Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; Myelodysplastic Syndromes ; diagnosis ; therapy

Objective We summarized the clinical experience of modified ileal ureter substitution for treating long segment ureteral defection.Methods We retrospectively analyze the clinical data of 2 patients with long segment ureteral defect who treated with Yang-Monti ileal ureter substitution between March 2015 and November 2015.One 75 years old male patient was diagnosed as upper ureteral malignance and solitary kidney.The length of defection from renal pelvis to bladder was 22 em.His serum creatinine was 100 μmol/L,blood urea nitrogen was 5.7 mmol/L,serum chloride was 98 mmol/L.Another one 41 years old female patient was diagnosed as middle and lower ureteral iatrogenic injury.The traumatic length was 15 cm.Her serum creatinine was 70 μmol/L,blood urea nitrogen was 5.1 mmol/L,serum chloride was 100 mmol/L.they were both treated by Yang-Monti ileal ureter substitution.The ileal intestinal segment was used for the ureteral replacement,which were more than 15 cm to the ilealcecum.The length of intestine was 10.0 cm and 7.5 cm,respectively.The ileal mesentery was preserved.After closing the mesangial hiatus,the ileal segment was pull into the retroperitoneal space and pulling out via descending colonic mesangial window.The ileal segment was divided into three parts,which was 2.5 to 3.0 cm in each part.Each part was opened via long axis and then rotated 90 degree.The 4-0 absorable suture was used to suture the edge of each intestinal part continuously.The sutured intestine was re-tubularized,using 4-0 absorable suture and the F16 catheter was used as the tube model.The length of reconstructed ureter was 22 cm and 18 cm,respectively.The neo-ureter was re-anastomosed with renal pelvis and bladder wall.Two F6 double J stents were placed in the neo-ureter.Results The operative time was 160 min and blood loss was 200 ml in the first case.In the second case,the operative time was 180 min and blood loss was 220 ml.No significant complications were noticed intra-operation and post-operation.Six months after operation,the male patient's serum creatinine was 112 pmol/L,blood urea nitrogen was 6.1 mmol/L,serum chloride was 106.0 mmol/L and electrolytes were normal.In another patient,serum creatinine was 79 μmol/L,blood urea nitrogen was 5.9 mmol/L and serum chloride was 103.0 mmol/L.The GFR was 24.9 ml/min and 22.1 m]/min 3 and 6 months after operation,respectively.Ureteral obstruction wasn't detected on IVU images 3 months after operation.Conclusions For patient with long ureteral defect,which cannot be replaced by other urinary tissue,YangMonti ileal ureter substitution is one of the optional modalities.As a new technique of ureteral substitution,Yang-Monti ileal ureter substitution is simple and fewer complications and can improve the quality of life in patient compared with traditional ureteral substitution.

Objective To establish a UV spectrophotometry method and an HPLC method respectively for the determination of the total content of coumarin and contents of four main constituents of coumarin in Fraxini Cortex extract.Methods UV spectrophotometry was used for the determination of the content of total coumarin in Fraxini Cortex extract. The reference substance was Aesculin, and the maximum ultraviolet absorption wavelength was 334 nm. The HPLC method was used to determine the contents of Aesculin, Fraxin, Aesculetin and Fraxetin in Fraxini Cortex extract, using gradient elution with acetonitrile-phosphate solution (0.01%) as mobile phase on Agilent ZORBAX SB-C18 chromatographic column (4.6 mm × 250 mm, 5μm) at room temperature.Results For the UV method, the linear range of the mass concentration of Aesculin was 5.76-23.04μg/mL (r=0.999 9), and the average recovery was 100.6% (RSD=1.8%). For the HPLC method, the linear ranges of the mass of Aesculin, Fraxin, Aesculetin and Fraxetin were 0.055 0-3.850 0μg (r=0.9997), 0.053 9-3.773 0μg (r=0.999 8), 0.060 0-0.660 0μg (r=0.999 9), and 0.056 2-0.618 2μg (r=0.999 9), respectively, and the average recoveries were 96.97% (RSD=1.26%), 100.80% (RSD=2.22%), 99.04% (RSD=2.47%), and 98.77% (RSD=1.94%), respectively.Conclusion Both of the two methods are simple, accurate and reliable, and can be used for the quality control of total coumarin and the main constituents of coumarin in Fraxini Cortex extract.

The technique introduced in this paper is applied in the endocardial catheter operation, which describes the 3D heart model reconstruction before the operation for the endocardial navigation. After a series of CT images of the thorax are processed, an accurate 3D endocardial model can be reconstructed. At first, the series of 2D CT images are preprocessed for denoising and the enhancement,then they are constructed as the volume data. After the region growing segmentation in the 3D volume data according to the grey value of the voxel in the heart cavity, the heart surface rendering is got and the 3D model of endocardial cavity is reconstructed.
Cardiac Catheterization ; methods ; Imaging, Three-Dimensional ; Models, Cardiovascular ; Tomography, X-Ray Computed ; methods

Objective To study the effects of different extraction processes on extraction rate of cortex fraxini total coumarin and active constitute percentage of major coumarin;To establish a proper extraction process.Methods Orthogonal design method was applied to set comprehensive index cortex fraxini total coumarin extraction rate as inspecting index. Water and alcohol were used as solvent respectively to optimize the extraction process of cortex fraxini.Results Optimal water extraction process:cortex fraxini decoction pieces mixed with nine times of water, decocted for three times, 90 mins each time. The pasty fluid generating rate of cortex fraxini was 28.87%, total coumarin percentage was 19.26%, extraction rate was 5.56%, total percentage of Aesculin, Aesculetin, Fraxin, Fraxetin was 13.47%, when water was used as solvent. Optimal alcohol extraction process:cortex fraxini decoction pieces mixed with eight times of 75% ethyl alcohol, refluxed twice, two hours each time. The pasty fluid generating rate of cortex fraxini was 30.47%, total coumarin percentage was 21.72%, extraction rate was 6.62%, total percentage of Aesculin, Aesculetin, Fraxin, Fraxetin was 15.29%, when alcohol was used as solvent. It was found that using alcohol as solvent had a 5.54% higher pasty fluid generating rate, a 12.77% higher total coumarion percentage, a 19.06% higher total coumarin extraction rate, and a 13.51% higher percentage of total four coumarin constitutes than using water, with statistical significance. Conclusion Extraction process by using alcohol as solvent is better than using water. So the optimal and stable extraction process of cortex fraxini total coumarin is using 75% alcohol as solvent.

Objective To study the determination method of total flavonoids in Gansu Astragali Radix and Hedysarum Polybotrys. Methods Calycosin glycosides etc. was selected as reference substances, comparison on the difference of absorption curves was done by ultraviolet spectroscopy and colorimetric method (NaNO2-Al(NO3)3-NaOH, AlCl3, Mg(Ac)2, NaOH, phosphomolybdic acid, HCl-Mg power). Results With colorimetric method, the maximum absorption wavelength of referrence and the test was inconsistent. The absorption peak shape was also different. With UV method, Calycosin glycosides in band Ⅱ (260 nm) showed a shoulder absorption. Astragali Radix and Hedysarum Polybotrys also showed characteristic shoulder absorptions in band Ⅱ with absorption wavelength at 263 nm and 265 nm. So the sample absorption wavelength is basically the same as that of the control sample. Conclusion Colorimetries usually used for determination of total flavonoids are not suitable for the comparison determination of Gansu Astragali Radix and Hedysarum Polybotrys. It is suitable for determining the contents of total flavonoids in samples by UV spectrophotometry at the band Ⅱ, which is the characteristic absorption band of isoflavone compound.

OBJECTIVETo observe the expression of phospholipid scramblase 1 (PLSCR1) in matrine (MAT) induced differentiation of all-trans retinoic acid (ATRA) resistant acute promyelocytic leukemia (APL) cells, and to explore its correlation to cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signal pathway.

METHODSNB4 (an APL cell line sensitive to ATRA) and NB4-R1 (a resistant strain of ATRA) were observed as subjects in this study. Effects of combined treatment of 0.1 mmol/L MAT and 1 [mol/L ATRA on the differentiation of two cell lines were detected using nitroblue tetrazolium (NBT) reduction test and flow cytometry (CD11b). Expressions of PML/RARot and PLSCR1 protein/gene were detected using Western blot and Real-time fluorescence quantitative PCR assay. Meanwhile, H89, PKA antagonist, was used to observe cell differentiation antigen and changes of aforesaid proteins and genes.

RESULTSMAT combined ATRA could significantly elevate positive rates of NBT and CD11 b in NB4-R1 cells, and significantly down-regulate the expression of PML/RARapha-fusion protein/gene (P < 0.05, P < 0.01). ATRA used alone could obviously enhance the expression of PLSCRI in NB4 cells at protein and mRNA levels (P < 0.01). But the expression of PLSCR1 was up-regulated in NB4-R1 cells, but with statistical.difference only at the protein level (P <0. 01). In combination of MAT, PLSCR1 protein expression was further elevated in the two cell lines (P < 0.01). Besides, there was statistical difference in mRNA expressions in NB4-R1 cells (P < 0.05). All these actions could be reversed by treatment of 10 micromol/L H89 (P < 0.05, P < 0.01).

CONCLUSIONMAT combined ATRA could significantly induce the differentiation of NB4-R1 cells, and inhibit the expression of PML/RARalpha fusion gene/protein, which might be associated with up-regulating PLSCR1 expression.

Alkaloids ; Antineoplastic Agents ; Cell Differentiation ; Cell Line, Tumor ; Down-Regulation ; Humans ; Leukemia, Promyelocytic, Acute ; metabolism ; Phospholipid Transfer Proteins ; metabolism ; Quinolizines ; RNA, Messenger ; Signal Transduction ; Tretinoin ; Tumor Cells, Cultured ; Up-Regulation

This paper analyses the data structure of DICOM standard by the applications in the Non-DICOM format fluoroscopic images converted into the DICOM format images. It puts forward a solution to integrate the Multi-Channel Electrophysiology Recorder System with the X -ray system in the cardio-catheter room.
Computer Communication Networks ; Diagnostic Imaging ; instrumentation ; methods ; Electrophysiologic Techniques, Cardiac ; instrumentation ; Fluoroscopy ; instrumentation ; Humans ; Image Processing, Computer-Assisted ; instrumentation ; methods ; standards ; Information Storage and Retrieval ; Radiology Information Systems ; standards ; Software Design ; Video Recording ; instrumentation ; methods ; standards

OBJECTIVETo study the accuracy of position estimation of right-sided double-lumen endobronchial tubes (DLTs) without carinal hook in elderly patients according to the changes of inspiratory peak airway pressure (Ppeak), lung compliance (Cdyn), pressure-volume loop (P-V loop), and flow-volume loop (F-V loop).

METHODSNinety-six elderly patients undergoing thoracic surgery were intubated with right-sided Mallinckrodt DLTs, the depth of which was determined based on the regressive equation. After 15 min of two lung ventilation (TLV), the Ppeak showed a more than 50% increase from the baseline in 22 patients when switching to one lung ventilation (OLV) with Cdyn less than 50% of the baseline and Ppeak in excess of 22 cmH(2)O. In these 22 cases, the position of the DLT was determined by fiberoptic bronchoscope (FOB) and adjusted to the precise position at 15 min of OLV.

RESULTSDLTs were inserted into the right middle bronchi in 19 cases and the right lower lobe bronchi in 3 cases. At 124-/+39 s after OLV, the SpO(2) began to decrease, and the Ppeak of OLV increased by 91.0% and Cdyn decreased by 62.7%. The slope of P-V curve was reduced and the P-V loop extended, with reduced increment of the expiratory limb and the area of the F-V loop, so that the tips of the DLT were withdrawn by 0.5 to 1.9 cm. The Ppeak of OLV increased only by 43.4% when DLT was in correct position, and was Cdyn decreased by 33.6% ( P<0.01).

CONCLUSIONWhen changes of Ppeak and Cdyn in excess of above guidelines occurs after switching from TLV to OLV in the elderly patients, FOB should be applied to determine the tip position of DLT before SpO(2) reduction takes place.

Aged ; Bronchoscopy ; methods ; Female ; Fiber Optic Technology ; Humans ; Intubation, Intratracheal ; adverse effects ; methods ; Male ; Respiratory Mechanics ; Spirometry ; Thoracic Surgical Procedures

OBJECTIVETo investigate the clinical effect of Chinese herbal medicine combined with auto-hemopoietic stem cell transplantation for refractory severe autoimmune disease (RSAID).

METHODSAuto-hemopoietic stem cell transplantation was conducted for the treatment of 7 patients with RSAID, including 4 cases of systemic lupus erythematosus (SLE), 2 myasthenia gravis (MG) and 1 polymyositis (PM) with the FAC program (consisting of fludarabine, antithymocyte globulin, and cyclophosphamide FAC) as for pretreatment. Traditional Chinese medicine (TCM) was given orally after transplantation to patients according to their syndrome type.

RESULTSThe hemopoiesis function was smoothly re-established in all patients, with their clinical symptoms and signs obviously improved, laboratory indexes negatively conversed or obviously decreased, and withdrawal or dose reducing of medicines.

CONCLUSIONCombined use of TCM after auto-hemopoietic stem cell transplantation can accelerate patients' hemopoiesis function re-establishment, with significant effects in reducing complications, improving clinical symptoms and signs.

Adolescent ; Adult ; Antilymphocyte Serum ; therapeutic use ; Autoimmune Diseases ; therapy ; Combined Modality Therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Lupus Erythematosus, Systemic ; therapy ; Male ; Middle Aged ; Phytotherapy ; Transplantation, Autologous ; Treatment Outcome ; Vidarabine ; analogs & derivatives ; therapeutic use ; Young Adult