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Objective:To study the efficacy of 68Ga-PSMA PET/CT in evaluating lymph node metastases (LNMs) in patients with prostate cancer (PCa). Methods:Patients who recieved 68Ga-PSMA PET /CT examination in the First Affiliated Hospital of Air Force Military Medical University from July 2021 to February 2022 were enrolled. The patients’ age was (64.4±6.1) years old, with median total prostate specific antigen (tPSA) 34.5 (6.1-99.0) ng/ ml, including PSA<10ng/ ml in 12 cases, 10-20ng/ ml in 21 cases, and > 20 ng/ml in 25 cases. Preoperative clinical staging: 1 case in T 1 stage, 38 cases in T 2 stage, 16 cases in T 3stage, 3 cases in T 4 stage. Preoperative Gleason score of 10 cases was <7, 20 cases was 7, and 28 cases was > 7. According to D 'Amico risk grouping criteria, there were 8 cases in the low-risk group, 20 cases in the medium-risk group and 30 cases in the high-risk group. Preoperative examination of 68Ga-PSMA PET/CT showed no distant metastasis such as visceral metastasis and bone metastasis. All patients underwent radical prostatectomy and pelvic lymph node dissection. The following patients were excluded: patients received preoperative prostate surgery, patients received endocrine therapy, chemotherapy and radiotherapy for prostate cancer before surgery, a history of other malignant tumors in the past 2 years, biopsy pathological diagnosis of neuroendocrine cell prostate cancer and other special types of prostate cancer, prior history of major pelvic surgery, etc. Radical prostatectomy was performed. 38 patients received laparoscopic surgery and 20 patients received robot-assisted laparoscopic surgery. The sensitivity and specificity of 68Ga-PSMA PET /CT for the diagnosis of lymph node metastasis of prostate cancer were calculated according to the comparison of lymph node metastasis in postoperative pathological results and preoperative examination. Results:Postoperative pathological diagnosis: Gleason score of 9 cases was <7, 19 cases was 7, and 30 cases was >7. 37 cases were in pT 2 stage, 17 cases in pT 3 stage, and 4 cases in T 4 stage. There were 12 cases (20.7%) of positive resection margin, and 7 cases (12.1%) of lymphatic fistula. There were 10 patients with lymph node metastasis diagnosed by 68Ga-PSMA PET/CT before surgery, and 17 positive lymph node regions. A total of 11 patients were pathologically positive in lymph nodes, and a total of 20 lymph nodes regions were positive. Based on the number of patients, the specificity and sensitivity of 68Ga-PSMA PET /CT in diagnosing lymph node metastasis in patients were 97.9% (46/47) and 81.2% (9/11), respectively. Based on the number of regional lymph nodes, the specificity and sensitivity of 68Ga-PSMA PET /CT for regional lymph node diagnosis were 99.4%(326/328) and 75.0%(15/20), respectively. The specificity of lymph node metastasis in the external iliac group, the internal iliac group and the obturator group were 100.0%(114/114), 99.1%(110/111) and 98.1%(101/103), and the sensitivity was 100.0%(2/2), 60.00%(3/5) and 69.2%(9/13), respectively. Conclusion:68Ga-PSMA PET/CT can be used as a strong tool for precise guidance of PLND in PCa patients.
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Objective:To explore the clinical value of introducing 68Ga PSMA PET / CT into the prostate cancer(PCa)screening clinic, and to analyze the incidence rate and biopsy of PCa in the screening clinic of our hospital. Methods:The data of the people who participated in PCa screening in the urology screening clinic of our hospital from March 2021 to November 2021 were retrospectively analyzed. Serum PSA was used as the screening index. The subjects with PSA≥4ng/ml were first examined by mpMRI to find suspicious nodules, and the positive ones were further examined by 68Ga-PSMA PET/CT to determine the lesions.The puncture target was outlined, and systematic+ targeted puncture was conducted under ultrasound guidance. The age, PSA distribution, puncture detection rate, Gleason score and clinical stage of patients with PCa were recorded. Results:A total of 1 079 subjects were included in the screening, with an average age of (63.9±9.9)(ranging 40-92) years old, and 249 patients (23.1%, 249/1 079) with PSA≥4ng/ml. Among them, 87 cases (87/249, 34.9%) received mpMRI, and 34 cases (34/249, 13.7%) had PI-RADS score ≥3 points. These 34 patients with suspected nodules on MRI were further scanned with 68Ga-PSMA PET/CT, and 11 cases (11/249, 4.4%) had abnormal uptake of PSMA nuclide. A total of 32 patients (12 patients with PSA abnormalities and 20 patients with positive imaging) finally received prostate biopsy, and 11 patients were diagnosed with PCa, with a positive detection rate of 34.4% (11/32), accounting for 1.0% (11/1 079) of the screening population. Among them, 20 patients with positive imaging (9 patients with only mpMRI positive and 11 patients with both mpMRI and 68Ga-PSMA PET/CT positive) underwent system + targeted fusion biopsy, and the positive rate was 45% (9/20). 12 patients (only PSA abnormal) underwent routine systematic puncture biopsy, and the positive detection rate was 16.7% (2/12). The difference between the two groups was statistically significant ( P<0.05). Among the patients with confirmed PCa, 27.3% (3/11) had Gleason score less than 7, and 72.7% (8/11) had Gleason score≥7. Localized PCa (≤T 2) accounted for 45.4% (5/11), local progression (T 3-T 4) accounted for 18.2% (2/11), and metastatic PCa suggested by 68Ga-PSMA PET/CT accounted for 36.4% (4/11), including 3 systemic multiple bone metastases and one bone metastasis with distant lymph node metastasis. Clinically significant PCa accounted for 90.9% (10/11) of the confirmed patients, and the proportion of high-risk patients in localized or locally advanced PCa was 71.4% (5/7). Conclusions:In PCa screening, if 68Ga-PSMA PET/CT is introduced on the basis of conventional mpMRI, the detection rate of clinically meaningful PCa can be improved. Combined with targeted puncture, tumor lesions can be found early and the screening efficiency of PCa can be improved. In this study, the detection rate of PCa in outpatient screening reached 1.0%. In confirmed cases, the proportion of high-risk patients and metastatic patients was higher.
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Objective:To investigate the risk factors for biochemical recurrence after radical prostatectomy.Methods:The clinical data of 558 radical prostatectomy patients admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2010 to December 2020 were retrospectively analyzed. The average age was 67.9 (40-87) years old, and the average body mass index was 24.56 (15.12-35.94) kg/m 2. The average PSA was 41.07 ng/ml, including 48 cases<10 ng/ml, 98 cases 10-20 ng/ml, and 412 cases>20 ng/ml. There were 123, 214, 118, 89, and 14 cases with biopsy Gleason 6-10 score, respectively. The clinical stage : 90 cases in ≤T 2b, 273 cases in T 2c, and 195 cases in ≥T 3 . 558 cases underwent radical prostatectomy, including 528 robotic-assisted laparoscopic surgery, 25 laparoscopic surgery, and 5 open-surgery. The risk factors for postoperative biochemical recurrence were analyzed by Cox regression. Results:A total of 63 patients had postoperative pathological stage pT 2a, 32 patients had pT 2b, 241 patients had pT 2c, and 222 patients had ≥pT 3. A total of 210 cases developed biochemical recurrence after surgery, and the mean time to biochemical recurrence was 33.3 (3-127) months after the radical prostatectomy. The biochemical recurrence rates at 1, 3, and 5 years were 9.7% (54/558), 21.5% (120/558), and 31.7% (177/558), respectively. Among pT 2a and pT 2b patients, 7 (11.1%) and 4 (12.5%) cases developed biochemical recurrence, respectively. Among pT 2c stage patients, 145 (60.17%) cases had positive cut margins, treated with androgen-deprivation therapy (ADT) after surgery. 68 (28.21%) cases of pT 2c stage patients had biochemical recurrence at mean 36.1 (3-106)months after the radical prostatectomy. Among ≥pT 3 patients, 147 patients with positive margins, perineural invasion, seminal vesicle invasion and positive pelvic lymph nodes were treated with postoperative androgen deprivation therapy (ADT) + radiotherapy. 98 of 147 patients (66.67%) had biochemical recurrence, and the average time to biochemical recurrence was 30.6 (24-98) months.75 patients of ≥pT 3 without positive margins, perineural invasion, seminal vesicle invasion or positive pelvic lymph nodes, were treated with postoperative ADT. 33 of them (44%) had biochemical recurrence, and the average time to biochemical recurrence was 32.5 (21-106) months. 5-and 10-year survival rates of 210 patients with biochemical recurrence were 89.05% (187/210) and 78.09% (164/210) respectively, 5- and 10-year tumor-specific survival rates were 92.57% and 87.69%, respectively. 46 of 210 cases died, of which 31 (67.39%) died from prostate cancer, and 15 cases (32.61%) died from cardiovascular and cerebrovascular diseases. Multifactorial Cox regression analysis showed that patient's age ≥70 years, initial PSA > 20ng/ml, ≥pT 3 and Gleason score ≥7 were independent risk factors for biochemical recurrence. Conclusions:After radical prostatectomy, patients were treated according to their pathological stage and surgical margins. Patients with positive margins have a higher risk of biochemical recurrence. The independent risk factors for biochemical recurrence included age ≥70 years, initial PSA > 20ng/ml, ≥pT 3 and Gleason score ≥7.
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Ischemic brain stroke is pathologically characterized by tissue acidosis, sustained calcium entry and progressive cell death. Previous studies focusing on antagonizing N-methyl-d-aspartate (NMDA) receptors have failed to translate any clinical benefits, suggesting a non-NMDA mechanism involved in the sustained injury after stroke. Here, we report that inhibition of intracellular proton-sensitive Ca2+-permeable transient receptor potential vanilloid 3 (TRPV3) channel protects against cerebral ischemia/reperfusion (I/R) injury. TRPV3 expression is upregulated in mice subjected to cerebral I/R injury. Silencing of TRPV3 reduces intrinsic neuronal excitability, excitatory synaptic transmissions, and also attenuates cerebral I/R injury in mouse model of transient middle cerebral artery occlusion (tMCAO). Conversely, overexpressing or re-expressing TRPV3 increases neuronal excitability, excitatory synaptic transmissions and aggravates cerebral I/R injury. Furthermore, specific inhibition of TRPV3 by natural forsythoside B decreases neural excitability and attenuates cerebral I/R injury. Taken together, our findings for the first time reveal a causative role of neuronal TRPV3 channel in progressive cell death after stroke, and blocking overactive TRPV3 channel may provide therapeutic potential for ischemic brain injury.
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Objective:To investigate the removal of ALTPF pedicled with the lateral branch of the descending branch of the lateral femoral circumflex artery and its application in wound repair.Methods:From January, 2019 to March, 2021, 32 cases of limb wounds were repaired with ALTPF pedicled with the lateral branch of the descending branch of the lateral femoral circumflex artery, including 25 males and 7 females. The age ranged from 21 to 63 years, with an average of 34 years. Injury mechanism: there were 12 cases of traffic accident injury, 8 cases of machine injury, 6 cases of heavy object crushing injury and 6 cases of chronic infectious wound. The area of soft tissue defect was 8.2 cm × 6.3 cm-18.6 cm × 11.2 cm. There were 25 cases of direct suture and 7 cases of free skin grafting. All patients who needed flap repair underwent CTA and high-frequency CDU before operation to judge the approximate direction of the lateral branch of the descending branch of the lateral femoral circumflex artery and the position of the perforating branch. All patients were followed-up regularly for 3 - 13 months, with an average of 11 months.Results:All patients who underwent free flap surgery had no vascular crisis and the flap survived smoothly. At the last follow-up, the appearance of the flap was beautiful without bloating and there were no complications in the donor area.Conclusion:Compared with the traditional ALTPF, the perforator flap of the lateral branch of the descending branch of the anterolateral femoral artery is relatively simple, which can replace the traditional ALTPF to a certain extent, and is worthy of popularization and application in clinic.
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Objective:To investigate the short-term clinical effect of using fibular flap with preserving the continuity of fibula in hip preservation surgery for femoral head necrosis.Methods:From September, 2017 to November, 2020, 13 cases of femoral head necrosis were repaired with fibular flap. The fibular flaps were cut with an improved method for preserving the continuity of the fibular cortex, and the donor sites were sutured directly. The fibuls were inserted into the femoral heads with single or double segment folding support. Autogenous iliac crest combined with platelet-rich plasma(PRP) was used for impaction of bone grafting in femoral head, and the fibular flaps were anastomosed with 1 artery and 2 veins. All follow-up data were obtained, including bone union by X-ray and CT as well as the functional recovery of the hip joint and donor site. Statistical analysis was performed. P<0.05 was considered statistically significant. Results:The followed-up time ranged from 6 to 23 months. The fibular bones were significantly thicker and the incisions healed well at the donor sites. There was neither abnormal sensation in toes, dorsal foot, and lateral of the leg, nor significant influence on foot function. The hip joint activities were normal. The outcome was proved to be remarkable according to the Harris score(from 58.9±10.6 points before surgery to 81.7±10.6 points after surgery), the difference was statistically significant ( P<0.05) . Conclusion:The method of the improved fibular flap in hip preservation surgery is beneficial to the repair and reconstruction of the necrotic femoral head since the donor area is less traumatic, and a satisfactory clinical effect can be obtained.
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To report a 4-year-old boy with severed right index finger amputations in 2 segments. There were severe contusion on the 2 amputated sections of finger. According to the prevention and control requirement for the novel coronavirus disease(COVID-19), the patient was firstly checked to exclude the COVID-19. Then the replantation surgery was successfully carried out under the strict protective measures. The replanted index finger survived well at 2 weeks after surgery.
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Objective:To explore the application of the superficial iliac perforator flap (SCIP) based on the concept of "Donor site under swimming wear" in the repair of wounds of extremities.Methods:From June, 2018 to March, 2019, a total of 20 patients with traumatic soft tissue defects of the extremities were treated. All defects were repaired with free SCIP, including 16 males and 4 females. Location of defects: 10 in the hand, 4 in the forearm, 4 in the shank, and 2 in the foot. Wound areas were 7.3 cm×5.6 cm-16.3 cm×7.7 cm. Patients received routine CTA and high-frequency CDU examinations before surgery to assist in identifying the location of the perforating vessels and the running of the superficial and deep branches of the superficial iliac circumflex artery (SCIA). Combined intraoperative light transmission experiments were used to determine the dominant branch. The superficial branch of SCIA was used as the dominant branch in 18 cases, and the flap was cut in the superficial layer of Scarpa's fascia. The deep branch of SCIA was used as the dominant branch in 2 cases and the flap was cut in the superficial layer of the deep fascia. The donor site was directly sutured. Regular postoperative follow-ups were conducted without lost.Results:All flaps had no vascular crisis after surgery and survived successfully. All patients were followed-up regularly for 8 to 16 months, with an average of 12 months. At the last followed-up, the appearance and texture of the flaps in the recipient area were good, and roughly similar to the healthy tissues around the affected limb. The function of the affected limb recovered well. There was only a linear scar in the donor area.Conclusion:The SCIP based on the concept of "Donor site under swimming wear" is soft in texture, moderate in thickness, and concealed in the supply area. The patient can directly hide the scars of the donor areas after wearing the swimming trunks, which meets the concept of minimizing the damage to the donor area. It deserves to be promoted.
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Objective@#To explore the method of replanting severed piercing finger micro tissue blocks.@*Methods@#From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were replanted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative followed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function.@*Results@#One case had partial epidermal necrosis, and healed after change of dressing. The finger-disconnected micro tissue blocks of other 15 cases survived well. After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S3 to S4. The appearance of the 16 fingers was good, and the function of joints was restored.@*Conclusion@#The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance.
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Objective To explore the method of replanting severed piercing finger micro tissue blocks. Methods From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were re鄄planted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative fol鄄lowed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function. Results One case had partial epidermal necrosis, and healed after change of dressing.The finger-disconnected micro tissue blocks of other 15 cases survived well.After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S3 to S4. The appearance of the 16 fingers was good, and the function of joints was restored. Conclusion The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance.
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Objective To compare the diagnostic efficacy of 68Ga-PSMA-617 PET/CT and multiparameter MRI in the diagnosis of primary tumors of newly diagnosed prostate cancer.and analyze the correlation between SUVmax and clinical parameters of prostate cancer.Methods A retrospective analysis of the clinical data of 104 patients with newly diagnosed prostate cancer who underwent 68Ga-PSMA-617 PET/CT and multi-parametric MRI from June 2017 to April 2018.The final pathological results were used as the gold standard for diagnosis.The age ranged from 42 to 89 years,with an average of (70.4 ± 8.9) years.The median total serum PSA was 18.44 (8.71,48.01)ng/ml.The pathological results were positive in 68 cases and negative in 36 cases.The sensitivity,specificity was calculated,the ROC curve was drawn and AUC value was calculated.The relationship between SUVmax value of prostate cancer and clinical parameters was analyzed.Results The sensitivity of 68Ga-PSMA-617 PET/CT was 95.59％ (65/68) and the specificity was 88.89％ (32/36);the sensitivity of MRI examination was 91.18％ (62/68) and the specificity was 63.89％ (23/36).There were statistical differences between the specificity of the two examination (P =0.012).The ROC curve of 68 Ga-PSMA-617 PET/CT was plotted and the AUC value was 0.954.Among the 104 suspected prostate cancer patients,the median SUVmax of benign prostatic tissue was 3.20(2.83,3.70),and the median SUVmax of prostate cancer tissue was 12.21 (7.48,17.46).Among 68 patients with prostate cancer,there were statistical differences between SUVmax values of prostate cancer tissues with different Gleason scores (P ＜ 0.01),ISUP group (P ＜ 0.01),risk grades (P =0.021),and SUVmax values.There was a positive correlation with Gleason score and ISUP group (r1 =0.7420,P＜0.01;r2 =0.754,P＜0.01).Conclusions The 68Ga-PSMA-617 PET/CT examination had higher diagnostic efficacy than the multiparametric MRI for prostate cancer.The higher the SUVmax value predict the higher grade and higher risk.
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Objective To compare the diagnostic differences for the detection of bone metastases between 68Ga-PSMA-617 PET/CT and 99Tcm-MDP bone scintigraphy in preliminary diagnosed prostate cancer patients.Methods Seventy-three patients who were diagnosed with prostate cancer by pathology were retrospectively analyzed from June 2017 to February 2018,and they all underwent both ss Ga-PSMA-617 PET/CT and 99Tcm-MDP bone scintigraphy without therapy beforehand.Mean age was 69.1 (range 40-88) years,the mean PSA level was 144.59 (range 5.62-1 260.00) ng/ml,and the Gleason score ranged 6-10.The patients were divided into two groups by whether or not had bone metastases according to the aforementioned two examinations.Both the sensitivity and specificity are calculated.The number of bone metastatic focus of the two examinations were also compared through the Wilcoxon rank testing.Results Thirty-two of 73 patients were diagnosed with bone metastases.68Ga-PSMA-617 PET/CT and 99Tcm-MDP detected 32 and 31 bone metastases,with the sensitivity of 100.0％ (32/32,95 ％ CI 89.1％-100.0％) and 90.6％ (29/32,95％ CI 75.0％-98.0％),the specificity of 100.0％ (41/41,95％ CI 91.4％-100.0％) and 95.12％ (39/41,95％ CI 83.5％-99.4％),and the AUC of 1.000 (95％ CI 0.951-1.00) and 0.929 (95％ CI 0.844-0.976),respectively.There was significant difference in AUC between the two methods(P =0.034).Two examinations exhibited significantly different number of metastatic sites (Z =-2.949,P =0.003).Conclusions 68 Ga-PSMA-617 PET/CT outperform 99Tcm-MDP bone scintigraphy for the detection of bone involvement in prostate cancer patients.It will be an important imaging supplement for prostate cancer patients and play an important role in term of the accurate treatment based on the more accurate evaluation.
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Objective To observe the clinical efficacy of screwing via the paraspinal muscle approach plus single-segment laminectomy decompression via the dorsomedian approach for thoracolumbar fractures complicated with spinal cord injury.Methods From February 2013 to September 2015,21 patients with thoracolumbar fracture plus spinal cord injury were treated at our department.They were 15 men and 6 women,aged from 20 to 54 years (average,33.2 years).The injury was located at T1 1 in 2 cases,at T12 in 6,at T12 and L1 in one,at L1 in 7 and at L2 in 5;the injury was rated as grade A in one case,grade B in 3 cases,grade C in 8 and grade D in 9 according to the American Spinal Injury Association (ASIA) grading system.A1 the patients were treated by screwing via the paraspinal muscle approach followed by single-segment laminectomy decompression via the dorsomedian approach.Results The operation time averaged 116.1 + 24.5 minutes and the amount of bleeding 580.7 + 80.8 mL.At 3 days after surgery and the final follow-up,their visual analogue scale (VAS) score,anterior vertebral height and cobb angle were significantly improved in comparison with the preoperative values (P ＜ 0.05).At the final follow-up,their Japanese Orthopaedic Association (JOA) the score were also significantly better than the preoperative one (P ＜ 0.05),giving 12 excellent cases,6 good ones and 3 fair ones.Their ASIA grading at the final follow-up showed one case of grade B,2 cases of grade C,6 cases of grade D and 12 cases of grade E.Conclusion Treatment of thoracolumbar fractures complicated with spinal cord injury by crewing via the paraspinal muscle approach plus single-segment laminectomy decompression via the dorsomedian approach is a good way due to limited invasion,less bleeding,simple operation,excellent reduction,reliable fixation and rapid recovery.
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In order to produce hyaluronate lyase of high yield, we optimized the fermentation Arthrobacter globiformis A152 in quadruple fermentation of 5 L, and studied the kinetics of fermentation. Both the highest biomass and enzyme activity could be achieved when the rotation speed was 400 r/min and the ventilation volume was 3.5 L/min. In addition, digital models of cell growth, product synthesis and substrate consumption were built by equation of logistic, luedeking-piret, product synthesis and substrate consumption. Nonlinear fitting and estimation of optimal parameters were obtained by MATLAB. The model correlated well between prediction and experimental data, and reflected the change rules of cell growth, hyaluronidase synthesis and substrate consumption during the process of producing hyaluronate lyase. The establishment of fermentation kinetics digital models could provide basis for controlling and prediction of the production process.
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Objective To evaluate the effect of resolvin D1 on focal cerebral ischemia?reperfusion ( I∕R) injury in rats. Methods One hundred and twenty adult male Sprague?Dawley rats, aged 7 weeks, weighing 260-280 g, were randomly divided into 5 groups ( n=24 each) using a random number table:sham operation group (group S), group I∕R, low?dose resolvin D1 group (group LRD), medium?dose resolvin D1 group ( group MRD) , and high?dose resolvin D1 group ( group HRD) . Focal cerebral I∕R was induced by right middle cerebral artery occlusion using a nylon thread inserted into internal carotid artery and advanced cranially until resistance was met. The occlusion was maintained for 2 h followed by 24 h reperfusion. In LRD, MRD and HRD groups, 0.03, 0.10, 0.30 nmol resolvin D1 5 μl was injected into the lateral cerebral ventricle at the beginning of reperfusion, respectively. Neurological deficits were evaluated at 24 h of reperfusion and scored. The rats were then sacrificed, and their brains were removed for determination of infarct volume (by TTC staining), cerebral water content, Evans blue content and expression of matrix metalloproteinase?9 ( MMP?9) in the ischemic cortex. Results Compared with group S, the neurological deficit scores, cerebral infarct volume, and cerebral water and Evans blue content were significantly increased, and the expression of MMP?9 was up?regulated in the other 4 groups. Compared with group I∕R, the neurological deficit scores, cerebral infarct volume, and cerebral water and Evans blue content were significantly decreased, and the expression of MMP?9 was down?regulated in group MRD and group HRD, and no significant change was found in the parameters mentioned above in group LRD. Conclusion Resolvin D1 can attenuate focal cerebral I∕R injury in rats, and down?regulation of MMP?9 expression and decrease in permeability of blood?brain barrier may be involved in the mechanism.
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Objective To evaluate the effects of gender on the pharmacokinetics of propofol in patients.Methods Twenty ASA physical status Ⅰ or Ⅱ patients of both sexes (10 male,10 female),aged 42-59 yr,weighing 46-76 kg,scheduled for elective surgery for gastrointestinal cancer,were randomly divided into 2 gender groups (n =10 each):male group and female group.Combined intravenous-inhalational anesthesia was performed during surgery.Anesthesia was induced with iv injection of 2％ propofol 2 mg/kg,remifentanil 1.5 μg/kg,and suxamethonium chloride 1.5 mg/kg.The patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of the mixture of 1％-2 ％ isoflurane and nitrous oxide (N2 O ∶ O2 =1 ∶ 1.),iv infusion of remifentanil 0.2-0.3 μg/kg and intermittent iv boluses of atracurium.Blood samples were taken from the central vein before propofol administration,and at 1,2,3,4,6,10,15,30,45,60,90,120,180,240,360 and 720 min after propofol administration for determination of the plasma concentration of propofol by high-performance liquid chromatography.The blood concentration-time curve of propofol was drawn and the pharmacokinetic parameters were calculated.Results The blood concentrations of propofol were significantly lower at each time points within 10 rmin after administration of the single bolus of propofol in female group than in male group (P ＜0.05).The blood concentration-time curves of propofol were fitted to a three-compartment open model in the 2 groups.The central volume of distribution and clearance rate were significantly larger in female patients than in male patients (P ＜ 0.05).Conclusion After iv injection of propofol,the blood concentration of propofol is lower,and the central volume of distribution and clearance rate are larger in female than in male,suggesting that gender has significant effect on pharmacokinetics of propofol.
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Objective To investigate a method of repairing complex tissue defects one stage in one finger or several fingers for more fine recipient site repairing and less donor area traum. Methods From August 2007 to August 2010,eight cases of 20 fingers were reconstructed according to the state of complex tissue defects in a hand,second toes (right or left side) were split into two or three parts as complex tissue flaps that may including joints,tendons,skin,nail beds,et al.These flaps then were translated to hand to repair complex tissue defects by anastomosing vessels.Results Twenty fingers in 8 cases were successfully reconstructed.Follow-up ranged from 3 months to 36 months,external appearance were fine.According to the Trial Evaluation Standard of Reconstructed Finger Function of Handsurgery Society of China,sixteen fingers were excellent,three fingers were good,one finger was fine.And there was no effect on foot.Conclusion Spliting single second toe is a good method for repairing more complex tissue defects in a hand.
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Objective To investigate a more pedect method for a nice outward appearance of a reconstructed thumb.Methods A free one-stage plasty second toe transfer for thumb reconstruction by interchanging the whole skin-nail flap from the great toe with another one from the second toe.Results There were 12 cases in this group,following-up 6-9 months in 8 cases,7 cases was excellent and 1 cases was good.The reconstructed thumb got a nice looking and more normal function while no blight to the great toe occurred.Conclusion It is an effective new procedure in ameliorating outward appearance of the reconstructed thumb by transferring the free moulded second toe.