Objective To discuss the technical points and the clinical application of single wire-guided inverted Y-shaped tracheal stent implantation under general anesthesia in treating complex tracheal diseases. Methods During the period from January 2014 to October 2014 at authors’ hospital, a total of 6 patients with complex tracheal diseases received inverted Y-shaped tracheal stent implantation. The diseases included trachea-pleural fistula(n=1), trachea-esophageal fistula(n=2) and complex tracheal stenosis(n=3). Under general anesthesia and guided by DSA, inverted Y-shaped tracheal stent implantation was carried out in all the 6 patients. The results were analyzed. Results A total of 6 Y-shaped tracheal stents were used in the 6 patients, and single wire-guided implantation technique was employed in all procedures. In one case , the right branch of the Y-shaped tracheal stent was placed in the right upper lobe bronchus by mistake , and in the remaining 5 cases the stent implantation was successfully accomplished with single manipulation. Conclusion Under general anesthesia, Y-shaped tracheal stent implantation can effectively obstruct the trachea-pleural fistula and left main bronchus-esophageal fistula, and it can also quickly and significantly relieve the complex airway stenosis located at the tracheal carina region. This treatment is safe and reliable with satisfactory short-term effect. Moreover, single wire-guided manipulation is technically simpler, easier and faster than dual wire-guided manipulation. Therefore, this technique should be recommended in the clinical practice.

OBJECTIVE: To explore the expression of hypoxia inducible factor-1alpha (HIF-1alpha) and erythropoietin in the hippocampus of aging rats, and to investigate the role of HIF-1alpha and erythropoietin in the aging of nervous system. METHODS: The expression of Nissl body, HIF-1alpha, and erythropoietin in the CA1 region of the hippocampus in different months was observed by Nissl staining and immunohistochemical technique. RESULTS: Nerve cells became bigger and appeared sparse, and the Nissl bodies decreased with age. HIF-1alpha positive cells increased significantly with age in the CA1 region of the hippocampus (P<0.05). The expression of erythropoietin presented a parabola with aging in the CA1 region of the hippocampus. The increase from 3 to 18 months and the reduction from 18 to 30 months of erythropoietin positive cells had statistical significance (both P<0.05). CONCLUSION HIF-1alpha and erythropoietin are parallelly incremental before middle age, and are separated after middle age, suggesting decreased activity of HIF-1alpha and recession of protein synthesis function may be the main reasons for decreased expression of erythropoietin in the brain during aging. Strengthened endogenous HIF-1alpha activity and supply of exogenous erythropoietin may delay the aging of the nervous system.
Aging ; metabolism ; Animals ; Erythropoietin ; metabolism ; Hippocampus ; metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley

This paper summarized Professor ZHOU Zhongying's experience in differentiating and treating hepatitis and liver cirrhosis from deficiency and excess. It is considered that the pathogenesis of hepatitis and liver cirrhosis belongs to deficiency in root and excess in branch， with depletion of liver， spleen and kidney as the root， and constraint and bind of damp-heat and stasis toxin as the branch. Moreover， mutual cause and promotion between deficiency and excess leads to the disease. For general principle of treatment， it is recommended to clear and transform pathogenic excess， supplement deficiency and rectify the healthy qi. In the early stage of hepatitis and cirrhosis， excess pathogen hyperactivity is the main manifestation， which can be treated by clearing and transforming damp-heat and stasis toxin， supplemented by regulating spleen and stomach， with modified Yinchenhao Decoction （茵陈蒿汤） and Biejiajian Pill （鳖甲煎丸）. In the middle and late stages， cases with deficiency-excess complex were more common， which should be treated by clearing damp-heat and stasis toxin， regulating and supplementing liver-spleen-kidney， using medicinals with the function of clearing heat and dispelling damp， dissolving stasis and resolving toxins to treat the branch. Moreover， Liujunzi Decoction （六君子汤）， Yiguan Decoction （一贯煎）plus Erzhi Pill （二至丸） and Buzhong Yiqi Decoction （补中益气汤） modifications are suggested respectively in correspondence to the different kinds of root deficiency including irregular liver and spleen， liver and kidney yin deficiency， and liver-spleen-kidney deficiency.