BACKGROUND:How to promote wound healing is always the research focus of the surgical physicians in the clinic. Recombinant human epidermal growth factor (rhEGF) can effectively promote wound healing. However, as a biological agent, it is easy to be decomposed under normal temperature.
OBJECTIVE:Toexplorethe mechanisms underlying the promotion of wound healing in the back of rabbits by bletila carrying exogenous rhEGF.
METHODS:Model rabbitswith ful-thickness skin defects in the back were treated with bletila carrying exogenous rhEGF (combined treatment group), bletila, rhEGF, or saline (control group).
RESULTS AND CONCLUSION:The time of wound healing was the shortest (P< 0.05) and the wound healing rate was the highest (P< 0.05) in the combined treatmentgroup. On postoperative days 3 and 10, newly formed granulation tissue, capilaries, and colagenous fibersshowed by hematoxylin-eosin staining staining and Masson staining and the strongest immunoreactivity of vascular endothelial growth factor determined by immunohistochemical staining were found in the combined treatment group (P< 0.05). These findings confirm that bletila carrying exogenous rhEGF promotes wound healing by accelerating the forming of granulation tissue, new-born capilaries, and colagenous fibers, and the effects are superior to either of them alone.

Objective To investigate the diagnostic and predictive value of measuring peritoneal inflammatory cytokines in predicting biliary fistulas in patients undergoing biliary surgery.Methods Peritoneal samples and serum samples of 3227 biliary surgery patients were collected on the first,third,fifth postoperative day,and IL-6,IL-8,IL-10,TNF-? and CRP of the samples were measured.Patients were divided into two groups:those with clinical evidence of biliary fistulas and those without any evidence of biliary fistulas.The age,sex,operative method and operative time between the two groups were compared.Results There was a negative correlation between biliary fistulas and age,sex and operation mode;but blood loss,operation time and common bile duct diameter had positive correlation with biliary fistulas.Peritoneal cytokine levels were significantly higher in patients with biliary fistulas as compared to those without biliary fistulas.Conclusions The peritoneal cytokine level is a sensitive parameter of peritoneal inflammation and can be as an additional diagnostic tool for the early prediction of biliary fistulas after biliary surgery.

Background:Chronic atrophic gastritis(CAG)is a kind of chronic gastritis with atrophic changes of gastric mucosa. The studies on peripheral blood biomarkers in CAG are rare. Aims:To investigate the methylation of peripheral blood CpG sites in Runx3 gene promoter region in CAG patients. Methods:Eighty-two mild CAG patients,73 moderate to severe CAG patients from June 2013 to May 2014 at Daqing Oilfield General Hospital were enrolled,and 45 patients with normal gastric mucosa were served as controls. The methylation of CpG sites in Runx3 gene promoter region was measured by MALDI-TOF-MS. mRNA expression of Runx3 was determined by fluorescent quantitative PCR,and the protein expression of Runx3 was determined by Western blotting. Results:Compared with the control group and mild CAG group,methylation levels of CpG13,CpG14 and CpG15 sites in Runx3 gene promoter region were significantly increased in moderate to severe CAG group(P < 0. 05),the mRNA and protein expressions of Runx3 were significantly decreased( P < 0. 05). No significant differences in methylation of CpG sites in Runx3 gene promoter region and mRNA and protein expressions of Runx3 were found between mild CAG group and control group( P >0. 05 ). Conclusions:The hypermethylation of peripheral blood CpG13,CpG14 and CpG15 sites in Runx3 gene promoter region can inhibit the expression of Runx3 in CAG patients,and can be used potentially as the biomarker for clinical staging of CAG.

Adult ; CD56 Antigen ; metabolism ; Diagnosis, Differential ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Killer Cells, Natural ; pathology ; Lymph Nodes ; pathology ; Lymphoma ; metabolism ; pathology ; virology ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Male

Objective To find out prevelence of thyroid goiter on school-aged children in excessive iodine region of Shandong Province.Methods By employing B-ultrasonography and palpation method,the thyroid volume were investigated and the thyroid goiter rate were calculated among 6415 children aged 8～10 years old in execssire iodine region.Results By employing B-ultrasonography method.The volumes of thyroid in goiter children aged 8,9,10 years were(5.67±1.49),(6.07±1.24),(7.30±2.01)ml,respectively.The goiter rates were 28.84%(683/2368),20.89%(448/2144),11.82%(225/1903).The volumes of thyroid in non-goiter children aged 8,9,10 years were(3.36±0.67),(3.64±0.77),(4.02±0.94)ml.When the normal value of thyroid volume in 8 and 9 year-groups lowered 0.5 ml,the goiter rate would be changed to 18.20%(430/2368)and 12.92%(277/2144) respectively.The thyroid volumes of boys and girls were(4.20±1.38),(4.18±1.73)ml,respectively.The goiter rates of boys and girls were 21.92%(732/3340)and 20.29%(624/3075)respectively.The rates of goiter detected by palpation in 8,9 and 10 year-groups were 10.05%(238/2368),10.31%(221/2144)and 14.45%(275/1903) respectively.Conclusions Along with the increasing age,the volume of thyroid in children aged 8～10 is increasing in excessive iodine region of Shandong Province.But the goiter rate is decreasing ahmg the increasing age.This phenomena may be caused by improper normal value of thyroid volume.Therefore,the normal value of thyroid volume should be revised urgently.

OBJECTIVEThe study was aimed to investigate the inhibitory effect and mechanism of astragaloside IV (ASI) on the activation of microglial cells.

METHODAfter pre-incubated with ASI for 2 h, microglial cells BV-2 were stimulated with interferon-γ (IFN-γ) for 1. 5 h and 24 h, respectively. Secretion of nitric oxide (NO) in the medium was measured by Griess method. Production of tumor necrosis factor alpha (TNF-α) was detected by ELISA approach. Cellular gene expressions of CD11b, TNF-α, interleukin 1β (IL-1β) and induced nitric oxide synthase (iNOS) were examined by quantitative-PCR analysis. Total and phosphorylation of STAT1, IκB and NF-κB was analyzed by Western blot method.

RESULTASI could significantly inhibit the increased secretion of TNF-α and NO from BV-2 cells upon IFN-γ stimulation (P < 0.001). Further study showed that ASI significantly down-regulated gene expression of IL-1β and TNF-α (P < 0.01, P < 0.05) and exhibited a trend to reduce that of iNOS. IFN-γ and ASI have no obvious effect on gene expression of CD11b. Moreover, ASI inhibited the phosphorylation of STAT1, IκB and NF-κB elicited by IFN-γ stimulation.

CONCLUSIONASI could restrain microglial activation through interfering STAT1/IκB/NF-κB signaling pathway, reducing gene expres- sion of IL-1β and TNF-α, and thus inhibiting the production of proinflammatory mediators such as NO and TNF-α.

Animals ; Astragalus Plant ; chemistry ; Drugs, Chinese Herbal ; pharmacology ; I-kappa B Proteins ; genetics ; metabolism ; Interferon-gamma ; genetics ; metabolism ; Mice ; NF-kappa B ; genetics ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; STAT1 Transcription Factor ; genetics ; metabolism ; Saponins ; pharmacology ; Signal Transduction ; drug effects ; Triterpenes ; pharmacology

Objective To analyze the clinical features of urothelial carcinoma in renal allograft re- cipients and to investigate its diagnosis and treatment.Methods A retrospective study was undertaken on 1293 renal allograft recipients in our center between 1998 and 2003.Of them ,21 cases(72.4% )had urothe- lial carcinoma(4 males and 17 females).All the cases had not had tumor before transplantation.In 17 cases the protopathy was chronic interstitial nephritis(CIN).The mean interval between tumorigenesis and trans- plantation was 26 months(range,6-62 months).Of the 21 cases,6 had bladder transitional cell carcinoma (TCC);6 had unilateral pelvic or ureter TCC;8 had unilateral pelvic or ureter and bladder TCC;1 had bilat- eral pelvic and ureter TCC.In 10 cases,the ipsilateral upper urinary tract of the graft was involved;and in 4 cases,the contralateral upper urinary tract was involved.Painless gross hematuria and iterative urinary tract infection were the cardinal symptoms.Surgical treatment was performed in 19 cases.Postoperatively,all the cases received immunosuppressants at one third reduction dose in combination with intravesical instillation chemotherapy.Results Two cases receiving palliative treatment died 5 and 8 months after diagnosis.The other 19 cases were followed for 2-5 years.Of them,13 cases had tumor recurrence.The recurrence sites were bladder and the contralateral upper urinary tract.All the cases had no acute rejection at reduced dose of immunosuppressants,and all had normal renal function except for 2 cases,who underwent removal of the graft and had dialysis again.Conclusions Renal allograft recipients whose protopathy is CIN and female recipients have the risk of urothelial carcinoma after renal transplantation.Urothelial carcinoma occurs more often in ipsilateral upper urinary tract of the graft than in contralateral upper urinary tract.Considering the high possibility of bilateral upper urinary tract involvement by TCC,prophylactic bilateral nephroureterectomy with bladder cuff excision should be considered in renal allograft recipients who have involvement of contra- lateral upper urinary tract of the graft.

OBJECTIVEWith functional magnetic resonance imaging (fMRI), cerebral function imaging of acupuncture and sham acupuncture at Taichong (LR 3) in patients with essential hypertension (EH) was observed to analyze central mechanism of Taichong (LR 3) to treat EH.

METHODSEighteen EH patients were divided into a twisting acupuncture group (10 cases) and a sham acupuncture group (8 cases), which were treated with twisting manipulation and sham acu- puncture at right Taichong (LR 3), respectively. The treatments were both given with 30-second manipulation and 30- second interval for totally 5 min. During the acupuncture, fMRI was adopted to scan the cerebral function imaging of EH patients on resting state, and the acquired data were analyzed with SPM2 module in Matlab software.

RESULTSAcupunc- ture at Taichong (LR 3) in EH patients mainly increased opposite-side oxygen consumption, which generally activated left anterior cingulated gyrus (BA 32), left inferior parietal lobule (BA 40), left inferior temporal gyrus (BA 19), left middle temporal gyrus (BA 37) and right anterior central gyrus (BA 6). The activated areas were related to motor, vision and cognition of emotion. Stimulation region of sham acupuncture mainly included right anterior cingulated gyrus (BA 24), left inferior parietal lobule (BA 40) and left inferior frontal gyrus (BA 7).

CONCLUSIONThe central mechanism of Tai- chong (LR 3) on antihypertensive effect and symptom improvement is not in thalamus and medulla that are traditionally believed to control blood pressure. Taichong (LR 3) could activate anterior cingulated gyrus to regulate parasympathetic nerve and lower blood pressure, and through anterior cingulated gyrus, the connection with the surrounding areas is strengthened to improve the cognitive impairment caused by long-term hypertension.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Brain ; diagnostic imaging ; Cognition ; Essential Hypertension ; Female ; Humans ; Hypertension ; diagnostic imaging ; psychology ; therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography

Objective To evaluate the clinical value of multislice-CT angiography (MSCTA)in planning for the patients undergoing deep inferior epigastric artery perforator (DIEAP) flap operations. Methods Eighteen patients were performed with a 16-slice CT scanner to evaluate the deep inferior epigastric artery perforator prior to DIEAP flap operations. Axial, multiplanar reconstruction( MPR), maximum intensity projection(MIP) and volume rendered (VR) images were analysed and the origins, calibers, courses and anatomic relationships of the deep inferior epigastric artery perforator were evaluated. The anastomosis between the superficial inferior epigastric artery and the main perforator was observed as well. The images were classified into three grades based on the vessels'appearance. A + indicated the vessel appeared clear,continuous and thick. A- indicated the vessel appeared foggy,discontinuous and thin or the vessel partly showed. B indicated no related vessel can be seen. Other 18 patients undergoing conventional abdomen-pelvis CT scans for other reasons were used for control group to compare their CT findings of the deep inferior epigastric artery perforator. Results MSCTA well showed the course of the deep inferior epigastric artery (DIEA). Of the 18 cases, 17 cases appeared as A +, another one A -. It precisely displayed the origins, subcutaneous and intramuscular courses, relations of the main perforators on all cases of showing A +. The exact points where the chosen perforator vessels emerged from the rectus abdominis muscle fascia were located precisely. The superficial inferior epigastric arteries were mostly displayed and the connection between the arteries and the largest-caliber perforator from the deep system could also be shown clearly. Strict concordance with operative findings was found in CTA. Conclusion MSCTA can precisely locate the chosen perforator vessels emerging from the rectus abdominis muscle fascia and it may be a feasible, fast, safe and effective method for preoperative evaluation of DIEAP.

Objective To evaluate the changes of the upper airway of the patients with obstructive sleep apnea syndrome (OSAS) before and after operations and to know the effects of operations by MSCT. Methods The upper airway dimensions of 26 patients with OSAS were measured on multiplanar reformatted (MPR), curved-planar reformatted (CPR), volume rendering(VR) images of 16-slice spiral CT. The measurements include the anteroposterior calibres and the areas on the reformatted axial images on the pharyngeal cavity levels, the calibres and the minimum areas in retropalatal and retroglossal regions, the areas of the soft palate and uvula on the reformatted sagittal view with maximum thickness, the maximum wall thickness of the right and left the upper airway on the coronary images, the volume of the upper airway before and after the operations. The measurements were correlated with the polysomnography (PSG) records. The data were analyzed paired-samples t-test and Pearson correlations. Results By comparison, the anteroposterior calibres and the cross-sectional areas on the reformatted axial view of the lower retropalatal region (slice 4) of the upper airway increased significantly after operations. The anteroposterior diameter increased from 5. 9 mm before operations to 12.8 mm after operations, where t = - 5.506, P < 0.05. The areas increased from 51.0 mm~2 before operations to 275.0 mm~2 after operations, where t = -5.011, P <0.05. In the higher retropalatal region (shce 2) of the upper airway, the anteroposterior diameter decresased from 14.8 mm before operations to 9.2 mm after operations, where t = 2.867, P < 0.05. The areas decreased from 241.0 mm~2 before operations to 128.0 mm~2 after operations, where t = 3.087, P < 0.05. The anteroposterior calibres of retroglossal region (slice 7) decreased from 12.7 mm before operations to 10.3 mm after operations,where t = 3.718, P <0.05. The L-R calibres and the minimum areas of of retropalatal increased significantly from 6.4 mm, 33.0 mm~2 before operation to 10.9 mm, 76. 0 mm~2 after operation, where t = -3.413, -2. 216, respectively and P < 0.05. Of the 9 cases whose apnea and hypopnea index (AHI) ≤5 events/hour after operations, the minimum areas of retropalatal region, the anterio-posterior diameter, L-R calibres increased significantly. The areas increased from 41.0 mm2 before operations to 76.0 mm~2 after operations, were t = -4. 932, P <0.05. The anteroposterior calibres increased from 4.6 mm before operations to 6.6 mm after operations, where t = - 7. 308, P < 0.05. The L-R calibres increased from 8.3 mm before operations to 13.6 mm after operations, where t = - 4.320, P < 0.05. Conclusions MPR、CPR、VR of MSCT can evaluate the not only the morphology but the function changes of the upper airways on the OSAS patients. The increasing of the minimum cross-sectional area may be one of the important indications for evaluating operations. The narrowing of the higher retropalatal region of the upper airway after operations should be an alert to the clinicians.