AIM:In order to improve the clarity and quality of Ginkgo leaf water-extraction solution,and optimize the production process. METHODS:The experiment was based on the optical absoiption and scattering rate,flocculation rate and loss in flavanones were used as two main parameters to estimate the effect of influencing factors on flocculation.It could be proved by analyzing the particle size in water-extraction solution before and after flocculation. RESULTS:The best flocculation technological parameters of water-extraction solution of Ginkgo leaf with chitosan were as follows:at flocculant concentration of 1.071 g/L,flocculation temperature of 40(?C),pH of 4.9. CONCLUSION:The flocculation of water-extraction solution of Ginkgo leaf with chitosan is effective and selective,it has the advantage over ethanol precipitation method.

Objective To research the biomechanical characteristics and clinical applicant of posterior transarticular screws (Magerl technique) with bene graft in atlantoaxial instability.Methods 30 fresh cadaver human cervical spine specimens were obtained and randomized subdivided into 5 groups:intact group,atlantoaxial destabilized group,atlantoaxial destabilized and fixed with pedicle screws group,fixed with Magerl screws group and fixed with Maged screws combined with Brooks way group.ROM(range of motion)and NZ(neutral zone)of extend,flex,right and left lateral bend,right and left rotation of each specimen in 5 groups were measured.Transarticular screws were placed in 23 patients with atlantoaxial instability from 2000 Feb.to 2005 Jan.,with 16 males and 7 females,age from 17 to 62 years.20 of them were traumatic dislocation and 3 were congenital instable.Results Biomechanical study indicated that stability of all 6 degrees were Magerl+Brooks＞Magerl screws＞Pedicle screws＞Intact＞Destabilized.23 patient were fixed with 46 Maged screws in total,none were suffered from vertebral artery injury and neurological deterioration.All patients were followed-up from 4 to 36 months.2 of them complained that difficult in rotation of head.Conclusion Single use of Magerl screw can provide enough biomechanical stable for adantoaxial instability,and is an effective,low-risky way combined with intra-spinal-process bone graft.

As a method of choice in the treatment of ampulary carcinoma,pancreaticoduodenectomy often demands open procedure.With the development of minimally invasive techniques,laparoscopic pancreaticoduodenectomy was realized in recent years.Because laparoscopic pancreaticoduodenectomy is high technique-demanding,its popularization is restricted.With flexible robotic arnls and three-dimensional imaging,Da Vinci surgical system has overcome the shortcomings of traditional laparoscope to some extent.In March 2010.a 60-year-old female patient with ampulary carcinoma underwent Da Vinci surgical system-assisted pancreaticoduodenectomy at the Southwest Hospital.The mean operation time and blood loss were 490 minutes and 450 ml respectively,and no blood transfusion was required.Out-of-bed activity began shortly after the operation.The gastric tube was removed and fluid diet was given on postoperative day 3.The patient was discharged on postoperative day 10 without incidence of complications.The Success of this case preliminarily demonstrats that Da Vinci snrgical system-assisted pancreaticoduodenectomy is safe and feasible.

BACKGROUND:Bioartificial liver could partial y replace the major liver functions, including detoxification, synthesis, secretion and biotransformation. OBJECTIVE:To use bibliometric indexes to track study focuses on bioartificial liver, and to investigate the relationships among geographic origin, impact factors, and highly cited articles indexed in Web of Science. METHODS:A list of citation classics for bioartificial liver was generated by searching the database of Web of Science-Expanded using the terms“artificial liver support system”or artificial liver or“bioartificial liver”. The top 33 cited research articles which were cited more than 100 times were retrieved. RESULTS AND CONCLUSIONS:Of 4 144 articles published, the 33 top-cited articles were published between 1992 and 2010. The highest citations paper was published in 2002, with a total of 668 citations, mean cited 55.67 per year. The total citations of 33 articles were 6 094 times, with a mean of 12.64 citations per article. These top-cited papers came from 11 countries, of which 12 articles came from the United States. University of Rostock led the list of classics with five papers. Harvard University and Massachusetts General Hospital ranked the second with four papers each. The 33 top-cited articles were published in 18 journals, predominantly Annals of Surgery and Hepatology, fol owed by Artificial Organs and Biotechnology and Bioengineering. Our bibliometric analysis provides a historical perspective on the progress of bioartificial liver research. Articles originating from outstanding institutions of the United States and published in high-impact journals are most likely to be cited.

Aim To determine the effects and mechanisms of isoflurane on energy metabolism during ischemia and reperfusion in isolated rat hserts.Methods The rat Langendorff model was used,and isolated per-fused rat hearts were separated into untreated,isoflurane,chelerythrine(PKC inhibitor)plus isoflurane,and chelerythrine groups.All the hearts were subjected to treatment before ischemia,followed by 30 min of ischemia and 60 min of reperfusion.Hemodynamic variables were recorded,and metabolites were measured by high-performance liquid chromatography,and analyzed subcellular localization of PKC isoforms by Western blot analysis.Results The recovery of left ventricular developed pressure after ischemia was(33?8)%,(56?9)%,and(30?5)% in the untreated,isoflurane,and isoflurane with chelerythrine groups respectively.Compared with the untreated hearts,isoflurane significantly improved the recovery of left ventricular developed pressure(P

Aim To establish a method to quantitatively determine cardiolipin content and investigate effects of age and ischemia on cardiolipin in isolated rat hearts.Methods Male SD rats, 4 months old,12 months old and 24 months old were used throughout the experiment. Each had 24 ones,which were randomly distributed to control,ischemia 30 min and ischemia 40 min groups(n=8). Control group hearts were perfused for a total of 70 min and ischemia groups hearts were perfused for a 20 min equilibration period,and then underwent 30 or 40 min of no-flow ischemia followed by reperfusion for a 20 min period, respectively.Cardiolipin was quantitatively determined by high-performance liquid chromatography following extraction of lipids from subsarcolemmal mitochondria(SSM)and interfibrillar mitochondria(IFM).Results Under the condition of HPLC,the retention time of cardiolipin was 13.092 min. The standard curve was Y^ (?V?s) =20 877 455X(mmol?L-1)-352 028(r=0.9993) with a validated quantitation range of 0.2～3.2 mmol?L-1,and the lowest concentration of detection was 0.005 mmol?L-1 (S/N=3). At the concentration of 0.2,0.8,3.2 mmol?L-1,absolute recovery rates ranged from 0.8505 to 0.9519 and relative recovery rates ranged from 0.9898 to 1.0429. The RSD of the precision within-day and between-day was less than 0.11. Cardiolipin content in SSM of nonischemic group of 24 months old rats was lower than that of both 4 months old and 12 months old, but no differences among them were observed in IFM.In all age rats, compared with control group,cardiolipin contents of SSM from ischemia 30 min and ischemia 40 min groups were lower, and effects of ischemia 40 min are not pronounced; there were no differences in CL contents of IFM among three groups.Conclusions The assay method was shown to be sensitive, suitable and accurate for determination of cardiolipin located in mitochondria from perfused hearts of rats. Myocardial ischemia and older age decreased cardiolipin content in SSM, and had no remarkable effects on cardiolipin in IFM.

Objective To investigate the clinical efficacy of laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach.Methods The clinical data of 68 patients who underwent laparoscopic anatomical hepatectomy by Glissonean pedicle transection approach at the Southwest Hospital of Third Military Medical University between March 2009 and December 2013 were retrospectively analyzed.All the patients received intravenous-inhalation general anesthesia.The splitting of liver was carried out after Glissonean pedicles were completely dissected and occluded under the laparoscope according to anatomical structure.The patients with hepatolithiasis underwent intraoperative bile duct exploration and stone removal with T-tube placement based on the conditions of extrahepatic biliary lesions.The fragmented specimens from benign lesions of liver were taken out through a Trocar hole with the diameter of 12mm.The complete specimens from malignancy tumors of liver were taken out through an enlarged Trocar hole or transverse incision at the symphysis pubis.According to the recheck results of benign and malignancy lesions,the patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as (x) ± s.The survival curve was drawn by Kaplan-Meier method.Results Among the 68 patients,laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach was performed on 64 patients and 4 patients were coverted to open surgery.Laparoscopic anatomical left hemihepatectomy was performed on 30 patients,anatomical right hemihepatectomy on 19 patients,anatomical right posterior lobectomy on 10 patients and anatomical right anterior lobectomy on 9 patients.The mean operation time,volume of intraoperative blood loss,rate of perioperative blood transfusion,time of postoperative gastrointestinal function recovery and duration of hospital stay were (224 ± 117)minutes,(413 ± 349) mL,5.9％ (4/68),(3.0 ± 0.5) days and (8.0 ± 3.0) days,respectively.There was no perioperative death,and 6 patients with postoperative complication were cured by symptomatic treatment.The tumor diameter and distance to resection margin in 29 patients with malignancy tumors of liver were (4.4 ± 1.6) cm and (2.0 ± 0.9)cm,respectively.The results of pathological examination showed that hepatolithiasis was detected in 22 patients,cavernous hemangioma of liver in 12 patients,hepatic focal nodular hyperplasia in 1 patient,hepatic adenoma in 1 patient,hepatic angiomyolipoma in 1 patient,hepatic multiple cysts in 1 patient,hepatic tuberculosis in 1 patient,hepatocellular carcinoma in 27 patients and cholangiocarcinoma in 2 patients.All the 68 patients were followed up for 6-60 months with a mean time of 24 months.No recurrence and residual stones or lesions in 39 patients with benign lesions of liver were detected during the follow-up.The 1-,3-,5-year overall survival rates and tumor-free survival rates in 29 patients with malignant tumors of liver were 92％,84％,60％ and 83％,59％,42％,respectively.Conclnsion Laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach is safe and feasible,and is suitable not only for left hemihepatectomy,but also for right hemihepatectomy of high technical specification.

Objective To validate the feasibility of the simulationmethod and the reliability of thesimulationresult through comparison between simulation and measurement of the energy spectrum from medical diagnostic X-ray (RQR-Radiation qualities in radiation beans emerging from the X-ray source assembly).Methods A simplified model of the medical diagnostic X-ray RQR radiation quality was established using code of BEAMnrc.The energy spectrum of the same RQR radiation quality were measured through a plane high-purity germanium spectrometer,and compared with the simulationresult.Results The difference of spectral distribution between measurement and simulation was less than 3％,in spite of the convolution processing not happened to the pulse height distribution measured by the spectrometer.And the spectral distribution,fluence,energy fluence,means energy distribution of the radiation was obtained using the code of BEAMDP.Conclusions As indicated above,it is possible to use the simulation of the energy distribution as a foundation for the establishment of X-ray RQR radiation quality.

Objective To investigate the clinical efficacy of laparoscopic hepatectomy and summarize its experiences.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 2 048 patients who underwent laparoscopic hepatectomy in the Southwest Hospital of the Third Military Medical University from March 2007 to October 2016 were collected.The resectability of lesions and liver functional reserve were preoperatively evaluated,and then laparoscopic hepatectomy was conducted.Observation indicators:(1)surgical and intraoperative situations;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the patients' postoperative survival up to June 2017.Measurement data with normal distribution were represented as (x)±s.Count data were evaluated by the percentage.The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgical and intraoperative situations:all the 2 048patients received successful laparoscopic hepatectomy,including 1 985 undergoing traditional laparoscopic hepatectomy and 63 undergoing Da Vinci robot-assisted and laparoscopic hepatectomy.Non-anatomical and anatomical hepatectomies were respectively applied to 1 052 and 996 patients.The rate of conversion to open surgery of 2 048 patients was 6.738％ (138/2 048).Operation time,volume of intraoperative blood loss and rate of intraoperative blood transfusion in 2 048 patients were (225±27)minutes,(455± 152)mL and 5.615％ (115/2 048),respectively.The incidence of postoperative complications was 11.816％ (242/2 048),42.149％ (102/242) of postoperative complications included reactive pleural effusion and effusion in the resection margin,and other postoperative complications included peritoneal effusion,pulmonary infection,abdominal infection,bile leakage,bleeding,incision liquefied,thrombus and acute liver injury.The incidence of postoperative severe complications was 0.488％ (10/2 048),including 6 with intraperitoneal bleeding,1 with acute respiratory distress syndrome,1with cardiac failure,1 with hepatic failure and 1 with renal failure.Of 242 patients with postoperative complications,6 with intraperitoneal bleeding received reoperations and were improved,1 died of extensive thrombus of portal vein system induced liver failure,and 235 were improved by conservative treatment.Duration of hospital stay in 2 048 patients was (10.7± 1.0)days.(2) Follow-up situations:912 of 1 070 patients with malignant liver tumors were followed up for 8-120 months,with a median time of 51 months.The 1-,3-and 5-year overall survival rates and 1-,3-and 5-year tumor-free survival rates in 912 patients with malignant liver tumors and follow-up were 94.1％,82.2％,53.6％ and 82.3％,61.3％,32.8％,respectively.Conclusions Laparoscopic hepatectomy is safe and feasible,with definite effects.In the premise of breakthroughs of technical bottlenecks in the bleeding control and exposure of special liver segment,the indications for laparoscopie hepatectomy have been expanded and there is no restricted area.