Adult ; Chylothorax ; etiology ; Female ; Humans ; Neck Dissection ; adverse effects

Objective To study prognosis of patients with fulminant hepatitis after plasma ex- change treatment using model for end-stage liver disease(MELD)scoring system.Methods 160 pa- tients were randomly divided into plasma exchange group and control group,and MELD score was calculated according to the original formula for each patient.The efficacy of plasma exchange was as- sessed by mortality and improvement in biochemical parameters and MELD score.Results The levels of total bilirubin(TBIL),INR and MELD score of patients whose MELD scores were between 30 and 40[TBIL,(379.4?40.4)?mol/L; INR,2.5?0.2; MELD,30.8?3.8]were lower than before PE treatment[TBIL,(509.7?64.6)?mol/L;INR,3.5?0.3;MELD,37.3?3.5].The levels of TBIL and INR and MELD score of patients whose MELD scores were higher than 40 [TBIL,(595.6?61.5)?mol/L;INR,3.8?0.4;MELD,39.8?3.5]were lower than before PE treatmem [TBIL, (650.4?66.3)?mol/L;INR,4.4?0.6;MELD,45.2?4.2].The mortality of patients in PE group with MELD score from 30 and 40 was 50.0%,while it was 86.7% in control group,showing significant differ- ence between PE group and control group(P＜0.01).The mortality of patients with MELD scores higher than 40 was 91.2% in PE group and 100% in control group,showing no significant difference between these two groups(P＞0.05).Conclusions Plasma exchange treatment can decrease the serum TBIL level, INR and MELD score of patients with fulminant hepatitis and improve liver function.Compared with the control group,plasma exchange can significantly decrease the mortality of patients in PE group with MELD score from 30 to 40,but no effect on patients with MELD score higher than 40.

Objective:To observe the effects of Yikunjing capsules on the bone histomorphometry indexes and the serum Interleukin-6 (IL-6) level in mice with osteoporosis.Methods:60 cases ofC57 female mice were randomly divided into 5 groups,such as model group (equal volume of normal saline),estrogen group (nilestriol,0.25 mg/kg),Yikunjing capsules high dose group (1.44 g/kg),Yikunjing capsules medium dose group (0.72 g/kg) and Yikunjing capsules low dose group (0.36 g/kg),sham group (equal volume of normal saline) were treated with sham operation.The mice in each group was intragastrically administrated for 70 days.Enzyme linked immunosorbent assay (ELISA) was used to detect the serum IL-6 level.The bone histomorphometry index were detected with BI-2000 Medical Image Analysis System.And the Number of blood vessels in distal femoral metaphysis of each group was measured by CT.Results:Compared with the sham group,the width and area of trabecular bone,the thickness of cortical bone,area of trabecular bone,the number of osteoblasts,the bone mineral density and the number of blood vessels in model group were significantly reduced(P＜0.05),while the number of osteoclasts and serum IL-6 level were significantly increased (P＜0.05).Compared with the model group,above indexes in estrogen group,Yikunjing capsules high,medium,low dose group were improved (P＜0.05),and the effect of Yikunjing capsules high dose group and estrogen group was almost the same (P＞0.05).Conclusion:Yikunjing capsules can rectify the bone histomorphometry indexes reduce the serum IL-6 level and increase the number of blood vessels in mice with osteoporosis,and intragastrically administrating 1.44 g/kg Yikunjing capsules could get the better effect.

Objective Objective To explore the reasons of lung hypervolemia after liver transplantation and the corresponding treatment strategies.Method 291 patients received liver transplantation,in which 35 cases underwent pulmonary edema at early stage (pulmonary hypervolemia group),and the rest without pulmonary hypervolemia served as control group.Average central venous pressure (CVP) was recorded pre-,intra-and post-operatively.Total intake,total discharge and fluid balance were also recorded intraoperatively and 3 days post-operatively.Result In pulmonary hypervolemia group,CVP was (12.33 ± 5.08),(14.33 ± 3.03) and (16.50 ± 4.57) mmHg pre-,intra-and post-operatively,significantly higher than that in control group (P＜0.05 for all).Total intake,total discharge and fluid balance in pulmonary hypervolemia group were significantly higher than those in control group intraoperatively and 3 days post-operatively (P＜0.05 for all).After diuretic therapy and hemodialysis,30 cases in pulmonary hypervolemia group recurred,and 5 cases died of infection.Conclusion Pulmonary hypervolemia at early stage after liver transplantation is related to fluid balance.The reasonable control of total intake,total discharge and fluid balance is necessary.

Objective To search for the metabolites that associated with articular cartilage damage in the urine of rat model with articular cartilage destruction induced by T-2 toxin.Methods Thirty healthy male Wistar rats aged 4-5 weeks were numbered by weight,randomly divided into two groups (n =15 per group),namely the control group and the model group.The rats in the control group were fed with standard rat diets,and those in the model group were given diets contaminated by T-2-toxin (300 μg/kg).Throughout the experiment,all animals were given free access to distilled water and diets.After continuous treatment for 3 months,all the rats were sacrificed.The changes of articular cartilage in rat knee joints were observed by histopathological method,the metabolic profile of rats' urine was determined by ultra performance liquid chromatography/quadrupole time of flight-mass spectrometry (UPLC/QTOF-MS) technique.Combined with multivariate statistical analysis,database searching was applied to explore and confirm the different metabolites associated with cartilage damage.Results Light microscope showed that rats' articular chondrocytes in the control group presented cells in neat rows and eumorphism,rats' articular chondrocytes in the model group presented extensive areas of chondrocyte degeneration,necrosis and loss.In rats' urine metabolic profiles,5 different metabolites associated with cartilage destruction were detected,such as 4-hydroxynonenal (HNE),trans-4,5-epoxy-2(E)-decenal (EDE),5-methyldeoxycytidine,and 5-L-glutamyl-glycine and prolyl-valine.Compared with the control group (mass spectrum peak area:65820 ± 5200,22080 ± 3538,4292 ± 3520,3277 ± 2025,1104 ± 990),all of them increased in the model group (mass speetrum peak area:90240 ± 18863,25610 ± 5071,9702 ± 6562,6029 ± 3905,4144 ± 5322,t =-3.903,-2.209,-2.814,-2.424,-2.174,all P ＜ 0.05).Conclusions The articular cartilage destruction induced by T-2 toxin could cause the changes of related metabolites in the urine;the 5 kinds of changed metabolites in urine are related to articular cartilage destruction.

Objective To investigate the impact of fatty liver and its related factors on the effi- cacy of antiviral therapy in patients with chronic hepatitis C.Methods ninety-eight patients with chronic hepatitis C were treated with 180?g peginterferon?-2a plus ribavirin.Hepatitis C virus (HCV) genotypes were measured by enzyme-linked immunosorbent assay (ELISA) and fatty liver were detected by ultra sonography.The body mass index (BMI),waist to hip ratio (WHR) and ho- meostasis model assessment of insulin resistance (HOMA-IR) were calculated.The serum HCV RNA level was determined by polymerase chain reaction (PCR) and serum insulin level was detected by chemiluminescence analysis.The impact of fatty liver and its related factors on the efficacy of antiviral therapy were analyzed by multivariate Logistic regression analysis.Results Of 98 patients with chro- nic hepatitis C,35 (35.7%) were genotype 1,41 (41.8%) were genotype 2,13 (13.3%) were gen- otype 3,9 (9.1%) were undetermined genotype.The incidence of fatty liver in HCV infection of genotype 1,2,3 and undetermined genotype was 11.4%,9.8%,38.5% and 11.1%,respectively (X~2=7.83,P

Objective To evaluate expression of inducible nitric oxide synthase (iNOS) in human abdominal aortic aneurysm (AAA) and to identify its initiation in the oxidative vascular injury. Methods This study included 22 AAA patients and 10 cadaveric normal abdominal aorta. In situ hybridization and immunofluorenscent staining were used to localize iNOS messenger RNA (mRNA) and protein. Double staining with a combination of in situ hybridization and immunofluorenscent staining was used to simultaneously demonstrate iNOS mRNA expression and its cellular localization. The presence of end-product of oxidative injury induced by iNOS was indirectly assessed with immunofluorenscent staining by anti-nitrotyrosine antibody, its cellular localization were assessed by double immunofluorenscent staining. Results In situ hybridization and immunohistochemistry confirmed the presence of iNOS in media and adventitia of AAA in all 22 patients. Specific cell markers identified iNOS mRNA-positive cells were T and B lymphocytes, macrophages, and smooth muscle cells. Positive immunostaining for nitrotyrosine was present in macrophages and smooth muscle cells. Normal abdominal aorta demonstrated virtually no iNOS or nitrotyrosine expression. Conclusion Stimulated expression of iNOS is associated with degeneration of AAA in human beings leading to oxidative tissue and cellular injury in AAA.

Objective: To study the chemical constituents from the leaves of Nitraria tangutorum. Methods: The chemical constituents were isolated by solvent extraction, repeated silica gel chromatography, and preparative-HPLC. Their structures were elucidated by physicochemical properties and 1H-NMR and 13C-NMR data. Results: Nine compounds were isolated from the ethanol extract of the leaves of N. tangutorum and their structures were identified as 4-oxo-β-ionol β-D-glycopyranoside (1), (6R,9R)-3- oxo-α-ionol β-D-glycopyranoside (2), blumenyl C β-D-glucopyranoside (3), blumenyl A β-D-glucopyranoside (4), syringaresinol- 4'- O-β-D-glucopyranoside (5), citrusin B (6), nikoenoside (7), 2-phenylethyl-β-D-glucopyranoside (8) and indole-3-ethyl-β- D-glucopyranoside (9). Conclusion: All the isolates are reported from the plants of Nitraria L. for the first time and the 13C-NMR data of compound 9 are also reported for the first time.

ObjectiveTo probe the effect of the electroacupuncture on vascular dementia(VD) and content of arginine vasopressin(AVP) in brain of rats. Methods30 Sprague Dawley rats were made renal hypertension(RHR) by the kidney arteries pinched with silver clip.After 42 days, their bilateral common carotid arteries were blocked repeatedly to cause cerebral ischemia.The Hypertension Vascular Dementia model was made. Then they were divided into model group,electroacupuncture group and medicine group(Dihydroergotoxine,DHET) with 10 in each group. The course was 28 days. The ability of learning and memorizing was observed by water maze, and the content of AVP in brain was detected after treatment. ResultsThe latent period of the electroacupuncture group and medicine group was shorter than that of the model group(P<0.05-0.005), and that of the electroacupuncture group was shorter than medicine group(P<0.05-0.005). In frontal lobe, the contents of AVP in the electroacupuncture and medicine groups were higher than that of model group( P<0.01,P<0.05), and the electroacupuncture group was higher than medicine group in striatum (P<0.05). Conclusions It indicated that electroacupuncture therapy can promote the ability of learning and memorizing and enhance the content of AVP in the brain of VD rats. It's therapeutic effect is better than that of DHET.

OBJECTIVETo investigate the prognostic factors of hepatocellular carcinoma.

METHODSThe purpose of this study was to retrospectively analyze the surgical outcomes of hepatocellular carcinoma (HCC) in 832 patients who underwent hepatic resection between February 2002 and June 2010 in the Cancer Hospital of Chinese Academy of Medical Sciences. Post-resection prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model.

RESULTSThe overall 1-, 3- and 5-year survival rates were 92.0%, 70.2% and 53.6%, respectively. The disease free survival rates (DFS) were 90.2%, 61.5% and 40.5%, respectively. The univariate analysis showed that a better prognosis for overall survival (OS) was associated with asymptomatic presentation, small tumor, single lesion, high-grade histological differentiation, no vascular tumor embolus, negative serum alpha-fetoprotein (AFP), negative serum alkaline phosphatase (ALP), Child-Pugh class A, no ascites, no/mild cirrhosis, new surgical techniques, no blood transfusion, no regional lymph node metastasis, no major vascular invasion, and no extra-hepatic invasion. The multivariate analysis showed that asymptomatic presentation, small tumor, single lesion, no tumor embolus, negative serum alpha-fetoprotein (AFP), no regional lymph node metastasis, no major vascular invasion, no extra-hepatic invasion, no/mild cirrhosis, and surgical techniques are independent factors for a longer overall survival.

CONCLUSIONSThe prognosis of HCC after resection is influenced by a number of factors. Therefore, regularly screening and early diagnosis, applying surgical techniques to minimize the liver injury, and preventing the aggravation of cirrhosis are important measures to improve the overall survival of HCC patients. For those patients with high risk factors of recurrence, routine follow-up is one of the best methods to be recommended.

Alkaline Phosphatase ; blood ; Blood Loss, Surgical ; Bone Neoplasms ; secondary ; Carcinoma, Hepatocellular ; blood ; pathology ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; blood ; pathology ; surgery ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Tumor Burden ; alpha-Fetoproteins ; metabolism