Objective To explore the efficacy of coblation nucleoplasty for the treatment of lumber disc herniation.Methods A total of 40 patients with lumber disc herniation were treated with coblation nucleoplasty in our hospital.Discogram was taken before the surgery.The patients with negative results were excluded from this series.Results The operation was completed in all the 40 cases(44 interspinous spaces).They were followed up for 2 to 8 months(mean 5 months).According to the Nakano's criteria,the outcome of the surgery was excellent in 8 and good in 29,accounting for 92%(37/40)of the patients.In the patients with central type lumber disc herniation,8(80%,8/10)had excellent or good outcome;whereas,in those with lateral type herniation,97%(29)of the 30 patients had such results.None of this series had complications.Conclusion Coblation nucleoplasty is a simple,safe,and effective surgery with minimal invasion for lumber disc herniation.

Objective To discuss the surgical characteristics,safety and perioperative management of carotid stent angioplasty (CSA) for the treatment of severe carotid artery stenosis (＞85％).Methods From December 2011 to May 2016,a total of 25 patients with carotid artery stenosis (＞85％) were treated with CSA.According to the stenotic characteristics of the lesion,distal cerebral protection device was employed in performing CSA.During the operation,attention was paid to individualized and detailed surgical management and perioperative management program;the revascularization and the dropping-off of thrombus in cerebral protection device were under close observation,while effort was made to control the occurrence of complications.The patients were followed up for one year to observe the occurrence of ischemic cerebrovascular events.Results The cerebral protection device was successfully deployed after it passed over the severe carotid artery stenosis.After balloon pre-dilation the stent was deployed,and the stent showed satisfactory shape.North America Symptomatic Carotid Endarterectomy Testing (NASCET) showed that the average degree of carotid artery stenosis was decreased from preoperative (91.0±3.1)％ to postoperative (21.0±5.1)％.The protective umbrella was successfully retrieved in all patients,and deciduous tissue fragments were observed in 6 retrieved protective umbrellas.During the perioperative period no severe complications,such as cerebral hemorrhage,cerebral infarction,hyper-perfusion syndrome or death,were observed.All the 25 patients were followed up for one year,and no transient ischemic attack,stroke or death occurred.Conclusion In treating severe carotid artery stenosis with CSA,in order to ensure a successful surgery and patient's safety the following points are very important:in-operative individualized and detailed management,perioperative preventive measures,and use of appropriate cerebral protection device.

OBJECTIVE:To establish UPLC fingerprint of Gehua formula granules. METHODS:UPLC method were adopted. The determination was performed on Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water at the flow rate of 0.5 mL/min. The detection wavelength was set at 264 nm,column temperature was 25 ℃,and the sample size was 1 μL. Using tectorigenin as reference substance,UPLC chromatograms of 10 batches of Gehua formula granules were determined. The common peak identification and similarity evaluation were conducted by TCM Chromatogram Fingerprint Similarity Evaluation Sys-tem(2004 A edition). RESULTS:14 common peaks were identified in UPLC chromatograms of 10 batches of Gehua formula gran-ules and similarities were all higher than 0.90. UPLC chromatograms of 10 batches of samples were in good agreement with control fingerprint. CONCLUSIONS:Established UPLC fingerprint can provide reference for identification and quality evaluation of Gehua formula granules.

Objective To study influences of intervention in pregnant women with positive thyroid autoantibodies on the thyroid function of babies. Methods A total of 55 pregnant women were enrolled with positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) during prenatal checkup. They were randomly divided into two groups: intervening group( n= 36, newborn group A) was treated with levothyroxine ( L-T4 ), and non-intervening group ( n= 19, newborn group B) was not treated. 30 cases of pregnant women with negative thyroid autoantibodies served as a normal population control group (newborn group N). Serum TSH, TPOAb, TgAb, TT3, TT4, FT3 and FT4 were measured by high-sensitive immunochemiluminescent assay ,and urinary iodine was also examined in the pregnant women. Fetal plasma TSH, TT3, TT4, FT3, and FT4 levels were measured after cutting the umbilical cord from placenta, and repeated measurements were made by 3-4 weeks and 8-10 weeks postpartum. Results At baseline, serum TSH levels of the pregnant women in intervening and nonintervening groups were significantly higher than that in control group ( P＜0.05 ). Non-intervening group had higher TSH and lower TT3, TT4, FT4 compared with the other two groups (P＜0. 05 or P＜0.01 ). The cord blood TSH levels of the neonates in both group B [(7.06 ± 1.31 ) mIU/L] and group A [(6.23 ± 1.26 ) mIU/L] were significantly higher than that of group N [(5.48±1. 17) mIU/L, P＜0.01 and 0. 05]. By 3-4 weeks postpartum,the serum TSH level [(3.21±0.70)mIU/L] in group B was significantly higher than those in group N [(2.72±0.51)mIU/L] and group A [(2.78±0.42) mIU/L, all P＜0.05]. The serum TSH level in group B [(2.99±0.57) mIU/L] was still higher than those in group N [(2.48±0.68) mIU/L] by 8 to 10 weeks postpartum (P＜0.05 ). Multiple stepwise regression analysis revealed that TSH, TPOAb, and urine iodine levels of mothers were independently related to TSH of their infants. Conclusion When differences in thyroid function exist in pregnant women, these differences also reside in their offspring. The thyroid function in neonates correlates with both the thyroid autoantibodies and thyroid function of their mothers.

Objective To evaluate the safety and effective of ultrasound-guide percutaneous radio frequency ablation (RFA).Methods Retrospectively analyze the incident,management and influence factors of complication of ultrasound-guide percutaneous RFA.Results From 2001 to 2011,536 patients with 762 lesions underwent RFA were enrolled in this study.Incident of RFA complication was 2.03％ (11/536),including 5 (0.92％) major complication.The complication covered fever (1 case),massive hydrothorax (2 cases),hydrothorax accompany with ascites (1 case),massive ascites (1 case),liver abscess (1 case),liver capsule hemorrhage (1 case) and hemothrorax (1 case).No RFA relate mortality was observed.According to logistics regression analysis,the liver function Child-Pugh grading was associated with the RFA complication (P =0.005).Conclusions Ultrasound-guide percutaneous RFA is a safe and effective local treatment approach for hepatocellular carcinoma.It's necessary to comprehensively think over the basic condition of patients and the characters of tumor such as tumor location,size and abutting organs.Nevertheless,an appropriate treatment plan and closely monitor during and after RFA are crucial.

AIM To establish the HPLC fingerprints of Cajanus cajan (L.) Millsp.leaves and to determine the contents of orientoside and luteolin.METHODS The analysis of 65％ methanol extract from C.cajan leaves was performed on a 25 ℃ thermostatic Agilent Zorbax SB-C18 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of methanol-1％ acetic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 260 nm.RESULTS There were twenty-one common peaks in ten batches of samples (S1-S10),whose similarities were more than 0.950,except for that of S3 (0.516).Orientoside and luteolin showed good linear relationships within the ranges of 0.089 5-3.960 μg and 0.015 5-0.408 μg,whose average recoveries were 99.43％ (RSD =1.32％) and 98.50％ (RSD =0.82％),respectively.The contents of two constituents in the samples from three growing areas (Guangdong,Yunnan and Hainan) showed obvious differences.CONCLUSION This simple,accurate and reproducible method can be used for the quality control of C.cajan leaves.

Objective To explore the effect of risk assessment tracking management in reducing unplanned extubation in patients with tracheal intubation.Methods From January to December 2015,120 patients with tracheal intubation in ICU were selected as the control group with routine nursing care of indwelling endotracheal intubation.From January to November 2016,120 patients with tracheal intubation were selected as the observation group,where the risk assessment and risk management were done on the basis of routine nursing as in the control group.The two groups were compared in terms of tracheal intubation and unplanned extubation related knowledge,the implementation of the risk assessment,the accuracy in risk assessment and the incidence of unplanned extubation.Result The tracheal intubation and unplanned extubation related knowledge in the observation group was lower than that of the control group (P＜0.001),The implementation rate of the risk assessment and the accuracy in risk assessment in the observation group were significantly higher than the control group,and the rate of unplanned extubation in the observation group was significantly lower than in the control group (all P＜0.01).Conclusion The implementation on risk assessment and extubation-preventing nursing quality tracing management can enhance the awareness and knowledge of preventing trachea cannula exodus,improve the quality of nursing and reduce the rate of unplanned extubation.

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

Animals ; Humans ; Thymic Stromal Lymphopoietin ; Pyroglyphidae/metabolism* ; Cytokines/metabolism* ; Asthma/metabolism* ; Respiratory System ; Epithelial Cells/metabolism*

Novel biologics that redirect cytotoxic T lymphocytes (CTLs) to kill tumor cells bearing a tumor associated antigen hold great promise in the clinic. However, the ability to safely and potently target CD3 on CTL toward tumor associated antigens (TAA) expressed on tumor cells remains a challenge of both technology and biology. Herein we describe the use of a Half DVD-Ig format that can redirect CTL to kill tumor cells. Notably, Half DVD-Ig molecules that are monovalent for each specificity demonstrated reduced non-specific CTL activation and conditional CTL activation upon binding to TAA compared to intact tetravalent DVD-Ig molecules that are bivalent for each specificity, while maintaining good drug like properties and appropriate PK properties.
Animals ; Antibodies, Bispecific ; immunology ; Antibodies, Monoclonal ; immunology ; pharmacokinetics ; CD3 Complex ; metabolism ; Cell Line, Tumor ; Cytotoxicity, Immunologic ; ErbB Receptors ; metabolism ; Female ; Humans ; Lymphocyte Activation ; immunology ; Mice, SCID ; Neoplasms ; immunology ; pathology ; Rats, Sprague-Dawley ; T-Lymphocytes, Cytotoxic ; immunology