Objective To investigate the clinical manifesfations and diagnostic and therapeutic features of cholangiocarcinoma associated with hepatolithiasis.Methods The clinical data, the diagnotic and therapeutic featares of 54 cases of cholangiocacinoma associated with hepatolithiasis were retrospectively analyzed.Results The occurrence rate of hepatolithiasis concomitant with hepatocholangiocarcinoma was 11.8%.Due to a lack of specific clinical manifestations, the preoperative diagnosis of this condition was difficult. In this series, the (correct) diagnotic rate of hepatocholangiocarcinoma before operation was only 11.1%. The radical resection rate was 51.8%. Radical resection of the tumor had a better prognosis than that of non-resection of tumor.(Conclusions) Patients with long-term recurrent hepatolithiasis tended to have associated cholangiocarcinoma. Early diagnosis of the disease was difficult, and the treatment results and prognosis were poor. Therefore, (patients) with hepatolithiasis, espesially those with recurrent attacks, should undergo operation early. In cases diagnosed as hepatic cholangioearcinoma at operation, a radical resection should be performed, if possible, and a favorable outcome may be attained.

Objective To study the effects of the active components of eight kin ds of Chinese herbs on cytochrome P450 enzymes (CYP) 1A1,2E1,3A4 and 3A5 mRNA expression. Methods The mRNA expression levels of four CYP enzymes were determin ed by real-time quantitative reverse-transcriptase polymerase chain reaction. Results Baicalin,baicalein and artemisinin induced CYP1A1 expression at differe nt concentrations. Compared with baicalin and baicalein,the effect of artemisin in was weaker. The expression of CYP3A4 gene was significantly obvious after ind uced by sodium aescinate,baicalein and artemisinin. Conclusion HepG2 cells shou ld be an appropriate in-vitro system for investigating potential human CYP indu cing agents. CYP1A1 and CYP3A4 expression could be significantly induced by baic alin,baicalein,artemisinin and sodium aescinate,which would supply the eviden ce for the interaction of herbal medicine and western medicine based on cytochro me P450 and toxicology.

Objective Applying color Doppler ultrasonic test on the first dorsal metatarsal arteries,to acquire relevant Doppler bloodstream parameters,and in the end,to explore the clinical value of this approach.Methods Applying GE-LOGIQ-400 color Doppler high-frequency ultrasonic test on the first dorsal metatarsal arteries of 100 diabetes patients,contrasting to those of 60 normal persons,observing the origination,trend,smooth of bloodstream,angioplerosis Status,analyzing bloodstream spectrum(including the interior diameter of blood vessel,spectrum status,bloodstream speed,drag index,erc.),and contrasting the resuits.Results The first dorsal metatarsal arteries of diabetes patients have narrower interior diameter,faster bloodstream speed,higher drag index than those of non-diabetes patients.Conclusion The high-frequency color Doppler ultrasonography can provide objective clinical evidence on the test of the first dorsal metatarsal arteries diseases.

Objective To investigate in evaluation of various capacity requirement of probationer nurs-ing students by nurses in operation room in order to improve clinical teaching work. Methods A self-de-signed questionnaire was applied, 191 qualified teaching nurses from nine grade three A general hospitals in Beijing were invited to fdl the questionaires. The results underwent subsequent analysis. Results The teach-ers had high expectations for various capacity of the probationer nursing students. Conclusions Clinical teachers should establish feasible teaching scheme according to the existing teaching syllabus in order to in-crease teaching quality, make students gain new insights through reviewing old materials, so that they can mas-ter various technique in operation room in short time.

Objective To investigate the status of structural empowerment,job stress and burnout,and to explore the relationship aunong them.Methods The questionnaires of CWEQ-Ⅱ,job stressors and MBI were used to investigate 350 nurses working at tertiary-level hospitals.Results The average score of CWEQ-Ⅱ was (2.23±0.59),the score of EE of MBI was (29.75±13.94),PA was (27.40±11.21),both of them showed a high level of exhaustion,DP was (8.07±5.82),which showed a middle level of exhaustion.The findings showed that workload and time pressure were the most frequently encountered job stressor among staff nurses,the score was (3.23±0.95).There was a significant correlation among structural empowerment,job stressors and the level of burnout.Hierarchical regression analysis and structural equation modeling showed that structural empowerment had significant influence on every factor of job stressors and burnout,job stressors had significant influence on the every factors of burnout.Conciusins It is suggested to pay attention to the main job stressors,and take proper interventions to enhance nurses' structural empowerment to prevent burnout,and thereby to raise the quality of care.

Objective To study the effect of Licofelone,a novel non-steroid anti-inflammatory drug,on the expression of Fractalkine induced by interleukin-18(IL-18) in mesangial cells.Methods Rat mesangial cells were cultured and divided into IL-18 stimulated group,Licofelone-treated group and normal control group.The cells in IL-18 stimulated group were stimulated by 10 ?g/L IL-18 for 24 h.In Licofelone-treated group,ahead of exposure of IL-18 for 24 h,cells were treated with Licofelone in the doses of 10,50 and 100 ?mol/L for 30 min.Additionally,the mesangial cells without treatment of IL-18 and Licofelone were used as normal control group.Reverse transcription-polymerase chain reaction(RT-PCR) was used to measure the level of Fractalkine mRNA.The expressions of Fractalkine protein in every group were detected with enzyme linked immunosorbent assay (ELISA).Results In normal control group,the expression level of Fractalkine mRNA was 179.0?21.0.After exposure of IL-18 for 24 h,the level of Fractalkine mRNA was 1 220.1?185.7,which was higher than that in normal control group (t=9.646 P

Objective To study the trends over time in meningococcal meningitis with Neisseria meningitidis .Methods Routine reported data on Meningococcal meningitis with Neisseria meningitidis in Shijiazhuang from 1949 to 2014 were used to study the trends of disease severity,disease distribution and serogroup switching of Neisseria meningitidis strains over time.The qualitative description and the quantitative evaluation was performed by the annual percent change (APC)in incidence to demonstrate the secular trends.The t test and χ2 test were performed when appropriate.Results From 1949 to 2014, 53 779 meningococcal meningitis cases were reported in Shijiazhuang.Of the 53 779 cases,36 170 were male and 17 609 were female,which was significantly different (χ2 =581 .04,P =0.000).It occurred all the year round,with an increased incidence between February and April,accounting for 81 .44%.The epidemic peak occurred about every 10 years.The range of annual incidence rate was from 0.01/lakh to 387.21/lakh.APC was -4.65 (t=-11 .72,P =0.000).The significant decline of APC were found in the age group of 0—1 year (t=-10.56,P =0.000),1 —5 year (t =-14.32,P =0.000),5 —10 year (t=-11 .01 ,P =0.003 ),10—15 year (t = -8.34,P =0.033 )and 40—50 year (t = -7.42,P =0.045).The risk population was those under 5 years old during 1949 to 2002 period and the serogroup was dominated by A strains.Whereas during 2003 to 2014,that was those of 5 —15 years old,and the dominant serogroup was C strains. Conclusions There is a remarkable decline in incidence of meningococcal meningitis in Shijiazhuang.The serogroup changes from A strains to C strains and the risk population of cases shifts to older children.

TA method for the content determination of methionine sulfoxide and methionine sulfone in compound amino acid injection (18AA-II) was established in order to investigate their level in 155 batches of this product, and to explore the reason for the generation of these two impurities.The determination was performed on an Agilent Poroshell 120 EC-C18 column with mobile phases of sodium acetate/tetrahydrofuran solution (A) and sodium acetate solution -acetonitrile-methanol (B, 200∶400∶400) (gradient elution) at the flow rate of 0.5 mL/min.The excitation wavelength and the emission wavelength of the fluorescence detector were 233 nm and 441 nm, respectively.The column temperature was 40 °C, and the injection volume was 8 μL.The contents of methionine sulfoxide and methionine sulfone from 155 batches of compound amino acid injection (18AA-II) was determined using this method, and the residual oxygen content was detected by headspace gas analyzer.The results showed that the linear range of methionine sulfoxide and methionine sulfone were 0.128 1-10.250 0 μg/mL (r = 0.999 9) and 0.261 0-10.440 0 μg/mL (r = 0.999 8), respectively.The limits of quantitation were 0.13 μg/mL and 0.26 μg/mL, respectively; the limits of detection were 0.04 μg/mL and 0.09 μg/mL, respectively.RSDs of precision, stability and repetitive test were all lower than 1.3%.The recoveries ranged 98.00%-100.79% (RSD = 1.15%, n = 9) and 98.19%-102.31% (RSD = 1.33%, n = 9).The content level of oxidized related substances from different manufacturers showed significant difference, showing relevance with the residual oxygen content to some extent, yet no significant correlation with the added amount of antioxygen (sodium pyrosulfite).The method is validated to be useful for the content control of methionine sulfoxide and methionine sulfone in compound amino acid injection (18AA-II).It is quite necessary to include the determination of oxidized related substance into the quality specification.Manufacturers should strengthen the control of remaining oxygen in their products.

Objective To investigate the effect and safety of transcutaneous electrical stimulation at Zusanli acupoint for elimination of gastrointestinal poison in patients with oral organophosphorus pesticide poisoning. Methods A prospective study was conducted, including 62 patients with oral organophosphorus pesticide poisoning from September 2013 to February 2015 in the Department of Emergency of Xingtai People's Hospital of Hebei Province. The patients were divided into a observation group and a control group (each, 31 cases) in accord with the principle of simple random sampling. All the patients in two groups were given comprehensive treatment according to the diagnosis and treatment of the guide for organic phosphorus pesticide poisoning. In addition, the transcutaneous electrical stimulation at bilateral Zusanli acupoints was carried out in the observation group, once therapeutic time 30 minutes and every 8 hours once, and stopped until the discharge of melena. The incidence of vomiting after application of cathartics, the first stool time, the time of melena discharge, daily defecation frequency, the time of reaching atropinization, the total amount of atropine used, the time of cholinesterase (ChE) activity returning to its 1/2 normal activity, the length of stay in hospital, cure rate and mortality were observed in both groups. The changes in hemodynamics and pulse blood oxygen saturation (SpO2) were observed before and after transcutaneous electrical acupoint stimulation, and the occurrence of adverse reactions in the therapeutic course were observed in the observation group.Results After application of cathartics, the incidence of vomiting in control group was significantly higher than that in the observation group [32.2% (10/31) vs. 9.7% (3/31),P < 0.05]. In the observation group, the first stool time (hours: 9.3±3.6 vs. 11.6±5.2) and the time of melena discharge (hours: 11.3±5.3 vs. 14.5±6.8) were significantly shorter than those in the control group (both P < 0.05); while the frequency of bowel movements during catharsis was higher than that of the control group (times/d: 4.3±0.5 vs. 3.1±0.4,P < 0.01). In the observation group, the time reaching atropinization (hours: 66.3±22.8 vs. 84.6±24.2), the total amount of atropine used (mg: 66.3±22.8 vs. 84.6±24.2), and the time of ChE activity returning to its 1/2 normal range (days: 6.1±2.4 vs. 8.3±3.9) were significantly shorter than those in the control group (allP < 0.01). At the end of treatment, the average length of stay in hospital was shorter (days: 11.3±2.8 vs. 13.4±4.2,P < 0.05) and the cure rate was higher [96.8% (30/31) vs. 83.9% (26/31),P < 0.05] in the observation group than those in the control group; in observation group, the hemodynamics and SpO2 before and after acupoint electrical stimulation did not change significantly; in the course of treatment, no adverse reactions occurred.Conclusion The addition of transcutaneous electric stimulation at bilateral Zusanli acupoints in patients with oral organophosphorus pesticide poisoning has following advantages: lowering the incidence of vomiting during catharsis, enhancing the cathartic effect, promoting gastrointestinal poisoning discharge as soon as possible, reducing total atropine used during hospitalization, shortening the time reaching atropinization, shortening the duration of hospitalization, promoting the recovery of cholinesterase activity and elevating clinical therapeutic effects.

To discover novel fluoroquinolone lead compounds as possible anti-infective or/and antitumor chemotherapies, combination principle of pharmacophore-based drug design, a series of novel tricyclic fluoroquinolone title compounds, [1,2,4]triazino[3,4-h][1,8]naphthyridine-8-one-7-carboxylic acid derivatives ( 5a-5p), were designed and synthesized with a fused [1,2,4]-triazine ring unit. Their structures were characterized by spectral data and elemental analysis and the in vitro antibacterial and anti-cell proliferation activities were also evaluated. The results showed that the titled compounds exhibited more significant inhibitory activities against drug-resistant bacteria (Methicillin-resistant Staphylococcus aureus and multi drug-resistant Escherichia coli strains) and three tested cancer cell lines (human hepatoma SMMC-7721, murine leukemia L1210 and human murine leukemia HL60 cells). Interestingly, SAR showed that compounds with electron-donating groups attached to benzene ring had stronger antibacterial activity than antitumor activity, but electron-withdrawing compounds displayed more potential antitumor activity than antibacterial activity, especially antitumor activity of nitro compounds was comparable to comparison doxorubicin. Thus, novel triazine-fused tricyclic fluoroquinolones as potent anti-infective or/and antitumor lead compounds are valuable to pay attention and for further development.
Animals ; Anti-Bacterial Agents ; chemical synthesis ; chemistry ; Antineoplastic Agents ; chemical synthesis ; chemistry ; Carboxylic Acids ; Carcinoma, Hepatocellular ; Cell Line ; Cell Proliferation ; Drug Design ; Escherichia coli ; drug effects ; Fluoroquinolones ; chemical synthesis ; chemistry ; HL-60 Cells ; Humans ; Leukemia L1210 ; Liver Neoplasms ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Mice ; Naphthyridines ; Triazines