Objective To investigate the clinical features , treatment regimen , and prognosis evaluation of tertiary peritonitis (TP). Methods Seventy-eight cases with TP were randomly enrolled into 2 groups, including the simple western medicine-treated group (32 cases) and the integrated traditional Chinese and western medicine-treated group (46 cases). The prognoses were evaluated according to the acute physiology and chronic health evaluationⅢ (APACHEⅢ, APⅢ) scoring. Results The mortality rate was 71.9% (23 of 32) in patients received the simple western medicine and was 32.6%(15 of 46) in patients received the integrated traditional Chinese and western medicine with significant difference between these two groups (P < 0.01). There was a significant correlation between AP Ⅲscore and actual mortality (r=0.73,P<0.01), and predicted mortality (r=0.76, P<0.01). Conclusions The therapeutic effect is acceptable and satisfactory for the TP patients received the integrated traditional Chinese and western medicine. The AP Ⅲ scoring system can be used to predict the prognosis of TP patients.

Objective To study arterial distribution of rectus abdominis musculocutaneous flap and to evaluate whether it can be divided into several units for reconstruction. Methods The arteries of the rectus abdominis musculocutaneous flap were studied on 60 sides of cadavers by dissection and angiography. Results The superior epigastric artery (SEA) and the inferior epigastric artery (IEA) continued in a longitudinal direction. Most of their branches took on a typical spiral configuration and communicated with each other within muscle above the level of umbilicus. Many perforating arteries penetrated through the anterior rectus sheath to get to the overlying skin, but the highest concentration of major perforators were in the paraumbilical area. The inferior epigastric artery was more significant than superior epigastric artery in supplying the skin of the musculocutaneous flap. Based on thefstudies of the vascular anatomy of muscles, we could classify arterial distribution into 3 types: type Ⅰ (SEA 26.5 %, IEA 34.6%) revealed a single main intramuscular artery: type Ⅱ (SEA 64.7 %, IEA 48.1%) had two major intramuscular branches; type Ⅲ (SEA 8.8%, IEA 17.3 %) revealed three intramuscular branches. Our anatomic studies showed that the superior and inferior epigastric artery bifurcated or divided into more than two main branches in the majority of cases (SEA 73.5%, IEA 65.4%). Conclusion The rectus abdominis musculocutaneous flap could often be divided into several regions for breast construction which is based on the distribution of each branch of the artery.

Objective To investigate the effects of total nutrient admixture (TNA) on the recovery of patients with gastric cancer after radical gastrectomy.Methods The clinical data of 50 patients with gastric cancer who were admitted to the Affiliated Hospital of Luzhou Medical College between March 2013 and March 2014 were retrospectively analyzed.Among 50 patients receiving radical gastrectomy,26 patients receiving TNA were allocated to the experimental group and 24 patients receiving conventional fluid infusion were allocated to the control group.Patients in the experimental group received the nutritional support therapy using TNA at preoperative day 5 and at postoperative days 1-5,and patients in the control group received the postoperative intravenous rehydration including water,glucose,electrolyte,vitamins and micro elements.The nutritional indexes [albumin (Alb),prealbumin,transferrin and hemoglobin (Hb)],time to anal exsufflation,incidence of complications (wound infection,anastomotic leakage,blooding and intestinal obstruction) and duration of hospital stay were observed before nutritional support therapy and at postoperative day 8.The count data were analyzed using the chi-square test.The chi-square value of correction for continuity was used when 1 ≤ minimum theoretical frequency ≤ 5.The measurement data with normal distribution were presented as (x) ±s and analyzed using the t test or repeated measures ANOVA.The ordinal data were analyzed by the analysis of variance.Results The Alb,prealbumin,transferrin and Hb in the experimental group were (38.6 ± 2.0) g/L,(281 ± 33) mg/L,(2.5 ± 0.9) g/L and (111 ± 20) g/L before nutritional support therapy and (38.2 ± 1.9) g/L,(277 ± 16) mg/L,(2.3 ± 1.1) g/L and (112 ± 37) g/L at postoperative day 8,respectivley.The Alb,prealbumin,transferrin and Hb in the control group were (38.3 ±2.4) g/L,(287 ± 34) mg/L,(2.4 ± 1.1) g/L and (107 ± 21) g/L before nutritional support therapy and (30.3 ±2.3) g/L,(190 ± 41) mg/L,(1.6 ± 0.3) g/L and (93 ± 22) g/L at postoperative day 8,respectivley.There were significant differences in the nutritional indexes at postoperative day 8 between the 2 groups (F =174.042,95.637,9.529,4.919,P ＜ 0.05).The time to anal exsufflation in the experimental group were (52 ± 11) hours,which was significantly different from (70 ± 12) hours in the control group (t =-5.176,P ＜ 0.05).The incidence of complications was 15.4％ (4/26) in the experimental group,which was significantly different from 58.3％ (14/24) in the control group (x2=6.460,P ＜0.05).Patients with complications in the 2 groups were cured by anti-infective or symptomatic treatment.The duration of hospital stay was (9 ± 3) days in the experimental group and (12 ± 4) days in the control group,with a significant difference between the 2 groups (t =-2.912,P ＜ 0.05).Conclusion TNA can improve the nutritional status of patients after radical gastrectomy in a short time.It could help patients to get through the perioperative period smoothly,and enhance the postoperative recovery.

The paper is to report the establishment of three methods for determination of methyl salicylate-2-O-beta-D-galactopyranoside (1-4)-beta-D-glucopyranoside (MSG) by HPLC, UV or potentiometric titration. The results determined by the three methods turned out to be of no significant difference (P>0.05). The method was chosen according to MSG difference test demands.

Objective To explore the clinical value of combined detection of serum carbohydrate antigen 724 (CA724),carcinoembryonic antigen (CEA),and tumor necrosis factor-α (TNF-α) for the diagnosis,assessment of curative effect,and illness monitoring for advanced gastric cancer (AGC).Methods Serum levels of CA724,CEA and TNF-α were measured by the methods of chemiluminescence and compared in 20 patients with AGC (Group A),20 patients with benign gastric disease (Group B),and 20 healthy adults (Group C).Also,serum levels of CA724,CEA and TNF-α in peripheral blood as well as in portal vein were measured and compared before and after surgical treatment in patients of group A.Results The serum levels of CA724,CEA and TNF-α in patients of group A were significantly higher than groups B and C (P ＜ 0.05).In addition,the serum levels of CA724,CEA and TNF-α in patients of group A were decreased after surgical treatment and increased slightly after one month (P ＜ 0.05).Conclusions The serum levels of CA724,CEA and TNF-α in most patients of AGC are significantly elevated and the combined detection of serum CA724,CEA and TNF-α contributes to the diagnosis,assessment of curative effect,and illness monitoring for AGC.

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

Injectable lipid emulsions have been routinely used in patients since 1960s as a nutritional supplement for patients requiring parenteral nutrition. In recent years, lipid injectable emulsions have been extensively studied as a kind of novel drug carrier, also the quality problems of the lipid emulsion attract more and more attentions gradually. Large diameter tail of injectable lipid emulsions as a significant quality control indicator should pay more attention. Regarding to the defect of detecting large diameter tail of lipid injectable emulsions in our country, the purpose of this article is to summarize the techniques of detecting large diameter tail, illustrate the impacts of large lipid droplet on the quality of lipid injectable emulsions, emphasize the importance of detecting large diameter tail in lipid emulsions and provide guidance for researching and developing lipid emulsions in domestic market.

Objective To investigate the stimulation of exosome derived from osteosarcoma cells suppressing cytotoxic T cells and the inhibitory effect of active T cells for surpressing osteosarcoma cells. Methods Exosome derived from tumor cells was isolated and purified by ultracentrifugation. Its morphology was observed with transmission electron microscope, and the major histocompatibility complex-I ( MHC-I) molecules were analyzed by western blot. Mice bone marrow-derived dendritic cells were pulsed with exosome. Surface membrane MHC-I molecules were analyzed with flow cytometry. The effect of active T cells on the growth of osteosarcoma cells were detected by MTT assay after the T cells being stimulated by exosome-pulsed dendritic cells. Results The exosome was round or near round corpuscle, and the diameter was about 50-100 nm by transmission electron microscope. The size was relatively homogeneous. Western blot showed that the exosome expressed MHC-Ⅰmolecules. Surface membrane CD80,MHC-I and II molecules were expressed on 77. 16%, 83. 21%, and 91. 26% of LPS-treated dendritic cells, respectively, which were up-regulated compared to untreated cells. Dendritic cells pulsed with exosome derived from osteosarcoma cells caused significantly higher T cells stimulation and osteosarcoma cells inhibition as compared to un-pulsed dendritic cells. (P<0.05). Conclusion T cells can inhibit the growth of osteosarcoma cells after being stimulated by exosome-pulsed dendritic cells in vitro.

OBJECTlVE To study the effect of ganoderma poIysaccharide( GLP)on zebrafish ( Danio rerio)survivaI,deveIopment and senescence. METHODS A p53-knockout zebrafish modeI was estabIished by injecting of morphoIino phosphorodiamidate(mO)into normaI zebrafish eggs in the singIe ceII deveIopment stage. Different concentrations of GLP 1,2 and 3 g·L-1 were used to treat both wiId type and p53-knockout zebrafish embryos 8 h post fertiIization(8 hpf)under 28℃ for 3 d. The survivaI and maIformation rates were caIcuIated after 72 hpf,and the effect of GLP on ceII senescence was evaI-uated by senescence associated β-gaIactosidase(SA-β-gaI)staining both in wiId type and p53-knockout zebrafish embryos. In addition,the differentiaI gene expression of cancer inhibitor gene(p53),teIomer-ase reverse transcriptase( TERT),murine doubIe minute2( mdm2)and p21 was examined by RT-PCR both in wiId type and p53-knockout zebrafish embryos after treatment with different concentrations of GLP. RESULTS GLP 1 and 2 g·L-1 had no effect on deveIopment of wiId type zebrafish embryos,but after GLP 3 g·L-1 treatment,most of zebrafish embryos dispIayed maIformation and the survivaI rate was onIy 48.6%. GLP 1,2 and 3 g·L-1 had no effect on survivaI and deveIopment of p53-knockout zebrafish embryos. After GLP 2 g·L-1 treatment for 3 d,the SA-β-gaI staining positive rate of wiId type zebrafish embryos was reduced compared with controI group(P﹤0.01),whiIe there was no significant change in p53-knockout zebrafish embryos. The resuIts of RT-PCR showed that GLP 2 g·L-1 treatment depressed p21 and p53 gene expression(P﹤0.05,P﹤0.01),and had no effect on mdm2 and TERTgene expres-sion of wiId type zebrafish embryos. For p53-knockout zebrafish embryos,the TERT,mdm2,p21 and p53 gene expression dispIayed no significant difference after GLP 2 g·L-1 treatment. CONCLUSlON GLP 2 g·L-1 may improve senescence of wiId type zebrafish embryo ceIIs. GLP ≥3 g·L-1 may Iead to death and abnormaI deveIopment of wiId type zebrafish embryos. The improvement of GLP on senescence of wiId type zebrafish embryo ceIIs might be mediated by its down-reguIation of p21 and p53 gene expression.

Related literature and studies concerning the kinematics in patients after cervical arthrodesis have extensive?ly reviewed and comprehensively analyzed in 4 terms of changes in adjacent segment range of motion, motion segment per?cent contributions, motion pattern of cervical facet joints, and deviated center of rotation at adjacent segments. These report?ed researches of in-vivo kinematics after cervical arthrodesis are almost on the sagittal plane. Few data have been reported on the 6DOF kinematics under physiological loading conditions. Whether adjacent segment pathology caused by hypermobili?ty remains controversial. Long-term follow-up of large sample randomized controlled studies and obtaining the accurate 6DOF kinematics are the best way to resolve controversy.