Objective To evaluate the effect of continuous adenosine infusion on mesentery microcirculation during cardiopulmonary resuscitation in rats with asphyxia. Methods Rat model of asphyxia was established in 22 healthy Wistar rats. The animals were then randomly divided into normal saline group (group A, n=10), epinephrine group (group B, n=6) and epinephrine plus adenosine group (group C, n=6). After a 3-min asphyxia without intervention, cardiopulmonary resuscitation (CPR) was started. The cardiac compression was carried out with an electric cardio-pulmonary resuscitation machine (200 times/min). Respiration was restored and maintained with a ventilator with tidal volume of 4ml, breathing rate 50times/min and FiO2 100%. After a 4-min CPR, rats in group A and group B were given normal saline and epinephrine (bolus of 90?g/kg) respectively, and in group C epinephrine (bolus of 90?g/kg) plus 70?g/kg adenosine were given. Electric defibrillation would be initiated if there was ventricular fibrillation. The reperfusion rate of mesentery arterioles and venules, diameter of blood vessels and relative blood velocity were observed. Results The reperfusion rate of mesentery arterioles and venules was significantly higher in group C than in group B (P

Objective To evaluate the role of standard CPR training in Beijing Olympics medical volunteers by compared with the no-traimng medical personnel.Method Performance qualities of CPR was evaluated in the 44 medical vohmteers,who worked in a Beijing Olympic Venue.They received the training On standard CPR for 6 monthes,and served as training group.The performance of another 72 emergency medical workers from first-class hospitals without the training on stand CPR within 1 year(control group) Was compared with training group.Phillips QCPR3535 monitor was used to measure the compression frequency,depth and chest re-expand between the compression and the operation time via the sternal chest compression pad fitted with an accelerometer.Personal practical results of 5 circles of CPR operation were recorded in a table and the numbers ofpractical. Compression in one minute were counted.Data Were analyzed with chi-quare test and t-test.The parameters ofthe influence fac.tor(gender,age,hand placement,hand skill,compression posture and standard training)were brought into logistic regression analysis.Results Compared with the control group,the qualification rate of general CPR performance in the training group was much higher(86.4%vs.31.9%),and the compression cpmlification rates of the chestcompression,depth and chest re-palld betweenthe compression wcfe higher(88.6%,93.2%,95.5% vs.40.3%,43.0%,86.1%,P<0.01),the duration of ventilation in each operationstion was shorter[(6.38±1.3)vs.(7.57±1.6),P0.05],pratieal compressionn flberin oneminutewas not different[(77.2±3.5)vs.(77.8±12.2),P>0.05)],the ratios of the duration of compression to that of ventilation was higher(2.6:1 vs.2.1:1).Logistic analysis showed that hand skill,compression posture and standard CPR trainings were high correlated with the CPR performance qualities(P<0.05).Conclusions The performance quahty of training group is much higher thanthat ofcontrol group.The standard and continuous CPR training is elfecfive in improving the quality of CPR operation.

Objective To summarize the clinical characteristics and diagnosis and treatment of hemangioma of small intestine in children.Methods Location,pathology,clinical manifestation,diagnosis and treatment of 3 cases from our hospital and 44 cases reported in our courtry with hemangioma of the small bowel were analyzed from 1994 to 2004.Results These tumors locating in jejunum,ileum,duodenum as well as parts small intestine were 31.9%,42.6%,4.2% and 21.3%,respectively.Solitary and multiple tumors were 29.8% and 70.2% separately.The histopatholical report of 10 cases revealed that capillary,cavernous,mixed type hemangioma and hematolymphangioma were 2,6,1 and 1 cases,respectively.Thirty nine children presented with recurrent black stool.Five patients manifest in the form of intussusception.One child passed a bloody stool so massive as to cause shock.Small-bowel obstruction occurred in 5 cases.The hemoglobin of 38 patients were lower than 90 g/L.The incidence of preoperative diagnosis was only 10.6%.All of patients were performed operation.Conclusions The frequent locations of hemangioma of small intestine are in ileum and jejunum,and multiple tumors are common.The diseases are characterized as recurrent hematochezia with painlessness.Preoperative diagnosis of a small bowel hemangioma can be very difficult.The segments of small bowel with hemangioma resection are the most method of the treatment.

OBJECTIVETo study the effects of the superficial venous trunk (SVT) and its nourishing vessels on early revascularization of the reverse-flow random flap in order to provide theoretical evidences for clinical applications.

METHODSThe morphologic changes of micrangium of the reverse-flow random flap with SVT and without SVT were observed at different phases and compared by optical microscopy and stereological methods.

RESULTSThe micrangium density of the flaps with SVT and without SVT showed a tendency of increasing at 3 days after the operation. At 5 to 10 days, the micrangium density of the flap with SVT was much higher than the flap without SVT. There was significant difference between the two groups, which was proved by the optical microscopy observation.

CONCLUSIONSThis study suggests that SVT and its nourishing vessels could promote early revascularization of the flap after transplantation. The SVT can be of benefit to the survival of the reverse-flow random flap.

Animals ; Graft Survival ; Microcirculation ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; blood supply ; Swine ; Swine, Miniature ; Veins ; transplantation

OBJECTIVETo explore the effect of Buyang Huanwu decoction (BHD) drug serum on rat's in vitro cultured cerebral cortical neuron apoptosis induced by hypoxia, and on the expression of p53 and p21 genes in hypoxia process.

METHODSThe model of hypoxia neuron apoptosis was established adopting Daniel method and treated with BHD drug serum. The neuron apoptosis rate was determined by flow cytometry with propidium iodide staining, the p53 and p21 gene expression was tested by immunohistochemical method with flow cytometry.

RESULTSBHD could significantly inhibit the neuron apoptosis induced by hypoxia and down-regulate the expressions of p53 and p21 genes.

CONCLUSIONBHD shows inhibition on neuron hypoxia apoptosis and down-regulating of the p53 and p21 gene expression is one of its mechanisms.

Animals ; Apoptosis ; drug effects ; Cell Hypoxia ; Cells, Cultured ; Cerebral Cortex ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Male ; Neurons ; pathology ; Oncogene Protein p21(ras) ; biosynthesis ; genetics ; Rats ; Rats, Wistar ; Serum ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics

OBJECTIVETo evaluate the available surgical treatment modalities so as to explore the optimal strategy of managing early breast cancer.

METHODSThe clinical data of 2173 consecutive early-stage breast cancer patients treated by surgery treatments were retrospectively reviewed in order to clarify the indications and contraindications of different modalities. Therapeutic outcome of different surgical treatment modes were compared in terms of recurrence-free survival ( RFS) , disease-free survival ( DFS) , overall survival (OS). The cosmetic results of breast conservation and reconstruction were also evaluated .

RESULTSThe median age of these patients was 51 years ranging from 18 to 91. Of 2173 patients, 547 had stage 0- I lesions and 1626 stage II , and 1155 (53. 2% ) premenopausal. The proportion of patients who received radical surgery, breast conservation and reconstruction after mastectomy was 83. 6% (1817/2173), 10. 5% (229/2173) and 2. 5% (55/2173) , respectively. Younger and premenopausal patients prefer conservative and reconstructive surgeries, which are reasonable for stage 0-I and non-invasive breast cancer patients. Conservative surgery was not suitable for Paget's disease of breast (P = 0. 004) , mastectomy followed by reconstruction in this type of cancer was up to 38. 5%. The recurrence and metastasis rate of conservation or mastectomy were similar with a comparable 3-year RFS of 97. 4% and 95. 4% , respectively; there were also no significant differences in RFS(P =0. 2435) , DFS( P =0. 1395) and OS(P =0. 9406) after having been followed for 3 to 64 months. Similarly, immediate reconstruction did not show any negative effects with only 1 recurrence and 1 metastasis. Aesthetic outcomes were assessed as excellent or good in 90. 0% of breast conservation surgery, and the acceptability of reconstruction was 94. 5%.

CONCLUSIONBreast conserving surgery not only has comparable survival as mastectomy, but also has better cosmetic outcomes. Immediate breast reconstruction can be a suitable option without compromising survival. It is very important in the management for early breast cancer by selecting the most suitable surgery mode for every individual patient not only to cure her disease but also to satisfy the patient psychologically. Conservation should be preferred prior to reconstruction whenever possible.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; pathology ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Paget's Disease, Mammary ; pathology ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies

OBJECTIVEApneaGragh is a new device for simultaneous determination of obstructive sleep apnoeic events and continuous pressure measurements for localization of upper airway obstructive site. This study is to evaluate the clinical value of it.

METHODSFrom April to October in 2006, 32 obstructive sleep apnea (OSA) patients diagnosed by polysomnography (PSG) were examined by two methods: Endoscopy with müller's maneuver at daytime and continuous upper airway pressure recording with ApneaGraph at night in Peking Union Medical College Hospital. The upper airway obstructive sites determined by the two methods were compared. ApneaGraph transducer catheter contains two pressure sensors and two temperature sensors used for obstruction site determination and detection of apnoeic events during sleep. Obstructive sites were divided into upper (retropalatal oropharynx) or lower level (retroglossal region). The lower limit of upper airway obstruction was determined by observed pressure pattern. Used constituent retio to reflect the obstructive proportion of different levels. The apnea hypopnea index (AHI) measured by PSG and ApneaGraph were also compared.

RESULTSTwo patterns of obstruction were observed in our group: 1. The site of obstruction was located only at the upper level. 2. The obstruction of upper and lower level all present. Site of obstruction determined by Apneagraph: 28 (87.5%) cases had predominant sites of obstructions in upper level (the constituent retio of retropalatal obstruction > 50%), the others in lower level (the constituent retio of retroglossal obstruction > 50%). Endoscopy localization of obstruction: 18 cases had retropalatal obstructions alone, 13 cases had obstructions of retropalate combined with retroglossa, only 1 patient didn't have obstruction. Defined the constituent retio higher than thirty percent the criteria of obstruction, then identical results were obtained by both methods in retropalatal segment in 27 (84.4%) of the patients, while in only 17 (53.1%) obstructions was determined by the both methods in retroglossal areas. The polysomnograpic AHI (x +/- s) was 52.2 +/- 18.1, versus 50.2 +/- 16.0 obtained by ApneaGraph. There was a significant correlation between them (r = 0.876, P < 0.001).

CONCLUSIONSApneaGraph can identify the level of upper airway obstruction more accurate than fiberoptic pharyngoscopy. In the meantime, it also can serve as a portable PSG to diagnose sleep disordered breathing qualitatively.

Adult ; Aged ; Continuous Positive Airway Pressure ; instrumentation ; methods ; Endoscopy ; methods ; Humans ; Middle Aged ; Monitoring, Ambulatory ; instrumentation ; methods ; Polysomnography ; instrumentation ; methods ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology ; Young Adult

OBJECTIVETo construct a novel kind of nonviral gene delivery vector based on polyethylenimine (PEI) conjugated with polypeptides derived from ligand FGF with high transfection efficiency and according to tumor targeting ability.

METHODSThe synthetic polypeptides CR16 for binding FGF receptors was conjugated to PEI and the characters of the polypeptides including DNA condensing and particle size were determined. Enhanced efficiency and the targeting specificity of the synthesized vector were investigated in vitro and in vivo.

RESULTSThe polypeptides were successfully coupled to PEI. The new vectors PEI-CR16 could efficiently condense pDNA into particles with around 200 nm diameter. The PEI-CR16/pDNA polyplexes showed significantly greater transgene activity than PEI/pDNA in FGF receptors positive tumor cells in vitro and in vivo gene transfer, while no difference was observed in FGF receptors negative tumor cells. The enhanced transfection efficiency of PEI-CR16 could be blocked by excess free polypeptides.

CONCLUSIONThe synthesized vector could improve the efficiency of gene transfer and targeting specificity in FGF receptors positive cells. The vector had good prospect for use in cancer gene therapy.

Animals ; Binding Sites ; Carcinoma ; therapy ; Cell Line, Tumor ; Cell Survival ; drug effects ; Dose-Response Relationship, Drug ; Female ; Fibroblast Growth Factors ; metabolism ; Gene Transfer Techniques ; Genetic Vectors ; chemical synthesis ; chemistry ; pharmacology ; Humans ; In Vitro Techniques ; Ligands ; Liver Neoplasms ; therapy ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Particle Size ; Peptides ; chemistry ; metabolism ; pharmacology ; Polyethyleneimine ; chemistry ; metabolism ; pharmacology ; Prostatic Neoplasms ; therapy ; Receptors, Fibroblast Growth Factor ; drug effects ; genetics ; metabolism ; Structure-Activity Relationship ; Surface Properties ; Transfection ; Transplantation, Heterologous ; Xenograft Model Antitumor Assays

Objective: To observe the effect of coxsackie virus B3 on airway tract and lung morphology, and to study the relation between CVB infection and asthma. Methods: We established CVB3 infective model: 5 d neonatal rats inhaled CVB3 by ultrasonic brume. CVB3-IgM was examined 10 d after inoculating of CVB3, and LW/BW, airway tract and lung pathological change 10 d and 30 d after inoculation of CVB3 were observed. Results: Rats from the virus group had higher D of CVB3-IgM than control's (+2s ) and had higher LW/BW 10 d after inoculation of CVB3 than control (P<0.01). Neonatal rats had acute inflammatory changes 10 d after inoculation of CVB3 and persistent changes in morphology and cytology. Conclusion: Neonatal rats virus model is established. Respiratory infection by CVB3 in neonatal rats has persistent changes in airway tract inflammatory and morphology.

OBJECTIVESevere nasopharyngeal stenosis (NPS) is a rare complication of uvulopalatopharyngoplasty (UPPP) and very difficult to manage. This report presents our successful treatment experience.

METHODSFrom Nov 1997 to Feb 2006, 6 adults patients with NPS secondary to UPPP were treated in Peking Union Hospital. Two cases was grade II stenosis, received surgery of local pharyngeal and soft palate mucosa flap rotation to enlarge nasopharyngeal airway with stenosis; For the remaining 4 cases with more severe NPS (grade III) who had received 1-3 times unsuccessful repair procedures previously, prolonged nasopharyngeal hollow obturators were used for 6 months after stenosis repair surgery.

RESULTSWith 9-48 months follow-up, All cases results were satisfactory. Nasal obstruction symptom was eliminated, NPS corrected, no velopharyngeal insufficiency complication happened. Daytime removable nasopharyngeal hollow stent obturators with palate support device is more comfortable for patients.

CONCLUSIONSLocal flap rotation to enlarge stenosis airway and prolonged use nasopharyngeal hollow obturators are reliable methods of correction NPS following UPPP.

Adult ; Cicatrix ; complications ; surgery ; Humans ; Male ; Middle Aged ; Nasopharyngeal Diseases ; etiology ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Reoperation ; Treatment Outcome ; Uvula ; surgery