Objective To design and apply a kind of controllable enema input apparatus in patients with spinal cord injury (SCI). Methods 20 SCI patients with chronic constipation were included. Their defecation time, nature of defecation and usage of enema of 5 times of defecation were recorded before and after using the new apparatus. Results There were significant differences in the defecation time, nature of defecation and usage of enema before and after using the new apparatus (P<0.05). Conclusion The application of the new controllable enema input apparatus may shorten the defecation time, improve the nature of defecation, and reduce the usage of enema in SCI patients with chronic constipation.

Our study demonstrated that ARS cells can be induced to differentiate into macrophage-like cells with changes in phenotype, nonspecific esterase activity and phagocytic function by adding ginsenosides in short-term cultures. Synthesis of DNA, mitosis and the growth of the culture cells transplanted in mouse are also inhibited in this condition. The size of cells, nuclei and nucleoli, as well as nuclear-cytoplasmic ratio of ginsenosides treated cells are diminished significantly. Microvilli of these cells are reduced in number with formation of. ruffles on the cell surface. Mitochondria are increased, their size and distribution become regular. The fact that numerous small cells, induced by ginsenosides exhibit the most conspicuous alteration mentioned above along with marked phagocytic activity indicates that they are highly differentiated macrophage-like cells. Whether the inhibition of cell growth and induction of differentiation by ginsenosides is caused through its action on the molecules regulating the gene expression of cell growth and differentiation needs further study.

Objective To studied perioperative changes in blood coagulation and the fibrinolytic system in patients undergoing acute aortic disec tion repair analyse the reason and outcome for these changes.Methods Between August 2011 and December 2011,30 patientsk[22 male and 8 female,mean aged (43.0±9.13) years] had undergone open repairs of aortic dissection or aneurysm with DHCA.Indications for surgical intervention were type A sortic dissection in 26 patients and aortic aneurysm in 4 patients.According to the time from clinical onset of the dissection to operation,acute group(less than 7 days,A group) 20 patients; chronic group (more than 30 days and aortic aneurysm,C group) 10 patients.Data were gathered for muhiple preoperative and intraoperative factors including age,sex,diagnosis,aortic dissection type,preoperative ejection fraction,aortic surgery history,surgical intervention type,cardiopulmonary bypass (CPB) time,aortic cross-clamp time,blood transfusion volume (PRBC),mechanic ventilation time,ICU length of stay and hospital length of stay.Platelet (PLT),fibrin degredation product (FDP),D-dimmer,thrombin-antithrombin (TAT),and soluble fibrin monomer complex (SFMC) were assayed before and after operation,as well as 0 h,24 h,48 h,72 h.These valuables were recorded and compared statistically between two groups.Results Preoperative serum level and postoperative peak level of FDP and D-dimmer in group A were significant higher than in gnoup C (P ＜ 0.05)and postopertive serum peak level in group C were significant higher than preoperative level (P ＜ 0.05 ).Preoperative snd postoperative most hours there was significant intergroup difference on the serum levels of SFMC and TAT (P ＜ 0.05 ).Preoperative level of PLT in group A is lower than in group C significantly (P ＜ 0.05 ).The level of PLT in each hour after surgery were much lower than the level before surgery in both group (P ＜0.05 ).In addition,thromhus fonantion in ascending aortic falsc lumen in group A was much moee common than in group C (P ＜0.05 ).There was significant difference on incidence of postoperative complications between two groups (P ＜ 0.05 ).Conclusion Activation of coagulation and fibrinolysis which results from acute aortic dissection and surgical procedure was obscrved before and after surgery to treat acute aortic dissection.There is increasing risk for consumption coagulopathy and thromboembolism during perioperative period.

It is now thought that atherosclerosis,although due to enhanced lipid deposition,is mainly the result of a series inflammatory process.Total saponins of Aralia elata (Miq)Seem(TASAES)from the Chinese traditional herb Longya Araliachinensis L.,a folk medicine used for treating various diseases, increasing energy and improving the body′s ability to prevent hypoxia in Asian countries has attracted widespread attention. However, the ability of TASAES on inflammation-triggered vascular endothelial cell injury, a key early event in the pathogenesis of atherosclerosis, and its potential mechanisms of this protection have never been demonstrated. The present study determined the anti-inflammatory and anti-apoptoticactivities and protective mechanisms of the total aralosides of Araliaelata(Miq)Seem (TASAES) ameliorate tumor necrosis factor-α (TNF-α)-induced human umbilical vein endothelial cells (HUVECs) injury. Our results indicate that TASAES pretreatment provided cytoprotective effects by suppressing TNF-α-induced HUVECs apoptosis, mitochondrial membrane depolarization, caspase-3 activation, and modulation of inflammatory factors (IL-6, MCP-1 and VCAM-1), meanwhile inhibiting NF- κB transcription. Furthermore, the effect was correlated with the activation of the PI3K/Akt signal pathway. Blocking Akt activation with the PI3K inhibitor LY294002 effectively reversed the protective effect of TASAES against TNF-α-induced cell apoptosis.Moreover,the PI3K inhibitor partially blocked the effects of TASAES on the increasing of Bcl-2 and Bcl-xl protein expression,and inactivation of Bax protein expression. In conclusion, the results showed that TASAES decreased the inflammation and apoptosis of HUVECs caused by TNF-α treatment,and PI3K played a crucial role in enhancing cell sur-vival during this process.

Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
Anastomosis, Surgical ; Bronchi/*surgery ; Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pneumonectomy/*methods ; Pulmonary Surgical Procedures/*methods ; Recovery of Function ; Treatment Outcome

Objective · To observe effect of 17β estrodial (17β E2) with different concentrations on C type natriuretic peptide (CNP), insulin like growth factor 1 (IGF1), and natriuretic peptide receptor B (NPR-B) expression and proliferation of growth plate chondrocytes of rats in vitro. Methods · Eight Wistar rats were sacrificed and their epiphyseal cartilages of the upper tibias were separated to obtain chondrocytes on the 14th day after birth. Then chondrocytes were cultured with 17β E2 in different concentrations (10-4、10-6、10-8、10-10 and 10-12 mol/L) for 48 h, while control group was cultured without 17β E2. CCK8 method, ELISA and qRT-PCR were used to analyze the proliferation of chondrocytes, the levels of CNP and IGF1 in culture medium and mRNA levels of CNP, NPR-B and IGF1, respectively. Results · 17β E2 in different concentrations affected the proliferation of growth plate chondrocytes significantly. When the concentration of 17β E2 was 10-8 mol/L, it had the strongest effect on the cell proliferation. When the concentration increased to 10-4 mol/L, the proliferation of chondrocytes was inhibited. With the increasement of 17β E2 concentration, the levels of CNP in the culture medium and the mRNA levels of CNP in the chondrocytes were significantly different. The highest levels of CNP protein and mRNA both appeared in 10-8 mol/L group, while the lowest levels both appeared in 10-4 mol/L group. IGF1 and its mRNA also reached the highest levels in 10-8 mol/L group,but the lowest concentration and mRNA level were in 10-10 mol/L group and 10-12 mol/L, respectively. Both CNP mRNA and protein levels were positive correlated with the proliferation of chondrocytes (P=0.000). Nevertheless, there was no significant correlation between the proliferation of chondrocytes and IGF1 mRNA or protein levels (P>0.05). Conclusion · 17β E2 modulates proliferation of rat growth plate chondrocytes in a dose-effect manner. It enhances proliferation at relatively low concentrations (10-10-10-8 mol/L) and inhibits proliferation at high concentration. This effect is positively related to CNP expression in chondrocytes.

Objective To study the clinicopathologic features and differential diagnosis of deep angiomyxoma(DAM). Methods Seven cases of DAM were collected from 2000 to 2008. All the patients were examined by microscopy and immunohistochemistry. Results 6 patients with DAM were females and 1 was male, with median age of 48.5 years. Median maximum dimension was 5.9cm, with invasive growth pattern. The tumor cells of DAM were infantile, spindle or stellate,diffuse and nodular arrangement. A distinctive histologic feature of DAM was its vascularity. Non-arborizing, thin-wall, ectastic capillaries or more commonly, small thick-wall vessels were dispersed throughout the tumor. Mast cells and extravasated red blood cells were frequently found in the stroma, immunohistochemical study showed that 7 cases were positive for vimentin, desmin, ER and PR, 5 for CD34 and SMA, and negative for S-100 and CK. Conclusion DAM is a rare soft tumor that occurs principally in the vulval and vagina region of woman. Misdiagnosis has happened frequently. Immunohistochemical staining are helpful to diagnosis for DAM, but no significance to distinguish it.

Objective To discuss the technical points and clinical effects of thoracic reconstruction after resection of the sternal tumnors with autogenous rib graft and pedicle oinental flap. Method A retrospective study was made on 12 patients,who underwent resection of sternal tumors and thoracic reconstruction with autogenous rib graft and pedicle omental flap between January 2004 and March 2010. The tumor involved the manubrium in 4 patients and the sternal body in 8 patients. Results All operations of 12 patients were succeed with no perioperative mortality or severe complications. Incisions healed by primary intention healing,and no paradoxical breathing was found. The postoperative period was uneventful.Conclusion It's an effective way to treat sternal tumors by the resection and thoracic reconstruction with autogenous rib graft and pedicle omental flap.

Objectives To investigate the dynamic change of galectin-1 in myocardium of mice with viral myocarditis (VMC). Methods A total of 58 male BALB/c mice were selected and randomly divided into CVB3 group (n=50) and control group (n=8). Mice in CVB3 group were infected with 0.10 ml 10-5/L CVB3 through intraperitoneal inoculation, and 8 mice were killed on day 7, 10, 14 and 28 respectively after inoculation. Mice in control group inoculated with 0.10 ml eagle reagent was killed on day 28. The myocardial pathological changes were observed using light microscope. In addition, expressions of serum galectin-1 were detected by ELISA and expressions of myocardial galectin-1 were detected by real-time quantitative-polymerase chain reaction (RQ-PCR). Results Compared with control group, the myocardial expression of galectin-1 mRNA in CVB3 group was obviously increased on day 7 and day 10 (all P<0.05);the serum concentration of galectin-1 in CVB3 group was obviously increased on day 7, day 10 and day 14 (all P<0.05). Conclusion The expressions of galectin-1 in myocardium of mice with viral myocarditis were in dynamic changes. Galectin-1 may play a role in the pathogenesis and development of viral myocarditis.

Hepatic ischemia/reperfusion injury is an important restricting factor of clinical liver resection and liver transplantation.When the liver is transiently deprived of blood followed by repeffusion,a large number of various mediators are released that can lead to cellular and,eventually,organ dysfunction.This review summarizes the pathogenesis and the protection mechanisms of hepatic ischemia/reperfusion injury.