Objective To compare the efficacy and survival of patients with malignant obstructive jaundice using either endoscopic self-expandable metallic stents or surgery,and to evaluate the compounding factors influencing prognosis.Methods 56 patients with malignant obstructive jaundice treated with endoscopic self-expandable metallic stents (the endoscopic group) were compared with 90 patients who received surgery (the surgery group) during the same study period.Clinical data and survival of the 2 groups of patients were retrospectively analyzed.Results The success rate was 100％ in the endoscopic group.The serum bilirubin,alkaline phosphatase (ALP) and γ-glutamyl transferase (γ-GT) decreased significantly by using either therapeutic endoscopy or surgery (P＜0.01).There was no significant difference between the two groups in the reduction of serum total bilirubin.The mean survival of the endoscopic and surgery groups were 340 d and 795 d respectively.The accumulative survivals of the endoscopic group at 3,6 and 12 months as evaluated by the Kaplan-Meier method were 82.6 ％,61.1％ and 46.6 ％,respectively,and for the surgery group were 97.0％,90.9 ％ and 65.4％ respectively. There was a significant difference in survival between the two groups (P＜0.01).Survival after therapeutic endoscopy was similar to surgery for patients with metastasis and hilar biliary obstruction.Conclusions Self-expandable metallic stents gave similar palliation in the relief of jaundice in patients with malignant biliary obstruction.The stents had no effect on the primary tumor.Therapeutic endoscopy with self-expandable metallic stents is a safe and effective method for the relief of jaundice in patients with obstructive jaundice caused by non-resectable malignant tumors.

Background Medical refraction after cycloplegia is the preferable choice for precise measurement of degree of refractive error.Drugs used in China for cycloplegia include atropine and tropicamide,and the use of cyclopentolate is an alternative for ophthalmologist.However,the data for the evaluation and comparison of efficacy of the available drugs in cycloplegia is still lacking.Objective This system analysis was to evaluate the difference between atropine and cyclopentolate in cycloplegia in children.Methods A systematic literature retrieval was conducted in MEDLINE,EMbase,Google residual accommodation after cycloplegia by atropine and cyclopentolate were compared.Statistical analysis was performed using the RevMan 5.1.0 software.Results A total of 7 studies were included in this meta analysis,including 6 cohort study design and 1 randomized,doubleblinded clinical trial and 1232 eyes.For retinoscopic evaluation after cycloplegia,no significant differences were found between cyclopentolate and atropine in children with hyperopia and myopia (WMD =-0.21,95％ CI:-0.47-0.06,P=0.13 ; WMD =-0.10,95％ CI:-0.36-0.15,P =0.43).For residual accommodation after cycloplegia,no significant difference was seen between cyclopentolate and atropine in ammetropic children (WMD =0.30,95％ CI:-0.10-0.71,P =0.15).Conclusions Cyclopentolate shows the same effect on the cycloplegia as atropine in children,and it can take the place of atropine in cycloplegia in childhood.

Objective To study the expression and significance of Neogenin,Hepcidin and serum ferritin(SF)in patients with cancer-related anemia.Methods To test the serum levels of Neogenin,Hepcidin and SF in 107 cases,including 55 cases with cancer-related anemia and 52 cases of non-anemia with tumor by ABC-ELISA.Results ①The serum levels of Neogenin in patients with cancer-related anemia were 0.77 ± 0.45 ng/ml,which were lower than 0.98 ± 0.60 ng/ml in non-anemia group (t=2.003 8,P <0.05).The serum levels of Hepcidin in patients with cancer-related anemia were 6.03±4.25 μg/ml, which was higher than 4.51±2.23 μg/ml in non-anemia group (t=2.319 5,P <0.05).②There were no difference in pa-tients between anemia and non-anemia (t=1.898 0,P >0.05).③In patients with cancer,there were positive correlation be-tween Neogenin and Hb (r=0.212 4,t=2.226 4,P <0.05),there were negtive correlation between Hepcidin and Hb (r=-0.310 1,t=3.345 2,P <0.01),but there were no correlation between SF and Hb (P >0.05).④There were positive cor-relation between Hepsidin and SF (r=0.486 6,P <0.01).Conclusion There were lower expression of Neogenin,higher ex-pression of Hepcidin in patients with cancer-related anemia is a complex process.The abnormal expression of Neogenin and Hepcidin which were lead to the loss of use of iron are the key factors attribute to anemia in patients with cancer.

The purpose of this study was to fabricate decelluarized valve scaffold modified with polyethylene glycol nanoparticles loaded with transforming growth factor-β1 (TGF-β1), by which to improve the extracellular matrix microenvironment for heart valve tissue engineering in vitro. Polyethylene glycol nanoparticles were obtained by an emulsion-crosslinking method, and their morphology was observed under a scanning electron microscope. Decelluarized valve scaffolds, prepared by using trypsinase and TritonX-100, were modified with nanoparticles by carbodiimide, and then TGF-β1 was loaded into them by adsorption. The TGF-β1 delivery of the fabricated scaffold was measured by asing enzyme-linked immunosorbent assay. Whether unseeded or reseeded with myofibroblast from rats, the morphologic, biochemical and biomechanical characteristics of hybrid scaffolds were tested and compared with decelluarized scaffolds under the same conditions. The enzyme-linked immunosorbent assay revealed a typical delivery of nanoparticles. The morphologic observations and biological data analysis indicated that fabricated scaffolds possessed advantageous biocompatibility and biomechanical property beyond decelluarized scaffolds. Altogether this study proved that it was feasible to fabricate the hybrid scaffold and effective to improve extracellular matrix microenvironment, which is beneficial for an application in heart valve tissue engineering.

Four new triterpenoids, together with six known analogues, were isolated from an aqueous extract of the Ziziphus jujuba var. spinosa seeds, by multiple column chromatographic separation methods using stationary phases of macroporous adsorption resin, MCI resin, normal phase silica gel, Sephadex LH-20, and Toyopearl HW-40C as well as preparative thin-layer chromatography and reversed-phase HPLC. Their structures were determined by spectroscopic data analysis, the new structures were trivially named jujubaceanothoside A (1), 23-epijujuboside A (2), and jujubosides J and K (3 and 4), while the known analogues were identified as jujubosides A-C (5-7) and II (8), alphitolic acid (9), and betulinic acid (10). The structure of 1 was confirmed by single crystal X-ray diffraction.

Ten dimeric phthalide racemates (1-10) were isolated from an aqueous extract of the Angelica sinensis root head (Guitou) by separation techniques of column chromatography over macroporous adsorbent resin, MCI resin, silica gel, and Sephadex LH-20, together with preparative thin-layer chromatography and reversed phase HPLC. The racemates were further separated into (+)-/(-)-1-(+)-/(-)-10 with chiral HPLC. Their structures including absolute configurations were elucidated by comprehensive analysis of spectroscopic data, combined with electronic circular dichroism (ECD) and NMR calculations as well as single crystal X-ray diffractions. Compounds (+)-/(-)-1-(+)-/(-)-10 are either new structure or new natural product, named (+)-/(-)-angelidipthalidic acids A-H [(+)-/(-)-1-(+)-/(-)-8] and (+)-/(-)-angelidipthalidols A and B [(+)-/(-)-9 and (+)-/(-)-10], respectively. Meanwhile, dimeric phthalide mono- and bis-lactone derivatives with 3.3′a,8.6′- and 3.6′,8.3′a-coupling patterns as well as determination of their relative configurations are discussed.

Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Cytarabine ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Female ; Fever ; blood ; chemically induced ; diagnosis ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; drug therapy ; Teniposide ; therapeutic use

To observe the effects of ultrasound-guided stellate ganglion block (SGB) on cerebral oxygen metabolism and postoperative cognitive dysfunction (POCD) of elderly patients, we collected 80 elderly patients undergoing selective coronary artery bypass graft under cardiopulmonary bypass. The Mini Mental State Examination (MMSE) was applied to test the cognitive function. The SjvO2, Da-jvO2 and CEO2 were used for the analysis of the cerebral oxygen metabolism. We found that POCD was related to disequilibrium of cerebral oxygen metabolism. Ultrasound-guided SGB before surgery reduced the incidence of POCD because of the improvement of cerebral oxygen metabolism.
Aged ; Autonomic Nerve Block ; Cardiopulmonary Bypass ; Cognition Disorders ; prevention & control ; Coronary Artery Bypass ; Humans ; Neuropsychological Tests ; Oxygen Consumption ; Postoperative Complications ; Stellate Ganglion ; diagnostic imaging ; Ultrasonography

Adolescent ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Drug Interactions ; Drug Therapy, Combination ; Female ; Humans ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Sex Factors ; Tetrahydrofolates ; administration & dosage ; therapeutic use ; Treatment Outcome

Ten glycosidic compounds were isolated from an ethanol extract of Machilus wangchiana by a combination of various chromatographic techniques including column chromatography over silica gel and Sephadex LH-20 and reversed-phase flash chromatography and HPLC. Their structures were identified by spectroscopic data analysis (IR, MS, and NMR) as icariside B1 (1), boscialin-3-O-β-D-glucopyranoside (2), pisumionoside (3), isolariciresinol-9'-O-β-D-xylopyranoside (4), 5'-methoxyisolariciresinol-9'-O-β-D-xylopyranoside (5), lyoniresinol-9'-O-β-D-xylopyranoside (6), (E) -4-hydroxyphenylprop-7-ene 4-O-β-D-glucopyranoside (7), (E) - 4-hydroxy-3-methoxyphenylprop-7-ene 4-O-α-L-rhamnopyranosyl-(1 --> 6) -β-D-glucopyranoside (8), 4-hydroxy-3-methoxyphenylprop-8-ene 4-O-β-D-xylopyraosyl-(1 --> 6) -β-D-glucopyranoside (9), and 4-hydroxy-3,5-dimethoxyphenylprop-8-ene 4-O-α-L-rhamnpyranosyl-(1 --> 6)-β-D- glucopyranoside (10), respectively.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Lauraceae ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization