ObjectiveTo investigate the learning curve of total thoracoscopicy cardiac surgery.MethodsClinical data of a succession of 125 patients undering total thoracoscopicy ASD and VSD repair between October 2004 to January 2010 were collected and reviewed.The procedure was perfomed by the same surgeon.The patients were divided equally into 5 groups (groupA,B,C,D and E,n =25 in each group ) according to the sequence of the operation.The operative time,extracorporeal circulation time,aortic cross-clamped time,the rate of conversion rate to thoracotomy and postoperative complications were compared between the 5 groups.ResultsThere were no statistically significant differences between the 5 groups with respect to age,gender,weight,dieases and surgical approach(P ＞ 0.05).The operative time,extracorporeal circulation time and aortic clump time in group A and group B significant longer then that in group C,group D and group E(P ＜0.05).Group A and group B was no statistically significant difference each other( P ＞ 0.05 ).Group C,D and E have no statistically significant differences between(P ＞0.05 ).The rate of conversion rate to thoracotomy and postoperative complications in 5 groups have no statistically significant differences comparative( P ＞ 0.05 ).ConclusionThe learning curve of total thoracoscopicy surgery is approximalely 50 cases.

Objective To compare the effects of electroacupuncture at points Shangjuxu(ST37), Zusanli(ST36), Xiajuxu(ST39) and Yanglingquan(GB34) on colonic expressions of interleukin-1b (IL-1b) and nicotinic acetylcholine receptor a7 mRNA (nAchRa7mRNA) in ulcerative colitis rats and investigate if large intestine lower He-Sea point Shangjuxu has relative specificity to fu organ diseases. Method Seventy healthy SD rats were randomized into blank, model, Shangjuxu, Zusanli, Xiajuxu, Yanglingquan and Chengjin groups, 10 rats, half male and half female, each. A rat model of ulcerative colitis was made by induction of 2-4-6 three nitrobenzene sulfonic acid/ethanol solution enema in every group except the blank group. After successful model making and ten days of treatment, rat colonic mucosal ulcers and inflammation were observed macroscopically, colonic IL-1bcontent was measured by ELISA and the expression of nAchRa7mRNA was determined by RT-PCR. Result Compared with the model group, colonic lesions were reduced in varying degrees, colonic IL-1b content was significantly lower and the expression of nAchRa7mRNA was higher in every acupoint group (P<0.05, P<0.01);the colonic ulcer score was lower in the Shangjuxu and Zusanli groups (P<0.05, P<0.01). Compared with the Shangjuxu group, colonic expression of nAchRa7mRNA was lower in the other four acupoint groups (P<0.01); colonic mucosal ulcers and inflammatory lesions were more severe and the colonic ulcer score and the IL-1bcontent were higher in the Xiajuxu, Yanglingquan and Chengjin groups (P<0.05, P<0.01). Conclusion The mechanism of electroacupuncture treatment for ulcerative colitis may be that it regulates abnormal immunologic function by modulating IL-1b and nAchRa7mRNA and reduces mucosal lesions. The overall therapeutic effect of Shangjuxu is better than those of Zusanli, Xiajuxu, Yanglingquan and Chengjin, indicating that Shangjuxu has relative specificity to fu organ large intestine.

Objective To determine the drug-resistance rate of Enterococci isolated from patients of 5 padiatric hospitals located at different areas in China,and to investigate the distribution of resistance genes ermB,mefA,tetM and the integrase gene intTn of Tn1545 in Enterococci.Methods The antimicrobial susceptibility to 8 antibiotics of 2 216 Enteroeocei isolates was determined.PCR was used to detect the macrolide resistance genes ermB and mefA,tetracycline resistance genes tetM,and the integrase gene int-Tn of Tn1545.Results The resistance rates to erythromycin,ampicillin,gentamicin and teicoplanin were 86.5%,48.0%,60.5% and 0.7%,respectively.All isolated Enterococci straim were found sensitive to vancomycin.Of the detected 225 strains,70.7% of the 225 detected strains carried ermB gene while 75.1% of them carried tetracycline resistance gene tetM:only one strain had mefA.The presence of ermB gene in erythromycin MIC＞256 mg/L straim group(95.7%)strains was higher than those in erythromycin MIC＜256 mg/L group(2.5%).The int-Tn gene was detected in 40.9%(92/225)of the 225 test strains.The presence of ermB gene in int-Tn positive group strains was higher(84.8%)than those in int-Tn negative strains group(60.9%).So did the tetM in int-Tn positive group(83.7%)compared with those in int-Tn negative group(70.0%).Conclusions Enterococci sbowed a high resistance rate to the antibiotics we monitored,especially to erythromycin;but still very senstive to glycopeptide antibiotics. Resistance to macrolide in Enterococci collected from clinical in five Children's Hospital was generally mediated by methylation of 23S rRNA via ermB methylase. Enterococci resistance to tetracycline was predominantly due to ribosomal protection encoded by tetM. There was a strong relationship of the ermB and tetM genes with Tn1545-related elements.

Polymeric micelles which are self-assembled from amphiphilic copolymers are thermodynamically stable, and they can solubilize hydrophobic drugs by the hydrophilic core. Many excellent active compounds are confined because of general low oral bioavailability due to poor solubility. Take into account from the two points above, polymeric micelles may be used as proper oral carrier to improve the dissolubility of hydrophobic drugs, and enhance the permeation though gastrointestinal tract, therefore, the pharmacodynamics is elevated. Meanwhile, the segments in copolymers are multivariate, so many kinds of micelles can be obtained, such as, pH- or thermo- sensitive as well as mucoadhesive ones. The modified micelles can alter drug release profiles while solubilizing them, that is why the oral bioavailability increase further. In this review, recent progress of polymeric micelles used in oral administration is summarized, and the prospect of polymeric micelles' application in this field is also evaluated.
Administration, Oral ; Animals ; Area Under Curve ; Biological Availability ; Drug Carriers ; Drug Delivery Systems ; Humans ; Micelles ; Pharmaceutical Preparations ; administration & dosage ; Poloxamer ; chemistry ; Polyethylene Glycols ; chemistry ; Polymers ; chemistry ; Risperidone ; administration & dosage ; pharmacokinetics ; Silymarin ; administration & dosage ; pharmacokinetics ; Solubility

AlM: To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis ( AS) .
METHODS: Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate ( ESR ) , C - reactive protein ( CRP ) and magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis ( ElU ) clinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed.
RESULTS: ln the 55 patients with AS, ElU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR (r=0. 869, P<0. 001) and CRP (r=0. 485, P<0. 001). The degree of anterior uveitis in AS patients was not correlated with inflammation of sacroiliac joint (r=0. 237, P=0. 081).
CONCLUSlON: Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.

Child, Preschool ; Humans ; Magnetic Resonance Imaging ; Male ; Mastoiditis ; complications ; Sinus Thrombosis, Intracranial ; etiology

OBJECTIVETo compare the immediate effect of moxibustion on Yanglingquan (GB 34) on body surface thermograph between the patients with myofascial pain syndrome (MPS) and healthy people.

METHODSThirty-five cases of MPS were selected in observation group and 15 cases of healthy people were in control group. ATIR-M301 medical infrared imaging device was used to observe the changes in body surface thermograph before and 15 min after moxibustion on Yanglingquan (GB 34) The qualitative analysis of picture pattern and the quantitative analysis of temperature were integrated to compare the differences between two groups.

RESULTSConcerning to the infrared thermograph expression on the back of MPS cases in observation group, the abnormal thermal zone presented in 88.6% of the cases, mostly distributed in the upper and secondly in the lower back. The spinal thermal line was broken or disappeared ine about 50% of cases. The location of pain complained by 71.4% of cases was coincident with the zone of infrared thermograph expression. There was statistical significant difference in the temperatures difference of the two sides in the upper abnormal thermal zone on the back in observation group as compared with control group (P < 0.001). Body surface thermograph on the back were impacted by moxibustion on Yanglingquan (GB 34) for either MPS patients or healthy people, especially in upper back and rhomboid fossa. Moxibustion on Yanglingquan (GB 34) increased much more apparently the temperature on the upper back in MPS patients as compared with healthy people (P < 0.05).

CONCLUSIONMoxibustion on Yanglingquan (GB34) brings the immediate improvements in the back thermograph for MPS patients.

Acupuncture Points ; Adult ; Aged ; Body Temperature ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Myofascial Pain Syndromes ; physiopathology ; therapy ; Thermography ; Young Adult

OBJECTIVETo investigate the feasibility and advantages of transurethral transumbilical laparoendoscopic single-site surgery (TU-LESS) for radical prostatectomy.

METHODSFive patients with prostate cancer underwent TU-LESS for radical prostatectomy, with a four-channel single-port device inserted into a 2. 5 cm periumbilical incision and another placed through the urethra, followed by analysis of the perioperative data.

RESULTSAll the operations were successfully accomplished, with neither conversion to open surgery nor additional channel. The mean operation time, intraoperative blood loss, and postoperative hospital stay were 168 min, 120 ml, and 15 d, respectively. No severe perioperative complications were observed. TNM stage classification manifested T2cN0M0 in 2 cases and T2bN0M0 in the other 3. Postoperative pathology showed no negative surgical margins in any of the cases.

CONCLUSIONTU-LESS is safe and feasible for radical prostatectomy and can reduce the complication of low urinary tract surgery by single-site laparoendoscopy.

Blood Loss, Surgical ; Feasibility Studies ; Humans ; Laparoscopy ; Length of Stay ; Male ; Natural Orifice Endoscopic Surgery ; methods ; Operative Time ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery ; Umbilicus ; surgery ; Urologic Surgical Procedures, Male ; methods

OBJECTIVETo investigate the effect of Qianlie Huichun capsule on the microstructure and ultranstructure of prostate glandular tissue in the model rat.

METHODHynertophy of prostate model rat was established by injecting testosterone to gelding male rats. After having been fed with Qianlie Huichun capsule for 30 days, the rats were killed and prostate tissues were resected for pathomorphological studies with microscope and electromicroscope, and the diameter of glandular lumer and the height of glandular epithelial cells were measured under the microspcope for different groups of rats.

RESULTIn the model groups, the glandular epithelial cells mutiplycated notably, showing stratified and pseudostratified cells that made the glandular lumer cramped. Under the electromicroscope, the glandular epithelial cells became high columnor and the rough endoreticulum extremely expanded. But in treatment groups, the change of the diameter of the glandular lumer and the height of the glandular epithelial cells were less remarkable than those in model groups. So the differerence between the model group and the treatment groups was remarkable (P < 0.01).

CONCLUSIONQianlie Huichun capsule can depress the glandular epithelialceu multiplication of prostate gland in model rats.

Animals ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Epithelial Cells ; pathology ; Male ; Materia Medica ; administration & dosage ; pharmacology ; Plants, Medicinal ; chemistry ; Prostate ; pathology ; ultrastructure ; Prostatic Hyperplasia ; chemically induced ; pathology ; Rats ; Rats, Sprague-Dawley

BACKGROUNDCurrently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus (T2DM). We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control.

METHODSA number of 159 bone fracture patients with T2DM were divided into two groups. One group (n = 81) received multiple subcutaneous insulin injections (MSII group) and the other (n = 78) received continuous subcutaneous insulin infusion (CSII group). Blood glucose (BG) levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups.

RESULTSBoth regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group (2.5 days) was significantly shorter than that in the MSII group (7.3 days; P < 0.001). Mean insulin dosage in the CSII group (0.66 IU×kg(-1)×d(-1)) was significantly lower than that in the MSII group (0.74 IU×kg(-1)×d(-1); P = 0.005), as were the incidences of hypoglycemia (15.4% vs 32.1%) and infection (6.4% vs. 23.5%). Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index (BMI), diabetes mellitus course, glycated hemoglobin A1c (HbA1c), and β-hydroxybutyric acid, and was negatively associated with age.

CONCLUSIONThe efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.

Adult ; Aged ; Blood Glucose ; analysis ; Body Mass Index ; Diabetes Mellitus, Type 2 ; drug therapy ; Female ; Fractures, Bone ; blood ; Glycated Hemoglobin A ; analysis ; Humans ; Insulin ; administration & dosage ; Male ; Middle Aged ; Perioperative Period ; Regression Analysis ; Retrospective Studies