OBJECTIVETo observe the therapeutic angiogenesis effect of naotai recipe (NR) on local ischemia/reperfusion (I/R) injury of rats by observing signaling pathway of hypoxia-inducible factor-lα (HIF-1α) and vascular endothelial growth factor (VEGF).

METHODSTotally 120 Sprague-Dawley (SD) rats were randomly divided into 4 groups, namely, the normal control group (n =12), the sham-operation group (n =12), the I/R model group (n =48), and the NR group (n =48). Cerebral I/R injury models were established using thread suture method. Rats in the I/R model group and the NR group were sub-divided into 4 sub-groups according to the 1st, 3rd, 5th, and 7th I/R day (n =12). The phenomenon of neovasculization was observed by immunofluorescence staining. The protein and mRNA expression levels of HIF-la, VEGF-A, and VEGFR II receptor were detected by RT-PCR.

RESULTSThere were a large amount of labels for neovasculization in the ischemic area of the NR group. Double-immunofluorescence labeling [vWF (red) and BrdU (green)] was observed in the NR group. Compared with the model group, the HIF-1α protein expression was obviously enhanced on the 1 st day of I/R (P <0.01), and the VEGF protein expression started to enhance on the 3rd day in the NR group (P <0.01). The VEGFR protein expression level was the highest in the NR group on the 5th day of I/R (P <0.01). The protein expression of VEGF and HIF-1α started to decrease on the 7th day of I/R.

CONCLUSIONNR could strengthen angiogenesis after I/R by elevating the expression of HIF-lα and activating HIF-lα/VEGF signaling pathway.

Animals ; Brain Ischemia ; metabolism ; Cerebral Infarction ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; Ischemia ; Neovascularization, Pathologic ; Rats, Sprague-Dawley ; Reperfusion Injury ; Signal Transduction ; Vascular Endothelial Growth Factor A ; biosynthesis

OBJECTIVETo evaluate the experience of surgical treatment of pulmonary tuberculosis with endobronchial tuberculosis.

METHODSThe clinical data of 85 patients with pulmonary tuberculosis and endobronchial tuberculosis undergoing surgical resection from 1967 to 2004 were reviewed retrospectively. Forty-five cases were bronchial stenosis. Four cases were tracheal stenosis. Sixteen cases underwent right upper lobectomy. One case underwent right upper and middle lobectomy. Three cases underwent right middle lobectomy. Five cases underwent right middle and lower lobectomy. Two cases underwent right lower lobectomy. Twelve cases underwent left upper lobectomy. Four cases underwent left lower lobectomy. Eight cases were assisted with sleeve lobectomy. Six cases underwent right pneumonectomy (with partial tracheal resection and tracheal reconstruction in 3 cases). Thirty cases underwent left pneumonectomy. One case underwent left lower lobectomy who underwent left upper lobectomy 2 years ago. Four cases were assisted with sleeve pneumonectomy. Three cases underwent tracheal segment resection and tracheal reconstruction. One case underwent left upper bronchial and pulmonary artery sleeve resection. One case underwent biopsy.

RESULTSNo surgical mortality occurred. There was 1 case of bronchopleural fistula and 1 case of empyema in the 35 cases (without sleeve lobectomy) who underwent lobectomy. There were 3 cases of bronchopleural fistula and 4 cases of empyema in the 33 cases (without sleeve pneumonectomy) who underwent pneumonectomy (P < 0.05). There were 5 cases of atelectasis in the 35 cases who underwent lobectomy and 3 cases of atelectasis in the 8 cases who underwent sleeve lobectomy (P < 0.01). In the follow-up of 3 to 10 years, 1 case died due to acute respiratory distress syndrome 7 years postoperatively.

CONCLUSIONSIt is important to resect all the tissue which has been infected. With the routine anti-tuberculosis chemotherapy during the perioperative period, the effect of surgical treatment is superior to others. Fewer pneumonectomy is also important.

Adult ; Aged ; Bronchi ; surgery ; Bronchial Diseases ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pneumonectomy ; methods ; Retrospective Studies ; Trachea ; surgery ; Tuberculosis ; surgery ; Tuberculosis, Pulmonary ; surgery

OBJECTIVETo investigate the clinical features of postoperative ventilator-associated pneumonia (VAP) after lung surgery.

METHODSOf 104 patients who had undergone lung surgery and been treated with ventilator in our surgical intensive care unit between January 2003 and March 2005, 35 patients met with the criteria of both VAP and postoperative pneumonia (POP), and 41 cases had no evidences of pneumonia. The clinical and laboratory data of all 76 cases were recorded and analyzed by a statistical software package (SPSS).

RESULTSThe diagnosis of postoperative VAP was established clinically in 35 patients (46.1%), and etiologically in 33 cases. Compared to the patients without postoperative VAP, the patients with postoperative VAP had a significantly longer mean interval between intubation and operation [(2.7 +/- 2.9) days vs. (1.6 +/- 1.7) days, P = 0.039], a longer duration of mechanical ventilation [(32.2 +/- 37.7) days vs. (4.2 +/- 2.9) days, P < 0.001], and higher morbidity (20.0% vs. 2.4%, P = 0.013). There was a significant difference in mean duration of mechanical ventilation between the 15 cases of early-onset VAP and 20 cases of late-onset VAP (17 +/- 15 days vs. 43 +/- 46 days, P = 0.042). Among the initially detected pathogen, Staphylococcus aureus remains the most common Gram-positive coccus whereas Acinetobacter Baumannii took the place of Pseudomonas aeruginosa as the top Gram-negative rod.

CONCLUSIONPostoperative VAP after lung surgery has different clinical features from VAP in medical ICU.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Ventilator-Associated ; diagnosis ; epidemiology ; etiology ; Postoperative Complications ; Pulmonary Surgical Procedures ; adverse effects ; Respiration, Artificial ; adverse effects ; Retrospective Studies ; Risk Factors ; Time Factors

OBJECTIVETo compare the mandibular indices differences between periodontitis and non-periodontitis subjects by digital panoramic tomograms in order to find a simple and effective method to evaluate the density of alveolar bone and study the relativity between local bone loss and systemic bone loss.

METHODSStandard digital panoramic tomograms of sixty periodontitis subjects and sixty non-periodontitis subjects were taken. Density and height cortical width (CW) and panoramic mandibular index (PMI) of alveolar bone were measured on the digital panoramic tomograms. SPSS 12.0 was used for statistics analyses.

RESULTSThe periodontitis subjects had lower height of alveolar bone (8.76 mm vs. 11.85 mm, P=0.000), lower density of alveolar bone (106.08 vs. 113.33, P=0.034), thinner cortical width (3.80 mm vs. 4.27 mm, P=0.008), while the difference of PMI between the two groups was not significant (P>0.05). The relativity between both density and height of alveolar bone with CW was significant (P<0.05), but not significant with PMI (P>0.05).

CONCLUSIONThe optical method is a simple and effective method to measure the density of the alveolar bone. Compared with the non-periodontitis subjects, the periodontitis subjects not only have alveolar bone changed significantly but also have thinner cortical width.

Alveolar Bone Loss ; Bone and Bones ; Female ; Humans ; Male ; Mandible ; Periodontitis ; Radiography, Panoramic

OBJECTIVETo investigate the effect of ketogenic diet (KD) on the clinical and electroencephalogram features in children with pharmacoresistant epileptic encephalopathy.

METHODThirty-one children (19 boys, 12 girls) aged 7 months to 7 years (mean 2 years 5 month) with epilepsy refractory to conventional antiepileptic drugs (AEDs) were included in this study. In addition to their original AED treatment, the children were assigned to different ketogenic diets based on their age. The prospective electro-clinical assessment was performed prior to the KD and then one week, one month and again 3 months after the initiation of therapy, respectively.

RESULTThe reduction of seizure frequency in 52%, 68% and 71% of all patients exceeded 50% one week, one month and three months after KD treatment respectively. KD is particularly effective in myoclonic astatic epilepsy (MAE; Doose Syndrome) and West syndrome with 100% and 81.25% of the patients having a greater than 50% seizure reduction, respectively. After 3 months of KD treatment, more than 2/3 patients experienced a reduction in interictal epileptiform discharges (IEDs) and improvement in EEG background.

CONCLUSIONThe clinical and electroencephalographic improvement confirms that KD is beneficial in children with refractory epilepsy.

Anticonvulsants ; therapeutic use ; Brain ; diagnostic imaging ; physiopathology ; Child ; Child, Preschool ; Diet, Ketogenic ; methods ; Dietary Fats ; administration & dosage ; Electroencephalography ; Epilepsy ; diagnosis ; diet therapy ; drug therapy ; Female ; Humans ; Infant ; Intellectual Disability ; diet therapy ; drug therapy ; Lennox Gastaut Syndrome ; Male ; Radiography ; Retrospective Studies ; Spasms, Infantile ; diet therapy ; drug therapy ; Syndrome ; Time Factors ; Treatment Outcome

Objective To observe the influence of circadian rhythm disruptions on exercise capability in rats. Methods A total of 30 spontaneously hypertensive rats (SHR) and age and weight matched homologous normal blood pressure WKY rats were randomly divided into normal circadian rhythm group (control group), twelve hours cir-cadian rhythm disruption group (observation group 1), six hours circadian rhythm disruption group (observation group 2). Each group included ten SHR rats and WKY rats, changing the light/dark time to construct circadian rhythm disruption model. Exercise endurance, blood pressure and heart rate after exhaustion were measured be-fore and one, two and three months after modeling. Results The interaction of time and circadian rhythm was significant on the exhaustion time of SHR rats (F=2.409, P=0.047). After three months of modeling, the exhaustion time of the control group was more than that of the obser-vation groups 1 and 2 (F=4.290, P=0.032). The interaction of time and circadian rhythm was not significant on the exhaustion time of WKY rats (F=0.717, P=0.638), there was no significant difference in the exhaustion time among groups (P>0.05). For SHR rats, after three months of modeling, the systolic pressure, diastolic pressure and mean arterial pressure after exhaustion of the observation group 1 were higher than those of the control group and the observation group 2 (P<0.05), the heart rate of the observation groups 1 and 2 was higher than that of the control group (P<0.05). But there was no significant difference in the systolic pressure, diastolic pressure, average arterial pressure and heart rate of WKY rats among groups (P>0.05). Conclusion Circadian rhythm disruptions can reduce the exercise endurance of SHR rats, which may be related to the cardiovascular function impairment.

Objective To investigate the status of syphilis and HCV infection and the influencing factors among community drug addicts in Jiaxing City.Methods HCV and syphilis were detected among community drug addicts in Jiaxing City from 2014-2015 and a questionnaire survey were conducted.Influencing factors of syphilis and HCV was analyzed in this study.Results A total of 449 drug users including 356 males (79.29％) and 93 females (20.71％) were investigated,with the age ranged from 16 to 47 and averaged 27.50 ± 12.28.A total of 370 of them take addictive drugs (82.41％),including 42 of them take more than 2 kinds of drugs.15 cases of Syphihs (double positive) were found,and the positive rate was 3.34％.There were significant difference among community drug addicts with different education level (P ＜0.05).The positive rate of HCV among males were lower than that of females (P ＜ 0.05),and the positive rate of HCV among heroin addicts were higher than other drug addicts (P ＜ 0.05).The positive rate of HCV of injection drug users were higher than oral drug addicts(OR =17.341,95％ CI:8.387-35.857,P ＜ 0.01).There was associations among condom use with double positive syphilis and HCV (OR =0.210,95％ CI:0.064-0.689,P ＜0.01;OR =0.131,95％ CI:0.063 -0.273,P ＜ 0.01),respectively.Conclusion Community drug addics are mainly young adults,drug injection and not using condom may increase the risks of TP and HCV infection.

OBJECTIVETo compare video-assisted thoracic surgery (VATS) and open thoracotomy (OT) on acute inflammatory responses and immunosuppression after lobectomy for early non-small cell lung cancer (NSCLC).

METHODSPresent prospective randomized study. OT or VATS lobectomy was performed in patients who met enter criteria and clinical data was collected. Plasma concentration of IL-6, IL-8 and IL-10 were measured before surgery and at postoperative day (POD) 1 and POD 3. There were 271 patients underwent lobectomy for early NSCLC, including of 133 patients in group VATS and 138 patients in group OT from January 2007 to June 2008. There were 132 males and 139 females, aging from 19 ∼ 70 years with a mean of (56 ± 8) years.

RESULTSCompared with OT group, shorter postoperative hospital stay [(8.2 ± 2.5) d vs. (9.8 ± 6.2) d, P = 0.03], lower morbidity rate (11.3% vs. 21.7%, P = 0.02) and lower increase of plasma concentration of IL-6 at POD 1 [(35 ± 25)% vs. (65 ± 43)%, P = 0.00], IL-6 at POD 3 [(14 ± 22)% vs. (55 ± 44)%, P = 0.00] and IL-10 at POD 1 [(25 ± 20)% vs. (43 ± 35)%, P = 0.00] were observed in patients of VATS group.

CONCLUSIONVATS lobectomy for early NSCLC is associated with less acute inflammatory responses and less immunosuppression when compared with OT.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood ; surgery ; Female ; Follow-Up Studies ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Interleukins ; blood ; Lung Neoplasms ; blood ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods ; Prospective Studies ; Thoracic Surgery, Video-Assisted ; Thoracotomy ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the early outcome of patients who underwent video-assisted thoracic surgery (VATS) lobectomy for primary lung carcinoma.

METHODSThe records of 121 patients with lung cancer undergoing VATS lung resection from 1997 to 2004 were reviewed retrospectively, I stage: 101 cases, 34 cases underwent right upper lobectomy, 13 cases underwent right middle lobectomy, 17 cases underwent right down lobectomy, 21 cases underwent left upper lobectomy, 16 cases underwent left down lobectomy. Thirty-eight cases underwent VATS lobectomy without assisted mini-incision.

RESULTSThere were 18 cases of morbidities (15%) and no surgical mortality. The 1-year, 2-year and 3-year survival rates of primary non-small cell lung cancer with I stage is: 99% (76/77), 96% (49/51) and 79% (15/19), respectively. There are statistic difference (P < 0.01) between adenocarcinoma and the others. There are no statistic difference (P > 0.05) between the VATS lobectomy with assisted mini-incision (n = 38) and without (n = 63), also no statistic difference (P > 0.05) between the VATS lobectomy and the standard procedure.

CONCLUSIONOur findings suggest that VATS lobectomy is superior regarding its ability to achieve the same survival rates and little morbidities in comparison with the standard procedure.

Adult ; Aged ; Carcinoma, Bronchogenic ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Time Factors ; Treatment Outcome

OBJECTIVETo evaluate the access to the frontal recess by identifying the agger nasi cell and uncinate process.

METHODSForty-seven patients (85 sides) who underwent endoscopic frontal sinus surgery in our department constituted the study population. Computed tomographic (CT) scans of the sinuses were obtained in coronal and axial views. The frontal ostium was identified by using agger nasi cell approach or identifying the uncinate process.

RESULTSThe frontal sinus ostium was identified in 100% of patients (85 sides). After an average follow-up of 9 months, 41 sides of 49 sides (84%) had endoscopically healed sinuses by using agger nasi cell approach. And 21 sides of 36 sides (81%) had endoscopically healed sinuses by identifying the uncinate process.

CONCLUSIONSThe agger nasi cell approach to the frontal recess gives an access and allows identification of the frontal ostium. In addition, it provides direct visualization with a 0 degree endoscope into the frontal recess.

Adult ; Chronic Disease ; Endoscopy ; methods ; Female ; Frontal Sinus ; surgery ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Nose ; surgery ; Paranasal Sinuses ; Sinusitis ; surgery