Objective To investigate application value of cutter stapler in transumbilical single port laparoscopic left lateral lobectomy.Methods The retrospective cohort study was adopted.The clinical data of 26 patients who underwent transumbilical single port laparoscopic left lateral lobectomy at the Shengjing Hospital of China Medical University from January 2010 to February 2016 were collected.Nine patients who received liver parenchyma using ultrasonic knife were allocated into the ultrasonic knife group,17 patients who received liver parenchyma using cutter stapler were allocated into the cutter stapler group.Observation indicators included (1) operation situations:operation time,volume of intraoperative blood loss,postoperative complications,time of postoperative bowel function recovery,time of abdominal cavity drainage tube removal,duration of postoperative hospital stay.(2) Postoperative reexamination and follow-up:ultrasound or computed tomography (CT) examination was performed when necessary for detecting local exudation or encapsulated effusion.The patients were followed up at postoperative 1 to 3 months with telephone interview for whether with abdominal distension or abdominal pain till March 2016.Measurement data with normal distribution were presented as (x) ± s and analyzed by using t test.Measurement data with skewed distribution were presented as M (range) and analyzed by ranksum text.Comparison of count data was analyzed by the Fisher' s exact probility.Results (1) Operation situations:all the 26 patients received transumbilical single port laparoscopic left lateral lobectomy with no conversion to porous laparoscopic surgery or open surgery.The operation time was (114 ± 54) minutes,the volume of intraoperative blood loss was 100 mL (range,20-800 mL),and no intraoperative blood transfusion was adopted.The operation time and volume of intraoperative blood loss were (135 ±43)minutes and 200 mL (range,20-800 mL) in the ultrasonic knife group,(103 ±57)minutes and 100 mL (range,20-300 mL) in the cutter stapler group,respectively,showing no statistically significant difference between the 2 groups (t =1.500,Z =-0.961,P ＞ 0.05).All the 26 patients recovered well after surgery,with no postoperative complications as postoperative hemorrhage,bile leakage,incision infection or death.The time of postoperative bowel function recovery,time of abdominal cavity drainage tube removal and duration of postoperative hospital stay was (1.5 ±0.4) days,(5.8 ± 2.0) days and (7.0 2.0) days in the ultrasonic knife group,(1.1 ± 0.3) days,(4.1 ±1.1) days and (4.9 ± 1.4) days in the cutter stapler group,respectively,showing statistically significant differences between the 2 groups (t =2.599,2.875,3.036,P ＜ 0.05).(2) Postoperative reexamination and follow-up:of 26 patients,11 patients received ultrasound or CT examination after surgery and detected no obvious local exudation or encapsulated effusion,with no special treatment.The other 15 patients didn't receive ultrasound or CT examination.All the 26 patients were followed up for 1-3 months,with no occurrence of upper abdominal distension or abdominal pain.Conclusion Transumbilical single port laparoscopic left lateral lobectomy is safe and feasible,the application of cutter stapler is helpful to safety and success of the operation,further accelerating the postoperative recovery of patients.

Lactic acid production of twelve strains of LAB isolated from broiler intestine and tolerance property of three strains were investigated. The results of lactic acid production showed that among all strains K6 exhibited the most rapid production during the first twelve hours, the seconds were K9 and C1; D17 exhibited the highest production of lactic acid by twenty-four hours, C1 exhibited the highest production of lactic acid by forty-eight hours. The pH values in three strains of K9、D17 and C1 culture showed the fast decline during the first twelve hours, with the final values significantly lower than those of other strains cultures. The results of tolerance property showed that the survival counts of C1could be detected when pH value was at 2 after three hours, but the survival counts of D17 and K9 could not be detected after one hour. When pH value was at 2.5 after three hours ,the survival counts of C1 declined from 10~ 8.2 /mL to 10~ 4.8 /mL, K9 from 10~ 8.2 /mL to 10~ 4.6 /mL, the survival counts of D17 could not be detected. 0.08% bile had few effects on the survival counts of three strains; when incubated in the medium with 0.40% bile, the survival counts of C1 declined from 10~ 8.4 /mL to 10~ 6.5 /mL,D17 from 10~ 10.3 /mL to 10~ 7.5 /mL, and K9 from 10~ 9.8 /mL to 10~ 7.7 /mL. When the group treated with 37℃ for 20 minutes was served as the control, the survival counts of C1 and K9 was not detected when treated with 80℃, but the survival counts of D17 were 10~ 4.9 /mL, when treatment with 65℃ the survival counts of C1 and K9 decreased significantly .

Objective To establish a rapid and precise continuous flow-injection chemiluminescence method for the determination of tetracycline and oxytetracycline. Methods In NaOH solution, tetracycline and oxytetracycline can sensitize obviously the chemiluminesence (CL) intensity of the reaction of luminol with KIO4, the sensitized CL intensity is proportional to the concentration of tetracycline and oxytetracycline. So, a new flow-injection CL method has been developed. The optimum chemical conditions for the CL reaction were investigated. Results Under the optimized conditions (KIO4 concentration: 1.0×10-5 mol/L; NaOH concentration: 0.1mol/L; luminol concentration: 1.0×10-4mol/L), tetracycline and oxytetracycline were determined. The linear range of the working curves was 1.0×10-7 -1.0×10-4g/mL, the detection limits was 1.0×10-8g/mL and 1.1×10-8g/mL, and the relative standard deviation was 2.6% (CS=1.0×10-6g/mL; n=11) and 2.0% (CS=1.0×10-6g/mL; n=11) respectively. Conclusion The method is simple, rapid, and sensitive, and it has been successfully applied to the the determination of tetracycline and oxytetracycline tablets, the mean recoveries being 99.7% and 98.8% respectively.

Objective To explore the clinical and pathologic features of Langerhans cell histiocytosis(LCH).Method Thirty-eight cases of LCH from both in hospital and outpatient department in dermatology and pediatry department from Jan.1991 to Jun.2006 were analyzed about the features of clinic,pathology and immunohistochemistry.Results The mean age of onset was 2.18 years old.The male /female ratio was 1.71.Skin lesions occurred in 78.9% of the patients.Among them,68.5% were as the first manifestation.The eruptions mainly distributed on trunk,90% of them presented as hemorrhagic maculopapules,nevertheless,3.3% of the eruptions showed as crust with hilar depression,which was similar to pityriasis lichenoides etvarioliformis acuta.Fever,hepatomegalia and splenomegia occurred in patients at a rate of 60.5%,68.4%,55.3% respectively.Thirty-one point six percent of the patients had got lymphadenectasis,the neck and inguinal lymph nodes were the common site to be affected.Ossature involvement occurred in 31.6% of the patients,which 8.3% got multiple injuries,howe-ver,91.7% got a solitary bone involved.Skull was the main site to be injured,else were lumbar,humerus,hipbone,an so on.Respiratory tract,auditory canal,mucosa were also the sites involved in this disease,but the incidence rate was lower than 10%,respectively.The laboratory data showed that 81.3% of the patients were anaemia,60.7% with abnormal subgroup of T-cell,and 32.1% positive for EBV-IgG.The skin histopathology data of 26/30 cases revealed that lichenoid infiltrates of Langerhans cells confined to the upper dermis.Cytologic features were cells with abundant eosinophilic cytoplasms,and longitudinally grooved or reniform nuclei.Lymphocytes and a few eosinophils also could be seen.Four cases of thirty showed that the proliferative Langerhans cells were with pale cytoplasms,besides,there were numerous eosinophils,and sometimes a few multinucleate cells were scattered.The immunity test of 20 cases of thirty displayed that CD1a(+)S100(+)KP-1(-).Biopsy of lymphaden and tumor of the skull of the rest 8 patients were all diagnosed as eosinophilic granuloma through both hematoxylin and eosin-stained section and immune marks.Conclusions Multiple systems can be involved in LCH.Hemorrhagic maculopapules,fever and splenohepatomegalia are common presentations in this disease.The morphous of nucles of histiocytes is particular,and to diagnose definitely,both CD1a(+) and S-100(+) are needed.

Animals ; Fatigue ; enzymology ; Male ; Mammillary Bodies ; metabolism ; Nitric Oxide Synthase Type I ; genetics ; metabolism ; Physical Exertion ; physiology ; Random Allocation ; Rats ; Rats, Wistar ; Stress, Physiological ; physiology

Objective To observe the effect of dexamethasone(Dex)on the proliferation and os- teogenic differentiation of human marrow stromal cells(MSCs)in vitro.Methods The primary human MSCs were isolated and cultured by Ficoll seperation culture in vitro.In subcultures,human MSCs were respectively treated with dexamethasone 10~(-9),10~(-8) and 10~(-7) mol/L.The proliferation of human MSCs was measured using MTF method;cytoplasmic alkaline phosphatase(ALP)activity was measured;the osteogenic marker osteopontin (OPN)mRNA were examined by reverse transcriptase polymerase chain reaction(RT-PCR).Results The op- tical density values in cultures treated with dexamethasone 10~(-8) and 10~(-7) mol/L for 8 days were significantly lower than those in the controls(P＜0.05).Treatment of cells with Dex for 12 days led to a significant increase in cytoplasmic ALP activity(P＜0.05)in a dose-dependent manner.Dex induced OPN mRNA.Conclusion Dex inhibits the proliferation of human MSCs and dexamethasone 10~(-7) mol/L leads to a strong decrease in cell number.Dex induces human MSCs differentiate to osteoblastic cells.

To study the chemical constituents of the branches of Tamarix rasissima, repeated silica gel column chromatography, Sephadex LH-20 chromatography and recrystallization were applied for chemical constituents isolation and purification. Ten phenolic compounds were isolated from the n-BuOH fraction and their structures were elucidated by physical properties and spectra analysis such as UV, ESI-MS and NMR as monodecarboxyellagic acid (1), ellagic acid (2), 3, 3'-di-O-methylellagic acid (3), 3, 3'-di-O-methylellagic acid-4-O-beta-D-glucopyranoside (4), 3, 3'-di-O-methylellagic acid-4'-O-alpha-D-arabinfuranoside (5), ferulic acid (6), isoferulic acid (7), caffeic acid (8), 4-O-acetyl-caffeic acid (9), and 4-methyl-1, 2-benzenediol (10). All compounds except for isoferulic acid were isolated firstly from this plant except for isoferulic acid, and compounds 5, 9 and 10 were obtained from Tamarix genus for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Phenols ; chemistry ; isolation & purification ; Spectrometry, Mass, Electrospray Ionization ; Tamaricaceae ; chemistry

OBJECTIVETo analyze the effects of acupuncture on the level of atrial natriuretic peptide (ANP), C-type natriuretic peptide (CNP) in adrenal gland and the content of corticosterone (CORT) in plasma in rats withchronic emotional stress anxiety, and to explore the partial action mechanism of acupuncture on anxiety disorder.

METHODSThirty-two healthy Sprague-Dawley (SD) rats, after 7 days of feeding and domestication, were randomly divided into a blank group (10 rats), a model group (11 rats) and an acupuncture group (11 rats). The rats inthe model group and acupuncture group were treated with unpredictable chronic emotional stress (CES) method toestablish the model of anxiety. Rats in the acupuncture group were treated with acupuncture at "Neiguan" (PC 6)and "Shenmen" (HT 7), once every other day, 30 minutes each time. The model establishment and treatment lasted 15 days. Rats in the blank group were treated with identical immobilization but no treatment was given. Theelevated plus maze was used to test the behavioral changes of rats with anxiety; the level of CORT in plasma wasdetected by ELISA, and the expression level of CNP and ANP in adrenal cortex and medulla was detected by immunohistochemical method.

RESULTS(1) The percentage of open-arms time in total time (OT%) in elevated plus maze in the model group was significantly lower than that in the blank group (P<0. 05); the OT% in the acupuncture group was significantly higher than that in the model group (P<0.01). (2) The content of CORT in plasma in the model group was higher than that in the blank group (P<0. 05), while that in the acupuncture group was significantly lower than that in the model group (P<0. 05). (3) The expression of ANP in adrenal medulla and cortex in the model group was lower than that in the blank group (P<0. 01), while the expression of CNP in adrenal medulla and cortex in the model group was higher than that in the blank group (P<0. 01).

CONCLUSIONThe effects of acupuncture against anxiety are likely to be related to the regulation on the expression of ANP and CNP in adrenal medulla, affecting the release of CORT and inhibition on the activity !f hypothalamic-pituitary-adrenal axis (HPA axis).

Acupuncture Therapy ; Adrenal Glands ; metabolism ; Animals ; Anxiety ; blood ; psychology ; therapy ; Atrial Natriuretic Factor ; blood ; metabolism ; Behavior, Animal ; Corticosterone ; blood ; Humans ; Male ; Natriuretic Peptide, C-Type ; blood ; metabolism ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological

OBJECTIVETo observe the clinical effects of two different circumcision procedures with the Shang Ring and compare their advantages and disadvantages.

METHODSA total of 527 adult males with phimosis or redundant prepuce underwent Shang Ring circumcision by conventional outward replacement (n = 254) and inward placement (n = 273), respectively. We observed the in-ring nocturnal pain, complications, ring-removal pain, degree of edema, recovery time, and patients' satisfaction after surgery, and compared them between the two groups.

RESULTSCompared with the conventional outward placement (5.9%) of the Shang Ring, the inward placement method showed the advantages of mild in-ring nocturnal pain, a low complication rate, significantly reduced ring-removal pain, and mild edema, but exhibited longer healing time.

CONCLUSIONIn Shang Ring circumcision for phimosis and redundant prepuce in adult males, each of the outward and inward placement methods has advantages and disadvantages of its own, but the latter is more advantageous and feasible.

Adult ; Circumcision, Male ; adverse effects ; instrumentation ; Edema ; etiology ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Pain, Postoperative ; Patient Satisfaction ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Prostheses and Implants ; Wound Healing

To report a case of 16-month-old boy with anhidrotic ectodermal dysplasia with immunodeficiency who experienced disseminated herpes simplex infection. From 2 months of age, the patient experienced multiple pyrexial episodes of undetermined origin, which responded well to anti-inflammatory agents after undressed. Abnormal sweat with dry skin was noted; therefore, the skin biopsy of right axilla was performed at 7 months of age, and suggested a diagnosis of anhidrotic ectodermal dysplasia. Since 6 months of age, he developed recurrent upper respiratory infections and 2 episodes of pneumonia. Twenty days before, several glossal erosions occurred in the patient, supervened by painful and erosive eruptions and numerous blisters around the mouth and both hands with hyperpyrexia. Four days before, the patient was transferred to the department owing to skin lesion exacerbation. Cutaneous examination showed multiple crested or ulcerated plaques distributed eriorificially (mouth and nasal cavity) on the face. Several irregular, demarcated ulcers were scattered on the buttocks, scrotum and lower limbs, surrounded by grouped and umbilicated vesicles arising on erythema. Both hands were swelling, crusting and painful. Dentition was abnormal, and the patient had only 2 upper conical incisors. Routine investigation revealed that white cell count and C-reactive protein extremely elevated. Immunologic profile showed an abnormal distribution of lymphocyte subsets with decreased CD3+ T cells, CD8+ T cells and NK cells. Serum IgM level was slightly low. IgM antibodies to herpes simplex virus type 1 (HSV-1) were detected by serological testing. Based on the above-mentioned features, a diagnosis of anhidrotic ectodermal dysplasia with immunodeficiency and disseminated herpes simplex infection was confirmed. The patient was resolved favourahly after intravenous ganciclovir and antibiotics for 3 weeks without relapse of skin lesions.