Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

AIMTo search for flavonoids which possess stronger vasorelaxation action.

METHODSFour quercetin glycosides (1a - d) were synthesized from quercetin in three steps i. e. selective protection of quercetin, condensation with corresponding acetyiglycosyl bromide, and then removal of the protecting group; Six flavone compounds (2a - f) were prepared from phloroglucinol according to the conventional methods; The structures of synthetic compounds were confirmed by IR, 1H NMR, 13C NMR and MS. Vasorelaxation action of ten synthetic quercetin derivatives (or analogues) and four natural flavonoids compounds were examined on the isolated rat thoracic aorta rings; Comparative octanol-water partition coefficients (logP) were measured using a reversed-phase HPLC method.

RESULTSMost of the tested flavonoids showed concentration dependent relaxation effects against PE-induced contractions of rat aortic rings. These compounds had stronger action with the augment of logP values.

CONCLUSIONCompound 3-bromo-5 ,7-dihydroxyflavone (2d) was identified to have the most potent vasodilating action. These compounds exert vasodilating effects that are related to the logP values. A structure-activity relationship of flavonoids was suggested.

Animals ; Aorta, Thoracic ; drug effects ; Dose-Response Relationship, Drug ; Flavonoids ; chemical synthesis ; chemistry ; pharmacology ; Male ; Molecular Conformation ; Molecular Structure ; Quercetin ; administration & dosage ; analogs & derivatives ; chemical synthesis ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Structure-Activity Relationship ; Vasodilation ; drug effects ; Vasodilator Agents ; administration & dosage ; chemical synthesis ; pharmacology

ObjectiveTo investigate the expression of programmed death receptor ligand 1 ( PD-L1 ) of peripheral blood mononuclear cells (PBMCs) in patients with hepatic cystic echincccccosis (HCE) and its relation with interferon-γ.MethodsThe clinical data of 63 patients with HCE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from June 2010 to February 2011 were retrospectively analyzed.All patients were divided into HCE active group (38 patients) and HCE non-active group (25 patients) according to the system established by the World Health Organization's Informal Working Group on Echinocoecosis.Twenty patients with hepatic hemangioma or healthy individuals were recruited in normal control group.The positive rate of PD-L1 expression was detected by flow cytometry and immunocytochemistry.The expression of interferon-γ was detected by enzyme-linked immtmosorbent assay (ELISA).All data were analyzed by the t test,one-way analysis of variance,LSD test and chi-square test.The relationship between the expression of interferon-γ and positive rate of PD-L1 expression was analyzed by the Pearson test.ResultsThe results of flow cytometry showed that the positive rates of PD-L1 expression in the HCE active group,HCE non-active group and normal control group were 12.1％±3.8％,10.9％ ± 2.5％ and 9.1％ ±2.5％,respectively.There was a significant difference in the positive rate of PD-L1 expression between the HCE active group and normal control group (t =3.327,P ＜ 0.05 ).The results of immunohistochemistry showed that the positive rates of PD-LI expression in the HCE active group,HCE non-active group and normal control group were 11.9％ ± 3.4％,i0.6％ ± 2.9％ and 9.5％ ± 3.6％,respectively.There was a significant difference in the positive rate of PD-L1 expression between the HCE active group and normal control group (t =2.470,P ＜ 0.05 ).The expressions of intefferon-γ in the HCE active group,HCE non-active group and normal control group were ( 141 ± 38 ) μμg/L,( 124 ± 32 ) μg/L and ( 105 ± 42 ) μg/L.There wasasignificant difference in the expression of interferon-γ between the HCE active group and normal control group ( t =3.280,P ＜ 0.05).The results of flow cytometry and immunohistochemistry revealed that the positive rate of PD-L1 expression was positively correlated with the expression of interferon-γ( r =0.59,0.61,P ＜ 0.05 ).Conclusion With the help of interferon-γ,PD-L1 may play an important role in promoting the immune.evasion of echinococcus.

Objective To determine the effectiveness of preoperative sedation with rectal midazolam and atropine alone or combined with ketamine in infants and young children.Methods One-hundred and six ASA Ⅰ or Ⅱ infants and young children aged 2 months-2 years scheduled for elective general surgical operation were studied in a double blind fashion.The patients were randomly divided into 3 groups:group M received rectal atropine 0.02 mg?kg~(-1) and midazolam 0.5 mg?kg~(-1)(n=39);group MK and MKK received rectal atropine 0.02 mg?kg~(-1), midazolam 0.5 mg?kg~(-1) and ketamine 4 mg?kg~(-1)(MK,n=34)or 8 mg?kg~(-1)(MKK,n=33).The patients were transferred from the ward to the operating room(OR)30 min after rectal administration.Depth of sedation was evaluated before and 15 min after rectal administration; when the patients were separated from their parents and on arrival in OR using De Jong's sedation score system.SpO_2 and HR were monitored in OR.Results The patients were better sedated in group MK and MKK than in group M after rectal administration.Significantly more patients were asleep on seperation from their parents and on arrival in OR in group MK and MKK than in group M. Significantly more patients were calm and not crying at venepuncture in group MKK(63%)and group MK(32%) than in group M(18%).Conclusion Rectal midazolam combined with ketamine and atropine results in better preoperative sedation than rectal midazolam alone in infants and young children.

Uridine diphosphate (UDP)-GalNAc : polypeptide N-acetylgalactosaminyltransfemse (ppGalNAcT) catalyzes the initial step in mucin type O-glycosylation in the Golgi apparatus. Here generation and characterization of a polyclonal antibody to human ppGalNAcT2 were described. The subcellular location of ppGalNAeT2 in SGC7901 cell line was investigated using Western blot analysis of fractionated cell extracts and confocal microscopy with this antibody and two Golgi markers: Golgi SNARE (soluble N-ethylmalemide-sensifive factor attachment protein receptor) of 28 ku (GS28) and trans-Golgi network (TGN) 38, markers for the c/s- and trans-Golgi apparatus, respectively. Morphometric analyses indicated that ～60% of the ppGalNAcT2 signal colocalized with the GS28, while～36% of the c/s-Golgi marker colocalized with the ppGalNAeT2. Approximately 34% of the ppGalNAcT2 signal colocalized with the TGN38, whereas 38% of the trans-Golgi marker colocalized with the ppGalNAcT2. The results provide unequivocal evidence for the location ofppGalNAcT2 within the Golgi apparatus, and further highlight the importance of this organelle in the initiation of O-linked glycosylation.

Objective To investigate the correlation of Bax and apoptosis in enterocytes of neonatal rats with necrotizing enterocolitis (NEC).Methods Forty-eight neonatal rats (1 day) were randomly divided into control group (n =24) and NEC model group (n =24) by use of odd and even.The rats in control group were maternal breast-fed.The rats in NEC model group were separated from their mothers.To be given formula feeding,cold exposure after hypoxic-reoxygenation treatment.The intestinal tissue located at the boundary of ileum and caecum of two groups were gained on the 24 h,48 h and 72 h with which that all rats were sacrificed by cutting neck.Section of intestinal tissue were stained with immunohistochemistry to detect the expression of Bax and were stained with TdT mediated dUTP nick end labeling(TUNEL) to evaluate the apoptosis in each group.Results The integrate optical density (IOD) value of expression of Bax in the NEC model group began to increase on the 24 h [(1 005.06-± 11.96) IOD] and reached the summit on the 72 h [(3 340.66 ±68.72)] compared with the control group[(666.55 ± 15.77)IOD].A few of TUNEL positive cells began to increase with time dependence.A lot of TUNEL positive cells could be found in NEC model group on the 24 h [(15.04 ± 0.24) ％],and the apoptotic index reached the peak on the 72 h [(35.65 ±0.61) ％] compared with the control group[(4.73 ±0.04) ％,P ＜0.01]-There was a significantly positive correlation between the cell apoptosis and the ratio change of Bax in NEC model group (r =0.94,P ＜ 0.01).Conclusion There is a significantly positive correlation between the cell apoptosis and the ratio change of Bax in enterocytes of neonatal rats with NEC.The cell apoptosis in enterocytes of neonatal rats with NEC maybe be induced by Bax.

Objective To investigate the adjustment methods and evaluation for children after cochlear implantation. Methods 6 children after artificial cochlear implantation were debugged by subjective psychological physical test, objective methods such as electricity induced composite action potential (ECAP), electrically evoked stapedius reflex threshold (ESRT) and electrically evoked auditory brainstem response (EABR). Results All the children got satisfied data. Conclusion For the children after cochlear implantation, objective methods such as ECAP, ESRT, EABR combined with subjective psychological physical test all together are helpful to obtain accurate threshold.

Nosocomial infection (NI) is one of the most significant complications arising after open heart surgery,and leads to increased mortality,hospitalization time and health resource allocation.This study investigated the morbidity,mortality,and independent risk factors associated with NI following open heart surgery.We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI.The NI selection criteria were based on the Centers for Disease Control and Prevention (CDC) guidelines.The term NI encompasses surgical site infection (SSI),central venous catheter-related infection (CVCRI),urinary tract infection (UTI),respiratory tract infection and pneumonia (RTIP),as well as other types of infections.Of 1606 cardiovascular surgery patients,125 developed NI (7.8％,125/1606).The rates of NI following surgery for congenital malformation,valve replacement,and coronary artery bypass graft were 2.6％ (15/587),5.5％ (26/473) and 13.6％ (32/236),respectively.The NI rate following surgical repair of aortic aneurysm or dissection was 16.8％ (52/310).Increased risk of NI was detected for patients with a prior preoperative stay ≥3 days (OR=2.11,95％ CI=1.39-3.20),diabetes (OR=2.00,95％=CI 1.26-3.20),length of surgery ≥6 h (OR=2.26,95％ CI=1.47-3.47),or postoperative cerebrovascular accident (OR=4.08,95％ CI=1.79-9.29).Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.

OBJECTIVETo investigate the effect of recipient derived bone marrow stromal cells (BMSCs) on immunological rejection in mouse allogeneic skin transplantation.

METHODSThe C57BL/6 to BALB/c allogeneic skin transplantation model was created. The bone marrow stromal cells (BMSCs) were isolated from BALB/c by gradient density centrifugation and adhesion separation. The BMSCs were injected back through tail vein. The mouse were divided into three groups as group A (BALB/c + BMSCs), group B (BALB/c with skin transplantation), and group C (BALB/c with skin transplantation + BMSCs). The pathologic examination of the graft was performed and the cytokines such as IL-2, IFN-gamma were detected at the different time.

RESULTSThe attained BMSCs in the experiment had the characteristics of BMSCs. The acute immunological rejection reaction detected by immunohistochemistry staining was alleviated noticeably in group C than that in group B. The concentrations of cytokines IL-2, IFN-gamma in group B were lower than that in group C at 7 d (F = 248,954.6, P < 0.05; F = 148,311.7, P < 0.05) and 14 d (F = 117,372.3, P < 0.05; F = 126,743.3, P < 0.05) after skin transplantation.

CONCLUSIONSRecipient derived BMSCs transfusion can alleviate the acute immunological rejection after allogeneic skin transplantation. The possible mechanism maybe related to the inhibitory effect on the secretion of cytokines like IL-2, IFN-gamma.

Animals ; Bone Marrow Transplantation ; Female ; Graft Rejection ; Interferon-gamma ; metabolism ; Interleukin-2 ; metabolism ; Mesenchymal Stem Cell Transplantation ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Skin Transplantation ; Stromal Cells ; cytology