Objective To summarize the treatment results,operative complications and experiences of laparoscopic modified pull-through(Soave)precedure.Methods Twenty children with Hirschsprung disease(HD),16 males and 4 females,with age from 3.5 months to 4 years old,underwent laparoscopic modified pull-through(Soave)precedure under whole anesthesia and tracheal intubation,and the pathological colon was freed by ultrasonic surgical knife.Results All cases were operated on successfully.The average operating time was 132 min.The average resection colon was 35 cm and the average volume of bleeding was about 14 mL without blood transfusion.Two patients had postoperative enterocolitis;3 patients were no complications postoperation,such as constipation,soiling,intestinal obstruction,preianal intestine prolapse or cuff narrowing,and all patients had 1-2 bowel movements per day during a period of 6 months to 3 years follow-up.Conclusion Laparoscopic modified pull-through(Soave)precedure has smaller incision,less bleeding,quick recovery and less complications.

Ginsenosides are the abundant secondary metabolites in American ginseng (Panax quinquefolium), it could be released into soil through root exudation and decomposition during plant growth. This study determined ginsenoside contents in American ginseng cultivated soil by HPLC. Three ginsenosides, Rb1, Rb2 and Rd, were detected in the rhizosphere soil of 3-4 years old American ginseng cultivated in Huairou District, Beijing, and their contents were 0.80-3.19 mg x kg(-1). Correspondingly, the contents of the three ginsenosides in soil solution were 4-16 mg x L(-1) at field water-holding capacity of 20%. According to the field soil test data, we designed the concentration of ginsenosides for bioassays (0.2-125 mg x L(-1) in solution or 0.2-125 mg x kg(-1) in soil). The results showed that radicle lengths of American ginseng were reduced by 6%-23% in solution containing 0.2-125 mg x L(-1) ginsenoside extract, and a significant difference was observed at concentration of 125 mg x L(-1) (P < 0.05). The shoot lengths of American ginseng were not significantly inhibited by 0.2-125 mg x L(-1) ginsenosides extractions. After 20 days of growth in nutrient solution amended with 25 mg x L(-1) ginsenosides extraction, plant height of 3-year-old American ginseng seedling was decreased by 28% compared to the control, and the biomass of aerial parts was also reduced by 50% (P < 0.05). However, the growth of newly-grown fibrous root was not significantly inhibited. Comparatively, when American ginseng embryos were cultivated into sterile or non-sterile soil, neither radicle lengths nor shoot lengths were significantly affected by 0.2-125 mg x kg(-1) ginsenoside extracts. In conclusion, ginsenosides showed autotoxic effect on growth of American ginseng radicle and adult seedling, however, this effect was weakened in field soil.
Chromatography, High Pressure Liquid ; Culture Media ; chemistry ; metabolism ; Ginsenosides ; analysis ; metabolism ; toxicity ; Panax ; chemistry ; drug effects ; growth & development ; metabolism ; Plant Roots ; chemistry ; drug effects ; growth & development ; metabolism ; Soil ; chemistry

OBJECTIVETo explore the difference in the efficacy and effect mechanism of subcortical ischemic vascular disease (SIVD) complicated with depression between acupuncture and medication.

METHODSSixty patients were randomized-into an acupuncture group and a medication group, 30 cases in each one. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Shuigou (GV 26), Fengfu (GV 16), Fengchi (GB 20) and the others, once a day, 6 times a week. The treatment of 4 weeks made one session and totally 2 sessions were required. In the medication group, nimodipine 30 mg, three times a day and fluoxetine 20 mg, once a day were prescribed for oral administration, for 8 weeks totally. Before treatment, at the end of the 4th week and at the end of the 8th week of treatment, cerebral blood flow velocity (CBFV) and solubility CD40 ligand (sCD40L) were determined respectively. The scores in Montreal cognitive assessment (MoCA) and Hamilton' s depression scale (HAMD) were evaluated in the two groups. The efficacies on cognitive function and depression symptoms were compared in the patients between the two groups. Results Compared with the outcome before treatment, mean blood flow velocity (Vm) of middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was increased significantly at the end of the 4th week of treatment in the two groups (all P<0.05). At the end of the 8th week, Vm was increased much significantly (all P<0.01). The differences were not significant in comparison between the two groups (all P>0.05). Compared with the expression before treatment, sCD40L was reduced significantly after treatment in the patients of the two groups (all P<0.01), but the differ- ence was not significant between the two groups (all P>0.05). Compared with that before treatment, MoCA score was increased significantly after treatment in the two groups (all P<0.01), HAMD score was reduced sig- nificantly (all P<0.01), the differences were not significant in comparison between the two groups (all P>0.05). The total effective rate of cognitive improvement was 86.7% (26/30) in the acupuncture group and was 80.0% (24/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05). The total effective rate of the improvement in depression was 93.3% (21/30) in the acupuncture group and was 86.7% (26/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05).

CONCLUSIONAcupuncture could significantly increases CBFV and reduces serum sCD40L expressions in the patients of SIVD complicated with depression, and significantly improves cognitive function and relieves depression symptoms. The efficacy of it is similar to that of western medication. The increase of serum sCD40L expression is possibly involved in the occurrence and development of SIVD. Reducing sCD40L expression contributes to the alleviation of damage induced by cerebral ischemia and reperfusion.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cerebral Infarction ; complications ; drug therapy ; therapy ; Depression ; drug therapy ; etiology ; therapy ; Female ; Fluoxetine ; administration & dosage ; Humans ; Male ; Middle Aged ; Nimodipine ; administration & dosage ; Treatment Outcome

Objective To investigate the present status of casualty epidemiology in Zhengzhou and the effects of different trauma care model.Method Statistic study of the classification of emergency disease and the number of ambulance responses to the call in Zhengzhou emergency rescue center from January,2004 through December 2006 was carried out and the efficiency between the trauma care model of an inclusive emergency rescue survices station and that of a simple emergency survices station was analyzed.Results The percentage of ambulance departure responses by Zbengzhou emergency rescue center for trauma care was 45.3 %,44.7 % and 45.8% of in 2004,2005 and 2006,respectively.There were 26 emergency rescue service stationa in Zhengzhou, including one independent station,eight internal medicine dominated semi-independent stations and seventeen simple model stations.The indicated surgical intervention can lye performed on the patients with severe multi- trauma in the independent emergency station in order to win the optimal operation time and reduce the mortality. Conclusions The trauma is the major reason for the emergency call.Emergency rescue service stations properly distrihtted,can offer quick and efficient pro-hospital first aid.The independent emergency rescue service station can increase successful resuscitation rate of serious casualties.

Objective To measure the proximal femoral parameters which can provide anatomic evidence for the design of internal fixation components for intertrochanteric fractures of femur.Methods Femoral speci- mens were harvested randomly from 120 healthy adult cadavers(left 60,fight 60).The neck shaft angle,greater trochanter slope length,tilt angle of greater trochanter,axial length of head and neck,lengths of upper and lower borders of the neck,and the minimum transverse diameter of the neck were measured.On the basis of the anatomic study,a two-claw plate was designed to treat 145 cases of femoral intertrochanteric fractures.Results The femoral neck shaft angle was 128.59??6.31?,femoral greater trochanter slope length was(5.5?0.58)cm,tilt angle of femoral greater trochanter was 42.76??5.20?,and axial length of head and neck was(9.42?0.38)cm. There was a correlation between the parameters.All the patients were followed up for a mean time of 23.6 months. The fractures got clinic union in 3 to 6 months.Two cases experienced detachment of claws and hooks but their final outcome was not affected.Three cases suffered coxa vara.All the other cases obtained normal motion function of hips and normal neck shaft angle.No breakage of claw,hook or nail was found in them.Conclusions It is necessary to design an internal fixator that can fit the anatomical features of Chinese femurs in the treatment of intertrochanteric fractures of femur.The two-claw plate designed by us is a good attempt to improve the clinical effect.

Objective:To investigate the influence of sCD80-Linker-sCD40L fusion protein on the unspecific anti- tumor immunity in vitro.Methods:Ovarian cancer SKOV3 cells were separately transfected with recombinant adenoviral vectors containing sCD80-Linker-sCD40L fusion gene,sCD80 gene,sCD40L gene or with control adenovirus.The expres- sion of the sCD80-Linker-sCD40L fusion protein,sCD80 protein and sCD40L protein in the supernatants of SKOV3 cells was determined by ELISA.Dendritic cells(DCs)were cultured with peripheral blood mononuclear cells from a patient with ovarian carcinoma.DCs and autologous T cells were co-cuhured and were exposed to different supernatants for 48 h. The allostimulatory effects of DCs on T cells were determined by mixed lymphocyte reaction(MLR).The unspecific kill- ing activities of induced T cells against SKOV3/K562 cells were measured by LDH-releasing assay.Results:ELISA assay showed that levels of the sCD80-Linker-sCD40L fusion protein,sCD80 protein and sCD40L protein in the supernatants of transfeced SKOV3 cells were 2.791 ng/ml,1.956 ng/ml and 1.407 ng/ml,respectively.The fusion protein-exposed DCs ([0.382?0.053]vs[0.167?0.028],P

Background There are a lot of studies about the carrier of corneal endothelial transplantation,but the best carrier has not been defined.Objective This study was to investigate the biocompatibility of chitosan carrier with rabbit corneal endothelium in vivo.Methods Fresh eye-balls were obtained from 10 New Zealand white rabbits.Rabbit corneal endothelial cells (CECs) were isolated and cultured on chitosan carrier in vitro.The morphology and density of rabbits CECs were observed every day,and the expressions of fibronectin (FN),collagen-1 (Coil-I) and Zonula occludens 1 (ZO-1) were detected by immunoinfluorescence.The morphology and ultrastructure of CECs were observed under the scanning and transmission electron microscope.Chitosan carrier with CECs was implanted into the anterior chamber of the left eyes in ten healthy New Zealand white rabbits,and only paracentesis of anterior chamber was performed in the right eyes as controls.The inflammation of ocular anterior segment was examined under the slit lamp microscope,and corneal thickness was measured 1 week,4 and 8 weeks after operation.Corneal endothelium cell density and morphology were examined under the corneal endothelial microscope at postoperative 2 weeks.Corneal samples were collected for the regular histopathological examination to observe the inflammatory reaction at postoperative 1 month and 3 months.Paired t test was used for statistical analyses between the control group (left eyes) and the experimental group (right eyes).The use and care of the animals followed the Statement of ARVO.Results CECs formed an intact monolayer of cells with the uniform shape and size on the chitosan membrane after incubated for 5 days.The cells reached confluence of 90％ 7 days after cultured with the 40％ hexagon cells.Under the scanning electron nicroscope,rabbit CECs showed the round or polygon in the shape with the microvillus on the cell surface.The cells connected closely by desmosome.The processes,pseudopodiums and microvillus on the cellular surface,vacuole in the cytoplasm,expanded endoplasmic reticulum with ribosome and abundant chromatin were exhibited under the transmission electron microscope.The immunofluorescence examination revealed the positive expressions of FN,Coll-Ⅰ and ZO-1 in the CECs on the chitosan carrier.In the in vivo experiment,the exudation in the anterior chamber and corneal edema were seen under the slit lamp microscope 3 days after implantation of chitosan carrier with CECs.However,the inflammation was gone 14 days after operation.The differences of the corneal thickness were no significant between the experimental group and the control group 1 week and 4,8 weeks after operation (t =1.377,P=0.265;t =1.795,P=0.165 ; t =0.390,P =0.760).In addition,no significant differences were found in the CECs density and the hexagon cells rate between the two groups(P =0.365,0.062).The histopathological examination showed that the inflammatory cells around the chitosan membrane were disappeared 3 months after operation and showed a good corneal structure.Conclusions Chitosan carrier has a good biocompatibility with rabbit CECs and anterior chamber,and it may be a potentially good carrier for CECs transplantation.

· AIM: To investigate the role of intercellular adhesion molecule-1 (ICAM-1) in the graft rejection of rabbit penetrating keratoplasty (PKP).· METHODS: Sutures were used to produce corneal neovascularization (CNV) on New Zealand white rabbits to make PKP model. Graft mean survival time and rejection index were determined. The levels of sICAM-1 in serum and aqueous humor were dynamically determined by enzyme-linked immunosorbent assay (ELISA).Immunohistochemical technique was used on cornea to get the evidence of expression and distribution of ICAM-1.· RESULTS: Graft mean survival time is (12.4±1.3) days.The mean sICAM-1 levels in aqueous humor and serum in the control animals that did not undergo surgery were (16.6±3.6)ng/L and (95.2±6.3) ng/L respectively. Levels in aqueous humor and serum for the graft rejection group increased postoperatively, continued to increase to (53.9±19.2)ng/Land (378.8±30.6)ng/L, compared to those in the other group (P ＜0.01). ICAM-1 positive cells were found in the graft rejection group.· CONCLUSION: ICAM-1 plays a critical role in initiating and maintaining corneal graft rejection. Sequential determination of serum sICAM-1 after operation may be of value in the prediction and diagnosis of acute rejection.

AIM: To evaluate the safety, efficacy and stability of posterior chamber phakic intraocular lens ( ICL ) implanation and clear lens extraction for the correction of high myopia.
METHODS: The study enrolled 56 cases ( 100 eyes ) of high myopia. Group I comprised 32 cases ( 58 eyes ) receiving ICL implantation and Group II comprised 24 cases (42 eyes) undergoing clear lens extraction. In this study, we evaluated the two groups of subject's the visual and refractive results, intraocular pressure ( IOP ) , endothelial cell density ( ECD ) , anterior chamber depth ( ACD) , lens transparency, the surgical complications as well as visual adverse symptoms before and after surgery.
RESULTS: The postoperative subjects in group I and group II were followed, uncorrected vision acuity ( UCVA)>0. 5 were 69. 0% in group I and 71. 4% in group II after 3mo. UCVA>0. 5 were 72. 4% in group I and 73. 8% in group II after 1a. Predictability of the manifest spherical equivalent refraction within±1. 00D was achieved in 62. 1%of eyes in group I and 57. 1% in group II after 1a. The central vault of the ICL ( distance from posterior surface of ICL to the crystalline lens ) measured with anterior segment optical coherence tomography ( AS-OCT ) was 0. 35-0. 54 (0. 40±0. 16) mm. Twelve point one percent of eyes in group I and 7. 1% of eyes in group II had transient mild increase in IOP. Here were statistically significant differences between preoperative and postoperative ECD (P<0. 001 ). Complications of surgery: 1 eye had ICL spontaneous rotation, 2 eyes had anterior subcapsular cataract, 4 eyes noticed halos around lights at night in group I. Three eyes had posterior capsule mild opacification, 3 eyes noticed halos around lights at night, 12 eyes had difficulty in near vision in group II.
CONCLUSION: ICL implantation and clear lens extraction are effective, safe and predictable surgical option for the management of high myopia. No severe complications occurred, but its long time effect and safety still need more time to prove.

Animals ; Electromagnetic Fields ; Embryo, Mammalian ; metabolism ; Female ; Mice ; Pregnancy ; Proto-Oncogene Proteins c-fos ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction