Perihilar surgery is full of challenge,risk,variability and uncertainty.Because of the anatomic variability,the pathophysiological complexity and invasion of the diseases,hepatic hilar biliary surgery has the characteristics of high operative difficulties,low resection rate,easy intraoperative bleeding,more postoperative complications,high recurrence rate and mortality rate.The cure rate and safety of the operation can be improved only through comprehensive imaging examinations and preoperative evaluation of liver function as well as the correct use of surgical techniques of anatomic paths,lesions excision and hepatic hilar reconstruction.The core of perihilar surgical techniques is hepatic hilar anatomy and explosion,including hilar plate dissection,dissection of liver along the medial fissure,quadrate lobe of liver resection and perihilar resection.Perihilar surgery is a comprehensive technique involving preoperative,intraoperative and postoperative procedures.The cure rates of perihilar biliary diseases can be improved by a combination of enhanced recovery after surgery and optimized and individualized surgical plans for patients.

Objective To explore the effects of different concentrations of propofol postconditioning against glutamate neurotoxicity to brain slices of neonatal rats.Methods The brain slices of neonatal rats were prepared and cultured in complete medium.They were randomly divided into five groups:the normal control group,glutamate injury group(RI group),1 mg/L propofol postconditioning group(PL1+RI group),3 mg/L propofol postconditioning group(PL3+RI group),5 mg/L propofol postconditioning group(PL5+RI group),12 cases in each group.The RI,PL1+RI,PL3+RI,PL5+RI groups were cultured for 6 days,then the brain slices were moved into the culture medium containing glutamate(1 mmol/L) and incubated for 30 minutes.And then,respectively,the brain slices of RI group were put into another complete culture medium,the PL1+RI group,PL3+RI group and PL5+RI group were put into the medium containing corresponding concentrations of propofol medium and long chain fat emulsion injection.All of the above were cultured for 24 hours in order to establish the injury model.The numbers of the Nissl body,the LDH release rates and the brain tissue damage rates of each brain slice were detected to evaluate the effects of propofol postconditioning on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.Results Compared with the RI group,the numbers of the Nissl body of the PL1+RI group,PL3+RI group and PL5+RI were higher,the LDH release rates and the brain tissue damage rates of the PL1+RI group,PL3+RI group and PL5+RI were lower,the diferences were significant(P<0.05).Among the three PL+RI groups,the LDH release rates and the brain tissue damage rates of the PL3+RI group were lower than those of the other two groups,the diferences were significant(P<0.05),at the same time,the numbers of Nissl body were more than the other two groups,the diferences were significant(P<0.05).Conclusion Propofol postconditioning has protective effects on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.However,the protective effects are not dose-dependent,and 3 μg/mL is the best dose of propofol to keep the glutamate-damaged brain slices from reperfusion injury in this research.

Adult ; Cardiac Catheterization ; Female ; Heart Septal Defects ; therapy ; Humans

Animals ; Cell Membrane ; metabolism ; Humans ; Protein Transport ; Receptors, N-Methyl-D-Aspartate ; chemistry ; genetics ; metabolism ; Synapses ; physiology

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult

[Objective] To study the methods of inducing bone mesenchymal stem cells(BMSCs)of rabbits into chondrocytes in vitro and the interaction of transforming growth factor ?1(TGF-?1),insulin-like growth factor-Ⅰ(IGF-Ⅰ)and basic fibroblast growth factor(bFGF).[Methods]BMSCs of rabbits were primarily cultured and subcultured in vitro,and then divided into four groups according to the difference of factors:group A receiving TGF-?1 and bFGF;group B receiving TGF-?1 and IGF-Ⅰ;group C receiving TGF-?1;group D receiving no cell growth factor.After three weeks all the four groups were detected by methyl thiazolyl tetrazolium(MTT)assay,measurement of glycosaminoglycan(GAG)and immunohistochemistry.[Results]Immunohistochemical detection of collagen Ⅱ was positive in groups A,B and C.The results of the MTT assay and the GAG content in groups A and B were obviously higher than those in groups C and D.[Conclusion]Rabbit BMSCs can be induced into chondrocytes under certain conditions.TGF-?1,IGF-Ⅰ and bFGF have synergy effect in the differentiation from BMSCs into chondrocytes.

[Objective] To observe the de-jaundice of severe jaundice hepatitis with TCM enema.[Method] 87 cases of chronic virus hepatitis with hyperbilirubinemia were randomly divided into 2 groups,the treatment group treated with TCM preserving enema and routine combination of TCM and western medicine which could protect liver and decrease enzyme and de-jaundice.The control one used only the later,observed for 6 weeks.[Result] The reduction of total bilirubin of the treatment group was larger than control group,P

Objective To investigate the effect of preconditioning electrostimulation of fastigial nucleus (FNS) on the neuronal mitochondrion of rats early after cerebral ischemia. Methods Forty Wistar rats were used and divided into 5 groups: a normal control group, a sham FNS group and 3 FNS groups. The FNS of the rats in the FNS groups was conducted for 1 hr, 1 day or 7 days, respectively, before the models of middle cerebral artery occlusion(MCAO)were made with them. Three hours after the model was established, the animals were sacrificed and the water content of the brain of the ischemic side was measured. The neuronal mitochondrion was observed by electron microscope, and its Vv, specific volume (Sv) and specific surface (Ss) were analyzed. The rats in the normal control group were not given any special treatment. For the rats in the sham-FNS group, intrinsic neurons of FN were destroyed with ibotenic acid (IBO), and 5 days later, the FN was electrically stimulated, and 1 day later, MCAO models were made. Results Three hours after MCAO, the water content of the brain increased and neurological function score decreased in the sham-FNS group, while the Vv and Sv of neuronal mitochondrion increased and the Ss decreased, which were significantly different from those of the normal control group(P

Objective To study the protective effect of hyperoxic liquid preconditioning in myocardial ischemia-reperfusion injury. Methods Thirty rabbits were randomly divided into three groups: group A undergoing all procedures except ischemia-reperfusion, group C receiving the routine infusion of hyperoxic liquid 15mL/kg for seven days, and group B receiving the routine treatment infusion of saline instead of hyperoxic liquid 15mL/kg. Seven days later, the myocardial ischemic reperfusion model (I/R) was fabricated, ECG and homodynamic index were monitored simultaneously. Plasma MDA and SOD level was assayed before ligation, 30min after ligation and 1, 2, 3h after reperfusion. Results Hyperoxic liquid preconditioning can lower ST segment and improve index of hemodynamics and significantly reduce myocardial infarction size in group C compared with group B((P

Objective To explore the effect of inadequate reduction of the medial wall on the postoperative varus deformity following calcaneal fracture surgery and other influencing factors of varus deformity.Methods A retrospective analysis was conducted of the 60 patients with calcaneal fracture involving the medial wall (60 feet) who had been treated from October 2005 to September 2015.They were 51 men and 9 women,18 to 55 years of age (average,38.4 years).According to the Sanders classification,24 patients belonged to type Ⅱ,30 to type Ⅲ,and 6 to type Ⅳ.We measured the integrity of the pre-and post-operative medial walls,the height and width of the pre-and post-operative calcanei,the pre-and post-operative B(o)hler angles and the pre-and post-operative calcaneal varus angles for statistical analysis.Results The effect of postoperative height reduction of the medial wall on the postoperative correction of varus angle was significantly larger than that of the lateral wall (P ＜ 0.05).The higher the integrity of the postoperative medial wall,the larger the correction of the postoperative varus angle.The normal rate of postoperative calcaneal varus angle significantly decreased with the increased Sanders classification severity (P =0.001).The postoperative reduction of the height and width of the calcaneus and the integrity of the preand post-operative medial walls were significantly positively correlated to the normal rate of postoperative calcaneal varus angle (P ＜ 0.05).Conclusions The medial wall has a large influence on the postoperative calcaneal varus angle.The higher integrity of the preoperative medial wall,and the more adequate reduction and fixation of the postoperative medial wall as well,the higher rate of postoperative normal calcaneal varus angle.The postoperative reduction of the calcaneal height also affects the varus angle.When the heights of the medial and lateral walls are recovered,the normal rate of varus angle is the highest;when reduction of the medial wall is inadequate but reduction of the lateral wall is fine,the normal rate of varus angle is the lowest.