Objective To study the influence of intraoperative use of saline and balanced salt solution on postoperative nerve function recovery in patients with brain trauma.Methods Totally 120 patients were randomly divided into the saline group and the balanced salt solu-tion group,and the postoperative nerve function recovery of the two groups were observed.Results The level of pH and HCO3 -24 hours af-ter operation in the saline group were lower than those in the balanced salt solution group (P <0.05),while the level of Cl - in the saline group was higer than that in the balanced salt solution group (P <0.05).The intracranial pressure and preoperative Glasgow coma score (GCS)of the two groups had no statistical significance (P =0.94).And the Glasgow coma score at 336 hours and 672 hours after opreation of the two groups were of statistical significance (P =0.00,P =0.03).The mortality of the saline group and the balanced solution group 28days after surgery were 15% and 10% respectively,and there was no significant difference between the two groups (P =0.58).Conclusion Saline resuscitation during surgery would lead to hyperchloremic acidosis as well as worse nerve function.However,the perfusion of balanced salt solution during the operation is more favorable to the recovery of neurological function.

Objeetive To investigate the outcome of microvascular reconstruction of the tongue with anterolateral thigh flaps in the treatment of middle-late stage tongue cancer patients. Methods From December 2003 to March 2007,nine patients underwent simultaneous reconstruction of the tongue and oral floor defects with anterolateral thigh flaps after resection of squamous cell carcinoma of tongue.The flaps ranged from 7 cm×10 cm to 10 cm×12 cm in size,and were adjusted to the defect of the tongue and oral floor.The vascular pedicle included descending branch of the lateral femoral circumflex artery and the accompanying veins.The outcome of reconstruction was evaluated by follow-up examinations,considering the contour and mobility of the reconstructed tongues,the swallowing function and the speech function.Results All of the donor sites were closed directly,with minimal donor-site morbidity. All patients recovered unevenffully from surgery,with no immediate postoperative complications:no flap necrosis,no wound infection or wound dehiscence.The transplanted flaps survived well.The average follow-up period was 18 months.During the follow-up period there was no tumor recurrence and the contour of the reconstructed tongues showed sufficient bulk.The patients demonstrated good mobility of the reconstructed tongue.The swallowing and speech function recovered satisfactory.Two months postoperatively the patients were able to ingest a solid or semisolid diet,and six months postoperatively the patients developed intelligibe language.Conclusion The anterolateral thigh flaps are suitable and reliable for the microsurgical reconstruction of the large defects caused by middle-late stage tongue cancer.

In order to investigate the biological function of transforming growth factor-β1 (TGF-β1) during fibrosis in denervated skeletal muscle, we recruited sciatic nerve injury model of SD rats in which denervated gastrocnemius was isolated for analysis. At different time points after operation, denervated muscle was examined by several methods. Masson trichrome staining showed morphological changes of denervated skeletal muscle. Quantitative RT-PCR detected the rapid increase of TGF-β1 expression at mRNA level after nerve injury. It was found that a peak of TGF-β1 mRNA expression appeared one week post-operation. The expression of collagen I (COL I) mRNA was up-regulated in the nerve injury model as well, and reached highest level two weeks post-injury. Immunoblot revealed similar expression pattern of TGF-β1 and COL I in denervated muscles at protein level. In addition, we found that the area of the gastrocnemius muscle fiber was decreased gradually along with increased interstitital fibrosis. Interestingly, this pathological change could be prevented, at least partly, by local injection of TGF-β1 antibodies, which could be contributed to the reduced production of COL I by inhibiting function of TGF-β1. Taken together, in this study, we demonstrated that the expression of TGF-β1 was increased significantly in denervated skeletal muscle, which might play a crucial role during muscle fibrosis after nerve transection.

Objective To explore the advantages and disadvantages of ultrasound guided puncture microwave ablation and traditional surgical treatment of nodular goiter.Methods From January 2014 to June 2015,102 cases of nodular goiter who were treated in the Traditional Chinese Medicine Hospital of Gaozhou Affiliated to Guangzhou University of Traditional Chinese Medicine were randomly divided into two groups,51 cases in each group.Respectively by ultrasound guided puncture nodules of thyroid swollen microwave ablation (microwave ablation group) and traditional operation type removed most of the thyroid nodules (traditional surgery group) in the treatment of containing.The amount of bleeding,operation time,hospital stay,medical cost,clinical efficacy,postoperative complications and the degree of pain,and thyroid function were compared between the two groups.Results The amount of bleeding,operation time and length of hospital stay in the microwave ablation group were better than those in the traditional operation group((2.02±0.79) ml vs.(28.24±18.49) ml,(34.20 ±9.60) min vs.(75.59±25.41) min,(3.55± 1.05) d vs.(10.27±2.68) d),the medical cost of the microwave ablation group was higher than that of the traditional operation group((14 341±593) yuan vs.(5 812±970) yuan),the differences were statistically significant (t =-10.12,-10.88,-16.68,53.54;P ＜0.01).There were significant difference in terms of the postoperative pain and complications between the groups (x2=50.86,13.22;P＜0.01).The total absorption rate was 100％ in 18 months after the ablation of the nodule.There was no significant difference about postoperative residual small nodules between the two groups(P ＞0.05).Conclusion Compared with the traditional treatment,the microwave ablation treatment of nodular goiter with less complications,is a new technique of minimally invasive,beauty,safe and feasible,the exact clinical effect,and worthy of popularization and application.

[ ABSTRACT] AIM: To investigate the influence of advanced glycosylation end products-modified bovine serum albumin (AGE-BSA) on mammalian target of rapamycin complex 1 (mTORC1), urokinase-type plasminogen activator re-ceptor ( uPAR) , and cell mobility in the podocytes, and to further explore the probable relationship.METHODS: The conditionally immortalized mouse podocyte cell line was cultured in vitro.MTT assay and immunofluorescence were used to analyze the cell viability and cytoskeleton of the podocytes treated with the stimuli and intervention agents.The activity of mTORC1 and the expression level of uPAR in normal podocytes and podocytes treated with control BSA or AGE-BSA were detected by Western blotting.The migration ability of the podocytes was determined by would-healing assay.Rapamycin was added to inhibit the activity of mTORC1 along with the addition of AGE-BSA to observe the changes of uPAR and the motility of podocytes.RESULTS:No significant difference of the cell viability or cytoskeleton in the podocytes treated with the stimuli and intervention agents was observed.AGE-BSA up-regulated the activity of mTORC1 and the expression of uPAR, and induced the high mobility of the podocytes.Rapamycin obviously reduced the high expression level of uPAR and the increase in the migration ability of podocytes caused by AGE-BSA treatment.CONCLUSION: AGE-BSA might cause the high migration of podocytes through the mTORC1/uPAR signaling pathway.

Objective To investigate the expression of peroxiredoxin 1 (Prx 1) in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to evaluate the relationship between the expressions of Prx 1 and the postoperative recurrence of this disease. Methods Immunohisto chemistry and Western blotting were performed to examine the expression of Prx 1 protein in 40 patients with HCC with PVTT. Experiments on Sprague Dawley (SD) rat hepatoma model were further carried out to observe the pathological changes of Prx 1 by immunohistochemistry. Clinical outcomes were analyzed to find a correlation between the recurrence and positive rate of Prx 1. Results The expression level of Prx 1 was significantly up-regulated in primary tumor tissues than in tumor thrombosis samples (P＜0.01). Immunohistochemistry results showed that the positive rate of Prx 1 in primary tumor tissues were higher than that in tumor thrombosis. Western blotting confirmed a same trend in the level of Prx 1, the average luminosity of the blots were 1534.2 and 735.6, respectively. There was a significant difference in SD rat hepatoma model, the 4, 8, 12, 16, 20 and 24-week positive rates of Prx 1 in liver tumor tissues were 60%, 80%, 75% ,65%, 40% and 25% respectively. Clinical outcomes showed that the time to first postoperative recurrence of Prx 1 in the primary tumor positive group was significantly higher than that in the negative group (6. 3 vs 3. 7 months, P＜0. 01). Conclusions Prx 1 protein was down-regulated in HCC with PVTT. There was a negative correlation between the expression of Prx 1 and recurrence.

OBJECTIVETo detect the mutation sites of exons 2, 20, 11A and 11B in Chinese patients with breast cancer.

METHODSA total of 86 patients with breast cancer without blood relationship were randomly selected. Polymerase chain reaction (PCR) and double-strand DNA direct sequencing were applied.

RESULTSNo mutations, especially deletions were found in exons 2, 20 and 11 with carefully checking the sequencing results, although they were reported frequently in Europe populations with breast cancer. We found one polymorphism in exon 11, with high frequency, and in the test of chi-square, the frequencies of two alleles had no significant difference between the patients and controls.

CONCLUSIONThe above results suggest this SNP may not be associated with the breast cancer in Chinese population, and indicates that the gene sequence of what we have studied doesn't account much for occurrence of the breast cancer in the population of China.

Asian Continental Ancestry Group ; genetics ; BRCA1 Protein ; genetics ; Breast Neoplasms ; genetics ; Exons ; Female ; Gene Frequency ; Humans ; Mutation ; Polymorphism, Genetic

Objective To explore the value of minimally invasive puncturation via the hard tunnel in decompression before craniotomy for acute subdural hematoma combined with cerebral hernia.Methods A retrospective method was adopted to analyze the clinical data of 303 patients with traumatic acute subdural hematoma combined with cerebral hernia treated from January 2004 to October 2016.There were 206 males and 97 females,with age range of 12-77 years [(43.6 ± 20.1) years].The Glasgow coma scale (GCS) was 3-5 points in 187 patients and 6-8 points in 116.The patients were divided into study group (n =199) and control group (n =104) according to the different surgical procedures.For study group,the patients were treated with disposable ventricular needle to suck out and drain the intracranial hematoma,and the skull was opened through the large craniotomy to remove the subdural hematoma.For control group,the skull was opened through the large craniotomy which was used to directly remove the subdural hematoma according to the traditional instruction.The differences between two groups were compared with regard to time from confirming the cerebral hernia to the first decompression,time of regaining consciousness after surgery,hospitalization duration and cranial cavity infection after surgery.Glasgow outcome scale (GOS) was used to evaluate the prognosis.Results The time to first decompression was 10-15 minutes [(12.5 ± 1.7)minutes] in study group and 50-75 minutes [(133.0 ± 7.9) minutes] in control group (P ＜ 0.05).Regaining consciousness within 3 days after surgery was found in 62 patients of study group and 18 of control group.Regaining consciousness at days 4-7 after surgery was found in 76 patients of study group and 22 of control group.Regaining consciousness at days 8-15 days after surgery was found in 26 patients of study group and 29 of control group.Regaining consciousness over 15 days after surgery was found in 10 patients of study group and 12 of control group.Postoperative unconsciousness including death was found in 25 patients of study group and 23 of control group (P ＜ 0.05).The hospitalization duration was (19.5 ± 1.1) days in study group and (22.8 ± 2.8) days in control group (P ＜ 0.05).No cranial cavity infection was found in study group,while cranial cavity infection occurred in one patient in control group.According to the GOS,the outcome in study group was good in 133 patients,moderate to severe disability in 41,vegetative state in 7 and death in 18,while the outcome in control group was good in 34 patients,moderate to severe disability in 47,vegetative state in 9 and death in 14 (P ＜ 0.05).Conclusion The minimally invasive puncturation via the hard tunnel to remove the hematoma is capable of reducing the intracranial pressure before craniotomy for acute subdural hematoma combined with cerebral hernia,can decrease the disability rate and hence is prioritized to clinical application.

OBJECTIVETo analyze the relationship between hemomyelogram and sererity of acute appendicitis and identify the best routine blood test feature for perforation.

METHODS721 patients were included in this study, all of whom underwent appendectomy for the clinical diagnosis of appendicitis during the years of 2010-2013. The initial preoperative hemomyelogram was evaluated at different stages of appendicitis. The area under the ROC curve was used to assess the clinical feature with greater diagnostic accuracy of perforation. Total lymphocyte counts of 1.83 was used in the prediction of perforative appendicitis. A group of 467 patients was used for validation to confirm the diagnostic value of the cut-off value.

RESULTSThe percentage of lymphocytes had the closest association with the evolutionary phase of acute appendicitis. Total lymphocyte counts < or=1.83 indicated perforation, with high sensitivity and low specificity.

CONCLUSIONThe percentage of lymphocytes and total lymphocyte counts are helpful as a diagnostic paramete for different stages of acute appendicitis.

Acute Disease ; Appendectomy ; Appendicitis ; diagnosis ; Humans ; Lymphocyte Count ; ROC Curve ; Sensitivity and Specificity

The aim of this study was to investigate the mechanism of deposition of extracellular matrix induced by TGF-β1 in skeletal muscle-derived stem cells (MDSCs). Rat skeletal MDSCs were obtained by using preplate technique, and divided into four groups: group A (control group), group B (treated with TGF-β1, 10 ng/mL), group C (treated with TGF-β1 and anti-connective tissue growth factor (CTGF), both in 10 ng/mL), and group D (treated with anti-CTGF, 10 ng/mL). The expression of CTGF, collagen type-I (COL-I) and collagen type-III (COL-III) in MDSCs was examined by using RT-PCR, Western blot and immunofluorescent stain. It was found that one day after TGF-β1 treatment, the expression of CTGF, COL-I and COL-III was increased dramatically. CTGF expression reached the peak on the day 2, and then decreased rapidly to a level of control group on the day 5. COL-I and COL-III mRNA levels were overexpresed on the day 2 and 3 respectively, while their protein expression levels were up-regulated on the day 2 and reached the peak on the day 7. In group C, anti-CTGF could partly suppress the overexpression of COL-I and COL-II induced by TGF-β1 one day after adding CTGF antibody. It was concluded that TGF-β1 could induce MDSCs to express CTGF, and promote the production of COL-I and COL-III. In contrast, CTGF antibody could partially inhibit the effect of TGF-β1 on the MDSCs by reducing the expression of COL-I and COL-III. Taken together, we demonstrated that TGF-β1-CTGF signaling played a crucial role in MDSCs synthesizing collagen proteins in vitro, which provided theoretical basis for exploring the methods postponing skeletal muscle fibrosis after nerve injury.
Animals ; Cell Differentiation ; drug effects ; physiology ; Cells, Cultured ; Fibrillar Collagens ; biosynthesis ; Male ; Myoblasts, Skeletal ; cytology ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; cytology ; drug effects ; metabolism ; Transforming Growth Factor beta1 ; pharmacology