Selectins are a family of adhesion molecules,including P-,L-,E-selectins.The three adhesion molecules all participate in the inflammatory processes of ischemia-reperfusion injury of brain.P-selectin is expressed on activated platelets as well as on endothelial cells.E-selectin is only expressed on endothelial cells.P-and E-selectin mediate the adhesion of the leukocytes,platelets and endothelial cells.L-selectin is mainly expressed on leukocytes and mediates leukocytes rolling contact with microvascular endothelial cells.

Objective To investigate the efficacy of a modified duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis.Methods The clinical data of 109 patients with chronic pancreatitis who received modified DPPHR at the Union Hospital of Huazhong University of Science and Technology from January 2004 to June 2013 were retrospectively analyzed.Of the 109 patients,66 were with mass in the head of the pancreas,29 were with calcification of the head of the pancreas,14 were with atrophy of the head of the pancreas and stones in the main pancreatic duct.The level of glucose of 56 patients were normal,34 patients had glucose tolerance abnormalities and 19 were complicated with diabetes mellitus.Modified DPPHR was carried out after confirming the diagnosis of chronic pancreatitis and excluding the malignancies by frozen pathological examination.The head of the pancreas was completely resected.The posterior pancreaticoduodenal aortic arch running parallel to the duodenum was preserved to guarantee the blood supply to the remaining duodenum.A thin sheet of the pancreatic tissue behind the intrapancreatic common bile duct and between the common bile duct and the duodenum was preserved to guarantee the blood supply to the common bile duct.The gastrointestinal tract was reconstructed with an anastomosis of the distal pancreas and the jejunum and an end-to-en anastomosis of the proximal jejunum and the distal jejunum.Patients were followed up via out-patient examination to learn the frequency of abdominal pain,analgesics usage and the endocrine function.The pain scale,life quality and endocrine function were evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30),Gastrointestinal Quality of Life Index (GLQI) questionnaire,and oral glucose tolerance test (OGTT),respectively.Patients were followed up till January 2014.The measurement data and the count data were analyzed using the t test and the chi-square test,respectively.Results No patients died during the operation.The operation time,volume of blood loss and blood transfusion were (3.5 ± 0.7) hours,(360 ± 125) mL and (260 ±220) mL,respectively.After the operation,5 patients were complicated with pancreatic leakage,5 with bile leakage,2 with duodenal fistula and 1 with peritoneal bleeding,and all the patients were cured after conservative treatment.Four patients were complicated with abdominal abscess,1 patient of whom was treated by conservative treatment,and the remaining 3 patients were cured by drainage guided by B sonography.The duration of hospital stay was 13.8 days (range,10.0-32.0 days).The median time of follow-up was 18.0 months (range,3.0-24.0 months).A total of 102 patients were followed up for more than 9 months.At postoperative month 9,the ratio of patients with abdominal pain was decreased from 78.90％ (86/109) to 18.63％ (19/102),and the ratio of patients administered analgesics was decreased from 76.47％ (78/102) to 12.75％ (13/102),with significant difference between the indexes before and after operation (x2=76.57,74.31,P ＜ 0.05).The score of the EORTC QLQ-C30 was decreased from 58 ±36 before operation to 15 ±4 after operation,with significant difference (t =11.39,P ＜ 0.05).The score of GLQI was increased from 69 ± 8 before operation to 87 ± 15 after operation,with significant difference (t =20.05,P ＜ 0.05).The patient with diabetes mellitus was cured,and no newly onset of diabetes was found.Two patients received reoperation because of recurrence of stones in the distal pancreatic duct and pancreatogenic portal hypertension.Conclusion Modified DPPHR is effective for the treatment of chronic pancreatitis with low incidence of postoperative complications.

Objective To research the early effects and side-effects of the local advanced nasopharyngeal carcinoma patients using intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy.Methods From January 2005 to January 2007,60 patients with nasopharyngeal carcinoma of stage m-IV b were received IMRT combined with concurrent chemotherapy in our center.Sixty patients were divided into paclitaxel concurrent group(32 patients)and cisplatin concurrent group(28 patients).The prescribing doses of the primary tumor were 68-72 Gy for each group.The patients of paclitaxel concurrent group patients of the cisplatin concurrent group got earlier radiodennatitis and radiation-induced mucositis but also got significantly higher rate of radiodermatitis,radiation-induced mucositis,radiation-induced leucopenia and gastrointestinal toxicity,as well as the loss of weight.No significant difference was found on liver and renal funcfons between two groups.Four patients(12.5%)of the paclitaxel concurrent group were broken-off,which was much better than the cisplatin concurrent group.There was no significant difference on the specific length of break-off time,the 2-year overall survival rate and the 2-year diseaee-free survival rate between two groups.Conclusions IMRT combined with concurrent chemotherapy of paclitaxel liposome for local advanced nasopharyngeal carcinoma results in less side-effects and better tolerance than IMRT combined with concurrent cisplatin chemotherapy.

Objective To study the methods and effects by using thrombolytic catheter in interventional treatment for patients with acute lower limb arterial thrombosis or embolism. Methods One hundred and twelve patients suffered acute lower limb arterial thrombosis or embolism. There were 85 cases of acute lower limb arterial embolism induced by atrial fibrillation in coronary or rheumatic heart disease,other 27 cases of arterial thrombosis caused by different reasons. Interventional treatment by inlying thrombolytic catheter was applied and continuous perfusion was received locally in all patients. Results Complete recanalization was got in 77 cases (68.8%) of 112 cases. Partial re canalization was got in 23 cases (20.5%), and ischemia limbs were saved in spite of chronic limb ischemia(chronic spasmodic limb) occurring in the later follow-up. Nine cases (8.0%) were amputated as a result of irreversible limbs necrosis, 3 cases (2.7%) died from acute renal failure resulting from reperfusion injury or recurrent cerebral embolism.Conclusion Interventional treatment by inlying thrombolytic catheter is a safe and effective method with lower amputation rate for acute lower limb arterial thrombosis or embolism in patients.

Objective The aim of this study is to address learning curve and clinical outcomes of totally robotic atrial septal defect repair on the basis of a single - center experience.Methods 54 cases of atrial septal defect (ASD) were repaired using “da Vinic S surgical system on arrested ( group Ⅰ,54 cases) or beating heart ( group Ⅱ,40 cases) from January 2007 to December 2010.Learning curves were assessed by means of regression analysis with logarithmic curve fit.The effect of operative variables on clinical outcome was analyzed by linear by regression using the Spearman's rho coefficient.Results All cases were accomplished successfully without complications.No residual shunt was detected at intraoperative or postoperative echocardiography.Significant learning curves were noted for corss clamp time in group Ⅰ:y (min) =68.741 -8.283 (n) (x)( r2 =0.489 ; P ＜ 0.01 ) ; the operation time in group Ⅱ:y (min) =355.51 - 56.29 (n) (x) ( r2 =0.581 ; P ＜ 0.01 ).No correlation was detected between operation time,cardiopulmonary bypass time,or cross clamp time and intubation time,intensive care unit stay,or total length of stay.Conclusion The robotic atrial septal defect repair can be performed safely.The learning curves is steep and the longer cardiopulmonary bypass times,operation time or cross clamp time had no negative impact on intraoperative and postoperative outcome.

Objective To observe the outcomes of fast track surgery program applied in thoracoscopic/laparoscopic esophagectomy.Methods From March 2010 to December 2012,99 esophagus cancer patients were randomly allocated to receive thoracoscopic/laparoscopic esophagectomy[minimally invasive esophagectomy (MIE) group,50 cases] and open esophagectomy [open esophagectomy (OE) group,49 cases].Same fast track surgery program was applied in both groups.Perioperative data of all patients were collected and analysized.Results The baseline of both groups was similar.Compared with OE group,MIE group got more abdominal lymph nodes resection,13(6-40) vs.4(0-20),P ＜0.05.In both groups,the level of the total albumin,hemoglobin and total cholesterol in the 8th postoperative day was higher than that of the 1 st postoperative day,P ＜0.05.Statistical difference was observed in the 48 h patient controlled analgesia usage,24 h and 48h visual analogue scales score of motion and less motion,postoperative creatine kinase level,the white cell count and C-reaction protein level in the 8th postoperative day,of which the MIE group got better results,P ＜ 0.05.Patients in MIE group took less time to begin oral nutrition (6 days vs.9 days P ＜ 0.05),besides,the parenteral nutrition duration [(7.9 ± 2.4) days vs.(8.6 ± 2.9)days,P ＜ 0.05] and postoperative hospital stay [(12.5 ± 3.1) days vs.(17.1 ± 6.3) days,P ＜ 0.05] were also shorter,P ＜0.05.Conclusion Fast track surgery program is safe and feasible for patients receiving esophagectomy.MIE combined with fast track surgery program can promote early rehabilitation by easing pain,reducing inflammatory response,improving nutrition state,lowering postoperative morbidity,shortening hospital stays,and as a result,have more obviously advantages.

In order to breed and spread a new cultivar of Curcuma wenyujin, the C. wenyujin germplasm resources were investigated in authentic regions. Better varieties were chosen by comparing the yield, economic characters and quality differences between different cultivars. The results showed that the character of new selected cultivar was stable, the yield of zedoary, turmeric and curcuma was reached 313.7, 177.9, 91.2 kg per 667 m2, respectively, it increased 11.6%, 10.2%, 14.2% comparing with farmer varieties. The volatile oil contents in zedoary and turmeric was 4.0%, 3.0%, respectively. The target ingredients (germacrone) content was stable. It is demonstrated that the new cultivar "Wenyujin No. 1" has value for extension at authentic regions.
Breeding ; China ; Curcuma ; chemistry ; growth & development ; Oils, Volatile ; analysis ; Plant Extracts ; analysis

Objective To determine the safety and efficacy of robotic mitral valvereplacement using da Vinci S system.Methods From August 2008 to April 2011, over 400 cases of robotic cardiac surgery have been completed in Chinese PLA general hospital, in which 20 patients with isolated mitral valve stenosis underwent robotic mitral replacement, including 7 male and 13 female patients with a mean age of (44.7 ±9.8) years (ranging from 32 to 65 years). 16 patients had a NYHA class Ⅰ～Ⅱ heart function and 4 patients were NYHA class Ⅲ. Fifteen patients were concomitant with atiral fibrillation. Surgery approach was achieved through 4 right chest ports with femoral perfusion and Chitwood aortic occlusion. Antegrade cold blood cardioplegia was administered directly via chest for myocardial protection. The transesophageal echocardiography was used intraoperatively to estimate the surgical results. Results All patients had successful valve replacement including mechanical and tissue valve replacement. There was no conversion to a median sternotomy. The mean cardiopulmonary bypass and arrested heart time were(137.1 ±21.9) minutes and (99.3 ±17.4) minutes. Echocardiographic follow-up in all patients revealed no complications. Conclusion Robotic mitral valve replacement is safe and efficacious in the patients with isolated mitral valve disease.

Objective To evaluate the early clinical efficaoy of hybrid procedure for infants less than six months old with ventricular septal defect and coarctation of aorta.Methods From January 2010 to July 2011,20 patients with ventricular septal defect and coarctation of aorta received hybrid procedure in our center.The body weight was (4.5 ± 1.6) kg ( ranged from 1.9 kg to 6.5 kg) and the age was ( 56 ± 45 ) days ( ranged from 18 days to 6 months).The pressure gradient of the coarctation of the aorta ranged from 30 mm Hg to 56 mm Hg,5 patients of them were diagnosed as hypoplasty of aortic arch.The size of the ventricular septal defect ranged from 8 mm to 16 mm.Results The mortality was zero in all the 20 cases during the surgery,and the mobidity was 20％ (4/20).The complications were pneumonia in 2 cases,infective endocarditis in 1 case and pneumothorax in 1 case.The diameter of coarctation of the aorta ranged from 1.5 mm to 3.4 mm,and the size of the balloon ranged from 4 mm to 12 mm.The pressure gradient of the coarctation of the aorta decreased to 0 to 27 mm Hg.The bypass time ranged from 40 minutes to 87 minutes,and the crossclamp time of the aorta ranged from 20 minutes to 41minutes.The atrial septal defects were repaired and the patent ductuses were ligated during the surgery without leaving the sternum open.The total operation time was (4.0 ± 0.7 ) hours ( ranging from 3.0 hours to 5.2 hours).The mean ventilation time was (2.2 ± 1.4) days and mean ICU stay time was (5 ± 3 ) days.All the patients were followed up for ( 10.0 ± 3.6) months without aneurysm in arch and obstruction in airway.The residual obstructive pressurc gradicnt in the aortic arch ranged from 12 mm Hg to 35 mm Hg and 2 patients received reintervention.One patient received re-balloon dilation and the other received surgery.The cardiac function reached NYHA Ⅰ - Ⅱ in all eases.Conclusion The early outcome of the hybrid procedure (balloon dilation of the coartation of the aorta and surgical repair of ventricular septal defect) for infants with ventricular septal defect and coarctation of aorta was satisfying,which could avoid from circulatory arrest.It is a relatively safe procedure which could be the optional method for one-stage surgical repair.

Objective To explore the inhibitory effects of Corilagin on the production of proinflammatory cytokines in microglia induced by radiation. Methods The cytotoxicity of Corilagin was measured by MTT assay. Microglia BV-2 cells were irradiated 0 or 32 Gy after pretreated with Corilagin for 12 hours. Realtime-PCR was used to detect the mRNA levels of inflammatory cytokines, such as IL-1β,TNF-α on several time-points. The content of nitric oxide (NO) was determined with nitrate reductase method. The translocation of NF-κB was measured by Western blot and immunocytochemical stain.Confocal microscopy was used to observe the expression of Iba-1 and Nemo. Results No cytotoxicity was detected on BV-2 cells with 1-10 μg/ml Corilagin. Iba-1 expression in microglia cells was activated by irradiation, the expression levels of inflammatory cytokines, such as IL-1β, TNF-α and NO were also elevated. Whereas, the production of IL-1 β, TNF-α in activated microglia cells was significantly inhibited with 5 μg/mL corilagin ( tIL-1β = 6. 341, tTNF-α = 3.41 1, tNO = 3. 134, P ＜ 0. 05 ). Corilagin significantly inhibited the expression of Nemo and the translocation of NF-κB p65. Conclusion Corilagin could inhibit the activation of irradiated microglia cells and down-regulate the expression of inflammatory cytokines, via inhibition of the NF-κB signaling pathway.