Objective To evaluate the feasibility and safety of laparoscopic right hemihepatectomy under selective hemihepatic inflow occlusion.Methods In performing this procedure,first dissect the right hepatic portal,and under selective hemihepatic inflow occlusion,laparoscopie Peng's multifunctional operative dissector (LPMOD) was used to transect the hepatic parenchyma by stepwise curettage and aspiration.Results Procedures were successful in all six patients of benign liver diseases,though a small subcostal auxiliary incision was needed in one case to control the middle hepatic vein branch hemorrhage.Operation time was 300-540 min[mean,( 399 ± 75 ) min].The time of hepatic portal dissect was 30-75 min[mean,(51 ± 16) min].The time of liver parenchyma transection was 60-160 min[mean,( 116 ± 32) min].Intraoperative blood loss was 600-3000 ml[mean,( 1486 ± 809 ) ml].The level of ALT increased to (302-557) U/L[mean,(386 ± 85 ) U/L]after the operation,and back to normal level in 5-11 d[mean,( 7.1 ± 2.0) d].The postoperative hospital stay was 10-18 d[mean,( 12.4 ± 2.6 ) d].No severe complication occurred after the operation.Conclusions Laparoscopic right hemihepatectomy under selective hemihepatic inflow occlusion is safe and feasible.

Objective To detection the urine of bacteria hyphae and intracellular bacterial communities in patients with indwelling urinary catheter and discuss intracellular bacterial comnmunities in the pathogenesis of catheter-related urinary tract infection.Methods From May 2014 to February 2016,95 cases with D-J stent indwelling were enrolled in this study,including 38 male patients and 57 female patients.The mean age was (43 ±21)years old,ranging from 25 to 83 years old.We recorded those patient g clinical symptoms,middle urine culture results.If the middle urine culture was positive,further pathology test and scanning electron microscopy for bacteria hyphae and intracellular bacterial communities would be considered.Results The middle urine culture showed positive in 21 cases (22％,21/95);The classification of bacteria included E.coli in 11 cases,dung enterococcus in 2 cases,klebsiella pneumonia in 4 cases,pseudomonas aeruginosa in 3 cases,epidermis staphylococcus aureus in 1 case.Among those 21 patients,9 cases had the symptoms of fever and shiver.Urine pathology testing found hyphae in 6 cases (6％,6/95).all others were E.coli infection.For scanning electron microscope,6 cases were found rodshaped bacteria and hyphae.3 cases were found intracellular bacterial communities.Conclusions The presence of intracellular bacterial communities made urothelial itself the source of endogenous bacteria of urinary tract infection.Catheter-related urinary tract infections in patients with recurrence maybe basically homology bacteria.

Objective To study the safety and feasibility of laparoscopic left lateral sectionectomy using the Glissonian pedicel approach.Methods The root of the round ligament of the liver was exposed and the Glissonian pedicel of the left lateral section was dissected,starting from left and using the lapa roscopic Peng's multifunctional operative dissector (LPMOD).After the Glissonian pedicel of segment Ⅱ and Ⅲ was dissected,clipped and cut,the ischemic boundary showed up.The liver was transected at the boundary of the ischemic liver,and the left hepatic vein and its branches were cut. Resutts The surgery was successtully performed in 8 patients.There was no conversion to open operation.The operative time was 110- 190 (151.0±35.4) min.The time of Glissonian pedicel dissection and liver resection was 70- 135 (101.0±24.1) min.Operative blood loss was 100-300(210.0± 89.4) ml.The ALT increased by 35- 102 (75.4± 26.5) U/L after operation and decreased to a normal level in 2-6 (3.0± 1.7) d.The postoperative hospital stay was 6-10 (8.2± 1.6) d.There was no major complication.Conclusion Laparoscopic left lateral sectionectomy using the Glissonian pedicel approach is safe and feasible.

This study aimed to simultaneously determine the contents of astilbin and engeletin in dong medicine "sunl gaems" of Guizhou origin by quantitative analysis of multi-components by single marker (QAMS), with astilbin as the internal standard substance. On UPLC and HPLC chromatograms, different models of instruments were used to investigate relative correction factors (RCF), in order to discuss the interoperability of RCFs established in different chromatographic systems. The engeletin content was calculated based on the established RCFs and compared by the one point external standard method and the external standard working curve method, in order to verify the accuracy of QAMS. According to the result, in different chromatograms, the ratios between RCF and retention time of engeletin and astilbin had a good reproducibility, with RSD between 2.0% and 1.8%, both were less than 3%. The relative differences among results of QAMS, the external standard working curve method of dong medicine "sunl gaems" ranged between 1.6% and 3.9%, with RSD between 2.02%-0.80% in line with relevant requirements and Pearson correlation coefficient at 0.9998 (P <0.01). The findings showed that QAMS was an accurate, reliable and highly reproducible method to determine the contents of astilbin and engeletin in dong medicine "sunl gaems" of Guizhou origin and so could be used to control the inherent quality of the herb.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Flavonols ; analysis ; Glycosides ; analysis

OBJECTIVETo study the effects of icariin on Bcl-2 and Bax protein expressions and eosinophils apoptosis in bronchial asthmatic mice.

METHODS48 female Balb/c mice were randomly divided into 6 groups, i.e., the normal control group, the model group, the Dexamethasone group, the low dose icariin group, the middle dose icariin group, and the high dose icariin group, 8 mice in each group. Bronchial asthma in mice were induced by intraperitoneal sensitization and challenged with nebulized ovalbumin (OVA). The mice of each treatment group were administrated with different doses of icariin by peritoneal injection from the first asthma sensitization (the 3rd week after the modeling) to the day before killing once every other day, while mice in the normal control group were administrated with physiological saline. The mice were killed after 6 weeks of treatment. The apoptosis of eosinophils and the Bcl-2 and Bax protein expressions of the lung tissues were detected by TUNEL and immunohistochemical assay respectively.

RESULTSAs compared with the model group, the apoptosis ratio of eosinophils were higher in the rest four treatment groups (P<0.05). The Bcl-2 protein positive areas in the lung tissues and the airway wall were significantly lowered (P<0.05). The Bax protein positive area significantly increased (P<0.05).

CONCLUSIONIn bronchial asthmatic mice, icariin could enhance the apoptosis of eosinophils and lessen their infiltration by decreasing the expression of Bcl-2 protein and increasing the expression of Bax protein in lung.

Animals ; Apoptosis ; drug effects ; Asthma ; metabolism ; Eosinophils ; drug effects ; metabolism ; Female ; Flavonoids ; pharmacology ; Mice ; Mice, Inbred BALB C ; bcl-2-Associated X Protein ; genetics ; metabolism

Abstract?AIM: To investigate mechanism of bradykinin ( BK) on inflammations of retinal pigment epithelium ( RPE) cells.?METHODS: ARPE -19 cells were cultured in vitro, stimulated by 100nM BK for 24h. Cell morphology changes were observed by microscope, and BK receptor localization was detected through cell immunofluorescence. Changes of Ca2+in BK and BR antagonist stimuli were detected by laser scanning confocal microscopy.The expressions of COX-1, COX-2, eNOS and iNOS protein in control group and BK group were detected by Western Blot.?RESULTS: After the stimulation of BK, there was no significant changes of ARPE-19 cells in morphology.Kinin B1 receptors ( B1R ) and B2 receptors ( B2R ) could be detected in ARPE-19 cells.Compared with control group, Ca2+concentrations significantly increased in BK group; in B1R antagonist group and B2R antagonist group Ca2+concentrations increased less than BK group; B1R and B2R antagonist group showed no obvious changes in Ca2+concentrations.Compared with control group, COX-2 and iNOS protein concentrations were significantly increased in BK group (P<0.001).?CONCLUSION:BK induces the increasing expression of COX-2 and iNOS in the cultured ARPE cells through binding with either B1R or B2R.

OBJECTIVETo investigate the relationship between the 3 polymorphic loci of endothelin receptor type A (EDNRA) gene and intracranial aneurysms.

METHODSThree EDNRA gene polymorphisms (rs5335, rs6842241, and rs6841581) were genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis. The genotype and allele frequencies were calculated in the patients and the control group to analyze the association between the gene and the size of aneurysms.

RESULTSNo significant difference was found in the distribution of the EDNRA gene genotypes or allele frequencies between the patients and the control subjects. Only GG genotype of rs6841581 was found to significantly correlate with the size of aneurysms.

CONCLUSIONEDNRA gene rs6841581 has significant associations with the size of intracranial aneurysms, indicating a possible role of EDNRA in the genetic mechanisms of intracranial aneurysms and subarachnoid hemorrhage.

Adult ; Aged ; Case-Control Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Intracranial Aneurysm ; genetics ; pathology ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Receptor, Endothelin A ; genetics

Objective To evaluate the clinical efficacy and safety of akatinol memantine in the treatment of Alzheimer's disease (AD).Methods Two hundred and forty-one patients with AD were randomly assigned to receive 10 mg of donepezil daily or 20 mg of memantine daily for 24 weeks.The primary efficacy variables were the Clinician' s Interview-Based Impression of Change Plus (CIBIC-Plus),the Alzheimer Disease Assessment Scale-cognition (ADAS-cog) and the Activities of Daily Living (ADL).The secondary efficacy variables were the Neuropsychiatric Inventory (NPI) and the Mini-Mental Status Examination (MMSE).Results Two hundred and seven patients completed the study and were evaluated at week 24.Both memantine and donepezil had significant efficacies at the end point, according to the ADAS-cog, the ADL, the NPI and the MMSE.Patients receiving memantine had a similar outcome as those receiving donepezil, according to the results of all the variables changes (CIBIC-Plus: memantine 3.4±0.8vs donepezil 3.5±0.8; ADAS-cog: memantine-4.7±5.8 vs donepezil-4.6±6.5; ADL: memantine -2.4±6.7 vs donepezil-2.2±5.3 ; NP1: memantine-5.8±9.0 vs donepezil-3.1±8.5 ; MMSE:memantine 1.7±3.1 vs donepezil 1.8±2.8, all P >0.05).The adverse events were as following: donepezil group 41.88% and memanintine group 30.58%.Conclusion The memantine as a new drug for AD, has the similar efficacy as donepezil, and it is safe.

OBJECTIVETo investigate the effect of baicalin on the experimental periodontitis in rats, as well as the expression of MMP-1, MMP-2, MMP-9.

METHODSTwenty-seven adult male Sprague-Dawley rats were divided into three groups, with 9 rats in each group. A nylon thread was placed around the lower first molars of rats, which were sacrificed after 7 days. Baicalin (200 mg/kg) was administered to the experimental group by oral gavage, starting one day before the induction of periodontitis. The negative control group received vehicle (0.5% carboxymethylcellulose) alone. The blank control group did not get induction of periodontitis. The alveolar bone loss (ABL) and the area fraction (AA% ) occupied by collagen fibers were assessed. MMP-1, MMP-2 and MMP-9 protein expressions in the gingiva were detected by immunohistochemistry.

RESULTSBaicalin treatment significantly decreased ABL compared with the negative control group (P = 0.009). AA% of collagen fibers was significantly higher in baicalin-treated group than in the negative control group (P = 0.047). Baicalin treatment significantly down-regulated the protein expression for MMP-1 (P = 0.023) and MMP-9 (P = 0.042) and decreased the expression for MMP-2 (P = 0.099) compared with the negative control group.

CONCLUSIONSBaicalin protects against tissue damage in ligature-induced periodontitis in rats, which might be mediated in part by its inhibitory effect on the expression of MMP-1, MMP-2 and MMP-9.

Animals ; Flavonoids ; pharmacology ; Gingiva ; drug effects ; metabolism ; Male ; Matrix Metalloproteinases ; metabolism ; Periodontitis ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo analyze the discrepancies between clinical and autopsy diagnoses in hospitals of different grades and with respect to duration of hospitalization.

METHODSA total of 188 autopsy cases collected from hospitals of different grades were retrospectively reviewed and the discrepancies between clinical and autopsy diagnoses were analyzed.

RESULTSThe overall rate of misdiagnosis was 48.9% (92/188). The misdiagnosis rate in grade I hospitals (75.8%, 25/33) was significantly higher than that in grade III (39.6%, 38/96; chi(2) = 12.861, P = 0.000) and grade II hospitals (49.2%, 29/59; chi(2) = 6.179, P = 0.016 ). The misdiagnosis rate of patients beyond 24 hours of admission was lower than that admitted within 24 hours (chi(2) = 20.991, P = 0.000). The overall rate of missed diagnosis was 34.6% (65/188). The rate of missed diagnosis in grade I hospitals was remarkably higher than that of the grade III hospitals (chi(2) = 8.241, P = 0.006). There was no difference between grades I and III hospitals on the rate of missed diagnosis within 24 hours of admission, however, this rate was lower in grade III hospitals in comparing with that of grade I hospitals in patients admitted beyond 24 hours (chi(2) = 5.181, P = 0.047). The distribution of disease entities commonly encountered in patients of both misdiagnosis and missed diagnosis were heart problems, infections, arterial diseases and pulmonary embolism.

CONCLUSIONSThe rate of discrepancies between clinical and autopsy diagnoses is relatively high. The misdiagnosis and missed diagnosis rate in grade I hospitals was significantly higher than that in grade III hospitals and was closely related with the duration of hospitalization. Autopsy study thus still remains an important measure in clinical audit.

Adult ; Aged ; Aortic Aneurysm ; diagnosis ; pathology ; Autopsy ; Cause of Death ; Diagnostic Errors ; statistics & numerical data ; Female ; Hospitals, Community ; Hospitals, General ; Hospitals, Teaching ; Humans ; Infection ; diagnosis ; pathology ; Length of Stay ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; pathology ; Myocarditis ; diagnosis ; pathology ; Pulmonary Embolism ; diagnosis ; pathology ; Retrospective Studies ; Young Adult