Objective To investigate the pathological changes of brain tissues from contused and contralateral non-contused sides and their significance.Methods A total of 100 healthy adult Wistar rats were assigned to brain contusion group and sham operation group according to the random number table.Ten rats in each group were sacrificed at 1,3,6,12,and 24 hours respectively.Brain samples were collected to perform pathophysiological analysis of brain tissues and test blood brain barrier (BBB)permeability by semiquantitative immunohistochemical staining of IgG.Results There was no damage to the bilateral brain tissues in sham operation group and IgG stain was negative.In brain contusion group,angioedema characterized by the breakdown of BBB was seen in the contused side at 1 hour followed by cellular edema at 3 hours,with aggravation of both over time.Moreover,tissue necrosis,inflammatory cell infiltration,and microglia proliferation emerged at 12 hours.Besides,IgG-positive staining was seen at 1 hour,was strongest at 6 hours,and remained a high level at 24 hours.With respect to the non-injured side in brain contusion group,no pathological abnormalities and negatively stained IgG were observed at 1 hour; cellular edema and weakly positive-stained IgG were found at 3 hours; aggravated cellular edema,emergence of angioedema,and IgG strongly positive staining were noted at 6 hours;cellular edema continued aggravation,but angioedema tended to be attenuated,IgG staining weakened,and microglia proliferation were observed at 12-24 hours.Conclusion Pathological changes of brain tissues from the contused and contralateral non-contused sides are differed,which provides a basis in determining treatment choices.

Objective This study was designed to investigate the correlation between the apparent diffusion coefficient(ADC)value and pathological change of the non-injured side brain tissue of traumatic brain injury(TBI)of rat.Methods Sixty healthy adult Wist-ar rats were randomly divided into two groups:the control or TBI groups.The TBI group was divided into five sub-groups according to the different time intervals:1,3,6,12,24 h(n = 10).The animal brain of each group was scanned with MR-DWI,and the ADC value of damaged areas and contralateral non-damaged areas were measured.After that the brains were taken out at different time points after TBI.The cerebral edema and blood-brain barrier(BBB)changes in structure were examined with an optical micros-copy and transmission electron microscopy,and the IgG content in the same tissues were determined by means of immunohistochem-istry.The data was analyzed with SPSS 13.0 statistical software.Results There was no signal abnormality on MR-DWI and tissue structure in control group,and the IgG stain was negative.In the contralateral non-damaged areas of TBI group,pathological obser-vation revealed no variation at 1 h after TBI,and the IgG stain was also negative.Cellular edema was shown at 3 h and the IgG stain was slight positive.The cellular edema aggravated with time and angioedema appeared at 6 h.IgG stain was shown significantly posi-tive.At 12~24 h,cellular edema kept increasing more severe,however angioedema had a trend to mitigated along with time,IgG stain became slight and the proliferation of glial cells could observed.Compared with control group,the ADC values of the contralat-eral non-damaged areas in each group showed no significant difference (P >0.05).However,in the damaged areas of each group, angioedema appeared at 1 h and gradually aggravated,cellular edema occurred at 3 h,Both of them were aggravated with time. ADC values increased at 1 h,and then decreased until 6 h,then followed a climbing up to 24 h,showed as a “V”-shaped.Con-clusion When contused on one side brain,the contralateral non-inj ured side tissue also has pathological changes that occurs later than those on the inj ured side.Cellular edema of the tissues ap-peares first and is followed by angioedema,which lessens over time..There is no significant difference of ADC values between con-tralateral side of TBI groups and control group(P >0.05),which reveals a “pseudo-normal”phenomenon.

Objective To investigate the expression of aquaporins 4 (AQP4) and histopathological changes in early phase of traumatic brain edema and the correlation between AQP4 expression and structural damage to blood-brain barrier (BBB).Methods A total of 120 healthy adult Wistar rats were divided into sham operation group and brain trauma group (which was subgrouped at hours 1,3,6,12 and 24 postinjury) according to random number table,with 20 rats per group.At each time point,brain water content was measured; brain edema and BBB structural changes were observed pathologically;IgG and AQP4 expressions in traumatic brain tissues were detected with immunohistochemical method and Western-blotting.Results In sham operation group,negatively stained IgG was observed and there were no abnormalities in brain tissue structure,brain water content as well as AQP4 expression.In brain trauma group,cerebral water content presented notable increase at 6 hours postinjury and peaked at 24hours; IgG expression showed significant increase at 1 hour postinjury,peaked at 6 hours postinjury and remained a high level at 24 hours.Pathologic observation revealed damage to BBB,blood red cells leaking out of the blood vessels,and tissue gap widening at 1 hour postinjury,which manifested as vasogenic brain edema.Further,those phenomena were gradually aggravated over time and became obvious at 6 hours postinjury.Intracellular edema occurred at 3 hours postinjury,with the presence of increased glial cell body,cytoplasm light staining or vacuolar degeneration,as well as mitochondria swelling and was also aggravated with time,particularly at 6 hours postinjury.Except that the previously mentioned two forms of edema coexisted at 12 hours postinjury,tissue necrosis,inflammatory cell infiltration and microglia proliferation were emerged and aggravated at 24 hours postinjury.AQP4 level decreased at 1 hour,minimized at 6 hours and regained at 12 hours,showing a V-shape curve.Conclusions Vasogenic edema characterized by BBB disruption is the primary histopathological change in early-phase of brain trauma,followed by the coexistence with intracellular edema and aggravation of the two forms of edema over time.AQP4 expression is down-regulated in the vasogenic edema phase but highly expressed at phase of the intracellular edema.

Animals ; Autophagy ; Biomarkers, Tumor ; metabolism ; Caveolin 1 ; deficiency ; metabolism ; Drug Delivery Systems ; Humans ; Myofibroblasts ; pathology ; Neoplasms ; metabolism ; pathology ; Prognosis ; Stromal Cells ; metabolism ; Tumor Microenvironment

OBJECTIVETo compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up.

RESULTSThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036).

CONCLUSIONBoth HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.

Aged ; Holmium ; Humans ; Laser Therapy ; adverse effects ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Middle Aged ; Penile Erection ; Prostatectomy ; adverse effects ; methods ; Prostatic Hyperplasia ; surgery ; Quality of Life ; Retrospective Studies ; Thulium ; Transurethral Resection of Prostate ; Treatment Outcome ; Urine

Forty cases of hyperlipidemia were treated by herbal moxa stick moxibustion and compared with 22 cases treated by Oenothera Oil Capsules. The results showed that LipidDecreasing Herbal Moxibustion could decrease the serum cholesterol and triglyceride and elevate high-density lipoprotein and change the ratio of TC-HDL-C/HDL-C in the patients, and its therapeutic effect was better than that of the control group treated by Oenothera Oil Capsules (P ＜ 0.01). Lipid-Decreasing Herbal Moxibustion can also improve the clinical symptoms and reduce the body weight.

Objective To summarize and analyze clinical diagnosis and surgical treatment methods of 11 cases with congenital coronary arterial fistula (CCAF). Methods The clinical data of 11 patients who were definited by ultrasonic cardiogram, CT angiography (CTA) and coronary angiography were analyzed retrospectively. Four cases were simple CCAF, 7 cases coexisted with other heart abnormalities. Six cases were given surgical closure of fistula without cardiopulmonary bypass. One of the cases adopted coronary artery under the tangent cotton-padded mattress suture, and 4 cases fistula arterial were ligatured directly. Six cases were given surgical closure of fistula under cardiopulmonary bypass. The right coronary arterial was opened in three of the cases with right coronary artery aneurysm to close fistula. The chambers of heart in the others were opened to close fistula. Results All patients received surgical treatment successfully, and no death happened during the operation. The ultrasonic cardiography showed that all patients recovered well. Follow-up was conducted on 10 patients with the time period ranging from 3 months to 5 years. There was no death and no complication. Conclusions Combined application of ultrasonic cardiogram, coronary angiography and CTA increases the accuracy rate of diagnosis greatly and offers visual bases to formulate operation plan. Surgical operation is quite effective for congenital coronary arterial fistula after definite diagnosis. Operator should try to reserve the expanded coronary arterial, strengthen the anticoagulant after opeation to prevent thrombosis.

Objective To explore the effects of nurses′ risk perceptions of occupational HIV exposure and the self-efficacy on their attitudes and behavior of self-protection in nursing care. Methods An anonymous survey was conducted in eligible nurses with self-designed questionnaire in three conveniently selected comprehensive hospitals in Wuhan. Structural equation modeling was applied in the data analysis. Results Risk perceptions exerted positive effects on the attitudes of self-protection. The standardized path coefficient was 0.45 (P=0.009). The attitudes of self-protection and the risk perceptions exerted no impact on the behavior of self-protection (P > 0.05).The impacts of the self-efficacy on the attitudes and the behavior of self-protection was positive. The standardized path coefficient was 0.15(P=0.02)and 0.53 (P<0.01), respectively. Conclusions Risk perceptions exerted positive effects on the attitudes of self-protection. But the attitudes of self-protection and the risk perceptions exerted no impact on the behavior of self-protection. Self-efficacy can improve the attitudes of self-protection and enhance the behavior of self-protection.

Objective To systematically review the effect of traditional Chinese medicine (TCM) in an animal model of lung injury induced by paraquat (PQ),and to provide a theoretical basis for future clinical trials.Methods The Wanfang,CNKI,VIP,PubMed/MEDLINE,EMBASE database (from January 1979 to September 2012) were searched.All papers concerning TCM in animal model of lung injury induced by PQ were retrieved.Study selection and data extraction were performed on the basis of Cochrane systematic review methods.Weighted mean difference (WMD) and 95％ confidence interval (95％CI) with random effects model was adopted to investigate the effect of TCM on lung injury induced by PQ.Results Eighteen papers involving 1 188 rats met our criteria.Meta-analysis showed that TCM could improve the lung coefficiency (WMD-0.07,95％ CI-0.14 to-0.01,P=0.03),reduce lung wet/dry weight ratio (WMD-1.15,95％CI-2.03 to-0.27,P=0.01),increase the serum superoxide dismutase (SOD) activity (WMD 56.08,95％CI 23.46 to 88.70,P=0.000 8),improve plasma glutathione peroxidase (GSH-Px) level (WMD 26.64,95％CI 18.95 to 34.33,P＜0.000 01),and lower serum malondialdehyde(MDA) level (WMD-0.65,95％CI-1.00 to-0.30,P=0.000 2),however there was no significant difference in the level of serum tumor necrosis factor-α (TNF-α) and hydroxyproline (HYP) level between TCM and controls (TNF-α:WMD-25.15,95％CI-54.87 to 4.57,P=0.10; HYP:WMD-0.11,95％CI-2.71 to 0.48,P=0.17).Conclusions These findings demonstrate the efficacy of TCM in animal models of lung injury induced by PQ.However taking account of heterogeneity,the efficacy should be interpreted with caution.

OBJECTIVE: To evaluate the therapeutic effect of transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine for the treatment of limb ischemia. METHODS: Twenty-three patients with limb ischemia were treated. G-CSF was used to stimulate the bone marrow. The mononuclear cells were separated from the aspirated bone marrow fluid in the stem cell studio. The cell amount was above 1x10(9). The transplantation was performed by the way of intra-muscular multi-injection. Traditional Chinese medicine for replenishing qi to activate blood was prescribed from the first day after operation. The pain, poikilothermia, ulcer or necrosis and ankle/brachial index (ABI) of the ischemic limb were evaluated before and after the treatment. RESULTS: The pain score and poikilothermia score decreased one month after the transplantation, with distinct differences as compared with the scores before the treatment (P<0.05). The ABI increased gradually after the treatment, and one month after the treatment, it was 0.15 higher than that before the treatment. CONCLUSION: Transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine can decrease the symptoms and signs of severe lower limb ischemia effectively, and improve the circulation of the ischemic area.