Objective:To investigate the influence of preoperative biliary drainage (PBD) on morbidity of severely obstructive jaundice patients after pancreaticoduodenectomy (PD).Methods:A total of 98 severely obstructive jaundice(Serum total bilirubin＞300 μ mool/L) patients underwent PD between February 2010 and October 2015 were enrolled in the study.The patients were divided into two groups based on undergoing PBD or not.The no-PBD group comprised 52 patients and the PBD group comprised another 46 patients.Perioperatives parameters,including operative time,intraoperative blood loss,postoperative mortality and morbidity and postoperative hospital stay were compared between the two groups.Results:The demographics,preoperative examinations and pathological results were similar between the two groups (P＞0.05).Operative time of the no-PBD group was statistically longer than the PBD group (379.44 ± 88.57min vs 346.98 ± 57.17 min,P＜0.05).Besides,intraoperative blood loss of the no-PBD group were much more than the PBD group (365.00 ± 187.07mL vs 297.83 ± 139.57 mL,P＜0.05).There was no statistical difference of mortality rate between the no-PBD group and the PBD group(3.85％ vs 2.17％,P＞0.05).The overall morbidity rate of the 2 groups were similar (53.85％ vs 43.48％,P＞0.05),but the pancreatic fistula rate of no-PBD group was significantly higher than the PBD group (30.77％ vs 13.04％,P＜0.05).Conclusion:PBD could reduce operative time,intraoperative blood loss and pancreatic fistula rate after PD.Meanwhile,the mortality and overall morbidity rates were similar between the two groups.PBD should be considered for severely obstructive jaundice patients.

Background and purpose: Accumulating evidence has revealed that long non-coding RNA (lncRNA) is correlated with carcinogenesis and tumor development. Recent literature suggested that lncRNA promoter of CDKN1A antisense DNA damage activated RNA (PANDAR) was involved in the development of various cancers. However, the functional role of PANDAR in colorectal cancer (CRC) has not been elucidated yet. The present study aimed to explore the functional role of lncRNA PANDAR in promoting CRC metastasis and its mechanism.Methods: The expression of lncRNA PANDAR in CRC cell lines and tissues was detected by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR), and the correlation between lncRNA PANDAR expression and CRC clinicopathological characteristics was statistically analyzed. Then, lncRNA PANDAR stably silencing CRC cells (HCT116-shPANDAR), overexpression cells (DLD1-PANDAR) and control vector cells (HCT116-shNC and DLD1-vector) were established using lentiviral vectors. Moreover, Transwell assay and Matrigel assay were performed to investigate the function of lncRNA PANDAR in CRC migration and invasion. Furthermore, the expression of transcriptional factors mediating epithelial-mesenchymal transition of lncRNA PANDAR overexpression cells were monitored by RTFQ-PCR assay, and the function of the target gene in modulating lncRNA PANDAR mediated CRC metastasis was also explored. Results: The expression levels of lncRNA PANDAR in normal colorectal epithelial cells were much lower than in CRC cell. The levels of lncRNA PANDAR in tumor-adjacent tissues were verified to be much lower than in CRC tissues [(171.52±97.80)% vs (100.00±63.18)%, P<0.05]. Moreover, the expression of lncRNA PANDAR was detected to be significantly correlated with CRC TNM stage, lymph node metastasis and distant metastasis (P<0.05). Besides, lncRNA PANDAR deficiency significantly reduced the migration [100.00% vs (42.08±4.77)%, P<0.05] and invasion [100.00% vs (39.14±3.81)%, P<0.05] capabilities in CRC cells, in contrast, the migration [100.00% vs (194.12±9.33)%, P<0.05] and invasion [100.00% vs (204.08±12.27)%, P<0.05] capa-bilities of CRC cells were obviously increased with lncRNA PANDAR overexpression. Furthermore, zinc-finger E-box binding homeobox 1 (ZEB1) expression was detected to be positively correlated with lncRNA PANDAR expression, and ZEB1 silencing could significantly reverse the increased migration and invasion capabilities induced by lncRNA PANDAR in CRC cells. Conclusion: LncRNA PANDAR could promote CRC metastasis by potentially targeting ZEB1. LncRNA PANDAR might be a promising diagnostic marker and therapeutic target for CRC patients.

OBJECTIVE:To study the distribution characteristics of germacrone from zedoary turmeric oil (ZTO) in each tis-sue of mice,and to provide reference for further application of zedoary turmeric oil. METHODS:30 KM mice were given zedoary turmeric oil 0.5 mL;6 mice were randomly selected 1,2,4,8,12 h after medication,respectively. The contents of germacrone in heart,liver,spleen,lung and kidney tissues were determined by HPLC. 15 KM mice were selected,medication and sampling method were same as above;3 mice were collected at each time point respectively. The fluorescence intensity of germacrone in above sections were observed by fluorescence. The same number of mice were selected as control in 2 trials. RESULTS:The con-centration of germacrone in each tissue 1-4 h increased gradually as time and reached the peak value at 4 h. The contents of ger-macrone in liver and spleen were significantly higher than in heart and lung. The concentrations of germacrone in each tissue were ranked as liver>spleen>kidney>heart>lung. The results of fluorescence intensity observation was same as above results. CON-CLUSIONS:Results of 2 methods show same distribution characteristics of germacrone in mice tissues,and indicate that ger-macrone is distributed more in liver,spleen and kidney tissues and less in heart and lung.

Objective To explore the influence of epidural analgesia on stress,immune and survival in patients with ovarian cancer undergoing cytoreductive surgery.Methods 72 cases with ovarian cancer undergoing cytoreductive surgery were divided into group A and group B according to random number table method.Patients in group A were treated with epidural analgesia,while patients in group B were treated with intravenous analgesia.The stress index,the plasma cortisol and immune indexes,CD3+,CD4+,CD8+ and CD4+/CD8+ at 30 mins before surgery (T1),right after surgery (T2),12 h after surgery (T3),1 d after surgery (T4) and 3 d after surgery (T5) between the two groups were observed.The overall survival and free survival in the two groups were compared.Results The plasma cortisol levels was lower in group A than in group B (Fgroup=27.784,P=0.000).The plasma cortisol levels in the two groups increased first and then decreased (Ftime=109,268,P-=0.000),and the decrease ratein group A was higher than that in group B (Finteraction,=22.092,P=0.000).The levels of CD3+,CD4+ and CD4+/CD8+ werehigher in group A than in group B,while the level of CD8+ was lower in group A than in group B (Fgroup=5.893,6.110,7.283,5.593,P＜0.05).The levels of CD3+,CD4+ and CD4+/CD8+ in the two groups reduced first and then increased while the level of CD8+ increased first and then reduced (Ftime=12.220,14.430,15.592,11.102,P＜0.05).CD3+,CD4+ and CD4+/CD8+ in group A increased more while C D8+ reduced more than those in group B (Finteraction=8.251,9.792,8.092,7.103,P＜0.05).The overall survival rate and free survival rate of 3 years in group A and group B was 44.44％,22.22％ vs 38.89％,16.67％,respectivelyThedifferencehadnostatisticalsignificancebetweenthetwogroups (P＞0.05).Conclusion Epidural analgesia may reduce the stress response in patients with ovarian cancer undergoing cytoreductive surgery,and protect the immune function,but the influence on survival is not obvious.

Objective To identify the metabolic levels in prefrontal lobe in patients with post-concussion syndrome by proton magnetic resonance spectroscopy (1H-MRS), and to explore the relationship between metabolic levels and executive function. Methods The study was conducted in 40 patients with post-concussion syndrome and 20 normal controls. 1H-MRS on prefrontal lobe was performed in patients and controls, the NAA, Cho and Cr were measured and the ratios of NAA/Cr, Cho/Cr and NAA/(Cho + Cr) were determined. They were also evaluated executive functions by verbal fluency test (animal), Wisconsin Card Sorting Test (WSCT) and Tower of Hanoi (TOH). Results Compared with normal controls, the patients with post-concussion syndrome were significantly lower NAA/Cr and NAA/(Cho+Cr) ratios in left prefrontal lobe (P < 0.05). The NAA/Cr ratio in left prefrontal was significantly positive correlated with total scores of verbal fluency (r = 0.66, P < 0.05), categories of WSCT (r = 0.54,P < 0.05) and total score of TOH(r = 0.58, P < 0.05). The NAA/Cr ratio was significantly negative correlated with total errors (r = -0.53, P < 0.05) and persistent errors (r = -0.47, P < 0.05) of WSCT and mean executive time of TOH(r = -0.67, P < 0.05). Conclusions The metabolic levels of NAA in left prefrontal lobe in patients with post-concussion syndrome is significantly decreased , it is one cause of impaired executive functions.

BACKGROUND:In recent years, there are many animal studies and osteoblast studies on the anti-osteoporotic effects of puerarin, a kind of phytoestrogen. But few of them are reported on the effects of puerarin on osteoblasts in older patients with osteoporosis. OBJECTIVE: To observe the influence of puerarin on the proliferation ofin vitro cultured osteoblasts from older female patients with osteoporosis. METHODS:The older female patients with osteoporotic femoral neck fractures who underwent artificial femoral head replacement were included in this study. The femoral neck cancelous bone removed during the operation was colected. Primary cancelous bone osteoblasts were cultured using explant culture method. The cels were sub-cultured to the required amounts. Osteoblasts from the control group were cultured with culture medium without puerarin. Osteoblasts from the 0.01, 0.1, and 1 μmol/L puerarin groups were cultured with culture medium containing the corresponding concentrations of puerarin. After in vitro co-culture with different concentrations of puerarin for 1, 3, 5 days, the proliferation of osteoblasts was observed. RESULTS AND CONCLUSION:With the increase in the concentration of puerarin, the proliferative activity of
osteoblasts constantly increased at different time points (P < 0.05). At 3 days of culture, cel absorbance value in each group reached the peak level. These results suggest that 0.01, 0.1, 1μmol/L puerarin promotes the proliferation of osteoblasts in older patients with osteoporosis in a concentration-dependent manner.

OBJECTIVE:To investigate the effects of puerarin on bone mineral density around the femoral prosthesis of el-derly women after osteoporotic fracture artificial hip joint replacement. METHODS:99 elderly women after osteoporotic fracture artificial hip joint replacement were divided into control group(49 cases)and test group(50 cases)according to random number table. Control group received conventional treatment:calcium carbonate and vitamin D3+alendronate sodium+salmon calcitonin;test group was additionally given Puerarin injection 200-400 mg dissolved in Glucose injection 500 ml intravenously,qd,on the basis of control group. A treatment course lasted for 20 d,and both groups received 2 courses of treatment. The hip joint function score and bone mineral density around the femoral prosthesis of 2 groups were observed and compared after surgery,and the oc-currence of ADR was also observed. RESULTS:3 and 2 patients withdrew from control group and test group,respectively. 18 months after surgery,the patients with hip joint function score ranged 70-79 in test group was significantly less than in control group;the rate of excellent hip joint function score in test group was significantly higher than in control group,with statistical significance (P<0.05). 15 and 18 months after surgery,bone mineral density in R1-R5 range of Gruen range in test group was slightly higher than in control group,without statistical significance(P>0.05);bone mineral density in R6-R7 range was signifi-cantly higher than control group(89.58% vs. 69.57%),with statistical significance(P<0.05). The prosthesis loosening was not found in both groups,and ADR was also not found as fever,erythra,nausea,vomiting,headache,dizziness,etc. CONCLU-SIONS:For the use of puerarin in elderly women after osteoporotic fracture artificial hip joint replacement,puerarin can increase the periprosthetic femur bone mineral density with good safety.

Objective To simultaneously determinate the contents of four active ingredients (Ephedrine Hydrochloride, Pseudoephedrine Hydrochloride, Amygdalin and Glycyrrhizinate) ofSan Ao Decoction by HPLC; To optimize the extracting process ofSan Ao Decoction.Methods The orthogonal test was employed. Volume of water, time of extraction and times of extraction were set as investigation factors; the transport rates of Ephedrine Hydrochloride, Pseudoephedrine Hydrochloride, Amygdalin and Glycyrrhizinate and the extraction rates were set as investigation indexes to conduct multi-indexes grading.Results The influence factors of the extraction ofSao Ao Decoction were the times of extraction > decoction time > the volume of water. The best extraction condition was: ten fold water; extract for three times; 1 h for each time.Conclusion The optimized extraction process is stable and feasible.

OBJECTIVE:To optimize the technology conditions of water-soluble chitosan on Huang'e gel water extract solu-tion. METHODS:Using the comprehensive scores of transmittance ratio,impurity removal rate,naringin retention rate as indexes, Box-Behnken response surface method was used to optimize the amount of water-soluble chitosan,shocking time and temperature in clarifying technology,and verification test was conducted. RESULTS:The clarification effect was the best when the volume ra-tio of TCM extract solution with proportion ≥1.3 to amount of 0.01 g/mL water-soluble chitosan was 2.2,shocking for 100 min at 70 ℃. In the verification test,the average transmittance ratio was 87.3%,impurity removal rate was 41.5%,and naringin reten-tion rate was 131.38%. The measured values of comprehensive scores were 97.35%,98.92% and 98.04%,showing relative error of -0.87%,0.73% and -0.16% with the predicted values(98.27%),respectively. CONCLUSIONS:The method can effectively optimize the clarification technology parameters of water-soluble chitosan on Huang'e gel water extract solution.

Objective To evaluate K-wire leverage reduction and fixation via the triceps tendon for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ. Methods From June 2014 to March 2016, 31 children with irreducible supracondylar humeral fracture were treated operatively in our hospital. They were 23 boys and 8 girls, aged from 4 to 11 years ( average, 6. 3 years ) , involving 19 left and 12 right arms. Their clinical manifestations included elbow swelling at the affected arm, obvious tenderness, and limited movement of the elbow. The reduction was conducted under the guidance of C-arm roentgenography by inserting a piece of 3. 0 mm K-wire into the fracture ends via the posterior triceps tendon, inserting 2 pieces of 1. 5 or 2. 0 mm K-wire from the distal lateral humerus to the proximal through the opposite cortical bone, and inserting a piece of 1. 5 or 2. 0 mm K-wire into the opposite cortical bone through the ulnar aspect of the distal humerus. Results The operation time for the 31 patients ranged from 28 to 42 minutes ( 33 minutes on average ) . They were followed up for 6 to 18 months ( 12. 3 months on average ) . All fractures united after 4 to 6 weeks ( 4. 6 weeks on average ) . At the final follow-ups, the lengths of the affected and healthy arms were re-spectively 66. 4 ± 2. 7 cm and 66. 4 ± 2. 9 cm, showing no significant difference ( P> 0. 05 ) . The therapeutic outcomes by the Flynn criteria for the elbow function were rated at the final follow-up as excellent in 26 cases, as good in 4 and as fair in one, yielding an excellent to good rate of 96. 8％. Pin tract infection occurred in 2 patients, but no deep infection or osteomyelitis was observed during follow-ups. Conclusion K-wire leverage reduction and fixation via the triceps is an effective and simple treatment for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ.