Catheter Ablation ; methods ; Humans ; Hypertension, Renal ; surgery ; Kidney ; innervation ; surgery ; Sympathectomy

Animals ; Apolipoproteins E ; deficiency ; Female ; Hyperlipoproteinemia Type III ; blood ; metabolism ; Lipid Metabolism, Inborn Errors ; blood ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Receptors, Calcitriol ; metabolism ; Vitamin D ; blood

OBJECTIVETo study clinical effects of inversive LISS (less invasive stabilization system, LISS) plate combined with steel wire for the treatment of Seinsheimer type V subtrochanteric femoral fractures.

METHODSFrom January 2009 to Janurary 2012, 11 patients with Seinsheimer type V subtrochanteric femoral fractures were treated with inversive LISS plate combined with steel wire, including 8 males and 3 females, ranging in age from 35 to 61 years old (averaged, 51 years old). Causes of injury: 8 patients caused by accident and 3 patients caused by falling down. According to X-ray examination, all the patients were type V subtrochanteric femoral fractures and were treated with LISS plate combined with steel wire. Merle d'Aubigne scores were used to evaluate therapeutic effects on hip.

RESULTSThe mean period of follow-up was 16 months (ranged, 12 to 28 months). All the patients obtained bone union for average 3.8 months (ranged from 3 to 4.3 months). There were no complications such as deep infection,deep vein thrombosis, pulmonary embolism and bone nonunion. According to Merle d'Aubigne scores, 7 patients got an excellent result and 4 good.

CONCLUSIONInversive LISS plate combined with steel wire for the treatment of Seinsheimer type V subtrochanteric femoral fractures is satisfactory, Which can provide stable fixation for fracture end and provide an ideal internal fixation method for treatment of this kind of fractures in the future.

Adult ; Bone Plates ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

Objective:To observe the effect of acupuncture plus medium-frequency electric stimulation on bladder function after radical hysterectomy for cervical cancer. Methods:A total of 170 patients confirmed by biopsy and surgical pathology and treated with radical hysterectomy for cervical cancer were randomly divided into an acupuncture group, an observation group and a control group by random digital table. Fifty-six cases in the acupuncture group were treated with acupuncture after surgery, one session each day, till the extubation day; 58 cases in the observation group were treated with acupuncture plus medium-frequency electric stimulation after surgery, one session each day, till the extubation day; and 56 cases in the control group didn't receive any intervention, and the catheter was retained till the extubation day. On the postoperative day 14, all groups were dealt with catheterization to determine the residual urine volume, in order to observe the occurrence rate of urinary retention and the recovery of bladder function and to compare the differences of the therapeutic effects among the groups. Results:The occurrence rates of urinary retention were respectively 16.1%, 20.7% and 46.4% in the acupuncture group, observation group and control group, with significant differences (P<0.05). When comparing the acupuncture group and the observation group with the control group, there were significant differences (bothP<0.05). In comparison between the acupuncture group and the observation group, there was no significant difference (P>0.05). The recovery rates of bladder function in the three group were respectively 42.9%, 60.3% and 41.1% without significant differences (P>0.05). Moreover, there were no significant between-group differences (P>0.05), but acupuncture plus medium-frequency electric stimulation showed a better tendency. Conclusion: The single application of acupuncture therapy is effective and able to prevent urinary retention after radical hysterectomy for cervical cancer. Acupuncture plus medium-frequency electric stimulation can effectively enhance the recovery of bladder function and reduce the residual urine volume in the bladder to the maximum.

OBJECTIVETo study the influence of actual defect length and gap width of the limbs main artery on the method selection of repairing and reconstruction.

METHODSRetrospective study was carried out for 32 patients with extremity main artery injury from 1996 to 2009, including 30 males and 2 females; 30 adults with an average age of 36 years old ranging from 18 to 51 years, 2 children of 4 and 5 years old respectively. Injured body parts involved axillary artery in 4 cases,brachial artery in 7 cases,radial artery in 2 cases, femoral artery in 4 cases, popliteal artery in 13 cases, posterior tibial artery in 2 cases. Main arterial injury defect gap width of all cases were observed and the reasons were analyzed. All cases were repaired by the method of end to end anastomosis after vessels stretch.

RESULTSThe artery defect width was 3 cm to 7 cm with an average of (4.375 +/- 1.200) cm. Defect width of the upper extremity brachial artery and axillary artery group was (5.73 +/- 0.63) cm,the lower extremity femoral and popliteal artery group (3.80 +/- 0.73) cm, the posterior tibial artery group (3.25 +/- 0.35) cm, the radial artery group (3.00 +/- 0.00) cm. Defect width of upper extremity brachial artery and axillary artery group was larger than that of the other three groups (P < 0.01). End to end anastomosis was performed successfully in all cases. Blood supply recovered well. Because of the severe limb infection 2 patients had amputation in the late. All patients received follow-up. The patients without fracture were followed up to 2 weeks postoperatively, all patients with fractures were followed up to 1 year at least. Limb blood supply was good in all patients during the follow-up.

CONCLUSIONBlood vessel defect gap width is different from the actual vessel defect, but is larger than the actual vessel defect. Misjudgment of the vascular defect length will lead to more vascular transplantation. The vast majority of vascular defect can be directly repaired by the method of end to end anastomosis after the vessel free and stretch.

Adolescent ; Adult ; Arm ; blood supply ; surgery ; Axillary Artery ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Vascular Surgical Procedures ; Young Adult

OBJECTIVETo study the ischemic times of the main artery injury in the limbs and the influence on the limbs survival rate, and to analyze the reasons for the formation of the ischemia time.

METHODSFrom June 1996 to November 2012, 83 patients with completely severed limb main artery treated in our hospital were retrospectively studied. There were 77 males and 6 females, including 81 adults (ranging in age from 16 to 52 years old, with a median age of 35 years old) and 2 children (4 and 5 years old respectively). Seventy-five patients were treated with end to end anastomosis, 7 patients were treated with great saphenous vein transplantation, and 1 patient was treated with artificial blood vessel transplantation. The prior to admission ischemia time, after admission ischemia time and total ischemia time for successful and unsuccessful patients, as well as the causes of the formation of the ischemia time were studied. Limb survival rate of different ischemic time was counted. Sharpness injury or blunt injury ischemia time and amputation rate were researched statistically. All data were analyzed using SPSS statistical software.

RESULTSThere were 72 limbs survived, 11 amputated. The average ischemia time was (7.45±5.94) h for limb-salvage group and (13.73±14.00) h for amputation group. Prior to admission ischemia time between amputation and limb-salvage group had no significant difference. After admission the ischemia time in amputation group was longer than limb-salvage group. The amputation rate for ischemia time 21 to 44 h group was higher than other three groups (≤ 5 h, 6 to 10 h, 11 to 20 h) (P=0.023, 0.038, 0.044). Amputation reasons can be divided into anastomosis failure in the operation, vascular thrombosis 2 to 4 days after operation and late infection.

CONCLUSIONVascular injury limbs can tolerate longer ischemia time and the limb salvage succeed. Only too long ischemia time (> 20 h), limb amputation rate increases significantly. The main cause of long time ischemia is delayed diagnosis in the hospital. Whether limb-salvage success mainly depends on the degree of trauma and the quality of the anastomosis than ischemia time.

Adolescent ; Adult ; Amputation ; Extremities ; blood supply ; Female ; Humans ; Ischemia ; surgery ; Limb Salvage ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Vascular System Injuries ; surgery

Objective To investigate effect of paclitaxel on expression of programmed death ligand-1 ( PD-L1 ) in the surface of cervical cancer TC-1 cells and its mechanism. Methods ①The cells were divided into two groups: paclitaxel group, paclitaxel combined with PKD blocker (G? 6976) group. There were 4 concentration gradient and 5 holes for each group, and each hole has its corresponding concentration of drugs. Influence of paclitaxel on TC-1 cell viability and effect of PKD blocker G? 6976 on IC50 value of paclitaxel were evaluated by MTT method.②The cells were divided into 0. 9% sodium chloride solution ( NS) group and paclitaxel group, There were 5 holes of each group. Effect of paclitaxel on PD-L1 expression on the surface of TC-1 cells were measured by immunohistochemistry.③The cells were divided into 4 groups:NS+DMSO group, G? 6976 group, paclitaxel group and paclitaxel+G? 6976 group. There were 5 holes for each group. Effect of paclitaxel and G? 6976 on PD-L1 expression on the surface of TC-1 cells were measured by immunohistochemistry. The expressions of PD-L1 on the surface of cells were measured by immunofluorescence treated with different drugs. Results The IC50 value of paclitaxel was 40 μg·mL-1 in paclitaxel group, and 38. 9 μg·mL-1 in paclitaxel combined with PKD blocker G? 6976 group, without significant difference between the two groups (P>0. 05). The expression of PD-L1 in the surface of TC-1 cells were significantly higher in paclitaxel group than in negative control group [(88. 48±13. 44)% vs. (39. 59±5. 99)%, P<0. 05]. The expression of PD-L1 in the surface of TC-1 cells was (79. 7%±4. 7)% after treatment with paclitaxel combined with PKD blocker G? 6976 for 24 h, and it was significantly lower than that in paclitaxel group [(96. 8±2. 5)%, P<0. 05]. Conclusion Paclitaxel promotes the expression of PD-L1 in the surface of TC-1 cells, which could be significantly inhibited by blocking PKD pathway. Paclitaxel may exert its effect through PKD pathway.

Objective To establish a model, fetal rat brain damage made by lipopolysaccharide (LPS)-induced intrauterine infection and explore content change and significance of malondialdehyde(MDA),myeloperoxidase(MPO),intracellular free calcium in the development of fetal brain damage.Methods Twenty-eight pregnant rats were injected with LPS(500 ?g/kg)on gestation d20 intraperitoneally in experimental group rats;the same volume of normal saline was injected to 28 rats as control group;there were 8 pregnant rats as blank control rat. Fetal brain water,MDA,MPO,Ca~(2+) contents were measured, fetal brain,placenta for pathological check after injection 2,6,12,24 hours,respectively.Results Brain water,MDA,MPO contents of LPS group were higher than those of controls at 2 h,and Ca~(2+) content of LPS group was higher than that of controls at 6 h,they were continued to be on high level until 24 h.There were histopathological inflammation changes of placenta, edema,inflammation in fetal brain at 6 h ,degeneration and necrosis of nerve cell at 12 h.Conclusions Fetal rat brain damage is made by LPS-induced intrauterine infection.MDA,MPO,Ca~(2+) content increasing in fetal brain tissue that indicates there is lipid peroxidation damage in fetal rat brain damage due to intrauterine infection; damage of free radical,persistent activation of polymorphonuclear,calcium overlord are mechanisms of fetal brain damage .

Objective To investigate the safety and efficacy of treatment with CT-guided percutaneous irreversible electroporation (IRE) of locally advanced pancreatic cancer(LAPC). Methods Patients with unresectable radiographic stage ⅢLAPC were prospectively collected. Comprehensive blood and imaging (CT,MRI,PET-CT) baseline examinations were completed and analyzed preoperatively. Operations were performed under general anesthesia and the needles were inserted under the guidance of CT. Ablative parameters were altered depending on the tumor size, anatomical location, and the number of electrodes. Needle withdrawal combined segmental ablation was chosen and the active electrode exposure length was 1 cm. All the imaging and serological follow-up examinations were performed within 1 to 3 days after procedures, at day 7 postoperatively, 1 and 3 months postoperatively to evaluate the safety and efficacy of IRE(according to modified response evaluation criteria in solid tumours of WHO). Results All the procedures were completed successfully. Immediately postoperative CT and/or MRI images showed all the ablation areas were well-defined and presented low-density necrosis without enhancement. The CT scans at day 7 postoperatively showed all the 14 lesions were drastically necrotized and the surrounding tissues were unharmed. CT and/or MRI scans at 1 month postoperatively revealed hypodense or low signal ablation areas without enhancement and the peritumoral and involved vessels and pancreatic duct were undamaged. All the patients had a CA199 transient rising, but it decreased progressively within 3 days and then markedly decreased at 1 weak and 1 month postoperatively. The laboratory carcino-embryonic antigen was almost within normal lists. Peripancreatic exudation was noted in 3 cases immediately after the procedures. One patient developed retroperitoneal infection. Mesenteric(2 of 4)and portal(2 of 4)venous thrombosis were found on MRI images in 4 patients. One patient had a duodenum stenosis and 1 died from serious gastrointestinal bleeding 2.5 months after IRE(unclear etiopathogenisis). The postoperative 3 months dynamic imaging showed that 4 of 13 reached complete response (CR) ,7 of 13 reached partial response (PR) and 2 of 13 had stable disease (SD). Conclusion CT-guided percutaneous IRE is safe and effective in patients with locally advanced pancreatic cancer.

Nanoknife (irreversible electroporation) has demonstrated to be a safe and effective approach to tumor ablation,and plays a prominent role in application of treatment of pancreatic carcinoma,specifically locally advanced pancreatic carcinoma (LAPC).The complicated parameters of Nanoknife comparatively is still difficult.The advantage,optimal selection,adequate parameters regarding Nanoknife were reviewed in this article.