Objective To investigate the healing mechanism of the rabbit's selerotomy sites undergoing the transconjunctival su- tureless vitrectomy(TSV),and to compare the wound healing effect of the different surgery procedures.Design Experimental study. Participants New Zealand white rabbits.Methods Thirty-two New Zealand white rabbits were divided into four groups:the core vitrec- tomy and fluid-air exchange (Group A),the core vitrectomy (Group B),the non-core vitrectomy and fluid-fir exchange (Group C) and the non-core vitrectomy(Group D).Intraocular pressure(IOP)was measured on the day preoperatively and the day 1,3,5,7,14 postopera- tively with Tonopen tonometers.Sclerotomy sites were investigated with the ultrasound biomicroscope(UBM)on the day 1,5 and 9 postoperatively,and the internal and the external diameter of the wound was estimated on the day 1 postoperatively.The pathological sections of the sclerotomy sites on the day 3,5 and 9 postoperatively were observed under the light microscope.Main Outcome Mea- sures IOP,the internal and external diameter of the wound.Results The IOP of Group A was obviously higher than the other groups on the day 1 postoperatively (P

Objective To evaluate the toxicity of intravitreal injection of triamcinolone acetonide on the cornea,lens,ciliary body and retina in rabbit eyes. Methods Thirty-two gray rabbits were divided into four groups(n=8).The rabbits were intravitreally injected with buffered saline solution(control group),4 mg triamcinolone acetonide(group B),1.3 mg triamcinolone acetonide(group C) and vehicle(group D).Intraocular pressure,scotopic and photopic electroretinogram examinations were performed before injection and at different time points after injection.Histologic and ultrastructural changes were observed 1 week,1 month and 3 months after injection. Results Compared with the other groups,the intraocular pressure of group B was significantly increased on day 1,week 1 and week 2 after injection(P

Objective To investigate the level of uncertainty of illness and social support state in patients with prediabetes,and to discuss the correlation between the two.Methods 243 cases with prediabetes were analyzed by Uncertainty in Illness Scale and Social Support Rating Scale.Results There was a middle uncertainty in the elderly patients with prediabetes.The objective support,sabjective support,social support utilization degree and social support score were negatively related to the complexity of uncertainty(r--0.419,-0.433,-0.390 and-0.421,respectively,all P＜ 0.05).Conclusions Medical staff should evaluate the uncertainty in illness in elderly patients with prediabetes and conduct nursing intervention accordingly,in order to reduce the uncertainty,increase social support,and ultimately improve the quality of life.

Lactate and succinate were produced by Corynebacterium acetoacidophilum from glucose under oxygen deprivation conditions. To construct knockout mutant, lactate dehydrogenase gene (ldh) of C. acetoacidophilum was deleted by double-crossover chromosome replacement with sacB gene. Comparing with the wild strain ATCC13870, ldhA-deficent mutant produced no lactate with glucose consumption rate decreased by 29.3%, while succinate and acetate concentrations were increased by 45.6% and 182%, respectively. Moreover, the NADH/NAD+ rate was less than 1 (about 0.7), and the activities of phosphoenolpyruvate carboxylase and acetate kinase of the ldhA-deficent mutant were enhanced by 84% and 12 times, respectively. Our studies show that succinicate and acetate production pathways are strengthened by blocking lactate synthesis. It also suggests that improving NADH supply and eliminating acetate generation are alternative strategies to get high succinate-producer.
Corynebacterium glutamicum ; genetics ; metabolism ; Glucose ; Industrial Microbiology ; L-Lactate Dehydrogenase ; genetics ; metabolism ; Lactic Acid ; metabolism ; Oxygen ; metabolism ; Phosphoenolpyruvate Carboxylase ; Succinic Acid ; metabolism

Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

Objective To investigate the effects of informed consent on emotion and immunologic function in patients with laryngopharynx cancer.Methods Sixty patients with laryngopharynx cancer were divided into group A and group B by random digits table with 30 cases each group.In group A patients were informed consent,and in group B family were informed consent.The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores,as well as cellular immunity function were measured before informed consent and 2 weeks after surgery.Results The SAS,SDS scores and levels of cellular immunity function between two groups,differences was no statistically significant (P ＞ 0.05).The SAS,SDS scores 2 weeks after surgery in group A were significantly less than those in group B [(43.17 ± 7.63) scores vs.(47.84 ± 8.46) scores,(37.43 ± 8.69) scores vs.(42.67 ± 9.82) scores,P ＜ 0.05].The CD3,CD4,NK cells 2 weeks after surgery in group A were significantly higher than those in group B (0.5762 ±0.0941 vs.0.5160 ± 0.0821,0.3832 ± 0.0751 vs.0.3140 ± 0.0561,0.1521 ± 0.0491 vs.0.1163 ± 0.0422,P ＜ 0.05),CD8 and CD4/CD8 between two groups differences was no statistically significant (P ＞ 0.05).Conclusion The informed consent for patients with laryngopharynx cancer may relieve emotional disorders and avoid immunologic function decreasing.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To investigate and analyze the effect and insulin dosage of insulin pump in type 2 diabetes. Methods 63 hospital patients with type 2 diabetes(FPG≥12mmol/L), who had poorly controlled blood glucose, were treated by insulin pump for 14 days, without hypoglycemic agents. The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed. FPG, CBG, HbA1c, FINS/FPG, ISI, Homa-B and Homa-IR were measured before and after insulin pump. Results When blood glucose were well controlled, the mean time was (5.4+1.6) days, the insulin was (0.6+0.2)U/kg, the basal insulin was 38%. The dosage of insulin was decreased after blood glucose were controlled. Reaction of hypoglycemia was (0.6+0.2). After 2 weeks insulin pump intensive treatment, the result of FPG, CBG, HOMA-IR and HbA1c were significantly decreased (all P<0.01); FINS/FPG, HOMA-B and ISI were incleased (all P<0.01). Conclusion The excellent glycemic control and improvement of beta-cell function can be induced by short-term insulin pump intensive therapy in diagnosed type 2 diabetic patients with severe hypoglycemia.

Objective To summarize clinical experience of emergent surgery for severe liver trauma with rupture of major blood vessels. Methods The clinical data of 12 cases suffering from severe liver trauma with rupture of perihepatic and intrahepatic large blood vessels were retrospectively analyzed. These cases were from Dec 2000 to May 2008. All the cases underwent emergency operation, 6 cases were treated with liver lobectomy: among those 1 case with right posterior lobe liver resection, 1 case with irregular right lobe liver resection, 3 cases with left hemihepatectomy, and 1 case with left lateral lobectomy. Seven cases with rupture of major blood vessels were treated by repair or ligature and/or packing including repair of posthepatic inferior vena though the middle fissure in 2 cases, and through retrahepatic space in one case, interrupted suture of the portal vein in 2 cases, interrupted suture of the right hepatic veins in 2 cases. Mattress suture was applied to the ruptured hepatic veins in 7 cases including mattress suture of the branch of right hepatic vein and middle hepatic vein in 1 case, mattress suture of right hepatic vein in 1 case, suture of middle hepatic vein in 2 cases, and suture of left hepatic vein in 3 cases. One case was treated with ligation of hepatic artery and 3 cases with gauzes packing. Results Among all the 12 cases, 9 cases were cured, 3 cases died: two were caused by severe trauma together with hemorrhagic shock, one by sever brain injury together with hemorrhagic shock. Conclusions Prompt operation, precise stop bleeding and correct operation style are the key for successful rescue of patients suffering from severe liver trauma and massive bleeding.