Objective To investigate the surgical approaches indication, technique and efficacy for treatment of intracranial arachnoid cysts (IAC). Methods The clinical data of 56 patients with IAC who were diagnosed with MRI and/or CT techniques were retrospectively analyzed. According to the surgical approaches adopted, these cases were classified into 4 groups, group A with expectant treatment (12 cases), group B with endoscopic cystocisternal fenestration (15 cases), group C with cystoperitoneal shunting (21 cases), and group D with surgical cyst removal (8 cases). The outcomes of the patients were compared. Results The patients were followed up for 3 months to 46 months (mean 15 months). The rate of symptomatic improvement in group B was 14/15, in group C was 95.24%(20/21) and in group D was 5/8, and there was significant difference ( χ2=8.335, P<0.05). The rate of radiographic improvement in group B was 14/15, in group C was 90.48%(19/21) and in group D was 5/8, and there was significant difference (χ2=8.235, P<0.05). The rate of complication in group B was 1/15, in group C was 14.29%(3/21), and in group D was 5/8, and there was significant difference ( χ2=8.256, P<0.05) Conclusions In terms of therapeutic effect, surgical safety and minimal invasiveness, cystoperitoneal shunting and endoscopic cystocisternal fenestration should be the primary choice .

0.05), while there was significant difference in RI and S/D between the group without UCAN and the groups of UCAN with two loops and with three loops (P

AIM To establish the HPLC fingerprints of flavonoids in Ziziphi spinosae Semen and to determine the contents of two constituents.METHODS With spinosin as a reference peak,the HPLC fingerprints of ten batches of samples were established.The analysis of methanol extract of flavonoids in Ziziphi spinosae Semen was performed on a 30 ℃ thermostatic Agilent TC-C18column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％ acetic acid flowing at 1 mL/min in a gradient elution manner,and the detection wavelength was set at 280 nm.RESULTS There were ten common peaks in the HPLC fingerprints,eight of which (vicenin-Ⅱ,glucosylvitexin,isospinosin,spinosin,6'-pyridyloylspinosin,6'-p-hydroxybenzoylspinosin,6'-feruloylspinosin and 6'-p-coumaroylspinosin) were identified.Spinosin and 6'-feruloylspinosin showed good linear relationships within the ranges of 15.00-40.00 μg and 5.00-14.00 μg,whose average recoveries (RSDs)were 100.5％ (1.6％) and 100.4％ (1.6％),respectively.CONCLUSION This accurate,simple and reliable method can be used for the quality control of flavonoids in Ziziphi spinosae Semen.

Objective To compare the short-term efficacies of laparoscopic intersphincteric resection (ISR) and laparotomy for ultra-low rectal cancers by Meta-analysis.Methods We searched case-control trials that compared clinical outcomes of laparoscopic ISR and laparotomy from PubMed, EMBase, Ovid, CNKI and Wanfang database.Relevant published and unpublished data and conference papers were also retrieved.Two reviewers independently assessed the qualities of the included studies.Meta-analysis was performed by using of RevMan5.2 software.Results A total of 5 trials with 552 cases were included.The results of Meta-analysis showed that in terms of blood loss of the operation [mean difference (MD) =-65.42, 95％ CI:-93.45--37.38, Z=4.57, P＜0.000 01], flatus passage time (MD=-0.96, 95％CI:-1.45--0.47, Z=3.83, P=0.000 1) and hospital stays (MD=-1.69,95％CI:-2.19--1.19, Z=6.63, P＜0.00001),laparoscopic ISR were significantly superior than those of laparotomy, with significant differences.In terms of operation time (MD =6.61,95 ％ CI:-21.29-34.51, Z =0.46, P =0.64), the positive rate of circumferential resection margin (OR =1.01, 95％ CI: 0.37-2.80, Z =0.02, P =0.98) and postoperative morbidity (0R=0.73, 95％ CI: 0.45-1.20, Z =1.23, P =0.22), there were no significant differences in the two groups.However, laparotomy may clean more numbers of lymph nodes than those of laparoscopic ISR (MD =-1.16, 95％CI:-2.14--0.18, Z =2.31, P =0.02), with significant difference.Conclusion The shortterm efficacy of laparoscopic ISR is superior than that of laparotomy in the treatment of ultra-low rectal cancer.

Objective To investigate and analyse the status and influential factors of palliative care knowledge of nursing undergraduates,then provide theoretical basis for palliative care education. Methods Using random sampling method, 400 nursing undergraduates were investigated by Palliative Care Quiz for Nursing (PCQN) and palliative care attitude questionnaire. Results 366 nursing undergraduates completed the survey whose scores were 8.363 ± 4.240, and 66.9%(244/366) of them had never heard of palliative care. Choosed right rate of PCQN was 41.13% (150/366). The scores of palliative care philosophy and principles 0.298±0.248, pain and symptom control and psychological scores 0.436 ± 0.235 and social and spiritual support scores 0.499 ± 0.318 had significant difference (F=38.866, P=0.000). The scores of palliative care attitude questionnaire were 36.756 ± 3.183, and the average score of all items were over 3. The palliative care attitude scores had significant difference in different grade (F=2.737, P=0.043). Conclusions Nursing undergraduates hold positive attitudes of palliative care, but the cognition degree were at a low level. To promote the development of palliative care, it should be strengthened publicity, education and training in this area. It is necessary to carry out palliative care education in nursing undergraduate students.

Objective:To investigate therapeutic efficacy and mechanisms of action of oncolytic agent derived from herpes simplex virus type 2 (oHSV2) in a xenograft mouse model bearing CT26 colorectal cancer. Methods:BALB/c mice were subcutaneously inoculated with CT26 cells to establish a xenograft mouse model of colorectal cancer. 1) After intratumoral administration of oHSV2, enzyme-linked im-munosorbent assay was used to determine granulocyte-macrophage colony-stimulating factor (GM-CSF) expression levels in the blood. 2) Model mice were divided into three groups:PBS group (negative control), oHSV2 group, and 5-fluorouracil (5-FU) group (positive control). After drug administration, drug effectiveness was evaluated on the basis of weight, tumor volume, general state, and survival time. 3) Cells from the draining lymph nodes (TDLN) and tumor were surgical y removed and used to quantify mature dendritic cel s (DCs) and T lym-phocytes by flow cytometry. Result:1) In the CT26 xenograft model, level of GM-CSF continuously elevated. At day 8, peak value was attained in the blood at concentration of 3150±327.1 pg/mL. Then, GM-CSF expression gradually reduced as time progressed. 2) In in vivo study, both oHSV2 and 5-FU exerted antitumor effects relative to PBS group (50 days vs. 36 days, P<0.01;51 days vs. 36 days, P<0.01), and oHSV2 proved to be less toxic and safer. At day 28, the 5-FU group presented highly significant difference in mouse body weight compared with that of PBS group (16.61 g vs. 22.07 g, P<0.01). However, oHSV2 group did not show statistical y significant change (al P>0.05). Skin of virus injection region did not present necrosis and ulceration. 3) In the TDLN, the frequency of DC was increased when treated with oHSV2 compared with the control group (6.49%vs. 3.73%, P<0.01). Similarly, the percentage of CD4+and CD8+T-cel s from the oHSV2-treated group was signifcantly higher than mock-treated tumors (15%vs. 8.57%, P<0.01;8.19%vs. 5.15%, P<0.01). However, number of cells in the 5-FU group were significantly reduced with respect to that of the negative group (al P<0.01). Conclusion:oHSV2 exerted potent antitumor effects in a murine colorectal cancer model. Compared with 5-FU, oHSV2 treatment caused fewer side effects. Such antitumor effect may be induced by stimulation of immune activity by GM-CSF production.

ABSTRACT:Objective To observe whether N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP)can inhibit rat silicotic fibrosis by regulating stimulatory G proteinα(Gαs)/inhibitory G proteinα(Gαi)signal.Methods Male Wistar rats were randomly divided into three groups (n=1 0 ):control 1 6-w group,silicosis 1 6-w group,and Ac-SDKP pre-treatment group.The pathological changes of the lung tissue was observed by HE staining;the expressions ofα-smooth muscle actin (α-SMA),Collagen Ⅰ,fibronectin (Fn),Gαs,Gαi2 ,Gαi3 and cAMP were detected by Western blot.Immunofluorescence was performed on lung tissue sections to detect the coexpression ofα-SMA/Gαi3 . Results Within silicosis 16-w group,HE staining showed that the silicotic nodule volume increased,nodule fusion and the formation of interstitial fibrosis could be seen,and cell fibrous nodules were visible.Immunofluorescence staining showed the enhanced coexpression ofα-SMA/Gαi3 in fibrosis area.Compared with those in control group, the expressions ofα-SMA,Collagen Ⅰ,Fn,Gαi2 and Gαi3 significantly increased in silicosis 1 6-w group,but the expressions of Gαs and cAMP decreased.Compared with silicosis 1 6-w group,Ac-SDKP pre-treatment group had alleviated lung injury and decreased coexpression ofα-SMA/Gαi3 .The expressions ofα-SMA,Collagen Ⅰ,Fn,Gαi2 and Gαi3 protein significantly decreased in Ac-SDKP pre-treatment group,while the expressions of Gαs and cAMP increased obviously.Conclusion Ac-SDKP can regulate the expressions of Gαs and Gαi and promote the formation of cAMP,thus playing an effective role against silicotic fibrosis.

Purpose To investigate the value of real-time three-dimensional contrast-enhanced ultrasound (RT3D-CEUS) for the evaluation of blunt renal trauma hemorrhage. Materials and Methods Nine healthy New Zealand white rabbits were randomly divided into three groups, and after heparinization, the models of ongoing hemorrhage of blunt renal trauma were developed by self-made minitype striker in the three groups with different force levels:77.2 N (group A), 106.2 N (group B), 135.1 N (group C). All rabbits were performed ultrasonography (US), color Doppler flow imaging (CDFI) and RT3D-CEUS before and after strike (within 20 minutes). The results achieved by US, CDFI, 2D-CEUS (A-plane results in RT3D-CEUS) and RT3D-CEUS were compared with each other, and further compared with the pathological results of the executed animals after blood pressure decreased lower than 40 mmHg. Results All rabbits showed traumatic renal lesions and it proved that the bigger the force the heavier the injury (group A: 1 case of levelⅠ, 2 cases of levelⅡ;group B:3 cases of levelⅢ;group C:1 case of levelⅢ, 2 cases of level Ⅳ ). After strike, US identified the presence of increasing hematoma under the capsule but could not detect active bleeding. In CDFI, only 1 case was detected ongoing hemorrhage. 2D-CEUS clearly presented the bleeding in all cases. RT3D-CEUS presented a vivid real-time and stereoscopical image of active hemorrhage in all cases and also showed that the wider the bleeding area was shorter than the shock duration time. Conclusion RT3D-CEUS can present a real-time dynamic bleeding and locate headstream of blood in renal trauma vividly and stereoscopically, and can be used to preliminarily evaluate the degree of ongoing hemorrhage in traumatic kidney.

Purpose To prepare the tranexamic acid liposome with high encapsulation efficiency and stability, through interaction of avidin and biotin, and to prepare its microbubble-liposome compound whose properties are to be assessed. Materials and Methods Thin film hydration technology was used to prepare tranexamic acid liposome. Taking encapsulation efficiency as indication, the microbubble-liposome compound was optimized by the design of orthogonal experiment. The basic properties of the compound were tested and the acoustic characteristic was measured by ultrasound and gray-scale values. Results The optimum formula of tranexamic acid liposome were as follows:molar ratio of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine, cholesterol and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[biotinyl (polyethylene glycol) 2000] was 85∶10∶5;concentration of tranexamic acid was 5.0%;ultrasonic time was 15 min. The encapsulation efficiency was 62.62%. The size was approximately (104.00±1.84) nm. The Zeta potential was approximately (-50.50±0.56) mV. The liposome was good in stability. The size of the microbubble-liposome compound was approximately (4.56±0.28)μm. Under the microscope, they were round with transparent center, evenly distributed without aggregation. The acoustic characteristic of the compound in vitro showed typical characteristics of microbubble, which was compatible with the results under the microscope. As the concentrations of the compound increased, both ultrasound imaging effect and the gray-scale values enhanced. However, to avoid acoustic shadows, the imaging concentrations were supposed to be at least lower than 1.15×108/ml in vitro. Conclusion The preparation of the tranexamic acid microbubble-liposome compound can be optimized by taking encapsulation efficiency as reference, and it can be effectively traced by ultrasound according to its acoustic characteristics in vitro.