Consumer Product Safety ; legislation & jurisprudence ; Legislation, Food

Emergencies ; Food Services ; organization & administration ; Foodborne Diseases ; prevention & control ; Humans ; Risk Assessment

Adenoma ; metabolism ; Adrenal Cortex Neoplasms ; metabolism ; Biomarkers, Tumor ; metabolism ; Calcium-Binding Proteins ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; Humans ; Lung Neoplasms ; metabolism ; Neuroendocrine Cells ; metabolism ; Neuroendocrine Tumors ; metabolism ; Secretagogins ; Small Cell Lung Carcinoma ; metabolism

Objective To explore the feasibility and cosmetic results of video-assisted subcutaneous mastectomy and immediate reconstruction. Methods Two patients who suffered from breast diseases and need to excise the breasts received a video-assisted total subcutaneous mastectomy and immediate reconstruction in our center. Results Both patients felt satisfied on the cosmetic result. According to the operative experience of these two patents combined with review, the key point of the operation was summarized as follows. The incisions on the anterior axillary line were small and concealing. External retraction method was used to establish the working space. Video-assisted operation was combined with euthyphoria. Blunt dissection was combined with electrical surgery unit and ultrasound knife to isolate the breast skin flap. After breast glandectomy was completed, silica gel prosthesis was put into the interspace behind ectopectoralis. Pressure dressing for 3 weeks was done to prevent the prosthesis upward displacement. Conclusion The video-assisted subcutaneous mastectomy and immediate reconstruction is a safe and feasible operation method with the better cosmetic result.

Background: There are obvious changes in neuropeptides from plasma and cerebrospinal fluid in patients with vascular dementia (VaD), and regulating the levels of neuropeptides is a key for prevention and treatment of VaD. Objective: To observe the clinical efficacy of moxibustion at head-points in treatment of vascular dementia (VaD), and assess its effects on memory-related neuropeptides. Design, setting, participants and interventions: A total of 65 VaD patients from Acupuncture Hospital, Anhui University of Traditional Chinese Medicine, were randomly divided into moxibustion group (33 cases) and Western medicine group (32 cases). Patients in the moxibustion group were treated with indirect moxibustion with common monkshood cake for 20 min. Patients in the Western medicine group were orally administered piracetam tablets, 0.8 g for three times a day. One treatment course was 4 weeks, and they were treated for 4 treatment courses. Main outcome measures: The scores of Hasegawa's Dementia Scale (HDS), Mini-Mental State Examination (MMSE), and Activity of Daily Living Scale (ADL), as well as the levels of learning and memory-related neuropeptides from cerebrospinal fluid such as somatostatin (SS) and arginine vasopressin (AVP) were measured before and after treatment in the two groups. Results: Total response rate was significantly higher in the moxibustion group than in the Western medicine group (P<0.01). There were significant differences in scores of HDS, MMSE and ADL between before and after treatment in the two groups(P<0.05 or P<0.01). After treatment, the scores of HDS, MMSE and ADL in the moxibustion group were more improved as compared with those in the Western medicine group (P<0.05 or P<0.01). The levels of SS and AVP after treatment were higher than those before treatment in the two groups(P<0.01). After treatment, the increased levels of SS and AVP were higher in the moxibustion group than in the Western medicine group (P<0.01). Conclusion: Moxibustion is effective in improving the clinical symptom scores and regulating the levels of neuropeptides associated with learning and memory in VaD patients.

OBJECTIVETo explore the therapeutic effect of diagnosis and treatment program of integrative medicine (IM) on level 2 hypertension in the young and middle-aged patients and their ambulatory blood pressure.

METHODSA randomized, placebo parallel and controlled, multi-center clinical trial was performed. Totally 199 young and middle-aged level 2 hypertension patients were randomly assigned to the treatment group (99 cases) and the control group (100 cases). All received combined hypotensive treatment program by taking Nifedipine Sustained Release Tablet and Hydrochlorothiazide as basic drugs. Patients in the treatment group additionally took Western medicine (WM) combined Jiangyabao serial drugs (0.31 g per tablet, 2 tablets each time, twice daily), while those in the control group additionally took WM combined simulative agents of Jiangyabao serial drugs (0.31 g per tablet, 2 tablets each time, twice daily). The treatment course was 8 weeks for all, and 24-week follow-ups performed. 24 h ambulatory blood pressure and casual blood pressure, and their efficacies were compared between the two groups, and safety assessed as well.

RESULTSCompared with before treatment in the same group, daytime and night casual blood pressure, as well as 24 h ambulatory blood pressure were all obviously improved in the two groups (P < 0.01). Average diastolic and systolic blood pressures at night decreased more in the treatment group than in the control group with statistical difference (P < 0.05). There was no statistical difference in total efficacies of daytime casual blood pressure or ambulatory blood pressure (P > 0.05).

CONCLUSIONJiangyabao serial drugs combined WM in treating young and middle-aged level 2 hypertension patients showed obvious effect in improving night blood pressure, especially for night diastolic blood pressure.

Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; diagnosis ; therapy ; Integrative Medicine ; Middle Aged ; Nifedipine

BACKGROUND:The causes for abnormal liver function after liver transplantation is complex, and it is important for the treatment to clarify the causes of abnormal liver function. OBJECTIVE:To analyze the cause of abnormal liver function after liver transplantation, and to use it in clinical diagnosis and treatment. METHODS:The CNKI database and FMJS database were retrieved by computer for articles published from January 1991 to July 2012. Articles were searched with the key words of“liver transplantation, abnormal liver function, transaminase abnormalities, bilirubin increased, causes”in Chinese and English. A total of 98 articles were retrieved. Thirty-five articles directly related to abnormal liver function after liver transplantation and those published in authoritative magazines were included to review.RESULTS AND CONCLUSION:Many reasons can lead to abnormal liver function after liver transplantation, with complex clinical manifestations. The most common causes were acute rejection, biliary complications and virus infection. When the abnormal liver function occurred in the early postoperative period, especial y in one month after liver transplantation, the smal size syndrome and primary graft non-function should be vigilant. The transaminase and bilirubin levels were different for different causes. Transaminase increased more significantly than bilirubin in acute rejection, autoimmune hepatitis, viral infection, ischemia-reperfusion injury, portal vein and hepatic vein stenosis. However, obstruction enzyme such as alkaline phosphatase, glutamyltransferase, total bilirubin and direct bilirubin was increased more significantly in chronic rejection, biliary complications, hepatic artery, primary biliary cirrhosis and primary sclerosing cholangitis;transaminase increasing mainly and bilirubin increasing mainly can both appear in the patients with tumor, and which one wil happen depending on the size and oppression of the tumor. In addition, col ecting the medical history careful y can help to diagnose early as each patient have his special medical history. In a word, It’s important to col ect medical history careful y in clinical work, and the common cause of abnormal liver function should be consider firstly according to the increasing of transaminase and bilirubin, and other relatively uncommon causes should be considered after remove the common causes through clinical proven. It can help to diagnose and treat as soon as possible to make ful use of examinations, such as laboratory tests, imaging studies and liver puncture biopsy.

Objective To explore the relationship between serum HBeAg、the qualification of HBV DNA and the liver pathologic change in chronic hepatitis B virus (HBV)carriers with normal liver function.Methods Two hundred and forty-four chronic hepatitis B virus carriers with normal liver function were performed pathology examination by Liver biopsy.Meanwhile liver function,HBV DNA level and serological serum markers of B-hepatitis examination were detected.Results Pathology results showed that,of all 244 cases,7 cases was cirrhosis(2.9％),143 for slight CHB (58.6％),32 for moderate CHB (13.1％) and 9 for severe CHB (3.6 ％).And 53 (21.7％)chronic hepatitis B virus carriers were the normal histology morphology.Fony-eight cases (19.7％) were in inflammation stage G≥2 and 54(22.1％) were with fibrosis stage S≥2.For cases with HBV DNA positive,The inflammation and ftbrosis stages in HBeAg negative group were more severe than that in HBeAg positive group (P ＜ 0.05).The fibrosis stages in patients with low HBV DNA level were severe than that in high HBV DNA levels (P ＜ 0.05).No significant differences were observed in the inflammation stage between subjects with high or low HBV DNA level.Conclusion Most chronic HBV carriers with normal liver function were with different degrees of liver inflammation and fibrosis.HBeAg and HBV DNA associated with liver pathological change.

Objective To investigate the efficacy of tertiary liver transplantation.Methods The clinical data of 4 patients with hepatobiliary disease who were admitted to the General Hospital of Chinese People's Armed Police Forces from April 2002 to December 2012 were retrospectively analyzed.All the patients received orthotopic liver transplantation,and received tacrolimus + mycophenolate mofetil (MMF) + hormone after operation.All the patients were followed up till May 2014,and their prognosis was learned.The measurement data were analyzed using the t test.Results Three patients with benign hepatic disease received tertiary liver transplantation due to biliary complications and chronic rejection,and 1 patient with hepatic cancer received tertiary liver transplantation because of hepatic cancer recurrence.The average interval between the primary and secondary liver transplantation was 16.0 months,which was shorter than 22.5 months of the interval between the secondary and tertiary liver transplantation.The mean operation time in the secondary liver transplantation was (11.4 ± 1.0)hours,which was significantly shorter than (14.1 ± 2.2) hours in the tertiary liver transplantation (t =3.644,P ＜ 0.05).The median volumes of blood loss in the secondary and tertiary liver transplantation were 1 300 mL and 1 800 mL,and the median volumes of blood transfusion were 1 400 mL and 3 100 mL.The hepatic function of the 4 patients recovered smoothly at the early time after liver transplantation.Two patients (3 cases) were complicated with infection postoperatively (1 patient was infected by pseudomonas aeruginosa within 30 days after liver transplantation,and was cured by active antimicrobial treatment),and they were cured after anti-infectional treatment.One patient died of hepatic failure at the 80th month after the primary liver transplantation,1 died of hepatic cancer recurrence complicated by pulmonary,bone and retroperitoneal lymph node metastasis at the 107th month after the primary liver transplantation,and the other 2 patients survived for 104 months and 26 months after the primary liver transplantation,respectively.Conclusion Tertiary liver transplantation is effective for the treatment of biliary complications and chronic rejection after liver transplantation,and it can extend the life span of patients with hepatic cancer recurrence if there are insufficient donor resources.

Objective To evaluate the effects of mechanical ventilation on radiation induced lung injuries of apoptosis,acute inflammation,and oxidative stress by establishing a rat mechanical ventilation model and animal model.Methods Totally 40 male Sprague-Dawley(SD) rats were randomly divided into 4 groups with 10 rats in each group:control,radiation alone,high tidal volume ventilation,and high tidal volume ventilation following by radiation.After treatment,the pathological changes in lung tissue were observed,NF-κB activity was detected by electrophoretic mobility shift assay (EMSA),the expression of NF-κB subunit P65 protein level in lung cell nucleus was detected by Western blot,and the apoptosis of lung cells was detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) method.The wet to dry weight ratio (W/D) of lung,myeloperoxidase (MPO),malondialdehyde (MDA) and superoxide dismutase (SOD) were detected.In addition,the total protein and white blood cell number in lung lavage fluid were also measured.Results Compared to the control,the acute lung injury (ALI) score,W/D ratio,MPO activity,total protein level,white blood cell number,apoptosis index (AI),lung tissue MDA,NF-κB activity and P65 protein expression were increased significantly (q =0.000 32-0.004 81,P ＜0.05),while SOD values was decreased significantly (q =0.000 18-0.002 53,P ＜0.01),in other three groups.Compared with radiation and high tidal volume ventilation group,the above indexes were significantly higher (q =0.004 3-0.022 6,P ＜ 0.05) but the SOD value was significantly lower (q =0.002 9-0.008 3,P ＜ 0.05) than those in the high tidal volume ventilation plus radiation group.Conclusions High tidal volume ventilation delivered to the radiation group produced more transparent ventilator-induced lung injury (VILI) than the high tidal volume ventilation alone induced VILI including permeable pulmonary edema,acute inflammation,oxidative stress and apoptosis in lung.