Objective To examine the expression of transforming growth factor β(TGF-β) activated kinase 1 (TAK1) in esophageal organization and the impact of TAK1 expression on clinicopathologic data. Methods Specimens from 80 patients with esophageal adenocarcinoma managed in our hospital were included in this study. Immunohistochemical staining was used to detect the expression of TAK1 in 80 cases of esophageal squamous cell carcinoma tissues and 80 cases of normal esophageal mucosal tissues. All the specimens were confirmed by pathology for esophageal squamous cell carcinoma or esophageal normal tissues. Results The positive expression rate of TAK1 in esophageal cancer organizations and normal esophageal mucosal tissues were 80% and 11.25%, respectively. The positive expression rate of TAK1 in esophageal cancer were significantly higher than those in normal esophageal mucosal tissue (P < 0.05). The positive expression rate of TAK1 in esophageal cancer organizations has nothing to do with the age, sex, tumor differentiation degree and size (P>0.05), but with lymph node metastasis and clinical stage (P<0.05). Patients with positive TAK1 expression had significantly lower five-year survival rate than those with tumors having positive TAK1 expression Conclusion TAK1 played an important role in the pathology and development of squamous cell carcinoma , and could be an important therapeutic target in the treatment of esophageal cancer.

Animals ; Dental Implantation, Endosseous ; adverse effects ; Dental Implants ; adverse effects ; Dental Prosthesis, Implant-Supported ; adverse effects ; Dentition ; Humans ; Malocclusion ; etiology ; Maxillofacial Development

Objective To evaluate the value of mini-thoracotomy for open heart surgery.Methods From December 1995 to January 2008,810 patients including 660 cases of congenital heart diseases,129 cases of valvular heart diseases and 21 cases of heart myxoma,underwent open heart surgery by mini-thoracotomy through cardiopulmonary bypass in our hospital.Among the cases,superior median sternotomy was performed on 36 patients,inferior median sternotomy was made on 59,right parasternal mini-thoracotomy was carried out in 3,right anterolateral thoracotomy was done on 658,and right axillary mini-thoracotomy was used in 54.A total of 382 patients received beating-heart surgery.Results The postoperative mortality in our patients was 1.5%(12 cases).In this series,the mean postoperative mechanical ventilation time,drainage volume,and hospital stay were(6.7?4.2) hours,(210?165) ml,and(7.4?4.9) days respectively.421 of the patients received no blood transfusion.None of the patients developed sternal dehiscence or mediastinal infection.Follow-up was available in 690(85%) of the patients up to a mean of(48.2?25.3) months,none of them died during the period.The cardiac function of the patients was significantly improved after the operation(preparation vs postoperation: 310 cases vs 478 cases for grade Ⅰ,438 vs 212 for grades Ⅱ-Ⅲ,and 62 vs 0 for grade Ⅳ,Z=-13.21,P=0.000).The mean cardiothoracic ratio was decreased significantly after the operation(0.51?0.11 vs 0.53?0.08,t=4.065,P=0.000),while the left ventricular ejection fraction was increased markedly(0.63?0.11 vs 0.57?0.11,t=-10.529,P=0.000).Conclusions The mini-thoracotomy is superior in cosmetic results and the postoperative morbidity rates of sternal malformation and infection.Proper selection of patients,good exposure of the surgical field,and skillful surgical procedures are crucial for the outcomes of the operation.

OBJECTIVE To study the epidemiology and the sensitivity to antibiotics of bacteremia in intensive care unit,and provide the reference for the clinical antimicrobial agents usage. METHODS 465 cases of bacteremia from Jan 2005 to Dec 2007 in the First Affiliated Hospital,Medical College of Zhejiang University were retrospectively analyzed. RESULTS Totally 1465 strains of pathogens were isolated in three years,and the positive rates were 22.6%.From them 155 strains were fungi(10.6%),611 strains were Gram-positive bacteria(57.9%) and 392 strains were Gram-negative bacteria(37.1%).G + strains mainly included coagulase-negative Staphylococcus(CNS,43.0%) and Staphylococcus aureus(2.1%);the sensitive antibiotics were vancomycin and teicoplanin.G-strains mainly included Acinetobacter baumannii(8.6%);Stenotrophomonas maltophilia(6.6%);Pseudomonas(5.1%) and Klebsiella pneumoniae(5.3%),the sensitive antibiotics were cefoperazone/sulbactam. CONCLUSIONS The positive rates of blood culture are higher in intensive care unit than in others.We should pay more attention to CNS for its high infection rate.The sensitive antibiotics of G + are vancomycin and teicoplanin.The sensitive antibiotics of G-are cefoperazone/sulbactum.Antimicrobial therapy should be conducted according to susceptibility test.The candidemia caused by non-Candida albicans(NCA) is increaseing in recent 3 year.

OBJECTIVETo sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.

METHODSWe retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.

RESULTSFGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.

CONCLUSIONBoth ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Age Factors ; Aged ; Fournier Gangrene ; diagnosis ; mortality ; surgery ; Humans ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

Adult ; Facial Nerve Diseases ; complications ; Female ; Humans ; Mastoiditis ; complications ; Neurofibroma ; complications

ObjectiveTo investigate the effects of ligustrazine on renal tubulointerstitial injury in adriamycin nephrosis rats and its mechanism.MethodsForty male Sprague-Dawley rats were randomly divided into sham-operation group,model group,ligustrazine group and Benazepril group.The rat nephropathy model was established by adriamycin injection and unilateral nephrectomy.The 24-hour urinary protein excretion at the start,2nd,4th,6th weekends was analyzed.All rats were sacrificed at the 6th weekend,and then the renal function and the tubulointerstitial pathological injury were examined.Immunohistochemistry was used to measure the expression of ET-1.ResultsThe 24-hour urinary protein excretion [ (30.07 ±2.12) mg/24 h,(201.83 ± 8.63 ) mg/24 h,( 470.70 ± 58.79 ) mg/24 h ] ( at the 2th,4th,6th weekend),blood urea nitrogen[ BUN( 20.20 ± 2.65 ) mmol/L],serum creatinine[ Scr ( 86.79 ± 2.20 ) μmol/L),tubulointerstitial pathological injury (4.38 ± 0.26) and the expression of ET-1 ( 126.92 ± 3.63 )in model group were significantly higher than those in sham-operation group [ ( 6.75 ± 2.07 ) mg/24 h,( 8.28 ± 0.71 ) mg/24h,( 25.37 ± 4.30) mg/24 h,( 8.93 ± 1.05 ) mmol/L,(49.00 ± 5.34 ) μmol/L,1.06 ± 0.19,32.09 ± 3.71,P ＜ 0.01 ].Compared with model group,the 24-hour urinary protein excretion [ ( 176.93 ± 9.20)mg/24 h,( 270.45 ± 60.21 ) mg/24 h) ( at the 4th,6th weekend),BUN [ ( 13.75 ± 2.60 ) mmol/L ],Scr [ ( 62.49 ±3.29)μmol/ L ],Renal tubulointerstitial pathological injury (2.78 ± 0.10) and the expression of ET-1(57.44 ± 4.98 ) were significantly decreased in ligustrazine group( P ＜ 0.01 ).ConclusionsLigustrazine can downregulate the expression of ET-1 and decreased urinary protein excretion,leading to reduce tubulointerstitial inflammation and fibrosis.

Aim To evaluate the clinical value of two cervical spinallocking plates, Orion and Zephir, and a new anterior cervical instrumentalsystem combining an intradiscal cage with an integrated plate(PCB) afteranterior cervical decompression surgery. Methods 47 patients were followedup for 7 - 26 months with an average of 15 months after surgery. Of them, 30were treated with Orion, 1 1 with Zephir and another 6 with PCB. Results 26cases with preoperative intervertebral space constriction and 18 cases withchanges of cervical physiological protrusion all achieved satisfying effect ofrebuilding intervertebral space height after operation. The cases with obviousintervertebral space height loss were not seen after follow up. The physio-logical curvature corrected by operation was well kept. Neurological functionwas improved in 43 cases on different extent after operation. The other 4cases with no obvious recovery of neurological function were all that withcomplete paraplegia after trauma. Conclusion PCB is suitable for treatmentof the acute cervical protrusion or the cervical spondylotic myelopathy at onelevel. Zephir and Orion are suitable to all kinds of cervical vertebra lesions atmore than one level and complex lesion at one level, which helps the re-covery of cervical physiological curvature and height of disc space.

BACKGROUND:Orthotopic lung transplantation model in a rat is the key to investigate the chronic rejection after lung transplantation. However, the precise surgical technique and difficult operation limit the application of the model. OBJECTIVE:To improve the process of anesthesia and lung transplantation, and to establish a rapid, safe and reversible rat lung transplantation model. METHODS:A total of 42 rats were used to establish the model, including 21 donor models and 21 receptor models. The donor lung was excised by median sternotomy with dissection of the left lung and implantation of cuffs (intravenous catheters cut into 1.5 mm sections). The left lung was implanted in the recipient by lateral thoracotomy using the cuffs for anastomoses. The duration of surgery and success rate of transplantation were recorded and calculated. RESULTS AND CONCLUSION:The survival rate of rats after lung transplantation was 100%. The time of left donor lung extraction was (35.3±5.1) minutes in average. The time of placing cuff in donor lung was (12.5±4.6) minutes in average. The surgical procedure time of recipient was (50.2±3.3) minutes. The time of arteriovenous and bronchus casing anastomosis was (27.7±6.2) minutes. After pulmonary artery and vein blood flow was disparked, the whole lung turned red rapidly, blood perfusion was sufficient, venous returned unimpeded;after mechanical ventilation resumed, al graft lungs expanded wel . This improved anesthesia and lung transplantation technique in rats can provide a valid, reliable and reproducible animal model for studying immune responses and rejection in lung transplantation.

BACKGROUND:Previous studies showed that neurotrophic factor has a variety of functions, which can effectively maintain the survival of neurons after injury.
OBJECTIVE:To observe the effect of adenovirus-mediated brain-derived neurotrophic factor on the differentiation of endogenous neural stem cels after intracerebral hemorrhage in rats.
METHODS:A total of 90 Sprague-Dawley rat models of cerebral hemorrhage were made. At 12 hours after cerebral hemorrhage, 5-bromodeoxyuridine (BrdU) was intraperitonealy injected, twice a day, for 10 consecutive days. After model establishment, rats were randomly divided into three groups, 30 rats in each group, and were respectively subjected to brain stereotaxic injection of adenovirus vector, adenovirus-mediated brain-derived neurotrophic factor and physiological saline. At 1 day, 3 days, 1 week, 2 weeks, 3 weeks, and 4 weeks, neurological deficit score was evaluated. Absorbancevalue of growth associated protein around the area of hematoma after intracerebral hemorrhage was measured. At 4 weeks after injection, double immunostaining was used to detect the expression of BrdU/NeuN and BrdU/glial fibrilary acidic protein (GFAP).
RESULTS AND CONCLUSION:(1) With the passage of time, nerve function defect score decreased in the three groups. At 1-4 weeks after injection, nerve function deficit scoreswere lower in the adenovirus-mediated brain-derived neurotrophic factor group thanthat in the adenovirus vector group and saline group (P< 0.05). (2) With the passage of time, the average absorbance of three groups in the peri-hematoma region first increased and then decreased. The absorbance value was higher in the adenovirus-mediated brain-derived neurotrophic factor group than in the adenovirus vector group and saline group at 3 days-4 weeks (P< 0.05). (3) BrdU/NeuN and BrdU/GFAP rates were significantly higher in the adenovirus-mediated brain-derived neurotrophic factor group thanthat of adenovirus vector group and saline group (P< 0.05). (4) The results show that the brain-derived neurotrophic factor mediated by adenovirus, and intervention on cerebral hemorrhage in rats can effectively promote the differentiation of endogenousneural stem cels, and promote the recovery of neural function in animal.