Pancreaticoduodenectomy is the main treatment method for pancreatic head carcinoma and periampullary cancer,and is also the only possible cure way.With the development of minimally invasive surgery,laparoscopic pancreaticoduodenectomy has been widely carried out,it even has been the routine operation in some pancreatic surgery center.The traditional approach is still the main approach for laparoscopic pancreaticoduodenectomy.In recent years,the procedure of the artery approach with its advantages has been put forward and gradually developed in laparoscopic pancreaticoduodenectomy through the continuous study and exploration.On the basis of the early arterial approach,authors' center established an artery preferential disconnection procedure in laparoscopic pancreaticoduodenectomy,which has been named arterial first approach.In the clinical practices and studies,this procedure also represents its unique advantages.

Using the field sampling and indoor soil cultivation methods, the dynamic of ginseng rhizosphere soil microbial activity and biomass with three cultivated ages was studied to provide a theory basis for illustrating mechanism of continuous cropping obstacles of ginseng. The results showed that ginseng rhizosphere soil microbial activity and biomass accumulation were inhibited observably by growing time. The soil respiration, soil cellulose decomposition and soil nitrification of ginseng rhizosphere soil microorganism were inhibited significantly (P <0.05), in contrast to the control soil uncultivated ginseng (R0). And the inhibition was gradual augmentation with the number of growing years. The soil microbial activity of 3a ginseng soil (R3) was the lowest, and its activity of soil respiration, soil cellulose decomposition, soil ammonification and soil nitrification was lower than that in R0 with 56.31%, 86.71% and 90. 53% , respectively. The soil ammonification of ginseng rhizosphere soil microbial was significantly promoted compared with R0. The promotion was improved during the early growing time, while the promotion was decreased with the number of growing years. The soil ammonification of R1, R2 and R3 were lower than that in R0 with 32.43%, 80.54% and 66.64% separately. The SMB-C and SMB-N in ginseng rhizosphere soil had a decreased tendency with the number of growing years. The SMB-C difference among 3 cultivated ages was significant, while the SMB-N was not. The SMB of R3 was the lowest. Compared with R0, the SMB-C and the SMB-N were significantly reduced 77.30% and 69.36%. It was considered by integrated analysis that the leading factor of continuous cropping obstacle in ginseng was the changes of the rhizosphere soil microbial species, number and activity as well as the micro-ecological imbalance of rhizosphere soil caused by the accumulation of ginseng rhizosphere secretions.
Agriculture ; Ammonium Compounds ; metabolism ; Bacteria ; growth & development ; Biomass ; Cellulose ; metabolism ; Nitrification ; Panax ; growth & development ; microbiology ; Plant Roots ; growth & development ; microbiology ; Rhizosphere ; Soil ; chemistry ; Soil Microbiology ; Time Factors

Objective　To study the similarities and differences on in vitro replication and expression of hepatitis C virus (HCV) between human fetal hepatocytes (HFH) and 7721 cell line. Methods　Human fetal hepatocytes and a hepatoma cell line 7721 were incubated with a serum from hepatitis C patient. After incubation, the presence of HCV RNA, the expression of HCV NS3 antigens in cells and/or supernatant were examined by RT-PCR, in situ hybridization and immunohistochemistry, respectively. Results　It was found that: ①The intracellular HCV RNA was first detected on d 2～3 post-incubation and then could be intermittently detected in cells and/or supernatant subsequently (HCV RNA could be detected in 7721 cells during a period of at least 66 days. In HFH, HCV RNA could be detected up to 25 days after incubation); ②HCV-NS3 antigen could be expressed in infected cells; ③Minus-strand RNA of HCV was mainly located within cytoplasm by in situ hybridization. Conclusion　The results suggest that both the fetal hpatocytes and the hepatoma cell line 7721 are susceptible to HCV, and especially 7721 cell line can stably support HCV replication in vitro and may be used as the target cell for long-term cultures of HCV.

Objective To investigate the nursing points and the effect of the conjoint liver and kindey transplantation. Methods To review the concreted nursing experience among 13 patients who have accepted the conjoint liver and kidney transplantation from 1996 to 2004 in the First Affiliated Hospital of Sun Yat-Sen University,and then summarized the nursing key points of the operation. Results All the nursing measures during the course of operation were properly,the means time of operation was 9.5 hours,the means time of liverless was 65 minutes,the blood loss volume was 7 000 ml. Conclusion The nursing key points of conjoint liver and kidney transplantation include sufficient nursing prepare,homoiothermism during the operation,proper using drugs, proper blood-transfusion and fluid infusion.

Objective To investigate the clinical value of arterial first approach in laparoscopic pancreaticoduodenectomy (LPD).Methods The retrospective cohort study was conducted.The clinicopathological data of 181 patients with pancreatic head and periampullay tumors who underwent LPD in the Affiliated Tongji Hospital of Huazhong University of Science and Technology between October 2014 and December 2016 were collected.Among 181 patients,96 using arterial first approach and 85 using traditional approach were respectively allocated into the experimental group and the control group.Surgery was applied to patients in the same doctors' team,and there were the same extent of surgical resection,range of lymph node dissection and digestive tract reconstruction.Observation indicators:(1) intraoperative situation;(2) postoperative situation;(3) followup and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the tumor-free survival up to February 2017.Measurement data with normal distribution were represented as x±s,and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Comparison of count data were analyzed using the chi-square test or Fisher exact probability.Results (1) Intraoperative situation:all the patients underwent successful LPD.Overall operation time and time of digestive tract reconstruction were respectively (268 ± 20) minutes,(33 ± 10) minutes in the experimental group and (285±25)minutes,(30± 17)minutes in the control group,with no statistically significant difference between 2 groups (t =8.529,2.741,P＞ 0.05).Time of tumor resection with superior mesenteric venous invasion were respectively (216± 13)minutes and (264±22)minutes in the experimental and control groups,with a statistically significant difference between the 2 groups (t=41.826,P＜0.05).Time of tumor resection without superior mesenteric venous invasion were respectively (224± 14) minutes and (215±21) minutes in the experimental and control groups,with no statistically significant difference between the 2 groups (t =7.423,P＞ 0.05).Volumes of intraoperative blood loss and blood transfusion were respectively (99± 16)mL,(1.3±0.8)U in the experimental group and (131±27)mL,(2.8±1.2)U in the control group,with statistically significant differences between the 2 groups (t =3.670,0.562,P＜ 0.05).Five and 8 patients had intraoperative blood transfusion in the experimental and control groups,showing no statistically significant difference between the 2 groups (x2=1.195,P＞0.05).(2) Postoperative situation:time of drainage tube removal and duration of hospital stay were respectively (5.8±2.4)days,(18.3±6.3) days in the experimental group and (6.3±3.6)days,(19.6±7.1) days in the control group,with no statistically significant difference between the 2 groups (t =0.498,1.305,P＞0.05).Eleven patients in the experimental group had postoperative early complications,including 8with grade A pancreatic fistula (4 combined with diarrhea,2 combined with biliary fistula,1 combined with delayed gastric emptying and 1 with single pancreatic fistula),3 with grade B pancreatic fistula (2 combined with intra-abdominal hemorrhage and 1 combined with intra-abdominal infection).One patient with intra-abdominal hemorrhage in the experimental group died after treatment failure.Twelve patients in the control group had postoperative early complications,including 6 with grade A pancreatic fistula (2 combined with biliary fistula,2 combined with delayed gastric emptying,1 combined with diarrhea,1 combined with digestive tract hemorrhage),3 with grade B pancreatic fistula and intra-abdominal hemorrhage (2 combined with infection,including 1 death) and 3 with diarrhea.Other patients with complications were cured by symptomatic and supportive treatment.There was no statistically significant difference in overall complications between the 2 groups (x2 =0.287,P＞0.05).Results of postoperative pathological examination showed that case with R0 resection was 93 and 76 in the experimental and control groups,with a statistically significant difference between the 2 groups (x2 =4.057,P＜0.05).(3) Follow-up and survival situations:179 patients were followed up for 2-28 months,with a median time of 14 months.Postoperative 6-month tumor-free survival rate was 92.7％ (89/96) and 88.2％(75/85) in the experimental and control groups,with no statistically significant difference between the 2 groups (x2=1.060,P＞0.05).Conclusion Arterial first approach in LPD could significantly shorten the time of tumor resection of patients with superior mesenteric artery invading pancreatic head and periampullay region,significantly reduce the volumes of intraoperative blood loss and blood transfusion,and increase the rate of R0 resection.

Objective To know the quality of iodized salt and the current situation of the salt coverage in Tibet,and to provide scientific basis for proposing proper prevention and control measures to Iodine dificiency disorders(IDD). Methods In 2008, according to the "Sampling Methods of the Main Products in the Salt Industry",one batch fifteen salt samples were collected in iodized salt processing factory in Tibet. Five townships were chosen in each county based on 5 different directions of east, south, west, north and center. If the monitoring county has less than five townships, then all of the townships were sampled. In each township, four villages were selected withrandom sampling and importance sampling. In each township, 15 households were selected for salt collection. Results A batch of 15 salt samples in a salt processing plant were tested, and all of them were qualified with salt iodine(34.6±1.58) mg/kg. A total of 21 107 edible salt samples were tested, and 11 203 of them were qualified iodized salt. These results meant that the provincial iodized salt coverage rate was 53.08%. Shannan iodized salt coverage rate was 94.31% (3395/3600) which was the highest in Tibet. Those of Nagqu, Changdu, Ngari were lower, they were 29.84% (897/3006), 24.94% (823/3300) and 17.08% (205/1200), respectively. Conclusions The quality of iodized salt in Tibet is up to the national standard, but the coverage rate of iodized salt is very low.We suggest that the strategy should be carried out according to the national overall program strategy and supplement iodized oil capsule for special groups.

Objective:To investigate the risk factors of lower extremity venous thrombosis in elderly patients with femoral neck fracture during perioperative period after artificial bipolar femoral head replacement and the effect of Mailuoshutong in clinical prevention and treatment of thrombosis.Methods:A retrospective case-control study was conducted on the clinical data of 92 elderly patients with femoral neck fracture who were admitted to the Affiliated Hospital of North China University of Technology from January 2015 to January 2020.According to the treatment method, the patients were divided into an observation group (44 cases) and a control group (48 cases). Patients in the observation group were treated with the combination of Mailuoshutong Pill and low molecular weight heparin calcium.The control group was treated with low molecular weight heparin calcium.The patients in both groups started anti-coagulation therapy immediately after admission, and they stopped the drug one day before operation and continued to take the drug on the second day after operation.Venous ultrasound of both lower limbs was recorded at the time of admission, on the 7th day after admission, and 14 days after surgery.The changes in hemoglobin, red blood cell count and drainage volume before and after operation were recorded.Results:The incidence of thrombosis was 2 cases (4.54%) on the 7th day after admission in the observation group and 9 cases (18.75%) in the control group.The difference was statistically significant (χ 2=4.400, P=0.036). The incidence of thrombosis was 3 cases (6.82%) in the observation group and 11 cases (22.92%) in the control group 14 days after operation.The difference was statistically significant(χ 2=4.611, P=0.032). The hemoglobin changes of observation group and control group were (23.73±6.89) g/L and (22.10±5.18) g/L respectively on the first day before operation and 48 hours after operation.The red blood cell count changes were (0.67±0.32) × 1012/L and (0.56±0.36) × 1012/L respectively, and the drainage volume of drainage tube after operation was (100.27±23.73) ml and (102.40±20.90) ml, respectively.There was no significant difference in the above indexes between the two groups (all P>0.05). Multivariate Logistic regression analysis showed that only low molecular weight heparin calcium was used to prevent and treat thrombosis ( OR=10.281, 95% CI: 1.609-65.689, P=0.014); the elderly patients ( OR=1.190, 95% CI: 1.061-1.336, P=0.003) and the thrombosis at the time of admission ( OR=8.346, 95% CI: 1.773-39.281, P=0.007) were the risk factors for lower extremity venous thrombosis on the 14th day after surgery. Conclusion:Mailuoshutong pill combined with low molecular weight heparin calcium can safely and effectively treat lower extremity venous thrombosis in perioperative period of artificial femoral head replacement for femoral neck fracture in elderly patients.Mailuoshutong pill combined with low molecular weight heparin calcium was a protective factor for lower extremity venous thrombosis 14 d after operation, while advanced age and thrombosis at the time of admission were risk factors.

Objective To explore the clinical application and follow-up results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating proximal humeral fractures. Methods From December 2006 to September 2008, MIPPO using locking plate was employed to treat 36 patients (23 males and 13 females) with proximal humeral fracture. According to AO classification, there were four patients with type A2 fractures, 10 with type A3 fractures, five with type B1 fractures, 11 with type B2 fractures, three with type C1 fractures and three with type C2 fractures. Longitudinal or transverse incision was made through anterolateral acromial approach to separate the deltoid muscle and expose the fracture fragments. The direct and indirect reduction of the fractures were performed under direct vision. The locking plate was inserted distally beneath the deltoid muscle and a longitudinal incision was made at the lateral end of the plate. Locking screws were inserted to the proximal and distal plates. Postoperative follow-up was done to provide guidance to functional exercise and evaluate the clinical results. Results The operation lasted for (50.1±11.3) minutes, with intra-operative blood loss of(76±18.7) ml and average operative incision of (4.5±0.8) cm. All the patients were followed up for 12-17 months (average 14 months), which showed that the time of bone healing was (10. 1 ±1.2) weeks. Neer scoring standards showed the total excellence rate of 86%. Conclusion MIPPO is an ideal method for treatment of proximal humeral fractures, for it has the advantages such as safety, minor trauma, short bone healing time, alleviation of pain and good X-ray reduction.

The chemical consitituents from cytotoxic fraction of the Callicarpa nudiflora extract were isolated and purified by a combination of HP-20 macroporous resin, silica gel and Sephadex LH-20 column chromatographies. The structures were elucidated on the basis of the spectroscopic data and comparison of their spectroscopic data with reported data. The cytotoxicity was evaluated by the MTT assay. The 50% and 70% EtOH elutions of EtOH-extract showed significant cytotoxic activities, leading to the isolation of twelve compounds, which were identified as luteoloside(1), lutedin-4'-O-β-D-glucoside(2), 6-hydroxyluteolin-7-O-β-glucoside(3), lutedin-7-O-neohesperidoside(4), rhoifolin (5), luteolin-7, 4'-di-O-glucoside (6), forsythoside B (7), acteoside (8), alyssonoside (9), catalpol(10), nudifloside(11), and leonuride(12). Compounds 3-6, 10 and 12 were isolated from this genus for the first time, and compound 9 was isolated from this plant for the first time. The cytotoxicity assay demonstrated that flavonoids 1-6, in various concentrations, showed monolithic proliferation inhibitory activities against Hela, A549 and MCF-7 cell lines. Compounds 3, 5 and iridoid glycoside 11 possessed higher cytotoxicacivities. In short, flavonoids are the main components of cytotoxic extract from C. nudiflora, while phenylethanoid glycosides are the predominant ingredient but inactive to cancer cell lines. In addition, the minor iridoid glycoside expressed weak cytotoxic activity.
Callicarpa ; chemistry ; Cell Proliferation ; drug effects ; Cytotoxins ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; MCF-7 Cells ; Molecular Structure

OBJECTIVETo investigate whether inhaled sevoflurane is capable of producing delayed cardioprotection effect in rats and its underlying mechanisms.

METHODSMale Sprague-Dawley rats inhaled 1.0 minimum alveolar concentration (MAC) sevoflurane, 1.5 MAC sevoflurane,or O(2) for 1 h. After 24 h and 48 h the left coronary artery of rats was occluded for 30 min,followed by 120 min of reperfusion. Hemodynamics was continuously recorded and myocardial infarct size was determined by Evans blue and triphenyltetrazolium chloride staining. The expression of nitric oxide synthase (NOS) was assessed by immunoblotting.

RESULTS1.0 MAC sevoflurane and 1.5 MAC sevoflurane improved cardiac pump function after reperfusion and reduced myocardial infarct size with the increased iNOS expression (P<0.05). However,the expression of eNOS and p-eNOS was not affected (P>0.05). A selective iNOS inhibitor 1400 W abolished the cardioprotection effect induced by inhalation of 1.0 MAC sevoflurane for 24 h.

CONCLUSIONSevoflurane produces delayed cardioprotection through the up-regulation of iNOS expression.

Anesthetics, Inhalation ; pharmacology ; Animals ; Disease Models, Animal ; Ischemic Preconditioning, Myocardial ; Male ; Methyl Ethers ; pharmacology ; Myocardial Reperfusion Injury ; enzymology ; pathology ; prevention & control ; Myocardium ; enzymology ; pathology ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley ; Up-Regulation ; drug effects