Indocyanine green (ICG) is a fluorescent dye which has various advantages including high absorption,low toxicity,not involved in biotransformation in vivo and rapid excretion in near-infrared range.Due to the high penetrating ability in biological tissues and low rate of being affected by other factors,near-infrared optical imaging has become a major method of functional imaging and diagnosis.It shows great prospects in optical detection.As the only clinical using near-infrared optical imaging contrast enhancer approved by FDA,ICG has been widely used in biomedical imaging,photodynamic therapy,pathology detection and many other medical related areas.This article focuses on the recent development of ICG application,especially concentrates on the clinical uses.

Objective To study the effect of intra-pulmonary arterial anti-tumor necrosis factor-α antibody(TNF-α Ab) on ultra-structure of lung after cardiopulmonary bypass (CPB).Methods Forty New Zealand rabbits were selected and randomly divided into four groups:group Ⅰ-Ⅲ underwent CPB; group Ⅳ only received open chest operation.In the group Ⅱ,rabbit TNF-α Ab(27 ng/kg) was dropped into the pulmonary artery when the aorta was clamped and CPB continued 30 minute.Pulmonary arterial perfusion was given to the group I instead.Blood TNF-α and neutrophils count from right and left atrium and oxygenation index in the four groups were determined perioperatively.Lung water content,TNF-αmessenger RNA,Bcl-2 protein,Bax protein,Bcl-2/Bax,apoptosis index and pathomorphological change were measured in the lung tissues.Results TNF-α Ab can restrain leukocyte accumulation and reduce releasing of TNF-α in the lung and improve oxygenation index.Moreover,TNF-α Ab can reduce the expression of Bax on alveolar epithelial cells and alleviate the decreasing of the expression of Bcl-2.It can also reduce the occurrence of apoptosis and attenuate pathomorphological changes in the lung tissue.Conclusion Intra-pulmonary arterial antitumor necrosis factor-α antibody markedly lessens the injury of inflammatory reaction and ultra-structure of lung after CPB via Bcl-2/Bax pathway.

OBJECTIVE To establish the method to determine the microbial limit tests for Shuyu Capsules.METHODS According to the Chinese Pharmacopoeia 2005 edition,two testing methods had different percentage recovery with 5 control trains.RESULTS Shuyu Capsules were Tradional Chinese Medicine(TCM),and that had antimicrobial effects,which could be eliminated by media dilution method.CONCLUSIONS This method can achieve the destination which is feasible and accurate.

Objective To preliminarily explore the effects and brain protective mechanism of intermittent hypoxia preconditioning ( IHP) on rats with seizures induced by lithium-pilocarpine ( Li-pilo) .Methods A total of 96 8-week old male Sprague Dawley rats ( clean grade ) were randomly divided into control group , seizure group and four IHP-seizure groups.The animal model of epilepsy was established by intraperitoneal injection of Li-pilo in the seizure group and four IHP-seizure groups (Li-pilo was injected at 1, 3, 7, or 14 days after a 5-day regimen of IHP).Subsequent seizure behavior , the latency period and percentage of generalized seizures were quantitatively evaluated for 240 min and the cognitive function was tested by Morris water maze task , and followed by the detection of hippocampus neuron apoptosis and related protein (BCL-2, Bax, and cleaved-caspase-3) by TUNEL labeling and Western blot, respectively.Results The induced seizure peaked on an average between 50-150 min after Li-pilo administration , scored using a modified Racine scale.The average scores of modified Racine scale in the IHP-3d seizure group was significantly lower than that in the other groups.The latency period and percentage of generalized seizures in the IHP-3d seizure group rats were significantly different from the parameters in the seizure group rats (P<0.05).IHP-3d seizure rats showed lower escape latency, neuronal apoptosis counts and higher percentage of time in the probe quadrant compare with the seizure group and the other three IHP-seizure groups ( P <0.05 ) .Compared with the control group , the parameters of water maze and apoptosis detection in the IHP-3d seizure group showed no significant changes (P>0.05).Conclusions The results indicate that IHP treatment may help to decrease the susceptibility to epilepsy by reducing abnormal apoptosis , and has a brain protective effect on the seizure rats .

Objective To investigate the feasibility and safety,and short-term therapeutic effect of laparoscopic azygoportal disconnection without splenectomy for cirrhotic portal hypertension (PLT count ＞ 50 × 109/L).Methods Clinical data of 48 patients with bleeding portal hypertension and secondary hypersplenism (PLT count ＞ 50 × 109/L) undergoing laparoscopic splenectomy and azygoportal disconnection (LSD,n =26) vs.laparoscopic azygoportal disconnection (LD,n =22) between January 2014 and August 2015 were analyzed.Results Operative time (82 ± 29) min,intraoperative blood loss 20(10-50) ml,days of postoperative fever 0(0-3) d,rate of postoperative fever 10/22,postoperative hospital stay (7.0 ± 1.3) d,and WBC counts (3.8 ± 1.6) × 109/L,PLT counts 64 (49-88) × 109/L,and the incidence of portal vein thrombosis on POD 7 (14％),were significantly less in LD group than in LSD group [(180±41) min,80(20-500) ml,2(0-4) d,(22/26),(10.8 ±3.0) d,(9.1 ±3.1) × 109/L,156 (78-630) × 109/L,(42％)],(t =9.637,Z =-4.746,Z =-2.314,x2 =8.224,t =5.794,t =7.785,Z=-5.508,x2 =4.742,all P ＜ 0.05).Immune function was better in LD group than in splenectomy group at postoperative month 3.The serum proportion of CD4 + (58 ± 11) and the CD4 +/CD8 + ratio (1.9 ±0.7) at postoperative month 3 were significantly higher after LD than after LSD [(43 ± 14),(1.2 ± 0.9)],(t =-3.755,t =-2.509,all P ＜ 0.05).Conclusion Laparoscopic azygoportal disconnection without splenectomy is safe and effective for esophagogastric variceal hemorrhage and moderate hypersplenism (PLT ＞ 50 × 109/L) secondary to portal hypertension.

Objective To evaluate modified laparoscopic hepatic hemangioma extraction methods during laparoscopic hepatectomy.Methods From May 2009 to June 2013, 25 hepatic hemangioma patients were admitted for laparoscopic hepatectomy.Patients were divided into modified laparoscopic group with modified laparoscopic hepatic hemangioma extraction methods (MLH, n =11) and traditional laparoscopic group (TLH, n =14).Perioperative clinical parameters were compared between the two groups.Results Operative time (148.6 ± 18.0) min, time to removal of the HCH (15.7 ±4.6) min, visual analog scale pain score on the first postoperative day (2.3 ± 0.9), time to off-bed activity (2.5 ± 0.8) d, and postoperative hospital stay (8.5 ± 2.6)d in the MLH group were all less than those in the TLH group [(163.9±13.2)min, (33.9±3.1)min, (3.4±0.9), (3.1±0.8)d, (10.6±1.9)d] (t=-2.451,t =-11.800, t =-2.931, t =-2.156, t =-2.338,P ＜ 0.05).There were one in the MLH group and two cases in the TLH group developing postoperative complications (P =1.000).Conclusions Modified laparoscopic hepatic hemangioma extraction methods during laparoscopic hepatectomy for hepatic hemangioma is safe, feasible and of good therapeutic effect.

Objective To investigate the protective effect of icariin against varicocele-induced damage on rat epididymis. Methods Forty adolescent male SD rats were randomly divided into control group (n=10), experimental varicocele (EV) group (n=15), icariin (ICA) therapy group (n=15). Experimental varicocele model in the EV group and ICA group was established. The EV was induced by partial ligation of the left renal vein. The rats in the control group underwent a sham operation that separated the spermatic vessels without ligation. Each rat in the control group and EV group was lavaged with 2 mL physiological saline every day for 6 weeks. Each rat in the ICA group was lavaged with icariin [100 mg/(kg·d)] for 6 weeks. Rats in all groups were executed after 6 weeks. The contents of sialic acid were measured by spectrophotometry. Carnitine concentrations were measured by DTNB. HE stain was used to observe the microstructure changes in the epididymal tissue. Electron microscopy was used for observing the ultrastructural changes of the epididymis. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method was used to detect the apoptosis of the epididymal epithelium. Results Compared with the control group, the microstructure and ultrastructure of the epididymis in EV group showed pathological damage. Compared with the EV group, the damage of the epididymal microstructure and ultrastructure significantly alleviated. Apoptosis index (AI) of epididymal epithelium in the EV group was significantly higher than that in the control group (P<0.01). However, AI of epididymal epithelium in the ICA group was significantly lower than that in the EV group (P < 0.01). The sialic acid and carnitine concentrations of the epididymis in the EV group was significantly lower than that in the control group (P < 0.01), respectively. However, the sialic acid and carnitine concentrations of the epididymis in the ICA group was significantly higher than that in the EV group (P < 0.01), respectively. Conclusion This study indicates that varicocele could result in the apoptosis of epididymal epithelium and icariin decreased the varicocele-induced apoptosis , suggesting that varicocele could damage the structure and function of epididymis, which can be repaired by icariin.

Objective The aim of this study was to generate human cholesteryl ester transfer protein ( CETP) transgenic rabbits and analyze their biological properties.Methods We generated human CETP transgenic rabbits by DNA microinjection, and detected the expression of human CETP by real-time PCR and Western blot assay.The activity of CETP was measured using an activity assay kit.Results Human CETP transgenic rabbits were successfully generated by DNA microinjection.Compared with wide type rabbits, the expression of human CETP was dramatically increased in the liver of the human CETP transgenic rabbits.The plasma CETP activity was also much higher in the liver of human CETP transgenic rabbits than that of control rabbits.Conclusions The model of human CETP transgenic rabbits is successfully established by DNA microinjection.It will provide a useful tool for the studies of CETP biological function and its involvement in the mechanisms of cardiovascular diseases.

Objective To explore the clinical effects of S-1 single agent chemotherapy for the patients undergoing radical resection of cholangiocarcinoma.Methods The clinical data of 51 patients receiving radical resection of cholangiocarcinoma who were admitted to the Second Affiliated Hospital of Zhejiang University from November 2011 to December 2013 were retrospectively analyzed.After radical resection of cholangiocarcinoma,25 patients receiving non-special treatment and 26 patients receiving S-1 single agent chemotherapy were divided into the operation group and chemotherapy group,respectively.S-1 was taken orally twice per day.Forty mg/once of S-1 was applied to patients with the body surface area ＜ 1.25 m2,50 mg/once of S-1 was applied to patients with the body surface area ≥ 1.25 m2 and ＜ 1.50 m2,and 60 mg/once of S-1 was applied to patients with the body surface area ≥ 1.50 m2.The 14 days usage and 7 days withdrawal of S-1 were used as one course of treatment.The standard usage of S-1 was 6-8 courses of treatment.All the patients were followed up by outpatient examination and telephone interview till December 1,2014.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s and analyzed using the t test.Survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results Twenty-six patients in the chemotherapy group finished the courses of chemotherapy without chemotherapy-related death,and 14 patients had chemotherapy adverse reactions with remission after discontinuation of S-1.All the 51 patients were followed up for 5-37 months with a median time of 19 months.The median overall survival time,1-,3-year overall survival rates,tumor-free median survival time and 1-,3-year tumor-free survival rates were 22 months (range,18-27 months),72.3％,42.9％,21 months (range,16-26 months),60.0％,55.0％ in the operation group and 32 months (range,29-35 months),84.6％,44.4％,26 months (range,21-31 months),76.9％,61.9％ in the chemotherapy group,respectively.There was a significant difference in the overall survival between the 2 groups (x2=6.032,P ＜ 0.05).There was no significant difference in the tumor-free survival between the 2 groups (x2=0.498,P ＞ 0.05).Conclusion S-1 single agent chemotherapy after radical resection of cholangiocarcinoma could improve the survival of patients,while no obvious advantages of inhibiting tumor recurrence is observed.

Quality management covers every corner of hospital services,which upholds full-process quality management,continuous quality improvement and smooth management with patients at the center.By means of building a 3-tier quality management framework at the hospital,development of quality management criteria,appraisal indicators and documentation and use of quality management tools,quality management defects were identified from a third-party perspective.This effort has significantly improved quality of care at the hospital,and elevated the management execution and general service quality of the hospital.