Objective To investigate the microcirculative route of the arterialized venous flap.Methods Selecting 15 Chinese white rabbits designed the model of arterialized venous flap by anastomosis with from the central artery to central vein.The reversed blood flow perfusion was directly observed by the "ear windows" under the microscope and,simultaneous recording the changes in the microcirculation of the flap.Results All of the flaps were alived.The structure of the capillary net in the flap was a stereo-net .In the early arterialized stage,the upstream blood flows quickly in the venule;there was no blood flowing in the capillary net with the opening of the capillary net,the reconstructed procedure of the non-physilogical microcirculation was accomplished:the arterial blood mainly flow through small vein and venule,finally arrived the capillary net.Conclusions Keep up the drainage vein free,the arterialized venousflap could be alived by reconstructed effective microcirculation through the venous system.

BACKGROUND: Both apoptosis suppression gene Bcl-2 and apoptosis in duction gene Bax take parts in the apoptosis of neurons in ischemic penum bra. Whether would the polypeptide from chlamys farreri that is proved to be of anti-oxidation and anti-apoptosis in vitro protect the ischemic neurons from apoptosis? OBJECTIVE: To observe the effect of chlamys farreri on the Bcl-2 and Bax protein-associated apoptosis in penumbra and its role in neuron protection. DESIGN: A randomized trial.SETTING: Department of Anatomy, Medical College of Qingdao University.MATERIALS: The trial was conducted in Nerve Anatomy Laboratory of Medical College of Qingdao University from March to April 2000. The subjects were 32 adult Wistar rats that were randomly and averagely assigned into 4 groups: polypeptide chlamys farreri group, sterile water group, model control group and sham group. The chlamys farreri was provided by the Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences.INTERVENTIONS: Model of brain ischemia and reperfusion was made in rats in polypeptide chlamys farreri, sterile water and model control group by occlusion of middle cerebral artery. The model was not established in rats in sham group. The rats in chlamys farreri group received intraperitoneal injection of chlamys farreri of volume fraction 0. 1 at the dose of 0. 1 mL/kg each day for 2 days prior to modeling and an extra injection 15 minutes just before modeling. And the rats in sterile water group received intraperitoneal injec tion of sterile water with the dose of 0. 1 mL/kg each for two days and an extra injection 15 minutes before modeling. Those in model control group and sham group were exposed to nothing. Then models were established in rats in chlamys farreri, sterile water and model control group by inserting 4-0 nylons sutures from external carotid artery through bifurcation of carotid artery,extracranial and intracranial segments of internal carotid artery till the initial part of middle cerebral artery to make acute ischemia of middle cerebral artery perfusion area. The model was considered successful by the presentation of Horner' s syndrome, adduction-flexion of right forearm when tail being lifted and right turning during walk of the rat. The rats in sham group underwent the same procedures as that in the other groups except for the occlusion of middle cerebral artery. Then brains of the rats were taken for immunohistochemical determination of Bcl-2 and Bax proteins. The protein expression was expressed by absorbance of the products of their immunological reaction.MAIN OUTCOME MEASURES: The expression differences betweenBcl-2 and Bax proteins in penumbras of the groups.RESULTS: There were 32 rats entered the stage of analysis after complement of subjects. ① Bcl-2 expression in penumbra: The absorbance in model control group and sterile water group were higher than that in sham group (0.453±0.048,0.510±0.061,0.211±0.023, F=683.78, q=21.13 to 24.74, P ＜ 0.01), and that in chlamys farreri group(0. 954 ±0. 059) was more than that in model control group and sterile water group( q = 38.08 to 41.69, P ＜ 0.01) . ② Bax expression in penumbra: The absorbance in model control group and sterile water group were higher than that in sham group (0. 834 ±0. 082, 0. 790 ±0. 102, 0. 125 ±0. 017, F=590.44, q =49.57 to 51.98, P ＜ 0.01 ) ] and that in chlamys farreri group (0.471 ± 0. 045 ) was suppressed as compared with that in model control group and sterile water group(q=23. 80 to 26. 23, P ＜0. 01).CONCLUSION: Chlamys farreri is capable of increasing Bcl-2 protein and decreasing Bax protein in cerebral penumbra to brake the initiation of neuron apoptosis after ischemia-reperfusion and preserve neuronic function in penumbra.

Objective To study the immunohistochemistry change of neuronal nitric oxide synthase(nNOS) during the chronic spinal cord compression. Methods 18 healthy rabbits were randomly divided into normal,control and compressed groups.Membranous sac filled with cardiografin was applied to produce an animal model of chronic spinal cord compression.The sac was gradually enlarged resulting in chronic spinal cord compression in compressed groups for 12 weeks.Nissl's staining was applied to observe histopathological change and immunohistochemistry to nNOS change. Results The damage of motorneurons in the compressed block of compressed group was observed.No histopathological change was observed in normal and control groups.The number of nNOS positive motor neurons in the compressed block of compressed group was higher than that in the blocks of other groups.Conclusion\ The NO synthesis increased in chronic spinal cord injury.\;[

BACKGROUND:The sodium alginate film, jointly developed by our research team and the Institute of Polymer Material of Qingdao University, has good biocompatibility and is often used for the preparation of a variety of composite materials. OBJECTIVE: To observe the effect of sodium alginate film wrapping and covering nerve anastomotic stoma on the regeneration of injured sciatic nerve in rats. METHODS: A total of 36 male Wistar rats were randomly divided into two groups after the right sciatic nerve was cut. Control group: The nerve stump was sutured through epineurial end-to-end anastomosis; Experimental group: The nerve stump was sutured through epineurial end-to-end anastomosis, and wrapped with sodium alginate film, forming a regenerative environment for sciatic nerve regeneration. The degradation and absorption of sodium alginate film, as wel as the adhesion at suture site were observed post-operation. Interleukin-2 and interleukin-4 positive expression was detected with immunohistochemistry method. The histological sections were also detected with hematoxylin-eosin staining and osmium tetroxide staining. RESULTS AND CONCLUSION:At 4-6 weeks post-operation, sodium alginate film was mostly degraded and absorbed in the experimental group. The experimental group rats had less local adhesion, slighter infiltration of inflammatory cels, and fewer fiber tissue hyperplasia than control group rats. The contents of interleukin-2 and interleukin-4 were almost the same between the control and experimental groups at 1, 7, 14 days post-operation. At 6 weeks, the regenerated nerve fibers were distributed evenly with uniform shape, the number of nerve fibers, axons and myelin sheath were significantly better than the control group (P < 0.05). Sodium alginate film has good biological degradability and histocompatibility and plays an important role in promoting sciatic nerve regeneration.

This article summarized perioperative nursing experience of 6 patients underwent percutaneous microwave or radiofrequency ablation liver partition and portal vein embolization for planned hepatectomy(PALPP).The key points of nursing included:psychological counseling applied throughout the perioperative treatment;personalized preoperative biliary drainage;nursing intervention targeting at Enhanced Recovery After Surgery(ERAS);complication-directed prevention and nursing after microwave or radiofrequency ablation,portal vein embolization,and radical hepatectomy.All 6 patients were recovered and discharged successfully.

Objective To investigate the expressions of CXCR4,MMP-2 and VEGF in pancreatic carcinoma and the relationship with biological behavior of pancreatic carcinoma.Methods Immunohistochemical PV6000 technique was used to detect the expression of CXCR4,MMP-2 and VEGF in 47 cases of pancreatic carcinoma tissues,and the relationship between the expressions and pathologic parameters,and the relationship among the expressions of the 3 proteins were analysed.Results The expression rates of CXCR-4,MMP-2 and VEGF were 72.3%,66.O%and 61.7%in pancreatic carcinoma tissues,and all these proteins were correlated with metastasis,clinical staging and prognosis(X2=5.84～12.69;P＜0.05).The expression of CXCR-4,MMP-2 and VEGF was not correlated with sex,age,tumor size and differentiation(X2=0.03～4.27;P＞0.05).There was a positive relationship between the expression of CXCR-4 and MMP-2 or VEGF in pancreatic carcinoma(r=0.587,0.521;P＜0.01).Conclusions CXCR-4 could up-regulate the expression of MMP-2 and VEGF in pancreatic carcinoma,and they may contribute to metastasis and invasion of pancreatic carcinoma.

Anatomic structure in craniofacial region is very complicated and orthognathic surgery is difficultly performed.Therefore,it is necessary to generate virtual surgical model from CT scan data before operation on personal computer in order to make surgery more accurate.This technique has been increasingly interested in the field of orthognathic surgery both at home and abroad.The sample was scanned with thin-layer CT.CT image data (336 layer,1.0 mm slice thickness) were analyzed with the Mimics software.Simultaneously,three-dimensional model and virtual surgery of the facial cranium were established.The digitized virtual surgical platform of facial cranium was preliminarily created,and three common surgical methods in maxillofacial surgery,i.e.,LeFort Ⅰ osteotomy,mandibular angle osteotomy,and genioplasty,for maxillofacial surgery were simulated.The results showed that the digitized virtual surgical platform of facial cranium could be generated with the Mimics software on personal computer,which provides convenient and quick methods for research,teaching,and clinical surgery.More importantly,it creates theoretical basis for virtual surgical platform which can be widely used on personal computer.

OBJECTIVE To investigate the clinical character and risk factor of nosocomial lower respiratory tract(infection)(NLRTI) due to Burkholderia cepacia in intensive care units(ICU) and discuss how to control infection.METHODS The clinical data of 37 cases were reviewed and analyzed,and 43 cases with non-B.cepacia NLRTI served as control group.RESULTS The difference in ICU stay time,mechanical ventilation,bronchoscopy,H_2-receptor blocker/antacid,use of antibiotics≥2 kinds and vein catheter between patients with and without B.cepacia(NLRTI) was statistically significant.CONCLUSIONS ICU stay time,mechanical ventilation,bronchoscopy,(H_2-receptor) blocker/antacid,use of antibiotics≥2 kinds and vein catheter are risk factors of B.cepacia NLRTI.Susceptibility of antibiotics to B.cepacia showed multidrug resistance to which should be paid attention in ICU,respiratory tract invasive operation limitation,medical facility sterilization and rational use of antibiotics are very important.

Objective:To investigate the effects of laparoscopic surgery versus open surgery on acute appendicitis in children. Methods:We retrospectively analyzed the data of 50 children with acute appendicitis who underwent surgery in Zhoushan Women and Children Hospital from December 2016 to December 2019. They were randomly divided into observation ( n = 27) and control ( n = 23) groups. The observation group underwent three-port laparoscopy. The control group underwent open surgery. Operation-related indicators, postoperative recovery, parental satisfaction, and complications were compared between the two groups. Results:Operative time was significantly longer in the observation group than in the control group [(56.57 ± 5.35) minutes vs. (40.23 ± 6.31) minutes, t = 9.78, P < 0.001). Intraoperative blood loss was significantly less in the observation group than in the control group [(10.11 ± 2.36) mL vs. (18.36 ± 3.21) mL, t = 10.45, P < 0.001]. Duration of pain was significantly shorter in the observation group than in the control group [(1.23 ± 0.23) days vs. (2.98 ± 0.87) days, t = 10.06, P < 0.001). Time to postoperative exhaust was significantly shorter in the observation group than in the control group [(21.39 ± 4.35) minutes vs. (39.88 ±5.39) minutes, t = 13.35, P < 0.001]. Time to defection was significantly shorter in the observation group than in the control group [(50.12 ± 3.35) minutes vs. (61.23 ± 4.21) minutes, t = 10.33, P < 0.001]. Time to first diet was significantly shorter in the observation group than in the control group [(13.25 ± 2.56) hours vs. (19.96 ± 2.67) hours, t = 9.07, P < 0.001]. Length of hospital stay in the observation group was significantly shorter in the observation group than in the control group [(4.13 ± 1.12) days vs. (7.98 ± 1.96) days, t = 8.53, P < 0.001). Parental satisfaction was significantly higher in the observation group than in the control group [96.30% vs. 47.83%, χ2 = 13.360, P < 0.001]. The incidence of complications was significantly lower in the observation group than in the control group [7.41% vs. 52.17%, χ2 = 10.58, P < 0.001]. Conclusion:Laparoscopic surgery is superior and safer to open surgery in the treatment of acute appendicitis in children.

ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.