Objective:To evaluate the effect of enteral rehabilitative therapy in improving graft structure recovery in rat small bowel transplantation.Methods:Fourty eight recipients of rat allogeneic heterotopic small bowel transplantation(SD→Wistar rat)were dvided into 4 groups randomly according to the presence or absence of glutamine or rhGH in TPN regimen.Cyclosporine A was used as the immunosuppressant.The morphological mucosal indices of transplanted gut were observed and compared.Results:The application of rhGH and glutamine-enriched TPN,especially the enteral rehabilitation therapy which composed both these two agents,can promote the recovery of graft structure significantly compared with standard TPN support.On the postoperative day 14,in the enteral rehabilitation therapy group,all the morphological indexes of transplanted gut recovered to the preoperative state.Conclusion:Enteral rehabilitation therapy is appropriate to the host metabolic status,so it can improve the graft structure recovery more effectively.

Objective To study the effect of ultrasound guided curettage after methotrexate and mifepristone in the treatment of endogenous caesarean scar pregnancy.Methods A retrospective analysis was performed on 43 patients of endogenous caesarean scar pregnancy undergoing treatment of ultrasound guided curettage after methotrexate and mifepristone.Results 39 cases were successful,4 cases were transformed to laparotomy because of intraoperative blood loss,7 cases of bleeding after curettage were successful by uterine carity placed double lumina Foley catheter. Conclusion Ultrasound guided curettage after methotrexate and mifepristone is a safe,effective,little trauma and low cost method in the treatment of endogenous caesarean scar pregnancy,it especially adapts to primary hospital.

Objective To survey the effects of repetitive transcranial magnetic stimulation (rTMS) on learning,memory and the dendrite morphology of neurons in the CA1 area of the hippocampus in rats with vascular dementia.Methods Thirty-six male SD rats were divided into a control group,a model group and a rTMS group randomly,12 rats in each group.A model of vascular dementia (VaD) was established using the two vessel occlusion method.The rats in the rTMS group were given rTMS treatment.The rats in the other two groups had no therapy.The Morris water maze (MWM) test was used to evaluate the rats' learning and memory abilities on the 30th day after the operation.After the MWM test the dendrite morphology of the pyramidal cells in the CA1 area of the hippocampus was detected after Golgi-Cox staining using light microscopy and the expression of brain-derived neurotrophic factor (BDNF) was detected using immunohistochemistry methods.Results The average MWM escape latency in the rTMS group was shorter than in the model group on the 1 st,2nd,3rd and 4th day.The number of crossings of the platform quadrant in the rTMS group was significantly more than in the model group.The number of branch segments,their total length and the dendritic spine density of pyramidal cell dendrites in the CA1 area of the hippocampus were all significantly lower in the model group than in the control group,but in the rTMS group all these indicators were significantly improvedcompared with the model group.The expression of BDNF in the CA1 area in rTMS group was significantly higher than in the model group.Conclusions rTMS can improve learning and memory in VaD,at least in rats.The mechanism may be associated with rTMS promoting the expression of BDNF in the hippocampus and so improving the dendrite morphology of pyramidal cells.

Objective: To evaluate the safety of application of enteral rehabilitative therapy in small bowel transplantation.Methods: Forty-eight recipients of rat allogeneic heterotopic small bowel transplantation(SD→Wistar)were divided into 4 groups randomly according to the application or not of enteral rehabilitative therapy or cyclosporine A.The pathological changes of graft,IL-2 receptor expression of lamina propria lymphocyte,serum IL-2 concentration,transformation test of spleen lymphocyte and its IL-2 secretion capacity were determined and compared.Results: The enteral rehabilitative therapy may promote the immune function of recipient so to augment the acute rejection of small bowel transplantation.But such effects can be block by the common used immunosuppressant-cyclosporine A.Under the immunosuppression of CsA(10mg?kg -1 ?d -1 ,IM),application of enteral rehabilitative therapy can not induce or promote acute rejection of small bowel transplantation.Conclusion: Enteral rehabilitative therapy can augment the acute rejection of small bowel transplantation,but cyclosporine A can block its immunoenhancement effects.So under effective immunosuppression,application of enteral rehabilitative therapy is safe in small bowel transplantation.

Objective To evaluate availability and outcomes of using anterior half of the peroneus longus tendon (AHPLT) in knee ligament reconstruction as an autograft source.Methods From July 2007 to January 2008,100 patients with knee ligament injuries were recruited in this study.There were 33 males and 67 females aging from 16 to 62 years (mean,32.3 years).49 cases had undergone medial patellofemoral ligament reconstruction,19 cases multiligament reconstruction,18 cases double-bundle posterior cruciate ligament (PCL) reconstruction and 14 cases double-bundle anterior cruciate ligament (ACL) reconstruction.AHPLT was used as sole (49 cases) or part (51 cases) of reconstruction materials.One-incision or two-incision striping techniques were adopted to harvest AHPLT.Ligaments were fixed with screws.Post-operative assessments included Kujala knee score,Lysholm knee score,Marx knee score,International Knee Documentation Committee (IKDC) subjective evaluation form and objective evaluation grade,the Foot and Ankle Disability Index (FADI) and the American Orthopedic Foot and Ankle Society (AOFAS) scale.Results 92 cases were followed up for more than 24 months.Postoperative Kujala score,IKDC subjective score,Lysholm score and Marx score were improved significantly in all four groups of patients.According to IKDC objective evaluation grade,the number of patients reaching Grade A (normal) or Grade B (near-normal) in multiligament,PCL and ACL reconstruction were 17,15 and 12,with an excellent rate of 89.5％ (17/19),93.7％ (15/16) and 100％ (12/12),respectively.Preoperative and postoperative AOFAS scores were 97.4±2.0 and 97.2±1.6,respectively,while the FADI scores preoperatively and postoperatively were 96.8±2.2 and 96.9±2.5,respectively.These results had no statistical significance.No signs of peroneal nerve injury or peroneus longus tendon rupture was found.Conclusion It is acceptable to use AHPLT as an autograft due to its feasibility to harvest,good clinical outcome,and low rate of donor site morbidity at a minimum of two-year follow-up.

Objective To explore the effect of insulin subcutaneous pump combined with psychological intervention on gestational diabetes mellitus.Methods A total of 118 patients were enrolled in this study from November 2015 to October 2016 in Lishui central hospital.The patients were randomly divided into the experimental group and the control group according to the time of hospitalization.The experimental group was given insulin subcutaneous pump combined with psychological intervention.The control group was given insulin subcutaneous pump.Results After intervention, the degree of complete compliance in the experimental group was 86.44% and 28.81% before intervention, the difference was statistically significant(P<0.05).Compared with before treatment, blood glucose and glycosylated hemoglobin were decreased after treatment(P<0.05).The incidence of complications in the two groups include: pregnant women with excessive amniotic, neonatal hypoglycemia, pregnancy induced hypertension syndrome and so on.The difference of complication rate between the two groups was statistically significant(P<0.05).Conclusion The timely and accurate psychological guidance of pregnant women with diabetes mellitus can control the blood glucose in the normal range, reduce the occurrence and development of maternal and child complications, and ensure the safe and healthy mother and child health.

ObjectiveTo evaluate the safety and efficacy of biological meshes (human aceUular dermal matrix mesh) in single-stage repair of infected or contaminated abdominal abdominal wall defects and abdominal hernias. MethodsSeventeen patients with abdominal wall defects or abdominal hernias were enrolled. The wounds of all these patients were infected or contaminated due to the existence of enterocutaneous fistula or stoma, wound infection and synchronous colonic resection. The diagnosis included enterocutaeneous fistula 8 cases, incisional hernia 6 cases, incarcerated inguinal hernia 1 case and cylindrical abdominoperineal resection for rectal cancer for 2 cases. The sizes of abdominal defects ranged from 3 cm × 2 cm to 6 cm × 17 cm, and all the cases were repaired with human acellular dermal matrix mesh(RENOV(R)). Most of the patients were repaired with intraperitoneal onlay mesh technique( IPOM, for 12 cases), and other methods included Lichtenstein operation for 1 case, inlay repair for 2 cases and sublay for 2 cases. Results All the 17 patients recovered uneventfully. For 12 patients, the wounds were sutured at operation and only one case of delayed healing occurred due to fat liquefaction. For the other 5 patients, the wounds were left open and healed after vacuum assisted closure (VAC) therapy or wet- to- dry dressing changes. On follow up for 8.3 ±4.5 months ( 1 to 15 months), no occurrence of incisional hernia or recurrence was found. laxity of abdominal wall occurred in one case. A patient complained intermittent pain of the site of suture for mesh fixing two months after operation and the pain resolved spontaneously one month later. ConclusionsThe biological mesh, acellular dermal matrix mesh, could be used in single- stage repair of infected or contaminated abdominal wall defects safely and effectively, although the long-term outcome still needs further evaluation.

Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; enzymology ; pathology ; Female ; Fibroadenoma ; enzymology ; pathology ; Humans ; Middle Aged ; Telomerase ; metabolism

Meridians in human body were classified as white meridian and black meridian according to Tibetan medicine.Season and environment,improper diet,toxic heat and trauma were recognized as main reasons damaging the white meridian in Tibetan Medicine,leading to the emerge of white meridian disease induced by Long (one of the three factors) and blood disorder.White meridian disease in Tibetan medicine involved a series diseases,such as many clinical diseases,due to the damage of white meridian system caused by pathogenic factors.Stroke also belonged to white meridian disease.Drugs and treatments were selected based on the nature of disease such as cold and heat,onset,thelocation of disease and the three factors (Chi Ba,Long and Pei Gen).It was the fundamental principle of the treatment rules of white meridian disease in Tibetan medicine,namely,prescribing medication with the rule of diagnosis and treatment,comprehensive analysis of the causes of diseases and mastering the change law of diseases and syndromes in clinic.

Objective To discover the mutation of ADAR gene in a pedigree with dyschromatosis symmetrical hereditaria(DSH). Methods We investigated this family and collected blood samples of the individuals in this family. Mutation screening was carried out by PCR and direct sequencing. The allele specific primer was designed for the mutation point, and allele-specific PCR was carried out on the patients, normal family members and 40 normal individuals. Results A single nucleotide deletion (c.1642 delC) was identified in exon3 of ADAR gene in the patients of this family. This mutation was not detected in the normal family members and in any of the control individuals. Conclusion This single nucleotide deletion was responsible for the disease in the family.