Objective To discuss the manifestations, diagnosis and management of acute superior mesenteric artery occlusion (ASMAO). Methods The clinical data of 15 cases of ASMAO admitted in our hospital between 2000 and 2007 were analyzed retrospectively. Results The causes of ASMAO were mesenteric artery embolism in 11 patients and mesenteric artery thrombosis in 4 patients. All cases underwent emergency laparotomy, in which 2 cases underwent removal of the embolus, 11 cases were subjected to resection of necrotic bowel after removal of the embolus, and 2 cases gave up definite surgery. Postoperative heparin anticoagutherapy was used in all patients. The overall mortality rate was 27% (4 cases). Conclusions Acute superior mesenterie artery occlusion should be suspected in a patient with sudden abdominal pain, especially in those who have organic cardiac disease. Early diagnosis and prompt embolectomy are the key to save the patients.

Electrical stimulation is well used in medical therapeutics,but the mechanism still needs to be studied further. This paper applies an electrical stimulator to generate low frequency pulse,which is used to stimulate at the root of the thumb,right on the median nerve. EEGs were recorded before and after the stimulation. Comparing the EEGs changes between the former and latter using power spectral analysis,the effect of low frequency electrical stimulation on human nerve excitability is discussed.

Objective: To observe the role of parenteral nutrition and laparoscopic therapy in chylous ascites.Methods: A patient with chylous ascites was therapied with parenteral nutrition(4 weeks) and laparoscopic therapy and parenteral nutrition(1 week) subsequently.Output of ascites was daily measured from the drainage catheter of abdominal cavity.The body weight and other nutritional indexes were determined.Results: During the course of parenteral nutrition,the production and output of ascites gradually decreased,the body weight increased,and the serum album in level kept unchanged.After laparoscopic therapy and parenteral nutrition(1 week),ascites decreased significantly and did not rebound after diet,the body weight and the serum album in level also obviously increased.Conclusion: Laparoscopic therapy and parenteral nutrition are very useful in the treatment of patients with chylous ascites.

OBJECTIVETo compare the clinical outcomes of anterior cervical decompression plus sublevel fusion and posterior cervical laminoplasty in treating multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 56 patients with multilevel cervical spondylotic myelopathy were retrospectively analyzed from July 2009 to June 2012. There were 32 males and 24 females, aged from 42 to 79 years old with an average of (56.9 +/- 12.8) years. All patients had the typical clinical features of cervical spondylotic myelopathy,radiological evidences, and courses of disease were from 2 months to 16 years with an average of (10.6 +/- 3.2)years. Of them,34 patients were treated with anterior cervical decompression plus sublevel fusion (anterior fusion group) and 22 patients with posterior cervical laminoplasty (posterior laminoplasty group). JOA score and radiological data were used to evaluate the clinical results:

RESULTSNo complications about nerve and blood vessel was found and the patients were followed up from 24 to 36 months with an average of 28.6 months. In anterior fusion group, the cervical anterior column height was significantly increased and the anterior cervical curvature angle was significantly decreased at 2 weeks after surgery (P < 0.05). In posterior laminoplasty group, there was no significant difference in above items between preoperative and postoperative at 2 weeks,final follow-up. Postoperative at 2 weeks and final follow-up, there was significant difference in anterior cervical curvature angle between two groups (P<0.05). Postoperative JOA score had obviously improved in all patients, at 3 months after operation and final follow-up, anterior fusion group was better than that of posterior laminoplasty group (P < .05).

CONCLUSIONThe anterior sublevel fusion can effectively restore cervical anterior column height, and compared with the posterior cervical laminoplasty, it can obviously improve the spinal cord function. It is an effective method for the multilevel cervical spondylotic myelopathv.

Adult ; Aged ; Case-Control Studies ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spinal Fusion ; Spondylosis ; diagnostic imaging ; surgery

Objective Preparation of a stable and reliable atrioventricular blockage ( AVB) animal model is of great im-portance to anti-arrhythmic drugs and biological engineering research .The aim of the article was to establish a rat model of AVB in-duced by chemical ablation, providing an effective animal model for the development of new drugs . Methods 60 adult SD rats were randomly divided into 4 groups(n=15): normal saline (NS) group, Verapmil (Ver) group, chemical ablation group 1 and chemical ablation group 2.0.9%NaCl (5 mg/kg) was injected into caudal vein of each rat in NS group .Verapmil (5 mg/kg) was injected into the caudal vein in Ver group.Anhydrous ethanol(50μL)was injected into atrioventricular groove area in chemical abla-tion group 1.Anhydrous ethanol(50μL) was injected into atrioventricular node area in chemical ablation group 2.The electrocardio-grams of the rats were examined by electrophysiological recorder.HE staining and Connexin 43 (CX43) immunohistochemical tech-nique were applied to atrioventricular junctions of the rats . Results A rat model of AVB was successfully established .Compared with NS group([45 ±2.24]per field of view), there was a significant decrease in the CX43 expressions of chemical ablation group 1 and group 2 ([15.20 ±2.23]per field of view, [22.10 ±4.70]per field of view)(P<0.05).Concerning NS group and Ver group, myocyte tissues of the atrioventricular nodal region were detected to remain in order without obvious changes and the expres-sion of CX43 immunoreactive protein was obvious under light microscope.As to chemical ablation group 1 and group 2, myocyte tissues were in degenerative necrosis and the expression of CX43 im-munoreactive protein was in lighter staining.Compared with Ver group, the incidence rate(73.3%, 60.6%) and the mortality rate (33.3%, 26.7%)of third-degree AVB decreased remarkably(P<0.05). Conclusion Chemical ablation can be induced to estab-lish a stable and reliable rat model of AVB , providing an effective
animal model for the research and development of new anti-arrhythmic drugs.

OBJECTIVE: To construct eukaryotic expression plasmid of porcine CCK gene pIRES2-EGFP/CCK and express it in COS-7 cells and hamsters. Methods The aimed segments were obtained from intermediate vector pMD18-T/CCK and were inserted into an eukaryotic expression plasmid pIRES2-EGFP to construct a recombinant expression plasmid pIRES2-EGFP/CCK. The recombinant expression plasmid was transfected into COS-7 cells by liposome-mediated gene transfer method and was observed through fluorescence microscope. The plasmid was injected into the skeletal muscle of hamsters directly to detect the expression of the recombinant plasmid in vivo. RESULTS: A recombinant eukaryotic expression plasmid pIRES2-EGFP/CCK was successfully constructed. Green fluorescent protein could be detected in the transfected COS-7 cells 24, 48, and 72 hours after the transfection. On the 4th day postinjection into the skeletal muscle of hamsters, the protein could be detected at the injection site and the fluorescence intensity became much stronger on the 14th day than that on the 4th day. On the 42nd day the protein level increased. The green fluorescence protein was never expressed in the untransfected cells. CONCLUSION The porcine CCK gene eukaryotic expression plasmid pIRES2-EGFP/CCK is constructed successfully, and is expressed in mammal COS-7 cells and hamsters in vivo. The research paves the way for the cross immunity therapy of hamster pancreatic carcinoma.
Animals ; Base Sequence ; COS Cells ; Cancer Vaccines ; therapeutic use ; Chlorocebus aethiops ; Cholecystokinin ; biosynthesis ; genetics ; Cricetinae ; Eukaryotic Cells ; metabolism ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Molecular Sequence Data ; Muscle, Skeletal ; metabolism ; Pancreatic Neoplasms ; therapy ; Plasmids ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Swine ; Transfection

Purpose To observe the protective effects of low molecular hirudo peptides on focal cerebral ischemia reperfusion injury in rats and to explore its possible mechanism. Methods Middle cerebral artery occlusion (MCAO) was used to prepare focal cerebral ischemia and the neurological scores and infarction area of brain slices, and water content of brains were assessed. Superoxide dismustase (SOD) activity and malondi-aldehyde ( MDA) content in homogenate of ischemic brain tissue were determined by spectrophotometric assay. Results Hirudo peptides could reduce the percentage of infarction area and the water content in the cerebral hemisphere, increase SOD activity and decrease MDA content in ischemic brain tissue. Conclusion Low molecular hirudo peptides have protective effects on focal cerebral ischemia injury, and its mechanism may be related to the antioxidant action.

Objective To evaluate fluid responsiveness by stroke volume variation (SVV) in mechanically ventilated patients with refractory septic shock.Methods Forty-two refractory septic shock patients were enrolled in the study.According to the responsiveness of fluid loading, the patients were divided into responsive group and non-responsive group.The SVV values of two groups were retrospectively analyzed.The receiver operating characteristic curve was drafted to determine the cut-off value of SVV for predicting fluid responsiveness.Results Among the 42 refractory septic shock patients, 24 were found responsive to fluid loading, 18 were not;before the fluid loading, central venous pressure, heart rate, mean arterial pressure and global end-diastolic volume index in the both groups showed no significant differences whereas the SVV in the responsive group was much higher than that in the nonresponsive group (P =0.006).Using SVV ≥ 12% as the threshold to predict fluid responsiveness, the sensitivity was 77%,specificity was 85%.Conclusion SVV can accurately predict fluid responsiveness in refractory septic shock patients.

Animals ; Cell Culture Techniques ; methods ; Cell Separation ; methods ; Culture Media ; Epithelial Cells ; cytology ; Respiratory System ; cytology ; Swine

Objectives To investigate the efficacy and toxicity of bortezomib based combination therapy for Chinese patients with relapsed or refractory multiple myeloma(MM),and to determine the combination regimen,dosage and cycles in application of bortezomib for MM therapy.Methods Forty-six patients with refractory or relapsed myeloma were treated with bortezomib(1.3 mg/m2)as an intravenous bolus twice weekly for 2 weeks on day 1,4,8,and 11 in a 3-4 week cycle,in combination with dexamethasone,dexamethasone plus thalidomide, CD(C-cytoxan,D-dexamethasone),MD(M- mitoxsnteone),DCEP(E-etoposide,P-platinol),and DT-PACE regimens(T-thalidomide,A-adriamycin). Response to bortezomib was evaluated according to the criteria of the International Myeloma Working Group (IMWG)before initiation of each cycle.Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0.Forty-nine matched patients with relapsed and refractory MM who received thalidomide based combination therapy were used as a historical control group.Results Among 43 of the 46 patients whom could be evaluated,the overall response rate was 72.1%(the control group was 51.0%,P＜0.05),including complete response in 5 patients(11.6%),very good partial response in 12 patients(27.9%),and partial response in 14 patients(32.6%).The overall response rate after one and two cycles was 30.2%and 58.1%(P＜0.05),respectively.The frequent adverse events were thromboeytopenia(62.8%),fatigue(55.8%),nausea(51.2%)and peripheral neuropathy (30.2%);all of the events could be tolerated.The most common adverse event in the control group was constipation(69.4%),followed by fatigue(59.2%)and dizziness(46.9%).Conclusions Bortezomib based combination therapy is a new effective therapy in relapsed or refractory myeloma patients with a higher response rate and difierent toxicities as compared with thalidomide based combinations.