Objective To investigate the potential role of estrogen in the formation of granulation tissue hyperplasia-induced tracheal stenosis in rats.Methods Twenty-four female SD rats were ran-domly divided into three groups(n=8)using a random number table method:sham group(n=8),ovariectomized(OVX)group(bilateral ovariectomy,n=8),and ovariectomized+estrogen(OVX+E2)group(bilateral ovariectomy followed by exogenous estrogen intervention,n=8).Four weeks af-ter establishment of the Sham and OVX rat models,a granulation tissue hyperplasia-induced tracheal stenosis model was constructed in all rats using the oral nylon brush scraping method.On the first day of modeling,rats in the OVX+E2 group were administered 17β-E2 at a dose of 300 μg/kg via intrap-eritonealinjection daily,while rats in the other two groups were given the same volume of normal saline.After 7 consecutive days of administration,tracheal specimens were obtained.Hematoxylin and eosin(HE)staining was used to observe the pathological changes of tracheal granulation tissue hyperplasia in each group and calculate the tracheal stenosis rate.Masson staining was employed to analyze the collagen fibers in the tracheal granulation tissue and calculate the relative collagen deposition area.Immunohistochemical(IHC)staining was used to detect the protein expression levels of transforming growth factor-beta 1(TGF-β 1),vascular endothelial growth factor(VEGF),alpha-smooth muscle actin(α-SMA),and collagen type Ⅰ(COL-Ⅰ)in the tracheal granulation tissue,and the average optical density(AOD)was calculated.Results HE staining revealed granulation tissue hyperplasi-a and tracheal lumen stenosis in the tracheal walls of all three groups.The stenosis rate was the highest in the OVX+E2 group,followed by the sham group,and the lowest in the OVX group,with statistically significant differences(P＜0.05).Masson staining showed that the collagen fibers in the sham group were thicker and denser with more collagen deposition compared to the OVX group.In contrast,the OVX+E2 group had even thicker and denser collagen fibers with more collagen dep-osition than the sham group.IHC staining demonstrated that the protein expression levels of COL-Ⅰ,TGF-β1,VEGF,and α-SMA in the tracheal granulation tissue were the lowest in the OVX group,fol-lowed by the sham group,and the highest in the OVX+E2 group.Conclusion Estrogen can acceler-ate tracheal granulation tissue hyperplasia by upregulating the protein expression levels of COL-Ⅰ,TGF-β1,and VEGF,as well as promoting fibroblast activation,leading to aggravated tracheal stenosis.

China/epidemiology* ; Humans ; Pemphigoid, Bullous/epidemiology* ; Retrospective Studies

Objective:To study the clinical efficacy and lower limb temperature difference of bipolar radiofrequency combined with ozone in the treatment of lumbar disc herniation(LDH).Methods:A retrospective study was conducted on 105 inpatients with LDH. All patients were treated with bipolar radiofrequency combined with ozone. The interdisc impedance of the main electrode was measured before and after treatment, and the absolute temperature difference of infrared thermal imaging of both lower extremities before and after treatment was analyzed. Vasual analogue scale (VAS) score, JOA score and modified Macnab standard were used to evaluate the curative effect after treatment.Results:The VAS score after treatment was significantly lower than that before treatment( P<0.05), and the JOA score after treatment was significantly higher than that before treatment( P<0.05). The intervertebral disc impedance after treatment was significantly lower than that before treatment( P<0.05). The temperature difference between leg and plantar after treatment was significantly lower than that before treatment (all P<0.05). Conclusions:Bipolar radiofrequency combined with ozone therapy can relieve pain and improve function in patients with LDH. Infrared thermal imaging can sensitively reflect the changes of body surface temperature of lower extremities in patients with LDH, and has a certain value in the diagnosis and curative effect evaluation of LDH.

Pancreaticoduodenal anastomotic dehiscence complicated with peritoneal hemorrhage following pancreaticoduodenectomy is a serious complication which threatens patients'life.Prevention and mangement of pancreaticoduodenal anastomotic dehiscence and peritoneal hemorrhage is the focus in the surgical treatment.Operation is the most reliable treatment for bleeding.While reoperation is difficult for most surgeons and the risk of fistula and rebleeding after reoperation exist.Some procedures will affect the endocrine and exocrine function of pancreas.We applied pancreaticojejunal bridge drainage for most patients with hemorrhage after pancreaticoduodenectomy.This procedure is easy,safe,and can protect the pancreatic function.

Objective To compare the image quality of chest low dose CT (LDCT) using automatic exposure control (AEC) and constant current control (CCC) and explore a more reasonable scanning protocol. Methods Two hundred and eighty participants were examined with 64 CT scanner at 7 centers in China. All were divided into 4 groups. Two groups underwent LDCT using AEC with standard deviation set at 25 (A1) and 30 (A2) respectively and the tube current ranged from 10 mA to 80 mA. The other two groups underwent LDCT using CCC with tube current set at 40 mA (C1) and 50 mA (C2) respectively. The axial and MPR images were evaluated by two radiologists who were blinded to the scanning protocols.The radiation dose, noise and the image quality of the 4 groups were compared and analyzed statistically.Differences of radiation dose and noise among groups were determined with variance analysis and t test,image quality with Mann-Whitney test and the consistency of diagnosis with Kappa test. Results There was a significant lower DLP in AEC group than in CCC group [(82.62±40.31)vs ( 110.81±18.21) mGy·cm (F =56. 88 ,P ＜ 0. 01 )], whereas no significant difference was observed between group A2 and group A1 0. 05]. The noisy of AEC group was higher than that of CCC group both on lung window(41.50±9.58 vs 40.86±7.03) and mediastinum window (41.19±7.83 vs 40.92±9.89), but there was no significant difference( Flung =0.835, P=0.476, Fmediastinum =1.910, P=0.128).The quality score of axial image in AEC group was higher than that in CCC group (superior margin of the brachiocephalic vein level: 4.49±0.56 vs4.38±0.64,superior margin of the aortic arch: 4.86±0.23 vs 4.81±0.32,the right superior lobar bronchus Level:4.87±0.27 vs 4. 84 ± 0. 22, the right middle lobar bronchus Level: 4.90±0.25 vs 4.88±0.21) except on the right inferior pulmonary vein level(4. 92 ±0. 25 vs 4. 93 ±0. 17) and superior margin of the left diaphragmatic dome level (4. 91±0.27 vs 4.93±0.22) on lung window, but no significant differences (F=0.076-1.748, P＞0.05) were observed. A significant higher score in AEC group was observed on mediastinum window compared with CCC group on superior margin of brachiocephalic vein level (2.57±0.77 vs 2. 46 ± 0. 59, F = 8. 459, P ＜ 0. 05 ), however, the score of AEC group was lower than that of CCC group on other levels without significant differences (superior margin of the aortic arch:3.36 ±0. 63 vs 3.45 ±0. 60,the right superior lobar bronchus level: 3.94 ±0. 56 vs 3. 95 ±0. 51 ,the right middle lobar bronchus Level: 3.80 ±0. 58 vs 3. 87 ±0. 50,the right inferior pulmonary vein level: 3.72 ±0. 56 vs 3.78 ±0. 53, superior margin of the left diaphragmatic dome level: 3.58 ± 0.63 vs 3.68±0.56,F=0.083-3.380,P ＞ 0.05 ). The MPR image quality of AEC group was better than that of CCC group both on lung window and mediastinum window (Zlung =-2.258, Zmedlastinum=-1.330, P＞0.05). For all participants including the underweighted group, the normal group and the overweighted group, the image quality of A1 group was better than that of A2 group without significant differences (the underweighted group: Zlung=0.000, P=1.000, Zmedastinum= 0.000, P=1.000;the normal group: Zlung =-0.062, P=0.950, Zmediastinum =-0.746, P = 0.456; the overweighted group: Zlung = - 1.177, P = 0.239,Zmediastinum =-1.715, P=0.144) both on lung and mediastinum windows, and for the higher BMI participants, a better image quality was obtained in A1 group than in A2 group on the mediastinum window (Z = -1. 715, P = 0. 144). Conclusions The total radiation exposure dose of AEC group is significantly lower than that of CCC group, but no statistical significant differences are observed between both groups in image quality and noise level. The AEC technique is highly recommended in thoracic LDCT scan for screening program, and the SD25 ( SD value = 25) scan protocol is suggested for higher BMI population while the SD30 (SD value = 30) scan protocol for lower BMI population.

Objective The purpose of this study was to determine how to preserve the remaining pancreatic body and tail in the pancreatectomy. Methods In seven cases of pancreatectomy, three of them were the rupture of pancreatojejunal anastomosis, and four of them were the pancreatectomy for tumor in the pancreatic neck or body. During operations, a bridge internal drainages was used to drain the pancreatic juice into the adjacent jejunum. After the operations, the supportive treatment, continuous irrigation of peritoneal cavity and pancreatic enzyme inhibition were used. Results In all seven patients, the remaining pancreatic body and tail were successfully preserved. The endocrine functions of these patients recovered to nearly normal level and patients were discharged. Conclusions In preserving the remaining pancreatic body or tail, the bridge internal drainage has its advantage of convenience. It effectively preserves the exocrine of pancreas as well as its endocrine

Objective The purpose of this study was to discuss the therapies for hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.Methods After three cases of pancreatoduodenectomy,the disruptions of pancreatojejunal stoma resulted in serious pancreatic leakage and the hemorrage in abdominal cavity.During all the second operations,the drainage-tube insertions into the main pancreatic ducts were used to lead the pancreatic juice into the neighboring loop of jejunum.Results Afer the operations,the supportive treatment,continuous irrigation of peritoneal cavity and pancreatic enzyme inhabition were given to the patients of these cases and all of the patients were successfully cured.Conclusions The bridge-crossing internal drainage which inserts drainage-tube into the main pancreatic duct was a convenient and effective therapy and method to rescue the hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.While the patients' lives were saved,their functions of pancreas were preserved and the qualities of life were improved after the operations.

[Objective] To explore the best method for sequelae neuralgia of herpes zoster.[Method] Randomly divide the said patients into groups treated with external application of Chinese drugs and sky moxibustion,make observation and comparison between them.[Result] Both got high late curative effect,however most patients in the sky moxibustion group were cured without recurrence,the pain relieving rate was high once being cured,the reduce of pain index was apparent after treatment,which was of statistical meaning compared with drug application group.[Conclusion] The sky moxibustion method combines drugs and moxibustion well and has marked advantages in treating herpes zoster,worth of promotion and application.

Objective To summarize the experiences of middle pancreatectomy. Methods Eleven female and 4 male with a mean age of 49.4 years (23.8-73.1 years) who underwent middle pancreatectomy from January 2001 to October 2005 were collected. Eight patients with neuroendocrine tumor (non-function of 5 cases), 5 with serous cystadenomas and 2 with mucinous cystadenomas were included. The proximal apical end of pancreas was sutured, while distal end of pancreas was anastomosed to a Roux-en-Y jejunal loop. Results Mean operative time was 275 min (179-370 min), mean length of resected pancreas was 45 mm (30-60 mm) and max diameter of tumor was 23 mm (15-40 mm). Complication after operation was pancreatic fistula 4 cases (26.7%), in which 3 cases (20.0%) had intraabdominal blood. The mean time of follow-up was 23 months (3 months-5 years). one patient was died of multiple organs failure for pulmonary infections in month 3 after operation, and the others were alive without novo-diabetes. Conclusion Middle pancreatectomy is an effective operation for benign and borderline tumors of neck and body of pancreas without a significant increase of postoperative morbidity.

Haemorheological changes, including blood viscosity (?b) and plasma viscosity (?p) measured on a cone-plate viscometer, erythrocyte aggregation calculated, erytkrocyte deformability (DI) determined by the nuclear pore microfiltration technique and red blood cell shape using scanning electromicroscopy, were observed in patients during anesthesia There acs a significant reduction in ?b (at shear rates range 7. 68- 307. 20 s-l ), ?p and haemotocrit after induction (preintubation ) and 30 min after enflurane in the presence of iv fentanyl, compared with pre-aneathesia, accompanying remarkable increased DI. No changes of erythrocyte shape, however, was found add, nor was the difference of the index between induction period and maintenance of anesthesia. These findings suggest that general anesthesia leads to haemorheological alterations which may improve the microcirculation of the patients.