Objective To analyze the risk factors,clinical characteristics,and missed factors of acute pulmonary embolism (APE) after surgery,so as to advise clinicians to improve understanding of the early postoperative APE and enhance prevention concepts.Methods Retrospectively analyzed the general information of 43 cases of surgical patients with APE after surgery categories,risk factors,clinical manifestations and prognosis.Results APE after surgery had obvious risk factors; often occurred within 2 weeks after surgery; commonly seen in malignant tumors (53.5％,23/43),orthopedics (27.9％,12/43) and other major surgery; clinical manifestations wasn't typical,of which chest distress and dyspnea was the most common symptom (93.0％,40/43),and other pestoperative symptoms were similar,easy to misdiagnosis.Conclusions Surgery is one of the important risk factors of APE.Preoperatively evaluating underlying diseases,postoperative strengthening preventional methods,early detection,early treatment,have great significance in reducing the occurrence of postoperative APE and improve the prognosis.

OBJECTIVETo investigate the protective effect and mechanism of sequoyitol (Sep) on high glucose-induced human umbilical vein endothelial cells (HUVECs) injury.

METHODSHUVECs were cultured with high glucose (30 mmol/L) in the presence or absence of sequoyitol (0.1, 1 and 10 micromol/L) for 24 h. Cell proliferation was measured by BrdU marking and cell cycle was detected by flow cytometry. 2', 7'-dichlorofluorescein diacetate was used to evaluate intracellular reactive oxygen species (ROS) levels. The NO, malonydialdehyde (MDA) and H2O2 levels were determined by colorimetric method according to the manufacturer's instructions. The expression of endothelial nitric oxide synthase (eNOS) and NADPH oxidase 4 (NOX4) were measured by real-time PCR and Western blot.

RESULTSIn the present study, we found that sequoyitol pretreatment for 1 h significantly decreased cell injury, promoted cell proliferation. Meanwhile sequoyitol significantly down-regulated NOX4 expression and decreased the level of ROS, MDA and H2O2 and obviously increased NO levels and up-regulated eNOS expression.

CONCLUSIONSequoyitol alleviates high glucose-induced cell injuries in HUVECs via inhibiting oxidative stress and up-regulating eNOS expression.

Cell Proliferation ; Cells, Cultured ; Glucose ; toxicity ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; Humans ; Hydrogen Peroxide ; metabolism ; Inositol ; analogs & derivatives ; pharmacology ; Malondialdehyde ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Oxidative Stress ; Reactive Oxygen Species ; metabolism

The aim of the present study is to investigate the effects of sequoyitol (Seq) on expression of eNOS and NOX4 in aortas of type 2 diabetic rats. Type 2 diabetic rats induced by high fat and high sugar diet and low dose of streptozotocin (STZ, 35 mg x kg(-1)) and were administered Seq (12.5, 25 and 50 mg x kg(-1) x d(-1)) for 6 weeks. The fasting blood glucose (FBG) and body weight were tested. Acetylcholine (Ach) induced endothelium-dependent relaxation and sodium nitroprusside (SNP) induced endothelium-independent relaxation were measured in aortas for estimating endothelial function. Aortic morphological change was observed with HE staining. The level of serum insulin was measured by radioimmunoassay. The total antioxidative capacity (T-AOC), malondialdehyde (MDA) and NO levels in aortas were determined according to the manufacturer's instructions. In addition, the expressions of eNOS and NOX4 in aortas were measured by immunohistochemisty, real-time PCR or Western blotting. The results showed that Seq significantly decreased FBG and insulin resistance, and improved aortic endothelium-dependent vasorelaxation function. The expressions of NOX4 and MDA content were obviously decreased, while the expression of eNOS, the levels of NO and T-AOC increased significantly in aortas of diabetic rats with Seq treatment. In conclusion, Seq protects against aortic endothelial dysfunction of type 2 diabetic rats through down-regulating expression of NOX4 and up-regulating eNOS expression.
Animals ; Aorta ; metabolism ; pathology ; Blood Glucose ; metabolism ; Body Weight ; Diabetes Mellitus, Experimental ; chemically induced ; metabolism ; physiopathology ; Diabetes Mellitus, Type 2 ; chemically induced ; metabolism ; physiopathology ; Hypoglycemic Agents ; pharmacology ; Inositol ; analogs & derivatives ; pharmacology ; Insulin ; blood ; Insulin Resistance ; Male ; Malondialdehyde ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Oxidation-Reduction ; drug effects ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Vasodilation ; drug effects

Animals ; Arterial Occlusive Diseases ; physiopathology ; therapy ; Dogs ; Genetic Therapy ; Hepatocyte Growth Factor ; genetics ; Hindlimb ; blood supply ; Ischemia ; physiopathology ; therapy ; Male ; Plasmids

Objective To compare the appfication of rapid sequence induce nasotracheal intobation with awake nasotracheal intubation with fiberoptic bronchoscope (FOB) in patients with cervical vertebra injury.Methods Forty patients with cervical vertebra injury were randomly divided into group (rapid sequence induce nasotracheal intubation with FOB) and group II (awake nasotracheal intubation with FOB),20 patients in each group.Bp,HR,SpO2 before and during intubation,intubafion time and cases of re-intubation were observed.Results SpO2 maintained normal during intubation.Between group I and group II,there was no significance in intubation lime [(3.12±0.52)min and (3.34±0.65)mini and cases of re-intubafion (2 cases and 1 case) (P ＞ 0.05 ).During intubation,MAP and HR inceased significantly in group II than those in group I (P ＜ 0.05 ).Conclusion The application of rapid sequence induce nasotracheal intubation with FOB is better than awake nasotracheal intubation with FOB in patients with cervical vertebra injury,it is safe and valid.

Objective To identify dosimetric predictors for the development of gastrointestinal toxicity in patients with pancreatic adenocarcinoma treated with TOMO radiotherapy .Methods From January 2014 to Janu-ary 2015 ,we analysed the medical records of 68 pancreatic cancer patients who received helical tomotherapy from Air Force General Hospital .The stomach and duodenum were contoured separately to determine their dose volume histogram(DVH)parameters.Chi-square test was employed to analyze the count data .Spearman correlation anal-ysis was used to analyze the relationship between occurrence of gastrointestinal toxicity and clinical and physical factors.Logistic regression models was performed to identify risk factors associated with gastrointestinal toxicity . Results The median follow-up was 9 months(4~16 months).18 patients experienced grade II acute gastroin-testinal toxicity ,1 patient experienced grade Ⅲ acute gastrointestinal toxicity , whereas 17 patients experienced grade II late gastrointestinal toxicity ,1 patient experienced grade Ⅲlate gastrointestinal toxicity .On UVA,the vol-ume,Dmean,D1,D3,D5,D10,V5 to V40,and V5′to V45′of duodenum were significantly associated with GradeⅡor higher gastrointestinal toxicity ( P <0.05 ) .The MVA, V45′of duodenum was independent predictor for gradeⅡor higher gastrointestinal toxicity(P<0.05).The ROC analysis also showed that V45′of 0.5cm3 was the optimal threshold to predict for gastrointestinal toxicity for the entire cohort .Conclusion V45′of duodenum is of greater importance in the judgment of occurrence of hypofractioned radiation -induced gastrointestinal toxici-ty.

AIM: To systemically evaluate the clinical efficacy and safety of intraocular implants for vitreous retinal surgery.METHODS: We performed a comprehensive search for studies reporting vitreous surgery with intraocular implants randomized controlled and a retrospective controlled clinical trials from China Hownet ( CNKI ), Wanfang database, and VIP literature database. Studies obtained from those database were filtered according to the criteria, and data were retrieved from eligible studies for further analysis. Then we performed a meta-analysis to evaluate the efficacy and safety of intraocular implants using comprehensive Meta - analysis software version 2 (Biostat, Englewood, NJ).
RESULTS: In total 36 studies were recruited for our Meta - analysis, including 5 092 cases. Meta analysis showed: 1) regarding the efficacy of repairing the retinal detachment, silicone oil was a better intraocular implants than C3 F8(OR= 1. 76; 95% CI: 1. 19-2. 60, P = 0. 0047) and SF6( OR = 4. 68; 95% CI: 1. 48 - 14. 81, P = 0. 0087); 2) regarding the risk of postoperative cataract, silicone oil showed significant higher risk than BBS (OR = 3. 24; 95%CI: 2. 10-4. 99, P= 1. 09 e-7), and C3 F8(OR= 3. 03; 95% CI:1. 50 - 6. 10, P = 0. 0019 ); 3 ) regarding the risk of postoperative intraocular pressure, silicone oil showed significant higher risk than BBS (OR= 6. 74; 95% CI: 3. 38-13. 41, P= 5. 67 e-08), and C3 F8 also showed a higher risk than BBS (OR= 4. 79; 95% CI: 2. 37-9. 68, P = 1. 29 e-05). In addition, silicone oil showed significant lower risk as compared with heavy silicone oil (OR= 0. 16; 95% CI: 0. 08-0. 53, P= 0. 0026).
CONCLUSION: The intraocular implants for the treatment of retinal detachment in vitreous retinal surgery are mainly divided into two major categories, liquid and gas implants. The silicone oil, a major liquid implant, shows higher efficacy in terms of treating retinal detachment than the gas implants. However, the silicone oil is associated with a higher risk of postoperative cataract and intraocular pressure as compared with gas implants.

Background Vitretomy and lenstomy with silicone oil tamponade is an effective method for complicated vitreous retinopathy.The severe anisometropia after silicone retention is usually treated by two-point transscleral suture fixation for posterior chamber intraocular lens(IOL)implantation.In order to reduce the number and difficulty and complication of the operation,the surgical method should be improved.Objective The goal of this study was to observe the resuh of silicone oil removal combined with four-point trans-scleral suture fixation of posterior chamber IOL after vitrectomy.Methods A retrospective case-observational study design was adopted.Twenty eyes with silicone oil tamponade from 20 patients without lens and posterior capsule after vitrectomy were included in this study.Silicone oil removal with four-point trans-scleral suture fixation of posterior chamber IOL was performed.The anterior ocular inflammatory response,intraocular pressure,uncorrected and corrected acuities before and after operation,corneal endothelial cell counting and postoperative complications were observed and analyzed.Written informed consent was obtained from all patients prior to the operation.Results All of the operative eyes in this study showed improvement of visual acuity after operation.Of the 20 eyes,a visual acuity of ≥0.8 was seen in 2 eyes,0.6-0.7 in 6 eyes,0.3-0.5 in 8 eyes and 0.05-0.2 in 4 eyes 3 months after the removal of silicone oil.The uncorrected acuity postoperation was significantly improved in comparison with preoperation(H=10.147,P＜0.01),but no significant difference was found in the corrected acuity between preoperation and postoperation(X =2.089,P＜ 0.01).The number of the corneal endothelial cells was(2064±329)cells/mm2 before operation,and that after operation was(1987±269)cells/mm2,showing an insignificant change between them(t =1.660,P ＞ 0.05).No abnormality of IOL position was found in all 20 operated eyes.There was not serious postoperative complication in all 20 patients.Conclusions The combination of silicon oil extraction with four-point transscleral suture fixation IOL is effective in eyes without posterior capsule or lens after vitrectomy.It can reduce the operation time and improve the postoperative acuity and the quality of life of patients.

ObjectiveTo establish a method to induce heterotopic ossification (HO) after spinal cord injury. Methods10 New Zealand White rabbits underwent a complete transection of the thoracic (T10) spinal cord. Just after transection, the right hind limb of every rabbit was immobilized with a plaster support to keep the knee in extension and the hip unrestricted. The plaster was temporarily removed once a day (six times per week) to allow the knees passively mobilized at the maximum range for 5 min. Local swelling, local skin temperature and grade of ossification of the paraplegic limbs were observed. After 5 weeks, the rabbits were sacrificed, and the quadriceps muscles of the right hind limbs were removed for the histological examination. ResultsAfter 5-week immobilization and temporary passive mobilization, HO was successfully induced in all 10 rabbits. There was local skin temperature increase and local swelling in the right hind limbs. The histological changes were similar to those observed in clinical HO. Conclusion5-week immobilization and temporary passive mobilization approach may successfully induce HO, and it may be used to study the pathogenesis of HO after spinal cord injury.

Objective To analyze the clinical,radiological and pathological features of primary leiomyosarcoma of bone and to im-prove the diagnostic level.Methods Totally 6 cases of PLB proved by pathology were collected in our study.The clinical,radiologi-cal and pathological findings were retrospectively analyzed,and combined with the relevant literature to have a comprehensive analy-sis.Results The lesions of 6 patients were solitary,located in femoral (1 case),distal femur (1 case),proximal tibia (2 cases),is-chium (1 case)and humerus (1 case).There was no periosteal reaction in all 6 cases but they all had soft tissue mass,sometimes there may have some mineralization within the tumor.Ill-defined osteolytic bone destruction was detected in 5 patients,while expan-sion of cystic bone destruction was found in the other 1 patients.3 cases had hardened edge,2 cases with adjacent bone cortical thickening.The MR imaging in 5 patients showed iso-intensity signal on T1 WI,a slightly inhomogeneously higher signal on T2 WI and a significant heterogeneously enhancement after injected of Gd-DTPA.Another 1 patient showed a double ring sign,the central area onT1 WI and T2 WI expressed heterogeneous slightly higher signal,the peripheral annular zone was iso-intensity on T1 WI and slightly higher on T2 WI,after injected contrast medium,it was inhomogeneous enhancement.In immunohistochemically,all tumors reacted positively with SMA,3 patients with Desmin and Vimentin positive,2 patients with Ki-67 positive,and there had some scat-tered cells with CD68 positive,but the S-100 were all negative.Conclusion The clinical,radiological and conventional histological manifestations of PLB are not specific.Immunohistochemical and/or ultrastructural analysis who displayed smooth muscle differenti-ation can confirm the diagnosis.