Objective To discuss the effect of early application of vacuum sealing drainage (VSD) on the small vessels and microthrombus of congested flap.Methods 56 SD rats were randomly divided into 7 groups after operation:one-hour group,four-hour group,one-day group,two-day group,three-day group,four-day group and seven-day group.A flap was designed and put on either side of a rat's back.The flaps were randomly arranged into control group and the flaps on the other side served as the experiment group.The equipment of VSD was fixed to each experiment flap.We observed and measured the flap,survival area,the expression of HIF-1α and vascular endothelial cell and microthrombus on the flap at different time.Results Firstly,the damage of vascular endothelial cell and microthrombus in the experiment flaps was less than the control group of flaps at the same time,so as the expression of HIF-1α.Secondly,the trend of expression of HIF-1α did not rise obviously in first 3 days and rose obviously from the 4th day in the experiment flaps; but in the control flaps,when time-lapse,the expression of HIF-1α increased,reached the plateau level at 6th day.Thirdly,the congestion of experimental flap was mitigated as compared with those under control,and the survival area was bigger,and it reached the top on the third day.Conclusions The application of VSD early to flap can aspirate detained blood initiatively,reduce the ischemic and hypoxic status of the tissue of flaps,and so it can lessen the damage of vascular endothelial cell and the formation of microthrombus of flap,beneficial for the survival of flap.

AIM:To study lipopolysaccharide (LPS)-stimulated secretion of endothelin-1 (ET-1) and adrenomedullin (Adm) from human vascular endothelial cells (HVEC) and its mechanism. METHODS:In cultured HVEC, LPS was used to stimulate ET-1 and Adm secretion from HVEC. The contents of ET-1 and Adm in medium were determined by radioimmunoassay. RESULTS:LPS stimulated secretion of ET-1 and Adm from HVEC in time-dependent and concentration-dependent manner. The ratio of secreted ET-1 to Adm was not changed compared with the control group. The increase of ET-1 could be inhibited by inhibitor of extracellular signal-regulated protein kinases (PD098059) and inhibitor of P38 kinase (SB202190)（P＜0.01）, while the increase of Adm could only be inhibited by SB202190（P＜0.05）, both had no response to inhibitor of protein kinase C (H7), inhibitor of calmodulin (W7), inhibitor of calcineurin (cyclosporin A) and inhibitor of Ca2+ (nicardipine)（P＞0.05）.CONCLUSION:ERKs and P38 signal pathways may play an important role in the secretion of ET-1 from LPS -stimulated HVEC, while only P38 kinase signal pathway is invovled in the secretion of Adm.

AIM: To study lipopolysaccharide (LPS)-stimulated secretion of endothelin-1 (ET-1) and adrenomedullin (Adm) from human vascular endothelial cells (HVEC) and its mechanism. METHODS: In cultured HVEC, LPS was used to stimulate ET-1 and Adm secretion from HVEC. The contents of ET-1 and Adm in medium were determined by radioimmunoassay. RESULTS: LPS stimulated secretion of ET-1 and Adm from HVEC in time-dependent and concentration-dependent manner. The ratio of secreted ET-1 to Adm was not changed compared with the control group. The increase of ET-1 could be inhibited by inhibitor of extracellular signal-regulated protein kinases (PD 098059 ) and inhibitor of P38 kinase (SB 202190 )( P 0.05).CONCLUSION: ERKs and P38 signal pathways may play an important role in the secretion of ET-1 from LPS -stimulated HVEC, while only P38 kinase signal pathway is invovled in the secretion of Adm.

Objective To observe changes of the right ventricular (RV) myocardial strain and the time to peak strain (ST) before and after anticoagulant and thrombolytic therapy in patients with acute pulmonary embolism (APE) by two dimension speckle tracking imaging (2D-STI).Methods A total of 25 patients with APE along with 30 age-matched and gender-matched normal subjects (as control group) were examined by echocardiography.And basal,mid,apical segments of right ventrieular wall and septum (6-segments) longitudinal peak systolic strain (PSS) and the time to peak strain (ST) were analyzed by 2D-STI.The mean and standard deviation (STsD) of 6-segmental ST were calculated.Results ①Compared with control group cases,PSS of 6-segments were significantly impaired in patients with APE (P ＜0.05).②The PSS of 6-segments in APE patients after treatment were significantly higher than that of before treatment (P ＜0.05).The PSS of apical segment of the right ventricular wall and interventricular septum in APE patients after treatment showed no significant difference with the control group (P ＞0.05).The PSS of other segments in APE patients were significantly lower than that of control group (all P ＜0.05).③The STsD of APE patients before and after treatment were significantly higher than that of the control group (P ＜0.05).Conclusions The PSS of 6-segments of RV were decreased in patients with APE and STsD were increased.After treatment,the PSS of APE patients were returned.However,the PSS in APE patients were not returned to normal.Two-dimension STI can objectively assess the curative effect of APE patients after treatment.

Objective To optimize novel triazole antifungal compounds synthesis of key intermediates.Methods The or-thogonal experimental design is used,emphasizing on four factors including the reaction temperature,the weight ratio of mate-rial,reaction time and solvent on the yield.Results The effect of reaction temperature on the reaction yield is the most signifi-cant,followed by reaction time ;the weight ratio of material and solvent on the yield impact is not obvious.Conclusion The new technology has several advantages and yields up to about 50%,less reactive impurities,easy post processing.

OBJECTIVETo explore the changes of blood viscosity and external thrombus in patients with silicosis and silicosis complicated with tuberculosis (TB).

METHODBlood viscosity and external thrombus were measured in 288 patients with silicosis, 178 patients with silicosis complicated by TB and 150 healthy subjects.

RESULTSBlood viscosity and external thrombus value were significantly higher in the patients of silicosis and silicosis complicated with TB than in the healthy controls, except for patients of phase I of silicosis. Blood viscosity in the silicotics increased significantly with the advance of the disease, but no significant difference in external thrombus between patients in different phases. Apparent viscosity of whole blood significantly increased in the high-shear rate (200 s(-1)) and middle-shear rate (30 s(-1)) in patients of silicosis complicated with TB than in those without complication of TB at the same phases, but not seen in the low-shear rate (5 s(-1)) and in plasma viscosity, and the length and dried weight of external thrombus increased significantly too. There was no significant difference in blood viscosity and external thrombus between patients of silicosis at phase III and those of silicosis complicated with TB at the same phase.

CONCLUSIONBlood in patients with silicosis appeared highly viscous and highly coagulant status. Blood viscosity and external thrombus value significantly increased with the advance of the disease, especially in the patients complicated with TB.

Adult ; Aged ; Aged, 80 and over ; Blood Viscosity ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Silicosis ; blood ; complications ; pathology ; Thrombosis ; etiology ; Tuberculosis ; complications

Objective:To evaluate the clinical value of suspensory incision and suture technique in endoscopic full-thickness resection (EFTR) for muscularis propria tumor of gastric fundus.Methods:A retrospective analysis was performed on the data of 20 patients with muscularis propria tumor in gastric fundus and undergoing EFTR in the First Medical Center of PLA General Hospital from June 2017 to June 2019. Patients were divided into the observation group (9 cases) treated with suspensory incision and suture technique in EFTR and the control group (11 cases) treated with traditional EFTR method. The baseline data and perioperative data of the two groups were analyzed.Results:EFTR was successfully performed on all 20 patients. The tumor size of the observation group and the control group was 10.0 (7.5, 21.0) mm and 14.0 (10.0, 20.0) mm, respectively. The resection time of the two groups was 26.4±6.3 min and 35.5±11.4 min, respectively. The postoperative hospital stay was 6.4±1.0 d and 7.7±1.5 d, respectively. No postoperative delayed bleeding, perforation, or other complications occurred in the two groups.Conclusion:Using suspensory incision and suture technique is safe and effective during EFTR for muscularis propria tumor in gastric fundus, and can reduce operation time. This technique is worth applying in clinic.

Objective To calibrate contact parameters of liver tissue discrete element model. Methods Based on MATLAB image processing technology, the accumulation angle of liver tissues was measured. The ‘Hertz-Mindlin with JKR’ contact model was used to simulate the accumulation angle of liver tissues. The orthogonal experiment was designed with the coefficient of rolling friction and the energy of JKR surface as factors. The parameters of the contact model were calibrated by batch processing, and the optimal parameter combination was verified by secondary simulation calibration. Results The accumulation angle obtained by the physical test was 11.2°±0.86°. In the orthogonal experiment, the accumulation angle of the 6th set of parameter combinations was 11.8°, and the relative error was 5.1%. The simulation test and the physical test had a high similarity in accumulation angle and shape. The sequence of factors affecting the accumulation angle was the JKR surface energy between the tissue particles and the stainless steel plate > the rolling friction coefficient between the tissue particles and the stainless steel plate > the JKR surface energy between the tissue particles and the tissue particles=the rolling friction coefficient between the tissue particles and the tissue particles. Conclusions The optimization parameter could be used to further conduct the discrete element simulation between the tissue particles and the pulverizer, so as to reveal the accumulation and flow state of the tissue particles under the action of myoma pulverizer.

With the development of minimally invasive surgery, many open surgery has been replaced by intracavity surgery. In laparoscopic surgery, an electric fibroid morcellator must be used to remove large tissue specimens from a small abdominal incision. Of course, there are some complications in the use, in order to follow the principle of no tumor, the doctor used the laparoscopic pouch in clinical operation to reduce the risk of spreading potential tumor tissue. There are various kinds of pouches, which are classified according to their existing state before use, it can be classified into two categories:overlapping and non-overlapping. The advantages and disadvantages of different bags and pockets are also analyzed. It provides a theoretical basis for technological innovation and equipment improvement.
Laparoscopy ; instrumentation ; Minimally Invasive Surgical Procedures