Diagnosis and Treatment Guideline of Chronic Obstructive Pulmonary Disease,being established by Chronic Obstructive Pulmonary Disease Group of Respiratory Disease Branch of Chinese Medical Association,explains the correlative preclinical and clinical problems of chronic obstructive pulmonary disease from the aspects of western medicine.It is the guideline of clinical and basic study in western medicine.The author prehensioned and cognized it on the basis of TCM theory and clinic experience,and developed a new thinking of treating chronic obstructive pulmonary disease in stable phase by TCM,it made the Diagnosis and Treatment Guideline of Chronic Obstructive Pulmonary Disease serve for prevention and cure of chronic obstructive pulmonary disease by TCM better.

Chronic obstructive pulmonary disease is a common stubborn respiratory disease(COPD);it belongs to "lung-distension" in Chinese medicine.The author believes that its pathogenesis should be considered from clinical characteristics,in all COPD stages,according to the specific characteristics of the symptoms,listed several therapies:warming lung for dispelling cold,dispersing lung qi and clearing heat,benefiting qi for warming yang,eliminating phlegm and removing blood stasis,so as to improve the symptoms of patients with COPD.The author used Xiaoqinglong decoction,Buzhongyiqi decoction,Buyuan decoction,Gleditsia pills,Juanxiao decoction,Mahuang Xingren Shigao decoction combined with Mengshi Guntan pills,Mahuangfuzixixin decoction combined with Linguizhugan decoction to treat COPD in all phases.For example,the six cases about acute exacerbations and stable period had improved apparently.Treatment is basically to determine root vacuity and tip repletion,intermingled deficiency and excess.

BACKGROUND: Methyl cobalamin, a derivative of vitamin B12, .can promote the metabolism of nucleic acid protein, axoplasmic transport and axonal regeneration.OBJECTIVE: To observe the role of target muscular injection of methyl cobalamin ofdifferent dosages in the regeneration of peripheral nerve injury in rats.DESIGN: A randomized and controlled animal experiment.SETTING: Changzhou Second People's Hospital affiliated to Nanjing Medical University.MATERIALS: The experiment was carried out in March 2003. Thirty healthy Wistar rats were randomly divided into three groups with 10 rats in each group: high-dosage group, low-dosage group and blank control group.METHODS: All the rats were made into models of sciatic nerve injury by epineural suture immediately after transection of left sciatic nerve. Rats in high- and low- dosage groups were injected with methyl cobalamin of 300and 100 μg/kg per day respectively, and those in blank control group were injected with 1 mL normal saline of the same volume, and target muscular injection was given once a day postoperatively. At postoperative 4 and 8weeks, 5 rats were killed at one time; the wet mass of left triceps surae muscle was measured. Morphological observation of sciatic nerve under light and electron microscopes and imaging analysis were made as the detected indexes to analyze the effect of methyl cobalamin of different dosages on sciatic nerve injury in rats.sciatic nerve myelin sheath at postoperative week 8.parison of the wet mass of triceps surae muscle at postoperative 4 weeks: It was higher in high-dosage group than in low-dosage group and blank control group [(1.367±0.012) g, (1.164±0.011) g, (0.950±0.009) g, P ＜ 0.05].week 8: It washigher in high-dosage group than in low-dosage group and blank control group [(2.205±0.015), (1.611±0.013), (1.230±0.014) g, P ＜ 0.05].weeks postoperatively: It was obviously higher in high-dosage group than in low-dosage group and blank control group [(13.30±1.167), (9.453±1.233),atic nerve myelin sheath at 8 weeks postoperatively: It was thicker in highdosage group than in low-dosage group and blank control group [(1.145±0.108),(0.806±0.065), (0.560±0.045) mm, P ＜ 0.05].CONCLUSION: Target muscular injection of methyl cobalamin can promote the regeneration of peripheral nerve, and methyl cobalamin of high dosage can better play its role in nourishing injured nerve.

Objective To introduce a sort of method about thumb reconstruction to complex thumb defect. Methods From January 2003 to December 2006, 13 patients who incur sever thumb defect above5 grade adopt the upper limb lateral bone-skin flap combined with the second toe transplant primary thumb reconstruction, pestop follow-up visit 12 months to 3 years, according to hand surgery society of Chinese Medical Associaition thumb and finger reconstruction functional assessment probation standard to evaluatethe function of reconstituted thumb. Results All of the transplanted upper limb lateral bone-skin flaps and the second toes take, and function well. Conclusion The upper limb lateral bone-skin flap combined with the second toe transplant primary repair complex thumb defect had been tested one good method for thumb reconstruction to above 5 grade thumb defect.

BACKGROUND:Vascular endothelial growth factors (VEGF) can promote the division of endothelial cells and accelerate the growth of newborn vessels, whereas the expression and distribution of VEGF receptors (VEGFR) in spinal cord should be observed.OBJECTIVE: To observe the expression and distribution of VEGFR-1 and VEGFR-2 in rat spinal cord.DESIGN: A randomized controlled observation.SETTING: Department of Orthopaedic Surgery, the First Affiliated Hospital of Dalian Medical University; Department of Hand Surgery, Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Ten adult male Wistar rats of clean degree, weighing 180-200 g, were provided by the animal experimental center of Tongji Medical College, Huazhong University of Science and Technology. Immunohistochemical primary antibody was purchased from Santa Cruz Company; the second and third antibodies from Beijing Zhongshan Biotechnology Co., Ltd. Reverse transcription-polymerase chain reaction (RT-PCR) kit was the product of Promega,Trizol reagents were purchased from Invitrogen Company, and the VEGFR-1 and VEGFR-2 primers were designed by Beijing Aoke Company.METHODS: The experiment was carried out in the laboratory of Department of Hand Surgery of Wuhan Union Hospital from March to June in 2004. ① Detection of VEGFR expression in spinal cord anterior horn: The rats were anesthetized by 100 g/L chloral hydrate, spinal cord of lumbar 4-6 (L4-6) was fixed in fixation solution at 4 ℃ for overnight, then routine dehydration, hyalinization and paraffin embedding were performed, and serial sections of about 5 μm were prepared for observing the VEGFR expressions using immuniohistochemical staining. ② Detection of VEGFR mRNA expression in spinal cord: Five rats were selected, L4-6 spinal cord (50 mg) was removed and centrifugated, then the content of total RNA was determined with ultraviolet spectrophotometer. The synthetized cDNA was amplified with PCR, and the PCR products (10 μL) were treated with 20 g/L agarose gel electrophoresis, and stained with 0.1 mg/L ethidium bromide, the results were observed and recorded under ultraviolet lamp and photographed. The products were scanned and quantified with gel imaging analytical system to record the gray value of each band, the gray value of β-actin band was taken as 1,and those of the other objective fragments were compared with it to record the gray value ratio and analyze the expressions of the objective fragments.MAIN OUTCOMEMEASURES: ① Expression and distribution of VEGFR-1 and VEGFR-2 in rat spinal cord anterior horn;② Results of VEGFR mRNA expression in spinal cord.RESULTS: ① Both VEGFR-1 and VEGFR-2 were expressed in the microvessels of normal rat spinal cord tissue.Besides, VEGFR-2 mainly expressed in motor neurons, glial cells and the nerve fibers in surrounding white matter. ②The results of gel imaging analytical system showed that the VEGFR-2 content in normal spinal cord was obviously higher than VEGFR-1 (0.874±0.222, 0.486±0.181, P ＜ 0.05).CONCLUSION: VEGF promote the formation of microvessels through the combined effects of VEGFR-1 and VEGFR-2,and it plays the neurotrophic and neuroprotective role through VEGFR-2.

Objective To demonstrate the presentation of the extracellula ATP receptors in peripheral nerve in rats Methods Reverse transcriptase polymerase chain reaction was performed in sciatic nerve of rat Results There were three P2y receptor mRNA expressions in the in the sciatic nerve of the rat,they were P2y2 and P2y4 as well as P2y6 Conclusions Extracellular ATP,as a neurotransmitter,activates the P2y purinoceptors located on the axon regeneration after peripheral nerve injury and decided the direction of the regeneration axon The P2y receptors are related to the regeneration of the peripheral nerve

Objective To examine the effect of target muscle injection with different dosages of Methycobal in the sciatic nerve regeneration of adult rats so as to determine a better method and proper dosage of Methycobal for clinical treatment of peripheral nerve injury. Methods A total of 30 healthy Wistar rats were employed to make sciatic nerve injury model through immediate suture of the adventitia posterior to transection of the left sciatic nerve. The rats were divided randomly into three groups, ie, high dosage group (Methycobal for 300 ?g/kg, Group A), low dosage group (Methycobal for 100 ?g/kg, Group B) and control group (1 ml normal saline once a day, Group C),10 rats in each group. At 4 and 8 weeks, 5 rats from each group were taken to observe the effect of different dosages of Methycobal on rat sciatic nerve regeneration, where the detection indices included morphological changes and image analysis of sciatic nerves by optic and electron microscopic investigations as well as tricipital muscle wet weight. Results Four weeks after operation, tricipital muscle wet weight was (1.367?0.012) g in the Group A, (1.164? 0.011) gin the Group B and (0.950?0.009) g in the Group C, with significant difference among groups A, B and C (P

[Objective]To study the effect of End-to-side neurorrhaphy for protection target muscle.[Method]Twenty-six wistar rats were divided into two groups,with 13 in each group,peroneal nerve was transacted on the right side of all the animals,in one group,the proximal end of peroneal nerve was turned back and ligated,the distal end was sutured to the side of tibial nerve with perineurial window,in another group,both ends of the transacted peroneal nerve were turned back and ligated as contrast,no operation was done on the left side.Three months after operation,the peroneal nerve and the tibial muscle were taken for histologic exmination,and the muscle's wet weight was examed.[Result]Significant difference was seen between the two groups in the muscle wet weight,the muscle fiber cross sectional area,the moter endplate area and color(P

This study is to investigate the effect of local phVEGF(165) injection on sciatic nerve regeneration in the rats and to search for a new way in the further treatment of peripheral nerve injuries. Forty-five adult male Wistar rats received a neurotomy to bilateral sciatic nerves, which were subsequently reconnected with 10/0 epineurial nylon sutures. The injured segments was locally injected with normal saline (group A), or 25 microg of phVEGF(165) (group B) or 50 microg phVEGF(165) (group C). Nerve conduction and regeneration were evaluated in terms of the histological changes, weight of gastrocnemius muscles, electrophysiology and morphometric results. Our study demonstrated that rats of group C showed the best results in terms of nerve regeneration, followed by group B and group A. Our findings suggested that local injection of phVEGF165 can facilitate nerve regeneration and promote functional recovery in a dose-dependent manner.

To identify the best suture techniques for the tendon repair, the biomechanical properties of tendons sutured by different methods were dynamically examined. 140 chickens were divided into 2 groups equally: group A and group B. The tendon of the right side was subjected to injury-repair process, and the tendons of the left sides served as controls in both groups. In group A, "figure-of-8" suture, modified Kessler suture and Bunnell suture were used for the 2nd to 4th paws respectively, while in group B, Kleinert suture, Tsuge suture and Ikuta suture were used. On the day 0, 3, 7, 14, 21, 28, 42 after operation, 10 animals were sacrificed and the flexor tendons of both sides were harvested for strength test. The results showed that the initial strength of the repaired tendons and the strength after 6 weeks following tendon cut were far below those of intact tendons, irrespective of suture techniques used. With the 6 techniques, the P(max) of tendons repaired by Tsuge suture was increased continually, reaching the highest value on the 42nd day. The P(max) of tendons sutured by the modified Kessler suture was slightly lower than that by Tsuge suture, but it was increased steadily in healing. The tendons repaired by figure-of-8 suture yielded the lowest P(max). It was concluded that Tsuge suture and modified Kessler suture were the best techniques for tendon repair.
Biomechanics ; Chickens ; Suture Techniques ; Tendon Injuries/*surgery ; Tendons/*surgery ; Tensile Strength ; Wound Healing