【Abstract】Objective To study the effects of nitric oxide (NO) on the growth and metastasis of tumor.Methods The literatures of recent years were reviewed.Results NO had double effects on the growth and metastasis of tumor. NO promoted the growth and metastasis by regulating the expression of tumor proliferation gene and inducing tumor angiogenesis. On the other hand, NO had antitumor effects by interfering with the metabolism of tumor cells, inducing the damage of DNA, forming high toxic free radical, inducing apoptosis of tumor cells and mediating the antitumor action of endothelial cells and macrophages.Conclusion Selective blockage or induction of synthesis of NO may be a new way for tumor therapy.
Pelvic exenteration has become an important procedure for radical treatment of locally advanced/recurrent rectal cancer, and in recent years, with the advancement of surgical techniques and the improvement of perioperative management ability, the long-term prognosis of patients has been significantly improved. However, the high incidence of perioperative complications seriously impacts the quality of life of patients and the course of postoperative recovery, which remains a major problem for surgeons. Precise surgical levels and appropriate intraoperative position help to fully expose the surgical field, accurately identify major vessels, and reduce the risk of intraoperative bleeding. Biological mesh, myocutaneous flap and omentoplasty are common pelvic floor reconstruction methods, and combined repair of pelvic defects by two of them may further reduce the incidence of empty pelvic syndrome. Iliac revascularization could effectively prevent postoperative thrombosis and ventricular septal syndrome. The application of minimally invasive techniques and the implementation of pre-rehabilitation measures might help to reduce postoperative complications. This article reviews the prevention strategies of complications after pelvic exenteration in order to provide some reference for clinical practice and surgical promotion.
ObjectiveTo summarize the current status and the management and prophylaxis of complications in laparoscopic gastrectomy. MethodsThe literatures on laparoscopic gastrectomy in domestic and abroad were reviewed and analyzed combined with our experiences. ResultsThe complications of laparoscopic gastrectomy primary attributed to surgery itself and pneumoperitoneum. Limited field under laparoscopy, loss of threedimensional space and finger touch, new instrument and technology and working conditions increased the difficulty of operation and the possibility of surgical complications. Clear anatomical layer under laparoscopy, accurate dissection of lymph nodes, and digestive tract reconstruction were the basis to reduce the complications in laparoscopic gastrectomy. ConclusionCorrect surgical procedures may reduce the occurrence of complications in laparoscopic gastrectomy.
【Abstract】ObjectiveTo explore the effects of p38 mitogenactivated protein kinase (MAPK) on apoptosis of small intestinal epithelial cells after transplantation in rats. MethodsSmall intestinal transplantation was performed in SD and Wistar rats. The recipients were divided into three groups: isograft group (Wistar→Wistar group), allograft group (SD→Wistar group) and allograft+cyclosporine A group (SD→Wistar+CsA group). The grafts were harvested on day 1, 3, 5 and 7 after operation. All graft samples were subjected to histological examination. The apoptosis of graft epithelial cells was detected by TUNEL method. p38 MAPK was measured by Westernblotting method and serum TNFα was determined by ELISA. ResultsMild, moderate and severe rejection reaction occurred in the SD→Wistar group, it was showed that the number of apoptotic cells increased with the severity of the rejection reaction by TUNEL. In SD→Wistar group, the numbers of apoptotic cells were significantly higher than those of the other two groups （P＜0.01）. The severity of rejection reaction in SD→Wistar+CsA group was less than that of SD→Wistar group and the number of apoptotic cells increased with the severity of the rejection reaction (P＜0.01). The level of serum TNFα varied with the apoptotic degree of small intestinal epithelial cells in SD→Wistar group and SD→Wistar+CsA group （P＜0.01）. The expression of p38 MAPK increased with the number of the apoptotic cells in SD→Wistar group and SD→Wistar+CsA group （P＜0.01）, but there was no evident change in Wistar→Wistar group （Pgt;0.05）. The expression of p38 MAPK and the level of serum TNFα were positively correlated with apoptosis in small intestinal rejection after transplantation （r=0.875， P＜0.01； r=0.837， P＜0.01）. p38 MAPK and TNFα were also positively correlated （r=0.826，P＜0.01）. ConclusionApoptosis plays an important role in small intestinal rejection. p38 MAPK is involved in apoptosis and is an important regulator in signal pathway of cell apoptosis.
ObjectiveTo explore the effectiveness of hollow screw for the treatment of basilar part fracture of hamate hook.MethodsFive patients with basilar part fracture of hamate hook, aged 24-47 years (mean, 31 years) were treated with open reduction and hollow screw fixation between June 2015 and February 2019. There were 4 males and 1 female. The causes of injury were athletic injury in 3 cases, falling injury in 1 case, and crushing injury in 1 case. Among them, 1 case was combined with sensory disturbance of one and a half fingers on the ulnar side of the palm. The grip strength of the affected side was significantly decreased when compared with that of the healthy side in all patients. The intervals between injury and surgery were 3-8 days (mean, 4.2 days). Postoperative follow-up was conducted regularly to measure the grip strength of the affected and healthy fingers and the total motion of ring and little fingers of the affected side. Darrow criteria was used to evaluate the effectiveness.ResultsAll the incisions healed by primary intention. All the patients were followed up 6-32 months (mean, 16 months). X-ray films showed that the basilar part fracture of hamate hook reached bony union, and the healing time was 2.0-3.5 months (mean, 2.2 months). At last follow-up, the grip strength of the affected side was (35.80±3.76) kg, showing no significant difference when compared with healthy side [(36.00±4.94) kg] (t=0.094, P=0.930); and the total motion of ring and little fingers of the affected side was (529.0±8.9)°, which was significantly different from that before operation [(232.0±34.7)°] (t=18.108, P=0.000). In 1 patient with ulnar nerve injury, the two-point discrimination of the innervation area was 4 mm, and the pain sensation and temperature sensation returned to normal. Assessed by Darrow criteria, the results were excellent in 4 cases and good in 1 case.ConclusionFor the basilar part fracture of hamate hook, hollow screw fixation can obtain secure reduction and fixation and provide sustained compression and counter-rotation for the broken end of fracture, thus allowing early joint motion and promoting fracture healing and recovery of wrist function. It is a relatively good method for the treatment of basilar part fracture of hamate hook.
Objective To compare their competence of olfactory epithel ial gl iacytes, olfactory globular nerve layer (OGNL) gl iacytes and SC in repair nerve defect of sciatic nerve, and select the best gl iacytes for repair of peri pheral nerve defect. Methods Olfactory epithel ial gl iacytes, OGNL gl iacytes and SC were extracted from 20 female Wistar rats aged 2-3 months and cultured in vitro for 2 weeks, then purified and condensed for transplantation. Eighty adult female Wistar rats were randomized into groups A, B, C and D (n=20). The left sciatic nerves were excised 25 mm axons and retained epineuriumlumen anastomosed to proximal ends. The culture mediums, SC, OGNL gl iacytes, and olfactory epithel ial gl iacytes weretransplanted into the epineurium lumen of groups A, B, C and D, respectively. Three months postoperatively, the injured sciatic nerve regeneration was evaluated by methods of macroscopic observation, photomicroscope, transmission electron microscope, retro-marked fluorescence transportation distance, the gl ial fibrillary acidic protein (GFAP) and nerve growth factor (NGF) were assayed by immunofluorescence, and the myel in basic protein (MBP) and neurofilament (NF) protein were assayed by ELISA. Results The scores of ankle joint were (3.325 ± 0.963), (4.200 ± 1.005), (5.143 ± 0.635) and (5.950 ± 0.154) in groups A, B, C and D, respectively; showing statistically significant difference between groups (P lt; 0.05). The obse vations of gross, sections under microscope and transmission electron microscope showed the regeneration of defect nerve was best in group D, followed by group C, and group B was superior to group A. The transportation distance of retro-marked fluorescence was longest in group D, followed by group C, and group B was superior to group A. The concentrations of GFAP and NGF were largest in group D, followed by group C, and group B was superior to group A. The MBP concentrations were (9.817 ± 3.267), (12.347 ± 3.091), (14.937 ± 2.075) and (22.757 ± 0.871) ng/mL in groups A, B, C and D, respectively; showing statistically significant difference between other groups (P﹤0.05) except between group A and group B (P gt; 0.05). And the NF concentrations were (13.869 ± 5.677), (18.498 ± 3.889), (23.443 ± 2.260) and (27.610 ± 1.125) ng/mL in groups A, B, C and D, respectively; showing statistically significant difference between groups (P﹤0.05). Conclusion Olfactory epithel ial gl iacytes, OGNL gl iacytes and SC transplantation could repair injured nerve. The competence of olfactory epithel iums is superior to the OGNL gl iacytes andSC, and the OGNL gl iacytes is better than SC.
Objective To review the progress and application of peripheral nervous microelectrode. Methods The recent articles on peripheral nervous microelectrode were extensively reviewed. The classification, the progress of the peripheral nervous microelectrode and its utilizable prospect in the control of electronic prosthesis were summarized. Results The microelectrodes had favorable functions of selective stimulation and recording. It provided an information transmitting interface between the electric prosthesis and peripheral nerves. Conclusion Peripheral nervous signal is a feasible signal source to control electronic prosthesis.
【摘要】 目的 用老年大鼠建立一种与人类发病年龄相符的稳定可重复的急性心肌梗死动物模型。 方法 Wistar大鼠经戊巴比妥钠麻醉后，气管切开插管，连通呼吸机，开胸后结扎左冠状动脉前降支。分不同时间点测血流动力学后取出心脏行病理组织学观察。 结果 成功建立老年大鼠心肌梗死模型并进行病理组织学验证。 结论 建立老年大鼠心梗模型是可靠的，有助于指导临床实践。【Abstract】 Objective To develop a steady and repeatable acute myocardial infarction model in old rats in accordance to human age. Methods Wistar rats were anaesthetized with sodium phenobarbital. After tracheotomy intubation, respiration machine was linked. Left anterior thoracotomy was performed to ligate the left anterior descending coronary artery. After hemodynamic parameters were obtained at various time points, hearts of the rats were taken for pathologic and histological examinations. Results The model of acute myocardial infarction in old rats was established successfully and proved by pathologic and histological staining. Conclusion It is reliable to establish the myocardial infarction model in old rats, which is helpful in guiding clinical practices.
【Abstract】 Objective To investigate the feasibil ity of applying enzymatic method to prepare decellularizedporcine aorta and to evaluate its biomechanical properties, immunogenicity and cell compatibil ity. Methods 0.1% trypsin- 0.01% EDTA was appl ied to extract cells from porcine aorta under 37 continuously vibrating condition and its histology and microstructure were observed. The thickness, stress-strain curve, ultimate tension stress (UTS) and strain of failure (SOF) were compared before and after decellularization for 48, 96 and 120 hours under uniaxial tensile tests, respectively. The histological change was observed at 1, 3 and 6 weeks after the decellularized tissue was implanted subcutaneously in 3 dogs. According to the HE stains and a semi-quantitative Wakitani grading method, gross changes, category and amounts of infiltrated cells and neo-capillaries were compared between pre- and post-decellularization of porcine aortae. Endothel ial cells from canine external jugular vein were seeded onto the decellularized patches to observe the cell compatibil ity. Results Microscopy and electron microscopies examination identified that cell components was completely removed from the fresh porcine aorta and Masson’ strichrome showed that the structure of matrix (fibrins) was maintained intact at 96 hours using the decellularization method. There were no significant differences in the thickness, UTS and SOF between before and after decellularization (P gt; 0.05). However, The UTS values showed a decrease tendency and SOF showed an increase tendency. The stress-strain curve also verified a decrease tendency in mechanical intensity and an increase one in ductil ity after decellularization. After implanting the acellularized matrix subcutaneously in canine, moderately lymphocyte infiltration was seen at the 1st week and the infiltration was replaced by fibroblasts accompanied by neocapillary formation at the 6th week. A semi-quantity histological evaluation showed that there were differences in gross observation, category and the numbers of the infiltrated cells between decellularized and non-decellularized tissues（P lt; 0.05). A cell monolayer was identified by HE staining and scanning electron microscopywhen the endothel ial cells were seeded onto the inner luminal surface of the scaffold, al igned at the same direction on the whole. Conclusion The decellularized porcine aortic scaffold, prepared by trypsin-EDTA extraction under continuously vibrating condition, could meet the requirements of tissue-engineering graft in biomechanical properties, immunogenicity and cell compatibil ity.
ObjectiveTo summarize the relationship between shoulder instability and superior labrum anterior posterior (SLAP) lesion. MethodsThe characteristics of shoulder instability and SLAP lesion were analyzed, and the relationship between them in pathogenesis, clinical symptoms, and biomechanics was discussed by referring to relevant domestic and foreign literature. ResultsShoulder instability and SLAP lesion can occur both spontaneously and respectively. SLAP lesion destroys the superior labrum integrity and the long head of biceps tendon (LHBT) insertion, causing excessive humeral head displacement against glenoid, and leading to shoulder instability. While chronic repetitive or acute high-energy traumatic shoulder instability can in turn aggravate SLAP lesion, resulting in expansion and increased degree of the original lesion. Conclusion SLAP lesion destroys mechanisms of shoulder stability, while shoulder instability causes tears of the upper labrum and the LHBT, showing a connection between shoulder instability and SLAP lesion. However, the existing evidence can only demonstrate that shoulder instability and SLAP lesion induce and promote the development of each other, instead of a necessary and sufficient condition. Therefore, the specific causal relationship between the two remains unknown and needs to be further studied.