Objective To analyze clinical features and sum up experience for the treatment of ischemic bowel disease. Methods Clinical data of 73 patients with the diagnosis of ischemic bowel disease were retrospectively analyzed. ResultsTwenty-eight patients were male and 45 patients were female. The median of age was 65 years (range of 38 to 89 years). Forty-eight patients were associated with hypertension, 23%(17/73) patients had a history of coronary disease and 15% (11/73) had diabetes. Seventy patients presented symptom of abdominal pain and 93% (68/73) had hematochezia. Symptoms relieved by conservative treatment in 96% (63/66) patients. Nine patients underwent a surgery. One patient died of sepsis postoperatively. One suffered from colostomy necrosis and leakage of the rectum segment. Conclusion 1. Elder patients presenting symptoms of abdominal pain and hematochezia, especially with a history of cardio-cerebrovascular disease and diabetes should be considered for the possibility of ischemic bowel disease. 2. Most patients with ischemic bowel disease could be successfully treated by conservative therapy. 3. Surgery for patients with chronic relapsing and nonresponsible symptoms was difficult and patients often suffer from high postoperative complications.

OBJECTIVETo study the effects of Jinhuang Yidan Granule (JYD) on the bile compositions of primary bile duct pigment calculus patients.

METHODSSixty-six patients with primary bile duct pigment calculus were randomly assigned to the control group (who took no Chinese medicine) and the JYD group (who took JYD). The bile from T-tube during the operation, 3, 10, and 40 days after medication were examined. The contents of bile acids, bilirubin (conjugated bilirubin, mono-conjugated bilirubin), glucoprotein, calcium ion, beta-glucuronidase, superoxide radical anion, and other components were detected and compared.

RESULTSThree days after taking JYD, the total bile acids increased, the total bilirubin and beta-glucuronidase decreased, showing statistical significance when compared with the control group (P < 0.05). In the JYD group, the total bile acid increased, the total bilirubin, the conjugated bilirubin, the mono-conjugated bilirubin, glucoprotein, calcium ion, beta-glucuronidase, superoxide radical anions decreased 10 and 40 days after medication, showing statistical significance when compared with the control group (P < 0.05, P < 0.01). The level of the total bile acid increased, the levels of the total bilirubin, the conjugated bilirubin, the mono-conjugated bilirubin, glucoprotein, calcium ion, beta-glucuronidase, superoxide radical anions decreased after 40-day medication in the two groups, showing statistical significance when compared with the peri-operative indices of the same group (P < 0 05, P < 0.01).

CONCLUSIONSJYD could significantly improve the pathologic bile compositions of the bile duct calculus, improve the environment of the biliary tract, showing certain preventive and therapeutic effects on bile pigment calculus of the primary bile duct calculus. Better effects may be obtained by long-term taking.

Adolescent ; Adult ; Aged ; Bile ; chemistry ; Bile Pigments ; analysis ; Choledocholithiasis ; pathology ; physiopathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Young Adult

OBJECTIVETo investigate the methods of culturing and identifying mouse myeloid semimature dendritic cell (smDC) in vitro.

METHODSMyeloid monocytes derived from 6-week-old C57 BL/6 mice were cultured in RPMI-1640 medium containing 10% fetal bovine serum, 2 ng/ml recombinant murine granulocyte macrophage-colony stimulating factor (GM-CSF), and 20 ng/ml recombinant murine interleukin (IL)-4 for 9 days. Then cells were incubated with 40 ng/ml tumor necrosis factor-alpha (TNF-alpha) for 24 hours to obtain smDC. Meanwhile, smDC was differentiated into mature dendritic cell (mDC) or immature dendritic cell (iDC) by treatment with 1 micro/m1 lipopolysaccharide (LPS) or without LPS. The morphological features of smDC were assayed by inverted microscopy and scanning electron microscopy. Surface markers such as CD11c, CD4O, CD8O, CD86, and MHC-II were tested by flow cytometry. IL-1beta, IL-6, IL-12, and IL-10 in the supernatant were tested by ELISA. The activation of allogene lymphocyte (BALB/c mice) stimulated by C57BL/6 myeloid smDC in mixed lymphocyte reaction was examined by Cell Counting Kit-8 in vitro.

RESULTSThe shape of smDC was round or oval-shaped, and the diameter of smDC was about 15 microm. The length of smDC dendrite was between 5 to 10 microm. smDC, iDC, and mDC all expressed high level of CD11 c. The expressions of MHC-II, CD40, CD80, and CD86 on smDC were higher than those of iDC and lower than those of mDC. IL-1beta, IL-6, and IL-12 secretion of smDC was significantly lower than that of mDC (P < 0.01), and IL-12 was significantly lower than that of iDC (P < 0.05), while no significant difference of IL-1beta and IL-6 secretion was found between smDC and iDC (P > 0.05). Furthermore, IL-10 secretion was not significantly different among these three kinds of DCs (P > 0.05). The effect of allogene lymphocytes activation on smDC was significantly lower than that of mDC and positive control (P < 0.01), but had no significant difference when compared with that of iDC and negative control (P > 0.05).

CONCLUSIONSsmDC may be a relatively independent dendritic cell sub-population in terms of function and morphology. It is a feasible way to induce myeloid monocytes to differentiate into smDC using GM-CSF, IL-4, and TNF-alpha in vitro.

Animals ; Cell Culture Techniques ; Cell Differentiation ; Cells, Cultured ; Cytokines ; immunology ; Dendritic Cells ; cytology ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Monocytes ; cytology ; immunology

AIMTo approach the effects of multi-site synchronous ventricular pacing on myocardial mechanics and cardiac work.

METHODSFive modes of multi-site synchronous ventricular pacing were randomly performed in 12 dogs with anesthetized, opened chest and artificial-ventilation. Some parameters were measured simultaneously including: the peak of left ventricular pressure rise and fall (+/- dp/ dt(max)), the time constant of left ventricular relaxation(tau), the muscle tensile force in left/right ventricular wall (V-tensile force, V-TF), SV, LVSW and RVSW.

RESULTSThe myocardial systolic mechanical parameters: +dp/dt(max) and LV-TF of cHisB-LVPL and RVA-LVPL pacing by biventricular pacing modes were increased than that of cHisB-RVA pacing in right ventricular bifocal pacing mode. +dp/dt(max) in above two groups of biventricular pacing was increased than that in cHisB-RVA pacing. Tau value of cHisB-LVPL and RVA-LVPL pacing modes were shorted than that of cHisB-RVA pacing. The above parameters of cHisB-RVA-LVPL and cHisB-RVA-LVA biventricular trifocal pacing were superior to that of cHisB-LVPL and RVA-LVPL biventricular pacing. The +dp/dt(max), LV-TF and RV-TF of cHisB-RVA-LVPL pacing were increased as compared with that of cHisB-RVA-LVA pacing (P > 0.05). The -dp/dt(max) in cHisB-RVA-LVPL pacing were increased by 6.0% and tau value was shorted by 3.7% compared with those in cHisB-RVA-LVA pacing (P > 0.05). SV, LVSW and RVSW of cHisB-LVPL and RVA-LVPL biventricular pacing were increased than those of cHisB-RVA bifocal pacing. The above parameters of cHisB-RVA-LVPL pacing were increased than that of cHisB-RVA-LVA and cHisB-LVPL pacing.

CONCLUSIONIt was explained that the cHisB-RVA-LVPL biventricular trifocal sites synchronous pacing mode would increase the velocity of ejection and filling during myocardial contraction and relaxation and enhance cardiac work by maintaining normal VSS.

Animals ; Cardiac Pacing, Artificial ; methods ; Dogs ; Female ; Heart ; physiology ; Heart Ventricles ; Male ; Myocardium

OBJECTIVEAs a new technique of biomedical imaging, the optical in vivo imaging has been used in many research fields of biological processes, such as analyzing gene expression pattern, observing action of drug target. For extending its application field, this technique is initially used to investigate the effect of acupuncture in this study.

METHODSSeven SPF mice were randomly divided into an acupuncture group (4 cases) and a control group (3 cases). Fluorescent labeling Cy7 (Tf-Cy7) and Doxorubicin (Dox) were injected into the caudal vein of the nude mice, respectively. With the.stabilized distribution of Tf-Cy7 and Dox in vivo, "Yaoyangguan" (GV 3) point was acupunctured in the acupuncture group. The animals in the control group were not acupunctured. Then, the fluorescent irradiance of Tf-Cy7 and Dox was displayed by the optical in vivo imaging, the effect of acupuncture was analyzed.

RESULTS(1) After acupuncture, the fluorescent intensity of Tf-Cy7 started to decrease in the blood-brain barrier and heart, but tended to increase in the liver and spleen, in which the highest intensity of Tf-Cy7 was demonstrated at 50 min during the acupuncture. It was obviously different from that of the control group. (2) The fluorescent intensity of Dox tended to increase in the brain and lung after 20 min of acupuncture, and reached the highest concentration at 30 min.

CONCLUSIONAcupuncture can influence the action of Tf-Cy7 targeting and distribution of Dox, which is clearly showed with the optical in vivo imaging. Thus, this technique provides a new approach for the acupuncture and meridian research.

Acupuncture ; Animals ; Blood-Brain Barrier ; physiology ; Female ; Heart ; physiology ; Liver ; physiology ; Male ; Mice ; Mice, Nude ; Molecular Imaging ; methods ; Pilot Projects ; Random Allocation ; Research Design ; Specific Pathogen-Free Organisms

OBJECTIVEThe traditional gracilis musculocutaneous flap is supplied by a branch of deep femoral artery, which enters the muscle in between the upper and middle third of it. So the flap barely reaches the pelvis and perineum region for reconstruction. By exploring the blood supply pattern we tried to rotate the flap Upon at the higher point starting at the obturator foramen in order to let it cover a bigger area.

METHODSanatomical reviewing of the blood supply of the gracilis branches of obturator, medial femoral circumflex and deep femoral arteries. Based on this a new type of longitudinal gracilis musculocutaneous flap supported only by the obturator artery was designed to reach the pelvis, female genitalia, pubic symphysis, inguinal area easily.

RESULTSThe new kind of flap has been applied to 9 patients for deformity repairing and tissue replacement in the pelvic and perineal area. All the flaps survived and achieved satisfactory result with 3 months to 3 years' follow up.

CONCLUSIONSLongitudinal gracilis musculocutaneous flaps supplied by the obturator artery can be used as regular musculocutaneous flap clinically.

Female ; Femoral Artery ; surgery ; Humans ; Muscle, Skeletal ; blood supply ; transplantation ; Surgical Flaps ; blood supply

OBJECTIVETo probe into a safe and effective method for treatment of functional ventricular premature, and develop a new preparation of Chinese herbs with high science and technique contents.

METHODSTwo hundred and thirty-eight cases were randomly divided into a slowly-releasing medication group (n = 118) and a western medicine group (n = 120). The slowly-control needle group were treated with intramuscular injection of slowly-releasing medication new type preparation made by proved recipe of Chinese herbs with replenishing and strengthening pectoral qi, and nourishing yin and tranquillization into Tanzhong (CV 17), Neiguan (PC 6), Xinshu (BL 15), Pishu (BL 20) and Feishu (BL 13) by a trocar to slowly release and control releasing of the medicine so as to maintain lasting stimulation; the western medicine group with oral administration of Rythmol, thrice daily, 150 mg each time.

RESULTSThe cured rate and the cured and markedly effective rate for the ventricular premature was 51.7% and 71.2% in the slowly-releasing medication group, which were significantly higher than 28.3% and 50.8% in the western medicine group (P < 0.001).

CONCLUSIONThe slowly-releasing medication new type preparation has a better therapeutic effect on functional ventricular premature, with high safety.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Delayed-Action Preparations ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Ventricular Premature Complexes ; physiopathology ; therapy

Objective To estimate the intangible cost and associated factors on patients with hepatitis B-related diseases, so as to explore the differences of the three elicitation techniques on the health economics-related information by trained investigators, using a structured questionnaire. WTP was employed to estimate the intangible cost while an open-ended question format, together with iterative bidding game and payment card were respectively used to elicit WTP for the hypothetical cure of hepatitis B-related diseases. A Multiple linear stepwise regression model was determined to identify those factors potentially affecting the intangible cost. Results A total of 564 subjects from 641 patients with hepatitis B-related diseases were identified for the inclusion of this study. The average annual intangible cost of patient with hepatitis B-related diseases was 54 320.4 Yuan (Ren Minbi).The intangible cost accounted for 53.0% of the total cost, which was much more than the proportions of the direct and indirect costs (38.5% and 8.5%, respectively). Among annual personal and the household income of the patient, proportions of intangible cost were 262.6% and 67.6% respectively,suggesting that the patients were under huge spiritual and psychological pressure. Response rate of the approach, combined open-ended questions with iterative bidding game, was the highest (76.6%) among the three elicitation formats. Considered the characteristics of data being gathered, the approach seemed to be more reasonable. Further studies were needed to examine the results yielded from other WTP elicitation formats. We also noticed that the progression of disease was associated with the increase of direct and indirect costs, but not with the intangible cost. Data from the multiple linear stepwise regression analysis indicated that the types of hospital and commercial medical insurance were significantly different in explaining the variation of the intangible cost. Conclusion Measures should be taken to reduce the intangible cost of hepatitis B-related diseases. The approach regarding the combination of open-ended questions with iterative bidding game should be recommended when carrying our further WTP studies of this kind.

OBJECTIVETo investigate the safety and feasibility of steroids minimization immunosuppressive regimen in liver transplantation.

METHODSOne hundred and sixteen patients in line with the selecting criteria from January 2005 to June 2008 were divided into three groups according to the withdrawal of steroids: 40 cases in 3 months withdrawal group, 40 cases in 7 d withdrawal group and the other 36 cases in 24 h withdrawal group. The difference of recipients' survival, infection, acute rejection and steroids resistant acute rejection, wound healing, recurrence of HBV and hepatocellular cell (HCC), new on-set of diabetes, hyperlipidemia and hypertension between the three groups were compared.

RESULTSThe difference of recipients' survival, acute rejection including steroids resistant acute rejection, recurrence of HBV and HCC, hyperlipidemia between the three groups were not significant (P > 0.05), the incidence of wound un-healing and hypertension in 24 h withdrawal group was significantly lower than that in the other 2 groups (P < 0.05), the incidence of infection and new on-set diabetes in 24 h withdrawal group and 7 d withdrawal group was significantly lower than that in 3 months withdrawal group (P < 0.05).

CONCLUSIONSteroids minimization immunosuppressive strategy is safe and feasible in liver transplantation field, it will significantly reduce the steroids related complications without increasing the risk of rejection.

Adult ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Immunosuppression ; methods ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Liver Transplantation ; Male ; Middle Aged ; Postoperative Care ; Prognosis ; Retrospective Studies ; Steroids ; administration & dosage ; therapeutic use ; Young Adult

OBJECTIVETo study on the efficacy, prognosis and security of high-intensity focused ultrasound (HIFU) combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC).

METHODSTotally 72 HCC patients treated by HIFU from December 2009 to January 2011 were divided into two groups according to treatment methods: 40 cases in HIFU group, 32 cases in TACE + HIFU treatment group (combined group). Then set up a control group include 40 cases treated by only TACE in the same period (TACE group). The improvement of clinical symptoms, AFP, reduce rate of tumor volume, survival rate of 1 year after operation and postoperative complications in front and behind the treatment were analyzed.

RESULTSThere was no significant statistical difference on the improvement of clinical symptoms in all these three groups (P > 0.05) after treatment for HCC. There is no significant statistical difference also on reduce rate of tumor volume and decrease rate of AFP in both HIFU group (35.0%, 41.4%) and TACE group (37.5%, 41.9%) (χ² = 0.054, P = 0.816; χ² = 0.002, P = 0.965). Both reduce rate of tumor volume (62.5%) and decrease rate of AFP (72.0%) in combined group were better than HIFU group (χ² = 5.394, P = 0.020; χ² = 5.098, P = 0.024) and TACE group (37.5%, 41.9%) (χ² = 4.448, P = 0.035; χ² = 5.062, P = 0.024). Kaplan-Meier survival curve showed that there was no significant statistical difference on short-term survival rate in the 3 groups. But the long-term survival rate of combined group was better than TACE group and HIFU group.

CONCLUSIONTACE combined with HIFU is a effective, safe and noninvasive treatment method to HCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Prognosis ; Treatment Outcome ; Ultrasound, High-Intensity Focused, Transrectal