OBJECTIVE: To observe the expression of discs large homolog 4 (DLG4) protein in hippocampus, amygdala and frontal cortex of rats and evaluate postsynaptic density in heroin dependence. METHODS: The rat heroin dependent model was established by increasing intraperitoneal injection of heroin. DLG4 proteins in hippocampus, amygdala and frontal cortex of heroin dependent 9, 18, 36 days rats were detected with immunohistochemical staining and compared with that in the control group. RESULTS: DLG4 proteins in hippocampus, amygdala and frontal cortex were gradually reduced with extension of heroin dependent time. CONCLUSION Heroin dependence can affect postsynaptic density of hippocampus, amygdala and frontal cortex. The changes become more apparent with extension of heroin dependence time.
Amygdala/metabolism* ; Animals ; Disks Large Homolog 4 Protein ; Frontal Lobe/metabolism* ; Heroin/pharmacology* ; Heroin Dependence ; Hippocampus/metabolism* ; Injections, Intraperitoneal ; Intracellular Signaling Peptides and Proteins/metabolism* ; Membrane Proteins/metabolism* ; Rats

OBJECTIVETo compare therapeutic effects of acupuncture at pain points and massage combined with medicine on myofascial pain syndrome (MPS).

METHODSOne hundred and fifty cases were randomly divided into an observation group (n=90) and a control group (n=60). The observation group was treated with needle-sticking method combined with single-finger meditation pushing therapy at pain points, and the control group with local application of Votalin Emulgel combined with Tuina. All the patients were treated for 1 course and followed up after 3 months and their therapeutic effects were compared.

RESULTSThere were significant differences in cumulative scores of symptoms before and after treatment in the two groups (both P < 0.01), and there were no significant differences in the pain and pressure pain between the two groups (P > 0.05), and there were significant differences in the muscle spasm and joint range of motion between the two groups (P < 0.05); after treatment, the markedly effective rate and the total effective rate in the observation group were 57.8% and 94.4% respectively, and were 31.7% and 73.3% respectively in the control group, with a significant difference between the two groups (both P < 0.05).

CONCLUSIONNeedle-sticking method combined with single-finger meditation pushing therapy at pain points can effectively alleviate pain and pressure pain in the patients with MPS and it has better therapeutic effect in the markedly effective rate and the total effective rate as well as improvement of muscle spasm and joint range of motion than local application of Votalin Emulgel combined with Tuina.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myofascial Pain Syndromes ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo compare clinical therapeutic effect of surrounded needling therapy and medication on acute gouty arthritis.

METHODSSixty cases of acute gouty arthritis were randomly divided into a surrounded needling therapy group and a western medicine group, 30 cases in each group. The surrounded needling therapy group was treated with shallow needling on local affected area as main and 4-5 distant acupoints as adjuvant, once each day; the western medicine group was treated with oral administration of Indomethacin and Allopurinol, thrice each day. They were treated for 15 days. The clinical therapeutic effects, the changes of serum uric acid content and the adverse reaction were observed in the two groups.

RESULTSThe total effective rate was 93.3% in the surrounded needling therapy group and 80.0% in the western medicine group, with a significant difference between the two groups (P < 0.01); the serum uric acid contents before and after treatment were (516.85 +/- 48.63) micromol/L and (293.77 +/- 68.45) micromol/L in the surrounded needling therapy group, and (509.66 +/- 51.11) micromol/L and (333.66 +/- 89.22) mciromol/L in the western medicine group, respectively, with significant differences before and after treatment in the two groups (both P < 0.05), and with a significant difference in the serum uric acid content after treatment between the two groups (P < 0.01). The surrounded needling therapy group had no adverse reaction, and the adverse reaction rate of the western medicine group was 46.7%, with a significant difference between the two groups (P < 0.01).

CONCLUSIONSurrounded needling therapy is superior to the western medicine in the therapeutic effect on acute gouty arthritis, and it is a safe and effective method for acute gouty arthritis.

Acupuncture Points ; Acupuncture Therapy ; Acute Disease ; therapy ; Adult ; Aged ; Allopurinol ; therapeutic use ; Arthritis, Gouty ; blood ; drug therapy ; therapy ; Humans ; Indomethacin ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome ; Uric Acid ; blood

Adult ; Aged ; Carcinoid Tumor ; diagnosis ; surgery ; Endosonography ; methods ; Female ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; diagnosis ; surgery ; Treatment Outcome

OBJECTIVETo summarize the technique and therapeutic effect of free posterior tibial artery perforator (PTP) flap for skin defect on the dorsum of hand or foot.

METHODSThe lower leg was divided into 6 sections equally from the level of tibial tuberosity to the connection of medial and lateral malleolus. The free PTP flap was designed along the inner edge of tibia within the proximal section 2 and 3. The flap was harvested with 2-3 bundles of the saphenous nerve included. The size of skin defects on the dorsum of hand or foot ranged from 3.0 cm x 7.5 cm to 6.0 cm x 12.0 cm.

RESULTSFrom Jan. 2009 to Dec. 2010, 11 cases were treated with free PTP flaps. All the flaps survived completely. The follow-up period ranged from 3 to 10 months. The flaps had good color and texture. Two point discrimination recovered to 7-10 mm, leaving linear scar at the donor site. The appearance and function of the hand or foot was satisfactory.

CONCLUSIONSThe free PTP flap is thin with good sensation, leaving less morbidity at donor site. The posterior tibial artery can be reserved. It is an ideal method for skin defect on the dorsum of hand or foot.

Adult ; Female ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin ; injuries ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Tibial Arteries ; surgery ; Young Adult

OBJECTIVEMalignant middle cerebral artery (MCA) infarction is characterized by mortality rate of up to 80%. The aim of this study was to determine the value of decompressive craniectomy in patients presenting malignant MCA infarction compared with those receiving medical treatment alone.

METHODSPatients with malignant MCA infarction treated in our hospital between January 1996 and March 2004 were included in this retrospective analysis. The National Institute of Health Stroke Scale (NIHSS) was used to assess neurological status on admission and at one week after surgery. All patients were followed up for assessment of functional outcome by the Barthel index (BI) and modified Rankin Scale (RS) at 3 months after infarction.

RESULTSTen out of 24 patients underwent decompressive craniectomy. The mean interval between stroke onset and surgery was 62.10 h. The mortality was 10.0% compared with 64.2% in patients who received medical treatment alone (P<0.001). The mean NIHSS score before surgery was 26.0 and 15.4 after surgery (P<0.001). At follow up, patients who underwent surgery had significantly better outcome with mean BI of 53.3, RS of 3.3 as compared to only 16.0 and 4.60 in medically treated patients. Speech function also improved in patients with dominant hemispherical infarction.

CONCLUSIONDecompressive craniectomy in patients with malignant MCA infarction improves both survival rates and functional outcomes compared with medical treatment alone. A randomized controlled trial is required to substantiate those findings.

Adult ; Aged ; Craniotomy ; methods ; Decompression, Surgical ; methods ; Female ; Humans ; Infarction, Middle Cerebral Artery ; diagnosis ; surgery ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

OBJECTIVETo evaluate the clinical value of submucosal tunneling endoscopic resection(STER) for gastric submucosal tumor(SMT) originating from the muscularis propria (MP) layer.

METHODSClinicopathological data of 23 cases with gastric SMT originating from the MP layer treated with STER from September 2010 to December 2011 were analyzed retrospectively.

RESULTSThere were 13 males and 10 females. The age ranged from 28 to 73(mean, 52.4) years old. Of the 23 SMTs, 11 were located in the cardia adjacent to the gastric body, 4 in the cardia adjacent to the fundus, 5 in the lesser curvature of gastric body and 3 in the gastric antrum of greater curvature. All the SMTs originating from the MP layer, 14 were located in the superficial MP layer and 9 in the deep MP layer(including 5 gastric SMTs close to serosa). En bloc STER was performed successfully in all the patients. The mean lesion size was 2.1 cm(range 1.5-3.2 cm). The mean procedure time was 54.8 min(range 30-125 min). Pathological examination showed that the lesions were leiomyomas(n=10), stromal tumors(n=8), glomus tumor(n=2), Schwannoma(n=2), and calcifying fibrous tumor(n=1). Both lateral and vertical margins were negative in all the cases. Three patients developed pneumothorax and subcutaneous emphysema and 5 pneumoperitoneum. One patient developed effusion under the left half of the diaphragm and secondary infection. All of them recovered uneventfully after conservative treatments. No delayed bleeding or GI tract leakage was noticed. None of the 23 cases encountered submucosal hematoma or infection. No tumor residual or recurrence was found during the follow up(range, 3-18 months).

CONCLUSIONSSTER is a safe, effective for appropriate lesions in the MP layer of the stomach. En bloc resection and accurate histopathological evaluations can be achieved.

Adult ; Aged ; Female ; Follow-Up Studies ; Gastric Mucosa ; surgery ; Gastroscopy ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo develop a quantitative method for methylation analysis of the p16 gene based on mismatch hybridization and chemiluminescence.

METHODSGenomic DNA was modified by sodium bisulfite to convert all unmethylated but not methylated cytosines to uracil, and subsequently a pair of primer having no CpG sites was designed for amplification target DNA containing methylated or unmethylated CpG sites. The PCR product spanning CpG sites were hybridized with two oligonucleotide probes which perfectly matched the methylated and unmethylated CpG sequences respectively, and the hybrids were detected by chemiluminescent method. The percentage of methylated target sequences could be estimated by calculating the ratio of signals obtained with two probes.

RESULTSThe percentage of methylation of artificial mixtures DNA showed a linear relation. There was a negative correlation between the methyaltion index with p16 transcriptional mRNA of p16 gene in tumor cell lines.

CONCLUSIONCompared with existing methods, this assay is nonisotopic, rapid, simple, and can be widely applied to the study of DNA methylation.

Cell Line, Tumor ; CpG Islands ; DNA Methylation ; Genes, p16 ; Humans ; Luminescent Measurements ; Nucleic Acid Hybridization ; Promoter Regions, Genetic ; Reverse Transcriptase Polymerase Chain Reaction ; Sulfites

Objective:To explore the application of 3D visualisation technology combined with perforator flap transfer in reconstruction of soft tissue defects in traumatic hand and foot injury and explore the clinical outcomes.Methods:Between January 2021 and February 2023, a retrospective analysis was conducted in the Department of Emergency of the Affiliated Hospital of Jiangsu University and the Department of Sports Medical of Wuxi No. 9 People's Hospital, on the data of 12 patients (13 flaps) who received surgery of 3D visualisation technology combined with perforator flap transfer for soft tissue defects left by traumatic hand and foot injuries. The patients were 7 males and 5 females aged 45 [36.5, 55.8] years old. Nine patients had the defects in hand and 3 in foot, with 3 in the left and 9 in the right. The sizes of defects ranged from 8.0 cm×6.0 cm to 18.0 cm×17.0 cm. The time from injury to surgery was 13.5 [8.3, 20.8] days. Preoperative CTA scans of donor and recipient sites were performed, and the imaging data were processed for 3D image reconstruction and visualisation. A total of 13 flaps were designed and harvested, including 10 free anterolateral thigh perforator flaps (ALTPFs) and 3 pedicled perforator flaps of fibular artery containing fibular nerve nutrient vessel chains. The flap sizes ranged from 9.0 cm×6.0 cm to 20.0 cm×15.0 cm. Five of the donor sites were directly closed by suture and 8 by skin grafting. Monthly outpatient follow-ups were conducted for the first 3 months after surgery, and then the follow-up reviews were conducted through visits of outpatient clinic or reviewed via WeChat interviews. Information about the outcomes of the transferred flaps, complications and function recovery were recorded on all patients.Results:All 13 flaps were successfully harvested and transferred with the assistance of 3D visualisation technology. Preoperative location of perforator vessels was accurate and flap design was reasonable. The 3D visualisation provided an effective guidance for surgical manipulation. Twelve flaps survived completely after surgery. One flap that had partial necrosis healed after skin grafting. All patients were included in more than 6 months of postoperative follow-up, with a mean follow-up duration of 8.1 months±1.7 months. All flaps had good colour and texture. Four flaps that had swollen appearance received secondary thinning surgery with satisfactory outcomes. The recovery of 9 patients with hand injury was evaluated according to the Blood Circulation Elauation of Severed Finger Replantation Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association. At the final follow-up, the blood supply of flaps was excellent in 11 flaps and good in 2 flaps. Hand function was excellent in 2 hands, good in 4 hands and poor in 3 hands. Scores of American Orthopedic Foot and Ankle Societ(AOFAS) ankle-hindfoot was used for foot function evaluation and all 3 patients were in excellent. Of the postoperative complications, due to a haematoma beneath the flap, a local infection and a delayed fracture healing were occurred in 3 patients separately.Conclusion:The 3D visualisation technology assisted perforator flap transfer can achieve high-quality reconstruction of defects in hand and foot through precise preoperative flap design and simulated surgical incision, therefore it provides a better treatment outcomes for patients.

AIMTo study the clinical effects of a disposable circumcision device in treatment of male patients of different ages with either phimosis or excess foreskin.

METHODSOne thousand two hundred patients between the age of 5 and 95 years underwent circumcision using this procedure in the 2-year period between October 2005 and September 2007. Of these cases, 904 had excess foreskin and 296 were cases of phimosis.

RESULTSIn 96.33% of the cases the incision healed, leaving a minimal amount of the inner foreskin with no scarring and producing good cosmetic results. There were no incidents of device dislocation or damage to the frenulum. The average operative time was 2.5 min for excess foreskin, and 3.5 min for phimosis. During the 7 days of wearing the device, mild to moderate edema occurred in 10.08% of cases with excess foreskin and in 2.58% of those with phimosis. Edema in the frenulum was seen in 1.67% of patients, and only 0.67% had an infection of the incision. A total of 86.25% of patients reported pain due to penile erection. After removal of the device, 0.58% of the cases had minimal bleeding around the incision, and 2.42% had wound dehiscence.

CONCLUSIONThe new device can be applied to an overwhelming majority of patients with phimosis and excess foreskin. This technique is relatively simple to perform, and patients who underwent this surgery had very few complications. Antibiotics were not required and patients reported less pain than those who were circumcised using conventional methods. Circumcision with this device requires minimal tissue manipulation, and is quicker and safer than circumcision using conventional techniques.

Adolescent ; Child ; Child, Preschool ; Circumcision, Male ; methods ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Pain, Postoperative