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 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 compare the clinical effectiveness of blind intubation through the Cookgas intubating laryngeal airway(CILA) or Fastrach intubating laryngeal mask airway(FT-LMA) for anticipated difficult tracheal intubation.

METHODSEighty-six patients with anticipated difficult tracheal intubation who were undergoing elective plastic surgery under general anesthesia were randomly allocated into CILA group(n=43) and FT-LMA group(n=43) . After general anesthesia being induced and CILA or FT-LMA being inserted, the patients were treated with blind intubation through CILA or FT-LMA. In each case, the number and the time of intubating laryngeal airway(ILA) insertion and blind intubation attempts and ILA removal were recorded. The view of glottis under fiberoptic bronchoscope(FOB) via CILA or FT-LMA was recorded. In addition, noninvasive blood pressure and heart rate were recorded before and after intravenous anesthetic induction, at ILA insertion, at intubation, at ILA removal and every minute thereafter for 5 minutes.

RESULTSCILA or FT-LMA was inserted successfully in all 86 patients. The rate of the first successful insertion was not significantly different between two groups(P>0.05) . In CILA group, the first intubation attempt succeeded in 35 patients;5 and 2 cases were intubated blindly at the second and the third attempt, one patient failed who was intubated successfully by FOB via CILA. In FT-LMA group, 32 patients were intubated successfully at the first attempt, 4 at the second attempt, 3 at the third attempt, and 4 cases failed, three of them were intubated smoothly with FOB through FT-LMA, one failed patient was intubated by FOB. The time of FT-LMA insertion(34.2∓13.9) s was significantly longer when compared with CILA(22.4∓18.9) s (P<0.05) . However, the time of blind intubation through CILA and FT-LMA [(46.0∓26.7) s vs.(51.8∓41.1) s]and the time of ILA removal[(39.3∓11.9) s vs.(35.3∓10.4) s] were not significantly different between groups(P>0.05) . Hemodynamic changes during blind intubation in the two groups showed no significant differences(P>0.05) .

CONCLUSIONSBlind intubation via CILA or FT-LMA is safe and effective for anticipated difficult tracheal intubation. Nevertheless, CILA is easier to be inserted, with relatively higher success rate of blind intubation.

Adolescent ; Adult ; Anesthesia, General ; Bronchoscopy ; Humans ; Intubation, Intratracheal ; instrumentation ; Laryngeal Masks ; Middle Aged ; Young Adult

OBJECTIVETo study the effects of phytoestrogen alpha-zearalanol (alpha-ZAL) on normal human breast.

METHODSTen specimens of normal human breast tissues were subcutaneously implanted into 30 athymic nude mice aged 9-10 weeks, one for 3 mice. These mice were then randomly divided into three groups: control group (without hormone treatment, n = 10), 1 mg/kg alpha-ZAL group (n = 10), and 5 mg/kg alpha-ZAL group (n = 10). All breast tissues were taken out 6 weeks later. Immunohistochemistry was used to determine the protein expressions of proliferating cell nuclear antigen (PCNA), inhibiting apoptosis gene Bcl-2, estrogen receptor (ER), and progesterone receptor (PR). Reverse transcription polymerase chain reaction (RT-PCR) was used to measure the expression levels of estrogen sulfotransferase (EST) mRNA and bridging integrator protein-1 (BIN1) mRNA. Morphological features of grafts before and after treatment were also observed.

RESULTSAlpha-ZAL had no significant effects on Bcl-2, PCNA, ER, and PR expression of mammary epithelial cells in graft specimens. Alpha-ZAL upregulated BIN1 mRNA expression in grafts, but had no significant effect on ESTmRNA expression.

CONCLUSIONSAlpha-ZAL does not affect the morphology, proliferating, and apoptosis of epithelial cells in normal human breast tissues implanted into nude mice, but it may increase the gene expression of tumor-inhibiting BIN1, suggesting that alpha-ZAL may have potential proteotive effect on normal human breast.

Adult ; Animals ; Breast ; chemistry ; drug effects ; Estrogens, Non-Steroidal ; pharmacology ; Female ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Phytoestrogens ; pharmacology ; Proliferating Cell Nuclear Antigen ; analysis ; Random Allocation ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis ; Zeranol ; pharmacology

Acute Disease ; Biomarkers, Tumor ; analysis ; Child ; Cyclin-Dependent Kinase Inhibitor p16 ; analysis ; Histocytochemistry ; Humans ; Leukemia ; metabolism ; pathology ; Proliferating Cell Nuclear Antigen ; analysis ; Proto-Oncogene Proteins c-bcl-2 ; analysis