Objective To summarize the experience of hybrid repair performed in high risk patients with dissection involving the aortic arch.Methods From Sep.2007 to Mar.2015,hybrid repair was performed in 33 high risk patients with dissection involving the aortic arch including acute (n =8),subacute (n =15),or chronic (n =10) cases.Descripitive statistics were computed for continuous and categorical variables.Results There were 22 male and 11 female patients with a mean age of(69 ± 10) years,and ASA Physical Status Ⅲ-Ⅳ.Simultaneous (n =27) and staged (n =5,mean interval 5.0 ± 1.3 days)endovascular repair were performed via femoral artery.The technical success rate was 100％.The average hospital stay was (16 ±6) days.One case died of cerebral infraction.There were two with strokes,one with pneumonia and two with renal failure as complications.Median follow-up was 47 months (3-66 months).There were four deaths with two were related to aortic artery.Endoleak was found in 3 during follow-up.One type Ⅰ endoleak was cured after remedy hybrid repair.Conclusions Hybrid repair performed in patients at high risk with dissection involving the aortic arch is less invasive with favorable medium and long-term outcomes.

Child, Preschool ; Edema ; diagnosis ; Female ; Humans ; Hypoproteinemia ; diagnosis ; Stomach Diseases ; diagnosis

Objective To explore the influence of mononuclear cells (MNC), CD34+ cells, CD3+ , CD3+ CD4+ , CD3+ CD8+ , CD4+ CD25+ T cells, CD3- CD16+ CD56+ natural killer cells (NKs), and dendritic cells (DCs) doses in graft on acute graft-versus-host disease (aGVHD) following HLA-identical sibling allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT).Methods Sixty-five patients receiving HLA-identical sibling allo-PBSCT were studied.The number of CD34+, CD3+, CD3+ CD4+, and CD3+ CD8+ T cells in the graft was counted by fluorescence-activated cell sorting (FACS).The number of CD4+ CD25+ T cells, CD3 CD16+ CD56+ NKs, and DCs in the graft was also measured by FACS in 31 patients among above-mentioned 65 patients.The doses of each kind of cells in the graft were calculated according to per kilogram of recipients body weight.The patients were divided into high or low dose groups according to whether or not more than or equal to median of MNC, CD34+, CD3+, CD3+ CD4+, CD3+CD8+, CD4+ CD25+, CD3 CD16+ CD56+ or DC cell doses, respectively.Acute GVHD was analyzed between two groups.Results The frequency of the cumulative incidence of grade Ⅱ～Ⅳ aGVHD was increased in CD3+ CD4+ and CD3+ CD8+ T cells high dose groups as compared with correspondingly low dose groups, but the difference had no statistically significant difference (P = 0.089 and 0.098, respectively).Recipients in CD4 + CD25 + T cells high dose group had significantly reduced cumulative incidence of grade Ⅲ～Ⅳ aGVHD as compared with those in correspondingly low dose group (P< 0.05).The cumulative incidence of total aGVHD was significantly higher in DC1 high dose group than in correspondingly low dose group (P<0.05) and the cumulative incidence of grade Ⅱ～Ⅳ aGVHD was also higher in high dose group, but the difference had no statistically significant difference (P = 0.069).There was no significant difference in cumulative incidence of total and grade Ⅱ～Ⅳ aGVHD between MNC, CD34+ , CD3+, NK or DC2 high dose groups and correspondingly low dose groups (P>0.05, respectively).Conclusion Recipients in DC1 high dose group have significantly increased cumulative incidence of total aGVHD, but those in CD4+ CD25+ T cells high dose group have significantly reduced cumulative incidence of grade Ⅲ～Ⅳ aGVHD.

Objective To investigate the application of PDCA circulation in the patients undergoing liver transplantation.Methods Apart from 1 of experiment and 3 of control group failed to be followed up,116 cases undergoing liver transplantation in our liver transplant center from April 2009 to May 2011 were divided into the experiment group (n =59) and control group (n =57) by registration order.PDCA circulation was used in the experiment group,but in the control group,routine management mode was used.A self-designed questionnaire about the compliance of liver transplantation and the Satisfaction Degree of Patients to the Nursing Work and Quality of Life Index (QL-Index) were used to investigate at the first follow-up time.Results There was a significant difference between two groups in the aspects of habits and customs,drug-taking compliance,reasonable physical training,self-monitoring and the satisfaction degree of patients to the nursing work [57 vs 44,52 vs 39,51 vs 40,52 vs 40 ; 94.92％ vs 82.46％ ; x2 =6.3096,6.6646,4.5365,5.6991,4.5225,respectively;P ＜ 0.05].Overall life quality score of experimental group (6.52 ± 0.53) was higher than that in control group (4.36 ± 0.78),and the difference was statistically significant (t =17.498,P ＜ 0.05).All the items of QL-Index showed a significantly statistical difference between two groups (P ＜ 0.05).Conclusions Applying PDCA circulation can enhance the compliance and quality of life of patients undergoing liver transplantation and improve their satisfaction degree to the nursing work.

OBJECTIVETo observe the clinical efficacy of combination of traditional Chinese medicine and western medicine in the treatment of patient bitten by agkistrodon halys pallas, and the changes in peripheral blood inflammatory factors (hs-PCR, IL-6, TNF-alpha).

METHODNinty-eight patients were divided into three groups according to their hospitalization dates: the western medicine group, in which 32 patients were treated with antivenom serum (6 000 U) for five days, once every day; the traditional Chinese medicine group, in which 32 patients were treated with anti pit viper No. 2 concentrated decoction (300 mL), twice to three times every day, for five days; and the combined traditional Chinese medicine and western medicine group, in which 35 patients were treated with the combination of Chinese and Western medicine treatment described above. Then blood samples of all of patients were obtained, and serum factors (hs-PCR, IL-6, TNF-alpha) in peripheral blood were measured by Elisa assay. Another 30 health volunteers were chosen as the normal control group.

RESULTThe serum inflammatory factors were significantly higher in all patients of the three groups than that in healthy control before treatment (P < 0.01), and decreased significantly after treatment. In particular, the more remarkable reduction was found in the combined traditional Chinese medicine and western medicine group compared with the western medicine group and the traditional medicine group (P < 0.01). Symptom elimination in the three groups was superior to the western medicine group and the traditional medicine group at the first day and the third day of treatment (P < 0.05, P < 0.01). Total clinical effective rate was 100% in the combined traditional Chinese medicine and western medicine group, 84. 37% in the traditional medicine group and 65.62% in the western medicine group, the clinical effective rate of the combined traditional Chinese medicine and western medicine group was notably superior to that of the western medicine group and the traditional medicine group (P < 0.01).

CONCLUSIONThe serum inflammatory factors increased significantly in patients bitten by agkistrodon halys pallas. Treatment with the combined traditional Chinese medicine and western medicine can significantly decrease the serum inflammatory factors, and increase clinical effect, with more obvious clinical efficacy compared with the western medicine group and the traditional medicine group.

Adolescent ; Adult ; Aged ; Antivenins ; administration & dosage ; Child ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Interleukin-6 ; blood ; immunology ; Male ; Middle Aged ; Snake Bites ; blood ; drug therapy ; immunology ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood ; immunology ; Young Adult

OBJECTIVETo study on clinical role of acupuncture at Tanzhong (CV 17) for treatment of postpartum hypolactation and to provide clinical basis for indications of acupoints.

METHODSThis was a single blind randomized controlled multi-center study by Beijing obstetrical and gynecological hospital, Beijing Mother and Child health institute and Haidian Mother and Child health institute, 276 cases of postpartum hypolactation were randomly divided into an acupuncture group and a Chinese drug group. The acupuncture group were treated with acupuncture at Tanzhong (CV 17) and the Chinese drug group with traditional drug Tongre Decoction. Degree of breast engorge, lactating volume, prolactin, neonate body weight, artificial feeding frequency and volume, urination frequency and crying time of neonate were recorded for comparison of therapeutic effects.

RESULTSAfter treatment, degree of breast engorge, lactating volume, neonate body weight, artificial feeding frequency and volume, urination frequency and crying time of neonate were significantly improved in the two groups, with no significant difference between the two groups.

CONCLUSIONAcupuncture at Tanzhong (CV 17) can effectively promote lactation with a same therapeutic effect as the traditional Chinese drug Tongru Decocnon.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Lactation Disorders ; therapy ; Puerperal Disorders ; therapy ; Single-Blind Method

Objective To discuss the clinical diagnostic value of 16-slice spiral computed tomography angiography (CTA) for intracranial aneurysm. Methods Seventy-four patients with suspected intracranial aneurysm were examined with 16-slice spiral CTA. The post-processing techniques including multiplanar reconstruction (MPR), curved planar reformation (CPR), maximum intensity projection (MIP), volume rendering (VR) and virtual endoscopy (VE) were used, and their diagnostic accuracy was evaluated and compared with the results of digital subtraction angiography (DSA) and operation. Results A total of 77 aneurysms were detected by 16-slice spiral CTA in 65 patients. Among them, 55 patients had single aneurysm, 9 patients had double aneurysms, and only 1 patient had 4 aneurysms. The smallest diameters of aneurysm were 2.0 and 1.5 mm, and the largest were 49 and 8.5 mm at body and neck, respectively. The coincidence of aneurysms confirmed by operation and those detected by 16-slice spiral CTA was 94.74%. There were no significant difference in the sensitivity and the accordance rate of diagnosis between DSA and 16-slice spiral CTA (P>0.05). Conclusions 16-slice spiral CTA clearly showed the location, axis pointing, neck, parent artery ofa aneurysm, as well as the spatial relationship with the surrounding structures. The accuracy of 16-slice spiral CTA is higherin the diagnosis of intracranial aneurysm. It can be used as the first and effective choice for diagnosis of acute intracranial aneurysm.

Fifteen known compounds were isolated from Swertia delavayi by silica gel, Sephadex LH-20 and Rp-18 column chromatographies. Based on extensive spectroscopic analysis (MS, 1H, 13C-NMR), their structures were identified aserythrocentaurin (1), erythrocentaurindimethylacetal (2), sweroside (3), swertiamarin (4), gentiopicroside (5), swertiakoside A (6), 2'-O-acetylswertiamarin (7), 4'-O-[(Z) -coumaroyl] swertiamarin (8), 1,5,8-trihydroxy-3-methoxyxanthone (9), 8-O-β-D-glucopyranosyl-1-hydroxy-2,3, 5-trimethoxyxanthone (10), 8-O-[β-D-xyl- opyranosyl-(1 --> 6)-β-D-glucopyranosyl]-7,8-dihydroxy-3-methoxyxanthone (11), isovitexin (12), β-sitosterol (13), daucosterol (14), and oleanolic acid (15). Among them, ten ones (14, 7-11, 13) were obtained from S. delavayi for the first time. The isolates were evaluated for their anti-HBV activities in HepG 2. 2. 15 cell line in vitro. The results showed that compound 1, 2, 6, 7, 9 and 12 exhibited significant inhibitory activity on HBV DNA replication with IC50 values from 0.05 to 1.46 mmol x L(-1).
Antiviral Agents ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Hepatitis B virus ; drug effects ; genetics ; Magnetic Resonance Imaging ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Swertia ; chemistry

Adolescent ; Adult ; Aged ; Child ; Female ; Hemorrhagic Fever with Renal Syndrome ; physiopathology ; Humans ; Liver ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Prognosis

Objective: To develop a high efficient expression, purification system of recombinant arginine deiminase(ADI).Methods: cDNA fragment encoding for mycoplasma ADI was obtained by artificial synthesis and was cloned into prokaryotic expression vector(pBV220). The recombinant ADI was generated by the transformation of the recombinant vector into the host strain DH5?. Anion exchange and gel filtration chromatography was carried out for purification of the recombinant ADI. The biological activity of final product was detected by the assay of agrinine degradation in vitro. Results: A prokaryotic expression plasmid pBV220-ADI was generated successfully, and was identified by DNA sequencing; the recombinant protein was highly expressed in DH5?, the proportion of the recombinant protein is exceeded 35% of the whole protein. The inclusion bodies were solubilized with 6mol/L guanidine hydrochloride under reducing conditions in order to avoid incorrect disulfide-bond formation of the recombinant ADI molecules. Dilution and dialysis at lower degrees temperature were the optimum renaturation methods. After gel filtration, the purity and specific activity of rADI reached 95% and 80 IU/mg respectively. Conclusions: A set of protocols for high efficient rADI expression and purification has been established, which is simple, efficient and applicable.