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Objective To explore the best formula of the 0 5% liposome podophyllotoxin chitosan film. Methods Chitosan,acetic acid and gelatin were selected as three factors to prepare film, each factor including three levels, and 0 5% liposome podophyllotoxin served as blank factor. The films of different formula were prepared according to orthogonal design. The evaluation was made on the basis of the characteristics of conglutination and dissolution, then the best formula was determined finally. Results The results showed that the conglutination and dissolution of the film which was made of 2% chitosan, 1%acetic acid, 2% gelatin and 0 5% liposome podophyllotoxin chitosan was the most perfect. Conclusion The film designed according to orthogonal experiment was coincidenced with the requirements in aspect of conglutination and dissolution, and its appearance was perfect.

Objective: To present a modified method for harvesting and shaping fibular flap in reconstruction of mandibular defect. Methods: Fibula flap harvesting was performed under non-blood-evacuation of the donor limb and two gaps were made at the upper and lower ends of the fibular flap during the flap harvesting. Step-like osteotomy was performed to obtain 3 segments(each segment was 3~5 cm in length) of fibular bone. The shaping was achieved by fitting the bone segments together based on the natural contour of the mandible. The modified operation was conducted in 7 patients for mandibular reconstruction. Results:The method was successfully used in all patients with less bleeding during the flap harvesting and after reconstruction.The bone segments were rigidly fixed with good bony consolidation and contour. No complications occurred.Conclusion: The modified fibular flap harvesting method is feasible in mandible reconstruction.

OBJECTIVETo observe the clinical efficacy on constipation predominant irritable bowel syndrome (IBS-C) treated with acupuncture for regulating the mind and strengthening the spleen and the impacts on the quality of life in the patients.

METHODSSixty patients of IBS-C were randomized into two groups. In the acupuncture group (30 cases), acupuncture was applied to Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Taichong (LR 3), Sanyinjiao (SP 6), Yintang (GV 29) and Baihui (GV 20), once a day, 5 treatments a week and 4 weeks treatment as one session. In the western medication group (30 cases), lactulose oral solution was prescribed, 15 mL each time, three times a day, 4 weeks treatment as one session. The symptom grade scale and the quality of life scale (IBS-QOL) were adopted to observe the changes in clinical symptoms and quality of life before treatment, after treatment and 2-month follow-up after treatment in the patients of the two groups separately.

RESULTS(1) Clinical symptom score: the difference in the symptom score at each time point was significant statistically in intra-group comparison (P < 0.01). In 1 week, 4 weeks of treatment and 2 months after treatment, the clinical symptom scores in the acupuncture group were lower than those in the western medication group (P < 0.05, P < 0.01). (2) IBS-QOL score after treatment was improved as compared with that before treatment in the two groups (P < 0.01). The improvement of IBS-QOL at 2 months after treatment in the acupuncture group was apparently superior to the western medication group (P < 0.05). (3) The total effective rate was 90.0% (27/30) in the acupuncture group and was 83.3% (25/30) in the western medication group. The overall efficacy in the acupuncture group was better than that in the western medication group (P < 0.01).

CONCLUSIONAcupuncture for regulating the mind and strengthening the spleen significantly relieves the clinical symptoms of IBS-C and improves QOL of patients. The total efficacy is superior to lactulose oral solution and presents a certain of long-term efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Constipation ; physiopathology ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; physiopathology ; therapy ; Male ; Middle Aged ; Quality of Life ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult

Objective: To review the feasibility of transradial percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients elder than 80 years of age. Methods: A total of 661 CAD patients elder than 60 years with PCI in our hospital from 2013-12 to 2015-12 were enrolled and divided into 2 groups: Observation group, the patients with the mean age of (83.2±3.8, 80-92) years,n=76 and Control group, the patients with the mean age of (68.3±5.2, 60-79) years,n=585. Clinical features, coronary lesions, radial puncture failure rate, PCI success rate and intra-, post-operative complications were retrospectively analyzed and compared between 2 groups. Results: In Control group and Observation group, the patients from failed radial artery puncture changing to brachial artery puncture were 1.0% and 2.6%, from failed radial artery puncture changing to femoral artery puncture were 1.5% and 2.6% respectively; PCI success rates were 96.5% and 96.4%, operational times were (45.7±21.2) min and (47.6±18.5) min, the contrast agent used in coronary angiography (CAG) were (28.9±10.2) ml and (30.6±8.8) ml and in CAG+PCI were (150.4±35.7) ml and (155.6±28.2) ml, intra-operative cardiac events were 0.7% and 1.3%, post-operative vascular complications were 0.9% and 2.6%, post-operative hospital stay times were (5.7±1.9) days and (6.3±2.7) days respectively; the above differences had no statistic meaning. Conclusion: Transradial PCI is safe and feasible in elder CAD patients.

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Objective To investigate the relationship between serum uric acid level and atrial fibrillation in patients with coronary heart disease.Methods Two hundred and forty-seven inpatients with coronary heart disease were selected.All the patients were divided into simple coronary heart disease group (90 cases),coronary heart disease with paroxysmal atrial fibrillation group (85 cases) and coronary heart disease with continuous/permanent atrial fibrillation group (72 cases).The age,history of cardiovascular events,uric acid,echocardiographic characteristics and drug-taking history were carefully recorded.The risk factors of atrial fibrillation in patients with coronary heart disease were analyzed by Logistic regression.Results The level of history of smoking,diastolic blood pressure,body mass index,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,creatinine,fasting plasma glucose,postprandial 2 h plasma glucose,interventricular septal thickness,carotid intima-media thickness and drug-taking history among the 3 groups showed no statistical differences (P ＞ 0.05).The age,systolic blood pressure,uric acid,left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD) in coronary heart disease with paroxysmal atrial fibrillation group and coronary heart disease with continuous/permanent atrial fibrillation group were significantly higher than those in simple coronary heart disease group,the left ventricular ejection fraction (LVEF) was significantly lower than that in simple coronary heart disease group,and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The result of Logistic regression analysis showed high uric acid,high age,expanded LAD and LVEDD were the independent risk factors of atrial fibrillation in patients with coronary heart disease,and uric acid showed the most significant correlation (P =0.001,OR =1.061,95％ CI 1.026-1.096).Conclusion High serum uric acid level maybe a risk factor of atrial fibrillation in patients with coronary heart disease.

Objective To investigate the efficacy of endoscopy for the treatment of benign biliary stricture after biliary surgery.Methods The clinical data of 127 patients with benign biliary stricture after biliary surgery at the First Hospital of Lanzhou University from January 2007 to December 2011 were retrospectively analyzed.According to the Bismuth classification,there were 60 patients with type Ⅰ,35 with type Ⅱ,21 with type Ⅲ and 11 with type Ⅳ.The efficacies of endoscopy for the treatment of biliary stricture with different Bismuth subtypes were analyzed.Results The location and severity of biliary stricture were confirmed by endoscopic retrograde cholangiopancreatography (ERCP) + cholangiography.Sixteen patients ( including 7 with type Ⅲ and 9 with type Ⅳ) were transferred to surgical treatment due to severe biliary stricture.A total of 111 patients underwent endoscopic treatment successfully,with the success rate of 87.4％ (111/127).The success rates of endoscopy for the treatment of patients with Bismuth Ⅰ,Ⅱ,Ⅲ and Ⅳ biliary strictures were 95％ (57/60),86％ (30/35),9/14and 1/2,respectively.Twenty-nine patients were implanted with retrievable metallic biliary stent,and 82 were implantated with plastic biliary stent.Of the 111 patients,only 6 patients were complicated by acute pancreatitis,and they were cured by conservative treatment.The alleviative rates of yellow skin and icteric sclera,tenderness and distending pain of right upper quadrant,fever were 73％ (81/111 ),83％ (74/89),90％ (73/81 ) and 89％(68/76) at 1 week after treatment,and they were 88％ (98/111),91％ (81/89),94％ (76/81) and 92％(70/76) at 8 weeks after treatment.The efficacy of endoscopy was good in 97 patients and poor in 14 patients,and the 14 patients were converted to open surgery.The symptoms including yellow skin and icteric sclera,tenderness and distending pain of right upper quadrant,fever were completely alleviated at postoperative month 6.Conclusion Endoscopic treatment for benign biliary stricture is safe and effective.

To examine the histological changes of diabetic rats' skin and the effects on the percutaneous absorption of hydrocortisone (HC, a glucocorticoid), male Wistar rats were randomly divided into five groups: control group, diabetes one-week group (W1), two-week group (W2), three-week group (W3), and four-week group (W4), while each group contained 6 rats. Diabetes mellitus (DM) rat model was prepared with the method of streptozocin (STZ, 40 mg x kg(-1)) intraperitoneal injection. Abdominal skin was cut to carry out an in-vitro penetration experiment on an improved Franz diffusion cells, and phosphate buffer (PBS, pH 7.4) was used as receptor solution. The solution was analyzed with HPLC, and then the penetrating rate can be calculated. Meanwhile, rats' abdominal skins of different DM periods were HE stained and made into tissue slices to find if any histological changes occurred. The penetrating rate of control, W1, W2, W3, and W4 groups were 2.39 +/- 1.25, 3.22 +/- 1.72, 3.02 +/- 1.89, 3.63 +/- 2.02 and 5.00 +/- 3.36 microg x h(-1) x cm(-2), respectively. There was significant difference between the control and the W4 group (P < 0.05), but no significant differences were found between any other two groups (P > 0.05). The tissue slices showed that compared to the normal rats' skin, little change was observed in one-week DM rats' skin, but the skin of one-month DM rats' skin was observed thinner, and it became much thinner than that of rats with two-month diabetes, especially the epidermis. After making a rat into diabetic, the rats' skin goes through a pathological change, and this change is closely interrelated with the increase of the permeation of HC. Therefore, it is necessary to adjust the dose while some drug was applied on the skin in case of diabetes mellitus.

Objective To investigate the expression and role of cyclooxygenase-2(COX-2)in the ischemia reperfusion in"ury in liver transplantation in rat.Methods Fifty-four male Wistar rats were divided into control group(n=6),liver transplantation group(n=24)and NS398 treated group(n=24)according to random number table.The expression of COX-2 mRNA was detected by RT-PCR,the distribution of COX-2 positive cells by immunohistochemistry.and the content of serum TNF-αand IL-10 by enzyme-linked immunosorbent assay.All the data were processed by one-way ANOVA.Results The serum indexes and changes of TNF-α.expression were in accordance with the histological injury of liver graft.The expression of COX-2 mRNA was essential to the ischemia reperfusion injury of the liver graft.Inhibition of the expression of COX-2 mRNA would aggravate the isehemia reperfusion injury of the liver graft.Conclusions COX-2 plays an important role in the ischemia reperfusion injury in liver transplantation.COX-2 may decrease the isehemia repertusion injury of liver graft.