BACKGROUND: Endoscopic transnasal lacrimal duct reconstruction by grafting of autogenous tissue is a novel method for treatment of severe lacrimal duct obstruction and it needs detailed anatomical data for surgery.OBJECTIVE: To study the applied microsurgical anatomy of lacrimal duct and to provide anatomical evidence for endoscopic transnasal lacrimal duct reconstruction by grafting of autoganous tissue.DESIGN, TIME AND SETTING: This study was performed at the laboratory of the Department of Ophthalmology, Armed Police General Hospital from July 2006 to June 2007.MATERIALS: Twenty 10% formaldehyde-treated adult cadaveric heads, 14 males and 6 females, comprising 40 lacrimal ducts were included in this study.METHODS: The cadaveric heads were split on the level of the line between the superior border of the superciliary arch and the site 10 mm higher than occipital tuberosity. After removal of brain tissue,the heads were decalcified for approximate 1 week with 10%nitric acid. This promised non-alteration of morphological structure and facilitation for surgical cutting. Following dissection of facial cranium in the median sagittal plane, the nasal septum was excised to expose the lateral wall of the nasal cavity.MAIN OUTCOME MEASURES: The anteroposterior diameter and depth of lacrimal fossa; at middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section area of nasolacrimal canal upper opening, middle part, and lower opening; horizontal distance, 30° oblique distance, and 45°oblique distance from lacrimal caruncie to nasal cavity; distance from lacrimal caruncle to nasolacrimal canal upper opening; and the included angle between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane.RESULTS: The length, anteroposterior diameter, and depth of lacrimal fossa were (17.85±1.72) mm, (6.74+1.28) mm, and (3.09+0.78) mm, respectively. At middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest,perpendicular bisector, and posterior lacrimal crest was (4.03±0.89) mm, (0.61±0.36) mm, and (0.63±0.24) mm, respectively.Anterior lacrimal crest was significantly thicker than vertical middle line and posterior lacrimal crest (P ＞ 0.05). Horizontal distance, 30°oblique distance, and 45° oblique distance from lacrimal caruncle to nasal cavity was (17.23±0.70) mm,(14.51±1.72) mm, and (17.34±2.38) mm, accordingly, with a difference which was not significant (P ＞ 0.05). The distance from lacrimal caruncle to lateral wall middle point of nasolacrimal duct superior opening was (11.86±1.84) mm, and the included angle between lacrimal caruncle-lateral wall middle point of nasolacrimal duct superior opening line and Aeby's plane averaged (49.9±1.8)°.CONCLUSION: The distances from lacrimal caruncle to nasal cavity and lacrimal sac and the included angles between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane provide guidance significance for selection of bony opening position on the lateral wall of nasal cavity and determinations of tunnel oblique angle and autogenous tissue length. Creation of bony tunnel should start from the middle or posterior middle part of lacrimal fossa and then extend towards anterior inferior region with an optimal downward oblique angle of 45°. The length of autogenous tissue used for lacrimal duct reconstruction should exceed 21.22 mm.

Objective To explore the effectiveness of different peak negative pressure ultrasound irradiated microbubble destruction on the control of rat blood brain barrier permeability.Methods Thirty healthy SD rats were divided into 5 groups according to different ultrasound pressure level (62 kPa,86 kPa, 1 81 kPa,324 kPa,708 kPa).After intravenous injection of microbubble,the rats were underwent ultrasonic irradiation for 9 minutes,and the contralateral hemispheres were served as controls.The permeability of blood brain barrier was determined by the quantitative analysis of Evans blue and lanthanum nitrate extravasation.Results Quantitative analysis results revealed a leakage in Evans blue about(4.52 ± 0.1 1 )μg/g and (10.56±0.13)μg/g in group 1 81 kPa and 708 kPa,respectively.A wide endothelial cell gap with lanthanum nitrate trace leaked out was shown at the group of ultrasound pressure of 1 81 kPa,and erythrocytes extravasations were found when ultrasound pressure at 708 kPa.Conclusions The pressure amplitude in microbubble enhanced cavitation can effectively regulate and control blood-brain barrier opening in rats.

The applicator therapy is a unique method to treat infant diarrhea in traditional Chinese medicines and widely applied in clinical practice. Currently, many researchers have proved the rationality of the therapy based on the traditional Chinese medicine mechanism and on the data from clinical practice, but its action mechanism is uncertain at present. In this study, with the assistance of pediatric practitioners, the automated ribosomal intergenic-spacer analysis (ARISA) was adopted to study the effect of the adjuvant therapy with Dingguier umbilical paste on intestinal flora of diarrhea infants, in which Dingguier umbilical paste served as the adjuvant therapy in oral traditional Chinese medicines and fecal samples of infants with different diarrhea symptoms were collected and used as the study materials. The results showed that the adjuvant therapy had a significant effect on the shift of intestinal flora, which was associated with the decrease in the similarity difference to the normal control group and the increase in the number of operational taxonomic units (OTUs) shared with the normal control group. Additionally, adjuvant therapy with Dingguier umbilical paste also showed long action duration and increased OTUs number. These results indicated that Dingguier umbilical paste has the effect in restoring the micro-ecosystem of unbalanced intestinal bacteria. Intestinal flora may be one of major targets for the applicator therapy for the infant diarrhea, but not for the single oral traditional Chinese medicine for infant diarrhea.
Adjuvants, Pharmaceutic ; therapeutic use ; Diarrhea ; drug therapy ; microbiology ; Feces ; microbiology ; Female ; Humans ; Infant ; Intestines ; drug effects ; microbiology ; Male ; Medicine, Chinese Traditional ; methods ; Ointments ; Treatment Outcome ; Umbilicus

Objective To investigate the possible role of interstitial cell of Cajal (ICE)in the pathogenesis of diabetic gastroparesis and the protective effect of"Xiaopi prescription (消痞方)".Methods Fifty healthy male Spregue-Dawley (SD) rats were randomly divided into 5 groups (each n=10):normal, model,and 3 Xiaopi prescription groups:low,middle and high dosages.Diabetes was induced by intravenous injection of alloxan,and equal amount of normal saline was intravenously injected in the normal group.Gastric lavage method was used to administer the traditional Chinese medicine decoction of Xiaopi prescription in corresponding amount (5,10 and 20 g?kg~(-1)?d~(-1)) in respective low,middle and high dosage groups.In the normal control group and diabetic model group,only equal amount of normal saline was administered into the stomach.Gastric emptying rate was measured by method of nutritious semisolid paste;c-kit positive cells of ICC were quantitatively measured with immunohistochemistry assay and computer image analysis system;c-kit mRNA positive cells were quantitatively measured with in situ hybridization and computer image analysis system.Results①Gastric emptying rate:The rate was significantly lower in the model group than that in the normal control group (P0.05),but higher than those in the model group and the low dosage group (all P0.05).②c-kit immmunohistochemistry:c-kit positive cell presented yellow in color,and its membrane was stained yellow,this kind of cells primarily were distributed around the neural plexus in the inter-space between the circular and longitudinal muscular fibers, and around the ganglionic cells forming"sheath-like"structure.The results of numbers of c-kit positive cells in the various groups:the number of the cells in the model group was significantly lower than that in the normal group (P0.05),but the numbers in the former two dosage groups were obviously higher than those in the model group (all P0.05),being significantly lower than that in the normal group,middle and high dosage groups (all P0.05),but obviously higher than those in the model group (all P0.05),being significantly lower than that in the normal,middle and high dosage groups (all P

0.05. Conclusion The tumour chemosensitivity test in vitro gave some prediction and guidances for the clinic chemotherapy,and it could discover the drug resisting cases.The combined chemotherapy should be selected for gastric carcino- ma patients.

BACKGROUNDOne stage transanal Soave pull-through procedure (TSPP) is a recent popular operation in the treatment of Hirschsprung's disease (HD). With no visible scar and a short hospital stay, it is well accepted by surgeons and mothers. In the conventional Soave procedure, a long rectal muscular cuff left for anocolic anastomosis might increase the incidence of postoperative enterocolitis and constipation. This study presents a modified transanal Soave pull-through procedure (MTSPP) which includes an oblique mucosectomy and an oblique anastomosis with a short split muscular cuff.

METHODSA review of two groups of HD patients was made: 112 underwent conventional transanal Soave procedure from 1999 to 2001 (group 1) and 140 underwent modified transanal Soave procedure from 2002 to 2004 (group 2). A comparison was made between the two groups on operative data and postoperative complications. The data included: age at the operation, operating time, blood loss, time to feeds and hospital stay, occurrence of postoperative enterocolitis or constipation, need for anal dilatation, postoperative bowel function and perianal skin problems.

RESULTSThere was no significant difference between two groups with respect to age, gender, length of colon resected, operating time, blood loss and hospital stay. However occurrence of postoperative enterocolitis, constipation, anastomotic stricture and time needed for anal dilatation were evidently less in group 2 (MTSPP). The mean operating time in group 1 was (106 +/- 39) minutes with a range of 60 to 170 minutes; in group 2 was (101 +/- 36) minutes with a range of 66 to 190 minutes. The average length of the bowel resected in group 1 was (24 +/- 7) cm, range 15 to 58 cm; in group 2 was (26 +/- 8) cm, range 15 to 70 cm. Two patients, one in each group, required laparoscopic assistance because of long aganglionic colon. Another patient in group 2 required laparotomy because of total colonic aganglionosis. Postoperative complications in group 1 included: temporary perianal excoriation in 34 patients (26 were < 3 months of age), enterocolitis in 21, anastomotic stricture in 11, recurrent constipation in 12, cuff abscess in 1, anastomosis leak in 1, soiling in 3 and rectal prolapse in 1. In group 2 post operative complications included: transient perianal excoriation in 37 patients (30 were < 3 months of age), enterocolitis in 13, anastomotic stricture in 5, recurrent constipation in 6, anastomotic leak in 1, adhesive bowel obstruction in 1 and soiling in 4. Complete bowel continence was found in 97 children (86.6%) in group 1 and in 129 children (92.1%) in group 2 at one year followup after operation.

CONCLUSIONSModified transanal Soave pull-through procedure for HD with oblique mucosectomy and anastomosis and a short split muscular cuff is a safe and feasible operation with low incidence of postoperative complication. It is an encouraging improvement of the conventional transanal Soave pull-through procedure. MTSPP is a preferable choice in the surgery of HD.

Adolescent ; Child ; Child, Preschool ; Digestive System Surgical Procedures ; methods ; Enterocolitis ; etiology ; Female ; Hirschsprung Disease ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Minimally Invasive Surgical Procedures ; Postoperative Complications ; etiology

OBJECTIVETo investigate the effects of different anesthetic and analgesic protocols on the cellular immune function and stress hormone in patients undergoing lobectomy for esophagus cancer.

METHODSSixty ASA I or II patients undergoing lobectomy for esophagus cancer were randomly divided into two groups to receive postoperative general anesthesia and intravenous analgesia (group A, n=30) or intraoperative general anesthesia combined with thoracic epidural anesthesia with postoperative epidural analgesia (group B, n=30). The cervical venous blood samples were obtained from the patients at 30 min before anesthesia induction (T(0)), 2 h after skin incision (T(1)), and at 4 h (T(2)), 24 h (T(3)) and 48 h (T(4)) after the end of operation. The T-lymphocyte subsets (CD4(+) and CD8(+)) were analyzed by flow cytometry, serum concentrations of sIL-2R and IL-2 determined by ELISA, and the levels of growth hormone (GR), prolactin (PRL), IL-8 and cortisol (Cor) measured by radioimmunoassay. Visual analogue scale (VAS) was used for assessment of the postoperative analgesic effects.

RESULTSThe VAS scores were significantly lower in group B than in group A at T(2) and T(3) (P<0.05). The percentage of CD4(+) cells and the CD4(+)/CD8(+) ratio in the two groups began to decrease significantly at T(1) (P<0.05), reducing to the lowest level at T(2) in group B and at T(3) in group A. From T(1) to T(4), the percentage of CD4(+) in group B remained significantly higher than those in group A (P<0.05), and from T(3) to T(4), the CD4(+)/CD8(+) ratio in group B were significantly higher than those in group A (P<0.05). The IL-2 level in the two groups began to decrease significantly at T(1) (P<0.05), reaching the lowest level at T(2) in group A and at T(3) in group A. IL-2 level was significantly higher in group B than in group A from T(3) to T(4) (P<0.05). sIL-2R level in group A began to increase at T(1) and peaked at T(3), showing significant differences from the T(0) level, but the level showed no significant variations in group B compared with the T(0) level. From T(2) to T(4), sIL-2R level was significantly higher in group A than in group B (P<0.05). The levels of GH, PRL and Cor increased significantly, while IL-8 decreased in the two groups from T(1) to T(4) (P<0.05), but remained stable in group B.

CONCLUSIONGeneral anesthesia combined with thoracic epidural anesthesia may reduce the perioperative stress reaction and adverse effect on cellular immune function in patients undergoing lobectomy for esophagus cancer.

Adult ; Aged ; Analgesia, Epidural ; methods ; Anesthesia, Epidural ; methods ; Anesthesia, Intravenous ; methods ; Esophageal Neoplasms ; immunology ; surgery ; Female ; Humans ; Immunity, Cellular ; drug effects ; Male ; Middle Aged ; Pain, Postoperative ; drug therapy ; Postoperative Period ; Stress, Physiological ; drug effects ; T-Lymphocytes ; immunology

OBJECTIVETo observe the effect of Yougui Formula Granule (YFG) on ovarian granulosa cells gene expression profiles in in vitro fertilization-embryo transfer (IVF-ET) patients of Shen yang deficiency syndrome (SYDS) from the viewpoint of genomics.

METHODSTotally 72 infertility patients undergoing IVF-ET were randomly assigned to the treatment group and the control group according to random digit table, 36 in each group. Patients in the treatment group took YFG combined gonadotropin (Gn), while those in the control group took placebos combined Gn. All medication lasted for 3 menstrual cycles before IVF. With high-throughput gene sequencing technology, gene expression profiles of ovarian granulosa cells in the two groups were analyzed to explore the difference by gene ontology (GO) enrichment analysis and kyoto encyclopedia of genes and genomes (KEGG) pathway analysis.

RESULTSOvarian granulosa cell gene expression profiles from the follicular fluid showed, when compared with the control group, 391 differential genes were found in the syndrome-control group, 153 down-regulated and 238 upregulated. Enrichment of differentially expressed cellular location and molecular function of genes involved cell proliferation and apoptosis associated cyclin, protein ubiquitination, construction of microtubules and microfilament, mitochondrial function and energy-related factors, regulatory factors for hormone synthesis. Participated pathways involved energy metabolism pathway and transforming growth factor-β (TGF-β) signaling pathway.

CONCLUSIONSThere existed significant difference in gene expression profiles of ovarian granulosa cells between the treatment group and the control group. Differentially expressed genes involved in biological processes correlates with Shen yang deficiency induced proliferation of germ cells, confused apoptosis, and hindered process during which mitochondria produced energy.

Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Embryo Transfer ; Female ; Fertilization in Vitro ; Follicular Fluid ; Gene Expression ; drug effects ; Gonadotropins ; Granulosa Cells ; Humans ; Syndrome ; Transcriptome ; Yang Deficiency

OBJECTIVETo explore the relationship between nitrite levels in the exhaled breath condensates (EBC) and the severity of asthma.

METHODSSixty asthmatic patients with exacerbation (including 23 with mild, 21 with moderate, and 16 with severe asthma) and 23 healthy nonsmokers were enrolled in this study. The lung function tests were performed and nitrite levels measured in the EBC by the spectrophotometry and nitric oxide assay kit in these subjects. The percentage of eosinophils was also measured in induced sputum by Wright staining.

RESULTSThe concentrations of nitrites in the EBC and the percentage of eosinophils in induced sputum in the asthmatic patients were significantly higher than those of the healthy subjects (P<0.01), and showed positive correlations to the disease severity. A significant positive correlation was found between nitrites in the EBC and percentage of eosinophils in induced sputum (r=0.706, P<0.01). The concentration of exhaled nitrites was inversely correlated to MEF50% (r=-0.806, P<0.01) and FEV1% (r=-0.724, P<0.01).

CONCLUSIONNitrite level in the EBC may serve as useful indicators for estimating the severity of asthma.

Adult ; Asthma ; metabolism ; Breath Tests ; methods ; Case-Control Studies ; Exhalation ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Nitrites ; analysis ; Respiratory Function Tests ; Severity of Illness Index ; Young Adult

OBJECTIVETo study the effect of the Chinese compound prescription Ginkgo biloba Pingchan Recipe (GBPR) on experimental Parkinson disease (PD) in mice and explore the possible mechanism.

METHODSMale C57/BL6J mice were divided into normal control, PD model and treatment groups. PD model was established by intraperitoneal injection with 1-methl-4-phenyl-1,2,3,6-tetrahydropyridin (MPTP) in the mice, and in the treatment group, GBPR was administered intragastrically after the injection. The mice were sacrificed 14 and 28 days later, and using in situ hybridization with Digoxin-labeled nNOS cDNA oligonucleotide probe, neuronal nitric oxide synthase (nNOS) mRNA was detected in the striatum and substantia nigra in the brain of mice.

RESULTSnNOS mRNA expression was detected in the striatum and substantia nigra of the PD model mice, and GBPR treatment significantly reduced its expressions.

CONCLUSIONGBPR has obvious inhibitory effect against the neurotoxicity of NO probably by producing an anti-oxiditive effect through decreasing nNOS synthesis in the brain.

Animals ; Brain ; drug effects ; enzymology ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Regulation, Enzymologic ; drug effects ; Ginkgo biloba ; chemistry ; Male ; Mice ; Mice, Inbred C57BL ; Neostriatum ; drug effects ; metabolism ; Nitric Oxide Synthase Type I ; genetics ; Parkinson Disease ; enzymology ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Substantia Nigra ; drug effects ; metabolism