OBJECTIVETo study the effects of sacral nerve root electrostimulation (SNS) on the colon function and its mechanisms in rats with spinal cord injury (SCI).

METHODSOne hundred and four Wistar rats were divided into three groups: A, B and C. A group ( n = 24) was divided into three subgroups (n = 8) for studying the bioelectricity: Normal group (NG), SCI group (SCI) and SCI group with SNS(SNS); B group( n = 24) was divided into three subgroups( n = 8) for studying the colon motility: NG, SCI and SNS. C group( n = 56) were divided into three groups for studying the change of morphology and neurotransmitters(SP and VIP): NG (n = 8), SCI (n = 24), and SNS (n = 24) . In SCI and SNS, included of three subgroups: 24, 48, 72 h after spinal cord injury (n = 8).

RESULTSIn SCI group, the activity of bioelectricity in proximal and distal colon was reduced; the colon motility was lessened, and colon mucosa appeared different degree of damage; cell-cell connections between intestinal epithelial cells were destroyed. The expressions of substance P(SP) and vasoactive intestinal peptide (VIP) in colon were decreased obviously. SNS was found to activate the bioelectricity, promote the colon motility, improve the intestinal mucosal, and increase the expressions of SP and VIP. Conclusion: SNS can activate the peristalsis, rehabilitate the motility of denervated colon, protection of the intestinal mechanical barrier between intestinal epithelial cells and tight junction, rebuild the colon function through activating the bioelectricity and increase the expressions of SP and VIP.

Animals ; Colon ; physiopathology ; Electric Stimulation Therapy ; Epithelial Cells ; drug effects ; Intestinal Mucosa ; drug effects ; Lumbosacral Region ; innervation ; Neurotransmitter Agents ; metabolism ; Rats ; Rats, Wistar ; Spinal Cord Injuries ; therapy ; Substance P ; metabolism ; Vasoactive Intestinal Peptide ; metabolism

OBJECTIVETo observe the ultrastructural change of the route of gut bacterial translocation in a rat with spinal cord injury (SCI).

METHODSForty Wistar rats were divided into the following groups: control group and 3 SCI groups (10 in each group). The rats in the SCI groups were established SCI model at 24 h, 48 h, and 72 h after SCI. Small intestine mucous membrane tissue was identified and assayed by transmission electron microscope, scanning electron microscope and immunofluorescence microscopy.

RESULTSSmall intestine mucous membrane tissue in control group was not damaged significantly, but those in SCI groups were damaged significantly. Proliferation bacteria in gut lumen attached on microvilli. The extracellular bacteria torn the intestinal barrier and perforated into the small intestinal mucosal epithelial cell. The bacteria and a lot of particles of the seriously damaged region penetrated into the lymphatic system and the blood system directly. Some bacteria were internalized into the goblet cell through the apical granule. Some bacteria and particles perforated into the submucosa of the M cell running the long axis of M cells through the tight junctions. In the microcirculation of mucosa, the bacteria that had already broken through the microvilli into blood circulation swim accompanying with erythrocytes.

CONCLUSIONThe routes of bacterial translocation interact and format a vicious circle. At early step, the transcellular pathway of bacterial translocation is major. Following with the destroyed small intestine mucous, the routes of bacterial translocation through the lymphatic system and the blood system become direct pathways. The goblet cell-dendritic cell and M cell pathway also play an important role in the bacterial translocation.

Animals ; Bacteria ; Bacterial Translocation ; Epithelial Cells ; microbiology ; Goblet Cells ; microbiology ; Intestinal Mucosa ; microbiology ; pathology ; ultrastructure ; Intestine, Small ; microbiology ; pathology ; ultrastructure ; Microvilli ; microbiology ; Rats ; Rats, Wistar ; Spinal Cord Injuries ; microbiology

Objective:To evaluate the clinical efficacy of treatment of sudden deafness using hyperbaric oxygenation, and to provide guidance for its treatment. Methods:The studies about sudden deafness treated with hyperbaric oxygenation combined with drug were retrieved in Cochrane Library, PubMed , MEDLINE, Wanfang Database and CNKI up to July 2016.RavMan 5.3 provided by Cochrane was used for Meta-analysis.Results:Thirty-nine studies which were randomized controlled trials (RCTs)were included, a total of 4 599 cases,of which 2 418 cases received hyperbaric oxygenation therapy combined with drug treatment as treatment group and 2 181 cases received drug treatment alone as control group.A total of 36 studies about the comparison of clinical efficacy between treatment group and control group were included in the Meta-analysis, the result showed that treatment group had a significant clinical efficacy than control group(RR:1.26,95%CI:1.22-1.30,P<0.0001).A total of 6 studies about the improvement of the pure tone average(PTA)in the two groups were included in the Meta-analysis, the PTA gain was significant better in hyperbaric oxygenation group(WMD:11.8,95%CI:4.77-18.83,P<0.000 1).A total of 11 studies about the stage of using hyperbaric oxygenation therapy were included in the Meta-analysis, the result suggested that the early use of hyperbaric oxygenation therapy had better effect than the late use of hyperbaric oxygenation (RR:1.42,95%CI:1.31-1.53,P<0.000 01).Conclusion:The clinical efficacy of hyperbaric oxygenation combined with drug therapy is better than drug therapy alone, the PTA gain is significantly improved and the introduction of hyperbaric oxygenation therapy at the earlier stage shows better results.

Since cardiopulmonary resuscitation(CPR)guidelines was constituted in 1974,it was adopted many times.The American Heart Association,in collaboration with the International Liaison Committee on Resuscitation(ILCOR),adopted new CPR science guidelines in January,2005.This article gives a short introduction of CPR,and showes the progress of several editions.

OBJECTIVE To investigate the time and dose relation of new urine bio markers in rat model of acute kidney injury induced by genta mycin (GM)to search for more sensitive,noninvasive and specific markers than traditional approaches to monitor nephrotoxicity.METHODS SD Rats were im treated with GM5,20,80 mg·kg -1 or saline once daily.Rats were randomly divided into 20 subgroups:treated for 1 ,3,7,14 d and 14 d followed with 28 d recovery period.Ten rats per group (5 rats per sex)were scarified at 24 h after the last dosing or the end of recovery period.Blood sa mples were col-lected for blood urea nitrogen (BUN)and creatinine(CRE)analysis.Urine was collected at each nec-ropsy for urine protein by dry che mistry method,for kidney injury molecule-1 (KIM-1 )analysis by ELISA, and for β2-microglobulin (β2-MG)analysis by ELISA.Kidneys were obtained for histological exa mination after HE stains.RESULTS Positive protein(3 +)was noted for several fe male animals treated for 7 or 14 d at 80 mg·kg -1 and the tendency of recovery were noted at the end of recovery period.Co mpared with those in saline control group treated for 7 d,the seru m BUN and CRE levels for fe males and the CRE level for males were significantly increased at 80 mg·kg -1 (P <0.05),and the BUN level showed the tendency of increase for males at 80 mg·kg -1 (P >0.05).When treated for 14 d,the seru m BUN and CRE levels for fe males and males at 80 mg·kg -1 and the seru m CRE level for fe males at 20 mg·kg -1 were significantly increased when compared with those in saline control group(P <0.05). The seru m BUN and CRE recovered to base line for all animals treated for 14 d followed by a 28 d recov-ery period.Histopathological observation of kidney tissues indicated that focal tubule dilatation was noted for animals treated for 3 d at 20 and 80 mg·kg -1 ,infla mmatory cell infiltration and focal tubule dilatation were noted at 20 mg·kg -1 and focal renal tubular epithelial cell degeneration,infla mmatory cell infiltra-tion,focal casts (lightly)were noted at 80 mg·kg -1 for animals treated for 7 or 14 d.For animals treated for 14 d followed by a 28 d recovery period,only basophilic tubules and renal casts were noted at 80 mg·kg -1 .New urine bio markers determination indicated that KIM-1 level was significantly increased at 20 and 80 mg·kg -1 for animals treated for 3,7 or 14 d when compared with that in saline control group (P<0.05).For animals treated for 14 d followed by a 28 d recovery period,the KIM-1 level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and males at 20 mg·kg -1 (P <0.05 ),but there was evidence for reversal.The β2-MG level was significantly increased at 80 mg·kg -1 for animals treated for 3 d(P<0.05),at 20 or 80 mg·kg -1 for animals treated for 7 or 14 d(P<0.05 or P<0.01 ),when compared with that in the saline control group.For animals treated for 14 d followed by a 28 d recovery period,the β2-MG level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and fe males at 20 mg·kg -1 (P <0.05),but there was also evidence for reversal.CONCLUSION Urine KIM-1 and β2-GM are more sensitive and specific markers for early diagnosis of kidney injury induced by GM when compared with the traditional approaches to monitor nephrotoxicity.

Objective To investigate the relationship between the color doppler sonography and contrast-enhanced echocardiography(CEE)in assessment of intrapulmonary shunting in patients with hepatopulmonary syndrome and HIF-1α,iNOS and portal hemodynamic.Methoods To examine the portal vein diameter and blood flow velocity by color Dop-pler,and intrapulmonary shunting by contrast-enhanced echocardiography(CEE).The expressions of HIF-1α and iNOS in serum were determined by ELISA in the normal,hepatocirrhosis amalgamating HPS and unamalgamating HPS separately.Comparison of HIF-1α and iNOS in plasma was carried out and relationship between the portal hemodynamic and the intra-pulmonary shunting was examined in three groups.Results The levels of HIF-1α and iNOS in hepatocirrhosis amalgamating HPS were higher than those in unamalgamating HPS,the diameter of portal vein dilated and the velocity of portal vein dropped,there was correlation(P＜0.05).There were positive correlation with intrapulmonary shunting.Conclusion The color doppler sonography and contrast-enhanced echocardiography (CEE)which reflected HIF-1α,iNOS and the hemodynamic played an role in developing of HPS,and was available to early examine change of intra-pulmonary vessel.

BACKGROUND:Synthetic patch as an important substitute to pelvic tissue can replace damaged pelvic fascia tissue, and has been widely used in the pelvic floor reconstruction. OBJECTIVE:To observe the efficacy and complications of pelvic floor reconstruction with mesh, and to explore its safety and effectiveness. METHODS: Forty-five pelvic organ prolapse female patients were divided into two groups according to patient’s wilingness: experimental group, pelvic floor reconstruction with mesh (n=25); control group, transvaginal hysterectomy combined with vaginal wal repair (n=20). Perioperative conditions were recorded, and uterine prolapse staging, complications, pelvic floor function, pelvic discomfort, as wel as an objective cure rate were evaluated in the two groups during the folow-up. RESULTS AND CONCLUSION:Compared with the control group, the experimental group was characterized as shorter operative time, less amount of bleeding, milder infections, and faster recovery (AlP < 0.05). At 6 months of folow-up, the score on uterine prolapse staging was higher in the experimental group than the control group; at 12 months, the scores on pelvic floor function and pelvic discomfort as wel as the incidence of complications were significantly lower in the experimental group (P < 0.05), but the objective cure rate was higher compared with the control group (P < 0.05). These findings suggest that pelvic floor reconstruction with mesh for pelvic organ prolapsed can reduce the operative time and blood loss and promote postoperative recovery. Meanwhile, it can significantly improve pelvic floor function, pelvic discomfort, postoperative complications, the rate of exposure, and the objective cure rate, which is safe and effective during the short-term folow-up.

Objective To investigate the effects of different therapeutic strategies on recurrence of postoperative Crohn's disease (CD) patients.Methods From September 2009 to September 2014,85 CD patients with intestinal resection were enrolled.The clinical features and maintenance therapeutic medication were retrospectively analyzed.The patients were divided into non-treatment group (induding continuously or cumulatively taking medicine less than three months),5-aminosalicylic acid (5-ASA) group and immunosuppressant agents group (including azathioprine,methotrexate and thalidomide).Kaplan-Meier method was performed to compare the recurrence rate in postoperative CD with different therapeutic medication and the risk factors of postoperative recurrence were also analyzed.Results Among 85 CD patients,there were 32,21 and 32 patients in non-treatment group,5-ASA group and immunosuppressive agents group,respectively.After surgery,the one year accumulated clinical recurrence rate of immunosuppressant agents group was 12.5％ (4/32),which was significantly lower than that of non-treatment group (56.3％,18/32) and 5-ASA group (38.1％,8/21),and the differences were statistically significant (x2 =12.250,P＜0.01;x2 =4.102,P =0.043).After surgery,the two years accumulated clinical recurrence rate of immunosuppressant agents group was 12.9 ％ (4/31),which was significantly lower than that of non-treatment group (75.9％,22/29) and 5-ASA group (47.6％,10/21),and the differences were statisitcally significant (x2 =17.840,P＜0.01;x2 =6.597,P=0.010).After operation,the one year accumulated endoscopic recurrences rates of non-treatment group,5-ASA group and immunosuppressant agents group were 39.1％ (9/23),5/16 and 34.6％ (9/26),respectively;while the two year accumulated endoscopic recurrence rates were 59.1％ (13/22),6/16 and 44.0％ (11/25),respectively.However,there was no statistically significant difference among the groups (all P＞0.05).Penetrating lesion was an risk factor of postoperative clinical recurrence in CD patients (x2 =4.963,P=0.026,oddsratio (OR) =2.221,95 ％ confidence interval (CI) 1.121 to 5.775).Conclusions Immunosuppressive agents rather than 5-ASA have remarkable effects in preventing postoperative clinical recurrence in CD patients.Postoperative clinical recurrence is more likely to happen in patients with penetrating lesions.