Objective To investigate effects of cerebral isehemic preconditioning on neurological function,in- farct volume,and the expression of caspase-3 in brain issue after brain ischemia again,and to investigate the brain protection mechanism produced by cerebral ischemia preconditioning.Methods 48 healthy male Sprague-Dawley (SD)rats(weighted 200～250g)were randomly divided into 2 groups:ischemia group(n=24),ischemia precondi- tioning group(namely preconditioning group,n=24).Each group was divided into 4 subgroups according to 6h,1d, 2d,4d after ischemia again.Results At the same point of time after ischemia,neurological deficit in preconditioning group was much less than that in ischemia group,the difference was significant(P

Objective To evaluate the clinical efficacy of facial acupoint catgut embedding therapy in the treatment of skin aging.Methods The sixty patients with facial skin aging were randomly divided into catgut embedding group and sham embedding group,30 cases each.Catgut embedding group received catgut embedding therapy; the control group also received acupuncture but not the filling line.Two groups were operated 2 times,once every 21 days,a total of 42 days.The facial skin aging were evaluated and analyzed using VISIA and CK complexion analysis system.Results In catgut embedding group,wrinkles,pores,texture,moisture and elasticity were improved signficantly (P＜0.05).Ultraviolet,pigmentation,telangiectasia and melasma were not obviously improved.There was no significant change in the sham embedding group.Conclusions Facial acupoint catgut embedding therapy is an effective method for the treatment of skin aging with no significant side effects.

Purpose:To evaluate the efficiency of mediastinal lymph nodes dissection (MLND) and to determine a reasonable extent of dissection in the treatment of patients with clinical stageⅠ A non small cell lung carcinoma (NSCLC). Methods:From January 1988 to June 1995, one hundred and forty seven patients with clinical stageⅠ A NSCLC were treated by surgery. All the patients were divided into three groups according to the type of procedure, that is, resection without MLND, resection with selective MLND and systematic MLND. According to their clinical characteristics patients in each group were matched and assigned once again, and 93 cases were enrolled. Survival rates were calculated by Kaplan meier method and survival curves were prepared and survival difference was compared by Log rank test. Results:Survival rates at 5 year of no MLND, selective MLND and systematic MLND groups were 22.6%, 48.4%, and 51.6%, respectively. Survival rates of two MLND groups were higher than that of no MLND group. Log rank test presented significantly statistical difference between them ( P

Objective To analyze prognostic relative factors in treatment by evaluating the surgical results of tibial pilon fracture retrospectively. Methods 32 cases with unilateral tibial pilon fracture were treated operatively between January 1997 and December 1999. Among them, 16 cases were found with unsatisfied results due to incisional complications, degenerative changes and stiffness of the ankle joint. Of 16 cases, there were 13 males and 3 females. The average age was 36.5 years (range, 25 to 55 years). The mechanisms of injury were fall in 7 cases, traffic accident in 5 cases, crash in 3 cases and other cause in 1 case. 6 cases with open fracture were treated in emergency. However, 10 cases with closed fracture were operated with an average interval of 8.1 days from injury to surgery(range, 2 to 25 days). According to the Ruedi-Allgower classification, there were type Ⅱ fracture in 7 cases and type Ⅲ fracture in 9 cases. Furthermore, there were 14 cases associated with fibular fracture. During operation, 7 cases were treated with open reduction and internal fixation with plates and screws, and 9 cases were treated with open reduced minimally and external fixation with a cast. Results The average period of follow-up was 24 months (range, 12 to 36 months). According to Mazurs criterion, the result of the treatment was evaluated as fair in 6 cases, 4 cases of which were type Ⅱ fracture, and 2 cases type Ⅲ fracture; poor in 10 cases, 3 cases of which were type Ⅱ fracture, and 7 cases type Ⅲ fracture. Complications included wound dehiscence in 1 case; infection in 4 cases, 2 of which with open fracture were superficial infection, and 2 cases with closed fracture were deep infection; posttraumatic arthritis of the ankle joint in 9 cases; and severe varus deformity in 2 cases.11 cases suffered from ankle stiffness. Conclusion Discouraged results of pilon fractures are significantly related to fracture type, reduction status and time of operation, reduction and fixation of fibular fracture, and bone grafting.

Alanine aminotransferase (ALT)abnormality is an indicator of the degree of liver inflammation caused by immune activation in patients with chronic hepatitis B (CHB).However,approximately half of the CHB patients with normal or mildly elevated ALT levels have concealed significant changes in hepatic histology.CHB patients with normal or mildly elevated ALT levels may have significant histopatho-logical changes in hepatic tissues,and those changes vary between HBeAg(+)and HBeAg(-)CHB patients.Attention and investigation on the clinical management of CHB patients with normal or mildly elevated ALT levels may have great significance in grasping the right treat-ment opportunity and reducing the risk of liver cirrhosis.

Objective To test and evaluate the geometric accuracy of delineation of organs at risk ( OARs) in head and neck cancer using an atlas?based autosegmentation ( ABAS) software. Methods The atlases for the ABAS software was generated using images from 40 patients with head and neck cancer undergoing intensity?modulated radiotherapy. The software was tested in 40 new patients. Automatic delineation of OARs was carried out on computed tomography images by single?( one to one ) and multi?template ( ten to one) approaches. In order to evaluate the feasibility of the automatic delineation in clinical application, differences in volume (ΔV%), position (Δx,Δy, andΔz), conformability (sensitivity ( Se ), specificity ( Sp ) , and dice similarity coefficient ( DSC) ) , and delineation time were assessed between the automatic and manual delineation. The comparison between the two automatic delineation approaches was made by paried t test. Results For all OARs, the multi?template automatic delineation achieved a significantly smaller mean ΔV% value and a significantly larger mean DSC value than the single?template automatic delineation (-0.02%± 0?29% vs. -0.16%± 0?41%, P<0?05;0.74± 0?16 vs. 0.68± 0?20, P<0?05);the position differences between two automatic delineation approaches were less than 0?4 cm in all three directions except for the temporal lobe, lower jaw, and spinal cord;in the receiver operating characteristic curve defined by Se versus 1-Sp , the data points were all within the first quadrant except for the optic nerve and chiasm;automatic delineation saved 42%?72% of time compared with manual delineation. Conclusions The ABAS software achieves satisfactory results of automatic delineation for most of OARs in patients with head and neck cancer. The multi?template automatic delineation, particularly, has better outcomes than the single?template one. In addition, it greatly shortens the time the clinicians spend on delineation of OARs.

The effects of E-cadherin-transfected neural stem cells (NSCs) transplantation for spinal cord injury (SCI) in rats were investigated. Sixty SD rats were randomly divided into model control group, NSCs group, empty plasmid group and E-cadherin overexpression group (n=15 each). The animal SCI model was established by using the modified Allen's method. NSCs were cultured. Rats in NSCs group were subjected to NSCs transplantation. E-cadherin gene eucaryotic expression vector and pcDNA3.1-E-cadherin were respectively transfected into cultured NSCs, serving as empty plasmid group and E-cadherin overexpression group respectively. At 7th day after transplantation, neurological function of all rats was assessed by Tarlov score. After rats were sacrificed in each group, the number of BrdU and Nestin positive cells was counted by immunohistochemistry. Immumofluorescence method was used to detect the expression of neurofilament protein (NF) and glial fibrillary acidic protein (GFAP). As compared with model control group, the Tarlov score and the number of of BrdU and Nestin positive cells, and the expression of NF and GFAP in NSCs group, empty plasmid group, and E-cadherin overexpression group were increased significantly (P<0.05), and those in the E-cadherin overexpression group were increased more significantly than the other transplantation groups (P<0.05). It was suggested that E-cadherin could be conductive to nerve regeneration and repair probably by promoting the proliferation and differentiation of NSCs.

Objective To analyze and discuss the possible reasons of the bone resorption beneath the prostheses after chin augmentation.Methods Twelve patients were admitted to our department for further correction after chin augmentation with materials.The bone resorption was observed through the clinical research and X-ray examination.Results All the patients were underwent the removal of the materials,genioplasty was performed in 8 patients,and two patients were treated by chin augmentation with polyethylene.All the patients were satisfied with their facial contouring.Mild bone resorption was found in seven patients (depth of bone resorption ≤2 mm),in which five patients were used with silicone materials,two patients were performed with expanded polytetrafluoroethylene implants.Moderate bone resorption was seen in three cases.All of them were used with silicone implants (2 mm ＜ depth of bone resorption ≤4 mm).Severe bone resorption happened in two patients (depth of bone resorption ＞4 mm).One was used with silicone implant,and the other one was carried out with expanded polytetrafluoroethylene implant.Conclusions The imbalance among mentalis muscle,materials and underlying bone might be one of the key reasons.Thus for mild and moderate microgenia cases,chin augmentation with material is suitable,while long-term fellow-up study is necessary.But for the cases of severe mirogenia or microgenia and micrognathia with dentofacial deformity or mentalis muscle hyperactivity,genioplasty might be performed as well to correct their deformities.

Objective To explore the effect of tumor necrosis factor-alpha(TNF-α) blockade therapy on circulating Th17 cell percentage and serum interleukin (IL)-17 level in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods Twenty-seven RA and 22 AS patients were recruited, of which 14 cases from both diseases received 40 weeks TNF blockade therapy. Twenty-four healthy blood donors were used as controls. The frequencies of circulating Th17 cells were determined by flowcytometry, and serum IL-17 level were measured by enzyme linked immunosorbent assay(ELISA). Results Significantly higher baseline circulating Th17 cells were observed in active RA and AS patients compared with the healthy controls[RA 1.03%(0.66%,1.78%) vs controls 0.50%(0.43%,0.67%), Z=-3.236, P<0.01; AS(1.16±0.09)%vs controls (0.59 ±0.061)% , t =5.226, P <0.01]. Similarly, serum IL-17 level were significantly elevated in patients with both diseases compared with controls[RA(32.3±2.5) pg/ml vs controls(14.3±2.5) pg/ml, t=5.070, P<0.01; AS 28.98(23.84,36.14) pg/ml vs controls 11.84(5.33,22.12) pg/ml, Z=-4.103, P<0.01]. After TNF-α blockade therapy, serum IL-17 was significantly decreased in both diseases groups[RA △(-13.5± 5.0) pg/ml and AS △(-16.0±1.9) pg/ml]. In contrast, no significant differences were found in the frequencies of circulating Th17 cells[RA △(0.104 5±0.212 6)% and AS △(0.002 5±0.183 8)%]. Conclusion Th17 cells and IL-17 have been implicated in the pathogenesis of RA and AS. TNF-α blockade can partially inhibit the function of Th17 cells. However, it is unable to reduce the frequencies of these cells in the circulation after 40 weeks therapy, which may explain the reasons for the relapse.

ObjectiveTo modify the technique of whole small bowel transplantation in rats to improve the survival.MethodsOne hundred and six SD rats served as donors and recipients to establish a homogeneous and orthotopic model of small bowel transplantation without fistula.Anastomosis of aorta and vein was done with three- cuff technique,the vena mesenterica superior of recipient was done under a surgical microscope.End-to-end anastomosis was performed between donor proximal small intestine and receptor jejunum,and also between the remote and receptor ascending colon.Surviving more than 3 days after surgery was defined as the operation was successful.ResultsThe operation was successfully carried out in 48 cases with the survival rate of 90.6％ (48/53).The average warm ischemic time was 0 minute,and the average cold ischemic time was(30 ±2.48)min.The survival rate( ＞7 d) was 97.9％ (47/48).ConclusionsOn the basis of three-cuff technique,the survival of SBT was greatly improved.When the vena mesenterica superior of recipient was done under a surgical microscope,the surgical training time was shortened.