Modified Bascom cleft lift procedure for chronic pilonidal sinus / 中华普通外科杂志

Objective To evaluate the clinical efficacy of modified Bascom cleft lift procedure in the treatment of chronic sinus.Methods Modified Bascom cleft lift procedure was performed in 53 patients admitted from Oct 2012 to Jul 2016.49 cases were male and 4 were female.The average age was (25.4± 2.3) years.Results All patients were satisfied with the operation.There were 49 cases of primary healing and 4 cases of incision complications.The average follow-up was (12.1 ±4.3) months,no recurrence was observed.Conclusion The modified Bascom cleft lift technique is effective and reliable,with less complications and a lower recurrence rate.

The therapeutic evaluation of video-assisted anal fistula treatment for Parks Ⅱ anal fistula / 中华普通外科杂志

Objective To evaluate video-assisted anal fistula treatment (VAAFT) for Parks type Ⅱ anal fistula.Methods 40 Parks type Ⅱ anal fistula patients underwent VAAFT procedure from June 2015 to June 2017.Results were compared with 40 cases treated by incision and thread drawing.Results There was no significant difference between the two groups for curative effect,postoperative urinary retention,wound edema,bleeding and recurrence rate after 6 months of operation (90％ vs.95％,x2 =0.722,P =0.697;5％ vs.8％,x2 =0.213,P=1.0;2％ vs.8％,x2 =1.053,P=0.615;0 vs.5％,x2 =2.051,P =0.494;10％ vs.5％,x2 =0.721,P =0.675).Pain on first day and one week after operation in the VAAFT was less [(1.9±0.6) vs.(3.7±1.0),t =9.438,P=0.001;(0.9±0.7) vs.(1.9±0.8),t=6.269,P=0.001],hospital stay was shorter [8.4 ±1.3) d vs.(9.2 ±2.2) d,t =2.030,P=0.047],wound healing was faster [(27 ±8) dm.(38 ±6) d,t =7.328,P =0.001].The Jorge-Wexner incontinence score [(0.5±0.7) vs.(1.2±1.3),t =2.951,P=0.005] and the fecal incontinence severity index [(1.1±1.6) vs.(5.1 ±3.2),t =7.097,P=0.001] were lower in patients receiving VAAFT procedure.Conclusion Video-assisted anal fistula treatment is a safe and effective surgical method with the advantages of less trauma,and pain,quicker recovery and no damage to the anal sphincter.

Clinical observation of the ligation of intersphincteric fistula tract in the treatment of simple anal fistula / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) in the treatment of simple anal fistula, including transphincteric anal fistula and insphincteric anal fistula.</p><p><b>METHODS</b>Clinical data of 52 patients with anal fistula receiving surgery treatment in Beijing Anorectal Hospital from January to October 2014 were analyzed retrospectively. Adoption of surgical procedure was based on rectal endoluminal ultrasound and patients' decision. Patients were divided into LIFT group and seton group. The two groups were compared in terms of operation time, blood loss, postoperative pain score, incidence of urinary retention, wound healing time, cure rate, recurrence, and the anal incontinence score.</p><p><b>RESULTS</b>There were 52 patients in the entire cohort including 28 cases of transphincteric anal fistula (14 cases of LIFT and seton placement groups) and 24 cases of intersphincteric anal fistula (12 case of LIFT and seton placement). The operation time was shorter in seton placement group in patients with two simple anal fistula [(23.9±5.0) min vs. (46.3±7.7) min, P<0.05]. LIFT postoperative pain score [(1.6±0.6) vs. (6.1±1.3)], wound healing time [(7.9±2.0) days vs. (30.0±5.1) days], postoperative hospital stay [(10.3±3.1) days vs. (20.7±7.1) days], and anal incontinence scores [(1.1±0.4) vs. (4.9±1.1)] were better than that of anal fistula seton (all P<0.05). There was no statistically significant difference in intraoperatie blood loss [(23.1±4.7) ml vs. (23.3±4.7) ml, P>0.05]. The cure rate of intersphincteric anal fistula was 83.3%(10/12) in LIFT group, and 100%(12/12) in the seton group. The cure rate of transphincteric anal fistula was 78.6% (11/14) in LIFT and 92.9%(13/14) in anal fistula seton group. There was no statistically significant difference (P>0.05).</p><p><b>CONCLUSION</b>In the treatment of transphincteric fistula tract and intersphincteric fistula tract, LIFT procedures should be considered.</p>

Effects of Ca2+ on salicylic-acid induced biosynthesis of salvianolic acid B in young seedlings of Salvia miltiorrhiza Bunge / 生物工程学报

In order to study the effects of Ca2+ in the biosynthesis of salvianolic acid B (Sal B) induced by salicylic acid (SA) in the young seedlings of Salvia miltiorrhiza, we used confocal laser scanning microscopy and high performance liquid chromatography to measure the change of relative fluorescence intensity of Ca2+ and the contents of Sal B induced by SA before and after the application of extracellular calcium channel inhibitors (VP and LaCl3), intracellular calcium channel inhibitor (LiCl), as well as intracellular calmodulin antagonist (TFP). SA could induce the calcium burst, and the Ca2+ peak could last to 2-3 min in the guard cells of S. miltiorrhiza, which prompted the biosynthesis of Sal B after the Ca2+ burst. Both Vp or LaCl3, and LiCl or TFP could inhibit the burst of Ca2+ and the biosynthesis of Sal B. The above results demonstrated that Ca2+ from the extracellular and the intracellular calcium store regulate the biosynthesis of Sal B elicited by salicylic acid in S. miltiorrhiz young seedlings.

Effect of calcium on medium alkalinization induced by salicylic acid in Salvia miltiorrhiza suspension cultures / 生物工程学报

We studied medium alkalinization in Salvia miltiorrhiza suspension cultures treated with salicylic acid and the effect of Ca2+ in this process through application of calcium channel antagonists (Verapamil, LaCl3, LiCl, 2-APB) and ionophore A23187. The results show that salicylic acid could induce significant medium alkalinization in S. miltiorrhiza culture. Verapamil and LaCl3 or LiCl and 2-APB, two different groups of calcium channel antagonist, significantly inhibited the medium alkalinization induced by salicylic acid. However, the suppression effect of verapamil or LaCl3 on medium alkalinization induced by salicylic acid was higher than that of LiCl or 2-APB. When two types of calcium channel inhibitor (LaCl3 and 2-APB) were used together, the medium alkalinization induced by salicylic acid was completely suppressed and even reduced the pH in medium. On the other hand, A23187 could promote the medium alkalinization. Based on the results above, we speculated that salicylic acid could induce significant medium alkalinization in S. miltiorrhiza culture, depending on the calcium from both extracell and intracell. Moreover, calcium from extracell plays a more dominant role in this process. Reveal of relationship in this research between Ca2+ and medium alkalinization can provide theory evidence for mechanism of the plant secondary metabolism.

Hydrogen peroxide is involved in the signal transduction of salicylic acid-induced salvianolic acid B biosynthesis in Salvia miltiorrhiza cell cultures / 生物工程学报

Hydrogen peroxide (H2O2), one of reactive oxygen species, is widely generated in many biological systems, and it mediates various physiological and biochemical process in plants. To investigate the role of H2O2 as a signaling molecule in the process of salicylic acid (SA)-induced Salvianolic acid B (Sal B) accumulation, we separately inspected the cultured cells of Salvia miltiorrhiza with SA, H2O2, catalase (CAT), 2-(4-carboxy-2-phenyl)-4,4,5,5-tetramethylimidazoline-l-oxyl-3-oxide (DMTU) and Imidazole (IMD) to investigate the influence on the activity of phenylalanine ammonia-lyase (PAL) and tyrosine aminotransferase (TAT) and the accumulation of Sal B. Treatment of S. miltiorrhiza cells with SA resulted in an increase of H2O2, the increase of PAL and TAT and accumulation of Sal B. Exogenous application of 10-30 mmol/L H2O2 was found to effectively increase PAL and TAT activity as well as the Sal B content. CAT, a H2O2 scavenger, eliminated the Sal B-accumulating effects of exogenous H2O2 and SA. These indicated that H2O2 may serve as an upstream signaling molecule in the SA-induced accumulation of Sal B signal transduction pathway. Disposed by DMTU, a chemical trap for H2O2, as observed to be effective in inhibiting SA-induced accumulation of Sal B. IMD strongly inhibits the activity of NADPH oxidase, which is one of the main sources of H2O2 formation in plant cells. IMD treatment strongly inhibited the accumulation of Sal B in cultured cells of S. miltiorrhiza, but the effects of IMD, can be partially reversed by the exogenous SA. The accumulation of Sal B was blocked once the generation of H2O2 by NADPH oxidase was inhibited, and H2O2 served as signaling molecule mediated the SA-induced Sal B accumulation.

Effects of calcium on synthesis of rosmarinic acid and related enzymes in suspension cultures of Salvia miltiorrhiza / 生物工程学报

We studied the influence of the concentration of Ca2+ (0-50 mmol/L) in culture medium on the synthesis of rosmarinic acid (RA) and related enzymes in Salvia miltiorrhiza suspension cultures. Using verpamil (VP, a calcium channel antagonist) and ionophore A23187, we studied the mechanism of secondary metabolites of Salvia miltiorrhiza suspension cultures influenced by the concentration of Ca2+ in the culture medium. The synthesis of intracellular RA in 6-day incubation was significantly dependent on the medium Ca2+ concentration. At the optimal Ca2+ concentration of 10 mmol/L, a maximal RA content of 20.149 mg/g biomass dry weight was reached, which was about 37.3% and 20.4% higher than that at Ca2+ concentrations of 1 and 3 mmol/L, respectively. The variation of the activity of PAL and TAT, two key enzymes of the two branches of RA, could be affected by the concentration of Ca2+ in culture medium. The change of their activity occurred prior to the accumulation of RA, which suggested both of the key enzymes be involved in the synthesis of RA. Meanwhile, the enzymatic action of PAL was more distinct than TAT. The treatment of VP and A23187, respectively, indicated that the influence of RA affected by the concentration of Ca2+ in the culture medium was accomplished by the intracellular Ca2+, and the flow of Ca2+ from the extracellular to the intracellular environment could also participate in this process.

Ulnar impaction syndrome misdiagnosed by soft tissue injury in wrist / 中国矫形外科杂志

[Objective]To explore the reason of ulnar impaction syndrome misdiagnosed by tissue injury in wrist.[Method]From December 1998 to December 2005,216 cases who were diagnosed for soft tissue injury in ulnar wrist were checked and discriminated according to X-ray and MRI of the injured wrist,and 48 cases were re-diagnosed for ulnar impaction syndrome.The misdiagnosis rate was 22.2%.[Result]Most cases of ulnar impaction syndrome had positive lunar variance(68.8%).Carpal avascular necrosis were found in about 27.1% of cases through X-ray of wrist and 100% through MRI.Different degree changes of abnormal signal intensity were found in soft tissue,triangular fibro cartilage(TFC) and carpal bones by MRI which displayed swelling of soft tissue in carpal joint,strip-shape high signal intensity or mixed signal intensity at ligament around wrist and enhanced signal intensity at TFC area extending to ulnar carpal articular facet.The appearance of MRI in carpal bones showed local abnormal signal,articular cartilage thickening and hydropsia in bone below cartilage and marrow.[Conclusion]The misdiagnosis can be reduced through elevating acquaintance level of ulnar impaction syndrome basing on clinical symptoms,making the most use of imaging,especially MRI.