Objective: To evaluate the significance of occlusion of hemihepatic inflow plus major ipsilateral hepatic veins in anatomic hepatectomy. Methods: One hundred and two cases were divided into 3 groups for anatomic hepatectomy: Group A (hemihepatic inflow plus major hepatic vein occlusion, n=42), Group B (hemihepatic inflow occlusion, n=30)and Group C (Pringle maneuver, n=30). The amount of intraoperative bleeding, time of operation, postoperative liver function, liver function recovering and complications were compared. Results: The average amount of hemorrhage in Group A, Group B and Group C were(453.5?87.9)、(612.8?101.6)and(646.7?136.6)mL, respectively. The mean blood loss in Group A was significantly more than that in Group B and Group C (P0.05). The levels of serum alanine transaminase (ALT)and bilirubin of 3rd and 6th day of postoperation in Group A and Group B were significantly lower than that in Group C, while the level of serum albumin in Group A and Group B was significantly higher than that in Group C(P0.05). Incidence of ascites in Group C was significantly higher than in Group A and Group B (P

Objective Clinical reports on perilymphatic fistulae(PLF) of the round window membrane(RWM) have shown different degrees of hearing loss. For the unknown mechanisms of hearing loss, the morphological changes of cochlea with perilymphatic fistulae(PLF) was studied.Methods Among 10 guinea pigs, each ear on one side was punctured and the ear of another side was used as control. 4 hours after operation, the morphological changes of cochlea were observed.Results It was found that 2 ears with endolymphatic hydrops, 1 ear with strica vascularis stripped, venous hyperemia and hemorrhage in cochlea, 7 ears with no changes.Conclusion The study suggestes that the normal and the abnormal morphological changes of cochlea can all be seen after the rupture of RWM.

0.05).The birth weight in PIH group and the asphyxia incidence rate in PROM group were lower than those in the other groups(P0.05).However,the incidence of abnormal cruor was significantly higher in the placental abruption group than that in other groups(Pa

Objective To investigate the effect of the teaching modes based on problem-based learning (PBL) and lecture-based learning (LBL) in clinical practice of hepatobiliary surgery.Methods 166 5-year program students were divided into 2 groups:PBL group (n=83)and LBL group (n=83).The performance in interrogation,physical examination,medical records and theoretical tests were analyzed.Results PBL group had better performance in all the above aspects compared to LBL group (P<0.05).Conclusions The teaching mode based on PBL is a good method,which Can inspire the students and improve their ability to solve problems in clinical practice of hepatobiliary surgery.

Fructose-1, 6-bisphosphatase (FBPase), a rate-limiting enzyme involved in the pathway of gluconeogenesis, can catalyze the hydrolysis of fructose-1, 6-bisphosphate to fructose-6-phosphate. Upon inhibiting the activity of FBPase, the production of endogenous glucose can be decreased and the level of blood glucose lowered. Therefore, inhibitors of FBPase are expected to be novel potential therapeutics for the treatment of type II diabetes. Recent research efforts were reviewed in the field of developing allosteric inhibitors interacting with the AMP binding site of FBPase.

Objective To investigate the diagnosis and treatment of functional pancreatic endocrine tumors (PETs). Methods The clinical data of 45 patients with functional PETs who were admitted to the Southwest Hospital from January 1998 to December 2008 were retrospectively analyzed. Etiologic and localization diagnosis were made preoperatively according to the manifestation and the results of color doppler ultrasound and computed tomography, respectively. Eight patients received resection of the body and tail of the pancreas and spleen, 32 received tumor enucleation, one received resection of the pancreaticobiliary junction and four received pancreaticoduodenectomy. All patients received chemotherapy after the operation. Results Thirty-four cases of the PETs were benign and the rest eleven cases were malignant. Eight cases of the PETs were in the head of the pancreas,26 in the tail of the pancreas, seven in the body of the pancreas and four cases were with multiple PETs. The diameters of the PETs were 0. 3-5.0 cm, and the diameters of the PETs in 19 cases were above 2.0 cm. Eight patients were complicated with pancreatic leakage, two with incision infection and one with abdominal infection. Of the 33 patients with insulinoma, the blood glucose of five patients with multiple PETs was still abnormal after the operation, three patients underwent reoperation and the other two were treated by diazoxide to control the blood glucose in the normal range. The clinical symptoms of the seven patients with gastrinoma disappeared after the operation, and the gastric ulcer was healed, the 12-hour gastric juice volume and the level of the gastric acid were in the normal range after a continuous treatment with proton pump inhibition agents for 6 months. Necrotizing or migratory rash and diabetes of the four patients with glucagonoma were cured three weeks later, and the level of the amino acid was back to normal. Diarrhea and electronic disturbance of one patient with vasoactive intestinal peptide tumor were alleviated after the operation. Thirty-nine patients were followed up for 20-120 months. Of the 32 patients with benign PETs, two patients had tumor recurrence, and three patients died of other diseases. Of the seven patients with malignant PETs, two patients survived, and three patients died of hepatic metastasis or tumor recurrence, two patients died of other diseases. Conclusions Surgical treatment is effective for the treatment of functional PETs. Palliative resection of the tumor also can obviously improve the life quality of patients with fuctional PETs.

Objective To investigate the distribution of high-arsenic drinking water in Honghu city of Hubei province in order to provide a scientific basis for prevention and control of endemic arsenic disease.Methods Investigations were made in 22 townships(towns,districts),68 natural villages of the drainage areas of the Dongjing River,the Neijing River and the Yangtse River in 2006 and 2007,with the townships(towns,districts)around Shahu town in Xiantao city as the focal point.1000 water samples were drawn each year,which was 10% of all the wells in every natural village.Using sampling investigation,water arsenic Was determined by half-quantitative fast reagent kit.All samples of water with arsenic exceeding the standard(≥0.03 mg/L)were re-determined according to state standard.Surveys on the disease was carried out in the villages(brigades)where arsenic exceeded the standard.Results A total of 2000 samples were surveyed from 68 natural villages,of which there were 401 samples from 48 villages exceeding the standard in a rate of 20.05%(401/2000).The highest arsenic content Was 0.71 mg/L.The high arsenic water sources were distributed mainy in the drainage areas of the Dongjing River and the Neijing River,but no patients with endemic arsenic disease were found.Conclusions The high arsenic water sources are distributed mainly in the drainage areas of the Dongjing River and the Neijing River.It is suggested that the interrelated government departments should take precise measures to impmve the quality of drinking water and ensure safe water to the residents in high arsenic areas.

Objective To study the clinical value and the safety of endoscopic retrograde cholangio-pancreatography(ERCP)for chronic pancreatitis in the pediatric population.Methods Clinical data,endo-scopic reports,and radiography of chronic pancreatic patients aged from 2 to 17 years old who underwent ERCP between Jan.1,2008 and Apr.30,2014 at Endoscopy Center of Ruijin Hospital were reviewed.These patients were divided into 3 groups,patients aged from 2 to 6 years old as children group(n =27),patients aged from 7 to 12 years old as juvenile group(n =35)and patients aged from 13 to 17 as adolescent group(n =25). Their clinical data and complications were analyzed by groups.Results A total of 170 ERCP procedures were performed in 87 patients,with the success rate of 99.4%(169 /170).All patients were diagnosed as having chronic pancreatitis by ERCP.Success rates of children group,juvenile group and adolescent group were 97.6%(40 /41),100.0%(72 /72)and 100.0%(57 /57)respectively.There was no statistically significance among the three groups(P =0.207).No serious complications like bleeding or perforation occurred.No proce-dure-related mortality occurred in this study either.The rate of post-ERCP adverse events in children group, juvenile group and adolescent group were 41.5%(17 /41),25.0%(18 /72)and 24.6%(14/57),respective-ly.Children group had more adverse events than the juvenile group(P =0.039)and adolescent group(P =0.045).Conclusion Pediatric ERCP is highly effective in the pediatric population with chronic pancreatitis. The incidence of post ERCP adverse events is higher among the youngest children.

OBJECTIVETo observe the clinical effect of Yangyin Yiqi Huoxue Recipe (YYHR, the basic recipe of Yangyin Tongnao Granule) in treatment of ischemic stroke patients of deficiency of qi and yin syndrome (DQYS) and static blood obstructing collaterals syndrome (SBOCS).

METHODSTotally 312 patients were assigned to the control group (86 cases) and the treatment group (226 cases) using strati- fied randomized allocation method. Patients in the treatment group were treated with modified YYHR, while those in the control group took Xueshuan Xinmaining. The treatment course was 4 weeks for all. Constituent ratios of the acute stage and the recovery stage of DQYS and SBOCS and their complicated syndromes were observed in the two groups. Changes of the clinical curative effect, clinical symptoms integral, whole blood viscosity ratio, plasma viscosity ratio, hematocrit, erythrocyte sedimentation rate (ESR), total cho- lesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were detected in the two groups before and after treatment.

RESULTSThere was statistical difference in constituent ratios of the acute stage and the recovery stage of DQYS SBOCS and its complicated syndromes between the two groups (P < 0.01). DQYS and SBOCS was basic syndrome types of the two groups. The cured and markedly effective rate was 71.24%(161/226) in the treatment group and 43.02% (37/86) in the control group. The total effective rate was 91.15% (206/226) in the treatment group, higher than that of the control group (76.74%, 66/86) with statistical difference (P < 0.01). There was statistical difference in the clinical symptoms integral, whole blood viscosity ratio, plasma viscosity ratio, hematocrit, ESR, TC, TG,HDL-C, and LDL-C (P < 0.05, P < 0.01).

CONCLUSIONSSymptoms of ischemic stroke patients could be improved by modified YYHR. Indices such as the whole blood viscosity, plasma viscosity ratio, hematocrit, ESR, abnormal metabolism of blood lipids were also significantly improved. Pathological changes of blood stasis induced by qi-yin deficiency exist in ischemic stroke patients, and DQYS and SBOCS were basic syndrome types.

Aged ; Biomedical Research ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hematocrit ; Humans ; Male ; Middle Aged ; Qi ; Stroke ; drug therapy ; Triglycerides ; blood ; Yin Deficiency ; therapy

The aim of the present studies was to investigate the cardioprotection of late IP at 72 h and determine the involvement of iNOS, nNOS and COX-2 in this protection. Conscious rabbits were preconditioned with three cycles of 5-minute coronary occlusion/5-minute reperfusion. The myocardial infarct area in the rabbits preconditioned 72 h earlier was significantly smaller than that in control rabbits. The activity of lactate dehydrogenase (LDH) and the level of 6-Keto-PGF1alpha in the rabbits preconditioned 72 h earlier were lower than those in control rabbits. The left ventricular systolic pressure (LVSP) and maximal velocity of contraction and relaxation (+/- dP/dtmax) were improved in rabbits preconditioned 72 h earlier. The nNOS-selective inhibitors N-propyl-L-arginine and selective cyclooxygenase-2 (COX-2) inhibitor celecoxib completely blocked the protection of late IP at 72 h, whereas the iNOS selective inhibitor S-methybisothiourea had no effect. In conclusion, the cardioprotection observed in the final stage of late IP (72 hours) is mediated by nNOS or COX-2, but not by iNOS.
Animals ; Cyclooxygenase 2 ; metabolism ; physiology ; Ischemic Preconditioning, Myocardial ; Male ; Myocardial Infarction ; enzymology ; pathology ; prevention & control ; Myocardial Reperfusion Injury ; enzymology ; metabolism ; prevention & control ; Nitric Oxide Synthase Type I ; metabolism ; physiology ; Rabbits ; Random Allocation ; Time Factors