ObjectiveTo develop an experimental model of orthostatic hypotension (OH) after spinal cord injury (SCI) in rabbits and investigate the effect of tilting table exercise and Shengmaiyin on it. MethodsRabbit model of OH after SCI were induced by complete transection of spinal cord at the T5 spinal segment and raised to 60° head up tilt (HUT) on a tilting table. Tilting table exercise and Shengmaiyin were applied to different groups for 28 d from 4 days after operation. Systolic blood pressure (SBP) and pulse rate (PR) were observed with non-invasive sphygmobolometer of rabbit 3, 10, 17, 24, 31 d after the operation. Liquid chromatography with electrochemical detection(HPLC-ECD) was used to detect the concentrations of plasma norepinephrine (NE) and epinephrine(E) with horizontal position and HUT 60° on the 31st day. ResultsSBP with HUT 60° in rabbits of combined treatment group was significantly higher than that in rabbits of SCI group on the 24th day after operation,and the drop in SBP from horizontal position to HUT60° was significantly lower than that in rabbits of SCI group. SBP with HUT 60° in rabbits of exercise group and combined treatment group was significantly higher than that in rabbits of SCI group on the 31st day after operation. The drop in SBP from horizontal position to HUT 60° was significantly lower in rabbits of Shengmaiyin group, exercise group and combined treatment group than that in rabbits of SCI group on the 31st day after operation. The concentration of E and NE of SCI group, Shengmaiyin group, exercise group and combined treatment group was lower than that of sham group, but there was no significant difference among these groups. ConclusionThe treatment with tilting table exercise and Shengmaiyin can improve OH after SCI partially in rabbits without involving norepinephrine and epinephrine significantly. The period of treatment can be shorten when both therapies used together.

ObjectiveTo assess the efficacy and results of cervical double door laminoplasty for the treatment of cervical spinal cord injury without radiographic spinal fracture and dislocation.Methods24 patients (all men) with cervical spinal cord injury without radiographic spinal fracture and dislocation were treated with operation of cervical double door laminoplasty. The follow up period ranged from 3 months to 21 months. ASIA scores of motion and sensation before and after operation were compared.Results After surgical treatment, ASIA scores of motion and sensation of patients were improved from 35.2±7.1 and 72.4±13.1 to 59.3±6.8 and 122.2±15.2 respectively and having a significant difference compared with that before operation (P<0.01).Conclusion Cervical double door laminoplasty, which is characterized by thorough decompression of spinal cord and preserving the posterior supporting tissue as much as possible to maintain the stabilization of cervical spine after operation, is an ideal optional method for cervical spinal cord injury without radiographic spinal fracture and dislocation.

OBJECTIVETo explore the value of employing the small intestinal feeding tube in treating high position intestinal obstruction of newborn infant.

METHODFive newborn infants (3 males and 2 females; 1 premature infant and 4 fully-mature infants; 2 had membranous atresia of duodenum, 1 had annular pancreas, and 2 had proximal small intestine atresia; 1 infant had malrotation). The duodenal membrane-like atresia and the blind-end of small intestine were removed and intestinal anastomosis was performed, which was combined with intestinal malrotation removal. Before the intestinal anastomosis surgery, the anesthetist inserted via nose a 6Fr small intestinal ED tube, made by CREATE MEDIC CO LTD of Japan[

REGISTRATION NUMBERthe State Food and Drug Administration-instrument (Im.) 2007-NO.2661620]. Twenty-four hours after surgery, abdominal X-ray plain film was taken and patients were fed with syrup; 48 hours later, formula milk was pumped or lactose-free milk amino acids were given by intravenous injection pump through the feeding tube. The amount of milk and fluids was gradually increased to normal amount according to the condition. In initial 3 days the intravenous nutrition was given and one week after operation, the infants were fed through mouth in addition to pumping milk through the tube and stopped infusion. Ten to 22 days after operation, the tube was removed and the infant patients were discharged.

RESULTAll the five infants showed that the feeding through the nutrition tube was accomplished and the time of venous nutrition was reduced and fistula operation was avoided. None of the infants on question was off the tube and no jaundice exacerbation was found and the liver function was also found normal. At the very beginning, the tube was occasionally blocked by milk vale in one infant and after 0.9% sodium chloride solution flushing patency restored. After that, the feeding tube was washed once with warm water after feeding. In one infant vomiting occurred due to enough oral milk. The photograph of upper gastrointestine did not show anastomomotic stricture or fistula, or intestinal obstruction. After pulling out the tube, the symptoms disappeared and then the patient was discharged. One child was found to have diarrhea with no lactose nutrition liquid and given compound lactic bacteria preparations for oral administration, the symptom disappeared. In the 5 cases, the shortest hospital stay was 10 days and the longest was 22 days, the average stay was 16 days. Three to 5 days after operation the weight restored to birth weight, the weight had increased, when discharged, to an average of 5.5 g (kg·d).

CONCLUSIONThe small intestinal feeding tube was very effective for the postoperative nutrition maintenance of high position intestinal obstruction in newborn infants.

Anastomosis, Surgical ; Enteral Nutrition ; instrumentation ; methods ; Female ; Humans ; Infant, Newborn ; Intestinal Atresia ; surgery ; Intestinal Obstruction ; surgery ; Intestine, Small ; abnormalities ; surgery ; Intubation, Gastrointestinal ; instrumentation ; methods ; Length of Stay ; Male ; Nose ; Postoperative Care ; methods ; Retrospective Studies ; Time Factors ; Weight Gain

OBJECTIVETo study the content variation of furmarid acid and isofraxidin in Sarcandra glabra from 21 different provenances and provide the basis for resource utilization and quality optimization of S. glabra.

METHODHPLC method was developed to determine the contents of furmarid acid and isofraxidin in 330 samples of S. glabra which were collected respectively from 21 different provenances.

RESULTThere were significant differences in the contents of isofraxidin and furmarid acid in S. glabra from different provenances. The contents of isofraxidin and furmarid acid dropped off from low altitude to high altitude, which were also close with longitude and latitude. The content of isofraxidin in S. glabra at central area of natural distribution was the highest. The different parts of the plant had different results, the influence on the contents of the acitive components in stem were more obvious than the leaf.

CONCLUSIONThis simple, accurate and reproducible method could be use to determine the contents of furmarid acid and isofraxidin in S. glabra. The results represented the status of medicines quality and difference of Chinese S. glabra. These agreed with the traditional views that the medicines quality of Sarcandra glabra in Jiangxi, Fujian, Zhejiang was better. These provenances were considered as important areas of medicines breeding and bases building on S. glabra in future.

Chromatography, High Pressure Liquid ; Coumarins ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Fumarates ; chemistry ; Magnoliopsida ; chemistry ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Reproducibility of Results

BACKGROUNDThe large phage antibody library is used to obtain high-affinity human antibody, and the Loxp/cre site-specific recombination system is a potential method for constructing a large phage antibody library. In the present study, a phage antibody library vector pDF was reconstructed to construct diabody more quickly and conveniently without injury to homologous recombination and the expression function of the vector and thus to integrate construction of the large phage antibody library with the preparation of diabodies.

METHODSscFv was obtained by overlap polymerase chain reaction (PCR) amplification with the newly designed VL and VH extension primers. loxp511 was flanked by VL and VH and the endonuclease ACC III encoding sequences were introduced on both sides of loxp511. scFv was cloned into the vector pDF to obtain the vector pDscFv. The vector expression function was identified and the feasibility of diabody preparation was evaluated. A large phage antibody library was constructed in pDscFv. Several antigens were used to screen the antibody library and the quality of the antibody library was evaluated.

RESULTSThe phage antibody library expression vector pDscFv was successfully constructed and confirmed to express functional scFv. The large phage antibody library constructed using this vector was of high diversity. Screening of the library on 6 antigens confirmed the generation of specific antibodies to these antigens. Two antibodies were subjected to enzymatic digestion and were prepared into diabody with functional expression.

CONCLUSIONSThe reconstructed vector pDscFv retains its recombination capability and expression function and can be used to construct large phage antibody libraries. It can be used as a convenient and quick method for preparing diabodies after simple enzymatic digestion, which facilitates clinical trials and application of antibody therapy.

Bacteriophages ; genetics ; Digoxin ; immunology ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; Immunoglobulin Fragments ; biosynthesis ; immunology ; Peptide Library

OBJECTIVETo evaluate the impact of hand video-assisted thoracoscopic surgery (HVATS) and Ivor-Lewis surgery on short term quality of life (QL) of patients with esophageal cancer.

METHODSThirty-nine consecutive patients with esophageal cancer were classified into HVATS group (n = 21) and Ivor-Lewis group (n = 18) randomly, all patients completed the Chinese versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and QLQ-OES18 before treatment and at regular intervals until 6 months after operation. MEAN scores were calculated for every patient.

RESULTSBaseline functional and symptom QL MEAN scores were similar in both groups. All patients reported worse functional, symptom and global QL scores (QOL) within 6 months after operation than before. HVATS group gained higher functional, global QL scores and lower symptom scores than Ivor-Lewis group, moreover, patients' QL scores of HVATS group returned to preoperative levels more quickly than those patients in Ivor-Lewis group. Significant differences were found in global health (QOL), physical functioning, fatigue and pain scales between groups. In both groups, QLQ-OES18 dysphagia scales were improved after surgery,but no significant differences were found at scales respect to esophageal cancer.

CONCLUSIONSHVATS esophagectomy is a safe procedure which has a low disturbance to patients' short term Quality of Life compared with Ivor-Lewis esophagectomy. It might seem reasonable to choose HVATS esophagectomy for patients with early stage esophageal cancer.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Thoracic Surgery, Video-Assisted ; Time Factors ; Treatment Outcome

OBJECTIVETo explore the manifestation of CT for excavated-type of rhomboid fossa of the clavicle.

METHODSNine cases with rhomboid fossaes of the clavicle of 8 patients accepted CT and 1 case added MRI together;all 8 patients were male who aged from 17 to 70 years old with mean age of 42.5 years old;three dimensional reconstruction of all CTs were made, the distance between focus and inside end of clavicle and the size of all focus were measured respectively, then the position, shape, margin of focus were analyzed.

RESULTSAll focuses located near the inside end of clavicle and the distances between focus and inside end of clavicle were lower than 2 cm and the mean value was 1.3 cm, the size of all focuses was from 1.05 to 3.45 cm and the mean value was 2.18 cm. All 9 focuses of 8 patients located in the posterior and nether edge of inside end of clavicle, 5 cases located in right and 4 cases located in left side(both right and left side occurred in 1 patient. Seven focuses showed "fishhook sign" and the rest 2 focuses were small and without fishhook shape;the cortex of clavicle of all 9 cases showed local minus and nearly marrow showed integrated sclerotic margin. Regular soft tissue as strip can be seen in 7 focuses and the rest small focuses without the symptom.

CONCLUSIONSCT could show certain characteristics for excavated-type of rhomboid fossa of the clavicle and certain value for its diagnosis and identification.

Objective To investigate the underlying mechanisms of Miller-Fisher syndrome (MFS) and Bickerstaff' s brainstem encephalitis (BBE) by studying their clinical and electrophysiological characteristics.Methods The clinical and electrophysiological characteristics of 13 MFS and 7 BBE cases in Peking Union Medical College Hospital between 2000 and 2011 were retrospectively analyzed.The electrophysiological parameters included sensory and motor nerve conduction,electromyography,F wave,sympathetic skin response and brainstem auditory evoked potential and blink reflex.Results MFS and BBE had similar clinical characteristics:respiratory symptoms were the most common infectious symptoms before disease onset; Ophthalmoplegia,facial palsy and bulbar symptoms were common; They both had cerebrospinal fluid albuminocytological dissociation and positive serum anti-GQ1b antibody.However,BBE had more central nervous system lesion signs clinically such as conscious disturbance,positive Babinski' s sign and central facial palsy.Electrophysiologically,MFS and BBE also had similar electrophysiological features:sensory nerve abnormality ratios were 6/13,2/7 respectively,with prominently reduced sensory nerve active potential amplitude,normal or slightly slowed sensory conduction velocity; Motor nerves abnormality ratios were 2/13,1/7 respectively,with slightly prolonged distal motor latency and normal compound muscle action potential; Electromyography abnormality ratios were 1/7,0/4 respectively; F wave frequency abnormality ratios were 3/13,5/7 respectively,and in some cases,F wave frequency would restore; Sympathetic skin response abnormality ratios were 1/2,1/3 respectively; Blink reflex abnormalityratios were 1/2,1/1 respectively,with central involvement in BBE; Brainstem auditory evoked potential abnormality ratios were 3/5,1/4 respectively,with wave Ⅰ latency or amplitude abnormality.Conclusion The similarities of clinical and electrophysiological features suggest that MFS and BBE have the same mechanism and they form a continuous spectrum with variable central nervous system and peripheral nervous system involvement.

AIM:To investigate the protective effect of Zhenrenyangzang decoction (ZRYZ) on the intestinal mucosal barrier function and the expression of tight junction proteins,zonula occludens-1 (ZO-1) and occludin,in the co-lon of rats with trinitrobenzenesulfonic acid (TNBS)-induced ulcerative colitis in order to explore the possible mechanism involved. METHODS:Male Wistar rats were randomly divided into normal group, model group, salazosulfapyridine (SASP) positive control group,high-dose ZRYZ(ZRYZ-H) group and low-dose ZRYZ(ZRYZ-L) group. Except the nor-mal group,the rats in other groups were given the TNBS/50% ethanol mixed solution by enema to make the ulcerative coli-tis model. The rats in positive control group were given SASP suspension liquid. The rats in ZRYZ-H group and ZRYZ-L group were orally administered with ZRYZ at doses of 30.4 g/kg and 15.2 g/kg, respectively, while the rats in normal group and model group were orally administered with saline. All the drugs were administered to the rats for consecutive 21 d. Disease activity index (DAI) was investigated during the drug treatment, and colon samples were collected after drug administration for evaluating morphological damage score. Intestinal mucosal permeability was measured by detection of lac-tulose/mannitol (L/M) in urine. Colonic myeloperoxidase(MPO) activity and goblet cell number,serum diamine oxidase (DAO) and D-lactic acid (D-LA) levels, and the colonic expression of ZO-1 and occludin were also measured. RE-SULTS:Compared with normal group,DAI,morphological damage score,L/M value,colonic MPO activity as well as se-rum D-LA and DAO levels in model group significantly increased(P<0.05),while goblet cell number as well as the ex-pression levels of ZO-1 and occludin in model group were significantly reduced(P<0.05). Compared with model group, DAI,morphological damage score,L/M value,colonic MPO activity as well as serum DAO and D-LA levels in ZRYZ-H group and ZRYZ-L group were reduced significantly(P<0.05),while goblet cell number as well as the expression of ZO-1 and occludin in ZRYZ-H group and ZRYZ-L group increased significantly(P<0.05). CONCLUSION:ZRYZ protects the intestinal mucosal barrier function in ulcerative colitis rats by reducing intestinal mucosal permeability,and its mecha-nisms may be related to increasing the expression of ZO-1 and occludin.

OBJECTIVETo report the operative techniques and clinical results of specially designed sural neurocutaneous vascular flap pedicled on a dominant perforator (the diameter > or = 0.8 mm) of the peroneal artery for coverage of soft tissue defects overlying the Achilles tendon.

METHODSAn approximately rectangular sural neurocutaneous vascular flap pedicled on the lowest dominant perforator arising from the peroneal artery was designed and harvested to repair defects over the Achilles tendon. The pedicle was located at a certain part of the flap, which divided the flap into the distal and the proximal parts. After the tendon was repaired, the flap was rotated 180 degrees based on the perforator and the position of the distal and proximal parts of the flap was changed to cover the defects and part of the donor site respectively. In most cases, skin graft was not needed.

RESULTSThe modified flaps were applied in 15 cases. All flaps (ranged from 13 cm x 15 cm - 18 cm x 9 cm ) were transplanted successfully without necrosis, and no vascular problems occurred. Following up for 10-17 months showed both satisfactory functional and cosmetic results.

CONCLUSIONSThe modified flap has reliable blood supply and the special design provides nearly normal outline of the ankle which favorites shoe wearing. It' s an excellent option for covering defects overlying the Achilles tendon.

Achilles Tendon ; injuries ; surgery ; Adolescent ; Adult ; Arteries ; transplantation ; Child ; Female ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Sural Nerve ; blood supply ; Surgical Flaps ; blood supply ; innervation ; Wound Healing ; Young Adult