Perihilar surgery is full of challenge,risk,variability and uncertainty.Because of the anatomic variability,the pathophysiological complexity and invasion of the diseases,hepatic hilar biliary surgery has the characteristics of high operative difficulties,low resection rate,easy intraoperative bleeding,more postoperative complications,high recurrence rate and mortality rate.The cure rate and safety of the operation can be improved only through comprehensive imaging examinations and preoperative evaluation of liver function as well as the correct use of surgical techniques of anatomic paths,lesions excision and hepatic hilar reconstruction.The core of perihilar surgical techniques is hepatic hilar anatomy and explosion,including hilar plate dissection,dissection of liver along the medial fissure,quadrate lobe of liver resection and perihilar resection.Perihilar surgery is a comprehensive technique involving preoperative,intraoperative and postoperative procedures.The cure rates of perihilar biliary diseases can be improved by a combination of enhanced recovery after surgery and optimized and individualized surgical plans for patients.

Objective To explore the effects of different concentrations of propofol postconditioning against glutamate neurotoxicity to brain slices of neonatal rats.Methods The brain slices of neonatal rats were prepared and cultured in complete medium.They were randomly divided into five groups:the normal control group,glutamate injury group(RI group),1 mg/L propofol postconditioning group(PL1+RI group),3 mg/L propofol postconditioning group(PL3+RI group),5 mg/L propofol postconditioning group(PL5+RI group),12 cases in each group.The RI,PL1+RI,PL3+RI,PL5+RI groups were cultured for 6 days,then the brain slices were moved into the culture medium containing glutamate(1 mmol/L) and incubated for 30 minutes.And then,respectively,the brain slices of RI group were put into another complete culture medium,the PL1+RI group,PL3+RI group and PL5+RI group were put into the medium containing corresponding concentrations of propofol medium and long chain fat emulsion injection.All of the above were cultured for 24 hours in order to establish the injury model.The numbers of the Nissl body,the LDH release rates and the brain tissue damage rates of each brain slice were detected to evaluate the effects of propofol postconditioning on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.Results Compared with the RI group,the numbers of the Nissl body of the PL1+RI group,PL3+RI group and PL5+RI were higher,the LDH release rates and the brain tissue damage rates of the PL1+RI group,PL3+RI group and PL5+RI were lower,the diferences were significant(P<0.05).Among the three PL+RI groups,the LDH release rates and the brain tissue damage rates of the PL3+RI group were lower than those of the other two groups,the diferences were significant(P<0.05),at the same time,the numbers of Nissl body were more than the other two groups,the diferences were significant(P<0.05).Conclusion Propofol postconditioning has protective effects on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.However,the protective effects are not dose-dependent,and 3 μg/mL is the best dose of propofol to keep the glutamate-damaged brain slices from reperfusion injury in this research.

Alu Elements ; physiology ; Chromosome Aberrations ; DNA Topoisomerases, Type II ; metabolism ; DNA, Neoplasm ; metabolism ; DNA-Binding Proteins ; genetics ; metabolism ; Humans ; Sarcoma ; genetics ; metabolism ; Soft Tissue Neoplasms ; genetics ; metabolism ; Translocation, Genetic

Age Factors ; Aged, 80 and over ; Female ; Hip Fractures ; surgery ; Humans ; Male ; Orthopedic Fixation Devices

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult

Objective To explore the effect of eletroacupuncture (EA) on angiogenesis after cerebral ischemia and reperfusion through observing the number of peripheral blood endothelial progenitor cells (EPCs) and the expression of vascular endothelial growth factor (VEGF) in the hippocampus.Methods Among 50 male Sprague-Dawley (SD) rats,10 were randomly selected as a control group (CG).Qi deficiency and blood stasis were induced in the other 40 rats by intragastric administration of dahuang daily for 7 days.A model of focal cerebral ischemia and reperfusion injury was then created by thread-occlusion of the middle cerebral artery,except in 10 rats selected for the sham operation group (SOG) who received the same operation without tightening the thread.The successfully modeled rats were divided into a model group (MG,n =10) and an electroacupuncture group (EAG,n =10).The rats in EAG started acupuncture treatment the next day after modeling,while no treatment was given to those in the other groups.On day 1,3 and 7 after the modeling,the neurological functioning of the 4 groups was assessed using Basso-Beattie-Bresnahan locomotion scoring and the number of EPCs in the peripheral circulation was detected by flow cytometry.On the 8th day,all the rats were decapitated and the VEGF expression was detected immunohistochemically.Results The average BBB locomotion score of the EAG rose significantly from (4.50 ± 1.05) on day 1,to (13.67 ± 1.21) on day 3,and then further to (20.00 ±0.89) by day 7,significantly higher than that of MG at the same time points,but still significantly lower than that of the control group.The average number of EPCs in the peripheral circulation in the MG also increased from (26.83 ± 6.05) on day 1 to (33.67 ± 5.39) on day 3,and decreased to (32.83 ± 5.04) on day 7 after modeling,significantly lower than that of the CG [(45.50 ±9.40),(42.17 ±4.62) and (41.33 ±5.50)],the SOG [(58.00 ±8.05),(59.67±4.84) and (53.83 ±5.38)[and the EAG [(66.17 ±4.36),(127.50 ±73.75) and (55.00 ±35.15)] at each time point.After occlusion,the average expression of VEGF-positive cells in the hippocampus of the EAG [(27.80 ± 2.39)％] was significantly higher than that of the MG,and both were significantly higher than that of the CG.Conclusions Eletroacupuncture can up-regulate VEGF expression and EPCs in the peripheral blood in rats after cerebral ischemia-reperfusion,which can promote angiogenesis and neural functional recovery.

Objective To study the protective effect of hyperoxic liquid preconditioning in myocardial ischemia-reperfusion injury. Methods Thirty rabbits were randomly divided into three groups: group A undergoing all procedures except ischemia-reperfusion, group C receiving the routine infusion of hyperoxic liquid 15mL/kg for seven days, and group B receiving the routine treatment infusion of saline instead of hyperoxic liquid 15mL/kg. Seven days later, the myocardial ischemic reperfusion model (I/R) was fabricated, ECG and homodynamic index were monitored simultaneously. Plasma MDA and SOD level was assayed before ligation, 30min after ligation and 1, 2, 3h after reperfusion. Results Hyperoxic liquid preconditioning can lower ST segment and improve index of hemodynamics and significantly reduce myocardial infarction size in group C compared with group B((P

Objective To investigate the changes in gastric intramucosal pH(pHi) and the effect of hyperoxic liquid on intramucosal pH(pHi) after myocardial ischemia-reperfusion injury in rabbits.Methods Twenty healthy male adult rabbits,weighing 2.3-3.0 kg,were randomly divided into two groups: control group(n=10) and hyperoxic liquid group(n=10).Hyperoxic liquid group received the routine infusion of hyperoxic liquidle of 10 mL/kg for seven days,while control group received the routine treatment infusion of saline instead of hyperoxic liquid of 10 mL/kg.Seven days later,the myocardial ischemic reperfusion model(I/R) was established,and ECG and homodynamic indexes were monitored simultaneously.Hemodynamic indexes and pHi were measured before myocardial ischemia,30 min after myocardial ischemia as well as 1 h and 2 h after reperfusion.Results Hyperoxic liquid could lower ST segment and improve hemodynamic indexes.pHi decreased significantly after myocardial ischemia-reperfusion injury in both groups.Compared with that in control group,pHi was significantly higher at 1 h and 2 h after reperfusion in hyperoxic liquid group(P

[Objective] To observe the de-jaundice of severe jaundice hepatitis with TCM enema.[Method] 87 cases of chronic virus hepatitis with hyperbilirubinemia were randomly divided into 2 groups,the treatment group treated with TCM preserving enema and routine combination of TCM and western medicine which could protect liver and decrease enzyme and de-jaundice.The control one used only the later,observed for 6 weeks.[Result] The reduction of total bilirubin of the treatment group was larger than control group,P

Persistent infection of hepatitis C virus (HCV) remains as a worldwide threat to public health,which involves a complex interaction between virus- and host related factors.HCV is classified as six genotypes and many subtypes according to the sequence heterogenecity.HCV genotype should be determined prior to treatment initiation since it plays a key role in selection of therapeutic regimen for chronic hepatitis C.Development of the antiviral treatment with protease inhibitor in combination with pegylated IFN-α and ribavirin requires the accurate determination of subtypes,e.g. 1a and 1b,as well.Genotyping methods based onsequenceanalysis, reversehybridizationorreal-timePCRhavebeendevelopedand evaluated.Some issues,however,should be settled to standardize the utility and result interpretation of these methods.More recently,host genotypes of IL28B have been found to be closely associated with HCV spontaneous clearance and the response to antiviral therapy.Moreover,polymorphisms in inosine triphosphate pyrophosphatase gene affect ribavirin-induced anemia.Therefore, host genotyping will be beneficial in predicting the outcome of chronic hepatitis C and monitoring the drug-induced adverse events.