Objective Extrapolate the relationships between the width of circumferential rectal mucosa re-sected and the method of either performing single purse-string or performing double purse-string during per-forming the procedure for prolapse and hemorrhoids (PPH), and to assess the impact of both the level of sta-ple line and the width of rectal mucosa resected on clinical outcomes after stapled hemorrhoidpexy. Meth-ods Twenty-eight adult patients with Ⅲ-Ⅳ hemorrhoids were assigned to two groups: 15 patients using sin-gle pursestring and the remaining 13 patients using double purse-string. The mucosal width of doughtnuts of both groups were measured and the data recorded. The doughtnuts resected were sent to pathology examina-tion after stapled hemorrhoids pexy to identify whether or not the specimens involved the smoth muscles. The demographic complications (bleeding, postoperative pain, urinary retention, fecal urgency) were compared and statistically analysed between the two groups, respectively. Results There were no statistical differ-ences between the two groups in terms of postoperative short-term results and complication rates, as well as the proportion of involving smooth muscle in specimens(P >0.05). However, when compared the width of doughtnuts resected in single-pursestring group was smaller than that in double-parse-string group (P < 0. 01). Conclusion The single or double-purse-string suture in PPH can control the width of resected rectal mucosa.

OBJECTIVE: To evaluate the effects of the therapy mainly for strengthening healthy energy to promote blood circulation in treating diabetic patients with gangrene. METHODS: A series of 112 diabetic patients with gangrene were investigated before and after treatment in the changes of wounds, clinical symptoms and quality of life. RESULTS: Fifty-eight cases were cured, 12 cases showed response, 36 cases improved, and 6 cases failure of treatment. The total obvious effect rate was 62.5% (70/112) and the amputation rate was 8.9% (10/112). The 104 diabetic cases of three-stage gangrene were classified into grade I, II and III. The total effect rates of the diabetic cases of grade I, II and III were 83.3% (30/36), 55.6% (35/63) and 20% (1/5), and the amputation rates were 0%, 12.7% (8/63), and 40% (2/5) respectively. After the treatment, the clinical symptoms, gangrene number, gangrene area and gangrene depth were obviously improved (P<0.05), and the quality of life was obviously improved (P<0.01), especially in physical condition, emotional well-being and therapeutic effects on patients (P<0.05). CONCLUSION: Strengthening healthy energy to promote blood circulation is effective in treating diabetic patients with gangrene.

DNA End-Joining Repair ; Humans ; Immunologic Deficiency Syndromes ; genetics

Hypoxic-ischemic brain damage is a serious complication of perinatal asphyxia. Enriched environment is the living condi-tions for the promotion of feeling, cognition and behavior. Enriched environment may promote the repairing of hypoxic-ischemic brain dam-age in term of praxiology, morphology and molecular biology, that enriched environment may regulate the secretion and release of various factors, and enhance synaptic plasticity, induce neuron regeneration, inhibit its apoptosis, and result in ethological and morphological recov-ery.

Objective To investigate the effect of exercise preconditioning on serum level of tumor necrosis factor α (TNF-α), interleukin (IL) -1β and IL-6 in rats after cerebral ischemia-reperfusion (I/R). Methods 24 male Sprague-Dawley rats were randomly divided into exercise preconditioning group (n=8), model group (n=8) and sham group (n=8). The middle cerebral arteries were occluded for 120 min and re-perfused. All the rats were evaluated with neurological deficit score 2 hours, 24 hours after I/R. The serum levels of TNF-α, IL-1β and IL-6 was detected with enzyme-linked immunosorbent, and the pathology was observed with HE staining 24 hours after I/R. Results The neurological deficit score decreased in the exercise preconditioning group compared with that in the model group, as well as the serum TNF-α, IL-1β and IL-6 (P<0.05) 24 hours after I/R. The pathological damage and interstitial edema alleviated in cerebral ischemia cortical, and the degeneration and necrosis of the neurons in the ischemic area significantly reduced in the exercise preconditioning group. Conclusion Exercise preconditioning may inhibit inflammatory response in I/R rats to protect neurological function from impairment.

Objective To study the effect of cluster needling of scalp acupuncture combined with rehabilitation on neurological function and expression of basic fibroblast growth factor (bFGF) and angiostatin (AS) in rats after focal cerebral ischemia. Methods 90 male Sprague-Dawley rats were randomly divided into sham operation group, model group, acupuncture treatment group, rehabilitation treatment group and acupuncture and rehabilitation treatment group, each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Permanent cerebral ischemia rat model was established according to Longa's method. The model group and the sham operation group accepted no treatment, the acupuncture treatment group was treated by cluster needling of scalp acupuncture, the rehabilitation treatment group received the treadmill training, the acupuncture and rehabilitation treatment group was treated by acupuncture and rehabilitation therapy. 3 days, 7 days, 14 days after operation, the neural function was evaluated with the modified Neurological Severity Score (mNSS), the expression levels of bFGF and AS proteins were detected by Western blotting. Results Compared with the model group, the acupuncture treatment group and the rehabilitation treatment group, mNSS decreased, the expression of bFGF protein increased, and the expression of AS protein decreased in the acupuncture and rehabilitation treatment group 3 days, 7 days, 14 days after operation (P<0.05). Conclusion Acupuncture and rehabilitation therapy can reduce the neurological function defect in rats with focal cerebral ischemia, which may be related to the upregulation of bFGF protein expression and down-regulation of AS protein expression.

Objective This study aimed to analyze the clinical features of novel H7N9 avian influenza virus infection in human and its prognosis after integrative treatment.Methods Eighteen H7N9 infected patients were admitted to Shanghai Public Health Clinical Center from 5 April 2013 to 19 April 2013,and were divided into mild group (8 cases) and severe group (10 cases) based on their baseline disease conditions.Patients in mild group were administered modified Yinqiao powder and Shengjiang powder,while patients in severe group were administered modified Qinwen Baidu Decoction or Xuanbai Chengqi Decoction,in addition to antiviral,anti infection,glucocorticoids and human immunoglobulin treatment in both groups.Baseline characteristics and outcomes of these patients were analyzed,and factors associated with prognosis were also evaluated.Measurement data were compared by t test or rank sum test,categorical variables were compared by chi square test or Fisher exact test.Factors associated with prognosis were evaluated by Logistic regression analysis.Results Compared to mild group,patients in severe group suffered from a significantly elevated C reactive protein [(102.61± 30.80) mg/L vs (38.44± 22.31) mg/L; t=4.717,P＜0.01],and significantly lowered CD3+,CD4+,CD8+ and CD45+T cell levels (all P＜0.05).Compared to regimens with glucocorticoids and human immunoglobulin,traditional Chinese medicine (TCM) contained therapy achieved a higher recovery rate in H7N9 infected patients,but with no statistical significance (P＞0.05).Univariate Logistic regression analysis showed that myoglobin might be a risk factor associated with prognosis of H7N9 infection (P =0.029),and rnultivariable analysis showed that high levels of myoglobin might be negatively related to the prognosis of H7N9-infected patients,But with no statistical significance (P＝0.053).Conclusions Severe H7N9-infected patients suffer from active inflammation and lowered T cell mediated immune response.Integrative therapy is effective for novel H7N9 avian influenza virus infection,and helps to improve the outcomes of infected patients.

OBJECTIVE: To explore the effects of Chinese herbs for replenishing qi and resolving stagnation on hypoxia-inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) in granulation tissue of skin ulcers in rats with syndrome of blood stasis and qi deficiency. METHODS: Diabetic rats with back full-thickness skin lesion and syndrome of blood stasis and qi deficiency were divided in to five groups: untreated group, basic fibroblast growth factor (bFGF)-treated group, Yiqi Huayu Recipe (a recipe for replenishing qi and resolving stagnation)-treated group, Yiqi Recipe (a recipe for replenishing qi)-treated group and Huayu Recipe (a recipe for resolving stagnation)-treated group, and another eight normal rats served as normal control group. Immunohistochemical method and image analysis were used to test the expressions of HIF-1alpha and VEGF in granulation tissue of skin ulcers in rats with diabetes. RESULTS: In the untreated group, the expression of HIF-1alpha was significantly increased and the expression of VEGF was significantly decreased as compared with those in the normal control group (P<0.01). The expression of HIF-1alpha was obviously lower (P<0.01) and the expression of VEGF was significantly higher in the four drug treated groups as compared with those in the untreated group. In the Yiqi Huayu Recipe-treated group, the expression of HIF-1alpha was obviously lower than those in the bFGF-treated, Yiqi Recipe-treated and Huayu Recipe-treated groups (P<0.05 or P<0.01), and the expression of VEGF was significantly higher than that in the bFGF-treated group (P<0.01). CONCLUSION: Chinese herbs for replenishing qi and resolving stagnation can promote the wound healing in rats through reducing the expression of HIF-1alpha, accelerating the expression of VEGF in granulation tissue of skin ulcers in rats with diabetes and ameliorating the status of ischemia and hypoxia.

Objective To study the expression and significance of proliferation cell nuclear antigen (PCNA) ,cyclin dependent ki‐nase 4(CDK4) and p16INK4a in nonneoplastic epithelial disorders of vulvar(NNEDV) and explore the correlation of them .Methods Fifty‐two vulvar lesion samples(lesion group) and 52 vulvar skin surrounding the lesions samples(lesion‐adjacent group) were col‐lected from NNEDV patients ,and lesion group include 27 samples with squamous hyperplasia of vulvar(VSH) ,15 samples with li‐chen sclerosus of vulvar(VLS) and 10 samples containing both lesions(mixed‐lesion) .25 vulvar skin samples were collected from patients receiving perineal repair operation as control group .The expression of PCNA ,CDK4 and p16INK4a was detected by immuno‐histochemistry assay .Results The expression of PCNA in lesion group was significant higher than those in lesion‐adjacent group and control group (P< 0 .05) ,while there was no significant differences among VSH ,VLS and mixed lesion ,and there was no sig‐nificant difference between lesion adjacent group and control group (P> 0 .05) .The expression of CDK4 in lesion group and lesion‐adjacent group were significant higher than that in control group (P < 0 .05) ,while there weren′t significant differences among VSH ,VLS and mixed‐lesion (P> 0 .05) ,and there was no significant difference between lesions group and lesion‐adjacent group (P> 0 .05) .The expression of p16INK4a in lesion group was significant lower than those in lesion‐adjacent group and control group (P< 0 .05) ,while there was no significant differences among VSH ,VLS and mixed‐lesion (P> 0 .05) ,and there was no significant difference between lesion‐adjacent group and control group (P> 0 .05) .About PCNA and CDK4 ,there was a positive correlation in lesion group (P< 0 .05) and there were no correlations in other groups (P> 0 .05) .About PCNA and p16INK4a ,there was a negative correlation in lesion group (P< 0 .05) and there were no correlations in other groups (P > 0 .05) .About CDK4 and p16INK4a ,there were no correlations in all groups (P> 0 .05) .Conclusion expression of PCNA ,CDK4 and p16INK4a may be related of abnormal in‐creasing of cell proliferation and acceleration the process of cell cycle ,which may be applied to molecular target for treatment .