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@#（正）食管癌是我国高发的消化道恶性肿瘤，目前食管癌的治疗仍然以手术方式为主，化疗、放疗等方法为辅[1]。食管癌手术切除术式经过多年的演变，从开放左胸一切口、二切口，发展到开放右侧进胸二切口、三切口。随着高清晰度胸腔镜、高科技内镜手术器械和先进麻醉技术的应用，微创食管切除手术技术得到迅猛的发展并趋于成熟。胸腔镜手术具有创伤小、恢复快等优势，已经在胸外科手术中得到了充分肯定[2-3]。本视频旨在展示胸腹腔镜联合食管癌手术的手术入路和操作要点。
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OBJECTIVE:To evaluate the availability and equipment of antidiabetic drugs in public hospitals from Shaanxi prov-ince. METHODS:Using a standardized methodology developed by WHO and Health Action International,the availability and equipping rate of the most common oral antidiabitic drugs were investigated and evaluated in public hospitals of Shaanxi province. RESULTS:The availability and equipping rate of tertiary hospitals and secondary hospitals were all higher than those of community health service centers. Among generic drugs,the availability of metformin was the highest (94.4%),and those of glibenclamide and repaglinide were the lowest(5.6%). Among original drugs,the availability of acarbose was the highest(68.1%). The equip-ping rate of original drugs was higher than that of generic drugs. The equipping rate of generic drugs(25.0%)was higher than that of original drugs(12.5%)in community health service center,but the equipping rates of generic drugs and original drugs were in low level. CONCLUSIONS:General hospitals (especially tertiary hospitals) have high equipping rate of original antidiabetic drugs,the community health services have low availability and equipping rate. Comprehensive measures should be taken to im-prove the availability of drugs in primary medical institutions and ensure drug use of chronic disease patients in primary hospitals.
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Objective A easier and faster rat model of organ injury caused by cardiopulmonary bypass was developed to provide a stable and economical experimental platform for the research of CPB ( cardiopulmonary bypass ) .Methods Twenty male Sprague-Dawley rats weight between (288.8 ±26.1)g were randomly divided into sham group and CPB group .The right external jugular vein and bilateral femoral arteries were punctured in sham group ,while the rats in CPB group underwent 60 minutes cardiopulmoanry bypass with the perfusion flow no less than 120 mL· kg-1· min-1 .And the weight ,blood pressure ,blood gas and electrolytes were monitored and analyzed throughout the experi -ment.The serum,lung,liver and kidney were collected at 72 h after the operation for further detection .Results The rat model of cardiopul-monary bypass was established successfully with 90%survival rate .The changes of blood gas during intraoperative and postoperative were in accordance with clinical reality and the injury of lung ,liver and kidney were confirmed by serum results and pathological changes .Conclu-sion The model has the characteristics of lower weight ,less priming solution ,no need for endotracheal intubation and easier to assemble the bypass line ,furthermore the methods of puncture and CPB were exhibited through a large number of pictures .As a consequence ,the difficul-ties of establishing the rat model of CPB were reduced significantly .The changes of pathophysiology during intraoperative and postoperative were similar to clinical realities ,the survival rate and organ injury were satisfactory .So it can be used as an effective tool for the research of organ injury and the evaluation of therapeutic strategies associated with CPB .
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Objective To apply the BestSeqTM new generation pathogenic gene detection technology to perform the genetic detec‐tion in the patients with progressive muscular dystrophy (PMD) validating its sensitivity and specificity .Methods The BestSeqTM new generation pathogenic gene detection technology was used to perform the gene sequencing in 2 cases of limb‐girdle muscular dystrophy(LGMD) and 6 cases of Dunchenne′s muscular dystrophy(DMD) ,and the found point mutations were confirmed by the Sanger sequencing method .Results This study completed the genetic detection in above 8 cases ,2 cases of large fragment deletion and 10 cases of micromutations were detected ,in which 8 micromutations were the new mutation discovered ffor the first time and verified by the Sanger sequencing .Conclusion The BestSeqTM new generation pathogenic gene detection technology greatly increa‐ses the detection efficiency by using the high density imbricate type probe and multiple tag technology ,and has the better clinical ap‐plication prospects .
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[Abstract ] Objective The aim of the study was to investigate the effects of recombinant human erythoropoietin (EPO) and bone marrow mesenchymal stem cell (BMSC) transplantation on renal inflammatory response following cardiopulmonary bypass (CPB). Methods Forty sprague-Dawley male rats were randomly divided into five groups (n=8):shame operation group, CPB group, EPO group, BMSC group and EPO +BMSC group.CPB model was built in shame operation group without CPB .The other four groups un-derwent CPB, following by jugular vein infusion of 1.5 ×106 BMSCs after an hour′s 100 L/kg/min bypass .Jugular vein infusion of 3000 IU/kg EPO was done in EPO group , while the combination of EPO with BMSCs was infused in EPO +BMSC group.The same volume of isotonic saline solution was infused via jugular vein in CPB group and shame operation group respectively .Rats were sacrificed at 24 hours after CPB termination .Blood samples were collected for the determi-nation of creatinine(Cr) and urea nitro(BUN) levels.HE staining was applied in the examination of renal tissues .ELISA was used in the determination of serum interleukin 6 (IL-6) and interleukin 10 (IL-10) levels and western blot was taken to test the expressions of tumor necrosis factor (TNF-α) and insulin-like growth factor 1 (IGF-1). Results In CPB group, the levels of Cr, BUN, IL-6 and the expression of TNF-αwere increased, while IL-10 level and of IGF-1 expression were decreased(P<0.05).TNF-αexpression was increased while IGF-1 expression was decreased in renal tissue (P<0.05).HE staining results showed the renal injury in EPO +BM-SC group was significantly lower than those in EPO group , BMSC group and CPB group , along with the decrease in the levels of Cr , BUN, IL-6, the increase in IL-10 level(P<0.05), as well as the decline of TNF-αexpression and the rise of IGF-1 expression(P<0.05). Conclusion The combination of EPO and BMSCs which reduces renal inflammatory response following CPB has protective effects on renal injury following CPB in rats , which is better than single application of EPO or BMSCs .
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Mastoparan(MAS) and α-latrotoxin(α-LTX) are two kinds of insulinotropic peptides obtained from insect toxins which can interact with islet β-cells and induce insulin secretion. The signal mechanism of these insulinotropic peptides regulating insulin-releasing attracts notable attention and has been elucidated more and more details. MAS mainly acts on the molecular components of exocytosis at a late stage. Insulin secretion induced by MAS is obviously dependent on GTP, which subsequently activates G-protein located on insulin secretion granules(ISG), or activates the Rho subfamily of small G proteins to evoke exocytosis and sensitize fusion machinery. The MAS stimulated insulin-releasing activity can be augmented by nutrients. However, its effect is not Ca~(2+) dependent. There are two regulatory pathway triggered by α-LTX: one way is pore formation caused through plasma membrane, another way is the transmembrane signal transduction evoked by cytosolic second messengers. Tetrameri complexs assembled at high concentration of α-LTX toxin or in the presence of extracellular Ca~(2+), can insert α-LTX into plasma membrane to form Ca~(2+) permeable channels and trigger Ca~(2+)-dependent secretion. By binding to transmembrane receptors and activating phospholipase C, α-LTX induces the generation of second messenger DAG and IP3. IP3 triggers Ca~(2+) influx and subsequently activates CaMK pathway, however, DAG also activates PKC pathway to increase insulin release.