predominance. They were mainly located in lamina I, lamina II, lamina IV, lamina V and lamina VII of the gray matter and also in the gray matter commissure posterior to the central canal. Comparing the distribution patterns of the projection neurons in the cervical, thoracic, lumbar and sacral segments, we did not find any distinct differences. The fact that the parabrachial nucleus receives a wide extensive projections form the spinal segments suggests that the spino-parabrachial pathways are possibly involved in the transmission of multiple sensory inputs.

Objective To evaluate the application effect of clinical nursing pathways in acute myocardial infarction patients by using the Meta-analysis.Methods Published randomized controlled trials (RCT) in acute myocardial infarction patients were searched and screened in CNKI,VIP,Wanfang database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.0 software was taken for analysis.Results Totally 18 studies including 1877 cases were eligible to the criteria (894 in the experimental group and 983 in the control group) altogether.The Meta-analysis showed there was significant difference between the experimental group and the control group in hospitalization days,patients' satisfaction degree and rate of mastering knowledge.Significant difference existed between the experimental group and the control group in bedridden time,complication rate and the recurrence rate of myocardial infarction.Conclusions Application of clinical nursing pathway in acute myocardial infarction patients can shorten hospitalization days,increase patients' satisfaction degree and rate of mastering knowledge,decrease bedridden time,complication rate and the recurrence rate of myocardial infarction.

Objective To investigate the synergistic effect of calcium channel blocker on cyclosporine-induced gingival overgrowth (GO). Methods 130 renal transplant patients treated with cyclosporine were divided into group A (with calcium channel blocker) and group B (without calcium channel blocker). Demographic, pharmacologic and periodontal data were recorded. The prevalence and severity of GO were compared between the two groups. Three calcium channel blockers, including nifedipine, amlodipine and felodipine, were administered in the patients of group A. The relationships between these three calcium channel blockers and the prevalence of GO were analyzed. Results The patients receiving calcium channel blocker showed significantly higher prevalence of GO (44/73,60 % ) than those without calcium channel blocker (22/57, 39 %) (P＜0. 05). A higher proportion of mild GO (37 %) in group A was also observed than in group B (19 %, P＜0. 05). There were no significant differences in the proportions of moderate and/or severe GO between the two groups (P＞0. 05). Periodontal variables, including plaque index and papilla bleeding index, were significantly higher in GO patients than in those without GO in both two groups (P＜0. 05). In addition, the prevalence of GO in patients receiving nifedipine (77 %) was higher than in those receiving amlodipine (57 %) or felodipine (50 %). Conclusion The combination with calcium channel blocker is a risk factor of cyclosporine-induced GO and the use of nifedipine should be avoided for these at-risk patients.

Objective:To evaluate the effect of iliac bone graft and radial forearm flap in the reconstrucion of maxilla.Methods:Maxilla defects were reconstructed using iliac bone graft and radial forearm flap in 4 patients.The effects were evaluated clinicaly.Results:In all the 4 cases,palatal defects resulted from maxillectomy were optimally reconstructed with non-vascularized iliac graft and radial forearm flap.The masticatory function of the upper jaw,intelligible speech,swallow and natural facial appearance were recovered.As a result,quality of life of the patients was improved.Conclusion:Iliac bone graft and radial forearm are feasible in the reconstruction of maxilla defects.

On the basis of analyzing characteristics of ordinary agents warehouse to strengthen the management of the warehouse and give the ways of improving supply level,such as classified location management,ABC key management methods and sound inventory plan.It is an effective way to ensure the warehouse management.

Objective To study the repairing effects of nerve growth granule(NGG) on rat common peroneal nerve transection injury.Methods After 50 Sprague-Dawley rats were subjected to nerve suture after transaction,they were randomly divided into 5 groups for daily intragastric administration of drugs:NGG high-dose(5.2g/kg),medium-dose(2.6g/kg),low-dose(1.3g/kg) groups,mecobalamin group(positive control) at 625 ?g/kg,control group(control group control).The drug administration lasted for 4 weeks.Footprint test was performed 2-,3-and 4-weeks after surgery to evaluate toe spread function(TSF).Electrophysiology was performed 4 weeks after operation to determine the compound muscle action potential(CMAP) and nerve action potential(NAP).The number of regenerated myelinated nerve fibers,thickness of myelin sheath and cross sectional area of tibial muscle were measured by histomorphology.Results TSF,amplitude and recovery rate of CMAP and NAP,the number of regenerated myelinated nerve fibers,thickness of myelin sheath and section area of tibial muscle were all increased significantly in a dose-dependent manner compared with the control group.Conclusion NGG contributes to axon growth and myelination,and thus promotes peripheral nerve regeneration in rats with functional recovery.

Objective The report was focused on polycystic ovary syndrome(PCOS) in female adolescents related to homosexual precocious puberty,and the new awareness of its influence on long-term health of homosexual precocious girls.Methods A girl with idiopathic central precocious puberty (ICPP) but diagnosed as PCOS in adolescence was reported and the data were reviewed.Results A girl was diagnosed as ICPP when she was near 8 years old with obesity,but without hyperinsulinemia,then she received the treatment of a 3.75 mg dose gonadotropin hormone analogues (GnRHa) every 28 days.Her gonads development was under control while her growth was arrested.Growth hormone(GH) injection started at 13 months.She stopped all medications when finished GH and GnRHa treatment for 12 months and 25 months.She went to see doctors again because of no menarche after discontinuing medication for nearly 2 years.She appeared obese and acne,hirsutism,athanens negricans and purple purple striae on the skin.Hyperinsulinemia and hypertestosterone were demonstrated.Pelvic B ultrasonography showed polycystic ovary,and she was diagnosed as PCOS.She was ordered to lose weight and to take metformin.And adrenocorticotropic hormone stimulating test was done,and B ultrasonography again ruled out atypical congenital adrenal hyperplasia and tumor of adrenal gland.She got her menarche 1 month later.Twelve months after the PCOS diagnosis and treatment,she had 4 menses,her insulin level decreased,glucose tolerance and her serum testosterone level turned normal.At the same time,the form of ovarian and follicular was significantly reduced.After taking mefformin for 20 months,her height and weight did not change,her menstrual was regular every 35-40 days,each time lasting about 7 days.She was followed up.We also reviewed literatures and learnt that precocious puberty might not be a benign situation and it might have an intrinsic relation to obesity,precocious puberty and PCOS.It might be the cofactors for causing PP and PCOS that accessed luteinizing hormone(LH) secretion and disorder of hypothalamus pituitary gonad(HPG) axis except obesity with hyperinsulinemia.Reported pubertas praecox in childhood developed to PCOS at 30％ with high prevalence of obesity.GnRHa suppressive therapy might relate to PCOS and had disputation for improving final height.There were fewer investigations on adolescent PCOS,and no consensus guideline on it in China.Conclusions Girls with ICPP may develop to PCOS some time later.The clinical features of the reported girl and the knowledge from literatures support the hypothesis that inner relationship between the CPP and the PCOS.The LH high secretion and disorder of HPG axis may be the causes of them; LH treatment on suppressing obesity should be cautious during treatment.The benefit and risk from GnRHa treatment should be evaluated thoroughly.Further clinical research should be conducted on adolescent PCOS.

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

Objective Calcification and graft failure may occur in aortic valved homografting as a result of immune rejection. This study was designed to examine the effects of immunosuppression in reducing immune rejection response and preventing calcification in rat aortic valved homograft(AVH). Methods Animals were randomly assigned into 3 test groups and 1 control group. SD-Wistar rats in the test groups received AVH of cryopreservation (group A), received AVH of cryopreservation followed by CsA treatment (group B), and received AVH preconditioned with monoclonal antibody against dendritic cells (DcmAb) diluted in 1:5 and cryopreserved then were treated with DcmAb postoperatively (group C), respectively. Rats in the control group(group D) were Wistar→Wistar.Rat AVH with myocardial cuff were transplanted into the abdominal aorta of rats. The rats were sacrificed in batchs at 2, 4, 8, 12 and 16 weeks postoperatively. Blood samples were obzained for detecting the expression of TCR-αβ, CD28. The AVH specimens were obtained for observing the change of endotheliocyte and smooth muscle cells with light and electron microscopes. At the same time, calcium contents of AVH tissues after transplantation were measured. Results As compared with the control group, the expression of TCR-αβ and CD28 in test groups was increased significantly at each time point(P<0.01) and reached peaks 2 to 4 weeks after operation, then gradually reduced and was closed to the level of controls at 12 weeks. Calcium contents of AVH tissues in the test groups was increased gradually since 4 weeks and reached the peak 12 to 16 weeks after operation. No significant difference in calcium level was found in the control group over 5 different periods (P>0.05). Calcium contents of AVH tissues at 4 and 8 weeks postoperatively were (2856±79)μg/g and (3587±168)μg/g in the groups with cryopreservation;(2518±73)μg/g,(3237±187)μg/g in the CsA treatment group;(2176±210)μg/g, (3089±176)μg/g in the DCmAb treatment group; (860±60) μg/g, (870±50) μg/gin the control group. Conclusion The immunosuppressive treatment had substantial effects on AVH calcification as a result of reduction in immune rejection response and delay in the development of calcification.