Objective To evaluate the clinical value of carbon nanoparticles suspension in gallbladder carcinoma lymphadenectomy.Methods 21 cases of gallbladder carcinoma who received radical resection from January 2008 to August 2013 were randomly divided into experimental group (11 cases received carbon nanoparticles injection into the subserosa around the tumor before operation) and control group (10 cases did not receive any tracer).The number of dissected lymph nodes,black-stained lymph nodes and positive lymph nodes were analyzed.Results A total of 138 lymph nodes were resected in experiment group,average 12.546±5.047 lymph nodes per patient,which was significantly more than that in control group in which there were overall 87 lymph nodes,average 8.700±2.497 lymph nodes per patient (t =2.176,P =0.042).The blacken rate of lymph nodes in experimental group was 56.522 ％ (78/138).There were 46 metastasis lymph nodes out of 79 blacken lymph nodes,and the positive rate was significantly higher than that of non-blacken lymph nodes [58.228 ％ (46/79) vs 38.983 ％ (23/59),P=0.039].There was no local or systemic adverse reaction occurred in experimental group.Conclusions Carbon nanoparticles suspension maybe helpful for lymphadenectomy during radical gallbladder carcinoma dissection to reduce operating damage and be safe.

Objective To investigate the clinical effect of low molecular weight heparin (LMWH) and pressure pump on perioperative deep vein thrombosis (DVT) in patients with hip fracture and analyze the effect of LMWH on coagulation function. Methods Retrospective analysis of 95 cases hip fractures patients with clinical data, according to the preventive medication of DVT were divided into LMWH group of 42 cases and LMWH joint pressure pump group of 53 cases. The incidence rate of DVT and the degree of limb swelling after operation in two groups were observed. The differences of blood coagulation function indexes, blood rheology and hip function recovery were compared between the two groups. Results The the incidence rate of DVT in combination group was 1.89% (1 cases ), lower than LMWH group of 14.29% (6 cases )(χ2=5.278,P=0.022). After two weeks' treatment, the difference of anterior thigh circumference and calf circumference in combination group was less than LMWH group (P<0.05). The prothrombin time (PT) and activated partial thromboplastin time (APTT) in two groups post-treatment were lower than those pre-treatment, the D-dimer (D-D) was higher than that pre-treatment(P<0.05), but there was no significant difference between two groups. After 3 months' treatment, the Harris functional independence measure (FIM) in combination group was higher than that in LMWH group (P<0.05). Conclusion LMWH combined with pressure pump could significantly reduce the incidence of perioperative DVT in patients with hip fracture, improve the blood coagulation function and hip function.

Objective To investigate platelet-derived growth factor ( PDGF ) protection on blood flow and mitochondrial function of hemorrhagic shock rats. Methods Ninety-six SD rats were randomly divided into six groups including shock group, lactated ringer's solution (LR) resuscitation group,PDGF treatment groups(1,3. 5,7,15μg/kg). Laster-Doppler and oxygen concentration determination method were applied to observe the protective effect of PDGF treatment on animal survival,blood flow and mitochondrial function in liver and kidney. Re-sults As compared with LR resuscitation group,PDGF treatment increased animal survival rate and also improved blood fiow of liver and kindy,mitochondrial respiration control ration(RCR),of which the group with 3. 5μg/kg had the best result. Conclusion This finding sug-gests that PDGF may be a potential agent to treat acute critical such as hemorrhagic shock.

BACKGROUND:For treatment of spinal cord injury, exogenous neural stem cell transplantation still faces many problems.Thus, the strategy of supplementary treatment of activating exogenous neural stem cells has been a hot focus.It has been found that lithium chloride can significantly inhibit differentiation and promote proliferation of neural stem cells, whose effects are correlated to Wnt signal pathway.OBJECTIVE:To investigate the effect of lithium on endogenous neural stem cells after spinal cord injury in rats.DESIGN, TIME AND SETTING:The randomized controlled animal study was performed at the Central Laboratory, Zhujiang Hospital from March to August 2008.MATERIALS:A total of 55 adult female Wistar rats were assigned into normal control group(n=5), simple injury group(n=25), and lithium chloride group(n=25).Lithium chloride was purchased from Guanghua, Guangzhou, China.METHODS:In the simple injury group and lithium chloride group, rat models of acute spinal cord injury at T10 segment were made by Allens method.From 1 hour following model induction, rats in the lithium chloride group received 3 mmol/kg per day lithium chloride through intraperithoneal injection.Samples were directly obtained.In the simple injury group, rats received an equal volume of saline.Rats in the normal control group were left intact.24 hours before samples were obtained, rats in each group were intraperitoneally injected with Brdu solution for labeling, once every 8 hours, totally 3 times.Spinal cord at 5 mm from the center of damage region received Brdu, catenin immunohistochemistry.MAIN OUTCOME MEASURES:BrdU-positive cell number and area of catenin-positive expression were measured.RESULTS:There were a few Brdu-positive cells and less expression of catenin in the center canal and adventitia of spinal cord in the normal control group.Many Brdu-positive cells and a little expression of catenin were found in gray matter and ependyma of injury area in the simple injury group 24 hours after model induction, which reached the peak at 1 week, and declined gradually at 2 weeks.Just a few Brdu-positive cells and little expression of catenin existed at 4 weeks.Compared with the simple injury group, there was no difference in Brdu-positive cells and the expression of catenin at 24 hours following model induction in the lithium chloride group.There were more Brdu-positive cells and the expression of catenin in the center canal and adventitia of spinal cord at 1 week(P

Objective The prevention effect of CAUTI by long-acting antibacterial material JUC was evaluated by meta analysis.Methods China digital hospital library full-text database,Chinese biomedical literature CD database,China hosptial knowledge database (CHKD) in China national knowledge internet (CNKI),VIP information Chinese science and technology periodical database were retrieved to fully collect the literature from 1995 to 2012 regarding JUC's prevention effect of CAUTI.The inclusion and exclusion standard of literature was made,and the effect index was made from the literature.Two researchers collected the literatures independently,and the included literatures were meta-analyzed by Review Manager 4.2 software,and the risk difference of infection rate and 95％ CI were calculated in both the treatment group and control group.Those literatures which could not be meta-analyzed were performed descriptive analysis to evaluate the efficacy of JUC objectively.Results 20 related articles were retrieved,including 1 multicenter randomized control study,18 monocentric randomized control studies,and 1 uncontrolled study.3172 cases were included with 1526 cases in control group (usual care) and 1646 cases in treatment group (usual care with JUC).The difference between the two groups is significant (RD =-0.15,95％ CI:-0.18 ～-0.13,P ＜ 0.05).Conclusions Long-acting antibacterial material JUC can diminish the incidence of CAUTI significantly.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.

OBJECTIVE：To establish the UPLC fingerprint of Polygonum cuspidatum ，and to determine the contents of four active ingredients and to provide reference for the quality evaluation of P. cuspidatum . METHODS ：The determination was performed on Waters BEH C 18 column（100 mm×2.1 mm，1.7 μm）with mobile phase consisted of acetonitrile- 0.2％ formic acid （gradient elution ）at flow rate of 0.4 mL/min. The column temperature was 40 ℃，and detection wavelength was 290 nm. The sample size was 1 μL. The fingerprints were evaluated by similarity calculation，cluster analysis and orthogonal partial least square discriminant analysis （OPLS-DA）. Using polydatin as internal standard ，relative calibration factors of resveratrol ，emodin-8-O- β-D-glucoside and emodin were determined to develop a method of QAMS. The contents of 4 above components in 15 batches of P. cuspidatum were calculated by relative calibration factors. The results of QAMS were compared with those of external standard. RESULTS：UPLC fingerprints of 15 batches of P. cuspidatum were established ，and 12 common peaks were confirmed. Five components were identified ，i.e. polydatin ，resveratrol，emodin-8-O-β-D-glucoside，emodin，emodin methyl ether. The fingerprint similarity of 15 batches of P. cuspidatum was in the range of 0.865-0.976. According to cluster analysis ，15 batches of P. cuspidatum were classified into 4 categories，showing certain regularity of origin. Seven markers were identified by OPLS-DA method. The order of difference significance was peak 7＞emodin-8-O-β-D-glucoside＞resveratrol＞peak 8＞polydatin＞peak 1＞ peak 10. The relative deviation among the contents of resveratrol ，emodin-8-O-β-D-glucoside and emodin in 15 batches of P. cuspidatum determined by QAMS and external standard method was less than 5.0％，indicating that there was no significant difference between the two methods. CONCLUSIONS ：UPLC fingerprint combined with QAMS method is convenient and reliable for the quality evaluation of P. cuspidatum ；the quality of P. cuspidatum produced in Chongqing and Anhui province is better.