Objective To compare the therapeutic results of laparoscopic and open treatment for choledocholithiasis. Methods A prospective comparison was conducted between 29 cases of laparoscopic choledocholithotomy and 35 cases of open choledocholithotomy in terms of stone removal,operative time,hospitalization day,hospitalization cost and postoperative complications. Results Stone removal was achieved in 28/29 patients by a laparoscopic approach and in 32/35 patients by a open approach( ? 2=0 71, P =0 399);average operative time was (178 3?32 4) min in laparoscopic approach and (145 8?27 1)min in open approach( t =4 27, P =0 01);the patients in laparoscopic procedures had flatus in (20 8?2 9) hour and those in open procedures did in (58 2?4 9) hours( t =37 8, P 0 05);no major complication was found in laparoscopic approach. Conclusions Laparoscopic choledocholithotomy is safe and effective and it is superier to open treatment.

Objective To investigate the expression of interleukin-6 (IL-6) and its role in incisional pain in the rat model.Methods Incisional pain rat model was established by a longitudinal incision in right plantar hind paw of isoflurane-anesthetized rats.Spinal cords were removed at various postoperative times (1,6,24,72 h).The gene expression of IL-6 in the spinal cord was determined by a Real-time PCR.Immunohistochemistry and double-labeling immunofluorescence were performed to determine the expression of IL-6 after incision.Intrathecal injection of IL-6 antibodies was performed to modulate the spinal IL-6 after surgical incision,and the mechanical hypersensitivity was assessed by paw withdrawal thresholds from mechanical stimuli of von Frey filaments.Results After hind-paw incision,the IL-6 mRNA level was upregulated in the ipsilatcral lumbar spinal cord.The immunoreactivity of IL-6 in spinal cord was increased after hind-paw incision at 6 hours after incision.The upregulated spinal IL-6 was mainly localized in the neurons and endothelial cells.Intrathecal injection of IL-6 antibodies dramatically inhibited the surgical incision that evoked pain hypersensitivity.Conclusions The present study showed that the upregulated IL-6 in the spinal cord contributed to the pain hypersensitivity after surgical incision,inhibiting the upregulated IL-6 in the spinal cord may be a possible new therapeutic target for the treatment of postoperative pain.

Objective:To explore the effect of tibial nerve vibration on triceps surae spasticity in stroke survivors and its electrophysiological mechanism.Methods:Thirty stroke survivors with upper limb spasticity were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine rehabilitation training while the treatment group was additionally provided with local vibration of the tibial nerve with an amplitude of 0.3mm at 60Hz. Before and after the treatment, the modified Ashworth scale (MAS) and Clonus grading were used to assess muscle tone and spasticity. Electrophysiological functions were evaluated using the tibial nerve motor and sensory conduction test and F wave and H reflex sensing.Results:Before the treatment there were no significant differences between the two groups in their average MAS scores, Clonus grading, maximum H amplitude (Hmax), the ratio of maximum H to maximum M amplitude (H/M) or the intensity of stimulus required to elicit Hmax. After the treatment, however, all of those measurements had improved significantly in both groups with the average improvements in the treatment group significantly greater than those in the control group.Conclusions:Local vibration of the tibial nerve combined with traditional rehabilitation is more effective than traditional rehabilitation alone in relieving triceps surae spasticity and reducing muscle tone after a stroke. The vibration seems to inhibit excitation of the reflex pathway.

Objective To explore the regulating effects of Egr-1 promoter activated by ionizing radiation (IR) and doxorubicin (ADM) on the expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) genes. Methods The human GM-CSF cDNA and enhanced green fluorescent protein (EGFP) cDNA were linked together with IRES(internal ribosome entry site) and then inserted into the expression vector pCIneo under control of the Egr-1 promoter(Egr-EG). The vector was transferred into human bone marrow stromal cell line HFCL by liposome transfection. And the cells were exposure to ADM and IR. The activity of EGFP in HFCL/EG cells were detected by FACS. The effect of N-acetylcysteine on the expression of EGFP following exposure to ADM and IR was examined. The amounts of GM-CSF in HFCL/EG after chemotherapy or radiation were measured with ELISA. The effects of GM-CSF in HFCL/EG cultural supernatants on expansion of CFU-GM derived from cord blood were also studied. RT-PCR analysis for the expression of GM-CSF mRNA in HFCL/EG after exposure to ADM or IR. Results The percentage of EGFP+ HFCL/EG cells exposed to ADM and IR was increased compared with non-treatment group (1.2 % and 15.2 % vs 18.2 %, t = 5.11, P < 0.01). The levels of secreted GM-CSF in HFCL/EG cells exposed to ADM and IR was increased (P < 0.01), but no difference between ADM group and IR group (P 0.05). The expression of EGFP by HFCL/EG treated with ADM and IR was significantly decreased by N-acetylcysteine. The effects of GM-CSF in HFCL/EG cultural supernatants on expansion of CFU-GM in ADM group and IR group were significantly higher than that in HFCL group and non-treatment group. However, The CFU-GM count of IR group was higher than that of ADM group. The expression of GM-CSF mRNA in HFCL/EG cells exposed to ADM and IR was significantly increased(t = 4.37, P < 0.01). Conclusions GM-CSF gene expression regulated by Egr-1 promoter induced by ADM and IR could help the recovery from hematopoietic injury.

Objective To investigate the role of miR-203 in radiation-induced thymic lymphoma (RITL).Methods A 60Co irradiator was used for total-body irradiation.MicroRNAs(miRNAs) level was assayed by qRT-PCR.Cell proliferation was assayed by MTT assay.Cell apoptosis was examined by fluorescence activated cell sorter (FACS).Dual luciferase reporter assay system was used to detect the 3'UTR reporter.Results MiR-203 was down-regulated in RITL tissues.Overexpression of miR-203 strongly inhibited the proliferation of both NIH3T3 cells and EL4 cells and vice versa.MiR-203 inhibited cells proliferation and induced apoptosis via TANK-binding kinase (TBK1),SLUG (SNAI2) and Cyclin D1 (CCND1).Conclusions Radiation down-regulated the level of miR-203 in thymic,which promoted radiation-induced thymic lymphoma by targeting TBK1,SNAI2 and CCND1.

Objective To study treatment of Vancouver type-B periprosthetie femoral fractures after total hip arthroplasty.Methods There were 10 cases with Vancouver type-B periprosthetic femo- ral fractures after total hip arthroplasty being treatment,including three cases with type-B1 undergone open reduction and allografi strut to fix the fracture,two with type-B2 undergone open reduction and revi- sion with a long stem and five with type-B3 undergone open reduction,revision with a long stem and al- lograft strut to restore bone.The mean duration of follow-up was 27 months(8-36 months).The Harris Hip Score and radiographs were used to evaluate the outcome.Failure of the procedure.was defined as the need for revision surgery because nonunion of fracture,implant loosening,and infection.Results All cases obtained successful fracture healing,with no stem loosening or infection.Of all,nine cases were a- ble to walk by themselves but one needed aid in walking.The Harris Hip Score was 83 at the time of the final follow-up.Osseous union of the allograft to the host femur occurred in eight hips and mild graft re- sorption in two.The cotex thickness of host femur was increased more than 3-5 mm.Conclusions Stem stability and bone quality are important factors determining the outcome of treatment for periprosthet- ic femoral fracture after hip arthroplasty.Good outcome can be achieved by adopting different treatments according to sub-classification of Vancouver type-B fractures.The allograft strut for the treatment of a Vancouver type-B periprosthetic femoral fracture can not only provide fixation,but also make fracture heal fast and augment bone mass and strength.

Objective To observe the effect of T-2 toxin on growth and development of rat epiphyseal plate of left knee and metaphyseal bone of femur and tibia in normal and low nutritional status, to find out possible pathogenic factors of Kashin-Beck disease and provide experimental basis for early intervention. Methods Ninety 3-week-old Wistar rats, weighing 60 - 70 g, were randomly divided into three groups: control group(general feed), T-2 toxin + general feed group, T-2 toxin + low nutrition feed group, thirty rats in each group with equally sex ratio. T-2 toxin (1.0 mg/kg) was administered orally 5 times a week via a gavage needle for 4 weeks. The change of hair, activity and body weight was observed. After 1, 2, 4 weeks, the epiphyseal plate of left knee and metaphyseal bone of femur and tibia (including distal femur and proximal tibia) were collected. Specimens were processed with HE and Masson staining. The morphology of chondrocytes and matrix collagen content in epiphyseal plate was observed. Trabecular bone volume fraction in tibial metaphyseal bone was analyzed by Image-Pro Plus 6.0 software. Results In the control group, rats were in good movement and hair with light, but in T-2 toxin + general feed group and T-2 toxin + low nutrition feed group, rats were found with reduced activities and hair with dark color. Body weights(g) of the control group, the T-2 toxin + general feed group and the T-2 toxin + low nutrition feed group were 81.0 ± 6.2, 79.0 ±5.1, 77.0 ± 7.5, respectively, by the end of first week; 101.8 ± 6.7, 97.0 ± 6.8, 93.0 ± 5.3, respectively, by the end of second week; 151.1 ± 15.7, 126.5 ± 11.9, 106.5 ± 11.5, respectively, by the end of fourth week. There was significant difference in groups by second week and the fourth week (F = 9.72, 41.65, all P ＜ 0.05 ). There was significant difference among multi-groups by the fourth week(all P ＜ 0.01 ). Under light microscope, at the second weeks, coagulative necrosis of chondrocytes was found in hypertrophic zone in the two groups with T-2 toxin; at the fourth weeks, cell necrosis increased. Masson staining showed collagen staining in the two groups with T-2 toxin significantly turned to clear pale coloration, indicating that the collagen matrix was significantly reduced. Image analysis showed there was significant difference in groups at the second and fourth week(F= 9.72, 41.65, all P＜ 0.05)in tibial metaphyseal trabecular bone volume fraction. There was significant difference between T-2 toxin + low nutrition feed group[(0.55 ± 0.12)％, (0.21 ± 0.0)％] and control group[(0.67 ± 0.09)％, (0.51 ± 0.14)％] by the second and fourth week(all P ＜ 0.01 ). Conclusions Under normal nutritional status, T-2 toxin can induce hypertrophic epiphyseal cartilage necrosis, collagen content decreased in epiphyseal plate, metaphyseal trabecular bone formation disorders; in the low nutritional status, T-2 toxin can lead to rat epiphyseal necrosis and significant metaphyseal bone disorder, but whether the performance is related to Kaschin-Beck disease needs to be studied further.

AIMTo study the synthesis of 5-(3'-indolyl)-oxazoles and their antioxidative activity.

METHODSThe amides were prepared from tryptophan and different acid derivatives by the catalytic dehydration of dicyclohexyl carbodiimide (DCC). The characteristic heterocyclic ring system of 5-(3'-indolyl)-oxazoles was constructed by oxidative cyclization of amide, using dicholorodicyanoquinone (DDQ). Their antioxidative activity in vitro was tested using DPPH system.

RESULTSEleven 2-substituted phenyl-5-(3'-indolyl)-oxazoles were prepared, the compounds 21 and 22 have shown antioxidative activity 3-4 times stronger than that of Vit E, and the compound 29 showed antioxidative activity almost as same as Vit E.

CONCLUSIONThree 5-(3'-indoyl)-oxazole compounds synthesized showed potent antioxidative effect and they would be a good antioxidants.

Antioxidants ; chemical synthesis ; chemistry ; Indoles ; chemistry ; isolation & purification ; Molecular Structure ; Oxazoles ; chemistry ; isolation & purification

OBJECTIVETo investigate whether photochemical smog emitted during the process of electric arc welding might cause oxidative stress and potential oxidative damage in the bodies of welding operators.

METHODSSeventy electric arc welding operators (WOs) and 70 healthy volunteers (HVs) were enrolled in a randomized controlled study design, in which the levels of vitamin C (VC) and vitamin E (VE) in plasma as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), and the level of lipoperoxide (LPO) in erythrocytes were determined by spectrophotometry.

RESULTSCompared with the average values of the above experimental parameters in the HVs group, the average values of VC and VE in plasma as well as those of SOD, CAT and GPX in erythrocytes in the WOs group were significantly decreased (P < 0.005-0.0001), while the average value of LPO in erythrocytes in the WOs group was significantly increased (P < 0.0001). The findings from the partial correlation analysis on the controlling of age suggested that with a prolonged duration of exposure to photochemical smog the values of VC, VE, SOD, and GPX, except for CAT, in the WOs were decreased gradually (P < 0.05-0.005), the value of LPO in the WOs was increased gradually (P < 0.001), and that with the ozone dose increased in the air in each worksite VC, VE, SOD, CAT and GPX decreased (P < 0.005-0.001), but LPO increased (P < 0.001). The findings from the reliability analysis for the VC, VE, SOD, CAT, GPX, and LPO values which were used to reflect oxidative stress and potential oxidative damage in the WOs showed that the reliability coefficients' alpha (6 items) was 0.8021, P < 0.0001, and that the standardized item alpha was 0.9577, P < 0.0001.

CONCLUSIONFindings in the present study suggest that there exists an oxidative stress induced by long-term exposure to photochemical smog in the bodies of WOs, thereby causing potential oxidative and lipoperoxidative damages in their bodies.

Adult ; Antioxidants ; metabolism ; Ascorbic Acid ; blood ; Catalase ; blood ; Erythrocytes ; metabolism ; Glutathione Peroxidase ; blood ; Humans ; Lipid Peroxides ; blood ; Middle Aged ; Nitric Oxide ; blood ; Oxidants, Photochemical ; adverse effects ; analysis ; Oxidative Stress ; Ozone ; analysis ; toxicity ; Risk Assessment ; Smog ; Superoxide Dismutase ; blood ; Vitamin E ; blood ; Welding

OBJECTIVETotal hip arthroplasty (THA) and hemiarthroplasty (HA) are effective methods currently used to treat femoral neck fracture in elderly patients, but the two options remain controversial in patients over 70 years old. The main purpose of our study was to determine whether THA or HA is a superior treatment of femoral fractures involving a displaced neck in patients who are over 70 years of age.

METHODSA computer-based online search of Medline (1970-2011), PubMed (1977-2011), and the Cochrane Central Register of Controlled Trials (2002-2011) was conducted. Six relevant randomized controlled trials with a total of 739 patients were included for the final analysis. The analysis was performed with software RevMan 5.0.

RESULTSWe found that compared with THA, HA needed shorter average time and lost less blood. While over the long-term follow-up, THA patients exhibited significantly less pain and better function and were less likely to require a revision hip surgery. Postoperative infection was equally common among HA and THA patients.

CONCLUSIONSThe significant differences in outcomes suggest that THA is a valuable treatment option for active elderly hip fracture individuals. However, patients who are older, impaired or institutionalized benefit from HA.

Arthroplasty, Replacement, Hip ; Femoral Neck Fractures ; surgery ; Hemiarthroplasty ; Humans ; Postoperative Complications ; Reoperation