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Liver is rich in blood supply, with soft and crisp texture, therefore its resection requires accurate and safe bleeding control techniques. The hemostatic effect of complete hepatic inflow occlusion is complete, but the side effects are comparatively serious and the blocking time is limited. The side effects of anatomical hepatic inflow occlusion are light, but there is more bleeding in the process of practice, especially the bleeding of the preserved side of the liver. Based on the dynamic watershed theory, there is traffic flow between hepatic segments and lobes, which is the reason for the poor effect of anatomic hepatic blood flow occlusion. We propose cross interface blood control maneuver. In this strategy, we use a variety of blood control methods alone or in combination, to control the borderline blood flow between segments/lobes. Therefore, compared with anatomic hepatic blood flow occlusion, this strategy can control bleeding well and reduce various side effects of total hepatic blood inflow occlusion.

Objective: To investigate the clinical efficacy of robotic surgery for pancreatic serous cystadenoma., Methods: There were 148 patients with pancreatic serous cystadenoma underwent robotic surgery from April 2015 to June 2019 in our department, the clinical data including intraoperative data, perioperative complications, and histopathological results were retrospectively analyzed., Results: Among the 148 patients, there were 39 cases (26.4%) of the tumors located in pancreatic head, 15 cases (10.1%) in pancreatic neck and 94 cases (63.5%) in pancreatic body and tail. Pancreaticoduodenectomy, distal pancreatectomy, central pancreatectomy, and enucleation were performed in 26 cases (17.6%), 71 cases (48.0%), 24 cases (16.2%) and 27 (18.2%) cases, respectively. The incidence of serious postoperative complications were 7.7%, 2.8%, 0, 0, respectively, and grade B pancreatic fistula were 7.7%, 7.0%, 41.7%, 14.8%, respectively. 90-day mortality was 0. Compared with pancreaticoduodenectomy, enucleation of the pancreatic head tumor had shorter operation time ( P <0.001), less intraoperative blood loss ( P <0.001), and shorter length of hospital stay ( P <0.001). Compared with central pancreatectomy+pancreaticojejunostomy, Rong central pancreatectomy had shorter operation time ( P =0.007) and length of hospital stay ( P =0.040)., Conclusion: Robotic surgery for pancreatic serous cystadenomaisis safe and feasible. Rong central pancreatectomy for serous cystadenoma in middle segmental pancreas could achieve feasible results., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)

Objective: To compare the long term and short term outcomes between robotic and open surgery for hilar cholangiocarcinoma radical resection. Methods: This is a single-center and retrospective case-control study. Patients underwent hilar cholangiocarcinoma radical resection between January 2016 and December 2016 at Department of Hepatobiliary Surgery of the General Hospital of the Chinese People's Liberation Army were included. Safety, effectiveness and long-term prognosis of tumors were evaluated. Patients were divided into robotic hilar cholangiocarcinoma radical surgery group (robotic group, n= 16) and open hepatic hilar cholangiocarcinoma radical surgery group (open group, n= 31) . All cases were confirmed by pathology histological. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS) , and overall survival (OS) were retrospectively collected and analyzed.In the follow-up cohort, the primary outcome was patient death and the secondary outcome was tumor recurrence. Continuous variables were expressed as means and medians and were compared using the Student t test if normally distributed or Wilcoxon-Mann-Whitney test for nonparametric variables. Discrete variables were expressed as frequency and percentages and χ(2) or Fisher exact test, when appropriate, were used for comparisons. Kaplan-Meier curves were used to calculate the probability of survival and comparisons were performed using log-rank test. Results: In this study, compared with the open group, the robotic group had a longer operation time ( (338±71) minutes vs . (256±56) minutes, t= 4.251, P= 0.001) , but the intraoperative blood loss was less (100 ml vs . 200 ml, Z= 121.50, P= 0.040) , the gastric tube removal time was earlier (3 days vs . 4 days, Z= 136.0, P= 0.011) , and the postoperative hospital stay was shorter (9 days vs . 12 days, Z= 144.50, P= 0.040) , and the difference was statistically significant.There was no significant difference in the blood transfusion rate, R0 resection rate, and tumor size between the two groups.The recurrence rates in the robotic group and open surgery were 53.3% and 67.0%, respectively (χ(2)=1.04, P= 0.307) .The median survival time of the robotic group and the open group was 22.0 months and 25.0 months. There was no significant difference in the overall survival rate between the two groups ( P> 0.05) . Conclusion: Compared with laparotomy, robotic HCC radical resection could have an equivalence or non-inferiority approach with acceptable long-term outcome.

Objective: To assess the safety and advantages of robotic pancreatic surgery (RPS) based on the single-team experience with 1010 cases., Methods: The clinical data of 1010 cases of RPS performed by a single team from November, 2011 to September, 2017 in our hospital were collected prospectively and analyzed. In most of cases the surgeries were performed using the third-generation da Vinci robotic surgical system., Results: The 1010 cases receiving RPS included 417 cases of robotic pancreatoduodenectomy (RPD), 428 cases of robotic distal pancreatectomy, 60 cases of robotic central pancreatectomy, 53 cases of robotic pancreatic tumor enucleation, 3 cases of Appleby procedure, and 49 cases of other operations (including 4 cases of innovative robotic retroperitoneal laparoscopic surgery, 4 cases of robotic pancreatic tumor enucleation combined with main pancreatic duct bridging repair, 1 case of single incision robotic pancreatic tumor enucleation, and 2 cases of robotic central pancreatectomy combined with end-to-end anastomosis reconstruction). The median operative time was 210 min (30-720 min) with a median intraoperative blood loss of 80 mL (10-2000 mL), a conversion rate of 4.06% (41/1010), a blood transfusion rate of 6.7% (68/1010), a mean post-operative stay of 10.87∓6.70 days, a complication rate (beyond grade III according to Clavien-Dindo scoring system) of 8.0% (81/1010), and a pancreatic fistula rate (beyond) grade B of 9.21% (93/1010). The mortality rate of the patients was 0.69% (7/1010) in 30 days and 1.31% (12//934) in 90 days. The application of RPS in total pancreatectomy increased steadily from the rate of 10.44% in 2012 to 72.06% in 2017., Conclusion: This represents to our knowledge the world largest series of robotic pancreatic resections. RPS is expected to gradually replace open procedure and laparoscopic procedure to become the primary choice of approach for pancreatectomy. After the learning curve, RPS procedure including distal pancreatectomy, robotic Appleby procedure and other operations can be safely performed, and the experiences from other centers can be beneficial to reduce severe complications in the early stage of learning.

Objective: To evaluate the feasibility and strategy of the lesser omentum approach for laparoscopic pancreatic enucleation. Methods: Between June 2011 and October 2013, 6 laparoscopic pancreatic enucleations were performed by lesser omentum approach.The average age was 42 years, including 1 male and 5 female.The preoperation diagnosis of 6 cases were pancreatic islet cell tumors determined by abdominal CT/MRI, ultrasound and digital subtraction angiography.The tumors of 3 cases located in pancreatic neck, 2 tumors located in neck and body of pancreas, and 1 tumor located in pancreatic body.Their biggest tumor diameter were 0.8-2.5 cm. Results: Among the 6 cases, all laparoscopic pancreatic enucleations were successfully performed.None of the patients were converted to open operation.Eestimated blood loss was (26.7±18.6)ml, operating time was (82.5±19.4)minutes, and postoperative length of stay was (5.17±1.17)days.Additionally, postoperative complication included grade A pancreatic fistula in 1 case.After 36-64 months followed-up, there was no tumor recurrence and clinical symptom disappeared. Conclusion: For the islet cell tumors located in pancreatic neck and body, the lesser omentumapproach may contribute to good surgical view and operative space, which can make pancreatectomy safer and easier for clinical application.

Objective: To investigate the feasibility and security of robotic resection of tumor in segment Ⅷ primarily. Methods: The clinicopathologic data of 7 patients who underwent robotic resection of tumor in segment Ⅷ using daVinci robotic system in the Department of Hepato-pancreato-biliary Surgical Oncology, Chinese PLA General Hospital from June 2016 to December 2016 were retrospectively analyzed. The lesion size, the tumor malignance degree mean operation time, intraoperative blood loss and the rate of conversion to laparotomy, postoperative hospital stay, mobidity and motality of all the 7 patients were collected. Results: All the 7 operations were successfully performed with radical resection.The mean tumor diameter was (4.6±1.2)cm. The mean operation time, intraoperative blood loss and postoperative hospital stay were(120.7±21.7)min, (100±106.7)ml, and(7.3±1.8)days respectively.All the patients were discharged successfully with no severe complications. Conclusions: According to our experiences, as a new operationmodel of minimally invasive surgery, robotic resection of tumor in segment Ⅷ has manyadvantages in laparoscopic like less trauma, less intraoperative bleeding, light postoperative pain, shorter postoperative hospital stay and so on. There are some certain advantages in exposure of Ⅷ segment under robotic surgery system. Robotic surgery system is safe and feasible for tumorresection of segmentⅧ, andhas clinical promoting value and application prospect.

Objective: To evaluate efficacy and advantages of the Traditional Chinese Medicine (TCM) synthetic rehabilitation therapy in the treatment of wrist dysfunction after distal radius fractures., Methods: From May 2014 to October 2015, 72 patients with distal radius fracture meeting standards were treated using central randomization system for clinical research. All the patients were divided into two groups: 36 patients in test group and 36 in control group. Sixty-nine cases were finished treatment and followed up in the end. The test group fell off 1 case, and the control group fell off 2 cases. The test group was given TCM synthetic rehabilitation (manipulative therapy, joint mobilization, soaking-washing with Chinese medicinal herbs, functional exercise), and the control group was given functional exercise as well as soaking-washing with Chinese medicinal herbs, 3 weeks for both. Five evaluation standards were used in this research, which were grip strength, patient-rated wrist evaluation (PRWE), Gartland and Werley wrist score, self-rating anxiety scale(SAS) and the overall curative effect evaluation. Before treatment(baseline), after 3 weeks of treatment and 3 months after fracture were the three points in time when collected the data., Results: After 3 weeks of treatment and 3 months after fracture, the test group had a significantly better results than those of control group in the PRWE, G-W wrist score and the overall curative effect evaluation( P <0.05). In terms of grip strength recovery, after 3 weeks of treatment, the intergroup difference between the test group and the control group were statistically significant relative to the baseline regarding grip strength of ipsilateral wrist by group t-test( P <0.05). However, the test group and the control group had no statistically significant relative to the baseline at 3 months after fracture in grip strength( P <0.05). For the anxiety of patients, compared with the test group and control group at before and after rehabilitation treatment, the anxiety of both test group and control group cases was eased( P <0.05). However, The degree of anxiety relief in test group and control group cases had no difference( P >0.05)., Conclusions: The TCM synthetic rehabilitation therapy has better curative effects on the treatment of functional disability of wrist joints after distal radius fractures than the general therapy of soaking-washing with Chinese medicinal herbs and functional exercise., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

Objective: To study the clinical value and operation skills of nasal endoscopy-assisted bulboprostatic anastomosis in the treatment of posterior urethral stricture., Methods: Between January 2012 and November 2014, we performed nasal endoscopy-assisted bulboprostatic anastomosis for 12 male patients with posterior urethral stricture. We recorded the operation time, blood loss, exposure of operation visual field, and success rate of anastomosis and summarized the operation skills., Results: Eight of the patients experienced first-stage recovery. Two underwent a urethral dilation at 3 months postoperatively, 1 received 10 urethral dilations within 5 months after surgery, and 1 underwent internal urethrotomy after failure in urethral dilation, but all the 4 cases were cured., Conclusion: Nasal endoscopy can significantly improve the operation field exposure, elevate the precision, reduce the difficulty, and enhance the efficiency of bulboprostatic anastomosis in the treatment of posterior urethral stricture.

Objective: To evaluate the efficacy of nucleos(t)ide analogues (NA) treatment and to assess the long-term outcomes, including survival, liver function improvement and virologic response, in patients with decompensated cirrhosis due to hepatitis B virus (HBV) infection., Methods: Patients with Child-Turcotte-Pugh (CTP) scores more than or equal to 7, who had been treated with either lamivudine or other agents, but who were free of co-infection with other hepatitis virus were enrolled between January 2005 and December 2009. The study participants were subgrouped according to the antiviral drugs received or model for endstage liver disease (MELD) score for comparative analyses.Additionally, the 19 patients who were treated with NA for more than 5 years were investigated for changes in biochemical and virological indices, before and after the antiviral treatment., Results: A total of 166 patients (125 males; 89 e-negative) and 52 untreated healthy patients (as control) were analyzed.The cohort of patients receiving antiviral therapy had significantly better 5-year actuarial survival than the untreated patients (74.1% vs.34.9%, P less than 0.001). For patients with MELD score more than or equal to 18, actuarial survival was not significantly different between the two groups (P=0.073)., Conclusion: Antiviral therapy significantly increases survival and improves the clinical long-term outcome of patients with HBV-induced decompensated cirrhosis.Antiviral treatment should be initiated at an early stage to maximize benefit in the improvement of clinical status.

Objective: To explore the categories of drugs causing hepatotoxicity and analyze the clinical and histological features of the corresponding drug-induced liver injury (DILI), in order to gain insights into potential diagnostic factors for DILI., Methods: A total of 138 DILI patients treated at our hospital from April 2008 to April 2010 were retrospectively analyzed. The responsible drug for each DILI case was recorded. The Roussel Uclaf Causality Assessment Method (RUCAM) had been used to diagnose DILI. Only cases that had scored as highly probable or probable (more than or equal to 6 points by RUCAM) were included in this study. The patients' general condition, clinical manifestations, and serum biochemical and immunological parameters were assessed. Sixty-six of the patients underwent liver biopsy, and were assessed for liver pathological changes. Clinical and laboratory test data were collected and used to classify the total 138 cases as hepatocellular injury, cholestatic, or mixed hepatocellular-cholestatic types., Results: Within our patient population, the leading cause of DILI was Chinese herb medicine, accounting for 53.62% of cases. Antibiotics were implicated in 7.97% of cases, and dietary supplement in 6.52% of cases. Correlation between the clinical features and histological injury pattern was stronger at the time of biopsy (more than or equal to 3 days after laboratory results) (kappa = 0.63, P less than 0.05) than at the onset of DILI (kappa = 0.25, P less than 0.05). All modified hepatic activity index (HAI) necroinflammatory scores and fibrosis scores were more severe in the cholestatic and mixed injury types than in the hepatocellular injury type (P less than 0.01 and P less than 0.05, respectively)., Conclusion: Chinese herbal medicine, dietary supplements and antibiotics were the main causes of DILI in our patient population. The clinical and histological features correlated well, especially at later stages of DILI. The degree of inflammation and fibrosis was significantly higher in cholestatic and mixed hepatocellular-cholestatic injury types than in the hepatocellular injury type. Assessment of both clinical and pathological features may represent a more accurate diagnostic method for DILI.

Objective: To compare the clinical effects of transurethral detaching resection (TUDRP) and plasmakinetic transurethral resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH)., Methods: We collected by the single blind method the clinical data of 81 cases of BPH treated by PKRP (n=41) and TUDRP (n=40), and compared the two groups of patients in their age, preoperative prostate volume, weight of the resected gland, operation time, intraoperative bleeding, time of postoperative Foley's catheter retention, and pre- and post-operative IPSS., Results: The post-operative IPSS was significantly higher in the PKRP than in the TUDRP group (9.95 +/- 1.54 vs. 8.70 +/- 1.13, t = 0.0029, P = 0.0059)., Conclusion: TUDPR has a better clinical effect than PKRP in the treatment of BPH.

Objective: To summarize the experience with a modeling method for laparoscopic left lateral segment liver resection (LLLR)., Methods: The surgical procedures of LLLR were carried out with the patient placed in a supine position and 4 trocars placed on the abdomen. After complete dissociation of the left lobe, the segment II and III vascular pedicles were freed with a harmonic scalpel and transected with a linear cutter stapler. The left hepatic vein (LHV) was dissociated with a harmonic scalpel with a slightly left direction of liver dissection, followed by complete resection of the LHV and finally by wound surface management, specimen removal, wound drainage, and abdominal incision closure., Results: Between July, 2003 and August, 2010, this modeling method for LLLR was performed successfully in 48 cases without conversion to laparotomy. The mean operation time was 75∓30.8 min, blood loss was 58∓36.4 ml, and length of postoperative hospital stay was 4.8∓1.5 days. Postoperative complications occurred in 3 cases, including ascites in 2 cases and mild biliary leakage 1 case, all cured conservatively., Conclusion: This modeling method can simplify the surgical procedure of LLLR, reduce blood loss, and avoid air embolism due to vein injury. Being less technically demanding, this method can be safely performed in hospitals at various levels.

Objective: To compare the clinical results of laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP), confirm the potential advantages of LDP., Methods: The medical records of 30 consecutive patients who underwent LDP were reviewed and compared with those of 42 patients who underwent ODP., Results: Operation time was longer for LDP than for ODP [(186.33±58.98 min) vs (149.29±29.00 min), P=0.001], but blood loss [(223.33±143.68 ml) vs(251.19±103.29 ml), P=0.341] and spleen-saving rate(42.3% vs 61.8%, P=0.192) were no significant difference between the 2 groups. Decreased postoperative bowel recovery time [(2.37±0.85 d) vs (2.81±0.67 d), P=0.016], oral intake time [(2.37±0.85 d) vs (2.81±0.67 d), P=0.016] and length of stay [(7.43±1.57 d) vs (9.67±1.41 d), P=0.000] were seen in LDP group. However, the rate of postoperative pancreatic fistula (16.67% vs 21.43%, P=0.619) was no significant difference between the 2 groups. 3 cases of wound infection and 2 cases of lung related complication were occurred in ODP group, but none in LDP group., Conclusion: LDP is a safe and effective surgical approach, providing the same surgical results comparable to that of ODP, and substantially faster recovery. However, high requirement of laparoscopic technique and equipments limited its further clinical application.

Objective: To observe the clinical efficacy and complications of intradiscal electrothermal therapy for treatment of discogenic low back pain., Methods: Forty patients with discogenic low back pain were treated with intradiscal electrothermal therapy, and the changes in the VAS, functional status and complications after the treatment were analyzed. RESULTS The VAS score was decreased and the functional status improved obviously after the treatment, which caused no severe complications., Conclusion: Intradiscal electrothermal therapy is safe and effective to rapidly achieve pain relief and obviously improve the functional status of patients with discogenic low back pain with few complications.

Objective: To summarize the experiences of laparoscopic pancreatectomy and to discuss its clinical indications and operative techniques., Methods: From March 2003 to February 2010, 49 patients with pancreatic diseases, including 18 males and 31 females with a mean age of (42 ± 14) years old (range: 21 - 77), underwent laparoscopy at our department. The preoperative diagnoses included insulinoma (n = 38), cystadenoma (n = 4), cystadenocarcinoma (n = 1), nonfunctional islet cell tumor (n = 5) and solid-pseudopapillary tumor (n = 1)., Results: Thirty-nine cases underwent total laparoscopic surgery and 8 cases converted to open surgery. The operative duration was (245 ± 146) minutes (range: 90 - 960). The mean intraoperative blood loss was (191 ± 306) ml (range: 20 - 1500). Secondary operations were needed in 3 cases and pancreatic fistula occurred in 7 cases. The postoperative hospital stay was (10 ± 7) days (range: 4 - 31)., Conclusion: Laparoscopic pancreatectomy is safe and feasible in the treatment of most benign pancreatic diseases and some malignant tumors.

Objective: To discuss the localization diagnosis value of laparoscopic ultrasonography in laparoscopic surgery of insulinoma., Methods: Retrospectively reviewed the results of laparoscopic ultrasonography in 32 patients from Jan 2007 to Aug 2008 with insulinoma which confirmed after surgery, and analyzed the detection rate of laparoscopic ultrasonography., Results: Insulinoma tumors were success located in 31 patients among 32 patients by laparoscopic ultrasonography. The detection rate was 96.9% and the location accurate rate was 100%. Thirty-seven insulinoma tumors were detected in 31 cases, including 29 solitary insulinoma and 2 multiple insulinomas. One patient did not show a definite tumor in the pancreas and extrapancreatic organ during the laparoscopic ultrasonography examination., Conclusion: Laparoscopic ultrasonography has a high detection rate in localizing diagnosis of insulinoma and can clear display the relationship between tumor and adjacent tissue. It is useful for surgeon to select the suitable operation modality.

Objective: To investigate the effect of pentoxifylline on one-lung ventilation injury in rabbits., Methods: Twenty rabbit models of one-lung ventilation by intrabronchial intubation after tracheotomy were randomly allocated in control group (with one-lung ventilation) and experiment group (with one-lung ventilation and intravenous pentoxifylline administration). One-lung ventilation was maintained for 3 h in both groups using the volume-control mode (tidal volume of 8 ml/kg at the frequency of 30 per min). Arterial blood samples were taken after anesthesia and at 3 h of one-lung ventilation for arterial blood gas analysis to obtain the oxygenation index. At the end of the experiment, the pulmonary wet/dry ratio (W/D), tumor necrosis factor-alpha (TNF-alpha), NO, malondialdehyde (MDA) and superoxide dismutase (SOD) contents in bronchoalveolar lavage fluid (BALF) were measured and the histological appearance of the lung tissue was observed., Results: The oxygenation index was significantly higher (P<0.05), W/D ratio lower (P<0.05), and contents of TNF-alpha, NO and MAD in the BALF lower in the experimental group than in the control group (P<0.05). The activity of SOD increased significantly in the experimental group as compared with the control group (P<0.01), and the rabbits in the experimental group showed milder pathological changes., Conclusion: Intravenous pentoxifylline may improve pulmonary ventilation function and alleviate pulmonary injury, thus offering protection against pulmonary injury after one-lung ventilation.

Objective: To establish a convenient realtime PCR which can detect microRNAs in the human hepatoma cell line, Huh7 cells., Methods: Total RNAs in Huh7 cells were extracted. MicroRNA 122, 24 and 146a were assayed by microRNA array, and then verified by Northern blot. Stem-loop RT-PCR and poly(A)-tailed RT-PCR were used to detect the above microRNAs. Data were analyzed with Quantity One software and 7500 system software., Results: Microarray signal intensity of microRNA 122, 24 and 146a in Huh7 cells was 2201.49, 410.20 and 4.70, whose relative expression was confirmed as 0.0383, 0.0249, 0.0001 through Northern blot. While the poly(A)-tailed RT-PCR might only measure microRNA 122, Stem-loop RT-PCR could detect microRNA 122, 24 and 146a, whose average dCt was 2.5, 5.8 and 12.1 in accordance with microRNA array and Northern blot., Conclusion: Stem-loop RT-PCR can specifically and sensitively quantity microRNA levels, regardless of their abundance.

Objective: To investigate the role of voltage-gated potassium channels in the acute hypoxic pulmonary vasoconstriction., Methods: Thirty Wistar rats were divided into two groups, namely the normoxic group and hypoxic group. The single smooth muscle cell was obtained from the pulmonary artery of Wistar rats with acute enzymatic digestion method. The conventional whole-cell patch clamp technique was used to record the resting membrane potential(Em) and the potassium currents of voltage-gated potassium channel (IKv) in rat pulmonary arterial smooth muscle cells(PASMC). Intracellular application of Kv1.2, Kv1.3, Kv1.5, and Kv2.1 antibodiesè1:125éwas conducted through the whole-cell patch clamp system., Results: Em of PASMC was depolarized in hypoxia compared with that of control cells. The mixture of Kv1.2, Kv1.3, Kv1.5, and Kv2.1 antibodiesè1:125é depolarized Em and inhibited Ikv in PASMC from normoxic rat,whereas the mixture of Kv1.2, Kv1.3, Kv1.5, Kv2.1 antibodiesè1:125éhad no effects on Ikv and Em in hypoxic rats., Conclusion: Kv1.2, Kv1.3, Kv1.5, Kv2.1 might be oxygen sensitive potassium channels which mediated acute hypoxic pulmonary vasoconstriction.

Objective: To evaluate the advantage of Gukangling Decoction (GKLD), a compound traditional Chinese herbal medicine, combined with technetium [(99)Tc] methylene diphosphonate injection ((99)Tc-MDP) in treating osteoporosis in rabbits., Methods: A rabbit model of osteoporosis was established by intramuscular injection of dexamethasone (DX). Fifty-six rabbits were divided into 8 groups: Group A, B, C, D, E, F, G and H. Rabbits in groups A and B were intramuscularly injected normal saline as normal control, groups C and D were untreated groups, rabbits in group E were treated by (99)-MDP, rabbits in group F were treated by aminodiphosphate, rabbits in group G were treated by GKLD, and rabbits in group H were treated by (99)-MDP and GKLD. Rabbits in groups A and C were executed to demonstrate the establishment of the rabbit model of osteoporosis at the 8th week of experiment. Rabbits in the other six groups were executed after 16-week experiment (8-week treatment), and then bone structure and cell shape were observed by electron microscope, X-ray, CT and emission computed tomography (ECT). Bone density, biomechanical parameters, the levels of bone specific alkaline phosphatase (BALP) and bone Gla protein (BGP) were measured too., Results: After 8-week of intramuscular injection of DX, the bone trabecula in group A were regular and showed normal configuration, while the bone trabecula in group C were sparse, ruptured and showed damaged form. The bone density and biomechanical parameters in group A were higher than those in group C, indicating that the rabbit model of osteoporosis was established successfully. At the 9th week of experiment, the results of cell pathology in group D showed that the bone trabeculas were sparse, ruptured, defected or had hollow section, but the bone trabeculas in group B were regular and dense. The bone trabeculas in groups H and E were restored, and were thicker than those in group D. The bone quality in groups H and E was better than group D significantly, the bone quality in group F was better than group G, and the bone quality in group G was better than group D slightly., Conclusion: GKLD combined with (99)-MDP had superiority in treating osteoporosis of rabbits as compared with the respective single therapy.

Objective: To assess the role of vanilloid receptor (VR) in thermal hyperalgesia induced by intraplantar endothelin-1 (ET-1) injection., Methods: VR gene-knockout mice (KO group) and wild type C57BL/6J mice (WT group) in 3 subgroups were subjected to intraplantar administration of ET-1 at the doses of 3, 10, 30 and 100 pmol (dissolved in 10 microl of PBS, pH 7.4, n=6 in each group), respectively. The latency time of paw withdrawal (PWT) from heat irradiation stimulation was recorded before injection and 15, 30, 45 and 60 min after injection., Results: ET-1 induced thermal hyperalgesia in both groups. The mice in WT group showed a more sharply shortened PWT than those in KO group. ET-1 decreased PWT as the dose administered increased in WT group, which was different from the responses of the KO mice. At the dose of 100 pmol of ET-1, no further decrement of latency time was observed in WT group, whereas such response occurred at 30 pmol in KO group., Conclusion: Intraplantar injection of ET-1 induces thermal hyperalgesia mediated partially by VR.

Objective: To investigate the association of the left double-lumen endobronchial tube (DLT) and the inner diameter of the left main bronchus., Methods: Totally 100 adult patients who required intubation of a left-sided DLT during anesthesia for elective thoracic surgery were randomly enrolled in this study. All the participants underwent a preoperative chest CT scan by a spiral CT scanner. The diameters of the trachea and left main bronchus were measured with three-dimensional image reconstruction technique. All the measurements were performed using the electronic calipers of the spiral CT scanner and the left-sided DLT (Portex SIMS, USA) of the sizes 41Fr, 39Fr, 37Fr, and 35Fr were selected, being predicted according to the inner diameter of the left main bronchus. The placement of DLT was performed after anesthesia induction, and a DLT of a smaller size was selected if the bronchial end of the DLT failed to enter the left main bronchus after two attempts. The trachea and left main bronchus were examined for injury and other complications with postoperative fibreoptic bronchoscopy (FOB)., Results: All the 100 patients were intubated with DLT of appropriate sizes and satisfactory lung isolation was achieved. Postoperative complications of the trachea and bronchus were observed in none of the patients with FOB examination. The appropriate size of DLT is correlated with the left main bronchial diameter (correlation coefficient r=0.7346)., Conclusion: Clinically, the size of DLT can be determined in accordance with the inner diameter of the left main bronchea.