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 retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced (VNE) dual-energy computed tomography (CT), and to evaluate the possibility of VNE images in diagnosis for those lesions.Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced (TNE) phase and arterial phase were performed with single-energy CT (120 kVp) and portal venous phase was performed with dual-energy CT (100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio (CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate (SSDE) were also calculated.Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images (164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR (10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR (17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images (0.69±0.88 vs. 0.72±0.85 cm, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30 (23.4%) lesions, lighter density in 88 (68.8%) lesions, while failed to show 10 (7.8%) lesions, and showed the same size in 61 (47.7%) lesions and smaller size in 57 (44.5%) lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mSv, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 mSv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively.Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cmcould be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.

OBJECTIVETo observe the therapeutic effect of integrative traditional Chinese and Western medicine in treating patients with pulmonary infection after renal transplantation.

METHODSThirty-four inpatients were randomly divided into the treated group (n=18) and the control group (n=16). They were treated with conventional therapy, including corticosteroid, anti-viral, anti-bacterial, symptomatic and supporting therapy, to the treated group, the modified qingwen baidu decoction (MQBD) was administered additionally.

RESULTSFifty of the 18 patients in the treated group were cured, 2 improved and 1 died, the cure rate being 83.3% and the total effective rate 94.4%; while 8 of the 16 patients in the control group were cured, 2 improved and 6 died, the cure rate being 50.0% and the total effective rate 62.5%, comparison between these two groups showed significant difference (P < 0.05).

CONCLUSIONPromising effect could be obtained for treatment of patients with pulmonary infection after renal transplantation by adding MQBD, a Chinese herbal medicine for clearing heat and detoxication, cooling blood and removing fire, on the basis of conventional western medical treatment.

Adrenal Cortex Hormones ; therapeutic use ; Adult ; Anti-Infective Agents ; therapeutic use ; Drug Administration Schedule ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Kidney Transplantation ; adverse effects ; immunology ; Male ; Middle Aged ; Phytotherapy ; Pneumonia ; drug therapy ; etiology

Objective To investigate the clinical diagnosis,treatment and prevention of fallopian tube prolapse(FTP)after hysterectomy.Methods A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital,including 6229 cases of trans-abdominal hysterectomy(TAH),780 cases of transvaginal hysterectomy(TVH),and 940 cases of laparoscopic assisted vaginal hysterectomy(LAVH).Nine cases(including 1 case from other hospital)of FTP after hysterectomy were analyzed retrospectively for their symptoms,diagnosis and treatment.All of them were diagnosed according to the results of histology and follow-up.Results The overall incidence of FTP after hysterectomy was 0.11%(9/7949).Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229),after vaginal hysterectomy 0.51%(4/780),and after laparoscopic assisted vaginal hysterectomy 0(0/940).There were no symptoms in 3 cases,but the other 6 cases had symptoms.The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases.All of them were excised vaginally and cauterized.The results were confirmed by histological examination.No recurrent cases were reported in follow up.Conclusions FTP is a rare complication after hysterectomy.The prognosis is well after proper diagnosis and treatment.Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.

Objective To establish the chick embryo chorioallantioc membrane(CAM)as a model for in vivo research on endometriosis.The model was used to investigate the mechanism of anti-vascular endothelial growth factor(VEGF)antibody for treatment of endometriosis.Methods Human endometrial fragments were explanted onto the CAM.Then anti-VEGF antibody was used for the endometriosis-like lesions after transplantation of human endometrial fragments.The CAM models were treated respectively as control groups and experimental groups.The terminal deoxynucleotidyl transferase-mediated biotin- deoxyuridine triphosphate(dUTP)nick end labeling(TUNEL),proliferating cell nuclear antigen(PCNA) and microvessel density(MVD)were used in vivo for analysis of anti-angiogenesis.Results The apoptosis intensity of anti-VEGF antibody treated groups(6.7?0,9,6.9?0.8)was significantly higher than that of the control groups(5.0?0.9,5.4?1.1;P

OBJECTIVETo explore the effect and mechanism of Danshao Granule (DSG) in treating Henoch-Schonlein purpura nephritis (HSPN) in children.

METHODSThe 63 patients with HSPN were randomly divided into two groups. The 32 patients in the treated group were treated with DSG and the 31 patients in the control group were treated with Tripterygium polyglycosides tablet and composite Salviae tablet. The therapeutic course for both groups was one month. The skin purpura, macroscopic hematuria, hypertension and edema subsidence time, 24 hrs urinary protein content, serum levels of immunoglobulins (IgA, IgG, IgM), superoxide dismutase (SOD) activity and malonyldialdehyde (MDA) content were observed before and after treatment.

RESULTSTherapeutic effect in the treated group was better than that in the control group in curing skin purpura and macroscopic hematuria (P < 0.05). The 24 hrs urinary protein content and serum levels of IgA, SOD and MDA were improved after treatment in both groups significantly (P < 0.01). However, the improvement of 24 hrs urinary protein, serum SOD and MDA in the treated group was more significant than that in the control group respectively (P < 0.05).

CONCLUSIONDSG can alleviate the injury of free radicals in organism, so it is an ideal remedy for treatment of HSPN.

Adolescent ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Malondialdehyde ; blood ; Nephritis ; blood ; drug therapy ; etiology ; Phytotherapy ; Purpura, Schoenlein-Henoch ; blood ; complications ; drug therapy ; Salvia miltiorrhiza ; Superoxide Dismutase ; blood

OBJECTIVETo observe the effect of electro-acupuncture (EA) on alteration of immune function of patients undergoing open-heart surgery with cardiopulmonary bypass (CPB), and to appraise the value of acupuncture-drug compound anesthesia in the operation.

METHODSThirty patients undergoing atrial septal defect repairing operation were selected and divided into three groups, Group A was the general anesthesia group; Group B, the acupuncture anesthesia group and Group C, the general anesthesia plus EA group. Peripheral venous blood of patients was collected at different time points, i.e. before anesthesia, before CPB, 30 min and 24 hrs after CPB, to determine natural killer cells activity (NKCA), and the levels of interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) in supernatant of cell culture were also tested.

RESULTSNKCA was significantly lowered in Group A before CPB but increased in Group B, while no evident change was found in Group C, so the level of NKCA in Group B was significantly higher than in the other two groups. It lowered in all the three groups after CPB, especially evidently in Group B, so as to cause the NKCA level in Group B lower than that in Group A. The lowering further progressed, 24 hrs after CPB, NKCA in Group B was more reduced than that in Group C. Levels of IFN-gamma and IL-2 lowered in all the three groups after CPB, and further lowered at time point of 24 hrs after CPB, but the parameters in Group C were significantly higher than those in Group B.

CONCLUSIONEA could enhance NKCA, but acupuncture anesthesia couldn't inhibit the suppressive effect of CPB on NKCA, IL-2 and IFN-gamma, suggesting that the immunosuppression induced by stress has a prior effect. General anesthesia plus EA yielded better effect than general anesthesia and acupuncture anesthesia, but it could't improve the immunosuppression completely, indicating that the compound anesthesia could partially improve the immunosuppression induced by CPB.

Acupuncture Analgesia ; Adult ; Anesthesia, General ; Cardiopulmonary Bypass ; Electroacupuncture ; Female ; Heart Septal Defects, Atrial ; immunology ; surgery ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Killer Cells, Natural ; immunology ; Male ; Middle Aged

The present study was undertaken to investigate the linkage between angiotensin-(1-7) ［Ang-(1-7)］ and the release of amino acid neurotransmitters in the the rostral ventrolateral medulla (RVLM) by techniques of microinjection, microdialysis combined with high performance liquid chromatography (HPLC)-fluorescent detection. Unilateral microinjection of Ang-(1-7) into the RVLM of anesthetized rats produced an increase in mean arterial pressure (MAP) accompanied by an increased release of glutamate (Glu). In contrast, microinjection of Ang779, a selective antagonist of Ang-(1-7) receptor, caused a decrease in MAP with a decreased releaceof Glu and an increased release of glycine,taurine and r-aminobutyric acid.The pressor effect of Ang-(1-7)and the depressor effect of Ang779 were in part blocked by corresponding andtagonists of aminoacid receptors.These results suggest that the pressor effect of Ang-(1-7)in the RVLM may be partially due to an increased release of Glu,whereas the depressor effect of Ang779 may be partially attributed to a decreased release of Glu and an increased release of inhibitory amino acid neurotransmitters

Ferroptosis is a form of cell death resulting from the disruption of iron metabolism within cells and excessive accumu-lation of lipid peroxides.Research indicates that,under the influence of various pathogenic factors,ferroptosis impacts the male repro-ductive system and fertility by affecting the synthesis of testicular hormones and regulation of cellular functions through different path-ways and numerators.This paper provides an overview of the action mechanisms of ferroptosis in the testis and its correlation with path-ogenicity,offering some new insights into the treatment of male reproductive system diseases.

Objective To investigate the prevalence and percentage of dyslipidemia awareness among overweight and obese residents in Beijing community. Method Cross-sectional data of 9786 subjects from capital cholesterol education and intervention program (CCEIP) were analyzed. Participants were divided into 3 groups (Normal, overweight and obese) based on body mass index (BMI). Blood lipid levels were determined from overnight fasting plasma samples. Questionnaires were collected to estimate awareness of dyslipidemia. Result ( 1 ) Blood lipids levels were positively correlated with BMI ( r = 0. 17, 0. 18,-0.26 and 0. 35 between total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and BMI,respectively, all P <0. 01 ). (2) Prevalence of dyslipidemia increased in proportion with increase of BMI. The age-standardized prevalence of dyslipidemia of normal, overweight and obese population was 23.9%,43.3% and 65.4% in men and 17.9%, 29.2% and 42. 3% in women. Dyslipidemia was more frequent in obese men than obese women(65.4% vs. 42. 3% ,P <0. 01 ). However, this gender difference decreased gradually with the increase of age. Risk of hypercholesterolemia, high LDL-C, low HDL-C and hypertriglyceridemia in obese men was 1.6, 2. 9, 2. 4, and 2. 7 folders higher than in the normal body weight men and was 1.3, 1.9, 1.7 and 2. 1 folders higher in obese women than in normal body weight women. (3) Unexpectly, the percentage of dyslipidemia awareness in overweight and obese population was not significantly higher than in the normal body weight group (P > 0. 05). Conclusion The prevalence of dyslipidemia was high while the percentage of dyslipidemia awareness was rather low in obese population. Aggressive intervention should be taken in obese population, especially in the young obese men, to effectively reduce dyslipidemia.