ObjectiveTo explore the diagnostic methods and surgery pattern at the first time of spontaneous perforation of congenital choledochal cyst.MethodsEleven cases(4 male,7 female) with spontaneous perforation of congenital choledochal cyst were 6 months to 5 years old,and their average course of disease were 4 days.Gustily abdominal distension,abdominal pain,crying and fever were present in all cases.Jaundice(7 cases) and emesis(5 cases) appeared.All cases were detected with physical sign of peritonitis by physical examination.Choledochal cysts were confirmed by CT or B ultrasound in 8 cases.All cases accepted abdominal paracentesis and biliary ascites was drawn.Three different operative procedures were performed:choledochocyst excision & Roux-Y choledocho-jejunostomy(2 cases),choledochotomy with T-tube drainage(3 cases),and cholecystostomy(6 cases).Nine children receiving external drainage operation accepted a second operation to rebuild biliary tract(choledochocyst excision & Roux-Y choledochoje-junostomy) after 3 to 6 months.ResultsAll cases had got satisfactory therapeutic efficacy without any grave complication such as fistula of anastomotic stoma,infection of biliary tract or obstruction of biliary tract.During operation,perforations were located in the juncture of choledochus and cystic duct in 5 children and were not found in the other 6 children.In the second operation,the cases receiving cholecystostomy had less peritoneal adhesion,anatomic structure changes,haemorrhage[(30-50) mL vs(100-200) mL] and operation time[(2.5-3.0) h vs(3.5-5.0) h] than those receiving choledochotomy with T-tube drainage,and did not appear inadequate drainage for cystic duct obstruction.ConclusionsFor children with more organ inflammatory edema and adherence and in a bad overall condition,the first-time operation of cholecystostomy is more reasonable.

Objective To observe the effect of early intervention on the oligodendrocyte-myelin glycoprotein(OMgp) mRNA expression of brain injury neonatal rats caused by intrauterine infection.Methods 1.Twenty-eight Wistar pregnant rats were randomly divided into 2 groups:lipopolysaccharide(LPS)-treated group and saline control group.Pregnant rats were consecutively injected with LPS (450 ?g?kg-1) or saline on the 18th gestation age.After birth,the placentas were taken out and made HE staining to observe intrauterine infection.2.Thirty neonatal rats in the saline control group and 55 rats in the LPS-treated group were randomly selected which were divided into intervention group (n=25) and no-intervention group (n=25).The second post-natal day (P2) rats in intervention group were treated by early touch and enriched environment.The neonatal rats in the no-intervention group and saline control group were fed in a routine way.Five cases of P1 rats were selected respectively from the LPS-treated group and saline control group,and brain tissue pathological section was made to observe the condition of brain injury.3.Five cases of P1,P3,P7,P28 and P42 rats were selected from the saline control group,intervention group and no-intervention group to detect the OMgp mRNA expression levels by using the real time polymerase chain reaction me-thod.Results 1.There were a great number of neurophilic granulocytes in the placentas in the LPS-treated group.2.Brain tissue pathological of P1 in the saline control group had complete substantia alba structure,ordered disposition and lightly stained clear chromatospherite.While in the LPS-treated group, there existed brain tissue looseness,colloid cell aggregation and oligodendrocyte cytoreduction in the position of substantia alba,callositas and capsula interna.Intraventricular hemorrhage,substantia alba blood vessel dilatation and blood capillary angiorrhexis and hemorrhage could also be found.3.There was a higher increase in OMgp mRNA expressions of brain tissue in the LPS-treated group at P1,P3,P7,P28,P42 than those in the saline control group (Pa

BACKGROUND:Intraocular refractive operation with phakic intraocular lens implantation has been used in highly refractive errors patients with over-high diopter and thinner corneal thickness, which has the advantages of reversibility and retain the eye's accommodation. OBJECTIVE:To evaluate the safety and stability of posterior chamber phakic intraocular lens implantation in comparison with Lasik correction for high myopia. METHODS:Total y 126 col ege students with high myopia, 63 males and 63 females, aged (21.87±1.18) years, were randomly divided into test and control groups. In the test group, col ege students received posterior chamber phakic intraocular lens implantation, while those in the control group were subject to Lasik correction. During 1-year fol ow-up, naked vision, corrected visual acuity, contrast sensitivity, and postoperative untoward reaction were observed, and the effectiveness and safety indexes were calculated in the two groups. RESULTS AND CONCLUSION:The effectiveness and safety indexes in the test group were both superior to those in the control group (P<0.05). After 1 year of fol ow-up, the contrast sensitivity light and dark environment in the test group was significantly improved, which was also higher than that in the control group. Decreased night vision and glare was found in five cases of the control group and one case of the test group. These findings indicate that posterior chamber phakic intraocular lens implantation is safe and effective that can improve the visual quality in clinic.

Objective To investigate the clinical efficacy of DPP-4 inhibitors in the treatment of newly diagnosed type 2 diabetes mellitus and its effect on blood pressure and body weight.Methods A total of 100 newly diagnosed elderly patients with type 2 diabetes mellitus were enrolled in this study from July 2013 to June 2015 in this hospital.They were divided into observation group and control group(n=50).The control group was treated with placebo on the basis of diet control and exercise.The observation group was treated with sitagliptin on the basis of diet control and exercise.Fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG) and glycated albumin (GA) were measured before and after treatment,and the incidence rate of hypoglycemia,blood pressure,body weight and other adverse reactions were monitored.Results After treatment,two groups of patients,condition were significantly improved,FPG,2 h PG,GA changes in observation group were significantly better than that of control group,the difference were statistically significant(P＜0.05).There was no significant difference in blood pressure,body weight and body mass index before and after treatment,and also between the two groups(P＞0.05).The incidence of adverse reactions in the observation group and the control group were 10.0％ and 8.0％,The incidence of adverse reactions in the two groups was not statistically significant(P＞0.05).Conclusion The clinical efficacy of DPP-4 inhibitor siglitazide in the treatment of newly diagnosed elderly patients with type 2 diabetes mellitus is good,and it is very useful in the treatment of these patients.

Objective To study the differential proteome of kidney between lupus nephritis mouse and normal mouse.Methods The proteins of kidney were separated by two-dimensional gel electrophoresis(2-DE).The gels stained by silver were scanned by ImageScanner and analyzed by PDQuest software.Results About 573?52 and 658?43 protein spots were found in the three maps of control group and LN group respectively;the match ratio was 83% and 87% respectively.One hundred and fourteen spots were found increased that showed a two fold increase as comparing to control group.Conclusion A significant difference in protein expression of LN mouse kidney was found and may be related to the pathogenesis of LN.

Objective: Daidzein was efficiently purified by agar gel microspheres bonded β-cyclodextrin (AG-β-CD). Methods: Using agar as raw material, after emulsification, crosslinking, and bonding β-CD as functional group, AG-β-CD was synthesized for the purification of daidzein, and the purification process was determined and proved with mobile phase, flow rate, and loading capacity of microspheres. The structure of daidzein was identified by MS and NMR, AG-β-CD was chromatographically evaluated with daidzein, EGCG, and puerarin as the following tripartition such as difference of retention behavior on C18 reversed phase column chromatography, molecular simulation by autoDOCK4.0, and retention time curves on AG-β-CD with different contents of acetonitrile. Results: The main component of soybean isoflavone was daidzein (57.14%). The loading quantity of AG-β-CD was 1.33 mg/mL, flow rate was 2 BV/h, eluted by 2 BV of 20% ethanol, 1.33 BV of 40% ethanol, and 6-7 BV of 70% ethanol, the content was ≥ 95%, purity of daidzein (96.98%) was obtained with 97.86% yield. Chromatographic mechanism research showed that AG-β-CD had hydrophilic interaction chromatography and reversed-phase chromatography. Conclusion: AG-β-CD is capable of highly efficient purification of daidzein.

Objective To explore the mechanism of protecting cells from ischemic reperfusion injury by constructing specific small interference RNA (siRNA) to inhibit Na+-H+exchanger-1 (NHE-1) expression in human renal tubular epithelial cell (HKC). Methods The siRNA was designed and synthesized based on human NHE-1 complete sequence,and was transfected into HKC.The irrespective siRNA transfected group was used as control.The cells were treated with 10 μmol/L antimyein A to induce ischemia and anoxyaemia environment.NHE-1expression was examined by RT-PCR and Western blot.The intraeellular pH (pHi),Ca2+ or Na+ concentrations were detected by BCECF/AM,Fluo-3/AM and SBFI-AM,respectively,combining with laser eonfocal assay system.Nucleic morphology was determined by Hoechst 33342.Cellular apoptosis was examined by Annexin V/PI staining and flow eytometry.Fluorescent probe JC-1 was used to detect the change of mitechondrial transmembrane potential. Results The specific siRNA could efficiently inhibit NHE-1 expression in HKC.Compared with the irrespective siRNA transfected group,the mRNA and protein expression of NHE-1 was significantly down-regulated in NHE-1 siRNA transfeeted group (all P＜0.05).After treatment with antimyein A,the mRNA and protein expression of NHE-1 was significantly up-regulated in both groups,however,it was less than that in irrespective siBNA transfected group.At the same time,the ratio of apoptosis decreased (8.9% +2.9% vs 18.8%±3.2% , 17.4%±3.6% ,P＜0.05) and mitochondrial transmembrane potential rose significantly in NHE-1 siRNA transfected group as compared to irrespective siRNA transfected group and antimycin A group.The intracellular Na+,H+ and Ca2+concentrations increased in NHE-1 siRNA transfected group treated with antimyein A,but their levels were lower than those in irrespective siRNA transfected group with the same treatment(P＜0.05). Conclusions The synthesized siBNA can inhibit the expression of NHE-1 and can protect HKC from isehemia reperfasion injury induced by antimyein A.The mechanism might be via suppressing the expression of NHE-1 to delay intracelluar Na+ accumulation,attenuate intracellular Ca2+ overloading,and inhibit the decrease of mitechondrion transmembrane potential and reduce cellular apoptosis.

Objective To analyze the influencing factors on hospitalization costs of osteoporosis hip fracture in elderly patients.Methods The hospitalization expenses of patients with osteoporotic hip fracture and influencing factors were analyzed by single factor analysis of variance and multiple regression analysis method in Beijing Ji Shuitan Hospital from 2009 July to 2010 December.Results Among 565 patients who underwent operation treatment,hospitalization costs of femoral neck fracture was (42 127±20 821) yuan,wherein the treatment fee was (27 283± 14 959) yuan,other expenses (expenses for medicine,examination and chemical examination) were (14 844 ± 8717) yuan.The above values of intertrochanteric fracture were (52 965± 15 901) yuan,(36 872±11 763) yuan and (16 093±7793) yuan,respectively.Treatment fee occupied 65％ of hospitalization expenses.Multivariate regression analysis of influencing factors of costs intertrochanteric revealed that femoral neck fractures hip arthroplasty,femoral intertrochanteric fracture,venous thrombosis of the lower extremity,and albumin infusion in perioperative period were correlated firmly with the increased hospitalization expenses and treatment expenses (P＜0.001).Comorbidities such as diabetes and anemia,perioperative complication such as delirium,cardiac disease,pulmonary embolism,pulmonary infection were related to the other higher expenses (P＜0.05).The longer of hospital stay resulted in higher cost of hospitalization (P ＜ 0.001).Conclusions Comorbidities and preoperative complications can increase other expenses.Osteoporotie hip fracture,with a high hospitalization cost,is a heavy economy burden.It is important to emphasize the disease prevention of both osteoporosis and aging chronic illness.

To study the protective effect and the mechanism of asiatic acid (AA) from Potentilla chinensis on alcohol hepatic injury in rats. Male Wistar rats were randomly divided into six groups: the normal control group, the AA control group (8 mg · kg(-1) AA), the model group (5.0-9.0 g · kg(-1) alcohol) and high, medium and low-dose AA-treated groups (alcohol + 8, 4, 2 mg · kg(-1) AA). Each group was orally administered with the corresponding drugs once a day for 24 weeks. Approximately 1. 5 hours after the final administration, all rats were killed, and their blood samples and hepatic tissues were collected. The AST and ALT in rat serum and the contents of MPO, TNF-α, IL-1β, SOD, GSH-Px, GSH-Rd and MDA in hepatic tissues were detected. The expressions of NF-κB, TLR4, CD14, MyD88, TRIF and protein expression in hepatic tissues were measured by western blot. The pathological changes in liver tissues were observed by histological examination. The results showed that compared with the model group, the AA-treated groups showed significant decreases in serum ALT, AST and MDA and increases in the activities of SOD, GSH-Px, GSH-Rd and MPO. Moreover, AA markedly inhibited the expressions of TNF-α, IL-1β, TLR4, CD14, MyD88 and NF-κB. The histological examination showed alleviated hepatic issue ijury to varying degrees. In short, asiatic acid (AA) from P. chinensis could protect alcohol-induced hepatic injury in rats. Its mechanism may be related to the inhibition of NF-κB inactivation and the reduction of inflammatory response.
Animals ; Liver ; drug effects ; pathology ; Liver Diseases, Alcoholic ; prevention & control ; Male ; NF-kappa B ; physiology ; Pentacyclic Triterpenes ; pharmacology ; Potentilla ; chemistry ; Protective Agents ; pharmacology ; Rats ; Rats, Wistar ; Toll-Like Receptor 4 ; antagonists & inhibitors

Objective Biodegradable polycaprolactone (PCL)/poly D,L-lactic/glycolic acid (PLGA) scaffold is a promising modality for diffuse coronary atherosclerosis diseases unavailable to bypass graft.The purpose of this study was to evaluate the long-term performance of PCL/PLGA scaffold in vivo following polymer degradation.Methods Two scaffolds with and without heparin modification [Heparinized Scaffold (HS) and Blank Scaffold (BS)] were implanted.Except for control group,bone marrow mesenchymal stem cells (MSCs) were also transplanted around the scaffold.Animals were grouped into control BS group,BS-MSCs group and HS-MSCs group (each n =6) and survived 6 months.Patency and integrity of scaffold were evaluated by echocardiography and 3D-DOCTOR software.Endothelium coverage of the lumen was evaluated by scanning electron microscopy.Neovessles and collagen fiber within the scaffold were identified by histological staining.Prostacyclin (PGI2) and thromboxane (TXA2) production in the plasma were measured by ELISA.The expression of cyclooxygenase (COX-1,COX-2) and prostacyclin synthase PGIS was detected by Western blot.Results The heparinized scaffold kept patent up to 6 months and the lumen was covered by confluent endothelial cells.Histological staining revealed remodeling of collagen fiber and reconstruction of neovascular network immediately around the lumen.PGI2 production and PGIS expression in BSMSCs group and HS-MSCs group significantly increased compared with BS group (P ＜ 0.05 and P ＜ 0.01,respectively).Nonetheless,TXA2 production and COX-1 expression in BS-MSCs group was more pronounced than HS-MSCs group (P ＜ 0.01),showing no difference between BS-MSCs and BS group (P ＞ 0.05).Conclusion Despite polymer degradation and entire heparin release,the scaffold could continuously keep the structual integrity and lumen patency until 6 months by reinforcement of host collagen fiber and PGI2 expression.