Administration, Inhalation ; Adolescent ; Adult ; Aged ; Blood Loss, Surgical ; Budesonide ; administration & dosage ; Child ; Endoscopy ; Humans ; Middle Aged ; Nose ; surgery ; Young Adult

Coronary Artery Disease ; diagnosis ; etiology ; Graft Occlusion, Vascular ; diagnosis ; etiology ; Heart Transplantation ; adverse effects ; Humans

Objective To introduce a new extracapsular approach for thyroidectomy in patients with surgical thyroid disease. Method Clinical data of 104 cases undergoing this procedure were retrospectively analyzed. Results From May 1990 to May 2000, 104 patients underwent either total or subtotal thyroidectomy by extracapsular approach. One patient suffered from postoperative temporary recurrent laryngeal nerve palsy. No morbidity such as postoperative thyroid crisis, hemorrhage leading to airway compression, permanent hypoparathyroidism nor mortality developed. Conclusion The total extracapsular approach for thyroidectomy is safe, less of complication and effective.

Brain Infarction ; diagnosis ; etiology ; therapy ; Cerebral Angiography ; Child ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Neoplasms ; complications ; diagnosis ; surgery ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male ; Myxoma ; complications ; diagnosis ; surgery ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Thrombosis ; diagnosis ; etiology ; therapy

BACKGROUND:Osteoporosis and its complications severely threaten the elder’s health. Simvastatin, widely accepted as a lipid-lowering drug, is reported to potentialy promote bone formation, but it is in debate when oraly administered, and there is no evidence to support whether this is due to the region difference.
OBJECTIVE:To investigate the effect of oraly administered simvastatin on bone mass and biomechanical properties of the femur and vertebrae in osteopenia rats induced by ovariectomy (OVX).
METHODS: Twenty-four 6-month-old female Sprague-Dawley rats were subjected to OVX+oraly administered saline vehicle (OVX group,n=8), OVX+oraly administered simvastatin (5 mg/kg/d; intervention group,n=8) or sham surgery (sham group,n=8). After 8 weeks of treatment, al rats were sacrificed and the level of procolagen type I N-terminal propeptide in blood serum was assessed by ELISA. Bone mineral density was determined in the L5 vertebra and left femur using dual-energy X-rays. Furthermore, the biomechanical properties of the L4 vertebra and right femur, including maximum load and elastic modulus, were detected by compression testing and three-point bending test, respectively.
RESULTS AND CONCLUSION: The serum level of procolagen type I N-terminal propeptide in the sham group was significantly lower than that in the other two groups. OVX rats showed significantly lower bone mineral density in both the L5 vertebra and left femur than sham rats (P < 0.05). Rats in the intervention group showed higher bone mineral density than those in the OVX group, with statisticaly significant difference in the L5 vertebra (P < 0.05), but insignificant difference in the femur. Maximum load and elastic modulus of the L4 vertebra in the OVX group were significantly lower than those in the sham and intervention group. Markedly lower elastic modulus of the femur was found in the OVX group than the sham and intervention groups. These findings demonstrate that simvastatin treatment can partialy prevent bone loss in OVX rats with more notable effect on the vertebrae than the femur, and for this model, the vertebra is superior to the femur used in biomechanical test.

BACKGROUND:Nano-hydroxyapatite/polyamide artificial bone has good biocompatibility and strong tissue binding force, which exerts a significant role in the recovery of neurological function. OBJECTIVE: To investigate the clinical effect of nano-hydroxyapatite/polyamide artificial bone in anterior cervical fusion. METHODS: Ninety patients with cervical spondylosis and traumatic dislocation of the cervical spine were randomized into observation group and control group. Patients in the two groups underwent nano-hydroxyapatite/polyamide artificial bone and autologous iliac bone implantation, respectively. Surgical condition, Japanese Orthopaedic Association score, vertebral height loss and bone fusion rate were compared and analyzed at different time after implantation. RESULTS AND CONCLUSION:There were no significant differences in surgical time, out of bed time, postoperative hospitalization time between the two groups (P > 0.05), but the intraoperative blood loss was significantly lower in the observation group than the control group (P < 0.05). Japanese Orthopaedic Association scores were significantly increased in the two groups at 3 and 6 months after operation and at last folow-up than before (P < 0.05), but there was no difference in the Japanese Orthopaedic Association score between the two groups (P> 0.05). The vertebral height loss and bone fusion rate had no difference between the two groups at 6 months after operation and at the last folow-up (P > 0.05). No adverse effects occurred in the two groups. These findings indicate that nano-hydroxyapatite/polyamide artificial bone has good clinical effects in anterior cervical fusion, and the treatment effect is equivalent to autologous iliac bone graft.

Amblyopia greatly affects the physical and mental development of children. Acupuncture is effective for amblyopia, though its mechanism remains unclear. This article summarized the mechanism of acupuncture treatment of amblyopia from the perspectives of morphology of neurons in visual cortex, visual electrophysiology, and molecular biology, etc. It was found that acupuncture may treat amblyopia through repairing the morphological and ultrastructural damages of neurons in visual cortex, promoting the electrical activities in visual pathway and visual cortical neurons, and modulating the synthesis and expression levels of factors involved in visual system. Nevertheless, further studies are required to unveil the mechanism of acupuncture treatment of amblyopia.

Objective To determine the effects of histone deacetylase inhibitor suberoylanilide hydroxamic acid(SAHA) on the cell proliferation and apoptosis of the human hepatic stellate cell line LX-2.The possible underlying mechanisms were also investigated.Methods The LX-2 cells were treated with SAHA in vitro.The morphology of LX-2 cells in different concentrations groups was observed by inverted microscope;the proliferation of LX-2 cells was measured by MTT assay;the Annexin V-FITC and PI staining was used to detect the apoptosis of LX-2 cells by flow cytometry and fluorescence microscope;the expression of α-SMA,collagen Ⅰ,acH3K9,acH3K14 and acH3K18 were detected by Western blot.Results The morphology change of LX-2 cells showed that SAHA inhibited the proliferation rate of LX-2 cells and in a dose dependent manner(P<0.05).The LX-2 cells were sensitive to SAHA along with time increasing,and in a time-dependent manner(P<0.05).Western blot showed that the expression levels of α-SMA and collagen-Ⅰ were significantly lower(P<0.05),on the contrary,the acetylation levels of acH3K9,acH3K14 and acH3K18 were significantly higher (P<0.05).Conclusions The increased acetylation of the histone acH3K9,acH3K14,acH3K18 and the lower expressed α-SMA and collagen-Ⅰ in LX-2 cells may be one of the mechanisms of SAHA.

Objective To study the effect of target controlled infusion of etomidate and propofol during general anesthesia induction period on haemodynamics and stress by cerebral state index (CSI) in elderly hypertensive patients. Methods Forty ASAⅠor Ⅱelderly hypertensive patients undergoing selective laparoscopic cholecystectomy were randomly divided into two groups by random digits table method with 20 cases each: propofol group and etomidate group. CSI, mean arterial pressure (MAP), heart rate, blood glucose, concentration of plasma cortisol in the two groups were observed before induction of anesthesia, at 1 min before intubation, and at 1 min, 3 min and 5 min after intubation. Results The level of CSI, MAP, heart rate, blood glucose, cortisol between two groups at before induction of anesthesia had no significant difference (P>0.05).The levels of CSI in two groups at 1 min before intubation, and at 1 min, 3min after intubation were significantly lower than that at before induction of anesthesia, but compared with that at 1 min before tracheal intubation, CSI was significantly higher in two group at 1 min, and 3 min after intubation, and there was significant difference (P<0.05). The level of MAP in etomidate group was higher than that in propofol group at 1 min before intubation, and at 1 min , 3 min and 5 min after intubation: (85.9 ± 9.2) mmHg (1 mmHg = 0.133 kPa) vs. (70.8 ± 8.1) mmHg, (112.6 ± 9.8) mmHg vs. (90.6 ± 10.8) mmHg, (96.5 ± 8.2) mmHg vs. (86.5 ± 8.6) mmHg, (95.2 ± 8.3) mmHg vs. (80.6 ± 8.7) mmHg, and there was significant difference (P<0.05). The level of heart rate at 1 min before intubation in propofol group was lower than that before induction of anesthesia and that at the same period in etomidate group: (65.1 ± 6.2) bpm vs. (85.8 ± 10.2) bpm, (78.2 ± 6.7) bpm], and there was significant difference (P<0.05), while there was no significant differenc in the level of heart rate in etomidate group at each time point (P>0.05). Compared with before induction of anesthesia, the concentrations of blood glucose and cortisol at 1min before intubation in patients of the two groups decreased significantly, while glucose and cortisol concentrations at 1 min, 3 min and 5 min after intubation in two group significantly increased , and there was significant difference (P<0.05);cortisol concentration in etomidate group at 1 min before intubation and 1 min, 3 min, 5 min after intubation was significantly lower than that at the same period in propofol group:(260.6 ± 39.6) nmol/L vs. (290.2 ± 35.6) nmol/L, (380.3 ± 37.6) nmol/L vs.(410.8 ± 46.6) nmol/L, (361.2 ± 25.2) nmol/L vs. (392.6 ± 31.6) nmol/L, (352.3 ± 25.6) nmol/L vs. (370.3 ± 28.8) nmol/L, and there were significant differences (P < 0.05). Conclusions During induction of general anesthesia with the guidance of cerebral state index, target controlled infusion of etomidate has more stable hemodynamics, and also attenuates the stress response to tracheal intubation in elderly hypertensive patients.

BACKGROUND:Previous studies have demonstrated that simvastatin that can promote osteogenic differentiation of bone marrow stromal stem cel s in vitro, is likely to be a new osteogenic drug. While it is stil unknown whether there is time-dependent stimulation of simvastatin on the expressions of bone morphogenetic protein 2 and col agen type I. OBJECTIVE:To investigate the expressions of bone morphogenetic protein 2 and col agen type I in rat bone marrow stromal stem cel s in vitro stimulated by simvastatin at different time points. METHODS:Passage 1 bone marrow stromal cel s were divided into control and simvastatin group, fol owed by cultured in osteogenic differetiation medium with or uithout 10-7 mol/L simvastatin. After 7-day intervention, expression of alkaline phosphatase was detected in passage 3 cel s. Passage 4 cel s were divided and cultured as described above, and afterwards, RNA and proteins were extracted at 12 and 36 hours to detect the expressions of bone morphogenetic protein 2 and col agen type I using real-time PCR and western blot assay. RESULTS AND CONCLUSION:Both two groups could express alkaline phosphatase, while the rate of positive cel s significantly increased in the simvastatin group compared with the control group (P<0.05);at 12 and 36 hours after intervention, mRNA expressions of bone morphogenetic protein 2 and col agen type I in the simvastatin group were significantly higher than those in the control group (P<0.05). Besides, western blot assay showed:at both 12 and 36 hours, simvastatin significantly enhanced the expression of bone morphometric protein 2, while the expression of col agen type I significantly increased at 12 hours (P<0.05), but not at 36 hours. In conclusion, simvastatin can promote the expressions of bone morphometric protein 2 and col agen type I in rat bone marrow stromal cel s, with more favorable outcomes after 12-hour treatment.