OBJECTIVETo discuss the reasons and the treatments for the femoral refracture.

METHODSFrom 2004 to 2008, 10 cases of femoral refracture after plate removal were selected and treated with open reduction and bone nail internal fixation, included 4 males and 6 females ranging from 19 to 48 years with an average age of 33 years old. According to Müller classification, there were 4 cases of type A, 3 of B, 3 of C. The skeletal tissues were taken for pathological analysis.

RESULTSTen patients were followed-up for 10 to 18 months (averaged 14 months). All wound healed at one stage,there were no complications. The fuction of lower limbs walking and weight loading werer recovered. Pathological section showed that part of the lamellar bone tissues were necrotic. The bone architectures were chaotic, micrangium blocked, Haversian canals were atrophy, new vessels and Haversian canals growed in necrotic bone. The tunnel in rigid bone and new Haversian system were formed. The structure was cutting cone. It was the process of new bone substitutting necrotic bone in bony remodeling.

CONCLUSIONThe internal fixation using ordinary plates overwhelmingly destroy blood circulation of bone and cause necrosis of bone. It can also effect bone remodeling and descent mechanical property. Refracture can readily happen after the plate removal. Treatment of open reduction and bone nail internal fixation can achieve excellent and good effect.

Adult ; Bone Plates ; Female ; Femoral Fractures ; pathology ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Recurrence

OBJECTIVETo evaluate the feasibility, the radicalness and efficacy of laparoscopy for advanced colorectal cancer.

METHODSFrom June 2006 to December 2007, laparoscopic surgery and open radical resection were performed in 191 cases of colorectal cancer. The curative effect and clinical data were collected and analyzed.

RESULTSThe patients were randomized to two groups, 98 patients underwent laparoscopic surgery and 93 open operation. Five cases(5.1%) were converted to open surgery in laparoscopic surgery group. The average intraoperative blood loss of open surgery group was(279.5+/-189.4) ml, while that of laparoscopic surgery group was(87.2+/-27.1) ml, the difference between the two groups was statistically significant(P=0.011). Within postoperative 48 hours, the intestinal function and early mobile physical activity were restored in 37.8% (37/98) and 30.6% (30/98) patients of laparoscopic surgery group, while in 6.5%(6/93, P=0.000) and 3.2% (3/93, P=0.000) patients of open surgery group, the differences between two groups were statistically significant. The average hospital stay of laparoscopic surgery group was (8.9+/-5.9) d, whereas open surgery group(12.1+/-7.6) d, the difference was statistically significant(P=0.036). No significant differences were found between the two groups in gender, age, tumor location, resection range of surgery, TNM staging, post-operative complication and lymph node harvest(P>0.05).

CONCLUSIONSLaparoscopic surgery is feasible for the patients with advanced colorectal cancer. The radicalness of laparoscopic surgery is similar to that of open surgery, and laparoscopic surgery can provide less intraoperative blood loss, better intestinal function restoration, early mobile physical activity and shorter hospital stay.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Laparotomy ; methods ; Male ; Middle Aged ; Neoplasm Staging

OBJECTIVEDingchuantang is a traditional Chinese medicine decoction which has the Qing, Xuan and Jiang components which have the ability to dispel (Xuan), depress (Jiang) and heat clear or febrigugal (Qing). It has been used for asthma and respiratory syncytial virus (RSV) infection. However, the therapeutic mechanisms of the decoction have not been identified. To understand the mechanism of the anti-RSV property of Dingchuantang, this study investigated the effects of Dingchuantang and its three components on the levels of interleukin-4 (IL-4) and interferon-gamma (gamma-IFN) in mice infected by RSV.

METHODSOne hundred and twenty mice were randomly assigned into Normal, Infected, Dingchuantang-treated, Qing component-treated, Xuan component-treated and Jiang component-treated groups (n=20 each). The RSV infection model was prepared in the rats from the last 5 groups. The 4 treatment groups were administered with Dingchuantang, Qing component, Xuan component and Jiang component by gastric lavage respectively 2 hrs after RSV innoculation. The contents of RSV in the lungs were tested by reverse transcription polymerase chain reaction (RT-PCR). The levels of IL-4 and gamma-IFN in broncho-alveolar lavage fluid (BALF) were measured by enzyme linked immunosorbent assay (ELISA).

RESULTSThe contents of RSV of lungs in the Dingchuantang-treated group, and Qing and Xuan component-treated groups were significantly lower than those in the untreated Infected group. There was no significant difference between the Jiang component-treated and the Infected group. Dingchuantang treatment decreased the IL-4 level and increased the gamma-IFN level. The Xuan and Jiang component treatment decreased the IL-4 level but had no effect on the gamma-IFN level, while the Qing component treatment increased the gamma-IFN level but had no effect on the IL-4 level.

CONCLUSIONSDingchuantang can inhibit RSV reproduction and this effect works by Qing and Xuan components. Dingchuantang can also restore the imbalance TH2/TH1 by depressing IL-4 levels, worked by Xuan and Jiang components, and increasing gamma-IFN levels, worked by Qing component.

Animals ; Female ; Interferon-gamma ; biosynthesis ; Interleukin-4 ; biosynthesis ; Mice ; Mice, Inbred BALB C ; Plant Extracts ; therapeutic use ; Respiratory Syncytial Virus Infections ; drug therapy ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology

AIMTo establish the methods for determining the activity of sphingosine kinase(SPK) and the content of sphingosine 1-phosphate (S1P) in biological samples.

METHODSThe ECV304 cells were transfected with pcDNA3 vector encoding Flag-labeled SPK gene. The expression of SPK was measured by Western blot assay and the activity of SPK was determined by enzymatic reaction, isotope incorporation and thin-layer chromatography methods. The S1P in biological samples was extracted, digested by alkaline phosphatase and then catalyzed by SPK. The S1P contents were determined according to the amounts of products.

RESULTSSPK gene transfection could enhance the expression and activity of SPK in cells markedly, and the cellular S1P was also increased obviously. HGF stimulation could increase the activity of SPK and cellular S1P in ECV304 cells.

CONCLUSIONMethods for determining the activity of SPK and the content of SPK in biological samples were established.

Cell Line ; Cytophotometry ; Humans ; Isotope Labeling ; Lysophospholipids ; metabolism ; Phosphotransferases (Alcohol Group Acceptor) ; metabolism ; Sphingosine ; analogs & derivatives ; metabolism

OBJECTIVETo explore the indication and efficacy of transanal local excision for low rectal cancer.

METHODSA total of 40 consecutive patients undergoing transanal local excision of low rectal cancer were analyzed retrospectively.

RESULTSThe mean operative time was 50 (30-85) minutes. The mean intraoperative blood loss was 40 (10-100) ml. The mean hospital stay was 5 (2-10) days. The local recurrence rate was 20.0% (8/40). The 5-year survival rate was 90.0%. Local recurrence rate was 17.9% (5/28 cases) for T1, and 25.0% (3/12) for T2 lesions. However, the difference between the two groups was not statistically significant (P=0.61). Local recurrence rate was significantly lower for moderate differentiated than that for well-differentiated cancer [12.9% (4/31) vs. 44.4% (4/9), P=0.037]. Tumor diameter less than 3 cm was associated with a significantly lower local recurrence rate as compared to the counterparts (10.7% vs. 41.7%, P=0.03). No significant correlations were found between local recurrence and other variables including tumor location (P=0.93), tumor classification (P=0.53), and method of surgical excision (P=0.41).

CONCLUSIONSIndications for transanal local excision of low rectal cancer include T1 and T2 tumors with well differentiation and the diameter less than 3 cm. Clinical outcome may be favorable if patients are carefully selected for transanal local excision.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Stomach Neoplasms ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVETo investigate the factors related to the outcome of patients with chronic severe hepatitis B and effectiveness of antivirus therapy.

METHODSThe effects of the factors including age, prothrombin activity (PTA), serum HBeAg, Anti-HBe, HBV-DNA load, with or without complication, antivirus therapy and so on, on outcome of 330 patients with chronic severe hepatitis B were analyzed in this retrospective study.

RESULTSThe mortality of patients with chronic severe hepatitis B was significantly higher among patients at higher age, with lower PTA, and with more complications. The mortality of patients with HBV-DNA more than 1x10(5) copies/ml (52.3 percent) was higher than that of patients whose HBV-DNA was less than 1x10(5) copies/ml (32.9 percent). There was no correlation between serum HBeAg or anti-HBe and the mortality. The mortality of patients with HBV-DNA higher than 1x10(5) copies/ml (30.38 percent) who were treated with lamivudine in 2005 was lower than that of patients whose HBV-DNA was less than 1x10(5) copies/ml (54.64 percent) who were not treated with any antiviral therapy in 2001.

CONCLUSIONThe higher serum virus load is the key factors of the mortality in addition to the other factors such as older age, lower PTA, more complication in the patients with chronic severe hepatitis B. The usage of antivirus therapy may be associated with lower mortality.

Adult ; Age Factors ; Aged ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; genetics ; Hepatitis B, Chronic ; drug therapy ; metabolism ; mortality ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Prothrombin ; metabolism ; Treatment Outcome ; Viral Load

ObjectiveTo introduction of perforator flaps,muscle flaps pedicled by descending branch of lateral circumflex femoral artery,method and their clinical application that multiple soft tissue defects of hand are repaire by muliplefoliated tissue flap only branch lateral circumflex femoral artery.MethodsFifteen patients with multiple soft tissue defects of hand were repaired muliplefoliated tissue flap only pedicled bydescending branch lateral circumflex femoral artery.At first,the anterolateral thigh perforator flap was designed and harvested according to the soft tissue defects of hand, then the descending branch lateral circumflex femoral artery was dissected at the same time the segmented perforator flap,fascia lata flap,rectus femoris muscle flap, vastus lateralis muscle flap, vastus intermedius muscle flap and distal spatium intermusculare flap were harvested in need according to distance among soft tissue defects.The muliplefoliated tissue flap was harvested only pedicled by descending branch lateral circumflex femoral artery, at last muscle flaps and fascia lata flaps were covered by skin graft, so the multiple soft tissue defects of hand were repaired in one time.ResultsNo vascular crisis happened. All skin grafts survived well, the contour of all repaired soft tissue defects was good and protective feeling was recovered by skin grafts of all flaps. All cases were got follow-up and the range was from 6 to 20 months(the average was 8.7 months).Wound of donor site healed well, muscle strength of quadriceps and motion of knee were normal. Three cases were excellent,nine cases were well and 3 cases were good, according to upper extremity function evaluation criteria of Chinese Medical Society for the Surgery of the Hand, the rate of good was 80 percent.ConclusionMultiple soft tissue defects of hand can be repaired by muliplefoliated flap only pedicled by descending branch of lateral circumflex femoral artery. Its advantages included reduction of operation time and treatment, good recovery of hand contour and function. It is a good method to repair multiple soft tissue defects of hand.

Objective To improve the voltage regulator for the traditional X-ray machine to provide heating voltage and current to X-ray tube filament heating circuit.Methods The circuits included the ones for regulator output voltage sampling,desired voltage generation,control voltage generation,synchronous pulse triangular signal generation,phase control,siliconcontrolled rectifier (SCR) and regulator input voltage sampling.Negative feedback control was executed by the sampling,detection and comparison of the regulator output voltage,and the comparison was carried out with the synchronous pulse triangular signal to generate the signal for controlling SCR.The regulator output voltage was kept stable by regulating the modes of SCR conduction angle.Results Installing and debugging of designed circuit for domestic power frequency X-ray machine contributed to realizing voltage regulation for the filament heating circuit.The test also measured voltage waveform distortion in AC circuits,and this kind of adverse effect did not affect the filament heating circuit.Conclusion The improved system has small volume,low heat,little noise and high performance,which can replace the traditional MSVR.

The paper is to report the study of pharmacokinetics of transdermal administered nicotine in the brain of freely moving rat by using microdialysis with stable labeled isotope as internal standard. The pharmacokinetic behavior of nicotine in Sprague Dawley rat brain was investigated after intranasal administration (3.75 mg). Brain fluid samples were collected by intracerebral microdialysis with DL-nicotine as internal standard. Concentrations of nicotine and DL-nicotine in the sample were measured by HPLC-MS/MS. Main pharmacokinetic parameters were calculated and analyzed by Das 2.0 pharmacokinetic software. The recovery of nicotine and the delivery of DL-nicotine were the same. The fate of absorption and distribution was two compartment model and the values of t1/2alpha was 170.31 min, t1/2beta was 263.30 min and the AUC(0-infinity) was 2.75 x 10(5) microg x L(-1) min separately. DL-nicotine can be used to calibrate the recovery of nicotine, and the new method of stable isotope microdialysis can be used to study the pharmacokinetics of freely moving rat. It will make sense for the treatment of addiction of tobacco and provide a new thought for the research of pharmacokinetics-pharmacodynamic combination.
Administration, Cutaneous ; Administration, Intranasal ; Animals ; Area Under Curve ; Brain ; metabolism ; Chromatography, High Pressure Liquid ; Deuterium ; Female ; Isotope Labeling ; methods ; Male ; Microdialysis ; methods ; Nicotine ; administration & dosage ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry