Objective To study the effects of continuous passive motion(CPM)on tissue blood oxygen saturation(StO2)in the edge of wound after anterior cruciate ligament(ACL)reconstruction in rabbits.Methods Twenty male New Zealand rabbits,aged 8 months,received an ACL reconstruction by using double semitendinous tendon autograft in the right hind leg.The rabbits were randomly divided into 2 groups postoperatively,namely Cage activity group(n=10)and CPM group(n=10),treated with cage activity and activity by rabbit knee joint continuous passive motion apparatus respectively.On the following day after operation,a near-infrared optical device and ODISseyTM Tissue Oximeter were applied to measure the changes of tissue oxygen saturation(StO2)in the edge of the wound in each cycle(with flexion of 30?-110?)and various CPM speeds(2.35?/s,3.2?/s,and 8?/s),and the optimal CPM range and speed was thus selected for analyzing the changes of StO2 in local tissues of wounds with various angles of CPM in knee joint before the operation and on the 2nd,4th,6th,8th,10th,and 14th postoperative days.Results There was a significant difference with regard to StO2 between CPM group and Cage activity group(P0.05),however,a significant difference was observed among different time points(before the operation,and 2,4,6,8,10,14 days after the operation)(P

AIM:To observe the expression of TLR2 and TLR4 on mast cells (MCs) in the periapical tissues from different types of human chronic periapical diseases , and to analyze the role of TLR 2 and TLR4 on tryptase-positive MCs in the immunopathogenesis of human chronic periapical diseases .METHODS: A total of 60 donors, including healthy control group , periapical granuloma group and periapical cyst group , were enrolled in the study .The periapical tis-sue specimens were fixed in 10%buffered formalin and stained with hematoxylin and eosin for histopathology , or stained with double-immunofluorescence for identification of TLR 2-tryptase and TLR4-tryptase double-positive MCs in the periapical tissues.RESULTS:Compared with the healthy control , the densities of TLR2-tryptase and TLR4-tryptase double-positive MCs in periapical tissues were significantly increased in human chronic periapical diseases (P<0.01).The densities of TLR2-tryptase and TLR4-tryptase double-positive MCs in periapical cyst group were significantly higher than those in peria-pical granuloma group (P<0.01).CONCLUSION:TLR2 and TLR4 were expressed on the MCs in the periapical tissues of human chronic periapical diseases .TLR2-tryptase and TLR4-tryptase double-positive MCs may participate in the patho-genesis of chronic periapical diseases .

[ ABSTRACT] AIM:To investigate the role of chronic psychological stress on periodontitis and the effects of hy-perbaric oxygen ( HBO) on periodontitis with psychological stress in rats.METHODS:Male special pathogen-free Wistar rats (n=80) were randomly divided into 4 groups:(1)normal control group;(2)experimental periodontitis group:the pe-riodontitis model was induced by wrapping 3/0 silk ligature inoculated with Porphyromonas gingivalis around the left maxil-lary second molar of the rats; ( 3 ) psychological stress stimulation group; ( 4 ) periodontitis model with stress stimulation group.Psychological stress was removed at the 9th week after ligature, and 4 rats from each experimental group were ran-domly chosen for HBO treatment.The rats were sacrificed at the 2nd, 4th, 8th and 10th weeks after ligature.The levels of blood glucose, adrenocorticotropic hormone ( ACTH) , corticosterone and adrenaline were measured as the stress markers. The histological changes of periodontal tissues were observed under microscope with HE staining.RESULTS:The levels of blood glucose, ACTH, corticosterone and adrenaline in psychological stress stimulation group and periodontitis with stress group were significantly higher than those in control group and experimental periodontitis group at the 2nd and 4th weeks af-ter ligature (P<0.05).The levels of the stress markers were significantly lower than those in untreated groups in the 10th week after HBO (P<0.01).The sites of gingival attachment were normal in control group and psychological stress stimu-lation group.Periodontal pocket, and periodontal attachment loss ( AL) were observed in experimental periodontitis group. The tissue damage was much heavier in periodontitis model with stress stimulation group as the furcation of tooth was ex-posed and the tissue damage was observed on both sides of the adjacent teeth.No significant difference of AL between psy-chological stress stimulation group and normal control group during the experiment was observed.The AL in periodontal model with stress stimulating group was significantly higher than that in experimental periodontitis group at the 2nd, 4th and 8th weeks (P<0.01).The level of AL was attenuated at the 10th week after HBO (P<0.01).No difference of histologi-cal change in periodontal tissues was observed between control group and psychological stress stimulation group.Severer in-flammatory changes and alveolar bone destruction were observed in periodontitis with stress group than those in experimental periodontitis group.The levels of inflammation reduced at the 10th week after HBO.CONCLUSION:Stress stimulation is one of the inducing factors of periodontitis in rats, which aggravates periodontitis.HBO may represent a useful way in trea-ting psychological stress periodontitis.

OBJECTIVE: To compare the effectiveness of vocal cord cyst excision with electronic laryngoscope (EL) and self-retaining laryngoscope (SRM). METHOD: Nightly-two patients, diagnosed as vocal cord cyst with strobolaryngoscope or electronic laryngoscope, were randomly divided into two groups. One group was 48 cases treated with electronic laryngoscope and another group was 44 cases treated with self-retaining laryngoscope. Electronic laryngoscopy examination and voice function assessments were performed to all patients, preoperatively and postoperatively at one week, three months and six months. RESULT: One failed cases under SRM, difficult exposure of glottic portion, were treated under EL. The recurrence rate of the two groups was of no statistical significance in three months after operation. Voice function assessment of the two groups was of no statistical significance at one week, three months and six months after operation. CONCLUSION The operation under electronic laryngoscope is a minimal invasive procedure to the laryngeal mucosa. Electronic laryngoscope had advantages such as clear view, accurate operation. Furthermore, it can be used for those that could not be treated under self-retaining laryngoscope.
Adult ; Aged ; Cysts ; surgery ; Female ; Humans ; Laryngeal Diseases ; surgery ; Laryngoscopy ; methods ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Vocal Cords ; surgery

OBJECTIVETo evaluate the efficacy and safety of pylorus-preserving pancreatico-duodenectomy(PPPD) in the treatment of periampullary adenocarcinoma by using Meta-analysis.

METHODSFrom January 1, 1980 to November 8, 2013, the articles of randomized controlled trials (RCTs) about PPPD versus PD in the treatment of periampullary adenocarcinoma were collected from Cochrane Libriary, Embase, PubMed, Ovid, Web of science and CBM etc. The methodological quality of the included studies was evaluated according to Cochrane system review valuator handbook of risk of bias standards. Meta-analysis was performed by RevMan 5.2 software.

RESULTSSeven RCTs were enrolled in the meta-analysis. Compared to PD group, PPPD group was associated with significantly less intraoperative blood loss (MD=-200.10, 95% CI:-400.66 to 0.46, P=0.05), shorter operation time (MD=-46.55, 95% CI:-91.02 to -2.07, P=0.04), and less postoperative blood transfusion (MD=-0.89, 95% CI:-1.59 to -0.19, P=0.01). There were no significant differences between the PPPD and PD group in pancreatic fistula, biliary fistula, intestinal fistula, abdominal abscess, postoperative bleeding, wound infection, relaparotomy, mortality and survival rate(all P>0.05).

CONCLUSIONSPPPD in the treatment of the periampullary adenocarcinoma is safe and effective with similar survival of PD surgery. PPPD can reduce operative time, intraoperative blood loss, transfusion and does not increase the surgery complications as compared to PD.

Adenocarcinoma ; Ampulla of Vater ; Duodenal Neoplasms ; Humans ; Intestinal Fistula ; Operative Time ; Pancreatic Fistula ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Pylorus ; Randomized Controlled Trials as Topic ; Survival Rate

BACKGROUNDAnaphylactic reactions during anesthesia and operation are common and life threatening. Follow-up investigation is necessary for avoiding potential re-exposure of the patients to the offending drugs. The purpose of this study was to assess cellular allergen stimulation test (CAST) as a diagnostic instrument in immunoglobulin E (IgE)- and non-IgE-mediated anaphylactic reactions.

METHODSThis study included 25 patients who developed perioperative anaphylactic reactions and 10 subjects that tolerated anesthetics and other drugs during perioperative period from September 2009 to October 2013 in Peking Union Medical College Hospital. We performed skin tests and flow cytometric analysis of basophil activation-based CAST in all subjects.

RESULTSOf the 25 patients, 17 had IgE-mediated anaphylactic reactions (causative agent identified by skin tests) and 8 had non-IgE-mediated anaphylactic reactions (negative skin tests). CAST showed a sensitivity of 42.9%, specificity of 90%, and negative predictive value of 80.6% for neuromuscular blocking agents.

CONCLUSIONSCAST may be useful for the diagnosis of anaphylactic reactions during perioperative period. Our findings call for further investigation to increase the sensitivity of the test.

Adult ; Allergens ; immunology ; Anaphylaxis ; diagnosis ; Drug Hypersensitivity ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period ; Skin Tests ; methods ; Young Adult