Objective To investigate the neuroprotective effects and mechanisms of 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ IMP cyclohydrolase(AICAR) supplement (AMPK activator) in different stages of neonatal rats sufferring from hypoxia-ischemia encephalopathy ( HIE). Methods Neonatal rat hypoxia-ischemia brain injury model was employed in this study. A total of 160 neonatal rats were distributed into five groups: sham, model control,AICAR30 min, AICAR24 h and AICAR72 h. The neuroprotective effects of AICAR supplement (30 min, 24 h, 72 h post operation) were compared by cresyl violet staining; Expressions of P-AMPK,AMPK in the brain tissue were measured by Western blotting.Foot-faults method was used to evaluate the long-term prognosis of the rats. Results Compared with the sham group, the survival of rats brain in model control group was significantly decreased [(100.0± 0.1)% and (45.3± 6.3)%, P< 0.05]. AICAR had neuroprotective effects when treated at 30 min and 24 h post operation,while the protective effects disappeared when treated later (72 h post operation) (P>0.05). Compared with the sham group, the expression of P-AMPK significantly increased about three times, while ATP level decreased close to the same. Conclusion Early AICAR treatment can protect hypoxia-ischemia brain injury by increasing AMPK-ATP level.

Objective To analyze postoperative effect of a new rectopexy technique with Douglas pouch elevation for complete rectal prolapse (CRP) in adults.Methods From January 2010 to May 2011, 52 CRP cases were treated by rectopexy with Douglas pouch elevation.In terms of different surgical techniques, patients were divided into two groups : Group A (n =28) received laparoscopic rectopexy with Douglas pouch elevation;and Group B (n =24) received laparoscopic rectopexy with Douglas pouch elevation combined with procedure for prolapse and hemorrhoids (PPH).Rectal prolapse, constipation, and fecal incontinence in the two groups were assessed respectively before surgery, and on the 6th, 12th, and 24th month after surgery, postoperative complications were evaluated with severe grading of surgical complications.Results Symptoms of rectal prolapse disappeared at half a year after surgery in all patients, and relapsed to different extent afterwards.However, two years after operation, the status of rectal prolapse in Group B tended to be stable.The trend of constipation after surgery was consistent with that of rectal prolapse.In addition, fecal continence improved gradually on half a year after surgery in the two groups and recovered to the optimal status in the first postoperative year.However, in the second year, the results of fecal incontinence reduced slightly in Groups A, and Group B became stable.Two years after surgery, four cases in Groups A relapsed while there was no recurrence in Group B.Difference of Grade I to Grade Ⅲ complications among the two groups was statistically insignificant (x2 =0.05, P ＞ 0.05).Conclusions The clinical effect of laparoscopic rectopexy with Douglas pouch elevation associated with the procedure for prolapse and hemorrhoids (PPH) is better than that without PPH for female and male CRP patients with severe symptoms.

Weighted topsis method is applied to evaluate the key factors in medical management of diabetes mellitus.The key factors are admission examinations,drug selection,patient serf-management skills,nursing quality,and physicians'capability.

As a kind of commonly used traditional Chinese medicine, ginseng has a high reputation at home and abroad. The research of ginseng has been expanded to medicine, pharmacy, biology, food science and other fields, with great achievements in recent years. Ginseng contains ginsenosides, volatile oil, carbohydrates, amino acids, polypeptides, inorganic elements and othser chemical constituents. Each component has extensive physiological activity, and is the base of ginseng's effect. After processing, the complicated changes are taken place in the constituents of ginseng, and some new substances produced. This paper aims to review the studies on chemical constituents and their mechanisms during ginseng processing, and the ideas, methods and the direction of the development of traditional Chinese medicine processing in the future.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry

The primary processing is important links and closely related to the quality of traditional Chinese medicinal materials, and is not only cleaning of remove the non-officinal parts, drying for termination the physiological status of organisms, but also retaining the most active substances, decreasing the toxic components, and promoting the transformation among chemical ingredients through primary processing. So the traditional primary processing endows with characters, quality, specifications and properties of traditional Chinese medicine, and embodies some important science truth. The traditional primary processing method and technology systems are derived from the long-term practices and experiences, which are distinctive, colorful, diverse, and scientific, which are helpful to development and utilization of traditional Chinese medicine resources. This paper systemically expounds the research status of the Chinese medicine processing method, summarizes the problems in the primary processing of traditional Chinese medicinal materials research, and prospects its bright future.
Chemistry, Pharmaceutical ; methods ; trends ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Medicine, Chinese Traditional

AIM: To compare the safety and efficacy of conjunctival autograft transplant ( CAT ) and limbal - conjunctival autograft transplant (LCAT) for primary pterygium.
METHODS: In this prospective, randomized and controlled clinical study, 120 patients ( 120 eyes ) diagnosed with primary pterygium were collected in NO. 474 Hospital of Chinese PLA from January 2014 to January 2015. The 120 patients enrolled in the study in turn, and divided into two group by the odd and even number. The odd number underwent CAT and the even number underwent LCAT.
RESULTS:One hundred and seven patients (107 eyes) completed the follow-up of 1a, including 54 patients (54 eyes) from the CAT group and 53 patients (53 eyes) from the LCAT group. Four patients (4 eyes, recurrence rate 7. 4%) in the CAT group and 2 patients ( 2 eyes, recurrence rate 3. 8%) in the LCAT group developed recurrence. However, there were no significant in recurrence rate between CAT group and LCAT group (P =0. 678).
CONCLUSION: CAT and LCAT might be both effective treatment for primary pterygium for reducing the recurrence rate of pterygium. However, LCAT is the optimal surgical method for primary pterygium.

Background To study diabetic retinopathy (DR) related risk factors is very important in the prevention of DR.Platelet endothelial cell adhesion molecule-1 (PECAM-1) is an important mediator that mediates high blood glucose-induced vascular diseases in diabetic patients.However,its mechanism is still below understood.Objective This clinical study was to investigate the effect of serum level changes of PECAM-1 on DR in type 2 diabetic patients.Methods Fifty-four patients with type 2 diabetes were enrolled from the endocrinology department of the Third People' s Hospital of Nantong City.Fundus examination was performed using the ophthalmoscope and fundus fluorescence angiography (FFA) on all the patients,and these patients were grouped as the non-DR (NDR)group (18 cases),non-proliferative DR(NPDR) group (20 cases) and proliferative DR group (PDR) (16 cases) based on the DR staging criterion of the Chinese Medical Association (1987 version).Eighteen age-and gender-matched normal subjects served as the normal control group.Peripheral blood was collected,and serum PECAM-1 levels were assayed using ELISA.Serum HbA1c levels were detected using the high performance liquid colorimetric(HPLC) method.The correlation of serum PECAM-1 level with serum HbA1c level was analyzed.All results were compared among the groups.Results The serum PECAM-1 levels were (10.907 ± 2.792),(7.024 ±2.377),(5.231 ± 1.816) and (3.817 ± 1.045) μg/L,respectively,in the PDR group,NPDR group,NDR group and normal control group,showing a significant difference among the 4 groups (F =12.630,P =0.02).Serum PECAM-1 content was significantly higher in the PDR group when compared with the NPDR group,NDR group and normal control group (P＜0.05).The serum HbA1c levels were (12.596±3.148)％,(9.118±3.356)％,(5.491±1.017)％ and (4.992 ± 0.725)％ in the PDR group,NPDR group,NDR group and normal control group,respectively,with a significant difference among these 4 groups (F =7.130,P =0.015),and those in the PDR group and NPDR group were significantly elevated in comparison with the NDR group and normal control group (P＜0.05).Significantly positive correlations were seen between serum PECAM-1 level and HbA1 c level in the PDR group,NPDR group and NDR group (r=0.799,P＜0.01 ;r =0.647,P＜0.01 ;r =0.685,P＜0.01).Significantly more patients with a disease course of ≥ 10 years were in the NPDR group in comparison with the PDR group (P =0.023).Conclusions Increase of serum PECAM-1 level is closely associated with blood glucose level,and it is an important factor in the pathogenesis and development of DR.These results imply that control of blood glucose is crucial for the prevention of DR in patient with type 2 diabetes.

Objective To sum up experience with surgical excision of isolated local recurrence for renal cell carcinoma. Methods From March 2004 to November 2007, 7 patients (five cases un-derwent radical nephrectomy and two nephron-sparing surgery) with isolated local recurrence of renal cell carcinoma were treated at our department. All patients underwent extensive surgery for local re-currence. Results The mean patient age was 42 years (range 19 to 6). The mean time to local re-currence was 23.3 months (range 12 to 54). The Mean size of the recurrent tumor was 5.2 cm(range 2.5 to 10.5). Peritoneal exploration was performed in 7 patients and 5 had complete en bloc excision of the renal cell carcinoma mass. 2 patients gross disease was excised. The mean blood loss was 1050 (150-3000) ml. Surgical complications occurred in 2 patients, iliohypogastric nerve injure in one and ileus performation in another one. All patients recovered finally. Six patients were followed and one lost follow-up. Mean follow-up time was 13(8-27) months. One patient died of metastatic disease at 22 months after excision of the renal cell carcinoma mass. Conelusion En bloc excision of isolated locally recurrent renal cell carcinoma is possible, and complete surgical resection could lead to pro-longed disease-free survival.

Objective To discuss the relations between optimal surgical margin and local recurrence and the impact of preserving segment of sacral nerve root on neural functions based on the clinical and pathological features of giant cell tumor(GCT).Methods From August 1996 to August 2008,48 patients with sacral GCT undergoing tumor resection were respectively analyzed,including 20 males and 28 females with an average of 34.7 years(range,19-74).The tumors were located in S1-S5 in 4 patients,S1-S4 in 7,S1-S3 in 15,S1,2 in 12,S2-S5 in 8,and S3-S5 in 2.Surgical methods included single posterior approach in 29 cases,combined anterior-posterior approach in 19.The surgical margins adopted were en-bloc in 2 patients,marginal in 15,marginal and curettage in 25,and curettage in 9.Results Forty-one of 48 cases were successfully followed up,the average time was 43.5 months(range,18-115).The average blood loss during surgery was 3560 ml(range,550-12 000).Benign lung metastasis occurred in one case 6 years after operation,2 patients died of malignant transformation.Local recurrence occurred in 15 cases.The recurrence rates in patients with en-bloc resection,marginal resection,marginal resection combined with curettage,and curettage were 0,18.2%,40.9%,66.7%,respectively.The recurrence rate of marginal group was significantly lower than that of the curettage group.Of 27 cases with bilateral S3 nerve root preservation,2 sufiered from urine or fetal dysfunction.with an incidence rate of 7.4%.While 4 of 12 patients with unilateral S3 nerve root preservation suffered from sphincter disturbance,with an incidence rate of 33.3%.The significant difference between groups in nerve root preservation was confirmed.Conclusion Optimal surgical margin for sacral GCT is of great importance to local control of tumor recurrence,the surgical procedure of sacral GCT should aim at the marginal resection on the basis of rational sacral nerve roots preservation;preservation of bilateral S3 nerve roots contributes to the recovery of sphincteral function in most patients.

Objective To explore the efficacy and safety of mild hypothermia (MH) in treating the infants with moderate-to-severe neonatal hypoxic-ischemic encephalopathy(HIE),and to make a follow-up of the nerve motor development of the infants at 18 months old after discharge.Methods Totally 61 neonates with moderate-to-severe HIE in Neonatal Intensive Care Unit (NICU) from Jan.2007 to Dec.2013 were retrospectively analyzed.According to before and after MH therapeutic apparatus was used by NICU of Shanghai Children's Hospital,61 neonates of HIE were divided into 2 groups,the conventional treatment group(25 cases) and MH treatment group(36 cases).The patients in both groups were measured respectively by using the amplitude integrated electroencephalography (aEEG) before MH treatment and at 72 hours after M H treatment,by neonatal behavioral neurological assessment(NBNA) on the 28th day after birth,and by adopting Bayley Scales of Infant Development at 18 months old.The adverse reactions,serious disability cases and deaths of MH treatment were recorded.Results Compared with the conventional treatment group,aEEG recording before treatment showed no statistically significant differences in MH treatment group [maximum voltage:(22.4 ±3.1) μV vs(18.6 ±2.5) μV,maximum voltage:(8.2 ±2.6)μV vs(6.5 ±1.9) μV,t =1.264,0.852,all P ＞ 0.05].However,aEEG recording at 72 h after treatment showed statistically significant differences in MH treatment group [maximum voltage:(24.1 ± 3.2) μV vs (30.6 ± 2.8) μV,maximum voltage:(9.7 ± 3.4) μV vs (13.3 ± 2.2) μV,t =6.376,4.257,all P ＜ 0.05].Severe disability cases [24.0％ (6/25 cases) vs 5.6％ (2/36 cases),x2 =4.405,P ＜ 0.05] and deaths [16.0％ (4/25 cases) vs 0 (0/36 case),x2 =6.1 64,P ＜ 0.05] in MH treatment group were significantly decreased,and there was significantly difference in NBNA on the 28th day after birth[(35.9 ± 2.1) vs(39.1-± 1.6),t =3.361,P ＜ 0.05],and scales of neurobehavioral evaluation through follow-up of 18 months old [mental development index (MDI):(85.2 ± 10.7) vs (96.5-± 13.1),t =7.839,P ＜ 0.05].Very few neonates had apnea,coagulation dysfunction,arrhythmia and other adverse reactions in MH treatment course.Conclusions MH treating moderate-to-severe HIE is safe and effective.MH is effective in reducing death and major disabilities in neonates with moderate-to-severe HIE and without significant side effects.MH can obviously improve the development of nervous system disorders in 0-18 months infants,and can significantly improve these infants' Bayley developmental scale neurobehavioral scores.