Objective:To investigate the clinical value of indocyanine green(ICG) fluorescence imaging in complex laparoscopic cholecystectomy.Methods:The data of 96 patients with complicated gallbladder stones with cholecystitis and cholecystitis who underwent laparoscopic cholecystectomy(LC) from July 2018 to August 2020 in Hepatobiliary and Pancreatic Surgery of Huangshi Central Hospital of Edong Healthcare Group were retrospectively analyzed. Before operation, the patients were divided into experimental group( n=44) and control group( n=52) according to whether indocyanine green was injected intravenously. Seven hours before operation, the experimental group was injected with 2.5 mg indocyanine green, the experimental group underwent LC under guidance of ICG fluorescence imaging technology. The control group underwent conventional LC. The recognition rate of common bile duct and cystic duct, complete anatomy time of gallbladder triangle, operation time, intraoperative blood loss, bile duct injury and residual stone rat were compared. The measurement data obeying normal distribution was expressed by ( Mean± SD), and the t test was used comparison between groups, and the chi-square test or Fisher exact probability was used comparison between enumeration data. Results:The operation was successfully performed in both groups, In the control group, 1 case was converted to laparotomy, There was no perioperative death. Before the incision of the serosa of the triangle of the gallbladder, In the experimental group, the common bile duct recognition rate was 84.1%(37/44), the recognition rate of cystic duct was 72.7%(32/44). In the control group, the common bile duct recognition rate was 26.9%(14/52), the recognition rate of cystic duct was 28.8% (15/52). There were statistically significant differences in the recognition rate of common bile duct and cystic duct between the two groups ( P< 0.05). In experimental group, the time of complete dissection of gallbladder triangle, the operation time, the intraoperative blood loss were (30.2±8.6) min, (48.2±9.8) min, (16.3±5.2) mL, and (46.7±13.9) min, (65.2±15.4) min, (26.1±11.3) mL in the control group, there were statistically significant difference in the above indicators between experimental group and control group( P<0.05). There was no extrahepatic bile duct injury and residual stones in the experimental group. In the control group, there was 1 case of right posterior hepatic duct injury, 2 cases of common bile duct injury and 1 case of residual gallstone. There was no significant difference in extrahepatic bile duct injury and postoperative stone residual rate between the two groups ( χ2=3.532, P=0.081). Conclusion:ICG fluorescence navigation is helpful for early identification of common bile duct and cystic duct in laparoscopic complex cholecystectomy, which can avoid iatrogenic bile duct injury and has good clinical value.

Objective To investigate the clinical significance of the electrocardiogram (ECG) to cardiac involvements in Systemic lupus erythematosus (SLE). Methods 80 cases without sign and syndrome of cardiac involvements were analyzed retrospectively in our hospital between January 2004 and April 2009.Results In 80 cases without sign and syndrome of cardiac involvements, 46 cases had ECG changes,with the positive rate being 57.5% . In the next echocardiography examination, 39 cases had heart struction or function change,with the positive rate being 48.8% . Conclusion For SLE patients, ECG examinations can find the change,and in the next echocardiography examination, cardiac involvements degree can be sure. It can provid an early important information for diagnose and treatment.

OBJECTIVE:To study the characteristics of adverse drug reactions(ADR) induced by gatifloxacin.METHODS:A total of 866 ADR cases induced by gatifloxacin collected in Zhejiang ADR Monitoring Center between Oct.30,2003 and Oct.30,2006 were analyzed with Excel.RESULTS:The common ADR induced by gatifloxacin were lesions of skin and appendages,gastro-intestinal system,systemic and nervous system.Most of the cases were slight in symptoms,but gatifloxacin could also induce severe ADR such as dysglycemia etc that resulting in potential risks to vital human organs.CONCLUSION:ADR monitoring should be emphasized when using gatifloxacin so as to decrease or avoid the occurrence of ADR.

Objective To elucidate the inhibitory effect of 131I-fulvestrant on the growth of human breast cancer cells and the effect on the important organs.Methods MTT assay was used to clarify the difference in killing effects of the 131I-fulvestranton on MCF-7 cells and MDA-MB-231 cells.Breast cancer MCF-7 cell xenografts in nude mice was establishied,and two different administration methods of the 131I-fulvestrant in the MCF-7 cell to nude mice were given respectively.Organs and tumours of nude mice were observed.Results MTT assay demonstrated that 131I-fulvestrant had similar cytotoxicity against MCF-7 cells and MDA-MB-231 cells,and the former was slightly stronger.Transient contact experiments showed that 131I-fulvestrant could play a tumor suppressor effect on MCF-7 cells continually,but MDA-MB-231 cells wasn't.After the injection of 131I-fulvestrant via caudal vein,the radioactivity concentration on tumor site accounted for (4.33 ± 0.28)％ of the total injection,and the volume of the tumor reduced before gradually increasing again.Radioactivity in the blood accounted for (20.76 ± 2.54)％ of the total injection.Qrgans like liver and kidney also showed radioaction distribution.Its distribution was accorded with the distribution of estrogen receptor.Local injection of 131I-fulvestrant got powerful killing effect on the tumor,and the distribution of the radioaction was mainly confined within the tumor.Conclusion 131I-fulvestrant has a good inhibitory effect on MCF-7 breast cancer cells,which is a superposition of radiotherapy and endocrine therapy,and it is controllable on the general condition and important organs of nude mice.

Objective To observe the effect of buyanghuanwu decoction on expression of immunoreactive protein and mRNA of NMDA receptor 2B subunit in rats hippocampal with vascular dementia to investigate the mechanism of buyanghuanwu decoction. Methods One hundred and forty-four rats were randomly divided into 4 groups: sham-operated group, VD model group,nimodipine group and buyanghuanwu decoction treatment group. The rats models of vascular dementia were built up by four vessels occlusion method. VD rats were treated with in-tragastrical buyanghuanwu decoction suspension (50 pharmacognostic g·kg-1·d-1) and nimodipine suspension (20 mg·kg-1·d-1) for 30 days. The learning and memory abilities were evaluated by Morris water maze tests. The change of NR2B protein in hippocampal of each group of rats were measured with immunohistochemistry and Western blot techniques and the expression of NR2B mRNA in hippocampus were observed by real-time fluorescence quantitative PCR techniques. Results Water maze tests,compared with sham-operated group((24. 18 ± 7.90)s,(7.99 ±1.32)/min) ,the escape latency(51. 25 ±18.28)s to explore the extension and the average spatial probe number ((5. 26 ±0. 74)/min) reduced in VD model group (P < 0. 05). Buyanghuanwu decoction ((25.91 ±9.56)s,(7. 52 ± 1. 27)/min) had significantly improved the above-mentioned rat model of learning and memory performance (P<0.05). There was no significant difference among sham-operated group,nimodipine group and buyanghuanwu decoction treatment group (P>0. 05). Similarly,as compared rats with sham-operated group(0.71 ±0.13), (5887 ±501), the expression of NR2B protein (0. 33 ± 0. 06) and its mRNA(593 ±53) were apparently decreased in VD rats (P< 0.05). The expression of NR2B protein(0.66 ±0. 11) and its mRNA (5692 ±482) in neuron of hippocampus were increased by buyanghuanwu decoction compared with the model group (P < 0. 05), and no difference was discovered between sham operation group and nimodipine group (P > 0.05).Conclusions Buyanghuanwu decoction improves the learning and memory abilities in VD rats, the therapeutic mechanism was concerned with lessening the injury of neurons on CA1 field in hippocampus and promoted the expression of NR2B protein and its mRNA.

Objective To evaluate the effects of electromagnetic irradiation of 2000 μW/cm2 exposure on mRNA and protein expression levels of immunoreactive protein and mRNA of NMDAR1 in rats hippocampal,and to explore the impaired mechanism of electromagnetic irradiation on learning and memory.Methods Rats were randomly divided into normal control group, sham-radiated group, and 1 h/d, 2 h/d, and 3 h/d radiation groups.The rats in the radiation groups were fixed and recieved microwave exposure of 2000 μW/cm2, then their learning and memory abilities were tested by Morris water maze experiment, the change of NR1 protein in hippocampal neurons of each group of rats was measured with immunohistochmistry and western blot techniques, and the expression of NR1 mRNA in hippocampus was determined by RT-PCR.Results In the water maze test,compared with the normal control group (8.8 ± 1.66 ), the escape latency of three radiated groups rats ( 1 h/d ( 12.29 ±1.36) s,2 h/d ( 17.99 ±2.25) s,and 3 h/d (24.66 ±5.56) s) were significantly longer (P＜0.05).In the radiation group,the hippocampal neurons of rats showed evident reduction in the ratio of NR1 positive cells,irregular,and arrayed in disorder.Moreover,compared with the normal control group ( (0.70 ±0.11 ), (0.68 ±0.11 ) ) ,the expession of NR1 protein ( 1 h/d (0.122 ±0.026) ,2 h/d (0.102 ±0.023) ,and 3 h/d (0.060 ± 0.009) ) and its mRNA ( 1 h/d (0.46 ±0.07) ,2 h/d (0.35 ±0.05) ,and 3 h/d (0.12 ±0.02) ) in hippocampal neurons was significantly decreased (P＜0.05).Among the indicators, there was no significant difference between sham-radiated group and normal control group.Conclusions Electromagnetic irradiation of 2000 μW/cm2 exposure can impair the learning and memory abilities of rats possibly through a mechanism correlated with the lower expression of NR1 protein and its mRNA in hippocampus.

Objective To obtain a more accurate assessment of prognostic significance of NLR in ovarian cancer. Methods A systematic literature search was conducted using the electronic databases PubMed ,Web of Science,and Embase up to May 2016. Hazard ratio(HR)and odds ratio(OR)with 95% confidence interval (95%CI)were calculated. Statistical analysis was performed using Stata 12.0. Results 12 studies,consisting of 3 ,854 patients ,were selected in this meta-analysis. High NLR level was significantly associated with poorer overall survival(OS)(HR:1.69)and shorter progression free survival(PFS)(HR 1.63). Additionally,increased NLR was significantly correlated with advanced FIGO stage(OR 2.32),higher level of CA-125(OR 3.33),more extensive ascites(OR 3.54)as well as less chemotheraputic response(OR 0.53). Conclusions Elevated pretreat-ment NLR can serve as a predicative factor of poor prognosis for ovarian cancer.

AIM:To observe the effect of buyanghuanwu decoction,a Chinese medicine,on the expression of AMPA receptor GluR1 subunit in mRNA and protein levels in rat hippocampus with vascular dementia (VD). METH-ODS:One hundred and forty -four rats were randomly divided into 4 groups:shamoperation group,VD model group,nimodipine group and buyanghuanwu decoction treatment group. The rat model of VD was built up by the method of 4 vessel occlusion. The VD rats were intragastrically treated with buyanghuanwu decoction suspension (pharmacognostic 50 g. kg -1.d -1) and nimodipine suspension (20 mg?kg -1.d-1) for 30 d. The learning and memory abilities were evaluated by Morris water maze testing. The change of GluR1 protein in hippocampal neurons in each group of rats was measured with immunohistochemistry and Western blotting techniques. The expression of GluR1 mRNA in hippocampus was determined by real -time fluorescence quantitative PCR. RESULTS:Compared to sham -operation group,the average escaping latency period (s) of Water maze tests in VD rats prolonged significantly and crossplatform time (numbers/min) shortened distinctly (P 0. 05). Compared to the rats in shamoperation group,the mRNA and protein levels of GluR1 were apparent-ly decreased in VD rats (P 0. 05). CONCLUSION:Buyanghuanwu decoction improves the learning and memory abilities in VD rats. The therapeutic mechanism is associated with lessening the neuron injury on CA1 field in hippocampus and restoring the mRNA and protein ex-pression of GluR1.

Objective To evaluate carotid sinus block (CAS) in preventing the low hemodynamic state in the perioperative period of carotid artery stenting (CAS).Method A prospective single-center randomized controlled study was conducted on 172 patients with internal carotid artery stenosis receiving CAS from May 2015 to May 2018.Patients were randomly divided into group A treated with local anesthesia of the carotid artery sinus of the trouble side under the guidance of ultrasound preoperatively and group B without local block anesthesia.The carotid artery stenosis rate,the maximum intraoperative reduction of blood pressure and heart rate,the use of atropine and vasopressor were monitored and compared between the two groups.Results There were no significant differences between the two groups in preoperative general data,degree of stenosis,plaque nature,degree of residual stenosis (P ＞ 0.05).The maximum reduction of intraoperative blood pressure and heart rate in group A was significantly lower than that in group B,and the number and dose of intraoperative atropine were smaller than those in group B (P ＜ 0.05).The number of postoperative patients with low hemodynamic status in group A and the time period of vasopressor use were significantly less than those in group B (P ＜ 0.05).Conclusion Preoperative carotid sinus block anesthesia is safe and effective in preventing low hemodynamic status in perioperative period of CAS.

Objective: To investigate potential biomarkers for different types of hand, foot and mouth disease(HFMD). Methods: Nuclear magnetic resonance(NMR)-based metabolomics methods were used to analyze the metabolic differences in serum of HFMD and healthy controls.Partial least squares discriminant analysis(PLS-DA)and orthogonal partial least square discriminant analysis(OPLS-DA)were used for analysis of metabolite profiles.Differential statistical analysis was performed by t tests using GraphPad Prism 5 software. Results: The levels of lipid, leucine, valine, β-hydroxybutyric acid, acetone, glucose, glycoprotein, glycerol, glycine, choline, trimethylamine oxide and lactate in HFMD increased significantly compared with healthy controls, whereas the levels of acetic acid and creatine decreased significantly.Additionally, the level of acetone further increased in the severe type of HFMD compared with the mild type, whereas the levels of lipid and trimethylamine oxide decreased. Conclusion These statistically significant differences are involved in lipid metabolism, glucose metabolism and protein metabolism in different types of HFMD.Lipid, acetone and trimethylamine oxide can be used as potential biomarkers of HFMD.