Objective To investigate indications,technique,prognosis and complications of anterior flap hemipelvectomy (hemipelvectomy using a quadriceps femoris muscle flap with superficial femoral artery)in the treatment of pelvic tumors.Methods From April 2009 to October 2010,10 patients with pelvic tumors underwent anterior flap hemipelvectomy in our department.There were 9 males and 1 female,aged from 30 to 62 years (average,46 years).There were 7 cases of chondrosarcoma,1 case of epithelioid sarcoma,1 case of pleomorphic liposarcoma and 1 case of spindle cell sarcoma.Results Nine patients were followed up for 12 to 30 months (average,21.5 months).Superficial skin necrosis occurred in 1 patient,while there was no wound infection.Local recurrence (33.3％) occurred in 3 patients,including 2 cases of chondrosarcoma and 1 case of epithelioid sarcoma.Three patients died at last,including 2 patients with local recurrence and 1 with pulmonary metastasis from liposarcoma.Two patients survived with pulmonary metastasis,and remaining 3 patients survived without recurrence and metastasis.Conclusion Anterior flap hemipelvectomy is indicated for:(1) patients with extensive soft tissue sarcoma in the buttock,and the tumor or reaction zone involve the subcutaneous tissue; (2) patients with recurrent pelvic tumors,and the conventional posterior flap can't be used due to contamination by the original incision; (3) patients whose posterior flap has poor blood supply due to radiotherapy or other factors.The prerequisite of the surgery is that the blood stream between external iliac artery and femoral artery is unobstructed; moreover the blood vessels are not in the tumor reaction zone.Compared with conventional posterior flap,the anterior flap hemipelvectomy is an easier procedure,which not only can easily cover surgical defect and obtain better surgical margin,but also has less complications.

Objective To evaluate the efficacy of tolterodine in preventing bladder spasm during the operation to BPH.Methods One hundred and twelve cases of BPH patients were randomized to two groups:56 cases in one group were prescribed tolterodine 4-5 d before operation and 3-4 d after operation (2 mg twice daily),another 56 cases did not take any anti-spasm drugs.The bladder spasm occurring or not,frequency and continuing time of bladder were evaluated and recorded.Results In the controlling group:the non bladder spasm in 12.5% (7/56),mild bladder spasm in 14.3% (8/56),severe bladder spasm in 73.3% (41/56),In the treatment group:non bladder spasm in 87.5% (49/ 56),mild bladder spasm in 8.9% (5/56),severe bladder spasm in 3.6% (2/56).There was signifi-cant difference between the 2 groups (P<0.001).Conclusion Tolterodine could alleviate bladder spasm around the operation to BPH.

Objective To explore the pathogenesis of ischemic preconditioning to warm ischemia reperfusion injury of hepatocytes in rats. Methods Ninety SD rats were randomly divided into three experimental groups:sham operation group (group A), warm hepatic ischemia/reperfusion group(group B and group C). Group C was given ischemic preconditioning treatment. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected 0 h, 2 h, 6 h, 12 h and 24 h after ischemia reperfusion injury. Levels of TNF-α and IL-1β were tested detected by ELISA. Levels of malondialdehyde (MDA) and superoxide dismutase (SOD) of hepatocytes were detected at the same time points. Mitochondrial membrane potential was examined to assess ischemia reperfusion injury of hepatocytes in rats using chart of intensity of JC-1 in mitochondria. Results The serum levels of ALT, TNF-α, IL-1β, and MDA were significantly higher in hepatic warm ischemia reperfusion group and ischemic preconditioning group than those in sham operation group (P<0.05). Values of prothrombin activity and cholinesterase were significantly lower in liver warm ischemia reperfusion group and ischemic preconditioning group than those of sham operation group (P<0.05). The SOD level of liver was significantly lower in warm ischemia reperfusion group and ischemic preconditioning group than that in sham operation group. The indexes were better in ischemic preconditioning group than those of warm ischemia reperfusion group (P<0.05). The mitochondrial membrane potential level of liver cells reached the lowest value 0 hours after ischemia and reperfusion, and then increased gradually within 24 hours (P<0.05). And the level of mitochondrial membrane potential of liver cells was significantly higher in ischemic preconditioning group than that in warm ischemia reperfusion group (P<0.05). Conclusion Ischemic preconditioning may play a protective role in warm ischemia-reperfusion injury in rats. Ischemic preconditioning may significantly decrease the levels of ALT, AST, TNF-α, IL-1βand MDA, and increase the SOD activity in hepatocytes. Thedamage of mitochondrial membrane potential is decreased after ischemic preconditioning, which might be the pathogenesis of ischemic preconditioning to warm ischemia reperfusion injury of hepatocytes in rats.

Objective To establish the quality standard of Alatan Wuwei Pill. Methods Chebulae Fructus and Granatii Fructus were identified by TLC. Gallic acid and ellagic acid in Gardeniae Fructus and Granatii Fructus were determined by HPLC. Results The TLC spots developed were clear. Gallic acid showed good linear relationship in the range of 0.058 72-1.056 96 mg (r=1.000 0), the average recovery was 99.15%(RSD=1.3%). Ellagic acid showed good linear relationship in the range of 0.079 64-1.194 6 mg (r=1.000 0), the average recovery was 100.02% (RSD=2.3%). Conclusion The method is simple and reproducible. It can be used to control the quality of Alatan Wuwei Pill.

China ; epidemiology ; Databases, Bibliographic ; Humans ; Lead Poisoning ; epidemiology ; Occupational Exposure ; Workplace

Objective:To explore the changes of NK and NKT cells and the expression levels of their activated, inhibitory receptors in the peripheral blood of patients with newly diagnosed rheumatoid arthritis ( RA), and to reveal the potiential role of NK and NKT cells played in the pathogenesis of RA.Methods:32 patients with new onset RA and 15 healthy controls were recruited.Activated and inhibitory NK and NKT cells in peripheral blood were quantified by flow cytometry.The frequency of spontaneous and stimulated IFN-γ+NK and NKT cells and CD107aγ+NK cells were examined.Finally,the potential relationship between the frequency of NK and NKT cells subsets and clinical indexes were analyzed.Results:The frequencies of NK cells in peripheral blood in RA patients were sig-nificantly lower than those in the controls ( P=0.026 ).The frequencies of NKG2D+, NKP46+activated NK cells and NKG2C+, NKG2D+,NKP46+activated NKT cells in RA patients were significantly higher than those in the controls (P=0.011,P=0.010,and P<0.001,P=0.032,P=0.001,respectively),whereas the frequencies of KIR2DL3+,KIR3DL1+and NKG2A+inhibitory NK cells and KIR2DL3+,NKG2A+inhibitory NKT cells in RA patients were significantly lower (P=0.002,P=0.002,P=0.014,and P=0.027,P=0.002,respectively).Moreover, the frequencies of stimulated IFN-γ+NK cells and IFN-γ+NKT cells, spontaneous and stimulated CD107 aγ+NK cells in RA patients were significantly higher than that in the controls ( P=0.037, P=0.004 and P=0.001, P=0.001, respectively).Furthermore,the frequencies of NK cells,NKG2Aγ+and KIR2DL3γ+inhibitory NK cells were correlated significantly with the values of DAS28 in RA patients (r=0.357,P=0.045;r=0.399,P=0.024;r=0.468,P=0.021,respectively).Conclusion:Lower frequencies of NK cells, higher frequencies of activated NK cells and activated NKT cells, lower frequencies of inhibitory NK cells and inhibitory NKT cells, and higher NK cell activity may induce the autoimmune reaction involved in the pathogenesis of RA.

Objective To investigate the role of hypoxia inducible factor(HIF)-prolyl hydroxylase 1 (HPHl)and factor inhibiting HIF-1(FIH-1)in placentas in the pathogenesis and development of severe pre-eclampsia.Methods RT-PCR and western blot analyses were used to detect the HPH1 and FIH-1expression levels in placentas of 34 patients with severe pre-eclampsia and 24 cases of term pregnancy (normal pregnancy group)and their correlations with symptoms were analyzed.Results (1)The HPHI mRNA and protein expression levels in placentas of severe pre-eclampsia group were 0.40±0.04 and 59.5±3.4 separately,significantly lower than those of normal pregnancy group,0.84±0.12 and 71.6±1.7(P<0.01).The FIH-1 mRNA and protein expression levels in placentas of severe pre-eclampsia group wereQ 31 ±0.05 and 45.6±2.4 separately,significantly lower than those of normal pregnancy group,0.43±0.04 and 54.9±2.1(P<0.01).(2)The mRNA and protein expression levels of HPH1 and FIH-1 in severe pre-eclampsia group were all negatively correlated with mean arterial pressure(MAP)[the Spearman correlation coefficient was-0.854(P<0.01)],urinary protein per 24 hours[the Spearman correlation coefficient was-0.936(P<0.01)1 and the occurrence of fundus oculi artery spasm[the Spearman correlation coefficient was-0.854(P<0.01)].(3)rrhe expression of HPHl mRNA in placentas of all the 58 cases WBB 0.58±0.27.higher than the expression of FIH-1 mRNA,which was 0.39±0.10.There was a positive correlation between them.The pearson correlation coefficient was 0.686(P<0.01).The expression of HPH1 protein in placentas of all the 58 cases was 64.5±6.7,higher than the expression of FIH-1,which was 49.4±5.2.There was a positive correlation between them.The Pearson correlation coefficient was 0.947(P<0.01).Conclusion The expression imbalance of HPH1 and FIH-1in palcenta may play an important role in the pathogenesis and development of severe pre-eclampsia through inhibiting HIF-1a.

Objective To study the effect of acupuncture on the ratio of CD4+ CD25+ regulatory T cells and expression of transcription factor Foxp3 in patients with septic shock.Methods Sixty-four patients with septic shock were randomly divided into two groups by using the random number table method.Acupuncture group (34 cases) was treated with both western medicine and acupuncture,and control group(30 cases) was treated with western medicine.The period of treatment was 7 days.After treatment,the ratio of CD4+ CD25+ T cells in peripheral blood was determined by flow cytometry.And the expression of Foxp3 mRNA in peripheral blood was detected by quantitative real time PCR.Results After treating for 7 days,the ratios of CD4+ CD25+ Treg cells and CD4+ CD25+ Foxp3 + Treg cells were (20.23 ± 1.12) ％ and (78.70 ± 7.65) ％ respectively in peripheral blood of the control group,which in the acupuncture groupwere (17.32 ± 0.78) ％ and (68.53 ± 8.01) ％,the differences were statistically significant between the two groups(t =2.587,2.749,all P ＜ 0.05).The levels of Foxp3 mRNA in peripheral blood were (1.21 ±0.02) and (1.02 ± 0.04) in the control group and acupuncture group,the difference was statistically significant(t =2.119,P ＜ 0.05).Conclusion Acupuncture can adjust immune status of patients with septic shock by reducing the ratio of CD4+ CD25+ Treg cells and down-regulating the expression of Foxp3 mRNA.

Objective To summarize the clinical experience of off-pump coronary artery bypass grafting (OPCABG) for treating high risk coronary artery disease (CAD,SinoSCORE ≥ 6 points),and to evaluate its safety and efficacy.Methods The clinical data of 73 patients with high risk coronary artery disease treated through OPCABG (high risk group)in our center from April 2012 to December 2015 were retrospectively analyzed and compared with those of other low or moderate risk 78 patients treated through OPCABG (SinoSCORE＜ 6 points,low or moderate risk group) at the same period.Results All operations in the high risk group were successfully performed.Compared with the low or moderate risk group,the rate of using left internal mammary artery grafts in the high risk group was reduced significantly (P＜0.05),the operation time,postoperative ventilator support time,postoperative intensive care unit stay time and postoperative hospitalization time were prolonged significantly (P＜0.05),the rate of using intraaortic balloon pump support was increased significantly (P＜0.05),and the occurrence rate of postoperative severe complications was also increased significantly (P＜0.05).Sixty-nine cases were postoperatively followed up for (18.3±8.6) months.During the following-up period,2 cases died.11 branches of internal mammary artery grafts patency (11/11) and 38 branches of great saphenous vein grafts patency (38/43) were confirmed in 18 cases by coronary artery computer tomography angiography or coronary angiography.One cases was performed the PCI therapy due to angina relapse,and other cases had no angina symptoms with good life quality.Conclusion OPCABG is a relatively minimally invasive and safe operative mode.Strengthening perioperative management can reduce the operation risk and achieves good short or middle term efficacy in the patients with high risk CAD.

Objective To investigate the specific application of ergonomics for design of operation field in sanitary train. Methods The use of ergonomics theory, the layout of operation field, personnel operating capacity, environmental comfort and operation security were analyzed, surveyed and discussed. Results The principles and guidelines for design of opera- tion field in sanitary train were proposed in order to make full development the efficiency of "operator-equipment-environ- ment" mode. Conclusion The application of ergonomics for design of operation field in sanitary train can be improved the rationality of the layout of field of operation, environmental comfort and work efficiency.