Objective To evaluate the effect of sevoflurane on liver injury in a pig model of hemorrhagic shock.Methods Twenty-four Bama miniature pigs of both sexes,weighing 20-25 kg,aged 3-5 months,were equally randomized into 3 groups using a random number table:sham operation group (group S);hemorrhagic shock group (group HS);sevoflurane group (group Sev).Hemorrhagic shock was induced by withdrawing 40％ of blood volume from the right femoral artery within 15 min (30 ml/kg) in HS and Sev groups.The animals inhaled 2％ sevoflurane for 30 min after establishment of the model in group Sev.Before hemorrhagic shock (T0),and at 30,60,90,120,180 and 240 min after hemorrhagic shock (T1-6),blood samples were collected from the femoral artery for determination of plasma alaninc aminotransferase (ALT) and betaine-homocysteine S-methyltransferase (BHMT) concentrations (by enzymelinked immunosorbent assay).After blood sampling at T6,the animals were sacrificed,and the right lobes of livers were removed for examination of the pathological changes with light microscope.Results Compared with group S,the plasma ALT concentrations were significantly increased at T4-6,the plasma BHMT concentrations were significantly increased at T3-6 (P＜0.05),and significant liver pathological changes were observed in HS and Sev groups.Compared with group HS,the plasma ALT concentrations were significantly decreased at T4-6,the plasma BHMT concentrations were significantly decreased at T3-6 (P＜0.05),and the liver pathological changes were significantly attenuated in group Sev.Conclusion Sevoflurane can mitigate liver injury in a pig model of hemorrhagic shock.

OBJECTIVETo evaluate cost-effectiveness of poking reduction and open reduction for the treatment of Sanders type II calcaneal fractures, in order to provide evidence for standard treatment.

METHODSFrom 2006.10 to 2008.10, 80 patients with Sanders type II calcaneal fractures were selected from Shandong Provincial Hospital of Traditional Chinese Medicine and randomly divided into poking reduction group and open reduction group with 40 cases in each group. There were 26 males and 14 females in poking reduction group and 30 males and 10 females in open reduction group. The average age of patients in poking reduction group was (36.60+/-3.15) years, and (37.10+/-3.45) years in open reduction group. Bohler angle, Gissane angle, the width of central calcaneus, stance phase of gait, HM-HL,arch index and subtalair joint flexibility were measured. The clinical results and expenses of the two treatment schemes were compared and concluded with the method of cost-effetiveness analysis.

RESULTSIn the poking reduction group and open reduction group, the Böhler angle were (30.32+/-1.72) degree and (30.54+/-3.13) degree, Gissane angle were (133.73+/-6.73) degree and (134.86+/-4.90) degree, the width of central calcaneus were (30.18+/-1.59) mm and (30.24+/-1.25) mm, stance phase of gait were (0.679+/-0.070) s and (0.715+/-0.090) s, HM-HL were--(36.49+/-7.56) N and -(34.32+/-6.50) N,arch index were (30.26+/-2.69) and (30.47+/-1.89), and subtalair joint flexibility were (10.53+/-2.30) degree and (10.89+/-1.86) degree respectively. The cost-effectiveness ratio (C/E) were 6.06 and 136.19 respectively.

CONCLUSIONCost-effectiveness ratio of the poking reduction is superior to that of the open reduction in treating Sanders type II calcaneal fractures. Poking reduction is a useful method to treat Sanders type II calcaneal fractures with rapid wound healing and less cost.

Adult ; Calcaneus ; injuries ; surgery ; Cost-Benefit Analysis ; Female ; Fracture Fixation, Internal ; economics ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

Objective To evaluate the surgical techniques and clinical applications of single-port transumlilical laparoscopic dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction (UPJO). Methods From August 2009 to March 2010, 15 patients were treated with single-port transumbilical laparoscopic dismembered pyeloplasty. There were 12 males and 3 females,aged 12 to 55 years with an average age of 20 years, who were diagnosed by diuretic renography,IVU, and MRU et al. A single umbilical incision of 3. 5cm was made for single-port trocar and a flexible-tip 0°digital video-laparoscope was used in all cases. The procedures were performed according to the methods used in classical laparoscopic dismembered pyeloplasty with general instruments. ResultsAll operations were performed successfully without conversion to open surgery. The mean operative time was 90 (75-145) min, and the mean hospital stay length was 6 days. No organs injury occurred during operation, and no urine leakage was found afer operation. The symptoms of low back pain disappeared and hydronephrosis reduced apparently or dispeared without any anastomotic stenosis after follow-up of 4-6 months. Conclusions Single-port transumbilical laparoscopic dismembered pyeloplasty is feasible, effective and safe for the treatment of UPJO.

Benzene ; poisoning ; Hazardous Substances ; Humans ; Occupational Exposure ; prevention & control

Objective To evaluate the changes in sagittal profiles and complications during treatment with growing rods (GRs) in hyperkyphotic early-onset scoliosis (EOS).Methods From December 2009 to December 2016,a total of 32 EOS patients who received growing rods treatment in our center,including 8 males and 24 females,were reviewed retrospectively.All the patients had minimum 2-year follow-up and over 2 lengthenings.Based on the reference value of thoracic kyphosis (TK) in T2-12 of normal children,the patients were categorized into an N group (20°≤TK≤50°,15 cases,4 males and 11 females) or K group (TK≥50°,17 cases,4 males and 13 females).The distribution of etiology was similar between the two groups.The average age was (6.2±2.0) years and (6.3±2.3) years respectively,curve flexibility was 34.6％± 10.4％ and 35.8％± 11.2％ before surgery.The precontoured rods were tunneled submuscularly,connecting proximal and distal anchors,and tandem or domino connectors.The rods were then locked after applying direct distraction that allowed appropriate elongation.The connectors were all placed under the deep fascia.Results The mean follow-up in the N and K groups was (5.5±1.9) years and (5.5±2.1) years,respectively.The distribution of proximal and distal anchors was similar between the two groups.The N and K groups,respectively,had an average number of lengthenings of 5.1±2.0 and 5.3±2.3,with mean lengthening intervals of (11.3±2.3) months and (10.9±1.9) months,respectively.In the N group,TK was decreased from 36.0°±9.4° to 30.6°±.8.3° after surgery,and to 32.2°±7.8° at the last follow-up,demonstrating it was maintained within the normal range.In the K group,TK was markedly reduced from 67.6°±11.6° to 41.7°±8.7° after the index surgery,with a correction rate of 38.3％± 14.6％,and the difference was statistically significant.And then it slightly increased to 46.5°±8.4° at the last follow-up,with correction loss of 7.1％±4.2％,and the difference was not statistically significant compared with the postoperatiom.The complication rate in the K group was significantly higher than in the N group (76.5％ vs.33.3％,P=0.031).The most common implant-and alignment-related complication in both groups was rod fracture (15.6％) and proximal junctional kyphosis (21.9％),respectively.The incidence of rod fracture in the N group and K group was 6.7％ and 23.5％,respectively.And the incidence of proximal junctional kyphosis was noted as 13.3％ and 29.4％ in the N group and K group,respectively.Proximal junctional angle (PJA) in the K group was greater than that in the N group preoperatively,postoperatively and at the last follow-up.Moreover,the increasing amount of PJA was significantly greater in the K group compared to the N group (1.6°± 1.0° vs.0.7°±0.8°).Four and seven complication events in the N and K groups,respectively,were evaluated with Grade Ⅰ.Four and seven complication events in the N and K groups,respectively,were classified as Grade Ⅱ A.Conclusion GRs can effectively restore the sagittal profile in hyperkyphotie EOS patients,but with a higher complication rate compared to the patients with normal kyphosis.

Objective To explore the value of enhanced T2 star weighted angiography(ESWAN)in the treatment of uterine fibroids with high intensity focus ultrasound(HIFU) by analyzing the changes of ESWAN. Methods Uterine fibroids were detected through pelvic conventional MRI and ESWAN 1 day before and after HIFU operation. Different indexes of ESWAN were measured ,and differences were compared with the paired t-test. Results The preoperative and postoperative values of magnitude were 1624.59 ± 53.07 and 1750.13 ± 39.81, phase values were 0.0012 ± 0.0081 Hz and 0.0025 ± 0.1063 Hz,R2*value were 27.69 ± 1.27 Hz and 24.19 ± 1.20 Hz,and T2*values were 34.66 ± 2.07 ms and 36.46 ± 2.14 ms. After HIFU operation,magnitude value,phase value and T2*value were higher(P=0.04,P=0.91 and P=0.45),and R2*value was lower(P=0.019). Conclusions ESWAN can provide more information about histopathologic changes of uterine fibroids after HIFU.

Objective To study the clinical value of DTI in the evaluation of high intensity focused ultra-sound (HIFU) for treating uterine fibroids by analyzing the characteristics of DTI before and after surgery. Methods DTI was performed before and after HIFU. The study included 25 patients with 30 uterine fibroids. All data were processed using GE AW4.5 Workstation. ADC,FA,VRA and T2-weighted trace of uterine fibroids before and after HIFU were recorded and analyzed. Results After HIFU,no enhancement was observed in uterine fibroids on DCE-MRI. The signal of uterine fibroids on FA,VRA map was lower after HIFU. No statistical differences were found between ADC and T2-weighted trace before and after the surgery(P>0.05). FA and VRA of uterine fibroids after HIFU were lower than those before the surgery(P<0.05). Conclusion FA and VRA can reflect micro differ-ence of uterine fibroids before and after HIFU ,which is useful for assessing the curative effect after HIFU.

AIM To investigate the effect of Shenfu Injection on atherosclerosis (AS) models of high-fat apolipoprotein E-deficient (ApoE-/-) mice,and to explore its anti-atherosclerosis mechanism through the observation of oxidative stress (OS) variation.METHODS C57 mice were used as controls.ApoE-/-mice fed with 20-week high fat diet were randomly divided into model group,Shenfu group for subsequent 4-week continuous corresponding intervention,after which the mice had their blood lipid levels measured,their levels of MPO and NOX4 identified by ELISA,and their T-SOD activity determined by hydroxylamine method,their MDA level detected by TBA,their plaque formation observation achieved by HE staining of aortic gross and red O of all the aorta,and their Nrf2 mRNA expression detected by real time qPCR method.RESULTS Compared with the control group,the model group manifested with increased contents of TG,TC,LDL,decreased HLD;decreased activity of SOD,increased contents of MPO,NOX4 and MDA,and down-regulated expression of aortic Nrf2 and Keap1 mRNA.Compared with the model group,Shenfu Injection group was observed with no obvious blood lipid level change,but a reduction of plaque area,and an effective inhibition on OS as revealed by improved levels of Nrf2 and Keap1 mRNA.CONCLUSION Shenfu Injection can activate Nrf2 and interfer the relevant enzymes,thus prevents the atherosclerosis progression through OS reduction.

Objective: To survey the current situation of radiological protection in primary medical institutions in Xi′an, analyze the existing problems, and provide countermeasures and suggestions for further strengthening the radiological protection management of radiological diagnosis and treatment in primary medical institutions. Methods: A total of 58 primary medical institutions in Xi′an were selected by stratified cluster sampling according to the work plan of national radiological health monitoring project and the related implementation plan in Shaanxi province. Data were collected by using a unified design questionnaire to investigate and analyze the basic protection situation, radiological diagnosis and treatment equipment, protective auxiliary equipment and their use situations as well as the standardization of the machine room of these radiological diagnosis and treatment institutions. Protective monitoring of the machine room was conducted by the Radiological Health Department of Xi′an CDC together with the relevant data being recorded. Results: The survey found that the holding rate of the license of radiological diagnosis and treatment in primary medical institutions was 96.6%, the ratio of professional and technical workers with professional expertise in radiological diagnosis and treatment 89.6%, the training rate of radiological staff 89.6%, and the proportion of protective equipment 85.7%, the utilization rate of protective equipment 74.3%, the rate of physical examination for radiation workers 91.4%, and the rate of personal dose monitoring 96.5%. There was no statistically significance in the area and at the shortest side of the machine rooms between different types(P>0.05). There were statistically significances in ventilation (χ²=7.034, P<0.05), tidiness (χ²=29.075, P<0.05), warning sign equipment (χ²=23.156, P<0.05) and status indicator light equipment (χ²=23.478, P<0.05) between different types of primary medical institutions. The qualified rate of radiation protection in the workplace of the radiological diagnosis and treatment institutions was 74.1%, and the difference in radiation dose levels in the surrounding environment of the workplace of the radiological diagnosis and treatment institutions between different types was statistically significant (χ²=14.028, P<0.05). Conclusions The patients′personal protective equipment allocation rate and the utilization rate of examined individuals′ protective equipment in the primary medical institutions are low, the standardization of the radiation workplace is poor, and the radiation protection in the workplace needs to be improved.

Objective To discuss the semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008, 36 patients (20 males and 16 females with mean age of 43 years) underwent retroperitoneoscopic adrenalectomy in 60° -70° semilateral supine position. There were adrenal cortex adenomas in 18 cases, pheochromocytoma in 6 cases, adrenal cysts in 3 cases, myelolipoma in 2 cases, gangliocytoma in 1 case, lymphangioma in 1 case, metastatic tumor in 1 case and corticohyporplasia in 4 cases. The mean diameter of the tumors was 2.6 cm( 0.5 - 7.7 cm ). The tumors were superior to the renal pole in 5 cases, anteromedial in 10 cases and superomedial in 17 cases. The three ports that were usually used in lateral position and were placed anteriorly to create retroperitoneal place: the first port was placed 2 -4 cm superior to the iliac crest along the anterior axillary line, the other two were placed just below the costal margin along the midaxillary line and at the same level along the midclavicular line, and dissected along the anterior surface of kidney to its superomedial aspect, so as to avoid the hampering of the kidney in the exposing of the diseased adrenal gland. Results The procedure was completed successfully in all of the cases with the operating time of 37 - 145 min ( mean 69 min) and intraoperative blood loss of 30 - 100 ml (mean 48 ml). Six cases had rupture of peritoneum, which were sutured and the procedure was continued to completion. The postoperative hospital stay was 3 -8 d (mean 5 d ). Thirty-five patients were available for follow-up of 3 - 28 months ( mean 14 months). The case of metastatic tumor died of the primary diseases in the 12th month postoperatively. No other complication was found. Conclusion With this alternative position and ports' location, the procedure of retroperitoneoscopic adrenalectomy could be easier and safer than the conventional position.