Objective To explore the difference of the level of Th1/Th2 balance and change of CD4+ CD45R cell after treated by laparoseopy-assisted rectal cancer surgery and conventional open rectal cancer surgery, so to compare the effect of the two procedures on immunity function of the patients. Methods CD4+ IFN-γ+ T cell (Thl cell), CD4+ IL-4 + T cell( Th2 cell)and the ratio of Th1/Th2 were detected by flow cytometery ; The levels of IFN-γand IL-4 were measured by ELISA. The changes of CD4 + CD45RA+ T cell and CD4+ CD45RO+ T cell were detected in the different procedures so that the effect of the two procedures on eytoimmunity and immune balance were analyzed. Results Compared with baseline levels, the level of Th1 cells was decreased [ (4.51±1.52 ) %, (7.26 ±2.59) % vs. ( 12.06 ±1.82 ) % ] (P < 0.05 ) ; The level of Th2 cells was increased [ (6.70 ± 2.41 ) %, (6.70 ± 2.41 ) % vs. (4.47 ± 1.90) % ] ( P < 0.05 ) ; The level of IFN-γ was decreased [ (57.15± 23.64) ng/L, (72.70 ± 27. 31 ) ng/L vs. ( 123.47 ± 32. 52) ng/L ] ( P < 0. 01 ) ; The level of IL-4 was increased [(55.55±7.29)ng/L,(57.56 ±7.13)ng/L vs. [(41.87±5.83)ng/L] (P<0.05) on 2nd and 7th day after conventional open reeatal cancer surgery; The level of Thl, Th2, IFN-γ and IL-4 in the laparoscopy-assisted rectal cancer surgery was not different ( P > 0.05 ). At 7 day postoperatively, the level of the CD4+ CD45 RA+ T cells was in-creased (35.11 ±7.82) and the CD4+ CD45RO+T cells was decreased(61.21±9.13) compared with surgery be-fore(31.11±6.72) and (68.11 ±11.42) respectively (P< 0.05). Conclusions The laparoscopy-assisted rec-tal cancer surgery has less influence on immune balance, thus protect systemic cell immunity.

Objective To observe the effect of transfer factor on immunity in patients with varruca plana and the clinical effect of treatment. Methods Sixty patients with varruca plana were randomly divided into a treatment group (treated with transfer factor) and a control group (treated with routine therapy). Before and after the treatment, T-lymphocyte subgroups in peripheral blood of all the patients were determined by flow cytometry and serum levels of interleukin-10 (IL-10)and in-terferon-gamma (INF-γ)were detected by ELISA. The same detections were done to the twenty healthy volunteers as healthy controls. Results Effective rates in the treatment group and control group were 76.67 % and 43. 33 %, respectively (x2=5. 63,P<0.05). Decrease of CD3+ cells, CD4+ cells, CD4+/CD8+ ratio and increase of CD8+ cells were found in varruca plana group as com-pared with the healthy controls(P<0.01 ). After the treatment of transfer factor, increase of CD3+ cells ,CD4+ cells (P<0.05), CD4+/CD8+ ratio (P<0. 01)and decrease of CD8+ cells(P<0.01)were found in the treatment group as compared with those before treatment, while there were no significant difference in the control group before and after the treatment. Higher IL-10 and lower INF-γ in serum were found in varruca plana group as compared with the healthy controls (P<0.05). After the treat-ment of transfer factor, decrease of IL-10 and increase INF-γ in serum (P<0. 05)were found in the treatment group as compared with those before treatment, while there were no significant difference in control group before and after the treatment. Conclusion The results reveal that immunity is im-paired in patients with varruca plana. Transfer factor can enhance the immunity of the patients. Therefore, varruca plana patients treated with transfer factor receive better effects.

Objective To explore the relationship between the osteonecrotic volume (lesion size), angle and the index of necrotic extent on the femoral head. Methods Fifty-one hips in 39 patients with non-traumatic avascular osteonecrosis on the femoral head were divided into 12 equal segments from the head to the neck junction (a turning point of the spherical curve of the head) with whole hip displacement, each with 30 degrees on a coronal plane of weight-bearing surface. The osteonecrotic angle of the arc of each necrotic segment from the center of the femoral head was measured at the point of one- to 12-o'clock on imaging of two dimensional reconstruction of computerized tomography (CT) scans and anteroposterior and lateral radiographs. Necrotic volume on each segment of the femoral head was calculated with fluid displacement method. The index of osteonecrotic extent on the femoral head was calculated using direct anatomical measurements. Results Osteoneerotic volume on the femoral head at the point of 12- to one-o'clock on coronal plane was (74. 5 ± 7.4)% of the sphere equivalent of the whole femoral head, which was positively correlated to its necrotic angle [ (41.9±8. 3) degrees] at the point of one-o'clock on the plane, with a coefficient of correlation of 0. 843, and that at the point of one- to two-o'clock on the plane was (73.7 ±0. 4) %, which was positively correlated to its necrotic angle [ (41.9 ± 1.8) degrees] at the point of two-o'clock, with a coefficient of correlation of 0. 543. Osteonecrotic volume on the point of 11- to 12-o'cleck was (83.6±8.6)%, and the necrotic angle at the point of 12-o'clock was (44. 9±3.9) degrees, which were positively correlated each other, with a coefficient of correlation of 0. 701 (P <0. 01 ). Osteonecrotic volume on the femoral head was positively correlated to its necrotic angle , modified index of necrotic extent, index of necrotic extent and Kerboul conjugated necrotic angle, with coefficients of correlation of 0. 798, 0. 701, 0. 377 and 0. 398 ( P < 0. 01 ), respectively, at the point of one o' clock. Conclusions Measurements of osteonecrotic volume was positively correlated to the index of necrotic extent and necrotic angle on the femoral head, respectively. Necrotic angle on the plane at 30-degree of the trochanter on the femoral head can well reflect its necrotic volume.

We evaluated the patient in the early,advanced or healing phase of the disease by MRI in the treatment of chronic brucellosis spondylitis and to guide the clinical treatment.MRI images of 40 patients with clinically diagnosed chronic brucellosis spondylitis were analyzed retrospectively.The imaging findings of early,advanced and healing patients were summarized.MRI showed abnormal signals in the vertebral body,intervertebral disc,paraspinaI and psoas muscle.It is early stage if the intervertebral space was normal,and advanced stage if combined with interverbral space stenosis.It demonstrated short T1 and short T2 signal or similar to the normal vertebral body,combined with intervertebral space stenosis,for the healing stage.According to the specific imaging manifestations of chronic brucellar spondylitis in the course of disease development,it is possible to evaluate the clinical stage of the disease and guide the rational selection of clinical treatment.

Objective To analyze the characteristics of the F waves,H-reflex and nerve conductions and its diagnostic value in the patients with Guillain-Barré syndrome(GBS)onset within 4 weeks.Methods The electrophysiological data of the 40 patients with GBS were analyzed retrospectively.These patients were divided into 2 groups according to the duration of illness including in 2 week' s group and over 2 week' s group.The results of the F waves,H-reflex,the motor nerve conduction velocity (MCV),and the sensory nerve conduction velocity(SCV)of these patients were analyzed.Results The abnormality rate of the F waves was 17/20 and 7/18 respectively in less 2 week' s group and over 2 week' s.The H-reflexes were 13/20 and 12/19.The MCV was 28.4％(25/88)and 32.9％(26/79).The distal motor latency was 40.9％(36/88)and 36.7％(29/79).The compound muscle action potential amplitude was 35.2％(31/88)and 32.9％(26/79)respectively in these two groups.The abnormality rate of the SCV was 11.2％(10/89)and 25.2％(24/95)respectively in the two groups.The higher abnormality rate of these tests was the F waves and H-reflex in both the groups.The abnormality rates of the F waves(x2 =8.657,P =0.003)and SCV(x2 =6.002,P =0.014)were significantly different between the two groups.There were no significant differences in the other tests.Conclusion The electrophysiological tests are valuable in the diagnosis of GBS.The F waves and H-reflex are more significant for early diagnosis of GBS.

Objective To clarify the protective effect of nrsodeoxycholic acid ( UDCA ) on endoplasmic reticulum stress-mediated apoptosis in pancreatic β-cell of streptozotocin ( STZ )-induced diabetic rats.Methods Rats( n =40) received a single injection STZ( 50 mg/kg) intra-peritoneally and formed a β-cell injury model.Weight-matched normal rats( the control group,n =10 ) were injected with the buffer alone.STZ-treated rats with persistent random blood glucose higher than 16.7 mmol/L for 1 week were considered as diabetic status( n=14 ),then divided randomly into STZ-induced diabetes mellitus ( DM ) group ( n =7 ) and UDCA-treated DM group ( n =7 ).UDCA (40 mg· kg- 1,d-1 ) was administered daily by intragastric intubations throughout the experimental period (30 d).During the entire experiment,blood glucose in all rats was assessed.By the end of the experiment,all rats were sacrificed with the pancreas removed and the blood sample collected immediately.Fasting insulin levels were assayed by radioimmunoassay.The morphological changes of pancreatic β-cells apoptosis were determined by TUNEL assay.RNA in pancreas was abstracted and microarray containing 89 pieces of apoptosis related genes was applied.The related gene expressions were detected by RT-PCR and Western blot.Results The concentration of blood glucose in diabetic rats was gradually decreased after UDCA treatment,but at the end of the experiment it was still higher than that in the normal control group.The treatment with UDCA raised the fasting insulin level in diabetic rats,but this concentration was significantly lower as compared to the control group.Based on TUNEL stained tissue sections,the percentage of β-cell apoptosis of UDCA-treated DM group was significantly lower than that of STZ-induced diabetic group(P＜0.05 ).Among 89 genes,42 genes up-regulated and 46 genes down-regulated in diabetic rats,some of which were ameliorated by UDCA treatment.The expressions of Caspase-3,Bax,Bip,and CHOP mRNA in pancreas of DM group were significantly up-regulated as compared with those in the control group ( P ＜ 0.05 ) ; while the expression of Bcl-2 mRNA was markedly down-regulated (P＜0.05 ).However,these parameters in the U DCA-treated animals showed a marked improvement.Conclusion Ursodeoxycholic acid seems to protect pancreatic β-cell from apoptosis in STZ-induced diabetes by attenuating the severity of endoplasmic reticulum stress.

Objective To determine the effect of losartan on vascular remodeling and the underlying mechanism in spontaneously hypertensive rats(SHR). Methods SHR of 12 weeks old were given losartan orally [0,15,30 mg/(kg·d),n=12]. The tail arterial pressure was measured every week.Eight weeks later, the pathological changes and p22phox expression in the thoracic aorta, the activity of catalase (CAT), the contents of H2O2 and AngⅡ in the plasma were evaluated. Results Blood pressure was increased in the SHR accompanied by the thickened wall and increased p22phox expression in the thoracic aorta. The plasma levels of H2O2 and AngⅡwere elevated while the CAT level was decreased in the SHR. Administration of losartan reversed the thickened wall and increased the CAT activity concomitantly with the decreased plasma levels of H2O2 and p22phox expression in the SHR. The plasma level of AngⅡincreased after the losartan treatment. Conclusion Oxidative stress induces the vascular remodeling of the aorta in the SHR. Losartan can reverse the vascular remodeling through down-regulating p22phox expression and inhibiting the oxidative stress.

Objective To evaluate the feasibility and safety of transrudial cerebral angiography and to discuss the technique points, advantages, disadvantages, indication and contraindication. Methods Transradial cerebral angiography was performed in 52 patients who were not suitable for transfemoral access or could not suffer from being kept in bed for 24 hours after transfemoral angingraphy, related comphcations and success rate of puncture and selective angiography were recorded and compared with transfemoral group (n = 83 ). Chi-square test was used for statistics. Results The success rate of puncture and selective angiography and the comphcation rate of transradial and transfemoral groups were 96.2% (50/52),94.2% (49/52),9.6% (5/52) and 100% (83/83),95.2% (79/83),8.4% (7/83),respectively. There were no significant differences between two groups (X2 = 0.000, P>0.05). After angiography, 2 patients of transradial group developed a mild bruise at the puncture site, no hematoma,pseudoaneurysm and artery- venous fistula occurred. Conclusion Transradial selective cerebral angiography is technically feasible and safe with comfortable and minimal comphcations. It should be used as the choice of mutes for selective cerebral angiography.

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome