Thyroid surgery without antibiotic prophylaxis: experiences with 1,030 patients from a teaching hospital in China.

OBJECTIVE: Our objective was to evaluate the outcome of thyroidectomy without the use of prophylactic antibiotics. This study was held from January 2005 to May 2012 in a teaching hospital in Dongguan, China. METHODS: A total of 1,030 thyroidectomy patients were retrospectively reviewed and basic data were recorded, including age, sex, peri-operative antibiotic use, type of thyroid surgery done, and post-operative complications. Either an open approach or an endoscopic approach was performed according to the doctor's or patient's preference following a strict aseptic technique. The drain was routinely placed. Any complications were analyzed. RESULTS: A total of 834 (81 %) females and 196 (19 %) males were included, giving a ratio of 4.2:1. The average age was 38.3 years. The mean operation time was 85.3 min. Pathological type included 818 (79.4 %) nodular goiter, 34 (3.3 %) Graves' disease, 102 (9.9 %) nodular papillary hyperplasia, 12 (1.2 %) Hashimoto's disease, 62 (6 %) papillary carcinoma, and 2 (0.2 %) medullary carcinoma. Four patients had postoperative bleeding, four had temporally recurrent nerve paralysis. Only one had wound infection (0.09 %). CONCLUSION: Antibiotic prophylaxis in elective thyroidectomy is not an essential pre-operation preparation for all patients, if guidelines for antibiotic prophylaxis in clean surgery are adhered to and surgeons have sophisticated skills in the procedure.

Human acupuncture points mapped in rats are associated with excitable muscle/skin-nerve complexes with enriched nerve endings.

As part of our ongoing investigation into the neurological mechanisms of acupuncture, we have tried to correlate the distribution of afferent nerve endings with acupuncture points (AP) in the rat hind limbs. In vivo extracellular microfilament recordings of Aalpha/Abeta/Adelta fibers were taken from peripheral nerves to search for units with nerve endings or receptive fields (RF) in the skin or the muscles. The location of the RFs for each identified unit was marked on scaled diagrams of the hind limb. Noxious antidromic stimulation-induced Evans blue extravasation was used to map the RFs of C-fibers in the skin or muscles. Results indicate that, for both A- and C-fibers, the distribution of RFs was closely associated with the APs. In the skin, the RFs concentrate either at the sites of APs or along the orbit of meridian channels. Similarly, the majority of sarcous sensory receptors are located at the APs in the muscle. Results from our studies strongly suggest that APs in humans may be excitable muscle/skin-nerve complexes with high density of nerve endings.

A study on the inhibitory effect of Radix Semiaquilegiae extract on human hepatoma HEPG-2 and SMMC-7721 cells.

The main objective of this paper was to investigate the extraction process of ethanol extract of Radix Semiaquilegiae, as well as its inhibitory activity on human hepatoma HepG-2 and SMMC-7721 cells, and to compare the inhibitory effects of different concentrations of ethanol extracts against these two hepatoma cells. Ethanol reflux extraction and ultrasound-assisted extraction with ethanol at room temperature were used in the extraction process, and MTT assay was mainly used in the activity experiment to perform in-vitro anti HepG-2 and SMMC-7721 cell activity screening of ethanol extract, and to calculate the cell inhibition rates of the extracts. The results showed that among the two types of extracts, ethanol reflux extract had more superior antitumour activity to that of the ultrasonic extract, but all of the extracts obtained had certain anti-cancer activities, and the anti-proliferative activity increased with the increase of concentration.

[Dense innervation of acupoints and its easier reflex excitatory character in rats].

OBJECTIVE: To study the innervating character of tissues around the acupoints and along the meridian course and to analyze the reflex activity correlation between acupuncture points in a given meridian in the rat. METHODS: Forty Wistar and 15 SD rats were used in this study. Electrical activities of microfilaments of the afferent nerves (deep tibial nerve, peroneal nerve and the lateral cutaneous nerve of the leg) were observed for identifying their receptive field and the type of nerve fibers. Nerve stem-antidromic stimulation induced Evan's blue extravasation method was employed to compare the difference of the nerve ending distribution in the acupoint area and non-acupoint area. The reflex activities evoked by electric stimulation of the acupoint were used to analyze the interrelation between acupoint and meridian. RESULTS: Findings showed that a great majority of the afferent nerve endings supplying the tibialis anterior/rectus femoris muscle and the foot skin distributed in an uneven pattern in the sites being in accord with acupoints or with the orbit of meridians. Antidromic stimulation of C-fibers in the deep tibial nerve evoked extravasation of Evan's blue from the plasma into the interstitial fluid, blue foci appeared at the acupoints of the Stomach Meridian and along the orbit of the Stomach Meridian. The special distribution of the afferent nerve endings in the acupoint was also associated with the special reflex activity originating from the acupoints of the muscle group of a given meridian. CONCLUSION: The acupoint is an excitable muscle/skin-nerve complex with greatest concentration of nerve endings. The meridian consists of acupoints that possess a close interaction in physiological reflex activities.

[Protective effect of donator liver ischemic preconditioning on posttransplant liver graft function in Chinese miniature pigs].

OBJECTIVE: To investigate the protective effect of the ischemia preconditioning of the donor liver on posttransplant liver graft function in Chinese miniature pigs. METHODS: Twenty-five partially inbred Chinese miniature pigs were randomized into three groups, namely the normal control group, the ischemia-reperfusion group and ischemic preconditioning group. Biopsies of the liver graft were performed to analyze HSP70 expression by means of immunoblotting, and the changes of serum AST/ALT levels were assayed using an automated biochemical analyzer. Histopathological assessment was carried out to identify the hepatocyte injury using optical and transmission electron microscopy. RESULTS: Ischemia preconditioning resulted in a notable increase in HSP70 expression and milder injury of the hepatocyte microstructure, whereas ischemia-reperfusion caused a significant increase of serum transaminases level (P<0.01) with declined HSP70 expression and obvious microstructural changes of the liver tissue. CONCLUSION: Ischemic preconditioning can produce obvious protective effects on the donor liver, and positively regulates the expression of shock protein.

[Protective effect of protein kinase C and mitogen-activated protein kinases and its mechanism in liver ischemic preconditioning].

OBJECTIVE: To investigate the protective effects of protein kinase C (PKC) and mitogen-activated protein kinases (MAPKs) their and mechanisms in liver ischemic preconditioning. METHODS: In rat models of liver ischemia-reperfusion (IR) and ischemic preconditioning (IP), the liver function was evaluated by examining serum alanine aminotransferase and aspartate aminotransferase levels, and the morphological changes of the liver cells were observed under microscope. PKC activator phorbol 12-myristate 13-acetate(PMA) and inhibitor chelerythrine(CHE), as well as MEK inhibitor PD98059, were utilized to analyze the phosphorylation of PKC and P44/42 MAPKs. RESULTS: Compared with the control rats, the liver function was best protected in rats of IP group, but not in those of IP group with PD98059 or CHE treatment. The rats in IR group showed improved liver function after PMA treatment. Similarly, the phosphorylation of PKC and P44/42 MAPKs was correlated with the liver function, and highly enhanced PKC and P44/42 MAPKs activity was observed in IP and IR+PMA groups, but decreased activity in IR and IP+CHE groups. CONCLUSION: Phosphorylation of PKC and MAPKs plays a pivotal role in the preservation of the hepatocytes during IP.