Objective: To assess whether the level of γ-glutamyltransferase(GGT) correlates with severity and stability of coronary atherosclerosis and other established cardiovascular risk factors. Methods: According to the results of coronary angiography, 132 patients with coronary heart disease(CHD) were selected to the CHD group. These patients were further divided into subgroups according to the clinical types, the number of diseased coronary branches. They were devided into one-vessel, two-vessel or three-vessel disease on the basis of the number of diseased coronary branches; were devided into stable angina pectoris and acute coronary syndrome according to the clinical types. 30 patients without CHD were selected to the control group. The level of GGT, white blood cell (WBC) count, total bilirubin(TBiL), fasting plasma glucose(FPG), total cholesterol (TC), triglyceride(TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL),glutamic-pyruvic transaminase(ALT), high sensitive C reactive protein(hs-CRP),systolic blood pressure(SBP), diastolic blood pressure(DBP), body mass index(BMI)were measured, and age, prior medical histories including hypertension? diabetes mellitus and smoking status were obtained. The level of GGT was compared statistically between the subgroups, and correlation coefficients of GGT level with other conventional risk factors for CHD were calculated. Results: The level of GGT in CHD patient was significantly higher than that in controls. The level of GGT increased with the increasing number of diseased coronary branches. No significant difference was found in the level of GGT between patients with acute coronary syndrome and stable angina pectoris. The level of GGT was positively correlated with TC, TG and LDL, weakly correlated with WBC count and FPG, not correlated with hs-CRP, negatively correlated with TBiL. HDL. Conclusion: The level of GGT is associated with pathological severity of coronary atherosclerosis and other established cardiovascular risk factors, though it is not associated with stability of pathological changes of the coronary artery. The plasma level of GGT may be an independent risk factor for CHD.

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.

OBJECTIVETo compare clinical outcomes of superior labrum from anterior to posterior (SLAP) repair and biceps tenodesis in treating type I SLAP injury.

METHODSFrom March 2009 to March 2012, 38 patients with type II SLAP injury were treated with SLAP repair and biceps tenodesis, and all patients were unilateral SLAP injury. Sixteen patients treated with biceps tenodesis included 8 males and 7 females with an average age of (49.3±3.7) years old (ranged, 45 to 54); 10 cases were on the left side and 6 cases on the right side; 10 cases were caused by falling down, 2 cases were caused by throwing damage and 4 cases were caused by daily life damage; the time from injury to operation were from 3 to 8 weeks. Twenty-two patients treated with SLAP repair included 14 males and 8 females with an average age of (49.0±2.8) years old (ranged, 44 to 56); 13 cases were on the left side and 9 cases were on the right side; 14 cases were caused by falling down, 5 cases were caused by throwing damage and 3 cases were caused by daily life damage; the time from injury to operation were from 3 to 7 weeks. Preoperative, postoperative at 6 months, 1 year and 2 years' UCLA and SST score were compared between two groups.

RESULTSThere was no significant differences in UCLA and SST score between two groups before operation. At 6 months after operation, UCLA and SST score in biceps tenodesis group was higher than SLAP group, and action,range of anteflexion, strength of anteflexion, degree of satisfaction in biceps tenodesis group was higher than SLAP group. There was no significant meaning in SST and UCLA score between two groups at 1 and 2 years after operation.

CONCLUSIONShort-term efficacy of biceps tenodesis for SLAP injury is better than SLAP repair, but long-term efficacy is fairly.

Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Shoulder Joint ; injuries ; surgery ; Tendon Injuries ; surgery ; Tenodesis

OBJECTIVETo explore the prophylactic effect of acupuncture Neiguan (PC 6) on nausea and vomiting after laparoscopic operation.

METHODSOne hundred patients with laparoscopic gastrointestinal operation were randomly divided into an acupuncture group and a control group, 50 patients in each group. The operation was carried out with the combined infusion and inhalation anesthesia. The patients in the acupuncture group were being punctured at bilateral Neiguan (PC 6) before anesthesia and during the operation. The needles were extracted after operation, and the acupoints were covered with opaque tape. In contrast, the patients in the control group only accepted tape covering without acupuncture. After operation, all patients were given the self-controlled intravenous analgesia, and followed up at 6 h, 12 h, 24 h, 48 h for recording the incidence rate of the nausea, retching and vomiting, then scoring with VAS.

RESULTSAt 6 h, 12 h, 24 h, 48 h after operation, in the acupuncture group, the incidence rates of the nausea were 12.0%, 6.0%, 6.0% and 2.0%, and the incidence rates of the retching were 0, 0, 2.0% and 2.0%, respectively; in the control group, the incidence rates of the nausea were 28.0%, 20.0%, 12.0% and 2.0%, and the incidence rates of the retching were 2.0%, 6.0%, 2.0% and 0, respectively. At 6 h, 12 h after operation, the incidence rates of the nausea and retching in the acupuncture group were lower than those of the control group (P < 0.05, P < 0.001). The vomiting was not happened in both groups. There was no difference between the two groups according to the scoring with VAS.

CONCLUSIONAcupuncturing at Neiguan (PC 6) can reduce the incidence rates of the patients' nausea and retching after laparoscopic operation, especially in 24 h.

Acupuncture Therapy ; Adult ; Aged ; Analgesics ; adverse effects ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Nausea ; prevention & control ; therapy ; Postoperative Complications ; therapy ; Vomiting ; prevention & control ; therapy

OBJECTIVETo investigate the changes of EEG approximate entropy (ApEn) in rats during focal cerebral infarction.

METHODSTwenty-four Sprague-Dawley (SD) rats were randomly divided into infarction group (n=12) with middle cerebral artery occlusion and sham-operated group (n=12). The EEG data (ApEn) was recorded in the bilateral areas (C3, C4) of the rats with focal cerebral infarction before the infarction and immediately and at 5, 15, 30, and 60 min after the infarction. The same measurement was carried out in the sham-operated group.

RESULTSIn the sham-operated group, ApEn in C3 and C4 showed no obvious differences at the time points (P>0.05), but in the infarction group, ApEn in C3 and C4 increased significantly after the infarction. ApEn in the ischemic area (C4) was significantly lower than that in the non-ischemic area (C3) (P<0.05). The bilateral ApEn decreased with the passage of time. ApEn in the ischemic area (C4) was significantly lowered at 30 min after the infarction in comparison with that before infarction (P<0.05). In the sham-operated group, ApEn showed no significant difference between C3 and C4. ApEn was comparable between the two groups before the operation.

CONCLUSIONApEn can help monitor the occurrence of focal cerebral infarction of rats, and may be used to assess the extent of cerebral ischemia after infarction.

Animals ; Cerebral Infarction ; physiopathology ; Electroencephalography ; Entropy ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the effects of pravastatin, fosinopril and their combination on ventricular remodeling, cardiac function, tumor necrosis factor-alpha (TNF-alpha) mRNA expression, and matrix metalloproteinases (MMPs) activities after myocardial infarction (MI) in rats.

METHODSAcute myocardial infarction (AMI) was established by ligation of the anterior descending coronary artery in male Sprague-Dawly (SD) rats. Twenty-four hours after the procedure, the 48 surviving rats were grouped randomly as AMI control, fosinopril (10 mg.kg(-1).d(-1)), pravastatin (20 mg.kg(-1).d(-1)) and a combined use of the 2 drugs. Sham-operated group (n = 8) was taken randomly as non-infarction control. Six weeks after treatment with the drugs by gastric gavage, heart function and left ventricular remodeling were assessed. Left ventricular weight (LVW)/body weight (BW) ratio was determined. The relative expression of myocardium TNF-alpha mRNA was assessed by reverse transcription-polymerase chain reaction. Left ventricular myocardium MMPs activities were assessed by Zymography.

RESULTSThere were no significant differences among the four AMI groups in infarction size (P > 0.05). In comparison with the AMI group, left ventricular end-diastolic pressure, left ventricular end-diastolic diameter, LVW/BW all decreased significantly (P < 0.05 - 0.01); while dp/dtmax, dp/dtmin, fractional shortening (FS) and ejection fraction (EF) increased significantly in all three drug-treated groups (P < 0.05 - 0.01); increments of FS, LVEF and dp/dtmax were more evident in the combination group than either the fosinopril or pravastatin group (P < 0.05). The levels of TNF-alpha mRNA in AMI rats treated with fosinopril, pravastatin and their combination reduced 29%, 26% and 33%, respectively (P < 0.01); MMP-2 activity reduced 25%, 30% and 35%, respectively (P < 0.01); MMP-9 activity reduced 20%, 18% and 24%, respectively (P < 0.01). There were no significant differences in other variables among the 3 treatment groups (P > 0.05).

CONCLUSIONPravastatin, fosinopril and their combination showed favorable effects on left ventricular remodeling after AMI in rats and demonstrated improved cardiac function. The combined treatment group yielded better results in the context of improving left ventricular systolic function. These effects could be relevant to the attenuation of increased MMP-2 and MMP-9 activities and left ventricular expression of TNF-alpha.

Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Animals ; Drug Therapy, Combination ; Fosinopril ; administration & dosage ; therapeutic use ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Myocardial Infarction ; drug therapy ; pathology ; physiopathology ; Pravastatin ; administration & dosage ; therapeutic use ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; genetics ; Ventricular Remodeling ; drug effects

BACKGROUNDThe aim of this research was to determine the efficacy of combination therapy using an alginate dressing and mouse epidermal growth factor (mEGF) on proliferation and differentiation of epidermal stem cells (ESCs) in patients with refractory wounds.

METHODSEighteen patients (12 males and 6 females, aged from 18 to 61 years (mean 36.4 years)) with various skin wounds, were treated by dressing changing for one month. The wounds were located in the foot (11), calf (3), thigh (2) and forearm (2). The patients were randomly divided into 3 groups: alginate dressing and mEGF (group A; n = 6), mEGF (group B; n = 6) and control (group C; n = 6). Wound closure indexes were measured at 7, 14, 21 and 28 days. Samples were harvested for pathologic examination, at 7 and 14 days following treatment. Cytokeratin 10 (CK10) and cytokeratin 15 (CK15) positive cells were evaluated using the super-sensitivity (SP) immunohistochemical staining technique.

RESULTSWound healing was promoted in groups A and B. In group A, the wound closure index was increased significantly (P < 0.05), and in one case the maximum cure area reached 102 cm(2). Pathological examination identified a thicker epidermis, active angiogenesis and enhanced granulation in group A compared with groups B and C. Using the SP immunohistochemical staining technique, we showed that ESCs in group A were bigger in size and larger in number than in groups B and C. Overall, there was a significant difference in ESCs proliferation and differentiation between group A and group B (or C).

CONCLUSIONSCombination therapy using an alginate dressing and mEGF shows increased proliferation and differentiation of ESCs in patients with refractory wounds compared with those treated with mEGF alone.

Adolescent ; Adult ; Alginates ; therapeutic use ; Animals ; Bandages ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Epidermal Growth Factor ; therapeutic use ; Epithelial Cells ; cytology ; Female ; Glucuronic Acid ; therapeutic use ; Hexuronic Acids ; therapeutic use ; Humans ; Immunohistochemistry ; Keratin-15 ; metabolism ; Male ; Mice ; Middle Aged ; Stem Cells ; cytology ; drug effects ; Wound Healing ; drug effects ; Young Adult

OBJECTIVESTo address the difference of pathologic and clinical characteristics of the young and the middle-aged and elderly patients with advanced rectal cancer after neoadjuvant radiotherapy.

METHODSA total of 252 patients undergoing radical surgery from January 2000 to January 2005 were included in this study. The patients were divided into two groups according to the age at diagnosis:young-patient group (< 40 years) and old-patient group (≥ 40 years). The pathologic and clinical materials were collected and the oncologic outcome was compared between the two arms.

RESULTSA total of 252 patients were included in this study, included 54 patients in young-patient group and 198 patients in old-patient group, respectively. There was no significant difference in gender, clinical stage and pretreatment serum carcinoembryonic antigen (CEA) between the two groups. However, the proportion of mucinous and signet-ring cell cancer was significantly higher in young-patient group (20.4% vs. 4.0%, P < 0.05), and furthermore, the proportion of pathologic stage later than IIIA was also significantly higher in the young-patient group (61.1% vs. 42.9%, P < 0.05). There was no significant difference in local recurrence rate between the patients who received neoadjuvant radiotherapy and those who did not in the young-patient group, whereas the difference was observed significant in the old-patient group (3.3% vs. 11.2%, P < 0.05). There was no significant difference in both the disease free survival and overall survival between the two arms (5y-DFS: 63.3% vs. 68.5%, P > 0.05; 5y-OS: 73.5% vs. 72.9%, P > 0.05).

CONCLUSIONSRectal cancer in young patients has poorer histologic differentiation and more advanced pathologic stage, but the long-term survival is similar to that in middle-aged and elderly patients. The local control effect of neoadjuvant radiotherapy on rectal cancer in young patients still need to be further investigated.

Adult ; Age Factors ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Preoperative Care ; Prognosis ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; pathology ; radiotherapy