Objective To study the relationship between the bile flow and CCK, GAS and SEC hormones in the rabbits after traumatic stress. Methods Bile flow was counted by bile duct intubation and the models of traumatic stress were produced by cutting the hind legs of rabbits. Bile flow, CCK, GAS and secretin in plasma were measured before and after stress. Results Bile flow after traumatic stress was significantly increased (P

Objective To evaluate the operative technique,perioperative management and ontcome of single lung transplantation and ventricular septal defect repair for Eisenmenger syndrome.Methods A 16 years old male patient with end-stage ventricular septal defect who received open heart exploration 12 years ago underwent right single lung transplantation and ventricular septal defect repair on Oct.22,2004.The operation was carried out under cardiopulmonary bypass(CPB) with beating heart.The donor lung was perfused with modified LPD solution.Tacrolimus(FK506),mycophenolate mofetil (MMF) and corticosteroid regime was used for immunosuppressive therapy.CPB time was 244 min,and donor lung ischemic time was 6 h.Results During the operation,the pulmonary artery pressure was reduced from 110/60 mm Hg to 53/39 mm Hg after transplantation.The patient weaned from the ventilator at the 12th postoperative day.An acute rejection episode occurred on the 14th postoperative day.ICU stay was 30 days.99m-Tc-MAA pulmonary perfusion scan demonstrated predominant right lung blood flow.UCG assessed improved heart functions,intact ventricular septum and mean pulmonary artery pressure of 45 mm Hg.The exercise tolerance was prominently improved.The patient was discharged on the 62nd day after transplantation.Conclusions Single lung transplantation and congenital heart defect repair is effective for end-stage left-to-right shunt congenital heart diseases with satisfying short-term results.Closed follow-up and surveillance are needed for long-term outcomes.

BACKGROUND: Mesh plug tension-free hernioplasty is commonly used for inguinal hernia. In the operation, different mesh materials can be selected, among which the modified Kugel mesh is extensively applied. OBJECTIVE: To observe the biocompatibility of modified Kugel mesh in mesh plug tension-free hernioplasty for inguinal hernia. METHODS: Total y 79 cases of inguinal hernia were treated by mesh plug tension-free hernioplasty. The patients were randomly divided into observation group repaired with Bard mesh (modified Kuge) (n=38) and control group repaired with Prolene mesh (n=41). After 12-month fol ow-up, levels of interleukin 6, C-reactive protein and tumor necrosis factor α were detected and compared before and after treatment;adverse events, including wound infection or infection caused by the mesh in the two groups were recorded. RESULTS AND CONCLUSION: Levels of interleukin 6, C-reactive protein and tumor necrosis factor α in the two groups were significantly decreased after treatment than before treatment (P < 0.05). No wound infection or infection caused by the mesh appeared in both two groups. Although scrotum effusion occurred in two cases of each group, their outcomes al improved significantly after active puncture and suction treatment without other serious problems. No recurrence was found during the 12-month fol ow-up. These results show that the modified Kugel mesh has good biocompatibility in mesh plug tension-free hernioplasty for inguinal hernia.

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Objective To analyze the distribution and antibiotic resistance of pathogens isolated from sputum in early postoperative patients after esophageal surgery, and investigate the risk factors of pulmonary infections after esophageal carcinoma and reasonable application of antibiotics during perioperative period.Methods The clinical data of 414 patients with esophageal carcinoma who were admitted to the Affiliated Hospital of Binzhou Medical University from January 2012 to June 2014 were retrospectively analyzed.The second generation cephalosporins were used as preventive antibiotics for the 181 patients between January and December 2012 and the third generation cephalosporins were used for the 233 patients between January 2013 and June 2014.Sputum samples were collected and inspected before operation and in the first three days after operation for observing distribution and antibiotic resistance of pathogens.The incidence of postoperative pulmonary infection was observed in the two kinds of patients.The risk factors closely related to the occurrence of postoperative pulmonary infections were analyzed.Comparison of rate and univariate analysis were done by chi-square test.Multivariate analysis was done with logistic regression.Results The positive rate of early post-operative sputum culture was 24.64％ (102/414), 32.04％ (58/181) in patients receiving the second generation cephalosporins and 18.88％ (44/233) in patients receiving the third generation cephalosporins, respectively, with a significant difference between the two generations of cephalosporins (x2 =9.502, P ＜ 0.05).A total of 131 strains of pathogens were isolated from early postoperative sputum samples including 12 strains of gram-positive bacteria and 119 strains of gram-negative bacteria.The top three bacteria were Klebsiella pneumoniae subsp pneumoniae (33 trains), Acinetobacter baumannii (20 strains) and Pseudomonas aeruginosa (19 strains).The resistance rate of gram-negative bacteria in early postoperative sputum samples to meropenem, ciprofloxacin and levofloxacin were 5.0％-25.0％, 2.6％-15.2％, 2.6％-20.0％, respectively.Among cephalosporins, the resistance rate to ceftriaxone, cefotaxime, cefepime, ceftazidime, cefuroxime and cefazolin were 10.3％-20.0％ , 5.3％-30.0％ , 12.8％-31.6％, 15.4％-42.1％ , 21.2％-55.0％ and 15.2％-60.0％, respectively.The overall postoperative pulmonary infection rate was 18.60％ (77/414).The pulmonary infection rate of patients receiving the second generation cephalosporins was 26.52％ (48/181), which was higher than 12.45％ (29/233) of patients receiving the third generation cephalosporins (x2=13.326, P ＜ 0.05).The results of univariate analysis showed that smoking, chronic obstructive pulmonary disease, application of the second generation cephalosporins during the perioperative period and early postoperative sputum culture positive were correlated with the postoperative pulmonary infection after esophageal carcinoma surgery (x2 =5.149, 22.765, 13.326, 159.092, P ＜ 0.05).Multivariate statistical analysis with logistic regression demonstrated that application of the third generation cephalosporins during the perioperative period was independent protective factor of postoperative pulmonary infection (OR =2.582, 95％ confidence interval: 1.331-5.009, P ＜ 0.05).Conclusions The pathogens from sputum in early postoperative period after esophageal surgery are complicated with gram-negative bacteria as the main pathogens especially Klebsiella pneumoniae subsp, pneumoniae, and different levels of antibiotic resistance are ubiquitous.The third generation cephalosporins can effectively prevent the postoperative pulmonary infection after esophageal carcinoma surgery.

Objective To investigate the efficacy and feasibility of segment-orientated anatomical liver resection for the treatment of hepatic alveolar echinococcosis (HAE) in the middle lobe of the liver.Methods The clinical data of a female patient with HAE in the middle lobe of the liver who was admitted to the First Affiliated Hospital of Xi'an Jiaotong University in September 2013 were retrospectively analyzed.Before operation,various surgical plannings were facilitated by a three-dimensional reconstruction system,and then the surgical planning was determined with the assistance of the multivariate analysis (volume measurement of liver,resectability of remnant functional liver,evaluation of vascular resection and reconstruction,Child-Pugh score and indocyanine green retention at 15 minutes).Segment-orientated anatomical liver resection(segment Ⅴ,Ⅷ and Ⅳb) was performed on the patient.There was a close relationship between the HAE and the first and the second hepatic portal during operation,and the anatomical liver resection of segment Ⅴ,Ⅷ and Ⅳb was precisely carried out.The patient was followed up by outpatient examination and telephone interview every month up to April 2014.The condition of the liver was observed by B ultrasound and computed tomography examinations.Results The three-dimensional reconstruction of the CT data of the patient clearly displayed the anatomical structure and adjacent relationship between the tumor,abdominal organs and major abdominal vessels.The preoperative evaluation of the anatomy of tumor based on three-dimensional images was confirmed with operative findings.The operation time and volume of blood loss were 410 minutes and 1 000 mL,respectively.The patient did not receive blood transfusion.The intraoperative vital signs of the patient were stable.There were no complications such as hepatic insufficiency.The duration of postoperative hospital stay was 15 days.Surgical incision was healed at discharge.The results of blood routine and blood biochemistry test,daily diet and basic self-care ability were in normal condition.HAE was diagnosed based on the result of pathological examination.Albendazole was administered with 1 200 mg/d after operation.The patient was followed up for 6 months and returned to work.The weight of the patient increased by 5 kilograms than that at discharge,without complaint of discomfort.There was no recurrence of HAE and hepatic echinococcosis of organs.Conclusions Segment-orientated anatomical liver resection is not only a method for complete resection,but also maximizes the functional remnant of liver on the basis of intraoperative three-dimensional reconstruction system together with selective hepatic inflow occlusion and vessel reconstruction technique.The patient gets a full recovery with satisfactory outcome.

The system of meridians and acupoints in the traditional Chinese medication (TCM) builds up a complex network. We analyze the features and properties of the system of meridians and acupoints as a complex network based on knowledge of TCM and mathematics. The system shows some important features of complex networks such as the small-world effect and the scale-free property. A preliminary discussion on the robustness of the meridian system as a complex network, and the biomedical functions of such robustness is also given.

Objective Methods To explore the value of VEGF levels in serum and pleural effusion for diagnosis of benign and malignant tumors, and evaluate clinical value of VEGF-A, C, D in malignant pleural effusion.Methods Serum and pleural effusion of 34 cases patients with lung cancer were collected in our hospital, the application of ELISA method for the detection of VEGF level in serum and pleural effusion in patients with lung cancer and with benign pleural effusion.VEGF-A, C, D levels were detected.Results VEGF levels in serum and pleural effusion in malignant group were significantly higher than those in benign group(P<0.05).In addition, patients with lung cancer before initial treatment, the VEGF levels in serum and pleural effusion of distant metastasis group were significantly higher than those of without distant metastasis group(P<0.05).There was a correlation between the level of VEGF and the malignant pleural effusion(r=0.878, P<0.05).No correlation existed between VEGF level and benign pleural effusion.The content of sVEGF-A in serum had no statistical difference in cancer group and benign group.Effusion supernatants of pVEGF-A content in lung cancer group were higher than those in benign effusion group(P<0.05).pVEGF-A and sVEGF-A levels were similar in benign effusion group. Effusion supernatants pVEGF-A in malignant group was higher than that in benign effusion group(P<0.05).pVEGF-A was significantly higher than that of sVEGF-A in malignant effusion(P<0.05).Serum VEGF-C, VEGF-D content had no significant difference between cancer group and benign group. pVEGF-C, pVEGF-D content had no significant difference between cancer group and benign group.Conclusion Level of VEGF in serum and pleural effusion detection would help to diagnose and differentially diagnose benign and malignant pleural effusion.Effusion VEGF-A is different in benign and malignant effusion, which may become benign and malignant effusion tumor markers.

Dioscin is the main ingredient of Dioscorea,a tradi-tional medical herb.Traditional theory of Chinese medicine be-lieves that Dioscorea has effects of clearing lung,digesting food, diuresis, improving blood circulation, relaxing muscles and stopping attack of malaria.Pharmacological studies have shown that dioscin has many pharmacological effects,particularly the anti-tumor effect.Many studies have also shown dioscin im-proves symptoms of atherosclerosis and protects blood vessel en-dothelium,reduces ischemia-reperfusion injury of heart,brain and kidney,lowers blood sugar,inhibits hepatic fibrosis,im-proves menopausal osteoporosis,relieves rheumatoid arthritis, ulcerative colitis and other inflammatory disorders,and posses-ses anti-bacterial and anti-viral activity.This article focuses on the progress of the modern pharmacological study of dioscin,and reports its advances in recent years.