Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer.Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2-II B cervical cancer patients were divided into observation group(n=43) and control group(n=37),the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer,patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect,operation time,intraoperative blood loss,postoperative pathological risk factor differences of two groups of patients were compared.Results (1)Evaluated the curative effect of neoadjuvant chemotherapy,squamous cell carcinoma group complete remission(CR) 4 cases,partial remission(PR) 22 cases,stable disease(SD),6 cases of disease progression(PD) in 0 cases,in adenocarcinoma group CR 1 cases,PR 3 cases,SD 5 cases,PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group,the difference was statistically significant(z=2.4968,P=0.0063).(2)The operation time((215±57) min) and intraoperative blood loss((682±145) ml) in the observation group were significantly lower than those in the control group(((259±62) min,(758±193) ml)),the difference was statistically significant(t=3.8780,2.2528,P=0.0002,0.0263).(3)The two groups of patients with ureteral fistula(P=0.5039),vesicovaginal fistula(P=0.3639),wound healing(P=0.5182),lower extremity deep venous thrombosis(P=0.4818) complications had no significant difference.(4)The positive rate of the observation group of lymph nodes(χ2=8.2005,P=0.0000),parametrial infiltration rate(χ2=8.1553,P=0.0000) was significantly lower than the control group,the difference was statistically significant.Two groups of patients with deep myometrial invasion rate(χ2=0.0991,P=0.7516),the incidence of cancer embolus(χ2=0.0130,P=0.9176) compared to no statistical significance.Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer,neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer,operation time and blood loss are lower,node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect.

A good funds budget can optimize efficiency of the research funds. Through the implementation of a National Science and Technology Major Project, the authors analysed the budget management proposed some skills and suggestions for the planning and management of budget.

Child ; Child Behavior Disorders ; etiology ; Child, Preschool ; Encephalitis ; complications ; metabolism ; virology ; Enterovirus ; Female ; Humans ; Infant ; Male ; Nerve Growth Factors ; metabolism ; S100 Calcium Binding Protein beta Subunit ; S100 Proteins ; metabolism

Objective To investigate the effects of endogenous sulfur dioxide (SO2) on the oxidative stress induced by cobalt chloride (CoCl2) in the rat pulmonary artery smooth muscle cells (PASMCs).Methods Rat PASMCs were treated with 200 μ mol/L CoCl2 to mimic the hypoxia insult.Endogenous SO2 generating enzyme aspartate aminotransferase 1 (AAT1) expression was upregulated or downregulated (AAT1 sh) by transfection with lentivirus.Rat PASMCs were randomly divided into 8 groups:vehicle group,vehicle + CoCl2 group,AAT1 group,AAT1 + CoCl2 group,scramble group,scramble + SO2 group,AAT1 sh group and AAT1 sh + SO2 group.SO2 donor Na2 SO3/NaHSO3 at concentration of 100 μ mol/L were added in scramble + SO2 group and AAT1sh + SO2 group.The expressions of AAT1,superoxide dismutase 1 (SOD1) and SOD2 in PASMCs were detected by Western blot method.In situ SO2 content in PASMCs was detected by fluorescent probe.The superoxide anions in PASMCs were labeled by dihydroethidium (DHE) probe under fluorescent microscope.Results Compared with the vehicle group,the levels of SO2 and the expressions of AAT1 (0.221 ± 0.002 vs.0.446 ± 0.004),SOD1 (0.076 ± 0.028 vs.0.171 ± 0.019) and SOD2 (0.080 ± 0.031 vs.0.196 ± 0.018) significantly decreased (all P ＜ 0.01),and superoxide anion increased in rat PASMCs of vehicle + CoCl2 group.Meanwhile,compared with vehicle + CoCl2 group,the levels of SO2 and the expressions of AAT1 (0.839 ± 0.056 vs.0.221 ± 0.002),SOD1 (0.177 ± 0.020 vs.0.076 ± 0.028) and SOD2 (0.195 ±0.018 vs.0.080-± 0.031) markedly increased (all P ＜ 0.01),and superoxide anion decreased in rat PASMCs of AAT1 + CoCl2 group.On the contrary,compared with the scramble group,the levels of SO2 and the expressions of AAT1 (0.062 ±0.017 vs.0.354 ±0.034),SOD1 (0.054 ±0.029 vs.0.157 ±0.023) and SOD2(0.180 ±0.100 vs.0.586 ± 0.176)significantly decreased (all P ＜ 0.01),and superoxide anion increased in rat PASMCs of AAT1sh group.Furthermore,compared with the AAT1 sh group,the levels of SO2 and the expressions of SOD1 (0.155 ± 0.022vs.0.054 ± 0.029) and SOD2 (0.578 ± 0.200 vs.0.180 ± 0.100) significantly increased (all P ＜ 0.01),and superoxide anion decreased in rats PASMCs of AAT1sh + SO2 group.Conclusion Endogenous SO2/AAT1 inhibits CoCl2-induced oxidative stress in rat PASMCs.

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

Objective To make students at different levels not only learn theoretical knowledge of acupuncture-moxibustion manipulation skills but also achieve full operating training, strengthen the combination of theory and practice and improve the teaching quality of clinical disciplines by applyingmultimedia-subject participationteaching method to acupuncture-moxibustion manipulation techniques in the experimental teaching of acupuncture and moxibustion. Method The students were randomized, according to grade, into experiment (n=114) and control (n=115) groups. The teaching content was the same in the two groups. The experiment group received multimedia-subject participationteaching method. After the multimedia teaching, the students did an independent demonstration and made a self-evaluation, the teachers made a comment and the students did independent practice again in groups. The control group received conventional theory teaching and did practice under demonstration in the experimental lesson. The examination and questionnaire were used as assessment indicators to evaluate the effect ofmultimedia-subject participationteaching method applied to acupuncture-moxibustion technique teaching. Result Statistical analysis was made using the SPSS11.5 statistical software package. The independent samples t-test is used for a between-groups comparison. The statistical result showed that satisfaction was 100%in the experiment group and 75.7%in the control group;there was a statistically significant difference between the two groups (P<0.05). Conclusion Multimedia-subject participationteaching method is an innovation in acupuncture-moxibustion technique teaching and helps the students to better master acupuncture-moxibustion manipulation skills. Mastery of theoretical knowledge before real practice is the key to proficient manipulation. The combination of the two in classroom teaching yields twice the result with half the effort. Carrying out multimedia-subject participation teaching method will help to further deepen the teaching reform and to improve the level and quality of“Acupuncture and Moxibustion”teaching.

OBJECTIVETo investigate the effect of compound Coptidis Rhizoma capsule (CCRC) on unbalanced expression of renal tissue TGF-β1/BMP-7 and Smad signaling pathway in rats with early diabetic nephropathy (DN), and discuss CCRC's effect on DN rats with early diabetic nephropathy and its possible mechanism.

METHODDN model rats were established by injecting streptozotocin (STZ). The rats were randomly divided into seven groups: the normal group, the model group, the enalapril treatment group, the xiaoke pill treatment group and three CRCC treatment groups. They were orally administered once a day for five weeks. The fasting blood glucose (FBG), blood urea nitrogen (BUN), serum creatinine (Scr), insulin (Ins), 24 h urinary protein (24 h Upro) and 24 h urinary microalbumin (24 h UmAlb) were tested. The pathological changes in renal tissues were examined by optical microscopy. Immuno- histochemical measures were used to detect the expressions of TGF-β1, BMP-7, Smad2/3, Smad1/5, and Smad7 protein, and RT-PCR was used to detect TGF-β1 mRNA and BMP-7 mRNA in renal tissues.

RESULTCompared with model group, BUN, Scr, Ins, 24 h Upro and 24 h UmAlb levels decreased at different degrees in CCRC treatment groups; the abnormal pathomorphology in renal tissue was improved; immunohistochemistry results showed that the expression of TGF-β1 and Smad2/3 were reduced, while the expression of BMP-7, Smad1/5 and Smad7 increased in CRCC treatment groups; the expression of TGF-β1 mRNA were reduced, but the expression of BMP-7 mRNA had no obvious change in CRCC treatment groups.

CONCLUSIONCRCC can improve the early renal function, delay the progression of chronic renal pathology and maintain the dynamic balance of TGF-β1/BMP-7 expression in renal tissues of DN rats. The mechanism may be related to down-regulation of renal TGF-β1 and up-regulation of BMP-7 through Smad signaling pathway.

Animals ; Bone Morphogenetic Protein 7 ; genetics ; metabolism ; Coptis ; chemistry ; Diabetic Nephropathies ; drug therapy ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Signal Transduction ; drug effects ; Smad Proteins ; genetics ; metabolism ; Transforming Growth Factor beta1 ; metabolism

Objective To explore the feasibility and clinic outcome of the modified latissimus dorsi flap when it is used to repair huge soft tissue defects in lower limbs.Methods The latissimus dorsi muscle is rich blood supply and available for harvest huge areas.According to these characteristics the modified latissimus dorsi flap was designed:a limited latissimus dorsi skin flap with a large area of latissimus dorsi muscle flap,skin graft area was transferred from donor-site to recipient-site.From April 2009 to August 2011,ten patients with large soft tissue defects in lower limbs were treated with modified latissimus dorsi flap.The size of skin and soft tissue defects range from 19 cm × 10 cm to 32 cm × 16 cm.Ten modified latissimus dorsi flaps had been used for coverage of these wounds,which were amplified 1-2 cm compared with the corresponding wounds.The size of skin flap was 20 cm × 6 cm-33 cm × 10 cm which was allowable to get direct closure of donor-site wounds.Results All the flaps and skin graft survived completely with no complication.Donor-site and recipient-site were primary closed and healing in all patients.All of the patients had got follow-up from 6 months to 36 months.All flaps survived with excellent color and quality,and no extremely fat contour.The results in donor site were satisfying and only left liner scar.It has no effect in the shoulder function.Conclusion The modified latissimus doris flap can provide with a huge amount of skin and soft tissue and be designed in various ways.It is a safe and reliable way to reconstruct huge skin and soft tissue defect in lower limbs.

Objective To explore the feasibility of building a new model of free superficial epigastric artery perforator flap with New Zealand white rabbits.Methods Twenty-five healthy New Zealand white rabbits were used.Five rabbits were dissected to assess the vascular territory,the source and dimension of the superficial epigastric.According to the anatomic results,the superficial epigastric artery perforator flap were designed and harvested with 6 cm× 3 cm in the abdominal,anastomosis had been done between femoral artery/vein and carotid artery,jugular venous to build an animal model of transplantation of epigastric artery perforator flap.The donor sites were directly closured.Results Superficial epigastric artery originated from the proximal femoral artery,and the diameter of superficial epigastric artery was (0.15 ±0.02) mm,2-3 perforators support the areas of the skin of the lower abdominal wall.A rabbit died in the surgery because of anesthesia,the other animals were alive.The results showed that all flaps were survived in the experiment except a flap lost due to venous crisis.Conclusion The experimental model of free superficial epigastric artery perforator flap can be built in New Zealand white rabbits.It is a simple,practical and reliable model for future physiologic and pharmacologic studies.

Objective To investigate the change of dynamic expression of t-PA and PAI-1 during early venous crisis after free perforator flap transplantation.Methods Thirty healthy New Zealand white rabbits weighed 2.5-3.0 kg were chosen and randomly divided into experimental group (n =15) and control group (n =15).Free transplantation of superficial epigastric artery perforator flap (SEAPF) was implemented in all rabbits firstly.Then the model of venous crisis was established by ligating the anastomosis vein in order to interrupt venous blood outflow in experimental group.The blood supply of all flaps was monitored by observing their color,swelling degree and the filling reaction of the capillaries after operation.Peripheral blood was drawn from femoral artery at different time point for measuring the concentration of t-PA and PAI-1 by Elisa.Partial flap tissue was harvested for pathological examination at corresponding time point.Data analysis was performed by using SPSS 17.0 statistical software.P ＜ 0.05 was considered statistically significant.Results One rabbit died of anesthesia,and the venous congestion was observed in 1 rabbit in control group.The models of free transplantation of SEAPF and venous crisis were established successfully in the remaining rabbits.No significant appearance change was observed within 1 h after the outflow vein being ligated,while typical appearance of venous crisis could be observed 2 hours after the outflow vein being ligated.Compared with the control group,the concentration of t-PA was lower,but the concentration of PAI-1 was higher in experimental group at 2 hours,4 hours,6 hours,8 hours after the outflow vein being ligated(P ＜ 0.05).However,there was no obvious differences between two groups at other time points (P ＞ 0.05).The pathological examination showed the red cells gradually got together and adhered to the venous wall,eventually the microcirculation had been blocked completely and theflap became necrosis after venous crisis being occurred.Conclusion t-PA and PAI-1 can't be used to diagnose early venous crisis of perforator flap transplantation.