AIM:To study the parameters of supercritical CO_2 extraction of essential oil from valeriana efficinalis by orthogonal design. METHODS: Four factors,such as extraction pressure,extraction temperature,extraction time and separation temperature were chosen by the observation of orthogonal design,each factor was assigned to three levels.Bornyl acetate content was selected as a marker in a position to determine optimal extraction. RESULTS: Pressure and temperature were the main factors in effecting the extraction of bornyl acetate,extraction time was minor factor relatively. CONCLUSION: The optimal extraction is as follow,parameters were extraction pressure:12 MPa,extraction temperature:45 ℃,extraction time:1 hour,separation temperature:35 ℃,it gave the best recoveries of essential oils and bornylacetate.

Objective To investigate the effects of 17-β estradiol on hepatocyte apoptosis and the expression of Bcl-2 and Bax in hepatic tissue after reduced-size ischemia reperfusion injury and its mechanism in liver protection.Methods A rat model of reduced-size hepatic ischemia-reperfusion injury was established in 75 male Sprague-Dawley rats.They were randomly allocated into three groups:Sham group,ischemia-reperfusion(IR)group,and 17-β estradiol(E2 + IR)group.Liver functions,liver histology and hepatocellular apoptosis rates were observed after reperfusion.Hepatocellular ap optosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)method and the expression of Bcl-2 and Bax were determined by Western blotting.Results The levels of ALT and AST were higher and peaked after 12 h of reperfusion in the IR group compared with the sham group.The histological changes in the liver of the IR group consisted of hepatocyte swelling,hepatic sinusoids narrowing,inflammatory cell infiltration and hepatocyte necrosis in some areas of the livers.The IR group also exhibited an increased rate of hepatocellular apoptosis at 12 h after reperfusion.The protein expression of Bcl-2 decreased while the expression of Bax increased.In the 17-β estradiol group,the levels of ALT and AST were lower,the pathological changes were milder and the rate of hepatocellular apoptosis was lower at 12 h in comparison to those of the IR group.The expression of Bcl-2 was higher and the expression of Bax was lower in the 17-β estradiol group in comparison to those of the IR group.Conclusions 17-β estradiol can relieve the hepatic ischemia reperfusion injury in rat livers.17-β estradiol may inhibit apoptosis in hepatic tissue by up regulating Bcl-2 and down-regulating Bax,thus producing a protective effect on hepatic ischemia-reperfusion injury.

Objective To explore the influences of selenium,age,sex,education level,occupation and other factors on cognitive function in elderly of rural areas in Shandong Province.Methods Rural Chinese aged 65 years or older were sampled from Gaomi County and Zichuan County from 2006 to 2007 in Shandong,Province by cluster sampling method.Demographic characteristics were collected,and cognitive functions were surveyed using dementia community survey(CSID),including dementia test,CERAD word list learning,recall test,Indiana University (IU) story recall test and impact test on animals.The nail samples were collected and the selenium content was tested using 2,3-diamino-naphthalene fluorescence assay.The relationship between selenium and other related factors(age,sex,education level,occupation,et al) With cognitive function was analyzed.Results A total of 1 000 people aged 65 years or older were investigated.In which,457 were males,and 543 were females.Most elderly were farmers and illiteracy.The differences of CSID total scores and IU story recall scores between different selenium groups were statistically significant(F =2.56,9.18,P ＜ 0.05 or ＜ 0.01).Multiple linear regression model analysis showed,age,sex,education level,occupation,hypertension and nail selenium content had significant impact on CSID scores(t =-9.942,-6.848,5.391,2.276,-2.863,2.309,all P ＜ 0.05).Age,sex,education level,occupation and nail selenium content had significant impact on IU story recall test (t =-4.252,-2.021,8.203,2.528,4.490,all P ＜ 0.05).While age,sex,education level,occupation were main influence factors to animal fluency test(t =-7.951,-6.166,7.544,2.824,all P＜ 0.05).Conclusions Selenium is a protective factor for cognitive function of elderly in Shandong Province.Besides,age,sex and education level also have impact on cognitive ability of rural elderly.

Objective:To investigate the efficacy of Silybinin meglumine on hepatic fibrosis rats and possible mecha -nisms.Methods:The liver fibrosis rats were randomly divided into 4 groups,the model group,Silybinin meglumine 120 mg/kg group, Silybinin meglumine dose group 60 mg/kg and Silybinin meglumine low dose group 30 mg/kg,and the control group.All groups had been treated for 4 groups.Results:No deaths rat.Compared with the control group ,the reduced body weight ,less dynamic,dark hair, decreased liver and spleen indexes ,increased ALT,AST,TBIL,TG,TC and LDLC,and the decreased ALB, and the increased LXRαand SREBP1c had been observed in the model group (P<0.05).Compared with the model group ,better activity and body weight ,the in-creased liver and spleen indexs decreased ALT ,AST,TBIL,TG,TC and LDLC,and the increased ALB , and the decreased LXRαand SREBP1c had been observed in the Silybinin meglumine groups (P<0.05),in a way of dose-depended.Conclusion: The Silibinin meglumine can treat liver fibrosis ,by improving liver function,lowing lipid and decreaseing LXRαand SREBP1c expression in liver tis-sue.But the mechanism of two proteins reduced remains for further investigation .

Objective To explore the relationship between case mix index ( CMI ) and the bed allocation in clinical departments, and to evaluate the performance of bed scale of departments at tertiary hospitals based on CMI. Methods Based on the HIS system of a tertiary hospital, the authors collected the disease treatment information and bed allocation information of each clinical department in 2015. The CMI value was calculated by means of diagnosis-related group( DRG) , while the proportion of cases and average daily beds occupancy corresponding to the quartile of the CMI value of each department was also counted. Then the bed occupancy and distribution of various patients were analyzed. Results The hospital′s overall CMI value, DRG groups, DRG cases at the departments, days of stay, DRGs, CMI values and its quartiles were calculated. It was found that the medical and surgical CMIs had a linear relationship with the critical proportion (r=0. 998, 0. 996, P<0. 001). The main influencing factors of average daily bed occupancy were ranged from high to low as followed: the number of cases that were allocated in the group, employee numbers and CMI (F=87. 656, P<0. 001). Conclusions CMI is an ideal indicator for the difficulty of medical services at different departments and for evaluating the bed scale performance. Hence it can be used as an important reference for bed number adjustment in hospitals.

Objective To explore the clinical utilization value of regional blood flow fluorescence visualization in selective arterial clamping robotic partial nephrectomy.Methods 12 cases of robotic partial nephrectomy with indocyanine green-based regional blood flow fluorescence visualization selective arterial clamping between October 2016 and June 2017 by our team were retrospectively analyzed.There were 9 males and 3 females with age between 36-78 years,mean age(51.2 ± 11.0) years,BMI 20.1-36.2 kg/m2,mean of (25.6 ± 4.8) kg/m2,tumor diameter 2.0-5.1 cm,mean of(3.3 ± 0.9) cm,and R.E.N.A.L.score 4-10,mean(7.3 ± 2.0).Preoperative renal function status of eGFR (estimated glomerular filtration rate) was 82-133 ml/(min · 1.73 m2),mean (101.9 ± 13.7)ml/(min · 1.73 m2) and split ECT-GFR of 44.5-70.6 ml/min,mean of(53.8 ± 8.5) ml/min in operated kidney;48.2-71.1 ml/min,mean of(56.8 ±6.8) ml/min in contralateral kidney;in total,92.7-139.1 ml/min,mean of(109.8 ± 14.6)ml/min.Perioperative information including operative time,blood loss,warm ischemia time,surgical complications,pathologic outcomes and follow-up data of included patients were analyzed.Results All procedures were done smoothly without open or radical conversion,with operative time of 95-203 min,mean of (170.6 ±38.6)min,and estimated blood loss of 60-1 000 ml,mean of(178.3 ± 206.9)ml.According to the visualize uptake of fluorescence imaging perfusion area visualization after selective arterial clamping,1 case underwent unclamping robotic partial nephrectomy,1 case converted to main renal artery clamping with warm ischemia time of 18 min,10 cases performed via renal arterial branch clamping with an average ischemia time of (25.5 ± 10.5) (range 17-46)min,1 of which due to parenchymal bleeding obscuring visualization necessitated clamping of the main renal artery with 1000 ml blood loss,46 min of arterial branch occlusion and 16 min of main artery clamping.The average postoperative hospital stay was (5.8 ± 0.9) (range 5-8)days,and the duration of drainage was (3.5 ± 0.5) (range 3-4) days.No postoperative complications occurred.Postoperative pathology:all margins were all negative,11 cases of clear cell carcinoma,eosinophilic adenoma in 1 case.The average eGFR of 9 cases of renal arterial branch clamping was (94.5 ±22.5)(range 56-140)ml/(min · 1.73 m2) at discharge with a 5％ percentage decrease versus preoperative level.Among them,4 cases obtained with ECT-GFR data 1 month postoperatively had a mean of(37.6 ±13.2)(range 20.8-55.8) ml/min with 29％ percentage decrease on the surgical side,an average of (58.5 ± 6.9) (range 51.2-68.4) ml/min with 2％ compensatory increase of the contralateral side,and (98.7 ± 16.2) (range 79.3-124.3) ml/min in total with a 10.4％ overall decrease.Conclusions The visualization of blood flow imaging based on indocyanine green fluorescence can clearly and intuitively show the effect of branching arterial occlusion in robotic partial nephrectomy,guide the optimization of surgical resection strategy,and improve safety and clinical outcome.

BACKGROUND: Models concerning tumor external environment mainly concentrated on laboratory two-dimensional culture and in vitro animal experiment, which lack of three-dimensional stereo.OBJECTIVE: To establish in vitro bone metastasis stereo models of human prostate carcinoma, and to investigate the effect of stem cells on proliferation rate and clustering size of prostate carcinoma cells. METHODS: Bone marrow mesenchymal stem cells (BMMSCs) were extracted from 2 clean grade SD rats. Alginate was used to simulate medullary microenvironment, where prostate carcinoma cells and BMMSCs were co-culturedd. Growth of the cells in the three-dimensional model was observed through microscope and histological sections. The carcinoma cells were transfected with green fluorescent protein. The proliferation of monoclonal cells clustering was observed under light microscope and fluorescence microscope. RESULTS AND CONCLUSION: In the co-culture group, the clustering speed, clustering amount and tumor formation rate were greater that those of the control group. The monoclonal cells clustering was formed at 7.75 days and 6.00 days in the control and co-culture groups, respectively, with cell counts of (95.13±11.63) and (112.53±14.67) after 10 days. The formation rate of fluorescent cell clones was (77.10±6.85)% in the control group and (64.55±6.21)% in the co-culture group, the difference had significance. The results suggested that: the alginate microenvironment is conductive to proliferation and clustering of prostate carcinoma cells and BMMSCs.

Objective To evaluate the feasibility of T2 *mapping T2 *value combined with DWI ADC value in quantitative assessment of the activity of sacroiliitis.Methods 30 patients diagnosed with ankylosing spondylitis (AS)were divided into 2 groups as acute group (n=17)and chronic group (n=13)according to the BASDAI scores of the clinical severity of disease.And 20 healthy adults were recruited as control group.All groups were examined by MR with traditional sequence,T2 *mapping and DWI in the sacroiliac joint.The T2 *value and ADC value of the bone marrow edema region and normal region were measured.Furthermore,the imaging data and the clinical scores were statistical analysis and compared among three groups.Results T2 *values and ADC values in acute group of AS patients were higher than chronic group (P<0.05),as well as compared with healthy volunteers (P<0.05).There was no statistically significant difference between the chronic group of AS patients and control group (P>0.05).Positive correlation between ADC value and BASDAI was observed in patients group.Conclusion T2 *mapping combined with DWI imaging in AS is beneficial for early diagnosis and quantitative analysis of the activity of sacroiliitis.

Objective This study is to explore the safety,feasibility and efficacy of robotic laparoendoscopic single-site(LESS) zero-ischemia partial nephrectomy.Methods Two patients underwent robotic laparoendoscopic single-site zero-ischemia partial nephrectomy by our urologic surgical team at 22-May-2017 and 31-May-2017 in our institution.The salient patient demographics and tumor characteristics,including age,gender,body mass index (kg/m2),Charlson Co-morbidity Index (Age-weighted),tumor laterality,diameter (cm),R.E.N.A.L.nephrometry score and preoperative split renal function GFR [ml/(min · 1.73 m2)] were:73/56,female/male,25.2/19.8,2/0,lcft/right,1.8/1.4,5a/4a,left 43.8、right 49.2/left 38.8 、right 48.7 respectively.A 2-3 cm longitudinal skin incision was made at 4 cm below the inferior margin of rib arch at the level of midaxillary line (case NO.1) or peri-umbilicus (case NO.2).The da Vinci Si robotic Single-siteTM Port was inserted.The line of Toldt was incised with the colon medially mobilized.Gerota's fascia was opened,the main renal artery or its branches were dissected,then the renal mass fully dissected and exposed.The renal mass was entirely removed with approximately 0.5-1.0 cm surrounding normal renal parenchyma (unclamping in case NO.1,and selective branch clamping in case NO.2) and kidney reconstruction was conducted with 1-0 Quill Suture via hem-o-lock sliding technique.Results The two procedures were smoothly completed without any extra skin incision.Operative duration,estimated blood loss and skin incision length was respectively 230/190 min,100/60 ml,3.6/2.5 cm.Duration of two selective renal artery branches clamping in case NO.2 was 39 and 24 min.Postoperative pain measured by the visual analog pain scale (VASP) at day 1,day 2,day 3 was 5/4,3/3,2/1,Time off oral intake,duration of drainage and length of stay after surgery was 2/4 d、2/4 d、6/7d,respectively.The recovery of both patients were uncomplicated and discharged smoothly.Pathological examination revealed oncocytoma in case NO.1 and papillary renal cell carcinoma in case NO.2.Conclusions The initial experience shows the robotic laparoendoscopic single-site zero-ischemia partial nephrectomy is a safe,feasible and efficacious procedure.It may exhibit clinical benefits for patients in terms of pain control,convalescence and cosmesis,but in this early stage the clinical indications should be strictly controlled.

BACKGROUND:Deep vein thrombosis after hip replacement has a high incidence rate. Moreover, deep vein thrombosis can induce pulmonary embolism that can endanger patients’ life and dysfunction of distant deep vein. The appearance of deep vein thrombosis is a great obstacle for the gradual y increased hip replacement.
OBJECTIVE:To observe the occurrence of deep vein thrombosis of lower limb after total hip replacement in elderly patients, and to screen the risk factors for the occurrence of deep vein thrombosis of lower limbs.
METHODS:Clinical data of 128 elderly patients with hip replacement were analyzed retrospectively. Al patients were examined with color Doppler ultrasound in double lower limbs at 1 day before replacement and 7 days after replacement. Multifactor unconditional logistic analysis was conducted on clinical related factors and the formation of lower limb deep vein thrombosis.
RESULTS AND CONCLUSION:At 7 days after the operation, 16 patients affected deep vein thrombosis of lower limb. The factors for deep vein thrombosis contained female, general anesthesia, bilateral hip replacement and the application of bone cement (P<0.05). The risk for deep vein thrombosis after total hip replacement significantly increased in elderly patients aged over 70 years. Multifactor unconditional logistic analysis exhibited that the multiple risks of sex, obesity and the use of bone cement in elderly patients with deep vein thrombosis increased to 11.398, 3.109 and 8.925. The patients with a blood type O at the age of over 70 years experienced a decreased risk for deep vein thrombosis after total hip replacement. The occurrence of deep vein thrombosis decreased to 0.186 times after replacement. Blood type O could be considered as a protective factor for the occurrence of deep vein thrombosis.