Abstract In case of sciatic nerve injury, there is degeneration of neuron in the corresponding segment of spinal cord. To study whether NGF could protect the dorsal root ganglia in this situation, the following experiments were performed: 72 SD mice were divided into 2 groups. In each mouse, the sciatic nerve was sectioned at the middle of the right thigh, and then,the proximal end of the sciatic nerve was inserted into a one ended silastic tube. The NGF 0.15ml (contain 2.5S NGF 0.15mg) was injected into the tubes of the experimental group, while a equal amount of normal saline was injected into the tubes of the control group. After 1, 3, 5, 9, 20 and 30 days, 6 mice of each groupwere sacrificed respectively, and 5th to 6th lumbar segments of the spinal cords were resected for examination. By histochemical study, the activity of fluoride resistant acid phosphatase (FRAP) of each animal was detected. The results showed: (1) Excision of the sciatic nerve led to decrease of FRAP activity, it suggested that the injury of sciatic nerve could damage the dorsal root ganglia; (2) The use of exogenous NGF could protect the FRAP activity. It was concluded that NGF played an important role in protecting the dorsal root ganglia in peripheral nerve injury, in vivo.
OBJECTIVE: To explore the possibility of repair of the extensive bile duct injuries with expanded polytetrafluoroethylene (ePTFE). METHODS: A total of 36 local healthy hybrid dogs were employed to establish bile duct injury models by means of partial removal of bile duct (group A, 14 dogs), excision of a segmental duct (group B, 10 dogs), and ligation of the lower part of common bile duct(group C, 5 dogs; group D, 7 dogs). Group A were patched with ePTFE mesh, group B replaced by ePTFE tube. Interposition of the grafts between gallbladder and duedenum or jejunum was performed on group C and group D. The animals’ postoperative performance status were evaluated. Cholangiography was used to define the patency of bile ducts. Tissues of bile ducts and liver were taken at 3 days, 2, 4, 8, 12 and 52 weeks for microscopic and ultrastructural examination to observe the healing process of bile duct and morphological changes in the liver. RESULTS: Group A with ePTFE patch covered by epithelium had a high patency rate of 75%(9/12) and pathological damages were not found in the liver. The patency rate of group B was merely 40%(4/10), to some extent, accompanying damages in the liver. The grafts of group C and group D were fully expelled, ultimately leading to cystic-duodenal or cystic-jejunal fistulas formation. CONCLUSION: The study suggests that application of ePTFE patch to repair bile duct defects is feasible.
ObjectiveTo detect 5-FU concentration and investigate the changes of pathology， and Ki-67 protein expression after intraoperative regional chemotherapy (RC) for colon cancer. MethodsAll the patients were randomized into two groups: RC group (n=20), received intraoperational RC with 100 ml physiological saline contained 5-FU (15 mg/kg) and camptothecine (0.06 mg/kg)； control group (n=20), saline alone. The samples from portal vein blood, peripheral blood, peritoneal fluid， and peri-cancerous tissues in RC group were taken to detect the 5-FU concentration by high performance liquid chromatography (HPLC), respectively at 2, 5, 10, 20, 30, and 60 minutes after treatment. The pathological changes were observed and Ki-67 protein expressions were examined by immunohistochemical staining for all the cancer tissues postoperatively in two groups. ResultsPeak concentration of 5-FU appeared at 2 min after treatment, and decreased gradually. 5-FU concentration in peritoneal fluid was the highest, and the lowest in the peripheral blood (Plt;0.01). In RC group， light karyopyknosis, nuclear swelling, and coagulative necrosis of cancer cells, and light intercellular substance hydropsia, inflammatory cells invasion were observed under light microscopic examination; light vasculitis presented also in five cases. Nuclear swelling, heterochromatin agglutination, perinuclear gap expansion, mitochondrial swelling, endoplasmic reticulum expansion, and Golgi complex expansion were observed with transmission electron microscope. Ki-67 protein expression of colon cance tissues in RC group was lower than that in control group （Plt;0.05）. Conclusions Intraoperative RC for colon cancer may sustain a high concentration of chemotherapy drugs in peritoneal fluid and portal vein blood, and alter histopathological morphology of cancer cells, and suppress Ki-67 protein expression. So, intraoperative RC may play an important role in preventing intraoperative spreading and postoperative recurrence of colon cancer.
Objective To investigate the therapeutic effects of tiotropium in the treatment of stable COPD ( chronic obstructive pulmonary disease) patients of group D. Methods Sixty-two subjects with stable COPD in group D classified by combined COPD assessment in GOLD 2011, were randomly divided into a treatment group ( n = 32) and a control group ( n = 30) . The treatment group was treated with tiotropium ( 18 μg, inhalation, once daily) plus salmeterol /fluticasone ( 50/500 μg, inhalation, twice a day)and the control group was treated only with salmeterol / fluticasone ( 50/500 μg, inhalation, twice a day) . The exercise tolerance, dyspnea score and lung function were measured before and 1, 8,24, and 48 weeks after the treatment respectively. Results 8, 24, 48 weeks after the treatment respectively, there were improvements of 6 minute walk test and the dyspnea score of medical research council scale( MRC) in both groups than before treatment, and which was better in the treatment group. Compared with baseline and the control group, significantly greater improvements in the FVC, FEV1 and FEV1% pred were seen in the treatment group at all time points. In the control group, FVC, FEV1 and FEV1% pred 1 and 8 weeks after treatment were higher than those before treatment, but there was no significant difference after treatment of 24 and 48 weeks.Conclusion Combination treatment with tiotropium and salmeterol / fluticasone inhalation results in greater therapeutic benefits than salmeterol / fluticasone inhalation alone in stable COPD patients of group D.
Objective To investigate the retinal toxicity and verify the safe dose of intravitreal injecting fluconazole. Methods Twelve healthy adult white rabbits were divided at random into 6 groups：a normal control group and 5 groups received intravitreal injection of a single dose of fluconazole ranging from 10 to 200 mu;g respectively.Retinal toxicity was examined by ophthalmoscopy, electroretinography, light and transmission electron microscopy (TEM) on the third and fourteenth day after injection. Results The ultrastructures of the retinal tissues of the normal control group and fluconazole 10～150 mu;g groups were normal on the third and fourteen day after injection.The light microscopy and TEM showed that cells of all the retinal layers in the 200 mu;g group revealed apparent degenerative changes on the fourteenth day after injection, and the light microscopic picture showed the vacuolar degeneration of outer segments of photoreceptors, the nuclei in outer nuclear layer drop out into inner segments, the vacuolar degeneration of nerve fiber layer, and the proliferation of pigment epithelium. TEM revealed expansion of paranucl eus space and karyopyknosis of the bipolar cells, the swelling of nerve fibers and disappearance of the synapses in the inner plexiform layer, the vacuolation and disappearance of microvilli of the pigment epithelium cells. Conclusion The safe dose of fluconazole injected intravitreally should be 100～150 mu;g. (Chin J Ocul Fundus Dis，2000，16：139-212)
ObjectiveTo investigate healing of rat colonic anastomoses after early postoperative intraperitoneal chemotherapy (EPIC).MethodsFortyfive Wistar rats with colonic anastomoses were divided randomly into 3 groups (15 rats each). From postoperative 1 day to 5 day, rats were injected with normal saline (NS) to the peritoneal cavity with 20 ml/(kg·d) for the NS group; 5Fu with 20 mg/(kg·d) for the 5Fu group; 5Fu with 20 mg/(kg·d) and leucovorin with 10 mg/(kg·d) for the 5Fu+LV group. On the 7th postoperative day, rats were killed and the anastomoses were evaluated whether anastomotic complications (leakage or dehiscence) occurred, the anastomotic bursting pressure (ABP) and hydroxypoline content (HPC) were measured. ResultsIn the NS group, 1 rat had incision dehiscence, another one had anastomostic leakage with but no death. In the 5Fu+LV group, 2 rats showed anastomotic leakage and 1 death. On the 7th postoperative day, the ABP in NS, 5Fu and 5Fu+LV groups were (169.1±32.6) mm Hg, (116.8±25.5) mm Hg and (154.9±31.2) mm Hg respectively; the HPC was (1.54±0.28) μg/mg, (0.9±0.33) μg/mg and (1.24±0.29) μg/mg respectively. Both the ABP and HPC, in the NS group were much significantly higher than in 5Fu group (P＜0.01). Both the ABP and HPC in the 5Fu+LV group were significantly higher than which in the 5Fu group (P＜0.05).ConclusionEPIC with 5Fu significantly impairs healing of the colonic anastomosis. 5Fu combined with LV for EPIC might reduce this inhibition to the process of the anastomotic healing.
ObjectiveTo systematically review the safety of propofol versus sevoflurane for pediatric surgery. MethodsEMbase, PubMed, The Cochrane Library, CSCD, CNKI, WanFang Data were searched to collect randomized controlled trials (RCTs) about propofol versus sevoflurane for pediatric surgery from inception to January 2015. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then metaanalysis was performed by using RevMan 5.3 software. ResultsFifteen RCTs involving 1 065 children were included finally. Meta-analysis results showed that, compared with the sevoflurane group, the propofol group could reduce the incidence of emergence agitation (OR=0.23, 95%CI 0.16 to 0.34, P<0.000 01) and the incidence of postoperative vomiting (OR=0.32, 95%CI 0.20 to 0.51, P<0.000 01). There were no significant differences between the two groups in extubation time (MD=0.98, 95%CI -0.26 to 2.21, P=0.12), eye-opening time (MD=3.32, 95%CI -2.65 to 9.29, P=0.28) and postoperative analgesic requirements (OR=0.60, 95%CI 0.30 to 1.23, P=0.16). ConclusionIn reducing the incidence of emergence agitation and postoperative vomiting, propofol is superior to sevoflurane, so propofol is safer than sevoflurane for children's surgery.
Objective To study the inhibitive effect of adenovirus mediated CD gene and 5-FC on proliferative human retinal pigment epithelial (HRPE) cells, and to search for an effective method to take precautions against proliferative vitroretinopathy (PVR).Method Different concentrations of CD and 5-FC were added respectively to the cultured third-growth-generation HRPE cells.Transferance rate was detected by positive HRPE cells marked by X-gal and LacZ. The number of HRPE cells were counted and evaluated by methylthiazol-tetrazollium (MTT) method. Results The adenovirus mediated CD gene could be transfered into HRPE cells with a dose-dependent manner. Positive HRPE cells with CD gene could transform 5-FC to 5-Fu,which could inhibit the increase of HRPE cells effectively. No obvious bystander effect on the growth of HRPE cells was detected.Conclusions The adenovirus may introduce a foreign gene into cultured HRPE cells efficiently. It could be a good method to treat and prevent PVR by medication. (Chin J Ocul Fundus Dis，2003，19：168-171)
ObjectiveTo observe the morphological and pathological changes after transplantation of polytetrafluoroethylene (PTFE) in vivo. MethodsPTFE microporous polypropylene tube which was encircled by spiral steel wire was used to prepare the artificial trachea.Forty New Zealand white rabbits (weighing,4-5 kg) were selected,and were divided into 2 groups.After the cervical trachea (2 cm in length) was removed,the end-to-end anastomosis between the trachea and PTFE artificial trachea was performed in the experimental group (n=20),and end-to-end anastomosis of the trachea in the control group (n=20).The survival of the rabbits was observed after operation;the X-ray,gross,and histological observations were carried out at 2,4,and 6 months after operation.The longitudinal tensile and radial support biomechanical tests were performed before and after transplantation. ResultsThe survival time was more than 2 months and the artificial airway was patency in 15 rabbits of the experimental group;the tissue outside the artificial trachea was like tracheal tissue,which filled in the defect,but it was more than 4 months.X-ray observation showed that the PTFE artificial trachea had no obvious displacement in the experimental group,and no tracheostenosis was observed in the control group.After 2 months,there was no epithelial tissue on the artificial airway wall;after 4 months,there was some epithelial cells on the artificial airway wall,incomplete endothelialization and trachea layer structure were seen with no tracheal ciliated columnar epithelium;after 6 months,the artificial trachea wall was covered with epithelium basically,and some ciliated columnar epithelium cells were found,which had the physiological function of the trachea.The transplanted PTFE artificial trachea could keep the stability of the biological mechanics performance,and could be used for the rabbit tracheal reconstruction. ConclusionPTFE artificial trachea can induce to form a tracheal tissue in the trachea tissues of recipients,each layer of the trachea is relatively complete and the experiment animals can be short-term survival.
Objective To assess the efficacy and safety of sevoflurane versus ketamine in the anesthesia of child short period surgery. Methods Such databases as EMbase, PubMed, The Cochrane Library, CNKI, VIP, CBMdisc, Ongoing Controlled Trial and Conference Articles were searched from their establishment to April 2011 to collect randomized controlled trials (RCTs) and the quasi-RCTs. The quality of those studies meeting the inclusive criteria was assessed, the data were extracted and the meta-analysis was conducted by using RevMan 5.1.1 software. Results Ten studies involving 600 participants were included. Seven studies showed that the intraoperative heart rate of the sevoflurane group was lower than that of the ketamine group (MD= –11.85, 95%CI –16.47 to –7.23, Plt;0.000 01). Nine studies showed that the revival time of the sevoflurane group was shorter than that of the ketamine group (MD= –29.05, 95%CI –37.98 to –20.12, Plt;0.000 01). Three studies showed that the anesthesia induction time of the sevoflurane group was shorter than that of the ketamine group (MD= –208.45, 95%CI –359.22 to –57.68, P=0.007). Six studies showed that the influence on mean arterial pressure (MAP) had no significante difference (MD= –4.86, 95%CI –10.02 to 0.29, P=0.06). Meanwhile, seven studies showed that the adverse events of the sevoflurane group were fewer than those of the ketamine group (Peto OR=0.29, 95%CI 0.20 to 0.40, Plt;0.000 01). Conclusion The results of this system review show that sevoflurane is more effective than ketamine with fewer adverse reactions, and it provides a new choice for clinical anesthesia for child short period surgery. However, ketamine is still the main drug in clinical anesthesia for the child short period surgery at present, so high quality studies are needed for further clinical researches.