Objective:To summarize the curative effect in treatment of Raynaud's syndrome with chemical thoracic sympathectomy(CTS) guided by X-ray since 2001.Methods: From March 2001 to August 2007,97 patients with Raynaud's syndrome(186 limbs) were treated by CTS.Guided by X-ray,a needle was punctured through the back skin to the second thoracic sympathetic ganglion beside the thoracic vertebrae and 2 mL of 5%(v/v) phenol was injected.Results: The first CTS treatment produced a good effect on 146 limbs with an effective rate of 78.5%(146/186).The same treatment was performed on the limbs with no effect 1-2 days after the first treatment and produced good effect on 13 limbs with an effective rate of 32.5%(13/40).The total effective rate of the patients who were hospitalized for the first time was 85.5%(159/186).Of the 97 patients,78 patients(80.4%) were followed up for 47 months on an average with an effective rate of 69.5%.And the rate of complications was 11.4% for pheumothorax,and 3.9% for hydrothorax.Hyperalgesia on axillary region and anterior chest wall;Horner syndrome and sinus bradycardia were rare.Conclusion: CTS is minimally invasive and effective in treatment of Raynaud's syndrome.

Objective To analyze the clinical characteristics and therapy of levofloxacin-induced prolonged Q-T interval in patients with multi-drug resistant tuberculosis ( MDR-TB) . Methods Clinical materials of 6 patients with MDR-TB who developed prolonged Q-T/QTc interval caused by levofloxacin therapy were analyzed. Those cases were collected from the Tuberculosis Prevention and Control of Wuhan City form April 2010 to August 2014. Results The proportion of patients with levofloxacin-induced prolonged Q-T interval was approximately 3.0%.The condition occurred 2-8 months after the administration. The initial value of QTc interval ranged from 397 ms to 439 ms, while the average was (410.17±14.62) ms.The value of QTc interval was extended to 470-486 ms after treatment of levofloxacin, while the average was (476.33±6.16) ms.The increase of QTc interval was 47-85 ms, while the average was ( 66 ± 11. 48 ) ms. None of them developed Tdp. Conclusion The application of high dosage and long treatment course of levofloxacin in patients with MDR-TB could result in the extension of the Q-T/QTc interval, which should arouse our serious attention. In order to detect the abnormal Q-T/QTc interval in early stage, electrolyte level examination as well as ECG examination should be considered as routine tests before initiation of treatment and during the follow-up treatment.

BACKGROUND: Matrix metalloproteinase (MMP) is a kind of protease family, its activity can be inhibited by tissue inhibitor of metalloproteinase (TIMP), especially by TIMP-3.OBJECTIVE: To fully isolate and purify natural TIMP-3, and to create enzyme-linked immunoassay of TIMP-3.DESIGN: Single-sample observation SETTING: Central Laboratory of Shenyang Medical College MATERIALS: Human placenta from Department of Obstetrics & Gynecology, Fengtian Hospital Affiliated to Shenyang Medical College (Informed consent was obtained from the relatives of patients) and MMP-1 from Research Institute. Fuji Chemical Industries, Ltd.METHODS: This experiment was conducted in the Central Laboratory of Shenyang Medical College between March 2001 and May 2002. Firstly,4 mol/L urea Tris-buffer solution (pH8.0) was used to prepare homogenate solution of placenta. Secondly, homogenate solution was performed chromatography through CM52 positive ion-exchange resin and Sephacryl S200 gel filtration. Thirdly, relative molecular weight and purity were detected by SDS- polyacrylamidedel gel electrophoresis (SDS-PAGE).Fourthly, Western blotting was used to identify the characters of purified protein. Fifthly, the inhibitory rate of TIMP-3 to MMP-1 was measured with immumofluorescence method.MAIN OUTCOME MEASURES: ① The relative molecular mass of protein showed by PAGE. ② Results of Western blot. ③ The inhibitory rate of TIMP-3 for MMP-1. ④ The recovery rate of TIMP-3 following purification.RESULTS: ①The isolated and purified TIMP-3 from human placenta consisted of non-glycosylated and glycosylated protein, with relative molecular mass of 24 000 and 27 000, respectively. ② The inhibitory concentration of non-glycosylated and glycosylated TIMP-3 was 1.1×1010 mol/L and 1.2×1010 mol/L respectively to MMP-1. The inhibitory concentration of placenta-derived TIMP-3 was significantly higher than that of recombinant TIMP-3 for MMP-1. ③ The recovery rate of TIMP-3 was 23.4% following two-step chromatography.CONCLUSION: Extracellular matrix of human placenta-derived TIMP-3 consists of non- glycosylated protein and glycosylated protein; Two kinds of purified TIMPs-3 have remarkable inhibitory concentration for MMP-1, and significantly higher in comparison with recombinant metalloproteinase inhibitory factor-3.

Objective: To study the protective effect of vitamin E in preventing contrast-induced nephropathy (CIN) in patient with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).
Methods: We prospectively studied 206 CAD patients with elective PCI in our hospital and divided them in 2 groups: Treatment group, the patients received oral vitamin E combining vinous hydration,n=102 and Control group, the patients received vinous hydration only,n=104. CIN was deifned by at 48h after contrast media injection, serum cretinin increased up to 25% from the baseline, or reached 44.2 μmol/L. Excluding the other kidney injury factors, the renal functions at 48 h before and after PCI were compared, the occurrence rate of CIN were also compared between 2 groups.
Results:①Overall, there were 19/206 (9.22%) patients suffered from CIN, the occurrence rate in Treatment group (4.90%) was lower than Control group (13.46%), χ2=4.506,P=0.034. For patients with hypertension, diabetes, chronic kidney disease, anemia and mehran risk score<10, the occurrence rate of CIN in Treatment group was lower than Control group,P<0.05.②Compared with pre-operative condition, at 48 h post-operation,Control group showed increased serum creatinine (Scr), blood urea nitrogen (Bun) and decreased creatinine clearance rate (Ccr), allP<0.05.③At 48 h post-operation, compared with Control group, Treatment group presented decreased Scr (86.72 ± 17.73) μmol/L vs (95.13 ± 21.67) μmol/L and increased Ccr (96.75 ± 27.23) ml/min vs (90.70 ± 17.85) ml/min, allP<0.05.④Multivariate regression analysis revealed that elder than 75 years of age (OR=7.278, 95% CI 5.158-11.480), diabetes (OR=3.919, 95% CI 1.330-8.200), chronic kidney disease (OR=6.325, 95% CI 2.137-16.816) and mehran risk score>10 (OR= 4.461, 95% CI 1.589-14.724) were the independent risk factors for CIN occurrence, allP<0.05.
Conclusion: Short-term application of vitamin E may reduce the risk of CIN occurrence at certain degree in CAD patients after PCI.

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

This study aimed to evaluate the feasibility and effectiveness of closing the small bowel in an ex vivo porcine model with high-frequency welding device. A total of 100 porcine small bowels were divided into two groups, and then were closed with two different methods. The fifty small bowels in experimental group were closed by the high-frequency welding device, and the other fifty small bowels in comparison group were hand-sutured. All the small bowels were subjected to leak pressure testing later on. The speed of closure and bursting pressure were compared. The 50 porcine small bowels closed by the high-frequency welding device showed a success rate of 100%. Compared with the hand-sutured group, the bursting pressures of the former were significantly lower (P<0.01) and the closing process was significantly shorter (P<0.01). The pathological changes of the closed ends mainly presented as acute thermal and pressure induced injury. Experimental results show that the high-frequency welding device has higher feasibility in closing the small bowel.
Animals ; Feasibility Studies ; Intestine, Small ; surgery ; Suture Techniques ; instrumentation ; Swine

Objective:To investigate whether the omental-adipose stromal cells (O-ASCs) exposing to gastric cancer-conditioned medi-um (CM) could be inducted to differentiate into carcinoma-associated fibroblasts (CAFs) and the effect of ERK signaling pathway in the process. Methods: We identified O-ASCs by examining their ability to differentiate osteogenic and adipogenic lineages and through flow cytometry. O-ASCs were co-cultured with MGC803 and SGC7901CM. The expression of CAFs markers (α-SMA, FSP-1, and vimentin) and paracrine factors (VEGFA, TGF-β1, FAP, and SDF-1) were evaluated by RT-PCR and Western blot. In vitro cultures of O-ASCs were divided into three groups:the control, SGC7901-CM, and SGC7901-CM+U0126 groups. Cells were collected after 12 h. West-ern blot was performed to evaluate the expression ofα-SMA, FSP-1, ERK, and p-ERK1/2. Results:The primary cells were O-ASCs. The expression levels of CAFs markers (α-SMA, FSP-1, and vimentin) and O-ASC paracrine factors (VEGFA, TGF-β1, FAP, and SDF-1) clearly in-creased (P<0.05). In comparison with the control, the expression of ERK in SGC7901-CM group did not change (P>0.05), while the ex-pression of p-ERK1/2,α-SMA, and FSP-1 significantly improved (P<0.05). Comparison of SGC 7901-CM+U0126 and SGC 7901-CM groups showed that the expression levels of ERK had no statistical difference (P>0.05), while the expression levels of p-ERK1/2,α-SMA, and FSP-1 decreased (P<0.05). Conclusion:O-ASCs participate in the peritoneal metastasis of gastric cancer through differentiation by CAF and paracrine factors. The ERK signaling pathway is important in the differentiation of O-ASCs towards CAFs.

Objective To analyze the angiography procedure,distribution of cerebral vascular lesions and complications of cerebral angiography in patients 75 years or older with cerebrovascular diseases.Methods A total of 83 consecutive patients 75 years or older (range 75-89 years) diagnosed as cerebral vascular diseases underwent cerebral angiography with a coverage of all arteries supplying blood to the whole brain including bilateral subclavian arteries between June 2003 and June 2009.The angiogram showed 61 patients (73.5%) with ischemic cerebralvascular diseases,22patients (26.5%) with hemorrhagic cerebralvascular diseases.Results The 78 (94.0%)angiographies were performed using transfemoral access.Composite curve catheters such as Simmons curve were selected in 11 (13.3%) angiographies.In patients with ischemic cerebralvascular diseases,159 stenotic lesions were detected,among which 107 (67.3%) lesions located at the anterior circulation and 52 (32.7%) lesions located at the posterior circulation;97 (61.0%) lesions were extracranial and 62 (39.0%) lesions were intracranial.The 9 unruptured aneurysms were incidentally detected in 8 patients.In patients with hemorrhagic cerebralvascular diseases,19 aneurysms were detected in 16 (72.6 % ) patients.Complications occurred in 5 (6.0 % ) patients:transient neurological complications occurred in 2 (2.4%) patients,hematoma at the puncture site occurred in 2 (2.4%)patients and uroschesis occurred in 1 (1.2%) patients.Conclusions As a kind of diagnostic technology,cerebral angiography is safe in patients 75 years or older with cerebral vascular diseases.The incidence of complications especially permanent neurological complications is low.

Objective To explore the diagnosis, treatment strategies and clinical outcomes of spontaneous subarachnoid hemorrhage in elderly patients. Methods A total of 68 patients aged over 60 years presenting with spontaneous subarachnoid hemorrhage underwent cerebral angiography. And 72 intracranial aneurysms were detected in 60 patients, among whom 47 patients with 59 aneurysms underwent endovascular coil embolization, 6 aneurysms in 6 patients were clipped in microneurosurgery operation, and 7 patients chose conservative treatment. Results A total of 57 aneurysms (96.6%) were embolized successfully, among which 40 aneurysms (70.2%) reached dense occlusion and 17 aneurysms (29.8%) reached incomplete occlusion. Among 47 patients undergoing endovascular treatment, 39 patients (83.0%) were evaluated as good, 7 patients (14.9%) were moderately to seriously disabled according to Glasgow Outcome Scale when they were discharged, and one patient died. Conclusions Active treatment such as endovascular coil embolization can acquire good outcome in elderly patients with spontaneous subarachnoid hemorrhage, especially in elderly patients detected with aneurysms.

Objective To understand the running status and distribution of water-improving pmjects in Anda city.Methods The running and management of the water-improving projects were investigated and located the position by Global Positioning Systerm(GPS)in Anda city.Results Among 317 water-improving projects,16.09%were either long-term projects or in poor management or had already stopped usage,77 projeets were broken,accounting for 24.29%;all inadequate supply of equipment and pipeline,83 projects had never been started,accounting for 26.18%;now,106 projects were running,accounting for 33.44%.In only 46 projects,the water fluoride concentration was lower than 1.00 mg/L,accounting for 14.51%,as a result 36 thousand people benefited.Conclusions The running status of water-improving projects was unacceptable,most of them stopped running and endemic fluorosis control was still severe in Anda city.