OBJECTIVE:To optimize the formula technology of puerarin derivative 4ac-loaded nanoparticles by central composite design. METHODS:4ac nanoparticles were prepared using solvent evaporation method, with mean diameter, encapsulation rate and yield as dependent variables, multi-linear regression and binomial fit were performed on the 3 independent variables at different level:dosages of supporter lactic acid/ glycolic acid copolymer and surfactant polyvinyl alcohol, and the diameter of pinhole. The optimum experimental conditions were predicted by response surface method. RESULTS:The binomial fitting equations of indexes were all superior to their multi-linear regression equations, and the predictive values in the established mathematical model were in good conformity with the experimental values. CONCLUSION:Central composite design plus response surface method shows a good predictability in optimizing the formula technology of 4ac-loaded nanoparticles.

Objective To explore the application effect of hyperbaric oxygen ( HBO ) in the treatment of refractory peptic ulcer .Methods Clinical data of 259 patients with refractory peptic ulcer were retrospectively ana-lyzed.According to whether received HBO therapy , these patients were divided into the HBO group ( n=127 ) and control group(n=132).The total effective rate,Helicobacter pylori(Hp) eradication rate and relapse rate of the two groups were compared .Results The total effective rate ,Hp eradication rate of the HBO group were 93.7%,92.1%, respectively,which were significantly higher than 65.2%,56.1% of the control group (χ2 =31.97,7.32,all P<0.05).The relapse rate of the HBO group was 8.4%,which was significantly lower than 33.3%of the control group (χ2 =12.51,P<0.05).Conclusion HBO combined with conventional drug in the treatment of refractory peptic ulcer has significant effect .

AIM:To establish a method for determining the contents of salvianolic acid B,danshensu and protocatechuic aldehyde,the effective components of Shuangdan Oral Solution(Radix et Rhizoma Salviae miltiorrhizae,Cortex moutan) by HPLC.METHODS:Experiment was carried out on a Phenomenex Luna C_(18) column(4.6 mm?150 mm,5 ?m) with a mobile phase methanol-acetonitrile-methane acid-water(30:10:1:59) at a flow velocity of 1.0 mL/min and detection wavelength at 286 nm for salvianolic acid B,a mobile phase methanol-acetonitrile-methane acid water solution [HCOOH:H_2O(2:98)](9:4:87) at a flow velocity of 1.0 mL/min and detection wavelength at 281 nm for danshensu and protocatechuic aldehyde.RESULTS:The average recoveries of salviano-(lic) acid B,danshensu and protocatechuic aldehyde were 98.6%(RSD=1.91%,n=6),99.2%(RSD=2.2%,n=6) and 97.3%(RSD=2.5%,n=6) respectively.CONCLUSION:The results show that this method is easy to operate and accurate,and can be used to determine the contents of the three effective components in Shuangdan Oral Solution.

Objective To investigate the correlation between plasma D-dimer with delayed encephalopathy (DE) in patients with acute carbon monoxide poisioning(ACOP).Methods According to the severity of disease,100 patients with ACOP were divided into mild group (27 cases),moderate group (31 cases),severe group (42cases).And depending on whether DE occured,all patients were divided into DE group(20 cases) and no DE group (80 cases).4 venous blood samples were obtained separately from each subject in 1,7,14 days after their admission to hospital by using latex immunoturbidimetry.The levels of blood plasma D-dimer of patients in each group were detected by immune turbidimetry and analyzed,1th,7th and 14th day after admission.Results The plasma D-dimer level of the mild group at different time points was in the normal range,and the difference was not statistically significant(all P ＞ 0.05) ;The plasma D-dimer level of the severe group and moderate group was significantly higher than that of the mild group(all P ＜0.01),and it reached a peak in one week(7 days),and showed a downward trend after two weeks(14 days).The DE all occurred in the moderate and severe group.The plasma D-dimer levels of the DE group were higher than those of no DE group from admission to the 7 th and 14 th day (all P ＜ 0.01).Conclusion The dynamic monitoring plasma D-dimer is helpful in assessing to the severity and prognosis of ACOP,and could surpport positive clinical significance for the prevention and treatment of DE.

Objective To explore the expression and clinical significance of Twist. E-cadherin and N-cadherin in gallbladder carcinoma. Methods From 2000 to 2008, in Zhejiang Provincial People's Hospital, the expression of Twist, E-cadherin and N-cadherin protein were detected in 79 surgically removed gallbladder carcinoma tissue specimens in paraffin blocks and 20 normal gallbladder tissue specimens by tissue microarray technique and immunohistochemistry. Results Compared with normal gallbladder tissues, the expression of Twist and N-cadherin was up-regulated in gallbladder carcinoma tissues and the positive percentage was 68.3％ and 49.4％ respectively, while which both were 1/20 in normal gallbladder tissues. The percentage of high E-cadherin expression in gallbladder carcinoma tissues was only 27.8 ％, which was significantly lower than that in normal gallbladder tissues (20/20;X2 ＝29.31, P＜0. 05). The expression of Twist was correlated with T classification, lymph node metastasis, distant organ metastasis, hepatoduodenal ligament invasion, lymphatic invasion and UICC stage of gallbladder carcinoma (P＜0.05). The expression of E-cadherin was correlated with T classification, distant organ metastasis, hepatoduodenal ligament invasion, differentiation degree and UICC stage of gallbladder carcinoma (P＜0.05). The expression of N-cadherin was only correlated with lymphatic invasion of gallbladder carcinoma (P ＜0.05 ). There was significant negative correlation between Twist and E-cadherin expression (P＜0. 01). All the 79 gallbladder carcinoma patients were followed up after the surgery, the mean follow-up time was 30.6±14.3months. The 3-year survival rates of patients with low or high Twist expressions were 66％ and 7％ respectively,there was significant difference between the two groups(P＜0. 01). The 3-year survival rates of patients with low or high E-cadherin expressions were 25 ％ and 86 ％ respectively, the difference of two groups was significant(P＜0.01). The 3-year survival rates of patients with low or high Ncadherin expressions were 39％ and 41％ respectively, there was no significant difference between the two groups(P＞0.05). The multivariate analysis indicated that the Twist expression was one of independent prognostic factors of gallbladder carcinoma. Conclusion The abnormal expression of Twist and E-cadherin was correlated with the development and progression of gallbladder carcinoma,and Twist expression was one of the independent prognostic factors of gallbladder carcinoma.

Objective To assess the effect of three different liver vascular exclusions on prognosis of patients undergoing hemihepatectomy.Methods Clinical data of 216 patients undergoing hemihepatectomy were analyzed retrospectively.Ninety-eight out of 216 patients received Pringle maneuver during hepatectomy in group A,71 patients of selective liver inflow and outflow vascular exclusions in group B,47 patients using liver hanging maneuver combining with selective liver inflow and outflow vascular exclusions were in group C.Results There was no difference in operation time between the three groups ( t =0.72,0.83,and 0.67,P ＞ 0.05 ).The intraoperative blood loss and transfusion in group B and C were less than that in group A (t =3.72,3.83 and 4.11,4.07,P ＜0.05).Serum albumin level on day 1 and day 3 in group B and C were higher than that in group A (t =3.65,3.77,and 3.90,3.74,P ＜0.05 ).Serum total bilirubin level on day 3 and 5 in group B and C were lower than that in group A ( t =4.13,5.01,and 4.09,3.99,P ＜0.05).Serum alanine aminotransferase on day 1,3 and 5 in group B and C were lower than that in group A ( t =5.36,6.14,and 5.70,7.01,and 4.94,3.98,P ＜ 0.05 ).Postoperative complication rate in group A was higher than that in group B and C ( x2 =13.71 and 23.56,P ＜ 0.05 ).The 3-year survival rate of patients with malignant tumor in the three groups were not significantly different (t =2.38,P ＞ 0.05 ).Conclusions Intraoperative blood loss and transfusion and postoperative complication rate can be reduced,and liver injury can be diminished in hemihepatectomy using selective liver inflow and outflow vascular exclusion alone and or in combination with a liver hanging maneuver.

Objective To evaluate the result of multiple segmentectomy under selective occlusion of hepatic inflow for complicated intrahepatic cholangiolithiasis. Methods In this study 12 cases of complicated intrahepatic cholangiolithiasis receiving multiple segmentectomy under selective occlusion of hepatic inflow during 2004. 1 - 2010. 10 were reviewed retrospectively. The short-term and long-term outcomes of the patients were analyzed. Results There was no surgical mortality in this group. The segmentectomy performed were Ⅱ + Ⅲ + Ⅴ in 1 case; Ⅱ + Ⅲ + Ⅵ in 2 cases; Ⅱ + Ⅲ + Ⅴ + Ⅵ in 1 case;Ⅱ +Ⅲ+Ⅵ +Ⅶ in4 cases; Ⅱ +Ⅲ +Ⅳ +Ⅵ in 3 cases and Ⅱ + Ⅲ +Ⅳ +Ⅵ +Ⅶ in 1 case. The average intraoperative blood loss was 560 ± 291 ml. Postoperative complications were wound infection in 2 cases, bile leakage in 1 case, abdominal infection in 1 case. There were no liver failure, intrabdominal hemorrhage or hemobilia; stone clearance rate at 10 days after operation was 83% (10/12) and 92%(11/12) at 6 weeks after operation following postoperative choledochoscopic lithotripsy. 92% (11/12) cases were followed-up with the median follow-up period of 31 months. The result was excellent or good in 92% (11/12) cases. Conclusions Multiple segmentectomy was the choice for complicated intrahepatic cholangiolithasis, and the procedure could be safely performed under selective occlusion of the hepatic inflow.

This study was aimed to verify the chemical component cantharidin from Chinese blister beetle by LC-MS/MS. Components were first processed by HPLC to choose the appropriate separation conditions before LC/MS/MS analysis. Through the positive and negative ions pre-scan, positive ions scanning way was selected in the scanning of each separate component. The scanned maps were obtained and the relative molecular mass was deduced. The results showed that 8 types of cantharidin compounds were identified, including three isomers. It was concluded that LC-MS/MS was able to determine the chemical component cantharidin from Chinese blister beetle rapidly and accurately, which was existed in the body by the form of combined amino acid.

Objective To evaluate hepatic vein exclusion (HVE) outside the liver in the resection of giant hepatic hemangioma near the second hepatic hilum. Methods From January 2003 to December 2009, giant hepatic hemangiomas near the second hepatic hilum were resected in 19 cases. Preoperatively 19 cases were divided into two groups: HVE group (9 cases) and IVE group ( 10 cases). Data regarding the intra-operative and postoperative courses of the patients were analyzed. Results There was no difference between the 2 groups regarding the age, sex and tumor size. No damage of hepatic vein was happened in HVE group. Resection of the hemangioma was applied in all cases of HVE group, and 1 case in IVE group had right hemi-hepatectomy. Hepatic veins rupture occurred in 4 cases in IVE group and 2 cases of them had massive bleeding, while in HVE group hepatic veins rupture occurred in 5 cases but no massive bleeding occurred. Intra-operative blood loss was significantly less in HVE group than IVE group. The serum ALT value in postoperative day 1 and total bilirubin in postoperative day 3 in HVE group was significantly lower than that of the IVE group. The mean drainage volume in HVE group was significantly less than that of the IVE group on postoperative day 1 and day 2. The total cost of patient in HVE group were significant less than in IVE group. Conclusions The use of hepatic vein exclusion reduces the risk in the resection of giant hepatic hemangioma near the second hepatic hilum.

Objective To investigate the clinical influence about levetiracetam on cognitive function and emotional influence in the patients with partial epilepsy.Methods A total of 62 patients with partial epilepsy were divided into carbamazepine group (30 cases) and levetiracetam group (32 cases) by random digits table method,carbamazepine group was treated by carbamazepine while levetiracetam group was treated by levetiracetam.The patients were assessed before treatment and 4,8,12,16 weeks after treatment by the Montreal cognitive assessment scale (MoCA),self rating anxiety scale (SAS) and self rating depression scale (SDS).Results There was no significant difference in MoCA score between two groups before treatment and 4 weeks after treatment (P ＞ 0.05).MoCA score at 8,12,16 weeks after treatment in levetiracetam group was better than that in carbamazepine group [(22.6 ± 2.1) scores vs.(20.8 ± 2.6) scores,(23.5±2.7) scoresvs.(21.3± 2.8) scores,(24.6±4.7) scoresvs.(21.2±3.0) scores],the difference was statistically significant (P ＜ 0.05).There was no significant difference between SAS score,SDS score between two groups before and after treatment (P ＞ 0.05).Conclusion In the process of treating the patients with partial epilepsy by drug,levetiracetam is superior to carbamazepine on the improvement of cognitive function,but the mood improvement is not obvious.