Acute Disease ; Adolescent ; Adult ; Bridged-Ring Compounds ; poisoning ; Cardiomyopathies ; etiology ; therapy ; Creatine Kinase ; blood ; Creatine Kinase, MB Form ; Electrocardiography ; Foodborne Diseases ; blood ; complications ; therapy ; Glutamyl Aminopeptidase ; blood ; Humans ; Isoenzymes ; blood ; Male ; Middle Aged ; Nausea ; etiology ; Seizures ; etiology ; Treatment Outcome

Objective To observe osteocyte survival and osteogenesis after nonvascularized free bone graft transplantation for canine mandible mass defect restoration. Methods An experimental canine premolar was extracted. 1 month later, the length of 3.0 cm edentulous mandible was cut off, as the same length as that nonvascularized and soft-free tissue complete ilium block was cut off and fixed into mandible defect in 40, 120 min. The survival osteocyte and osteogenesis of the nonvascularized graft were detected 4 and 8 weeks after transplantation. Results The continuity of canine mandible segmental defect of 3.0 cm length was repaired by free nonvascularized free bone graft, live osteocytes and osteogenesis were observed in non-vascularized free bone graft at off-body 40 min group in 4-8 weeks. But the nonvascularized free bone graft off-body 120 min was a dead bone, no survival osteocytes were observed, some osteoclasts were seen in the bone graft. Conclusion The length of 3.0 cm canine mandible defect can be restored by non-vascularized free bone graft; the osteocyte survival and osteogenesis are related to their off-body time before they are fixed into recipient.

Objective To evaluate the long-term therapeutic results of intersphincteric resection (ISR) in the treatment of ultra-low rectal cancer.Methods Sixty cases of ultra-low rectal cancer with the inferior border of the tumor within 5 cm to the edge of anus underwent intersphincteric resection (ISR),and the clinical data were analyzed retrospectively.There were 39 males,21 females and their average age was 55 years old (range from 30 to 77 years old).The inferior border of the tumor were from 28 to 50 mm to the edge of anus,averaging 42 mm.Results Sixty patients underwent intersphincteric resection successfully with 3 cases developing anastomotic leakage and 2 cases anastomotic stenosis postoperatively.After a median follow-up period of 49 months (range from 18 to 90 months),local and distant recurrence were observed in 6 and 4 patients respectively.Five-year overall survival rate and disease-free survival rate were 88.3％ and 83.3％ respectively.The mean stool frequency were (3.8 ± 1.3) times in each day based on data from 53 patients,and the stool control function of 73.6％ of all patients was preserved satisfactorily according to Kirwan classification.Conclusions This study indicated that intersphincteric resection might be a candidate technique in the treatment of early stage ultra-low rectal cancer restricted within rectal wall and could achieve satisfactory long-term results in both oncologic and functional respects.

Objective To evaluate the long-term functional outcome after ileal pouch anal anastomosis with modified double-stapled technique.Methods From January 2002 to March 2011,forty-five patients underwent ileal pouch anal anastomosis with modified double-stapled technique.The clinical data of these patients were reviewed.The postoperative anal function was assessed by Kirwan classification and Oresland pouch-specific function score.Results During the median follow-up of 65 months,2 patients with malignant adenomatous polyps died,2 patients were diagnosed dysplasia by biopsy,4 patients developed mild to moderate anastomotic narrowing,1 patient developed persistent anastomotic stricture needing surgical intervention,16 patients developed at least 1 episode of pouchitis.There was no incontinence in these patients,and the median functional Oresland score was 6,3 and 2 after 1 year,2.5 years and 5 years respectively.Conclusion The functional results of ileal pouch anal anastomosis with modified double-stapled technique are promising,with no incontinence in our patients.

Objective To compare the application,safety and theraputic effect of local resection of early rectal tumours by transanal endoscopic microsurgery(TEM) and the conventional transanal excision(TAE).Methods The data of seventy-six patients who were treated by conventional transanal excision from January 2003 to July 2006 and fifty-three patients who were treated by transanal endoscopic microsurgery from September 2006 to February 2010 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were reviewed.Results Age,sex,tumour size,blood loss,postoperative hospital stay were similar in the two groups(P＞0.05).The median distance from the anal verge was significantly higher in the TEM group ( TEM/TAE =7.0/5.0 cm,P ＜ 0.01 ).The operation time was significantly longer in the TEM group (TEM/TAE =70.00/30.00 min,P ＜ 0.01 ).There was no operation-related mortality in both groups (P ＞ 0.05 ).Two patients in the TEM group developed postoperative haemorrhage,and one patient developed pulmonary infection and retention of urine respectively.There were two secondary haemorrhage cases in the TAE group.On median follow-up of 30 months,there was 7.8％ recurrence rate in the TEM group,compared with 23.2％ the in TAE group.Conclusions Transanal endoscopic microsurgery is a safe and effective mininally invasive surgical technique for the treatment of early rectal neoplasm.It has broader indication,and better theraputic effect than the conventional transanal excision.

A 38-year-old woman presented with a 20-year history of yellow papules and band-like atrophy on the right neck. The lesions developed slowly and were asymptomatic. There was no history of long-term sun exposure or family history of similar diseases. Skin examination revealed multiple irregularly sized yellow papules and plaques on the right anterior neck following cleavage lines, multiple pin cap-sized perifollicular papules on the posterior right neck. Well-defined band-like atrophic patches with fine wrinkling were observed in the whole right neck, giving an aged appearance. The skin of the left neck was nearly normal. Pathological examination of biopsy specimens from the yellow papules showed a normal epidermis, scant lymphohistiocytic and melanophage infiltrates around the vessels in the superficial dermis without solar degradation. The collagen bundles in the mid dermis were slightly thickened and arranged tightly in parallel to the skin surface with the absence of inflammatory infiltrate. Verhoeff-van Giesen's staining confirmed a nearly complete absence of elastic fibers in the mid dermis as well as obvious swelling and breakage of resident scant elastic fibers. Von Kossa's staining was negative. Based on the above findings, the diagnosis was made as unilateral mid-dermal elastolysis.

Objective To elucidate the evaluation of therapeutic effects and surgical treatments of 45 cases of inflammatory bowel disease. Methods Clinical data of 45 cases with inflammatory bowel disease by surgical treatment in recent 6 years were retrospectively analyzed. Results Patients received emergency operation in 16 cases, Crohn' s disease in 9 cases, Ulcerative Colitis( UC) in 7 cases. Among 13 cases of Crohn' s disease, partial enterectomy occured in 6 cases, partial enterectomy and colectomy and anastomosis in 1 patient because of internal fistula, repair of ileal perforation in 1 case, laparoscopic ileocolic resection in 5 cases. Among 32 cases of UC, 25 cases underwent ileal pouch-anal anastomosis operation, 3 cases underwent ileostomy with total colectomy, and 4 cases only underwent ileostomy. Twenty- seven cases were cured by operation, 14 cases were improved and 4 cases died. Conclusion It is the key point to achieve successful operation that the corresponding operative modes for varied manifestations of inflammatory bowel disease should be adopted.

OBJECTIVETo investigate the regulation of Cha Gan Beng Ga on the activity of biomarker PGC-1α in vivo and in vitro, and lay the foundation for studying the efficacy result of Cha Gan Beng Ga on xenograft tumor model and extracting active constituents.

METHOD(1) The coarse powder of Cha Gan Beng Ga was extracted with 70% ethanol solution through heating and refluxing, and finally was used to freeze dry powder. (2) 50 mg x kg(-1) of freeze-dried power was orally administrated to KM and C57BL/6J mice once daily, lasting for 5 consecutive days; different concentrations of extracted materials was given to non-small cell lung cells A549. (3) The expression level of PGC-1α mRNA was quantitatively determined in lung tissue of mice and non-small cell lung cells A549.

RESULTThe expression levels of PGC-1α in lung tissue of different mice strains had an increasing tendency. Furthermore, the expression levels of PGC-1α in non-small cell lung cells A549 also had an increasing tendency, showing dose and time-dependent relationships.

CONCLUSIONMongolian Medicine Cha Gan Beng Ga could induce the over-expression of PGC-1α mRNA in lung tissue of mice and in non-small cell lung cells A549. The present results will lay foundation for studying the efficacy result of antitumor and active constitutes in future.

Aconitum ; chemistry ; Animals ; Biomarkers, Tumor ; genetics ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Lung ; drug effects ; metabolism ; Lung Neoplasms ; genetics ; pathology ; Male ; Medicine, Mongolian Traditional ; Mice, Inbred C57BL ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Plant Extracts ; pharmacology ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors ; Transcription Factors ; genetics

BACKGROUND:Traditionally, forced expiratory volume in one second (FEV1) was used to evaluate exercise response of patients with asthma; however, patients obviously had panting after exercise, so FEV1 was affected commonly. Impulse oscillometry (IOS) is a new technique for measuring respiratory impedance that do not require maximal inspiration and forced expiration.OBJECTIVE: To study airway resistance with IOS before and after exercise in healthy and asthmatic patients and investigate the significance of exercise excitation and IOS assessment.DESIGN: Synchronically non-randomized case contrast study.SETTING: Department of Respiratory Medicine, East Hospital Affiliated to Tongji University.PARTICIPANTS: A total of 14 male patients with bronchial asthma who were regarded as the asthmatic group were selected from Department of Respiratory Medicine of Shanghai East Hospital from January to October 2006. They were in a clinical stationary phase. Another 14 male healthy subjects were selected as the control group and ages of all subjects ranged from 29 to 50 years. All subjects provided the confirmed consent.METHODS: IOS was used to measure basic value of respiratory resistance, and then subjects underwent exercise challenge. Nose of subjects was clipped breathing through mouth. Within 3-4 minutes, heart rate was increased to 90% and maintained for 6 minutes during challenge. Respiratory resistance was repeatedly measured at 1, 5, 10, 15 and 20 minutes after exercise, including airway hyperresponse (AHR), total respiratory resistance, central resistance, peripheral resistance and resonance frequency at 5, 20 and 35 Hz of pulse frequency, elasrtic resistance and inertia resistance (X5 and X35) at 5 and 10 Hz of pulse frequency. In addition, difference of AHR at 5 and 35 Hz was calculated, and change ratios of both Rcentral and Rperipheral were calculated as (highest value after exercise-baseline value)/baseline value × 100%.MAIN OUTCOME MEASURES: Basic value of respiratory resistance by using IOS and exercise challenge test.RESULTS: All 14 patients with bronchial asthma and 14 healthy subjects were involved in the final analysis. Peripheral resistance (Rperiphera) was significantly higher than central resistance (Rcentral) in asthmatic patients (P ＜ 0.01). The maximal increase of respiratory impedance occurred from 5 minutes to 10 minutes after exercise in asthmatics. Resonance frequency (Fres) of asthmatics before and after exercise was significantly increased than that of controls (P ＜ 0.01).Change ratios of Fres from asthmatics were higher than that from control group (P ＜ 0.01). After challenge, R5, R5-R20,Zrespir and X5 from asthmatics changed significantly than that from controls (P ＜ 0.01). The increment change value of After exercise Zrespir increased significantly, because obstruction of small bronchi during expiration and impedance increased abruptly. Air trapping was expressed in VT-Zrespir graph in 57.1% patients. There was no difference in the VT-Zrespir graph of controls before and after exercise.CONCLUSION: The main site of airflow obstruction was in small airways in asthmatics after exercise challenge. The general acceptance of IOS method was good among the asthmatic patients. The airway response of exercise challenge may be assessed more accurately with IOS that do not require a maximal inspiration and forced expiration.

Objective To investigate the risk factors and clinical characteristics of deep venous thromboembolism (DVT) of the lower extremities in Chinese people. Methods The clinical manifestations and risk factors in 2742 DVT patients diagnosed by phlebography were retrospectively studied. Results DVT made up 22.39% of all the venous diseases of the lower extremity. The most common clinical presentations of DVT were swelling and pain (92. 34% ), varicose vein ( 32. 57% ), pigmentation (24. 95% ) and ulceration( 18.45% ). The left lower extremity was more frequently involved. The whole limb type was 60. 09%, 80. 23% DVT patients had identified risk factors including age over 40 years old (76. 29% ), history of major surgery ( 12. 18% ) and severe trauma ( 8.42% ), pregnancy and the puerperium ( 4. 87% ). The history of general surgery ( 26. 05% ), vascular surgery ( 23. 35% ), gynaecoiogy and obstetrics (20. 96% ), orthopaedics ( 16. 47% ) and urinary surgery (7.49%) was among the most common surgery. Primary hypercoagulable syndrome was identified in 0. 22% DVT patients. Conclusion DVT makes up 22. 39% of the disease of veins of the lower extremity. The most common clinical presentations of DVT were swelling and pain. The most common risk factors were age over 40 years, major surgery, severe trauma. Primary hypercoagulable syndrome is a heritage risk factor for DVT pathogenesis.