Objective To analyze the clinical data of patients with post-hepatectomy haemorrhage (PHH) and to discuss the treatment strategies.Method The clinicopathologic data of patients with PHH between 2005-2014 in the HPB Surgery Ward I,Peking University Cancer Hospital,were studied retrospectively.Results In the study period of 10 years,25 of 1 548 patients who underwent hepatectomy suffered from PHH,and 76％ (19/25) of these patients had underlying liver diseases.The common surgical operations followed by PHH were right hemihepatectomy (11/25),and segment Ⅶ/Ⅷ resection (8/25).The median time for PHH to be diagnosed was 27 h,and the median time from diagnosis of postoperative bleeding to reoperation or intervention was 3.5 h.Using the classification of PHH by the International Study Group of Liver Surgery (ISGLS),there were 1 patient in grade A,16 patients in grade B,and 8 patients in grade C.The perioperative mortality of PHH was 8％ (2/25).The most common bleeding site was from the hepatic artery.Conclusions PHH is a serious complication after liver resection,with low occurrence but high mortality.Most patients with PHH can be managed by conservative treatment.Emergency reoperation is required when instability in vital signs appears.Careful evaluation before operation,strict hemostasis during operation,and close monitoring after operation can effectively reduce the incidence and mortality of PHH.

Objective To evaluate the feasibility and clinical outcomes of second sacral alar-iliac (S2AI) technique utilized in patients with tuberculosis of Lumbosacral spine.Methods 24 cases (15 male,9 female,aged 36-73 years old,average 47.1 years) of tuberculosis of Lumbosacral spine were collected for surgery using spinal and pelvic fixation system (S2AI or IS) between January 2014 and May 2016.Lumbosacral pain and restricted movement were noticed in all cases,of which 9 cases with radiating pain of lower limb and 7 cases with intermittent claudication,2 cases with saddle anesthesia.Formal anti-tuberculosis medicine treatment was given for at least 2-3 weeks before operation.All patients with lumbosacropelvic fixation were compared by recording with ESR/CRP,preoperatively,postoperatively and the last following-up.The clinical effect oswestry disability index (ODI) score,visual analogue scale (VAS),ambulatory status,SF-36 scale and related complications of 2 groups were also compared.Results The average follow-up period was average 23.4 months in the two groups.The results show that operative time,blood loss,drainage time,hospitalization days and fusion time were not statistically significant;the recording of ESR,CRP,ODI,VAS scores and ambulatory status scores between S2AI and IS groups showed no significantly different,preoperatively,postoperatively and the last following-up.Comparisons within each group were improved at postoperatively and the last following-up related to preoperatively;The difference of the SF-36 scales in each group was statistically significant between preoperatively and the last following-up;There was no statistically difference in recurrence,sinus,pseudarthrosis between two groups,but The S2AI technique was associated with lower rates of symptomatic screw prominence compared to the IS technique.Conclusion Application of S2AI screw technique in the treatment of lumbosacral tuberculosis can achieve solid fixation and satisfactory clinical effect,and reduce the complications of traditional IS screws,which is an alternative method of posterior structure reconstruction of lumbosacral tuberculosis.

Objective:To investigate the influence of sCD80-Linker-sCD40L fusion protein on the unspecific anti- tumor immunity in vitro.Methods:Ovarian cancer SKOV3 cells were separately transfected with recombinant adenoviral vectors containing sCD80-Linker-sCD40L fusion gene,sCD80 gene,sCD40L gene or with control adenovirus.The expres- sion of the sCD80-Linker-sCD40L fusion protein,sCD80 protein and sCD40L protein in the supernatants of SKOV3 cells was determined by ELISA.Dendritic cells(DCs)were cultured with peripheral blood mononuclear cells from a patient with ovarian carcinoma.DCs and autologous T cells were co-cuhured and were exposed to different supernatants for 48 h. The allostimulatory effects of DCs on T cells were determined by mixed lymphocyte reaction(MLR).The unspecific kill- ing activities of induced T cells against SKOV3/K562 cells were measured by LDH-releasing assay.Results:ELISA assay showed that levels of the sCD80-Linker-sCD40L fusion protein,sCD80 protein and sCD40L protein in the supernatants of transfeced SKOV3 cells were 2.791 ng/ml,1.956 ng/ml and 1.407 ng/ml,respectively.The fusion protein-exposed DCs ([0.382?0.053]vs[0.167?0.028],P

OBJECTIVETo investigate the feasibility and effect of different types of axial pattern flaps in repairing soft tissue defects of the fingers.

METHODSFive types of axial pattern flaps were used to repair soft tissue defects of the fingers of 30 patients admitted to the Second Hospital of Shaoxing Municipality from 2005 to 2010, including distally-based dorsal thumb neurocutaneous vascular flaps in 4 cases, free flaps from the fibular side of the great toe in 6 cases, modified retrograde dorsal metacarpal artery flaps in 8 cases, free flaps based on the radial dorsal septum muscular perforator of the posterior interosseous artery in 6 cases, and free posterior interosseous artery flaps carrying a long segment of the posterior interosseous artery in 6 cases. The flap size ranged from 2.5 cm × 2.0 cm to 8.0 cm × 3.0 cm. The donor sites were sutured directly or covered with skin graft. The condition of flaps was observed. The local feeling, function, and appearance of affected hands were followed up.

RESULTSTwenty-seven flaps grew well without infection. Partial necrosis at the distal portion in two flaps and venous congestion in 1 flap were observed after surgery, and they were healed with suitable treatment. Eighteen patients were followed up for 1 to 12 months. The flaps were found to have good color, texture, and thickness. Satisfactory appearance and function both in the donor sites and in the recipient areas were found in most patients. The sense of two-point discrimination of repaired fingers ranged from 5 to 9 mm.

CONCLUSIONSOptimizing the repair method for soft tissue defects in the fingers by taking both the characteristics of various axial pattern flaps and the specific conditions of soft tissue defects into account can achieve expected effect.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Young Adult

Clinical guideline is of important significance to standardize clinical practice. Clinical guideline of evidence-based medicine puts stress on the classification and evaluation of evidences, especially in randomy controlled trial and gives recommendation based on the different grades and intensities of evidences. Since Chinese medicine has its own theoretical system in diagnosis and treatment, and the integrative Western and Chinese medicine (ICWM) is characterized by complicated intervention, making up a clinical guideline for Chinese medicine or ICWM based on the evidence obtained from modern medical research is apparently not so suitable. In this paper, the authors offered to develop a practice-based ICWM clinical guideline, which could be used in complementation with the evidence-based medical clinical guideline, and have a discussion on our preliminary research, looking forward to provide a new thinking path for constructing clinical guideline for Chinese medicine, ICWM and modern medicine.
China ; Data Collection ; Evidence-Based Medicine ; Humans ; Integrative Medicine ; standards ; Medicine, Chinese Traditional ; standards ; Practice Guidelines as Topic

Objective To explore the effects of the community-based rehabilitation on schizophrenia. Methods 100 patients with schizophrenia from 4 communities were assigned to intervention group (n=50) and control group (n=50). The intervention group accepted comprehensive intervention for 6 months. All the patients were followed up for 12 months, and assessed with the Positive and Negative Symptoms Scale (PANSS), Personal and Social Function Scale (PSP), the General Quality of Life Inventory (GQOLI-74). Results 48 cases of the intervention group and 44 of the control group finished the study. The scores of negative symptoms and general spirit pathology were less in the intervention group than in the control group (P<0.01). The score of PSP was more in the intervention group than in the control group (P<0.01), as well as the total score and score of dimensions of physical function, mental health and social function (P<0.05). Conclusion Community-based rehabilitation can control the mental symptoms, and improve the social function and the quality of life of patients with schizophrenia.

OBJECTIVETo assess the recovery of the reproductive endocrine function in rats following orthotopic transplantation of fetal ovarian allograft.

METHODSNinety female SD rats (50-60 days old) were randomized into graft recipient group (n=50), positive control group (n=20), and negative control group (n=20) to receive orthotopic transplantation of fetal (17-19 gestational days) ovaries following bilateral oophorectomy, sham abdominal surgery, and bilateral oophorectomy, respectively. At 45 days after the surgeries, serum estradiol and progesterone levels were measured and the ovaries were removed for evaluation of the ovarian volume and follicle development.

RESULTSOn day 45 after the operations, the estradiol or progesterone levels showed no significant difference between the recipient group and positive control group (P>0.05), but both were significantly lowered in the negative control group (P<0.05). The ovarian volume was comparable between the recipient group and positive control group (P>0.05), and optical microscopy showed follicles in different stages of development and formation of corpus luteum in the ovaries in both groups.

CONCLUSIONFetal rat ovary allografts can develop into functional ovaries capable of ovulation to restore the reproductive endocrine function of recipient female rats.

Animals ; Estradiol ; blood ; Female ; Fetus ; Ovariectomy ; Ovary ; physiology ; transplantation ; Ovulation ; physiology ; Pregnancy ; Progesterone ; blood ; Rats ; Rats, Sprague-Dawley ; Transplantation, Homologous

AIMTo study the characteristic pattern of the age-related growth of the human prostate gland.

METHODSThe volume (weight) of the prostate in 1,601 males, aged from newborn to 92 years, was determined by B-ultrasonography.

RESULTSProstatic volume determination by B-ultrasonography in 1601 males (1301 normal subjects and 300 BPH patients) pointed out that the age-stratified growth of human prostate could be categorized into 4 life stages: (1) the first slow growing phase (from newborn to 9 years): the prostate grows slowly at a rate of 0.14 g per year; (2) the first rapid growing phase (from 10 to 30 years): the prostate grows at a rate of 0.84 g per year; (3) the second slow growing phase (from 30 to 50 years), the prostate grows at a rate of 0.21 g per year; (4) the second rapid growing phase (from 50 to 90 years): the prostate grows at one of the following rates: in one group the growth rate is of 0.50 g per year and in the other 1.20 g per year, leading to benign prostatic hyperplasia (BPH).

CONCLUSIONThe volumes of the prostate are different in different age groups and it grows with age at different rates in four life phases. The prostate growth in phases can be expressed by the following equation: Y=19.36+1.36X'-0.58X'(2+0.33X'3), where Y = prostate volume, X = age (up to 70 years), X'=(X-35.5)/10.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aging ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Organ Size ; Prostate ; anatomy & histology ; diagnostic imaging ; growth & development ; Ultrasonography

OBJECTIVETo look for the evidences of motilin receptor expression on interstitial cells of Cajal (ICC) of the rabbit.

METHODSmooth muscle segments with ICC were isolated from the small intestine of 10-day old rabbits. The tissue segments equilibrated in Ca(2+)-free Hanks' solution were dispersed with an enzyme solution containing collagenase type II and then Ficoll density centrifugation was used to dissociate ICC. The cells were suspended and cultured in the M199 medium. The c-kit antibody was applied to distinguish the cultured ICC. The motilin receptor was identified by immunocytochemical assay with GPR38 antibody, c-kit antibody and hoechst 33342 combined to label ICC. Cells cultured for a few days were sorted for ICC with c-kit stained green fluorescent through flow cytometry. The total RNA and proteins extracted from the sorted ICC were respectively used to verify motilin receptor on the ICC by reverse-transcriptase polymerase chain reaction (RT-PCR) and Western blotting.

RESULTWe had successfully dissociated and cultured ICC of rabbit small intestine in vitro. Fluorescent staining with c-kit antibody confirmed that the culture ICC was successful. Triple-labeled immunofluorescent staining had detected the motilin receptor on membrane of ICC. Flow cytometry analysis showed that the ratio of c-kit positive cell in the cultured cells was 64.3%. The number of sorted ICC was 6.7 × 10(5) and 5.6 × 10(6). The results of RT-PCR and Western blot confirmed that the ICC had motilin receptor expression.

CONCLUSIONOur study demonstrated presence of motilin receptor on ICC of the rabbit. The present results may suggest that ICC play an important role in gastrointestinal movement induced by motilin.

Animals ; Cells, Cultured ; Interstitial Cells of Cajal ; metabolism ; Intestine, Small ; cytology ; Rabbits ; Receptors, Gastrointestinal Hormone ; metabolism ; Receptors, Neuropeptide ; metabolism

The purpose of this study is to investigate the transdermal delivery characteristics of Gentiana macrophylla complex components system through different parts of the skin under micro-needles conditions. Two-chamber diffusion cells were used, different parts of isolated skin and micro-needle pretreated isolated mouse skin were applied separately, high performance liquid chromatography (HPLC) similarity evaluation methods were used to evaluate transdermal delivery characteristics of Gentiana macrophylla complex components system on receiving pool and the permeation rate and penetration amount of Gentiopicroside at different parts of mouse skin. In the 24 h, the similarity between receiving fluid which was on passive transdermal delivery and micro-needle transdermal delivery conditions and original fluid were ranged from 83.0% to 98.9%; By the micro-needle pretreatment with different parts of the mouse skin, the time that Gentiana macrophylla complex components system though abdominal skin to the receiving fluid which reached 90% similarity compared with that of original fluid was 4 h, which was 18 h at back skin and 12 h at neck skin separately. Micro-needles can be used as the ideal ingredients for traditional Chinese medicine complex transdermal delivery; transdermal absorption time delay could be greatly reduced and its bioavailability was improved. The permeation rate and similarity to original liquid of Chinese medicine complex components increased significantly in the abdominal skin relative to the neck and back skin under micro-needle conditions.
Administration, Cutaneous ; Animals ; Biological Availability ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacokinetics ; Gentiana ; chemistry ; Iridoid Glucosides ; pharmacokinetics ; Mice ; Needles ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Skin Absorption