Hilar cholangiocarcinoma is a rare tumor with a poor prognosis.Due to advances in preoperative imaging and enhanced comprehension of tumor biological behavior,surgical management of hilar cholangiocarcinoma has evolved since its original description.Currently,it has been accepted that complete surgical resection provides the only possibility for cure or long-term survival,however,the surgical management of hilar cholangiocarcinoma is extremely challenging because of its anatomical location and vascular proximity.In order to achieve complete resection, several surgical approaches have been investigated and evaluated regarding major hepatic resection,lymph node dissection,vascular resection,extended resection and liver transplantation,however,there are still many disputations. Furthermore,many surgical technical difficulties exist in biliary reconstruction after resection owing to anatomical problems.Focusing on the disputes and problems mentioned above,we herein review and discuss surgical strategies in managing hilar cholangiocarcinoma.

Objective:To investigate the adverse drug reactions ( ADR) caused by carbapenem antibiotics and discuss the influen-cing factors to provide reference for the rational use of carbapenems in clinics. Methods:The ADR caused by carbapenems from March 1, 2008 to August 1, 2014 in our hospital were statistically analyzed. Results:Totally 73 cases of ADR were caused by carbapenems. The number of ADR for men and women was similar. The ADR occurred in 80-year-old people with more frequency. The incidence of ADR on the first day of administration was relative high. The ADR were mainly manifested as skin and appendages disorders and nerve system damage. Conclusion: Great attention should be paid to the ADR of carbapenems and the state of patients. The medication should be adjusted in the patients with declined renal function and nerve system basic diseases in order to reduce the damage of ADR.

10.3969/j.issn.1000-3606.2013.06.023

Objective To study the effect of continuous passive motion (CPM) on hemiplegic patients with shoulder pain.Methods Forty-four patients were divided into a treatment and a control group.Routine stroke treatment was given to the patients in the control group,and CPM was added for patients in the treatment group.A visual analogue scale for pain (VAS) ,Fugl-Meyer(FM) upper extremity motor scale and functional independence measure (FIM) were used to evaluate the results.Results The VAS,FM and FIM scores of both groups improved after treatment,but the VAS results among the treatment group were significantly better than in the control group. Conclusion CPM can be a good treatment for hemiplegie patients with shoulder pain.

Child ; Humans ; Laryngostenosis ; diagnosis ; therapy ; Tracheal Stenosis ; diagnosis ; therapy

Esophageal Diseases ; Humans ; Medicine ; Tracheal Diseases

Vitreous liquefaction is an age-related degenerative change,which will further alter the physicochemical properties of the vitreous and its surrounding tissues,resulting in various related eye diseases.The principal pathologic changes of that are the gradual depletion of hyaluronic acid and the collapse of collagen fibrillar network,with a series of biomechanical changes in vitreous body.This article reviews biomechanical properties of normal vitreous,the current measurements of these properties,formation mechanism and changes of biomechanics properties of vitreous liquefaction and correlation between synchesis and related ocular diseases,which provide insight into the ideas for the effective reduction and treatment of vitreous liquefaction.

26 heterotrophic bacteria strains were isolated from grown abalone digestion guts and their fanning waters in Jiansheng Abalone Farm in Shangwei, Guangdong province. Analyses of extra-cellular pathogenic factors were performed and API 20 E strips were employed to identify all the isolates. Results indicated that isolates from digestion guts displayed greater ability of producing protease , amylase, gelatinase and/or hemolysis than those from farming waters, while their ability of producing lipase and phospholipase were lower than the later. Regardless of their source of origins, there were some isolates which had great abilities of producing extra-cellular products and most of them were Sphingomonas paucimobilis. Therefore, Sphingomonas paucimobilis should be considered as an opportunistic pathogen in the abalone fanning environments, while the digestion guts and fanning waters should be both regarded as the sources of harboring potential pathogens. In addition, apart from predominant strains, the roles of extra-cellular products of the bacteria community as a whole should be taken into consideration when dealing with fish diseases.

Objective: Ginsenoside Rg3 was prepared by converting protopanaxadiol (PPD)-type saponins using lemon juice as the catalyst. Methods: Preparation of ginsenoside Rg3 was optimized by response surface method (RSM) based on a four-factor and five-level central composite design. Results: The optimal yield of ginsenoside Rg3 was predicted to be 75.98% in the combination of the factors (PPD-type saponins concentration of 23.6 mg/mL, lemon juice concentration of 97.6% at 85.7 °C for 130.0 min) through the canonical analysis and ridge analysis with maximum responses. Under the optimum conditions, the actual yield of ginsenoside Rg3 was 75.57%. Conclusion: RSM is effective to optimize the preparation of ginsenoside Rg3 by lemon-catalyzed PPD-type saponins. The achievement for the preparation of ginsenoside Rg3 would promote the development of health-care production. © 2013 Tianjin Press of Chinese Herbal Medicines.

Objective: To prepare 20(R)-ginsenoside Rg3 selectively and to provide the theory basis for the preparation. Methods: 20(R)-Ginsenoside Rg3 was prepared by hydrolyzing protopanaxadiol (PPD)-type saponins using tartaric acid as the catalyst. The preparation condition was optimized by one-factor experiment and orthogonal test, and the reaction products were analyzed by HPLC. Results: The optimization result of orthogonal test showed that when PPD-type saponins (10 mg/mL) were hydrolyzed by tartaric acid (1.5 mol/L) at 110°C for 2.5 h, all the ginsenosides Rb1, Rc, Rb2, Rb3, and Rd were converted, the yields of 20(R)-ginsenoside Rg3 was 50.15%, and the diastereomer excess percentage (de%) was 93.12%. Conclusion: This method is simple, low-cost, and suitable for the mass production, which is very important to promote the study on the pharmacological activities of 20(R)-ginsenoside Rg3.