Intervetional therapy as an important therapeutic method for malignant biliary obstruction has been used extensively,but there still remain some problems worthy for our emphasis and research. We retrospectively reviewed more than 800 patients with malignant obstructive jaundice during 12 years. Indications,contraindications,complications and corresponding treatment methods were studied. Furthermore,discussion including methods of biliary drainage,proper time of stent implantation,methods of anesthesia,usage of antibiotics and haemostat were also carried out. Use of analgesics (pain-suppressal)pre-and post procedure,development of acute pancreatitis and its management,and peri-operative mortality were further investigated in detail. We hope our experiences and lessons would give interventional doctors some help in their career.(J Intervent Radiol,2007,16: 649-651)

AIM: To explore the delayed protection of heme oxygenase-1 (HO-1) in the exercise preconditioning (EP) from the myocardial relative ischemia reperfusion injury (rI/R). METHODS: 40 Wistar Rats were divided into 5 groups randomly: control group (CN), rI/R group (IR), EP+rI/R group (EI), HO-1 inductor hemin+rI/R group (HE) and HO-1 inhibitor ZnPP+EP+rI/R group (EZ). The following indexes were detected, including the HO-1activity in myocardium, the cardiac function parameter-pressure-rate product (heart rate × left ventricular developed pressure, PRP) and the content of MDA in coronary effluent. RESULTS: After myocardial rI/R, HO-1 activity increased significantly. Moreover, EP or HO-1 inductor could enhance this effect manifestly. Nevertheless, when the HO-1 inhibitor was administered before EP,HO-1 activity decreased. In addition, there was no distinct difference in the HO-1 activity between EI group and HE group. At the 30 min point of reperfusion, the PRP recovery rate of EI group was higher clearly than that of IR group. However, there was reverse effect between the EZ group and the EI group. The MDA in coronary effluent of EI group, EZ group and HE group were lower obviously than that of IR group and there was significant difference between EI group and EZ group. CONCLUSION: EP could protect the heart from the rI/R injury occurring 24 hours later, which might be performed through activating the HO-1.

Objective To investigate the effects of nimesulide, a selective cyclooxygenase-2 (COX-2) inhibitor, on human cholangiocarcinoma QBC939 cell line in vitro. Methods The effects of nimesulide on QBC939 cells were observed with the following techniques: the influence of nimesulide on the proliferation of QBC939 cells was determined by MTT assay; the apoptosis of QBC939 cells was viewed and measured by transmission electron microscopy and flow cytometry, respectively; the expressions of proliferation cell nuclear antigen (PCNA) and COX-2 of cholangiocarcinoma cells were detected by immunocytochemistry. Results Nimesulide inhibited the expressions of PCNA and COX-2 and the proliferation of cholangiocarcinoma QBC939 cells, whose effects intensified as the dose increased and time elongated. Flow cytometry showed that the apoptotic rates of QBC939 cells increased significantly as the dose of nimesulide increased. The typical morphologic features of apoptosis were also observed by transmission electron microscopy. Conclusion Nimesulide significantly inhibits the proliferation of QBC939 cells in vitro by inducting cell apoptosis, which may be associated with the downregulation of COX-2 expression, and it also presents the features of dose and time dependents.

Objective To investigate the effect of a selective inhibitor of COX-2 nimesulide on growth and apoptosis of human cholangiocarcinoma cell line QBC939 in vitro. Methods MTT assay was used to determine the influence of nimesulide on the proliferation of QBC939 cells, apoptosis of QBC939 was measured by transmission electron microscopy and flow cytometry.Expression of apoptosis related genes mRNA and bcl-2 ,bax, survivin were detected by RT-PCR and immunocytochemistry. Results Nimesulide effects a dose-dependent and time-dependent growth inhibition on QBC939 cells. High concentration of nimesulide (200 ?mol/L) not only inhibits the growth of QBC939 cells but also induces apoptosis cell nuclear condensation and apoptotic bodies were seen by transmission electron microscopy. Immunocytochemistry and RT-PCR shows upregulation of bax and down regulation of bcl-2 and survivin. Conclusion Nimesulide significantly inhibits the proliferation of QBC939 in vitro by induction of apoptosis in a dose- and time- dependent manner.

Objective To evaluate the radiosensitization effect of gemcitabine in human cholangiocarcinoma cells(QBC939)in vitro. Methods The IC10,IC50 and IC90 of gemcitabine in QBC939 cells were determined by clonogenic assay,which were adopted in the following experiments.The cells were divided into five groups:control group,chemotherapy group,radiation group,radiation after chemotherapy(C+R)group and radiation before chemotherapy(R+C)group.The radiation dose ranged from 1 Gy to 10 Gy.The cell survival Curves were fit using two-component equation and the sensitive enhancement ratio(SER)was calculated.Results The IC10,IC50 and IC90 of gemcitabine in QBC939 cells were 0.1 nmol/L(low concentration),11.0 nmol/L(moderate concentration)and 21.5 nmol/L(high concertration),resDectively.Gemcitabine in low concentration radiosensitized the cells at low irradiation dose(≤2 Gy)in R +C group(SERDq=1.52).Gemcitabine in moderate concentration had radiosensitization effect at all irradiation doses in C+R group(SERD0=1.27,SERDq=116.93),and at low irradiation dose(≤2 Gy)in R+C group.Gemcitabine in high concentration had radiosensitization effect at all irradiation doses in both R+C and C+R groups,which was most markedly at low irradiation dose(≤2 Gy)in R+C group(SERDq =323.30). Conclusions Gemeitabine has radiosensitization effect in QBC939 cells,which is based on the optimal scheduling and concentration.

BACKGROUND: Biliary tract complications are one of the most common postoperative problems after liver transplantation.Balloon dilation and percutaneous transhepatic biliary drainage (PTBD) has become an effective method to improve biliary complication after orthotopic liver transplantation (OLT).OBJECTIVE: To evaluate the balloon dilation and PTBD in the treatment of biliary stricture after OLT through case follow up.DESIGN, TIME AND SETTING: A total of 53 consecutive patients underwent interventional procedures to treat biliary stricture after OLT in the Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University from July 1999 to March 2007 and were recruited for this study. The series included 46 men and 7 women, with 17-64 years of age. After OLT transplantation, all patients had abnormally elevated serum bilirubin level, and confirmed to suffer from obstruction of biliary tract by CT or MRI examinations.METHODS: Of 50 patients who received PTBD treatment, 36 underwent PTBD through right bile duct, 14 underwent bilateral (right bile duct and left bile duct) PTBD with 6 patients through left bile duct in the second treatment. A total of 13 underwent balloon dilation, and 3 were subjected to balloon dilation alone.MAIN OUTCOME MEASURES: An averaged 9.6 months of follow up was performed in 53 patients to observe obstructive jaundice recurrence induced by abnormally elevated serum bilirubin level after percutaneous transhepatic biliary interventional procedures.RESULTS: Follow up results showed satisfactory clinical outcome with obstructive jaundice resolved in all patients, except one patient, who received treatment with T tube, died of acute rejection at month 1 during the follow up, and one patient with liver failure had extremely poor prognosis after discharge at month 1 during the follow up. Obstructive jaundice was recovered even healed and serum bilirubin level was decreased to normal level in 51 patients at the end of follow-up. Primary success rate was 79% (42 in 53 cases), and assisted success rate was 21%. The first interventional procedure failed to treat obstructive jaundice in 5 patients. Obstructive jaundice recurred after primary percutaneous procedure in other 6 cases. No procedure related severe complications happened.CONCLUSION: Balloon dilation and PTBD are safe to treat biliary tract complication after OLT, without complication.

Data Mining ; Humans ; Medicine, Chinese Traditional ; Stomach Diseases ; therapy

To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases, and summarize the main connotations of traditional Chinese medicine advices, relevant TCM advices in Treatise on Febrile Diseases were collected, screened, compared, summarized and analyzed according to TCM dosage form preparation methods, TCM administration methods, medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted, summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods, e. g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre, pill, medicine spoon). Administration times, temperature and frequency shall be adjusted according to target positions, functions and stage of illness. As for dietary contraindications during medication, thick porridges are recommended, where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions, particularly warm porridges can go with diaphoretic recipes, while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements, and blood form. In conclusion, Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study, new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology.
Chin ; Cooking ; Drug Administration Routes ; Drug Administration Schedule ; Drug Interactions ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; history ; Fever ; drug therapy ; history ; History, Ancient ; Humans ; Medicine in Literature

Objective To explore effect of Xylazine hydrochloride on Bama minipigs under general anesthesia. To emphasize safety consciousness of general anesthesia. To research cardiac main function and structure of normal Bama minipigs in preparation for the subsequent comparative medicine research. Methods 43 Bama minipigs, inject in post aurem muscles of neck with 5 mL of mixed drug conclude Xylazine hydrochloride (2 mL), Atropine Sulfate(1 mL) and Droperidol(2 mL) on each one. Echocardiography after general anesthesia. Observe induction and recovery time of anesthesia, anesthesia maintaining time, total check time and the others. Introduce the method of simple endotracheal intubation. Results Anesthesia, induction period (18 ±3)min, maintaining period (40 ±5)min, recovery period (60 ± 10)min. Echocardiography, LAD (2?54 ± 0?20) cm, LVDd (3?41 ± 0?25) cm, LVDs (2?28 ± 0?23) cm, IVSTd (0?60 ± 0?07) cm, LVPWTd (0?59 ± 0?07) cm, AoD (1?77 ± 0?18) cm, EDV (48?59 ± 8?31) cm, ESV (18?28 ± 4?46) mL, SV ( 39?30 ± 5?16 ) mL, LVEF ( 62?76 ± 5?01 )%. Conclusions Intramuscular injection of xylazine hydrochloride with droperidol and atropine sulfate on bama minipigs for general anesthesia is a highly conserved specie in cardiovascular system and safe. We obtained some information of cardiac main function and structure of normal Bama minipigs which could provide reference for scientific research and veterinarian clinic.

Objective To summarize the clinical nursing experience for patients with malignant obstructive jaundice after receiving percutaneous biliary radiofrequency ablation (RFA) and stent implantation. Methods The postoperative nursing experience in 9 patients with malignant obstructive jaundice who received percutaneous biliary RFA together with stent implantation were retrospectively analyzed. The postoperative complications and the nursing intervention measures were analyzed and evaluated. Results Biliary RFA and subsequent stent implantation were successfully carried out in all 9 patients. After the procedure, biliary fistula occurred in one patient, biliary hemorrhage in 2 patients and biliary infection in 2 patients. The patient, who developed biliary fistula, died one week later, and the clinical conditions in the remaining 4 patients were improved after symptomatic treatment. During the follow-up period of one month, the patients were in good condition. Conclusion The main purpose of postoperative nursing for patients after receiving percutaneous biliary RFA is to prevent the occurrence of bile duct perforation, hemorrhage, infection, etc. It is very important to keep the patients under close observation and comprehensive nursing so as to make an early detection and timely treatment of such complications, thus to reduce the incidence of complications causing serious consequences as well as to promote an early recovery.