Objective The aim of this study was to evaluate the left transthoracic approach in simultaneous antireflux surgery at the time of CDH repair in Infancy.Methods Between June 2008 and June 2012,18 patients underwent a left transthoracic approach in the treatment of type Ⅲ and Ⅳ hiatal hernia.,including 1 gastric volvulus.Clinical presentation in these patients included vomiting(n =12) 、pulmonary infections (n =9)、symptomatic anemia、failure to thrive (n =18).All the patients were evaluated before and after the surgery on clinical presentation,symptoms and functional assessment.Surgical techniques included extensive mediastinal esophageal dissection,Nissen fundoplication,resection of the hernial sac,crural closure.Results The average of operative time was 90 minutes.The mean blood loss was 5 ml.The average length of stay was 15 days.The hours stayed in PICU were 21.5 h.Mean follow-up was 22 months.There was no hospital mortality and hernia recurrence.Only one patient suffered gastroesophageal reflux disease after operation,and was controlled with antireflux medications.Conclusion Transthoracic is the optimal operative approach for treating the esophageal hiatal hernia,with relatively low postoperative morbidity and recurrence rates.Advantages of the transthoracic approach include the facilitation of Nissen fundoplication、esophageal lengthening procedures,and excellent exposure for the crural suturing.

OBJECTIVETo study the effects of pulsed ultrasound (PUS) and pulsed electromagnetic fields (PEMF) on the secretion of extracellular matrix from a culture complex during in vitro chondrogenesis.

METHODSAll the rat bone marrow mesen- chymal stem cell pellets were cultured in achondrogenic medium. Different intensities of PUS (100, 150, and 200 mW · cm⁻²) and PEMF (1, 2, and 5 mT) were applied to the cell pellets for 2 weeks. Group N was cultured without PUS and PEMF stimu- lation as control. The culture medium was collected after 2 weeks of culture. Enzyme-linked immunosorbent assay (ELISA) was used to detect the type of collagen and glycosaminoglycan (GAG) in the culture medium.

RESULTSPUS increased the secreting-type collagen and GAG from cell pellets compared with group N (P < 0.05), whereas there was no difference in different intensities (P > 0.05). PEMF had no significant effect on the secretion of the type of collagen (P > 0.05). A PEMF of 1 mT had no significant effect on the secretion of GAG (P > 0.05). A PEMF 2 and 5 mT decreased the secretion of GAG (P < 0.05).

CONCLUSIONTo prevent the secretary of extracellular matrix may play a role in chondrogenic effect of PEMF.

Animals ; Bone Marrow Cells ; radiation effects ; Cells, Cultured ; Chondrogenesis ; radiation effects ; Electromagnetic Fields ; Extracellular Matrix ; Glycosaminoglycans ; Hematopoietic Stem Cells ; Mesenchymal Stromal Cells ; radiation effects ; Rats ; Ultrasonic Waves

Objective To investigate the effect of the artificial cycle on the prognosis after transcervical resection of adhesion (TCRA) and its mechanism .Methods 80 patients with intrauterine adhesion were randomly divided into the observation group and the control group .The observation group were performed TRCA and postoperative artificial cycle for successive 3 months :oral es-tradiol valerate(9 mg once daily) for 21 d ,adding oral medroxyprofgesterone acetate(10 mg once dialy) on 15 d ,then the medication discontinuation for 7 d ,which was taken as 1 cycle;the control group received only TCRA .The re-examination was performed after 3 months .The levels of follicle stimulating hormone(FSH) ,luteinizing hormone(LH) ,estradiol(E2 ) ,prolactin(PRL) ,progesterone (P) and testosterone(T) were examined by ELISA after TCRA three months .The expression of MMP-9 and TGF-β1 in adhesive endometrium were detected by real-time PCR and Western blot .Results Compared with the control group ,the artificial cycle thera-py combined with the operation could significantly increase the effective rate of TCRA for treating mild and moderate intrauterine adhesion(P<0 .05);the seum levels of FSH ,LH ,E2 ,PRL ,P and T had no statistical differences between the observation group and the control group(P>0 .05);the artificial cycle significantly improved the adhesive degree of intrauterine adhesion ,increased the MMP-9 expression and decreased the TGF-β1 expression .Conclusion Artificial cycle could improve the degree of uterine cavity ad-hesion after TCRA ,which the mechanism might be related to the increase of MMP-9 expression and decrease of TGF-β1 expres-sion .

Objective To investigate the infection and distribution of human papilloma virus (HPV) types in patients with infiltrative cervical cancer (ICC) and cervical intraepithelial neoplasia (CIN) in Chongqing. Methods Fifty-eight cases diagnosed with ICC or CIN[KG-*6]Ⅱ to Ⅲ,which were confirmed by histopathology in the Tumor Hospital of Chongqing,were included in the analysis. DNA enzyme immunoassay (DEIA) and SPF10 LiPA25 (version 1) testing was used for DNA extraction and extension,and linear probe reverse hybridization to detect lesions HPV type. Results HPV infection were detected in 56 of 58 specimen,the positive rates of CINⅡ,CINⅢ and cervical cancer were 100.00%,100.00% and 95.00% respectively. A total of 13 types were detected. HPV16 infection rate was up to 60.00%,followed by HPV18(7.69%),HPV58(7.69%),and HPV31(4.62%). Conclusion HPV16 is still the most common type in Chongqing. HPV18,HPV58 and HPV31 also has a high prevalence.

BACKGROUND:Core decompression may provide insufficient support for the subchondral bone in the treatment of early avascular necrosis of the femoral head and increase the risk of fracture and colapse. Quadratus femoris implantation cannot only provide good biological support, but also promote the revascularization at necrotic regions, thus repairing the necrosis of femoral head. OBJECTIVE: To compare the clinical effects of core decompression with bone paste implantation and core decompression with quadratus femoris implantation on early and middle-stage avascular necrosis of the femoral head. METHODS:Eighty-three patients with early avascular necrosis of the femoral head (92 hips) admitted at the Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, China, from January 2009 to January 2012 were enroled and divided into groups of core decompression with bone paste implantation (46 cases, 49 hips) and core decompression with quadratus femoris implantation (37 cases, 43 hips) that were respectively injected with bone meal and autogenous bone and osteoinductive materials. RESULTS AND CONCLUSION: Al involved patients were folowed up. After 1 year of treatment, Harris scores in the two groups were both increased (P < 0.05). But the Harris score of core decompression with bone paste implantation group was lower than that of core decompression with quadratus femoris implantation group (P < 0.05). After 3 years of treatment, X-ray scores in the core decompression with quadratus femoris implantation group were significantly higher than those in the core decompression with bone paste implantation group (P < 0.05). These findings indicate that compared with core decompression with bone paste implantation, core decompression with quadratus femoris implantation is better to prevent femoral head colapse, improve hip function and delay the process of osteonecrosis of the femoral head.

ObjectiveTo explore the effects of epidermal proteins and lamellar bodies on skin barrier in glucocorticoid-dependent dermatitis.MethodsTotally,60 patients with glucocorticoid-dependent dermatitis and 40 normal human controls were eligible for this study.A noninvasive method using TewameterTM was applied to determine transepidermal water loss (TEWL) value in these subjects.Tissue specimens were obtained from the lesions of 13 patients with glucocorticoid-dependent dermatitis and normal skin of 10 human controls.Subsequently,haematoxylin and eosin(HE) staining was performed to observe the histopathological changes,immunohistochemistry to detect the protein expressions of K6,K10,K14,K15,loricrin,filaggrin,involucrin in epidermis,and electron microscopy(EM) to estimate the density of lamellar bodies in tissue specimens.ResultsCompared with the normal controls,the patients displayed an elevated TEWL value (P ＜ 0.05),which suggested an impaired epidermal barrier.Histopathology of lesions revealed nonspecific inflammatorychanges withmarkeddifferencesbetweendifferentclinicaltypesofglucocorticoid-dependentdermatitis.Immunohistochemistry revealed an attenuated expression of K10,K14,loricrin,filaggrin,involucrin and abnormal expression of K15 in lesional epidermis compared with the normal epidermis (all P ＜ 0.05),hinting a suppression of epidermal differentiation and proliferation as well as an impairment of cornified envelope structure.The number and density of lamellar bodies were also reduced in lesional epidermis compared with the control epidermis.ConclusionsCompared with normal skin,the structure of skin barrier is impaired in lesions of glucocorticoid-dependent dermatitis,to restore skin barrier is essential for the treatment of this entity.

Abscess ; therapy ; Adult ; Aged ; Catheterization ; methods ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Objective:To compare the modified Qjng Long Bai Wei needling method and ordinary acupuncture method in the effects of improving the levels of interleukin (IL)-1β,IL-6 and tumor necrosis factor (TNF)-α in the treatment of knee osteoarthritis (KOA),and to determine the advantage of the modified Qing Long Bai Wei needling method for KOA.Methods:One hundred KOA patients were randomized into a treatment group and a control group by using the random number table,with 50 cases in each group.The treatment group was intervened by the modified Qing Long Bai Wei needling method,and the control group was given ordinary acupuncture.The two groups were observed before and after the treatment to determine the changes in the levels of IL-1β,IL-6 and TNF-α in synovial fluid,and the clinical efficacies were compared between the two groups.Results:The total effective rate and clinical recovery rate were 97.9％ and 52.1％ respectively in the treatment group,versus 85.1％ and 25.5％ in the control group,and the between-group differences were statistically significant (both P＜0.01).After the treatment,the levels of Ib1β,IL-6 and TNF-cα in synovial fluid changed significantly in both groups (all P＜0.01);there were significant differences in the levels of IL-1β,IL-6 and TNF-α in synovial fluid between the two groups (all P＜0.01).Conclusion:The modified Qjng Long Bai Wei needling is an effective method for KOA and it can significantly improve the levels of IL-1β,IL-6 and TNF-α in synovial fluid.

Objective: To observe the clinical efficacy of sinew-bone balancing manipulation in treating lumbar disc herniation (LDH) and offer clinical evidence to support the concept of paying equal attention to sinew and bone. Methods: Sixty LDH patients were randomized into an observation group and a control group, with 30 cases in each group. The observation group was treated with the sinew-bone balancing manipulation, and the control group received conventional Tuina (Chinese therapeutic massage) manipulation. The clinical efficacy and posterior muscle chain tone effect were compared between the two groups by observing the visual analog scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and posture-associated indicators. Results: The total effective rate was 86.7％ in the observation group, higher than 76.7％ in the control group, but the between-group difference in efficacy was statistically insignificant (P>0.05). After treatment, the VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry showed significant changes in both groups (P<0.05). The VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry in the observation group were significantly different from those in the control group after treatment (P<0.05), but the between-group difference in the general posture symmetry was statistically insignificant (P>0.05). Conclusion: Both the sinew-bone balancing and conventional Tuina manipulations can reduce pain in LDH patients, improve lumbar function, and adjust the angle-dependent muscle tone coefficient of the posterior muscle chain and lumbar posture symmetry; except for the general posture symmetry of the posterior muscle chain, the sinew-bone balancing manipulation wins out over the conventional Tuina manipulation.

OBJECTIVETo investigate the relationship between activation of nuclear factor-kappa gene binding (NF-kappaB) and apoptosis induced by matrine in hepatocellular carcinoma cell line HepG2.

METHODSHepG2 cells were stimulated by different concentrations of matrine (0.8, 1.0, 1.5, 2.0, 2.5 g/L). The HepG2 cell survival rates were evaluated by MTT assay. Cultured HepG2 cells were implanted in culture flasks and divided into four groups: a control group, a pyrrolidine dithiocarbamate (PDTC) group (20 micromol/L), a matrine group (1.5 g/L) and a combination group, PDTC (20 micromol/L) + matrine (1.5 g/L) combination group. Apoptosis induced by matrine was analyzed by flow cytometry (FCM) and TUNEL. The DNA-binding activity of NF-kappaB was determined by electrophoretic mobility shift assay (EMSA).

RESULTSPDTC enhanced the inhibition of matrine on cell proliferation (F=183.92, P less than 0.01). The apoptosis and activation of NF-kappaB of HepG2 cells were induced by matrine. PDTC significantly suppressed NF-kappaB activation induced by matrine in HepG2 cells. PDTC increased the apoptosis induced by matrine of the HepG2 cells from 6.11% +/- 0.81% to 12.95% +/- 0.02%, chi2=9.67, P less than 0.01.

CONCLUSIONSMatrine could induce apoptosis, and at the same time induce activation of NF-kappaB in HepG2 cells. PDTC increases the apoptosis in hepatocellular carcinoma cells and it may be related to suppressing NF-kB activation of HepG2 cells.

Alkaloids ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; pathology ; Drug Synergism ; Hep G2 Cells ; Humans ; Liver Neoplasms ; pathology ; NF-kappa B ; metabolism ; Proline ; analogs & derivatives ; pharmacology ; Quinolizines ; pharmacology ; Thiocarbamates ; pharmacology