Objective To study the nursing of totally endoscopic coronary artery bypass grafting (TECAB)using da Vinci robot.Methods 60 patients who accepted TECAB from January 2007 to December 2010 were selected.All patients underwent coronary arteriography,which showed severe stenosis in left anterior descending artery(LAD).8 of them complicated with right coronary artery stenosis or left circumflex coronary (LCX)stenosis.All patients were given education and nursing care from admission to discharge.Results After operation,angina pectoris alleviated in all cases,no surgery-related complications occurred.The bridge vessel was all cleared.All patients were discharged after rehabilitation.Conclusions Totally robotic TECAB is a new minimally-invasive surgery.Perioperative education is important.In early postoperative course,nurses should pay attention to bleeding condition of drainage and pulmonary nursing.Early postoperative exercise is a must,which can promote the recovery of all systems.

Chronic inflammation,oxidative stress and retinal ganglion cell apoptosis play important roles in the development of diabetic retinopathy.Fenofibrate,a peroxisome proliferator-activated receptor α agonist,is used for dyslipidemia.In addition to its lipid-modulating effects,fenofibrate also has antiinflammatory,antioxidant,anti-apoptotic and anti-angiogenesis properties that may be useful to delay the progression of diabetic retinopathy.Some clinical studies have already confirmed that fenofibrate has therapeutic effect on diabetic retinopathy.Further studies the application of fenofibrate in the treatment of diabetic microangiopathy to clarify the safety and efficacy of fenofibrate is of great significance.

Objective To observe the inhibitation and radiosensitization effect of hematoporphyrin and radiotherapy on H22 liver cancer mice.Methods Mice models of liver cancer were established by subcutaneous injection of H22 cells,tumor-bearing mice were randomly divided into:control group, simple radiotherapy group, small dose hematoporphyrin with radiotherapy group (combined treatment group Ⅰ), middle dose hematoporphyrin with radiotherapy group(combined treatment group Ⅱ),and high dose hematoporphyrin with radiotherapy group (combined treatment group Ⅲ).Tumor volumes,inhibition rate,sensitizing factor,the survival time of mice,pathology,apoptosis and other indicators in five groups were observed after14 days. Results Hematoporphyrin and radiotherapy can inhibit tumor growth in mice,The q values in three combined treatment groups were all above 1.0 at different time points ,and combined treatment groupⅢwas the highest.The three combined treatment groups had higher apoptosis rate than control group and simple radiotherapy group,but the difference within groups were not statistically significant. The survival time in three combined treatment groups were higher than control group,the combined treatment group Ⅱ was the longest and simple radiotherapy group was the shortest.Conclusion Hematoporphyrin has tumor inhibitition and radiation sensitizing effect on H22 liver cancer mice,and the effect was positive correlation with drug dose. Hematoporphyrin combined with radiotherapy can extend the lifespan of mice in H22 liver cancer,its sensitizing mechanism may be association with induction of H22 cell apoptosis.

Robotic catheter minimally invasive operation requires that the driver control system has the advantages of quick response, strong anti-jamming and real-time tracking of target trajectory. Since the catheter parameters of itself and movement environment and other factors continuously change, when the driver is controlled using traditional proportional-integral-derivative (PID), the controller gain becomes fixed once the PID parameters are set. It can not change with the change of the parameters of the object and environmental disturbance so that its change affects the position tracking accuracy, and may bring a large overshoot endangering patients' vessel. Therefore, this paper adopts fuzzy PID control method to adjust PID gain parameters in the tracking process in order to improve the system anti-interference ability, dynamic performance and tracking accuracy. The simulation results showed that the fuzzy PID control method had a fast tracking performance and a strong robustness. Compared with those of traditional PID control, the feasibility and practicability of fuzzy PID control are verified in a robotic catheter minimally invasive operation.
Algorithms ; Computer Simulation ; Fuzzy Logic ; Humans ; Minimally Invasive Surgical Procedures ; Robotic Surgical Procedures ; Robotics

Objective　To Compare the anti hypertensive effects of felodipine and amlodipine on 24 hours blood pressure in patients with essential hypertensin. Method A Radomized， single blind and contro11ed study was perfo rmed and blood pressuree was measured by 24 hours ambulatory blood pressure monitoring. Results Felodipine and amlodipine signiflcantly reduced both s ysto1ic and diasto1ic casual b1ood preessure when compared with placebo and no differences were observed between the two drugs． Felodipine and amlodipine reduce 24h mean，daytime mean ambulatory blood pressure．The rapid rise in blood pressure i n the morning hours was well contro11ed by the two drugs. Conclusion:Felodipine and amlodipine used once daily could cont rol 24 h blood pressure effectively in patients of essential hypertension．

ObjectiveTo investigate the preventive effects of rosiglitazone on nonalcoholic steatohepatitis (NASH) rats and to explore the potential mechanisms in modulating peroxisome proliferator-activated receptor gamma (PPARγ),nuclear factor kappa B (NF-κB),and cyclooxygenase-2 (COX-2) expression.Methods Thirty male SD rats were assigned into the normal group ( n =10),the model group ( n =10),rosiglitazone prevention group [ n =10,simultaneously 4mg/( kg · d) gavage daily at beginning].Liver appearance,liver index,and histological changes were assessed.Serum tumor necrosis factor-o (TNF-c) and prostaglandin E2 (PGE2) were determined using enzyme-linked immunosorbent assay.The expressions of PPARγ,NF-κB,and COX-2 in liver were determined using immunohistochemical methods.The mRNA and protein expressions of COX-2 were disclosed by real-time polymerase chain reaction and Western blot analysis.ResultsCompared with the normal group,the liver index significantly increased in model group (3.92 ±0.72 vs.5.71 ± 1.05,P =0.004).HE and Masson staining showed significantly increased steatosis,inflammation,and fibrosis.The serum levels of TNF-α,PGE2 in high-fat-diet-fed rats were significantly increased ( 11.72 ± 2.47 vs.29.39 ± 5.32,P =0.002 ; 236.60 ± 24.90vs.288.24 ± 17.17,P =0.004).Immunohistochemistry showed NF-κB and COX-2 in livers were significantly elevated,but PPARγ wasdecreased in nonalcoholic steatohepatitis rats.Real-time polymerase chain reaction and Western blot found mRNA and protein expressions of COX-2 were increased in the model group (0.57 ± 0.08 vs.2.83 ± 0.24,P =0.0007 ; 0.38 ± 0.03 vs.1.00 ± 0.03,P =0.004).Compared with the model group,the expressions of PPARγsignificantly increased and the expressions of NF-κB and COX-2 significantly decreased ( mRNA:2.83 ± 0.24 vs.0.46 ± 0.11,P =0.002 ; protein: 1.00 ± 0.03 vs.0.62 ± 0.02,P =0.006 ) in the rosiglitazone prevention group.ConclusionBy inhibiting NF-κB and COX-2 expressions,rosiglitazone can reduce insulin resistance and then prevent the occurrence and deve lopment of nonalcoholic steatohepatitis.

OBJECTIVETo investigate the application and therapeutic effect of frontal muscle fascia compound flap suspension for congenital blepharoptosis in children.

METHODSFrom July 2010 to March 2012, 21 children (23 eyes) with congenital blepharoptosis were treated with frontal muscle fascia compound flap suspension. The therapeutic effect was observed and followed up.

RESULTS17 patients were followed up for 3-6 months with relapse in one case. The ptosis was corrected in the other 1 cases.

CONCLUSIONThe frontal muscle fascia compound flap suspension is effective and practical with minimal morbidity and lower complication for the correction of congenital blepharoptosis.

Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Child ; Facial Muscles ; Fascia ; transplantation ; Frontal Bone ; Humans ; Oculomotor Muscles ; Recurrence ; Surgical Flaps ; transplantation

Objective To investigate the effect of the histological changes on rat dorsal root ganglia (DRG) after 125I seed brachytherapy.Methods Twelve adult male Sprague-Dawley rats ( 150-180g each) were randomly divided into 6 groups,125I seeds with different activities of 0 (Titanium shell),14.8,18.5,22.2,25.9 and 29.6 MBq were implanted to 6 groups of rats respectively and the behavioral changes of rats were observed.The rats were killed in different periods after implantation,the morphological changes in DRG and surrounding muscle tissue were observed with an Olympus BX51 optical microscope and then the irradiation doses were estimated.Results After 125I seed implantation,the movement function of rats was not affected and the weight of rats gained after 7 days.After the titanium shell implantation,very few mild swelling was induced in neuroganglion cells that still had clear nucleolus and normal cytoplasm.At 14 days after 18.5 MBq seed implantation,cell swelling was more serious and cell dehydrating,nuclear condensation and nuclear fragmentation appeared after 30 days.At 60 days after 29.6 MBq of seed implantation,nuclear dissolution and cytoplasmic shrinkage were induced in a large number of cells.In general,the severity of fibrosis was aggravated with the time post-irradiation and the dose in the muscles around the ganglion.Conclusions After 125I seed implantation,the injury degree of DRG tissue is dose-dependent,and the 125I seed irradiation would have analgesic effect on releasing intractable pain.

The structure and 5-HT immunoreactivity in the brain and suboesophageal ganglion of three beetles, Ambrostoma quadriimpressum, Henosepilachna vigintioctomaculata and Oxycetonia jucunda, were first studied by means of colophony-paraffin embedding serial section technique and strepteavidin-peroxidase immunohistochemical method. The results showed that the brains of these three taxonomically closely related beetles were remarkably different in composition and size. Mushroom bodies and antennal lobes in Oxycetonia jucunda were conspicuous. Calyces and lobes of the mushroom bodies.were much developed. In contrast, calyces of Ambrostoma quadriimpressum and Henosepilachna vigintioctomaculata were extremely undeveloped. However, the postretinal fibres and circumpharyngeal nerves of Ambrostoma quadriimpressum were highly developed. In the three beetles, 5-HT immunoreactivity was present in all neuropils of the brain and the suboesophageal ganglion. The pattern of 5-HT immunoreactivity and the localization of immunoreactive somata which often clustered into groups were similar among these beetles, while the immunoreactivity intensity was distinct, especially in the lamina. The results suggest that the three beetles have given rise to adaptive radiation under the evolutionary pressure because of the long-term different life styles and living environments in which the taxonomic status of Ambrostoma quadriimpressum is relatively low. The similarity of the pattern of 5-HT immunoreactivity and localization of some positive somata among the three beetles raise the possibility that 5-HT seemes to serve similar physiological function in different insects. Furthermore, 5-HT might be involved in modulating the ingestion by regulating muscular activity and visual sensitivity.

Objective: To explore the clinical presentation and therapy of primary cutaneous anaplastic large cell lymphoma (PCALCL). Methods:We reviewed and analyzed six cases of PCALCL who were treated at our hospital from January 2009 to Decem-ber 2012. Results:The subjects were three males and three females with a median age of 54 years old (range:38 years to 60 years). Three patients had a single subcutaneous nodule and three had multiple nodules. The subcutaneous lesions appeared red, solid, and sta-ble nodules. Some patients developed pruritus around the lesions, or developed more nodules, which coalesced with other nodules. Some of the lesions exhibited partial spontaneous regression and new nodules appeared at the same site or at different sites. Finally, the lesions changed color from red to brown. The surfaces of some lesions developed ulcerations. Only 1 case had superficial lymph node metastasis. Three cases with single lesions received surgical excision plus radiotherapy, chemotherapy, or radiochemotherapy;all three cases survived and achieved complete remission. The three cases with multiple lesions mainly received systemic chemotherapy, with two of the cases recurring and one surviving with complete remission. The median follow-up was 24 months (range: 11 months to 35 months), with a progression free survival of 66.7%and an overall survival of 100%. Conclusion:Surgical excision or radiotherapy provides satisfactory control in patients with single lesions. Chemotherapy may be prescribed to patients with multiple lesions or with extracutaneous metastasis.