ObjectiveTo study the clinical effect of improved decortication in treatment of tuberculous empyema as well as the safety of operation.MethodsEighty-two cases who diagnosed as tuberculous empyema by pathology and operation from January 2007 to September 2010 were selected including improved decortication 44 cases,total empyema decortication 28 cases,thoracoplasty 10 cases.The operation time,peri-operative bleeding,postoperative complication and lung function recovery after 6 months operation were followed-up.ResultsAll the patients were in good recovery and there was no death in the operation for 1 year.The peri-operative bleeding in improved decortication was less than that in total empyema decortication and thoracoplasty [(56.23 ± 15.56) ml vs. (78.65 ± 23.14) and (66.92 ± 19.83) ml],and there was significant difference among them(P＜ 0.01 ).There was no postoperative complication in improved decortication,but 2 cases (7.1％,2/28) of partial lung recruitment maneuvers in total empyema decortication,1 case ( 10.0％,1/10) of extensive staxis with selective surgery in thoracoplasty.The proportion of forced vital capacity (FVC),forced expiratory volume in one second (FEV1),peak expiratory flow (PEF) turning to normal after 6 months operation in improved decortication [95.5％(42/44),93.2％(41/44),97.7％(43/44)]were higher than those in total empyema decortication[ 75.0％ (21/28 ),78.6％ (22/28),85.7％ (24/28) ]and thoracoplasty [ 80.0％ (8/10),90.0％ (9/10),80.0％ ( 8/10) ],and there was significant difference among them (P ＜0.01).There was no significant difference in the operation time among them(P ＞0.05).ConclusionImproved decortication has remarkable superiority in curing tuberculous empyema especially it is small in traumatic with less blood loss,fewer postoperative complications,lung function recovery rapidly after operation.

BACKGROUND:Drainage has been applied as a routine to hip and knee replacement surgery. However, as a potential channel, drainage could become a portal for bacteria and other pathogens to invade the joint cavity. OBJECTIVE:To evaluate the clinical significance and safety of drainage in total knee arthroplasty.
METHODS:The 80 patients were prospectively randomized into two groups:Group 1 included 38 patients with wound drainage;Group 2 included 42 patients without any drainage. According to a formula calculation, blood loss, the number of subjects requiring blood transfusion, volume of blood transfusion, complications and the recovery of function after total knee arthroplasty were statistical y analyzed.
RESULTS AND CONCLUSION:The subjects were fol owed up for 2 years after discharge. Two patients lost to fol ow up in the non-drainage group. 78 patients were involved in the result analysis. The total blood loss, the number of subjects requiring blood transfusion and volume of blood transfusion were more in the drainage group than those in the non-drainage group after surgery. At 3 days after arthroplasty, active range of motion was larger in the drainage group than that in the non-drainage group. No significant differences in hemoglobin levels and Keen Society Score scores were detected after arthroplasty between the two groups. Results suggested that draining wil increase the blood loss and blood transfusion, but it may contribute to the early recovery of knee function. No significant differences in long-period Keen Society Score scores and postoperative complications were detectable between the two groups.

This study is to investigate the effects of paeoniflorin on cerebral blood flow and the balance of PGI2/TXA2 of rats with focal cerebral ischemia-reperfusion injury. A total of 72 SD rats (3) were randomly divided into 6 groups: sham operation group, cerebral ischemia-reperfusion model group (I/R gourp), low (10 mg.kg-1), middle (20 mg.kg-1) and high (40 mg.kg-1) doses of paeoniflorin groups and nimrnodipine group. Focal cerebral ischemia in rats was made by inserting a monofilament suture into internal carotid artery for 90 min and then reperfused for 24 h. The effects of paeoniflorin on neurological deficit scores and the infarction volume of brain were detected. Relative regional cerebral blood flow (rCBF) was continuously monitored over ischemic hemispheres by laser-Doppler flowmetry (LDF). The expression of COX-2 in hippocampal CAl region was estimated by immunohistochemistry and the contents of prostacyclin I2 (PGI2), thromboxane A2 (TXA2), and ratio of PGIJ2/TXA2 in serum were measured by ELISA kits. Paeoniflorin significantly ameliorated neurological scores, reduced the infarction volume, and increased regional cerebral blood flow relative to the I/R group. In addition, paeoniflorin could inhibit COX-2 expression and the release of TXA2 and prevent the downregulation of PGI2 induced by I/R injury. The neuroprotective effects of paeoniflorin against focal cerebral ischemia-reperfusion rats might be attributed to improve the supply of injured hemisphere blood flow and adjust the balance between PGI2/TXA2.

Objective To investigate the effectiveness and safety of wound infiltration with rop-ivacaine for postoperative analgesia as a fast-track approach in patients undergoing open hepatectomy. Methods Fifty-two patients with hepatocellular carcinoma,32 males,20 females,aged 18-70 years, scheduled for selective open hepatectomy were enrolled in this trible-blind,randomized,controlled study.Patients were randomized to receive 0.75% ropivacaine (group ROP)or 0.9% normal saline (group NS)wound infiltration before incision closures at a total volume of 10 ml.Numerical rating score (NRS)at 6,12,24 and 48 hours after surgery,length of hospital stay,time to bowel recovery,ambulation and drainage tube extraction were recorded.Side effects, including post-operative liver and renal function,allergic reaction,nausea and vomiting,and wound infection,were also assessed.Results NRS was significantly decreased at 6 [(3.85±1.29)scores vs.(5.30±1.76) scores],12 [(3.38±0.85)scores vs.(5.69 ±1.38)scores]and 24 hours [(3.69 ±0.74)scores vs. (4.42±1.13)scores]after surgery in group ROP compared to group NS (P <0.05).Group ROP al-so showed shorter postoperative hospital stays [(1 7.92±1.97)d vs.(1 9.53±2.42)d],earlier anal exsufflation [(48.07±7.49)h vs.(53.42±10.38)h]and ambulation [(2.34±0.62)d vs.(2.80± 0.84)d](P <0.05).However,there were no significant differences between the two groups in re-garding post-operative liver and renal function.The incidence of nausea and vomiting was 1 5% (4 ca-ses)and 1 9%(5 cases)in group NS and group ROP,respectively.No allergic reactions occurred in either group.Conclusion The present study shows that ropivacaine wound infiltration could effectively release post-operative pain,and could be a safe and effective fast-track approach for patients undergoing open hepatectomy.

This study is to investigate the effects of paeoniflorin on cerebral blood flow and the balance of PGI2/TXA2 of rats with focal cerebral ischemia-reperfusion injury. A total of 72 SD rats (3) were randomly divided into 6 groups: sham operation group, cerebral ischemia-reperfusion model group (I/R gourp), low (10 mg.kg-1), middle (20 mg.kg-1) and high (40 mg.kg-1) doses of paeoniflorin groups and nimrnodipine group. Focal cerebral ischemia in rats was made by inserting a monofilament suture into internal carotid artery for 90 min and then reperfused for 24 h. The effects of paeoniflorin on neurological deficit scores and the infarction volume of brain were detected. Relative regional cerebral blood flow (rCBF) was continuously monitored over ischemic hemispheres by laser-Doppler flowmetry (LDF). The expression of COX-2 in hippocampal CAl region was estimated by immunohistochemistry and the contents of prostacyclin I2 (PGI2), thromboxane A2 (TXA2), and ratio of PGIJ2/TXA2 in serum were measured by ELISA kits. Paeoniflorin significantly ameliorated neurological scores, reduced the infarction volume, and increased regional cerebral blood flow relative to the I/R group. In addition, paeoniflorin could inhibit COX-2 expression and the release of TXA2 and prevent the downregulation of PGI2 induced by I/R injury. The neuroprotective effects of paeoniflorin against focal cerebral ischemia-reperfusion rats might be attributed to improve the supply of injured hemisphere blood flow and adjust the balance between PGI2/TXA2.
6-Ketoprostaglandin F1 alpha ; blood ; Animals ; Brain ; blood supply ; CA1 Region, Hippocampal ; metabolism ; Cyclooxygenase 2 ; metabolism ; Glucosides ; isolation & purification ; pharmacology ; Infarction, Middle Cerebral Artery ; blood ; metabolism ; pathology ; physiopathology ; Male ; Monoterpenes ; isolation & purification ; pharmacology ; Neuroprotective Agents ; isolation & purification ; pharmacology ; Paeonia ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Regional Blood Flow ; drug effects ; Reperfusion Injury ; metabolism ; physiopathology ; Thromboxane B2 ; blood

Anti-HER2 monoclonal antibody (Sc7301)-paclitaxel (TAX) immunoconjugate was prepared and its specific binding to tumor cells was investigated in this study. Sc7301 was conjugated to TAX by the active ester method and then the TAX-Sc7301 immunoconjugate was obtained. After purification and labeling by Cyano-fluorescein isothiocyanate (FITC), the specific binding of TAX-Sc7301 to HER2-positive tumor cells (SKOV3) and HER2-negative tumor cells (HepG2) was evaluated respectively. TAX-Sc7301 (20 nmol/L) showed distinct specific binding to SKOV3 cells rather than HepG2 cells. And the uptake of the immunoconjugate by SKOV3 cells was increased with the TAX-Sc7301 concentration (3-48 nmol/L) and the incubation time (P<0.05). It was concluded that the TAX-Sc7301 immunoconjugate is potentially applicable as a targeted agent against HER2-positive tumor cells.

l 1H-MRS was good for clinical purpose.

Nissl stain and immunocytochemical methods were used to observe the structure of the subnuclei of interpeduncular nucleus in human neonatal brain and their localization of substance P-, leu enkephalin-, and serotonin (5-HT)-like immunoreactive elements. It was detected that the human neonatal interpeduncular nucleus could be divided into five subnuclei, including: the dorsal, dorsolateral, lateral, central, and intermediate subnuclei. The immunocytochemical results showed that the substance P-containing cell bodies and fibers or terminals were distributed chiefly in the dorsolateral, lateral subnuclei and the ventral part of the intermediate subnucleus; the enkephalin-containing cell bodies and fibers or terminals were concentrated in the central subnucleus; and meanwhile the serotonin-containing cell bodies and fibers or terminals were found mainly in the dorsal subnucleus.

Using immunohistochemical technique, the distribution and development of substance P (SP)-, L-enkephalin (L-Enk)- and serotonin (5-HT)-like immunoreactivity in Gudden's dorsal tegmental nucleus (GDTN) of human foetus (fetal age 11.5 to 35 weeks)and neonate (two days) were demonstrated. Gudden's dorsal tegmental nucleus in the human might be divided into pars centralis and pars peripheralis; and the time of initial appearance for SP-, L-Enk- and 5-HT-like immunoreactivity in GDTN was different. SP-like immunoreactive fibers and terminals appeared first and were distributed mainly in the pars centralis and their density was very high. L-Enk-like imunoreactive cells, fibers and terminals were distributed in the pars peripheralis. 5-HT-like immunoreactive cells, fibers and terminals were distributed in the medial part of the GDTN; As the foetus developed further, SP-, L-Enk- and 5-HT-like immunoreactivity in the GDTN showed their own special ontogenetic changes respectively

Objective To comprehensively evaluate the relationship between children's high iodine goiter and excessive iodine . Methods A computerized literature search was carried out to collect articles published before 2014 in electronic databases CBM , WabFang ,VIP ,CNKI ,PubMed ,EMbase ,Ovid and Cochrane Library .The study type was randomized controlled trial or quasi‐ran‐domized control trial .Literature was analyzed by RevMan5 .0 software ,then calculated and combine RR and 95% CI .Publication bi‐as of Meta analysis was evaluated by Begg's test ,Egger's test and Macaskill's test .The result stability of Meta analysis was tested by sensibility analysis .Results A total of 10 controlled before and after studies were included in our meta‐analysis .The result showed that the iodine content of 150 -300 μg/L (RR:1 .54 ;95% CI:1 .14 -2 .07);301 -600 μg/L (RR:2 .33;95% CI:1 .43 -3 .82);601-900 μg/L (RR:2 .72 :95% CI:1 .01-7 .33) and greater than 900μg/L (RR:2 .41 ;95% CI:1 .38-4 .23) would result in chil‐dren goiter .Conclusion Iodine content greater than 150 μg/L would result in children goiter .