Objective: To investigate the feasibility and operative effect of the one-stage microsurgery for clipping of bilateral posterior communicating artery aneurysms (BpcoAA). Methods: The clinical data of 28 patients with BpcoAA were analyzed retrospectively. All patients underwent craniotomy and microsurgical clipping of BPcoAA via unilateral pterional approach. The patients were followed up for 6 months to 3 years after microsurgery. The head 3 D-CTA of the patients and their general conditions were reexamined. The Glasgow outcome scale (COS) scores were used to assess the prognosis. Results: Circled digit oneGood preoperative 3D-CTA showed 28 cases with 56 aneurysms, the aneurysms were clipped completely in 24 cases, the contralateral aneurysms were not clipped completely in 3 cases, the aneurysm was not clipped completely on the approach side in 1 case, and none of the patients died. The aneurysms ruptured in 8 cases on the approach sides during the microsurgery. Circled digit twoAfter microsurgery, 7 cases had hydrocephalus, and 5 had vasospasm on the approach sides and 3 on the contralateral sides, 3 suffered pulmonary infection, and 2 had oculomotor nerve injury on the contralateral sides. Circled digit threeThe mean follow-up time of the patients was 1.7 years. The GOS scores: 5 points in 10 cases, 4 points in 7 cases, 3 points in 9 cases, and 2 points in 2 cases. There were no aneurysm recurrence and new aneurysm formation. The patients whose aneurysms were not clipped completely had no recurrence of bleeding. Conclusion: According to 3D-CTA examination, using unilateral pterional approach, aiming at the location of the optic chiasm and the contralateral aneurysm pointing, the one-stage microsurgery for clipping of BpcoAA is safe and feasible.

0.05).Conclusion The incidence of VVC is higher in pregnant women with GDM than in pregnant women with GIGT,however, GCT,and OGTT show no statistical differences between women with VVC and those without VVC.

OBJECTIVE To study the efficacyof venlafaxine vs. paroxetine in treatment of peripheral vertigo patients with anxiety and depression. METHODS 180 peripheral vertigo patients with anxiety and depressionwere randomly divided into venlafaxine group(90cases) and paroxetine group(90cases), and were treated respectively for 6 weeks. The patients were assessed by Dizziness Handicap Inventory(DHI), Hamilton Depression Scale24(HAMD) and Hamilton Anxiety Scale(HAMA) before and after the treatment at the 2nd, 4th and 6th week respectively. The clinical efficacy of the two drugs was evaluated according to the reduction rate before and after the treatment. RESULTS Atthe 2ndweek, the scores of HAMA in venlafaxine group was lower than paroxetine groupstatistically(P<0.05). At the 4th week, both the HMAM and HAMD in venlafaxine group were lower than paroxetine groupstatistically(P<0.05). After 6 weeks, The total effective rate of anxiety and depression were 83.33% and 77.78% in venlafaxine group, while 76.67%and 74.45% in paroxetine group. But there was no statistical difference(P>0.05). The scores of DHI were decreased in both groups(P<0.05), and index p in venlafaxine group was lower than paroxetine group(P<0.05). CONCLUSION Both of them can reduce the physical symptoms and dysfunction, are effective on anxiety and depression, but venlafaxine is faster to take effect than paroxetine, and has a better patient compliance.

Seven terpenoids and three sterols were isolated from the methanol extracts of the aerial parts of Ricinus communis by chromatography methods and their structures were identified by spectra analysis as ficusic acid( 1), phytol(2), callyspinol(3) , lupeol(4), 30-norlupan-3beta-ol-20-one(5) , lup-20(29)-en-3beta,15alpha-diol(6) , acetylaleuritolic acid( 7), stigmast4-en-3-one(8) , stig-mast-4-en-6beta-ol-3-one(9) , and stigmast4-en-3,6-dione(10). Compounds 1-3 and 5-10 were obtained from this species for the first time and 5 and 6 showed significant inhibitive activity and good selectivity against 11beta-HSD of mouse and human in vitro. [Key words] Ricinus communis; terpenoids; sterols; 11beta-HSD
11-beta-Hydroxysteroid Dehydrogenase Type 1 ; antagonists & inhibitors ; 11-beta-Hydroxysteroid Dehydrogenase Type 2 ; antagonists & inhibitors ; Animals ; Diabetes Mellitus ; drug therapy ; enzymology ; Humans ; Hypoglycemic Agents ; pharmacology ; therapeutic use ; Inhibitory Concentration 50 ; Mice ; Ricinus ; chemistry ; Sterols ; pharmacology ; therapeutic use ; Terpenes ; pharmacology ; therapeutic use

At the moment,neural stem cells(NSC)therapy is one of the main means to improve stroke and neurodengenera?tive disease. This paper analyses the key molecular targets that promote NSC migration,such as chemokines,brain-derived neuro?trophic factor and vascular endothelial growth factor,and clarifies the relationships as well as important nodes between pathways,like PI3K/Akt,MAPK/ERK,and JAK/STAT.It is helpful to understand the molecular network mechanisms of NSC migration and provide ideas and targets to design creative drugs to promote NSC migration.

In this study, daphnetin and its major metabolites in the intestinal wall of rats were identified by liquid chromatography and quatrupole-time of flight mass spectrometry. Perfusion fluid of duodenum, jejunum, ileum and colon were collected separately for 2 hours from the rat intestine following perfusion with daphnetin. The metabolites of daphnetin in the perfusion fluid of different intestine segments were analyzed by the liquid chromatography and quatrupole-time of flight mass spectrometry. It is shown that the parent drug daphnetin and four metabolites were found in the perfusion fluid of duodenum, jejunum and ileum. However, no metabolites were found in the colon. Among the four metabolites, two daphnetin sulfates (m/z 257) were first discovered as the phase II metabolites of daphnetin in rats, which revealed a new way of daphnetin metabolism in rats.
Animals ; Chromatography, High Pressure Liquid ; Colon ; metabolism ; Duodenum ; metabolism ; Ileum ; metabolism ; Intestines ; metabolism ; Jejunum ; metabolism ; Male ; Perfusion ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spectrometry, Mass, Electrospray Ionization ; Umbelliferones ; metabolism ; pharmacokinetics

OBJECTIVETo compare two different procedures of colostomy in the laparoscopic- assisted abdominoperineal resection(LAPR), and to reduce the related complications of colostomy.

METHODSSixty- three cases with anorectal cancer undergone LAPR from June 2001 to December 2005 were registered and followed up. Circular stapler anastomosis with sigmoid colon and abdominal skin were applied on 61 cases of the colostomy, and 2 cases were hand sutured. All patients were assigned to group A and B. Thirty- seven cases received the procedure of colostomy through the rectus abdominis peritoneally in group A,other 26 cases through extraperitoneal tunnel and the rectus abdominis in group B.

RESULTSDescending colon, sigmoid colon and rectum were dissected using laparoscopic instruments in 63 cases. No conversion to open procedure and no operative death occurred in two groups of patients. There was no significant difference between two groups in mean operation time, but significant differences were found in the time of return of bowl function[A group (2.4 +/- 1.1)d vs B group (1.9 +/- 0.8)d,P < 0.05], duration of postoperative hospital stay [A group (19.9 +/- 7.8)d vs B group (14.5 +/- 3.9)d,P < 0.01] and stoma related complications(A group 29.4% vs B group 4.0%,P < 0.05). Postoperative hospital stay were shorter, and less colostomy related complications were found in group B.

CONCLUSIONColostomy through extraperitoneal tunnel and the rectus abdominis is a better procedure in LAPR, which can reduce the related complications of colostomy and shorten postoperative hospital stay.

Abdominal Cavity ; surgery ; Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Colostomy ; methods ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Staging ; Peritoneum ; surgery ; Rectal Neoplasms ; pathology ; surgery

OBJECTIVETo investigate the effect of lymphadenectomy adjacent to inferior mesenteric artery root on the prognosis of rectal cancer.

METHODSClinicopathological data of 260 cases with rectal cancer undergone radical operation were analyzed retrospectively. The patients were divided into two groups. Group D(2): the lymph nodes adjacent to mesenteric artery root were not excised (n=188). Group D(3): the lymph nodes adjacent to mesenteric artery root were excised (n=72). Prognosis of two groups was compared during the follow-up period.

RESULTSIn group D(2), the 1-, 3-, 5-year total survival rates (TS) were 97.3%, 87.2% and 77.1%, and tumor-free survival rates (TFS) were 93.1%, 83.0% and 76.8% respectively. In group D(3 ), the 1-, 3-, 5-year total survival rates (TS) were 94.4%, 79.2% and 73.6%, and tumor-free survival rates (TFS) were 86.1%, 76.4% and 71.0% respectively. The differences of TS and TFS between two groups were not significant according to Kaplan-Meier analysis (P>0.05). Multivariate analysis revealed that the excision of lymph nodes adjacent to mesenteric artery root was not statistically correlated with the recurrence, metastasis and survival time after radical operation of rectal cancer.

CONCLUSIONExcision of lymph nodes adjacent to inferior mesenteric artery root has no significant impact on prognosis and it is unnecessary in the radical operation of rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; methods ; mortality ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; Male ; Mesenteric Artery, Inferior ; surgery ; Middle Aged ; Prognosis ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Survival Rate ; Treatment Outcome

Objective To evaluate the segmental myocardium of left ventricular wall in patients with myocardial hypertrophic cardiomyopathy (HCM) by TDI-Q, explore whether the segmental myocardium contractile function is changed or not and determine the myocardial mechanics parameters variation. Methods Thirty-two healthy volunteers and twenty-one patients with hypertrophic cardiomyopathy were included and the standard dynamic two-dimensional tissue Doppler imaging (TDI) of mitral, papillary muscle and apical short axis view were collected in three consecutive cardiac cycles. The mechanical parameters variation and characteristics of systolic radial peak displacement (RD) and time to peak in left ventricle subendocardial, mid-myocardium and epicardial myocardium at different level and segment were analyzed.Results In healthy control group, at left ventricular basal, apical and papillary muscle level, there was no significant difference for time to peak and systolic radial peak displacement (F=0.74, 1.28 and 1.79, all P>0.05). In patients with HCM, time to peak of systolic RD at left ventricular different level was asynchronous. Time to peak of RD in septum at papillary muscle levels and apical lateral wall were longer than those of other segments. In healthy control group, except for apical inferior and lateral wall, RD of subendocardial myocardium was significantly greater than that of epicardial myocardium at different segments (t=-1.903, 4.574,-3.552,-2.614,-1.728,-1.790,-1.836,-2.794 and 2.733, all P<0.05 ). In patients with HCM, RD of subendocardial myocardium was significantly greater than that of epicardial myocardium in posterior wall, septum at basal level and in inferior wall, posterior wall and lateral wall at papillary muscle level (t=-2.305,-2.148, 3.550,-1.182 and-3.602, all P < 0.05). At the same segment, transmural RD of subendocardial and subepicardial myocardium in healthy subjects were greater than that in patients with HCM. In inferior wall, posterior wall, lateral wall and septum at basal level, in inferior wall, posterior wall and septum at papillary muscle level, and in lateral wall and septum at apical level, differences of transmural RD were statistically significant (t=-3.787,-2.983,-4.325,-6.972,-2.352, 2.823,-3.274,-1.338 and-2.857, all P<0.05). Conclusions In patients with HCM, synchrony of left ventricular motion at different level was abnormal and transmural RD of endocardial and epicardial myocardium was decreased, which suggested regional systolic dysfunction. Ultrasound assessment of left ventricular segmental transmural mechanics can further reveal left ventricular mechanical characteristics in patients with hypertrophic cardiomyopathy.

Objective To investigate the influence of iodine excess on expression of TRAIl/TRAIL-sR1 in NOD and Balb/c mice and to study the effect of TRAIl/TRAIL-sR1 on the pathogenesis of experimental autoimmune thyroiditis(EAT). Methods Both Balb/c and NOD mice were divided randomly into control and iodine excess group by feeding with water containing no NaI or 0.05% Nal. The mice were sacrificed after 8 weeks. TRAIL and TRAIL-sR1 mRNA levels were detected by RT-PCR. The function, morphology and apoptosis of thyroids were also observed by ELISA and Tunnel stain. Results Treated by HI, enlarged follicles and flattened epithelium by accumulation of colloid were found in thyroids of both NOD and Balb/c mice. But significant lymphoid cell infiltration and local fibrosis were only found in thyroids of NOD HI group. The relative weight of thyroids of NOD mice in HI group[(104.8±14.5)mg/kg]was heavier than that of control group [(71.8±20.4)mg/kg]. The level of TT4 declined in HI group[(30.77±3.59)mmol/L]compared with control group[(36.43±2.66)mmol/L], meanwhile, the level of TSH was higher in HI group[(6.98±0.66)μg/L]than that in control group [(5.55±0.56)μg/L]. The difference being statistically significant(t=7.773,-9.526,-4.458, all P < 0.05). The relative weight of thyroids of Balb/c mice of HI group[(155.8±20.8)mg/kg]also heavier than that of control group [(105.1±22.0) mg/kg]. The level of TT4 droped in HI group [(19.75±3.32) mmoL/L]was higher than that in control group[(23.46±6.21)mmoL/L], the level of TSH in HI group[(4.14±1.71)μg/L]was higher than that in control group[(3.55±1.41)μg/L], the difference being statistically significant(t=7.554,-7.239,3.140, all P< 0.05). A great deal of apoptotie ceils observed in NOD (3.97±0.91) and Balb/c mice (1.05±0.45) by Tunnel stain were greater than control groups (0.21±0.15, 0.10±0.03), the difference being statistically significant in beth of the two species(t=-7.167,-17.772, both P < 0.05). The apoptosis index of thyroid follicular epithelium in NOD was obviously higher than Balb/c(t=-7.625, P<0.05). The level of TRAIL mRNA did not remarkably change in Balb/c between control group(0.000 59±0.000 39) and HI group(0.001 24±0.000 46, t=-1.940, P>0.05), but it increased apparently in NOD mice HI group(0.018 88±0.005 77) than that of control group(0.009 61± 0.00591, t=-2.71, P<0.05). The level of the expression of TRAIL-sR1 mRNA increased in HI groups of NOD (0.000 53±0.000 15) and Balb/c mice(0.000 42±0.000 09) than that in control groups of NOD(0.000 28± 0.000 05) and Balb/c mice (0.000 17±0.000 06) and the differences were statistically significant between the two species(t=3.050,3.990, all P<0.05). The differences of the expression of TRAIL and TRAIL-sR1 mRNA between the two species were significant(t=-3.37,-4.76, all P<0.05). Conclusions Iodine excess induces colloid goiter in beth species of mice and thyroiditis in NOD mice. The increase of TRAIL and TRAIL-sR1 influenced by iodine excess is one of the molecular bases of follicular epithelium apoptosis and inflammation in thyroids. Genetic factor is a key factor in the pathogenesis of thyroiditis.