Objective:To compare the oncology effect and risk between hepatopplenectomy and conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, so as to provide guidance for clinical application.Methods:One hundred and eighteen patients with hepatic carcinoma with hypersplenism in the Private hospitals of Zhejiang Province Yiwu were studied retrospectively. Patients were divided into 2 groups according to different operation methods: combined hepatosplenectomy group and conventional hepatectomy group with 59 cases in each group. Blood routine, liver function, complication and tumor effect (local recurrence, distant metastasis and 1, 3, 5 years survival rate) was compared between two group.Results:There was no significant difference in operation time, intraoperative blood loss and hospitalization time between the two groups ( P>0.05). Compared with that of the control group, the clinical total effective rate of the combined group was significantly increased: 94.92% (56/59) vs. 79.66% (47/59), P<0.05; there was no significant difference in the incidence of complications between the two groups ( P>0.05); the two groups were followed up to August 1, 2019. The median survival time of the two groups was significantly higher than that of the open group (29 months vs 22 months) ( P<0.05); the local recurrence rate, distant metastasis rate, 1, 3 and 5-year survival rate between the two groups were statistically significant ( P<0.05). The platelet and white blood cells in the combined group were significantly higher than those in the control group after 7 days′ treatment: (264.48 ± 75.37) × 10 9/L vs. (153.53 ± 42.11) × 10 9/L, (7.86 ± 1.43) × 10 9/L vs. (3.48 ± 1.32) × 10 9/L, P<0.05. Compared with that of the control group, alanine aminotransferase and aspartate aminotransferase were significantly decreased: (49.42 ± 31.88) U/L vs. (84.22 ± 43.95) U/L, (36.50 ± 21.50) U/L vs. (49.98 ± 35.63) U/L, P<0.05. Conclusions:Compared with conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, combined hepatosplenectomy can effectively promote the increase of peripheral blood PLT and WBC and the recovery of liver function without increasing the risk of surgery, and the long-term follow-up results are more satisfactory, which has high clinical application value.

BCG Vaccine ; adverse effects ; Child ; Child, Preschool ; Genetic Diseases, X-Linked ; complications ; Granulomatous Disease, Chronic ; complications ; genetics ; Humans ; Infant ; Infant, Newborn ; Lymphadenitis ; etiology ; Male ; Membrane Glycoproteins ; genetics ; NADPH Oxidase 2 ; NADPH Oxidases ; genetics

2 g/L can′t excluded SCID.

ObjectiveTo explore the effect of earlier rehabilitation on activities of daily living(ADL) of patients with spinal cord injury(SCI).Methods50 SCI patients received earlier rehabilitation and improvement of ADL of patients was evaluated.ResultsAfter two months treatment,the scores of Barthel index,functional independence measure(FIM) grade of patients increased significantly compared with that of before treatment(P<0.05) and ADL improved.ConclusionEarlier rehabilitation can improve ADL of SCI patients.

Objective To screen for the potential protein biomarkers in serum for the diagnosis of idiopathic Parkinson's disease (PD) using proteomic fingerprint technology. Methods Proteomic fingerprint technology combining weak cation exchange (WCX) magnetic beads with MALDI-TOF-MS was used to identify and compare the serum proteins from 61 patients with idiopathic PD, 29 patients with other neurodegenerative diseases (OND) and 30 healthy blood donors. Model of biomarkers and proteomics patterns associated with PD was analyzed by Biomarker Patterns Software. The model also was validated by 40 newly recruited PD cases. Results A total of 17 discriminating M/Z peaks which were related to PD were identified ( nonparametric test, Z:-4.039--2.633, P<0.01 ). Five biomarkers with M/Z of 6121, 5234, 2961,4309 and 8170 respectively generated an excellent model of distinguishing between PD and healthy groups. The sensitivity was 98.4% and the specificity was 83.1%. Blind testing in 40 newly recruited cases demonstrated a sensitivity of 85.0% (17 of 20 PD) and a specificity of 70. 0% (14 of 20 controls). Conclusions Combination of WCX magnetic beads with MALDI-TOF-MS is a useful method in establishing proteomic patterns associated with PD. It also may be used to construct a diagnostic model with PD Biomarkers. Although this model of biomarkers fails to distinguish between PD and OND controls, it is able to differentiate PD from healthy controls.

Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

Euphorbia kansui (EK) is a toxic herbal drug, and often used after vinegar-processing to reduce its toxicity. In present study, a 1H-NMR based metabonomic approach was used to evaluate the detoxification effect of vinegar-processed EK. The water extracts of EK and VEK were administered orally to male SD rats at doses of 9 g x kg(-1) x d(-1) for 1 week, respectively, and one more week observation was further conducted. The control group was orally given with saline. Histopathological studies of liver samples on the 8th and 15th day were conducted, and the metabolites of rat urine and liver were analysed by 1H-NMR. Histopathological studies of liver samples from EK and VEK treated rats showed no negative impacts. In metabonomic analyses of urines, changes of metabolites indicated liver damages, kidney lesions and imbalance of gut microbes in the second week. VEK-treated rats showed a quite lower toxicity compared with EK-treated ones. The present study revealed that the metabonomic approach might be helpful for the evaluation of toxicity of EK and detoxic effect of VEK.
Acetic Acid ; chemistry ; Animals ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; toxicity ; Euphorbia ; chemistry ; Inactivation, Metabolic ; Liver ; drug effects ; metabolism ; Magnetic Resonance Spectroscopy ; Male ; Metabolomics ; methods ; Rats ; Rats, Sprague-Dawley ; Urinalysis

Objective To investigate the feasibility of setting mAs in liver enhanced CT scan according to plain scan noise with fixed mA CT scanner,in order to reduce the radiation dose.Methods One hundred continuous patients underwent liver enhanced CT scan (group A) prospectively.Two hundred and fifty mAs was used in plain and enhanced CT scans.Noises of plain and venous phase CT images were measured,and the image quality was evaluated.The equation between mAs of enhanced scan and noise of plain scan image was derived.Another 100 continuous patients underwent liver enhanced CT scan (group B).Enhanced scan mAs was calculated from noise on plain scan by using the equation above.Noises on venous phase images were measured and the image quality was measured.Based on body mass index (BMI),patients in groups A and B were divided into three subgroups respectively:BMI ＜ 18.5 kg/m2,18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2 and BMI ≥ 25.0 kg/m2.Image quality score was compared with nonparametric rank sum test,CT dose index (CTDI) and effective dose (ED) were measured and compared between each subgroup with 2 independent samples t or t' test.Results The equation between enhanced scan mAs (mAsX) and plain scan noise (SDp) was as follows:mAsX =mAs1 × [(0.989 × SDp + 1.06) /SDx]2,mAs1 =250 mAs,SDx =13.In patients with BMI ＜ 18.5 kg/m2,ED of group A [(6.86 ±0.38) mSv,n =12] was significantly higher than group B [(2.66 ±0.46) mSv,n =10)] (t =18.52,P ＜0.01).In patients with 18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2,ED of group A [(7.08 ± 0.91) mSy,n =66] was significantly higher than group B [(4.50 ± 1.41) mSv,n =73] (t' =10.57,P ＜ 0.01).In patients with BMI ≥25.0 kg/m2,there was no significant difference between EDs of group A (7.54 ± 0.62 mSv,n =22) and group B [(8.19 ±3.16) mSv,n =17] (t' =0.89,P =0.39).Image quality of 5 patients in group A and none in group B did not meet the diagnostic requirement.Conclusion Setting mAs of enhanced scan according to plain scan noise could reduce the radiation dose with maintainence of image quality.

Herpetin (HPT) is an active monomer constituent isolated from lignanoid in seeds of Herpetospermum caudigerum. HPT shows inhibitory effects in hepatic injury and HBV-DNA and the replication. In the study, we successfully prepare herpetin liposomes by film dispersion method for the first time. The prescription process was optimized, with the entrapment efficiency as the index. According to the optimized prescription, the mass ratio of HPT: phospholipids: cholesterol was 2.44:78.05: 19.51, the hydration and de-molding process was performed with 0.5% F68 solution at 50 degrees C, and the water-bath ultrasonic time was 20 min. The HPT liposomes prepared by this method showed an average entrapment efficiency of (94.50 +/- 2.15)% and a particle size of (119.2 +/- 10.7) nm, which was consistent with the trial expectations and will lay a solid foundation for the hepatic targeting delivery system in future.
Chemistry, Pharmaceutical ; methods ; Cholesterol ; chemistry ; Drug Compounding ; methods ; Drugs, Chinese Herbal ; chemistry ; Lignans ; chemistry ; isolation & purification ; Liposomes ; chemistry ; Phospholipids ; chemistry ; Ultrasonics