Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine(R) and chloroprocaine(C)for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups(n= 15 each);groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_(2,3)interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block(using Bromage scale)were assessed.The use of supplementary drugs(ketamine and ephedrine)and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ(0.75% R alone).The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.

Objective To report clinical study of diabetic foot with microsurgical treatment.Methods 32 cases basing on physical treatment underwent operation which included reconstruction of vessel under DSA and flap transfer and relaxation of nerves.Results 8 eases were examined with DSA after operation,it showed that the bypass grafts were unobstructed and the distal blood were improved;All flap were lively. Conclusion The ulcer of the patients with diabetic foot was closed early and the blood supply of the limb have been reconstructed by microsurgical treatment,it can not only avoid amputation or lower the limb amputation level,but also improve the life quality of patients and obtain social benefit.

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

OBJECTIVETo investigate the inhibiting action of transforming growth factor-beta type R II receptor(TGF-beta R II) antibody to fibroblasts.

METHODSFour groups of cultured skin fibroblasts were treated with different dosages of TGF-beta R II antibody. Examinations were performed with HYP, MTT, microscope, and flow cytometry techniques.

RESULTSTGF-beta R II antibody resulted in significant inhibition of fibroblasts(P < 0.01).

CONCLUSIONTGF-beta R II antibody has inhibiting effects on the proliferation of skin fibroblasts and with a dose-dependent manner.

Adolescent ; Antibodies, Monoclonal ; pharmacology ; Cell Division ; drug effects ; Cells, Cultured ; Child ; Fibroblasts ; cytology ; drug effects ; ultrastructure ; Flow Cytometry ; Humans ; Microscopy, Electron ; Protein-Serine-Threonine Kinases ; Receptors, Transforming Growth Factor beta ; analysis ; immunology

The fermentation process of recombinant human Endostatin expression in Escherichia coli BL21 (DE3) was studied. The effects of factors such as concentration of IPTG, induction time, cultivation temperature and feeding strategies were investigated. Beside that, by changing the temperature to 40 degrees C after induction, the high-density cultivation finished in a much shorter period. After 9 hours cultivation, the optical density (OD) at 600 nm reached 140 and the yield of inclusion body was 3 g/L. While E. coli system was used, protein with better activity and stability was obtained. The cost was much lower and the producing process was much steadier. It will meet the demands of the industrial production.
Endostatins ; biosynthesis ; genetics ; Escherichia coli ; genetics ; growth & development ; metabolism ; Fermentation ; Humans ; Protein Engineering ; Recombinant Proteins ; biosynthesis ; genetics ; Thiogalactosides ; chemistry

The study was aimed to investigate the influence of penicillin and streptomycin on proliferation, apoptosis and extracellular secretion (ECS) produced from human umbilical cord derived mesenchymal stem cells (MSC). MSC were isolated from umbilical cord tissue, then the immunotyping, multipotent differentiation and proliferation of these cells were assayed by cytometry, cytochemistry and MTT respectively. The expressions of ECS and apoptosis-related genes (bcl-2, bax) were detected by quantitative RT-PCR. The results showed that the phenotype of these cells matched with the characteristics of MSC. Penicillin and streptomycin of low concentrations promoted MSC proliferation, with the most effective concentration of 100 U/ml. Expressions of ECS cultured in addition of penicillin and streptomycin were down-regulated. Furthermore, apoptosis-related factor (bcl-2/bax) expression levels in low concentrations penicillin and streptomycin groups were higher than that in the control group. It is concluded that low concentrations penicillin and streptomycin can promote the proliferation and reduce the apoptotic rate, but high dose can inhibit the ECS component expression of MSC.
Cell Differentiation ; Cells, Cultured ; Extracellular Matrix ; secretion ; Flow Cytometry ; Gene Expression Regulation ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; secretion ; Penicillins ; pharmacology ; Streptomycin ; pharmacology ; Umbilical Cord ; cytology

OBJECTIVETo evaluate the RT-PCR-ELISA method applied for testing live attenuated hepatitis A vaccine titer.

METHODSA solid phase hybridization-enzyme colorimetric detection method was used for detecting specific nucleic acid. Primer labeled with biotin was used to amplify viral gene fragment, then the product was quickly hybridized with the specific probe covalently coupled on DNA-binding microplate wells. Finally, peroxidase-labeled streptavidin was used in colorimetric detection. The results were judged by reading A value. Eleven batches of live attenuated hepatitis A vaccine titer were tested by this method. The results were compared with that of routine cell culture method (CCID50).

RESULTSThe sensitivity was similar to routine cell culture method (P>0.05). This method was convenient, fast and specific.

CONCLUSIONCCID50 method may be replaced by the RT-PCR-ELISA method in evaluating the titer of live attenuated hepatitis A vaccine.

Base Sequence ; DNA, Viral ; analysis ; Enzyme-Linked Immunosorbent Assay ; Genes, Viral ; Hepatitis A Vaccines ; Hepatitis A virus ; genetics ; Quality Control ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Vaccines, Attenuated

BACKGROUNDSubthalamic deep brain stimulation (STN-DBS) has been shown to be effective in the treatment of Parkinson's disease. The site for permanent stimulation is still in debate. This study aimed to assess the position of active contacts in relation to the subthalamic nucleus.

METHODSWe reviewed the location of 40 electrodes in 34 patients who underwent STN-DBS. The position of electrode was evaluated by postoperative magnetic resonance imaging (MRI). The position of active contacts was compared with the subthalamic nucleus (STN) determined by intraoperative electrophysiological mapping and postoperative MRI.

RESULTSThe average position of the 40 active contacts was (11.7 + or - 1.2) mm lateral, (0.6 + or - 1.3) mm anterior, and (0.7 + or - 1.4) mm vertical to the midcommissural point. The dorsal margin of the STN was (11.6 + or - 1.1) mm lateral, (0.2 + or - 1.1) mm anterior, and (1.3 + or - 1.1) mm vertical to the midcommissural point. When compared with the dorsal margin of the STN, the active contacts were located more dorsally (P = 0.033) and anteriorly (P = 0.012), no significant difference was found in the lateral direction (P = 0.107). When compared with the position of the STN, 26 (65%) of active contacts were located in the region dorsal to the STN, only 13 (32.5%) were located in the upper two-thirds portion of STN.

CONCLUSIONSThe site for permanent stimulation appears to be in the subthalamic region dorsal to the STN, close to the dorsal margin of the STN. Besides the dorsal portion of the STN, other structures such as fields of Forel H and zona incerta may also be involved in the therapeutic benefit of deep brain stimulation.

Adult ; Aged ; Deep Brain Stimulation ; Electrophysiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Parkinson Disease ; pathology ; physiopathology ; therapy ; Subthalamic Nucleus ; pathology ; physiopathology

BACKGROUNDIt has been proposed that parkinsonian motor signs result from hyperactivity in the output nucleus of the basal ganglia, which suppress the motor thalamus and cortical areas. This study aimed to explore the neuronal activity in the globus pallidus internus (GPi) and the ventrolateral thalamic nuclear group (ventral oral posterior/ventral intermediate, Vop/Vim) in patients with Parkinson's disease (PD).

METHODSTwenty patients with PD who underwent neurosurgery were studied. Microelectrode recording was performed in the GPi (n = 10) and the Vop/Vim (n = 10) intraoperatively. Electromyography (EMG) contralateral to the surgery was simultaneously performed. Single unit analysis was carried out. The interspike intervals (ISI) and coefficient of variation (CV) of ISI were calculated. Histograms of ISI were constructed. A unified Parkinson's disease rating scale (UPDRS) was used to assess the clinical outcome of surgery.

RESULTSThree hundred and sixty-three neurons were obtained from 20 trajectories. Of 175 GPi neurons, there were 15.4% with tremor frequency, 69.2% with tonic firing, and 15.4% with irregular discharge. Of 188 thalamic neurons, there were 46.8% with tremor frequency, 22.9% with tonic firing, and 30.3% with irregular discharge. The numbers of three patterns of neuron in GPi and Vop/Vim were significantly different (P < 0.001). ISI analysis revealed that mean firing rate of the three patterns of GPi neurons was (80.9 +/- 63.9) Hz (n = 78), which was higher than similar neurons with 62.9 Hz in a normal primate. For the Vop/Vim group, ISI revealed that mean firing rate of the three patterns of neurons (n = 95) was (23.2 +/- 17.1) Hz which was lower than similar neurons with 30 Hz in the motor thalamus of normal primates. UPDRS indicated that the clinical outcome of pallidotomy was (64.3 +/- 29.5)%, (83.4 +/- 19.1)% and (63.4 +/- 36.3)%, and clinical outcome of thalamotomy was (92.2 +/- 12.9)%, (68.0 +/- 25.2)% and (44.3 +/- 27.2)% for tremor, rigidity and bradykinesia, respectively. A significant difference of tremor and rigidity was found between GPi and Vop/Vim (P < 0.05).

CONCLUSIONSDifferent changes in neuronal firing rate and the pattern in GPi and Vop/Vim are likely responsible for parkinsonian motor signs. The results support the view that abnormal neuronal activity in GPi and Vop/Vim are involved in the pathophysiology of parkinsonism.

Adult ; Aged ; Female ; Globus Pallidus ; physiopathology ; Humans ; Male ; Middle Aged ; Neurons ; physiology ; Parkinson Disease ; physiopathology ; Ventral Thalamic Nuclei ; physiopathology

OBJECTIVETo explore the clinicopathologic features, treatment and prognosis of gastrointestinal stromal tumor (GIST) complicated with synchronous other alimentary malignant tumors.

METHODSClinical data of 525 patients with GIST undergoing surgical treatment from August 2004 to November 2012 in Shanghai Renji Hospital were reviewed retrospectively, among whom 46 patients presented synchronous other alimentary malignancy.

RESULTSGIST and other alimentary malignancy coexisting cases were less likely to be screened out preoperatively (2.2%, 1/46) and associated with elder age (P=0.001), more likely arise from stomach (P=0.000), smaller tumor maximum diameter (P=0.000), and lower mitotic count (P=0.000). According to NIH postoperative risk classification, there were 36 at very low risk, 9 at low risk, and 1 at high risk. Although the risk of GIST recurrence was lower for GIST and other alimentary malignancy coexisting cases, their 5-year survival rate was lower than that of patients with GIST alone (36.1%VS. 82.2%, P=0.000).

CONCLUSIONSGIST patients complicated with synchronous alimentary malignant tumor are usually low or very low risk and has minimal impact on the prognosis. Survival depends primarily on the synchronous alimentary malignant tumors. Therefore, it is reasonable to lay emphasis on the treatment of the alimentary malignant tumor, and perform synchronous resection of GIST if possible.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; diagnosis ; pathology ; therapy ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies